COVID-19 Vaccine Information

The Michigan Department of Health and Human Services (MDHHS) is announcing an expanded partnership with the Rockefeller Foundation through Project Act to provide 300,000 COVID-19 tests to 60,000 households free of charge to at-risk communities. Michigan was previously enrolled in a pilot program that provided 250,000 tests to 50,000 households.

Residents are able to request tests once per month in July and August. Households will receive one kit each month containing five tests.

“Testing remains both a critical and helpful tool in managing the spread of COVID-19 and ensuring our loved ones and neighbors don’t get infected,” said Dr. Natasha Bagdasarian, MDHHS chief medical executive. “Providing free tests to those in need is necessary, and we are grateful for our partnership with the Rockefeller Foundation to ensure equitable access to tools that prevent COVID-19.”

Eligible individuals in vulnerable communities can order their free COVID-19 tests through AccessCovidTests.org. Each household will receive one kit with five tests, typically within a week of ordering. Individuals seeking to order tests will input their ZIP code to see if they live in a qualifying area. Individuals without internet access can contact 211 for assistance ordering tests. 

This program is in addition to free at-home tests available through the federal government partnership with the United States Postal Service. 

MDHHS continues to partner with libraries across the state to provide free at-home COVID-19 tests to Michiganders. Click here for a list of participating libraries. 

For more information about testing, visit Michigan.gov/Coronavirus.

The Michigan Department of Health and Human Services (MDHHS) is updating vaccine providers across the state about the U.S. Food and Drug Administration (FDA) limiting the authorized use on the administration of the Janssen (Johnson & Johnson) COVID-19 vaccine.

On May 5, FDA released a statement that it has revised its Emergency Use Authorization (EUA) and limited the authorized use of the Janssen COVID-19 vaccine.  The updated EUA limits use to:

• Individuals 18 years of age and older for whom other authorized or approved COVID-19 vaccines are not accessible or clinically appropriate; or
• Individuals 18 years of age and older who elect to receive the Janssen COVID-19 vaccine because they would otherwise not receive a COVID-19 vaccine.

Based on its investigation, the FDA has determined that the risk of thrombosis with thrombocytopenia syndrome (TTS), warrants limiting the authorized use of the vaccine. TTS is a syndrome of rare and potentially life-threatening blood clots in combination with low levels of blood platelets.  TTS linked with the Janssen COVID-19 vaccine has most frequently presented within 10 days to two weeks following vaccine administration.

The FDA and Centers for Disease Control and Prevention (CDC) have identified 60 confirmed TTS cases following the administration of Janssen COVID-19 vaccine, including nine fatal cases. The FDA has determined that the reporting rate of TTS is 3.23 per million doses of vaccine administered and the reporting rate of TTS deaths is 0.48 per million doses of vaccine administered.

“Throughout the pandemic, our federal partners have been committed to ensuring that science and data guided their decisions,” said Dr. Natasha Bagdasarian, MDHHS chief medical executive. “These new guidelines further underscore the robust safety review process in place for these vaccines. We continue to urge all Michiganders ages 5 and older to get their safe and effective COVID-19 vaccine as soon as possible and to get boosted if eligible.”

For individuals who have received the Janssen COVID-19 vaccine as their primary dose, it is recommended they receive a COVID-19 vaccine booster dose. mRNA vaccines are preferred for the first booster dose. Additionally, if Janssen COVID-19 vaccine was used for both the primary and booster doses, individuals are eligible for an additional dose of an mRNA vaccine. In both instances, vaccine protection has been shown to increase following administration of an mRNA vaccine.

Background & Safety Monitoring for Janssen (Johnson & Johnson) EUA

• On Feb. 27, 2021, Janssen COVID-19 vaccine was authorized for emergency use. On April 13, 2021, FDA and CDC recommended a pause in administration of the vaccine to investigate six reported cases of TTS, and to help ensure that health care providers were made aware of the potential for TTS, and could plan for proper recognition and management due to the unique treatment required for TTS.  
• On April 23, 2021, following a thorough safety evaluation, FDA and CDC lifted the recommended pause regarding the use of the Janssen COVID-19 vaccine. The agencies confirmed a total of 15 cases of TTS had been reported to the Vaccine Adverse Event Reporting System, including the original six reported cases, out of approximately 8 million doses administered. 
• In December 2021, after reviewing updated vaccine effectiveness and safety data, the CDC’s Advisory Committee on Immunization Practices made a recommendation for the use of mRNA COVID-19 vaccines over the Janssen COVID-19 vaccine.

To date, nearly 6.7 million Michiganders (67%) have received their first does of COVID-19 vaccine. More than 393,000 residents have received the Janssen COVID-19 vaccine.

Michigan residents seeking more information about the COVID-19 vaccine can visit Michigan.gov/COVIDvaccine. 

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Fact Sheet for Healthcare Providers Administering Vaccine

Fact Sheet for Recipients and Caregivers

Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States

• 2022 Janssen updated guidelines NR.pdf

The US Centers for Disease Control and Prevention (CDC) continues to recommend that all eligible adults, adolescents, and children 5 and older be up to date on their COVID-19 vaccines, which includes getting an initial booster when eligible.

Following FDA’s regulatory action last week, CDC is updating its recommendations to allow certain immunocompromised individuals and people over the age of 50 who received an initial booster dose at least 4 months ago to be eligible for another mRNA booster to increase their protection against severe disease from COVID-19. Separately and in addition, based on newly published data, adults who received a primary vaccine and booster dose of Johnson & Johnson’s Janssen COVID-19 vaccine at least 4 months ago may now receive a second booster dose using an mRNA COVID-19 vaccine.

These updated recommendations acknowledge the increased risk of severe disease in certain populations including those who are elderly or over the age of 50 with multiple underlying conditions, along with the currently available data on vaccine and booster effectiveness.

