Declaration Of Ramona Nichols

Summary

A declaration of Ramona Nichols filed November 1, 2021 as Document 30 in Together Employees v. Mass General Brigham Incorporated, Civil Action No. 1:21-cv-11686, in the U.S. District Court for the District of Massachusetts. The declarant states that she is Director, Employee and Labor Relations at Mass General Brigham and served as an advisor to the Religious Exemption Review Committee. The declaration describes the MGB COVID-19 Vaccination Policy sent to staff on August 10, 2021, which set a vaccination deadline of October 15, 2021 and a September 3, 2021 deadline to request a religious or disability exemption. It describes the committee's membership, training, use of follow-up questions and decision-making, and states that most approvals were emailed on or after September 6, 2021. It also records dates on which individual plaintiffs submitted requests and were notified of denial.

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              Case 1:21-cv-11686-FDS Document 30 Filed 11/01/21 Page 1 of 15




                                UNITED STATES DISTRICT COURT
                              FOR THE DISTRICT OF MASSACHUSETTS


TOGETHER EMPLOYEES, by Individual
Representatives, ROBERTA LANCIONE,
JOYCE MILLER, MARIA DIFRONZO,
MICHAEL SACCOCCIO, ELIZABETH
BIGGER, NATASHA DICICCO, NICHOLAS
ARNO, and RUBEN ALMEIDA

                                  Plaintiffs,                      Civil Action No. 1:21-cv-11686
                         v.

MASS GENERAL BRIGHAM
INCORPORATED,

                                  Defendant.


                              DECLARATION OF RAMONA NICHOLS


         I, Ramona Nichols, am above the age of 18 and competent to testify. All the information

in this declaration is based on my personal knowledge.

         1.       I am Director, Employee and Labor Relations at Mass General Brigham at

Massachusetts General Brigham Incorporated (“MGB”).

         2.       As part of my regular job duties, I direct the development and implementation of

the overall employee/labor relations strategy, and partner with HR and cross functional teams to

create and sustain positive Employee Relations programs and best practices.

         3.       I have a Bachelor’s of Science in Psychology from the University of Tennessee at

Chattanooga and a Master of Arts in Industrial Organizational Psychology from the University of

New Haven. In addition, I have completed the Massachusetts Commission Against

Discrimination’s training in both Employment Discrimination and Responding to

Accommodation Requests.



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4.       I served in a key role to the review committee (the “Religious Exemption Review

Committee”) that developed and implemented MGB’s interactive process for determining

whether or not to grant religious exemptions from the vaccine requirement established by

MGB’s COVID-19 Vaccination Policy.

         A.       MGB Announced Its Vaccination Policy, Requiring That Staff
                  Be Vaccinated against COVID-19 Unless Approved for a
                  Religious or Medical Exemption

         5.       On August 10, 2021, MGB’s President and CEO sent a notice to staff members

explaining its COVID-19 Vaccination Policy (the “Vaccination Policy”). A true and accurate

copy of the President’s communication is at Exhibit 2. The Policy initially indicated that

employees should be fully vaccinated by October 15, 2021, unless they were granted a religious

or disability exemption. (Later MGB revised the Vaccination Policy to require a first dose of a

two-dose series by October 15, 2021, followed by a later second dose). The deadline for

employees to request an exemption was September 3, 2021. See Declaration of Dr. Michael

Klompas filed contemporaneously herewith.

         6.       The announcement included a link to forms that employees could use to request a

disability or religious exemption from the Vaccination Policy. The link to the request forms was

also available on MGB’s employee intranet site. Managers were also empowered to help direct

employees to the forms.

         B.       MGB Provided a Simple Process for Employees to Request a
                  Religious Exemption

         7.       In order to request a religious exemption, an employee simply had to enter

information into an online form. A true and accurate copy of that form is at Exhibit 20.

         8.       The religious exemption form invited the employee to provide a narrative

explaining the basis for the request. The form asked the employee to “(1) identify your sincerely


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held religious belief, practice or observance and (2) explain why it prevents you from receiving a

COVID-19 vaccine.” The form advised each employee, “Please note that you may be required

to provide additional information or supporting documentation to support your request for an

exemption.”

         9.       There was no limit as to the number of characters that an employee could enter

into the form. Employees could write as long an explanation as they chose to write. In fact, it

said right on the form that the text box would expand as needed. See Exhibit 20.

         C.       The Religious Exemption Review Committee

         10.      MGB assembled the Religious Exemption Review Committee to review the

religious exemption requests. Each MGB entity was initially asked to identify one Human

Resources person from that entity to join the Committee. These Human Resources professionals

were trained in responding to accommodation requests and given additional training in

responding to religious exemption requests as part of this process. As the volume of requests

increased, certain entities with large numbers of requests were asked to identify one or more

additional well-qualified people to join the Committee.

