US DOL | Building Mental Health-Friendly Workplaces
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Infection Prevention and Control for the EMS/911 Workforce: Public Comment Requested
Draft Report on Infection Prevention and Control for the EMS/911 Workforce Released: Public Comment Requested
From EMS.gov on April 12, 2022
| The draft report for the technical brief on Infection Prevention and Control for the Emergency Medical Services (EMS)/911 workforce has been released by the Evidence-based Practice Center (EPC) Program at the Agency for Healthcare Research and Quality (AHRQ). The draft report is available for review and feedback through April 22, 2022 on Effective Healthcare’s website.
The technical brief summarizes the latest evidence on infectious pathogen exposure among the EMS/911 workforce and offers recommendations for the prevention, recognition, and control of infectious diseases and other related exposures that may be acquired in occupational settings. The AHRQ is requesting feedback from the community to improve the final technical brief. The agency values feedback and will consider all comments received.
AHRQ is a government agency that produces evidence-based guidance to improve the quality of healthcare delivery. It coordinates these efforts with partners in the field to ensure the evidence is understood and put into practice. For more information on the EPC Program, visit here. This project is supported by NHTSA’s Office of EMS, which strives to reduce death and disability by providing leadership and coordination to the EMS community in assessing, planning, developing, and promoting comprehensive, evidence-based emergency medical services and 911 systems. |
DOL Electronic Injury & Illness Reporting
Proposed Changes to the OSHA Electronic Injury & Illness Reporting Requirements
The U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA) is proposing amendments to its occupational injury and illness recordkeeping regulation, 29 CFR 1904.41. The current regulation requires certain employers to electronically submit their summary injury and illness data (Form 300A) to OSHA annually. OSHA uses these reports to identify and respond to emerging hazards and makes aspects of the information publicly available.
In addition to reporting their Annual Summary of Work-Related Injuries and Illnesses, the proposed rule would require certain establishments in certain high-hazard industries to electronically submit additional information from their Log of Work-Related Injuries and Illnesses, as well as their Injury and Illness Incident Report (Form 300, 300A, & 301). The latest proposed rule will require certain employers to submit more detailed information and is a return to the original electronic data submission rule that was proposed in 2016 and rolled back in 2017, prior to the rule taking effect. EMS organizations will be included in those industries that are considered high-hazard and thus, required to submit this information.
As we reported last month, OSHA reported that there was a 249% increase in illnesses and injuries reported by healthcare employers in 2020. This is no surprise given that this was at the heart of the pandemic. OSHA believes this rule will improve the agency’s ability to use the information in its enforcement and compliance assistance efforts to identify workplaces where workers are at high risk.
The proposed rule would:
- Require establishments with one hundred (100) or more employees in certain high-hazard industries to electronically submit information from their OSHA Forms 300, 301, and 300A to OSHA once a year. Currently, only the Form 300A summary data is submitted electronically.
- Update the classification system used to determine the list of industries covered by the electronic submission requirement.
- Remove the current requirement for establishments with 250 or more employees not in a designated industry to electronically submit information from their Form 300A to OSHA annually.
- Require establishments to include their company name when making electronic submissions to OSHA.
Under the proposed rule, establishments with 20-99 employees in certain high-hazard industries would continue to be required to electronically submit information from their OSHA Form 300A annual summary to OSHA annually.
Those interested can submit comments must do so by May 30, 2022. If you have questions about your organization’s reporting requirements under the OSHA Regulations, be sure to contact the AAA at hello@ambulance.org for assistance.
DOL COVID-19 Exposure Rule-Making
The United States Department of Labor (US DOL) has published a notice of intent to partially reopen the rule-making process to permit additional comment and a public hearing on certain aspects of the OSHA Emergency Temporary Standard for Healthcare employers which was originally published in June 2021. OSHA is seeking further input from stakeholders as they develop a final standard. The public hearing will begin on April 27, 2022.
The agency is reopening the rulemaking record to allow for new data and comments on topics, including the following:
- Alignment with the Centers for Disease Control and Prevention’s recommendations for healthcare infection control procedures.
- Additional flexibility for employers to permit less prescriptive requirements
- Removal of scope exemptions.
