County fears shortage of health care workers

Sep. 24—The Baker County Board of Commissioners approved an emergency declaration on Wednesday, Sept. 22 stating that Gov. Kate Brown's vaccine mandate for health care workers could leave fire departments in the county so understaffed, as workers quit rather than take the vaccine, that they won't be able to respond to traffic crashes and other emergency calls.

The declaration also stated that the mandate could render Saint Alphonsus Medical Center-Baker City unable to provide basic hospital care.

But the claim about the potential effects on Baker County's only hospital is wrong, hospital officials said on Thursday, Sept. 23. They called on the county to retract that part of the declaration.

Baker County Commissioner Mark Bennett said the county would do so.

The declaration calls on Brown to address the mandate — although it doesn't specifically propose that the governor cancel it — which sets an Oct. 18 deadline for health care workers, including paramedics and other emergency responders, to either be fully vaccinated or to have an approved medical or religious exception.

"The impending deadline for all health care workers to be fully vaccinated by October 18 has led to a series of difficult choices," Bennett said in a press release. "We can't head into a situation where there are not enough responders available to handle medical events throughout the county, including those that happen on the highways and interstate. We also cannot accept a situation where the hospital doesn't have sufficient staffing to provide basic hospital care. Our responsibility is to the health and safety of our community, and we have to come up with options for the inevitable times when accidents or health emergencies will occur."

The declaration states that if the governor decides that keeping the Oct. 18 deadline in place "is too critical to public safety," then the county would request that the governor "provide aid and assistance to Baker County in the form of such State assets and resources as is necessary to protect the citizens, and visitors of Baker County, along with the users of the state highway system."

In response to the emergency declaration, Saint Alphonsus issued a press release late Thursday afternoon calling on the county to remove the reference to the Baker City hospital.

"The request was made because the declaration was inaccurate in reference to the hospital, and the hospital was not notified nor asked to participate in any discernment or action as implied by the declaration," according to the press release.

The release also included a statement from Priscilla Lynn, president and chief nursing officer for the Baker City hospital.

Lynn said: "We are firmly committed to continuing to serve the residents of Baker County as always, and in addressing the COVID-19 pandemic with the resources available. We want to reassure the Baker County community at large that our colleagues and medical staff stand steadfast in our commitment to provide needed health care services, and address the COVID-19 pandemic with the resources available. We are extremely grateful for Governor Brown's support and allocation of additional resources as demonstrated by the recent authorization of National Guard and contracted clinical personnel to our hospital."

In an email to the Baker City Herald later Thursday evening, Bennett wrote that the county would revise the declaration as requested.

"Baker County is pleased that the St. Alphonsus Health system is able to handle the staffing needs," Bennett wrote.

Bennett conceded on Friday, Sept. 24 that the county "blindsided" hospital officials with the declaration. He said commissioners believed, based on "information we had received," that a staffing shortage was possible at the hospital.

Potential effects of vaccine mandate

According to commissioners, the state vaccine mandate is causing "significant numbers of the exhausted workforce" in health care to leave their jobs.

Bennett said in an interview on Thursday morning, Sept. 23, that county officials over the past few weeks polled emergency response agencies, including the Baker City Fire Department and the several volunteer rural protection districts that also serve as first responders. These include districts serving the Halfway and Richland areas, Haines and parts of Baker Valley, Sumpter Valley, the Burnt River Valley and Unity, and the Huntington area. Most don't have ambulances, although the Halfway/Oxbow and Richland areas have a local ambulance service.

Bennett said the county's conclusion is that, if the vaccination mandate continues on its current schedule, "we are going to be really short of people" to respond to emergencies.

Although the governor's mandate also gives unvaccinated employees the option of taking either a medical exception, which requires corroboration from a medical provider, or a religious exception, which employees can apply for by filling out a form, Bennett said he does not believe that a significant number of health care workers will opt for one of the exceptions in lieu of being vaccinated.

Bennett, who is vaccinated and is also a volunteer first responder in the Unity area, said the county's emergency declaration should not be construed as a comment regarding vaccinations.

"We're not taking a position on the vaccine, we're just saying, this is the problem," Bennett said.

According to the Oregon Health Authority (OHA), as of Sept. 5, 68% of licensed health care workers in Baker County were vaccinated. That list includes some workers who aren't part of the emergency response system, such as dentists and chiropractors.

Casey Johnson, president of the Baker City Firefighters Association union, said in an interview Thursday morning, Sept. 23, that "the OHA has provided exceptions for anyone who has a strong moral or religious opposition to the vaccine. So, right now we're looking at those options."

