Statewide Order Effective August 9, 2021 Full Facility Compliance by August 23, 2021

On the rising wave of Delta variant cases, the California Department of Public Health(CDPH) is ordering all health care providers - including hospitals, surgery centers, medical clinics and dental offices - to verify the COVID vaccination status of all "workers" and, for those unvaccinated, to require COVID testing at least once per week. The order also directs strict masking requirements for all healthcare workers whether or not vaccinated.

The July 26, 2021 order stems from California's "fastest increase in COVID-19 cases during the entire pandemic with 11.2 new cases per 100,000 people per day, with case rates increasing fivefold within two months. The Delta variant, which is very highly contagious and possibly more virulent, is currently the most common variant causing new infections in California."

The order states that "unvaccinated persons are more likely to get infected and spread the virus, which is transmitted through the air. Most current hospitalizations and deaths are among unvaccinated persons. Thanks to vaccinations and to measures taken since March 2020, California's health care system is currently able to address the increase in cases and hospitalizations. However, additional statewide facility-directed measures are necessary to protect particularly vulnerable populations, and ensure a sufficient, consistent supply of workers in high-risk health care and congregate settings."

The directive thus applies to acute health care and long-term care facilities (e.g., hospitals, skilled nursing facilities), high-risk congregate settings (e.g., adult and senior care facilities, homeless shelters, correctional facilities), and "other health care settings," including surgery centers, medical clinics, and dental offices.

The essentials include:

• The "workers" affected include "all paid and unpaid persons serving in health care ... settings who have the potential for direct or indirect exposure to patients/clients/residents or SARS-CoV-2 airborne aerosols." Affected workers with "indirect" exposure could include clerical, administrative, and billing personnel;
• Proof of vaccination is limited to a "COVID-19 Vaccination Record Card" (issued by the Department of Health and Human Services Centers for Disease Control & Prevention or World Health Organization [WHO] Yellow Card) which includes name of person vaccinated, type of vaccine provided and date last dose administered) or a photo or other electronic link to the card (including QR code);
• Facilities must have a plan for tracking worker vaccination status with records made available, upon request, to the local health authorities;
• Workers who are not fully vaccinated, or for whom vaccine status is unknown or documentation is not provided, must be considered unvaccinated;
• All affected facilities must strictly adhere to current CDPH Masking Guidance, with acute health care and long-term care facilities to supply approved respiratory protection devices (e.g., "an N95 filtering facepiece respirator") and other health care facilities to supply FDA-cleared surgical masks. Vaccinated individuals are not exempted from such requirements;
• Asymptomatic unvaccinated or incompletely vaccinated workers are required to undergo diagnostic screening testing (PCR or antigen) at least once weekly. "More frequent testing improves outbreak prevention and control and is encouraged, especially with antigen testing"; and
• Affected facilities should have a test tracking plan and conduct workplace contact tracing. Facilities must report tracing results to local public health departments. The order states: "There are IT platforms available that can facilitate these processes for facilities."

For more information, please contact Tim Bowles, Cindy Bamforth or Helena Kobrin.

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
July 30, 2021