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Workers in a healthcare setting (COVID-19 Vaccination Requirements) Direction

Summary

Effective from: 7.30pm AEST 10 November 2021

Posted: 10 November 2021

Direction from Chief Health Officer in accordance with emergency powers arising from the declared public health emergency

Public Health Act 2005 (Qld)
Section 362B

On 29 January 2020, under the Public Health Act 2005, the Minister for Health and Minister for Ambulance Services made an order declaring a public health emergency in relation to coronavirus disease (COVID-19). The public health emergency area specified in the order is for ‘all of Queensland’. Its duration has been extended by regulation to 26 December 2021 and may be further extended.

Further to this declaration, l, Dr Peter Aitken, Chief Health Officer, reasonably believe it is necessary to give the following directions pursuant to s362B of the Public Health Act 2005 to assist in containing, or to respond to, the spread of COVID-19 within the community.

Guidance

This public health direction applies to workers in healthcare who enter, work in, or provide services in a healthcare setting. The direction sets out the COVID-19 vaccination requirements for workers in healthcare, their employers and responsible persons in healthcare settings, with limited exceptions.

Preamble

  1. On 1 October 2021, the Australian Health Protection Principal Committee (AHPPC) issued a statement recommending mandatory vaccination for all workers in healthcare settings. This Public Health Direction implements the principles in that Statement, with limited exceptions, and complements existing mandatory vaccination requirements in other public health directions.

  2. To the extent of any inconsistency between this Public Health Direction and a requirement under legislation or a regulation, the Act or regulation applies or prevails.

  3. This Public Health Direction applies to workers in healthcare settings

  4. Separately from the requirements of Public Health Directions, under sections 362G and 362H of the Public Health Act 2005, an emergency officer (public health) can require a responsible person or person to comply with additional directions if the emergency officer believes it is reasonably necessary to assist in containing, or to respond to, the spread of COVID-19 in the community.

Citation

  1. This Public Health Direction may be referred to as the Workers in a Healthcare Setting (COVID-19 Vaccination Requirements) Direction.

Commencement

  1. This Direction applies from time of publication until the end of the declared public health emergency, unless it is revoked or replaced.

Application

  1. This Direction applies to workers in healthcare, including those in the National Registration and Accreditation Scheme, all self-regulated allied health professionals and all other individuals who work in healthcare settings.

PART 1 —COVID-19 VACCINATION REQUIREMENTS FOR WORKERS IN HEALTHCARE

  1. A worker in healthcare must not enter, work in, or provide services in a healthcare setting unless the worker in healthcare complies with the COVID-19 vaccination requirements.

  2. The COVID-19 vaccination requirements are that:

    1. by 15 December 2021, a worker in healthcare has received the prescribed number of doses of a COVID-19 vaccine; or

    2. where COVID-19 vaccination requirements in another public health direction or an employment direction also apply to the worker in healthcare, the worker must receive the prescribed number of doses of the COVID-19 vaccine by the date in those requirements; and

    3. as soon as reasonably practicable after each dose of the COVID-19 vaccine, the worker in healthcare must provide evidence of complying with the COVID-19 vaccination requirements to their employer, where applicable, and to the responsible person for the healthcare setting.

  3. Note: evidence of meeting the COVID-19 vaccination requirements may include a person’s MyGov record or immunisation history statement from the Australian Immunisation Register. A person’s immunisation history statement can be obtained from the Australian Government using myGov, the Medicare mobile app or by calling the Australian Immunisation Register and requesting a statement to be posted. Information is available at: https://www.servicesaustralia.gov.au/individuals/services/medicare/australian-immunisation-register/how-get-immunisation-history-statement.

    Note: the dates for COVID-19 vaccination requirements in the Health Employment Directive No. 12/21 Employee COVID-19 Vaccination requirements (the HED) and the Residential Aged Care Facilities Direction (N0.9) (the direction) continue to apply for persons to whom the HED or the direction applies.; The dates for COVID-19 vaccination for students undertaking a placement in connection with an enrolled course of study continue to apply as provided in the Hospital Entry Direction (No.5), the Residential Aged Care Facilities Direction (No.9), and the Disability Accommodation Services Direction (No.24), or the successor to any of these directions.