Click to view the full CDC Media Statement.

Federal OSHA’s COVID-19 Emergency Temporary Standard for Healthcare 1910.502 (ETS1): 

Federal OSHA has not yet rescinded its COVID-19 Emergency Temporary Standard for Healthcare 1910.502 (ETS1) and is using its enforcement discretion to not issue citations of ETS1 until they are officially rescinded. MIOSHA has been informed that OSHA is in the process of rescinding the relevant rules and the agency is preparing updated rules to align with the revised federal rules. Until updates to the rules are made at the federal and state levels, MIOSHA will not issue citations related to Part 505 - Coronavirus Disease.   

Federal OSHA's COVID-19 Emergency Temporary Standard for Vaccination and Testing 1910.501 (ETS2): 

On January 26, 2022, federal OSHA withdrew its COVID-19 Emergency Temporary Standard for Vaccination and Testing 1910.501 (ETS2). As a result, MIOSHA has not proceeded with the adoption of ETS2. As a reminder, employers are still subject to MIOSHA’s General Duty Clause and are expected to make reasonable efforts to protect their employees from pandemic hazards measured against Centers for Disease Control and Prevention (CDC) guidelines.

1/25/22: CMS Vaccine Mandate Update

The U.S. Supreme Court has upheld the CMS vaccination mandate for certain Medicare and Medicaid-Certified Provider and Supplier Types. MDHHS issued L 21-84 regarding the CMS vaccination mandate is consistent with CMS guidance on this topic, published in FAQ form.

Download the FAQ document from CMS regarding its vaccination mandate for healthcare staff. The following statements are provided on page 3 of this document.

• “This regulation only applies to Medicare and Medicaid-certified facilities. CMS does not have regulatory authority over care settings such as Assisted Living Facilities or Group Homes."
• “ … this regulation only applies to those Medicare and Medicaid-certified provider and supplier types that are subject to CMS health and safety regulations. CMS’s health and safety regulations do not cover providers of Home and Community-based Services.”

Based upon the provisions of the CMS Health Care Staff Vaccination Interim Final Rule and the FAQ document, affirmed by MDHHS L 21-84, the CMS vaccination mandate does not apply to residential or vocational settings which receive Medicaid funding through a Home and Community-Based Services Waiver. The CMS vaccination mandate also does not apply to licensed adult foster care facilities or licensed homes for the aged which do not receive Medicaid funding.

If your organization contracts with a provider or supplier which is subject to the CMS Omnibus COVID-19 Health Care Staff Vaccination Interim Final Rule, legal consultation should be obtained regarding whether the CMS vaccination mandate applies to your organization.

12/3/21: CMS Vaccine Mandate Faces Preliminary Injunction

A federal district court in Louisiana has issued a nationwide preliminary injunction against the Centers for Medicare and Medicaid Services’ new rule establishing mandatory COVID-19 compliance for healthcare workers and facilities.  This injunction joins a prior federal court issued injunction, impacting 10 states. Both courts found the plaintiffs are likely to succeed due to what is considered by some to be CMS’s broad overreach and inappropriate rulemaking procedures.

Earlier this week, the U.S. District Court for the Western District of Louisiana granted a nationwide preliminary injunction, immediately halting the Centers for Medicare and Medicaid Services’ (CMS) federal mandate requiring employees, volunteers, and third-party contractors working at healthcare facilities to be vaccinated against COVID-19. This decision followed another injunction issued a day earlier, by the U.S. District Court for the Eastern District of Missouri, which had blocked enforcement of this same mandate in Arkansas, Alaska, Iowa, Kansas, Missouri, Nebraska, New Hampshire, North Dakota, South Dakota, and Wyoming. 

Although these are only preliminary injunctions, they serve as an indication that if the vaccine mandate is fully tried on the merits, the federal government may lose.

As a reminder, the FAQ document that accompanied the rule's issuance states that the regulation only applies to Medicare and Medicaid-certified facilities. CMS further indicates that it does not have any regulatory authority over care settings such as Assisted Living Facilities or Group Homes. In addition, the FAQ document states that CMS’s health and safety regulations do not cover providers of Home and Community-Based Services.  Click to view the FAQ document.

11/11/21 Navigating the COVID Vaccination Regulations

NEW OSHA ETS: As reported last week, the Occupational Safety and Health Administration (OSHA) has issued an emergency temporary standard (ETS) to minimize the risk of COVID-19 transmission in the workplace.  The rule covers all employers with a total of 100 or more employees, with a few exceptions described in the links below. Covered employers must develop, implement, and enforce a mandatory COVID-19 vaccination policy, with an exception for employers that instead adopt a policy requiring employees to elect either to get vaccinated or to undergo regular COVID-19 testing and wear a face covering at work.

Click to view a fact sheet highlighting some of the ETS requirements.

Click to view the OSHA Summary of the standard.

Click to view a detailed FAQ page on the ETS requirements.

Click to view the full text of the standard.

OSHA HEALTHCARE ETS: OSHA states that this new ETS does not apply to settings providing healthcare services or healthcare support services subject to the previously issued COVID-19 Healthcare ETS. MIOSHA adopted the OSHA Healthcare ETS and applies this ETS to licensed adult foster care and licensed home for the aged settings.

However, please note that an employer who must comply with OSHA’s Healthcare ETS is not automatically exempted from compliance with OSHA’s COVID-19 Vaccination and Testing ETS. The COVID-19 Healthcare ETS is “settings” based and therefore an employer may have a portion of its employees covered by the COVID-19 Healthcare ETS and the remainder covered by the COVID-19 Vaccination and Testing ETS.

Click to view OSHA's Healthcare ETS.

Click to view the accompanying News Release, which summarizes the ETS.

Click to view the FAQ.

