Senior living communities should be prioritized for rapid response antigen testing and provided with implementation recommendations, industry representatives said Tuesday in a letter to U.S. Department of Health and Human Services Secretary Alex Azar.

Sept. 1, HHS announced that assisted living providers would be included in the distribution of 150 million BinaxNow COVID-19 Ag Card point-of-care antigen tests from Abbott Laboratories. Argentum said it will provide HHS with the number of tests needed and suggestions for distribution and administration of the tests.

In their letter to Azar, Argentum President and CEO James Balda and American Seniors Housing Association President David Schless called for prioritization and distribution of the antigen tests to all senior living communities — which they defined as independent living, assisted living, memory care and continuing care retirement communities, also known as life plan communities — to protect vulnerable older adults. They highlighted how asymptomatic senior living workers often transfer the virus into communities.

“This testing capability is critical in all senior living communities to prevent and mitigate the spread of COVID-19,” the letter stated. “It would be short sighted to not include the full continuum of care in senior living as you take steps to protect vulnerable seniors.”

The letter also provided recommendations to successfully implement an effective testing program, including:

  • Streamline and expand opportunities for use of the CLIA (Clinical Laboratory Improvement Amendments) certificate of waiver, including the potential application of an “umbrella waiver” for assisted living providers with a consultant pharmacist and long-term care pharmacy relationship.
  • Offer tests for family members, to facilitate visits.
  • Provide resources and education to those administering tests, to reduce false positives or negatives through the testing process.
  • Reimburse senior living communities for ongoing testing and personal protective equipment costs throughout the pandemic.
  • Provide legal protection for administering COVID-19 tests through the Public Readiness and Emergency Preparedness (PREP) Act, similar to protections that skilled nursing facilities have.

“Senior living communities are doing everything they can to protect their residents, staff and visitors from COVID-19,” the letter read. “But they need adequate testing to prevent and mitigate the spread of the virus, particularly given concern of asymptomatic spread.”

Argentum said it will share with HHS the number of tests needed by senior living communities and will continue to reach out to the Centers for Disease Control and Prevention, the administration and Congress to encourage priority testing access and financial support for senior living residents and staff.

“Protecting older adults from COVID-19, as well as the employees who care for them, needs to be among the highest priorities in final testing plans, with a number of objectives in mind,” Balda said, adding that plans should consider family members as well to allow  for socialization. “Final plans should also account for financial reimbursement, utilization guidance, state guidance and legal protections, among other considerations.”

Vaccine distribution

Although priority access to a vaccine, once developed, “looks promising,” Argentum and ASHA sent letters to Azar, CDC Director Robert Redfield, Vice President Mike Pence and congressional leaders last week asking for their help in ensuring that senior living residents and workers have that priority access.

Argentum said it was encouraged by the preliminary draft report from the National Academies of Sciences, Engineering and Medicine that assigned healthcare workers and high-risk seniors for inclusion in Phase 1 COVID-19 vaccine allocation. ASHA and Argentum submitted comments to support that recommendation, including a request for more specificity in the final vaccine allocation plan to ensure that senior living residents and employees are included in the recommended populations prioritized for a vaccine.

“The senior living industry is anxiously awaiting a safe and effective vaccine, which is critical to ensuring a responsible return to community operations, such as visitation from family and friends, and group dining and activities,” Balda said. “Given the COVID-19 risk factors for senior living residents and the employees who serve and care for them, we believe prioritization of a vaccine for these groups is essential.”

Argentum is continuing discussions with the CDC on the distribution and administration of a COVID-19 vaccine, providing background on senior living that includes the number of communities, residents and staff, as well as capacity for administering a vaccine. The organization said it will collaborate with the Association of Consultant Pharmacists to assist in this area.

COVID-19 relief package

LeadingAge sent a separate letter to congressional leaders on Tuesday urging action on a COVID-19 relief package and providing an updated national Situation Report on Aging Services & COVID-19 that highlights the effect of the virus among older adults, focusing on testing, PPE and funding. The report also reiterated LeadingAge’s “five essential actions.”

The organization’s president and CEO, Katie Smith Sloan, who also is acting president and CEO of VNAA/Elevating Home, reiterated the view that “no COVID-19 package should pass without including desperately needed support for older Americans and their care providers.” 

The report highlights that aging services providers are facing financial ruin and closing due to “exorbitant and unsustainable” costs for testing, PPE, staffing and related supplies. 

“It is imperative that policymakers step up now to save older adults and their care workers from more waves of needless death and suffering,” Sloan said. “Congress must support our mission-driven, nonprofit providers, who are working 24/7, risking their own lives, and paying escalating costs out of their own pocket. The essential care they deliver to those most vulnerable to the virus is simply unsustainable without a new federal lifeline.”