Hospital leaders cautiously optimistic as Washington's vaccine mandate deadline nears

This week marks the deadline for many Washington workers subject to the state’s Covid-19 vaccine mandate to complete their vaccinations, if they haven’t already, or risk losing their jobs later this month.

Roughly 400,000 workers in the state's healthcare sector are subject to the vaccine mandate, according to estimates from Governor Jay Inslee’s office.

Governor Inslee’s mandate requires workers to be fully vaccinated by October 18, meaning Monday, Oct. 4 was the last opportunity for workers to finish a two-dose series, or get the one dose Johnson & Johnson vaccine and be in compliance.

Hospital leaders said Monday they’re cautiously optimistic about vaccination rates among healthcare workers. The Washington State Hospital Association will conduct a survey in the coming week to determine how many workers are out of compliance, and may risk losing their jobs come the deadline.

By the numbers

As of the end of September, several hospital systems in the Seattle area were reporting high compliance. UW Medicine hospitals reported 97% of staff were vaccinated, with compliance upwards of 99% among physicians.

Swedish health services reported 98% of workers were either vaccinated or had an approved exemption, up from earlier in the month.

“If we’ve learned anything over the last several weeks it’s clear that a vaccine mandate works,” said Keegan Fisher, head of HR for Swedish.

Taya Briley is the executive vice president of the Washington State Hospital Association. She said many staff across the state are already vaccinated, and hospitals continue to provide resources and education to those who are not.

“The experience of New York and California suggests that as we get closer to the implementation date, the vaccination rates for hospital staff do go up, and we are seeing some similar trends here in Washington.”

Still, Briley said she’s concerned about potential staffing shortages and the impacts those could have on an already stressed system.

Dr. Tim Dellit, chief medical officer for UW Medicine, said he’s concerned that a loss of staff in areas with lower overall vaccine uptake could have ripple effects.

“We are concerned that, if other hospitals need to not use all their beds because of limited staffing, it does mean that we still need to figure out how to care for those patients and so it will affect all of us, even if we may have higher vaccination rates,” Dellit said.

Another surge of Covid-19 patients, an influx due to flu season, and additional needs from patients who had care delayed due to the most recent Covid surge could all further stress the system, hospital leaders said.

Still, Briley said she expects services to remain open come the October 18 deadline. But she said it’s possible that some areas will have to lower the number of patients they can take.

Exemptions and accommodations

Workers are entitled to exemptions from the vaccine mandate for genuine medical or religious reasons. As hospital systems have prepared for the upcoming deadline, they’ve fielded hundreds of exemption requests.

Not only do they have to consider whether the request can be granted, but they then have to decide whether they can accommodate that unvaccinated worker.

Dr. Tim Dellit said UW Medicine hospitals had received 423 exemption requests as of the end of September, and approved about a third of them.

A number of people who have had their exemptions denied have gone on to get vaccinated, according to Dellit.

Dellit said anyone interacting with patients would require accommodations that go beyond use of protective equipment.

“We would want to have twice weekly testing, we would not want to have unvaccinated individuals working with any of our populations that are immunocompromised,” he said.

Dellit said it can be difficult to accommodate unvaccinated workers in clinical settings. But he said the goal is to retain as many staff as possible.

At Swedish hospitals, less than 3% of their roughly 12,700 caregivers have received an exemption so far, according to Fisher.

Staff losses

Even in hospitals with high vaccination rates, some staff may be lost due to the vaccine mandate.

Keegan Fisher with Swedish HR said they do expect a small number of people to leave come October 18, and they’re putting contingency plans in place to ensure services continue.

At the end of September, less than half a percent of the staff at Swedish were indicating they wouldn’t comply with the mandate, Fisher said.

“Losing anybody right now is a challenge, but we also recognize that every one of our caregivers has an individual choice and a decision to make, and they will do what they believe is right for themselves and their families. And we’re having those conversations to understand their intentions, which helps us plan and ensure that we can provide all of our healthcare services following the October 18th deadline,” Fisher said.

Fisher and leaders at other hospitals said they don’t plan to immediately terminate staff who aren’t in compliance when the deadline hits. They will place them on unpaid administrative leave and continue conversations, encouraging them to get vaccinated and come back to work.

There are still question marks for hospital leaders about what things will look like in the final weeks of October.

For leaders at PeaceHealth, which has hospitals in Washington and Oregon, the answers are slightly clearer.

PeaceHealth implemented a vaccine mandate before the statewide order, giving them a window into what other hospitals may soon be dealing with.

About one percent of their roughly 16,000 workers ended up leaving because of the mandate. And another four percent were granted exemptions, with some still in the process of working out if they can be accommodated.

Dr. Doug Koekkoek is the chief physician officer for PeaceHealth. He said they have not had to curtail any services.

“We’ve had to do a variety of creative things,” Koekkoek said.

They’ve had part time staff flex up to full time, they’ve had people willing to work overtime.

“Probably the biggest factor for us is we’ve brought in agency and locums help, people from Michigan and Louisiana who have been willing to come to the Pacific Northwest and work.”

About 600 temporary staff have joined PeaceHealth hospitals in September.

Staffing has been tight for months across Washington. The state has secured a contract with a national staffing agency to bring healthcare workers in to help alleviate staffing strains, according to the hospital association.

The state is still working to secure federal funding for those staff who may be even more greatly needed if healthcare workers leave come the vaccine mandate deadline.

Deadline approaches for other sectors

Healthcare workers are not the only ones subject to the state’s vaccine mandate. Educators and state workers are also facing the same deadline.

However, some union represented and other state workers will get a little extra time to complete their vaccines, the Governor’s office confirmed this week. For example, if an exemption request is denied.

As of September 20, state data show about 68% of state workers in the executive branch – including agencies like the Department of Health, the Department of Corrections, and the Washington State Patrol – had been verified as fully vaccinated.

That number is up from earlier in September and is expected to rise.

State agencies will have a better sense of how many workers are in compliance with the mandate later this week.