California Demands Vaccines For Most Healthcare Workers In Healthcare Facilities | McDermott Will & Emery


On August 5, 2021, the California Department of Public Health (CDPH) released a new ordinance that impacts health care employers in California. The CRPD ordinance requires almost all healthcare employers to require their healthcare workers (and any workers who may be exposed to COVID-19) to be fully immunized, unless a worker qualifies for a religious exemption or medical. This decree does not invalidate the public health decree of July 26, 2021, which remains in force.


The decree applies to each of the following installations:

  • General acute care hospitals
  • Qualified nursing facilities (including subacute care facilities)
  • Intermediate care facilities
  • Acute psychiatric hospitals
  • Adult day care centers
  • All Inclusive Care Program for the Elderly (PACE) and PACE Centers
  • Outpatient surgery centers
  • Chemical addiction recovery hospitals
  • Clinics and medical offices (including behavioral health and surgery)
  • Collective living health establishments
  • Dialysis centers
  • Palliative care facilities
  • Pediatric day care and respite facilities
  • Residential addiction treatment and mental health facilities


The decree applies to all workers who provide services or work in the facilities listed above. In the Decree, the term “worker” is broadly defined to include all paid and unpaid persons who work in indoor environments where (1) patient care is provided or (2) patients have access to some purpose. whether it be.

This includes (but is not limited to) the following: nurses, nursing assistants, physicians, technicians, therapists, phlebotomists, pharmacists, and students and interns. It also applies to contractual staff not employed by the healthcare establishment and to people not directly involved in the care of patients but who could be exposed to infectious agents transmissible in the healthcare establishment (for example, office, dietary, environmental, laundry, security, engineering and facilities management services, administrative, billing and volunteer staff).


The order exempts workers from vaccination requirements if an establishment receives a refusal form, signed by the individual, indicating one of the following: (1) the worker refuses vaccination because of religious beliefs, or (2) the worker is exempt from receiving any COVID-19 Vaccine for qualifying medical reasons.

To be eligible for a qualified medical exemption, a worker must provide their employer with a written statement signed by a physician, nurse practitioner, or other licensed health professional licensed by a physician. The statement must both state that the person is eligible for the exemption (but the statement must not describe the underlying medical condition or disability) and indicate the likely duration of the worker’s inability to receive the vaccine. (or if the duration is unknown or permanent, then indicate).

If an operator of a covered establishment considers that a worker has met the requirements of a medical or religious exemption, the CDPH decree of July 26, 2021 remains in force, and the unvaccinated exempt worker must meet the following requirements when of his entry into or work in such an installation:

  • Test for COVID-19 with a polymerase chain reaction (PCR) or antigen test that has either an Emergency Use Clearance (EUA) from the United States Food and Drug Administration (FDA) , or that operates in accordance with the requirements of the test developed in the laboratory (LDT) by the United States Centers for Medicare & Medicaid Services (CMS). The test must take place twice a week for unvaccinated exempt workers in acute and long-term care facilities; it should happen once a week for these workers in other health establishments.
  • Wear a surgical mask or a higher level respirator approved by the National Institute for Occupational Safety and Health (NIOSH), such as an N95 filter mask respirator, at all times in the facility.

The facility must maintain records of worker immunizations, exempt status, and COVID-19 test results in accordance with all applicable privacy laws and regulations. The establishment must provide these files to the local or state public health official or his representative as soon as possible upon request, and in any event no later than the working day following receipt of the request.

These records should be kept in accordance with the CRPD Guidelines and Standards for Immunization Records with the following information: (1) full name and date of birth; (2) vaccine manufacturer; and (3) the date of administration of the vaccine (for the first dose and, if applicable, the second dose).


This decree entered into force immediately on August 5, 2021 at 12:01 a.m. Facilities must be in full compliance by September 30, 2021.

Full compliance means that all workers who provide services or work in facilities described in the order must receive their first dose of a one-dose regimen (Johnson and Johnson) or their second dose of a two-dose regimen. (Moderna or Pfizer-BioNTech) by September 30, 2021, except medical or religious exemption.

The full August 5th order can be found here:

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