Hospitals requiring staff to get flu vaccines
No vaccination, no job, some hospitals say. It’s civil rights versus health of patients.
Lehigh Valley Hospital RN Cheryl Hartman prepares an influenza vaccineâ¦ (HARRY FISHER, TMC )
December 01, 2012|By Tim Darragh, Of The Morning Call
As hospitals in recent years have stepped up their efforts to persuade the public to get annual flu vaccinations, their employees haven’t always heeded the call.
But federal health authorities believe that hospital workers who are anywhere near patients should be vaccinated for their welfare, as well as patients.’ And with the government dangling the carrot of Medicare reimbursement money, hospital administrators are wielding the stick.
Some of the Lehigh Valley region’s hospitals, including Lehigh Valley Health Network, Sacred Heart Hospital and Grand View Hospital, are mandating employees get flu vaccines if they have contact with patients â even if the employees don’t want the shots. If they don’t comply or get a valid exemption, they will be fired.
The list of staff affected by the policy is broad. It includes not only doctors and nurses and others directly involved in patient care but also housekeeping and maintenance workers.
The policy pits the civil rights of workers against the health of patients. And the health of patients trumps, said Lewis Maltby, president of the National Workrights Institute, a spin-off of the American Civil Liberties Union.
“You can’t stick a needle in somebody’s arm who doesn’t want it stuck in their arm,” Maltby acknowledged. But he also said that since health care workers are both a risk to themselves and patients â many of whom are already in a severely weakened state â the policy makes sense. “If the hospital wants to make it mandatory, [it] should be able to,” he said.
Maltby, whose organization regularly pushes back against what it views as threats to workers’ privacy rights, is firmly on the side of the health-care establishment in this case.
The Hospital and Healthsystem Association of Pennsylvania wants its members to go to mandatory flu shots as a condition of employment beginning next year.
The Joint Commission, the top health care accreditation agency in the nation, this year enacted a plan to have hospitals train and educate their staffs about the benefits of flu vaccines. Although it is not demanding mandatory vaccinations, the commission is requiring hospitals to show they are progressing toward 90 percent compliance by 2020.
Even more significantly, the Centers for Medicare and Medicaid Services issued new regulations that will cut hospital reimbursements by 2 percent beginning in 2015 if they fail to report patient quality measures, including health care worker vaccination rates, starting next month.
Hospitals across the country are getting tough. In Cincinnati, for example, a health system issued termination notices earlier this month to 150 workers who didn’t get flu shots. According to published reports, the workers were told to get vaccinated by Dec. 3 if they want to keep their jobs.
Health agencies say the facts about influenza make vaccination for everyone without a religious or health exemption a no-brainer. In a fact sheet, the hospital association notes the flu causes about 226,000 hospital admissions a year and 24,000 deaths and that people with the flu may be infectious for 24 hours before they develop symptoms.
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Further, it says worker vaccinations reduce the spread of the infection, patient mortality and worker absenteeism, and that vaccinations may, in the long run, save hospitals money.
Local hospitals are falling into line, with most saying they have been educating their staffs about flu shots. They said they made the shots free to staffers and available at different shifts and days. All have exemption policies that respect religious beliefs and cases where a vaccination could endanger an individual’s health, but the process includes providing evidence and acknowledging the implications of an exemption.
The U.S. Equal Employment Opportunity Commission says employers must respect individuals’ religious beliefs even if they are not members of an organized religion. But to show the emphasis on vaccinations, hospitals are reviewing and in some cases denying exemption requests.
Exempt employees usually are required to wear masks when near patients during flu season. That’s a difficult practice to maintain, said Dr. Jeffrey Jahre, senior vice president of Medical and Academic Affairs at St. Luke’s University Health Network.
“That’s not practical,” he said, noting masks have to be worn properly and changed regularly. “That’s not going to happen.”
Exception to rule
In some places, the period of simply encouraging compliance is over or about to end.
LVH, the area’s largest employer, now is making vaccinations a condition of employment for workers who might come near patients. That includes doctors and nurses, but also others such as food service delivery personnel and heating/ventilation/air conditioning workers.