7,700 RI health-care workers are unvaccinated. For some, the deadline was extended. What that means for the industry

PROVIDENCE — The potential for some unvaccinated health-care workers to keep working 30 days past the Oct. 1 COVID vaccination deadline — in places where their absence would compromise patient care — has not exactly elicited a sigh of relief.

The vaccination deadline mandated by Gov. Dan McKee was greeted initially with warnings of mass resignations and worker shortages in some quarters, such as nursing homes.

But the option the Rhode Island Department of Health announced Tuesday sparked confusion and worry in some of the same quarters, a serious look in the mirror in others and one angry letter.

A spokesman for CharterCARE, which encompasses the Roger Williams Medical Center and Our Lady of Fatima Hospital, told The Journal about 90% of employees in its network are vaccinated. 

But with the deadline approaching, "we continue to evaluate the need to request a 30-day grace period for critical areas,'' said the spokesman, Otis Brown.

Speaking Wednesday for about 80% of the nursing homes in the state, John E. Gage said the extension might give some homes needed breathing room to keep employees who have not yet had their second dose of vaccine on board until they get one.

More:AARP warns of rising COVID cases in RI nursing homes

"But outside of that, I don't know how much it actually helps,'' said Gage, president and CEO of the Rhode Island Health Care Association, which represents 64 for-profit nursing homes in the state. 

He said those nursing homes that opt for the 30-day extension to avoid significant staffing shortages could open themselves to serious consequences — including loss of their operating licenses — "if something unanticipated happens,'' such as a COVID-19 outbreak among their residents and staff.

"The underlying goal is to get as many people vaccinated as possible,'' agreed James Nyberg of LeadingAgeRI, an advocacy group that represents about 45 nursing homes, assisted-living centers and adult day-care services.

But he said the new option "adds a little bit of confusion'' and his group is pushing the Department of Health to reinstitute the "emergency temporary licenses'' for CNAs and other direct-care staff allowed in an earlier stage of the pandemic. 

More:'Panic mode': Nursing homes say RI vaccine mandate will cause more workers to leave

Nicholas Oliver, executive director of the Rhode Island Partnership for Home Care, went public with a letter to the state health director:

"The position that home care providers are in today will not change on September 30, 2021 or October 31, 2021.... Because of dramatically low reimbursement rates, we cannot compete in the labor market to replace health care workers for our patients and clients."

"Please do not place a "scarlet letter" on each home care provider that is attempting to balance mandatory complete vaccination compliance with continuity of care without any support to build back from our workforce losses due to adherence of your mandate." 

Their comments followed a day of dueling messages on Tuesday.

Gov. Dan McKee indicated in his weekly news conference on Tuesday that the state was holding firm to the Oct. 1 vaccination deadline.

Before the afternoon was over, however, state Health Director Dr. Nicole Alexander-Scott, had issued an advisory laying out this option:

"If there is a risk to quality of care and an unvaccinated worker must continue to work beyond October 1 to mitigate that risk, the employer has 30 days to ensure that role is fulfilled by a fully vaccinated health-care worker.”

She also vowed to publish the names of the vaccine-compliant nursing homes, which is already available — to some extent on Medicare.gov

The website shows vaccination rates for each nursing home in Rhode Island by name. It shows vaccination rates of 56.9% at one Providence nursing as of Sept. 5, near 93% at another, compared to a statewide average at that point of 79%.

The Oct. 1 vaccination mandate applies to about 57,612 licensed health-care workers in the state. As of Sept. 13, 49,889 — which equates to 86.6% — had been vaccinated, according to numbers compiled by the state.

Looked at another way: more than 7,700 licensed health-care workers in Rhode Island were still unvaccinated at that point.

The lowest vaccination rate was among nursing service agencies: 63.8%. 

Among nursing homes, the vaccination rate was 91.7%, but 850 of their employees were still unvaccinated at that point.

It remains unclear what the state intends to do at the state-run Eleanor Slater Hospital, where 706 of 864 health-care workers at the hospital were vaccinated as of Sept. 10. 

As for the Veterans Home, spokeswoman Meghan Connelly said:

"We hope all staff choose to be vaccinated by the October 1 deadline; however at this point, we are still awaiting confirmation of vaccination from 35 of 101 (34.7%) of our active state employee CNAs and nurses at the Veterans Home. To ensure high-quality care for our Veteran residents, we of course will be exploring contingency plans as necessary.".

What should facilities that won't hit the deadline do? 

In an interview Wednesday, Tom McCarthy, the state's COVID-response czar, said each facility that believes it needs the extra 30 days will have to present its case to the Department of Health, and submit what amounts to a corrective action plan for review.

With respect to unvaccinated EMTs and firefighters with EMT licenses who provide "direct patient care," he said each one will have to file a plan to get vaccinated within 30 days.

"If you are non-compliant, you must have a corrective action plan with us. If you do not have a corrective action plan and you remain non-compliant, we escalate from there."

"There's potentials for fines ... suspension of license ... revocation of license ... [and] that would be more a condition of employment with the fire department. You can't have unlicensed EMTs serving in that role."