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Supreme Court Ruling Means Fewer Disability Providers Face Vaccine Mandate

by Michelle Diament | January 20, 2022

Some workers supporting people with developmental disabilities across the nation will still be required to be vaccinated against COVID-19 despite a recent ruling from the U.S. Supreme Court blocking a wider mandate.

The high court struck down a sweeping Biden administration plan earlier this month that sought to require vaccinations or regular testing for workers at businesses with at least 100 employees.

At the same time, however, the court upheld a mandate for health care workers at facilities receiving funding from Medicare or Medicaid.

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The rule from the Centers for Medicare & Medicaid Services covering health care workers includes hospitals and long-term care facilities as well as staff at intermediate care facilities for individuals with intellectual disabilities, psychiatric residential treatment facilities, home health agencies and other providers.

However, CMS has said that staff at group homes and other home and community-based services settings will not be affected by the vaccine mandate because the agency lacks regulatory authority.

The rule is already in effect in about half of states. Now, CMS said that two dozen other states must establish plans and procedures to ensure staff are vaccinated.

Agencies providing home and community-based services could have been subject to the regulation covering large employers depending on the size of their workforce, disability advocates said, but after the court ruling that regulation is no longer in force. However, COVID-19 vaccines are being required for some of these workers at the state or local level.

“Making COVID vaccination optional for direct support workers harms people with disabilities who rely on direct support every day,” said Zoe Gross, director of advocacy at the Autistic Self Advocacy Network. “People who use HCBS may need assistance with tasks such as bathing, eating or transferring from a wheelchair — assistance that cannot be provided from six feet away. Vaccine mandates make it safer to receive these kinds of services by reducing the chance that a direct support worker will transmit COVID to the person they support.”

The push to require COVID-19 vaccines comes as many disability providers have struggled to attract and retain staff. In Maine, which imposed a mandate for group home workers last fall, for example, there were reports that resulting staff shortages could lead to closures and displace residents with developmental disabilities.

“We understand the Supreme Court’s reasoning in allowing CMS’s vaccination requirements to move forward and fully embrace the importance of vaccination for those who care for people with intellectual and developmental disabilities,” said Lydia Dawson, director of policy, regulatory and legal analysis at the American Network of Community Options and Resources, or ANCOR, which represents disability service providers across the country. “At the same time, the impact of this ruling on providers will ultimately depend on how the requirements are implemented given the dire direct support workforce crisis that has been amplified by the pandemic.”

Gross from the Autistic Self Advocacy Network said that the implications of the Supreme Court’s actions for people with disabilities will extend well beyond the requirements for support staff and into the general community.

“The ruling is bad news for people with disabilities,” Gross said. “Many people with disabilities work, and by eliminating vaccine mandates in some workplaces, this ruling makes it harder for us to be protected in those workplaces.”




Excess deaths in people with mental health conditions increased during the COVID-19 pandemic

by King's College London

Elderly woman talking with a doctor while holding hands at home and wearing face protective mask. Worried senior woman talking to her general pratictioner visiting her at home during virus epidemic. Doctor explaining about precautionary measures during virus pandemic to old lady and takes care of her. Credit: Ridofranz

The greater number of deaths amongst those with mental health conditions and intellectual disabilities has been amplified during the COVID-19 pandemic, a study based on more than 160,000 patients has revealed.  

Before the pandemic the rates of mortality in those with severe mental health conditions were already higher than the general population. New research published in The Lancet Regional Health—Europe shows that between March and June 2020, during the first wave of COVID-19, mortality further increased in people with mental health conditions and intellectual disabilities compared with the general population. 

The study was published in the run up to World Mental Health Day on 10 October 2021 which this year has the theme 'Mental Health in an Unequal World'.

Deaths from COVID-19 among those with learning disabilities were nine times higher than the general population during the first lockdown period, according to the study, and for those with eating disorders almost five times higher. For those with personality disorders and those with dementia, deaths from COVID-19 were about four times higher than the general population and more than three times higher in people with schizophrenia.

The research was part-funded by the National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre (BRC) and used the Clinical Record Interactive Search (CRIS) system to analyze anonymised data from clinical e-records of patients from South London.