         11.      A senior in-house attorney in MGB’s Office of the General Counsel with

extensive experience in labor and employment law served as Chair of the Religious Exemption

Review Committee.

         12.      MGB also arranged for certain employees with particularly relevant expertise to

serve as advisors to the Committee. I was designated as one of those advisors due to my training

and experience in Employee Relations and Accommodations at MGB. Thus, I was not assigned

specific requests, but rather I served as an advisor to the Committee and its members on a regular

basis and attended Committee meetings.



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          D.      MGB’s Urgent Health and Safety Priorities Provided
                  Guidance for the Religious Exemption Review Process

          13.     Prior to reviewing any exemption requests, the Religious Exemption Review

Committee was advised of MGB’s urgent health and safety priorities that would impact the

review process. These priorities were developed by senior leadership and health experts at

MGB, a widely renowned healthcare system.

          14.     First, the review process needed to be prompt, given the spread of the COVID-19

Delta variant and the need to have employees vaccinated by the deadlines set out in MGB’s

Vaccination Policy. Second, the review process was to be as stringent as possible consistent

with the law, so as to minimize the number of unvaccinated staff at MGB given the risks that

unvaccinated staff presented to MGB’s medically vulnerable patient population, other employees

and visitors and to ensure available staff to respond to the ongoing public health crisis. Third, it

would be an undue hardship for MGB to allow large numbers of employees to remain

unvaccinated while interacting with MGB’s medically vulnerable patient population, other

employees and visitors.

          15.     The Religious Exemption Review Committee was aware that the pandemic, and

particularly the rapid spread of the Delta variant of COVID-19, was a public health emergency,

and that MGB had an urgent responsibility to help patients diagnosed with COVID-19, as well as

to protect its staff, medically vulnerable population and visitors from infection. We were also

aware that as a major hospital, the perception of safety was critical for patients, visitors and the

public.

          16.     The Religious Exemption Review Committee was tasked with designing a process

that would be consistent with those urgent health and safety priorities. I was also aware that the




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impending fall and winter seasons were particularly concerning for new waves of COVID-19

infection especially given the Delta variant.

         E.       The Religious Exemption Review Committee Was Tasked with
                  Reviewing What Would Be a High Volume of Requests in an
                  Accelerated Time Frame, to Meet the Urgent Health and
                  Safety Priorities

         17.      The Religious Exemption Review Committee was also advised that exemption

requests were to be reviewed and processed as soon as possible, with the understanding that the

employees needed to receive a vaccine by October 15 under the Vaccination Policy.

         18.      This timeline was to ensure that any employee whose exemption was denied

would have adequate time to consider vaccination, and if they decided to vaccinate, to do so

under the schedule laid out in the Vaccination Policy.

         F.       The Religious Exemption Review Committee Received
                  Training on Applicable Legal Standards Regarding Religious
                  Exemptions

         19.      The Religious Exemption Review Committee received training by a senior

attorney in MGB’s Office of the General Counsel on the applicable legal standards that govern

religious exemptions, including what constitutes an undue hardship.

         G.       The Committee Met Frequently to Ensure a Process That Was
                  Fair, Consistent and Legally Compliant

         20.      The Religious Exemption Review Committee met frequently to discuss

developing a reasonably consistent approach to religious exemption requests.

         21.      This included a regular 90-minute meeting twice a week, and in one instance a

full day meeting, with many other additional and ad hoc meetings and discussions about general

themes to ensure consistent responses as needed.

         22.      The members of the Committee and the advisors to that Committee worked

tirelessly to review and process each request.

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         H.       The Religious Exemption Review Committee Carefully
                  Designed an Interactive Process

         23.      The Religious Exemption Review Committee designed an interactive process for

evaluating the religious exemption requests.

         24.      Each request was assigned to a member of the Religious Exemption Review

Committee. That member reviewed each request assigned to him or her. The member could also

raise the request for discussion with other Committee members or the full Committee as needed.

         25.      Each request received careful, individualized attention from at least one reviewer

from the Religious Exemption Review Committee, and often from more member(s) of that

Committee if not the full Committee.

         26.      In that interactive process, any employee who raised any substantive religious

objection to the vaccine would then receive follow-up questions requesting more information.

         27.      For those requests where more information was needed to assess the employee’s

religious belief, adherence to that belief, and how the belief prevented them from receiving the

COVID-19 vaccine, the Religious Exemption Review Committee designed an approach as to

which follow-up questions would be asked of employees. In designing that approach, the

Committee aimed to achieve reasonable consistency between follow-up questions but also to

provide each reviewer flexibility to customize the questions that were appropriate to that

particular request. Certain of the follow-up questions were broadly applicable to many or most

requests; others were developed specifically in response to certain common elements or themes

seen frequently in the pool of requests.

