On Tuesday, July 26, the California Department of Public Health issued an order for workers in healthcare facilities. In response to the increasing COVID-19 cases in California – caused primarily the Delta variant of the COVID-19 virus – the CDPH is taking action “necessary to protect particularly vulnerable populations, and ensure a sufficient, consistent supply of workers in high-risk health care and congregate settings.” Healthcare facilities were already subject to unique mask mandates, and as a result of this order, requirements for healthcare employers are increasing.
When does this new CDPH order take effect?
This order takes effect August 9, 2021, at 12:01a, and “facilities must be in full compliance with the order by August 23, 2021.”
Who does this new CDPH order apply to?
This order applies to organizations that fall under three broad categories: acute health care and long-term care settings, high-risk congregate settings, and other health care settings. Covered under these categories are facilities from hospitals and skilled nursing facilities to clinics/doctor’s offices, dental offices, and hospice facilities.
What are healthcare facilities required to do?
Healthcare facilities are required to take action documenting employee vaccination status, providing for/enforcing employee masking, and testing employees who are not fully vaccinated on a weekly basis.
Documenting Vaccination
All healthcare facilities must verify and track the vaccine status of their employees. Vaccination verification must be accomplished through one of the following:
1. COVID-19 Vaccination Record Card, including the type of vaccine and the date of the last dose administered
2. Photo of a COVID-19 Vaccination Record Card
3. Digital photo of a COVID-19 Vaccination Record Card
4. Documentation from a health care provider
5. A digital record with QR code (including the record available at https://myvaccinerecord.cdph.ca.gov/)
Facilities must have a plan for tracking worker vaccination status. When vaccination status is unknown or unverified, workers must be treated as unvaccinated.
Masks and Respirators
All healthcare facilities must follow current CDPH masking guidance. In an order issued June 15, the CDPH required masks for everyone at healthcare facilities, regardless of vaccination status. Where applicable, healthcare facilities must also follow Cal/OSHA’s Aerosol Transmissible Diseases (ATD) standard. Cal/OSHA’s emergency COVID-19 standard also requires that respirators be provided employees upon request.
For acute health care and long-term care settings, facilities must provide respirators to those not fully vaccinated who work indoors in close proximity to patients/residents or patient/resident areas. Workers are encouraged to wear respirators in these settings. These facilities must also instruct workers on how to wear respirators and perform a seal check.
For high-risk congregate settings and other health care settings, when respirators are not required, facilities must provide those not fully vaccinated with surgical masks. Surgical masks are required indoors whenever workers are nearby others.
Testing
For acute health care and long-term care settings, workers who are not fully vaccinated must be tested at least twice weekly. For high-risk congregate settings and other health care settings, workers who are not fully vaccinated must be tested at least once weekly. These tests can be either molecular or antigen as long as they have received Emergency Use Authorization. Facilities must have a plan for tracking test results and conducting contact tracing, and they must report results to the local public health department.
Those who are exempted from the vaccine requirement (e.g., due to a medical condition) are not exempt from this testing requirement. Additionally, those who previously recovered from COVID-19 over 90 days earlier are not exempt from this testing requirement.
What now?
Healthcare employers are now faced with a difficult choice – should you pay for expensive weekly testing for employees who are not fully vaccinated, or should you require vaccination as a condition of employment? Unfortunately, this CDPH order forces us into that very choice.
