Takeaway: A school district did not violate California's Confidentiality of Medical Information Act when it discharged a worker who refused to either provide verification of her COVID-19 vaccination status or undergo weekly testing as required by a then-operative order of the state public health officer.
A school district did not violate California law by terminating a school employee after she refused to provide verification of her COVID-19 vaccination status or undergo weekly testing as required by a then-operative order of the state public health officer, a California appeals court recently ruled. The school district's actions did not violate the state's Confidentiality of Medical Information Act (CMIA), the court concluded.
From March 4, 2020, until Feb. 28, 2023, California was in a state of emergency due to COVID-19. Midway through this period, on Aug. 11, 2021, the state public health officer issued an order requiring K-12 schools to verify the COVID-19 vaccination status of all school workers.
The order listed specific modes of proof of vaccination and further provided that unvaccinated workers were required to undergo diagnostic-screening testing at least once per week, using either PCR or antigen tests. The order specified that workers who were not fully vaccinated, or for whom vaccine status was unknown or documentation was not provided, were to be considered unvaccinated.
The order remained in effect until its rescission, effective Sept. 17, 2022. When the order went into effect, the plaintiff was working at an elementary school, providing in-person classroom assistance for children with special needs and children whose primary language is Spanish.
In September and October 2021, the school district began requiring proof of their workers' COVID-19 vaccination status. The plaintiff repeatedly refused to disclose her vaccination status or undergo weekly testing. She informed the school principal that she did not consent to him obtaining or disclosing her medical information. The principal told the plaintiff to remain at home in light of her refusals, and he offered her the option of working remotely. The plaintiff declined, believing that she could not fulfill her job duties remotely.
On Oct. 28, 2021, the school told the plaintiff that she was being placed on unpaid leave until she followed the test-or-vaccinate requirements. She still refused to comply. On July 7, 2022, the plaintiff received a formal letter of dismissal. Two weeks later, she filed suit under the CMIA, alleging discrimination due to her refusal to authorize release of her medical information and unauthorized use of her medical information. The trial court dismissed the lawsuit before trial, and the plaintiff appealed.
State Law
The CMIA is intended to protect the confidentiality of individually identifiable medical information obtained from a patient by a health care provider, while at the same time setting forth limited circumstances in which the release of such information to specified entities or individuals is permissible, the appeals court explained.
The CMIA mostly governs disclosures of patient medical information by health care providers, but one chapter governs the use and disclosure of employee medical information by employers. The substantive employer prohibitions—and their relevant exceptions—are found in subdivisions under section 56.20.
Section 56.20(b) consists of two sentences—the first a prohibition on discrimination, and the second a "necessity" exception: "No employee shall be discriminated against in terms or conditions of employment due to that employee's refusal to sign an authorization under this part. However, nothing in this section shall prohibit an employer from taking such action as is necessary in the absence of medical information due to an employee's refusal to sign an authorization under this part."
The term "authorization" is defined as a written document permitting a health care provider or an employer to disclose one's medical information to others.
The appeals court concluded that the necessity exception justified the employer's actions regarding the plaintiff. The school was acting to comply with a lawful order of a state public health officer, which carried the full force of law while it was in effect.
The order mandated that all K-12 schools verify vaccine status of all workers and test unvaccinated workers. The school could not fulfill either of these requirements without the cooperation of the plaintiff. Faced with the plaintiff's refusal to allow the school to comply with either its verification or test-reporting obligations, the school district had no choice but to impose disciplinary consequences precluding the plaintiff from working in person until she started reporting test results weekly, the court said.
Section 56.20(c) of the statute prohibits an employer from using or disclosing medical information pertaining to its employees, unless the employee signs an authorization permitting such disclosure, or one of several statutory exceptions applies.
The appeals court concluded that there was no violation of this subsection because there was no evidence that the school district used medical information that they possessed pertaining to the plaintiff.
Because the plaintiff never provided her vaccination status, the school district could not have used that medical information when they never possessed it, the court said.
Rossi v. Sequioa Union Elementary School, Calif. Ct. App., No. F085416 (Aug. 25, 2023).
Joanne Deschenaux, J.D., is a freelance writer in Annapolis, Md.