MaineHealth on Monday defended its decision to vaccinate all hospital employees against COVID-19, saying it followed federal and state guidelines that were in effect until that effort was well underway.

But Maine Medical Center, MaineHealth’s flagship hospital in Portland, was wrong to vaccinate “a small number” of out-of-state consultants who were hired to help fight an effort to unionize nurses, which happened after the state issued guidance limiting vaccination to Maine residents, network officials said.

“We understand that non-Maine residents are not eligible for any vaccine and acknowledge that we erred in vaccinating those individuals,” MaineHealth said in a written statement responding to a column by Bill Nemitz in this week’s Maine Sunday Telegram.

On Sunday, however, MaineHealth CEO Bill Caron sent a letter to the network’s board of trustees confirming that he had been told in December that the eligibility guidelines for the first phase would change to exclude hospital employees who don’t have face-to-face contact with patients, including remote, telehealth, administrative, information technology and billing staff.

Caron said he decided to continue vaccinating all hospital employees regardless of the rules as a necessary step to protect hospital operations and infrastructure.

Caron had a “somewhat heated” exchange with Dr. Nirav Shah, head of the Maine Center for Disease Control and Prevention, saying he was “changing the rules of the game – which he would not acknowledge,” Caron said. By that time, MaineHealth had inoculated patient-facing staff members, both clinical and non-clinical, and had begun vaccinating non-patient-facing employees.

“It was Dec. 29 that I made the decision that we would continue to vaccinate our Tier 5 care team members even if the governor changed the rules the next day,” Caron said in the letter to trustees. “That day I told our (MaineHealth management team) that I , and they, would potentially ‘have a bull’s-eye on our backs,’ but we needed to move forward to protect our health care infrastructure.”

Caron said he “would make the same decision today … and I know that the entire (management team) would be right there with me. Our decision was rooted in the values we espouse as a system and we were focused on protecting the valuable resource of health care infrastructure which has been entrusted to us. We were disciplined and followed the federal and state guidance we were given.”

MaineHealth CEO Bill Caron, photographed last week before the opening of a mass vaccination clinic at the former Scarborough Downs, said Monday that the company “followed the federal and state guidance we were given” in vaccinating all hospital employees. Derek Davis/Staff Photographer Buy this Photo

While Caron was told about the change Dec. 29, it did not appear in the guidance posted on the state website until Jan. 13, MaineHealth said Monday.

Caron noted that early on, the U.S. CDC defined “health care workers” to include all health care workers, with the goal of protecting health care infrastructure. In Maine, hospitals have stepped forward to lead the COVID-19 vaccination effort in the wake of severe public health budget cuts by former Gov. Paul LePage and a lack of advanced planning by the current administration.

Moreover, Caron said, after hospitals began vaccinating front-line health care workers in mid-December, Gov. Janet Mills and state health officials began facing increasing pressure from health care providers outside the hospital networks who wanted vaccine for their workers.

As of Monday, 68 percent of MaineHealth’s 22,500 employees had received both shots of either the Pfizer or Moderna vaccines, given three weeks apart, indicating that most had received at least one shot by the time the Maine CDC updated Phase 1A vaccination guidance on its online dashboard Jan. 13, MaineHealth officials said.

Shah declined a request for an interview on Monday and the Maine CDC didn’t respond to a request for documents showing various changes in Phase 1A vaccination guidelines.

Jackie Farwell, spokeswoman for the Maine Department of Health and Human Services, provided a link to and summary of the current guidelines, which reflect U.S. CDC guidelines and now exclude non-patient-facing administrative staff and employees working remotely.

“Maine DHHS has informed MaineHealth and other vaccine providers of these guidelines and consistently communicated this definition,” Farwell said in a prepared statement. “In late December, Maine DHHS further defined for MaineHealth and other vaccine providers which personnel qualify as health care staff eligible under Phase 1A to more effectively target vaccines toward front-line workers.”

However, an archived description of eligible Phase 1A health care workers that was on the Maine CDC’s dashboard before Jan. 13 said they are “paid and unpaid personnel serving in health care settings who have the potential for direct or indirect exposure to patients or infectious materials … (they) comprise clinical staff members, including nursing or medical assistants, and support staff members (e.g. those who work in food, environmental and administrative services).” It linked to the U.S. CDC website for further information. At the time, neither site excluded non-patient-facing personnel.

Meanwhile, on Jan. 12, National Nurses United and the Maine State Nurses Association filed a petition with the National Labor Relations Board to represent the 1,600 full-time, regular part-time and per diem nurses at Maine Med.

Within a few weeks, Maine Med hired Florida-based Reliant Labor Consultants to provide mandatory “training” to the nurses “to help them decide if they want a union to speak for them,” according to an internal memo. Reliant lists among its services “avoiding a union” and “fighting a union.”

Caron and other MaineHealth officials said Maine Med typically offers vaccination to contracted service providers who have regular contact with care team members or patients.

During the week starting Jan. 17, Maine Med offered vaccine to about 10 people from out of state who were brought in to “provide support” to nurses and managers in answering questions about the impact of joining a union, according to the MaineHealth statement.

However, on Jan. 18, the state issued new guidance that only Maine residents were eligible for vaccines and MaineHealth made an error in vaccinating the out-of-state consultants, the statement said.

MaineHealth’s decision to vaccinate all care team members has proven beneficial as it has begun to set up mass vaccination clinics across its service area, the statement said.

“A majority of those employees who have been working primarily from home during the pandemic are now being redeployed to staff vaccine clinics,” the statement said. “MaineHealth stands by its decision to secure its full health care system by vaccinating its full care team.  We believe that it is the best approach for patients, care team members and the communities we serve.”

Note: This story was updated Feb. 9 to clarify that both Pfizer and Moderna vaccines were used to inoculate MaineHealth employees.