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How a Vaccine Mandate Could Worsen a Shortage of Home Care Aides

JASA, an organization serving older adults in New York City, said that its staff members had rushed to be vaccinated this week after an all-out push by the agency. Among its 660 home health aides, some 94 percent are now vaccinated, up from 20 percent who had submitted proof by August, said Kathryn Haslanger, the organization’s director. Five people resigned over the mandate.

This week’s vaccine deadline, set in an Aug. 26 emergency regulation by the Department of Health, covers certified home health agencies, long-term home health care programs, hospices and adult care facilities.

As with the hospital mandate, limited medical exemptions are permitted. The regulation does not allow religious exemptions, but workers whose employers have approved their religious exemptions may be permitted to work for now while the issue is challenged in court.

The state’s hundreds of thousands of home health care workers have been largely out of the spotlight during the pandemic, despite the work they have done to care for high-risk patients. Home health workers were not initially included in New York’s highest priority category for vaccination, for example, though after lobbying efforts, they were added.

Most home health aides — the bulk of the home health work force — make close to the state minimum wage of $15 an hour. The home health care system, largely funded by Medicare and Medicaid, also relies on a smaller number of nurses, who help oversee care of homebound patients. Agencies also employ therapists and social workers.

Already facing an industrywide staffing crunch, agencies have begun to implement emergency staffing plans, which include limiting new admissions, asking family members of home care recipients to shoulder more of the burden, and authorizing overtime. The Visiting Nurse Service is asking to have until the end of the year to comply with the mandate.

Assemblyman Richard Gottfried, who chairs the health committee, said in an interview that “a short delay might well make sense,” given the ongoing staffing crisis in home care. He also suggested that the state use federal money to offer enhanced salaries and overtime incentives to help hire and retain home health aides.