CMS RULE: Also last week, the Centers for Medicare & Medicaid Services (CMS) issued regulations related to vaccine mandates for employees: the CMS Omnibus COVID-19 Health Care Staff Vaccination Interim Final Rule, which requires COVID-19 vaccination of eligible staff at health care facilities that participate in the Medicare and Medicaid programs. 

The Supreme Court ruled to block the OSHA Emergency Temporary Standard COVID-19 vaccine-or-testing rules for large private employers. This requirement, for businesses with 100 or more employees, would have applied to an estimated 84 million workers.The court did, however, give the Biden administration more latitude in the healthcare industry, allowing CMS to proceed with a vaccine mandate, which does not include a testing alternative, for more than 10 million healthcare workers. 

As a reminder, the FAQ document accompanying the CMS rule states that the regulation only applies to Medicare and Medicaid-certified facilities. CMS further indicates that it does not have any regulatory authority over care settings such as Assisted Living Facilities or Group Homes. In addition, the FAQ document states that CMS’s health and safety regulations do not cover providers of Home and Community-Based Services. 

Regarding another separate initiative relative to vaccination and testing, the White House Safer Federal Workforce Task Force published new guidance to help federal agencies set up testing programs to screen unvaccinated federal workers and some contractors for COVID by Feb. 15. The guidance requires agencies to test unvaccinated workers who report to a federal facility or otherwise interact with members of the public on a weekly basis. Testing should apply to federal employees who have either a pending or approved request for a vaccine exemption along with employees who are noncompliant with the vaccine mandate.

Unvaccinated employees who are working remotely are not required to undergo regular testing but should be tested in advance if they need to report to an agency facility. Based on SourceAmerica's analysis, generally speaking, agencies do not need to apply the same testing program to federal contractors who are onsite. However, agencies themselves may require more frequent testing depending on the contractor’s role, function, and work environment.

Click to view additional information regarding guidance implementation on the Safe Federal Workforce website.

12/17/21: US Court of Appeals Lifts Stay on OSHA Standard

The U.S. Court of Appeals for the Sixth Circuit dissolved the Fifth Circuit’s stay of the Occupational Safety and Health Administration (OSHA) Vaccination and Testing Emergency Temporary Standard.  OSHA can now resume implementation of the standard, designed to protect the health of workers by mitigating the spread of the COVID-19 virus in the workplace.

Several challengers, including business trade groups, immediately indicated they planned to file or already had filed emergency motions with the Supreme Court to again block the rule.  While a timetable is not yet known, it appears likely that the Supreme Court will consider this issue prior to January 4, when the vaccine and testing portion of the rule takes effect.

Late Friday evening, the US Department of Labor announced that OSHA would offer some latitude on issuing citations for noncompliance as follows, posted on the OSHA website: To account for any uncertainty created by the stay, OSHA is exercising enforcement discretion with respect to the compliance dates of the ETS. To provide employers with sufficient time to come into compliance, OSHA will not issue citations for noncompliance with any requirements of the ETS before January 10 and will not issue citations for noncompliance with the standard’s testing requirements before February 9, so long as an employer is exercising reasonable, good faith efforts to come into compliance with the standard. OSHA will work closely with the regulated community to provide compliance assistance.

As previously reported, the rule covers all employers with a total of 100 or more employees, with a few exceptions described in the links below. Covered employers must develop, implement, and enforce a mandatory COVID-19 vaccination policy, with an exception for employers that instead adopt a policy requiring employees to elect either to get vaccinated or to undergo regular COVID-19 testing and wear a face covering at work.

Click to view a fact sheet highlighting some of the ETS requirements.

Click to view the OSHA Summary of the standard.

Click to view a detailed FAQ page on the ETS requirements.

Click to view the full text of the standard.

OSHA has also provided employers with the two sample policies below to adapt for use in their organizations.

Click to view a sample mandatory vaccination policy.

Click to view a sample vaccination or testing and face covering policy.

11/19/21: OSHA Suspends Enforcement of Employer Vaccine Regulation

The US Department of Labor's Occupational Safety and Health Administration (OSHA) has indicated it is suspending activities related to implementation and enforcement of the recently issued Emergency Temporary Standard mandating that larger employers to either require that their workers get vaccinated against COVID-19 or undergo weekly testing.  OSHA, which posted the announcement on its website, also indicated that it "remains confident in its authority to protect workers in emergencies." 

The agency's decision to stop implementation and enforcement comes after a federal appeals court earlier this month temporarily halted the rule. The future of the government directive remains uncertain, with the case headed to the Sixth Circuit Court.

As previously reported in Updates and Info Alerts, businesses had been directed to implement the OSHA rule by January 4, 2022 — a timeline that does not provide employers much latitude if the Courts uphold the rule. Because of this potential deadline, most employment attorneys are encouraging businesses to move forward with compliance, to avoid being unprepared if the regulation withstands legal challenge.

On December 7, a federal court in Georgia issued a nationwide injunction prohibiting the enforcement of the vaccine mandate under Executive Order 14042 and the Safer Federal Workforce Task Force Guidance, with respect to federal contractors and subcontractors. This outcome supplements the ruling of a federal judge in Kentucky last week, which the federal government has appealed.

Additionally, the General Services Administration (GSA) has updated its website by announcing it will not take any action to enforce the vaccine mandate nationwide. GSA provides further clarification on what “not enforce” means: contractor and subcontractor employees do not have to comply with the vaccine mandate in the Guidance, and contractors will continue to be eligible for new contracts, orders, and extensions even if they have not agreed to the Clause through a modification.

Incompass Michigan will continue to monitor developments on this issue, as well as the legal status of other vaccine mandates, and keep members informed.

