The Arkansas Department of Human Services on Wednesday asked the state legislature for permission to require employees at seven of its health care facilities to be vaccinated against covid-19.
Legislative leaders expect similar requests from other state entities — like the University of Arkansas for Medical Sciences — by the end of the week.
The already contentious mandates have been further complicated by conflicting state and federal guidelines.
The federal Centers for Medicare and Medicaid Services released the vaccination requirement in November for workers at most healthcare facilities.
The federal rule directly conflicts with Law 977, a state law passed last year that states that vaccination against covid-19 “shall not be a condition of education, employment, entry or service or a state agency or entity” unless the Arkansas Legislative Council approves an exception.
Arkansas was one of 10 states to challenge the federal directive, but the U.S. Supreme Court upheld the mandate on January 13.
Arkansas Department of Human Services Secretary Cindy Gillespie has requested an exemption from state law to implement coronavirus vaccination requirements at seven of the agency’s facilities across Arkansas .
“This request is made solely to keep DHS in compliance with federal law and to protect federal funding that keeps our healthcare facilities open, as DHS opposes the [mandate] in principle,” Gillespie wrote in a letter to the co-chairs of the Legislative Council, State Representative Jeff Wardlaw, R-Hermitage, and State Senator Terry Rice, R-Waldron.
[DOCUMENT: Letter requests exemption allowing vaccine mandates at some DHS facilities » arkansasonline.com/120letter]
Gillespie’s letter indicates that Governor Asa Hutchinson approves of the request. A spokeswoman for Hutchinson did not provide further comment on Wednesday.
Wardlaw said the Legislative Council will hear and consider the request from the Department of Social Services at its regular meeting on January 28. The board expects similar requests from UAMS and the state Department of Veterans Affairs by Friday, he said.
He said the potential loss of Medicare and Medicaid funding would merit approving applications.
“It is what it is, and we can’t lose funding,” he said Wednesday.
The federal mandate applies to the five Human Development Centers, State Hospital and Arkansas Health Center operated by the Department of Human Services. They receive a total of nearly $125 million in Medicare and Medicaid funding.
Gillespie told the Legislative Council in November that she feared the mandate would push already understaffed facility staff to leave.
She sent a Dec. 17 letter to the Centers for Medicare and Medicaid Services — co-signed by Hutchinson as well as Wardlaw, Rice and other lawmakers — expressing her opposition to the “oppressive and expansive vaccine mandate” as part of the consultation period. public centers after the publication of the requirement.
[DOCUMENT: Letter opposes CMS vaccine mandate rule » arkansasonline.com/120rule/]
Five of the seven affected facilities are in rural areas of Arkansas, making staffing during a pandemic a challenge in itself, and healthcare workers across the country have shown resistance to getting vaccinated. against covid-19, wrote Gillespie.
“By directly threatening DHS’s ability to maintain the adequate staff that is critical to protecting the health and safety of residents of these facilities, the overall harm that will be inflicted by this [mandate] will far exceed any benefit that may come from the fight against covid-19,” Gillespie wrote.
At the time, 63% of employees at the seven affected facilities were fully vaccinated, she writes.
That number is now over 70%, according to data from social services spokeswoman Amy Webb.
The same facilities saw staff attrition rates between 26% and 79% between July 2020 and June 2021, and salary increases for healthcare workers have not alleviated the problem, Gillespie wrote.
On Wednesday, Gillespie presented the department’s fiscal year 2023 budget to the state legislature’s Joint Budget Committee. Rice asked if the department was prepared to lose employees who do not comply with the vaccination mandate.
“Our budget at this point unfortunately assumes the same type of turnover issues that we have had for the past two years, which is extremely high turnover at our facilities, and continuing to have to contract because that’s our reality as we face it today,” Gillespie said.
Rice also asked if the department would accept employees’ requests for medical and religious exemptions from the vaccination mandate. Such exemptions are permitted under the federal rule.
The department has already drafted an exemption policy that will go into effect if the Legislative Council approves the request, said Mark White, the department’s chief of staff for legal and legislative affairs.
A “sincere religious belief” has been the standard basis for exemptions, he said.
“We’re going to make this process as easy as possible for the employee because we don’t want to put obstacles in the way of employees who hold these beliefs and want to claim this exemption,” White said.
A firmly held belief, regardless of religion, has always been the determining factor in exemptions, said State Sen. Jonathan Dismang, R-Beebe, chairman of the Senate Budget Committee.
“I have heard some [health care workers], ‘It’s not against my religion and I think it would be wrong for me to sign this even though I’m not willing to take the vaccine,'” Dismang told Gillespie and White. “I understand that in many healthcare people, it’s a discussion that’s going on between their legal teams, and I’m sure yours are too, and one that we really need to make sure we understand as a legislative body.”
White said the law “doesn’t leave much guesswork” on whether a person’s strongly held beliefs are tied to religious beliefs.
UAMS is still seeking to meet with the Legislative Council, spokeswoman Leslie Taylor said. She said last week that the institution was reviewing the Supreme Court’s decision and would await further guidance from the Centers for Medicare and Medicaid Services.
Taylor did not say whether the institution will ask for a vaccination requirement a second time.
UAMS Chancellor Cam Patterson made the first request to the Legislative Council in November, saying $600 million in Medicare and Medicaid funding would be at risk if the institution failed to comply with the federal mandate. During the same hearing, Gillespie did not ask for compulsory vaccination but declared that he wanted to take measures in this direction.
The board voted to defer a decision on Patterson’s request pending a decision in the 10-state warrant challenge, and UAMS and the Department of Human Services withdrew their petitions to the board Nov. 30 after a Federal judge blocked the rule. enforcement.
The rule also applies to state veterans homes in Little Rock and Fayetteville, operated by the Arkansas Department of Veterans Affairs, which provides veterans with retirement home services such as hospice care. and physiotherapy and occupational therapy. A ministry spokesperson did not respond to a request for comment on Wednesday.
The federal mandate also applies to most private hospitals and clinics in the state, although most private facilities implemented vaccination requirements last year. Law 977 does not apply to private entities.
The federal mandate covers 17 million healthcare workers in 76,000 healthcare facilities across the United States, including home care providers. It originally stipulated that these employees should be fully vaccinated by January 4.
A facility with more than 80% of its staff fully vaccinated and a plan to reach 100% within 60 days will not face penalties, the rule states.
Florida has a state law similar to Arkansas prohibiting covid-19 vaccination from being a condition of employment, and Florida Governor Ron DeSantis said on January 13 that the state would not enforce the mandate of the Centers for Medicare and Medicaid Services. .