COVID-19 Vaccines: Step-by-Step Guide for Community Action

This step-by-step guide is intended to help the Community Action network be nimble with respect to their approaches to vaccines in the workplace and maintaining compliance with applicable federal mandates issued by Head Start and the Centers for Medicare & Medicaid Services (CMS). Various legal challenges to the mandates, including to the OSHA Emergency Temporary Standard and the Head Start vaccine mandate, have resulted in many CAAs no longer being subject to any federal vaccination, testing, or masking requirements. However, such CAAs may, subject to their state and local laws, voluntarily adopt their own workplace rules regarding COVID-19 vaccines, tests, and masks.

This guide helps CAAs subject to vaccine mandates as well as those voluntarily adopting a mandate think through their implementation and enforcement procedures. We describe the planning process your CAA should consider as you develop and update your COVID-19 approach. We also provide template policies and additional resources to assist your CAA in preparing for and implementing federal mandates and your own workplace rules. We will update this resource as additional guidance is issued and legal developments arise.

1. Identify if a mandate applies

2. Determine timeline

3. Identify an approach

4. Adopt written vaccine policy

5. Review leave policies

6. Maintain OSHA reports

7. Review accommodations process

8. Understand enforcement + penalties

9. Additional resources

As grant recipients of multiple funding sources with varying requirements, CAAs frequently juggle overlapping compliance obligations. If your CAA is subject to multiple employee vaccination mandates, think carefully before implementing a written policy. You have a choice between adopting the same employee vaccination rule across all programs or applying different mandates to different groups of employees. Before making your choice, consider where the rules that apply to your organization overlap and diverge using the chart below. Similarly, if your CAA voluntarily adopts a vaccine requirement, you can choose to apply the rules differently to groups of employees across your workforce. The chart below summarizes some of the key differences between the federal mandates currently in effect.

Rule CMS Rule Head Start Rule
Covered employers/entities:
Certain Medicare- and Medicaid- certified healthcare facilities
HS/EHS grantees, including CCPs and delegate agencies
Covered individuals:
All employees and those who provide services at a site of care or have contact with someone who may be present at a site of care
Staff who work with HS children and families regardless of funding; contractors with direct contact with children and families; volunteers in classroom or working directly with children; and children over age 2 (masking only)
Excluded individuals:
Individuals who perform all work-related duties remotely
None
Reasonable accommodations for religious and medical exemption requests:
Yes
Yes
Fully vaccinated individuals remain subject to masking requirement:
Silent (may be subject to existing universal masking requirements)
Yes
Individuals must be masked by:
Silent (may be subject to existing universal masking requirements)
November 30, 2021 regardless of vaccination status
Individuals must be fully vaccinated by:
Deadlines vary depending on state – see Section 2
January 31, 2022
Option to provide weekly negative test result instead of vaccination:
No
No
Requires collection of proof of vaccination:
Yes
Yes
Additional paid sick leave for vaccination:
Employer may, but not required to, provide
Employer may, but not required to, provide
Additional paid sick leave for vaccine side effects:
Employer may, but not required to, provide 
Employer may, but not required to, provide

From a compliance perspective, the easiest approach is likely adopting and applying the same employee vaccination rule across all programs. Doing so will help you avoid potential claims of discrimination from individuals in a protected class, as all employees will be subject to the same policies. With this approach, your CAA should apply the most restrictive employee mandate applicable to your organization. For CAAs subject to both federal mandates, that would mean requiring vaccines for all employees, and universal masking for individuals aged 2 and older when indoors or in a vehicle with another person, except that individuals who are not fully vaccinated must also mask when outdoors in crowded settings or during activities that involve sustained close contact with other people. Both the vaccination and masking requirements would be subject to reasonable accommodations for medical and religious exemptions.

If your CAA would rather apply the most restrictive mandate when necessary, it should make sure that its written policy clearly identifies which employees will be subject to which requirement. For example, a CAA covered by the CMS rule and the Head Start mandate may choose to divide its workforce and impose different vaccination mandates for each group in its vaccination policy. The CAA should also be prepared to explain that employees are being treated differently for a legitimate business reason (e.g., the stricter rules are funding source requirements, or certain employees have greater interaction with and exposure to the public).

When weighing the pros and cons of an approach, your CAA should also consider questions such as:

  • Does the CAA have the capacity to separately manage and track the requirements of each mandate?
  • Will the application of different vaccination mandates to different groups of employees have a negative effect on employee morale?
  • Is the CAA subject to a collective bargaining agreement that might govern the implementation of a vaccination mandate?
  • If the CAA plans to support employees by providing face masks, testing, etc., what funds can be used to do so? How will they be allocated?

It’s important to note that collective bargaining agreements cannot override applicable legal requirements such as the CMS rule and the Head Start mandate, but they may require employers to bargain over areas where they have some discretion (such as whether to apply the vaccine mandate to those not covered by the statute) or over the effects of the policy (e.g., paying for tests and paid leave). These areas will be governed by the bargaining agreement and state law. See NLRB Memo, November 10, 2021.

Finally, your CAA should consult with an attorney licensed in your state when developing a vaccine plan and policy to ensure compliance with applicable state laws.

This resource is part of the Community Services Block Grant (CSBG) Legal Training and Technical Assistance Center. It was created by CAPLAW in the performance of the U.S. Department of Health and Human Services, Administration for Children and Families, Office of Community Services, Cooperative Agreement Award Number 90ET0467-03-C3. Any opinion, findings, conclusions, or recommendations expressed in this material are those of the author(s) and do not necessarily reflect the views of the U.S. Department of Health and Human Services, Administration for Children and Families.