“Do I or don't I?” Some Texas hospitals grapple with new mandatory vaccine rule

Registered Nurse Lori Kelley dons a surgical gown and other PPE before entering the room of a COVID-19 patient at Goodall-Witcher Hospital in Clifton on Wednesday, August 3, 2021.

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Hundreds of hospitals across Texas on Friday were grappling with how to respond to an announcement from President Joe Biden earlier this week that they would be required to make vaccines mandatory for their employees — even as Texas Gov. Greg Abbott vows to fight the new rule.

While some, like Texas Children’s Hospital and Houston Methodist, had already announced such policies, the state’s roughly 120 public hospitals have so far been banned from enacting mandates under an executive order by Abbott — and find themselves in a far more complicated position.

“I’ve got President Biden telling me he’s going to mandate it, but I have Gov. Abbott who says I cannot mandate it,” said Adam Willman, chief executive officer of Goodall Witcher Healthcare public hospital in Clifton, outside of Waco. “Do I or don’t I? So I’m just kind of waiting for the dust to settle from yesterday to really sit down with my administrative team and see where we go from here.”

On Thursday, as deaths from the highly contagious COVID-19 delta variant climbed nationwide and new cases continued to put pressure on hospital intensive care units and emergency rooms, Biden announced that all businesses, public and private, with more than 100 employees will be required to mandate vaccinations for their employees.

At the same time, the U.S. Centers for Medicare & Medicaid Services said that in October, a new rule would require any hospitals, ambulatory surgical centers and similar facilities — regardless of the number of employees — to require employee vaccinations as a condition of participating in Medicare and Medicaid.

“There is no question that staff, across any health care setting, who remain unvaccinated pose both direct and indirect threats to patient safety and population health,” Xavier Becerra, secretary of the U.S. Department of Health and Human Services, said in a statement. “Ensuring safety and access to all patients, regardless of their entry point into the health care system, is essential.”

The news came down as the health care facilities continue to struggle with lower-than-desired vaccination rates among hospital workers, staffing shortages due to burnout, and an overwhelming number of COVID-19 patients as a result of the most recent surge fueled by the more contagious delta variant.

Many of the state’s larger private and faith-based hospitals have already begun mandating the vaccine for their employees.

In April, Houston Methodist hospital system was among the first in the nation to implement the policy and drew national attention when 150 employees who refused to comply either quit or resigned.

Since then, more large hospital systems have followed suit.

Texas Health Resources announced its mandatory policy in July, effective Friday.

In Wichita Falls on Wednesday, United Regional Health Care System announced a mandatory vaccination policy for its employees starting on Nov. 1.

“This was a very difficult decision,” Phyllis Cowling, president and CEO of the hospital, told the Wichita Falls Times Record News. “I recognize the political and cultural climate of our community, and I realize that feelings run strong on both sides of the vaccine divide.”

Administrators of rural hospitals, about two-thirds of which are public and therefore have not been allowed to enact mandates, have expressed mixed reactions to the announcement, said John Henderson, executive director of the Texas Organization for Rural and Community Hospitals.

Those facilities tend to be located in more conservative areas where vaccination rates are low.

Some administrators worried that the mandate would cause more staff to retire if they didn’t want to get the shot and were already considering leaving due to burnout. Others were glad to have some political and legal cover to enact a policy they said they wished they could have done sooner, Henderson said.

“I won’t say it’s been universally applauded or condemned [among the rural hospitals]. Initially it was, ‘We’re conservative, independent rural Texans that generally don't like to be told what to do,’ ” Henderson said. “This morning I started getting more positive reaction … Most private hospitals in Texas were already requiring it of their staff. You don't want a different standard of public vs. private, and when everybody is in it together and has to jump together, it helps with the nurse staffing musical chairs that we were in some ways expecting.”

The Texas Hospital Association, which represents the state’s nearly 650 hospitals — about 20% of which are public — said it is still reviewing Biden’s announcement and what impact it will have.

“We are definitely all for sending the message that people should get vaccinated, and we support the efforts that increase the number of vaccinated Texans,” said spokesperson Carrie Williams. “We are taking a close look at this and all its impacts going forward.”

Disclosure: The Texas Hospital Association has been a financial supporter of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here.

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