Order-of-the-SPHO-Adult-Care-Facilities-and-Direct-Care-Worker-Vaccine-Requirement-FAQ-11-30-21 Public Health Order Questions & Answers: Adult Care Facilities and Direct Care Worker Vaccine Requirement

​This Q&A is no longer in effect and is for historical purposes only.

Public Health Order Questions & Answers: Adult Care Facilities and Direct Care Worker Vaccine Requirement

Are Assisted Living Facilities covered by this Order?

Yes, Assisted Living Facilities are covered by this Order.

How will you verify workers are vaccinated or tested?

Each facility, employer, or employer-recipient will be required to verify and keep record of vaccination status or test results. Pursuant to the CDPH Guidance for Vaccine Records Guidelines & Standards, facilities have multiple options to verify vaccine status.

Are Long-Term Care Ombudsmen Who Provide Services in Adult and Senior Care facilities covered by this Order?

Yes. The Order requires all workers who provide services or work in Adult and Senior Care Facilities licensed by the California Department of Social Services to have the first dose of a one-dose regimen or the second dose of a two-dose regimen by November 30, 2021. This Health Order covers all paid or unpaid Long-Term Care Ombudsman representatives who provide services in those Adult and Senior Care Facilities.

Who will be responsible for enforcement of the requirements under this Order?

The employer or employer-recipient is responsible for enforcement of the requirements within this Order.  As defined in the Order, an "employer" refers to an organization that employs and directs the worker in providing services. An "Employer-Recipient" refers to the person receiving services from IHSS workers, WPCS workers, and independent registered home care aides. In the case of workers in a facility, the facility is the employer. In the case of certified home health aides and affiliated home care aides, the home health agencies and home care organizations are the employer.  Local health jurisdictions may also enforce the requirements in the Order.

What is the definition of "family member" as it applies to this Order?

A "family member" is defined by the agency or program that provides licensing, enforcement, and/or oversight (e.g. IHSS, CDSS, CDDS etc.) for the particular facilities or services being provided.

What are Qualifying Medical Reasons?

To determine qualifying medical reasons, the physician, nurse practitioner, or other licensed medical professional practicing under the license of a physician should refer to Interim Clinical Considerations for Use of COVID-19 Vaccines from the CDC, specifically, clinical considerations, as well as contraindications and precautions. The identified contraindications include:

  • Documented history of severe allergic reaction to one or more components of all the COVID-19 vaccines available in the U.S.
  • Documented history of severe or immediate-type hypersensitivity allergic reaction to a COVID-19 vaccine, along with a reason why you cannot be vaccinated with one of the other available formulations.

Additionally, the Interim Clinical Considerations for Use of COVID-19 Vaccines provides information on what are neither contraindications nor precautions to COVID-19 vaccination, which includes:

  • Allergic reactions (including severe allergic reactions) not related to vaccines (COVID-19 or other vaccines) or injectable therapies, such as allergic reactions related to food, pet, venom, or environmental allergies, or allergies to oral medications.

Will the State be providing a template declination / exemption form for use?

No, the State will not be providing a template declination/exemption form for use. Facilities may use any existing form or process previously used for other mandated vaccines. If an entity does not have a previously used form, they should ensure that the requirements as stated in the Order are met, including written health care provider's statement where applicable, and testing records pursuant to section (8) of the Order.

Who is responsible for collecting and tracking vaccine verification and declination forms?

The employer is responsible for collecting and tracking vaccine verification and declination forms. As defined in the Order, an "employer" refers to an organization that employs and directs the worker in providing services. In the case of workers in a facility, the facility is the employer. In the case of certified home health aides and affiliated home care aides, the home health agencies and home care organizations are the employer.

Which tests qualify for workers who have a valid exemption? (e.g., point of care tests, rapid tests, community testing sites and do tests need to be approved by the FDA?)

Antigen, PCR, or any Nucleic acid amplification (NAAT) test would qualify and must either have Emergency Use Authorization by the U.S. Food and Drug Administration or be operating per the Laboratory Developed Test requirements by the U.S. Centers for Medicare and Medicaid Services.

Do people exempt from vaccination need to be tested if they have had COVID in the last 90 days?

Workers meeting qualified exemptions from the vaccination requirement, who have recovered from a diagnosis of COVID-19 in the last 90 days, and remained asymptomatic, do not need to submit to testing until after 90 days has expired but must self-monitor for symptoms and continue to follow all other infection control requirements, including masking, as stated in the Health Care Worker Protections in High-Risk Settings Order. Workers must provide documentation of previous diagnosis from a healthcare provider or confirmed laboratory results to refrain from testing. Workers must immediately follow self-isolation guidelines and resume testing if new COVID-19 symptoms occur during the 90 days post-infection.

What should a facility do if they suspect a fraudulent vaccine card is being presented as proof?

Facilities should work with their counsel and may report suspected cases of healthcare fraud to the U.S. Health and Human Services through their tip line at 1-800-HHS-TIPS or by using other ways to contact the hotline.

Does the Order apply to California Children's Services (CCS) Medical Therapy Unit program staff or other public health staff who provide intermittent home visits?

Yes, the Public Health Order applies to all CCS Medical Therapy Unit staff, including those who conduct home visits.

Does the Order apply to outside vendors that may need to enter a facility or home (for example, those providing durable medical equipment into the home)?

Outside vendors who do not work in the facility or home for extended periods or on a regular basis are not covered by this Order. It is recommended that facilities set up daily symptom screening and antigen testing sites for vendors not covered by the Order and provide surgical masks and hand hygiene stations. Unvaccinated vendors must wear face coverings and vendors should minimize their time spent in the facility or home, if possible. Within the context of home health or similar services, the client has the right to request proof of vaccination from the vendor prior to entry.