Employees at the WahZahZhe Health Clinic and the tribal counseling center will be required to get vaccinated against Covid-19 under a policy approved March 17 by the Health Authority Board.
While few on the board were enthusiastic about requiring employees to get the shots, the clinic falls under federal jurisdiction and risks losing the Medicare and Medicaid payments that make up the bulk of its funding unless the policy is enforced.
“I don’t think we can not approve this,” said board chair Cindra Shangreau. “This affects our funding. I wish everybody would get a vaccine, but we can’t force people … However, if you want to stay employed with the Osage Nation health system, you will have to have a vaccine because it’s required for our funding. Some people may not agree with this, but we can’t afford to lose our funding.”
The issue came up during a discussion about the clinic’s accreditation, which is up for renewal next month.
According to the Centers for Medicare and Medicaid Services or CMS, healthcare workers in CMS-funding facilities were required to get the first dose of Covid vaccine by Feb. 14 and the second jab by March 15.
It was unclear why the WZZHC did not adopt the rule earlier. It is unknown, thus far, if any of its employees remain unvaccinated, which would put the clinic in violation of the rule.
The federal policy was issued Nov. 5, 2021, but court challenges delayed its enforcement. CMS says that the requirement applies to all current and future staff who provide “any care, treatment or other services to for the facility and/or its patients. This includes facility employees, licensed practitioners, students, trainees, and volunteers” as well as contractors.
There are limited exemptions allowed for medical and religious reasons, according to CMS guidelines, but they must be granted in accordance with federal law and be documented.
“[N]o exemption should be provided to any staff for whom it is not legally required or who requests an exemption solely to evade vaccination,” the CMS’s final rule says.
Shangreau said that it is unknown how many clinic employees remain unvaccinated because there is a bar on asking employees about their vaccination status. However, with the adopted policy, employees can be required to produce proof of vaccination.
“We hope that most of our clinic people are vaccinated but we might see some pushback from the counseling center,” she said. “Stacy (Lookout) said her staff had some concerns about it. We think that most of the staff at the clinic has been vaccinated but we’ll find that out once this policy has been set in place.”
The board approved the policy unanimously and sent it to the executive branch for final approval with a title change that removed the work “mandate” and replaced it with “policy.”
The rule was adopted as the Delta variant was taking hold, and was implemented quickly, without going through the usual notice and comment procedures associated with federal rulemaking. “Ensuring safety and protection from COVID-19 for anyone seeking care is the utmost priority,” explained CMS. “Given the rapidly evolving public health emergency, the increasing presence of the COVID-19 Delta variant, and the current instability within the health care system, CMS finds good cause to issue an emergency regulation … allowing the agency to take immediate action to protect the health and safety of residents, clients, patients, and staff.”
