California vaccine mandate extends to aides for people with disabilities

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.

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

Previous health orders covered only people working in licensed congregate settings like nursing homes, leaving out staff members who support 89% of people in California with developmental disabilities living with family, on their own or in group homes.

For months, that left people like Tim Jin who rely on aides for everyday tasks to wonder: Is the person brushing my teeth vaccinated?

"Due to my disability, I cannot do anything like cooking, eating, using the restroom or even using the microwave on my own. I am totally dependent on others to assist me," Jin said.

Jin has cerebral palsy and lacks the use of his arms or hands. He communicates mainly by typing with his toes on an iPad mounted next to his feet on his electric wheelchair. Up to six health aides come in and out of his home every day, helping him with intimate tasks like eating and bathing.

"The staff who come into my home should be vaccinated. It’s that simple," he said. “It’s a matter of life and death."

Only health workers with religious objections or a qualifying medical condition can be exempted from the vaccine requirement. They will be tested weekly for the virus that causes covid-19 and must wear high-grade masks when working.

In September, Los Angeles County included those aides in its vaccine mandate, following a KPCC/LAist story that reported on the discrepancy.

But the order applied only to L.A. County, leaving out the 200,000 Californians with developmental disabilities living elsewhere, including Tim Jin, who lives in neighboring Orange County.

Advocates for people with disabilities hoped state health officials would use L.A. County as a model, but California's Sept. 28 health order went further, mandating the vaccine for some in-home support service workers, as well as home health aides.

"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 Aragón, California's public health officer.

California has reported 19,830 confirmed covid 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.

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

"And when they do get diagnosed with covid-19, they are about two to three times more likely to die from the disease,” said Scott Landes, an associate professor of sociology at Syracuse University’s Maxwell School of Citizenship and Public Affairs.

Landes said cases seem to be dependent on two variables: preexisting 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."

This story is from a reporting partnership that includes Southern California Public Radio, NPR and KHN.