The state vaccine mandate has had some effect on the county’s already short-staffed health care and long-term care facilities, but many don’t anticipate any impact on patient care.
The mandate required all employees of hospitals, clinics, dental offices and long-term care facilities to be fully vaccinated by Monday, Oct. 18.
At Family Health Centers (FHC) clinics throughout the county, the majority of the employees were vaccinated even before the mandate, FHC Chief Health Officer James Wallace said.
About 7% of FHC’s 230 employees received a religious or medical accommodation. The accommodations include daily screening, masking at all times, and weekly testing, CEO Jesús Hernández said. About 2% of the staff resigned or were terminated, he said.
In fact, the mandate helped spur conversation about how to keep patients, staff and communities safe, Wallace said. Over the course of the pandemic FHC has had to quarantine employees — or even temporarily close a clinic — after an infection or exposure, so having everyone vaccinated means that is no longer necessary. That’s crucial when the workforce is already stretched thin because of COVID and other health issues, he said.
Still, Hernández is concerned that the mandate could affect patient care. “We’re not out of the woods yet. Exposures and positive test results result in significant staffing challenges when staff have to quarantine and their function cannot be done remotely. This places more burden on those that have to fill in the gaps and leads to more emotional and physical fatigue,” he said.
Administrative and non-patient-facing departments “play just as much of a role in patient care as our providers and clinical teams, so when they’re out or overwhelmed, it hits hard just the same. We really appreciate all the hard work and dedication our employees have contributed, without fail,” Wallace said.
At Jamie’s Place, the adult family homes in Winthrop, three of the 18 employees received a religious exemption. Jamie’s Place staff and board answered employees’ questions and made the vaccine available even before the state mandate took effect, Executive Director Rana Clarke said. Several who’d had doubts got vaccinated, but others resigned in anticipation of a mandate, she said.
In providing the exemptions, staff and board members worked hard to weigh the importance of these workers, who provide professional, compassionate care to the residents — and the fact that the residents all adore them, Clarke said. Staff with exemptions are tested twice a week and must wear certified N95 masks.
A greater loss in staffing could have meant the very real risk of having to close their doors completely — with dire effects. That just wasn’t an option, Clarke said.
The mandate comes after an especially trying year and a half of coping with the pandemic, Clarke said. Since the start of the pandemic — not connected with the mandate — Jamie’s Place has had a 75% turnover in staff, as people dealt with the physical and emotional stresses of the pandemic, Clarke said.
For example, last year, when understanding of the new virus was limited, residents could see visitors only through an outdoor window, and staff wore full-body protective gear, which was unsettling for everyone, she said. “It really took a toll on people,” Clarke said.
One of the biggest impacts is at Okanogan Behavioral Healthcare (OBHC), which lost many employees, primarily in their crisis-response division, according to Jessica Kuzma, who handles communications for Okanogan County Public Health.
“While we will continue providing our full range of behavioral health services, there may be a temporary reduction in our ability to do so in a timely fashion,” OBHC said in a press release last week. “Services will remain available in-person and via telehealth (telephone and online), although some delays may be expected until we are again fully staffed.”
OBHC could not be reached for more details by press time.
County hospitals are seeing few impacts from the mandate, but they are grappling with high caseloads from COVID and other conditions.
At Three Rivers Hospital in Brewster, out of 129 employees, 86% are vaccinated. The hospital didn’t lose any full-time employees and no one resigned because of the mandate, although they terminated six per-diem employees who hadn’t worked any shifts for a while, Business Development Coordinator Jennifer Best said.
About 9.3% of the staff received exemptions. The chief nursing officer is developing accommodations, including routine testing, to ensure that unvaccinated patients and staff are safe, Best said.
Thanks to mask mandates and fastidious hygiene and disinfecting, they’re not aware of any Three Rivers employee having contracted COVID-19 while at work. Non-patient-care departments haven’t lost any staff due to the mandate, Best said.
Mid-Valley Hospital in Omak has seen a high level of compliance with the mandate and granted accommodations where necessary. No employees were dismissed, Mid-Valley Executive Assistant Megan Barton said. They don’t anticipate any disruptions in care, she said.
At North Valley Hospital in Tonasket, 70% of the workforce is fully vaccinated, with a few people on leave until they transition from partially to fully vaccinated, CEO John McReynolds said.
North Valley has been able to provide religious and a few medical exemptions, meaning that less than 1% of the staff left employment due to the mandate. Staff with exemptions must wear masks and get weekly COVID tests. Employees in North Valley’s nursing home have more stringent requirements, McReynolds said.
While North Valley isn’t expecting any major impacts from the mandate, they are struggling with sustained high volumes of COVID patients in the emergency department and a high census of hospitalized patients, he said.
Local dental clinics are operating as normal. At Sawtooth Dental Care in Twisp, all employees jumped at the chance to get vaccines last December, as soon as they were available. At Steven Harrop’s dental practice in Winthrop, about half of the staff received religious exemptions.
People who work in a health care setting must provide proof of vaccination to the management, according to the terms of the mandate. Those who run their own medical offices are required to provide proof of vaccination if requested by a lawful authority. People who may have developed some immunity from having been infected with COVID do not get an exemption from the mandate.
Long-standing staff shortages
Many local health care providers were already coping with staff shortages before the pandemic hit. In fact, the Okanogan County Coalition for Health Improvement (CHI) is dedicating its monthly meeting to the issue this week. “We had a provider shortage long before COVID,” CHI said in an announcement of the meeting.
Three Rivers has had a shortage of nurses and staff such as laboratory and radiology technicians for a long time. It’s simply more difficult to recruit to a rural area, Best said.