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Home Health Agencies Not Tasked to Vaccinate Homebound So Who is Doing the Shots?

Home health agencies not tasked to vaccinate homebound so who is doing the shots?

Home Health Agencies Not Tasked to Vaccinate Homebound So Who is Doing the Shots?

By Liz Freeman, Naples Daily News (article)

Karen Heyden got her homebound parents vaccinated against COVID-19 in their Estero home even though she lives more than a thousand miles away in Illinois.

She has Zoom meetings with her parents’ in-home caregivers and learned that a private-duty home care agency, BrightStar Care of Naples & Fort Myers, is vaccinating homebound individuals.

Her parents, Robert and Marjorie Thrun, both 89, were immunized Wednesday by a BrightStar nurse at their breakfast table in their home in Pelican Sound Golf & River Club, a gated community.

The state in mid-March launched an email system for the homebound or their caregivers to get them signed up for getting the shots in their homes using state strike force teams. 

Estimates vary on the number of people who are homebound, and the state has not asked home health agencies with skilled nursing staff to help vaccinate this population, said Kyle Simon, spokesman for the Home Care Association of Florida.

He knew BrightStar took the initiative to enroll in the state's vaccination program but the association does not know how many other home health agencies are vaccinating the homebound.

"We should have been called from the start to do it," he said. "It is out of our hands."

The state also is not providing data on how many homebound have been vaccinated, Simon said.

Some people can be permanently homebound due to cognitive or physical decline while others are temporarily homebound after a medical event, said Sue Nimnuan, vice president of BrightStar in Southwest Florida.

All of that comes into play for why it is hard to pinpoint how many people are homebound and who needs to be vaccinated in their homes, she said.

The state Department of Health doesn’t have clear figures of how many people are homebound because there are different standards for being homebound and what services are available to them, said Tammy Yzaguirre, spokeswoman for the state health agency in Lee County.

The Area Agency on Aging for Southwest Florida estimates the homebound population based on the number of individuals receiving meals delivered to their homes and those wait listed for the service, according to Jenny Bilinovich, director of client services.

There are 986 homebound people in Lee County and 563 in Collier, according to the agency. Add figures for Charlotte, Hendry, Glades, Sarasota and DeSoto counties and the total comes to 2,800 homebound in the seven-county region.

“This is our best way to monitor seniors who are homebound,” Bilinovich said. “I have no doubt there are many more seniors who are homebound in our area, but if they have not come to us for assistance we don’t have a way of tracking their numbers.”

Statewide, roughly 350,000 Medicare beneficiaries are homebound, but that number includes only those 65 and older, Simon said.

How the Homebound Can Sign Up

Anyone in Florida who is homebound can sign up for the vaccines to be administered in their home at HomeboundVaccine@em.myflorida.com or by calling 866-799-6121.

Another option in Lee is preregistering locally for the vaccine through Tidal Basin, the vendor for appointments in Lee, according to Yzaguirre, spokeswoman for the Lee health department.

When Tidal Basin calls with appointment times, the homebound can tell the vendor they need the shots in their homes, she said. Health department clinicians in Lee will provide the shots in their homes.

“Over 500 homebound seniors have been vaccinated through partnerships with home health agencies, home visits by our staff and adult daycares,” Yzaguirre said.

Besides BrightStar, the Lee health department works with Hope PACE, a community-based health care agency, and two adult day programs, Sweet Home Adult Daycare and Loving Heart Adult Daycare, she said.

In Collier, homebound vaccination is strictly handled by the state Division of Emergency Management, according to spokeswoman Kristine Hollingsworth.

Emergency management officials did not respond to a request for how many homebound in Collier have been vaccinated or to a records’ request of who is providing the shots.

It’s a Real Challenge

BrightStar is not under contract with the state to do homebound vaccinations even though it meets state credentials to provide the vaccine and was approved to administer the vaccines in January, according to Nimnuan, vice president of the private-duty agency. 

Like many seniors, the homebound may not have grown children who can get them signed up for the shots or they don’t have caretakers who can handle the arrangements, she said.

More so, it's not possible for the homebound to sit in a car waiting for a shot in a county-run drive-up clinic or stand in line, she said.

Nimnuan said she's had to rely on the Collier and Lee health departments for her vaccine supply because the state's emergency management division has yet to provide BrightStar with the vaccine directly. She's been pushing for answers.

She's received 150 doses of the Johnson & Johnson from the Lee health department and 200 doses of Moderna from Collier.

Referrals are pouring in from home health agencies that don't have nursing staff to provide the vaccine and by word of mouth.

“My waiting list is in the hundreds for this,” she said. “My phone doesn’t stop ringing.”

Getting the Shots at Home

Heyden, who is the legal guardian of her parents in Estero, is relieved her parents got the shots without her having to spend countless hours on the phone trying to get it done.

“I was so thrilled,” said Heyden, 67. “I’m not sure (my father) understands how important it is to receive the shot. I have explained to him about the virus and he was horrified.” 

Her mother has dementia and her father shows signs of dementia and has significant hearing loss. They had no comprehension of the significance of getting immunized against the virus.

Michael Julyan, director of nursing with Brighter Home Healthcare prepares Rachelle Jacks' arm for a COVID-19 vaccine, Thursday, April 1, 2021, at Jacks' home in North Naples.

Rachelle Jacks, 85, who lives in Village Walk, a gated community in North Naples, was vaccinated by BrightStar at her home Thursday. She has short-term memory loss.

"It's so nice you come to the house," she told the BrightStar nurse. "I think it's wonderful. I don't need to be exposed to other people."

She and her significant other, Richard Gregory, 94, who got vaccinated through the Department of Veteran Affairs, have been home since the pandemic began. The only people coming to their home are caregivers.

"We try not to have too many people here," she said. "We just try to enjoy our life in the house."

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