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Federal Register / Vol. 86, No. 116 / Monday, June 21, 2021 / Rules and Regulations
8778895627. Due to copyright issues, OSHA cannot post consensus standards on the OSHA website or through www.regulations.gov.
List of Subjects in 29 CFR Part 1910
COVID19, Disease, Health facilities, Health, Healthcare, Incorporation by reference, Occupational health and safety, Public health, Quarantine, Reporting and recordkeeping requirements, Respirators, SARSCoV
2, Telework, Vaccines, Viruses.
Authority and Signature James S. Frederick, Acting Assistant Secretary of Labor for Occupational Safety and Health, U.S. Department of Labor, 200 Constitution Avenue NW, Washington, DC 20210, authorized the preparation of this document pursuant to the following authorities: Sections 4, 6, and 8 of the Occupational Safety and Health Act of 1970 29 U.S.C. 653, 655, 657; Secretary of Labors Order 82020
85 FR 58393 Sept. 18, 2020; 29 CFR
part 1911; and 5 U.S.C. 553.
James S. Frederick, Acting Assistant Secretary of Labor for Occupational Safety and Health.

For the reasons set forth in the preamble, chapter XVII of title 29 of the Code of Federal Regulations is amended as follows:
PART 1910OCCUPATIONAL SAFETY
AND HEALTH STANDARDS

1. Add subpart U to read as follows:

Subpart UCOVID19 Emergency Temporary Standard Sec.
1910.502 Healthcare.
1910.504 Mini Respiratory Protection Program.
1910.505 Severability.
1910.509 Incorporation by Reference.
Authority: 29 U.S.C. 653, 655, and 657;
Secretary of Labors Order No. 82020 85 FR
58393; 29 CFR part 1911; and 5 U.S.C. 553.

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1910.502

Healthcare.

a Scope and application. 1 Except as otherwise provided in this paragraph, this section applies to all settings where any employee provides healthcare services or healthcare support services.
2 This section does not apply to the following:
i The provision of first aid by an employee who is not a licensed healthcare provider;
ii The dispensing of prescriptions by pharmacists in retail settings;
iii Non-hospital ambulatory care settings where all non-employees are screened prior to entry and people with
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suspected or confirmed COVID19 are not permitted to enter those settings;
iv Well-defined hospital ambulatory care settings where all employees are fully vaccinated and all non-employees are screened prior to entry and people with suspected or confirmed COVID19
are not permitted to enter those settings;
v Home healthcare settings where all employees are fully vaccinated and all non-employees are screened prior to entry and people with suspected or confirmed COVID19 are not present;
vi Healthcare support services not performed in a healthcare setting e.g., off-site laundry, off-site medical billing;
or vii Telehealth services performed outside of a setting where direct patient care occurs.
Note to paragraph a2. OSHA does not intend to preclude the employers of employees who are unable to be vaccinated from the scope exemption in paragraphs a2iv and v of this section. Under various anti-discrimination laws, workers who cannot be vaccinated because of medical conditions, such as allergies to vaccine ingredients, or certain religious beliefs may ask for a reasonable accommodation from their employer. Accordingly, where an employer reasonably accommodates an employee who is unable to be vaccinated in a manner that does not expose the employee to COVID19 hazards e.g., telework, working in isolation, that employer may be within the scope exemption in paragraphs a2iv and v of this section.

3i Where a healthcare setting is embedded within a non-healthcare setting e.g., medical clinic in a manufacturing facility, walk-in clinic in a retail setting, this section applies only to the embedded healthcare setting and not to the remainder of the physical location.
ii Where emergency responders or other licensed healthcare providers enter a non-healthcare setting to provide healthcare services, this section applies only to the provision of the healthcare services by that employee.
4 In well-defined areas where there is no reasonable expectation that any person with suspected or confirmed COVID19 will be present, paragraphs f, h, and i of this section do not apply to employees who are fully vaccinated.
Note 1 to paragraph a. Nothing in this section is intended to limit state or local government mandates or guidance e.g., executive order, health department order that go beyond the requirements of and are not inconsistent with this section.
Note 2 to paragraph a: Employers are encouraged to follow public health guidance from the Centers for Disease Control and Prevention CDC even when not required by this section.

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b Definitions. The following definitions apply to this section:
Aerosol-generating procedure means a medical procedure that generates aerosols that can be infectious and are of respirable size. For the purposes of this section, only the following medical procedures are considered aerosolgenerating procedures: Open suctioning of airways; sputum induction;
cardiopulmonary resuscitation;
endotracheal intubation and extubation;
non-invasive ventilation e.g., BiPAP, CPAP; bronchoscopy; manual ventilation; medical/surgical/
postmortem procedures using oscillating bone saws; and dental procedures involving: Ultrasonic scalers; high-speed dental handpieces;
air/water syringes; air polishing; and air abrasion.
Airborne infection isolation room AIIR means a dedicated negative pressure patient-care room, with special air handling capability, which is used to isolate persons with a suspected or confirmed airborne-transmissible infectious disease. AIIRs include both permanent rooms and temporary structures e.g., a booth, tent or other enclosure designed to operate under negative pressure.
Ambulatory care means healthcare services performed on an outpatient basis, without admission to a hospital or other facility. It is provided in settings such as: Offices of physicians and other health care professionals; hospital outpatient departments; ambulatory surgical centers; specialty clinics or centers e.g., dialysis, infusion, medical imaging; and urgent care clinics.
Ambulatory care does not include home healthcare settings for the purposes of this section.
Assistant Secretary means the Assistant Secretary of Labor for Occupational Safety and Health, U.S.
Department of Labor, or designee.
Clean/cleaning means the removal of dirt and impurities, including germs, from surfaces using soap and water or other cleaning agents. Cleaning alone reduces germs on surfaces by removing contaminants and may also weaken or damage some of the virus particles, which decreases risk of infection from surfaces.
Close contact means being within 6
feet of any other person for a cumulative total of 15 minutes or more over a 24hour period during that persons potential period of transmission. The potential transmission period runs from 2 days before the person felt sick or, for asymptomatic people, 2 days prior to test specimen collection until the time the person is isolated.

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