Vaccine mandates imposed by some of New Jersey’s largest health systems, including Hackensack Meridian Health, RWJBarnabas Health and Virtua Health, have leveraged the threat of job loss to push tens of thousands of employees to get shots against COVID-19.
Now the federal government has imposed a deadline that requires almost all medical institutions across the country to adopt the same requirement, eliminating the testing option that some have permitted for employees who decline vaccination.
The new federal rule is expected to induce thousands more in New Jersey — and potentially tens of thousands of health care workers nationwide — to receive the shots.
An estimated 8,900 long-term care workers in New Jersey remain unvaccinated, as do an unknown number of employees of home health agencies, dialysis centers and residential health care facilities. Some 2,300 staff members at Atlantic Health System and a few hundred at other hospitals that have allowed frequent COVID testing as a vaccination alternative also will be affected.
The federal deadline for those who work in these facilities and have held out until now is Dec. 6 to get the first dose of a Moderna or Pfizer vaccine or the Johnson & Johnson vaccine.
The emergency rule, announced Nov. 4 by the federal Centers for Medicare and Medicaid Services, requires any health care institution that receives funding from Medicare or Medicaid to allow vaccine exemptions only for medical or religious reasons. Everyone else must be vaccinated.
The agency “considered requiring daily or weekly testing of unvaccinated individuals, [but] scientific evidence on testing found that vaccination is a more effective infection control measure,” the agency said.
The rule was announced without the usual long public comment period because “the prevalence of COVID-19, in particular the delta variant, within health care settings increases the risk of unvaccinated staff contracting the virus and transmitting the virus to patients,” the agency said. When illness leads to staff absences, the strain on the health system can limit patients’ access to care.
At Atlantic Health System, 87% of the 18,000 employees are vaccinated.
“Beginning Dec. 5, all team members must receive the first vaccine doses in a two-dose series or one dose of Johnson & Johnson,” said Luke Margolies, a spokesman for the system, which includes Morristown, Overlook, Newton, Chilton and Hackettstown medical centers, as well as scores of outpatient facilities. “The second doses of the two-dose series must be completed by Jan. 4.”
At Holy Name Medical Center in Teaneck, about 150 of 4,500 employees had opted for regular testing rather than vaccination. “There will no longer be an option for testing in lieu of full vaccination,” a spokeswoman said. “Holy Name plans to fully comply” with the federal mandate.
The requirement will apply to all employees, affiliated physicians, providers, students, volunteers and contractors, regardless of whether a staff member has direct patient contact, said Jeanette Hoffman, the Holy Name spokeswoman.
At St. Joseph’s Health, 62 employees who have not been vaccinated or obtained an exemption will be the focus of efforts to answer questions and allay doubts about the vaccines, said Pam Garretson, a spokeswoman. With hospitals in Paterson and Wayne, as well as a long-term care facility and numerous outpatient locations, the system will comply with the federal mandate, she said.
Currently, 98% of St. Joseph’s 6,000 employees are vaccinated, and 155 have exemptions, she said.
At New Jersey’s nursing homes and assisted living facilities, 83.7% of the staff was vaccinated as of Friday — significantly higher than the national rate of 71% and representing a steady climb from mid-July’s 70.5%. While the federal mandate does not apply to assisted living residences, it does affect nursing homes.
“We would expect that percentage to tick upwards as the deadline comes closer,” said Andrew Aronson, CEO of the Health Care Association of New Jersey, the long-term care industry trade group. But “there will be a handful who choose not to get vaccinated.”
For employers already struggling with labor shortages, any loss of staff due to the vaccine requirement will exacerbate a difficult situation. Nursing homes already are turning away patients because they lack staff to provide care, Aronson said. “If there’s not enough staff to take care of people, people end up not being taken care of,” he said.
Besides hospitals and nursing homes, medical facilities that will be affected by the new requirement include home health agencies, hospices, ambulatory surgery centers, community health and mental health centers, dialysis facilities, psychiatric residential treatment facilities and outpatient rehab centers. Physicians’ offices not regulated by Medicare do not need to comply.
Nationwide, the requirement applies to 17 million health care workers at 76,000 facilities.
Although New Jersey employers are taking steps to comply, the attorneys general in 10 other states have sued in federal court to block the regulation from taking effect. Led by Missouri and Nebraska, the suit filed in U.S. District Court in Missouri includes Alaska, Arkansas, Iowa, Kansas, New Hampshire, North Dakota, South Dakota and Wyoming.
They argue that the rule is unconstitutional, overly broad and an infringement on personal liberty, and they also say it has a heavier impact on rural states, where the labor shortage is more acute.
Meanwhile, on Monday, Hackensack Meridian Health became the latest health system in New Jersey to reach a self-imposed vaccine deadline, announcing that 99.8% of its 36,000 employees statewide were vaccinated. In the months since the requirement was announced at the 17-hospital health system, more than 10,000 of its employees accepted the shots.
Hackensack Meridian did not provide information about how many employees had lost their jobs by not complying. The system’s human resources department “called 800 team members to remind them that they had not been vaccinated and would be separated from the organizations if they did not comply,” in advance of the Oct. 1 deadline for first shots or a Johnson & Johnson vaccine, according to an article by Robert C. Garrett, the CEO, called “Lessons on a successful COVID-19 mandate.”
A small number of employees — 0.2%, or about 72 — appear to have received exemptions “for medical, religious or strongly held beliefs.” These decisions were made by a panel of bioethics experts who reviewed each case, Garrett wrote.
And around the state, vaccine mandates in health care settings have been overwhelmingly effective.
A month ago, as its Oct. 15 deadline passed, RWJBarnabas Health fired 118 employees, less than 1% of its workforce of 35,000 across 15 hospitals, 33 outpatient centers and dozens of other facilities. And 120 staffers at Virtua Health “elected to discontinue their employment” at that system’s five South Jersey hospitals and other centers, the system’s president said — about 1% of employees.
Lindy Washburn is a senior health care reporter for NorthJersey.com. To keep up-to-date about how changes in health care affect you and your family, please subscribe or activate your digital account today.
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