Disability Group Homes At Risk Of COVID Outbreaks As Staff Falls Behind In Vaccination

Workers at group homes for intellectually and developmentally disabled New Yorkers in New York State are falling behind in COVID-19 vaccinations, according to data from the state’s Office for People with Developmental Disabilities.

Residents and staff at these homes were among the first New Yorkers to become eligible back in January. But as of mid-June, just 33% of workers in group homes have received at least one dose.

That’s far below the rate for group home residents—86%—and New York state as a whole, which reached a milestone last week of 70% of adults being partially vaccinated. Mikayla Hoskins, a group home resident and member of the Self-Advocacy Association of New York State, was thrilled to get a COVID-19 vaccine herself. She wants more workers to get inoculated, both so life can get back to normal and staff can be protected from the virus.

“I think it’s very important that staff gets vaccinated because we want them to still be alive,” she said.

While this trend in group homes is on par with the staff vaccination rates of some congregate settings, like prisons, it’s well behind nursing homes where 64% of employees are inoculated, according to data from the New York State Department of Health.

Group home agencies are creating their own pro-vaccine messaging for staff, with some mulling the idea of cash and other incentives. But advocates and experts say the issues underlying low vaccination rates are systemic. Chronic understaffing and low wages drive workers to put in hours of overtime, making it difficult to schedule a period to get the shots and recover from its side effects. And many workers are distrustful of guidance from the state government, which advocates say left them unsupported during the darkest days of the pandemic.

“Why should I trust someone to vaccinate me when they can’t even compensate me or understand that what I do is important?” Yvette Watts, executive director of the New York Association of Emerging and Multicultural Providers, asked during a New York State Senate roundtable about the topic held on June 3rd. “We need those individuals to be vaccinated. But you cannot mandate [it] in individuals that don’t even want to work with you anymore.”

Akin to long-term care facilities, group homes were hit hard by COVID-19. More than 7,000 group home residents and 11,000 group home staff have tested positive for the coronavirus as of June 16th, according to data from the Office for People with Developmental Disabilities. A study published in October found that New Yorkers living in group homes were four times as likely as those in the general population to contract the virus.

Social distancing is difficult in group homes. Residents share kitchens and bathrooms. They receive help from staff with bathing, dressing and other daily activities. Because of understaffing, an agency may deploy its workers across multiple group homes, which increases the risk of transmission between resident communities as well as the staff’s families.

While the Cuomo administration has mandated regular testing for nursing home staff and rescinded a controversial order for these long-term care facilities to readmit COVID-positive residents discharged from the hospital, disability advocates and group home administrators say the state left them alone to figure out testing and quarantine protocols for residents discharged from hospitals.

It’s precisely because these communities were first in line that some were nervous about getting the vaccine, said Kristen Kopper, who worked in a group home in Schenectady, New York until this past April.

“At that point, the vaccine was new, and there wasn't as much information out about it as there is now,” Kopper told WNYC/Gothamist. “For [direct support professionals], there was a little bit of hesitancy about getting the vaccine.”

The speed of vaccine development, the temporary pause on the Johnson & Johnson shot and the legacy of medical racism in the United States also contributed to the reluctance, according to group home administrators and union leaders.

“The preponderance [of direct support staff] are women of color, and they all have their own, very valid reasons for feeling hesitant about the vaccine,” said Susan Constantino, president of CP Unlimited, which provides services to intellectually and developmentally disabled New Yorkers.

Workers and advocates say logistical barriers are feeding the low vaccination rates, too. State employees are allowed a four-hour paid vaccination leave to get their shots, but workers at understaffed group homes may have a tougher time receiving time off.

“Because the staffing crisis is so bad, [direct support professionals] are working insane hours,” said Kopper. “Even if they want the vaccine, it’s going to be hard to find the time to get to a vaccine site if you’re constantly working.”

For some workers, vaccine jitters and logistical hurdles are compounded by burnout, low wages, scant personal protective equipment and little support from the government for regular testing.

“People are just exhausted and weary, and the vaccination is just one more thing,” Randi DiAntonio, vice president of the New York State Public Employees Federation, told WNYC/Gothamist. “For some people, it’s like, ‘I can’t wait.’ For others, it’s like, ‘No, I’ll wait.’”

Unions, group home administrators and the Office for People with Developmental Disabilities say they’ve been trying hard to get more workers vaccinated. Their efforts include pop-up vaccination sites at residential facilities and offering to inoculate workers alongside residents. Many service providers and unions have also produced videos featuring personal stories from vaccinated workers. Advocates and union leaders are also pushing for regular onsite testing of staff to protect workers and unvaccinated residents.

The simple passage of time has made an impact, too, Constantino said.

“Watching that other people are not getting sick has made the biggest difference,” she said, adding that peer-to-peer conversations are helping, too.

Some group home administrators are also considering incentives for taking the shots, mainly cash bonuses for employees. But these providers, union leaders, advocates and workers agree that increasing pay and improving labor conditions would not only motivate staff toward vaccination but also keep employees from leaving outright. A survey of disability services agencies by New York Disability Advocates found that close to half had to scale down their operations this year because of staffing shortages.

“Our staff is emotionally drained, burnt out, we’ve lost many of them already, and we’re at risk of losing more,” Karen Nagy, of Eastern New York Developmental Disabilities Advocates, said at the roundtable. “Essentially, our workforce is in crisis.”

“These are hardworking, dedicated individuals who are essential to this field,” Watts said. “A lot of these incentives are necessary, but a living wage is most vital.”