The US Department of Labor Occupational Safety and Health Administration (OSHA) has posted on its website a public inspection copy (Subpart U) for an Emergency Temporary Standard (ETS) addressing COVID-19 safety standards in health care settings. The ETS follows President Biden’s Executive Order on Protecting Worker Health and Safety and calls on OSHA to determine whether an ETS that includes infection control standards is necessary—and if so, to put one forward.
While the ETS, issued as an interim final rule, has not yet been published in the Federal Register, it will be effective immediately upon publication, with compliance required for most provisions within 14 days of publication and the remaining provisions within 30 days. Public comments are due 30 days after publication. OSHA states it will continue to update the ETS as appropriate. Additional factsheets and summaries can be found on the OSHA website.
Overview of Key Components of the ETS
Covered Entities
The ETS applies to all settings where an employee provides healthcare services or healthcare support services: specifically, hospitals, nursing homes, assisted living facilities, emergency responders, home health care worker settings, and ambulatory care facilities where suspected or confirmed COVID-19 patients are treated. It also includes limited exceptions, including healthcare support services not performed in a healthcare setting (e.g., off-site laundry, off-site medical billing)”; “well-defined hospital ambulatory care settings 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 permitted to enter those settings” and “home healthcare settings 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.”
Health Care Employer Requirements
The ETS outlines key requirements for health care settings, including a requirement to develop and implement a COVID-19 plan that includes a designated safety coordinator, a workplace-specific hazard assessment, and policies and procedures to minimize the risk of transmission.
There are also a detailed set of infection control and related requirements, including on the following topics:
- Patient screening and management
- Standard and transmission-based precautions
- Personal protective equipment
- Aerosol-generating procedures on a person with suspected or confirmed COVID-19
- Physical distancing
- Physical barriers
- Cleaning and disinfection
- Ventilation
- Health screening and medical management
- Vaccination
- Training
- Anti-retaliation
Mini Respiratory Protection Program
The ETS requires the mini respiratory protection program to offer enhanced worker protection. The program would apply to circumstances in which workers are not specifically exposed to suspected or confirmed sources of COVID-19, but where respirator use could increase protections.
Recordkeeping and Reporting
Employers with 10 or more employees are required to, among other things, maintain a COVID-19 log to record each instance identified by the employer in which an employee is COVID-19 positive regardless of whether the instance is connected to exposure at work. This information must contain specific details and be recorded within 24 hours of the employer learning of the employee’s status. This requirement is in addition to an employer’s current obligations to record all work-related confirmed cases of COVID-19 pursuant to 29 CFR Part 1904.
Reporting COVID-19 Fatalities and In-Patient Hospitalizations
Employers must report to OSHA each work-related COVID-19 fatality within eight hours of the employer learning of the fatality and each work-related COVID-19 in-patient hospitalization within 24 hours of learning of the hospitalization.
GNYHA will work to advocate for more reasonable requirements under the ETS and will submit comments. To help formulate our comments, we request member input on the operational realities for compliance with these rules. Please share this bulletin with staff in your organization who could provide this input.