State Workforce Strategies

States are addressing the workforce challenges of the COVID-19 pandemic. Below are links describing their efforts.

(09/21/21) Washington State Seeks 1,200 Health Care Workers for COVID-19 ‘Hospital Crisis’
The governor of Washington, Jay Inslee, has requested help from the federal government to staff hospitals and long-term care facilities amidst recent surges in the delta variant of the coronavirus. Both clinical and non-clinical positions are needed as addressing surge capacity continues to be a challenge for the state.

(09/16/21) State Pursues Fixes to Deal With Health Care Workforce Shortage
Due to a chronic workforce shortage in hospitals and clinics coupled with staff losses since the COVID-19 pandemic, the healthcare system in New Hampshire has been strained. In response to the re-surge of COVID-19 cases, the state administration is planning to extend the executive order that has allowed health providers with an out-of-state license working without going through the licensing process of the state and considering mobilizing National Guard troops or other state workers.

(09/10/21) ‘World Is on Fire’: Kentucky Health Care Workers Exhausted Amidst Latest COVID-19 Surge
Hospitals in Kentucky are struggling to address surge capacity as Governor Andy Beshear claims the COVID-19-related hospital situation in the state is the worst in a lifetime. New weekly records of cases and high rates of hospitalization for unvaccinated individuals is contributing to burnout and fatigue among health care workers, as well as requiring the Kentucky National Guard and the Federal Emergency Management Agency to deploy at hospitals throughout the state.

(08/27/21) New York State Removes Religious Exemption From COVID-19 Vaccine Mandate
This article from Becker’s Hospital Review discusses New York state’s newly approved emergency regulations for health care workers which will supersede previous requirements. The previous emergency regulations permitted health care workers to receive medical and religious exemptions from the vaccination requirement. However, religious exemption from the vaccination requirement was removed and additional institutions were included in the mandate. Health care workers at hospitals and nursing homes are still expected to receive their first COVID-19 vaccination dose by September 27, 2021, but workers at newly added institutions have until October 7, 2021.

(08/27/21) Mississippi Now Has at Least 2,000 Fewer Nurses Than it Did at Start of Year
Mississippi is facing a severe statewide nursing shortage largely due to COVID-19 pandemic related stressors. According to Kim Hoover, PhD, RN, COO of the Mississippi Hospital Association, the nursing workforce lost 2,000 actively licensed registered nurses in a 7-month period. Hospitals have since requested more than 1,400 health care workers from the state in efforts to address the latest surge of COVID-19 cases and hospitalizations.

(08/26/21) South Carolina Health System Boosts Temp Hiring Amid Greater Vaccination Demand
Tidelands Health is a South Carolina based health system with four hospitals and more than 60 outpatient locations. In efforts to meet the rising demand for COVID-19 vaccinations, the health system is hiring more than 100 temporary workers for its regional vaccination sites and has more than 200 permanent jobs available, including positions for nurses.

(08/26/21) How Have States Used Medicaid Emergency Authorities During COVID-19 and What Can We Learn?
This brief from the Kaiser Family Foundation summarizes how states have used Medicaid emergency authorities in efforts to address the COVID-19 public health emergency. All 50 states and D.C. were approved to authorize temporary regulatory changes to their Medicaid state plans which impacted providers, beneficiaries, and long-term services and supports. Subsequently, states implemented policy changes to facilitate expanded access to Medicaid coverage, expand benefits for beneficiaries, and increase reimbursement for provider

(08/18/21) US to Require Nursing Home Employees to Get COVID-19 Shots
President Joe Biden and his administration has announced that it will require nursing home employees to receive the COVID-19 vaccination as a condition of employment at health facilities participating in Medicare and Medicaid programs. This announcement has come as the delta variant continues to spread and the vaccination rates among health care workers in nursing homes remains stagnant.

(08/18/21) Gov Polis Seeks Vaccine Requirement for Health Care Workers
This article highlights the efforts of Governor Jared Polis of Colorado state to increase the vaccination rates of health care workers at Colorado facilities who serve vulnerable populations and provide essential medical care to patients. Polis has written a formal letter to the state Board of Health asking the state Board of Health to add COVID-19 vaccination requirements for health care workers to their emergency rules.

(08/16/21) Cuomo: All New York Hospital, Health Care Workers Must Get COVID-19 Vaccine
A new executive order issued by New York Governor Andrew Cuomo mandates all staff working in hospitals and long-term care facilities in New York State will be required to be vaccinated. This order follows significant increases in COVID-19 cases across the US and in New York, with more than 80 percent of recent COVID-19 cases in New York linked to the Delta variant.

