Or. Admin. R. 333-019-1010 : — OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISIONINVESTIGATION AND CONTROL OF DISEASES: GENERAL POWERS AND RESPONSIBILITIES —019-1010 - COVID-19 Vaccination Requirement for Healthcare Providers and Healthcare Staff in Healthcare Settings

(1) It is vital to this state that healthcare providers and healthcare staff be vaccinated against COVID-19. COVID-19 undergoes frequent mutations as it replicates, which over time has resulted in variants that are more transmissible or cause more severe disease. Unvaccinated individuals exposed to COVID-19 are very likely to become infected in the absence of mitigation measures and may then transmit the virus to others. Fully vaccinated people get COVID-19 (known as vaccine breakthrough infections) much less often than unvaccinated people. Being vaccinated is critical to prevent spread of COVID-19. Healthcare providers and healthcare staff have contact with multiple patients over the course of a typical day and week. The CDC recommends vaccination against COVID-19 for all eligible individuals. This rule is necessary to help control COVID-19, protect patients, and to protect the state's healthcare workforce.

(2) For purposes of this rule, the following definitions apply:

(a) "Contractor" means a person who has healthcare providers or healthcare staff on contract to provide services in healthcare settings in Oregon.

(b) "COVID-19" means a disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

(c) "Documentation of a medical exception" means a form prescribed by the Oregon Health Authority (OHA), or a similar form, that contains all of the information required in the OHA form, signed by a medical provider who is not the individual, certifying that the individual has a physical or mental impairment that limits the individual's ability to receive a COVID-19 vaccination based on a specified medical diagnosis, and that specifies whether the impairment is temporary in nature or permanent.

(d) "Documentation of a religious exception" means a form prescribed by the Oregon Health Authority (OHA), or a similar form, that contains all of the information required in the OHA form, signed by the individual, stating that the individual is requesting an exception from the COVID-19 vaccination requirement on the basis of a sincerely held religious belief and includes a statement describing the way in which the vaccination requirement conflicts with the religious observance, practice, or belief of the individual.

(e) "Fully vaccinated" means having received both doses of a two-dose COVID-19 vaccine or one dose of a single-dose COVID-19 vaccine and at least 14 days have passed since the individual's final dose of COVID-19 vaccine.

(f) "Healthcare providers and healthcare staff":

(A) Means individuals, paid and unpaid, working, learning, studying, assisting, observing or volunteering in a healthcare setting providing direct patient or resident care or who have the potential for direct or indirect exposure to patients, residents, or infectious materials, and includes but is not limited to any individual licensed by a health regulatory board as that is defined in ORS 676.160, unlicensed caregivers, and any clerical, dietary, environmental services, laundry, security, engineering and facilities management, administrative, billing, student and volunteer personnel.

(B) Does not mean parents, family members, guardians or foster parents residing in the home and providing care to a child or foster child in the home.

(g) "Healthcare setting":

(A) Means any place where health care, including physical, dental or behavioral health care is delivered and includes, but is not limited to any health care facility or agency licensed under ORS chapter 441 or 443, such as hospitals, ambulatory surgical centers, birthing centers, special inpatient care facilities, long-term acute care facilities, inpatient rehabilitation facilities, inpatient hospice facilities, nursing facilities, assisted living facilities, residential facilities, residential behavioral health facilities, adult foster homes, group homes, pharmacies, hospice, vehicles or temporary sites where health care is delivered or is related to the provision of health care (for example, mobile clinics, ambulances) outpatient facilities, such as dialysis centers, health care provider offices, dental offices, behavioral health care offices, urgent care centers, counseling offices, offices that provide complementary and alternative medicine such as acupuncture, homeopathy, naturopathy, chiropractic and osteopathic medicine, and other specialty centers.

(B) Does not include a person's private home if the home is not otherwise licensed, registered or certified as a facility or home listed in paragraph (A) of this subsection.

(h) "Medical exception" means that an individual has a physical or mental impairment that prevents the individual from receiving a COVID-19 vaccination.

(i) "Proof of vaccination" means documentation provided by a tribal, federal, state or local government, or a health care provider, that includes an individual's name, date of birth, type of COVID-19 vaccination given, date or dates given, depending on whether it is a one-dose or two-dose vaccine, and the name or location of the health care provider or site where the vaccine was administered. Documentation may include but is not limited to a COVID-19 vaccination record card or a copy or digital picture of the vaccination record card, a print-out from the Oregon Health Authority's immunization registry, or a Quick-Response (QR) code from a verified digital vaccine record.

