New In-Home COVID-19 Testing Initiative Could Serve as National Roadmap

The Home Care Association of New York State (HCA-NYS), along with two health organization partners, announced a new COVID-19 training initiative for in-home testing on Tuesday. Moving forward, the initiative will serve as an early example of how the home setting can fit into the country’s progressive return to normalcy.

The new initiative, which will train home care clinicians on COVID-19 testing procedures that can be conducted in the home setting, is meant to expand New York’s testing capabilities and set the stage for the state’s reopening efforts. Iroquois Healthcare Alliance and Mohawk Valley Health System are working with HCA-NYS on the effort, with funding provided by Mother Cabrini Health Foundation grant.

The initiative will provide online training for roughly 18,000 clinicians, including home health RNs, nurse practitioners, physical therapists and respiratory therapists, Al Cardillo, president of HCA-NYS, told Home Health Care News.

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“[The training] is to be able to perform testing for COVID-19 on an in-home basis … but it also includes everything that would go along with an appropriate and safe test,” Cardillo said. “That means the appropriate personal protective equipment (PPE) — and the donning of that PPE for the safety of the worker and patient. The initiative will also include all of the techniques related to the collection of a sample, and the storage and transfer of that sample to a lab.”

HCA-NYS, one of the first home-based care advocacy groups that started gathering data on the coronavirus and its business impact, is a state trade organization that represents nearly 400 home- and community-based care providers and organizations.

Amid the coronavirus outbreak, New York has been a hotspot for COVID-19 cases. During the crisis, home care clinicians have been an untapped resource for COVID-19 testing, according to Cardillo.

More than 86% of in-home care providers have expressed interest in providing testing in the home care setting, but only 3% have had staff trained or equipped to do so, a recent HCA-NYS survey found.

Additionally, a broader HCA-NYS analysis found that over 50% of state in-home care providers had not been approached for COVID-19 testing collaborations with acute care providers.

“This is a situation where we are creating a home care infrastructure,” Cardillo said. “If you are ill because you have COVID symptoms, the last thing you should be doing is waiting in line in a congregate area for a test. This will enable doctors or facility care settings to contact in-home agencies to conduct tests for their patients.”

The in-home testing statistics from HCA-NYS likely aren’t a surprise for many, as testing in any setting has been difficult to come by. That’s true even for the nation’s nursing homes, which have been devastated by the spread of the coronavirus among residents and staff.

After death’s in New York nursing homes continued to rise this month, New York Gov. Andrew Cuomo issued an aggressive executive order requiring facilities to test all staffers for COVID-19 twice per week. Under the order, failure to do so could result in the threat of license revocation or monetary penalties ranging from $2,000 to $10,000 per day, Skilled Nursing News reported.

As of May 15, about 1.3 million New Yorkers had received tests since the beginning of the coronavirus outbreak.

“While we applaud Gov. Cuomo’s new testing directive to safeguard nursing home residents and staff, we will need significant assistance from state government to increase the availability of testing for skilled nursing and assisted living employees,” Stephen Hanse, CEO of New York State Health Facilities Association, said in a statement after the executive order was unveiled.

While New York has seen some of the most devastating impacts of COVID-19, in-home care agencies have been masterful in their navigation of the public health emergency, according to Cardillo.

“It’s been, perhaps, acknowledged far below what’s really occurring at the ground level,” he said. “What home care agencies have been doing is miraculous. As COVID rolled out, many of the regulatory policies and flexibility that needed to happen were not on the radar because the focus was on hospitals. It’s been an enormous challenge to get the flexibility needed. I think our state has done some great things, but we are still behind.”

Amid a national shortage, procuring PPE specifically remains a challenge for New York providers.

“The last survey that was conducted indicated that 80% of home care agencies were still working to get sufficient supplies of PPE from their local emergency management organizations,” Cardillo said. “We have a situation in New York where home care and hospice were not even on the original list of eligible participants in health care for PPE. It took a constant unwavering effort on our part to get this process rolling.”

Looking ahead, Cardillo doesn’t rule out a national version of the COVID-19 home testing training initiative.

“One thing that has already been broached with us is whether or not something like this might be available on a national level,” he said. “That’s something we are looking into. We would have to go back and consult with the grant foundation, but it’s something we’ve talked about.”

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