A Protest Mandate

Emotions boiled over Sunday as they sat around the room talking about their jobs, their lives, their careers, their families, their patients, their communities, their futures.

The anger, frustration, resentment, fear, hurt, betrayal and more could be heard in their words and their voices. Far more than 100 years of medical work experience was represented by the 16 hospital employees in the room that day as they gathered to make their emotional pleas for something to be done before Dec. 5.

That fateful day is the deadline for everyone who works at Memorial Hospital of Converse County – or does business on the hospital’s many properties in nine counties in the state – to be vaccinated against Covid-19 or receive a medical or religious waiver. To be clear, such waivers will be rare, probably less than 10% of the hospital’s 468 employees.

In simple terms, anyone who isn’t vaccinated or has a waiver won’t be working at the county-owned hospital any longer, though the administration is still trying to find other solutions and CEO Matt Dammeyer says the federal government – which is mandating the rule through its oversight of Medicare and Medicaid – may eventually alter its stance.

The reality is far more complicated than the simple terms and involves federal rules and funding for hospitals, but the end result may be the same for many – get vaccinated or get fired.

For now, the federal Centers of Medicare and Medicaid Services (CMS) is forcing nearly all health care facilities in the state and country to have employees, volunteers and contractors fully vaccinated against Covid-19 by early January. CMS is mandating the first shot by Dec. 5.

The emotions are raw and will be for some time, as could be seen at Tuesday’s rally and protest march from Washington Park to the Medical Office Building then west a block to the main hospital campus before ending at the administration building a block away.

Sibylle Smith, a former MHCC employee who said she organized the three days of rallies (noon to 3 p.m. Tuesday, Wednesday and Thursday) to show the community what is happening, to show support for the hospital staff and to show the administration how many people are behind the employees.

Of the 16 employees who gathered Sunday, most wouldn’t say if they would attend the rally and declined to speak on the record, fearing retaliation. Several mentioned they have felt or witnessed harassment or intimidation over the vaccine already.

Such comments echo divisions being reported across the country on all sides of the issue and from almost every angle – politically, economically, socially and emotionally. The vaccines and federal mandates are highly charged, emotional and sometimes bitter subjects everywhere.

For the hospital administration, the situation is equally as frustrating. Dammeyer said they are torn between trying to do what is right for the community – that is, provide safe health care that is available to everyone – and understanding the needs of their employees.

But even their employees are divided on the issue, both sides admit – though those gathered Sunday say they mostly hear support from friends, patients and colleagues once they understand they are simply taking a stand for personal freedom and against what they see as an unconstitutional intrusion into a personal medical decision.

“Every single one of us (is willing to lose our jobs and health insurance) to stand up for what is right. We love our jobs,” one said.

While MHCC officials are trying to get a handle on the number of employees likely to leave rather than get a vaccination or seek a waiver, they have no idea how many will actually  leave because they have until Friday to seek the waiver and Dec. 5 to get the first shot, Dammeyer explained.

And of the 16 meeting Sunday, many admitted they don’t know what they may ultimately decide – whether they can afford to lose their job versus getting a vaccination – but several said they are willing to make that last stand. In the end, they said, how many will leave isn’t known but it will have an impact on health care in Converse County.

One man, who noted he and his wife both work at the hospital, will lose everything but that may be what it takes to stop the government from attacking his freedom to chose.

“I don’t want to stop (working at MHCC),” said Jamie Stinson-Egner, a registered nurse with 22 years of experience. “I love my job. . . All we’re saying is let you chose for yourself and let me chose for myself.”

Anita Casperson, a certified medical assistant, echoed those sentiments, “We are scared about losing our jobs . . . We feel bullied. We really do. We won’t give up without a fight.”

She added that she is not anti-vax or a conspiracy theory buff but believes every one should have freedom of choice when it comes to medical decisions.

She and several others said no matter how many employees finally just leave, it will have a domino effect because the hospital is already understaffed, so those left will be overworked even more and less likely to stay.

THE POLICY

Dammeyer admitted the CMS rule is onerous but he’s studied it over and over again looking for a “middle ground” between the vaccination requirement for nearly everyone and an “opaque” exemption allowance that really doesn’t allow much of an exemption.

MHCC issued its policy last week in response to the CMS rules. Employees have until Monday, Nov. 22, to formally request a medical or religious exemption. An administrative and medical panel will review the requests and rule on each before the Dec. 5 deadline.

MHCC Board Chairman Bob Kayser wrote to the staff: “The (CMS) regulations are both specific and strict in regard to allowable exemptions from the vaccination mandate. While we will endeavor to interpret the exemptions as widely as possible, we must do so within the CMS allowable provisions. It is the decision of the Board of Trustees that Memorial Hospital of Converse County must comply with the CMS orders until and if a federal court of competent jurisdiction modifies or rescinds the order.”

“This is a stressful time for our organization,” Dammeyer wrote in that same hospital-wide email about the policy. “As always, I ask everyone to be sensitive toward those who hold different thoughts/ideas. This topic is obviously very emotionally charged, and I ask that we follow our values of compassion and respect as we navigate this challenge.”

During an interview Friday, Dammeyer called the situation a “true heartache” for everyone, from employees to the community and beyond, all with unknown consequences on staffing at the hospital.

“There will be impacts. What we don’t know is the exact magnitude of that impact,” he said while talking about the hospital as a whole, but he becomes much more emotional when talking about the impacts to individual employees and the gut-wrenching choice they have to make between their job and a medical decision they may not agree with.

While he, too, has heard from employees who believe he and the board could just ignore or fight CMS, Dammeyer said there’s too much misinformation about how much authority CMS actually has and its regulatory role when it comes to hospitals.

“They do have the authority to do what they are doing,” he said, “ but if you want to have a rural hospital you have to deal with CMS” because they run two agencies – Medicare and Medicaid – that cover the health insurance for a large segment of our population.

Between 30-45% of the hospital’s operating revenue comes from CMS programs, but even so Dammeyer said, this is “solely an economic issue.”

“It’s bigger than that. We need to be able to take care of the people who need us,” and many of them rely on Medicare and Medicaid. If the hospital defies CMS on this, one consequence could easily be CMS would stop allowing MHCC to treat patients with either of those – something Dammeyer is simply unwilling to do.

“Our job is to care for our community. Everyone,” he said.

Several of the employees said the hospital’s policy and exemption form are too limiting for religious exemptions, suggesting the administration could loosen up the criteria – or as one man put it to include “Christianity” as a religion to be exempted.

Dammeyer said CMS wants a 95% vaccination rate at hospitals and that includes contractors, but they used a 90% target in the policy to give as much latitude as they could. Yet, he isn’t sure that will fly with CMS in the end but he hopes the feds will change the rule after the 60-day comment period – which won’t happen until after the Jan. 4 deadline anyway.

“We’re trying to be sensitive to what our employees’ beliefs are, whether they’re legally required (exemptions) or not,” he said, but he understands they are “extremely passionate” and have “strong opinions” driving decisions. Instead, he hopes they take some time to calmly consider what they are doing.

“I think it is important, especially now, for us to listen to everyone across the entire spectrum (of opinion) . . . to follow regulations, communicate as clearly as we can and respect the divergences of thought,” he urged.

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