CMS to Require COVID-19 Vaccinations for Workers in ‘Most Health Care Settings’ — Including Home Health Care

President Joe Biden unveiled a new six-pronged national COVID-19 strategy on Thursday, including stronger requirements around vaccinations for U.S. workers.

Home health agencies were among the health care organizations explicitly mentioned in the plan. Along with either requiring or pushing American workers to get vaccinated, the Biden administration’s strategy calls for increased testing and masking while allocating more support for COVID-burdened hospitals.

“The President’s plan will reduce the number of unvaccinated Americans by using regulatory powers and other actions to substantially increase the number of Americans covered by vaccination requirements — these requirements will become dominant in the workplace,” the White House plan reads. “In addition, the plan will provide paid time off for vaccination for most workers in the country.”

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COVID-19 vaccines have been available to every person 16 and older since April 19, with individuals 12 and older able to receive vaccinations since May. Even so, just under 54% of the U.S. population is fully vaccinated against the coronavirus, according to CDC data.


From the White House COVID-19 strategy (Sept. 9, 2021)

Most home health and home care providers have strongly encouraged their front-line workforce to pursue vaccinations. Additionally, many currently operate in states like New York or Massachusetts that have adopted must-vaccinate policies.

Relatively few standalone in-home care providers, however, have gone so far as to issue mandates themselves. At the end of August, Dallas-based post-acute care company AccentCare told Home Health Care News that it was moving forward with mandatory vaccinations for leaders and managers.

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AccentCare CEO Steve Rodgers explained how it’s important for home health providers to adopt similar policies as their upstream referral partners in order to protect high-risk patient populations.

“As an industry, we do not want to be the last refuge of unvaccinated people,” Rodgers said. “I think we as an industry have the same obligations as our hospital partners and others out there to essentially move together. We need to collectively take a stand around this.”

The National Association for Home Care & Hospice (NAHC) has estimated that the vaccination range for home-based care workers is between 40% to 90%, depending on the company and the discipline of the worker.

Specifically, the Biden administration’s new plan says the Department of Labor’s Occupational Safety and Health Administration (OSHA) is developing a rule that will require all employers with 100 or more employees to ensure their workforce is fully vaccinated. Alternatively, companies can require any workers who remain unvaccinated to produce a negative test result on at least a weekly basis before coming to work.

The plan also mobilizes the U.S. Centers for Medicare & Medicaid Services (CMS) to require COVID-19 vaccinations for “most health care settings that receive Medicare or Medicaid reimbursement, including but not limited to hospitals, dialysis facilities, ambulatory surgical settings and home health agencies.”

Citing the growing spread of the COVID-19 virus in health care settings, a CMS announcement outlined that vaccinations will be required as a condition for participating in the Medicare and Medicaid programs.

“There is no question that staff, across any health care setting, who remain unvaccinated pose both direct and indirect threats to patient safety and population health,” U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra said in the announcement. “Ensuring safety and access to all patients, regardless of their entry point into the health care system, is essential.”

CMS is developing an interim final rule that will be issued in October with further details. In the meantime, the agency expects certified Medicare and Medicaid providers “to act in the best interest of patients and staff by complying with new COVID-19 vaccination requirements” as soon as possible.

“We know that those working in health care want to do what is best for their patients in order to keep them safe,” CMS Administrator Chiquita Brooks-LaSure said.

The stricter vaccine requirements will apply to roughly 50,000 providers and over 17 million health care workers at Medicare- and Medicaid-certified organizations.

“NAHC has encouraged vaccinations throughout the pandemic,” its president, Bill Dombi, said in a statement shared with HHCN. “We look forward to seeing the details of the President’s Executive Order.”

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