11/11/21 Navigating the COVID Vaccination Regulations

FEDERAL CONTRACTORS: As previously reported, last week the White House released a Fact Sheet announcing the imminent release of OSHA'S new ETS. The Fact Sheet discusses the interplay between the ETS and the Guidance issued by the Safer Federal Workforce Task Force (the “Task Force”). The ETS covers employers with 100 or more employees while the Guidance covers federal contractors.

Click to view the Fact Sheet.

Click to view the Task Force Guidance.

The updated Fact Sheet states the new deadline for the vaccine mandate for federal contractors is now January 4, 2022, which is the same deadline for vaccination under the ETS. This is a change from the original deadline under the Guidance of December 8, 2021.There is also a key difference between the Guidance and the ETS with respect to vaccination - the ETS offers a weekly testing option in lieu of vaccination, and the Guidance does not. In the Guidance, the only exceptions to the vaccination requirement permitted for federal contractors is for disability under the ADA or a sincerely held religious belief that prevents vaccination. In cases where companies may be covered by both, the Fact Sheet states that OSHA will make clear that the ETS will not apply to federal contractor workplaces covered by the Guidance.  There is still a possibility that a nonprofit agency may be covered by both the ETS and the Guidance if that NPA has 100 or more employees, has separate workplaces, and not all those workplaces are covered contractor workplace locations under the Guidance.

Following FDA approval, recommendations from the CDC’s Advisory Committee on Immunization Practices and the endorsement of the CDC director, the Michigan Department of Health and Human Services (MDHHS) is urging all eligible Michiganders to get a Johnson & Johnson, Moderna or Pfizer booster vaccine if they have received their primary COVID-19 vaccines. 

Eligible individuals may choose which vaccine they receive as a booster dose.  CDC’s recommendations now allow for this type of mix and match dosing for booster shots. Consult your healthcare provider if there is a question which vaccine is appropriate for you. 

Michiganders should bring their COVID-19 vaccine card or immunization record with them when getting their booster dose, which are available at any vaccine provider. Downloadable immunization records are accessible free at the Michigan Immunization Portal.

From January to November 5, unvaccinated Michiganders accounted for 88% of COVID cases, 88.2% of hospitalizations and 87.7% of deaths.

10/21/21: Expanded CDC Eligibility Guidance on  COVID-19 Vaccine Boosters

CDC Director Rochelle P. Walensky endorsed the CDC Advisory Committee on Immunization Practices’ (ACIP) recommendation for a booster shot of COVID-19 vaccines in certain populations. The Food and Drug Administration’s (FDA) authorization and CDC’s recommendation for use are important steps forward - updated information below.

For individuals who received a Pfizer-BioNTech or Moderna COVID-19 vaccine, the following groups are eligible for a booster shot at 6 months or more after their initial series:

• 65 years and older
• Age 18+ who live in long-term care settings
• Age 18+ who have underlying medical conditions
• Age 18+ who work or live in high-risk settings

For those who got the Johnson & Johnson COVID-19 vaccine, booster shots are also recommended for those who are 18 and older and who were vaccinated two or more months ago.

There are now booster recommendations for all three available COVID-19 vaccines in the United States. Eligible individuals may choose which vaccine they receive as a booster dose. Some people may have a preference for the vaccine type that they originally received, and others may prefer to get a different booster. CDC’s recommendations now allow for this type of mix and match dosing for booster shots.

Click to view the full text of the CDC guidance.

8/25/21: CDC Guidance on COVID-19 Vaccine Boosters

An advisory group of the Centers for Disease Control and Prevention (CDC) narrowed the Food and Drug Administration’s recommendation for who should get a third Pfizer shot - only to be overruled later that evening in an announcement by CDC Director Rochelle Walensky: along with Americans 65 and older, nursing home residents and people ages 50 to 64 with underlying medical conditions that the advisory panel had suggested should get shots, Director Walensky added individuals working in higher risk jobs.

The CDC has cited data supporting the need for a booster shot: studies show that after getting vaccinated against COVID-19, protection against the virus may decrease over time and be less able to protect against the Delta variant. Emerging evidence also shows that among healthcare and other frontline workers, vaccine effectiveness against COVID-19 infections is decreasing over time. This lower effectiveness is likely due to the combination of decreasing protection as time passes since getting vaccinated (waning immunity) as well as the greater infectiousness of the Delta variant.

At this time, per CDC guidance, only certain populations initially vaccinated with the Pfizer-BioNTech vaccine can get a booster shot.

• People aged 65 years and older and adults 50–64 years with underlying medical conditions should get a booster shot of Pfizer-BioNTech vaccine. 
• Residents aged 18 years and older of long-term care settings should get a booster shot of Pfizer-BioNTech vaccine.
• People aged 18–49 years with underlying medical conditions may get a booster shot of Pfizer-BioNTech vaccine based on their individual benefits and risks. 
• People aged 18–64 years at increased risk for COVID-19 exposure and transmission because of occupational or institutional setting may get a booster shot of Pfizer-BioNTech vaccine based on their individual benefits and risks. 

Occupations at increased risk for COVID-19 exposure and transmission include front line essential workers and health care workers as outlined by the CDC*

• First responders (healthcare workers, firefighters, police, congregate care staff)
• Education staff (teachers, support staff, daycare workers)
• Food and agriculture workers
• Manufacturing workers
• Corrections workers
• U.S. Postal Service workers
• Public transit workers
• Grocery store workers

*This list could be updated in the future

Click to view the full text of the CDC guidance. 

The CDC has not yet considered boosters for Moderna or Johnson & Johnson COVID-19 vaccines.

8/18/21: President Announces Plans on Vaccination Strategy

As the more transmissible Delta variant is driving a rise in cases, particularly in communities with low vaccination rates, the Biden Administration announced additional steps earlier this week to attempt to stay ahead of the virus and get more people vaccinated. These steps include a plan for COVID-19 booster shots; new vaccination requirements for long-term care workers; and a directive to ensure state and local leaders are providing students a safe return to in-person learning.

