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August 05, 2021 10:53 AM

Health systems get creative to implement vaccine mandates

Crain's New York Business
Maya Kaufman and Shuan Sim
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    New York City hospitals and health systems are developing expansive internal infrastructure to facilitate the rollout of newly announced staff vaccination policies, including an IT platform that tracks Covid-19 test results and 24-hour testing sites where employees can get swabbed during their shift.

    Each system faces the challenge of implementing mechanisms for communicating requirements, tracking compliance, vetting exemption requests and disciplining employees who flout the new rules. The guidelines so far range from a no-exceptions vaccine mandate for patient-facing employees at state-run hospitals such as SUNY Downstate in Brooklyn to weekly testing requirements for unvaccinated workers at the city’s public hospital system, Mount Sinai Health System and Northwell Health.

    Hospital executives said their goal is to make compliance easy.

    NYC Health + Hospitals, whose vaccine-or-test policy went into effect Monday, tapped its IT department to create a system wherein any test taken at any of the system’s locations will have results automatically uploaded to fulfill the criteria. Workers who fall short of the weekly testing requirement will be contacted by human resources and get the chance to take a Covid-19 test then and there, said Dr. Andrew Wallach, ambulatory care chief medical officer.

    Workers who get tested somewhere other than an H+H site will have to manually upload test results, Wallach said.

    At least 60% of the system's 42,244 employees have been vaccinated, although Wallach said that could be an undercount, as efforts to determine coverage are ongoing.

    Those who do not comply with the policy will not be cleared to enter the workplace, and they will be sent home without pay, Wallach said. There is no set number of strikes against workers, but if there is a pattern of noncompliance, the system will take “progressive disciplinary actions” up to and potentially including termination.

    “We hope we don’t have to use that,” Wallach said. “I’d rather we work out the kinks in the system.”

    Northwell Health, which announced a vaccine-or-test policy Monday, plans to offer 24/7 testing at all its hospitals so unvaccinated or partially vaccinated employees can get the required weekly test while on duty. Northwell said it will pay for the tests and process them in its own labs, with results made available within 48 hours, said Vicki Kahaner, Northwell’s vice president of employee relations. Unvaccinated employees will be permitted to work while awaiting their test results.

    “We are doing our best to make it as convenient as possible,” Kahaner said.

    Under the policy, which goes into effect Aug. 16, noncompliant staff will be subject to Northwell’s progressive disciplinary process, starting with a conversation to educate the employee about the policy. Those who consistently flout the requirements might get up to five chances to change their behavior or face termination.

    Of Northwell’s 76,000-person workforce, about 77% have been vaccinated.

    Health systems that are permitting medical or religious exemptions to their mandates have to develop protocol for reviewing applications.

    At Health + Hospitals, those requests will be reviewed by the system’s equal employment opportunity office. It might permit exemptions from weekly testing if employees are going on an extended vacation or if they are based remotely, Wallach said. In those situations, supervisors would have to be informed so weekly tracking of those workers can be lifted as needed, he added.

    New York–Presbyterian, which announced its vaccine mandate in June, is giving employees until Aug. 6 to apply for an exemption due to pregnancy or medical or religious reasons. It has not released details on its review process but said requests “will be carefully evaluated and accommodated, if appropriate.” Unvaccinated employees who are not exempt are subject to termination.

    At University Hospital of Brooklyn, part of SUNY Downstate Health Sciences University, more than 60% of employees have received a vaccine through the medical center, a spokeswoman said. Individuals who were vaccinated elsewhere were not included in the count. The Prospect Lefferts Gardens hospital has more than 4,000 employees, according to its website.

    The hospital will comply with established guidelines for religious and medical exemptions, the spokeswoman said. However, given the recency of Gov. Andrew Cuomo’s announcement regarding vaccinations, she said, policies and procedures around noncompliance have yet to be developed.

    This story first appeared in our sister publication, Crain's New York Business.

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