Will the end of CMS' vaccine mandate ease workforce shortages? 2 experts weigh in

In November 2021, CMS announced a vaccine mandate requiring facilities that receive Medicare and Medicaid funding to ensure staff are vaccinated against COVID-19, save for medical or religious exemptions. Now, with the imminent end of the mandate, Becker's spoke with experts to gain greater insights about what the decision could mean for hospital workforces.  

The Biden administration announced May 1 that it would end COVID-19 vaccine requirements for employees of CMS-certified healthcare facilities. The administration also announced it would drop COVID-19 vaccine requirements for federal employees and contractors and international air travelers May 11 — the same day as the end of the COVID-19 public health emergency

The CMS mandate has been the subject of challenges by some states, and more than a dozen states continued to petition against the rule even after the Supreme Court declined to consider the challenge. Meanwhile, some health systems fired workers for noncompliance, and some workers resigned or quit. 

Here, Todd Walrath, CEO of ShiftMed, a staffing platform that connects 350,000 healthcare professionals with jobs at healthcare facilities each quarter, and Stoel Rives Partner Brenda Baumgart, chair of the Portland, Ore.-based law firm's labor and employment group, discuss the mandate and the potential effects of the end of the rule.

Mr. Walrath estimates up to 90 percent of ShiftMed's workforce received the initial vaccine. 

"In the beginning, it was only about 10 percent, maybe 11 percent, who could previously pick up shifts and then weren't able to pick up shifts in our workforce," Mr. Walrath said.

He said fewer workers received boosters than the initial vaccine, which, along with various other pandemic-related factors, also affected the ShiftMed workforce. Some workers stopped doing bedside care, other workers began working in home health, and some workers left healthcare temporarily or altogether. 

With CMS dropping the requirement, ShiftMed is "excited about it, but we're pretty pragmatic," Mr. Walrath said. He estimates a single-digit boost in the percentage of healthcare professionals picking up shifts through the platform.

"We think we have a long way to go before all the needs are met," Mr. Walrath said. "There continues to be more and more patients every day who need care [as baby boomers age]."

"I would argue that we're not even in the first inning of the amount of people who are going to need care. And what we're trying to do at ShiftMed is provide flexibility, especially for part-time workers."

He said the idea is to create a local option of a pool of part-time workers that is available to hospitals and health systems to help fill staffing gaps.

Hospitals and health systems have long been grappling with staffing shortages, and these shortages don't appear to be going away. There are various reasons for this, including a generational gap as well as burnout and turnover.

Ms. Baumgart, who primarily represents healthcare clients, views the rollback of the CMS mandate as another step in an unprecedented time for hospitals and health systems. 

Through it all, these organizations are trying to balance a staffing shortage with ensuring safety of the public and patients, she said.

Some states have already ended their own vaccine mandates for healthcare workers. Oregon ended its mandate on May 11 to coincide with the end of the COVID-19 public health emergency. Beginning April 3, California ended its vaccination requirement for healthcare workers, including those in adult care, direct care, correctional facilities and detention centers. And Washington ended its rule last fall.

With the end of the CMS mandate, health systems are considering whether it's prudent to bring back some or all of the workers who they parted ways with because the workers were unable to comply with the vaccine requirement, Ms. Baumgart said.

"And if they do so, they're looking at the safety protocols or obligations" that could be involved, she said. 

Some healthcare organizations also decided to put employees on a leave of absence if they were unable to comply with the vaccine requirement. 

"And if that's a situation that employers are facing, then they are evaluating the circumstances," Ms. Baumgart said. "Might these employees have reinstatement rights? That would depend on the circumstances of their leave. It also may depend on the terms of any applicable agreement such as the collective bargaining agreement [with a union]."

She said she has talked with some health systems on the West Coast that have announced they will be returning unvaccinated employees to work who have maintained their status of unpaid administrative leave. 

Such systems are imposing additional safety requirements on unvaccinated employees, she said.

Additionally, healthcare employers have modified their hiring practices to comply with the CMS mandate or state mandates. Ms. Baumgart said they're looking at how they might need to change those hiring practices moving forward.

"Like any employee policy, announcing those changes prospectively is prudent," she said.

Overall, she said she doesn't see the end of the CMS mandate meaning the end of the healthcare staffing shortage. She also expects litigation to continue with lawsuits related to vaccine exemptions during the pandemic. 

"The rollback of the mandate will not impact pending litigation because, of course, those decisions are going to be governed by the law in effect at the time," Ms. Baumgart said. 

Hospitals and health systems said they continue to consider any next steps.

"We are evaluating the impacts of this announcement, and will determine what the best next steps are to help keep the Providence family of organizations' facilities safe for employees, patients and their families," a spokesperson from Renton, Wash.-based Providence told Becker's earlier this month.

A spokesperson for Reno, Nev.-based Renown Health said: "Renown Health extends sincere gratitude for every employee and provider who joined us in facing the uncertainty of the COVID-19 pandemic. We are prepared to return to vaccination standards prior to the pandemic and look forward to this next chapter of caring for our community."

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