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HHS, DOD Program Could Offer More Streamlined Access to School COVID-19 Testing Funds


NEW YORK – As state health departments work to develop programs for using the $10 billion in funds for K-12 COVID-19 screening provided through the American Rescue Plan Act, another federally funded program has begun distributing money to support COVID-19 testing in K-8 schools and other congregate settings including summer camps, shelters, and correctional facilities.

Called Operation Expanded Testing, the program has $650 million in funding from the US Department of Health and Human Services and the US Department of Defense to support COVID-19 testing and, according to one participating vendor, could offer a more streamlined source of test funding for schools and other facilities.

Launched at the end of May and currently slated to run until Nov. 25, OET is using three sets of federally funded contractors to provide testing to participating institutions. PerkinElmer is covering the western United States, Battelle is covering the Midwest, and Eurofins and Affinity Empowering are together covering the South and the Northeast.

In a discussion of the program during a Clinical Laboratory COVID-19 response call hosted by the US Centers for Disease Control and Prevention in April, Ellen Kersh, laboratory branch chief at the CDC and a member of the testing and diagnostics workgroup at HHS, said that the program aims to put spare testing capacity to use in order to make 25 million tests per month available to K-8 schools and underserved populations.

"We want to access unused capacity and untapped talent to expand testing," Kersh said on the call. "For example, in large university commercial laboratories, laboratory consortia, or other nonprofit organizations."

The plan, she said, called for the contractors, or "coordinating centers," to interact with local schools and institutions to "determine the local needs, schedules, and testing requests" and to assign testing to participating laboratories.

Scott Storrer, CEO of Alexandria, Virginia-based Affinity Empowering, said that while the OET funds and the $10 billion in COVID-19 testing funds provided by ARPA through the CDC target overlapping populations, the OET program allows institutions to access testing directly from the OET vendors at no cost. This could make it a simpler route for organizations looking to get COVID-19 testing programs up and running.

"There's no allocation process, no paperwork that a school needs to go through to have access to this program," he said, noting that institutions can simply contact the vendor for their region — in the case of Affinity Empowering, through its OET program website — and enroll in the program directly.

"There are no [requests for proposals], no going through school districts or a department of education to access funds, and there are no upfront costs or financial invoicing that has to go back and forth between the school and the" funding agency, he said. "It's very easy for someone to sign up and get going."

This contrasts with the $10 billion in CDC funds, for which many state health departments are still working on distribution plans. Passed in March, ARPA provided the funding for K-12 school COVID-19 screening that was distributed by the CDC to the states in early April. That money has largely gone unused to date, however.

In May, 360Dx contacted the departments of health for all 50 states, asking where they stood in implementing COVID-19 screening with the ARPA funds and distributing those funds to schools and districts. Of the 16 states that replied with details about their use of the ARPA money, nearly all said that they were still developing their plans for the funds and none had begun broadly distributing them to individual schools or school districts. While the states' plans differed in their specifics, the most commonly cited approach among respondents was to use the summer for piloting testing programs and gauging school interest with a more comprehensive rollout planned for the fall.

Some vendors working to provide school testing funded by the ARPA money also cited as an issue a lack of awareness on the part of schools as to the availability of funds for testing. Michael Tkach, chief operating officer for Affinity Empowering, said that this was a challenge for the OET program, as well.

"I think one of the primary obstacles that a lot of places face is that they recognize there is a need to do something, but they are not exactly sure what resources are there to help support them," he said. "The reality is that most schools are at a place where they are strapped for resources and time, and to think about trying to scurry around to look for funding resources, that can be a real barrier for some places to participate."

Tkach said the company was trying to address this challenge through media and outreach campaigns targeted at state leadership, executive bodies at individual schools, and administrators. Affinity Empowering and Eurofins launched their OET program in the beginning of June. Tkach said it has drawn strong interest from the audiences it has targeted, but he declined to say how many organizations had signed up for testing through the program.

He noted that the company had received some interest from summer programs and congregate settings other than schools, but that the bulk of the interest thus far had come from schools interested in getting testing programs in place for the fall.

"We're seeing a lot of schools interested in setting up something now to have that confidence that they are moving into the fall with a strategy and with some things in place," he said.

Storrer said the company projected it would be running between 1.5 million and 2 million SARS-CoV-2 tests per week in schools once the school year starts in September, adding that especially as flu season arrives, he expects increased demand.

Tkach said that Affinity Empowering and Eurofins would tailor testing strategies to individual schools as necessary but that its OET program standard strategy relies on pooled PCR testing with reflex to another round of PCR testing in the case of a positive test in a pool. Participants take two nasal swabs during sample collection to provide a second sample to the lab for immediate reflex testing in the case of a positive pool. Currently, the company is using pools of 24 samples.

Tkach said the company has averaged a turnaround time of 18 hours and aims to provide results in no more than 24 hours with that timeline expanded to around 36 hours when reflex testing is necessary.

Compared to the CDC funds, the OET money is approved for a more limited range of uses. For instance, it is not intended to support hiring of staff to facilitate testing or to purchase personal protective equipment.

Storrer said that Affinity Empowering is instructing teachers and school nurses on how to do sample collection using lower anterior nasal swabs. He added that students were also capable of sampling themselves using these swabs and noted that such an approach could prove particularly handy if increased demand for school testing makes trained personnel more difficult to come by — a phenomenon he said the company had seen in some of the areas it serves outside the OET program.

"Many schools are looking for nurses to come in to do collections because they don't have access to self-collected testing," he said. "We manage schools in the state of Colorado just as part of our normal [testing] business, and at times we have run into a block there where we can't find a nurse to go into the school to do a collection."