Registration for Working Quarantine Program

PURPOSE OF THIS DOCUMENT:

To ensure ongoing viability of our local essential critical infrastructure workforce, Lewis and Clark Public Health has developed a local Working Quarantine Program consistent with the Centers for Disease Control and Prevention or CDC’s Strategies to Mitigate Healthcare Personnel Staffing Shortages and/or CDC’s Interim Guidance for Implementing Safety Practices for Critical Infrastructure Workers Who May Have Had Exposure to a Person with Suspected or Confirmed COVID-19, as applicable.

Lewis and Clark Public Health recognizes that maintaining staffing levels of essential health care and critical infrastructure workers within our community is necessary in order to protect and maintain the safety and health of all county residents. As the COViD-19 pandemic continues staffing shortages within our critical infrastructure workforce will likely occur due to exposures, illness, or need to care for family members at home. Therefore, our local essential critical infrastructure workforce, as defined by the U.S. Department of Homeland Security’s Cybersecurity & Infrastructure Security Agency or CISA, must be prepared for potential staffing shortages.

To slow or stop the spread of COVID-19 it is extremely important that your entity exhaust all available contingency strategies prior to implementing your Working Quarantine Plan. Only essential critical infrastructure workers within our local essential critical infrastructure workforce may participate in the program. 

REGISTER YOUR ENTITY FOR THE WORKING QUARANTINE PROGRAM: To register your entity for the local Working Quarantine Program, complete the information on the following page and SUBMIT using the button at the end of this registration form.

RECEIVE NOTICE OF ELIGIBILITY: Lewis and Clark Public Health will determine your eligibility to participate in the LCPH Working Quarantine Program using criteria established by CISA in their August 18, 2020, Advisory Memorandum on Ensuring Essential Critical Infrastructure Workers Ability to Work during the COVID-19 Response. If your entity meets the eligibility criteria you will receive an email outlining roles and responsibilities for your entity and your employee.

COMPLETE THE WORKING QUARANTINE ORDER: If your entity meets the eligibility criteria you will receive an email outlining roles and responsibilities for your entity and your employee. You will also receive a link that the employee will use to complete the Order and submit to LCPH at the time that you are in need of a Working Quarantine.

WORKING QUARANTINE PROGRAM REGISTRATION AND PLAN

Date:

Name of Entity:

Applicant Name/Contact:

Phone Number of Applicant Name/Contact:

Contingency Strategies to be Considered/Used Prior to Implementation of the Working Quarantine Plan:

Please describe strategies you are implementing to reduce the use of working quarantine in your business. For example, canceling all non-essential procedures and visits to a healthcare facility and shifting healthcare personnel who work in these areas to support other patient care activities in the facility. Another example, communicate with other similar-service entities in the community to shift workload through the quarantine period such as collaboration between local volunteer fire departments to cover for an affected local fire department during quarantine.

Strategies:

Identification of Essential Critical Infrastructure Workers within your Eligible Essential Critical Infrastructure Workforce:

Working quarantine is intended to be used only for critical workforce. For example, a receptionist at a long-term care facility can be readily replaced by other entity staff or a temporary employment agency while essential skilled nursing staff or physician at the same long term care facility cannot be readily replaced. Another example, a snow-plow driver for a local Public Works Department performs essential duties for the community using specialized snow removal equipment and would therefore be deemed essential. In contrast, a Department manager at the same Public Works Department performs an essential role; however, that role likely can be performed remotely for the duration of quarantine; therefore, the Department manager would not meet the criteria for an essential critical infrastructure worker for the purposes of your Working Quarantine Plan.

Below, please list all staff that would be identified as Essential Critical Infrastructure Workers within your workforce.

Staff Member(s) Name and Job Title

Additional Notes/Comments:

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