Healthcare News of Note: Greater protections for healthcare workers are under consideration

• Lawmakers and government agencies are exploring greater protections for healthcare workers amid an outcry over pandemic-related safety concerns that have persisted for a year.
• This is the first time ECRI has cited differences in how health systems treat people of color as a top safety concern that poses the most risk for patients.
• Medically vulnerable people, who initially were cited as a top vaccination priority group, slowly found themselves lower on the list as the Centers for Disease Control and Prevention modified its guidelines to favor the elderly and other groups.

Over the last couple of weeks, I’ve found these industry news stories that should be of interest to healthcare finance professionals.

1. Stronger protections are on the way for healthcare workers, but no date set for implementation

A March 12 Healthcare Dive article reported, “Lawmakers and government agencies are exploring greater protections for healthcare workers amid outcry over pandemic-related safety concerns that have persisted for a year.

“During a House Education and Labor subcommittee hearing [March 11] on strategies for protecting workers from COVID-19 infections, a registered nurse with National Nurses United urged greater federal protections for healthcare workers, first by recognizing aerosol transmission of COVID-19 and having the Occupational Safety and Health Administration issue an emergency temporary standard.

“As of [March 12], the Centers for Disease Control and Prevention had counted more than 422,000 cases of COVID-19 among healthcare workers in the U.S and 1,397 deaths. That’s almost certainly an undercount, however, as that occupation information was only available in fraction of the data.”

Article author Hailey Mensik noted OSHA had not implemented emergency standards as of March 12 despite an executive order by President Joe Biden to “consider whether any emergency temporary standards on COVID-19, including with respect to masks in the workplace, are necessary, and if such standards are determined to be necessary, issue them by March 15.”

Whether and when ETS is released is unclear

According to a March 15 Bloomberg Law article, “The federal government’s workplace safety agency has drafted its first rule to protect workers against contracting Covid-19 on the job, but whether and when it would be released was unclear” as of March 15.

Ahead of “the March 15 deadline President Joe Biden set for an emergency temporary standard, U.S. Labor Department officials informed multiple business groups that its Occupational Safety and Health Administration had decided to issue a rule, which would set new infection prevention requirements for employers, said three sources familiar with the process.”

However, a March 16 report by Stinson LLP states, “The Department of Labor on March 12 issued the latest piece of the puzzle with a National Emphasis Program – Coronavirus Disease 2019 (COVID-19) and Updated Interim Enforcement Response Plan for Coronavirus Disease 2019 (COVID-19). OSHA did not discuss whether the National Emphasis Program and Updated Interim Enforcement Response Plan are part of a larger enforcement strategy with an Emergency Temporary Standard (ETS), or are freestanding or in lieu of an ETS.

“The National Emphasis Program (NEP) was launched to protect employees in high-risk industries or work tasks from COVID-19 hazards. The NEP targets workplaces that pose an increased potential exposure risk to their workers of contracting COVID-19 and sets out requirements for inspections. Some of the primary targets for the program are physicians, dentists, hospitals, care facilities, meat processing plants, supermarkets, discount department stores, warehouse and storage facilities, temporary help services, restaurants and correctional institutions. A complete list of industries is listed on Appendix A and B. Most inspections will be conducted in person. However, in limited circumstances, remote-only inspections may be allowed.”

Why ETS would create a rigid standard

According to Mensik’s article, the American Hospital Association (AHA) said in a letter to a House Education and Labor subcommittee that implementation of an emergency temporary standard “would create a rigid new standard that has ‘real potential to add for hospitals and health systems a new layer of conflicting and impractical regulatory burden at precisely the wrong time.’”

The AHA statement also said that with the standard in place, hospital staff would be forced to decide whether to not comply with the standards and treat all patients or stop treating patients once OSHA-required personal protective equipment ran out.

2. ECRI: Racial/ethnic disparities in health outcomes is top patient safety concern

A March 15 Modern Healthcare article reports, “Racial and ethnic disparities in health outcomes and crisis preparedness are the top concerns for patient safety that health leaders need to address, according to ECRI’s annual Top Ten Patient Safety Concerns for 2021.

“This is the first time ECRI has made differences in how health systems treat people of color a top safety concern that poses the most risk for patients. The not-for-profit patient safety organization recommends that health systems create health equity governance committees, and devote money and other resources to organizational efforts to address disparities.”

According to Marcus Schabacker, MD, PhD, the CEO of ECRI, there are two things hospitals and health systems must do initially to address disparities:

1. Recognize and accept that there’s an issue
2. Look at where the disparities are

Some of the other top patient safety concerns in ECRI’s list for 2021 include:

•  Pandemic preparedness across the health system
•   Supply chain interruptions
• Drug shortages

3. Medically vulnerable no longer considered a priority for a COVID-19 vaccine

Modern Healthcare was one of several news outlets to publish a March 13 Associated Press article that reported, “Across the United States, millions of medically vulnerable people who initially were cited as a top vaccination priority group got slowly bumped down the list as the Centers for Disease Control and Prevention modified its guidelines to favor the elderly, regardless of their physical condition, and workers in a wide range of job sectors.”

The article, by AP reporter Bryan Anderson, included stories about the measures that medically vulnerable people have taken to deal with the threat of contracting COVID-19 because they could not get the vaccine.

• A 50-year-old diagnosed with Stage IV breast cancer packed her bags and left her North Carolina home to live with her recently vaccinated parents after she was notified that her 17-year-old daughter was being sent home from school after exposure to the coronavirus.
• A 32-year-old man, who suffers from spinal muscular atrophy and who didn’t qualify for the vaccine since he doesn’t live in a long-term care facility, “jumped the line” to get vaccinated.

“North Carolina is one of 24 states that currently places people under 65 with ‘underlying medical conditions’ near the bottom of the pack to receive the vaccine, according to Jen Kates, senior vice president and director of global health and HIV policy at the Kaiser Family Foundation,” wrote Anderson. “A report she wrote for the foundation last month listed Pennsylvania as the lone state making vaccines available to the medically vulnerable during its first phase of distribution.”

The article also says that “states have begun revising their guidelines again” in response to frustrations of the medically vulnerable.