Introduction

In March 2022, the U.S. Health and Human Services Agency (HHS) initiated the "Test to Treat" program to make oral antiviral treatments more easily accessible throughout the country. Test-to-treat facilities are locations where individuals can get tested for COVID-19, speak to a health care provider about treatment options if they test positive, and leave with those treatments in-hand if they are eligible. These are crucial components to successful COVID-19 health care since most therapeutic options must be initiated as early as possible (usually within five to seven days of symptom onset) to be effective. By allowing patients to have a treatment prescribed and dispensed at the same location, the test-to-treat program saves valuable time for patients—especially for patients with limited mobility or modes of transportation – and reduces the chance of severe illness and hospitalization.

The California Department of Public Health (CDPH) has been working with local health departments (LHDs) to add state-selected Test to Treat sites to the system. This initiative will not replace or impact the existing allocation system of therapeutics to California, and HHS will continue to distribute COVID-19 treatments, including oral antivirals, to California for distribution to jurisdictions. All qualified healthcare providers can still prescribe these therapeutics to patients who are at increased risk for developing severe COVID-19. HHS has created a Test-to-Treat facility locator that is available in English, Spanish, and Chinese. This site includes both federally and state supported locations.

Characteristics of Test to Treat Sites

Test-to-treat sites need to have three components: (1) rapid testing; (2) an available physician, advanced practice registered nurse, or physician assistant (these individuals must be able to prescribe outpatient medications for COVID-19); and (3) a CA Board of Pharmacy licensed pharmacist/pharmacy. While it is best for these elements to all be housed in the same facility, some co-located (or closely located) clinic and pharmacy pairs have created test-to-treat partnerships.

CDPH suggests that all Test to Treat sites have the following characteristics:

• Services provided to all individuals, regardless of insurance status or ability to pay.
• Comprehensive, end-to-end test and treat services to support a seamless patient experience.
• Either on-site rapid COVID-19 testing (result available at time of visit) or the ability to provide an evaluation of at-home test results.
• Health care providers available to provide timely and thorough assessments and discussions relevant to treatment option(s), consistent with FDA requirements of these medications.
• Co-located pharmacy that can readily dispense oral medications to eligible patients.
• A plan to refer patients to a provider or alternate location for infusion of either an anti-SARS-CoV-2 monoclonal antibody or IV remdesivir should oral medications be contraindicated.

Becoming a Test to Treat Site

Local health departments will be responsible for vetting additional test-to-treat facilities in their jurisdictions. Once vetted and identified, test-to-treat facilities can be labeled and uploaded to the Health Partner Ordering Portal (HPOP) and will appear on the HHS Test to Treat locator. Sites that would like to become a Test to Treat site should contact their LHDs.

Originally published on June 15, 2022