On August 9, 2021, Governor Inslee signed Proclamation 21-14, which broadly requires all health care providers, all workers in a health care setting, and all workers in specified state agencies, Boards, and Commissions to be fully vaccinated against COVID-19 by October 18, 2021. Specifically, this broad mandate applies to the following:
- To all health care providers on an individual basis, subject to limited exceptions as described below;
- To each individual or entity who operates a health care setting. These individuals and entities must ensure the fully vaccinated status of all persons engaged to work in a health care setting as an employee, independent contractor (with some exceptions), service provider, volunteer, or through any other formal or informal agreement to provide goods or services, whether compensated or uncompensated, but does not include a visitor or patron;
- To specified state agencies and Boards, Counsels and Commissions; and
- To workers at many state agencies, including some non-employees such as certain independent contractors and providers of goods and services.
Under the Proclamation, a “health care setting” means any public or private setting that is primarily used for the delivery of in-person health care services to people, except for the limited exemptions below. This broad definition applies to nearly ever setting where health care services are rendered, including but not limited to:
- Acute care facilities, including but not limited to hospitals;
- Long-term acute care facilities;
- Inpatient rehabilitation facilities;
- Inpatient behavioral health facilities;
- Outpatient facilities, including, but not limited to, dialysis centers, physician offices, and behavioral health facilities (including offices of psychiatrists, mental health counselors, and substance use disorder professionals);
- Residential long-term care facilities;
- Mobile clinics or other vehicles where health care is delivered;
- Dental and dental specialty facilities;
- Pharmacies (not including the retail areas);
- Massage therapy offices (this includes designated areas where massage is administered within non-health care settings like spas and wellness/fitness centers);
- Chiropractic offices;
- Midwifery practices and stand-alone birth centers;
- Isolation and/or quarantine facilities;
- Ambulatory surgical facilities;
- Urgent care centers; and
- Hospice care centers.
The few exceptions to the “health care setting” definition include:
- Settings where sports and spectator events or other gatherings are held (including when credentialed athletic trainers are providing care to players), other than areas primarily used for the delivery of health care services, such as designated first aid areas (which are health care settings);
- Department of Children, Youth & Families (DCYF)-licensed foster homes that do not primarily provide health care services;
- Research facilities where no health care is delivered to people;
- Veterinary health care settings;
- Animal control agencies; and
- Non-profit humane societies.
There are also some limited exceptions to the vaccination mandate on “health care providers,” including individuals who provide personal care in a person’s home, individuals who are not actively practicing or providing health care services, and workers who do not provide services in a “health care setting, as described below.” The Proclamation also references narrow vaccine exemptions for individuals with disabilities and sincerely held religious beliefs.
The key takeaway is that the vaccine mandate is extremely broad and applies not only to all specified state agencies and health care providers, subject to the limited exceptions above, but to non-health care personnel who provide goods or services in health care settings, including but not limited to janitorial staff, receptionists, IT staff members, and other administrative personnel. Another key takeaway is that it applies to certain providers of goods and services to specified state agencies, Boards, Councils, and Commission, not just state employees.
Violators of the Proclamation may be subject to criminal penalties, so it is critical that health care organizations take the vaccine mandate seriously and implement appropriate policies and procedures. Organizations that have a unionized workforce will also have to consider collective bargaining issues related to the mandate.
This article is a brief overview of a complex topic that is in a state of flux, and it should not be relied on for any purpose. Please contact Karen Sutherland at firstname.lastname@example.org, Jennifer Berry at email@example.com, or Casey Moriarty at firstname.lastname@example.org if you would like more information about the new vaccine mandate for health care settings and providers of goods and services to specified state agencies, Boards, Councils, and Commissions.