Medical contraindication and other exceptional circumstances

  1. Paragraph 8 does not apply to a worker in healthcare who is unable to be vaccinated due to a medical contraindication where the responsible person for the healthcare setting:

    1. assesses the risk to the staff member, other staff, patients, clients and other persons at the healthcare setting; and

    2. determines that the unvaccinated worker may continue to work in the healthcare setting where their work cannot be performed outside the healthcare setting; and

    3. the unvaccinated worker complies with the requirements in paragraph 11.

  2. Example: a telehealth worker based at a private clinic who is unable to be vaccinated due to a medical contraindication can continue to work in a telehealth role based outside the healthcare setting in an office building. A worker who is unable to be vaccinated due to a medical contraindication, who repairs critical medical equipment onsite in healthcare settings can continue to perform that work if the responsible person for the healthcare settings assesses the risk to the staff member and others and determines the worker can continue to work there, if they comply with paragraph 11.

  3. A worker in healthcare to whom paragraph 10 applies must:

    1. comply with the National guide for safe workplaces and other COVID-19 guidance provided by Safe Work Australia for the healthcare setting; and

    2. produce a negative COVID-19 PCR test result before commencing each work shift in a healthcare setting;

    3. and wear PPE as required under an established PPE guideline for the healthcare setting; or

      Note: an established PPE guideline may include existing Queensland Health guidelines, existing guidelines used by the healthcare setting or as outlined in the COVID safe plan for the healthcare setting,

    4. where the worker in healthcare is a person to whom the Health Employment Directive 12/21 Employee COVID-19 Vaccination requirements (the HED) or the Residential Aged Care Facilities Direction (No.9) or its successor (the direction) applies, comply with the requirements relating to a medical contraindication or any other exceptions to mandatory vaccination requirements in the HED or the direction.

  4. A worker in healthcare to whom paragraph 10 applies must provide a medical certificate, issued by a medical practitioner, and their Australian Immunisation Record, specifying the medical contraindication that makes the person unable to be vaccinated and the period of the medical contraindication if it is temporary.

  5. Where the medical practitioner certifies that a person has a temporary medical contraindication for being unable to receive the COVID-19 vaccination, paragraph 10 only applies for the period specified in the medical certificate. If the medical contraindication continues beyond the specified period, the person must provide a new medical certificate from their medical practitioner, certifying the matters in paragraph 12.

  6. Paragraph 8 does not apply to an unvaccinated worker in healthcare who enters a healthcare setting to respond to an emergency. An unvaccinated worker in healthcare who enters a healthcare setting to respond to an emergency must comply with the PPE guideline requirements for the healthcare setting.

    Example: a contractor, who is not vaccinated, enters a private hospital to fix malfunctioning medical equipment required for critical patient care. The contractor may enter the hospital but must abide by the COVID-safe plan and practices of the hospital, including any PPE requirements.

  7. A worker in healthcare must report the entry under paragraph 14 to the responsible person or their delegate as soon as is reasonably practicable.

  8. A worker in healthcare who does not comply with the COVID-19 vaccination requirements may enter the healthcare setting in their personal or private capacity but must not enter, work in, or provide services as a worker in healthcare, and must comply with all other public health directions applicable to entering the healthcare setting.

    Note: an unvaccinated worker in healthcare may enter as a personal visitor of a patient, client or resident of the healthcare setting, as a parent or guardian of a patient, client or resident, or as a patient, client or resident of the healthcare setting.

PART 2 – REQUIREMENTS FOR WORKERS IN HEALTHCARE AND THEIR EMPLOYERS

  1. A worker in healthcare and their employer must take all reasonable steps to ensure that the worker in healthcare does not enter, work in, or provide services in a healthcare setting if the person is prohibited from doing so under this Direction.

