The California Department of Health has issued an All Facilities Letter addressing the administration of influenza and pneumococcal immunizations to facility residents aged 50 or older by licensed professional caregivers. The letter provides guidance for the provision and administration of these immunizations using standing orders and without patient-specific orders in skilled nursing facilities (SNF), nursing facilities (NF), and intermediate care facilities (ICF). Long-term care facilities serving Medicare and Medicaid residents must now provide immunization against influenza and pneumococcal disease to all residents if they want to continue in those programs. Standing orders are allowable in General Acute Care Hospitals but were previously prohibited in long-term care facilities. Effective immediately, long-term care facilities are encouraged to establish policies and procedures to implement the mandates of Health and Safety Code 1261.3 added by Assembly Bill 1711. The standing orders must be approved by the skilled nursing facility medical director and meet the recommendations of the Advisory Committee on Immunization Practices (ACIP) of the federal Centers for Disease Control and Prevention.

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