For many months, the healthcare world has been significantly affected by the swift and pervasive effects of SARS-CoV-2. The virus has severely affected the delivery of patient care by all providers, including those in hospitals and emergency care settings, who grappled with the response to massive influxes of COVID-19 patients, and those in practices forced to discontinue nonessential services for a period of time due to public health order restrictions. This public health emergency has created lingering uncertainty in determining how to provide healthcare in this new normal while also ensuring workforce and patient safety.
Explore This IssueAugust 2020
As we head into natural disaster and influenza season, providers should focus on several key practices to create a safer, more stable environment while remaining vigilant for a COVID-19 resurgence.
Continue COVID-19 Screenings
The CDC presented data-based forecasts of COVID-19 case trends for the United States showing that resurgences of COVID-19 will likely vary by geographic region. Thus, COVID-19 screening will continue to be important, both for employment and patient treatment purposes.
Providers should consider the differences between workforce and patient screenings, including business requirements, medical necessity requirements, and how the tests are regulated at federal and state levels. What remains abundantly clear for test administration is the obligation to provide accurate and reliable options under current guidance from the U.S. Food and Drug Administration.
The Occupational Safety and Health Act (OSHA) General Duty Clause requires employers to furnish to each worker a place of employment free from recognized hazards likely to cause death or serious physical harm.
Keeping employees and staff healthy is critical for businesses to continue operating seamlessly and to avoid possible transmission of the virus to patients. Outside of renewed or new public health orders, providers must determine what type of screening and testing protocols to implement for their workforces.
The Americans with Disabilities Act (ADA) applies to public employers and private employers with 15 or more employees. Enforced by the U.S. Equal Employment Opportunity Commission (EEOC), the ADA continues to apply during a pandemic but does not interfere with or prevent employers from following additional state or local orders set by governors, public health directors, or surgeons general.
The ADA requires any mandatory medical test for employees to be “job related and consistent with business necessity.” Thus, employers are permitted to test employees entering the workplace for COVID-19 because an individual with the virus poses a direct threat to the health of others, especially in a healthcare setting where patient safety is critical. Therefore, an employer may choose to administer a COVID-19 test or require employees to provide certification showing they are virus free.
In addition to testing, employers should ask employees to answer questions about fever, respiratory, and other symptoms, as well as contact with anyone exposed to or diagnosed with COVID-19 within a recent time period before reporting to work.
Employers must maintain such information as a confidential and separate medical record to be in compliance with the ADA.
Guidance issued by the Equal Employment Opportunity Commission (EEOC) states that reasonable inquiries, temperature checks, and certain medical tests are authorized under the ADA as employer-permitted practices that reasonably relate to a pandemic that poses risks to others. The EEOC has further stated that the use of on-site temperature checks when employees report to work may be helpful in providing practical, real-time answers about whether workers have symptoms and whether they can safely remain for their shift.