COFAR blog

[UPDATE: We have received unofficial information that staff of DDS state-operated group homes and at the Wrentham and Hogan Developmental Centers are subject to the vaccine mandate. It appears those staff fall under an executive order last month applying to executive branch employees.  

However, the much larger corporate provider-operated group home system does not appear to be subject to the vaccine mandate.  

This new information contradicts what an EOHHS spokesperson told us (see post below), which was that no congregate care staff are subject to the vaccine mandate.]

Despite a recent uptick in the number of residents in the Department of Developmental Services (DDS) system who have tested positive for COVID, the Baker administration is not including DDS system staff in a new requirement that health care workers in Massachusetts be vaccinated.

Once again, it appears, people with intellectual and developmental disabilities are subject to looser COVID protections than are the elderly or people with other types of disabilities.

According to the State House New Service, the Baker administration this month announced plans to require COVID-19 vaccinations for all staff at rest homes, assisted living residences, hospice programs, and for home care workers providing in-home, direct care services.

The administration first imposed a vaccine requirement in August on employees of skilled nursing facilities.

Last week, a spokesperson for the Executive Office of Health and Human Services (EOHHS) told COFAR that the latest vaccine mandate does not include “congregate care” staff. We had specifically asked whether the mandate includes DDS-funded group homes, developmental centers, and day programs for persons with intellectual and developmental disabilities.

Although the EOHHS spokesperson didn’t directly answer our question, DDS congregate care facilities would appear to consist of both provider-run and state-operated group homes, which together serve some 9,000 residents and employ tens of thousands of staff. [See updated information above pertaining to state-operated group homes and the developmental centers.]

The EOHHS spokesperson also did not respond to our follow-up question why DDS staff have not been included included in the vaccine mandate. DDS Commissioner Jane Ryder did not respond to an initial inquiry on the matter that we sent her on September 8.

We have raised concerns for several months about unvaccinated staff in the DDS system. It is not clear how many DDS system staff remain unvaccinated.

As of last April, the last time EOHHS apparently tracked staff vaccinations, less than 50% of staff in state-operated DDS group homes were fully vaccinated, and only 51% of staff in provider-run grop homes were fully vaccinated.

Apparent concern over staffing shortage in the DDS system

Given the lack of information or comment from the administration, we are guessing the lack of a vaccine mandate for DDS is due to a staffing shortage, which may be more acute in the DDS system than in nursing homes. It would appear the administration is concerned that requring those staff to be vaccinated would make the shortage worse.

Home care providers in Massachusetts, in fact, are already predicting the vaccine mandate will drive many of those workers to other fields.

One solution, of course, would be to pay direct care workers on the DDS system enough to retain the current workforce and recruit new caregivers. As we’ve reported, federal and state funding exists to do this. But there appears to be no sense of urgency in the state Legislature to distribute the funding, and no effort there to ensure the money will go toward those workers.

Rising number of infected residents

As the State House News Service reported last week, despite the fact that more than 4.54 million people in Massachusetts are now fully vaccinated, COVID continues to spread, apparently driven by the more infectious Delta variant.

The last two online COVID testing reports from EOHHS for congregate care facilities show an increase in residents testing positive in DDS provider-run group homes.

After declining dramatically from a high of almost 250 positive residents in January of this year to virtually zero in June and early July, there were 31 residents listed as positive in provider-run group homes as of this past week’s report (Sept. 7).

The positive COVID rate among provider-run group home residents in the DDS system had started to rise as of the August 10 EOHHS report.

EOHHS reports on COVID rates in DDS and other congregate care facilities are now provided once a month. EOHHS does not report specifically on the number of COVID-positive staff in provider-run group homes.

Importance of vaccinations of staff emphasized

The State House News Service quoted Tara Gregorio, president of the Massachusetts Senior Care Association, as stating that the administration’s vaccine mandates “will create parity, transparency, and accountability within the entire health care system, which is ultimately to the benefit of consumers and their caregivers.”

But parity, in particular, will not fully be achieved throughout the entire health and human services system if DDS staff are left out of the vaccine mandates. DDS manages a budget of more than $2 billion — the largest budget of any line agency in the EOHHS system.

We hope it finally begins to dawn on both legislators and the administration that DDS needs to be included in the staff vaccination mandates, and that those workers need to be paid enough to keep them from leaving the system.