COVID-19 Vaccines: Step-by-Step Guide for Community Action

This step-by-step guide is intended to help the Community Action network be nimble with respect to their approaches to vaccines in the workplace and maintaining compliance with applicable federal mandates issued by Head Start and the Centers for Medicare & Medicaid Services (CMS). Various legal challenges to the mandates, including to the OSHA Emergency Temporary Standard and the Head Start vaccine mandate, have resulted in many CAAs no longer being subject to any federal vaccination, testing, or masking requirements. However, such CAAs may, subject to their state and local laws, voluntarily adopt their own workplace rules regarding COVID-19 vaccines, tests, and masks.

This guide helps CAAs subject to vaccine mandates as well as those voluntarily adopting a mandate think through their implementation and enforcement procedures. We describe the planning process your CAA should consider as you develop and update your COVID-19 approach. We also provide template policies and additional resources to assist your CAA in preparing for and implementing federal mandates and your own workplace rules. We will update this resource as additional guidance is issued and legal developments arise.

CMS Mandate

CMS will enforce compliance with its rule through the network of state surveyors that assess CMS-certified providers and suppliers on a regular basis. CMS plans to issue interpretive guidelines for surveyors that will include instructions on reviewing an employer’s records of staff vaccinations, conducting interviews with staff to verify their vaccination status, and reviewing the employer’s vaccination policy. Providers and suppliers cited for noncompliance may be subject to enforcement remedies imposed by CMS depending on the level of noncompliance and the remedies available under federal law (e.g., civil money penalties, denial of payment for new admissions, or termination of the Medicare/Medicaid provider agreement). CMS will closely monitor the status of staff vaccination rates, provider compliance, and any other potential risks to patient, resident, client, and PACE program participant health and safety.

Head Start Mandate

The Head Start rule adds new provisions to the Head Start Program Performance Standards (HSPPS). The Office of Head Start will monitor compliance with the Head Start rule in the same way that it monitors other health and safety standards requirements in the HSPPS. As with other HSPPS, failure to comply can result in revocation of the award and recompetition for funding.

Equal Employment Laws

Failure to provide reasonable accommodations for employees on medical and religious grounds can have serious consequences for an employer. Equal employment laws such as the ADA and Title VII may be enforced by the EEOC or by individual plaintiffs. State-level anti-discrimination statutes may be enforced by the state attorney general or state equal employment office. Usually, an employee must go through the process of submitting a charge of discrimination to a local office before they can file a lawsuit. The EEOC or state office will notify the employer against whom the allegation has been raised and will seek to mediate or settle the issue. If they cannot reach an outcome that is acceptable to both parties, they may conduct an investigation and issue a determination on whether there is probable cause to believe that the employer violated the employee’s rights. This may give the employee the right to bring a lawsuit.

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.