  2. An employer of a worker in healthcare must keep a record of their having sighted evidence of, or verified, the workers’ vaccination status, evidence supporting a claimed medical contraindication, and of the negative COVID-19 PCR test result required before an unvaccinated worker commences each work shift.

  3. A worker in healthcare or, where applicable, their employer must provide the responsible person with confirmation that the worker in healthcare complies with the COVID-19 vaccination requirements.

  4. After 15 December 2021 - the responsible person for a healthcare setting should make reasonable efforts to obtain confirmation that any worker in healthcare that enters, works in or provides services in a healthcare setting has received the prescribed number of doses of a COVID-19 vaccine, or meets the conditions for an exception under this Direction.

PART 3 — RECORD KEEPING REQUIREMENTS – RESPONSIBLE PERSONS

  1. A responsible person or their delegate must keep a record, either locally or centrally, of COVID-19 vaccination information reported to it by a worker in healthcare or their employer. The information is collected and used for ensuring compliance with the Direction.

  2. The information must be stored in a secure database that is accessible to authorised persons only and maintained in accordance with the Information Privacy Act 2009 and the Public Records Act 2002.

PART 4 — EXCEPTION – RESPONDING TO CRITICAL WORKFORCE SHORTAGES

  1. The responsible person for a healthcare setting may permit a worker in healthcare who has not complied with the COVID-19 vaccination requirements to enter, work in, or provide services in the healthcare setting, for a short period until the critical workforce issue can be resolved, if:

    1. the responsible person has assessed the risk to other staff, patients and other persons accessing the healthcare setting; and

    2. the responsible person reasonably believes it is necessary to respond to a critical workforce shortage; and

    3. personal protective equipment is used by the worker in healthcare in compliance with the PPE guideline and any COVID safe plans for the healthcare setting; and

    4. a negative COVID-19 PCR test result is provided by the unvaccinated worker in healthcare before starting each work shift.

  2. Note: the use of PPE and daily PCR surveillance testing for COVID-19 is required to support a limited period such as three months when an unvaccinated worker in healthcare may enter, work, or provide services in a healthcare setting to respond to a critical workforce shortage while fully vaccinated workers are recruited or alternative arrangements are made to respond to the critical workforce shortage.

PART 5 —OTHER MATTERS

  1. An emergency officer (public health) can require a responsible person, a worker in healthcare, or their employer to comply with additional directions if the emergency officer believes the direction is reasonably necessary to assist in containing, or to respond to, the spread of COVID-19 within the community.

PART 6 — DEFINITIONS

  1. Definitions used in this Direction are in Schedule 1.

PART 7 — PENALTIES

A person to whom the direction applies commits an offence if the person fails, without reasonable excuse, to comply with the direction.

Section 362D of the Public Health Act 2005 provides:

Failure to comply with public health directions

A person to whom a public health direction applies must comply with the direction unless the person has a reasonable excuse.
Maximum penalty—100 penalty units or 6 months imprisonment.

Dr Peter Aitken
Chief Health Officer
10 November 2021
Published on the Queensland Health website at 7.30pm AEST

SCHEDULE 1 - Definitions

For the purposes of this Public Health Direction:

Authorised person is a person approved or permitted to access the information in accordance with licensing requirements, if any, the Information Privacy Act 2009 and the Public Records Act 2002 and related instruments of delegation.

Booster dose means an additional dose recommended by the Australian Technical Advisory Group on Immunisation (ATAGI) for use as a booster dose of COVID-19 vaccine for a person or group of people.

COVID-19 PCR test means tested for COVID-19 with an oropharyngeal and deep nasal swab for polymerase chain reaction (PCR) testing, undertaken in a clinical setting, and does not include a self-test.

COVID-19 vaccination requirements see paragraph 9.

COVID-19 vaccine is a vaccine for COVID-19 that is approved by the Therapeutic Goods Administration for use in Australia or that is endorsed by WHO-COVAX where the employee was vaccinated overseas.

Critical workforce shortage means a sustained workforce shortage in a healthcare setting that the responsible person for the healthcare setting considers may directly impact patient or client care or the effective operation of the healthcare setting.

