Massachusetts Vaccine Mandate ‘Will Absolutely’ Drive Home Care Workforce into Other Industries, Providers Say

Yet another East Coast state may soon see a COVID-19 vaccination mandate for home care workers.

Following last week’s news that New York state adopted a vaccination mandate for home-based care workers, Massachusetts is considering expanding the requirements in place for nursing homes to include this group.

Roughly a month ago, Massachusetts Gov. Charlie Baker’s administration required nursing home staff to get vaccinated against the coronavirus. This mandate is pending approval from the state’s Public Health Council.

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“We were somewhat surprised when the governor announced the expansion,” Pat Kelleher, executive director at Home Care Alliance of Massachusetts, told Home Health Care News. “We got about 24 hours’ notice that he was going to do it.”

Boston-based Home Care Alliance of Massachusetts is a nonprofit home care and home health trade organization. The organization represents 170 agency members.

If approved, the mandate would apply to assisted living facilities, hospice programs and home care workers at agencies enrolled in MassHealth, or those working under the state’s home care program.

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Kelleher believes that it’s likely the vaccination mandate will pass.

“I’m not sure whether they’ll make any changes or tweaks to it, but I’m confident the Public Health Council will approve the governor’s mandate,” she said. “I’m happy that we have some lead time, as the mandate requires the vaccinations by the end of October. We will continue to do what we have been doing since the emergence of the vaccine — trying to help our members address the concerns of their workers and continue to drive up the vaccination rate.”

Still, many providers have concerns about the impact the new requirements may have on staffing.

“[The vaccine] is certainly the best thing to protect the workforce and all of the providers, clients and consumers,” Michael Trigilio, CEO of HouseWork, told HHCN. “That is the most important thing, but I will say we are in an extremely tight job market today. Like any other industry, not every person wants to be vaccinated. This will absolutely drive some of our current workforce into other industries.”

Backed by health care investor RAB Ventures LLC, Newton, Massachusetts-based HouseWorks is an in-home care company that also offers home-modification services. HouseWorks is one of the nation’s largest independent home care companies.

At HouseWorks, over 75% of the staff has already been fully vaccinated, according to Trigilio.

“The challenge is that last 25%,” he said.

Similar to the original proposal in New York, Massachusetts would not require workers with medical exemptions to adhere to the policy. Massachusetts’s mandate would also accommodate individuals with religious concerns.

Another concern for providers is that, in Massachusetts, many seniors are already on the state home care program’s waiting list to receive care services. This means that a significant loss of workers could place a severe strain on an already overburdened workforce, further limiting access to care.

“I do think staffing is generally at a crisis stage for home health and home care in Massachusetts right now,” Kelleher said. “We are, of course, concerned that if we were to lose even 5% to 10% of our workforce, that erosion will significantly affect our ability to attract and keep workers.”

Moving forward, providers will be looking for more guidance from either the state or the CDC on how to navigate who qualifies for vaccination exemptions.

“What constitutes a medical exemption, what types of conditions,” Kelleher said. “I think it will be very difficult for agencies to have to be making those judgment calls and deciding who qualifies for reasonable accommodations.”

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