BUFFALO — Johnson County Healthcare Center is preparing for an impending COVID-19 vaccination mandate for its employees after the Biden administration announced its rules for health care facilities and large companies.

The rules announced last week — that require all employees to get the jab by Jan. 4 — would affect the facility's long-term care at Amie Holt Care Center and the hospital.

At last month's meeting of the hospital district board of trustees, CEO Luke Senden said he expects that the healthcare center will lose many of its employees who are not yet vaccinated.

"There's a potential we may need to shut things down in different departments in the facility," he told the board. "Hopefully, it doesn't come to that." 

At this point, Wyoming has one of the lowest percentages (54.3 percent) of its nursing home staff vaccinated against COVID-19 as of mid-October, according to the American Association of Retired Persons. Nearly 38 percent of Johnson County's population is vaccinated, according to the Wyoming Department of Health.

This scenario of potential shortages in medical staff is one that the state of Wyoming was attempting to avoid, and the reason for the Legislature's special session, according to Rep. Barry Crago, R-Buffalo. 

"That was what we were trying to work out down there, was to prevent that from happening," he said. "We're going to lose people from our health care facility, for sure." 

Hours after the Legislature adjourned its special session on Nov. 3 to combat federal vaccine mandates, the White House announced its COVID-19 vaccination rules for health care facilities and large companies.

The Biden administration announced on Nov. 4 that employers who fall under the purview of the federal vaccine mandate - those with more than 100 employees or federal contractors, and those who receive Medicare or Medicaid funding - must have all of their employees fully vaccinated by Jan. 4. 

The rules have changed slightly from President Biden's original announcement. 

For employees of companies with more than 100 workers, there will be a weekly testing option for those who have not received a COVID-19 vaccine. 

However, for health care facilities that receive funding from the Centers for Medicare and Medicaid Services, that same option does not exist. 

Charles Auzqui, Johnson County School District No. 1 superintendent, said he has similar fears as those of the hospital, of losing employees that are essential to operations. 

He said that, ultimately, the school district will await further guidance, from both the federal government and the Wyoming School Boards Association, which will meet next week. But at this point, it remains uncertain how the mandate will impact school districts.

"Input from the community - I want to make that very clear - will be allowed if we have to make decisions related to the new mandates," Auzqui said. "The concern with any type of mandate is the ability to keep the district up and functioning. I personally believe in choice, giving options. If it becomes a mandate, we'll be just like any other district in the state of Wyoming, and just like the local hospital. There will be concerns with how we - if we - can provide the staffing needed to educate our kids. So that is a legit concern."

According to the White House, the federal rules preempt any inconsistent state laws, including those that limit an employer's authority to require vaccination, masks or testing, which have been taken up by some states, including Wyoming. 

One such bill - House Bill 1002 - survived the weeklong legislative session. 

In it, lawmakers will appropriate $4 million to the governor's office for legal action related to the mandate. 

"Public entities," as defined in the bill, are also unable to require employees to comply with COVID-19 vaccine mandates, unless they receive federal funding that would be threatened by noncompliance. 

Sen. Dave Kinskey, R-Sheridan, said he is happy with the exemption in that bill, because public entities such as Johnson County Healthcare Center, which rely on CMS funding, will not be put at risk of losing financial stability.

"We can't risk Biden cutting off Medicare and Medicaid payments," he said. "That's not fair to the hospital or to the people who depend on those. We can't risk Biden cutting off all funding for the National Guard; it's too important to our security. Both receive federal funding, so that was an important exception." 

Crago said he hoped to pass legislation that addressed both public and private entities. The session, he said, was about finding a balance between the needs of employers and employees. 

"We need to find that balance that works for everybody," he said. "On the public side, we got close. We ultimately didn't accomplish anything on the private side as far as trying to balance." 

Gov. Mark Gordon and the state, however, will still attempt to stop the federal mandate through litigation. Wyoming recently joined a 10-state coalition in filing a lawsuit against the federal government that asks the court to declare the mandate unlawful.

"Ultimately, this is going to play out in the court," Crago said. 

In fact, a U.S. federal appeals court in Louisiana issued a stay this past weekend, freezing the administration's efforts for enforcement. The Biden administration asked the court to allow the mandate to proceed and is encouraging businesses to comply with the mandate. 

It's likely that the case will ultimately be heard by the Supreme Court. 

For Crago, the special session may not have amounted to as much legislation as he wanted to see passed, but it gave Wyomingites the opportunity to voice their opinions on the mandate.

"That was the best part, we got to hear all sorts of opinions from all over the board," he said. "We had people who said we've got to do this and fight the government, and others saying we cannot jeopardize our finances at our local hospitals, and we had everything in between. That was the good part, we got to learn a lot." 

Kinskey echoed that sentiment. 

"I've been in (the Legislature) for seven years, and I've never received as many phone calls, emails and texts as I have during this session," he said. "It's great to hear from folks." 

Now that the rules from the federal government are out and lawsuits are underway, Crago said, he expects the issue will come up again at the Legislature's regular session in February.