Do in-home and community based aged care workers need to be vaccinated for COVID-19?
5 minute read
We often get asked some version of this question. Sometimes it can get a bit sticky, like the beginning of an argument you might have with your aunt over Christmas lunch. But requirements have changed, so its important providers are aware of their new obligations and the decisions they are going to have to make.
The short answer is no, the COVID-19 vaccine requirement has been lifted. For state or territory specific information, we’ve listed the websites of each jurisdiction’s health department and work health and safety agency below.
It’s now up to providers to decide what their vaccine requirements will be. And doesn’t that open a can of worms?
What’s a provider to do?
First things first, it’s important to note that many older people would prefer that workers are vaccinated. But that doesn’t make it an obligation, right?
Looking at the legislation, work, health, and safety laws require providers to do what is reasonably practicable to minimise the risk of transmission of COVID-19, as well as other infectious diseases.
To determine what way to go, as work health and safety legislation is risk based, start with a risk assessment.
Assess what the potential impact COVID-19 would have if workers, clients, and others acquired it, as well as the likelihood that this may occur.
Then:
Consider if vaccinations and the other controls you already have in place are effective
Identify if there are other potential measures
Consult with workers
Consult with participants, where measures may impact them
Determine what control measures are reasonably practicable
And then implement the measures
Although vaccinations are still strongly recommended, they’re not the only measure to consider – there are others like elimination and isolation. But not all measures are as effective as others, so a good start is to refer to the hierarchy of controls.
For the safety geeks out there, I would place vaccinations under engineering (let me know what you think?)
Control type: Elimination
Examples:
Requesting people who are sick to stay home
Closing off a site to visitors
Completing appointments via online
Thorough hand hygiene
Thorough environmental cleaning
Control Type: Substitution
Examples:
Using single use equipment instead of reusable forms
Substitute face to face with online appointments
Control type: Isolation
Examples:
Management and storage of waste
Isolating a sick resident away from others in the house
Physical distancing
Control type: Engineering
Examples
Vaccination
Ventilation
Physical barriers used to separate people such as screens
Redesigning work areas such as positioning of workstations, directing airflow and reduced touch points
Engineered bins to reduce touching, such as sharps bins, bins with foot pedals and self-closing lids
Control type: Administrative
Examples:
Document plans, measures, and relevant instructions you need workers to follow
Put up signage, such as how to use PPE or wash hands
Train workers to implement the agreed controls
Develop an immunisation program
Control type: Personal Protective
Examples:
Suitable equipment, with adequate supply and which is easily accessible
Should providers mandate their workforce be vaccinated?
If you decide that one control measure is vaccination, then the next question is, are workers going to be encouraged to be vaccinated or will this be a mandatory requirement?
The reason governments implemented mandates in the first place is because many older people are particularly vulnerable. And there is still significant risk.
But any mandatory direction you give to workers needs to be lawful and reasonable.
To be lawful, the direction needs to comply with any awards, contracts, and agreements you have in place. Plus, relevant laws, for example anti-discrimination and privacy.
Measures need to be in place to avoid discriminating against candidates and workers, including having a process to consider each worker’s circumstance. For example, if they have a legitimate reason for not obtaining a vaccination. What process will you take if a worker states that they have a medical condition which prevents them from being vaccinated? What evidence will you ask them to provide? How will reasonable adjustments be made so they can continue to work?
If a worker’s reason for not wanting the vaccine is not due to a protected attribute under anti-discrimination laws - for example, if its personal preference - then this would not be discrimination.
You will also need to consider what private health information you retain. The golden rule is to keep as little information as possible. For example, a record that simply captures a yes or no answer to vaccination, rather than a copy of their vaccination history and information from their treating doctor regarding why a person is medically not able to be vaccinated.
To be reasonable is defined as being based on good judgement or sense.