- Tailoring controls to address interactions with people with suspected or confirmed COVID-19.
- Employer support for employees who wish to be vaccinated.
- Limited coverage of construction activities in healthcare settings.
- COVID-19 recordkeeping and reporting provisions.
- Triggering requirements based on community transmission levels.
- The potential evolution of SARS-CoV-2 into a second novel strain.
- The health effects and risk of COVID-19 since the ETS was issued.
OSHA made it clear that it is not proposing mandatory COVID-19 vaccination for healthcare workers. However, they are seeking comments regarding how it could help employers further support healthcare worker employees in their vaccination and boosting efforts. This could include paid leave, including travel time, for those seeking vaccinations or boosters.
The notice in the Federal Register had a slightly more relaxed tone as many areas in the country have seen a significant drop-off in cases. If you are interested in submitting comments, you can do so electronically at www.regulations.gov. If you wish to attend the video-based public hearing, you must file a notice of intention to appear with the US DOL within 14 days of the notice being officially published in the Federal Register.
If you have any questions about your current obligations under the OSHA rules, please email the AAA at hello@ambulance.org.
EMS Gives Life | EMT Reid Needs a Living Kidney Donor
URGENT: Fellow first responder Reid Cappel is in kidney failure and needs a kidney transplant. A living donor is his best chance at survival.
For years, Reid Cappel has selflessly served his New Jersey community as an emergency medical technician. Now, it is his turn to ask for a lifeline from his fellow public health and public safety professionals. Help Reid find a living kidney donor, so that he can get back to doing what he does best: caring for others.
Anyone who is healthy and eligible to be a kidney donor can give Reid the gift of life. A donor does not have to be a direct match, can live anywhere in the US, and will have access to donor protections and resources. EMS Gives Life, a nonprofit organization for first responders, by first responders, will provide guidance to our EMS, fire, and police brethren who are considering living donation.
All inquiries will be held in complete confidence. There is no commitment required to learn more. Meet Reid and learn more about living kidney donation at www.emsgiveslife.org/Reid.
Reminder for EMS Employers to Electronically Report 2021 Injury & Illness Data
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EMS Gives Life | EMT Reid Needs a Living Kidney Donor
URGENT: Fellow first responder Reid Cappel is in kidney failure and needs a kidney transplant. A living donor is his best chance at survival.
For years, Reid Cappel has selflessly served his New Jersey community as an emergency medical technician. Now, it is his turn to ask for a lifeline from his fellow public health and public safety professionals. Help Reid find a living kidney donor, so that he can get back to doing what he does best: caring for others.
Anyone who is healthy and eligible to be a kidney donor can give Reid the gift of life. A donor does not have to be a direct match, can live anywhere in the US, and will have access to donor protections and resources. EMS Gives Life, a nonprofit organization for first responders, by first responders, will provide guidance to our EMS, fire, and police brethren who are considering living donation.
All inquiries will be held in complete confidence. There is no commitment required to learn more. Meet Reid and learn more about living kidney donation at www.emsgiveslife.org/Reid.
Statement for House Ways & Means Hearing on America’s Mental Health Crisis
Committee on Ways and Means
U.S. House of Representatives Hearing on “America’s Mental Health Crisis”
Statement of Shawn Baird, President, American Ambulance Association
February 2, 2022
Chairman Neal, Ranking Member Brady, and members of the Committee, on behalf of the members of the American Ambulance Association (AAA), I greatly appreciate the opportunity to provide you with a written statement on America’s Mental Health Crisis. Simply put, America’s hometown heroes who provide emergency medical services and transitional care need the Congress to recognize the significant stress and trauma paramedics and emergency medical technicians (EMTs) have experienced as a result of this pandemic. The AAA urges members of Congress not to forget these heroes and to expressly include all ground ambulance service personnel in efforts to address America’s Mental Health Crisis.
Emergency medical services (EMS) professionals are ready at a moment’s notice to provide life-saving and life-sustaining treatment and medical transportation for conditions ranging from heart attack, stroke, and trauma to childbirth and overdose. These first responders proudly serve their communities with on-demand mobile healthcare around the clock. Ground ambulance service professionals have been at the forefront of our country’s response to the mental health crisis in their local communities. Often, emergency calls related to mental health services are triaged to the local ground ambulance service to address.
