This story has been edited to include comment from CDPH and to clarify that the CDPH is not forcing healthcare workers back but rather is allowing hospitals to do so.
In addition to unveiling a proposed $2.7 billion COVID-19 Emergency Response Package, Gov. Gavin Newsom’s California Department of Public Health issued a confusing new guidance allowing hospitals and health networks to force COVID-postive healthcare workers to continue working if they are asymptomatic. Healthcare workers don’t have to isolate or test negative and can immediately return to work if they are asymptomatic – even in skilled nursing facilities.
This comes after firing thousands of unvaccinated California healthcare employees. Kaiser Permanente suspended more than 2,000 unvaccinated employees in October and said those who still have not been vaccinated will be terminated this month.
“The department is providing temporary flexibility to help hospitals and emergency services providers respond to an unprecedented surge and staffing shortages. Hospitals have to exhaust all other options before resorting to this temporary tool. Facilities and providers using this tool, should have asymptomatic COVID-19 positive workers interact only with COVID-19 positive patients to the extent possible,” the health department said in a statement, according to NBC Bay Area. The CDPH does not yet have this on its website.
The CDPH says:
“We are extremely grateful to all the health care workers across California who have worked tirelessly over the course of the pandemic in support of Californians impacted by COVID-19. While vaccines continue to protect against serious illness, hospitals are reaching capacity and staffing shortages are making it difficult to treat those who need essential care. Given those conditions, the department is providing temporary flexibility to help hospitals and emergency services providers respond to an unprecedented surge and staffing shortages. Hospitals have to exhaust all other options before resorting to this temporary tool. Facilities and providers using this tool, should have asymptomatic COVID-19 positive workers interact only with COVID-19 positive patients, to the extent possible, and ensure the workers are always wearing N-95 respirators.”
The representative from CDPH directed California Globe to the All Facilities Letter it relied on for guidance:
“During this time, HCPs who have tested positive for SARS-CoV-2 and are asymptomatic may return to work immediately without isolation and without testing, and HCPs who have been exposed and are asymptomatic may return to work immediately without quarantine and without testing. These HCPs must wear an N95 respirator for source control. Facilities implementing this change must have made every attempt to bring in additional registry or contract staff and must have considered modifications to non-essential procedures.”
The representative pointed out that the language reads “may return” rather than “must return.” True enough, however none of that challenges the Globe’s central assertion, which is that the hospitals themselves are free to insist, with the apparent endorsement of CDPH, that healthcare workers who test positive must indeed return to work.
Confusing the guidance even more, workers who have not received a booster by January 7, 2022 are considered unvaccinated by the CDPH, according to an updated guidance.
Dental offices are not included in this Order.
The CDPH acknowledges that California the first state to allow COVID-positive healthcare employees to work: “We are not aware of another state with such comprehensive requirements.”
The original CDPH mandate addressed if 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 July 26 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.”
The CDPH says in the mandate booster-eligible workers who have not yet received their booster must be in compliance by no later than February 1, 2022. For those not yet eligible for a booster, they must be in compliance no later than 15 days once they become eligible for a booster.
What facilities are impacted by the order?
The following health care facilities will be impacted by the Order:
- General Acute Care Hospitals
- Skilled Nursing Facilities (including Subacute Facilities)
- Intermediate Care Facilities
- Acute Psychiatric Hospitals
- Adult Day Health Care Centers
- Program of All-Inclusive Care for the Elderly (PACE) and PACE Centers
- Ambulatory Surgery Centers
- Chemical Dependency Recovery Hospitals
- Clinics & Doctor Offices (including behavioral health, surgical)
- Congregate Living Health Facilities
- Dialysis Centers
- Hospice Facilities
- Pediatric Day Health and Respite Care Facilities
- Residential Substance Use Treatment and Mental Health Treatment Facilities
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