By JAN LARSON McLAUGHLIN
BG Independent News
Wood County Health Department is facing a dilemma – lose staff or lose federal funding for its health center.
Health Commissioner Ben Robison reported to the board Wednesday evening that the U.S. Centers for Medicare and Medicaid Services has issued orders that health facilities become fully vaccinated against COVID-19 or risk losing their Medicare and Medicaid reimbursements.
Those reimbursements add up to $843,211 a year – which is 55% of the annual revenue at the Wood County Community Health Center. And that could be just the start of the funding losses, since the eligibility for grants and other money may be cut to facilities that aren’t fully vaccinated, Robison cautioned.
And that would mean an end to the hard fought for community health center that was created to serve the local population of people who had no place else to turn for health, dental care and pharmaceutical services.
“This has weighed on me heavily,” Robison said to the board.
The CMS orders were just released, and leave several questions unanswered, Robison said. The biggest question is whether all Wood County Health Department staff would have to start the vaccination process by Dec. 6, or those just working in the community health center.
The Wood County Prosecutor’s Office has been asked to answer that question by the end of next week, Robison said.
It is clear that any facility will face penalties if they are not in compliance, he added.
If the prosecutor’s office rules that the CMS covers the entire health department, then any staff working in the building – including independent contractors, volunteers, students and health board members – would have to be vaccinated against COVID-19, Robison said.
There are few exemptions. While medical reasons could provide temporary exemptions, the only permanent medical exemption would be an allergy to the vaccine. There are religious exemptions, but few details were available.
Employees who refuse the vaccine without a bonafide exemption would face a two-week unpaid suspension, then termination without the chance to receive unemployment compensation, Robison said.
If the board chose to not require health department employees to be vaccinated, “the impact to the community health center would be extensive,” he said.
Board member Richard Strow, who noted the increasing demands for services at the community health center, asked if the facility could survive such a loss in funding.
It was concluded that survival would be unlikely.
“Like it or not, we couldn’t provide the services without the federal dollars,” Strow said.
Board President Cathleen Nelson spoke of the services provided at the clinic to unserved populations of the county.
“It’s not just the dollars. It’s about the people we are serving,” Nelson said.
“Do we continue to serve the people of Wood County?” Strow said. “Our hands are tied in this matter.”
But board member D.J. Mears said he has no intention of requiring staff vaccinations.
“I have an issue with that,” he said. “I’m not going to force every employee to be vaccinated.”
Instead, Mears suggested that if the prosecutor’s office rules that the vaccination requirement affects the entire health department that may have any contact with the health clinic, that other non-clinic staff be relocated.
Robison explained that doing so would be very difficult, since it must be acted on by Dec. 6. He also cautioned that separating offices would have to be complete – meaning the other staff could never interact with the clinic staff.
“Whatever the board wants us to do, we will do,” but it won’t be easy, Robison said.
Board member Dr. Tom Milbrodt said the vaccination requirement makes sense for a public health agency.
“We really would want everyone to be vaccinated anyway,” Milbrodt said. “They really ought to be anyway.”
But Nelson predicted that some staff will not comply.
“Employees are going to quit rather than get the vaccine,” she said.
Robison explained that the new rules apply to all health related facilities that receive funding from the CMS. That includes hospitals, clinics, and long-term care facilities.
“This is a challenge that’s being faced nationwide,” he said. The expectation nationwide is that 95% of employees will comply, he added.
Robison said he is uncertain how many of the approximately 60 employees at the county health department remain unvaccinated.
“There may be some, not many, that are still on the fence,” he said.
But most of those still unvaccinated have made definite decisions on the issue, and will likely choose to quit rather than get the shot, Robison said.
The CMS order is also being felt at hospitals and nursing home facilities. Under the new rules, the roughly 17 million workers at health facilities that receive federal Medicare or Medicaid will have to be fully vaccinated.
“We all really want our staffs to be vaccinated,” Wood County Hospital President Stan Korducki said last month. “I’m trying to depoliticize it – at least within our organization.”
Wood County Hospital is using factual information to convince employees that getting the vaccine is the smart step, Korducki said.
As of October, Ohio hospitals have reported that 97% of patients admitted for COVID are unvaccinated, and 99% of those who died from the virus did not have the vaccine.
“It says something about the efficacy of the vaccine,” Korducki said. “We’re all about helping patients get well and protecting our staff.”
Korducki said he isn’t sure if some hospitals might welcome a federal mandate, but he added that it is always preferable if people come to the decision themselves rather than through a mandate.
“Most people prefer to be persuaded rather than told,” he said.
It remains unclear how a vaccine mandate will affect the already stretched staffing at hospitals.
“Right now – in America, Ohio, Northwest Ohio – there aren’t enough nurses for the demand,” Korducki said. In addition to nurses, hospitals are short on respiratory therapists and medical assistants.
“None of us have enough of them,” he said.
In September, Wood County Administrator Andrew Kalmar expressed concern about the order that long-term care facilities receiving Medicare or Medicaid must require vaccines – with regular testing no longer being an option.
Nursing homes are already suffering from a labor shortage, he said, and requiring staff to be vaccinated will make it more difficult to fill positions.
“We’re being put in a very tough spot,” Kalmar said.
