Prowers County Medical Center

Prowers County Medical Center, courtesy Prowers County Medical Center.

The issue of vaccine mandates for hospitals is a touchy one, especially in rural communities with low vaccination rates.

That includes Prowers County, in southeastern Colorado. The board of directors for the Prowers County Medical Center (PMC) went so far as to hold a special meeting to explain why they have to adhere to the mandates, which produced what some are viewing as a threat to the board from state Rep. Richard Holtorf, R-Akron.

The mandate on vaccinations for healthcare workers, ordered in September by the Centers for Medicare and Medicaid Services (CMS), a branch of the U.S. Department of Health and Human Services, set a deadline of Sept. 30 for getting vaccinated. The mandate went to facilities that accept Medicaid and Medicare payments, such as PMC.

According to the Prowers County Journal, more than 100 people, both in person and by phone, attended the board's Sept. 29 meeting.

Board Chair Julie Branes said the medical center is obligated to follow the vaccine mandate, given that it is a Medicaid and Medicare facility, and ignoring the mandate could risk their license.

Out of 23 employees at PMC who sought exemptions from the vaccines, only one was granted. The rest were told they had to get vaccinated, but public comments, as reported by the Journal, leaned toward ignoring the federal requirement.

That included Holtorf, a resident of Washington County whose House district includes southeastern Colorado.

Holtorf reportedly told the board they would be liable for civil litigation "for denying hospital employees their right to work"  and suggested the board was violating its constitutional duty. The Akron Republican did not return a request for comment.

Colorado is not a "right to work" state, and according to Christopher Jackson, an attorney with Holland & Hart and a former assistant attorney general in Colorado, there is no provision of the federal or state constitution that explicitly forbids employers from firing someone for refusing a vaccine.

"Which side of the litigation will you be on in the future — you need to consider your liability as this can go before the state Supreme Court," Holtorf reportedly said. 

The third-year lawmaker also suggested the board send a protest letter to the Colorado Department of Public Health and Environment in advance of an Oct. 21 meeting. The state board of health plans to meet on that date to consider reducing the vaccination rate for healthcare workers from 100% to 90%. 

Holtorf then told the board that "I have background on some of you [board] members," without saying exactly what he intended to do with it. 

"Threatening our local hospital board members does not serve the greater needs of our community," Christi Stulp of Granada tweeted Wednesday with a link to the Journal article.

But according to a spokesperson for House Republicans, Holtorf was not threatening anyone.

"He was simply stating that he was aware of how the mandate was being handled by the hospital and board members. During the meeting he noted that he had 'background' information on how the board members had denied 22 of the 23 requests for medical or religious exemptions from the vaccine mandate. There were no threats made, just recognition of events that had been taking place," said spokesperson Isabelle Daigle.

She added that "Holtorf was speaking out in defense of staff's constitutional rights that are being violated with threats to pull licenses despite legitimate medical exemptions."

The Prowers County Medical Center employs about 320 people. It is a 25-bed critical access hospital and has a rural health care clinic. It does not have any ICU beds or ventilators, however. Those who need critical COVID-19 care have to go to Pueblo or Colorado Springs.

As of Oct. 5, 48.5% of Prowers county residents have been vaccinated. The statewide average is 77.5% for those who have received at least one dose and 71.2% for full vaccination.

As of Oct. 6, the county department of health reported a total of 1,513 cases. That includes 28 deaths and 109 hospitalizations, and the health department said every hospitalization and death was for an unvaccinated person. The county has reported 22 outbreaks during the pandemic, all now resolved, with the largest at the 60-bed Lamar Estates, a nursing home that has had two outbreaks, with 25 cases among residents, 36 cases among staff and 11 resident deaths.

As to mandates, an Oct. 6 bulletin from the county health department said, "Your local public health agency has no ability to change the vaccine mandates handed down by the state or federal government. Enforcement is not a part of our jurisdiction. In Colorado, local public health agencies can make rules tighter than those of the state but cannot loosen them. Prowers County Public Health and Environment has no intention of doing this and has not done this throughout the pandemic. Please direct your concerns to your Governor and state and federal legislators."

The county population, according to the 2020 census, is 11,999.