Massachusetts Proposes COVID Vaccine Mandate for Hospice, Home Care Workers

Massachusetts Gov. Charlie Baker (R) has proposed a vaccine mandate for health care workers in the commonwealth that would include hospice and home health staff. The requirement would also apply to employees at rest homes, assisted living facilities. Massachusetts announced a similar rule for skilled nursing facility staff last month. 

The state’s Public Health Council (PHC) must approve the requirement before it can be implemented. About 85 hospice programs operate in Massachusetts. The mandate would cover as many as 100,000 home care workers, according to Baker’s office. Workers would have to be vaccinated by Oct. 31 if the PHC approves the rule, with some exemptions for medical or religious reasons. 

“The vaccination requirement for home care workers applies to individuals providing in-home, direct care who are employed by an agency that is contracted or subcontracted with the commonwealth,” the governor’s office said in a statement. “The vaccination requirement also applies to independent, non-agency-based home care workers contracted with the state providing in-home, direct care.” 

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. Three states have laws in place that prohibit vaccination mandates: Florida, Montana and North Dakota. 

To date the outbreak has caused close to 630,000 deaths in the United States, according to the U.S. Centers for Disease Control and Prevention (CDC). While the widespread vaccination brought infection rates down during the spring and early summer months, the virus is surging once again largely due to the pathogen’s delta variant and the number of people who remain unvaccinated.

Nearly 99% of recent COVID-19-associated deaths have occurred among people who have not been vaccinated according to an Associated Press analysis of CDC data.

On the federal level, the Biden Administration has required some federal employees to be vaccinated. The White House  has indicated that the U.S. Department of Health & Human Services (HHS) would be developing regulations to require vaccinations for workers in the nation’s nearly 15,000 nursing homes, which have been hit particularly hard by the pandemic.

No plans have been announced thus far for a nationwide mandate that applies to all health care workers. Cabinet-level agencies such as the Department of Veterans Affairs and HHS have instituted vaccine requirements for health care workers in their employ. 

Some in the hospice community are advocating for a national vaccine mandate for health care workers, including the National Hospice & Palliative Care Organization.

“A national requirement for health care workers to be vaccinated would provide greater certainty for the health care sector,” NHPCO President and CEO Edo Banach said. “The requirement should include a clear timeline and implementation should be supported with financial resources, including but not limited to additional support under the Provider Relief Fund and sufficient home-based rapid testing supplies.”

A number of individual providers have implemented vaccine mandates for their employees. including Hospice & Palliative Care Buffalo, the organization members of Ohio’s Hospice, Ethos Home Health & Hospice, Blue Ridge Hospice, and the hospice and home health subsidiaries of Empath Health, to name a few.

Massachusetts-based hospice provider Care Dimensions instituted a vaccine mandate for staff with a deadline of Oct. 10, the date by which nursing home staff and contractors must be vaccinated in their home state. 

Care Dimensions CEO Patricia Ahern told Hospice News that the majority of their employees “applauded the decision and agreed that it’s an important and necessary step to protect the most vulnerable patients and our workforce.”

While some in the hospice community may oppose a mandate given the public controversy around the vaccines, none of the providers contacted by Hospice News expressed that point of view. Some home-based care companies told sister publication Home Health Care News that they expected to lose employees due to these requirements.

“While we are concerned about possible impacts on an already tight labor pool, the state mandate helps to level the playing field in health care employment and will hopefully help us encourage the small percentage of our workforce who has yet to be vaccinated,” Ahern said. “It also reassures and reinforces the message to our current workforce, patients, and families that we care about their health and are doing all we can to protect them.”