(08/12/21) HHS to Require COVID Vaccine for Agency Health Care Workers
The United States Department of Health and Human Services have recently implemented a COVID-19 vaccination mandate for its clinical and research staff. This requirement applies to all Indian Health Service and National Institutes of Health who interact with patients and serve federally operated health care and clinical research facilities.

(08/11/21) Rhode Island, Pennsylvania Order Vaccination of State Healthcare Workers
Rhode Island and Pennsylvania states have recently implemented COVID-19 vaccination mandates for state healthcare workers. Governor Tom Wolf of Pennsylvania has set a deadline of September 7, 2021, for full inoculation and has also required new hires to be fully vaccinated prior to beginning employment. Governor Dan Mckee of Rhode Island has set a deadline of October 1, 2021, for full inoculation but will allow medical exemptions from the vaccine requirement. Employees that refuse the vaccine will have the option to undergo weekly COVID-19 testing in Pennsylvania and bi-weekly testing in Rhode Island.

(08/10/21) Washington Requires COVID-19 Vaccine for Healthcare Workers, State Employees
Washington State Governor, Jay Inslee, has implemented an executive order which requires all healthcare workers to be fully vaccinated by October 18, 2021. Healthcare workers are expected to receive their second COVID-19 vaccination dose by October 4, 2021, in order to reach full inoculation by the proposed deadline. Employees that do not comply with the emergency proclamation will risk termination.

(08/02/21) NJ Gov. Murphy Mandates Vaccines for State Health-Care and Other Front-Line Workers
New Jersey Governor, Phil Murphy, has released a COVID-19 vaccination mandate for state health care workers and other front-line workers. The deadline for staff in hospitals, corrections facilities, and assisted living facilities to get vaccinated is September 7, 2021. Unvaccinated employees will be required to get tested for COVID-19 twice a week.

(07/28/21) California Mandates COVID-19 Vaccination for Long-term Care Workers
California Governor, Gavin Newsom, has released a COVID-19 vaccination mandate for long-term care workers and workers in other health care settings. Long-term care workers will be required to get vaccinated or participate in weekly COVID-19 testing. The mandate will take effect on August 9, 2021, and healthcare facilities will have until August 23, 2021 to become fully compliant.

(07/28/21) Governor Cuomo Announces Patient-Facing Healthcare Workers at State-Run Hospitals Will Be Required to Get Vaccinated for COVID-19 by Labor Day
Governor Andrew M. Cuomo has recently made an announcement that patient-facing healthcare workers at state-run hospitals will be required to receive the COVID-19 vaccination by Labor Day, September 6, 2021. Patient-facing healthcare workers who do not get vaccinated will not have the option to be tested for COVID-19 on a weekly basis.

(07/21/21) Mayor de Blasio Announces Health Worker COVID-safe Requirement
Mayor de Blasio has announced a new policy which will take effect on August 2, 2021. The Health Worker COVID-Safe Requirement policy will require all employees of city-run health care facilities to provide proof of vaccination or to take weekly COVID-19 tests.

(07/21/21) As COVID-19 Continues, So Do Troubles for Nurses
The COVID-19 pandemic has exacerbated existing nursing shortages across the nation. However, New Jersey nurse unions have expressed severe concerns as their members continue to face burnout amid steady COVID-19 related hospitalization rates. These nurse unions believe that suspended regulations which govern nurse staffing ratios and hospital scheduling contribute to these conditions.

(07/14/21) OSHA Maintains COVID-19 Safety Pressure on Healthcare Employers Despite Challenges From All Sides
Following the announcement of the Occupational Safety and Health Administration’s COVID-19 Emergency Temporary Standard rules, comments have come in from both employers and unions criticizing the ruleset and questioning the effectiveness. Health care organizations want more time to implement the ruleset, while health care labor unions question the ability of the new rules to address safety concerns.

(07/08/21) States Use Appendix K and Emergency Waivers to Support Home- and Community-based Services in Response to COVID-19
This tool from the National Academy for State Health Policy helps identify how states are utilizing Appendix K and emergency waivers to modify home- and community-based Medicaid services during the COVID-19 pandemic.

(07/08/21) Too Much, Too Late: Health Groups Pan OSHA Rule on COVID Precautions
As hospitals work to return to a pre-pandemic normal, some COVID-19 pandemic-era restrictions appear to be here to stay, given new direction from the Occupational Safety and Health Administration.

