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

Workers in a healthcare setting (COVID-19 Vaccination Requirements) Direction (No. 4)

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 March 2022 and may be further extended.

Further to this declaration, l, Dr John Gerrard, 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, to assist in containing the spread of COVID-19 in vulnerable settings, including health, disability and aged care settings, and in the broader community.

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 aligns with the principles in that Statement, with limited exceptions, and complements existing mandatory vaccination requirements in other public health directions.

2. 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.

Revocation

3. The Workers in a Healthcare Setting (COVID-19 Vaccination Requirements) Direction (No.3) made on 4 February 2022 is revoked from the time of publication of this public health direction.

Citation

4. This Public Health Direction may be referred to as the Workers in a Healthcare Setting (COVID-19 Vaccination Requirements) Direction (No.4).

Commencement

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

Application

6. 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 a healthcare setting.

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

7. A worker in healthcare, other than a residential aged care worker at a residential aged care facility, must not enter, work in, or provide services in a healthcare setting unless the worker in healthcare complies with the COVID-19 vaccination requirements.

   Note: the COVID-19 vaccination requirements for workers in healthcare who are residential aged care workers at residential aged care facilities are set out in Part 1A.

8. The COVID-19 vaccination requirements are that:

   1. a worker in healthcare must be fully vaccinated; and

   2. the worker in healthcare must:

      1. for a sole trader – provide proof of COVID-19 vaccination to any healthcare settings in which they work; or

      2. for an employee who is not a sole trader – provide proof of COVID-19 vaccination to their employer; or

      3. for an employer that provides staff or services to a healthcare setting – keep a record of the COVID-19 vaccination status of each employee who is a worker in a healthcare setting and confirm that employees are fully vaccinated, to the responsible person for each healthcare setting employees work in, and, if requested by the responsible person, provide evidence to support the undertaking.

   Note: an employer is not required to keep a copy of an employee’s evidence of vaccination or medical contraindication. The employer must record the employee’s compliance with the vaccination requirements. Assurance should be provided to the healthcare setting, advising all employees provided to the healthcare setting meet the COVID-19 vaccination requirements.

PART 1A ­­- COVID-19 VACCINATION REQUIREMENTS FOR WORKERS IN RESIDENTIAL AGED CARE

9. This part only applies to a person who is a residential aged care worker at a residential aged care facility.

10. A residential aged care worker must not enter, work in, or provide services at a residential aged care facility unless the residential aged care worker:

    1. has an up-to-date vaccination status; or

    2. they meet the requirements for an exception in paragraphs 15 to 19.

       Note: a residential aged care worker who works in or provides services at a health care setting that is not a residential aged care facility must comply with the COVID-19 vaccination requirements under Part 1.

11. An employer that provides staff or services to a residential aged care facility must keep a record of the COVID-19 vaccine status of each employee who is a worker in a residential aged care facility and provide an undertaking that employees have an up-to-date vaccination status to the operator of a residential aged care facility for each residential aged care facility employees work in, and, if requested by the responsible person, provide evidence to support the undertaking.

12. An operator must take all reasonable steps to facilitate access to COVID-19 vaccine for residential aged care workers engaged by the residential aged care facility, including access to off-site vaccination.

13. An operator of a Queensland Health residential aged care facility must ensure a health service employee who is unable to be vaccinated due to a medical contraindication or because they are a COVID-19 vaccine trial participant is temporarily deployed to another work unit until this Direction is revoked or the medical contraindication or COVID-19 vaccine trial participation no longer applies.

14. Where paragraph 13 applies and deployment is not reasonably practicable the health service employee must discuss the situation with their line manager, and the operator or their nominated representative must consult with the local Human Resources Team for other options.

PART 2 – EXCEPTIONS

15. This Part applies to all workers in healthcare, who are required to comply with the COVID-19 vaccination requirements under Part 1 or Part 1A, except workers in healthcare who are undertaking an educational placement.

Medical contraindication

16. Paragraphs 7 and 10 do not apply to a worker in healthcare, other than a student, who is unable to be vaccinated due to a current medical contraindication where the responsible person for the healthcare setting:

    1. assesses the risk to 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 17.

       Example: 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 others and determines the worker can continue to work there, if they comply with the necessary PPE and testing requirements.

