Home Care Workers Get Vaccine Prioritization in LA County, Setting Off Potential Domino Effect

Los Angeles County’s home care companies woke up to some welcomed news right before the new year.

Non-medical home care workers are now officially a part of the first tranche of individuals who can make an appointment for a vaccination, according to the Los Angeles County Department of Public Health.

Previously, home health care workers were clearly included in the county’s prioritization list. Home care providers, however, were unsure whether their employees made the cut.


Confusing and unclear guidance for non-medical home care operators has been a familiar problem across the country during the COVID-19 pandemic.

Los Angeles-based 24 Hour Home Care was among the organizations searching for answers to vaccine questions before Christmas. Its leadership was elated to learn that its caregivers could now begin scheduling vaccination appointments for themselves.

“This news was just fantastic for us, because we were kind of waiting to see what would happen when we saw that home health services were being considered,” Andy Matthews, vice president of business development at 24 Hour Home Care, told Home Health Care News. “But with the non-medical sector, there’s always confusion if we’re going to be included when [something] says ‘home health services.’ So to see that the non-medical side was included in that was such a breath of fresh air.”


Founded more than a decade ago, 24 Hour Home Care is an independent, non-medical home care provider with 20 locations across California, Arizona and Texas. It has over 10,000 caregivers in its network.

In LA County’s announcement, “home care organizations” are explicitly listed alongside “home health agencies.”

The clarity is especially helpful for agencies in the Los Angeles area, given that COVID-19 cases are currently spiking to unprecedented levels in the region. Nearly 820,000 cases have been reported out of the county, which accounts for more than a third of all of the cases in California.

The state reported its highest daily new case count — nearly 65,000 — the day after Christmas.

“This is impactful because it protects our caregivers and our field staff, which obviously indirectly affects our clients,” Ryan Iwamoto, the president and co-founder of 24 Hour Home Care, told HHCN. “At least from my team, too, there’s a fear that home care would be overlooked in this process, because we’re usually in the shadows of other post-acute care services. I think it was a great sign to see home care in the spotlight and elevated as an essential service in this pandemic.”

Los Angeles County is a large enough actor to sway other counties as well, which could go a long way to help home care advocacy efforts across California and the entire country. If home health employees are being prioritized in other regions, home care organizations should ask for clarification on whether that includes all home-based care workers, as 24 Hour Home Care did.

“You can use that as an example to say, ‘Hey, this [priority group] also should include home care as well,’” Iwamoto said. “Hopefully, we have set the precedent for other counties and states to include home care as a part of [that group].”

Los Angeles Mayor Eric Garcetti has complained about the amount of federal help the city has received for vaccine rollout. Far fewer doses have been administered at this point than what was expected, a trend playing out across the country.

“We have not been delivered what was promised at the national level,” Garcetti said on CBS’ “Face the Nation.” “We are at a pace right now to deliver vaccines in Los Angeles in over five years instead of over half a year.”

For home-based care organizations, available vaccinations are especially helpful because they are an invaluable resource to regions dealing with ongoing COVID-19 surges and in-patient capacity challenges.

As of Monday, nearly one-third of all in-patient beds in California were occupied by COVID-19 patients, according to the U.S. Department of Health & Human Services. Almost 90% of all ICU beds are occupied in the state.

Too much demand for home care

24 Hour Home Care is seeing 20% more inquiries than it did in November. Due to skyrocketing demand, it has been forced to turn down 26% of those inquiries after reaching operational capacity.

From a staffing perspective, more unemployment claims have hurt the agency as well during COVID-19. That’s likely to continue, with a new unemployment add-on provided by the recent government spending bill.

Before the public health emergency, the company usually experienced 250 to 300 unemployment claims per year. In 2020, at times, it saw that amount in just a week.

“I’ve never seen this type of supply and demand discrepancy in my 15 years of being in home care,” Iwamoto said. “We are being hit pretty hard.”

The company has established an affiliate network in the area to try to find care for the seniors that it has to turn away. That network has helped it turn inquiries over to other agencies when it cannot handle new cases, Iwamoto said.

It is also working with its assisted living partners to place patients there when they may fit better in that kind of setting.

In addition, 24 Hour Home Care is helping hospitals improve their home-based COVID-19 transition protocols and programs.

Hospitals, more than ever, are having to find ways to accommodate seniors who don’t want to stay inside their walls or go there in the first place.

“The good thing that has come from this is being able to work with our competitors and other home care companies,” Iwamoto said. “It’s actually been really, really cool to see our industry step up in this fashion.”

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