Lead author Dr. Jayati Das-Munshi, Reader in Social and Psychiatric Epidemiology at King's College London and Honorary Consultant Psychiatrist with South London and Maudsley NHS Foundation Trust, said: "The results from our study paint a stark picture of how the existing vulnerability of those with mental health conditions and intellectual disabilities have worsened during the COVID-19 pandemic. The higher death rates compared to the general population were associated with more deaths from COVID-19 infection itself, as well as deaths from other causes.

"People living with severe mental health conditions and intellectual disabilities should be considered a vulnerable group at risk of COVID-19 mortality, as well as deaths from other causes, throughout the pandemic. We suggest a need to prioritize vaccination and optimize physical health care and suicide risk reduction, before, during and after peaks of COVID-19 infection in people living with mental health conditions."

Through the NIHR Maudsley BRC's Clinical Records Interactive System (CRIS) researchers analyzed anonymised data from 167,122 patients at South London and Maudsley NHS Foundation Trust on deaths between 2019 and 2020. They assessed mortality ratios across nine mental health conditions and intellectual disabilities and by ethnicity. These were standardized by age and gender and were also compared with five-year average weekly deaths (from 2015 to 2019) from England and Wales. These were then standardized against population data from London, to assess whether estimates were accounted for by local area-level effects.

Senior author Rob Stewart, Professor of Psychiatric Epidemiology & Clinical Informatics at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, said: "These findings and their implications illustrate the importance of being able to learn from the information contained in health records. We have worked with the Maudsley's CRIS platform for nearly 15 years now and a key focus has been to highlight inequalities in mortality and general health. Because CRIS information is updated on a weekly basis, this has allowed us to track the progress of the COVID-19 pandemic and its impact on mental health services."

Deaths in those with mental health conditions and intellectual disabilities fell from July 2020 to September 2020 as COVID-19 cases fell and lockdowns eased, however remained double that of the general population which was similar to the figures before the pandemic.

Similar mortality trends were observed across minority ethnic groups within the sample, with South Asian and Black Caribbean people with severe mental health conditions and intellectual disabilities being 2.5 times more likely to die in the pandemic period compared to the year prior to the pandemic. Elevated mortality risks were also evident for White British and Black African people with severe mental health conditions and intellectual disabilities.

All Regional Center Employees and Service Providers Must be Vaccinated 

October 4, 2021

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, as well as In-Home Supportive Services (IHSS) providers, must be fully vaccinated by November 30, 2021, as mandated in a new order by the California Department of Public Health. The order, which also includes workers in a variety of facility-based and in-home services for seniors and people with disabilities, includes few exceptions, such as 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, as well as religious beliefs and qualifying medical reasons. 

As detailed in the order, “Among 19,830 confirmed COVID-19 outbreaks throughout the pandemic, 47% were associated with the health care, congregate care, and direct care sector. The top industry settings are adult and senior care facilities and in-home direct care settings (22%) where increasing numbers of workers are among the new positive cases and recent outbreaks in these types of settings have frequently been traced to unvaccinated individuals.”


People with developmental disabilities are at higher risks of serious illness and death if they contract COVID-19, so the new vaccine mandate provides relief to many individuals with disabilities and parents who have been frustrated by the inability to guarantee their direct support professional has been vaccinated. The new mandate will also potentially speed up the return to in-person services and supports for people with disabilities.


If, however, workers make the decision to not get vaccinated by November 30 and instead choose to leave the workforce that is providing supports and services to people with disabilities, then many in the community fear that our existing workforce shortage crisis could be substantially worsened.  


Senate Bill 639  - Minimum Wages:  Persons with Disabilities

September 27, 2021

SB 639, Durazo. Minimum wages: persons with disabilities.

(1) Existing law establishes a minimum wage for all industries and makes it a crime to pay an employee less than the minimum wage fixed by the Industrial Welfare Commission. Existing law, however, permits the commission to issue an employee who is mentally or physically disabled, or both, a special license authorizing the employment of the licensee for a period not to exceed one year from date of issue, at a wage less than the minimum wage. Existing law requires the commission to fix a special minimum wage for the licensee, which may be renewed on a yearly basis.

