Vaccination as a Condition of Employment: Interview with Andrew Banoff May 6, 2021

Regulation | May 06, 2021 | by Jill Schumann

Andrew Banoff, President and CEO of Jewish Senior Services, joined the LeadingAge Coronavirus Update Call on May 6, 2021.

Andrew Banoff, President and CEO of Jewish Senior Services, joined the LeadingAge Coronavirus Update Call on May 6, 2021. He responded to questions from Ruth Katz and from callers.

Q: You made a decision to require staff to be vaccinated. Please share your thinking.

A: Initially we focused on education hoping that our staff would want to be vaccinated. However, after the first three clinics, 55% of our staff were vaccinated. In February, we announced that by May 1 all staff would be required to be vaccinated as a condition of employment. We continued with education, individual conversations, and small group meetings and we saw an increase in the number of people agreeing to vaccination. Our message was simple – we have to do everything in our power to protect the people we serve.

Q: What are the current percentages of staff and residents who have been vaccinated?

A: Currently, we are at 95% of staff and 97% of residents who have been vaccinated. It is interesting to hear the stories of people who said they never would get vaccinated and the many people who encouraged and helped to influence them. We still have some hold outs. We extended the date a bit because of the Johnson and Johnson vaccine pause. We had some people who had agreed to the one-time J & J vaccine, so we moved the date to the end of May to accommodate them.

Q: What were the logistics of making this happen, particularly after the LTC Pharmacy Partnership had ended?
After the three initial clinics were finished, we used many different approaches to try to make it easy for people to get vaccinated. We had volunteers who helped people schedule appointments and get them to the appointments. We worked with two local hospitals to get groups of appointments of 25 – 50 slots at a time, and we took people to those appointments. Once the state partnered with LTC pharmacies, the pharmacists who came in to vaccinate new residents also vaccinated groups of staff members. Staff members have been supportive of each other and our board and volunteers have been great.

Q: Dr. Vish Viswanath said yesterday that mandating vaccination can be effective in getting “refusers” to comply. What is your thinking?

A: The most vocal of the group who didn’t want to be vaccinated talked about all of the reasons why not to get the vaccine. Many of those reasons involved significant misinformation which we attempted to correct. That group of refusers had to decide whether it was worth losing their jobs and most decided to get vaccinated. We have lost some staff members – about 15-20 people out of 750 employees who will choose to leave their jobs rather than receive the vaccine. We do have some people who have legitimate medical reasons for not getting vaccinated and we will accommodate them.

Q: We have members who indicate that they want employees to get vaccinated in a spirit of trust and understanding. It sounds like you used all of those tools and communication strategies as part of this process?

A: Yes, this has been a very iterative process – truly a Herculean effort. For many people it came down to discussions with their colleagues who wanted to see them get vaccinated and shared their own vaccine experiences. There were discussions in minority communities and among faith communities – it wasn’t just what we did here. Within our organizational culture in every single department we nearly literally held people’s hands while they got their shots. I can’t emphasize enough how important it is for all of us as providers to take this step. It is the only way to deliver the message to our current and future clients that their safety comes first.

Q: What is it like inside a nearly fully vaccinated community? What has changed?

A: It has been so good to see people together again as residents and families were able to be reunited. We can now do activities and meals without masks and without social distancing. It feels a bit like we are approaching the new normal. We feel like the worst is behind us. And we delivered the strong message – clients come first!

Q: What are you hearing from families? Are they requesting that only vaccinated staff interact with their loved ones?

A: The most challenging situations are the home care relationships because they are one-on-one. We can now say that our caregivers are vaccinated. We do have a few unvaccinated home care workers, for medical reasons. In those instances, we can say to a family member – you have had a relationship with this home care provider for a long time and you can choose whether to continue the relationship or not.

Q: How are you dealing with visitors, particularly unvaccinated visitors?

A: We have done informal surveys to learn more about visitor vaccination status. We cannot prevent unvaccinated people from visiting. We are seeing that about 90% of visitors are vaccinated. We set up a plan for green passes for visitors and residents who are fully vaccinated. We still screen everyone when they enter the building, but the green pass process makes visiting more streamlined. We are still restricting activities to residents only and families are not part of dining.

Q: Are more people likely to move in or receive services because your staff is vaccinated?

A: We have had a nearly complete recovery in census in our programs. Adult day, home care and hospice are all back to pre-COVID levels and census is up in residential programs as well. People trust us with their care and we have put their safety first.

Q: Do you think your decision has influenced other providers?

A: The state of Connecticut has been great, including LeadingAge Connecticut and our colleagues there. We share information across organizations, and several us have taken this step. We are proud of our staff and the quality care they provide and we know that people trust us.

Q: What have you learned through this COVID-19 experience?

A: We are more sensitive to issues of communication, family-resident connections, and infection control. Our relationships with state regulators are more collaborative. Within our organization we are all even more emotionally invested in our work because of the pains we’ve suffered together. The future is bright in that those who worked through this together have expanded their trust and collaboration.

Q: A caller asks: Have you been able to replace the staff members you lost?

A: Recruitment has been ongoing throughout the pandemic, so that process has never really waned. We did add some incentives for staff to recruit their friends. Staffing is an ongoing issue as it is for all of us. An upside is that everyone we are hiring is vaccinated.

Q: One member asks: We are 84% vaccinated. Is it worth making vaccination a condition of employment?

A: Yes, absolutely, it only takes one case to create a monster problem; and for ongoing recruitment purposes you send a message that this is a condition of employment for everyone.

Q: A caller asks about the responses of families.

A: The vast majority have been supportive and thankful. There were a couple of families who were concerned about the impact on staff of making it mandatory. One question we did get was about the EUA v. full approval and requiring vaccination. But the concerns were addressed and that was a tiny minority.

Q: Did requiring vaccination and having such strong uptake make a difference in resident and family vaccine uptake?

A: I don’t know, since we had really good resident uptake right from the start. Perhaps they have influenced one another.

Q: Does your organization have policies about vaccination and private care givers, outside home health workers etc.?

A: Everyone is treated exactly the same including our home care staff and also outside agencies. Everyone must be vaccinated. We are working to figure out exactly how to accommodate those staff and other individuals who for medical reasons cannot receive the vaccine.

Q: Are you using less PPE because of vaccination?

A: Yes, utilization has come down anyway since we have had few cases. But, clearly having a high percentage of staff and residents vaccinated has been helpful.