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Arkansas-run medical facilities still in vaccine bind after Supreme Court ruling

Medicare, Medicaid funds at risk if state law followed by Tess Vrbin | January 14, 2022 at 7:05 a.m.
The University of Arkansas for Medical Sciences' Little Rock campus is shown in this file photo.

State-run medical providers mulled over how to proceed Thursday after the U.S. Supreme Court upheld a covid-19 vaccination requirement at facilities that receive Medicare and Medicaid funding.

The federal mandate conflicts with a 2021 Arkansas law stating that receiving a covid-19 vaccine "shall not be a condition of education, employment, entry, or services from the state or a state agency or entity" unless the Arkansas Legislative Council approves an exception.

The Centers for Medicare and Medicaid Services issued the mandate in November, requiring health care workers to be fully vaccinated or receive medical or religious exemptions by Jan. 4. The rule covers 76,000 health care facilities, as well as home health providers.

The Arkansas Department of Human Services and the University of Arkansas for Medical Sciences issued vaccination requirements for employees within days of the federal rule. Both retracted their mandates at the end of November after a federal judge blocked the rule's enforcement in response to a lawsuit from 10 states, including Arkansas.

Officials at both agencies said Thursday that they were reviewing the high court's decision.

Human Services Department spokeswoman Amy Webb said the department encourages its employees to get vaccinated, but she did not respond when asked if any employees are still unvaccinated.

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Webb deferred additional comment to Gov. Asa Hutchinson's office.

"Due to the SCOTUS decision, state agencies which are CMS facilities will have to seek approval from Arkansas Legislative Council to allow the vaccine mandates to be implemented in those facilities," Hutchinson spokeswoman Shealyn Sowers said in an email Thursday afternoon.

UAMS will request a meeting with the Legislative Council, spokeswoman Leslie Taylor said, and await direct guidance from the Centers for Medicare and Medicaid Services.

"We need to follow federal law, but we also don't want to be in violation of state law," Taylor said.

Arkansas had a record number of new covid-19 cases Thursday with 12,990, according to data from the state Department of Health.

UAMS Chancellor Cam Patterson tweeted that the number did not surprise him and that the hospital had a record number of 80 covid-19 patients Thursday.

"We also have 735 employees off work with COVID infection or exposure, so staffing patients is very difficult and we are cutting back services in many areas," Patterson tweeted.

He approached the Legislative Council in November with a request for a vaccination requirement, saying the institution stood to lose $600 million in Medicare and Medicaid funding if it does not comply with the federal mandate.

The council voted to postpone a decision on Patterson's request while waiting for a decision in the 10-state challenge to the mandate.

The Department of Human Services runs seven facilities-- the five human development centers, the State Hospital and the Arkansas Health Center -- that receive a total of nearly $125 million in Medicare and Medicaid funding.

At the Legislative Council hearing in November, Human Services Secretary Cindy Gillespie did not present a request for a vaccination requirement but said she wanted to take steps in that direction. She also said she was concerned that the federal mandate would drive staff members at the already short-staffed facilities to leave.

The Centers for Medicare and Medicaid Services rule also applies to the state veterans homes in Little Rock and Fayetteville, run by the Arkansas Department of Veterans Affairs, which provides veterans with nursing home services such as hospice care, and physical and occupational therapy.

State Rep. Jeff Wardlaw, R-Hermitage, the council's House chairman, expressed concern Thursday and in November about the potential loss of Medicare and Medicaid funding if facilities do not comply with the federal mandate.

"I suspect the council would approve a request [to require vaccinations], since we would be giving up all federal money in those entities," Wardlaw said Thursday.

State Sen. Terry Rice, R-Waldron, the council's Senate chairman, also acknowledged the "quandary" facing health care facilities that rely on federal funding, but he said he expects the Legislative Council to hear from constituents about the Supreme Court decision in the near future.

"While [there] is a SCOTUS ruling, I think you will see as days move forward what the people's decision is, and I work for the people," Rice said.

The Centers for Medicare and Medicaid Services mandate also applies to most private hospitals in Arkansas. Private hospitals were not affected by last year's state law against vaccination mandates, and most already have such requirements in place.

The same Supreme Court ruling struck down the federal Occupational Safety and Health Administration's temporary requirement for companies with more than 100 employees to require vaccinations or covid-19 testing. Arkansas was one of several states to challenge that requirement.

Print Headline: State medical facilities again in rulings mire


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