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Note From the Maine DHHS Medical Directors Call (Tuesday September 7, 2021)

On Today's MD Call:

CDC Update from Dr. Stephen Sears:
Currently we are experiencing a surge in positive COVID cases across the state averaging about 400-600 per day. This is on par with the highest daily number of positive cases since the pandemic began.
The number of individuals needing hospitalization is also climbing. We currently have 128 individuals hospitalized, 28 of whom are on vents, and 69 in ICU.
The state positivity rate has also significantly increased. Facilities should monitor county positivity rates closely in the next few weeks. Your county positivity rate indicates the rate of testing and PPE needed within your home.
Several facilities have identified outbreaks and we are seeing an increase in these totals. The Maine CDC is also seeing some symptomatic people who are fully vaccinate test positive but we rarely see the need for hospitalization. The CDC does anticipate the number of outbreaks increasing in the next few days.
Vaccination Updates: CDC announced the recommendation for additional booster shots for individuals that are immunocompromised. That definition for immunocompromised exists here.
REGEN-COV, monoclonal ab therapy, is available through Omnicare, Pharmerica and MVH Pharmacy.  Guardian Pharmacy does not have it and looking to see if they can order it and the turnaround time to get it to a facility.
Infection Prevention and Control Reminders: Clarification on Mandated Vaccinations for HCWs
Mandated Vaccination for healthcare workers remains with an effective date still of October 1st. Surveyors will still validate for compliance between October 1 thru 30 but not site a facility for non-compliance. It will be noted by the survey team. Per the Governor's announcement “On August 12, 2021, the Mills Administration announced that health care workers in Maine must be fully vaccinated against COVID-19 by October 1. While the rule takes effect on October 1, the Mills Administration announced on September 2, that it will begin enforcement of its COVID-19 vaccination requirement for health care workers on October 29, 2021, providing an additional month for health care workers to complete their vaccination protocol and for health care organizations to use the $146 million in forthcoming funds to address workforce needs.”

Regarding whether homes can ask visitors about their vaccination status?
HIPPA is enforced by the Federal OIG, but the current regulations do not prohibit a facility from asking visitors about vaccination.  It does prohibit a facility from denying visitation for unvaccinated or requiring disclosure of vaccination status as a condition for visitation.  From CMS QSO 20-39 memo regarding visitation, "While visitor testing and vaccination can help prevent the spread of COVID-19, visitors should not be required to be tested or vaccinated (or show proof of such) as a condition of visitation. This also applies to representatives of the Office of the State Long-Term Care Ombudsman and protection and advocacy systems, as described below."

With the vaccine mandate for staff is there consideration for a vaccine mandate for residents? Not at this time. There is a federal requirement for nursing homes and ICF/IID homes educate residents on the benefits of COVID-19 vaccination.

Can a nursing home or residential care facility refuse to admit non vaccinated residents? There is nothing in the regulation that speaks to this. Bill will follow up on this question.

On September 15th there will be a congregate care call for one hour that will focus on strategies to support DCW staffing. If you are not on the invitation list please email nicole.rooney@maine.gov

These MD calls will resume twice monthly on the 1st and 3rd Tuesday of the month. The next meeting being September 21, 2021 at 11:00am.

Staff Contact: dwatford@mehca.org

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