August 18, 2021

Subpart U: OSHA’s COVID-19 Healthcare ETS

As of June 21, 2021, the U.S. Occupational Safety and Health Administration’s (OSHA) COVID-19 Healthcare Emergency Temporary Standard (ETS) is in effect to address exposure to SARS-CoV-2, the virus that causes COVID-19, in certain healthcare settings. The ETS is available at 29 CFR 1910, Subpart U.

Who Is Impacted by the Emergency Temporary Standard (ETS)?

The ETS applies to settings where any employee provides healthcare or healthcare support services. According to OSHA guidance,[1] this includes:

  • Employees in hospitals, nursing homes, and assisted living facilities
  • Emergency responders
  • Home healthcare workers
  • Employees in ambulatory care facilities where suspected or confirmed COVID-19 patients are treated

What are the Primary Requirements of the ETS Under OSHA Subpart U?

  • COVID-19 Plan
  • Patient screening and management
  • Transmission-based precautions
  • Personal protective equipment (PPE)
  • Aerosol-generating procedures on persons with suspected or confirmed COVID-19
  • Physical distancing
  • Physical barriers
  • Cleaning and disinfection
  • Ventilation
  • Health screening and medical management
  • Vaccination
  • Training
  • Anti-retaliation
  • Recordkeeping
  • Reporting COVID-19 fatalities and hospitalizations to OSHA
  • Mini respiratory protection program

Establishing compliance may not be particularly burdensome, as many healthcare organizations will already have processes in place, including those consistent with guidance from the Centers for Disease Control and Prevention (CDC), to mitigate potential SARS-CoV-2 exposure in the workplace.

5 Tips to Get You Started With OSHA Subpart U

Affected healthcare organizations were expected to comply with most parts of the standard by July 6, 2021, and with provisions regarding physical barriers, ventilation, and training by July 21, 2021. Healthcare employers should also be aware of OSHA’s Revised National Emphasis Program – Coronavirus Disease 2019 (COVID-19),[2] which went into effect on July 7, 2021, and establishes the agency’s aims to identify and reduce or eliminate exposures to SARS-CoV-2  through inspection targeting, outreach, and compliance assistance.

Here are five tips to help your organization comply with the ETS and prepare for potential inspection:

  1. Review the standard and guidance. Take a few moments to familiarize yourself with the information that OSHA has made available on its COVID-19 Healthcare ETS website.
  2. Start with a checklist. Download this COVID-19 Healthcare Worksite Checklist and Employee Job Hazard Analysis from OSHA, which will help you determine if the Healthcare ETS standard applies to your organization and, if so, to develop and implement appropriate worker safety protections.
  3. Develop a plan. One of the most important steps in the compliance process is having a written plan that you can produce in case of inspection. OSHA has created a document that can help. Download this COVID-19 Plan Template to get started. You’ll need to make sure your plan addresses all of the requirements of the ETS, including screening, PPE, distancing processes, physical barriers, cleaning, how you’ll document and report COVID-19-related hospitalizations and deaths, and more.
  4. Review the Mini Respiratory Protection Program requirements. Part of the COVID-19 Healthcare ETS, the mini respiratory protection program generally applies when workers are not exposed to suspected or confirmed sources of COVID-19, but where respirator use could offer enhanced worker protection. The mini respiratory protection program focuses on the safe use of respirators “that can be implemented more quickly and easily than the more comprehensive respiratory protection program required by the Respiratory Protection standard,” according to OSHA. This helpful fact sheet provides an overview.
  5. Find answers to your questions. Access this helpful FAQ for answers to additional questions you may have and to learn more about the steps you need to consider to help ensure your facility is prepared to meet the ETS requirements.

Note: Some states that have their own OSHA state plans have already published COVID-19 requirements. Employers in state plan jurisdictions (such as California, Oregon, and Virginia) need to ensure compliance with the requirements of those state OSHAs.

It may also be helpful to know that OSHA routinely updates (most recently on June 10, 2021) its Guidance on Mitigating and Preventing the Spread of COVID-19 in the Workplace[3] for employers not covered by the ETS.

The ETS is set to be in effect until “OSHA finds a grave danger from the virus no longer exists for the  covered workforce (or some portion thereof), or new information  indicates a change in measures necessary to address the grave danger.”[4] Additional OSHA information on COVID-19 can be found here.

These tips should help you get started and, as always, your workplace should review all applicable OSHA standards carefully to ensure you’re taking the right steps to protect your staff and provide a safe working environment.

If you need support to address compliance, Stericycle is here to help. Our experts can offer support to help you address the OSHA Healthcare ETS requirements at your facility. Learn more about our OSHA compliance solution.

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