Example: A critical workforce shortage may be a shortage of more than 10 per cent of staff for a sustained period of 7 days or more, however this will depend on the size of the healthcare setting and baseline staffing levels (including consideration of skills mix and rostering).

Educational placement means a placement in a healthcare setting, that is undertaken in connection with an enrolled course of study and under the supervision of an employee or contractor at the healthcare setting, or as part of a professional development arrangement

Emergency officer (public health) means an emergency officer appointed under the Public Health Act 2005.
Note: Emergency officers appointed under the Public Health Act 2005 include public health officers and police.

Employer means a person, or other legal entity that employs or otherwise engages a worker in healthcare who provides supplies or services in a healthcare setting.

Fully vaccinated means a person has received the prescribed number of doses, including a prescribed booster dose, of a COVID-19 vaccine approved for use in Australia by the Therapeutic Goods Administration, or endorsed by WHO-COVAX and the vaccine was received overseas, and two weeks has passed.

Healthcare means services, support and medical treatment provided to a person to support, promote or improve their health and wellbeing and includes:

  • medical care

  • allied healthcare

  • other healthcare, support services and personal care

  • disability support services

Healthcare setting means a setting or premises where healthcare is provided

Examples of a healthcare setting include:

  1. public hospitals, public health clinics, ambulance services, patient transport services, and other health services; or

  2. private health facilities, such as private hospitals or day procedure centres, or specialist outpatient services; or

  3. residential aged care facilities;

  4. shared disability accommodation services;

  5. private provider facilities, such as general practitioners, private nurse offices and allied health consulting offices, pharmacies, optometrists, dental surgeries and private pathology centres; or

  6. not for profit health organisations providing and/or commissioning public healthcare under a service agreement with any State or Commonwealth agency, including an Aboriginal and Torres Strait Islander Community Controlled Health Service; or

  7. Non Government Organisations (NGO) delivering healthcare services, for example Alcohol and other Drugs residential rehabilitation and treatment services; hospital and other public healthcare services on a Hospital and Health Service campus e.g. integrated mental health Step Up Step Down models; or

  8. education settings within a healthcare setting; or

  9. outreach services in other settings provided by the facilities in paragraphs (a) to (d), including in-home healthcare services; or

  10. Australian Red Cross Lifeblood collection centres

  11. In home delivery of intensive disability support services

  12. aged care services funded by the Australian Government and delivered in the home

  13. school based healthcare, including in special schools

  14. healthcare services provided in other settings such as gyms

  15. mobile services such as mobile dental clinic van or mobile health promotion van

Hospital means:

  1. a hospital, as defined in schedule 2 to the Hospital and Health Boards Act 2011; or

  2. a private health facility, as defined in section 8 of the Private Health Facilities Act 1999; or

  3. a multi-purpose service, as defined in section 104 of the Subsidy Principles 2014 made under section 96-1 of the Aged Care Act 1997 (Cth).

Disability support services means:

  1. assistance with daily life tasks in a group or shared living environment

  2. group and centre based activities that assist people with disability to access community, social and recreational activities in groups involving skilled and experienced support staff

  3. specialist supported employment which assist people with disability who have high support needs to maintain work in a social enterprise for example, sometimes referred to as Australian Disability Enterprises (ADEs)

  4. assistance with daily personal activities - assistance with, or supervision of, personal tasks of daily life to develop skills of the participant to live as autonomously as possible

  5. community nursing care to respond to the disability related health needs of a participant where that care is not the usual responsibility of the health system.

  6. therapeutic supports to facilitate functional improvement aimed at adjustment, adaption, and building capacity for community participation.

  7. other non-intensive supports including cooks and cleaners.

Medical contraindication means a temporary or permanent contraindication that is:

  1. recognised in guidance published by the Australian Technical Advisory Group on Immunisation (ATAGI) in relation to the use of a particular COVID-19 vaccine; or

  2. notified to the Australian Immunisation Register (AIR) by a medical practitioner in relation to a person and recorded on the person’s Immunisation History Statement (IHS).

