NYS DOH Call with Commissioner Howard Zucker

NYSHFA-NYSCAL participated in a conference call this morning with Dr. Howard Zucker NYSDOH Commissioner of Health regarding the New York State and Federal COVID – 19 vaccine mandate for healthcare workers. Dr Zucker discussed that a more robust effort is needed to ensure healthcare staff are vaccinated in order to protect our most vulnerable population. NYSDOH published a report in the recent CDC Morbidity and Mortality Weekly Report (MMWR) on the correlation of  vaccination and illness: https://www.cdc.gov/mmwr/volumes/70/wr/mm7034e1.htm?s_cid=mm7034e1_w

The Centers for Disease Control and Prevention (CDC) has identified a concerning national trend of increasing circulation of the Delta COVID-19 variant. See attached order for summary action.

Dr. Zucker shared key points from the call as follows:

Background data:

• NYSDOH reported in the CDC MMWR findings: during May 3–July 25, 2021, the overall age-adjusted vaccine effectiveness against hospitalization in New York was relatively stable (91.9%–95.3%). The overall age-adjusted vaccine effectiveness against infection for all New York adults declined from 91.7% to 79.8%.
• Only 68 % of the NYS nursing home staff have been vaccinated thereby not meeting the national goal of 75 % of population to be vaccinated.

Covered entities

• Covered entity shall mean a general hospital or nursing home pursuant to section 2801 of the Public Health Law. (Article 28)
• Covered personnel: All persons employed or affiliated with a covered entity who engage in activities such that if they were infected with COVID-19, they could potentially expose, patients, residents, or personnel working for such entity to the disease, whether paid or unpaid, including but not limited to employees, members of the medical and nursing staff, contract staff, students, and volunteers.
• Covered entities shall continuously require all covered personnel to be fully vaccinated against COVID-19, with the first dose for current personnel received by September 27, 2021. Documentation of such vaccination shall be made in personnel records or other appropriate records in accordance with applicable privacy laws.

Policy and Exemptions

• Covered entities shall develop and implement vaccination policies and procedures to ensure compliance with the provisions of Order.
• The number of employees with Medical and Religious exemptions must be reported to the DOH as part of the facility compliance plan.

• Medical Exemption.
• A licensed physician or certified nurse practitioner must provide certification that immunization with COVID-19 vaccine is detrimental to a specific member of a covered entity’s personnel, based upon a specific pre-existing health condition,
• The requirements of this section relating to COVID-19 immunization shall be subject to a reasonable accommodation of such health condition only until such immunization is found no longer to be detrimental to the health of such member.
• The nature and duration of the medical exemption must be stated in the personnel employment medical record and must be in accordance with generally accepted medical standards, (see, for example, the recommendations of the Advisory Committee on Immunization Practices of the U.S. Department of Health and Human Services).
• Documentation of medical exemptions and any reasonable accommodation must be recorded in the personnel records or other appropriate records in accordance with applicable privacy laws by September 27, 2021, and continuously, as needed, thereafter.

• Religious Exemption.
• May be granted for personnel if they hold a genuine and sincere religious belief contrary to the practice of immunization, subject to a reasonable accommodation by the employer.
• Documentation of religious exemptions and such reasonable accommodations must be recorded in the personnel records or other appropriate records in accordance with applicable privacy laws by September 27, 2021, and continuously, as needed, thereafter.

Terms of Employment

• Refusal of an employee to receive the vaccine without a documented exemption could be determined to be a termination with cause.  The employee would not necessarily be covered for unemployment benefits.
• Each facility should refer to their respective Union Collective Bargaining terms and conditions for information.

Notice of Hearing

• NYS will hold a Hearing on September 2^nd at 10:00am, via videoconference
• This is an opportunity to present any proof that failure to implement and comply with the requirements of this Order does not constitute a danger to the health of the people of the State of New York.
• Request to participate in the hearing must be done by written notification to Vaccine.Order.Hearing@health.ny.gov within 5 days of this Order.

Provider Feedback During the Question and Answer Session

Providers voiced concerns regarding the current state of critical healthcare shortages and the increased pressure of mandating the vaccine on the already healthcare staff shortages. Providers were told to notify the DOH if they were having dificulty with staffing. The DOH stated they will provide the phone number to all providers for the Nursing Home Assistance and Coordination Center (NHACC) to call if staff is needed.  Providers asked about conducting weekly testing for those who refused the vaccines and DOH stated it was not an option. Providers are concerned that other areas of healthcare not under this covered Order.  DOH reported further reviews and decisions will be determined about extending the Covered Entities at a future time. DOH share that more information will be forthcoming on details for obtaining additional vaccines (Booster Shots) as approved by the FDA and CDC.

NYSHFA/NYSCAL CONTACTS:

Jackie Pappalardi, RN, BSN
Executive Director
518-462-4800 x16

Lisa Volk, RN, B.P.S., LNHA
Director, Clinical & Quality Services
518-462-4800 x15