The chaotic rollout of coronavirus vaccines has roiled the American industry tasked with caring for children who live in residential settings — leaving tens of thousands of frontline workers who weren’t prioritized by federal officials to scramble for protection, while continuing to clock in at densely populated centers day after day.
Messaging around the shot to prevent coronavirus — what’s available, who can get it, and when and where — varies from state to state, county to county and even city to city, according to a survey of residential centers in 19 states conducted by the Association of Children’s Residential Centers for The Imprint.
Arizona placed behavioral health facility workers in the front of the line, while in Florida, one respondent has heard no mention of vaccinating group home workers. In Minnesota, a director wrote “Hooray!” to this week’s survey request. “Yes, we are a priority in our state and received the first shot last week, second scheduled for early February.”
Some congregate care workers have received both doses of vaccines, while others fear it may be April before they have even a first one. Proceed on your own to find a place to get the shot, some employees have been told. Workers in one city were able to receive the vaccine, while those just 2 miles away were not. Others got a first dose but have already missed the deadline for the second, with no word about when it will be scheduled.
A few facilities have had to fend for themselves, scouring the landscape for available vaccines — not through a public health department — but through personal connections. One response to the anonymous survey described group home staff receiving vaccines after an employee heard from a relative who worked as a doctor at a rural hospital that there were doses to spare.
In a Midwest state, “pleasant pressure” on health officials landed workers the shots they needed, while in a Southern state a residential care provider reported: “The supply of vaccine was quickly diminished to zero availability. Now it is, pretty much, first come, first serve. As soon as appointments are available people rush to sign up without concern for whether they meet the criteria or not.”
The disparate experiences stem from the fact that employees in group homes, residential treatment facilities and juvenile detention centers were not mentioned in December guidelines released by the Centers for Disease Control and Prevention, which focused on frontline health care workers and those in nursing homes.
“The chaotic rollout of a vaccine is not specific to our members, but they’re missing the acknowledgement that they are essential frontline health care workers in a congregate facility — often with kids who come in testing positive or go on home visits and test positive,” said Kari Sisson, executive director of the Association of Children’s Residential Centers, an international trade group based in Wisconsin. Sisson added that virtually every facility she is in touch with across the country has had at least one COVID-19 case.
“It’s quite a risk we’re asking them to take,” she said of the facility workers, “at a very low rate of pay.”
The association’s members include residential treatment centers serving children in foster care and other youth with behavioral, emotional and mental health issues. Recently, many states have pared down their use of so-called congregate care placements for foster youth — a move underscored by the Family First Prevention Services Act, which limits funding for such placements.
Still, more than 40,000 foster youth live in residential facilities, according to the most recent federal statistics; in 28 states, that amounts to at least 1 out of every 10 children in the system.
California included workers in these congregate care facilities in the first phase of its vaccine rollout, along with those in the state’s youth prison system, although staff in county juvenile halls have had to wait. Those who have already received a dose are thankful.
Aubree Sweeney, executive director of Rancho San Antonio, a boys’ residential treatment facility in suburban Los Angeles County, said getting the vaccine felt like a “badge of courage” — a hard-earned reward for frontline staff who persevered even as a terrifying winter surge turned Southern California into the new U.S. epicenter of the pandemic. Over the last two months, eight children and 13 staffers at Rancho San Antonio tested positive for COVID-19, according to county data.
In New York, staff in youth-serving facilities became eligible for vaccines on Jan. 11 — though statewide shortages mean many can’t make an appointment to receive them. To schedule a vaccination, some workers have had to find an open slot with a third-party provider, navigating overloaded state or county websites on their own.
Near New York’s capital in Albany, staff at two residential facilities run by Northern Rivers are finding the first appointments available through the state website aren’t until March or April, according to CEO Bill Gettman. Meanwhile, near the state’s border with Canada, Children’s Home of Jefferson County reported that it’s been unable to locate any vaccines since early January.
At Children’s Village, an agency with roughly 1,500 employees in and around New York City, CEO Jeremy Kohomban said he keeps a list of interested staff so he can call them if a nearby vaccination site alerts him that they have extra doses at the end of the day. Recently, he sent a dozen workers rushing across the Hudson River to receive doses that had gone unused at the psychiatric hospital in the neighboring county.
Kohomban hopes to put his agency’s medical staff to work running a vaccine clinic on the agency’s campus in suburban Westchester, just north of New York City. The plan has been drawn up and approved by the county, but so far, the local supply of vaccines is too small to support opening a new site.
Gettman, of Northern Rivers, also plans to leverage medical staff to create two pop-up vaccination events at his campuses in Albany and Schenectady. For the first one, he hopes to secure enough doses for 400 to 500 people, including both his own staff and eligible foster parents and clients from other local nonprofits.
So far, about 20% of his roughly 1,000 employees have received both doses of the vaccine; some drove up to an hour and a half to reach an available appointment.
On the other side of the country, things are no different.
“It’s a little all over the map,” said Chris Stoner-Mertz, executive director of the California Alliance for Children and Family Services, which represents most congregate care providers in the state.
“We’re hearing it’s really based on the county you’re in. In counties like L.A., where there’s a big effort and they have a pretty good handle on their providers, it’s rolling out,” Stoner-Mertz added. “In areas that are more rural, unless you’ve gone out of your way to advocate with public health and they know who you are, I think it’s been more of a challenge.”
Given the patchy access to vaccines and the fact that vaccinations for youth aren’t yet on the horizon, industry leaders say the precautions adopted in the past year — masking, social distancing, testing and quarantining — will almost certainly need to be fixtures of the year to come.
“I just don’t see any way to lessen our efforts or take any shortcuts at this point, to even hope for a day when we can be a little less attentive,” Kohomban said. “For the rest of 2021, at least, we’ve got to maintain the same levels of vigilance and expense and attention.”
Jeremy Loudenback contributed to this report.