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Home Health & Hospice Week

COVID-19:

Providers Struggle To Increase Worker Vaccination Rates

Published on Fri Feb 05, 2021

Some providers are offering cash bonuses, others education.

The rollout of COVID-19 vaccinations has picked up speed, but problems for home care and hospice agencies still persist, ranging from lack of access to worker refusals.

In Florida, many home care and hospice workers are still struggling to access COVID-19 vaccinations. While on paper home care workers are a priority group, in practice interpre­tations of the governor’s executive order on the COVID-19 vaccine have varied by county and resulted in home health workers being turned away at vaccination sites, reports CNN.

Florida has about 80,000 home health workers, says Kyle Simon with the Home Care Association of Florida, and only a “small fraction” of them have been vaccinated more than a month after Gov. Ron DeSantis (R) gave health care workers priority access to the vaccine, CNN says.

On Jan. 29, the Florida Department of Health launched a centralized preregistration system for vaccinations. Simon says he hopes the new centralized system will streamline the process for home care workers and other priority populations. “The county by county piecemeal approach clearly has not worked,” Simon told the news network.

Meanwhile, in areas where home health and hospice workers have better access, agencies face a different problem — workers declining to get vaccinated.

“The vaccines will only be effective if the workforce agrees to take advantage of them,” notes National Association for Home Care & Hospice President Bill Dombi in a letter to members. “Many workers are currently reluctant to do so.”

A lengthy New Yorker article takes a look at nursing assistants who don’t want to get vaccinated. The vaccine “came out too fast,” CNA Tiffany Chance told the magazine. “I think they removed a lot of barriers to get it done faster.” She continued, “I just don’t believe there’s been enough research yet. There’s no way they’ve been studying it for long enough.”

Likewise, “I’m not totally against it,” veteran CNA Kia Cooper told the New Yorker. “But it was so rushed. I want to wait and see how others do.”

Many assistants note that their employers often haven’t given them enough PPE nor granted them hazard pay, among other things. “You have to wonder, Are they doing it for us or are they just trying to make money?” Cooper asked.

“In many cases, vaccine hesitancy is not a lack-of-information problem, it’s a lack-of-trust problem,” David Grabowski, a professor of health-care policy at Harvard, told the magazine. “Staff doesn’t trust leadership. They have a real skepticism of government. They haven’t gotten hazard pay. They haven’t gotten PPE. They haven’t gotten respect. Should we be surprised that they’re skeptical of something that feels like it’s being forced on them?” asked Grabowski, who is also a Medicare Payment Advisory Commission member.

The problem is that building trust takes time — and time is short when it comes to COVID-19 vaccinations.

The list of companies offering bonuses for vaccinations continues to grow. Many grocery stores are offering a quarter or half-day’s pay, reports Fox Business News. Instacart is giving its workers $25.

In Chicago, BRIA Health Services is giving workers $150 for getting vaccinated. “The bonus is definitely appreciated,” BRIA nurse Tanya Tjavaras told the Chicago Tribune.

But some policy experts worry giving cash incentives for taking the vaccine may erode trust in it.

And acceptance seems to be growing anyway. Pat Meade, a nurse at Amita Health Saint Joseph Medical Center in Joliet, Illinois, says her colleagues who were hesitant at first are now signing up for vaccinations after seeing their coworkers handle it successfully, reports the Tribune.

And yet, large swathes of workers are still holding out. And NAHC aims to do something about it.

The trade group “is determined to help our members solve this problem,” Dombi tells members. “We are currently hard at work developing measures to help members effectively communicate with employees about the need to take the vaccine,” h e says.

“Sharing information and best practices among members is one of the reasons NAHC exists, so let’s work together to make home care and hospice stronger and protect our workers and patients,” Dombi exhorts. Agencies can submit their confidential success stories to tom@nahc.org.

Meanwhile, the Centers for Medicare & Medicaid Services is offering tools to help providers achieve higher vaccination rates at www.hhs.gov/coronavirus/education-campaign/index.html.

Tip: Target “‘the movable middle’ by educating those who are hesitant about COVID-19 vaccines so they are ready to get the vaccine when it is their turn,” CMS says. “Both the message and messengers must be credible.”

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