Health Board adopts CMS vaccine mandate

After disputes over mitigation requirements proposed by the public health department, the Washington County Board of Health voted unanimously on a policy to comply with the Centers for Medicare and Medicaid Service vaccine requirements.

“My purpose with all this is to find a middle ground that we all could feel good about and feel that meets the requirements that we are being held to,” Public Health Director Emily Tokheim said.

Tokheim said the policy was a mix of measures health agencies had already approved.

“I reached out to other county public health departments to get a better understanding of what local boards of public health were approving,” she said. “There were several suggestions, several different strategies used in other county health departments, so we essentially pulled pieces from each of those.”

The policy requires public health employees to submit proof of vaccination or a medical or religious exemption to the department by March 15, and enacts a variety of other COVID-19 mitigation measures, an open-ended requirement of the federal guidelines.

While the original policy included weekly COVID-19 tests for unvaccinated staff, that clause drew criticism from board members and didn’t make the final cut.

“I think it is a reasonable common ground we can have to have something we can document and not force or single out employees with exemptions, so I think that makes it more fair,” Board Member Dr. Trevor Martin said. “We wanted an alternative to forcing people to test and singling them out for exemptions.”

Martin and Board Member Chris Grier had suggested the use of vitamin D tests as a mitigation measure at an earlier meeting, but Tokheim said that didn’t make the final policy either.

"There were several concerns raised about the implementation of that, what that would look like,“ Tokheim said. ”There were several concerns raised about liability and safety, and not quite honestly being sure if any of them were well-founded, but if we were raising these questions, putting a halt to that and taking a step back and seeing what else we could get approved.“

The final policy does have a range of other COVID-19 mitigation measures.

Those precautions are mostly things already done by department staff, like wearing masks around patients and self-screenings for symptoms. The new policy, however, requires that employees certify in writing every week that they have not experienced two or more symptoms of COVID-19, part of the department’s efforts to meet documentation requirements from CMS.

“Surveyor guidance looks for … documentation of these mitigation strategies,” Tokheim said at an earlier meeting. “Hand washing, other PPE, those are all good hygiene practices (but) we did not feel that was adequate to meet the requirements of this policy.”

Comments: Kalen.McCain@southeastiowaunion.com