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Job ads for open positions in Nebraska’s state-run facilities highlight optional Covid-19 vaccines, a move that contradicts federal mandates for health workers and could cost the state some of its insurance reimbursements.
On Monday afternoon, Nebraska state Sen. Carol Blood received a Facebook message from a constituent containing a screenshot of an advertisement recruiting nurses for a veterans’ home in her district. The ad, posted earlier in August, opened with a $5,000 hiring bonus, followed by four words.
“No mandated Covid-19 vaccinations.”
The constituent wanted answers, said Blood, a Democrat from Bellevue. “They were asking, ‘How is this acceptable, that we would recruit nurses and encourage those that are not vaccinated to come and work around our most vulnerable?’”
Blood wanted answers, too. The job ads—46 of them, touting vaccine-optional positions in state-run veterans’ homes, youth detention facilities, psychiatric hospitals and prisons—were posted as Covid-19 cases continued to increase across the state. The policy seemed to directly contradict an earlier announcement from the U.S. Department of Veterans Affairs that all medical personnel working in its health facilities across the country would be required to receive the vaccine, as well as a similar mandate from the Biden administration for workers in long-term care facilities.
In a letter dated Aug. 23, Blood asked Gov. Pete Ricketts and Nebraska Department of Veterans Affairs Director John Hilgers to explain “why the state feels this is an acceptable option and the reasoning behind allowing unvaccinated staff into our facilities.”
“I do understand we have a serious shortage of staff. We also know that a part of these shortages are systemic issues under management,” she wrote. “With that said, putting those who live in these facilities at risk because we need to find bodies to hire is not acceptable.”
The recruitment campaign, it turned out, went further than she’d thought. Medical workers across the state—and some in Colorado—later reported receiving postcards in their mailboxes highlighting “an opportunity to continue your career as a nursing professional” at state-run facilities where Covid-19 vaccinations are “encouraged” but “not required.”
The ad blitz came after eight of Nebraska’s major private health-care systems said they would mandate vaccines for employees, leading to what Blood called less-than-ideal optics.
“It almost looks—and I don’t know that this is the case—like we’re trying to scoop up the people that want to leave those facilities because they don’t want to be vaccinated,” she said. “The science tells us that people need to be vaccinated and masked to slow the Delta variant down, but the state is ignoring that science, and I just want to know why. What are we basing that decision on? I think it’s a fair question.”
Blood asked Ricketts and Hilger to respond by Friday and, as of this morning, had not heard from either.
Taylor Gage, a spokesman for the governor, confirmed that Ricketts approved the ads, which also tout hiring bonuses of up to $5,000.
“The state has been pursuing a variety of strategies to address workforce challenges,” he said via email. “At the governor’s direction, the State Personnel Division consulted with state agencies to develop this recruitment effort.”
At a press conference Thursday, Ricketts said the ads were an extra recruiting push to shore up the state’s long standing nursing shortage and were not meant to target unvaccinated nurses specifically.
“We have a number of positions open at the state of Nebraska. We need nurses just like everybody else does,” he said. “We want to recruit them. We also heard from a lot of people when the hospitals made that announcement that they were very unhappy with their employers interfering with their personal health decisions. We want nurses to not leave the workforce, because we need them all.”
Campaign Angers Nurses and Hospitals
The move angered nurses across the state. In a letter to Ricketts, Kari Wade, president of the Nebraska Nurses Association, said the ads were a slap in the face for caregivers who have spent more than a year promoting public health measures proven to slow the spread of the virus, including face coverings and vaccination.
“The state of Nebraska’s recruitment approach of not requiring Covid-19 vaccination being used as an incentive demeans the dedication and diligence the nursing workforce has demonstrated during the pandemic to improve the health of all Nebraskans,” she said. “This promotion does not serve our state well.”
The Nebraska Hospital Association also panned the ads, saying in a letter that “promoting the lack of vaccine requirements as an incentive flies in the face of what we, as Nebraska hospitals and health systems, believe in terms of ethics and patient safety.”
The move could also have financial implications for the state. The Biden administration’s policy for long-term care workers stipulates that the Covid-19 vaccination is a “condition of participating in the Medicare and Medicaid programs,” meaning that facilities that don’t comply could be at risk of losing federal reimbursements for the care they give to patients covered under those plans.
But it’s unclear how much that might cost Nebraska. Officials from the Centers for Medicare and Medicaid Services did not return a request for information, and Blood said she had similar questions that would be addressed in a second letter if Ricketts did not respond to her original query by the end of Friday.
Ricketts on Thursday also declared a “staffing emergency” for the state’s hospitals, waiving some education and licensing requirements for providers and allowing “retired or inactive” health-care professionals to come back to work.
The governor said he was open to “further measures” to shore up staffing at hospitals, but would not approve a mandate for either face coverings or vaccines, despite believing that vaccinations are “our best tool against the virus.” That messaging is “absolutely not” hypocritical when compared to the language in the job advertisements, he added.
“If you go look at our advertisement, for example, we say, ‘while vaccines are encouraged, they’re not required,’” he said. “We need people to do this because it’s part of personal responsibility for themselves.”
Kate Elizabeth Queram is a senior reporter for Route Fifty and is based in Washington, D.C.