Mask Free - Not Quite Yet!
On Monday, June 21, 2021, the Occupational Safety and Health Administration (OSHA) published the COVID-19 Emergency Temporary Standard (ETS) for healthcare employers. The implementation deadline for partial compliance is July 5, 2021, and July 21, 2021, for complete compliance (including employee training).
Who Must Comply?
The ETS applies to workers who provide healthcare services (e.g., doctors, emergency medical personnel, and nurses) and those who provide healthcare support services (e.g., patient intake/admission, equipment and facility maintenance, medical equipment cleaning/reprocessing services).
Small employers are excluded. OSHA states, “The ETS provides that small employers with 10 or fewer employees on the date the ETS is published in the Federal Register are not required to comply with the recordkeeping provisions. This size exemption is based on the total number of employees in a firm, rather than the number of employees at a particular location or establishment.”
Before claiming exemption, a clinic should look at the number of employees on the payroll, not just onsite. According to OSHA, this includes “full-time, part-time, temporary, and seasonal employees. For businesses that are sole proprietorships or partnerships, the owners and partners would not be considered employees and would not be counted.”
Although there is a small employer exclusion, please take note, if the clinic classifies as a lower-hazard industry group under OSHA’s 29 CFR 1904.2 regulation, that does not exclude the clinic from ETS compliance. According to OSHA, “All covered employers, even those that are partially exempt under OSHA’s recordkeeping regulation, must comply with the recordkeeping requirements if they have more than 10 employees on the effective date of the ETS.”
Still Not Sure?
Numerous regulations have rolled out in the past year that can cause confusion as to what does and does not apply to each clinic. Unfortunately, clinics that meet the small employer exemption on specific COVID 19 regulations assume they are exempt on all including the ETS (based on type and size of business). OSHA has taken the guesswork out of this process by providing this flowchart; Is your workplace covered by the COVID-19 Healthcare ETS?
For those clinics that are not exempt, we recommend that they make it a priority to review all the terms of this requirement and start implementing policy, procedure, and staff training. The entire document is over 900 pages long and can be a bit overwhelming. For our KMC University members, we have summarized some of the key points and placed these resources in the Compliance Basics Library lesson.
It is Not All Bad News
For those clinics that must abide by ETS, some areas within the workplace can be mask free. According to OSHA, “The ETS exempts fully vaccinated employees from the requirements for PPE, physical distancing, and physical barriers in well-defined areas where there is no reasonable expectation that any person with suspected or confirmed COVID-19 will be present.” These areas can be identified through a hazard assessment, then documented in the COVID-19 plan. Effort must be made to maintain this area as non-hazardous.
Although the increased availability and use of COVID-19 vaccines is a remarkable achievement and has reduced risk to healthcare employees, it does not mean we can let our guard down. OSHA has provided an abundant number of resources for providers to assist with assessing their compliance needs on this topic. KMC University Library members can access additional information and resources in the library. There, you will find information on the impact ETS has on healthcare clinics, helpful tools for assessing compliance needs, and a quick summary of To-Dos. While this can be a confusing topic for many offices, keep in mind that KMC University is ready to help you. If you are a member, reach out to us on the Helpdesk; the information is on the right-hand side of your dashboard. If you aren’t a member, we are just a quick call away at (855) 832-6562. Additional information is available at the OSHA website.
Jill Foote currently contracts with KMC University as a Subject Matter Expert. She had over 13 years of chiropractic clinic experience in billing and practice management prior to working for the American Chiropractic Association. In her past position as Senior Manager of Coding and Practice Management she served as staff liaison to the ACA’s Coding Manual Workgroup, ICD-10 Taskforce and the Coding Committee where she was instrumental in coordinating the association’s coding initiatives and educational campaigns. As she worked with doctors on a national level, she saw a growing need for training in HIPAA compliance, especially as it relates to the IT world. She holds a certification as a HealthCare IT Specialist and is currently the owner/operator of Easy Tech Compliance.