NAHC Joins Partnership to Promote Vaccines for Home Health and Hospice Workers

The National Association for Home Care & Hospice (NAHC) and the National Minority Health Association (NMHA) are partnering to increase vaccination rates among the home health and hospice workforce. The combined $11.1 million effort, part of NMHA’s Flex for Checks program, aims to break down barriers preventing vaccination and curb the rising tide of COVID-19.

The coronavirus pandemic has claimed close to 627,000 lives since the deadly virus first struck the United States nearly a year and half ago, with more than 13,740 of those deaths reported since Aug. 1, according to a recent report from the U.S. Centers for Disease Control and Prevention (CDC).

The new B.1.617.2 (Delta) variant has caused infections to surge, particularly among the unvaccinated. Unvaccinated individuals are more likely to become infected and spread the virus, as well as experience more severe symptoms.

As the pandemic worsens, hospice providers are concerned about protecting their patients, families and their workforce.

“This is even more of an urgent issue with the Delta variant quickly spreading among the unvaccinated, coupled with colder winter months approaching,” said Bill Dombi, NAHC president and CEO. “We need to be honest and recognize our vaccination shortfall as an industry — but, as an industry, we need to come together to solve it. We are pleased to join with NMHA in this collaborative effort.”

A push towards vaccination has been a rising priority nationwide. NAHC was part of an effort in July made up of nearly 60 medical groups and senior services associations that joined forces to push for mandatory COVID-19 vaccinations among all health and long-term care workers, according to Home Health Care News, a sister publication of Hospice News.

The CDC reported that a little more than 73% of adults nationwide have received at least one vaccination dose. An estimated 40% to 90% of home-based care workers are vaccinated, including those in hospice, according to NAHC data. The range is largely dependent on the company and the employee’s professional discipline.

To date, 11 states have implemented vaccine mandates among health care workers, according to a recent report by the National Academy for State Health Policy, including states in which hospice utilization runs high among Medicare decedents such as Utah, Arizona and Florida.

Utah held the highest hospice utilization rate across the country in 2018 at 60.5%, while Arizona and Florida rest in the top five states at 58.8% and 57.9% respectively, according to the National Hospice & Palliative Care Organization. This was well above the national average of 50% reported by the Medicare Payment Advisory Commission that same year.

Many hospice providers are still reeling from the pandemic’s financial and operational impacts, with patient access and staffing shortages topping their list of concerns.

Hospices have seen drops in patient census since the outbreak’s onset as skilled nursing, long-term care facilities and hospitals closed their doors to visitors to prevent infections. Patients and families have also been reluctant and hesitant to seek hospice care in the home, concerned about unvaccinated staff potentially spreading infection.

Staffing shortages have been ongoing in the hospice industry for years, but providers have cited the pandemic as a mounting concern pressing the issue further. More than 35% of hospice leaders cited staffing shortages as a top concern for their organizations, along with regaining access to patients in facilities, according to a Hospice News survey earlier this year. Staff turnover has risen during the pandemic across a range of disciplines, including nurses, licensed independent practitioners, case managers and aides.

The vaccination efforts were funded with a grant NMHA received from the Health Resources and Services Administration (HRSA), which is part of the $125 million in funding available from the U.S. Department of Health and Human Services HHS American Rescue Plan of 2021. The plan aims to increase vaccine awareness through a community-based workforce, as well as address barriers to vaccination among vulnerable and medically underserved communities.

Funding received from HRSA fueled Flex for Checks, a community-based program intended to increase vaccination confidence and rates among demographics that experience health care disparities. The program is designed to encourage home health workers to provide education and information about vaccines to those populations. Flex for Checks offers incentives to workers who receive vaccinations themselves and for those who guide others to get the shots.

Dallas-headquartered AccentCare has joined the effort as well. The post-acute care provider recently announced plans to roll out 5,000 vaccinations through the Flex for Checks program among its staff of more than 30,000 professionals across 250 of its locations.

“We recognize that the industry has a problem when it comes to vaccinations,” said AccentCare CEO Stephan Rodgers. “Vaccination is the first line of defense against COVID-19 and we want to be part of the solution. This is why we are aggressively encouraging our team members to get vaccinated.”

AccentCare is a portfolio company of the private equity firm Advent International, which purchased the provider from Oak Hill Capital Partners in 2019. The company serves upwards of 200,000 patients and their families across 31 states nationwide and provides hospice, palliative skilled nursing and personal, non-medical care management. The company merged with Seasons Hospice & Palliative Care in late 2020.

“We are thrilled to partner with NAHC and AccentCare as we seek to get as many home care workers and people in underserved areas vaccinated as possible”, said NMHA Executive Director Burgess Harrison. “Nothing like this program has been undertaken in this manner, where home care agencies, workers, consumers, pharmacies and software companies come together and flex their arms in the fight of our lives against COVID-19.”