SACRAMENTO, Calif. -- Health care workers who don't get a flu shot wouldn't have to wear a mask under an amended bill that state lawmakers sent to the governor on Thursday.
The initial bill was designed to encourage health care workers to get influenza vaccines so they don't infect patients. But the California Nurses Association opposed a provision requiring unvaccinated medical employees to wear surgical masks while seeing patients during flu season.
The Senate passed the amended SB1318 after the provision was stripped away by the Assembly earlier this week. It is not clear how the bill would be enforced without the mask requirement.
The decision sparked finger-pointing between hospitals and the politically powerful nurses union.
The California Hospital Association blamed the union for blocking the mask provision. Hospitals opposed the final bill mainly because the mask provision was removed. The union is lobbying for flu vaccine incentives to be collectively bargained.
"We think wearing masks is the right thing to do for the patients," hospital association spokeswoman Jan Emerson-Shea said after the vote. "How do hospitals enforce this otherwise? ... We think the nurses' union is putting public health at risk by making that an issue for collective bargaining."
Union spokesman Chuck Idelson said the association is neutral on the overall bill and supports its requirement that 90 percent of health care workers be vaccinated by 2015.
"We do encourage people to get vaccinations. We don't think it should be mandatory, we don't think it should be punitive," Idelson said. "There are people who have specific health care concerns about masks, about vaccinations."
The measure on Gov. Jerry Brown's desk now requires health officials to develop a policy that will let hospitals reach that 90 percent vaccination goal. The requirement would apply to about 4,500 California health care facilities.
Dr. Charity Thoman, deputy health officer in Santa Barbara County, said in an email that only 63 percent of health care workers in California currently get the influenza vaccine - despite the dangers demonstrated by the H1N1 pandemic in 2009.
H1N1 spurred worldwide concern when the virus initially appeared to have a high mortality rate. Later investigation found the strain was deadly mostly for those with complicating circumstances. It is now considered a seasonal flu and included in the flu vaccine.
The California Medical Association, which sought the legislation, said the amended version will be effective.
It would require health facilities to begin education programs in January to encourage employees to be vaccinated. Employees who decline would be required to follow whatever steps their employer takes to prevent them from spreading the flu.
The bill's author, Sen. Lois Wolk, D-Davis, said she is satisfied that public health officials will develop powerful incentives for health workers to be vaccinated - incentives that might include the mask requirement.
"I think it's one of several tools and the most effective," Wolk said. "The masks could still be part of it, or not."
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