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OSHA ETS public comment period open thru July 21st, 2021

As you are aware, effective June 21st the Occupational Safety and Health Administration (OSHA) released Emergency Temporary Standards (ETS) to address exposure to COVID-19 to workers in healthcare settings.  This healthcare ETS applies to skilled nursing facilities, assisted living communities and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID).  Compliance is required within 14 days (July 6) for most items and 30 days (July 21) for a few requirements.  Please visit the AHCA/NCAL website for a link to a pre-recorded webinar for further details along with links to OSHA resources. MHCA in partnership with AHCA/NCAL is asking our members to submit comments before the July 21st deadline.  Comments may be submitted online here.  MHCA is working on comments to submit as well and ask members who wish to provide feedback as we develop comment on behalf of Maine members please email Danielle Watford at dwatford@mehca.org.

Key Items to Consider
  • OSHA ETS Addresses COVID-19 exposure to workers in healthcare settings
  • Applies to SNF, AL, and ICFs/IID
  • Effective date: June 21
  • Compliance date: July 6
    • Exception: physical barriers, ventilation and training by July 21
    • More information available on the OSHA ETS website
Example Comment Themes:
(Our comments and recommendations are made to ensure the intent and purpose of the standards are met.)

Comment: Many places throughout the standards refer to good faith efforts (e.g. physical barriers), encouraging providers to meet increased standards (e.g. encouraging elastomeric respirators or PAPRs during aerosol-generating procedures), implementing standards as feasible or if available (e.g. physical barriers or airborne isolation rooms). We appreciate and support OSHA's intent to enhance workplace safety for employees. However, some elements of these standards simply are not feasible to meet in long-term care. For example, we do not have airborne isolation rooms, nor is it feasible to add them. There are places in our facility where physical barriers are not feasible.

Recommendation:  We strongly encourage OSHA to maintain consistency with using enforcement discretion when OSHA evaluates compliance with these standards by recognizing situations where these options are not feasible and overall recognize providers for their good faith efforts to meeting the standards. 
 
Comment: Many places throughout the standards refer to good faith efforts (e.g. physical barriers), encouraging providers to meet increased standards (e.g. encouraging elastomeric respirators or PAPRs during aerosol-generating procedures), implementing standards as feasible or if available (e.g. physical barriers or airborne isolation rooms). We appreciate and support OSHA's intent to enhance workplace safety for employees. However, some elements of these standards simply are not feasible to meet in long-term care. For example, we do not have airborne isolation rooms, nor is it feasible to add them. There are places in our facility where physical barriers are not feasible.

Recommendation:  We strongly encourage OSHA to maintain consistency with using enforcement discretion when OSHA evaluates compliance with these standards by recognizing situations where these options are not feasible and overall recognize providers for their good faith efforts to meeting the standards. 
 
Comment: Many places throughout the standards refer to good faith efforts (e.g. physical barriers), encouraging providers to meet increased standards (e.g. encouraging elastomeric respirators or PAPRs during aerosol-generating procedures), implementing standards as feasible or if available (e.g. physical barriers or airborne isolation rooms). We appreciate and support OSHA's intent to enhance workplace safety for employees. However, some elements of these standards simply are not feasible to meet in long-term care. For example, we do not have airborne isolation rooms, nor is it feasible to add them. There are places in our facility where physical barriers are not feasible.
 
Recommendation:  We strongly encourage OSHA to maintain consistency with using enforcement discretion when OSHA evaluates compliance with these standards by recognizing situations where these options are not feasible and overall recognize providers for their good faith efforts to meeting the standards. 
 
Comment: Long Term Care has been hit extremely hard by this pandemic and continue to confront substantial staffing challenges. Some of the new standards require a level of resources that many facilities do not currently have available and will take extended time to fully implement. For example, designating a COVID-19 workplace safety coordinator is extremely difficult for small or independent facilities with limited resources staffing wise as well as financial due to census impacts from COVID-19. The timeline for full implementation is unrealistic in light of other requirements recently implemented for long term care facilities, such as CMS' recent rule on vaccine reporting for nursing homes, as well as day to day ongoing COVID-19 management. 
 
Recommendation: OSHA should recognize provider good faith efforts toward meeting these standards, allowing flexibility for full implementation beyond the designated deadlines as long as the facility is working towards full implementation. Also, we ask OSHA to provide more resources to long term care facilities in all states through their OSHA consultation. Finally, we would ask OSHA provide an email or phone support for providers who have questions on implementing these standards appropriately. 

COMMENTS MUST BE SUBMITTED BY JULY 21, 2021

COMMENTS CAN BE SUBMITTED AT HTTPS://WWW.REGULATIONS.GOV/DOCUMENT/OSHA-2020-0004-1033

Staff Contact: dwatford@mehca.org
 

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