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April 05, 2021 03:03 PM

Providers begin to mandate COVID-19 vaccine for workers

Ginger Christ
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    Image courtesy of Lambeth House.
    Jeré Hales, COO, Scott Crabtree, CEO, and Lynn Swetland, CFO receiving their COVID-19 vaccinations at the same time at Lambeth House.

    The Houston Methodist hospital system is hoping to "lead by example" by mandating the COVID-19 vaccine for all of its workers.

    "At Houston Methodist, we've made a commitment to offer our patients unparalleled safety, quality, service and innovation. When we choose to be vaccinated against COVID-19 we are prioritizing safety by helping stop the spread of this deadly virus and keeping our patients, visitors and colleagues safe," Houston Methodist President and CEO Dr. Marc Boom said in an email to managers.

    In what will be a phased approach, the hospital system is first requiring managers to either get the first dose of a vaccine or get an approved medical or religious exemption by April 15. Next, the vaccine will be mandated for employees, but the system hasn't set a timeline yet, Boom said.

    Already, 95% of the system's management, 100% of its executives and 83% of its employees have been vaccinated, and all new hires face mandatory vaccination, Boom said.

    "As part of Houston Methodist management, we must lead by example and get vaccinated ourselves," Boom said in the email.

    While healthcare providers have administered vaccines to their staffs for months, most haven't mandated employee vaccination. But Houston Methodist and some others say mandatory vaccination is an opportunity to lead the country out of the pandemic.

    "Most folks have been afraid to pull the trigger on that," said Hinshaw & Culbertson Partner Aimee Delaney, who counsels employers, including those in the long-term care industry. "The first question we always get is, 'Can we mandate?' Frankly, I think just as important of a question is, 'Should we mandate?' That may be the tougher question for people."

    Providers who require COVID-19 vaccinations have done their homework, she said. They offer religious and medical accommodations for employees, develop written policies and consult with legal teams. And they communicate clearly with employees about the mandate.

    Lambeth House, a retirement community in New Orleans, had an early cluster of COVID-19 cases in 2020, an "intense" and "emotional" time for staff and residents, said CEO Scott Crabtree, who doesn't like to talk about that period. Today, a banner on the facility's website declares, "At Lambeth House, 100% of our residents and staff received the COVID-19 vaccine."

    Crabtree said it would be "grossly irresponsible" for those in healthcare not to use vaccines to stop the spread of COVID-19.

    "How could we not make that decision given what our industry and our city and our state went through? It really wasn't even much of a deliberation that we had to be all in," Crabtree said.

    While some may consider mandating vaccines a harsh approach, it's actually a compassionate one, Crabtree said.

    "I think the fact that our demographic was the most impacted just left us no other choice. How could we have a tool that could possibly stop the spread for our residents from something that could literally kill them, how could we ignore that and not use that?" said Lambeth House COO Jeré Hales.

    Out of 160 employees, only 10 have chosen not to be vaccinated and have left the company. All of those employees have to opportunity to be rehired if they change their mind, Crabtree said.

    "We hate losing a single employee, especially in today's labor market," Crabtree said.

    Even though the pandemic has exacerbated the healthcare industry's staffing problem, Crabtree said it's worth the added challenge to protect residents.

    "You can't make your decisions based on what's easy," he said.

    Although the numbers are climbing, some healthcare workers have been hesitant to get vaccinated. About 18% of frontline healthcare workers do not plan to get vaccinated, according to a recent survey by Kaiser Family Foundation and The Washington Post.

    Delaney said that when employers are deciding if they should mandate the vaccine, they have to be prepared for the consequences.

    "We have to think through ahead of time what are the consequences for noncompliance, and are we prepared to enforce those?" she said. "Follow through becomes very important."

    Lambeth House had open communication with workers early on in the pandemic about safety precautions and personal protective gear, the leaders said. In the fall, the entire community, residents and staff alike, took a pledge to do everything they could to stop the spread of the virus. Those conversations naturally led to talk about vaccinations.

    "This was just an extension of that," Hales said. "Certainly, I don't want to suggest this was a cake walk. It was not...I think it really came down to drilling down and understanding what the fear was."

    The leadership team told employees back in October, before any vaccines had received emergency-use authorization from the U.S. Food and Drug Administration, that employees would be required to receive vaccines. That gave employees time to do research and ask questions, they said.

    Lambeth House's entire housekeeping department, all of whom are people of color, showed up together to be vaccinated together. "That was so moving. We made the entire department the employees of the month," Crabtree said.

    Image courtesy of Lambeth House
    The Lambeth House housekeeping department waiting to get their COVID-19 vaccines on vaccine day. They arrived together to support each other. (Front, Monica Hall, Environmental Services Director)

    At Houston Methodist, Boom said the system has said for months that vaccination would be mandatory and encouraged managers to start talking to employees about the importance of the vaccine.

    In a frequently asked questions notice, Houston Methodist said the vaccines will become part of workers' annual compliance requirements and that employees will lose their jobs if they do not get the vaccine, unless they have an approved exemption. The hospital said it, similarly, mandated the flu vaccine for employees in 2009.

    Delaney said the flu vaccine offers "some precedent" for mandating the COVID-19 vaccine.

    "Vaccinations for the healthcare industry aren't new, even though COVID and the pandemic are new," she said.

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