[Updated] Vaccine Mandate Might Be Right Around the Corner for Home-Based Care Providers

Editor’s note (Aug. 26, 2021): The Department of Health, Codes Committee of the Public Health and Health Planning Council adopted the emergency regulation on Thursday. More information is available here.

New York home-based care workers wondering if a COVID-19 vaccine mandate is around the corner will soon have an answer.

On Thursday, the New York Department of Health, Codes Committee of the Public Health and Health Planning Council (PHHPC) will meet to consider implementing an emergency regulation regarding “Prevention of COVID-19 Transmission by Covered Entities.”


If adopted, the regulation would mandate the vaccination of home health and personal care workers in the state, with the requirement that the first dose is administered by Oct. 7.

“The takeaway right now is to start preparing for the potential implementation because if this doesn’t pass, then there may be other attempts at the state level to require health care providers to vaccinate their home care workers,” Emina Poricanin, managing attorney of Poricanin Law, told Home Health Care News.

The Thursday meeting comes as the Delta variant continues to spread across the state. Overall, 95% of the sequenced recent COVID-19 positives in New York were for the Delta variant.


Those who are unvaccinated are 5 times more likely to be diagnosed with COVID-19 compared to vaccinated individuals. The risk of hospitalization is also higher among unvaccinated individuals, according to data from the CDC.

Specifically, the New York regulation would require home-based care providers to report and submit documentation that shows the number and percentage of vaccinated staff, as well as the number and percentage of staff who are granted medical and religious exemptions.

For now, providers should beef up their administrative manpower and keep the operational logistics of their business top of mind, according to Poricanin.

“I would start thinking about the logistics of who’s going to be responding to questions from caregivers,” she said. “I would think about who’s going to be the gatekeeper and maintain a list of all the vaccinated versus exempt people. Who’s going to be the one making schedule changes if a caregiver is refusing to get vaccinated and would rather quit?”

Moving forward, it will also be imperative for providers to take a hands-on approach to further educate their staff about the vaccine.

“It behooves providers to go on an education campaign and make sure their caregivers understand the vaccine implications and the studies — and that they have the correct data,” Poricanin said. “This helps caregivers make an informed decision. I think this is to the benefit of the providers because they will not lose caregivers who may be making the wrong decision — declining the vaccine — based on misconceptions.”

Empath Health introduces vaccine policy

Empath Health on Tuesday announced a policy that requires its staff, volunteers and vendors to be fully vaccinated against COVID-19 by Nov. 1.

“This was not a decision that was made lightly or quickly,” Dr. Neville Sarkari, chief medical officer at Tidewell Hospice, told HHCN in an email. “We spent a great deal of time debating this internally. The vaccines are effective and safe, so we felt it was the right thing to do to protect our patients and our colleagues.”

Tidewell Hospice is one of Empath Health’s hospice subsidiaries.

Sarasota, Florida-based Empath Health provides home health, hospice and home care services, in addition to primary care, palliative care and more. Empath Health also runs a Program of All-Inclusive Care for the Elderly (PACE) operation.

Under the new policy, Empath Health will require its staff and volunteers to provide proof of full vaccination status. Vendors who interact with clients, staff or volunteers are also subject to this requirement.

The company has plans to consider exemptions due to religious beliefs or medical concerns on a case-by-case basis.

In general, many providers have been reluctant to implement staff vaccination policies due to concerns that it would lead to a loss in staff. This isn’t the case for Empath Health, according to Sarkari.

“While staffing is always a concern, we are currently having to deal with many staff who are out due to COVID exposures or having COVID,” he said. “We don’t anticipate that the vaccination policy will make staffing any worse in the short run, and it should improve staffing over time.”

CMS raises payment rates for at-home vaccinations

In other vaccine-related news, the Centers for Medicare & Medicaid Services (CMS) announced Tuesday that it would offer additional payments to health care providers administering doses in the home.

The move is an effort to increase access to vaccinations and improve health equity.

“We are doing everything we can to remove barriers to vaccinations, including ensuring appropriate payment levels for vaccine providers to connect with more people in their communities who are unable to receive the vaccine in a traditional setting,” CMS Administrator Chiquita Brooks-LaSure said in a statement. “We’ve seen the difference that vaccinations have in communities, and we are calling on providers to join us as we continue to increase vaccination rates across the country. Today’s actions ensure that everyone has the ability to be vaccinated against COVID-19, including older adults with mobility or transportation challenges and other at-risk individuals.”

In the past, CMS increased the total payment amount for at-home vaccination from $40 to $75 per vaccine dose, in certain circumstances.

Now providers are eligible to receive the increased payment “up to five times when fewer than ten Medicare beneficiaries get the vaccine on the same day in the same home or communal setting,” according to the CMS announcement.

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