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PTs and PTAs in most settings are likely to be exempted from the U.S. Occupational Safety and Health Administration's recently released standards on workplace safety related to COVID-19 — provided the setting is non-hospital ambulatory care, proper non-employee screening is in place, and anyone suspected of confirmed COVID-19 isn't allowed to enter.

"This rule is aimed at protecting workers facing the highest COVID-19 risks, such as those in facilities where suspected or confirmed COVID-19 patients are treated," said Kate Gilliard, APTA senior policy and regulatory affairs specialist. "It won't apply to the vast majority of physical therapy settings."

But that doesn't mean there are no standards to be met. To be exempted from the OSHA emergency temporary standards, settings have to be non-hospital ambulatory care, with all non-employees screened before they're allowed in, and those who are suspected of or confirmed with COVID-19 denied entry. Hospital outpatient clinics and home health agencies are exempt if they screen entrants, refuse entry when indicated, and have fully vaccinated staff. OSHA has created a decision flowchart to help providers understand how and when the new standards apply.

According to an FAQ page accompanying the OSHA announcement, the required screening of non-employees can take different forms, but OSHA expects that at the very least it should include asking questions about symptoms and illness.

For settings that don't qualify for exemptions, the new standards lay out OSHA's expectations for a fairly extensive range of provisions, from social distancing and personal protective equipment requirements to policies and procedures around employees with suspected or confirmed COVID-19.

According to Gilliard, the rule also attempts to address what must be done when exempted settings have employees who aren't vaccinated.

"If you're in an exempted setting and your employees don't get the vaccine because of religious or disability-related medical reasons, you can still meet the exemption, but only if you provide accommodation to the unvaccinated employees," Gilliard said.

Also important to keep in mind: The OSHA rule doesn't preempt state laws if they're more strict than the OSHA standards.

"Basically," Gilliard said, “whenever state law and federal law overlap, obey the stricter law."


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