Guiding Principles for Allocation and Tiers

GUIDING PRINCIPLES FOR ALLOCATION AND TIERS:

• Protecting health care workers who fill a critical role in caring for and preserving the lives of COVID-19 patients and maintaining the health care infrastructure for all who need it.
• Protecting front-line workers who are at greater risk of contracting COVID-19 due to the nature of their work providing critical services and preserving the economy.
• Protecting vulnerable populations who are at greater risk of severe disease and death if they contract COVID-19.
• Mitigating health inequities due to factors such as demographics, poverty, insurance status, and geography.
• Data-driven allocations using the best available scientific evidence and epidemiology at the time, allowing for flexibility for local conditions.
• Geographic diversity through a balanced approach that considers access in urban and rural communities and in affected ZIP codes.
• Transparency through sharing allocations with the public and seeking public feedback.

TIER 1A
• Paid and unpaid workers in hospital settings working directly with patients who are positive or at high risk for COVID-19. Such as but not limited to:
• Physicians, nurses, respiratory therapists, and other support staff (custodial staff, etc.)
• Additional clinical staff providing supporting laboratory, pharmacy, diagnostic and/or rehabilitation services
• Others having direct contact with patients or infectious materials
a. Long-term care staff working directly with vulnerable residents. Includes:
b. Direct care providers at nursing homes, assisted living facilities, and state-supported living centers
c. Physicians, nurses, personal care assistants, custodial, food service staff
• EMS providers who engage in 9-1-1 emergency services like pre-hospital care and transport
• Home health care workers, including hospice care, who directly interface with vulnerable and high-risk patients
• Residents of long-term care facilities Tier 1b:
• Staff in outpatient care settings who interact with symptomatic patients. Such as but not limited to:
a. Physicians, nurses, and other support staff (custodial staff, etc.)
b. Clinical staff providing diagnostic, laboratory, and/or rehabilitation services
c. Non 9-1-1 transport for routine care
d. Healthcare workers in corrections and detention facilities
• Direct care staff in freestanding emergency medical care facilities and urgent care clinics
• Community pharmacy staff who may provide direct services to clients, including vaccination or testing for individuals who may have COVID
• Public health and emergency response staff directly involved in the administration of COVID testing and vaccinations
• Last responders who provide mortuary or death services to decedents with COVID-19. Includes:
a. Embalmers and funeral home workers who have direct contact with decedents
b. Medical examiners and other medical certifiers who have direct contact with decedents
• School nurses who provide health care to students and teachers

TIER 1C:
• People of all ages with comorbid and underlying conditions that put them at significantly higher risk
• Older adults living in congregate or overcrowded settings

TIER 2:
• K-12 teachers and school staff and child care workers
• Critical workers in high-risk settings— workers who are in industries essential to the functioning of society and substantially higher risk of exposure
• People of all ages with comorbid and underlying conditions that put them at moderately higher risk
• People in homeless shelters or group homes for individuals with disabilities, including serious mental illness, development and intellectual disabilities, and physical disabilities or in recovery, and staff who work in such settings
• People in prisons, jails, detention centers, and similar facilities, and staff who work in such settings
• All older adults not included in Phase 1

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