Immunisation - unlicensed elderly care homes a weak spot

Low Choon Chyuan
·7-min read
Immunisation - unlicensed elderly care homes a weak spot
Immunisation - unlicensed elderly care homes a weak spot

Although the senior citizens will be vaccinated under the second phase of the National Covid-19 Immunisation Programme which began last Monday, many operators of elderly care centres have complained that they haven’t received any instructions.

Adding to this concern is the existence of a large number of unlicensed old folks homes in the country, the operators of which are unwilling to register their residents for fear of being penalised for running an illegal business.

This could potentially undermine the national vaccination programme, say experts.

According to a statement issued by Pakatan Harapan's Committee on Covid-19 Vaccination, some 30,000 to 40,000 Malaysians who are aged above 65 are living across 1,500 care or nursing homes nationwide operated by 8,000 workers.

Delren Terrence Douglas, president of the Association For Residential Aged Care Operators of Malaysia (AgeCOpe) told Malaysiakini that under an arrangement with the Health Ministry and Social Welfare Department (JKM), the ministry will send its medical personnel to old folks homes to vaccinate the residents.

Towards this, a letter was issued by JKM on Jan 29 urging operators of elderly care centres to submit data on their residents, caregivers and staff as well as their willingness to be vaccinated. The deadline given was Feb 22. Douglas said the deadline later was extended to March 15.

Douglas complained that although operators were asked to submit in February, the authority has not replied since and the operators are still “in the dark” about the arrangement for vaccinating their residents.

AgeCOpe's president Delren Terrence Douglas
AgeCOpe's president Delren Terrence Douglas

“My members are asking me what is next? Why is there no news? Why are we in the dark?”

Similar concerns were expressed by the person in charge of the Green Acres Care Centre in Johor Bahru.

Asking to be identified only as "Mr Yeo", he said the home operators were given short notice to submit the data forms and although they rushed to submit them on time, the government hasn't followed up.

Residents face higher risks

According to Douglas, the association which was founded four years ago has 215 members. He said the elderly who live in old folks home face a higher risk of getting infected compared to those who live in their own homes.

“We were told, under the second phase, (residents of old folks home) would be the first batch (to get vaccinated) but I have heard that people who registered themselves through the MySejahtera app have already been vaccinated. They are faster than us.

“I feel that (as compared to the elderly who live in their own houses), those in care centres live in a community with 20 to 60 others, so they have higher risks.

“If any of them have relatives visiting or staff going in and out, they are more likely to be infected [...] their fatalities could be higher (if they are infected),” he said.

There were a few elderly care centre operators who were, in fact, visited and briefed by Health Ministry officers. When contacted, the operator of Ailins Retirement Home which is based in Melaka told Malaysiakini, the state Health Department’s officers held a briefing in their centre on April 22.

Residents and their next-of-kin were then briefed about the vaccination programme and letters of intent were submitted. But the exact date for the vaccinations was not fixed by the officers, said the operator.

Large number of unlicensed operators

Meanwhile, several reports have shown that unlicensed elderly care centres far exceed those with proper licenses.

Douglas said AgeCOpe was worried that these unlicensed operators may not participate in the vaccination programme either due to not being sent any official notice or for fear of being penalised for being illegal.

In February, the Malaysian Research Institute on Ageing at Universiti Putra Malaysia estimated that there are at least 1,000 old folks homes in Malaysia of which half are unknown to the Health Ministry and JKM and therefore cannot be contacted.

A World Bank report published last November estimated that there were 1,720 elderly care centres in Malaysia, of which only 19 percent or 320 were licensed.

A check with the JKM website and found that as of April 22, the country only had 389 elderly care centres registered with the department.

Give assurance, govt told

In order to remedy the situation, Douglas urged the government to hold a press conference or issue a statement assuring the unlicensed operators that no action would be taken against them when they come forward for the vaccination programme.

Although the government has promised not to take action against unlicensed elderly care centre operators who registered for vaccination, Douglas pointed out that this message wasn't extended to them.

“The government should hold a press conference or release a statement (on this matter) so that the unlicensed will come forward […] I think a part of them don’t know they need to register nor that there is a deadline for vaccination registration.”

According to Douglas further, not only were the unlicensed operators worried that they would be penalised for running centres without proper licenses but also for hiring undocumented migrant workers.

In order to remain undetected, they either let their residents register through the MySejahtera app, register online or even just ignore the fact that they have not registered at all.

Dr Noraliza Noordin Merican of the Health Ministry's Family Health Development Division in an earlier media report said vaccinating the elderly at care centres was “much more convenient and much safer” because bringing these senior citizens out into the public would put them at a higher risk of contracting Covid-19.

She assured the ministry would not take any action against unlicensed operators as the priority was to get as many as possible vaccinated rather than worrying over a centre’s legality or its employees’ immigration status.

The most important thing for the ministry, she said, was the total number of residents, the number of those willing to be vaccinated and whether they had any allergies. She added that for the data form, operators and staff could fill in the section asking for an identification card number or passport number with a mobile number or even leave it blank.

Complex, expensive requirements

Malaysiakini contacted several old folks homes operating without a license but their operators refused to be interviewed. Two of them claimed they have assisted their residents in registering for the vaccination online, while one operator shot back: “Isn’t the vaccination non-compulsory?”

Douglas explained that the phenomenon of unlicensed elderly care centres was due to a complicated, costly licensing procedure plus a list of complex licensing requirements.

Among others, the process involves getting permission from neighbourhood residents, converting residential land titles to commercial land titles, complying with fire fighting system standards all of which eventually deter many operators who are non-profit motivated.

Douglas urged the government to extend the vaccination registration deadline for the elderly in order to encourage more care centres to register their residents.

He said there were operators who had tried to submit their data after the given deadline but they were told that late registrations may not be processed.

They were told to register their residents through the MySejahtera app instead, he said.

“The ministry explained that they have to prepare for a vaccination session, do the stock count and everything, so for those who missed the boat they are supposed to register through the MySejahtera app.”

“I feel that it's not logical because many residents in old folks homes don’t have handphones.”

Malaysiakini has contacted the office of Khairy Jamaluddin, the coordinating minister for the National Covid-19 Immunisation Programme, the Social Welfare Department and the Family Health Development Division for their response on the above matters.

Phase 2 of the national immunisation programme involving the elderly aims to vaccinate 9.4 million people by August. Khairy said that Selangor would begin the second phase on April 26 as the frontline workers in the state were still in the midst of getting their vaccination under Phase 1.