"As far as Baker City and other departments I've been talking to, everybody's at the moment looking at those exceptions as a way to hold off termination and hopefully then that gives us time to fight this in court and get the governor's emergency manager status turned back," Johnson said. "I still think that vaccines overall are a very good thing, they keep the country healthy, but as far as mandating it goes, we're in strong opposition to the government telling us what we need to put into our bodies."

According to OHA guidelines, employees who claim a religious exception must fill out a form "stating that the individual is requesting an exception from the COVID-19 vaccination requirement on the basis of a sincerely held religious belief and including a statement describing the way in which the vaccination requirement conflicts with the religious observance, practice, or belief of the individual."

Local employers, not officials at the OHA or another state agency, will review and verify both medical and religious exception forms, said Jonathan Modie, a spokesman for OHA.

Medical exceptions must be signed by a medical provider who, according to OHA guidelines, certifies "that the individual has a physical or mental impairment that limits the individual's ability to receive a COVID-19 vaccination based on a specified medical diagnosis, and that specifies whether the impairment is temporary in nature or permanent."

There are no such criteria, however, for verifying a religious exception form.

The OHA guidelines state: "There is no specific verification documentation required to request an exception for a sincerely held religious belief."

Baker City Manager Jon Cannon said the city will receive and maintain records of exception forms. Based on his review of guidance from the Equal Employment Opportunity Commission, Cannon said he expects the city will accept religious exceptions. What's not clear, he said, is whether state officials would audit or otherwise review those exceptions.

"I don't feel like it says that I'm supposed to go and really dive in and study your religion and say 'Hey, your religion says no,' " Cannon said. "I don't think we take it to that level. I think we make sure the documentation is there, that they have affirmed that they have that sincerely held religious belief. We take that exception and we say OK and then we try to accommodate it. And assuming we can accommodate it then we're good to go. I think in most cases we'll be able to accommodate it."

Cannon said he understands the concern about the city and other agencies having enough employees to respond to emergencies. He said he agrees with county commissioners' decision to prepare for potential problems.

"I think we're all taking a more proactive approach to saying 'What is the worst case scenario and how are we doing to deal with it?' " Cannon said.

He said he expects that as the Oct. 18 deadline approaches, more affected employees will decide either to be vaccinated or to fill out an exception form.

"I think we start to realize how many of our firefighters are actually going to say 'I'm done, I'm going to walk out' and how many of them are going to say 'I really need that paycheck' or whatever it is so I'm going to either do an exception or get the shot," Cannon said. "And as we get closer and closer to that date, I think that number started as everybody and now that number's coming down. And so I'm hopeful that we'll get to that point and we'll be able to provide the service without it being as dire as (the scenario described in the county's declaration)."

According to OHA guidelines, agencies that have unvaccinated employees who submit a medical or religious exception must ensure that those workers "are protected from contracting and spreading COVID-19."

Among the possible actions to comply with that requirement are having unvaccinated employees wear N95 masks or submit to weekly COVID-19 tests.

The Baker School District, whose employees are affected by the same mandate and Oct. 18 deadline as health care workers, will require unvaccinated employees to choose one of those options.

Perspective from a volunteer fire protection district

Wes Morgan is chief of the Powder River Rural Fire Protection District in the Sumpter Valley. Morgan said he has eight volunteers, although not all are available to respond to every fire or medical emergency, such as a traffic crash on Highway 7.

Morgan said he and all his volunteers are vaccinated.

But that doesn't ease his concern about the potential effects of the vaccination mandate.

Morgan's greatest fear is that the mandate will leave the Baker City Fire Department unable to respond, with its paramedics and ambulances, to medical emergencies.

"Potentially it's going to be a disaster," Morgan said.

Morgan said he and his volunteers can provide only basic life support to injured people. They lack both the training and equipment that Baker City's paramedics bring to scenes. Rural districts such as Powder River also rely on the Baker City Fire Department to transport patients to the hospital, Morgan said.

His district has no ambulance, and is not licensed to transport patients.

Morgan describes himself and his volunteers, and other rural districts, as the true "first responders," and the Baker City Fire Department as "second responders."

If the city department can't dispatch paramedics and ambulances, Morgan said he's not sure that he, or his volunteers, would feel comfortable responding to a medical emergency knowing they would be the only ones to do so.

He personally fears the psychological effects of first responders, with their limited training and equipment, being unable to save a severely injured driver after a highway crash.

"I lose sleep at night thinking about it," Morgan said. "We volunteer for a reason. We want to help people, and we do help people. But we don't want to be the only ones who respond."

Morgan said he doesn't believe the governor's mandate is having, or will have, its intended effect, which is to encourage people to be vaccinated.

"I think it's doing the exact opposite of what they want it to do," he said. "I'm hoping that the governor comes to her senses and changes this."

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