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Elizabethtown high school and middle school students walk into school after embarking from their buses during the first day of school on Monday, Aug. 23, 2021.

The Pennsylvania Department of State is investigating a complaint about a Lebanon County doctor who offered a free-to-download, signed, no-questions-asked medical exemption for children to opt out of the state’s new mask mandate.

Filed with the Department of State by Jason Fritz on Sept. 6, the complaint alleges Dr. Joel E. Yeager issued physician orders for individuals who are not his patients and for whom he has no medical history.

“This physician is offering, essentially, a doctor’s excuse for patients that are not under his care; for patients he doesn’t even know,” Fritz, of Penn Township, told LNP | LancasterOnline.

Fritz is a respiratory therapist who has treated COVID-19 patients. He is also an administrator of the Manheim Central - Voice of Reason Facebook page, which supports science-based COVID-19 mitigation strategies in Lancaster County’s Manheim Central School District, including the mask mandate.

Wanda Murren, a Department of State spokesperson, declined to “confirm or deny whether any particular licensee is under investigation, or even whether a complaint has been filed.”

But Murren also said the department investigates all complaints.

Yeager said he received a copy of the complaint on Wednesday. The link for Yeager’s signed exemption form was taken down sometime Friday.

He defended the pre-signed blanket exemption, saying a medical examination was unnecessary and indicative of what he called the “overmedicalization” of American culture.

“It doesn’t really take a doctor to certify that a child has an asthma or an anxiety or an allergic diagnosis, for example!” Yeager said in an email to LNP | LancasterOnline. “Parents — who know their kids far better than their doctors — are certainly the most capable of making that determination in this case.”

‘Doctors are refusing to write valid medical exemptions’

That doesn’t jibe with federal Centers for Disease Control and Prevention (CDC) guidance.

Individuals with intermittent respiratory distress issues — such as asthma — would not likely qualify for an exemption because they generally can wear a mask safely, the CDC said when issuing its mask order on public transportation in January.

The CDC guidance says face masks should not be worn by children under the age of 2, those who have trouble breathing or who are unconscious, incapacitated or unable to remove a mask without assistance.

According to the CDC, only a “narrow subset” of persons with disabilities will be exempt from the mask requirement.

It appears there is widespread compliance with that policy.

“Many (if not most) doctors are refusing to write valid medical exemptions for their own patients,” Yeager said.

The Pennsylvania Department of State is charged with protecting the public by licensing business and health professionals. It is the state Board of Medicine that regulates medical practices in Pennsylvania and has the authority to take disciplinary or corrective action against licensees.

Yeager has no disciplinary actions.

He is a family physician who operates Heritage Family Health in Newmanstown with his wife. Heritage Family Health was incorporated in 2011, state records show.

State health officials declined to address the emergence in Pennsylvania of blanket medical exemptions that have cropped up elsewhere in California, Florida and Missouri, among others.

“Schools should follow the same protocols or established processes for determining a student eligibility for an exemption, including any medical documentation, as they would when implementing other directives concerning the health and safety of students in the classroom,” Mark O'Neil, a state health department spokesperson, said in an email.

‘Many online forms do not meet these conditions’

Yeager’s controversial exemption form was spurred by the Wolf administration’s new face mask order, issued by Acting Health Secretary Alison Beam on Aug. 31. The order, which went into effect on Tuesday, requires masks in school buildings, early learning programs and child care facilities. The order was put in place as COVID-19 hospitalizations and deaths have surged across the state.

For example, over the past week, Lancaster County’s three hospitals have had an average of 75 COVID-19 inpatients, up from 61 the previous week. On Wednesday, the patient count stood at 85, the most since late April.

From Aug. 25 to Sept. 5, the county had 19 COVID-19 deaths, up from just six in the preceding 12 days. At this pace, Lancaster County could be on track for 40 to 50 COVID-19 deaths in September. That’s more than the last three months combined.

It is unclear how many parents in Lancaster County’s 16 school districts have downloaded and used Yeager’s signed medical exemption to skirt the mask mandate.

Officials at a number of Lancaster County school districts are aware of the Heritage Family Health mask exemption and indicated they will not accept it.

For example, a mass email message Thursday from Superintendent Peter Aiken to parents in the Manheim Central School District said documentation of a medical or mental health disability is required before approving an exemption.

“Unfortunately, many online forms do not meet these conditions,” Aiken said in an email obtained by LNP | LancasterOnline. “Specifically the ‘Heritage’ form, ‘Certification of Need’ form, religious requests, or notes without details surrounding a medical or mental health condition or disability do not meet this requirement.”

The following Lancaster County school districts have also indicated they will not accept the Heritage form: Donegal, School District of Lancaster, Eastern Lancaster County, Pequea Valley, Cocalico, Ephrata Area, Penn Manor, Columbia Borough, Elizabethtown Area and Lampeter-Strasburg.

Fritz, who filed a complaint against Yeager, took it a step further.

Yeager’s exemption form, he said, was an extremely unethical, political stunt.

The board chair of the Pennsylvania Medical Society, Dr. Ed Balaban, cautioned members — regardless of their personal feelings on the matter — to stay “above board” in an Aug. 24 communication.

“Physicians can be subject to professional discipline for engaging in unprofessional or immoral conduct,” Balaban said. “Such conduct can include failure to maintain medical records for patients which accurately and completely reflect the evaluation and treatment of the patient as well as potentially violating standards of care.”

Staff writer Alex Geli contributed to this report.

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