    Note: a temporary vaccine exemption may apply until a specified date due to acute major illness, significant immunocompromise of short duration and recognised overseas vaccination.

PPE guideline means an established guideline appropriate for the setting, such as Queensland Health PPE guidelines, and may include existing guidelines used by the healthcare setting, or as outlined in the COVID Safe Plan.

Private health facility means a private facility licensed under the Private Health Facilities Act 1999

Public health officer includes an emergency officer (general), a contact tracing officer or an authorised person under section 377 of the Public Health Act 2005.

Residential aged care facility means a facility at which accommodation, and personal care or nursing care or both, are provided to a person in respect of whom a residential care subsidy or a flexible care subsidy is payable under the Aged Care Act 1997 of the Commonwealth, or funding is provided under the National Aboriginal and Torres Strait Islander Flexible Aged Care Program.

Responsible person for a healthcare setting means the person legally responsible for employing or engaging workers in healthcare and for facilitating their access to the healthcare setting. The responsible person includes a licensee, operator or chief executive, National Disability Insurance Scheme provider or their delegate in a healthcare setting.

Shared disability accommodation service means a service, including the forensic disability service under the Forensic Disability Act 2011, where:

  1. four or more people with disability reside with people who are not members of their family; and

  2. the residents share enclosed common living areas within the facility whether inside or outside, and

  3. the residents are provided with disability supports within the facility.

Student means a student who:

  1. in connection with an enrolled course of study, is undertaking a placement under the supervision of an employee or contractor at the residential aged care facility, hospital or shared disability accommodation service; or

  2. is entering the hospital as part of a placement in connection with an enrolled course of study.

    Example for paragraph (b): a paramedical student, a student nurse, a student on placement at a shared disability accommodation service.

Unvaccinated worker in healthcare means a worker in healthcare that is not fully vaccinated by 16 December 2021, or who has not met the COVID-19 vaccination requirements in another public health direction or Health Employment Direction that applies to the worker.

Worker in healthcare means a person who works, undertakes an educational placement, or volunteers in a healthcare setting, including:

  1. a person registered under the National Registration and Accreditation Scheme administered by the Australian Health Practitioner Regulation Agency (Ahpra), or

  2. a person who is a self-regulated allied health professional as published on the Australian Government Department of Health website [insert link: https://www.health.gov.au/health-topics/allied-health, or

  3. a qualified person who meets the requirements defined in the Private Health Insurance (Accreditation) Rules 2011 and who provides a service or treatment that attracts or is eligible for a rebate from Medicare or a private health insurance organisation; or

  4. any other person who works as a health professional, contractor, independent third party provider, other employee or volunteer in a healthcare setting, whether employed by the healthcare setting or performing the work under another arrangement.

    Examples of a worker in healthcare include:

    • a doctor who has consulting rooms at a private hospital, and their receptionist

    • a Visiting Medical Officer

    • Kitchen staff in a healthcare setting, including aged care or disability accommodation

    • volunteers who assist visitors to a healthcare setting.

    • an employee of a company that supplies and services medical equipment under a contractual arrangement with a public hospital

    • an agency nurse engaged for relief work in a specialist outpatient service

    • volunteers, including volunteers engaged by Health Consumers Queensland, providing face to face advice and support services across the health system in Queensland

    • exercise physiologists providing healthcare services in a gym;

    • an employee of a community pharmacy

    • Chaplains visiting patients in a hospital or other healthcare setting

    • Teachers in a hospital or other healthcare setting

    • Hospital Clown Doctors

    • Florist or coffee shop employees in a healthcare setting

    • Support worker providing services in supported independent living

    • NDIS funded psychologist or occupational therapist providing in home support for an NDIS participant’s wellbeing (whether a registered or unregistered NDIS provider);

    • Non NDIS support person that provides in home assistance to a person in residential aged care

Last updated: 10 November 2021

Understanding this Direction

Information to help you understand what this Direction means to workers in a healthcare setting

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