As the date of enforcement for Gov. Janet Mills’ COVID-19 vaccine mandate for healthcare workers approaches, hospitals and emergency medical services (EMS) are seeing employees resign rather than become immunized.
Some of Maine’s biggest hospitals have had close to 100 employees resign since the vaccine mandate was announced, exacerbating staffing shortages that existed before the pandemic and have been made worse by burnout and quarantines in response to exposure to COVID-19.
Central Maine Medical Center in Lewiston recently closed its neonatal intensive care unit and is working on a contingency plan to address staffing shortages that will cut its intensive care unit beds by 50% and its medical surgical beds by 40%. The hospital’s vaccination rate is approximately 75%. It confirmed that, as of Friday, it has 250 employees, 170 of whom are patient-facing, who have not provided the hospital with a record of vaccination.
Hospital representatives are reportedly planning to petition Gov. Janet Mills to build a testing option into the state’s COVID-19 vaccine mandate. They are also reportedly considering asking Mills to call on the Maine National Guard to help address staffing shortages.
As of October 1, Central Maine Healthcare had lost approximately 70 staffers across its system. Northern Light has lost 99 staffers, 46 in direct patient care and 53 in indirect patient care. MaineHealth has had 69 staffers resign since the beginning of August.
John Porter, who works in communication for MaineHealth, said the system’s doctors are close to 100% vaccinated. MaineHealth announced early in September that it was temporarily suspending some elective procedures in order to free up space for COVID-19 patients.
Porter was not concerned that the resignations would result in the suspension of any more services offered by MaineHealth facilities. According to Porter, hospital capacity was being affected by more than the number of COVID-19 cases, including labor market shortages and a busy summer in the emergency department because of the surge in tourism.
Porter noted that the number of staff out on quarantine has been higher than the number of employees MaineHealth has lost as a result of the mandate. He stated that MaineHealth’s recruiters have stated the vaccine mandate is helping them find new staff because healthcare workers are looking for a safe working environment.
A spokesperson for Northern Light said they do not anticipate resignations will affect patient care or cause their hospitals to suspend any services.
Enforcement of the mandate will begin October 29 and will require designated healthcare facilities to record and report the immunization status of employees to the Maine Centers of Disease Control and Prevention (CDC).
Asked about whether there is statewide concern that the number of resignations over the mandate will affect the quality of healthcare in Maine, the Maine Hospital Association said those questions are better directed to individual hospitals.
When the Mills administration first announced the vaccine mandate, it touted the support of the Maine Hospital Association. Maine Hospital Association president Steve Michaud was quoted in the Mills administrations’ press release announcing the policy.
‘“A statewide health care worker vaccine mandate protects our patients and workforce and is critically needed as we continue our battle with this pandemic. Patient safety is our number one priority and this initiative is the very best way to provide that protection. This will save lives, keep caregivers healthy, and keep our hospitals safe as we care for all of our patients, those with COVID-19 and those without,” he said.
Resignations among healthcare workers in protest of the vaccine mandate are also not limited to hospitals. Though not subject to the state’s other immunization requirements, dentists and EMS workers are required to receive the COVID-19 vaccine.
Waldoboro EMS’ ambulance service, which also serves two other towns, is experiencing a staffing shortage that town manager Julie Kreizer described as a “crisis.”
In a written statement, Maine EMS director Sam Hurley described concerns about staffing shortages as a “longstanding problem in Maine” that, like healthcare worker shortages, existed before the pandemic. According to Maine EMS, approximately 90% of workers across the state are vaccinated, making Waldoboro something of an outlier.
Waldoboro’s staffing problem may in part be the result of the relatively low pay ambulance workers receive. For many healthcare workers, keeping competitive pay and benefits are an incentive to get vaccinated.
But according to Hurley, “EMS clinicians are paid fairly low wages” compared to other healthcare workers.
Over the course of the pandemic, the government has offered financial help to many healthcare facilities to offset the costs of the pandemic. That includes $10 million in supplemental payments to hospitals and $20 million to nursing homes, long-term care facilities, and other congregate care facilities in the form of temporary MaineCare rate increases
But paramedics, who require 18 months or 2,000 hours of education to complete a program, have not received the same level of aid. According to Hurley, many locations across the state still pay EMS workers less than $20 per hour.
To EMS workers opposed to the vaccine mandate, that noncompetitive pay rate offers little incentive to remain on the job.
Also affected by staff shortages are nursing homes in the state. Since the beginning of September, Island Nursing Home in Deer Isle, Country Manor in Coopers Mills, and Somerset Rehabilitation and Living Center in Bingham have announced they will close this fall.
Nursing homes and other long-term care facilities in Maine face a long-standing staffing problem that Angela Westhoff, president of the Maine Health Care Association (MHCA), says has been exacerbated by the pandemic.
“It’s unfair to say the mandate alone contributed to staffing challenges,” said Westhoff.
According to data provided by the Department of Health and Human Services (DHHS), as of September 17, approximately 77.2% of nursing home workers are vaccinated.
“Our number one concern is the safety of residents. We know the vaccine is part of that. We continue to work on the vaccination rate of long-term care workers.”
Other problems Maine nursing homes face include “low reimbursement rates and chronic underfunding.”
Gov. Janet Mills’ announced in early September her administration was distributing $146 million to hospitals and long-term care facilities. Of that sum, $123 million was earmarked for nursing facilities, residential care facilities and adult family care homes.
Westhoff said providers have already seen the first half of these payments, which went out in late September, and will see the second half in October.
But these are one-time payments and don’t address long-term underfunding, said Westhoff.
The MHCA will be meeting with DHHS this week week.
“Our biggest concern is making sure more facilities don’t close,” Westhoff said.