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SSM Health Care requires flu vaccines and non-smoking history

This article first appeared in the St. Louis Beacon, June 20, 2011 - SSM Health Care employs nearly 30,000 health-care workers in Missouri, Illinois, Wisconsin and Oklahoma. The health system is insisting that its employees protect themselves and the public by requiring flu shots and no smoking as a condition of employment.

SSM Health Care has decided to require mandatory flu vaccinations for employees throughout its health system. The policy was one of two major workplace changes announced Friday in what SSM said was an effort to create a safer environment for patients and a healthier work force.

The other rule change calls for hiring only tobacco-free workers. Unlike the new vaccine policy, the smoke-free rule will apply only to workers in SSM Health Care facilities in Missouri.

SSM becomes at least the second area health system to implement a mandatory vaccine policy for its employees. BJC already has a mandatory vaccine policy for employees.

"Vaccinations protect our patients from additional illness when they are already in a vulnerable situation, and it is the right thing to do not only for our patients but their families as well," Dr. James Hinrichs, chief medical officer, SSM St. Joseph Health Center in St. Charles, said in a statement.

SSM employs 5,400 physicians and 23,000 other health workers in hospital programs in the four states. About 75 percent of those workers got flu vaccines last year, SSM said. It added that workers who had refused to get flu shots were asked to sign statements saying they understood the risks to themselves, patients and families.

Flu vaccinations will be mandatory for all volunteers, too. The only exceptions, SSM says, will apply to individuals who refuse vaccines for medical or religious reasons.

Sister Mary Jean Ryan, CEO of SSM Health Care says the vaccine and smoke-free policies will mean a better workplace.

"As a health-care provider, we need to take a leadership role on these major public health issues," she said in a statement. "Not hiring tobacco users is a first step toward creating a healthier workforce, and mandatory flu vaccinations will help protect our patients, our colleagues and their families."

SSM says its tobacco-free hiring policy is supported by the American Heart Association. It says its policy takes effect next month and will apply only to new employees. SSM operates nine hospitals in Missouri, including seven in the St. Louis area.

Federal laws against discrimination apply to cases involving race, sex, age, national origin, religion and disability, and have not protected a smoker seeking a job. About 30 states, including Missouri, have laws that generally protect smokers against job discrimination for smoking off the job. But Missouri's law includes an exemption for non-profit healthcare organizations, meaning the law's protection apparently does not apply to their employees or job applicants.

SSM's policy on smoking and vaccinaton seems to be in line with Equal Employment Opportunity Commission policy, says Barbara Seely, regional attorney for the St. Louis office of the EEOC.

Speaking in general terms, she says "SSM could argue that it's an undue hardship" to patients to not to have a mandatory flu vaccine policy for employees. At the same time, she said an employee must "make reasonable accommodations " if an employee has either a religious belief or a disability that might be affected by a mandatory vaccination policy.

Nationally, mandatory vaccine policies have been controversial since 2009. That year, several health care unions complained after New York issued an emergency regulation requiring mandatory H1N1 flu shots for most health workers. A state court judge later issued a ruling halting the order. The state later said it was suspending the requirement due to having a limited supply of the vaccine and wanting to use it for populations facing the most risks.

Funding for the Beacon's health reporting is provided in part by the Missouri Foundation for Health, a philanthropic organization that aims to improve the health of the people in the communities it serves.

Robert Joiner has carved a niche in providing informed reporting about a range of medical issues. He won a Dennis A. Hunt Journalism Award for the Beacon’s "Worlds Apart" series on health-care disparities. His journalism experience includes working at the St. Louis American and the St. Louis Post-Dispatch, where he was a beat reporter, wire editor, editorial writer, columnist, and member of the Washington bureau.