Rhode Island healthcare workers given choice: flu shots or masks

Rhode Island may be diminutive geographically speaking, but it is mighty when it comes to trying to protect healthcare workers and patients from the flu.

The state Health Department has revised its Rules and Regulations Pertaining to Immunization, Testing, and Health Screening for Healthcare Workers to make flu shots mandatory for all workers, students, trainees and volunteers who may have contact with patients at a healthcare facility (with some exceptions). Those who decline the vaccination will be required to wear a surgical mask whenever they are near patients during flu season.

The Rhode Island rule imposes a fine of $100 per violation on non-compliant individuals and their employers. Non-compliance also may result in loss of professional licensure.

“It is not the intent of these regulations to impose an unnecessary burden on healthcare workers but to effectively protect the public,” the document states.

Michael Fine, M.D., director of the RI Department of Public Health, said officials crafted the amendments after conferring with stakeholders. “Those who care for and interact with patients in a healthcare setting have a duty to protect the health and safety of those for whom they care,” he said.

The rule’s definition of healthcare facility is quite broad, including hospitals, nursing homes, rehab and surgi-centers, ambulatory care clinics and home health organizations. It does not apply to private doctors’ offices.

The RI Health Department’s move is significant given the debate over mandatory versus voluntary influenza vaccinations that has dogged the healthcare industry for years. While a growing number of hospitals are adopting policies that make vaccination a condition of employment, opponents say such strict policies may violate workers’ rights. There are others who question the efficacy of the vaccine.

In Rhode Island, workers and volunteers may obtain a medical exemption from a doctor, physician’s assistant or nurse practitioner. The exemption request must be submitted annually for approval by Dec. 15. Those who are opposed to having a flu shot but not medically exempt must submit a form to their employer annually by Dec. 15 that states:

“I understand that, by refusing such vaccination, it is my professional licensing obligation to wear a surgical face mask during each direct patient contact in the performance of my professional duties at any healthcare facility during any declared period in which flu is widespread. I understand that the consequence for failing to do so shall result in a $100 fine for each violation. Failing to do so may also result in a complaint of Unprofessional Conduct being presented to the licensing board that has authority over my professional license. I understand that such licensing complaint, if proven, may result in a sanction such as reprimand, or suspension or revocation of my professional license.”

In addition, RI healthcare facilities are required to:

  • develop an annual influenza vaccination plan in keeping with guidelines established by the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP);
  • maintain a surveillance program to track, record and report influenza vaccination levels among healthcare workers.

Meanwhile, out West, the Colorado Health Department also has been in the news lately as a vigorous flu shot proponent. Among requirements described in its Influenza Immunization for Healthcare Workers: Ready to Report Toolkit, the state allows licensed healthcare facilities to develop their own policies as long as they reach target vaccination rates:

  • 75 percent of all employees vaccinated by Dec. 31, 2013.
  • 90 percent of all employees vaccinated by Dec. 31, 2014 and every year thereafter.

To learn more about requirements affecting hospital employees in your state, visit the CDC’s vaccines and immunizations website.

It will be interesting to see if other states follow the lead of either Colorado or Rhode Island.

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