The Biden Administration’s COVID-19 Vaccine Mandate: Information for the HCH Community

The Biden Administration’s COVID-19 Vaccine Mandate: Information for the HCH Community

September 13, 2021

On Thursday, September 9, President Biden announced a six-pronged strategy intended to lead the country out of the COVID-19 pandemic. The first prong of the strategy defined several vaccine mandates that apply to most workplaces. In addition to these health care facilities, any non-health care employer with 100 or more employees now is subject to a vaccine mandate. The fourth prong of the strategy aims to increase access to testing by making tests more affordable and widely available.

The National HCH Council has previously endorsed organizations that issued vaccine mandates, and we are grateful to see these new policies announced. Further details on these requirements and their effective date will be posted in The Federal Register in October. To help with initial planning, below are answers to frequently asked questions for how the new federal strategy will impact the Health Care for the Homeless community.

Does the mandate apply to staff at FQHCs?
Yes, the new federal mandate applies to all employees, contractors, and volunteers of Federally Qualified Health Centers, including staff who do not interact with patients. Employees of FQHCs will not have the option to submit weekly COVID-19 testing as an alternate to getting vaccinated, though federal law does allow for medical and religious exemptions. Employers must provide staff with paid time off to receive and recover from the vaccine.

Does the mandate apply to staff at non-FQHCs, like medical respite care programs or homeless service providers?
It depends. Programs not included on the CMS required facilities list are not required to comply with the new vaccine mandate, however, the requirements for those facilities extend to contractors. If a medical respite care program (or other non-FQHC) is a contractor of a mandated facility (like an FQHC or a hospital), staff may be required to be vaccinated. Another element of the federal strategy requires all employers with 100+ employees to mandate vaccinations, or for staff to submit weekly negative test results. Some programs may be part of a larger organization that has 100+ employees total (e.g,. Catholic Charities or Salvation Army). Programs should consider their contracting relationships or other aspects of the requirements when determining if their facility or program falls within the vaccine mandate.

What vaccine exemptions are allowable?
Federal law requires that employers consider exemptions based on religious or medical factors, and provide reasonable accommodations if possible. The CDC has provided guidelines for the three contraindications that qualify for a medical exemption from the COVID-19 vaccine.

What does this mean for patients/clients?
The vaccine mandate does not apply to patients/clients who are accessing care at a health center. By November, patients/clients at any of the included health care facilities can be confident that all the staff at their venue of care will have been vaccinated. Patients/clients who work for an employer with 100+ employees will be subject to these new mandates and should seek vaccination if they have not already (or make plans for weekly testing if that’s allowed as an alternative to testing).

Will health care facility employees have the option to get weekly testing if they decline vaccination?
Employees of the required health care facilities will not have an option for weekly testing in lieu of vaccination. All employees, volunteers, and contractors of the health care facility must be vaccinated.

What steps are employers required to take?
OSHA will soon issue a rule that employers with 100+ employees must provide paid leave for the time it takes employees to get vaccinated and to recover if they are unwell post-vaccination. Employers may also be required to provide paid time off to take family members to get vaccinated.

Will FQHCs get more tests to meet higher patient demand?
The Administration will soon send 25 million free, at-home rapid tests to FQHCs and food banks. More details on this initiative are forthcoming.

We anticipate that HRSA and NACHC will be updating their FAQ with essential information for Health Centers. OSHA is expected to publish a new Emergency Temporary Standard (ETS) soon.

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