Title:

COVID-19 Vaccination, Testing and Face Covering

Effective Date:                                                           

December 4, 2021

 

Introduction:

On December 1, 2021, a preliminary injunction was implemented by a federal judge to temporarily stop implementation of the CMS mandate that was issued on November 5, 2021 announcing vaccination requirements for healthcare systems regulated by the Centers for Medicare & Medicaid (CMS) (ref. CMS Omnibus COVID-19 Health Care Staff Vaccination Interim Final Rule, source: https://www.cms.gov/files/document/cms-omnibus-covid-19-health-care-staff-vaccination-requirements-2021.pdf).

Purpose:

To provide clarification on the most recent changes regarding COVID-19 vaccination, testing and safety procedures.  Donald Martens and Sons Ambulance Service, Inc. (Martens Ambulance) encourages all employees to receive a COVID-19 vaccination to protect themselves, other employees, and the community.  Martens Ambulance is committed to providing first-class patient care and service excellence.  Vaccination of employees, along with other workplace safety procedures will contribute to the safety of our patients, workers’ families, customers and visitors, business partners, and the community.  However, should an employee not be vaccinated, this policy’s sections on testing and face coverings will apply.

 

Policy Statement:

Martens Ambulance is strongly encouraging all of our employees to receive the COVID-19 vaccine by January 4, 2022 or be tested for COVID-19 on a regular basis and wear face covering.

Scope:

This COVID-19 Policy on vaccination, testing, and face covering use applies to all employees of Martens Ambulance.   Human Resources will be maintaining this policy and secure database of employee vaccination and testing dates.

 

All employees are required to report their vaccination status and, if vaccinated, provide proof of vaccination.  Employees must provide truthful and accurate information about their COVID-19 vaccination status, and, if not fully vaccinated, their testing results.  Employees not in compliance with this policy will be subject to discipline, unpaid leave of absence, and may be terminated.

 

Employees may request an exception from vaccination requirements (if applicable) if the vaccine is medically contraindicated for them or medical necessity requires a delay in vaccination.  Employees also may be legally entitled to a reasonable accommodation if they cannot be vaccinated and/or wear a face covering (as otherwise required by this policy) because of a disability, or if the provisions in this policy for vaccination, and/or testing for COVID-19, and/or wearing a face covering conflict with a sincerely held religious belief, practice, or observance.  Requests for exceptions and reasonable accommodations must be initiated by the employee by December 4, 2021 (or during the onboarding process of employment for employees hired after the effective date of this policy) with detailed references to the type of request.  All such requests will be handled in accordance with applicable laws and regulations and employment policies as described in the employee handbook.

 

Procedures:

Overview and General Information

Vaccination

Any Martens Ambulance employee that chooses to be vaccinated against COVID-19 may schedule their vaccination appointments, e.g., through their own medical provider, or with a mass-vaccination clinic.  Employees may submit their vaccination and testing documentation to Human Resources via email HR@martensambulance.com.

Employees are considered fully vaccinated two weeks after completing primary vaccination with a COVID-19 vaccine with, if applicable, at least the minimum recommended interval between doses.  For example, this includes two weeks after a second dose in a two-dose series, such as the Pfizer or Moderna vaccines, two weeks after a single-dose vaccine, such as Johnson & Johnson’s vaccine, or two weeks after the second dose of any combination of two doses of different COVID-19 vaccines as part of one primary vaccination series.  Employees who are not fully vaccinated will be required to provide proof of weekly COVID-19 testing and wear a face covering at the workplace.

 

COVID-19 Testing

Effective December 4, 2021, to remain active on the work schedule, all employees who are not fully vaccinated (including those with medical or religious exemptions) must:

  1. Provide proof of a COVID test every seventh day, and wear a face covering when in the workplace (including while in the squad).
  2. Employees are responsible for getting COVID tests done every seven days and providing proof to Human Resources via email HR@martensambulance.com.

All employees who are not fully vaccinated will be required to comply with this policy for testing.  Failure to comply with the above will result in immediate removal from the schedule.

Employees can fulfill the weekly testing requirement by testing at authorized testing facility.  Testing must be completed every seven (7) days, or within seven days prior to reporting to work (refer to the examples below).  The cost of the test may be covered by the employee’s health insurance plan or paid for by the employee.  The employer does not pay for the cost of the COVID test.  Types of acceptable COVID-19 tests are PCR diagnostic testing with nasopharyngeal (NP) or anterior nasal swab issued by a certified provider with supporting documentation of the type of test issued, date of the test and the result.

