Missouri nursing homes fear staff will quit over vaccine mandate, lawmakers warned

Sep. 15—Missouri nursing homes fear they could lose half of their staff or more because of the federal COVID-19 vaccine mandate, the industry warned on the eve of a veto session where lawmakers are expected to vent their anger at President Joe Biden's vaccination push.

Missouri has one of the worst vaccination rates of nursing home workers in the nation, at 50.16%. Only two states, Florida and Louisiana, have lower rates, according to the Centers for Medicare and Medicaid Services.

The Missouri Health Care Association, which represents nursing homes across the state, told a House committee Tuesday that a federal mandate could trigger an exodus from the industry. More than 90 of 275 facilities surveyed by the association reported the potential for at least 50% of their staff to depart if vaccination is mandated, said Nikki Strong, the association's director.

"The responses I'm getting show that the mandate, rather than encouraging people to get vaccinated, has almost created more resistance to becoming vaccinated because somebody's going to tell me what I'm going to do with my body," Strong said.

The General Assembly will convene Wednesday for its annual veto session, where legislators will consider overriding a handful of vetoes issued by Gov. Mike Parson. But the major focus is expected to be Biden's vaccination effort.

Tuesday's House hearing, before an Appropriations subcommittee, offered a preview of how Republicans are likely to attack Biden's effort: as a burden on health care and other employers that could do more harm than good.

"If what you're doing creates a greater, more pronounced risk to the care of those who are needing nursing home services, sometimes you have to pump the breaks," said Rep. Doug Richey, an Excelsior Springs Republican.

Democrats emphasized that nursing homes have long faced staffing challenges and urged lawmakers to address the root causes, such as low pay. "We're talking about what we can do about the straw when the back is breaking already," said Rep. Peter Merideth, a St. Louis Democrat.

Biden announced last week the federal government will develop rules requiring most workplaces with more than 100 employees to either require their workers to be vaccinated to submit to regular COVID-19 testing. Vaccinations are also expected to be mandated for hospital employees and staff at other health care providers who participate in Medicare and Medicaid.

The directive came after the president in August said nursing home employees would have to be vaccinated.

The Biden initiative has sparked a furious backlash among Missouri Republicans, who have vowed to try to stop it. Attorney General Eric Schmitt, Parson and other top GOP leaders have made clear they plan to challenge the federal rules in court. Some GOP legislators have gone as far as urging Parson to call a special session, which the governor hasn't ruled out.

The General Assembly can't advance legislation related to vaccines this week unless Parson authorizes a special session. But the House Judiciary Committee will meet Wednesday for a hearing on the Biden announcement and lawmakers could offer floor speeches condemning the move.

"We in the Missouri House of Representatives will not stand for it, and we will do everything in our power to protect the personal liberties of Missourians," House Speaker Rob Vescovo, an Arnold Republican, said in a statement.

Biden has said he's disappointed that "some Republican governors have been so cavalier with the health of these kids, so cavalier with the health of their communities."

"We're playing for real here. This isn't a game," Biden said Friday. "I don't know of any scientist out there in this field who doesn't think it makes considerable sense to do the six things I've suggested."

Beyond vaccines, lawmakers are expected to weigh overriding a small number of Parson vetoes.

One vetoed bill would allow business owners property tax breaks if they were shut down due to public health orders during the pandemic. Parson wrote in vetoing it that the bill was "severely problematic" and "carries significant unintended consequences" for local governments. The bill passed with overwhelming votes in favor in May.

He also vetoed lifting auto emissions testing requirements in three St. Louis suburban counties, citing the requirements of the federal Clean Air Act. Another measure would require a separate state office to investigate safety complaints from employees of the embattled Children's Division.

Parson wrote that the additional oversight "unnecessarily undermines the existing administrative structure" of the child welfare agency, which has been the subject of sharp criticism from lawmakers over its handling of abuse claims at unlicensed boarding schools.

Parson vetoed four bills in total this year, in addition to cutting $115 million out of the state budget lawmakers sent him, including $5 million across departments for raises for state workers, and $2 million for raises for child welfare case workers.

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