17. A worker in healthcare to whom paragraph 16 applies must:

    1. comply with the PPE guideline requirements for the healthcare setting and any COVID safe plans for the healthcare setting; and

    2. on commencement of this Direction, on the worker’s next day of work, the worker undertakes a COVID-19 test before commencing duties and every second day thereafter, and provides a negative test result to the responsible person for the healthcare setting as soon as reasonably practicable after the result is received; or

       Example: an unvaccinated worker in healthcare who works consecutive shifts several days in a row is required to undertake a COVID-19 test before starting the first shift after commencement of this direction and every second work day thereafter.

    3. where the worker in healthcare is a person to whom the Health Employment Directive 12/21 Employee COVID-19 Vaccination requirements (the HED) applies, comply with the requirements relating to a medical contraindication or any other exceptions to mandatory vaccination requirements in the HED or the direction, or required by an employer to support best practice infection control.

       Example: an admissions clerk who provides evidence of a current medical contraindication is able to continue working in an alternative administrative role, using PPE consistent with the setting’s policies and the PPE guideline and must undertake a daily COVID-19 test and provide a negative COVID-19 test result when it is received.

18. A worker in healthcare to whom paragraph 16 applies must provide evidence of the current medical contraindication.

19. Evidence of a current medical contraindication provided by a worker in healthcare to a employer under a predecessor to this public health direction is deemed to be evidence provided for the purposes of paragraph 17 and additional evidence need not be provided for a current medical contraindication.

Participation in a COVID-19 Vaccine Trial

20. Paragraphs 7 and 10 do not apply to a worker in healthcare, other than a student, where:

    1. the worker in healthcare is a participant in a COVID-19 vaccine trial; and

    2. the responsible person for the healthcare setting assesses the risk to other staff, patients, clients and other persons in the healthcare setting and determines that the worker in healthcare may continue to work in the healthcare setting.

21. A worker in healthcare to whom paragraph 20 applies must notify the responsible person for the healthcare setting as soon as reasonably practicable upon completion of their participation in a COVID-19 vaccine trial.

22. The exception outlined in paragraph 20 ceases to apply upon the earlier of:

    1. the trial COVID-19 vaccine being recognised by the Therapeutic Goods Administration; or

    2. the trial COVID-19 vaccine being approved for use in Australia by the Therapeutic Goods Administration; or

    3. the trial COVID-19 vaccine being rejected for use in Australia by the Therapeutic Goods Administration.

Critical Support Needs

23. The responsible person may permit a worker in a healthcare setting who has not complied with the COVID-19 vaccination requirements to enter, work and remain at the healthcare setting for a maximum consecutive period of three months to provide support to a patient, client or person with a disability, if:

    1. the responsible person has assessed the risk to other persons in the healthcare setting; and

    2. the responsible person reasonably believes it is necessary to provide health, wellbeing, legal or advocacy support to the person; and

    3. personal protective equipment is used by the worker as required by the responsible person; and

    4. where the worker enters the healthcare setting for a single visit, a COVID-19 test is undertaken by the unvaccinated worker within 24 hours prior to entry; and

    5. where the worker enters the healthcare setting on multiple consecutive days, a COVID-19 test is undertaken by the unvaccinated worker before entering the healthcare setting every second day thereafter, and the test results provided to the responsible person for the healthcare setting as soon as reasonably practicable when received.

Critical Workforce Shortage

24. 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 maximum period of three months from 17 December 2021 or until the critical workforce shortage can be resolved, whichever is shorter, 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. the unvaccinated worker undertakes a COVID-19 test before commencing the next work shift in a healthcare setting and every second work day thereafter, and provides the COVID-19 test result to the responsible person for the healthcare setting as soon as reasonably practicable after the test result is received.

Note: the use of PPE and daily COVID-19 surveillance testing is required for a limited period of no more than 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.

25. Where a critical workforce shortage extends beyond three months only the Chief Health Officer or his delegate may approve a worker in healthcare who has not complied with the COVID-19 vaccination requirements to continue to enter, work in or provide services in the healthcare setting, on such conditions, including the use of PPE, as the Chief Health Officer or his delegate approves.

Emergency Entry

26. Paragraph 7 and 10 does not apply to an unvaccinated worker in healthcare who enters a healthcare setting for any of the following purposes:

    1. to respond to an emergency or to provide an emergency service; or

    2. to undertake a legislated regulatory or compliance function; or

    3. as part of official union duties in response to an emergent need.

       Examples: 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.