(07/07/21) OSHA Provides Inspection Guidelines on COVID-19 Health Care Safety Rule
The Occupational Safety and Health Administration (OSHA) has released new inspection guidelines and enforcement policies for health care employers impacted by the new COVID-19 safety rule. This article from the Society for Human Resource Management discusses the urgent need for health care employers to ensure that their workplace pandemic plan is ready for review and provides additional articles that expound on the emergency temporary standard.

(06/24/21) Times Are Changing: MIOSHA Rescinds COVID-19 Emergency Rules and Adopts Rules for Healthcare Workers
This article from the National Law Review discusses the Michigan Occupational and Health Administration’s decision to rescind its COVID-19 Emergency Workplace Rules which were previously issued on May 24, 2021. MIOSHA has simultaneously announced its adoption of the Federal OSHA Emergency Temporary Standards for health care employers.

(06/24/21) Nevada OSHA Adopts Federal OSHA’s COVID-19 Healthcare Emergency Temporary Standard, Issues Updated COVID-19 Guidance for All Other Businesses
The Nevada State Department of Business & Industry’s Division of Industrial Relations has announced its adoption of the U.S. Department of Labor’s OSHA COVID-19 Healthcare Emergency Temporary Standard (ETS). The Healthcare ETS establishes new requirements for healthcare employers which are effective July 1, 2021. Healthcare employers must comply with most provisions within 14 days and the remaining provisions within 30 days. Nevada OSHA has also updated its Guidance for Business Operations under the State of Nevada’s Declaration of Emergency for all non-healthcare businesses throughout the state effective June 24, 2021.

(06/23/21) OSHA Healthcare COVID-19 Requirements Take Effect
This article from the National Law Review provides an in-depth explanation of the Occupational Health and Safety Administration’s (OSHA) COVID-19 safety requirements for health care employers. OSHA’s Emergency Temporary Standard for COVID-19 requirements for the health care industry has officially taken effect on June 21, 2021. Most of the requirements must be followed by July 6, 2021, but some requirements such as the installment of physical barriers, improved ventilation systems, and employee training must be implemented by July 21, 2021.

(06/22/21) New York Requires Hospitals to Create Clinical Staffing Committees
New legislation from New York State requires hospitals in the state to develop clinical staffing plans, under the control of clinical staffing committees. These committees will include registered nurses, licensed practical nurses, ancillary staff members, and hospital administrators, in an attempt to address difficulties with allocation of staff and resources during the COVID-19 pandemic.

(06/21/21) Baker-Polito Administration Announces Medicaid Investments in Federally Qualified Community Health Centers
In June, the Governor and Lieutenant Governor of Massachusetts announced new investments to Federally Qualified Community Health Centers (FQCHs) through Medicaid payments, in response to the increased community health care needs during the COVID-19 pandemic. The Executive Office of Health and Human Services (EOHHS) also announced a new funding of $3.1 M that will support community health centers’ projects for vaccination and disadvantaged populations. The funds will be used to expand the coverage of medical care and address health disparities in the state.

(06/17/21) Audit Finds Telehealth Services for Mental Health May be at Risk
New York State’s COVID-19 state of emergency has enabled rapid expansion and adoption of telehealth services, however, without action from the state, hundreds of providers will no longer be able to provide services via telehealth once the state of emergency ends.

(06/03/21) COVID-19 Case Investigation and Contact Tracing in the US, 2020
A new study published in JAMA investigates COVID-19 contact tracing in the United States between June and October of 2020. The primary conclusions were that contact tracing was suboptimal in preventing COVID-19 transmission due to just one-third of positive cases being contacted and even fewer naming contacts.

(06/03/21) Why Contact Tracing Couldn’t Keep Up With the US COVID Outbreak
Surveys from the Johns Hopkins Center for Health Security were conducted five times to measure the contact tracing workforce of state and territorial health departments in the United States over the course of the pandemic. These surveys found that while the contact tracing workforce peaked in the US in December 2020, the US was never capable of keeping up with the need for contact tracing to make it most effective.

(06/02/21) California Bill Would Give Healthcare Workers COVID Bonuses
A new bill under consideration in California would require hospitals, clinics, and long-term care facilities to pay medical workers $10,000 bonuses for working during the COVID-19 pandemic. While private facilities and their advocacy groups are concerned about the cost of such action, the bill seeks to address burnout in workers and both California and the federal government may offer funds to pay substantial portions.

(05/20/21) New State Law Requirements for Health Care Worker Protections During A Declared State of Emergency
This memo from the Washington State Hospital Association highlights the requirements put into law for health workforce protections as a result of the COVID-19 pandemic and the declared state of emergency to deal with it.

See More Resources