Charles Miller watches TV while having lunch at Beechwood, a nursing home in New London. Family visitation at the nursing home slowly opened up from window visits to in-person visits. Miller was able to meet his wife twice a week. Yehyun Kim /
The state is requiring that nursing home workers be immunized against coronavirus. But the executive order behind that mandate expires soon after the vaccination deadline. AP Photo

Gov. Ned Lamont’s administration announced late last week that the deadline to vaccinate staff at nursing homes and assisted living centers would be delayed until Sept. 27, nearly three weeks after it was supposed to take effect.

But the governor’s emergency pandemic powers expire on Sept. 30, just days after the deadline, leaving limited time to enforce penalties for facilities that don’t comply. Homes that have unvaccinated staff (who haven’t claimed a medical or religious exemption) after the deadline are subject to fines of up to $20,000 per day.

Lamont imposed the mandate for those workers, along with employees of residential care homes, chronic disease hospitals, intermediate care facilities and managed residential communities, in early August. The biggest incentive to comply is the hefty fine.

If Lamont’s emergency powers are not extended by the legislature, the executive order behind the mandate will expire, meaning the state would only have three days to review data submitted by the nursing homes and other facilities, and issue fines.

“Gov. Lamont welcomes legislative involvement in the future of both civil preparedness and public health emergencies,” said Max Reiss, a spokesman for the governor. “If the emergency [powers] are not extended, then those vaccine requirements go away.”

Nursing home leaders said they had recommended pushing back the deadline because they need more time to ensure all facilities are fully compliant and to arrange for additional staffing in the event that workers quit.

As part of the extension, Lamont also resurrected an initiative used last year that allows nursing homes to hire temporary nursing assistants to help boost staffing.

“All along, there has been an underlying concern about staffing, and that issue doesn’t go away, whether [the deadline] is Sept. 7 or Sept. 27,” said Matthew Barrett, president and CEO of the Connecticut Association of Health Care Facilities, which represents 145 of the state’s 211 nursing homes. “There’s still a concern that there will be a disruption … either because people quit as we approach the deadline, or they’re simply unable to provide direct care services because they’re not vaccinated.”

Action needed

If the legislature does not extend Lamont’s emergency powers, it still can codify the vaccine mandate into law. Along with the nursing home edict, a number of other key executive orders are set to expire Sept. 30, including a mask mandate for children in K-12 schools, a requirement that state employees and teachers be fully vaccinated or face weekly COVID-19 testing, and an order that landlords must apply for federal financial assistance for tenants before they can evict them for non-payment of rent.

But whether lawmakers will extend Lamont’s powers or codify some of those rules into law is still up in the air. And there is no timetable yet for when legislators might take action.

“There are some things the legislature could codify for six months in a special act. But I also think there’s a need to continue to give the governor the ability to enforce certain requirements, like nursing home vaccinations for staff. That’s critical,” House Speaker Matthew Ritter, D-Hartford, said. “I think there will be a hybrid” effort.

Legislative leaders will meet in the coming days to discuss next steps. Ritter said maintaining the vaccine mandates is a priority.

“Especially as we get into the winter season, like last year, we could see an increase” in coronavirus cases, he said. “We’re also going to roll out booster shots, which hopefully will be very effective like the vaccines were when they were administered for the first time at nursing homes. We saw a precipitous drop [in cases]. But all that stuff doesn’t matter if there’s no mandate in place.”

For now, officials at the state Department of Public Health say they’re preparing to review the data that nursing homes submit on employee vaccinations and hand out fines if necessary, even if it’s just for three days.

“All long-term care facilities are required to complete attestations on their direct-care staff being vaccinated,” said Christopher Boyle, a spokesman for the department. “DPH will authenticate and complete audits between Sept. 27 and 30 and take any next steps in terms of enforcement.”

Nursing home leaders say they are treating the mandate as though it will continue beyond Sept. 30. Operators are still urging staff to get vaccinated.

“I think everybody’s just assuming it’s going to continue,” said Mag Morelli, president of LeadingAge Connecticut, which represents about 40 nonprofit nursing homes. “I have not heard any pushback that because [Lamont] doesn’t have emergency powers [beyond Sept. 30] that people are saying no, they don’t want to do it. Everybody was working to meet the [original] deadline on Sept. 7. It was a very last-minute postponement.”

Even if the governor’s emergency powers are not extended, the industry will eventually face a vaccine mandate. The Biden administration announced that it would order nursing home workers to be inoculated against coronavirus as a requirement of those facilities continuing to get Medicare and Medicaid payments. A deadline has not yet been set, and details about the requirement are forthcoming.

Another reason nursing home leaders asked for the extension at the state level is because they wanted to learn more about the federal mandate before Connecticut’s took effect to see if they need to reconcile the two.

Seventy-five percent of the state’s nursing home workforce has been immunized against COVID-19, according to data from the Centers for Medicare and Medicaid Services.

“The goal is to put this additional time to extremely good use and go all-hands-on-deck in terms of the ongoing effort to get voluntary compliance across the system,” Barrett said. “We’re definitely moving the dial.”

Jenna is CT Mirror’s Health Reporter, focusing on health access, affordability, quality, equity and disparities, social determinants of health, health system planning, infrastructure, processes, information systems, and other health policy. Before joining CT Mirror Jenna was a reporter at The Hartford Courant for 10 years, where she consistently won statewide and regional awards. Jenna has a Master of Science degree in Interactive Media from Quinnipiac University and a Bachelor or Arts degree in Journalism from Grand Valley State University.