Bradley Mattes, associate nurse leader at Central Maine Medical Center, questions patients at the emergency entrance to the hospital, Friday, March 13, 2020, in Lewiston. Credit: Robert F. Bukaty / AP

A Lewiston hospital plans to close its neonatal intensive care unit and is making drastic contingency plans in the event that it loses staffers who remain unvaccinated against COVID-19 with a mandate from Gov. Janet Mills set to go into effect at the end of the month.

The plan at Central Maine Medical Center is spurring local lawmakers to call on Mills to provide a testing opt-out to the mandate, something the Democratic governor has resisted so far. The hospital confirmed the worst-case scenario on Friday, saying 250 employees have no vaccination record with the hospital and 170 of them deal directly with patients.

The situation is one of the most dire outlined at a Maine hospital during the COVID-19 pandemic. It also presents a dire situation in Androscoggin County, where 58 percent of the population has had its final COVID-19 dose, according to state data. The hospital is in Maine’s second-largest city and caters to most of the region.

“We continue to work very closely with our as yet unvaccinated team members by giving them all the information they need to make an affirmative decision to receive the vaccine,” said Ann Kim, a spokesperson for Central Maine Healthcare, the hospital’s parent.

Maine Senate Minority Leader Jeff Timberlake, R-Turner, and Sen. Ned Claxton, D-Auburn, who were on a Friday call with hospital leaders, said members of the regional delegation are planning to petition Mills to consider a testing option for unvaccinated workers and to explore ways to provide aid to the hospital ahead of the deadline. They are also likely to ask Mills to consider deploying the Maine National Guard to bolster staffing.

Under the contingency plan, the hospital would slash intensive care unit beds by 50 percent and drop the number of medical surgical beds by 40 percent. The hospital had brought up staffing concerns to lawmakers just over two weeks ago, Claxton said. He said the hospital has described longer wait times for emergency rooms and struggling to find space for patients.

Timberlake said the hospital’s situation is compounded by a statewide staffing challenge in nursing homes and other rehabilitation facilities, since leaders described some patients who should have been discharged within two to four days remaining at the hospital for 10 to 14 days because they could not find a bed.

“There have been rare instances where a patient has picked up COVID from hospitals, thanks to the safety precautions staff take,” Claxton said. “If everyone is wearing face shields and gowns, do we really need to be pushing the mandate so hard?”

The Lewiston hospital had a 75 percent staff vaccination rate as of the end of August and it has an 80 percent rate now, with a higher rate across the rest of the Central Maine Healthcare system. There are another 500 job openings. The hospital has to report its count of unvaccinated staff ahead of an expected update on staff vaccinations for next week.

The mandate went into effect last Friday, but the state will not enforce it until Oct. 29. Workers have until Oct. 15 to get the Johnson & Johnson shot to comply with the mandate.

Maine Department of Health and Human Services spokesperson Jackie Farwell said the state was in touch with the hospital about staffing issues and offered to provide help with testing supplies, protective gear and workforce issues. She said $146 million set aside to help health care organizations with workforce struggles will be released later this month and reiterated the state’s position that vaccines are critical to keeping workers and patients safe.

Michaud said the situation in Lewiston was particularly bad for Maine but not unprecedented nationally. Hospitals here have canceled non-emergency surgeries and at times sent patients to other hospitals due to space and staffing constraints during the recent delta variant surge.

But he still said the mandate, which the hospital association backed, is necessary to protect people from the virus and to keep workers on the job, even if it leads to needing to manage care differently.

“If we get down the road and we have to assess where we are [on the mandate], we’ll do that,” he said. “That’s not where we are.”

Correction: Details contained in this original article have been corrected. Central Maine Medical Center plans to close its neonatal intensive care unit. It will not be closing a vaccination clinic at the Auburn Mall. Its contingency plan also envisions closing 40 percent of medical surgical beds, not that share of all beds.