         28.      The reviewer exercised his or her best judgment in choosing the follow-up

questions most fitting for each individual request.




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         29.      Employees were instructed to send responses to the follow-up questions to a

dedicated e-mail box at MGB. Employees were free to submit whatever information they

wanted to that e-mail box, including documents or attachments, along with their responses to the

follow-up questions. Many did choose to send documents or attachments. Many of the

documents were downloaded or purchased from online, or cut and pasted from internet forms.

The Committee became well acquainted with the many forms available online, as members saw

the same internet forms submitted by multiple employees.

         30.      Each employee’s response was then reviewed by the same Committee member

who had been assigned to that request. The Committee members carefully reviewed any follow-

up responses submitted by the employees to which they had been assigned.

         31.      In some cases, where a Committee member determined that more information was

needed, that member would send additional follow-up questions to the employee, and ask them

to submit a response to the same email box. The reviewers carefully reviewed any additional

information submitted by the employee in response.

         32.      Though MGB had set a deadline of September 3, 2021 for submission on

religious exemption requests, many employees submitted requests after the deadline. The

Committee reviewed and processed those late requests as well.

         I.       The Committee Members Made Thoughtful Decisions about
                  Each Employee’s Request

         33.      The Committee's process involved having the requisite interaction with each

employee to get an understanding of the nature of the sincere religious belief, the person's

adherence to the religious belief, and how that person's religious belief prevented them from

receiving the COVID vaccine.




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         34.      The Committee met frequently to discuss a consistent approach to making

decisions on requests that was consistent with MGB’s urgent health and safety priorities. The

Committee strove for a consistent and thoughtful approach, for example, to what would be

considered a sincere request; a religious request; and a conflict with the Vaccination Policy.

         35.      The Committee also factored into its decision-making MGB’s workforce and

public health considerations with allowing a large number of exemptions, because to do so

would impose an undue hardship given the risks that unvaccinated staff pose to MGB’s

medically vulnerable patient population, employees and visitors.

         36.      At least one Committee member made the decision as to each request. In more

detailed cases, a subset of the Committee or the whole Committee also participated in the

decision.

         J.       Communication of the Decision to Accept or Deny Request for
                  Religious Exemptions

         37.      After decisions were made, each employee who had requested an exemption

received by e-mail a written decision either approving or denying the request.

         38.      Most approvals were emailed to employees on or after September 6, 2021.

Denials were emailed as the decisions were made. We endeavored to ensure that all decisions

for requests received before the September 3, 2021 deadline were emailed at least three weeks

before the October 15 deadline for employee vaccination.

         K.       Some Employees Reached Out to the Committee About Denial
                  of Their Requests

         39.      Due to MGB’s urgent timeline to achieve its health and safety priorities, MGB

determined that they could not provide an appeal process for every employee whose requests

were denied. MGB also determined that an appeal process would likely result in duplication,



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with the Committee having to review substantially the same material submitted in the first round

of the process.

         40.      Some employees who were displeased with the denial of their requests wrote to

the Committee to express their disappointment with the decision or seeking to provide additional

information. Some of these interactions were very tense, and the Committee felt that it was

important to continue to use the dedicated email address for these sensitive and deeply personal

communications.

         41.      The Committee reviewed those additional communications to the extent feasible.

In particular, the Committee strove to ensure that each employee had the opportunity to provide

the necessary information to consider their request.

         42.      Because the surge in cases from the Delta variant in the summer and fall of 2021

was (and is) stressing the health care system and this was an emergency, MGB’s ability to

engage in this interactive process on these issues was not limitless.

         L.       Decisions on Individual Plaintiffs’ Requests for Exemptions

         Ruben Almeida

         43.      On or about September 1, 2021, Ruben Almeida (“Almeida”) submitted a

religious exemption request form. A true and accurate copy is at Exhibit 21.

         44.      On or about September 10, 2021, MGB requested additional information from

Almeida. A true and accurate copy is at Exhibit 22.

         45.      On or about September 12, 2021, Almeida responded to MGB’s request for

additional information. A true and accurate copy is at Exhibit 23.

         46.      On or about September 23, 2021, MGB notified Almeida that his request for a

religious exemption from the vaccination requirement had been denied. A true and accurate

copy is at Exhibit 24.

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         Nicholas Arno

         47.    On or about August 24, 2021, Nicholas Arno (“Arno”) submitted a religious

exemption request form. A true and accurate copy is at Exhibit 25.

         48.    On or about September 4, 2021, MGB requested additional information from

Almeida. A true and accurate copy is at Exhibit 26.

