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COVID-19 in NY: High infection, death rates in group homes prompt calls for probe


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COVID-19 disparities among New Yorkers with intellectual and developmental disabilities living in group homes have prompted calls for investigations into the state government's response within the vulnerable facilities.

With a COVID-19 death toll in group homes of at least 554 residents and more than 7,000 coronavirus cases, New Yorkers in group homes have been three times more  likely to contract and die from the respiratory disease than the public, according to state figures and advocates.

Some of the factors driving the group home crisis included a lack of access to personal protective equipment and COVID-19 testing, as well as governmental mismanagement during the pandemic, according to a recent report by Disability Rights New York and other advocacy groups.

Dutchess County Executive Marcus Molinaro last week cited the report’s findings in calling on state Attorney General Letitia James to launch an investigation of the state’s handling of COVID-19 in group homes.

“Continuing to ignore the problems that face our…group home populations will only lead to further heartbreak and death,” Molinaro, a Republican, wrote in a letter to James, whose office didn’t immediately answer questions Monday about the issue.

The request comes as the attorney general’s office probed rapidly expanding scandals encircling Gov. Andrew Cuomo’s administration, including sexual harassment accusations against the Democratic governor and the underreporting of COVID-19 deaths in nursing homes.

Group homes are regulated by the state Office for People with Developmental Disabilities, or OPWDD, which disputed many findings of the report.

“OPWDD is proud of the significant efforts New York has made to ensure the safety of people with developmental disabilities during the pandemic and strongly disagrees with the misrepresentations and false narratives being perpetuated by certain politicians for apparent political purposes," Jennifer O'Sullivan, an agency spokesperson, said in a statement Monday.

"Despite the slow response of the federal government at the onset of the virus, which impacted all citizens of New York state, OPWDD was able to minimize spread of the virus, work with providers to establish additional facilities to quarantine individuals when necessary, and provide financial and regulatory relief to its service providers during this unprecedented time,” she added.

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What advocates say about COVID in group homes

In addition to the disability rights group, New York Civil Liberties Union and New York Lawyers for the Public Interest issued the report on March 9 criticizing state officials for failing to properly protect group homes amid the pandemic.

The groups asserted the state government’s response to COVID in group homes failed on multiple levels, spanning from flawed health-related policies to poor emergency management coordination.

Central to the report are claims that state officials prioritized hospitals and nursing homes over the group homes, despite the heightened threat that coronavirus would spread rapidly in the congregate settings.

“The state's historic failure to support and serve people with intellectual and developmental disabilities has long been a crisis, but inaction during the pandemic worsened conditions and created a tragedy,” NYCLU Senior Staff Attorney Beth Haroules said in a statement.

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The flow of personal protective equipment, or PPE, during supply shortages last spring in New York, for example, was hindered by state government directives that gave priority to hospitals and nursing homes but excluded group homes, the report stated.

One Southern Tier region agency serving group homes reported receiving just 12 gowns, 112 face shields and 12 gallons of hand sanitizer in response to its request for thousands of masks, gowns and face shields to protect group home residents and staff, the report stated.

The agency instead formed a network with other regional providers to obtain PPE on the open market despite increased prices straining the effort, the report added.

Further, the lack of standardized COVID-19 testing protocols for group homes residents and staff contributed to outbreaks last spring, the report stated, adding the problem persisted now despite vast improvements in testing access elsewhere in New York.

“Even as the situation has evolved, New York has failed to implement policies or provide guidance or funding to provider agencies to ensure robust testing,” the report noted.

The lack of government transparency into COVID deaths and infections inside group homes limited efforts to improve conditions, the report stated, and further investigation is warranted surrounding future funding decisions, resuming activities at group homes and related issues.

The report cited research by SUNY Upstate Medical University and Syracuse University that attributed group homes' COVID-related infection and death disparity, in part, to the fact residents are living in close quarters and more likely to have underlying conditions that put them at risk of severe illness. 

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What state says about COVID in group homes

State officials defended the handling of COVID-19 in a detailed 10-page response letter disputing specific claims in the advocacy report.

As for PPE, the state’s response in part blamed problems at group homes on a “nationwide shortage of PPE that affected all healthcare organizations throughout the United States and universally.”

Group homes seeking PPE were directed to go through their respective county emergency management offices, and state officials assisted whenever possible to help prioritize the requests, the response noted.

On testing complaints, state guidance in late March 2020 required group home staff who were COVID symptomatic to be removed from their work sites and report to local health departments for testing, the state response noted.

In October, state guidelines also required group homes in COVID cluster zones with higher infection rates than other areas to refer staff and residents for weekly testing, the response added.

But the state response conceded that group homes lacked the medical resources available to nursing homes, which were mandated statewide to conduct regular COVID-19 testing of workers.   

Still, some group homes have organized pool testing and have ongoing relationships with local labs, while others have worked with local health departments to organize on-site testing efforts where resources were available, the state response added.

State officials asserted COVID death and infection numbers were regularly provided to stakeholders, including family members, during weekly phone calls. Since the report was released, further information was provided to advocates in response to a public-records request, the response added.

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COVID in group homes, nursing homes

Molinaro’s letter also raised questions about the potential impact of an April 10 state directive issued by the Office for People with Developmental Disabilities, or OPWDD, regarding group homes admitting COVID-19 patients.

Molinaro, who ran for governor in 2018, compared it to a controversial March 25, 2020, state order directing nursing homes to accept COVID-19 patients from hospitals, if medically stable.

But the April 10 directive noted any admission denial “must be based on the residential provider’s inability to provide the level of care required” by the patient, a key caveat missing from the March 25 nursing home directive.

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In an interview, Molinaro said the group homes “may well have had a slightly greater ability to deny (COVID admissions) than the nursing homes.”

“But these (group home) agencies are funded by, regulated by and many times pressured by the state government, so there isn’t a provider who truly feels unthreatened by the state of New York,” he added.

OPWDD spokesperson Jennifer O'Sullivan defended the April 10 directive as consistent with public health recommendations, adding those who could not be safely accommodated either remained at the hospital or were served in one of the over 100 temporary sites established for COVID-19 recovery efforts.

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Nancy Cutler of The Journal News/lohud contributed to this report

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David Robinson is the state health care reporter for the USA TODAY Network New York. He can be reached at drobinson@gannett.com and followed on Twitter: @DrobinsonLoHud