Planning to Offer COVID-19 Booster Shots Starting the Week of September 20: The U.S. Department of Health and Human Services (HHS) announced a plan for administering booster shots later this fall.  Under this plan, a booster would be administered, eight months after an individual’s second dose, beginning the week of September 20—at which point those individuals who were fully vaccinated earliest in the vaccination rollout will be eligible, including many health care providers, nursing home residents, and other seniors.

Requiring COVID-19 Vaccinations for Long-Term Care Workers Who Serve Medicare and Medicaid Enrollees. President Biden announced that HHS will develop new regulations requiring nursing homes to require that all of their workers be fully vaccinated against COVID-19 as a condition of participating in the Medicare and Medicaid programs. These new regulations would apply to nearly 15,000 nursing home facilities, which employ approximately 1.6 million workers and serve approximately 1.3 million nursing home residents.

Directing the Department of Education to Use All Available Tools to Safely Reopen Schools: President Biden also issued a memorandum to the Secretary of Education directing him to use all available tools to ensure that governors and other officials are providing a safe return to in-person learning for the nation’s children.

Click to view the full Fact Sheet from the White House in support of these new actions.

In response to Executive Order 14042, which requires contractors to ensure their employees are fully vaccinated for COVID-19 by December 8 (unless legally entitled to an accommodation), the Safer Federal Workforce Task Force published their Guidance on September 24. SourceAmerica has reviewed the Guidance to determine how the vaccination requirement and other safety requirements apply to SourceAmerica’s network of nonprofit agencies (“NPAs”). The general information below - if italicized, the language is directly from SourceAmerica - is being provided to NPAs as technical assistance and should not be treated as legal advice.

Requirements for NPA employees

The Executive Order specifies that vaccination will be required of all covered federal contractor employees, as well as subcontractor employees, with no testing option. This vaccine mandate applies to all covered contractor employees, including those working remotely. This may include employees who work in connection with a federal contract, or those who work at a building that is a covered contractor workplace. The only exceptions are those required by law, either due to a disability under the Americans with Disabilities Act (“ADA”) or a sincerely held religious belief under Title VII of the Civil Rights Act of 1964 (“Title VII”). Process those requests in collaboration with your HR and Legal advisors.

What it means to be “covered”

The term “covered” is used in four ways: covered contracts, covered contractor, covered contractor employee, and covered contractor workplace.

• Covered contracts: Any contract or contract-like instrument (“contract”) that includes a clause requiring compliance by the contractor and any subcontractors with all guidance published by the Task Force for contractor or subcontractor locations for the duration of the contract.
• Covered contractor: Any prime contractor or subcontractor at any tier who is a party to a covered contract.
• Covered contractor employee: Any full-time or part-time employee of a covered contractor working on or in connection with a covered contract or working at a covered contractor workplace. This includes employees of covered contractors in a covered contractor workplace who are not themselves working on or in connection with a covered contract.
• Covered contractor workplace: A location controlled by a covered contractor at which any employee of a covered contractor working on or in connection with a covered contract is likely to be present during the period of performance of a covered contract. This also applies to workplaces that are outdoors.

Remote working arrangements

An employee working on a federal contract from their residence must comply with the vaccination requirement for covered contractor employees. This applies even if the employee never works at either a covered contractor workplace or federal workplace during the performance of the contract. However, since a residence is not a covered contractor workplace, the employee does not need to comply with the masking requirement or distancing requirement at home.

Other safety requirements

In addition to the vaccination requirement, in covered contractor workplaces, all individuals, including covered contractor employees and visitors, are required to wear a mask and observe distancing requirements in covered contractor workplaces in accordance with CDC guidance. More specifically:

• In areas of high or substantial community transmission, fully vaccinated people must wear masks, with a few exceptions.
• In areas of low or moderate community transmission, fully vaccinated people do not need to wear a mask.
• Fully vaccinated people do not need to physically distance.
• Individuals not fully vaccinated must wear masks indoors at all times and in certain outdoor settings.
• Individuals not fully vaccinated need to maintain a physical distance of six feet at all times.
• Masks are to be worn over mouth and nose, and not like a chinstrap.

Per CDC guidelines, masks do not need to be worn when employees are:

• Alone in an office, or while eating or drinking.
• Engaging in activities of high intensity that may cause difficulty breathing or may get the mask wet.
• In situations where wearing a mask could create a risk to workplace health or safety (which would need to be approved by a “duly authorized representative” of contractor (e.g., a safety officer).

NPAs must check the CDC COVID-19 Tracker County View website at least weekly for community transmission information in each area where they have a covered contractor workplace. Additionally, NPAs must designate a person or persons to coordinate implementation of and compliance with the Guidelines and safety protocols.

Possible Exclusions

A few types of federal contracts are excluded from the Executive Order and Guidance—contracts or subcontracts for products, contracts for less than the Simplified Acquisition Threshold (“SAT”), grants, and contracts or agreements with Indian Tribes under the Self-Determination Act. The most notable exception is a contract or subcontract for products, as opposed to services. However, this exception, like the SAT, is open to doubt, as the Guidance also states that federal agencies are strongly encouraged to incorporate a clause requiring compliance with the Guidance even if the contracts are not covered or directly addressed by the Executive Order, such as product prime or subcontracts and contracts below the SAT ($250,000).

Implementation

The Guidance envisions December 8, 2021 as the outer date for all “covered contractor employees” to be fully vaccinated, but that would require the contractor to be a “covered contractor,” which would require it to be performing under a contract or subcontract containing the clause. Nevertheless, the GSA, DOD and other agencies have made it clear that they intend to move immediately with the issuance of modifications to existing contracts that they expect to be signed.

