Vaccine Mandates for Healthcare Personnel

Oregon Vaccination Mandate for Health Care Personnel

Published 8/24/21, Last updated 10/13/21

Who does it apply to?

Anyone who works in a healthcare facility in Oregon. Fully remote employees are exempt.

Overview of the Rule

Oregon Administrative Rule 333-019-1010 is an emergency temporary rule that will expire on January 31, 2022, unless it is made permanent. The rule requires health care providers and staff to be fully vaccinated against COVID-19 by October 18, 2021. Health care workers who are not fully vaccinated by this date, must provide documentation of a medical or religious exception in order to continue working in a health care setting. Similarly, an employer may not employ a health care provider or staff in a health care setting unless they have documented proof of vaccination or an exception. The rule carries civil monetary penalties for employers who do not comply.

Implementation Process

To begin implementing a rule like this, it is important to communicate and set expectations among those who are impacted (e.g., staff), as well as document the work you do toward becoming compliant. Below is more information about implementation broken down into three phases: planning, testing, and operations.

Planning Phase
To begin the planning phase, employers should pull together a team to review the rule and begin drafting policies. Be sure to alert your employees of the rule itself, as well as the work you are doing to draft policies in order to comply with the rule. As an employer, you may want to invite internal or external feedback about elements of the rule that may be confusing or challenging. No firm decisions need to be made in this phase, but again, key dates should be communicated such as the October 18, 2021, operational date, and other useful dates. For example, September 13, 2021, appears to be the latest date someone could start the first dose of a two-dose vaccine like Pfizer’s and be fully vaccinated under the rule (which says 14 days after the last required dose of a COVID-19 vaccine).

Testing Phase
This will be the most challenging phase given the short time frame set for the operational date. Here, employers should have temporary policies drafted and some initial decisions made about how to process exception requests under the rule. Monitoring potential rule changes, FAQs, and other industry efforts will be useful in tailoring and updating policies. Your team should keep meeting and document its progress with planning and testing.

Operational Phase
While you are allowed to begin implementing the rule before the October 18 operational date, you may want to aim to meet the rule’s documentation requirements at least a week before. A clear human resources challenge, additional staff time may be needed to post employer policies about the rule, answer employee questions about those policies, document proof of vaccination, process exception requests, and take any action necessary in response to exception requests.

Unfortunately, there is no one-size fits all for compliance with a rule. Each employer needs to tailor their efforts at implementing the rule to their setting and the needs of their patients and workforce. Below are additional resources to assist with implementation. Also, OMA’s Knowledge Center staff are available to field questions and connect members and their practice locations with additional resources such as human resource consultants or legal counsel.

As with most new rules, there will be challenges with implementation. The health care community in general is suffering from a severe shortage of providers and staff. The OMA continually is working alongside health care partners in communicating issues to OHA as they arise and is requesting as much detail as possible. Please check back regularly for updates.


CMS Health Care Staff Vaccination Rule

Who does it apply to?

It applies to most Medicare and Medicaid-certified providers and suppliers:

  • Ambulatory Surgery Centers
  • Clinics, Rehabilitation Agencies, and Public Health Agencies as Providers of Outpatient Physical Therapy and Speech-Language Pathology Services
  • Community Mental Health Centers
  • Comprehensive Outpatient Rehabilitation Facilities
  • Critical Access Hospitals
  • End-Stage Renal Disease Facilities
  • Home Health Agencies
  • Home Infusion Therapy Suppliers
  • Hospices
  • Hospitals
  • Intermediate Care Facilities for Individuals with Intellectual Disabilities
  • Long Term Care facilities
  • Programs for All-Inclusive Care for the Elderly Organizations (PACE)
  • Psychiatric Residential Treatment Facilities (PRTFs)
  • Rural Health Clinics/Federally Qualified Health Centers
    It does not apply to clinics that don't fall into one of the above categories.

    Overview of the Rule

    This rule requires that all staff to be vaccinated, unless they have a documented medical or religious exemption. First dose must be received by December 5th and second dose  (unless vaccinated with a single dose vaccine) by January 3rd.

    How does this differ from the state mandate?

    The requirements for this rule are similar to the state rule. However one difference is CMS requires more specific information than the state medical exemption forms. For medical exemptions documentation most include which authorized COVID-19 vaccines are clinically contraindicated and the recognized clinical reasons for the contraindications.  Clinics should refer to the CDC informational document, Summary Document for Interim Clinical Considerations for Use of COVID-19 Vaccines when considering medical exemptions.


    Interim Rule  
    Clinical Considerations for Use of COVID-19 Vaccines

    OSHA COVID-19 Vaccination and Testing Emergency Temporary Standard

    Who does this apply to?

    This ETS applies to employers with 100 or more employees, that are not subject to the COVID-19 Healthcare ETS. Most healthcare facilities are subject to the Healthcare ETS, one of the exceptions would be clinics that screen all patients and visitors for and COVID-19 and do not allow entry for people suspected or confirmed to have COVID-19.

    Overview Rural

    Beginning December 5, employers must determine vaccination status of all employees, provide paid time off for employees to get vaccinated and recover from side effects, report work related COVID-19 fatalities and hospitalizations, and provide employees with information about the ETS, CDC document on vaccine efficacy and safety; protections against retaliation and discrimination; and laws that provide for criminal penalties for knowingly supplying false statements or documents. Beginning January 4, unvaccinated employees must be tested weekly. 


    Emergency Temporary Standard
    Additional resources including, policy templates and employee informational sheets

    Disclaimer: This material is for informational purposes only and is not intended to constitute legal advice. The information, examples, and suggestions presented in this material (though reliable) should not be construed as legal or other professional advice. Before applying this information in legal situations, we recommend you consult with legal counsel or other professional advisors.