USA TODAY International Edition

Biden rule: 17M in health care get vaccines

Mandate sets Jan. 4 for workers to be immunized

- Ken Alltucker

The Biden administra­tion on Thursday unveiled a sweeping new COVID- 19 vaccinatio­n rule that would require about 17 million health care workers across 76,000 hospitals, nursing homes and other health care facilities to get fully immunized by Jan. 4.

The vaccine mandate for health workers and an accompanyi­ng one for businesses with 100 or more employees aims to reduce the ranks of the unvaccinat­ed, prevent workers and customers from getting sick and spur the economy by encouragin­g millions of Americans to return to work.

Unlike the companion mandate for private businesses, health care workers who refuse vaccinatio­n won’t have the option of getting tested in lieu of immunizati­on. Citing “higher bar” for health facilities because of their critical role in ensuring the health and safety of patients, President Joe Biden’s plan will allow only health care workers who qualify for a medical or religious exemption to skip the immunizati­on, a senior administra­tion official said.

The new rule requires employees of health care facilities to be fully vaccinated with either two doses of Pfizer or Moderna, or one dose of the Johnson & Johnson vaccine by Jan. 4.

The mandate applies to all facilities that take payments from Medicare or Medicaid, including hospitals, nursing homes, dialysis centers, ambulatory surgical centers and home health agencies. It applies to clinical workers such as doctors and nurses directly involved with patient care, and also nonclinica­l employees, students, trainees, and volunteers as well as contract employees who provide treatment or other services.

The Centers for Medicare and Medicaid Services will enforce the mandate through routine inspection­s, or surveys, of the facilities that participat­e in the federal insurance programs. Facilities that don’t meet the vaccine mandate can be cited or fined but will be given multiple chances to improve vaccinatio­n compliance, officials said.

The federal regulation­s aim to ensure health providers comply with the new vaccine mandate. “It is not to punish workers for health care facilities. However, we will not hesitate to use our full enforcemen­t authority to protect the health and safety of patients,” a senior administra­tion official said.

The new regulation stems from Biden’s announceme­nt in September that all hospitals and health facilities that take Medicare and Medicaid reimbursem­ent must vaccinate their workers.

States such as New York and California already have enacted mandatory vaccinatio­n for health care workers, and some hospitals have dismissed or suspended workers who have refused to comply. Only a small percentage of workers have quit or been dismissed over vaccine refusal.

While health leaders acknowledg­e and support mandatory vaccinatio­n, some worry workforce disruption­s could punctuate a widespread shortage of health care workers at hospitals and clinics nationwide. The number of health job openings swelled during the pandemic with the Bureau of Labor Statistics reporting 1.8 million health care openings as of July, up from 1.1 million open jobs in July 2020.

Rural hospitals had chronic doctor and nurse shortages before the pandemic began, and some worry workforce shortages could worsen under a federal vaccinatio­n mandate.

The National Rural Health Associatio­n “believes it is important for all healthcare workers to be vaccinated, to protect both themselves and their community,” CEO Alan Morgan said. “However, vaccine mandates will result in rural service disruption­s.”

Staffing agencies that provide nurses and other temporary health care workers said requests from hospitals have surged during the pandemic. And once the mandate kicks in for hospitals, requests for contract nurses are likely to go higher to fill vacancies amid a nationwide labor shortage, agencies said.

The American Hospital Associatio­n earlier said it “strongly supports” mandatory vaccinatio­n but urged the Biden administra­tion’s policy to be “feasible, transparen­t and fair” for all health providers subject to the mandate. The group, representi­ng nearly 5,000 hospitals and health systems, said any vac

cine mandate should apply to all Medicare- regulated health care providers.

As of late September, more than 2,500 hospitals and health systems announced mandatory vaccinatio­n policies. Hospitals faced a patchwork of state regulation­s on vaccine.

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