PINEDALE – Deadlines for health-care facilities to comply with vaccine mandates imposed by the federal Centers for Medicare and Medicaid Services (CMS) are forcing clinics and hospitals to weigh tough decisions.
The Sublette County Hospital District (SCHD) Board of Trustees contemplated exemption policies submitted by district administration at its Nov. 17 meeting.
Board chairwoman Tonia Hoffman opened the floor to hear concerns from board members and district employees about the mandate.
Hoffman emphasized the need for the district to be proactive if the federal government clamps down while also accommodating all district employees who may need exemptions.
Pending changes resulting from litigation against the CMS mandate, the agency requires health-care facilities to establish a policy for eligible employees to receive vaccines by Dec. 6, according to its website. By Jan. 4, all employees without an exemption must be fully vaccinated, CMS stated.
Gov. Mark Gordon announced Wyoming would join a multi-state lawsuit fighting the proposed mandate from CMS in a Nov. 10 press release.
Mike Hunsaker, chief operating officer for SCHD and Star Valley Health, said all health-care organizations faced “important and difficult” decisions regarding the vaccine mandate.
Many clinics and hospitals, including the SCHD, depend on funding from Medicare and Medicaid. Refusal to comply with CMS’ mandate would result in the loss of this vital source of funding, Hunsaker explained.
Cutting off Medicare and Medicaid reimbursement would severely limit the ability for organizations like the SCHD to “care for its most vulnerable citizens” and maintain its mission to serve the public, Hunsaker added.
Addressing employees from the clinics and EMS during the meeting, Husnsaker said the last thing he wanted to happen was to lose valued providers and staff over a decision to compel employees to get vaccinated.
“We’re constrained, but we want to do everything we can to keep you as employees,” he told those present at the meeting. “We wouldn’t exist without our staff. It’s a double-edged sword.”
Trustee Wendy Boman stated vaccination was an individual choice and worried a mandate would result in district staff members leaving their jobs.
Board secretary and treasurer Kenda Tanner stressed the need to navigate between retaining district employees and not lose Medicare and Medicaid reimbursement.
Trustee Dave Bell also expressed conflicted feelings about the situation. Bell believed the mandate “ignores everything that is good about America, including the freedom to choose.”
He hesitated to cast a vote to take a stand against the vaccine mandate without knowing the full ramifications to the district’s mission to serve the public if it chose not to comply.
Several SCHD employees rose to speak, representing the clinics and EMS. The overwhelming opinion was to take a stand against CMS’ vaccine mandate. One EMS employee raised concern about the decision-making process to grant exemptions. Another EMS employee stated they would quit if the district complied with the mandate.
Trustees bid to find middle ground
Following an hour-and-a-half executive session, the board reconvened and did not take any formal action to defy CMS’ vaccine mandate.
Hoffman announced that trustees had proposed several key changes to the exemption policy drafted by the SCHD’s administration in response to employee opposition to the mandate.
Hoffman told the Roundup the first modification was removing the weekly testing requirement for exempt employees.
The trustees’ revisions included the creation of a committee selected by the administrative team to oversee the exemption process. The district would adopt a “blind” approval process for exemptions, Hoffman explained, in order to maintain fairness and confidentiality.
The board simplified the religious exemption request forms and limited masking regulations to “current CDC guidelines,” Hoffman added, eliminating “discriminatory” regulations like demanding exempt people mask up at all times once the CDC lifts mask regulations.
Hoffman told the Roundup the hospital district’s attorney and administration were keeping “a close ear to the ground” regarding litigation against CMS.
Thinking outside the box on employee retention
Nationwide medical professional staff shortages are affecting health-care facilities’ operations, including crucial work done in the laboratory.
The SCHD is struggling to fill medical laboratory tech positions while dealing with a significantly increased workload, reported Sharon Rutsch, clinical services coordinator and laboratory director.
Rutsch presented a plan to assist three phlebotomists and a specimen collector already working for the district to pursue associates degrees to become certified medical laboratory techs.
Rutsch told the board she reached out to administration at Casper College and devised an arrangement for the SCHD laboratory employees to receive their medical laboratory tech certification through the college’s distance-learning program.
The requirement for hands-on, laboratory training initially posed a hurdle. Rutsch suggested hosting the labs in the Marbleton Clinic, a fully stocked lab, over the weekends via Zoom, eliminating the need for the SCHD employees to travel to Casper.
Casper College agreed to the terms as long as a certified SCHD medical laboratory tech was willing to proctor the sessions onsite. Rutsch said she and other medical laboratory techs stepped up to volunteer their time to make the program a reality.
Rutsch stated once the laboratory staff became certified medical laboratory techs, they were not only prepared to work in a clinic setting but could use their training in a critical access hospital.
Four SCHD employees already applied to Casper College’s program, Rutsch told the Roundup. Two received federal Pell Grants to help with tuition, Rutsch added.
Rutsch reached out to organizations like BOCES and the Green River Valley Health Foundation to discuss additional funding for the program, she told the board.
The SCHD trustees voted unanimously on a motion to expand their educational assistance program to help five district employees receive additional education.
Dave Doorn, SCHD administrative director, explained to the Roundup the money would be set aside as a backup in case scholarships do not come through or to supplement grants.
Board members thanked Rutsch for her creative thinking to come up with what Bell called an “absolutely wonderful idea” to retain and educate district employees.
“This was a phenomenal move on Sharon’s part,” Hoffman said.