N.Y. governor expands healthcare worker eligibility as hospitals suspend, fire unvaccinated staff

COVID-19 vaccine
New York enacted a statewide mandate requiring all healthcare workers to have received at least one dose of a COVID-19 vaccine. An estimated 8% of the state's healthcare workforce remained unvaccinated as of Monday night. (Getty/Meyer & Meyer)

Last night, New York Governor Kathy Hochul signed an executive order expanding healthcare worker eligibility requirements, an effort to head off potential staffing shortages fueled by the state’s new COVID-19 vaccination requirements.

The six-page order (PDF) allows out-of-state and out-of-country healthcare workers to practice in New York and lowers the barrier for those who have retired or are behind on registrations to rejoin the medical workforce during the course of “a statewide disaster emergency.”

It also includes provisions allowing recent graduates and emergency medical technicians to temporarily pitch in at additional healthcare settings; allows various types of healthcare workers to more easily administer and order COVID-19 vaccinations; enables telemedicine physician visits in nursing homes; permits facilities to more quickly discharge, transfer or receive patients; suspends preauthorization review for scheduled surgeries; and makes several other allowances intended to reduce workforce-based barriers to care delivery.

"The only way we can move past this pandemic is to ensure that everyone eligible is vaccinated, and that includes those who are taking care of our vulnerable family members and loved ones," Hochul said in a statement.

"On Saturday I released a comprehensive plan in advance of the deadline for the vaccine mandate that keeps New Yorkers safe, and tonight I am adding even more provisions to take bold action to alleviate potential staffing shortages. To monitor developments on the ground, I am also directing an around-the-clock operations center to assist local partners and troubleshoot staffing issues in real time," she said.

The governor’s office said it is monitoring staffing levels to determine whether a National Guard deployment will be necessary.

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Hochul is planning to work with federal and state leaders on expediting visa requests for international medical workers, according to the Monday night announcement. She indicated in a press conference last week that such a measure is unlikely to occur in the short term.

Although many hospitals and health systems across the country have been staring down a shortage of nurses and other healthcare professionals, New York’s workforce troubles were exacerbated yesterday when a statewide COVID-19 vaccination mandate went into effect for hospital and nursing home workers.

Citing preliminary data, Hochul’s office said Monday that 92% of the state’s hospital staff had received at least one dose of a COVID-19 vaccine. Seventy-seven percent were fully vaccinated prior to the Aug. 15 announcement of the vaccine mandate, with that number increasing to 84% by Sept. 22.

The percentage of nursing home staff who had received at least one vaccine dose has increased from 70% on Aug. 15 to 92% on Monday. Adult care facilities' staff single-dose vaccination rates increased from 76% to 89% across the same time period.

Suspensions, resignations and firings resulting from the state mandate and similar requirements enacted by individual organizations have placed more strain on some facilities than others.

RELATED: CMS to require staff at hospitals and other facilities to get COVID-19 vaccine or risk funding loss

New York City Mayor Bill de Blasio’s office said yesterday that about 5,000 of the city’s public hospital healthcare workers had not met the deadline, about 10% of its total workforce. The administration noted that these departures have not forced any reductions in services and was hopeful many of the suspended workers would choose to be vaccinated and return to their posts later this week.

NewYork-Presbyterian had "fewer than 250" team members who did not comply with a Sept. 22 vaccination mandate and "no longer work" at the organization, according to a statement provided to Fierce Healthcare. The system said it has reached more than 99% compliance among its 48,000 employees and affiliated doctors and will see no interruptions in care due to the mandate.

Erie County Medical Center has reportedly placed about 400 staff members who did not comply on leave. These employees represent about 5% of its total workforce and have forced the hospital to halt elective inpatient surgeries and cut back on other services.

On Tuesday, the American Medical Association and the Medical Society of the State of New York released a joint statement voicing "strong support" of the vaccination requirement for healthcare providers. 

"The path to ending the pandemic must be based on science, and vaccination is an indispensable part of the solution," the groups wrote in the statement. "We will continue to work with Governor Hochul and her administration to help promote vaccination for all as a key to ending this pandemic.”  

New York’s mandate is something of a test bed for other states like California or Maine that have announced requirements for full vaccination among healthcare workers. Those orders go into effect Sept. 30 and Oct. 1, respectively.

Numerous states and healthcare providers have been hesitant to introduce COVID-19 vaccination requirements across healthcare staff, citing concerns ranging from individual choice to dangerous staffing shortages. At the federal level, Biden’s Centers for Medicare & Medicaid Services has announced plans to make workforce vaccination a condition for participating in Medicare and Medicaid.