How to Comply with OSHA's Emergency Temporary Standard for COVID-19

What are medical and dental offices required to do?

OSHA's Emergency Temporary Standard (ETS) requires employers to provide COVID-19 training to employees and ensure a safe and healthful work environment in accordance with the provisions identified in the ETS. Fortunately, most medical and dental facilities will only have to comply with the provisions listed below and not have to adopt the mini respiratory standard required by the ETS when employees are providing care for suspected or known COVID-19 patients. 

1. Healthcare and Dental Facilities. The ETS is limited to healthcare because data shows that there is a substantial risk to employee health while caring for individuals with suspected or confirmed cases of COVID-19. Non-healthcare settings don't fall under the ETS because there isn't sufficient data to support a serious risk to employees if they aren't providing healthcare services. 
2. Some Exceptions to the Rule. OSHA requires a setting-based approach compared to a task-based approach to determine to what extent the rule applies. The ETS applies to workplace settings in which any employee provides healthcare services or healthcare support services, with some exceptions. The following instances are excluded from the standard’s requirements.

• First aid provided by a non-licensed healthcare provider, pharmacies in retail settings, non-hospital ambulatory care settings where all patients are screened prior to entry and deferred if suspected or confirmed COVID-19, well-defined hospital ambulatory care settings where all employees are fully vaccinated and patients are screened for COVID-19 and deferred if appropriate, healthcare support services not performed in a healthcare setting and telehealth services provided outside of a direct patient care setting.

3. Requires Adoption of a COVID-19 Policy. Employers must develop and implement a workplace COVID-19 plan for each workplace. The plan must include a workplace-specific hazard assessment and implementation of policies and procedures to minimize the risk of transmission of COVID-19. Your COVID policy should document the safeguards you have in place, including the ETS requirements listed below.
4. Requires Screening and Monitoring Points of Entry. The ETS requires employers to limit and monitor points of entry where patient care occurs and to screen patients for COVID-19. Screening could include asking patients if they are experiencing symptoms of COVID-19, temperature checks or a combination of both.             
5. Provide Appropriate Personal Protective Equipment (PPE). Employers are required to provide appropriate PPE including facemasks and respirators. Employees should be allowed the voluntary use of respirators instead of facemasks.
6. Identify Aerosol-Generating Procedures (AGPs). Employers are required to limit personnel present during the procedure to essential personnel only.
7. Implement Engineering and Administrative Controls.  Adopt and identify appropriate physical distancing, use of barriers, work practice controls and cleaning and disinfection procedures.
8. Identify the Adoption of Ventilation Protocols. The ETS ensures that ventilation protocols are followed with respect to HVAC systems. Be sure to identify any air purification, UV or other safeguards you have implemented. 
9. Employee Health Screening. The ETS requires employers to pay for the cost of employer-required testing as well as time spent obtaining the test and waiting for test results. The ETS does not require employers to conduct screening testing. 
10. Remove Potentially Infectious Employees from the Workplace. Employers are required to remove employees from the workplace under certain circumstances and provides different exclusion requirements depending on the reason for removal. Employees who have been removed from the workplace, but who cannot work remotely, must continue to be paid wages and benefits during the time they are excluded from the workplace. Payments to employees are subject to wage caps and are adjusted based on the size of the employer.
11. Vaccination Issues. Employers are required to support COVID-19 vaccination efforts by providing employees with reasonable time off and paid leave for the full vaccination series and for recovery from any side effects experienced following vaccination. The ETS does not require employees to be vaccinated for COVID-19. The standard advises employers who wish to more strongly encourage or mandate vaccinations beyond the requirements of the standard to Equal Employment Opportunity Commission.
12. Employee COVID-19 Training. The training requirements are an large part of the ETS. Employers are required to provide training to each employee on all workplace-specific policies and procedures that mitigate the risk of COVID-19 transmission. Like always, document employee training and keep the records for a minimum of three years.
13. Recordkeeping and recording obligations. Employers with more than 10 employees are required to maintain a COVID-19 Log, regardless if it was contracted at work or elsewhere. Employers must report work-related fatalities within 8 hours of learning about the fatality and within 24 hours of each work-related COVID-19 in-patient hospitalization.
14. Requirement to Notify. Employers must inform employees about potential exposures to COVID-19 in the workplace as a result of “close contact with a COVID-19 positive person.” The notification requirement is not limited to contact with patients but contemplates contact with any third party such as another employee, visitor, vendor or contractor. Employers must notify each employee who was not wearing a respirator or other required PPE and who was in close contact with the infected person within 24 hours of receiving information about the presence of a COVID-19 positive person in the workplace. OSHA provides an Employer Notification Tool that has a sample letter.

What does it mean for me?

If you don't have a site-specific COVID-19 protection policy, it's important to get it done. Although OSHA gives flexibility in the safeguards you implement, it's important to have documentation including policies and training records. Once again, OSHA wants you to maintain all revisions of your policies.

States that run OSHA approved programs must implement standards that are  identical to or “at least as effective as” the new standard, or “show that the existing standard covering this area is at least as effective as the new Federal standard.” Adoption of the Federal standard by State Plans must occur within 30 days of the Federal standard’s publication date in the Federal Register.

Oshaguard has provided in-office OSHA consultation for healthcare and dental professionals since 1992. Most of our customers use our OSHA Compliance System for Healthcare or Dentistry. It's a system that's designed to get you into compliance with OSHA quickly and affordably yourself. We provide step by step guidelines and offer toll-free phone support, but most of all we provide common-sense OSHA and HIPAA policies that make getting into compliance a breeze.