This bill would prohibit new special licenses from being issued after January 1, 2022. The bill would permit a license to only be renewed for existing license holders who meet requisite benchmarks. The bill would make the above-described provision authorizing a lesser minimum wage for an employee who is mentally or physically disabled inoperative on January 1, 2025, or when the multiyear phaseout plan as described below is released, whichever is later. The bill, commencing on the later of January 1, 2025, or when the plan is released, would prohibit an employee with a disability from being paid less than the legal minimum wage or the applicable local minimum wage ordinance, whichever is higher.  Click here for more:

California Assembly and Senate Budget Committees Champion a Budget Proposal that Invests in Services for People with Intellectual and Developmental Disabilities!

June 4,2021

Last week the California Assembly and Senate Budget Committees released their final proposal for the 2021-22 budget. We are very pleased that it includes a recommendation to implement the rate study over the next 3 years, restoration of social recreation and camp services, creation (and funding) of a direct support professional certification tied to wage increases. In addition, there are significant investments proposed for regional center service coordinators, performance incentives, language access and cultural competency, Early Start, and other critical investments and restorations. We thank the Assembly and Senate Budget Committees for their unprecedented proposal of much needed investments for developmental services. The next week is absolutely critical to advocate with the Governor’s office to pass the legislature’s proposal. A summary of the proposal includes the following:  click here for more

$600 Golden State Grant payments are being mailed out to SSI recipients

June 4, 2021

The Golden State Grant is part of California’s recent COVID-19 relief bill and provides direct aid to those most impacted by the pandemic. It provides a one-time $600 state supplementary payment (SSP) grant to SSI seniors and people with disabilities, which will help meet the high costs SSI recipients are struggling to pay during COVID. It also provides a one-time $600 grant for seniors and people with disabilities who receive Cash Assistance Program for Immigrants (CAPI).

Paper checks are being mailed out to SSI/SSP and CAPI recipients starting the week of May 24th. 

To learn more about the schedule for checks to be mailed and eligibility visit that CA4SSI website click here for more info

Californians can arrange an in-home vaccination or transportation to a vaccine site!

May 28, 2021

Californians can now get the vaccination done at home or they can arrange for transportation to take them to their vaccination location. This can be done by calling the California Department of Public Health and arranging for transportation by the calling COVID-19 Call Center at 1-833-422-4255. You will also need to register on the My Turn CA website. This is a two-step process for you to be able to get this service. No same day appointments are available. More info has been provided by DREDF and can be found at the following link

Suit Filed Against LAUSD on Behalf of Students with Special Needs

December 11, 2020

School closures have disrupted education for all of our children. But for vulnerable students with special needs, distance learning is impossible—resulting in learning loss, emotional damage, and irreparable harm, leaving families struggling to address one of the most fundamental needs of the children in their care for months without a plan.

That is why the Alliance for Children’s Rights, the Learning Rights Law Center, and Milbank LLP have filed suit today in the Supreme Court of California to force LAUSD to comply with its most basic duties under the law: to ensure that these students safely receive the in-person assessments and instruction that they need.      

Alliance Demands Immediate Support for LAUSD Students with Disabilities and Special Needs

November 5, 2020

The COVID-19 pandemic has affected everyone, but it has disproportionately impacted the 80,000+ students with special needs and disabilities in the Los Angeles Unified School District, virtually all of whom have not received a proper education since March. Despite the fact that schools have been continuously required to assess students’ need for special education services and continue to provide students who qualify with appropriate supports and services to benefit from their schooling, LAUSD has failed in this obligation.

For tens of thousands, individualized educational programs (IEPs) are not being developed or executed properly through small in-person cohorts, which LAUSD has failed to offer even though they are required by state and federal law and approved by public health officials almost 60 days ago.

For students with disabilities and special needs who require constant one-on-one supervision, distance learning is an oxymoron.

The Alliance has stepped up, along with 29 organization partners, seeking immediate action on behalf of these students—in accordance with public health guidance—to ensure that these students do not suffer irreparable damage. Although LAUSD has promised to begin providing these services, its announcements have lacked details and we want to help transform their goals from aspirational to operational.

The Alliance and its partners sent a letter to LAUSD Superintendent Beutner and State Superintendent of Public Instruction Tony Thurmond on November 5, requesting detailed information about how the District plans to provide (i) in-person assessments, (ii) in-person IEP services and (iii) in-person instruction in small cohorts, in compliance with the law and public health guidelines.

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