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.
The State of Vaccine Mandates in the U.S.
- Vaccine rules. On Aug. 23, the F.D.A. granted full approval to Pfizer-BioNTech’s coronavirus vaccine for people 16 and up, paving the way for mandates in both the public and private sectors. Such mandates are legally allowed and have been upheld in court challenges.
- College and universities. More than 400 colleges and universities are requiring students to be vaccinated against Covid-19. Almost all are in states that voted for President Biden.
- Schools. California became the first state to issue a vaccine mandate for all educators and to announce plans to add the Covid-19 vaccine as a requirement to attend school, which could start as early as next fall. Los Angeles already has a vaccine mandate for public school students 12 and older that begins Nov. 21. New York City’s mandate for teachers and staff, which went into effect Oct. 4 after delays due to legal challenges, appears to have prompted thousands of last-minute shots.
- Hospitals and medical centers. Many hospitals and major health systems are requiring employees to get vaccinated. Mandates for health care workers in California and New York State appear to have compelled thousands of holdouts to receive shots.
- Indoor activities. New York City requires workers and customers to show proof of at least one dose of the Covid-19 for indoor dining, gyms, entertainment and performances. Starting Nov. 4, Los Angeles will require most people to provide proof of full vaccination to enter a range of indoor businesses, including restaurants, gyms, museums, movie theaters and salons, in one of the nation’s strictest vaccine rules.
- At the federal level. On Sept. 9, President Biden announced a vaccine mandate for the vast majority of federal workers. This mandate will apply to employees of the executive branch, including the White House and all federal agencies and members of the armed services.
- In the private sector. Mr. Biden has mandated that all companies with more than 100 workers require vaccination or weekly testing, helping propel new corporate vaccination policies. Some companies, like United Airlines and Tyson Foods, had mandates in place before Mr. Biden’s announcement.
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.