Virus Outbreak Colorado Vaccine (copy)

Rebecca Hong, right, a registered nurse who is the assistant nurse manager in the mom/baby unit at Rose Medical Center, administers the COVID-19 vaccine to hospital worker Kudusan Tekle in December in the first round of staff vaccinations at Rose

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Fewer than 60% of Colorado's health care facilities are at least partially in compliance with the state's vaccine mandate, and despite pleas from health organizations, the state will not loosen its inoculation requirement next week, officials said.

The state's Board of Health passed an order in August requiring more than 2,400 Colorado health care facilities to vaccinate 100% of their workforce by Oct. 1. They also must report their progress every other week. But facilities and industry leaders have called that threshold "aspirational," and they've called for the health board to lower the requirement from 100% to 90%, to be in line with the state's flu inoculation standards. The board is set to meet again next week, and officials had hoped it would decide to loosen its order.

But health officials have rejected that call. That may change, the officials said, depending on what the federal government institutes with its own health care worker mandate. But for now, Colorado's facilities must fall into line.

"Since the passage of our emergency rule, the federal government announced plans to require vaccination in federally regulated facilities," Jill Hunsaker Ryan, the executive director of the state Department of Public Health and Environment, wrote in a letter to facilities late last week. " ... Given the uncertainty of what the federal requirement will entail, CDPHE will not pursue additional rulemaking at the October 21, 2021, Board of Health meeting but will instead wait to harmonize with the federal rule."

The requirement, the state health department said in an email Wednesday, "carries the weight of law" and facilities must follow it.

The decision leaves facilities with a little more than two weeks before the state will begin issuing citations for those out of compliance, health care industry officials said Wednesday. It's unclear how many facilities are in full compliance, nor is it clear the vaccination levels across specific industries — like long-term care facilities and hospitals. 

But the health department said in an email that of 2,422 facilities covered by the order, 1,394 had complied with the initial requirement that they report their vaccination levels by Oct. 1. Just over 196,000 employees from those facilities have been vaccinated. The health department did not respond when asked how many total employees worked within those organizations and should have been vaccinated by the beginning of the month.

The 1,394 facilities that are least partially in compliance represent 57% of the total covered by the order. That leaves more than 1,000 who are completely out of compliance with the order, even setting aside if they've hit the 100% rate.

"CDPHE has notified facilities that have not reported that they are out of compliance with the rule and will face citations if they do not report," the health department said.

The agency told The Gazette that full data will be available soon. A hospital official said Wednesday that the next batch of data must be reported by facilities Friday, and her understanding is that the state would release the data publicly after that.

Doug Farmer, whose Colorado Health Care Association represents nursing homes in the state, said he hadn't seen new data on how many long-term care employees had complied. But by the end of September, one in five — roughly 7,500 workers — were still unvaccinated. Facilities had not started significant layoffs or terminations at that point, Farmer said. But the state will begin enforcement actions Nov. 1, he said, and facilities will have to begin taking steps by then.

The state has said it will use "progressive" disciplinary actions for out-of-compliance organizations, state health department spokeswoman Jessica Bralish said last week, including revoking and summarily suspending licenses.

Farmer and Cara Welch, spokeswoman for the Colorado Hospital Association, both said it remained unclear exactly how the state would enforce the requirements and what the exact ramifications will be for those out of compliance. Farmer said his understanding is that the state would initially work with facilities collaboratively but "it's unclear what will happen on the 31st" if that work is unsuccessful.

"I'm concerned about the uncertainty, just now knowing exactly what that will mean," he said. "When the end of September deadline came around, there were some people that quit their jobs, some people that were fired. But I'm uncertain at this point just how many will choose on Oct. 31 to say, 'I'm not going to do this, I'm not sure I want to work in health care anymore.'"

"We can't really afford to lose anyone," he added. Long-term care facilities have long warned that their staffing levels are at the breaking point already.

Farmer's organization, as did Welch's, supported the vaccine mandate, though both said they were less supportive of the 100% requirement.

Welch echoed the concern about uncertainty about what will come next.

"Some are very close to 100%, then they've got exemptions for that bit that's not there," she said. "Other facilities are working hard to get above 90%. It's still mixed, and the hospitalizations are working very hard to be in compliance and come into compliance, but we'll have some that will have to terminate some of their employees."

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