       There is a salmonella outbreak at a healthcare setting and an environmental officer may investigate the setting, regardless of whether the person meets the COVID-19 vaccination requirements or is unvaccinated.

27. An unvaccinated worker in healthcare who enters a healthcare setting under paragraph 26 must comply with the PPE guideline requirements for the healthcare setting, unless to do so would be unsafe due to the nature of the emergency.

28. A worker in healthcare who enters a healthcare setting under paragraph 26 must report the entry under paragraph 26 to the responsible person or their delegate as soon as is reasonably practicable.

Entry in a private capacity

29. 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, including any mandatory vaccination requirements for visitors to a 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 unless a visitor vaccination requirement applies to them under another public health direction.

Entry to a healthcare setting for law enforcement

30. Where the responsible person for a healthcare setting is satisfied that a worker is entering for the purposes of law enforcement and disclosure of their compliance with the COVID-19 vaccination requirements is inconsistent with the law enforcement function, the responsible person may permit the worker to enter and remain in the healthcare setting without showing evidence of COVID-19 vaccination or of medical contraindication, and the responsible person is not required to record details in relation to the worker.

PART 3 – REQUIREMENTS FOR WORKERS IN HEALTHCARE AND THEIR EMPLOYERS

31. 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.

32. An employer of a worker in healthcare must keep a record of:

    1. the worker’s vaccination status; and

    2. the type of evidence of vaccination or of medical contraindication sighted; and

    3. the date the evidence is sighted; or

    4. for an unvaccinated worker permitted to continue working, sighting a negative COVID-19 test result as soon as practicable after pre-shift testing of the unvaccinated worker.

    Note: where the COVID-19 test undertaken is a COVID-19 PCR test, the result need not be provided for the test undertaken that day but can be provided as part of a rolling surveillance testing program.

33. A worker in healthcare or, where they are employed by another person their employer must provide the responsible person, or self-managed NDIS participant, with confirmation that the worker in healthcare complies with the COVID-19 vaccination requirements.

34. Where the responsible person for a healthcare setting is not the employer, the responsible person must take reasonable steps to notify employers of workers in the healthcare setting of the COVID-19 vaccination requirements and to record vaccination compliance as advised by the employer in relation to its workforce.

    Example: a specialist medical practice has consultation rooms at a hospital. The hospital should notify the specialist medical practice of their obligations and seek confirmation that specialists using the consultation rooms meet the COVID-19 vaccination requirements. The specialist medical practice must maintain the records in relation to employee vaccination and confirm employee vaccination compliance in writing to the responsible person for the healthcare setting.

    Example: unless they are an employer of a worker in healthcare, a support co-ordinator, NDIS plan manager and a self-managing NDIS participant are not a responsible person for a healthcare setting and are not responsible for ensuring another person complies with the vaccination requirements under this public health direction.

PART 4 – WORKFORCE MANAGEMENT AND PERSONAL PROTECTIVE EQUIPMENT FOR RESIDENTIAL AGED CARE FACILITIES

35. This part only applies to a residential aged care facility.

36. The operator of a residential aged care facility must develop a Workforce Management Plan that:

    1. requires residential aged care workers contractors, volunteers and students to notify a residential aged care facility of their additional place of employment, if relevant;

    2. requires residential aged care workers contractors, volunteers and students if they become aware of a COVID-19 case identified at an additional place of employment, to notify the operator of a residential aged care facility;

    3. identifies how workforce surge requirements will be met if there is a COVID-19 event at the facility, in accordance with relevant guidance provided by Queensland Health;

    4. provides that the operator must notify the local Health Emergency Operations Centre of a critical workforce shortage for notification purposes.

37. It is recommended that the operator of a residential aged care facility ensure, to the extent possible, that employees, contractors, volunteers and students do not work across multiple care facilities.

    Note: Care facilities include but are not limited to hospitals, retirement villages, residential aged care facilities and distinct sections of a facility providing multiple types of care such as a Multi-Purpose Health Service.

38. The operator of a residential aged care facility must ensure that where employees, contractors, volunteers and students do work across multiple care facilities, they must not enter, or remain on, the premises of the residential aged care facility without wearing appropriate personal protective equipment, in accordance with Queensland Health’s Residential Aged Care Facility and Disability Accommodation PPE Guidance.

    Note: A person who does not, or is unable to wear appropriate personal protective equipment, must not enter a residential aged care facility.

