As Essentia Health was in court with one union over its new mandatory flu shot policy on Tuesday, another was challenging the Duluth-based health system over the same policy.

The Minnesota Nurses Association, which represents 2,000 Essentia nurses, charged in a statement on Monday that the health system hadn't made good on a promise to hold off on enforcing the policy until negotiations took place. Instead, the MNA said, Essentia was ignoring that process and threatening to fire nurses who did not comply.

"Essentia's drastic change in its position is duplicitous, disappointing and wrong," the MNA said, calling it "bullying behavior."

Managers had told nurses that they would have to know by Friday if they were going to get the flu shot or they would be "off the schedule" as of Nov. 20, MNA spokesman Rick Fuentes said on Tuesday. Since talks between the union and the health system hadn't taken place, Essentia wasn't operating in good faith by moving to implement its policy, he said.

As a result, the MNA filed federal unfair-labor-practice charges against Essentia last Thursday over the matter, he said.

In spite of the dispute, the MNA and Essentia held talks on Tuesday as planned, Fuentes said. As of late afternoon, those talks still were in progress.

Meanwhile, a four-hour conference involving lawyers for Essentia and for the United Steelworkers in U.S. District Court in Duluth on Tuesday failed to reach a settlement over the union's objections to the flu shot policy, according to court records.

Justin Cummins, who represents the union, confirmed the lack of agreement but declined to comment further.

Essentia Health would not comment on either case "out of respect for the collective bargaining process," spokeswoman Miranda J. Anderson said in an email.

Anderson added, "We're pleased to report that nearly 90 percent of Essentia Health employees have been immunized already, doing their part to protect our patients, co-workers and communities this flu season."

Essentia had a vaccination rate among employees of 82 percent last year, according to Dr. Rajesh Prabhu, the health system's patient quality and safety officer.

The failure to settle means the two sides will appear at 3 p.m. today for a hearing in front of U.S. Magistrate Judge Leo Brisbois in federal court in St. Paul. The union is asking for a preliminary injunction to prevent Essentia from enforcing its policy.

Essentia first announced to employees in September that flu shots would be required this year as a condition for working or serving with the health system, with the exception of those who obtained religious or medical exemptions. The policy, which is uncommon in Minnesota but has been implemented by health systems in other states, also applies to vendors, volunteers and students who have roles at Essentia facilities or on behalf of the health system.

Prabhu has said the policy is needed to protect Essentia's patients and has pointed out that the same groups already are required to get other vaccinations.

Meanwhile, the state's leading health agency isn't taking a position on the flu shot mandate.

"We feel that it's up to each individual health system," said Kristen Ehresmann, infectious disease director for the Minnesota Department of Health. "We don't have a policy on it, and we haven't tried to seek any formal position."

The health department advocates flu shots for anyone who is at high risk for flu and anyone who is around people at high risk, Ehresmann said. That would include people in hospital or long-term-care environments.

However, there is no evidence to suggest that health care systems mandating flu shots have seen a significant reduction in influenza cases in their facilities, she said. "The data aren't there to support the mandate."

Volunteer turned down

An update: The hospice volunteer from the Cohasset area who declined to get a flu shot told the News Tribune in an email that her appeal for an exception to the policy had been denied.

"Essentia decided that I cannot be a hospice volunteer during flu season effective immediately," Noreen Hautala wrote in an email.

The News Tribune reported on Sunday about Hautala's refusal to comply with the policy as she aided a hospice patient in rural Itasca County. Hautala sought an exemption based on religious grounds. She responded to a query from the health system asking her to detail how her religious beliefs conflicted with being vaccinated, but didn't directly answer the questions.

She learned of Essentia's decision in a phone call from the volunteer coordinator, Hautala wrote.