GILLETTE — The Campbell County Health COVID-19 vaccine policy implemented this week will pose the decision to the organization’s 1,100 or so employees to either get vaccinated, file for a religious or medical exemption or lose their jobs.
Although exact vaccination figures for CCH employees are unclear, it is believed that about 40 percent of the organization is already vaccinated against COVID-19, leaving more than half of CCH employees to decide between the vaccine or their jobs.
In discussing the COVID-19 vaccine policy this week, hospital board trustees identified the religious exemption as a possible out for employees who want their jobs, but not the vaccine.
But that raises other concerns about the morality and ethics of using religion to avoid a vaccine that has carried political and social resistance from many.
“It’s one of those deals that morally and ethically, it feels dirty, 100-percent dirty,” said trustee Alan Stuber. “When we, a couple months ago, sat there and said we’re going to stand strong and stand up for the employees, I meant it. I can’t speak for anyone else or say they don’t want to, but to me, it just feels fake.”
The medical exemptions are very limited and specific in which conditions may apply. The religious exemption stipulates that the applicant hold a “sincere” religious belief that conflicts with taking the COVID-19 vaccine. It also requires the employee to agree that the conflict is religious and not a social, political, economic, personal or non-religious view.
Stuber was the lone trustee to vote against the approval of the vaccine policy Tuesday night. Prior to that, he motioned to table the vote until Dec. 2. That motion ultimately failed.
CCH employees will have to receive their first dose by Dec. 6 and have both shots by Jan. 4, unless they seek and are approved for a medical or religious exemption. The CCH policy came in response to federal Centers for Medicare and Medicaid Services guidelines requiring health care workers be vaccinated against COVID-19.
The state of Wyoming and nine other states filed a lawsuit Wednesday challenging the newly announced CMS health care requirements, but it is unclear what impact that could have or how long that could take to play out. Prior to the lawsuit being filed, hospital attorneys said that overturning the CMS requirements is very unlikely.
Approving the CCH policy within the CMS requirements was a necessary step to having the hospital stay open, said hospital board Chairman Adrian Gerrits.
“I don’t want to (mandate vaccinations) anymore than the next guy,” Gerrits said. “We can talk about what we’re going to do with employees that quit. We have lots of troubled waters ahead of us but all of that is a moot point if CMS shuts us down.”
Trustees had a lengthy discussion Tuesday night after Stuber motioned that the hospital board table the vote on the vaccine policy until the next regular board meeting on Dec. 2, leaving only a few days before the Dec. 6 CMS deadline for employees to receive their first shots.
Trustee Tom Murphy seconded the motion, which led to a roughly 30-minute conversation among trustees, administrators and attorneys.
“I’m still very uncomfortable with having our employees having to sign a form or a religious exemption or anything of that,” Stuber said at the meeting. “Our employees are scared, they’re overworked right now. I feel morally and ethically this is very wrong.”
Stuber said it could “buy us more time” to see if any federal changes occurred, upending or changing the CMS mandate.
Attorney Alison Ochs Gee said that although the OSHA rulings requiring vaccinations for some companies has been challenged, the CMS guidelines are not vulnerable to the same legal action. It would be up to the states to sue the federal government over the health care worker mandates.
However, on Wednesday, 10 states, including Wyoming, collectively sued the federal government in an attempt to thwart the COVID-19 vaccine requirements for health care workers.
When considering whether to table the vote, trustees decided to pass the policy to allow more time for the exemption approval and denial process.
The religious and medical exemptions are exemptions from enforcement of the policy. Without a policy in place to enforce, the exemptions could be collected, but not processed until a policy went in place, said attorney Bradley Cave.
Employees must have their exemptions filed by Nov. 22, according to the CCH policy. The exemptions will be reviewed, approved or denied by Cave and CCH Vice President of Human Resource Noamie Niemitalo.
Gerrits said that he is not comfortable asking hospital administrators to try complying with the policy in three days, which would happen if the policy was approved Dec. 2. He said the even shorter notice would also be unfair to employees who will seek vaccination or an exemption.
“We’re basically playing chicken with our hospital against CMS,” Gerrits said.
Murphy asked to have examples made available for employees of religious exemptions that would be approved under the CCH and CMS requirements.
“Legal needs to tell us if we can do that. I’m not comfortable we can do that,” interim CEO Jerry Klein said.
Cave said they can provide Equal Employment Opportunity Commission examples that help explain which principles would fit within the requirements but could not give employees a template for how to submit an approvable exemption form.
“We cannot draft a religious exemption for employees to use. The other requirement that the hospital will be held to is the determination the religious belief that the employee explains is sincerely held,” Cave said. “If we begin to get boilerplate religious exemptions where everyone is the same, because that’s the language that they’ve been given, it’s going to be really difficult for the hospital with a straight face to say ‘that’s a sincerely held religious belief.’”
Trustees voted five to one against the motion to table, with Stuber the lone vote in favor. They then voted five to one to approve the policy, with Stuber the lone objector. Trustee Sara Hartsaw was away from the call at the time of the vote.
“I don’t like that we have to do this, but we have to do this,” trustee Lisa Harry said.
Hospital board trustees and administrators have taken a stance as pro-vaccine but anti-vaccine mandate. They argued the potential of losing more staff while already dealing with a shortage amid an increase in inpatient workload could be detrimental to the community health system.
During a September hospital board meeting, CCH employees and members of the public packed the city hall meeting room to speak out against the potential vaccine mandate. Several employees there said they, or others in their departments, would quit if the mandate was enacted.
Employers found out of compliance with the mandate will be cited and given the opportunity to comply before further penalty. But if facilities still fail to comply, CMS “will not hesitate to use its full enforcement authority to protect the health and safety of patients,” the CMS press release said.
Not complying with the CMS requirements would effectively shut the hospital down, health care officials and legal counsel have said.
The guidelines apply to nearly all health care providers in the U.S., including others within Campbell County.
Although a CCH nurse likely would have to receive the COVID-19 vaccine in order to work for a different health care employer, non-medical personnel could potentially leave the organization for a non-health care job.
Although about 40 percent of CCH employees have been confirmed as vaccinated, it remains unclear how many employees will be affected by the adopted policy.
Niemitalo said that since CCH stopped vaccinating its own employees directly, keeping track of vaccination status has become more difficult. It is also unclear how many of the majority of CCH employees will apply for and be granted a medical or religious exemption.
“Unfortunately, it’s pretty much all a guess at this point,” Niemitalo said.
Employees have until Nov. 22 to decide to apply for the religious exemption. Until then, it remains to be seen how many CCH employees will fall on religion to help them avoid the vaccine.
“Morally and ethically, I don’t think it’s right that someone has to come in and fill out a form over a shot that dives into their (religious beliefs) … it’s almost a slap in the face to the churches and religious people around town that you’re using religion almost in a wrong way,” Stuber said. “But then again, that’s people’s choice if that’s what they want to do.”