Vulnerable teens and young adults living in New York group homes have apparently been eligible for vaccination against the coronavirus for as long as two months — but conflicting guidance and miscommunications between state agencies meant many providers didn’t know their residents could sign up until this week.
After weeks of confusion, the Office of Children and Family Services on Monday released new guidance stating that residents of youth congregate facilities ages 16 and older are part of what’s known as “phase 1a” — the first group eligible to be vaccinated. Vaccines have not yet been approved for youth 15 and younger, though ongoing studies are expected to yield lower age limits by midsummer.
The most recent state data shows there are already about 1,500 New York foster youth living in group settings who are eligible to get vaccinated.
“In theory, they could have been vaccinated back in December, but nobody told us that two months ago,” said Walt Joseph, executive director of the Children’s Home of Poughkeepsie. “They can’t retroactively say, ‘Hey, these kids are 1a’ — this stinks.”
In December, the Department of Health listed “residents and staff in congregate care facilities” among those eligible under the first phase of the vaccine rollout. But residents of institutions run by the Office of Children and Family Services (OCFS) were not specifically named, and attention focused largely on adults in nursing homes. The two agencies issued conflicting messages in the weeks to come and, as late as Jan. 21, an OCFS spokesperson told The Imprint that youth in congregate care settings were not included in either phase 1a or 1b.
On Feb. 9, the lead juvenile rights attorney with the Legal Aid Society sent a letter to the state child welfare agency, prodding officials to resolve the inconsistencies and prioritize youth in group settings. In it, Dawne Mitchell described the hardships faced by these often-overlooked youth, who spend their days in close quarters with a fluid mix of residents and staff and must quarantine for up to two weeks if they are exposed to the virus. Moreover, she noted, youth have often had to give up the few things that give them a break from life in a highly regulated group facility, including family visits and recreational outings.
In the one-page directive released on Monday, OCFS stated that young people living in foster group homes, juvenile detention or youth homeless shelters were in fact eligible under phase 1a.
The new guidance, first reported by The City on Wednesday, also instructed providers to help residents ages 16 and older schedule COVID-19 vaccines. However, a new hurdle quickly arose: The document did not specify how or where young people could secure an appointment.
That has left many of New York’s residential youth providers scrambling to locate vaccines on the same state website where millions of senior citizens and essential workers, including their own staff, have struggled to find appointments. Last week, workers at residential centers run by House of the Good Shepherd in Utica found the earliest appointments were in the last week of April.
“First, I couldn’t get my staff vaccinated, now I can’t get the kids vaccinated,” chief program officer Kathy Perkins said. “I don’t think the shortage is OCFS’s fault, but it’s disappointing that there’s no guidance in finding appointments.”
In Poughkeepsie, Joseph said some staff members have driven up to five hours round-trip for an open appointment, journeys that won’t be practical for eligible teens living in residential facilities.
After hearing CVS had provided on-site vaccinations for nursing homes, Joseph said he approached the pharmacy chain to set up a similar clinic, but was told that his facility, which currently houses 36 youth, didn’t fit the approved criteria. He’s now hoping the agency’s pediatrics provider — which currently has a waiting list for vaccines — will eventually have enough doses to share.
“This 1a status doesn’t facilitate getting vaccines to kids,” he said. “What we really want is for the National Guard to roll in here with a mobile clinic so we can line up 100 or 200 people.”
For visitors to the state’s vaccine scheduling website, it is not easy to figure out that people living in congregate settings are even eligible. The option is not visible until after a user has answered “No” to 14 other categories, including those for college professors, restaurant workers and for-hire vehicle drivers. Deep into the list of questions, a drop-down menu appears that includes group homes, homeless shelters and behavioral health facilities.
Other complicating factors are contributing to delays as well. Few vaccination sites have the ultra-cold storage needed to offer the Pfizer vaccine — the only one currently approved for 16- and 17-year-olds. And most teens younger than 18 cannot get a shot without consent from a parent or legal guardian, which could take weeks or months to obtain.
Eager to protect the youth in their care, some residential providers began scheduling vaccinations weeks ago, well before OCFS clarified that they were in fact eligible. At Northern Rivers in Albany, roughly a half-dozen young adults chose to get vaccinated, CEO Bill Gettman said, and staff were able to get them appointments at a nearby site run by the Office of Mental Health. Gettman added he’s hopeful that even more youth will opt in when a one-shot vaccine developed by Johnson & Johnson becomes available.
Yet other providers said they were afraid to act before receiving clear direction from OCFS, given the public condemnation of people who sought vaccines out of turn, as well as executive orders from Gov. Andrew Cuomo (D) that impose steep fines and license removals on medical providers who deviate from the state’s approved priority list.
“Given all the politics of people getting ahead of the line, none of us wanted to be accused of breaking some rule that we didn’t even understand,” said Jeremy Kohomban, CEO of Children’s Village, whose facilities house about 200 young people, about half in foster care. “What we needed was clear guidance, so we’ve been waiting for this.”
The vaccines will not only prevent young people from getting sick from COVID-19, but likely also reduce the risk of spreading illness to other youth, staff or family members, as ongoing studies suggest. For kids in group homes, vaccinations will make it safer to visit their families and go on outings after tedious months of sheltering in place in a highly regulated setting.
“We need to allow kids to explore again, to go different places — we’re keeping them away from their lives,” Perkins said. “I don’t know if they can spend another summer with the same six to eight people.”
Update: On Friday evening, the Office of Children and Family Services announced that staff and residents of youth congregate care facilities who are 18 or older can schedule appointments to receive the Moderna vaccine at sites operated by the Office of Mental Health. The link is https://omh.ny.gov/omhweb/o-lov-covid19-vaccine/index.html.