OR Manager November/December 2021 - 33

AMBULATORY
SURGERY CENTERS
with certain exemptions for medical or
religious reasons (sidebar, " The slippery
slope of exemptions " ).
BJCMG Orthopedics
and Sports Medicine
in Alton, Illinois, has
granted medical or religious
exemptions to
some 20% of
its employees.
" For those who
are unvaccinated and required
to undergo weekly
testing under the manJohn
W.
Stirton, MD,
MBA
date, a free testing site has been set up
on campus. Vaccines are also offered
conveniently on our campus, " says John
W. Stirton, MD, MBA, medical director of
the joint replacement center and associate
chief of surgery at BJCMG.
Northwell Health, before this article's
publication, was evaluating several
requests for exemptions. " Every exemption
request, religious or medical,
goes through a lengthy, rigorous review
process before any decision is made, "
said a Northwell Health spokesperson.
Pushback among employees
As in the case of Northwell Health and
other facilities, not everyone is ready
or willing to comply. " Many within the
healthcare workforce feel that in an attempt
to promote vaccination, some
institutions have compromised the essential
principles of patient autonomy
and informed consent, " says Dr Stirton.
The reasons and concerns over
vaccine mandates are multifactorial,
says Kirchner (sidebar, " One nurse's
perspective " ). " We found we had as
much pushback from physicians as we
did from nurses, " she said. Surveying
healthcare workers in the field, Kirchner
learned that some workers fear that the
mandate will lead to staffing shortages
if some do not get vaccinated. And in
the end, this will hurt patients.
Others say it is illegal to coerce; that
the responsibility is to educate about
vaccines, not mandate vaccinations.
Some have concerns about the safety
of the vaccine itself-that there are no
www.ormanager.com
The slippery slope of exemptions
The exemption process for COVID-19 vaccines
can be tricky. Beverly Kirchner, BSN,
RN, CNOR, CNAMB, compliance officer
of SurgeryDirect, LLC, discussed some of
the challenges during her presentation on
the COVID-19 vaccine mandate and future
policy considerations at the OR Manager
Conference.
" When you're working on this mandate
and policy exemption forms, you cannot
discriminate in any form or fashion. Beware
of that, " she noted at the conference. An
attorney should look over any language to
ensure it is not discriminatory.
Administrators need to be sure to look at
race, age, disability, gender reassignment,
marriage or civil partnership, pregnancy, and
maternity, she urged.
Title VII of the Civil Rights Act of 1964
and the Americans with Disabilities Act
legalize religious and medical exemptions.
Some medical exemptions are quite valid,
said Kirchner. Cancer patients undergoing
chemotherapy, for example, cannot get vaccinated
because the chemotherapy would
allergy tests for some of the ingredients,
for instance.
Then there is the question of natural
immunity-letting the virus run its
course until it becomes endemic in society.
Some people who have already
recovered from COVID-19 say they do
not need the vaccine.
Legal recourse?
Employers have their own concerns
about being sued if they terminate an
employee over the vaccination, and the
government will not protect them, says
Kirchner.
Dr Rouillard does not expect these
concerns to have much impact at The
Permanente Medical Group. " At the
same time, we have established contingency
plans in each of our markets
to ensure continuity of care, which may
include sourcing temporary staff, if
necessary, " she says.
immediately kill the vaccine.
For religious exemptions, the employer
must assess whether a request is based on
personal choice and belief, or on a sincerely
held religious belief. " We have to be careful
how we address the religious piece of it, "
she said.
Just like the mandate itself, exemptions
are bound to cause controversy and possibly
legal action.
Colorado for instance has a law that allows
exemptions for children based on their
philosophical beliefs. However, this exemption
does not apply to the vaccine mandate,
which some hospitals and health systems
in the state find discriminatory. Kirchner anticipates
seeing some class action lawsuits
arising from this debate.
For more on Kirchner's findings after researching
the vaccine mandate and developing
regulatory compliant policy, attendees
of this year's OR Manager Conference and
ENCORE Digital Event can revisit her presentation,
" COVID-19 mandatory vaccination
requirements. "
As of October 4, 2021, just over
2,200 had not responded to The Permanente
Medical Group's vaccine
requirement. These employees were
placed on unpaid administrative leave
across its national vaccination program.
" This number is declining daily, and as
employees respond, they may return to
work. Those not responding have until
December 1, 2021, to do so, " says Dr
Rouillard.
Employees who challenge these
mandates probably will not have much
success, offers Collins. This is especially
true if employees are allowed to
claim exemptions from the vaccine for
religious or medical reasons. " Cases
I have seen around the country have
overwhelmingly come down in favor of
mandates that allow for exemptions.
Even those that do not allow for exemptions
have been upheld. "
Continued on page 34
OR Manager | Nov/Dec 2021
33
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OR Manager November/December 2021

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