Dive Brief:

• The 8th U.S. Circuit Court of Appeals upheld a district court's ruling that a healthcare system can require an employee to be immunized against rubella as a condition of employment. The employer, Allina Health System, fired Janice Hustvet for refusing to undergo a medical examination and immunization to fulfill a job requirement. Hustvet sued Allina for allegedly violating the Americans with Disabilities Act (ADA) and the Minnesota Human Rights Act (MHRA) (Hustvet v. Allina Health System, No. 17-2963 (8th Cir., Dec. 7, 2018)).
• During Hustvet's employment, a merger occurred between two Allina entities, the Sister Kenny Rehabilitation Institute and the Courage Center, the latter being her employer. In March 2013, Courage Center employees were informed that the merger was approved and that they would effectively become Allina employees on June 1, 2013. In a May 2013 letter, Allina offered employment to Courage Center employees who met its employment conditions, which included a pre-placement health assessment screening. Hustvet completed her medical screening in May, but didn't get immunized over concerns about being exposed to the measles, mumps and rubella vaccine because of previous health problems. Allina ultimately fired Hustvet and she sued.
• The appeals court said that, while it disagreed with the district court's rationale that Hustvet didn't "suffer tangible injury" by refusing to complete the health screening and therefore her claim "failed as a matter of law," the court did agree that Allina's health screening complied with both ADA and MHRA.

Dive Insight:

The ADA prohibits employers from discriminating against individuals with disabilities in the context of their employment, advancement, termination, compensation, training or accommodation. Employers are generally required to reasonably accommodate the needs of workers with disabilities, provided those workers can perform the essential functions of a job.

As the court noted, employers are generally prohibited from making disability-related inquiries or medical-exam requirements before extending an offer of employment. However, the ADA allows employers to require prospective hires to undergo a medical exam after an offer is made and permits employers to make a final job offer depending on the screening's results.

Employers, particularly those in the healthcare industry, have required workers to get immunized against the flu and other contagious illnesses, but those policies have not gone without court challenges. For example, in 2017, Saint Vincent Health Center in Erie, Pennsylvania, paid $300,000 to resolve a U.S. Equal Employment Opportunity Commission suit over its mandatory flu shot policy after the agency alleged the policy discriminated against workers' religious beliefs.

It may be reasonable for hospitals, healthcare facilities and employers in general to want to prevent the spread of infection. But the Allina decision is an example of the case-by-case nature of ADA decisions, especially for employers in the healthcare industry.