Biden Admin Sets Date for Vaccine Mandates

On Thursday, the Biden administration issued two rules it argues will boost COVID-19 vaccination rates among workers — including healthcare workers — save lives, and strengthen the economy in the process.

The first rule, issued by Centers for Medicare & Medicaid Services (CMS), mandates that all healthcare workers whose organizations receive funding from Medicare or Medicaid be fully vaccinated against COVID-19 by Jan. 4, 2022. The second rule, issued by the Occupational Safety and Health Administration (OSHA), calls on business owners with 100 or more employees to require their workers to either get vaccinated or submit to weekly testing by this date.

“Ensuring patient safety and protection from COVID-19 has been the focus of our efforts in combatting the pandemic and the constantly evolving challenges we’re seeing,” CMS Administrator Chiquita Brooks-LaSure, said in a statement. “Today’s action addresses the risk of unvaccinated healthcare staff to patient safety and provides stability and uniformity across the nation’s healthcare system to strengthen the health of people and the providers who care for them.”

For facilities covered by the CMS regulation, organizations must establish a policy by Dec. 5, 2021 for ensuring workers receive their first dose of either mRNA vaccine or the single-dose Johnson & Johnson vaccine by the January deadline.

Also, in an attempt to simplify the implementation process for employers, officials said the administration has also pushed back the deadline for a previously announced vaccine requirements for federal employees and contractors to the Jan. 4, 2022 date as well.

Under the new Emergency Temporary Standard (ETS), as the rule from OSHA is known, employers must write, implement, and enforce either a mandatory COVID-19 vaccination policy or a policy that lets employees choose between vaccination and weekly COVID-testing plus masking. Healthcare workers will not have the option to submit to weekly testing in lieu of a vaccine.

“We have a higher bar for healthcare workers, given their critical role in ensuring the health and safety of their patients,” a senior administration official stated during a background phone call with reporters on Wednesday evening.

The two rules combined, in addition to previous regulations, will extend vaccination requirements to roughly two-thirds of all employees nationwide, including 17 million healthcare workers and 84 million employees, officials said. (Business groups had previously urged the administration to delay a vaccine mandate until after the holidays out of concern that it could worsen supply chain problems and labor shortages.)

The ETS will also call for employers to offer paid time off to allow employees to receive their shots and paid leave to recover from any side effects.

OSHA will also support employers to build their vaccine or testing requirements program by providing “robust compliance assistance” including sample plans, fact sheets, and frequently asked questions, noted officials on the press call.

The penalty for a single citation is approximately $14,000, they noted. For “willful penalties,” employers can be fined ten times that amount, roughly $140,000.

As for the agency’s legal authority to implement an ETS, a senior administration official said that 745,000 American deaths does indeed meet the criteria for a standard of “grave danger,” and the standard is also “necessary” to protect workers.

Experts clashed over whether the standard was indeed necessary, during a congressional hearing last week, and legal challenges are anticipated.

David Zaas, MD, CEO for MUSC Health’s Charleston division, who spoke about healthcare workforce issues during a virtual panel discussion hosted by the American Hospital Association on Tuesday, said the vaccine requirements MUSC implemented have helped to alleviate patients’ worries, but also served as a recruitment tool.

“I think people were choosing to work at places where they knew their co-workers were vaccinated,” Zaas said.

Leonard Hernandez, president and CEO for the Susan B. Allen Memorial Hospital in El Dorado, Kansas, said during the panel discussion that his organization would wait for the government to take action, before implementing any sort of mandate.

At least five or six nurses at his rural hospital have said they do not want to get vaccinated, he noted. “That’s a big part of our … nursing staff,” he said. “We will prolong … a decision until CMS says you have to do it.”

Vaccination rates have jumped to “well over 90%” among organizations that have implemented requirements voluntarily, an official said on the call.

Last Updated November 04, 2021

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