(j) "Religious exception" means that an individual has a sincerely held religious belief that prevents the individual from receiving a COVID-19 vaccination.

(k) "Responsible party" means a person or persons who have control or responsibility for the activities of healthcare providers or healthcare staff in a healthcare setting.

(3) After October 18, 2021:

(a) Health care providers and healthcare staff may not work, learn, study, assist, observe, or volunteer in a healthcare setting unless they are fully vaccinated or have provided documentation of a medical or religious exception.

(b) An employer of healthcare providers or healthcare staff, a contractor, or a responsible party may not employ, contract with, or accept the volunteer services of healthcare providers or healthcare staff persons who are working, learning, studying, assisting, observing or volunteering at a healthcare setting unless the healthcare providers or healthcare staff persons are fully vaccinated against COVID-19 or have an approved or accepted medical or religious exception.

(4) Employers of healthcare providers or healthcare staff, contractors and responsible parties who grant a medical or religious exception to the vaccination requirement in this rule must take reasonable steps to ensure that unvaccinated healthcare providers and healthcare staff are protected from contracting and spreading COVID-19.

(5) Nothing in this rule is intended to prohibit employers of healthcare providers or healthcare staff, contractors and responsible parties from:

(a) Complying with the Americans with Disabilities Act and Title VII of the Civil Rights Act, and state law equivalents, for individuals unable to be vaccinated due to a medical condition or a sincerely held religious belief.

(b) Having more restrictive or additional requirements, including but not limited to requiring healthcare providers and healthcare staff to have documentation of an additional or booster dose of a COVID-19 vaccine if that is recommended by the U.S. Centers for Disease Control and Prevention.

(6) Proof of vaccination documentation and documentation of medical and religious exceptions described in this rule must be:

(a) Maintained in accordance with applicable federal and state laws;

(b) Maintained for at least two years; and

(c) Provided to the Oregon Health Authority upon request.

(7) Employers of healthcare providers or healthcare staff, contractors and responsible parties who violate any provision of this rule are subject to civil penalties of $500 per day per violation.

(8) In addition to the imposition of civil penalties under section (7) of this rule, a violation of this rule may also be grounds for a licensing action authorized under the following statutes or rules:

(a) ORS 443.045; OAR chapter 333, division 27 (home health agencies, to the extent staff are providing services or care in healthcare settings).

(b) ORS 443.864, 443.869; OAR chapter 333, division 35 (hospice programs, to the extent staff are providing services or care in healthcare settings).

(c) ORS 441.030; OAR chapter 333, division 71 (special inpatient care facilities).

(d) ORS 441.030; OAR chapter 333, division 76 (ambulatory surgical centers, extended stay centers and birthing centers).

(e) ORS 441.030; OAR chapter 333, division 501 (hospitals).

(f) ORS 443.325; OAR chapter 333, division 536 (in-home care agencies, to the extent caregivers are providing care in healthcare settings).

(g) ORS 441.030; OAR chapter 333, division 700 (outpatient renal dialysis facilities).

(h) ORS 426.415; OAR chapter 309, division 22 (psychiatric residential treatment facilities).

(i) ORS 435.415, 443.421, 443.455; OAR chapter 309, division 35 (residential treatment facilities, community based residential treatment homes, secure residential treatment facilities).

(j) ORS 443.745, 443.790; OAR chapter 309, division 40 (adult foster homes).

Or. Admin. R. 333-019-1010

PH 38-2021, temporary adopt filed 08/25/2021, effective 08/25/2021 through 01/31/2022; PH 34-2021, temporary adopt filed 08/05/2021, effective 08/05/2021 through 01/31/2022; PH 42-2021, temporary adopt filed 09/01/2021, effective 9/1/2021 through 1/31/2022; PH 11-2022, adopt filed 01/31/2022, effective 1/31/2022; PH 52-2022, minor correction filed 05/03/2022, effective 5/3/2022

Statutory/Other Authority: ORS 413.042, ORS 431A.010, ORS 431.110, ORS 433.004, ORS 426.415, ORS 443.085, ORS 443.315, ORS 443.450, ORS 443.745, ORS 443.790, ORS 443.860 & ORS 441.025

Statutes/Other Implemented: ORS 431A.010, ORS 431.110, ORS 433.004, ORS 426.415, ORS 443.045, ORS 443.325, ORS 443.421, ORS 443.455, ORS 443.745, ORS 443.790, ORS 443.864 & ORS 441.030