Employees who report to the workplace at least once every seven days:

(A) must be tested for COVID-19 at least once every seven days; and

(B) must provide documentation of the most recent COVID-19 test result Human Resources via email HR@martensambulance.com no later than the seventh day following the date on which the employee last provided a test result.

Example:   COVID-19 testing documentation must be on file verifying the employee has been tested once every seven days and the employee cannot work if the most recent COVID-19 test is at the 7th day or older.

Any employee who does not report to the workplace during a period of seven or more days (e.g., part-time/PRN employees or employees on leave of absence):

(A) must be tested for COVID-19 within seven days prior to returning to the workplace; and

(B) must provide documentation of that test result to Human Resources upon return to the workplace.

Example:   The employee cannot report to work unless they have proof of a COVID-19 test done within the past 7 days.  The employee cannot work if the most recent COVID-19 test is at the 7th day or older.

Employees who have received a positive COVID-19 test, or have been diagnosed with COVID-19 by a licensed healthcare provider, are not required to undergo COVID-19 testing for 90 days following the date of their positive test or diagnosis.

 

 

Vaccination Status and Acceptable Forms of Proof of Vaccination

Vaccinated Employees

Employees may schedule their vaccination appointments through local pharmacies, through their own medical provider, or with a mass-vaccination clinic.

All vaccinated employees are required to provide proof of COVID-19 vaccination, regardless of where they received vaccination.  Proof of vaccination status can be submitted via email to HR@martensambulance.com or in-person at the HR office.

Acceptable proof of vaccination status is:

  1. The record of immunization from a health care provider or pharmacy;
  2. A copy of the COVID-19 Vaccination Record Card;
  3. A copy of medical records documenting the vaccination;
  4. A copy of immunization records from a public health, state, or tribal immunization information system; or
  5. A copy of any other official documentation that contains the type of vaccine administered, date(s) of administration, and the name of the health care professional(s) or clinic site(s) administering the vaccine(s).

Proof of vaccination generally should include the employee’s name, the type of vaccine administered, the date(s) of administration, and the name of the health care professional(s) or clinic site(s) that administered the vaccine. In some cases, state immunization records may not include one or more of these data fields, such as clinic site; in those circumstances Martens Ambulance Service will still accept the state immunization record as acceptable proof of vaccination.

If an employee is unable to produce one of these acceptable forms of proof of vaccination, despite attempts to do so (e.g., by trying to contact the vaccine administrator or state health department), the employee can provide a signed and dated statement attesting to their vaccination status (fully vaccinated or partially vaccinated); attesting that they have lost and are otherwise unable to produce one of the other forms of acceptable proof (refer to forms Addendum I and Addendum II in this policy)

Employee Notification of COVID-19 and Removal from the Workplace

Donald Martens and Sons Ambulance Service will require employees to promptly notify their supervisor when they have tested positive for COVID-19 or have been diagnosed with COVID-19 by a licensed healthcare provider.  Copy of the test results should be submitted to Human Resources via email HR@martensambulance.com.

Inform your supervisor immediately and follow the standard procedures for requesting time off, or calling off (ref. Employee Testing Policy During COVID-19 Pandemic, and Absenteeism and Tardiness policy).

Medical Removal from the Workplace

Employees who test positive for COVID-19 will be immediately removed from the workplace if they have received a positive COVID-19 test or have been diagnosed with COVID-19 by a licensed healthcare provider (i.e., immediately send them home or to seek medical care, as appropriate).

Return to Work Criteria

For any employee removed because they are COVID-19 positive, Martens Ambulance will keep them removed from the workplace until the employee receives a negative result on a COVID-19 nucleic acid amplification test (NAAT) following a positive result on a COVID-19 antigen test if the employee chooses to seek a NAAT test for confirmatory testing; meets the return to work criteria in CDC’s “Isolation Guidance”; or receives a recommendation to return to work from a licensed healthcare provider.

Under CDC’s “Isolation Guidance,” asymptomatic employees may return to work once 10 days have passed since the positive test, and symptomatic employees may return to work after all the following are true:

  • At least 10 days have passed since symptoms first appeared, and
  • At least 24 hours have passed with no fever without fever-reducing medication, and
  • Other symptoms of COVID-19 are improving (loss of taste and smell may persist for weeks or months and need not delay the end of isolation).

If an employee has severe COVID-19 or an immune disease, Martens Ambulance will follow the guidance of a licensed healthcare provider regarding return to work.  If the employee qualifies for FMLA, that procedure will apply (ref. Employee Handbook, Leave of Absence, Policy for Family and Medical Leave.)

