New DOH Return to Work Guidance for Exposed Staff Offers Some Flexibility
The Department of Health (DOH) has issued new guidance on Return to Work (RTW) for Health Care Personnel (HCP) who are exposed to COVID-19 or who travel to non-contiguous states or foreign countries. Notably, the new RTW guidance loosens work exclusion requirements in a limited way for exposed staff who are fully vaccinated and clears up some of the confusing language in the prior guidance documents.
The RTW guidance applies to all health care and direct care settings, although there are unique provisions for nursing homes, Assisted Living Programs (ALPs), and Enhanced Assisted Living Residences (EALRs). The RTW guidance applies only to asymptomatic staff who are exposed to COVID-19 or travel, not to staff who have been diagnosed with COVID-19 or exhibit symptoms. Members are encouraged to read the entire guidance document; however, the following are some key points:
- RTW for Nursing Home, EALR, and ALP Staff After Exposure: Asymptomatic HCP exposed to COVID-19 must be furloughed until the 14th day after exposure.
- RTW for Home Care, Adult Care Facility (ACF) (other than EALR and ALP) Staff, and Other HCP After Exposure: HCP may return to work after a 10-day quarantine without testing if no symptoms have been reported and they monitor symptoms through Day 14; continue hand hygiene, personal protective equipment (PPE), etc.; and self-isolate if symptoms develop.
- Asymptomatic HCP Who Have Been Fully Vaccinated: Asymptomatic HCP fully vaccinated against COVID-19 do not need to quarantine or furlough during the first three months after full vaccination if the HCP: (i) is fully vaccinated (which occurs two weeks after second dose or a single-shot vaccine); (ii) is within three months following receipt of the last dose in the series; (iii) has remained asymptomatic since the last COVID-19 exposure. The following conditions also apply:
- HCP working in a nursing home or ACF must still undergo testing twice per week and be assigned to areas, and have contact with, only vaccinated residents (except for those in pediatric facilities and units).
- HCP working in a hospital or health care facility (other than a nursing home or ACF) must be tested five to seven days after the current exposure, or as soon as possible if exposure is not discovered until Day 7 or later. Providers should attempt to assign these HCP to lower-risk patients.
- Under the guidance, all health care facilities are expected to know which of their staff have been vaccinated.
- Return from Travel to Non-Contiguous States or U.S. Territories: Asymptomatic HCP returning from travel may return to work consistent with essential worker provisions in the Travel Advisory. They must “receive a COVID-19 diagnostic test within 24 hours of arrival in NYS and again on the fourth day after their return.” We interpret this to mean that they may return to work immediately after receiving their first test within 24 hours of arrival and may continue to work through Day 4, assuming that they do not test positive. They do not have to be excluded from work until they present a negative test or until Day 4. However, facilities may choose to require a negative test prior to return to work for infection control purposes. All travelers (not just HCP) returning from travel must complete the traveler health form upon entry.
- Return from Travel to Foreign Countries: Asymptomatic HCP returning from travel to another country must follow the Centers for Disease Control and Prevention’s (CDC) international travel requirements and present proof of a negative test result no more than three days before flight departure or documentation of recovery from COVID-19 prior to boarding, and must either quarantine for seven days with a test three to five days after travel or quarantine for 10 days with no test. Essential worker exemptions do not apply to international travel.
- Mitigation Strategies for Providers Facing Current or Imminent Staffing Shortages: Facilities with staffing shortages are urged to contact the Surge and Flex Operations Center at 917-909-2676. It is open 24 hours per day, seven days per week. A facility that wishes to seek a RTW waiver to allow exposed staff to return to work early (see HCP RTW Waiver below) must first implement a variety of strategies. These strategies now include following the CDC recommendation that 'asymptomatic HCP who have recovered from SARS-CoV-2 infection may not need to undergo repeat testing or quarantine if exposed to COVID-19 within 3 months after the date of symptom onset from the initial SARS-CoV-2 infection or date of first positive diagnostic test if asymptomatic during illness.' Please note that LeadingAge NY has asked DOH whether this strategy was intended to apply to nursing homes and ACFs, as it is inconsistent with prior statements by the Department. We will notify members when we receive a response.
- Staffing Shortage HCP RTW Waiver: The guidance continues the availability of RTW waivers that allow facilities that are experiencing staffing shortages to reduce or eliminate the work exclusion period of exposed HCP who are asymptomatic and test negative. Facilities seeking waivers submit the online form and must attest that they have implemented the applicable staffing mitigation strategies and that they are experiencing current or imminent staffing shortages that threaten essential services.
Contact: Karen Lipson, klipson@leadingageny.org, 518-867-8838