A federal contractor who declines to sign will not have their contract terminated, but should not expect to be considered for any other contracts from the federal government. It is possible that this may even cast some doubt on renewal.  The GSA has encouraged all contractors who have not received a modification by October 15 to contact their contracting officer.

As a reminder, Executive Order 14042 applies to federal contractors and subcontractors, and OSHA's anticipated Emergency Temporary Standard (ETS) is a a separate regulatory initiative that will apply to private-sector businesses with at least 100 employees. Smaller businesses may not be subject to the OSHA ETS. The ETS hasn't been released, but it is expected to follow the safety protocols for federal contractors outlined in the executive order. The ETS, however, will give employers the option to allow employees to get vaccinated or to test regularly for COVID-19, and is expected to align with guidance on employer obligations to provide reasonable medical and religious accommodations under the ADA and the Civil Rights Act.

Incompass Michigan will continue to monitor this issue and keep members informed.

From the Michigan Unemployment Agency's Employer Advisor:

Whether an individual is disqualified from receiving unemployment benefits as a result of a separation for failure to take a COVID-19 vaccine, will depend on the facts and circumstances in each case. 

Whether an individual is disqualified for benefits starts with identifying how the separation occurred. For example, is the separation due to a discharge, voluntarily quitting or some other underlying factor? If an employee is discharged, the employer’s policies and work rules will be material in evaluating if misconduct applies. Misconduct is generally defined as “an intentional and substantial disregard of the employer’s interests or of the employee’s duties and obligations to his employer.” Qualification will be based on whether an individual’s failure to be vaccinated constitutes or rises to the level of misconduct. 

If a separation results from a worker voluntarily quitting, whether an individual is qualified for benefits will depend on whether the individual had good cause attributable to the employer for quitting the job. Factors for consideration will include but are not limited to, if there was a material change in the job requirements, whether the individual expressed concerns with the employer and gave the employer an opportunity to remedy those concerns and whether the individual’s quitting falls under a medical exception.

The facts and circumstances of each case will be important. Therefore, employers are encouraged to review their policies and work rules related to required COVID-19 vaccinations.

Click here for more information.

More and more employers, including the federal government, are considering either vaccine mandates or knowledge of an employee’s vaccination status.  President Biden will require vaccinations or knowledge of it for all government employees.  A recent blog post from the Small Business Association of Michigan addressed employer strategies for responding when employees reference HIPAA in response to consideration of mandates or vaccine status information.

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law that required the creation of national standards to protect sensitive patient health information from being disclosed without the patient’s consent or knowledge. The U.S. Department of Health and Human Services (HHS) issued the HIPAA Privacy Rule to implement the requirements of HIPAA.

The Privacy Rule standards address the use and disclosure of individuals’ health information (known as “protected health information” or PHI) by entities subject to the Privacy Rule. These individuals and organizations are called “covered entities.” The Privacy Rule also contains standards for individuals’ rights to understand and control how their health information is used. A major goal of the Privacy Rule is to ensure that individuals’ health information is properly protected while allowing the flow of health information needed to provide and promote high quality health care and to protect the public’s health and well-being.

The following types of individuals and organizations are subject to the Privacy Rule and considered covered entities:

• Healthcare providers
• Health plans
• Healthcare clearinghouses
• Business associates

Employers are generally exempt from HIPAA requirements.  Although vaccination information is classified as PHI and is covered by HIPAA Rules, HIPAA does not apply to these questions by employers. Hence, if an employer asks an employee to provide proof that they have been vaccinated in order to allow that individual to work without wearing a facemask, that is not a HIPAA violation.

Moreover, an employer should not require employees to disclose additional health information such as the reason why they are not vaccinated.  These questions could lead to liability under other federal laws such as the ADA. 

Click to view the full text of the SBAM blog post.

Michigan is following CDC recommendations for prioritization of distribution and administration of COVID-19 vaccines. Vaccine distribution and education is vital to reopening Michigan. New resources for helping to educate Michigan residents can be found here:

• "Doctor Advice" :30 (Coronavirus)
• Travel Guides for Summer During COVID-19
• CDC Fully Vaccinated Toolkit
• COVID-19 Cybercrime and Scams
• MI Safe Start Public Guidance
• MDHHS Text Messaging Program Information

*Blue Cross Blue Shield of Michigan and Meijer Pharmacy recently announced a regionally focused collaborative with services agencies to offer homebound individuals and people with disabilities COVID-19 vaccines. The effort will provide a local, convenient and access-sensitive environment for people still facing barriers in receiving vaccinations.

Meijer Pharmacy is dedicating COVID-19 vaccine supply to individuals through walk-ins or by scheduling their vaccine in advance and ensuring a safe and accessible environment for persons with physical or behavioral disabilities. Disability agency partners will be communicating to their consumer networks, assisting with appointment scheduling and transportation as available.

Individuals and caregivers can schedule COVID-19 vaccinations by texting “HEALTH” to 75049, a specified code for people with disabilities requiring possible accommodations within vaccination environments. Individuals can also visit https://clinic.meijer.com/register/CL2030 to start their vaccine scheduling process.

Click to view a flyer with additional program information.

*The Michigan Department of Health and Human Services (MDHHS) and the Protect Michigan Commission have launched a new text messaging program to share COVID-19 vaccine information and encourage Michiganders to get vaccinated.  The text messaging program will reach 1 million people in counties across Michigan, with a focus on high vulnerability communities and areas with low COVID-19 vaccination coverage.

The text messages will ask individuals about their plans around COVID-19 vaccination and then link people to vaccination sites in their area or direct them to sources for more information. The first message will clearly identify the sender as “the Michigan Department of Health and Human Services.” People have the option to opt out by replying “STOP” to any of the messages at any time. 

