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Rural Hospitals Fear A Vaccine Mandate Would Dwindle Already Overextended Staffs


Rural health providers are raising alarms about a new vaccine mandate that will start as soon as next month. The Biden administration wants every person working in a health care setting, from hospitals to dialysis centers, to be fully vaccinated for COVID-19. But in rural areas where vaccination rates are low and hiring is already difficult, they're worried there could be staffing shortages. NPR White House correspondent Tamara Keith has more.

TAMARA KEITH, BYLINE: Adam Willmann was born in Goodall Witcher Hospital in Clifton, Texas. Now he's its CEO, and he's worried his rural hospital may have to stop delivering babies.

ADAM WILLMANN: This mandate goes through - there are key personnel. OB is a very critical point for us.

KEITH: Some of the experienced nurses in the obstetrics department aren't vaccinated, and Willmann says they don't intend to be.

WILLMANN: They are also near retirement age. And a few of them have already voiced that I will just retire. And then a couple other nurses said, well, I'll just go work for my husband's construction company.

KEITH: Willmann has been pushing hard to get all of his 250 employees to take one of the COVID vaccines, and he's gotten to about 70% vaccinated - well above the rate in the surrounding community. But it's still not enough.

WILLMANN: But we're kind of at that point where everybody that's willing to get it, got it.

KEITH: That stagnation of vaccination rates in medical facilities all over the country is what drove the Biden administration to go for a mandate. Chiquita Brooks-LaSure is the administrator of the Centers for Medicare and Medicaid Services.

CHIQUITA BROOKS-LASURE: We did not undertake this decision lightly.

KEITH: Her agency is working on the details of a rule that will put the mandate in place. She knows some hospitals and nursing homes are worried it will cause staffing shortages. But she says health care workers who aren't vaccinated cause their own staffing challenges when they get sick or have to quarantine. And there's the matter of safety.

BROOKS-LASURE: And it's very clear from the data that staff who remain unvaccinated are affecting both the patients who are coming in to the facilities as well as their colleagues.

KEITH: Brooks-LaSure says it may not end up being as bad as some people fear. She points to Maine, where the governor already put in a mandate.

BROOKS-LASURE: Even though there was a lot of noise around what these mandates mean, the actual number of health care workers who quit is very limited.

KEITH: In New Hampshire's rural Coos County, North Country Health Care is out ahead of the forthcoming federal mandate.

TOM MEE: Our D-Day is October 23. On October 23, one way or another, our workforce will be 100% compliant with the vaccine.

KEITH: Tom Mee is CEO of the hospital system with about a thousand employees. He says the decision was easy to make because it was the right thing to do, but difficult to implement - complete with hate mail. But it's working. A month ago, 78% of staff were vaccinated. Now it's 90%.

MEE: When this is done, we'll be exiting a handful of employees from the system. That's inevitable.

KEITH: Some may quit. Others will be forced to leave. He's had to lay people off for financial reasons before, but never something like this.

MEE: It's a scene that you're going to see repeated throughout the United States. And I've been in health care for 34 years. I've never seen anything like this before.

KEITH: He expects to be able to shift staff around and keep serving patients as usual. But in many areas, there's not a deep bench of qualified people looking to get into health care, especially right now, says Alan Morgan, CEO of the National Rural Health Association.

ALAN MORGAN: Even if it would impact only 2- to 5% of the hospital staff, that's going to create a service disruption. Are we going to have to transfer existing patients? Are we going to have to put a halt on incoming patients?

KEITH: He's urging the Biden administration to come up with a plan to help with expected staff shortages once the mandate goes into effect - something like surging in people from the U.S. Public Health Service or the National Guard or FEMA. He's been asking and so far, hasn't gotten a reassuring response.

Tamara Keith, NPR News. Transcript provided by NPR, Copyright NPR.

Tamara Keith has been a White House correspondent for NPR since 2014 and co-hosts the NPR Politics Podcast, the top political news podcast in America. Keith has chronicled the Trump administration from day one, putting this unorthodox presidency in context for NPR listeners, from early morning tweets to executive orders and investigations. She covered the final two years of the Obama presidency, and during the 2016 presidential campaign she was assigned to cover Hillary Clinton. In 2018, Keith was elected to serve on the board of the White House Correspondents' Association.

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