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Colorado hospitals could turn to traveling nurses in a staffing shortage, but it'll cost them

Hospital systems in Colorado are still seeing a need for traveling health care workers, but rising costs are a big concern.

DENVER — Hospitals across Colorado are coming up with contingency plans in case they lose staff over COVID-19 vaccine mandates. 

All employees in licensed settings in Colorado had to get their first dose of the vaccine by Thursday or have an approved exemption. The vaccine process has to be complete by the end of October. 

"Yes, we have heard from some of our hospitals that some of their staff will leave because of the vaccine mandate," said Cara Welch with the Colorado Hospital Association (CHA). "It could be happening later this week. Some hospitals may choose to terminate employees that decide not to be vaccinated. It could be a choice that goes both ways."

Though, Ingrid Johnson with the Colorado Center for Nursing Excellence the issue of a staffing shortage goes beyond just vaccine mandates. Health care workers are also coping with burnout and how they have been treated throughout the pandemic. 

"I'm worried about the loss of nurses to our workforce everyday," said Johnson. "It's one of those things that wakes me up at night." 

With departures, Johnson is worried about losing expert nurses to help new nurses, as well.

She said throughout her career, there's always been a high need for traveling nurses but the need is greater now as hospital systems are facing so many more openings and staffing shortages. 

The cost of traveling health care workers

Part of the solution to labor needs throughout the pandemic has been to rely on traveling health care workers, but the cost has skyrocketed. 

"Hospitals say it's well beyond what they would normally pay and maybe even be able to afford, even in these extreme times," Welch with CHA said. 

Officials at Lincoln Health in Hugo, on Colorado's Eastern Plains, said they have come to rely on traveling staff for their long-term care facilities, and saw that need increase during the pandemic. 

"The need has always been there," said Carrie Owens, the chief operating officer for the hospital. "People got out of being a CNA, or resigned positions either because it was really hard during COVID. It was hard mentally on our staff and physically the work is hard." 

A CNA is a certified nursing aid. Owens said costs for a CNA doubled in less than a year. 

"Back in January of this year, the rate for a CNA was around $32 to $39 an hour for an agency," Owens said. "Now we are being told to be competitive in the market we need to be at $80 an hour." 

Owens said there are multiple factors, including a shortage of staffing plus an ask for hazard pay because of risks associated with COVID. 

The cost means this is not affordable for Lincoln Health long term. 

"No, we couldn't afford that," said Owens.

Lincoln Health is also in a part of Colorado where the need could be particularly high.

"The concern is for everyone, from my stand point, as a workforce center," said Johnson. "I'm worried across the board. If you ask me where it's critical, it's rural." 

That's because rural hospitals don't have as big of a budget and not as much staffing compared to urban larger hospital systems. 

"We are hearing concerns from rural hospitals," Welch said. "Which makes sense. If they have a staff of 100 and lets say five say they will leave over the mandate, that's a big shift."

An additional financial challenge, according to Owens, is that occupancy at long-term care facilities is down to as low as 40% to 50%. She said families have become more hesitant to put loved ones in these care facilities after seeing the impacts of the shutdown during COVID, and overall worries about the virus.

Filling the gaps

For the time being, Lincoln Health has been able to use some COVID aid to cover costs. They are now looking at different staffing models to help out, like employing more nurses and less CNAs. 

When it comes to helping fill the funding gaps, the Colorado Hospital Association hopes the state will be able to assist by using federal funds or other sources of money to put towards staffing. 

The Colorado Department of Public Health and Environment (CDPHE) said they have reactivated their Staffing Shortage Fusion Center, writing: 

"The Staffing Shortage Fusion Center was originally activated from November 2020 to March 2021 to support staffing shortages related to COVID-19 in which staff shortages are impacting patient care. During that time it filled 4,850 shifts with 160 supplemental staff in 58 facilities statewide. Between April 1 and September 30, CDPHE has continued to provide staffing resources for residential care facilities, filling 994 shifts in 31 unique facilities."

CDPHE also wrote: 

"The state's surge staffing strategies aren't directly tied to the vaccine requirement, as we are hopeful that most facilities will be able to retain healthcare workers. Facilities and the state are doubling down on messaging to the healthcare workforce that getting vaccinated is safe and effective-- and necessary to safely treat Coloradans. 

The staffing fusion center is intended to be a stopgap measure for temporary staff shortages directly related to COVID-19 when patient care may be impacted. As other states are experiencing severe healthcare worker shortages, fewer contract healthcare workers are available for facilities that normally rely on contract staff to augment staff. The fusion center also helps state agencies maximize efficiency and avoid competing with each other in a very tight healthcare worker labor market. The fusion center helps coordinate requests among various agencies. It is not intended to be a long-term staffing solution. "

The state said federal funding continues to help fund staffing support efforts. 

This is to help with staffing for multiple locations, including residential care facilities, hospitals, correctional facilities, and other licensed care settings. 

CHA also said many hospitals already had their own vaccine requirements in place and are now navigating both state and federal rules, as well.

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