West Texas healthcare providers grapple with new federal mandate requiring staff COVID vaccination

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FAR WEST TEXAS – Amid staffing shortages and vaccine hesitancy, some local healthcare providers are reluctant to implement mandatory vaccine policies ahead of a federal mandate that goes into effect in October.

Earlier this month, President Joe Biden announced that vaccines would become mandatory for all staff at healthcare facilities that accept Medicare and Medicaid. That expanded the requirement on nursing homes to now include hospitals, home healthcare providers, dialysis facilities and more. Failure to comply could lead to the withdrawal of Medicare funding.

Meanwhile, Texas Governor Greg Abbott plans to fight the mandate, having already banned public hospitals in the state from enacting vaccine requirement policies.

Last week, the Big Bend Regional Medical Center, the only hospital within the tri-county area, announced it is taking “new federal requirements seriously and have begun efforts to comply,” hospital spokesperson Ruth Hucke said. 

The facility is privately owned by Quorum Health and not subject to Abbott’s bans. Big Bend Regional Medical Center supports COVID-19 vaccines as one of the most effective measures against the pandemic,” Hucke said. “As we have throughout the pandemic, we continue to monitor developments and follow federal guidelines.”

Medical Center Hospital in Odessa –– which receives transfer patients from the tri-county and has recently served Presidio and Alpine residents hospitalized with COVID-19 –– has been more reluctant to implement the mandate. In a letter to employees, Russell Tippin, the Medical Center Health System President and CEO who oversees MCH in Odessa, wrote, “While we HIGHLY encourage all of our employees to be vaccinated against COVID-19 (more than 60-percent are fully vaccinated), this is NOT a decision that we want to be forced upon our employees by federal leadership.”

“As a healthcare facility that receives Medicare and Medicaid funding, not complying with this mandate would put us in a dire financial situation,” Tippin wrote. 

It was a message echoed by others, including Preventative Care Health Services CEO Linda Molinar. “The majority of our patients are using Medicaid and Medicare. To lose those patients, it’s not an option, those patients are the reason we’re here,” she said in an interview last week.

PCHS, a federally qualified health center that has clinics in Alpine, Marfa and Presidio is also waiting for the final implementation of the new rule to decide how to proceed. “We currently don’t require our staff to be vaccinated,” said Molinar. While she said most of the staff are vaccinated, “We’re still waiting for the last ruling to see what they say so we can come up with some kind of policy to put in place. We don’t force our staff or require them.”

Tippin of MCH isn’t just waiting for the final directive, however. The Odessa hospital plans to exhaust “all of our resources to determine how to approach this situation and a FINAL decision has NOT been made by hospital leadership and the Ector County Hospital District’s Board of Directors. We are already in the process of consulting with legal experts, as well as local, state and federal agencies to determine our rights and abilities under this federal mandate,” Tippin told employees.

Other privately run facilities in the tri-county area like the Marfa Clinic and Agave Home Health were already in compliance when the mandate was announced, with their staff fully vaccinated. Cynthia Kirkpatrick, the clinical manager for Agave Home Health, said, “I can tell you that we actually are fully vaccinated and we had done that prior to that order. It was all on a volunteer basis. Everyone was great, they just stepped up and volunteered.”

In contrast to some of the smaller facilities, those with a larger share of employees have struggled with vaccination rates and maintaining a full staff during the pandemic.

“During the most recent surge in cases, we experienced the same staffing concerns as hospitals around the country,” said Hucke of BBRMC. Molinar concurred, saying that the already existent staffing shortage in her facilities could be exacerbated with the new mandate. “We have a staff shortage, so if there’s another requirement on top of everything, of course it’s going to get more difficult,” she said.

Tippin shared the concern. “We understand that this mandate would affect roughly 40-percent of our employees, and if forced upon us, we know that we would inevitably lose a valuable portion of our staff – a loss that would be unimaginable in our current shorthanded situation,” he wrote earlier this month.

Another shared sentiment among the facilities is an uncertainty about how it will be implemented. Tippin believed there would be no alternative option like regularly scheduled testing for those refusing the vaccine. Hucke said BBRMC was “unclear if there will be a weekly testing alternative or other exception to the federal requirement, as our many states allow.” More information is expected to arrive in October to clarify.

Molinar of PCHS said, “I hope we don’t lose anybody and I hope it doesn’t affect recruiting, but we don’t have a choice.” The facility relies so heavily on Medicare and Medicaid patients, that to lose that funding would be too dire a consequence.

The Centers for Medicare and Medicaid Services (CMS) will issue an interim final rule with a comment period in October, expecting healthcare workers and support staff to immediately begin the process of getting vaccinated if not already.

“There is no question that staff, across any health care setting, who remain unvaccinated pose both direct and indirect threats to patient safety and population health,” said U.S. Department of Health and Human Services Secretary Xavier Becerra in a news release about the coming mandate. “Ensuring safety and access to all patients, regardless of their entry point into the health care system, is essential.”

The White House’s new directive comes during the continued spread of the delta variant of COVID-19 throughout the United States. According to the Texas Tribune, on average, over 250 Texans have died every day for the past 30 days from COVID-19.

According to CMS, data shows that higher vaccination rates among healthcare providers and staff correlate to lower infection rates among patients who see them for care.

“Now is the time to act,” said CMS Administrator Chiquita Brooks-LaSure. “I’m urging everyone, but especially those fighting this virus on the front lines, to get vaccinated and protect themselves, their families, and their patients from COVID-19.”


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