Patricia Scherle, vice president of Patient Care Services and chief nursing officer for St. Mary’s Regional Medical Center in Lewiston, talks Aug. 13 to Chief Medical Officer Doug Smith about the COVID-19 vaccine mandate and its impact on the staff. Andree Kehn/Sun Journal

LEWISTON — With less than a month remaining for health care workers in Maine to complete their vaccination series for COVID-19, local hospital systems say they are developing “contingency plans” in case of a substantial exodus of staff come Oct. 1.

The Maine Department of Health and Human Services rule dictating mandatory vaccinations against some diseases for health care workers and deficits across the workforce in Maine predate the pandemic.

“COVID really made (workforce shortages) worse,” St. Mary’s Health System President Steve Jorgensen said. “COVID has kind of pushed a lot of people that were maybe on the fence before towards either retirement or getting out of the health care industry.”

Now, Jorgensen said the system, which includes St. Mary’s Regional Medical Center and d’Youville Pavillion, both in Lewiston, is “dusting off” contingency plans from the early days of the pandemic that were made in case of staff shortages.

“We’re dusting those off and saying, if we do have a major deficit in our staff, and we hope we don’t, but if we do, what are the things we can do to limit our capacity so our existing remaining staff can provide the high-quality, safe care.”

Those plans include determining if and when to cut back on elective procedures, and lining up agencies, traveling health care workers and candidates to hire in the future.

As of the end of July, about 83% of St. Mary’s hospital staff and about 77% of d’Youville Pavillion were vaccinated. About 260 hospital staff and 80 at the nursing home were unvaccinated at that time.

Jorgensen said even “if everyone got vaccinated and everyone stayed, or they had the medical exemption granted, we are still actively recruiting in a very tight, competitive market” for both clinical and nonclinical positions.

Down the road, Central Maine Medical Center has had one of the lowest staff vaccination rates among Maine hospitals since mandatory reporting began, with about 66% of staff there vaccinated by the end of last month.

There were just under 900 staff that had yet to be vaccinated at that time, but Central Maine Healthcare’s chief medical officer, Dr. John Alexander, said “dozens and dozens” of team members have gotten their shots over the past couple of weeks.

“We recognize it as a difficult and a personal decision,” Alexander said. “And our intent is to respect our team members’ timing in terms of they’re going to make the decision when they’re ready to make it.”

But the clock is ticking. Friday was the last day to receive the first of the two-shot Moderna vaccine and Friday, Aug. 27, is the last day to receive the first of the two Pfizer shots. For the one-shot Johnson & Johnson vaccine, the deadline is Sept. 17.

Come the first day of October, if any staff at a state-licensed health care facility, dental practice or emergency medical services agency is not two weeks post-final shot, they will not be allowed to report to work.

Alexander said Central Maine Healthcare, which is the parent organization to CMMC, Bridgton Hospital and Rumford Hospital, has not yet decided if those team members will remain on the hospitals’ payroll.

“We have no plan to terminate them as of October,” he said, but in following with the state rule, “no key member will be allowed to report to work unless they’re fully vaccinated.”

Staff at the Bridgton and Rumford hospitals are 85% and 75% vaccinated, respectively.

About 80% of all hospital staff statewide have been fully vaccinated as of July 31.

Franklin Memorial Hospital in Farmington (71% vaccination rate) and Stephens Memorial Hospital in Norway (78% vaccination rate) are part of MaineHealth, which mandated COVID-19 vaccines for employees earlier this summer.

MaineHealth spokesperson John Porter told the Portland Press Herald that it would fire workers who refuse to get vaccinated.

Alexander and Jorgensen said the hospitals’ administration continues to work on education and outreach, and on making vaccines as accessible as possible.

As for potential staff shortages, Alexander said CMMC is already dealing with that.

“That’s not really a lot different than our normal day-to-day operations where we really work as diligently as we can to make sure that we can keep access open for our patients,” he said. “We have a lot of people who are very flexible and take on different roles and responsibilities as necessary and that’s what we’ll continue to do, really regardless of the vaccine mandates.”

When Gov. Janet Mills announced the mandate Aug. 12, she and DHHS Commissioner Dr. Jeanne Lambrew said the COVID-19 vaccine requirement would be added to an existing rule that says health care workers must be immunized against measles, mumps, German measles, chickenpox, hepatitis B and as of last year, seasonal influenza.

The rule does allow medical exemptions, which must be provided in the form of a written statement from a physician, nurse practitioner or physician’s assistant attesting that in their “professional judgment, immunization against one or more diseases may be medically inadvisable.”

The rule, which was first enacted in 2002, does not allow for religious or philosophical exemptions.

“What I focus on is this mandating of vaccines to protect patients and protect staff is not new,” Jorgensen, from St. Mary’s, said. “We’ve been mandating certain vaccines for a long, long time.”