39. The operator of a residential aged care facility must take reasonable steps to ensure the following, in accordance with relevant guidance provided by Queensland Health:

    1. employees, contractors who have contact with residents, volunteers and students undertake face to face infection control and personal protective equipment training; and

    2. ensure an adequate supply of personal protective equipment is available to respond to a confirmed case of COVID-19 within the residential aged care facility.

PART 5 – RECORD KEEPING REQUIREMENTS – RESPONSIBLE PERSONS

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

41. 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 6 – OTHER MATTERS

42. 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 7 — DEFINITIONS

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

PART 8 — 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 John Gerrard
Chief Health Officer
12 March 2022
Published on the Queensland Health website at 9:15 am

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.

Co-located means using shared buildings, amenities or grounds and where staff and users of the healthcare setting move freely between the co-located functions or settings.

Corrective Services Facility means—

(a)a prison; or

(b)a community corrections centre; or

(c)a work camp; or

(d)a temporary corrective services facility declared under section 268(2) of the Corrective Services Act 2006.

COVID-19 test means a COVID-19 PCR test or a COVID-19 RAT

COVID-19 PCR test means an oropharyngeal and deep nasal swab for a polymerase chain reaction (PCR) test approved for use in Australia by the Therapeutic Goods Administration to detect whether a person has the COVID-19 virus.

Note: A COVID-19 PCR test does not include a self-test.

COVID-19 RAT means a Rapid Antigen Test approved for use in Australia by the Therapeutic Goods Administration to detect whether the person has the COVID-19 virus.

COVID-19 vaccination requirements see paragraph 8 and 10.

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.

COVID-19 vaccine is a vaccine for COVID-19 that is approved for use in Australia or recognised by the Therapeutic Goods Administration.

COVID-19 Vaccine trial means a medical trial for a COVID-19 vaccine under either the Clinical Trial Notification or Clinical Trial Approval schemes regulated by the Therapeutic Goods Administration.

Covid-19 vaccine trial participant means a person who:

1. is an active participant in a COVID-19 Vaccine trial; and

2. provides a medical certificate or letter from a medical practitioner, registered under the Health Practitioner Regulation National Law (Queensland) associated with the COVID-19 vaccine trial confirming that:

   1. The worker in healthcare is participating in a Phase 3 or 4 clinical trial for a COVID-19 Vaccine; and

   2. The worker in healthcare has received at least one active dose of the COVID-19 vaccine being trialled.

Critical workforce shortage means a sustained workforce shortage in a healthcare setting and the geographical region in which the healthcare setting is located that the responsible person for the healthcare setting considers may directly and significantly adversely impact patient or client care.

In determining whether a critical workforce shortage exists, the responsible person for the healthcare setting must consider:

1. whether the remaining skill mix and rostering within the healthcare setting is unable to compensate for the shortage; and

2. whether the critical workforce shortage is not just within the facility but across the geographical area in which the healthcare setting is located.

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), and will depend on the nature and extent of the impacts on patient and client care and safety.

Disability support services means in-person supports related to a person’s disability, including:

1. assistance with daily life tasks - for example, assistance with everyday needs, cooking, household cleaning and yard maintenance

2. community access and centre based activities

3. specialist supported employment which assist people with disability in their workplace to perform their work tasks

4. assistance with daily personal activities for example, assisting a person with personal care, showering, dressing and eating.

5. community nursing care

6. therapeutic supports

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 environmental 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.

Facility means a residential aged care facility, a shared disability accommodation service or a hospital.

Fully vaccinated means a person aged 16 years and over has received the prescribed number of doses of a COVID-19 vaccine and one week 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; and

• allied healthcare; and

• other healthcare, support services and personal care; and

• disability support services.

Note: this does include community access but does not include general community based social activities undertaken for wellbeing benefits, and general non-healthcare services accessed by a patient or person with a disability.

Example: People with disability attending a council-run outdoor exercise session is not a healthcare setting.

Healthcare professional means:

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 to provide healthcare.

Healthcare setting means a setting or premises where healthcare is ordinarily provided by a healthcare professional, but does not include:

1. a health centre within a Corrective Services Facility; or

2. a person’s home or an office building where telehealth is provided entirely from that place and there is no face to face contact with patients, clients and others accessing the healthcare; or

3. a part of a healthcare setting that is not co-located and meets the following requirements:

   1. must be unoccupied by users and workers of a healthcare setting; and

   2. must be physically separate from the occupied part of the healthcare setting or be secured and delineated so that users and workers of the healthcare setting cannot enter; and

   3. must not have shared points of access with the users and workers of the healthcare setting; and

   4. must not be accessed by a person who uses the facilities (for example, toilets or lunchroom) in the healthcare setting.

