Health providers must start paying employees for time to get vaccinated and recover from any side effects under an emergency temporary standard order from the Biden administration. They'll also have to put in physical barriers where social distancing isn't possible.
The Occupational Safety and Health Administration's standards put new enforcement teeth on prior recommendations, and may add administrative burden and costs to health systems.
OSHA's guidelines are tailored to just healthcare providers, including hospitals, nursing homes, home health workers and ambulatory care facilities and will impact an estimated 10.3 million workers.
The agency received the most workplace-related COVID-19 complaints from healthcare workers, according to James Frederick, OSHA's acting assistant secretary of labor.
"These are the workers who go into work day in and day out to take care of us and we must make sure that we do everything in our power to return the favor to protect them while they care for us," Frederick said.
Providers must now provide paid time off for staff to be vaccinated and ride out side effects. Vaccination rates among healthcare workers vary widely. As of early March, about 48% of frontline healthcare workers hadn't received a vaccine dose. More than half of workers nationwide working in hospitals and outpatient clinics had received a dose, compared to a quarter of home healthcare workers, according to a Kaiser Family Foundation poll published in April.
Healthcare employers can apply for a refundable tax credit under the American Rescue plan to be reimbursed for the vaccination costs going forward.
OSHA also mandated health providers install physical barriers where social distancing isn't possible indoors within 30 days. Healthcare employees who are fully vaccinated are exempt from mask and social distance requirements, nor must they use barriers if there aren't suspected or confirmed COVID-19 patients.
"Because of these exceptions [with vaccinated workers], it does appear to be that you could create various areas where the emergency temporary standards just may not apply if you're checking the right boxes," said Kaiser Chowdhry, an associate at Morgan Lewis who advises clients on employment law issues.
Providers will have to maintain logs for employees with COVID-19 who contracted the virus even outside of work. They will also have to report COVID-19 related worker hospitalizations to OSHA within 24 hours. These changes are a shift from what's been recommended, and will likely extra attention to compliance assurance.
"There's administrative burdens with this, and then there's also the possibility for some confusion because there's going to be some lag time for entire work sites and management to get caught up to speed on how to implement all of this stuff," Chowdhry said.
OSHA's guidance also codified existing recommendations, such as screening incoming patients and visitors for COVID-19 and enforcing six-feet social distancing practices.
"Most healthcare employers, at least the larger ones that are more sophisticated that have the resources, they likely have written COVID-19 plans in place that address most of these requirements," Chowdhry said.
The standards, according to OSHA, will change when there's new Centers for Disease Control and Prevention guidance and as vaccination rates increase.
"While we are heartened by the pace of vaccinations and the current trajectory of the virus, not all workers are protected yet," Frederick said. "It is important that as vaccination efforts continue, every worker has the protections they deserve."