Internal and government vaccine requirements have hospices walking a fine line between the need to protect staff, patients and their families while also considering employees’ personal choices and medical or religious exemptions. Hospice leaders have shown concern that vaccine mandates could exacerbate long standing industry-wide staffing shortages, which have worsened during the pandemic.
Hospice & Palliative Care Buffalo is among the providers who decided to move forward with a vaccine requirement prior to the Biden Administration’s recent announcement of a federal mandate. Shortly after the hospice provider announced this decision, their home state of New York issued its own mandate for health care workers. The executive team knew they could potentially lose workers due to the mandate, but the ability to safely provide care takes priority, according to Cary Sisti, chief clinical operations officer.
Sisti has worked in a variety of clinical and leadership roles across the organization for more than 24 years. The New York state-based hospice and palliative care provider recently rolled out a two-phase approach mandating that all staff be vaccinated.
“Our decision to mandate the vaccine obviously came with risk. We know we risk losing employees — a loss that is personal and heartfelt,” Sisti told Hospice News. “Those who decide to leave are our friends, and differences in opinion do not change our fondness and respect. It’s important to emphasize that despite the potential for loss of staff, we are confident that we will safely continue to care for our current patients with no disruption in new admissions or operations.”
COVID-19 vaccinations were among the top concerns of providers heading into this year, according to a Hospice News survey. Almost 62% of respondents indicated that their organization would require those with direct patient contact to receive the coronavirus vaccine, and almost 75% of larger organizations indicated they would require it among staff. While some have instilled staff vaccine mandates, others have kept it optional.
The deadly virus has hit New York hard. The state has the third-highest number of COVID-19 deaths nationwide, more than 54,650 according to a recent Kaiser Family Foundation report. Only California and Texas came in higher at 67,118 and 60,240 deaths, respectively.
The pandemic has claimed upwards of 666,400 lives across the United States, according to the U.S. Centers for Disease Control and Prevention (CDC).
Since the outbreak’s onset, Hospice & Palliative Care Buffalo has maintained strict daily screening protocols for employees and patients to identify any potential risk of infection, quarantining employees when necessary. Additionally, employees were required to proactively use personal protective equipment (PPE) above and beyond CDC recommendations, according to Sisti. The vaccine policy is one more step in this direction, Sisti stated.
“Our decision to require COVID-19 vaccination as a condition of employment aligns with our priority and obligation to keep our patients, their caregivers and our staff safe and healthy,” said Sisti. “We’ve seen COVID-19 cases in both our employees and our patients or their caregivers throughout the pandemic.”
The vaccine policy applies to all staff in the organization and is not limited to clinical personnel. The second phase follows the U.S. Food & Drug Administration’s (FDA) full approval of the Pfizer-BioNTech vaccine.
About 90% of Hospice & Palliative Care Buffalo’s staff are now vaccinated, up from 80% at the time the policy was announced, Sisti told Hospice News. Vaccinations had been strongly encouraged among employees prior to the mandate.
The policy was met with support both internally and externally, but also with opposition and differences of opinion among staff, Sisti told Hospice News.
“We’ve heard a lot of feedback about fear of receiving the vaccine, so our phased approach to the vaccine policy has been geared toward giving people time to get more information,” Sisti said. “The leadership team has worked to support the staff through open communication, providing educational resources and time to consult with their physician to ask questions and get the information they need to make an informed decision.”
The hospice’s policy was in response to growing concern about the pandemic’s continued spread, largely due to the SARS-CoV-2 Delta variant, among others. Multiple variants of the virus have boasted surges as they circulate nationwide. Nearly 99% of the recent deaths occurred among the unvaccinated, according to an Associated Press analysis of CDC data.
A little more than 61% of the Empire State’s overall population has been fully vaccinated, and nearly 70% have received at least one vaccine dose, CDC reports.
To date, 22 states have implemented vaccine mandates among health care workers, according to a recent report by the National Academy for State Health Policy. The New York State Department of Health in late August announced updated regulations requiring that all health care workers receive their first vaccination dose by Sep. 27. The mandate expanded to apply to staff providing care in hospital, nursing, adult care and long term care facilities settings, among others.
The White House recently announced that CDC and U.S. Centers for Medicare & Medicaid Services (CMS) would collaborate on a new Conditions of Participation that would require all staff of Medicare- and Medicaid-certified health care providers be vaccinated against COVID-19.
The White House advised providers to begin employee vaccination efforts immediately to ensure they are in compliance when the rule takes effect.
Companies featured in this article:
Associated Press, Hospice and Palliative Care Buffalo, Kaiser Family Foundation, National Academy for State Health Policy
