Tennessee committee urges Health Facilities Commission to withdraw rule after debate over employee flu declination forms

The Tennessee Joint Government Operations Committee on April 29 voted to disapprove Health Facilities Commission licensing rules and urged the commission to withdraw them after heated debate over a provision requiring facilities to run annual influenza-vaccination programs for staff and to collect signed declination statements and reasons for nonparticipation.

Katie Thomas, the Health Facilities Commission representative, said the rules establish minimum licensing standards for PET and MRI services moved into the licensure program and that the declination-language is intended as an infection-control measure. "The declination statements aren't meant to be coercive," she said, adding they would allow staff and operators to know who is vaccinated in an outbreak so patient care can continue.

Several legislators and two public commenters said the provision went beyond the agency's statutory authority and risked coercion or privacy harms. "The declination form requires them to explain why they choose not to get it," Rep. Renault said, calling that requirement "coercive." Senator Bowling said the clause was "fear-mongering" and a violation of privacy.

Public commenter Britney Ruiz, who identified herself as a citizen advocate, urged the committee to issue a stay and to prevent rules that she said would allow facilities to "turn patients away for who they are." "This rule does not protect the limit the statute establishes," she said, arguing the rule conflicts with the Medical Ethics Defense Act's intent and the agency's cited authority.

Bernardet Pager, identifying herself as Tennessee director of Stanford Health Freedom, also criticized the flu requirement and questioned whether independent imaging-licensees have the expertise to educate staff about vaccines. "There's no opt out if somebody doesn't want to sign it," she warned, saying the language as written "tends toward coercion."

HFC counsel Scott Farra told the committee the language mirrors infection-control practices used elsewhere and that documenting declinations supports contingency planning during outbreaks. "It's to try to prevent the interruption of services for patient safety," he said.

Committee legal counsel Doug Garrett told members they could request the agency withdraw the rule, issue a negative recommendation, disapprove it, or move to stay its effective date for rolling 90-day periods while the agency reconsiders. After extended questioning and public comment, the committee voted to issue a negative recommendation and urged HFC to withdraw and rework the rules.

The committee's recorded Senate vote on the withdrawal motion was eight in favor and one opposed (Senator Kyle), and the motion carried in the House, with the clerk recording the action as a negative recommendation accompanied by a request to withdraw.

The Health Facilities Commission indicated willingness to consider revisions; members said they want clearer boundaries between staff-infection-control obligations and protections for patient privacy and anti‑discrimination safeguards.

The committee did not adopt the rule; HFC was asked to return with language the panel finds consistent with statute and less likely to be interpreted as coercive or as enabling discrimination.

The committee moved on to other items on its agenda.