Federal Vaccine Mandates: Step-by-Step Compliance Guide for Community Action

This step-by-step compliance guide is intended to help the Community Action network navigate the employee vaccination mandates announced by OSHA, Head Start, and the Centers for Medicare & Medicaid Services (CMS). We describe the planning process your CAA should consider as you develop and update your policies to reflect the new requirements. We also provide template policies and additional resources to assist CAAs in preparing for and implementing the mandates. We will update this resource as additional guidance is issued and legal developments arise.

1/13/22: The OSHA vaccine-or-test mandate has been blocked nationwide by the U.S. Supreme Court. The CMS vaccine mandate has been upheld by the U.S. Supreme Court and is currently in effect.

1/3/22: The Head Start Interim Final Rule establishing the Head Start vaccination and masking mandate has been preliminarily enjoined in 25 states: Alabama, Alaska, Arizona, Arkansas, Florida, Georgia, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia, and Wyoming. Head Start, Early Head Start, and Early Head Start-Child Care Partnership grant recipients in those 25 states are not required to comply with the rule pending future developments in the litigation.

As grant recipients of multiple funding sources with varying requirements, CAAs frequently juggle overlapping compliance obligations. If your CAA is subject to multiple employee vaccination mandates, think carefully before implementing a written policy. You have a choice between adopting the same employee vaccination rule across all programs or applying different mandates to different groups of employees. Before making your choice, consider where the rules that apply to your organization overlap and diverge using the chart below.

Rule OSHA ETS CMS Rule Head Start Rule
Covered employers/entities:
Private employers with 100 or more employees
Certain Medicare- and Medicaid- certified healthcare facilities
HS/EHS grantees, including CCPs and delegate agencies
Covered individuals:
All employees
All employees; those who provide services at a site of care or have contact with someone who may be present at a site of care
Staff who work with HS children and families; contractors with direct contact with children and families; volunteers in classroom or working directly with children; children over age 2 (masking only)
Excluded individuals:
Those who do not report to a workplace where other individuals are present; those working from home or exclusively outoors
Individuals who perform all work-related duties remotely
Reasonable accommodations for religious and medical exemption requests:
Fully vaccinated individuals remain subject to masking requirement:
Silent (may be subject to existing universal masking requirements)
Individuals must be masked by:
If not fully vaccinated, January 10, 2022
Silent (may be subject to existing universal masking requirements)
November 30, 2021 regardless of vaccination status
Individuals must be fully vaccinated by:
February 9, 2022
January 4, 2022
January 31, 2022
Option to provide weekly negative test result instead of vaccination:
Requires collection of proof of vaccination:
Additional paid sick leave for vaccination:
Silent (apply OSHA rule if applicable)
Silent (apply OSHA rule if applicable)
Additional paid sick leave for vaccine side effects:
Must provide if employee has none available
Silent (apply OSHA rule if applicable)
Silent (apply OSHA rule if applicable)

From a compliance perspective, the easiest approach is likely adopting and applying the same employee vaccination rule across all programs. Doing so will help you avoid potential claims of discrimination from individuals in a protected class, as all employees will be subject to the same policies. With this approach, your CAA should apply the most restrictive employee mandate applicable to your organization. For CAAs subject to all three federal mandates—OSHA, CMS and Head Start—that would mean implementing a vaccine mandate with no test-and-mask alternative, and universal masking for individuals aged 2 and older Both the vaccination and masking requirements would be subject to reasonable accommodations for medical and religious exemptions.

Adopting the most restrictive mandate as your approach also requires being aware of the benefits that some mandates provide and determining if you are required to extend them to employees covered by a different mandate. For example, the OSHA ETS requires employers to provide additional paid time off to receive a vaccination and additional leave, if the employee is out of leave and needs time to recover from vaccine side effects. OSHA has indicated that up to 4 hours of leave may be given for a vaccination and that two days of leave is a reasonable amount of time for someone recovering from vaccine side effects. Neither the CMS Rule nor the Head Start Rule provides paid leave for employees to receive and recover from vaccination, but to the extent that the employees are also covered by the OSHA rule, they must be provided with such leave.

If your CAA would rather only apply the most restrictive mandate when necessary, it should make sure that its written policy clearly identifies which employees will be subject to which requirement. For example, a CAA covered by the OSHA ETS, the CMS rule, and the Head Start mandate may choose to divide its workforce into three parts and impose different vaccination mandates for each group in its vaccination policy. The CAA should also be prepared to explain that employees are being treated differently, for a legitimate business reason (e.g., the stricter rules are funding source requirements, or certain employees have greater interaction with and exposure to the public).

When weighing the pros and cons of an approach, your CAA should also consider questions such as:

  • Does the CAA have the capacity to separately manage and track the requirements of each mandate?
  • Will the application of different vaccination mandates to different groups of employees have a negative effect on employee morale?
  • Is the CAA subject to a collective bargaining agreement that might govern the implementation of a vaccination mandate (e.g., though the OSHA ETS does not require employers to pay for face coverings, a collective bargaining agreement may require employers to cover these costs)?
  • If the CAA plans to support employees by providing face masks, testing, etc., what funds can be used to do so? How will they be allocated?

Finally, your CAA should consult with an attorney licensed in your state when developing a vaccine plan and policy to ensure compliance with applicable state laws.

This resource is part of the Community Services Block Grant (CSBG) Legal Training and Technical Assistance Center. It was created by CAPLAW in the performance of the U.S. Department of Health and Human Services, Administration for Children and Families, Office of Community Services, Cooperative Agreement Award Number 90ET0467-03-C3. Any opinion, findings, conclusions, or recommendations expressed in this material are those of the author(s) and do not necessarily reflect the views of the U.S. Department of Health and Human Services, Administration for Children and Families.