California health care employers that apply mandatory vaccination policies objectively can take great comfort in a recent California Court of Appeal decision. In Hodges v. Cedars-Sinai Medical Center, the court found Cedars-Sinai Medical Center (CSMC) did not violate the California Fair Employment and Housing Act (FEHA) when it terminated an employee for failure to comply with its mandatory flu vaccine policy. The employee was unable to establish an actual or perceived disability under FEHA; that her termination was pretextual; or a causal link between her request for accommodation and termination necessary to sustain a FEHA retaliation claim.

What to Know

• The court found the mandatory vaccination policy, implemented according to federal guidance and with concern for patient safety, was facially nondiscriminatory and objective, and was objectively applied.

• Termination for reasons nondiscriminatory on their face and honestly believed to be valid by the employer will suffice to show a legitimate reason for adverse employment action under FEHA.

The court decision can be found here.

Background

Deanna Hodges was employed by CSMC in an administrative role with no patient care responsibilities. CSMC implemented a mandatory vaccination policy, requiring all employees to get a flu vaccine regardless of their role. The policy made exceptions for employees who established “a valid medical or religious exemption.” Employees who declined the vaccine based on medical contraindications were required to submit an exemption request completed by their physician. The exemption request form identified two recognized contraindications: (1) a history of life-threatening allergic reaction to the flu vaccine or any of its components; and (2) a history of Guillain-Barré Syndrome within six weeks following a previous dose of any flu vaccine. The form also included space for physicians to state “other” reasons and advised the physician to provide supporting documentation.

Hodges submitted a note from her physician recommending Hodges be exempted from the vaccine mandate based on her history of cancer, neuropathy, and general allergies but did not attach any supporting documentation. CSMC’s exemption review panel declined her request, and when Hodges continued to refuse a flu vaccination, CSMC terminated her employment. 

Hodges brought action against CSMC in California state court, alleging disability discrimination and retaliation under FEHA. The trial court entered summary judgment for CSMC, and Hodges appealed.

Court of Appeal Decision

The Second District Court of Appeal affirmed the trial court’s grant of summary judgment in CSMC’s favor. The court applied the burden-shifting framework in McDonnell-Douglas Corp. v. Green, finding no direct evidence that CSMC acted with a retaliatory motive. Rather, the evidence showed that CSMC terminated Hodges for failing to comply with its policy, which is not prohibited by FEHA.

Applying that framework, the Court of Appeal held:

• Hodges did not establish she had a “disability” under FEHA. FEHA requires an employee claiming a disability to have, or be perceived by an employer as having, a condition that “limits a major life activity.” Hodges failed to show that she had a disability or that CSMC perceived her as having a disability. In fact, Hodges had previously admitted that her various illnesses in no way limited her ability to work.

• Even if Hodges established a prima facie case for discrimination, summary adjudication was proper because CSMC presented a legitimate, nondiscriminatory reason for terminating her employment. Employment termination for nondiscriminatory reasons and honestly believed by the employer will suffice to show a legitimate reason for the adverse employment action. Even if the reason is foolish, trivial, or baseless, the ultimate issue is whether the employer honestly believed the reasons offered for its action. 

• CSMC’s legitimate, nondiscriminatory reason for Hodges’ termination (her failure to get the flu vaccination pursuant to mandatory vaccination policy) was not pretextual (or a guise) because CSMC relied on federal guidance to conclude there was no objective evidence of disability, and the vaccination policy was both inherently objective and objectively applied to Hodges.

• CSMC did not have a duty under FEHA to engage in an interactive process to determine a reasonable accommodation for Hodges because there was no actual or perceived disability to accommodate.

• Hodges could not establish a causal link between her request for accommodation and her termination because her employment was terminated for her failure to obtain the flu vaccine, as mandated by the policy.

Takeaways

Although the Hodges decision provides comfort to health care employers seeking to enforce mandatory vaccination policies, important lessons emerge. Even when objectively appropriate vaccination policies exist, health care employers should take care to apply those policies in a fair, objective, and even-handed manner.