* Additionally, the U.S. Health and Human Services (HHS) announces the launch of a first-of-its-kind national hotline to connect people with disabilities to information and services to improve access to COVID-19 vaccines. The Disability Information and Access Line (DIAL) is now available to help people with disabilities find vaccination locations in their communities, assist callers with making vaccination appointments, and connect callers to local services – such as accessible transportation – to overcome barriers to vaccination.

Click to view the press release with additional info.

To help improve COVID-19 vaccination access for high-risk populations and settings across Michigan, the Michigan Department of Health and Human Services (MDHHS) and Department of Technology, Management and Budget (DTMB) have issued a Request for Proposals (RFP) to conduct mobile vaccination services.

Six site or setting types are included in the RFP:

1. Homebound vaccinations
2. Community-based mobile clinics
3. Neighborhood testing sites
4. Seasonal agricultural workers
5. Shelters, transient communities, other vulnerable populations
6. Medium to large vaccination sites 

Bidders will be required to schedule appointments and manage all logistics involved in providing mobile vaccinations. Bidders have the ability to bid on one or more regions in the state to provide any of the six sites or setting types. The regions are based on State of Michigan Prosperity Regions and include:

• Region 1 (Upper Peninsula)
• Region 2 (Northwest)
• Region 3 (Northeast)
• Region 4 (West Michigan)
• Region 5 (East Central)
• Region 6 (East Michigan)
• Region 7 (South Central)
• Region 8 (Southwest)
• Region 9 (Southeast Michigan)
• Region 10 (Detroit Metro) 

Awards will be based on the ability to provide services to one or more of the six site types and multiple awards may be issued. Contractors will also be responsible for rapid response to provide vaccinations (and potentially testing) at locations and community locations when COVID-19 outbreaks occur. Vaccinations are expected to serve on average 2,000 to 6,000 individuals per day statewide, across as few as one or as many as 15+ locations.

Bids are due Wednesday, May 12 by 3 p.m. RFP No. 210000001690 is posted on the SIGMA Vendor Self-Service at Michigan.gov/SIGMAVSS.

Click to view a press release from MDHHS and DTMB on this RFP.

The US Department of Health and Human Services (HHS) recently announced $100 million in funding to expand vaccine access for older adults and people with disabilities. Funds can be used for scheduling assistance, transportation, direct support services needed to receive the vaccine, connection to in-home vaccines, and education about the importance of vaccines. Approximately $5 million will be dedicated to a national hotline.

The additional funds will be distributed as follows:

• State Units on Aging and Area Agencies on Aging ($50 million)
• Aging and Disability Resource Centers ($26 million)
• Centers for Independent Living ($5 million)
• University Centers of Excellence in Developmental Disabilities ($4 million)
• Protection and Advocacy systems ($4 million)
• State Councils on Developmental Disabilities ($4 million)

Click to view the full HHS Press Release.

The Small Business Association of Michigan (SBAM) recently issued a helpful reminder on the important considerations for employers evaluating use of a vaccine passport - including concerns about privacy, liability, and corporate culture.

Vaccine passports, documentation that an individual received a vaccination and is presumably better protected against a virus or has recently been tested and found negative, are being debated and considered by many before allowing employees to return to work. Having one’s shots to travel internationally is not new. But expanding the use of a vaccine passport for entry into concert venues, sport events, or using that passport to come to work is new.

For decades travel to certain countries require proof of vaccination against yellow fever, rubella, and other diseases via a “yellow card.” Formally, this card is known as the International Certificate of Vaccination. Currently, one form of vaccine “passport” for COVID-19 is a paper certificate of vaccination provided by the Centers for Disease Control if you can get it.

In the State of Michigan, a person getting vaccinated receives a vaccination card. Would this suffice as a “vaccination passport” for employers?

Click to view the full SBAM posting.

The RELAUNCH Greater Lansing Task Force has produced an employer vaccine guidebook that can serve as a road map for how employers can manage the process of communicating with employees and protecting their team members and stakeholders’ safety and health. This helpful toolkit and online publication include a business preparedness checklist, FAQ’s, vaccination preparation plan, sample employee survey, and more.

Download the toolkit at https://files.constantcontact.com/9ec24982701/faa81541-abb2-4e59-8e3c-1b51475b3b10.pdf

More and more employers, including the federal government, are considering either vaccine mandates or knowledge of an employee’s vaccination status.  President Biden will require vaccinations or knowledge of it for all government employees.  A recent blog post from the Small Business Association of Michigan addressed employer strategies for responding when employees reference HIPAA in response to consideration of mandates or vaccine status information.

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law that required the creation of national standards to protect sensitive patient health information from being disclosed without the patient’s consent or knowledge. The U.S. Department of Health and Human Services (HHS) issued the HIPAA Privacy Rule to implement the requirements of HIPAA.

The Privacy Rule standards address the use and disclosure of individuals’ health information (known as “protected health information” or PHI) by entities subject to the Privacy Rule. These individuals and organizations are called “covered entities.” The Privacy Rule also contains standards for individuals’ rights to understand and control how their health information is used. A major goal of the Privacy Rule is to ensure that individuals’ health information is properly protected while allowing the flow of health information needed to provide and promote high quality health care and to protect the public’s health and well-being.

The following types of individuals and organizations are subject to the Privacy Rule and considered covered entities:

1. Healthcare providers
2. Health plans
3. Healthcare clearinghouses
4. Business associates

5. Employers are generally exempt from HIPAA requirements.  Although vaccination information is classified as PHI and is covered by HIPAA Rules, HIPAA does not apply to these questions by employers. Hence, if an employer asks an employee to provide proof that they have been vaccinated in order to allow that individual to work without wearing a facemask, that is not a HIPAA violation.

   Moreover, an employer should not require employees to disclose additional health information such as the reason why they are not vaccinated.  These questions could lead to liability under other federal laws such as the ADA. 

   Click to view the full text of the SBAM blog post.

