By: Joelle Harvill

On January 11, 2023, the Biden Administration renewed the COVID-19 Public Health Emergency. That means certain laws and regulations that were triggered by the Public Health Emergency will continue to be in effect as long as the Public Health Emergency continues. One of those things is the Medicare and Medicate Provider COVID-19 Vaccine Mandate. This affects nursing students and their clinical rotations.

Nursing students in North Carolina are required to offer proof of various vaccinations for the clinicals based on the state’s required childhood immunizations. College or high school students (or parents of minor students) can write a statement seeking a religious exemption. “Upon submission of a written statement of the bona fide religious beliefs and opposition to the immunization requirements, the person may attend the college, university, school or facility without presenting a certificate of immunization.” North Carolina General Statute 130A-157.

What about nursing students for clinical rotations? That’s more complicated because of a federal regulation that affects the facilities where most clinical rotations occur.

On November 4, 2021, the Centers for Medicare and Medicaid Services (CMS) issued an interim final rule (the “CMS Rule”) requiring COVID-19 vaccination for staff at Medicare- and Medicaid-certified providers and suppliers. That rule has been challenged by multiple States’ Attorneys General in two different lawsuits. The CMS Rule may eventually be overturned but that doesn’t help if a student needs the clinical to graduate before then. So what does a nursing student do?

In fall 2022, it appeared medical facilities were relaxing their vaccination requirements. On November 17, 2022, Attorney Generals in 21 states filed a petition to end the COVID-19 vaccination requirement. The Biden Administration pushed back on that request, and on November 22, 2022, announced a new enforcement guidance by CMS reminding healthcare providers of COVID-19 vaccine requirements. Here is the latest guidance revision.

The CMS Rule includes students in the definition of “staff” required to be vaccinated. Students have never been considered staff before this rule which has led to some confusion. It also requires providers and suppliers to implement a procedure for “staff” to be able to request an exemption for the COVID-19 vaccination requirements based on Federal law for ADA disability, medical conditions, or sincerely held religious beliefs, practice, or observance.

Many of the larger colleges are aware that clinical facilities are required to have a procedure for students to seek an exemption and will have exemption forms from the facilities for the student to submit. Other colleges may not know of this requirement or ignore it. A nursing student should ask the college nursing program clinical coordinator for a contact at the clinical rotation facility site to request an exemption for the COVID-19 vaccination per the facility’s procedure, as required by the CMS Rule. The clinical facility will most likely require testing and wearing of a fitted N95 mask as an accommodation for the request.

If you are a nursing student who has requested an exemption and are being passed around like a hot potato with no one willing to take responsibility for considering your request, we may be able to help. You can contact us at Envisage Law, (919) 755-1317.


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