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The Dose

Welcome to The Dose, which tackles the business and economics inside the turbulent world of health care and life sciences in Indiana. Your host is John Russell. To contact me call 317-472-5383.

Bill would let hospitals require flu vaccinations for clinical workers

January 16, 2017

Physicians and nurses, heal thyselves—or in this case, get vaccinations for thyselves.

That’s the goal of a bill winding through the Indiana General Assembly, which would allow hospitals to require workers to get vaccinations for the flu and other contagious diseases, or else take a hike.

The move comes just a year after a similar bill took a roller coaster ride through the Legislature and crashed. It would have allowed hospitals to fire clinical employees who refused to get immunizations.

The immunizations covered the flu, along with measles, mumps, rubella, tetanus, diphtheria, pertussis and meningococcal.

Last year’s bill passed the Indiana Senate unanimously but then ran into strong opposition in the House. Numerous people testified they had major apprehensions for a wide variety of reasons, from medical issues to philosophical concerns to bad personal experiences with flu vaccines.

Unable to reach an agreement between the two chambers, the General Assembly decided to send it to a health study committee for further review. Ultimately, the committee didn't make any recommendation regarding the bill.

Now, a very similar bill has been introduced. SB 133, sponsored by Sen. Frank Mrvan (D-Hammond) would authorize a hospital, if it has a written policy in place, to impose as a condition of employment a requirement that a worker have an immunization. The hospital can terminate an employee if he or she doesn’t get an immunization.

The bill provides for certain exceptions, including if the immunization would medically hurt the worker, or if the immunization would be against the worker’s religious beliefs. But the hospital would have the final call. “A hospital may establish a process for determining whether the tenets of the religion relied upon by an individual for the purposes of the exemption … prohibit the individual from receiving the immunization,” according to the bill.

Across Indiana, hospitals and health systems have various policies on such employee mandates, and all are free to require workers to comply or lose their jobs.

Some hospitals require all clinical workers to get a flu vaccination every year. Others require workers who don’t get a flu vaccination to wear a mask during flu season. Others simply make recommendations.

Indiana has no comprehensive law on the subject, so legislators have tried to address it. Sen. Mrvan did not return several phone calls from IBJ seeking comment.

In Indiana, 87 percent of health care workers get the flu vaccination, slightly above the national rate of 84 percent.

The issue has flared up repeatedly in recent years in Indiana. It reached a flash point in 2013, when Indiana University Health fired eight employees, including three nurses, from its Goshen Hospital for refusing to get a flu vaccination.

IU Health said the mandate was meant to improve patient safety. Hospital patients often already have compromised health, and many could be vulnerable to the flu and other maladies.

The Centers for Disease Control has a clear position on the issue: "All persons aged 6 months and older are recommended for annual vaccinations, with rare exceptions." The CDC also recommends that all U.S. health care workers who come into contact with patients get vaccinated annually against the flu.

The Indiana Hospital Association says it isn’t pushing for the bill. The association supports immunization for health care workers, but said the legislation is not the right away.

Brian Tabor, the association’s executive vice president, said the bill had too many exceptions that could actually set things back. He said the association’s goal is to achieve 100 percent compliance.

“If you pursue legislation in this fashion, it could have the unintended consequence of weakening efforts that hospitals have under way,” Tabor said.

Mrvan’s bill was assigned to the Senate Health and Provider Services Committee.

 

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