State officials say Oregon care homes are on track to test all residents and workers for the coronavirus by a looming Sept. 30 deadline, even as the state so far has offered little direct help to get that testing done.

Already nearly half of all staff and residents in Oregon’s nursing, assisted living and memory care homes have been tested at least once for the coronavirus since June 1, the Department of Human Services said.

While that’s a significant number in 10 weeks, that still leaves 32,000 of about 60,000 total residents and workers in need of testing with just seven weeks to go.

Gov. Kate Brown set the plan in motion because people in care homes are particularly vulnerable to complications and death from the coronavirus, with broad testing helping prevent and curb the spread of disease. Elderly residents in care centers account for about half of the state’s 385 reported fatalities.

“The key objectives of the testing plan have been met and are on track to be achieved,” the state human services department said in response to written questions from The Oregonian/OregonLive.

Indeed, broad testing has already revealed outbreaks in six facilities that would not have been identified were it not for the governor’s order, the state said. In all, about 80 care homes now have at least one case of COVID-19, up from 16 when Brown declared everyone must get tested.

But since Brown issued her mandate two months ago, state officials have subsequently realized they’ll need to play a bigger role to ensure testing is completed. They originally said facilities would be mostly on their own to line up tests to screen residents and workers, with state help only as needed – and the state wouldn’t necessarily reimburse facilities.

Now the state has promised to pay for testing or reimburse costs for every facility in Oregon.

But the Oregon Health Authority still has not hired contractors to do the work and only started looking for companies July 20, more than a month after Brown’s announcement. Complicating matters is limited testing supplies nationwide, delayed test results and, according to people in the industry, insufficient support from the federal government.

Philip Bentley, senior vice president of government relations with the Oregon Health Care Association, the main senior care trade association, said the state could face a crush of tests in the last month of the project if the health authority’s contract isn’t up and running soon.

“I don’t think we’re at a point where we would be sounding any alarm bells,” said Bentley, adding that the association believes it’s taken the state “longer than we would have preferred” to find labs to do the tests.

State officials announced late Friday that they plan to hire Metro West Ambulance Services, a medical transport company, to do part of the work.

Across-the-board testing is especially important now that the coronavirus is more readily present in the community than it was when Brown announced the testing plan. The more cases in a community, the more likely senior care homes are to get an outbreak, research shows.

It’s believed the disease is brought into the homes by workers who don’t know they’re sick and then pass it on to vulnerable residents who have a far slimmer chance of surviving an infection than the workers.

Obtaining test results can help facilities segregate residents with infections, ensure sick workers stay home and direct state inspectors to the facilities most in need of oversight.

While new state regulations say staff must get tested, residents are allowed to refuse.

More than a fifth of Oregon’s approximately 685 nursing, assisted living and memory care homes – 154 – said all staff and residents have been tested at least once since June 1, according to the Department of Human Services. Most have relied on agreements with local public health departments and their own contracts with testing laboratories.

Just 38 facilities got direct help from the state. Health and human services officials said they asked the federal government for help, with the federal Department of Veterans Affairs ultimately conducting testing for those facilities.

More than half of the facilities the state assisted had already identified outbreaks.

Marjorie Sharp, who manages the assisted living home Haven House Retirement Center, in Fossil, said she’s looking forward to getting all 30 or so staff and residents at the home tested in the coming days.

The company agreed to get tested through the Wheeler County public health department, which Sharp said started collecting samples Thursday. The county is using its rapid test and should be done with gathering and testing samples by early next week, she said.

“We want to know what we’re fighting,” Sharp said.

As the pandemic has evolved over the last two months, state officials have pivoted from initial plans. They originally expected to ensure across-the-board testing in counties with the majority of senior care facility outbreaks – with a special focus on nursing homes, where residents have the greatest medical needs.

But they’ve since decided to target homes that already identified outbreaks as well as those in counties on the state’s list of designated hot spots.

Oregon’s top senior care official, Mike McCormick, has suggested that care homes not test everyone themselves but, instead, wait for the state to find contractors to do that work.

The state’s contractors will be hired to test anywhere from 100 to 300 care homes, according to state records, including workers collecting samples and lab analysis.

“We’re going to take care of everything,” McCormick said in a July 24 webinar for care homes.

While care homes will be reimbursed for the tests they do, some can’t afford to pay costs upfront, said Bentley, the trade association executive.

The association is “eager to see the state-contracted lab process finalized and get them into the field,” he said.

Even facilities that have already begun testing have run into challenges. Among other things, obtaining test results can take a day to nearly two weeks, according to state and trade association officials, creating an unacceptably long window for undetected spread in a facility.

“The longer the turnaround time, the less valuable test results are in preventing new infections at a facility,” the Department of Human Services and the Oregon Health Authority said in joint responses to written questions. Neither agency made officials available for interviews.

Yet another challenge has been limited assistance from the federal government, Bentley said. Oregon hasn’t had nearly as much spread of the coronavirus as other states, meaning federal officials are currently unlikely to send specialized testing machines that can provide results within minutes.

The federal government has only in the last few weeks started to send the machines out to nursing homes in the country, prioritizing about 2,400 homes in disease hotspots and those that show particular risk of spread of disease.

Oregon officials received 15 Abbott ID NOW rapid test machines from the feds this spring. The state sent those to community health organizations or hospitals in rural areas, rather than keeping them for care facilities.

For now, most care homes have only been testing in response to suspected cases of the coronavirus, said Linda Kirschbaum, another executive with the association who has been working closely with the Department of Human Services.

Kirschbaum said catching infections early is one of the most important safeguards to preventing the disease from spreading in a facility.

“We just want to make sure that there’s consistent access to on-demand testing,” Kirschbaum said, and a “rapid response and turnaround for the testing.”

This article was originally published by The Oregonian/OregonLive, one of more than a dozen news organizations throughout the state sharing their coverage of the novel coronavirus outbreak to help inform Oregonians about this evolving heath issue.