COFAR blog

It appears that the Baker administration is examining what has been termed “encouraging” testing and hospitalization data on COVID-19 in considering whether to reopen the Massachusetts economy.

We hope the administration will consider, among other things, testing data in the Department of Developmental Services (DDS) system. If not, this could be another example of the apparent disregard the administration has shown for the risk the virus poses to people with intellectual and other developmental disabilities.

Over the past weekend, the Massachusetts State House News Service reported that the administration was looking at  “a number of (COVID-19) metrics considered key to resuming economic and social activity…” That data “showed positive signs” in the most recent report from the Department of Public Health (DPH ), the news service stated.

According to the News Service, the number of COVID-19 patients hospitalized in Massachusetts has declined in 10 of the last 13 days.

But the data isn’t encouraging in the DDS group home system. So, we are concerned that reopening the economy may add to the risks that residents and staff are facing in DDS group homes, in particular. If numbers of COVID-19 cases are still rising in the DDS system, it would have safety implications for all residents in the state.

Data from DDS show that the number of DDS provider-operated group homes reporting residents testing positive rose from 800 to 900 homes (out of 2,100 homes) in a four-day period, from May 4 to May 7. Eight additional residents and four additional staff tested positive at the Wrentham Developmental Center during that period, while the numbers at the Hogan Regional Center held steady.

Meanwhile, DDS is continuing to test residents and staff more slowly than planned, and the Department still has not made testing of staff mandatory.

Rate of testing in DDS group homes may be stalling

While testing all residents in all demographics is crucial in determining whether and when to reopen the economy and end the lockdown, the rate of testing in the DDS system does not appear to be meeting early expectations. In fact, it may actually be slowing.

Fallon Ambulance Service started testing group homes and developmental centers throughout the DDS system a month ago, and was supposed to be ramping up to 1,000 tests a day.

However, as of  April 29, Fallon was performing an average of only 405 tests a day, according to numbers we’ve analyzed from DDS. A week later, as of May 7, Fallon was actually performing an average of only 396 tests a day.

DDS reported that as of May 7, Fallon had done about 11,000 tests since starting on April 10. We are estimating that there are as many as 25,000 residents and staff in the group home system.

So, at that rate, it would still take Fallon at least another month to test the entire DDS system, and that doesn’t count retesting, which they apparently aren’t doing at all. In other words, more than half of the total residents and staff in the system still apparently have not been tested even once.

On a related note, we received a response on April 29 to a Public Records request to DDS for records on testing timelines and plans for testing all residents and staff in the system. DDS said they have no such records. They also have no records regarding the total number of staff in the provider system.

Seeking mandatory testing of staff

We also submitted written testimony today to the Legislature’s Public Health Committee to urge the adoption of legislation that would make it mandatory for staff in DDS facilities to be tested for COVID-19. As we have reported, staff are currently not required to be tested in the DDS system — a situation that leaves the residents in the system vulnerable to infected staff members who may well be asymptomatic.

The Public Health Committee is currently considering a nursing home safety bill (S.2657), filed by Senator Jamie Eldridge, which would require testing of all nursing home staff for COVID-19. We are urging the committee to amend the bill to include a provision for mandatory testing for all staff working in DDS-funded group homes.

As we understand it, the administration actually issued a requirement last month that all staff in nursing homes be tested. However, no such testing requirement has been imposed for staff in DDS facilities.

Questions about compliance with DDS guidance

We are also concerned about a possible lack of compliance among DDS group homes with the Department’s guidance on admission of staff and possibly visitors to those facilities, and on social distancing among other issues concerning care and conditions.

We received a report that staff from one group home took one or more residents to another of the provider’s group homes during the ongoing lockdown, and may have also admitted several people into a group home with no clear purpose for being there.

Late last week, we asked DDS whether the Department has policies or procedures in place for monitoring compliance by group homes with the Department’s guidance regarding the admission of staff into facilities, social distancing, proper use of personal protective equipment, and related issues.

A one-page guidance document sent last month to all providers by DDS states that there will be no one admitted to any facilities except for medically necessary reasons. Any visitors or staff must be screened and have no flu-like symptoms or a fever over 100 F. In addition, all staff should wear face masks during their shifts.

While it is important that DDS has issued this guidance, it means little if the Department has no way of determining whether the management and staff in the widely dispersed system are complying with it.

In sum, the well-being and even survival of people in the DDS system depends on the quality, speed, and thoroughness of the ongoing COVID-19 testing. The current state of that testing in the system raises many areas of concern for us.