In a shift from his previously hands-off approach to coronavirus vaccine mandates, Gov. Jared Polis on Tuesday sent a letter to the state’s Board of Health asking it to quickly write rules requiring vaccinations for a wide swath of the state’s health care workforce.
Polis asked that the mandate cover “all personnel working directly with our vulnerable populations, personnel working in facilities with medically vulnerable populations, and personnel in the settings where people receive essential medical care.”
This includes nursing homes and other long-term care facilities, as well as hospitals and surgical centers.
“These are settings in which we have a responsibility to keep people safe who have little choice about their presence there,” Polis wrote. “It’s critical that all personnel who are capable of bringing the deadly virus into facilities where our vulnerable populations are in their custody be fully vaccinated in order to save lives.”
Meanwhile, the state announced that it will require vaccination for certain employees at the Department of Corrections, the Department of Human Services and the Department of Public Health and Environment. The mandate will cover corrections officers, workers at state-run residential treatment facilities and others who interact with vulnerable populations.
“Some people will say that it is a personal choice whether or not they want to get vaccinated,” Dean Willians, the executive director of the Colorado Department of Corrections, said in a statement, “but it is very difficult to socially distance in congregate settings, and inmates do not have a choice regarding where they live and who they come in contact with. An individual who can get the vaccine and yet is avoiding it, is potentially putting the lives of the people around them at risk and individuals incarcerated at risk.”
In his letter to the Board of Health, Polis said that vaccination would be required of these state workers as a condition of employment — meaning people who do not comply could be fired. As with all vaccine mandates, federal law requires employers to provide narrow exemptions for medical and religious reasons.
Polis has previously left decisions on vaccine mandates up to employers and local governments. As recently as late last month, the governor’s office expressed little interest in a statewide vaccination mandate for health care workers.
But, in his letter Tuesday, Polis wrote with urgency about the need for a mandate, citing the rising number of infections and hospitalizations in Colorado due to the virus’s delta variant. He asked the Board of Health to begin writing rules about a coronavirus vaccine mandate “without delay.” He said the rules should require all affected health care workers to have at least one shot of vaccine by Sept. 30.
“I do not ask this of you lightly, nor with any pleasure,” Polis wrote. “This is a grave situation as we find ourselves staring down the far more contagious delta variant and knowing that the estimated 30-40% of unvaccinated staff provides too many opportunities for this virus to enter into these facilities.”
More than 1,000 people a day are currently testing positive for COVID-19 in Colorado. More than 500 people were admitted to Colorado hospitals last week with COVID-19, and the number of people currently hospitalized is higher than it has been since late spring.
In making his request to the Board of Health, Polis cited a law that gives rulemaking bodies, such as the board, the ability to issue emergency rules. The Board of Health has a meeting scheduled for Wednesday. As of Tuesday evening, the agenda for that meeting contained no mention of a vaccine mandate for health care workers, and it is unclear how quickly the board could move on Polis’ request. A spokesman for the governor expressed hope that the board would take up the matter at its Wednesday meeting.
“A more comprehensive approach”
Several Colorado hospital systems have already announced vaccination mandates for staff: UCHealth, SCL Health, Banner Health, Boulder Community Health, Denver Health, Children’s Hospital Colorado and National Jewish Health, as well as the U.S. Department of Veterans Affairs. That leaves a number of independent hospitals and two big systems in the state — Centura Health and HealthONE — without mandates.
Similarly, two large operators of senior living facilities, Vivage and Genesis, have issued mandates for workers.
In his letter, Polis said he took staffing concerns into consideration when deciding to push for a statewide vaccine mandate. One thing health care leaders in Colorado have feared when weighing mandates is that they could cause workers to leave — with the option of taking jobs at facilities that are not requiring vaccination.
Polis said leaders raised those concerns with him, as well.
“[T]hese leaders have shared that while they know they made the right decision and are willing to do their part, this is hard and could exacerbate workforce stress and shortages,” Polis wrote in his letter. “Therefore, they urged me and for the state to act on a more comprehensive approach to the entire healthcare and caretaker workforce in order to prevent more disruption to the workforce’s needs.”
Nursing homes are a particular focal point for concern. During previous surges in infections, nursing homes have accounted for a huge percentage of deaths — as of March, deaths in nursing homes made up about 40% of the state’s total COVID-19 deaths. Vaccination is also likely to be less protective for older people with underlying health concerns, such as those living in nursing homes. For those reasons, the state re-imposed a mask mandate in nursing homes and other residential health care facilities earlier this month.
So far, nursing homes in the state appear to be largely successful in keeping the virus out. CDPHE lists 17 active outbreaks at skilled nursing facilities across the state, all but three of those involving 10 or fewer cases.
Data submitted to the federal Centers for Medicare and Medicaid Services shows no spike in COVID-19 cases at Colorado nursing homes, though the virus is continuing to cause problems. From the beginning of June through the end of July, nursing homes in Colorado were reporting roughly 10 to 20 new COVID-19 cases per week among residents and up to four deaths per week. More recent numbers are still being reported.
Still, advocates for seniors cheered the move to mandate vaccinations for nursing home workers.
“These decisions are being made to protect the lives of patients, providers and their families and to stop the spread of the disease,” Bob Murphy, the AARP Colorado state director, said in a statement. “The key is to increase vaccinations and do it now.”
“It is incumbent upon us to do the right thing”
Polis had been reluctant to issue vaccine mandates for state workers. Late last month, he sidestepped a vaccination mandate by requiring unvaccinated state workers to instead undergo twice weekly coronavirus testing.
But, in his letter to the Board of Health urging a mandate for health care workers, Polis said Colorado would “practice what we preach.” Shortly after his office sent out a news release about Polis’ letter, the state announced the new mandates for workers in the three agencies — the Corrections, Human Services and Health departments.
The scope of these mandates varies across the agencies, though.
The Colorado Department of Public Health and Environment’s is limited to employees, temporary staff and contractors who conduct site visits at health care facilities — to perform inspections, for instance — or who work at vaccination or testing sites. It also applies to employees at the state laboratory and a handful of other workers whose jobs place them in face-to-face contact with people who might be vulnerable to a severe coronavirus infection. In an agency of ardent public health adherents, the department did not say how many of those workers are currently unvaccinated.
The Colorado Department of Human Services’ mandate applies to “direct care and support staff” who regularly enter CDHS facilities such as juvenile corrections centers or mental health hospitals. The agency said 77% of its direct care staff is fully vaccinated, as is 73% of its facilities’ residents.
“Our clients are in congregate care settings,” Michelle Barnes, CDHS’s executive director, said in a statement. “This virus and its variants have hit these environments hard. It is incumbent upon us to do the right thing for our clients, staff, loved ones and community.”
The biggest impact appears set to fall on the state’s Department of Corrections, where those confined in Colorado’s prisons currently have a higher vaccination rate than those hired to watch over them. CDOC says nearly 59% of all CDOC employees are fully vaccinated, compared with 64% of the current inmate population. An additional 8% of inmates have received a first dose of vaccine.
The agency says nearly 9,000 inmates have tested positive for COVID-19 since the beginning of the pandemic and 29 have died.
The vaccination requirement applies only to workers who interact with inmates, parolees or the public and to those who enter CDOC facilities as part of their job. The mandate also applies to visitors to Colorado’s prisons, though the agency said there would be “some accommodations made for extenuating circumstances.”
“We have a responsibility to protect the health and safety of our staff and the incarcerated individuals in our custody to the best of our ability,” said Williams, the executive director.