Digital Debut

Illinois Ends its Healthcare Worker COVID-19 Vaccination Mandate

Two states have now allowed shot requirements to expire

BY STEPHEN ABRESCH | OCTOBER 2022

The COVID-19 vaccination and testing requirements for healthcare workers in Illinois expired on October 14. Governor J.B. Pritzker issued an executive order on that day to reissue and extend previously issued COVID-19 executive orders, but he did not extend the healthcare worker vaccination and testing requirements established by another executive order in September 2021.

Background

In summer 2021, in the absence of a clear direction on federal vaccine requirements, states took it upon themselves to create their own vaccine mandates. California, the first state to act, issued an order on July 26, 2021, requiring state employees and healthcare workers to provide proof of vaccination or undergo regular testing for COVID-19. Other states quickly followed suit. By September 9, 2021, when the Biden administration released its COVID-19 action plan, Path Out of the Pandemic, eight states—California, Colorado, Illinois, New Jersey, New York, Oregon, Rhode Island and Washington—already had vaccination requirements for their healthcare workers. The Path Out of the Pandemic directed the Centers for Medicare & Medicaid Services (CMS) to require COVID-19 vaccinations for healthcare workers in settings that receive Medicare or Medicaid reimbursement.

By the end of January 2022, CMS implemented its nationwide healthcare worker vaccination mandate following a favorable opinion from the US Supreme Court and the dismissal of Texas’s lawsuit against the mandate. While the state orders remained in effect, differences between the federal requirement and most state requirements were small enough to not create additional burdens for ASCs. Certain states, like California, went further than the federal requirement and included staff testing and booster shot requirements in its vaccination order. New Jersey also added a booster shot requirement to its vaccination mandate.

Requirements of Illinois

The state-level requirements of Illinois also exceeded CMS’ mandates. While the vaccination requirements of the state were consistent with the CMS mandate, the state added testing requirements for healthcare workers who had not established that they were fully vaccinated by September 19, 2021. Beginning on that date, healthcare workers who had not been fully vaccinated were required to undergo testing for COVID-19 on a weekly basis, at a minimum, to continue working in their facilities. The testing was required to take place onsite at the facility or the facility had to obtain proof or confirmation from the healthcare worker of a negative test result obtained elsewhere.

ASCs in the state wanted to remove the testing requirement. The Illinois Ambulatory Surgery Center Association communicated its members’ concerns to the state and ASCs eagerly awaited each monthly extension of the governor’s COVID-19 executive orders for signs that the state would back off the requirement. The first indication came on July 12, 2022, when the governor extended and amended Executive Order 2021-22. This amendment required that unvaccinated healthcare workers must undergo testing once per week only if the Level of COVID-19 Community Transmission as defined and determined by the Centers for Disease Control and Prevention (CDC) is high. Weekly testing would not be required if the level were low, moderate or substantial. Three months later, the governor signed Executive Order 2022-21 and ended the state’s vaccination and testing requirements altogether. ASCs in the state will now need to comply with CMS’ vaccination mandate only, which requires that all staff in Illinois ASCs be fully vaccinated or obtain a qualifying exemption by March 28, 2022.

In a press release on the new executive order, Pritzker stated, “Thanks to the tremendous efforts of our health care workers and residents, Illinois has done better at keeping our people safe with vaccines, boosters, and masking, which puts us in a position to continue to scale back health care requirements in line with the CDC.” Sameer Vohra, MD, director of the Illinois Department of Public Health added, “As we continue to learn how to live with COVID-19, it is important for the State of Illinois to adapt our policies to better align with federal guidelines.” The release also noted that while the state’s vaccination mandate for healthcare workers was ending, facilities in the state would still need to comply with the federal vaccination mandate for healthcare workers.

To date, Colorado and Illinois are the only two states that have ended their vaccination mandates. Of the remaining six states that imposed their own mandates, California, New Jersey and Washington did so through executive or public health orders, while New York, Oregon and Rhode Island adopted the requirements as part of their healthcare facility regulations, making the process to secure changes that much more difficult.

Write Stephen Abresch with any questions.