Statewide Order Effective August 5, 2021 Full Facility Compliance by September 30, 2021

Tightening a statewide order issued only the week previous, the California Department of Public Health (CDPH) is now ordering certain health care providers – including hospitals, surgery centers, and medical clinics – to require COVID vaccination status of all “workers.” Other  providers, including dental offices, homeless shelters, and prisons, remain subject to the July 26, 2021 CDPH order allowing unvaccinated workers as long as they COVID test at least once per week.  See, Health Care Workers Must Vaccinate or Regularly Test (July 30, 2021).

The CDPH premises the August 5, 2021 order on California’s fastest increase in “COVID-19 cases during the entire pandemic with 18.3 new cases per 100,000 people per day, with case rates increasing ninefold within two months.” The order also cites the strength of the Delta variant,  with viral load “roughly 1,000 times higher … than those infected with the original coronavirus strain, according to a recent study.”

The order observes that the health care facilities affected are particularly high-risk settings with “frequent exposure to staff and highly vulnerable patients, including elderly, chronically ill, critically ill, medically fragile, and disabled patients. In many of these settings, the patients are at high risk of severe COVID-19 disease due to underlying health conditions, advanced age, or both.”

Concluding that vaccination is the most effective means of preventing infection, subsequent transmission and outbreaks, the order directs “all health care workers [in such facilities] must be vaccinated to reduce the chance of transmission to vulnerable populations.”

A “worker” under the order is any paid or unpaid individual who works in indoor settings where (1) care is provided to patients, or (2) patients have access for any purpose, including anyone who has “the potential for direct or indirect exposure to patients or SARS-CoV-2 airborne aerosols.” Workers thus include not only nurses, physicians, and others in immediate contact with patients but those “not directly involved in patient care, but who could be exposed to infectious agents that can be transmitted in the health care setting (e.g., clerical, dietary, environmental services, laundry, security, engineering and facilities management, administrative, billing, and volunteer personnel).”

A worker is exempted only upon providing the facility a signed form stating vaccination is declined (1) based on “Religious Beliefs” (undefined in the order); or (2) due to “Qualifying Medical Reasons” (signed written qualifying statement from a physician or other authorized practitioner, including the “probable duration of the worker’s inability to receive the vaccine [or if the duration is unknown or permanent, so indicate]).”

An unvaccinated exempt worker must test for COVID – twice weekly for acute health care and long-term care settings, and once weekly for other specified health care settings – and wear a surgical mask or approved higher-level respirator at all times while in the facility.

An affected facility must maintain adequate records of workers’ vaccination or exemption status and provide them within one business day of request by a local or state public health officer. For each vaccinated worker, records must specify: “(1) full name and date of birth; (2) vaccine manufacturer; and (3) date of vaccine administration (for first dose and, if applicable, second dose).” For each unvaccinated worker, facility records must include the signed declination form with written health care provider’s statement where applicable as well as testing documentation.

See also:

• Indoor Face Coverings Resurrected – LA County Mandates More Masks (July 29, 2021)
• Workplace Coordination, Defined – Our Employee Policy Handbook & Forms for 2021 (July 22, 2021)
• Easy Does It – Take Two – CAL/OSHA Revises Written COVID-19 Prevention Program (July 15, 2021)

Tim Bowles
August 13, 2021