On June 11, 2021, the Occupational Safety and Health Administration (OSHA) sent an email alerting the public about emergency temporary standards (ETS) for those working in “healthcare” to protect them from COVID-19 exposure now that vaccinations are available. These standards stem from one of President Biden’s first Executive Orders issued on January 21, 2021.
As with most health-related guidance, it is not obvious whether these standards apply to wellness providers, or “Complementary and Alternative Medicine (“CAM”) Providers.” Wellness providers might include health coaches, naturopathic doctors, ayurvedic medical providers, functional medicine providers, lifestyle medicine providers, acupuncturists, chiropractors, nutritional counselors, fitness professionals, yoga and meditation providers, to name just a few.
Before we address whether ETS applies to CAM and other wellness providers, it is important to understand what the ETS entail. Here is a summary of the requirements that those who deliver services in “healthcare settings” must meet:
That’s a lot of requirements, especially for smaller wellness practices with just a few employees.
The remainder of this blog post will address frequently asked questions about the applicability of these standards to various wellness practices.
Do the ETS Apply to Wellness Providers who Exclusively Provide Services via Telehealth?
No. According to the rules, telehealth services performed outside of a setting where direct patient care occurs are exempt from complying with the ETS. See ETS Rules at 419. That means if you provide health services out of your home via telehealth, you should be exempt from the ETS.
What about Wellness Providers who see Clients In-Person?
It depends on whether those providers are “professional healthcare practitioners” who deliver “healthcare services.” A common pain point I see when it comes to government guidance in health care is that usually fails to acknowledge that there are many providers of wellness services that fall outside traditional “health care.” As a result, we are often left wondering whether the government guidance is meant to include or exclude these wellness services. Examples of some “grey areas” are naturopathic services, ayurvedic medical services, meditation services, health and wellness coaching and nutritional counseling services. Nevertheless, OSHA did list the following types of health and wellness providers as being subject to the rule:
For purposes of the ETS, OSHA defines “healthcare services” as services “that are provided to individuals by professional healthcare practitioners for the purpose of promoting, maintaining, monitoring, or restoring health.” See https://www.osha.gov/sites/default/files/publications/OSHA4125.pdf.
Certainly most CAM and wellness providers help promote, maintain, and even restore health. Thus, CAM and wellness providers who are “professional healthcare practitioners” and view their job as promoting, maintaining or restoring health should assume they are subject to the ETS.
If I Qualify as a Professional Healthcare Practitioner who Provides Healthcare Services, Can I Still be Exempt from Complying with ETS?
Yes, if you meet the following three conditions:
If you do all those things, then you can avoid complying with the ETS provisions above.
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