The University of Arkansas for Medical Sciences and several other state-run health care providers dropped their vaccination requirements for employees on Monday after a federal judge blocked the enforcement of a federal rule requiring such mandates.
Arkansas Children's notified its employees that it had also lifted its vaccine requirement in light of the preliminary injunction issued in a lawsuit filed earlier this month by Arkansas and nine other states.
U.S. District Judge Matthew Schelp of the U.S. District Court for the Eastern District of Missouri said in the ruling that the federal Centers for Medicare and Medicaid Services exceeded its authority when it issued the emergency rule Nov. 4.
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He barred the federal agency from enforcing the rule, while the case is pending, in the states that signed onto the suit.
The rule, which remains in effect in the other 40 states and District of Columbia, requires workers in health care facilities that receive Medicaid or Medicare reimbursement to be fully vaccinated by Jan. 4.
Schelp, who was appointed by then-President Donald Trump in 2019, said the rule lacked a "clear authorization from Congress," which he said was needed given the cost of compliance and the potential for the rule to cause an "exodus of employees" who refuse to be vaccinated.
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"Likewise, the political significance of a mandatory coronavirus vaccine is hard to understate, especially when forced by the heavy hand of the federal government," Schelp said in the ruling.
"Indeed, it would be difficult to identify many other issues that currently have more political significance at this time."
In Arkansas, the rule prompted UAMS and other state-run health care providers to enact vaccine requirements even though the mandates had not been authorized by the Legislative Council as required under a law signed by Gov. Asa Hutchinson in April.
At a meeting earlier this month, the council, which meets when the Legislature is not in session, put off voting on whether to approve the requirements while it awaited Schelp's ruling.
UAMS Chancellor Cam Patterson notified employees in an email Monday that the university had dropped its mandate in response to the ruling.
He said UAMS Medical Center on Wednesday will close a vaccine clinic that had been set up in its lobby.
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The vaccine will still be available at UAMS' Student and Employee Health Clinic, he said.
He said he would notify employees again if "the injunction is appealed or the situation changes in any other way."
"I realize all of this may seem confusing," Patterson, a cardiologist, said in the email.
"We will continue to provide you with information as it is forthcoming to help you make informed decisions."
UAMS spokeswoman Leslie Taylor said about 82% of the university's 11,000 employees have been fully vaccinated, and an additional 632 had submitted requests for medical or religious exemptions.
OTHER FACILITIES
The Department of Human Services on Monday also dropped its vaccine requirement affecting employees at the state's five human development centers, the State Hospital in Little Rock and the Arkansas Health Center, a psychiatric nursing home in Benton.
"We will not require employees to get vaccinated as long as the injunction is in place, as we believe a mandate would impact our ability to staff properly to keep our facility clients safe," department spokesman Gavin Lesnick said in an email.
"We will continue to closely monitor the progress of the court case. We previously notified employees that we were hopeful the lawsuit would stop implementation of the mandate, and we will keep our staff updated on future developments."
He said about 61% of the employees at the human development centers, which care for people with severe developmental disabilities, had been vaccinated as of earlier this month.
That's just slightly above the almost 60% of all adults statewide who have been fully vaccinated.
The percentages of employees who had been vaccinated were 69% for the Arkansas Health Center and 65% for the State Hospital.
The state Department of Veterans Affairs had asked the Legislative Council for permission to draft a vaccine policy for employees at its veterans homes in Fayetteville and North Little Rock.
"This is a temporary injunction and we have sought guidance on how to proceed," department spokeswoman Sue Harper said in an email, referring to Schelp's ruling.
She said more than 85% of the employees at the two nursing homes had been vaccinated, and one had requested a religious or medical exemption.
Arkansas Children's said in a message to employees that it would "continue to encourage, but not require employee COVID-19 vaccinations as a condition of employment until further notice" in light of the court ruling.
"As these issues move through the court system, we will communicate additional information," the health system said in the message.
CEO Marcy Doderer announced in July that upper-level staff members would have to be fully vaccinated by Sept. 30.
An Aug. 27 memo extended the requirement, with the same deadline, to all medical staff members.
Arkansas Children's spokeswoman Hilary DeMillo said Monday that 91% of the organization's 4,600 employees had been fully vaccinated and an additional 3% were partially vaccinated.
RULING PRAISED
The federal rule set a deadline of Monday of next week for health care facility employees receiving a two-dose vaccine to have received their first dose.
Employees were required to receive their second dose or the single-shot Johnson & Johnson vaccine by Jan. 4.
Hutchinson and Arkansas Attorney General Leslie Rutledge, who signed onto the lawsuit challenging the rule on behalf of Arkansas, praised Schelp's ruling.
"Vaccine mandates are not the appropriate method to increase our vaccination rates, and the decision today shows that Arkansas is not alone in this position," Hutchinson said in a statement.
Rutledge said the federal rule "has no place in Arkansas."
"I will continue to protect Arkansans from having to decide between getting the shot or losing their job," Rutledge said in a statement.
The Arkansas Health Care Association, which represents the state's nursing homes, also welcomed the ruling.
