ALBANY — At Champlain Valley Physicians Hospital in Plattsburgh, administrators are trying to fill 219 vacant jobs, 85% of which are for positions providing direct care to patients.

But administrators say the labor shortage could soon become even more challenging to handle due to a looming mandate that forces all New York health care employees who are not vaccinated against COVID-19 to get the shots or stop showing up for work.

“New York State’s Covid vaccine mandate will surely compound the crisis,” Michelle LeBeau, Champlain Valley’s president, said in an open letter to the community this week.

The situation is much the same at other hospitals throughout the upstate region, said Gary Fitzgerald, president of the Iroquois Healthcare Alliance, which represents some 50 hospitals and health centers.

The deadline for compliance with the state’s vaccination mandate is Sept. 27, and many health care workers remain adamantly opposed to getting vaccinated, Fitzgerald said.

“Things are getting worse by the day,” Fitzgerald told CNHI, noting his organization has asked the state Department of Health to examine the repercussions of going forward with the vaccination mandate.

“Everything is slowing down because of the staffing problems,” Fitzgerald said. “They can’t accept patients from other, smaller hospitals. They just don’t have the capacity. It’s not that they don’t have the space. It’s that they don’t have the staff.”

Speaking to reporters in Albany this week, Gov. Kathy Hochul called the mandate “smart,” suggesting it has helped to spur some previously reluctant health care workers to get vaccinated.

“So we are having the effect we want,” Hochul said, while also acknowledging that “there will be some individuals who will try to defy this.”

Fitzgerald said the mandate has indeed prompted some hospital staffers to get the shots so their jobs will not be affected.

However, he also noted, surveys taken at hospital suggest the pool of unvaccinated staffers is not spread out evenly across the workforce. Instead, those individuals are often clustered together in the same units, raising the risk that certain specialties — maternity services, for example — will be hit hard by the mandate even as nearby units weather the impact.

Data collected by Iroquois from some 50 health care facilities along with statistics added by Rochester region hospitals show the upstate area with 2,311 vacancies for registered nurses, along with an additional 87 vacancies for registered nurses at long-term care facilities.

The health employers reported an additional 578 vacancies for physicians, 172 openings for imaging technicians, 150 job vacancies for respiratory therapists and 145 vacancies for medical technologists.

“The hospitals are doing everything they can think of to get more people vaccinated,” Fitzgerald said. “They are bringing in doctors to talk to the staff. We are pulling out all the stops. But every day, the hospital CEOs are becoming more worried about whether they will be able to provide needed services.”

Hochul said hospitals are required to have plans to deal with staffing emergencies.

“What if a mass flu hit a hospital and they had a staffing issue?” she said. “They need to prepare for this. But I’ll be there to help with the Department of Health.”

In a letter last week to Dr. Howard Zucker, the state health commissioner, Fitzgerald said the rate of unvaccinated hospital staffers in the upstate region ranges from a high of 38% to a low of 9.5%.

Meanwhile, questions are swirling about whether the vaccination mandate will be extended to direct care workers and support staff who assist individuals with developmental disabilities.

J.R. Drexelius, government relations counsel for the Developmental Disability Alliance of Western New York, said the organizations in that umbrella group are awaiting a decision from the state Office for People With Developmental Disabilities.

“We are concerned that if you mandate the vaccine, given the staffing shortage we have now, things will get worse, not better,” he said. “Having said that, we want to protect our folks. And the best way to protect our folks is if everyone gets vaccinated.