         49.    On or about September 7, 2021, Arno responded to MGB’s request for additional

information. A true and accurate copy is at Exhibit 27.

         50.    On or about September 14, 2021, MGB notified Arno that his request for a

religious exemption from the vaccination requirement had been denied. A true and accurate

copy is at Exhibit 28.

         Elizabeth Bigger

         51.    On or about September 3, 2021, Elizabeth Bigger (“Bigger”) submitted a religious

exemption request form. A true and accurate copy is at Exhibit 29.

         52.    On or about September 10, 2021, MGB requested additional information from

Bigger. A true and accurate copy is at Exhibit 30.

         53.    On or about September 13, 2021, Bigger responded to MGB’s request for

additional information. A true and accurate copy is at Exhibit 31.

         54.    On or about September 14, 2021, MGB notified Bigger that her request for a

religious exemption from the vaccination requirement had been denied. A true and accurate

copy is at Exhibit 32.

         Natasha DiCicco

         55.    On or about September 2, 2021, Natasha DiCicco (“DiCicco”) submitted a

religious exemption request form. A true and accurate copy is at Exhibit 33.



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         56.   On or about September 10, 2021, MGB requested additional information from

DiCicco. See Exhibit 34.

         57.   On or about September 10, 2021, DiCicco responded to MGB’s request for

additional information. A true and accurate copy is at Exhibit 35.

         58.   On or about September 14, 2021, MGB notified DiCicco that her request for a

religious exemption from the vaccination requirement had been denied. A true and accurate

copy is at Exhibit 36.

         Maria DiFronzo

         59.   On or about September 1, 2021, Maria DiFronzo submitted a religious exemption

request form. A true and accurate copy is at Exhibit 37.

         60.   On or about September 10, 2021, MGB requested additional information from

DiFronzo. A true and accurate copy is at Exhibit 38.

         61.   On or about September 13, 2021, DiFronzo responded to MGB’s request for

additional information. A true and accurate copy is at Exhibit 39.

         62.   On or about September 14, 2021, MGB notified DiFronzo that her request for a

religious exemption from the vaccination requirement had been denied. A true and accurate

copy is at Exhibit 40.

         Roberta Lancione

         63.   On or about September 3, 2021, Roberta Lancione (“Lancione”) submitted a

religious exemption request form. A true and accurate copy is at Exhibit 41.

         64.   On or about September 7, 2021, MGB requested additional information from

Lancione. See Exhibit 42.




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         65.    On or about September 12, 2021, Lancione responded to MGB’s request for

additional information. A true and accurate copy is at Exhibit 43.

         66.    On or about September 16, 2021, MGB notified Lancione that her request for a

religious exemption from the vaccination requirement had been denied. A true and accurate

copy is at Exhibit 44.

         Joyce Miller

         67.    On or about August 20, 2021, Joyce Miller (“Miller”) submitted a religious

exemption request form. A true and accurate copy is at Exhibit 45.

         68.    On or about September 4, 2021, MGB requested additional information from

Miller. A true and accurate copy is at Exhibit 46.

         69.    On or about September 7, 2021, Miller responded to MGB’s request for additional

information. A true and accurate copy is at Exhibit 47.

         70.    On or about September 14, 2021, MGB notified Miller that her request for a

religious exemption from the vaccination requirement had been denied. A true and accurate

copy is at Exhibit 48.

         Michael Saccoccio

         71.    On or about August 22, 2021, Michael Saccoccio (“Saccoccio”) submitted a

religious exemption request form. A true and accurate copy is at Exhibit 49.

         72.    On or about September 2, 2021, MGB requested additional information from

Saccoccio. A true and accurate copy is at Exhibit 50.

         73.    On or about September 7, 2021, Saccoccio responded to MGB’s request for

additional information. A true and accurate copy is at Exhibit 51.




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         74.   On or about September 11, 2021, MGB notified Saccoccio that his request for a

religious exemption from the vaccination requirement had been denied. A true and accurate

copy is at Exhibit 52.




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         M.    Any Unvaccinated Employee Can Return to Work Upon
               Vaccination

         75.   Any of the named Plaintiffs in this matter—or any MGB employee currently on

unpaid leave due to non-compliance with the MGB Vaccination Policy—is eligible to return to

work as soon as he or she is compliant with the Vaccination Policy.




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                                 CERTIFICATE OF SERVICE

        I hereby certify that on November 1, 2021, a copy of the foregoing document was filed
electronically through the Court’s electronic filing system (“ECF system”) and that counsel for
Plaintiffs is a registered user of the ECF system. Notice of this filing will be sent by operation of
the Court’s ECF system to all parties indicated on the electronic filing receipt. Parties may
access this filing through the Court’s ECF system.

                                              /s/ Katherine A. Perrelli
                                              Katherine A. Perrelli


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