SUBLETTE COUNTY – 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 and procedures submitted by district administration at its Nov. 17 board meeting.

Board chairwoman Tonia Hoffman opened the floor to hear concerns from board members and district employees. Hoffman emphasized the need for the district to be proactive if the federal government clamps down while accommodating all district employees who may need exemptions.

Hoffman explained the hospital district struggled to define itself within the federal guidelines. The clinics are not hospitals, yet the district provides comprehensive services beyond what is available at many providers’ offices.

Pending changes resulting from litigation against the Centers for Medicare and Medicaid Services’ mandate, the agency requires 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 in a Nov. 10 press release that Wyoming would join a multi-state lawsuit against CMS’ mandate.

Mike Hunsaker, chief operating officer for the 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 and Star Valley Health, depended on funding from Medicare and Medicaid. Refusal to comply with the CMS’ mandate would result in the loss of this vital source of funding, Hunsaker explained.

Once Medicare and Medicaid sources were cut off, the ability for organizations like the SCHD to “care for its most vulnerable citizens” and maintain its mission to serve the public would be severely limited, Hunsaker added.

Addressing employees from the clinics and EMS at the meeting, Hunsaker said the last thing he wanted to happen was to lose valued providers and staff over a decision to compel employees to get vaccinated.

Hunsaker understood employees’ and administrators’ desires to “dig in their heels” and fight the mandate.

“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 her opposition to the mandate, arguing that vaccination was an individual choice. Boman added her primary worry was losing district employees.

Board secretary and treasurer Kenda Tanner stressed the need to navigate a way to retain district employees without losing Medicare and Medicaid reimbursement.

Trustee Dave Bell also expressed conflicted feelings about the situation. Bell believed vaccination was a personal decision and the mandate “ignores everything that is good about America, including the freedom to choose.”

He questioned whether the time was right for the district to “dig in its heels,” however. He hesitated to cast a vote to take a stand against the mandate without knowing what the full ramifications would be to the hospital 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.

An EMS employee stated her biggest concern was over what kind of procedures the SCHD planned to put in place to grant exemptions to the mandates and how the procedures would be carried out.

Another EMS employee stated that they would quit if the district decided to comply with the mandate.

Trustees’ bid to find middle ground

Following employee testimony and an hour-and-a-half executive session, the board reconvened and did not take formal action to defy the vaccine mandate.

Hoffman announced that the trustees had proposed three key changes to the vaccine policy and exemptions drafted by the SCHD’s administration in response to employee opposition to the mandate.

Hoffman told the Examiner the first modification was removing the requirement that exempt employees receive weekly testing.

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 requiring exempt people to mask up at all times once the CDC lifts masking regulations.

Hoffman told the Examiner the hospital district’s attorney, Hunsaker, and the district’s administrative director, Dave Doorn, were keeping “a close ear to the ground” on litigation against CMS and any changes that might take place to the federal mandate.

USDA application update

The SCHD received written notification that its $32-million loan application through the U.S. Department of Agriculture to construct a critical access hospital received the stamp of approval at the state level.

Lorraine Werner, USDA program director for rural development, sent the application to the next stage, Doorn told the board on Nov. 17.

The next step is for the application to undergo a regional review before it is presented to the national loan committee for final approval, Doorn said.