ALBANY — A looming Oct. 7 vaccination mandate for New York home health workers is projected to have profound impacts on an industry that delivers medical services to frail seniors and disabled persons at their residences.
The state mandate facing home health agencies mirrors one that kicked in Monday for hospitals and nursing homes. It provides no COVID-19 testing option as a way to bypass the dictate that nurses, therapists, home health aides and other staffers must show they have been inoculated to continue to work in the field.o
There are approximately 1,500 home health agencies licensed in the state. The Home Care Association of New York reported that a survey of 189 of those agencies indicates that more than 12,000 of the staffers are refusing to be vaccinated and are thus willing to face termination from employment.
Gov. Kathy Hochul’s administration has signaled healthcare workers who are fired for refusing to abide by the vaccination order will be disqualified from collecting state unemployment benefits.
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The Home Care Association said the estimated number of staffers who could be forced out of their jobs is several times higher than the survey results found, given only a portion of the agencies were sampled,
Al Cardillo, president of the Home Care Association, said the survey indicates that those who have remain unvaccinated include 894 nurses, each of whom is typically responsible for planning care for 20 or more patients. Should they lose their positions, it would have major impacts on nearly 18,000 patients, though that again is likely a fraction of the full impact given the limited sample in the survey, he said.
Cardillo said the state could cushion the home health agencies from the impacts to the workforce by offering “a longer runway to move people into vaccination status.”
“I have reached out to the governor’s office and the (state) Health Department, and there has been no engagement to come to a plan to make this happen,” Cardillo said. “We are completely willing and have been reaching out in very good faith to say, ‘Work with us, so we do not compromise essential services to patients.’”
Gov. Kathy Hochul has been occupied this week from the fallout of the state vaccination order that has prompted a number of hospitals to trim patient services as a statewide labor shortage in the health care industry has worsened since the mandate took effect in that realm of care.
“Zero health care facilities across the state have been reported closed since the mandate went into effect,” the Hochul administration said in a prepared statement.
Hochul has signed executive orders aimed at facilitating the replacement of the unvaccinated hospital and nursing home staffers with foreign workers, newly credentialed health care workers and National Guard troops.
While Hochul, a Democrat, praised the health care workers who agreed to get vaccinated, she was strongly criticized by one upstate leader, Rensselaer County Executive Steve McLaughlin, a Republican, who argued the hard mandate will do more harm than good.
“This will do nothing to stop new cases (of COVID-19) but it absolutely will cost lives, potentially thousands, as our health care system collapses,” McLaughlin tweeted.
Bill Hammond, a fellow at the Empire Center for Public Policy who specializes in health care policy, said the state is gambling that most unvaccinated health care workers will get the shots rather than lose their jobs, a bet that appears to be driving up the percentage of health care staffers who are now inoculated. But he also said the hard mandate will likely aggravate a longstanding labor shortage at hospitals, nursing homes and now at home health agencies.
The mandate on home health agencies is also kicking in at a time when many frail adults are trying to avoid going into nursing homes, increasing the demand for home health services, he noted.
“I do think the state needs to be ready to be flexible because there is a point where the loss of staff is more dangerous than being exposed to an unvaccinated person,” Hammond said.
According to Hochul, many more health care workers have been vaccinated over the past few days, with 92% of hospital staff getting at least one shot and 87% now being fully vaccinated.
But the Home Care Association survey found that just 63% of home health aides have been vaccinated.
The association has also found that 76% of the agencies are encountering challenges in dealing with the increase they are getting in patient referrals from hospitals and other things because of the labor shortage.
Rural areas of the state, with limited transportation and a smaller labor pool, are particularly experiencing stress in attempting to fill home health aide jobs.
Cardillo said employers have been encouraging their staffers to get the shots, but many individuals remain reluctant to be vaccinated.
“We share the goal of getting everyone vaccinated,” he said. “But if you’re going to have that goal, it has to be done in a way that works.”