On June 10, the Occupational Safety and Health Administration (OSHA) announced it will issue an emergency temporary standard (ETS) to protect healthcare workers from COVID-19 exposures. The standard focuses on healthcare workers most likely to have contact with someone infected with the virus—primarily in hospital ambulatory care settings—but there are exemptions for healthcare providers that screen out patients who may have COVID-19. OSHA also announced updated guidance for non-healthcare employers that’s more closely aligned with recent public health recommendations from the Centers for Disease Control and Prevention (CDC).
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The ETS establishes new requirements for workplaces providing healthcare or healthcare support services, including emergency medical services, home health care, and skilled nursing homes. The agency has submitted rule text to the Office of the Federal Register. However, the ETS has not appeared in the Federal Register, but it will become effective immediately upon publication. Healthcare employers must comply with most provisions within 14 days and with the remaining provisions within 30 days.
Requirements of the standard include providing employees paid time off. Employers covered by the standard must provide workers with paid time off to get vaccinated and to recover from any side effects. Healthcare and healthcare support employees who have the coronavirus or who may be contagious must work remotely or otherwise be separated from other workers or provided paid time off up to $1,400 per week.
However, most businesses with fewer than 500 employees may receive reimbursement through tax credits under the American Rescue Plan.
Healthcare facilities must conduct a hazard assessment and develop a written plan to mitigate virus spread, and healthcare employers must provide some employees with N95 respirators or other personal protective equipment. Covered employers must ensure 6 feet of distance between workers. Where physical distancing is not possible, employers should erect barriers between employees where feasible.
Fully vaccinated workers are exempted from masking, distancing, and barrier requirements when in well-defined areas where there is no reasonable expectation that any person will be present with a suspected or confirmed coronavirus infection.
The ETS contains its own respiratory protection program requirements. Respirators include filtering facepiece respirators (FFRs), such as N95s; elastomeric respirators; and powered air-purifying respirators (PAPRs). The standard does not recognize face coverings, face masks, and face shields as respirators. Employers must provide respiratory protection training, including how to perform a user seal check. The ETS allows for the reuse of FFRs that are not visibly damaged or soiled.
Employers must require employees to discontinue respirator use if they experience any signs or symptoms (chest pain, shortness of breath, wheezing) related to their ability to use a respirator. Employers must not provide respirators to employees previously determined to not be medically fit to wear a respirator.
The ETS applies to hospitals, nursing homes, and assisted living facilities; emergency responders; home healthcare workers; and employees in ambulatory care settings where suspected or confirmed coronavirus patients are treated. Where healthcare services are provided in a non-healthcare setting, the ETS only applies to the portion of the facility where healthcare is provided. It also only applies to emergency responders and not facilities where they respond.
OSHA said it would use its enforcement discretion to avoid citing employers that miss a compliance deadline but are making a good-faith effort to comply with the ETS.
“Too many of our frontline healthcare workers continue to be at high risk of contracting the coronavirus,” said Secretary of Labor Marty Walsh in a statement. “As I said when I came to the department, we must follow the science.”
The American Society of Safety Professionals (ASSP) expressed support for OSHA’s healthcare ETS.
“The emergency temporary standard is a necessary action that will help employers across the healthcare sector take vital measures to better protect some of our most vulnerable workers and ultimately save lives,” ASSP President Deborah Roy said in a statement.
“We know there are benefits to having a unified approach with requirements and guidance to lead healthcare facilities in the same direction to achieve safer and healthier work environments,” Roy continued. “The use of standards is an effective way to implement strong controls that improve occupational safety and health.”