Monday is the deadline for staff at New York City hospitals and nursing homes to get at least one COVID-19 injection if they want to keep their jobs, and healthcare industry groups have done so. expressed concerns that this could lead to staff shortages in some establishments.
In New York City, 83% of hospital workers and 84% of nursing home staff were fully immunized as of September 22, according to state data. Many more have at least started the vaccination process, although exact figures are not available.
“We can increase the number, I’m sure,” Governor Kathy Hochul said at a press conference in her Midtown office Thursday morning. “It can be a perfect situation if we can make the holdouts understand the power they have to help us get back to normal, and I beg them to see it.” [from] this perspective.
Since the demands became more common this summer, major health unions in New York City have opposed the vaccination mandates, and some workers have rallied against them or quietly refused to comply. But despite the protests that have drawn attention, a vaccination mandate that has already gone into effect in New York’s Presbyterian health care system has met with resounding success.
The hospital network was the first in New York State to implement such a policy. Fewer than 250 of the 48,000 employees and affiliated doctors of the health system have refused to be vaccinated, according to data provided by a spokesperson. That’s more than a 99% compliance rate. At Weill Cornell Medicine, which is affiliated with NewYork-Presbyterian, acceptance reached 98.6% as of Sept. 23, with only about 120 of the 8,500 faculty and staff still unvaccinated.
“We will continue to provide exceptional care in all of our hospitals, without disruption,” NewYork-Presbyterian said in a statement.
However, the recalcitrant remain. NewYork-Presbyterian has extended its term of office from September 1 to September 15 to give employees more time. He then took unvaccinated staff on leave, giving them an additional seven days to show proof of vaccination before losing their jobs permanently. Weill Cornell put unvaccinated employees on unpaid leave quickly on September 1, but offered until September 30 to get vaccinated and save their jobs.
It is possible that in response to the state’s mandate, some unvaccinated healthcare workers will lose their jobs on Monday without receiving the same grace period. It is up to individual employers to determine how to implement the policy, a spokesperson for the state health department said.
Mount Sinai Health System, whose own mandate went into effect on September 13, said it expects to lose less than 1% of its 43,000-plus employees because of the policy, although it does not provide concrete figure nor does it indicate whether anyone has been made redundant so far.
The experience of these hospitals could bode well for the statewide mandate. But state data shows vaccination rates in hospitals and nursing homes vary widely, and some may face a more debilitating number of layoffs and resignations. Many facilities are still working to increase their immunization rates and develop contingency plans for staff leaving as the deadline approaches.
Prepare for the worst
Nursing homes, which already face recruitment and retention challenges, could be particularly vulnerable to staff shortages. Michael Balboni, executive director of the Greater New York Health Care Facilities Association, a professional organization for nursing home operators, had lobbied New York State to put in place a system of mutual aid between nursing home operators, so if one facility struggled with understaffing, they could seek backup from other nursing homes.
“There are people who believe they are going to be okay. They have high vaccination rates for their staff, ”Balboni said. “Then there are other facilities that frankly struggled with staff to begin with and are having issues with immunization rates.”
Some areas outside New York City are facing greater resistance to the tenure, said James Clyne, president of LeadingAge New York, which represents nonprofit nursing homes. But Balboni said there are individual facilities that will be affected statewide.
He said facilities with low immunization rates had started to develop contingency plans that included stopping new admissions to the facility in certain cases or restricting certain operations requiring additional staff.
Hochul said Thursday she was working with state and federal regulators and unions to see if certified healthcare workers from other states or countries could help fill the void. On Saturday, the governor’s office said it was ready, if necessary, to declare a state of emergency that would allow out-of-state medical professionals, recent graduates, as well as retirees and former incumbent workers to practice medicine in New York State. Medically trained National Guard members could also be called into action.
“The Ministry of Labor has issued guidelines to clarify that workers dismissed for refusal to be vaccinated are not eligible for unemployment insurance without a valid request for medical accommodation approved by a doctor,” we read in the governor’s statement. In the short term, Hochul is also working to implore reluctant healthcare workers to roll up their sleeves.
Balboni said he didn’t think the extra few days before the mandate went into effect would make a difference.
“It’s not a hesitation to vaccinate,” he said. “It’s the rejection of the vaccine. They just don’t want to be part of this effort.
Hospital operations could feel the fallout on individual campuses or even on individual units. A hospital in the upstate made headlines earlier this month when it announced it would temporarily stop giving birth due to understaffing due to resigns from its immunization mandate.
A spokesperson for Northwell Health, the state’s largest private healthcare provider with more than 77,000 employees, said about 10% of its staff had not yet been fully immunized. It is not known how many obtained at least one photo in accordance with the state’s mandate. Several hundred have called for religious exemptions.
Starting Monday, Northwell plans to start warning and even firing employees who haven’t been shot and asked for religious exemptions, starting with high-level management and working towards the bottom.
The vaccine’s mandate originally attempted to remove any religious exemption, but that stipulation is tied to a federal court. While this matter is pending, nursing home and hospital workers can still apply for religious exemptions if their employer allows them, and no one who claims a religious exemption can be reprimanded for not being vaccinated.
A hearing date previously set for Tuesday, September 28 has been canceled by a federal judge. Instead, both parties will present their case in written responses. The temporary restraining order regarding religious exemptions will remain in effect until a federal judge renders a decision based on the documents, which is expected to happen by October 12 at the latest, according to documents filed by the Federal Court.
“Northwell wants to reassure the public that patient care will not be affected by New York State’s 9/27 vaccine mandate,” the spokesperson said, adding they were working on plans emergency response to address potential staff shortages in all of their 23 hospitals and 830 outpatient facilities.
Across the city’s public hospital system as a whole, only 85% of staff are fully vaccinated, despite a previous mandate requiring city workers to get vaccinated or undergo weekly tests. A spokesperson for NYC Health + Hospitals wouldn’t say how many employees have at least started the vaccination process.
At NYU Langone Health, a spokesperson said Thursday that 96% of employees in the hospital system had either received at least one injection or had finally given in and made an appointment to get one.
Bea Grause, president of the Health Care Association of New York State, which represents hospitals, said her organization was working with its members to address potential labor shortages.
But, she added, “The good news is that the mandate is working. Immunization rates have increased in health facilities across the state. “
This story has been updated to add Governor Hochul’s statement regarding a potential emergency declaration.