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Workers Who Aid People With Disabilities Must Be Fully Vaccinated By Nov. 30

Tim Jin at his computer, using his feet to type.
People with developmental disabilities have argued that health aides who come to their homes should be required to be vaccinated. The state of California has now expanded its vaccine mandate to include such workers.
(Jackie Fortiér/LAist)
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Workers in adult and senior care facilities and in-home aides have been added to the list of California health workers who must be fully vaccinated against the coronavirus.

Staff who work directly with people with disabilities — such as employees paid through the state’s regional center network, contracted agencies and in-home support service workers who don’t live with the person they assist — are all included in the vaccine mandate. This new group must be fully vaccinated by Nov. 30.

Only health workers with religious or a qualifying medical condition can be exempted. They will be tested weekly for the virus, and they must wear high-grade masks.

Los Angeles County had already extended its vaccine mandate for health workers to include in-home health aides, following a KPCC/LAist story that reported on the discrepancy.

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Advocates for people with disabilities celebrated the state’s move.

“This new health order will undoubtedly save lives of people most at risk,” said Judy Mark, President of Disability Voices United. “These workers provide the same intimate care like toileting and eating as healthcare workers at nursing homes. The vaccine mandate expansion ensures people with developmental disabilities are protected,” she said.

Who Is Included?

  • All workers in adult and senior care facilities.
  • All in-home direct care services workers, including registered home care aides and certified home health aides, except for those workers who only provide services to a recipient with whom they live or who are a family member of the recipient for whom they provide services.
  • All waiver personal care services (WPCS) providers, as defined by the California Department of Health Care Services, and in-home supportive services (IHSS) providers, as defined by the California Department of Social Services, except for those workers who only provide services to a recipient with whom they live or who are a family member of the recipient for whom they provide service.
  • All hospice workers who provide services in the home or a licensed facility.
  • All regional center employees, as well as service provider workers, who provide services to a consumer through the network of Regional Centers serving individuals with developmental and intellectual disabilities, except for those workers who only provide services to a recipient with whom they live or who are a family member of the recipient for whom they provide services.

California has reported 19,830 confirmed COVID-19 outbreaks throughout the pandemic, and nearly 50% of those were reported in health care, congregate care, and direct care settings, according to the California Department of Public Health. Of these outbreaks, the most (22%) have occurred in adult and senior care facilities and in-home direct care settings. Cases and outbreaks often include workers and unvaccinated individuals.
Previous health orders included only staff working in licensed congregate settings, leaving out staff that supports the 89% of people in California with developmental disabilities who live with family, on their own or in group homes.

“These care settings are home to Californians with complex medical conditions, all of whom are at high risk of having severe but preventable outcomes including hospitalization, severe illness, and death,” said Dr. Tomás J. Aragón, California’s public health officer. “Increasing vaccination rates among those who are providing care will help curb the spread of COVID-19 in these high-risk settings.”

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Studies show that people with intellectual and developmental disabilities often have underlying health conditions that make them more susceptible to COVID-19.

“If you have an intellectual disability, and you're living in your own home or a family home, you're doing better than those living in a congregate setting. However, you still have some increased risk compared to the general population,” said Scott Landes, an associate professor of sociology at Syracuse University's Maxwell School of Citizenship and Public Affairs.

“And when they do get diagnosed with COVID-19," he added, "they are about two to three times more likely to die from the disease."

Landes said cases seem to be dependent on two variables: pre-existing conditions, and the amount of in-person intimate care that the developmentally disabled person needs.

“Which really just makes sense for COVID,” he said. “If you've got a caregiver that's right up next to you, all day, it's going to increase the chances that you could get the disease.”

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Some experts and people in the industry fear a statewide vaccine mandate for these workers may exacerbate the current staffing crisis.

The new requirement encompasses more health workers than a previous health order issued in early August. That order made California the first in the nation to require COVID-19 vaccinations for health care workers.

What questions do you have about the pandemic and health care?
Jackie Fortiér helps Southern Californians understand the pandemic by identifying what's working and what's not in our health response.