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Compliance with Proclamation 21-14 form

4 Sep 2021 3:46 PM | Marybeth Berney (Administrator)

Compliance with Proclamation 21-14 Vax Washington

 

The Washington Chiropractic Association (WSCA) has been kind enough to allow WSMTA to share with you the compliance tool that they created for complying with Governor Inslee’s Proclamation 21-14. Please make sure to download both pages.

WSCA -- Proclamation_21_14_Compliance_Document.pdf

First some background on the validity of governor Proclamations. The validity and enforceability of governor issued Proclamations has been upheld in the courts many times over many decades. Those court decisions have, in a nutshell, said that states have the right to infringe on individual liberties in some cases and especially in the case of public health matters. There are several Washington healthcare provider associations and unions that have expressed displeasure with the proclamation, as written, to the Governor’s office. But many attorneys have agreed that any type of prospective legal challenge would have zero chance of success as there is no standing to challenge. Once enforcement begins that may provide some type of standing for a legal challenge.

Please read the disclaimer on page 2 carefully as it contains steps that will help you to fill out the forms completely. This disclaimer page applies to WSCA and WSMTA. If you have questions beyond the scope of this article, please consult your attorney.

Who needs to fill out/maintain these documents

  • Every employee, contractor, and volunteer performing any kind of work in the facility where healthcare/massage is offered--whether directly interfacing with patients or not--must disclose the information requested in this document.
  • If you operate a massage facility and you have MTs that are independent contractors renting space inside your massage facility you, as the healthcare facility operator, must maintain these documents for those contractors.
  • If you employ your child/children to clean, do landscape maintenance or anything else at your healthcare facility they must have this document filled out and maintained by you.
  • In short anyone who is in your healthcare facility and is under your control needs to fill out this document and you need to maintain it.
  • Any new employees, contractors, volunteers that come to work in your healthcare facility on or after Oct 18, 2021, must fill out this document and you need to maintain it.
  •  If any of the information/conditions reflected in these documents changes at any time undated documents and supporting documents must be filled out to replace the outdated documents
  • If you are self-employed and are vaccinated, you need only have your vaccination record.  If you are self-employed and are filing a medical or religious exemption/accommodation, fill out the form and sign both as the employer and the employee.

How do I need to maintain the compliance document and supporting documents

  • This document and all supporting documents need to be maintained by you until the COVID-19 State of Emergency is ended or Proclamation 21-14 is amended or rescinded.
  • These documents should be maintained with the same security as healthcare records.
  • This document and all supporting documents need to be maintained at your healthcare facility and be readily available to any inspectors from the Department of Health, Labor and Industries, or any law enforcement agency.

Section 1

  • If you are self-employed, you will put your name in as employee and employer,

Section 2

  • You have 4 choices. If you/your employee, contractor, volunteer check the “fully vaccinated” box, then move to Section 3.
  • If you/your employee, contractor, volunteer check “request a medical exemption” then skip to Section 4.
  • If you/your employee, contractor, volunteer check “request a religious exemption” then skip to Section 5.
  • If you/your employee, contractor, volunteer check “will not comply with the Proclamation” then skip to Section 6. 

Section 3 - only if fully vaccinated

  • Fill in the appropriate dates of vaccination, brand of vaccination and what proof of vaccination was received. Keep a copy of the proof of vaccination with this document.

Section 4 - only when requesting medical accommodation

  • This section should be filled out by the employee, contractor, or volunteer. Attach supporting documentation from a medical provider with all the information that is indicated on the form.
  •  Make sure that the employee, contractor, or volunteer signs and dates this section.

Section 5 - only when requesting religious accommodation

  • This section should be filled out by the employee, contractor, or volunteer. Attach supporting documentation that provides all the information that is indicated on the form.
  • The religion does not need to be a “named” religion, written documentation from clergy is not required.

Section 6 - only when not complying with the Proclamation

  • Make sure that it is understood what the consequences are, have this section signed and dated by the employee, contractor, or volunteer.

Section 7 - to be completed by Employer/healthcare facility operator

  • Make sure this section is filled out completely and signed and dated by both parties.

Enforcement

We really will have no idea as to what enforcement is going to look like until it begins to happen. The Washington Department of Labor and Industries (L&I) has the authority to issue fines and shut you down until you come into compliance. The Department of Health has the authority to issue fines and provide other sanctions against your license. Law enforcement has the authority to charge you with a gross misdemeanor. 

The Department of Health has indicated that enforcement will be complaint driven, much like it is with any regulatory issue. Will the Department of Health or Labor and Industries come knocking on your door? We believe this is highly unlikely, but it could happen. Do you have other complaints against you, have you been flagged as a non-complier, then this could be more likely to happen to you. Will law enforcement come knocking on your door? Again, we think this is highly unlikely, but it is possible. If you have all your documentation for yourself, employees, contractors, and volunteers at the ready and you have made a good faith attempt to fully comply with the Proclamation you should be on firm ground from a legal/regulatory perspective.

Miscellaneous

  • The Proclamation allows the healthcare facility operator to handle exemptions, in good faith. This means the forms must be completely true and accurate to the best knowledge of those signing the documents.
  • When you issue a qualified exemption/accommodation you can impose conditions. For example, if you employ a biller who has requested a religious exemption/accommodation you can have that biller work off-site instead of on-site, or if you have a provider in your facility who is an independent contractor and you have issued a qualified medical exemption/accommodation you could impose the condition of being tested for COVID-19 on a regular basis.
  • It is not discrimination to not hire/not contract with someone who is not vaccinated.

We hope that you find this information to be helpful.

Marybeth Berney LMT

WSMTA President

 





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