On January 4, the New York Department of Health issued a GUIDANCE DOCUMENT
(Jan. 4) to clarify the return-to-work and quarantine/isolation guidelines it published on
December 24 (GUIDANCE DOCUMENT (Dec. 24)). These guidelines apply to
healthcare workers and, in many respects, defer to the CDC’s standards.

First, the applicable rule for an agency to follow with respect to personnel who are
COVID positive or that have been exposed to COVID will depend on whether the
agency is in (1) a conventional “strategy,” (2) contingency strategy, or (3) crisis
strategy. These “strategy” labels are CDC’s terms for the 3 operations stages, and each
stage is defined by healthcare personnel availability (i.e., the less healthcare workers
there are, the “higher” level of urgency and strategy).

In simplest terms, an agency is under a “conventional strategy” if it is following the
usual, non-emergency, and ordinary standards for operations during the pandemic. In
our experience, almost no agency is in this phase at the moment.
An agency is under a “contingency” strategy when it is experiencing staffing shortages
due to the pandemic, but it is able to continue providing patient care. We anticipate that
most providers are still in this phase.

Crisis strategies are implemented only after a contingency strategy is exhausted, and
the healthcare provider has notified the DOH that it is in a “crisis” state because it
cannot provide essential patient services despite instituting contingency strategies.
The quarantine, isolation, and return-to-work obligations are summarized in the DOH’s
January 4 guidance document. As most relevant to New York LHCSA and CHHA
providers:

  • For providers who are in the conventional strategy phase, infected staff that is
    fully vaccinated but not boosted must generally follow the CDC 10-day
    quarantine guidelines, or 7 days with a negative test. For staff that has been
    exposed but is not deemed infected, the same rule applies.
  • For providers that are in the contingency phase, infected staff who are fully
    vaccinated but not boosted are required to follow the DOH’s December 24
    guidance issued by the DOH, which generally provides for a 5-day isolation
    period. If the employee was exposed but is not deemed infected, no work
    restrictions are required with negative tests on days 1,2,3 and 5-7 (per CDC).
  • For providers that have activated their crisis strategy, fully vaccinated and un-
    boosted staff that has been exposed to COVID is not subject to any work
    restrictions. For fully vaccinated staff that are infected, the provider must contact
    the DOH and follow CDC Crisis Strategies, which currently contain no work
    restrictions for infected staff (if fully vaccinated).

Other rules apply for non-vaccinated staff and boosted staff. Please be sure to refer to

the January 4 “matrix” chart for those rules.

If you have any questions about these requirements for your staff, please let us know.

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