CORONAVIRUS (COVID-19) RESOURCE CENTER Read More
Add To Favorites

On first day, vaccine mandate having varied impacts on hospitals, nursing homes

Buffalo News - 9/28/2021

Sep. 28—ALBANY — Has a staffing crisis erupted at health facilities in New York because of non-compliance by thousands of workers who refused Gov. Kathy Hochul's order — which took effect Monday — that they get vaccinated against Covid-19?

Yes.

No.

Who knows?

It became slightly more obvious Tuesday that all three answers are correct in some form, as hospitals and nursing homes rushed to replace non-vaccinated workers with replacements who have moved from in and outside New York to new jobs left vacant by doctors, nurses, technicians and other staff who declined to get vaccinated.

One thing also emerging is clear: Hiring replacement workers from private staffing companies — which are paid premium contracts to lure travel health workers with short-term employment contracts — will be a costly affair for the state's health system. In just the public hospital system alone in New York City, officials reported that 500 replacement nurses were brought in to fill jobs of workers who refused to get vaccinated.

And even more clear on Tuesday after the mandate order by Hochul went into effect overnight: Staff losses due to workers who refused vaccinations only exacerbated a staffing shortage crisis that has been reducing access to care for many New Yorkers before and during the pandemic, according to industry insiders.

The Hochul administration on Monday and again on Tuesday did not answer a slew of questions, including:

—How many workers resigned, were placed on leave, suspended or fired because they would not get vaccinated?

—How many health workers declared a religious exemption, permitted under what might be a temporary order from a federal judge, to avoid the vaccination?

—How many elective surgeries have been put off because of additional, new strains on the health system?

—Has a crisis, warned about by Hochul for weeks, developed in hospitals and nursing homes this week?

The latest staffing problem for health care facilities is affecting all places that provide care.

The situation was bad enough that Hochul late Monday made public an executive order declaring a statewide disaster emergency in health care. In the order's first two paragraphs, she wrote that "current staffing shortages in hospital and other healthcare facilities are expected to impact availability of care, threatening public health and safety" and that the "severe understaffing at facilities" is expected to affect the ability to deliver care and adequately serve vulnerable populations.

"The only way we can move past this pandemic is to ensure that everyone eligible is vaccinated, and that includes those who are taking care of our vulnerable family members and loved ones," Hochul said in a statement that accompanied the disaster order.

Anecdotes abound about individual hospitals and nursing homes laying off or putting on leave unvaccinated workers. Erie County Medical Center stopped paying 176 workers, or 5% of its staff, for at least the next 30 days unless they are vaccinated.

But the state provided little in the way of specifics Tuesday.

Late Monday, Hochul released health worker vaccination numbers, some preliminary and at levels still not reported by the state Health Department. She said 92% of hospital and skilled nursing facility workers were vaccinated as of Monday night. If so, it means an estimated 45,000 workers still had not been vaccinated, based on a combination of overall employment numbers maintained by the state and health industries.

Stephen Hanse, president and CEO of the New York State Health Facilities Association and the New York State Center for Assisted Living, whose members include nursing homes throughout the state, said it was too early to say whether the mandate had exacerbated existing staff shortages.

Information about replacement worker totals, staffing numbers and details about people claiming religious exemptions will be reported by nursing homes to the state Health Department in the days ahead, he said.

It is not known how much of that data will be made public by Hochul. The state Health Department releases some health facility vaccination information based on daily reports made by nursing homes and weekly reports by hospitals. Based on that schedule, new hospital vaccination data, presumably, should be released on Wednesday.

Hochul's emergency disaster order halts or amends dozens of state legal statutes, pertaining to everything from licensure rules to relaxing certain preauthorization reviews for hospital surgeries and home health care visits. It will be easier for recent graduates from nursing schools or other schools to get a hospital or nursing home job, and doctors will be able to do telemedicine visits at nursing homes, among other changes.

Hanse praised the regulatory and administrative relief in the Hochul order, and said the new governor understands there is a long-term health worker staffing problem in New York that needs to be addressed.

Acute staffing shortages already were being reported at nursing homes in the Buffalo area, Rochester, North Country and parts of the Hudson Valley. But it isn't clear whether the effects are far-reaching or long-lasting.

"It's an evolving situation," said Bea Grause, president of the Healthcare Association of New York State, whose members include hospitals across the state.

Many health systems did not act until Tuesday against workers who refused the vaccine and did not resign ahead of time. The overwhelming response was to place them on unpaid leave for a period of time hoping they change their minds, while adjusting and cutting services as the vaccination mandate plays out.

Should all those workers become permanent staff cuts, it will be "deeply felt" across the health system in New York, Grause said.

Though no one has a statewide number regarding how many unvaccinated health workers are still on the job because they declared a religious exemption, Grause said that exemption has formed "a bit of a cushion" for facilities. Whether it continues, though, depends on ongoing litigation in a federal court in Utica in a case brought by a conservative group representing more than a dozen health workers. The Hochul administration is seeking to get the court-ordered exemption tossed out.

Health worker shifts are adding to the uncertainty. Some might not have to report back to work until late this week, making the staffing picture more blurry for now.

Republican lawmakers have been among the most outspoken against the Hochul vaccination mandate, which could become a template for other Covid-19 vaccine requirements, both in New York and elsewhere.

On Tuesday, the Assembly GOP conference wrote to Hochul, imploring her to halt the mandate and saying that her temporary health workers' staffing plans came just 48 hours before the order took effect — giving hospitals and nursing homes no time to prepare. They said hospitals are closing urgent care centers and nursing homes are limiting new admissions.

The GOP lawmakers expressed their support of the critical need to increase vaccination levels, but that her "all-or-nothing approach" to health workers "has become dangerous and counterproductive."

Hochul took to Twitter Tuesday afternoon, saying she has been in touch with various public and private health officials "to let them know they have our full support as they navigate potential preventable staffing shortages."

Later in the day, she said numbers showing rising health worker vaccination rates on Monday night — to 92% for hospitals and nursing homes and 89% at adult care facilities — show that "holding firm on the vaccine mandate for health care workers is simply the right thing to do to protect our vulnerable family members and loved ones from Covid-19."

In hospitals, which have 519,000 total staff statewide, Hochul said 85.2% have completed a vaccine series. She said 4.9% are medically able to receive a vaccine but are declining to do so, and that 2.4% of hospital staff still plan to get vaccinated. About 0.5% are medically ineligible.

___

(c)2021 The Buffalo News (Buffalo, N.Y.)

Visit The Buffalo News (Buffalo, N.Y.) at www.buffalonews.com

Distributed by Tribune Content Agency, LLC.

Nationwide News