Face Coverings

Martens Ambulance will require all employees who are not fully vaccinated to wear a face covering. Face coverings must:

  • completely cover the nose and mouth;
  • be made with two or more layers of a breathable fabric that is tightly woven (i.e., fabrics that do not let light pass through when held up to a light source)
  • be secured to the head with ties, ear loops, or elastic bands that go behind the head.
  • If gaiters are worn, they should have two layers of fabric or be folded to make two layers; fit snugly over the nose, mouth, and chin with no large gaps on the outside of the face; and be a solid piece of material without slits, exhalation valves, visible holes, punctures, or other openings.

Acceptable face coverings include clear face coverings or cloth face coverings with a clear plastic panel that, despite the non-cloth material allowing light to pass through, otherwise meet these criteria and which may be used to facilitate communication with people who are deaf or hard-of-hearing or others who need to see a speaker’s mouth or facial expressions to understand speech or sign language respectively.

Employees who are not fully vaccinated must wear face coverings over the nose and mouth when indoors and when occupying a vehicle with another person for work purposes.

Employees may wear their own face coverings provided they meet the specifics described in this policy, or may wear face coverings provided by the employer.

The following are exceptions to Martens Ambulance’s requirements for face coverings:

  1. When an employee is alone in a room with floor to ceiling walls and a closed door.
  2. For a limited time, while an employee is eating or drinking at the workplace or for identification purposes in compliance with safety and security requirements.
  3. When an employee is wearing a respirator or facemask.
  4. Where Martens Ambulance has determined that the use of face coverings is infeasible or creates a greater hazard (e.g., when it is important to see the employee’s mouth for reasons related to their job duties, when the work requires the use of the employee’s uncovered mouth, or when the use of a face covering presents a risk of serious injury or death to the employee).

 

New Hires:

All new employees are required to comply with the vaccination requirements outlined in this policy as soon as practicable and as a condition of employment.  Potential candidates for employment will be notified of the requirements of this policy prior to the start of employment and, if vaccinated, provide proof of vaccination, or religious or medical exemption during the onboarding clearing process.  Unvaccinated employees will be required to follow the testing and face covering procedures described in this policy.

 

 

Confidentiality and Privacy:

All medical information collected from individuals, including vaccination information, test results, and any other information obtained as a result of testing, will be treated in accordance with applicable laws and policies on confidentiality and privacy.

 

Questions:

Please direct any questions regarding this policy to the Human Resources Department via email HR@martensambulance.com, or tel. 440-260-3755.

 

 

 

 

_______________________________________________________________________________________________________________________________________________________

 

Addendum I

 

 

 

Employee Attestation Lost COVID-19 Vaccination Status

 

I have lost, and are otherwise unable to produce one of the following forms of acceptable proof of vaccination:

  1. The record of immunization from a health care provider or pharmacy;
  2. A copy of the COVID-19 Vaccination Record Card;
  3. A copy of medical records documenting the vaccination;
  4. A copy of immunization records from a public health, state, or tribal immunization information system; or
  5. A copy of any other official documentation that contains the type of vaccine administered, date(s) of administration, and the name of the health care professional(s) or clinic site(s) administering the vaccine(s).

 

Date(s) of Vaccination: 1st dose: __________________  2nd dose: ______________________

 

Vaccination Manufacturer: ____________________________________________________

 

Place of Vaccination: _________________________________________________________

 

“I declare that I have attempted to obtain a copy of my COVID-19 Vaccination card by contacting the vaccine administrator or state health department, and despite attempts to do so, this statement about my vaccination status is true and accurate.  I understand that knowingly providing false information regarding my vaccination status on this form may subject me to criminal penalties.”

Employee Name:  (print clearly) __________________________________________________

Employee Signature: ___________________________________________ Date: __________

 

________________________________________________________________________________________________________________________________________________________________________

 

Addendum II

 

 

Employee Attestation

COVID-19 Vaccination Card Validation

 

I have produced one of the following forms of acceptable proof of vaccination (check one):

 

____     The record of immunization from a health care provider or pharmacy;

____     A copy of the COVID-19 Vaccination Record Card;

____     A copy of medical records documenting the vaccination;

____     A copy of immunization records from a public health, state, or tribal immunization information system; or

____      A copy of any other official documentation that contains the type of vaccine administered, date(s) of administration, and the name of the health care professional(s) or clinic site(s) administering the vaccine(s).

 

“I declare that copy of my COVID-19 Vaccination card is true and accurate.  I understand that knowingly providing false information regarding my vaccination status on this form may subject me to criminal penalties.”

 

Employee Name:  (print clearly) ______________________________________________________

Employee Signature: ____________________________________________ Date: ______________