Reactions to exempting healthcare workers who work in private homes from vaccine requirement of industry

Home Care Providers Project Mass Discharge of Patients by October 1 – Hundreds of Home Care Workers Submit Resignations in Response to COVID-19 Vaccination Mandate

Rhode Island’s home care providers are anticipating a dramatic reduction in available workers as a result of 216-RICR-20-15-8, an emergency state regulation enacted on August 17, 2021 that requires all licensed healthcare workers and providers be vaccinated against COVID-19 by October 1, 2021.

While limited permanent medical exemptions will be granted by the Rhode Island Department of Health, religious exemptions and temporary medical exemptions are disallowed.

As a result, according to the Partnership, “home care providers are receiving hundreds of resignations from nurses, allied health professionals, nurse assistants, social workers, physical therapists, occupational therapists, speech-language pathologists and office staff that are not intending to be fully vaccinated by the regulatory deadline”.

Continuing with more details, the Partnership’s press release states: “Current projections have over 1,000 home care patients and clients without continuity of care by September 30, 2021 due to healthcare workforce displacement caused by enacting this emergency regulation. While this figure represents only a small fraction of providers’ cumulative census (approximately 4.7%), this will impact home care patients and clients residing in every Rhode Island city and town.

The Rhode Island Partnership for Home Care has requested that the Rhode Island Department of Health exempt home care from this mandate.

“Unlike facility-based healthcare settings, such as hospitals and nursing homes, home care providers cannot control their patients’ and clients’ care delivery environment”, said Nicholas Oliver, Executive Director of the Rhode Island Partnership for Home Care. “Home care patients and clients have the right to allow unvaccinated persons to live and visit their homes. These home environments offer greater risk of COVID-19 breakthrough variant exposure than healthcare workers that have been properly masking and wearing personal protective equipment for the past 18 months.”

Michael Bigney, President of the Board of Directors for the Rhode Island Partnership for Home Care and Administrator of Home Health and Hospice Care of Nursing Placement, headquartered in Pawtucket, added that “While home care administrators are supportive of patients, clients and employees getting vaccinated, it should remain a decision between an individual patient and their physician. We are losing excellent direct care staff that have been on the frontline throughout this pandemic. I hope that every displaced patient and client calls Governor McKee to tell him that this mandate is wrong. Discharging vulnerable homebound patients and clients without continuity of home care may contribute to more hospitalizations than any COVID-19 breakthrough variant. It does not seem that Governor McKee or his Health Department thought through this policy before enacting it.” 

Short of an exemption for this class of healthcare workers, the Rhode Island Partnership for Home Care requested that the Rhode Island Department of Health develop a process to accept neglect reporting specific to compliance with this emergency regulation. By creating a separate process, the Rhode Island Department of Health, the Rhode Island Office of the Long-Term Care Ombudsman, municipal senior advocate police officers and other state and local case management entities can prepare for the sudden influx of reported cases and identify alternative resources to stabilize each member of their community that are vulnerable, homebound and soon to be without care.

Oliver added, “While we hope that all remaining unvaccinated home care workers will reconsider their vaccination choice, we are requesting that the Health Department and municipal leaders prepare for this potential widespread problem caused by this emergency regulation. Mayors, city and town council members and General Assembly members should contact Governor Daniel McKee and request that home care providers be exempted from this emergency regulation because of its unique healthcare delivery environment and the subsequent consequences to cities and towns by a sudden reduction in available home care workforce.”

The Rhode Island Partnership for Home Care identifies as the only association in RI promoting access to quality home healthcare, committed to promoting quality home healthcare service delivery, ethical healthcare business practices, and positive patient and client outcomes to ensure that access to home care and hospice remains an integral component of our post-acute and long-term healthcare system.

For more information about the Rhode Island Partnership for Home Care, please contact (401) 351-1010 or www.riphc.org.

Home Health Care Reactions

RINewsToday checked with a few home health agencies and the RI Department of Health on the specifics of vaccine choice, and if they estimate employees will quit.

From Pinnacle Home Care, Warwick, RI:

“We at Pinnacle do believe in the importance of vaccination against COVID and, in fact, strongly recommend the vaccine for health care workers. But – we also strongly believe in a person’s right to choose whether to be vaccinated or not. We believe staff should be allowed to opt out of the vaccine for religious reasons and medical reasons (not just the 4 reasons the RIDOH have allowed). That being said, all staff who opt out should, in our opinion, be tested weekly and wear an N-95 mask during all patient contact. This lack of alternatives for unvaccinated staff will lead to us losing at least 5% of our staff on October 1, 2021. This is a great loss for our agency on top of the nationwide shortage of Health care workers. This will lead to us taking on fewer patients and a decrease in services leaving patient’s without care after surgery and illness. This mandate is the most restrictive in the country and many licensed staff will move to other states impacting healthcare in this state for years to come. There is a nationwide shortage of nurses due to lack of nursing instructors, lack of interest in going into the field and high number of nurse retirements. We are asking for an exemption, not a restriction! Thank You.”

Joni DeVita MSN, RN – Executive Director

From the Rhode Island Department of Health:

“People getting healthcare at home deserve to have providers who are as protected as the healthcare providers in healthcare facilities. In many instances, you are talking about more vulnerable people, so it is even more important that their caretakers are vaccinated. For context, licensed homecare providers are already required to get certain immunizations. Immunization as a precondition of employment is not at all new to licensed homecare providers.”

Joseph Wendelken | Public Information Officer

HopeHealth

“We anticipate minimal impact on staffing due to the COVID-19 vaccination mandate. Our estimate is that about 15 out of our total workforce of 600 will choose to leave. We support Rhode Island’s directive requiring that health care workers be vaccinated against the COVID-19 virus.” – HopeHealth President & CEO Diana Franchitto

Governor McKee

Gov. McKee was asked at yesterday’s press conference about this exemption request and he replied by saying that “we need to keep healthcare workers healthy” and would not support an exemption.