In this case of COVID vaccines, this could include that the decision was only made after considering:
Work, health and safety risks and legal obligations
The tasks the person would be required to complete, and if they would have unavoidable close interactions with clients
The availability and effectiveness of other control measures
Each worker’s circumstance
Refer to Fair Work Australia for further guidance.
What about relevant case law?
Relevant legal cases highlight the need for a consultative and considered approach before introducing vaccination mandates.
A case brought by a schoolteacher (Dawking), claimed she sustained a psychological injury due to the vaccination mandate. This issue was not the vaccination mandate, but rather, how it was communicated and implemented.
Dawking argued that no consideration was given to:
Her continuing to work remotely or redeployment
The fact that the pandemic would not last indefinitely, and that rather than termination she could have been suspended
Any special leave provisions
The fact that the only exemption to the vaccination mandate was on medical grounds
The court agreed and her claim for compensation was accepted. Following this case, the education department changed their practices to ensure that each objection to obtaining a vaccination was reviewed on a case-by-case basis.
How about a voluntary immunisation program?
Voluntary immunisation programs take the argument out of if someone wants to be vaccinated.
However, it’s likely that less people will keep their vaccinations up to date.
If you decide that you’ll encourage rather than mandate vaccinations, you can still develop an immunisation program.
You could include:
Promoting the benefits of vaccinations,
Providing guidance to workers on where they can get a vaccination
Giving workers time off work to obtain a vaccine, or even having a nurse administer them at the workplace.
An immunisation program may be included as part of a wellness program.
Lastly, if a client requests to only supported by vaccinated workers, you’ll need to work out some way to manage this.
Do I need to report the COVID 19 vaccination status of workers?
Yes, in-home and community aged care providers must still keep records of and report the vaccination status of their workers. This includes if they have a booster. For more information visit the Government Health website.
What about other types of vaccinations?
Influenza vaccinations are mandatory for residential aged care workers, and strongly encouraged for all other aged care workers.
The Department of Health and Aged Care also recommends that workers receive vaccines against:
Hepatitis A
Hepatitis B
The benefits may include reduced sick leave, reduced likelihood of transmission to participants and even an improved worker morale.
No matter which way you go, all providers still have an obligation under safety laws to implement reasonable measures to prevent workplace injuries and illnesses, as well as to comply with the standard to minimise infection related risks. What that looks like in practice can vary from provider to provider.
Further information
To assist each state and territory, health departments and safety regulators have advice and resources.
National
Safe Work Australia: https://covid19.swa.gov.au/covid-19-information-workplaces
Department of Health and Aged Care: www.health.gov.au/topics/aged-care/managing-covid-19/for-in-home-providers
NSW
Health department: www.health.nsw.gov.au/Infectious/covid-19/Pages/home-care-latest-advice.aspx
SafeWork: www.safework.nsw.gov.au/resource-library/COVID-19-Coronavirus/covid-19-vaccination
VIC
Health department: www.dffh.vic.gov.au/coronavirus
WorkSafe: www.worksafe.vic.gov.au/coronavirus-covid-19
Better Health Chanel: www.betterhealth.vic.gov.au/coronavirus-covid-19-victoria
QLD
Health department: www.qld.gov.au/health/conditions/health-alerts/coronavirus-covid-19/business/vaccination-for-workers
SA
Health department: www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/conditions/infectious+diseases/covid-19/vaccinations/covid-19+vaccinations
In home and community specific information: www.health.gov.au/our-work/covid-19-vaccines/information-for-aged-care-providers-workers-and-residents-about-covid-19-vaccines/in-home-and-community-aged-care-recipients-workers-and-providers
TAS
Health department: www.health.tas.gov.au/health-topics/coronavirus-covid-19/staying-well/workplace-settings
WorkSafe: www.worksafe.tas.gov.au/topics/Health-and-Safety/safety-alerts/coronavirus
WA
Health department:
www.wa.gov.au/government/covid-19-coronavirus
WorkSafe: www.commerce.wa.gov.au/worksafe/covid-19-coronavirus-0
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