CLIENT ALERT: What Federal Vaccine Mandates Mean (and Don’t Mean) for Health Centers

By | Published On: September 20, 2021

On September 9, 2021, the Biden Administration released a six-prong COVID-19 Action Plan designed to employ a “science-based approach to vaccinate the unvaccinated, protect the vaccinated, keep schools safely open, increase testing and masking, protect the economic recovery, and improve care for those with COVID-19.”

As health centers across the country grapple with whether to mandate vaccinations for employees and how to enforce such mandates, the following parts of the COVID-19 Action Plan are likely to influence the design of health center vaccination plans:

  • Employers with 100 or more employees to require vaccination or weekly testing of employees: In the COVID-19 Action Plan, the Biden Administration announced that the Department of Labor’s Occupational Safety and Health Administration’s (OSHA) will issue an Emergency Temporary Standard (ETS) requiring all employers with 100 or more employees to ensure:
    • Employees are fully vaccinated; or
    • If an employee is not fully vaccinated, the employee must show a negative test result at least on a weekly basis before coming to work.

Employers with 100 or more employees will be required to provide paid time off for employees to receive and recover from vaccination.

OSHA is expected to release this ETS in the next several weeks, just months after it its COVID-19 ETS for healthcare employers.

  • Medicare and Medicaid-certified facilities to require vaccination of employees: In the COVID-19 Action Plan, the Biden Administration announced that the Centers for Medicare & Medicaid (CMS) will require vaccinations for workers in most health care settings that receive Medicare or Medicaid reimbursement. The vaccination requirement will apply to “clinical staff, individuals providing services under arrangements, volunteers, and staff who are not involved in direct patient, resident, or client care.”

In a separate press release, CMS noted that it is developing an Interim Final Rule with Comment Period (IFR) that will be issued in October.  The extent to which this mandate will impact health centers and whether states will challenge it will depend upon the language in the IFR.

President Biden also signed two Executive Orders – one requiring the vaccination of federal executive branch employees and the other requiring the vaccination of federal contractors and subcontractors.

On September 23rd, Feldesman Tucker Leifer Fidell LLP will host a webinar on “Understanding the Biden Administration’s Workplace Vaccine Mandates” to review the specifics of the COVID-19 Action Plan and the Executive Orders; to discuss the impact on health centers, including how legal challenges might impact requirements to comply with the mandates; and to provide guidance on how to prepare for the mandates.


Ms. Pledgie is a member of the New York and Massachusetts Bars and is not licensed in Washington, DC. Her practice is limited to federal health care matters.


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