   Vaccine Eligible and Language Resources (Spanish, Arabic & Simplified Chinese).  [NOTE:  This document, when sent electronically, contains a link to the language assistance that 2-1-1 is able to provide over the phone.]
6. Vaccine Timeline Estimates (Spanish, Arabic & Simplified Chinese)
7. Seven Vaccine Fact Cards including: Do I pay for Vaccines; ID and Immigration Status; ID’s; Missing Work; Personal Information; Pregnant Women; and, Variants.  (Spanish, Arabic, Simplified Chinese, Farsi, Swahili, Kinyarwanda and Burmese)

These resources are available at https://www.michigan.gov/coronavirus/0,9753,7-406-98178_98541---,00.html

COVID-19 vaccination has lagged among underserved populations and communities of color in part because of a deeply rooted historical skepticism concerning the safety and efficacy of certain medical treatments and procedures. During this webinar, experts from Health Management Associates, Tufts Health Plan, and ConsejoSano will discuss how healthcare providers and public health officials can engage underserved populations and communities of color, build trust through tailored strategies, and raise the level of comfort and confidence among individuals still reticent to receive the COVID-19 vaccine.

Learning Objectives:

• Understand the drivers of lagging COVID-19 vaccination rates among underserved populations and communities of color.
• How to build confidence in the safety and efficacy of COVID-19 vaccines using strategies tailored to specific populations and healthcare settings.
• Understand the special challenges and promising strategies for increasing vaccine confidence among individuals with behavioral health issues.

Click to view a recording of the webinar.

The Michigan Department of Health and Human Services (MDHHS) announced a new program to enhance the state’s equity strategy to reach more Michiganders with the COVID-19 vaccine. Under the program, 41 federally qualified health centers across the state will start receiving vaccine allocations to help vaccinate individuals age 65 and older. MDHHS stated these community health centers are located in medically underserved areas and provide high-quality, affordable, and comprehensive medical services to everyone. 

MDHHS also emphasized that other groups are now eligible to begin receiving vaccines from federally qualified health centers. Beginning immediately, mortuary service workers are eligible; additionally, workers in food processing and agricultural settings will be able to be vaccinated beginning on March 1. MDHHS emphasized this move will help ensure the health and safety of Michigan’s essential food and agriculture workers and keep the state’s food supply chain moving.

Click to view a press release on these announcements from MDHHS.

Incompass Michigan joined with over 30 organizations in advocacy to make people with intellectual and developmental disabilities an immediate and higher priority in the COVID-19 vaccination rollout.  A collective letter has been issued noting that  people with disabilities are at a greater risk of contracting the coronavirus, and should therefore should be prioritized for COVID-19 vaccine access accordingly.

People with intellectual and developmental disabilities are three times more likely to die from COVID-19, and people with Down syndrome are 10 times more likely, than the rest of the population. Additionally, people with autism are at a higher risk of dying from COVID-19, and people with schizophrenia are nearly three times more likely to die, than the rest of the population. 

Click to view the full letter, and consider joining this opportunity to send this message to your county executives and state government officials.

Stop the spread of misinformation by setting the record straight about the importance of wearing a mask even after you have received the vaccine.

Visit the Vaccine Communications Toolkit for even more social media, digital, print, radio and video resources you can use to support the COVID-19 response. 

Identify volunteers in your organization or personal networks willing to promote positive, accurate, and credible vaccine information, and help us identify and report misinformation on social media, news media, and more by sending an email with any false or misleading news to ProtectMICommission@michigan.gov

Additional Resources

COVID-19 Vaccine Dashboard

Vaccination data will be updated Monday - Saturday from the Michigan Care Improvement Registry (MCIR).

COVID-19 Vaccine Prioritization Guidance

This guidance outlines the strategy for vaccine prioritization for the State of Michigan and will be used by MDHHS, as well as public health and health care, as they allocate and administer vaccines.

COVID-19 Vaccine FAQs

Frequently asked questions about the COVID-19 vaccines. The information in this document will change frequently as we learn more about COVID-19 vaccines.

Through its partnership with the national education technology company GetSetUp, the Michigan Department of Health and Human Services (MDHHS) Aging & Adult Services Agency is offering a series of sessions to walk older Michiganders through the Michigan COVID-19 vaccine website. The goal is to help them find their local health department to register online for a vaccine appointment or to be added to the waitlist.

Registration is required. To register, visit www.getsetup.io/michigan or call 1-888-559-1614.  Michiganders without internet access looking for vaccine information should contact the MDHHS COVID-19 hotline at 1-888-535-6136.

This flyer shares who is eligible at the TCF Center and how to make an appointment.

https://incompassmi.org/wp-content/uploads/2021/02/IMG_1857.jpg

Michigan launched a campaign to help educate residents about the COVID-19 vaccine and the path toward reopening our state. The campaign offers downloadable resources for helping to share this message with employees, persons served, families, and communities. Resources include an FAQ, Infographics, Print / Posters, and Social Media Assets.

Click to view the campaign message.

Click to view these downloadable resources.

COVID-19 Myth or Fact comparison sheet compiled by JVS Human Services with some information adopted from Beaumont and the Centers for Disease Control and Prevention.

Click to download.

Direct support professionals have been on the frontlines of supporting people with disabilities during the COVID-19 Pandemic. The COVID-19 vaccines are now here and becoming widely available. As this is good news, we also know there is some confusion and worry among people about the efficacy and safety of the vaccine. In this webinar, NADSP in partnership with the American Academy of Developmental Medicine & Dentistry (AADMD) will address vaccine concerns. Please join Rick Rader, MD as he shares up to date and research-based information on the COVID-19 vaccines.

Click to view the webinar.

COVID-19 Vaccination Conversation from Oakland Community Health Network and : The information in this presentation is reflective of the information known at this time. Recommendations may change based on information gathered in the future.

Click to view the presentation.