Health systems gird for challenges as mandate looms

With the deadline to vaccinate health care workers with at least one dose against COVID-19 close at hand, providers warn of possible delays in nonessential care and ask for patience and understanding. 

The scope of change at hospital systems hinges on the loss of staff on Sept. 27, the date the mandate goes into effect. 

Shortly before Gov. Andrew Cuomo resigned from his position, he issued a state mandate requiring all health care workers in New York State, including staff at hospitals and long-term care facilities such as nursing homes, adult care, and other congregate care settings, to be vaccinated against COVID-19. The state Department of Health issued Section 16 orders requiring these facilities to develop and implement a policy mandating employee vaccinations, with limited exceptions for those with religious or medical reasons. 

Health care workers at UR who have not received at least one shot of an approved COVID vaccine by Monday, or received an approved exemption, are ineligible to continue working in clinical facilities and nursing homes. 

At Monroe County’s COVID briefing Thursday, Michael Apostolakos M.D., chief medical officer at University of Rochester Medical Center, said contingency plans are in place to deal with any staff shortages. Many patients and staff members will face inconveniences after the mandate takes effect, but critically needed care and many non-critical services will continue without interruption, Apostolakos noted.

“We have made contingency plans to ensure that essential services continue, no matter how many, or which types of workers aren’t here on Monday,” he said, adding that UR Medicine is focused on providing needed services to the community.

Robert Mayo M.D., chief medical officer at Rochester Regional Health, said a cross-trained, diverse workforce is ready to help fill any gaps in care.

“The most accurate statement for the moment is for the public to check in with their health care providers if they have appointments scheduled to ensure that schedules are on time or if there’s been changes in the location or the timing of the expected services, and we will support our patients, our community through all of that,” he said.

At URMC, 99 percent of professional medical staff and 91 percent of all employees across the six UR Medicine hospitals were partially or fully vaccinated as of Sept. 20. Ninety-one percent of RRH health care workers are vaccinated and its employees are expected to quickly reach the 100 percent vaccination rate, officials said. Monroe Community Hospital’s employees—91 percent—and 99 percent of advanced practice professionals such as physicians, nurse practitioners, and physician assistants have been vaccinated.

Those numbers are growing as the vaccination deadline approaches.

“Medical professionals know that vaccination is the most powerful tool we have to keep ourselves, our families and the community safe. More people being vaccinated means fewer hospitalizations and fewer deaths,” Apostolakos said.

Gov. Kathy Hochul stood firm on the mandate at the state’s COVID briefing today. She said health care workers had no excuse not to get vaccinated. There was plenty of notice and vaccine availability to meet the deadline. In Rochester, Michael Mendoza M.D, Monroe County Health Commissioner, echoed those sentiments.

“There has been ample opportunity to research, learn and understand the science behind these vaccines,” he said. “There has been ample time to learn the facts and to overcome the fear. And I hope my unvaccinated colleagues use the next few days to really dig deep before choosing to leave this noble profession.”

Hospitals here and across the nation already face staffing shortages. Both UR and RRH are actively seeking health care workers. Rising demands for clinical services, retiring health care workers and others who are leaving their jobs because of COVID stress and fewer recruits have led to diminished staffs. 

“This is a nationwide issue with people leaving health care, the stress the pandemic has caused people to leave and less people to come in,” Apostolakos said. “And so, there are more and more institutions looking for relatively fewer health care workers.”

These staff shortages, unrelated to the mandate, have caused UR Medicine Labs to close some patient service centers temporarily, Strong to close hospital beds in several units, and Highland to postpone a small number of scheduled elective procedures, UR officials said. UR Medicine Urgent Care centers in Spencerport and Farmington have been temporarily closed. A two-week pause in scheduling new elective procedures at Strong will go into effect on Monday. 

RRH has shifted elective surgery schedules to lighten loads, and plans to continue to assess them each day, Mayo said.

“UR Medicine hospitals will remain open for business and ready to provide essential care for patients,” Apostolakos says. “We encourage every member of the public to get vaccinated against COVID, and please don’t put off seeking medical care whenever you need it.”

Some health care professionals are waiting for the outcome of a lawsuit filed by 17 medical workers that alleges the mandate violates constitutional rights and protections for religious beliefs. On Sept.14, Judge David Hurd of the U.S. District Court in Utica granted a temporary restraining order against Hochul, Health Commissioner Howard Zucker and Attorney General Letitia James. The order, which has been extended to Oct.12, goes into effect Sept. 27. It freezes enforcement of the vaccine mandate’s prohibition of religious exemptions but does not invalidate the vaccine mandate for health care workers who have not requested such an exemption. Hurd is expected to make his decision by Oct.12.

Health care workers who decide to get the vaccine after 5 p.m. on Sept. 27 will be rehired, UR and RRH officials said. 

“We know that … everyone is thinking through this day by day, and that people may change their minds,” Mayo said. “And we want people to know that they are welcome back and whether they get the exact same shift or the exact same position, I can’t say that in this moment. But … they will have a job and we’ll get them back into the workforce.”

Added Apostolakos: “We would welcome them back to our team at any time that they decide to comply with the vaccination mandate.”

Smriti Jacob is Rochester Beacon managing editor.