COFAR blog

While the Department of Developmental Services is now moving to test all residents in group homes throughout the state for COVID-19, COFAR is concerned about the slow pace of the testing and about a potentially major gap in the process.

That gap concerns the voluntary nature of the testing of staff in the thousands of group homes in the state. DDS officials acknowledged that staff can opt out of the testing and still continue to work in group homes.

More than 1,300 residents and staff of DDS group homes and developmental centers had tested positive for COVID-19 as of April 19, according to numbers that we are now beginning to get from DDS.

In the DDS group home system, 518 residents and 653 staff had tested positive, including both provider and state-employee staff.

More information has been available about the situation in the developmental centers than in the group homes.

As of April 19, 46 residents and 90 staff had tested positive at the Hogan Regional Center in Danvers. There has been one death at the center.

In the Wrentham Developmental Center, 14 residents and 13 staff have tested positive.

As of Wednesday, most clients at Hogan with COVID-19 were reported to have mild symptoms. Many were in recovery and had completed a 14-day quarantine period and  were symptom free. Workers at Hogan are reported to be fully gowned, gloved, and masked.

Staff testing is voluntary

Christopher Klaskin, the DDS ombudsman, said this week that staff in group homes can opt not to be tested even if residents in the homes in which they work are symptomatic or have tested positive. Under current DDS guidelines, the staff have to have their temperature taken before entering the residences and can’t have a temperature above 100.0 degrees.

COFAR is questioning the voluntary nature of the staff COVID-19 testing, arguing that staff who are positive but asymptomatic could be bringing the virus into group homes where the virus could then spread rapidly.

“Unless all staff and residents are tested, the virus still has the upper hand,” COFAR Board President Thomas Frain said.

Colleen M. Lutkevich, COFAR’s executive director, said the organization has received reports that testing of staff is not being offered by some providers and that each provider is making their own decision about it. Taking temperatures but not actually testing staff for the virus “misses all of the asymptomatic carriers in this vulnerable population,” Lutkevich said in an email to DDS.

Guidance issued by DDS to all providers on April 13 does not include any specific testing requirements for staff or residents other than stating that the permission of a guardian is needed before residents can be tested. DDS officials have stated that it would be unusual for a guardian to refuse to consent to testing of a resident for COVID-19.

Regarding staff, the DDS guidance states only that a staff member who does test positive for COVID-19, but who does not show symptoms of the virus, is excluded from working in the residence for at least seven days from the date of the test. A staff member who tests positive and who does have symptoms is excluded from working for three days after they have recovered from the illness and at least seven days since the symptoms first appeared.

Slow start to the testing

COFAR is also concerned about what appears to be a slow start to the testing of residents and staff in the group homes. Earlier this month, DDS announced that the state was contracting with Fallon Ambulance Service to begin testing staff and residents throughout the system.

Klaskin said DDS does not have a timeline for Fallon to complete its testing of what we are estimating to be 22,000 or more residents and staff in the DDS group home system. It’s unclear why the National Guard is apparently being used to test residents and staff in Department of Public Health (DPH) nursing homes and other long-term care facilities, but not in DDS facilities.

DDS reported that as of April 19, 1,964 residents and staff had been tested in DDS group homes and at the Wrentham and Hogan centers by Fallon. This averages to less than 196 tests a day over the first 10 days in the group homes.

In an email sent to a COFAR Board member earlier this month, DDS Commissioner Jane Ryder stated that Fallon had the capacity to do up to 1,000 tests a day.

DDS does not have data on total test numbers in group homes

It is apparently not possible to compare the number of residents and staff testing positive in DDS-funded group homes with the total number actually tested.

As noted, a total of 518 residents and 653 staff have tested positive in the group homes. That number, however, includes people tested before Fallon started, Klaskin said.

While Fallon has tested 1,964 residents in the past 10 days, Klaskin said DDS doesn’t have information on the total of the number of persons tested prior to Fallon. So there appears to be no way to compare apples to apples in that respect.

DDS testing numbers not broken out by either COVID-19 Command Center or DPH

DPH, meanwhile, continues to track and publicly report detailed numbers on COVID-19 cases in nursing homes and other long-term care facilities that the department oversees. But DPH does not report numbers on DDS long-term care facilities, including the group homes and developmental centers.

Even though the administration’s COVID-19 Command Center has begun putting out information that includes DDS facilities, the numbers for those DDS facilities are not broken out from the totals.

For instance, a Command Center report stated that as of April 19, 3,743 tests were done at 206 group homes and “care sites” involving 2,297 clients and 1,146 staff among facilities funded by DDS, DPH, the Department of Children and Families, and the Department of Mental Health. That information is potentially of limited value unless it were to show a breakdown of the numbers in the facilities for each of those agencies.

As we have noted to legislators and policymakers, the families and guardians of close to 10,000 DDS residential clients are still largely being left in the dark because so little information about their loved ones is forthcoming from the administration.

We have contacted the chairs of the Legislature’s Children, Families, and Persons with Disabilities Committee and asked them, among others, to follow up with the administration to urge improvements in these DDS testing and reporting practices.