OSHA’s COVID-19 Emergency Temporary Standard

OSHA's COVID-19 Emergency Temporary Standard

On June 21, 2021, the Occupational Safety and Health Administration (OSHA) issued an emergency temporary standard (ETS) specifically for the healthcare industry to protect workers from occupational exposure to COVID-19. The Occupational Safety and Health Act of 1970 provides OSHA the ability to promulgate an ETS without having to go through the normal review and comment process for rulemaking. OSHA has rarely acted on this authority, evidenced by the last ETS being issued in 1983 on asbestos.

As indicated by the use of the word "emergency" in its title, an ETS requires compliance in a very short amount of time. Most provisions of the COVID-19 ETS were enforceable 14 days after it was issued, with all provisions enforceable within 30 days. The good news is, OSHA stated in their news release in June that they will use enforcement discretion to avoid citing employers who miss a compliance deadline as long as they are making a good faith effort to comply with the ETS.

The ETS has several components that are workplace-specific, so compliance will require a hands-on approach with mandatory involvement from non-managerial employees. Fortunately, healthcare organizations already have many of the policies and procedures in place that are required by the ETS. These existing policies and procedures along with additional requirements of the ETS can be combined to develop a comprehensive COVID-19 Plan.

Does the ETS Apply to Your Organization?

The ETS applies to "settings where any employee provides healthcare services or healthcare support services" but there are some exceptions. The ETS does not cover non-hospital ambulatory care settings where all non-employees are screened prior to entry and people with suspected or confirmed COVID-19 are not permitted to enter. OSHA has provided a tool to help employers determine if they are considered a "covered employer".

ETS Requirements

The ETS requires covered employers to do the following:

• Conduct a hazard assessment, implement a COVID-19 Plan for each workplace, and engage employees in the development of the plan.
• Designate workplace safety coordinator(s), knowledgeable in infection control principles and practices, with the authority to implement, monitor, and ensure compliance with the plan.
• Limit and monitor points of entry to settings where direct patient care is provided; screen and triage patients, clients, residents, delivery people, and other visitors and non-employees entering the setting for symptoms of COVID-19; and implement patient management strategies.
• Develop and implement policies and procedures to adhere to Standard and Transmission-Based Precautions in accordance with Centers for Disease Control (CDC) guidelines.
• Provide and ensure employees wear facemasks when indoors and when occupying a vehicle with other people for work purposes; provide and ensure employees use respirators and other personal protective equipment (PPE) for exposure to people with suspected or confirmed COVID-19 and for aerosol-generating procedures (AGPs) on a person with suspected or confirmed COVID-19, and provide respirators and other PPE in accordance with Standard and Transmission-Based Precautions.
• Perform AGPs on persons with suspected or confirmed COVID-19 in an airborne infection isolation room, if available; limit employees present to only those essential, and clean and disinfect surfaces and equipment promptly after the procedure is completed.
• Keep employees at least 6 feet apart from others when indoors, unless not feasible for a specific activity (e.g., hands-on medical care).
• Install cleanable or disposable solid barriers at fixed work locations in non-patient care areas where employees are not separated from other people by at least 6 feet.
• Follow standard practices for cleaning and disinfection of surfaces and equipment in accordance with CDC guidelines inpatient care areas, resident rooms, and for medical devices and equipment or in all other areas when a person who is COVID-19 positive has been in the workplace in the last 24 hours; in all other areas, clean high-touch surfaces and equipment at least once a day; and provide alcohol-based hand rub that is at least 60% alcohol or provide readily accessible handwashing facilities.
• Provide and ensure employees wear facemasks when indoors and when occupying a vehicle with other people for work purposes; provide and ensure employees use respirators and other personal protective equipment (PPE) for exposure to people with suspected or confirmed COVID-19 and for aerosol-generating procedures (AGPs) on a person with suspected or confirmed COVID-19, and provide respirators and other PPE in accordance with Standard and Transmission-Based Precautions.
• Perform AGPs on persons with suspected or confirmed COVID-19 in an airborne infection isolation room, if available; limit employees present to only those essential, and clean and disinfect surfaces and equipment promptly after the procedure is completed.
• Keep employees at least 6 feet apart from others when indoors, unless not feasible for a specific activity (e.g., hands-on medical care).
• Install cleanable or disposable solid barriers at fixed work locations in non-patient care areas where employees are not separated from other people by at least 6 feet.
• Follow standard practices for cleaning and disinfection of surfaces and equipment in accordance with CDC guidelines inpatient care areas, resident rooms, and for medical devices and equipment or in all other areas when a person who is COVID-19 positive has been in the workplace in the last 24 hours; in all other areas, clean high-touch surfaces and equipment at least once a day; and provide alcohol-based hand rub that is at least 60% alcohol or provide readily accessible handwashing facilities.
• Ensure adequate ventilation in accordance with the ETS, if the employer owns or controls buildings or structures with an existing HVAC system(s) and/or existing AIIR(s).
• Screen employees before each workday and shift for COVID-19 symptoms; require each employee to promptly notify the employer when the employee is COVID-19 positive, has been told by a licensed healthcare provider that they are suspected to have COVID-19, or experiencing certain symptoms; and notify potentially exposed employees within 24 hours when a person who has been in the workplace is COVID-19 positive.
• Remove any employee who is COVID-19 positive or has been told by a licensed healthcare provider that they are suspected to have COVID-19, certain COVID-19 symptoms, or have had close contact with a person who is COVID-19 positive in the workplace; in some cases, provide pay and benefits to employees removed from the workplace.
• Provide paid time off for vaccinations and vaccine side effects.
• Train employees on workplace policies and procedures regarding COVID-19 in accordance with the ETS.
• If an employer has more than 10 employees on the effective date of this ETS, record all employee cases of COVID-19 on a COVID-19 log without regard to occupational exposure.
• Report work-related COVID-19 fatalities to OSHA within 8 hours of employer knowledge and in-patient hospitalizations within 24 hours of employer knowledge.[1]

Where to Begin

The list of requirements from the ETS is long and will require a significant amount of time, energy, and input from the entire workforce to achieve compliance. OSHA has provided a number of tools and resources to help employers with implementing the requirements. To further assist our clients, HCP has developed two NEW training modules, utilizing the resources from OSHA and guidance from the Centers for Disease Control (CDC).

New HCP Module: OSHA COVID-19 - Emergency Temporary Standard (ETS) for Healthcare (29 CFR 1910.502)

New HCP Module: OSHA COVID-19 - Emergency Temporary Standard (ETS) Mini Respiratory Protection Program (MINI RPP)

Additionally, we have created an Implementation Guide that provides step-by-step instructions for creating a customized COVID-19 Plan, conducting a workplace-specific hazard assessment, and customizing our new training modules to fit the specific needs of your organization. These courses and the implementation guide are available to our OSHA+ clients in the COVID-19 Toolkit. If you are unsure if you have access to the HCP COVID-19 Toolkit, you can contact your Support Team or call us at 855-427-0427.