"Our member facilities support vaccination as a tool to prevent outbreaks and serious illness, but our fear is that the mandate would close the doors of some of our providers who are are already struggling with staffing without the mandate," association Executive Director Rachel Bunch said.
She said four of the state's approximately 320 nursing homes had closed in the past few months.
"In all my time here, I can't think of another time we've had that many at once," she said.
According to the Centers for Medicare and Medicaid Services, about 77% of workers and 86% of residents in Arkansas nursing homes have been fully vaccinated.
Bunch said some homes will keep their vaccination requirements, but most "will wait for whatever the federal rule is."
She said the association has advocated for allowing employees to be regularly tested in lieu of being fully vaccinated, which would help homes in rural areas retain staff.
"We do a lot of testing anyway," Bunch said.
"Doing that would be a really big help in some of these areas."
Legislative Council House Chairman Jeff Wardlaw, R-Hermitage, said he had planned for the council to meet Friday to consider the requests by UAMS and other state-run health care organizations to impose vaccine requirements.
In light of the court ruling on Monday, that meeting likely won't happen, he said.
He said he was "very pleased" by the ruling.
"I'm not anti-vax by no means, but I think you tell people the benefits of the vax along with the drawbacks, being the side effects, and you let them make a personal decision," Wardlaw said.
Legislative Council Senate Chairman Terry Rice, R-Waldron, said he hopes private health care providers will also reconsider their vaccine requirements in light of the ruling.
He said he heard from a woman whose daughter, a nursing home employee, is "scared to death" of getting the vaccine because of her health conditions but couldn't get an exemption.
Another woman, a nurse at a hospital in western Arkansas, wanted to file for a religious exemption but discovered she could be held liable if she became infected and was suspected of passing the virus to patients or other workers.
"It's putting people in a tough place," Rice said.
PRIVATE HOSPITALS
Arkansas Children's was among several Arkansas health care organizations that had announced vaccine requirements before the federal rule was issued.
Jonesboro-based St. Bernards Healthcare fired about 40 employees who failed to meet a Nov. 1 deadline to be fully vaccinated, spokesman Mitchell Nail said.
He said the health care system, which includes St. Bernards Medical Center in Jonesboro, CrossRidge Community Hospital in Wynne and St. Bernards Five Rivers Medical Center in Pocahontas, doesn't plan any changes to its policy in response to Schelp's ruling.
"We made the decision [to impose the requirement] based on what we felt was right for our health care system as a whole, not because we were trying to comply with something," Nail said.
CHI St. Vincent, which has hospitals in Little Rock, North Little Rock, Hot Springs and Morrilton, announced in August that its 4,200 employees would have to be fully vaccinated or receive an approved exemption by Nov. 1.
Health system spokeswoman Bonnie Ward said Monday that fewer than 9% of the system's employees have received an approved medical or religious exemption or "chosen not to receive the vaccine at this time."
"CHI St. Vincent continues to closely follow developments regarding rules from the Centers for Medicare & Medicaid Services as well as other state and federal [rules] regarding vaccine requirements to ensure how best our ministry can remain in compliance," Ward said in an email.
Baptist Health, which has 11 hospitals in Arkansas, "does have a plan in order to be compliant with the CMS mandate by January 4, 2022," spokeswoman Cara Wade said in an email.
"This includes a process for exemptions and reviews of those as well as coordination of proof of vaccination for our 11,000 employees. However, we are reviewing the implications of today's ruling."
The lawsuit was among at least four legal challenges by states to the federal rule.
U.S. District Judge M. Casey Rodgers, an appointee of then-President George W. Bush, this month rejected a request by Florida to issue a temporary order similar to the one issued Monday by Schelp.
Rodgers said Florida didn't provide evidence that "irreparable injury" would occur if the rule is enforced.
The other lawsuits include one filed in federal court in Louisiana by 14 states. Texas has also filed its own legal challenge.
In addition to Arkansas, Schelp's ruling affects Alaska, Iowa, Kansas, Missouri, Nebraska, New Hampshire, North Dakota, South Dakota and Wyoming.
A Justice Department spokeswoman declined to comment on the ruling or say whether the department would appeal.
APPEAL REJECTED
Separately, the U.S. Supreme Court turned away an emergency appeal from employees at the largest hospital system in Massachusetts who object to the vaccine on religious grounds.
Justice Stephen Breyer did not comment Monday in rejecting the request from employees at Mass General Brigham for a religious exemption to the system's vaccine requirement.
Lawyers for the employees said in court papers that six have been fired, one has resigned and another was vaccinated in order to remain employed.
Mass General Brigham, which with 80,000 workers is the state's largest private employer, told employees they would be terminated if they did not receive their first shot by Nov. 5.
The employees who sued contend the requirement violates federal workplace discrimination laws.
Breyer, who handles emergency appeals from Massachusetts, acted on his own and without even asking Mass General Brigham for a response. Lower courts also had denied the request.
The Supreme Court currently is weighing an appeal from health care workers in New York who object on constitutional grounds to a state vaccine mandate that does not offer a religious exemption.
Last month, the justices turned away a similar appeal from Maine, over three dissenting votes.
Information for this article was contributed by The Associated Press.