Some Oregon long-term care facilities had to fight to get vulnerable seniors vaccinated

Janice Biggerstaff has spent the last two months asking when it will be her turn to get a COVID-19 vaccine.

“It’s been an emotional roller coaster,” she said. “And I have been exceedingly stressed about it.”

Biggerstaff is 91 and, as she proudly notes, she’s turning 92 in May. At her age, the risk of dying from COVID-19 is roughly 600 times higher than it is for a younger person.

Compounding her risk, Biggerstaff lives on the fourth floor of a bustling residential care facility, Friendsview Manor. The manor is the heart of a sprawling senior living community for people 62 and over, founded by Quakers in Newberg. It’s home to about 500 residents and employs 200 staff.

For months, nobody could tell Biggerstaff when she was going to get vaccinated, because Friendsview was among at least 18 large assisted living and residential care facilities in Oregon that were left out of the federal campaign to deliver COVID-19 vaccines directly to the people most at risk.

Biggerstaff, a retired science teacher with a hint of an East Texas drawl in her voice, says she’s spent most of the pandemic alone in her room on the 4th floor of the manor, an experience that’s left her physically and mentally weaker.

She was finally able to get her first dose of the COVID-19 on Feb. 5 and is now counting down the days until she gets her second shot.

“I’m going to hug my family. I haven’t touched them since March 11,” she said, her voice catching. “I have just one child and one grandchild, and we’re quite close. The idea that I have not been able to hug or kiss them just breaks my heart. That’s the first thing I’m going to do.”

Big gaps in vaccine delivery

Biggerstaff is still independent, but on other floors of the manor where she lives, there are people with advanced Alzheimer’s, people who need help remembering their medication, and residents in hospice care.

Friendsview is what’s known as a “life plan” or continuing care retirement community. You pay to move in when you’re still independent and stay for the rest of your life with escalating levels of health care provided.

It’s one of the types of long-term care facilities that the government said would be included in a campaign to deliver vaccines directly to long-term care facilities, which have been hit hardest by COVID-19. So it was a shock when Friendsview administrators learned they’d been left out of the plan to get the COVID-19 vaccine to care facilities.

Friendsview has managed to avoid a full-blown COVID-19 outbreak, but by this winter, a handful of individual staff and assisted living residents had tested positive for the virus.

“We’ve been working really hard, overtime, to keep this thing at bay,” said Kathy Watson, the facility’s medical director. “Not knowing when that help is arriving has been really hard to live with.”

The Centers for Disease Control has provided the vaccine to long-term care facilities through a partnership with pharmacies. Watson tried to enroll in Friendsview back in October. She selected CVS as her pharmacy. She submitted her paperwork and confirmed with her county health department that the CDC had received it.

By December, the vaccine was authorized for use, but Watson still hadn’t heard anything from CVS or the CDC about when doses would arrive at Friendsview.

“I spent every day trying to think, who else can I reach out to. Is Friendsview really on the list? Are we really going to get vaccines? If not, why not?” she said.

Finally, the CDC emailed her a brief response. It said, “independent living facilities are ineligible for this initial program.”

That response confused Watson and still does. Though Friendsview has residents who live independently, it is a continuing care retirement community, not an independent living community. That should have been clear from their application, she said.

Friendsview was not the only place left out. In January, Patrick Allen, director of the Oregon Health Authority, told state senators he was struggling to understand why hundreds of facilities had been unable to enroll or had been, as he put it, dis-enrolled at the last minute.

“This is completely a federal program that we have no influence or control over and have very little visibility into,” Allen said.

The biggest gap was adult foster care. Those are facilities that care for up to 5 seniors or adults with disabilities in a home-like setting.

The Oregon Health Authority says its Office of Developmental Disabilities Service sent names and information for all of the state’s group homes and foster homes for adults with intellectual & developmental disabilities to the CDC to be enrolled in the federal pharmacy partnership program

Only 347 were accepted, and 1,719 were not enrolled.

No one has a good explanation for what went wrong. Miscommunication between the state and the feds seems to have played a role.

A spokeswoman for the CDC answered OPB’s questions via email. Nationally about 100,000 long-term care facilities applied for the program. More than a quarter were found ineligible, she said.

She says the CDC was focused on reaching bed-bound individuals and disqualified independent living facilities.

“Individuals living in independent living retirement communities, however, are often highly active and can go offsite to get vaccinated, which is more efficient for vaccine delivery,” said Chandra Zeikel, the CDC spokeswoman.

And according to the CDC, Oregon’s adult foster homes were left out because the state failed to send critical information about their bed counts.

Relief, finally

With the supply of the vaccine increasing, county public health departments have been able to help a lot of the care facilities left out of the federal effort.

That’s what happened at Friendsview. On a recent afternoon, a line of seniors spilled out the big double doors. Inside, a wheelchair user reaches the front of the line and got his shot from a local firefighter.

This was the third trip the Yamhill County public health department has made to bring shots to Friendsview, 100 or 200 doses at time, using whatever they had leftover from other community events to vaccinate the staff and residents.

Kathy Watson, Friendsview’s medical director, said she’s almost finished getting everyone their first dose.

“Then we start it all over and hope for second does,” she said.

Janice Biggerstaff, the 91-year-old retired science teacher, said she’s grateful to everyone who helped get her vaccinated without having to leave her community.

“I read in the paper where people for days call these numbers and try to get an answer. And we certainly did not have to do that,” she said.

But she’s not impressed with how the country as a whole has handled the pandemic or the vaccine rollout.

At best, she says, we’d get a D.