By Lee Slaton, Vice President of Healthcare; Smart TrainingThe Texas State Board of Dental Examiners (TSBDE) COVID-19 Emergency Rule expired this past Friday, June 18, and the TSBDE Board announced during its meeting on the same day that the rule would not be extended further. Among other things, this rule required patient and dental staff screening for COVID-19 symptoms and that any staff wear an N95 respirator, or its substantial equivalent, within six feet of any and all aerosol generating procedures.
After we’ve all had a chance to exhale, let’s take a look at the requirements still in place to help ensure dental staff and patients stay safe. Remember, TSBDE is just one of basically four alphabet-soup regulatory or advisory bodies dental practices have to contend with—the other three being OSHA, CDC, and NIOSH. The CDC and NIOSH are essentially advisory in nature. HOWEVER, if OSHA doesn’t have a specific regulatory standard, it frequently refers to CDC and NIOSH recommendations and cites them when issuing violations.
To those of us who keep up with OSHA regulations as part of our job, it came as no surprise that OSHA just released a new Emergency Temporary Standard (ETS) for COVID-19 on June 10. The final rule has not been published in the Federal Register yet, which gives us a little time to prepare. Practically speaking, most of you should already be in compliance with “most” of the standard, as it applies to dental practices.
The ADA and others have advised that dental practices are “mostly exempt” from this new standard. That is correct if you adhere to the “big IF”:
*IF* all non-employees are screened prior to entry and people with suspected or confirmed COVID-19 are not permitted to enter those settings.
I.e., to fall under this exemption, you need to continue pre-appointment screenings of patients.
If it sounds like I’m trying to make a big deal out of this caveat, you would be correct. Wanna know why? At Smart Training, we’ve observed an increasing number of practices taking their feet off the gas of late with regard to COVID-19 protocols. In many Texas communities, the COVID-19 vaccination rate is low. That’s not implying any kind of political statement; it’s just a fact. Several recent investigations show an alarming, but unfortunately not surprising, trend of COVID-19 cases and hospitalizations surging in communities with low vaccination rates. Putting those two items together illustrates why it’s so important you stay on your toes and screen everyone prior to entry into your practice and keep out the ones who are suspect. There are a world of things in OSHA’s new ETS that you have to contend with if you don’t comply with the requirements of the exemption. Suffice it to say, stick to the pre-screening protocol with the persistence of a dog with a bone; you’ll save yourself a lot of trouble and headaches.
The Emergency Temporary Standard calls for implementing a COVID-19 plan that includes “a workplace-specific hazard assessment to identify potential workplace hazards related to COVID-19.” Even if your office is exempt under the ETS, OSHA’s Recommended Practices for Safety and Health Programs indicates employers should have a plan with a hazard assessment put in place to mitigate risk to employees. An OSHA inspection for any reason will likely begin with a request for your office’s plan. The ADA has several good tools to assist you in conducting this hazard assessment and COVID-19 plan.
Once the final rule is published, we’ll know for sure what we’re dealing with. Based on past experience, I don’t see the final rule being that different from the ETS. Most of you should already have the basic building blocks of compliance to this rule in place. The bottom line is: Don’t take your foot off of the gas. History provides numerous examples where soldiers died needlessly within days of wars’ ends because they relaxed and let down their guard. Don’t let that be you or your practice!