The Occupational Safety and Health Administration (OSHA) released new COVID-19 guidelines – called Emergency Temporary Standards (ETS) – for all healthcare providers and those who provide support services. The new rules are binding on all employers unless they meet one of several exemptions. For most of our clients, the applicable exemptions may include: if you’re a “non-hospital ambulatory care setting where all non-employees are screened prior to entry and people with suspected or confirmed COVID-19 are not permitted to enter those settings” and “home healthcare setting where all employees are fully vaccinated and all non-employees are screened prior to entry and people with suspected or confirmed COVID-19 are not present.”
While most of our clients have a screening process, you may not have evidence of 100% vaccination among the staff and you may also have an obligation to treat patients with or suspected to have COVID, so the ETS apply to you. Per OSHA, a fully vaccinated individual – someone who received the final dose of the COVID-19 vaccine more than two weeks prior – is exempt from masking and physical distancing requirements, but you need a mechanism to determine vaccine status (and document that).
Below is a summary of high-level points for your plan, which must be oriented toward minimizing risk of transmission.
Providers need a designated COVID-19 safety coordinator. This is the person who will conduct hazard assessments and make sure all your org’s COVID processes are being carried out successfully. In all likelihood, someone has been acting as your COVID-19 point person, so that may be whom you officially designate; the key is to put it in writing.
Speaking of writing… you need a COVID plan. Most providers have been following a series of processes for the past 15 months, but the point is you need to have those in written form. Remember that the plan needn’t to be fancy; just create a document that summarizes your operational changes thanks to COVID.
Daily screening. Your company needs to be able to limit and monitor points of entry, screen patients and visitors for symptoms and follow a process to relocate those individuals away from the rest of your patient population. Employees also need to be screened, and if someone in the workplace is COVID-19 positive, you need to notify certain employees within 24 hours. If you’ve relaxed some of your screening process, this is the time to bring it back in full-force and document if for posterity – and OSHA.
Personal protective equipment (PPE). You must supply facemasks to your employees and make sure they wear them when inside your premises. Of course, there are exceptions, such as if an employee is alone in a room or is eating/drinking at least six feet away from others or behind a physical barrier. If you provide or allow employees to wear respirators, you will need to provide instructions for use, specify when they are to be used, conduct a user-seal check and provide training. Note that this item is binding on the employer if your employee wears this on his/her own, not just if you require it.
Paid leave (if you have more than 10 employees). Regardless of whether you require vaccination or not, you must provide employees with paid “reasonable time” to be vaccinated and/or if they experience any side effects from the vaccination. The official wording says “benefits to which the employee is normally entitled,” and “must also pay the employee the same regular pay the employee would have received had the employee not been absent from work, up to $1,400 per week, until the employee meets the return to work criteria.” By now, I bet you can spot things that need to be in your COVID plan… like return to work criteria. This may require discussion with a medical practitioner, or review of CDC guidelines so you can stipulate how and when employees may return to work.
Aerosol-generating procedures. Be sure to include in your plan that only the employees essential for patient support and to perform the procedure are allowed to be present during it, and cover your requirements and process for cleaning and disinfecting the surfaces and equipment used in the procedure.
Physical distancing. Have you relaxed physical distancing requirements? Again, this is the time to reinforce keeping at least six feet apart when indoors. Remember that fully vaccinated employees (as described above) are exempt from this requirement.
Cleaning and disinfecting. By now, we’re all familiar with CDC guidelines for cleaning and disinfecting surfaces and equipment in patient care areas, but the plan requires that high-touch surfaces and equipment also be cleaned once daily. OSHA also requires that you make hand sanitizer that is at least 60% alcohol readily available in handwashing facilities.
The OSHA guidelines contain much more information, so be sure to familiarize yourself with them, but this gives you a starting point from which to write your plan. Here‘s a more readable summary from the National Law Review. The ETS take effect on July 6, 2021.