      Examples: Construction works on a free-standing building not connected to an occupied healthcare setting (new build or refurbishment) or installation of a modular building at a school or health campus.

Note: if a person engaged or employed to undertake work in that part of the healthcare setting enters the occupied healthcare setting, the person must comply with the visitor requirements.

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 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. disability support services delivered in the home

12. aged care services funded by the Australian Government and delivered to a client or patient in their 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

A person solely providing healthcare services from their home or another location via telehealth and who is not providing any in-person services is not considered in-scope for the purposes of this Direction.

Health service employee means an employee engaged under the Hospital and Health Boards Act 2011 in Hospital and Health Services and the Department of Health.

Note: a health service employee who works in a multi-purpose health facility must be vaccinated if they will enter, work in, or perform services in the residential aged care portion of the facility.

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).

Medical contraindication means a person has a current

1. COVID-19 vaccine medical exemption recorded on the Australian Immunisation Register, or

2. Australian Immunisation Register (AIR) immunisation medical exemptions form completed and signed by an eligible health professional for the COVID-19 vaccine.

Notes: some medical contraindications are temporary and therefore the record or completed form may only be valid for a period of time. A current completed and signed AIR immunisation medical exemption form is valid in printed or digital form. (See paragraph 12)

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

Proof of COVID-19 vaccination means any evidence required to support a person’s claims of having received the prescribed number of doses of a COVID-19 vaccine and includes a COVID-19 digital certificate, an immunisation history statement (printed or digital) or an international COVID- 19 vaccination certificate.

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.

Queensland Health residential aged care facility means the following Queensland Health facilities and for a multi-purpose health service, means the aged care portion in which accommodation, and personal 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 Commonwealth Government National Aboriginal and Torres Strait Islander Flexible Aged Care Program or Multi-Purpose Services Program:

Residential aged care facility means a facility, including a Queensland Health residential aged care 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.

Residential aged care worker means any person:

1. employed or engaged by or on behalf of a residential aged care facility (whether as an employee, contractor or agency staff) to work in, perform duties or provide services for residents at a residential aged care facility on a full time, part time or casual basis; and

2. includes a health service employee and a person engaged by Queensland Health (whether as an employee, contractor or agency staff) to work in, perform duties or provide services at a Queensland Health residential aged care facility and/or at a residential aged care facility; and

3. for the purposes of Part 1A, includes a medical practitioner and allied health professional, including paramedics and emergency services staff. who regularly attends and provides care to residents of a residential aged care facility whether employed or engaged by the resident, residential aged care facility or another person;

Example: a nurse contracted to fill a staffing shortage and provide care for residents in a nursing home may be a contractor but is also a residential aged care worker.

Note: volunteers who are not engaged by the residential aged care facility, for example community visitors providing companionship to a resident at the request of the resident, are not persons to whom this Part applies

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 (NDIS) provider or their delegate in a healthcare setting, and does not include a support co-ordinator, NDIS plan manager, or a self-managing NDIS participant, where the self-managing NDIS participant does not directly employ a worker in healthcare.

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, in short-term or long-term accommodation; 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 means the person has not received the prescribed number of doses of a COVID-19 vaccine or does not have an up-to-date vaccination status where that is required.

Up-to-date vaccination status means either:

• Prior to 31 March 2022, a person who is fully vaccinated; or

• From 31 March 2022 a person who is 16 years or older who has received a COVID-19 vaccine booster dose during the period from 3 to 6 months after being fully vaccinated, and continues to receive booster doses within the recommended dosing interval.

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

1. a healthcare professional providing healthcare, except to the extent the person works entirely from their home or outside a healthcare setting, to deliver healthcare services that do not involve face to face contact with patients or clients; and

2. any other employee, contractor, independent third party or volunteer in a healthcare setting, whether employed by the healthcare setting or performing the work under another arrangement.

   Note: Corrective Services Officers who escort prisoners to Correctional Health Facilities are not included as healthcare workers but will be required to be vaccinated under another public health direction.

Examples of a worker in healthcare include:

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

• a Visiting Medical Officer

• an employee or contractor of a disability accommodation service

• 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