While paramedics and EMTs provide important emergency health care services to those individuals suffering from a mental or behavioral health crisis, these front-line workers have been struggling to access the federal assistance they need to address the mental health strain that providing 24-hour care, especially during a COVID-19 pandemic, has placed on them. We need to ensure that there is equal access to mental health funding for all EMS agencies, regardless of their form of corporate ownership so that all first responders can receive the help and support they need.
EMS’s Enhanced Role in the Pandemic
As if traditional ambulance service responsibilities were not enough, paramedics and EMTs have taken on an even greater role on the very front lines of the COVID-19 pandemic. In many areas, EMS professionals lead Coronavirus vaccination, testing, and patient navigation. As part of the federal disaster response subcontract, EMS personnel even deploy to other areas around the country to pandemic hotspots and natural disasters to bolster local healthcare resources in the face of extraordinarily challenging circumstances.
Mental & Behavioral Health Challenges Drive Staffing Shortages on the Front Line
Myriad studies show that first responders face much higher-than-average rates of post- traumatic stress disorder[1], burnout[2], and suicidal ideation[3]. These selfless professionals work in the field every day at great risk to their personal health and safety—and under extreme stress.
Ambulance service agencies and fire departments do not keep bankers’ hours. By their very nature, EMS operations do not close during pandemic lockdowns or during extreme weather emergencies. “Working from home” is not an option for paramedics and EMTs who serve at the intersection of public health and public safety. Many communities face a greater than 25% annual turnover[4] of EMS staff because of these factors. In fact, across the nation EMS agencies face a 20% staffing shortage compounded by near 20% of employees on sick leave from COVID-19. This crisis-level staffing is unsustainable and threatens the public safety net of our cities and towns.
Sadly, to date, too few resources have been allocated to support the mental and behavioral health of our hometown heroes. I write today to ask for Congressional assistance to help the helpers as they face the challenges of 2022 and beyond.
Equity for All Provider Types
Due to the inherently local nature of EMS, each American community chooses the ambulance service provider model that represents the best fit for its specific population, geography, and budget. From for-profit entities to municipally-funded fire departments to volunteer rescue squads, EMS professionals share the same duties and responsibilities regardless of their organizational tax structure. They face the same mental health challenges and should have equal access to available behavioral health programs and services.
Many current federal first responder grant programs and resources exclude the tens of thousands of paramedics and EMTs employed by for-profit entities from access. These individuals respond to the same 911 calls and provide the same interfacility mobile healthcare as their governmental brethren without receiving the same behavioral health support from
Federal agencies. To remedy this and ensure equitable mental healthcare access for all first responders, we recommend that:
- During the current public health emergency and for at least two years thereafter, eligibility for first responder training and staffing grant programs administered by the U.S. Department of Health and Human Services (such as SAMHSA Rural EMS Training Grants and HHS Occupational Safety and Health Training Project Grants) should be expanded to include for-profit entities. Spending on training and services for mental health should also be included as eligible program
- Congress should authorize the establishment of a new HHS grant program open to public and private nonprofit and for-profit ambulance service providers to fund paramedic and EMT recruitment and training, including employee education and peer-support programming to reduce and prevent suicide, burnout, mental health conditions and substance use
- Any initiatives to fund hero pay or death benefits for first responders should be inclusive of all provider models—for-profit, non-profit, and
The rationale for the above requests is twofold. First, ensuring the mental health and wellness of all EMS professionals—regardless of their employer’s tax status—is the right thing to do.
Second, because keeping paramedics and EMTs employed by private ambulance agencies who are on the frontlines of providing vital medical care and vaccinations during this pandemic is the smart thing to do.
Thank you for considering this request to support ALL of our nation’s frontline heroes. They are ready to answer your call for help, 24/7—two years into this devastating pandemic, will Congress answer theirs?
Please do not hesitate to contact American Ambulance Association Senior Vice President of Government Affairs, Tristan North, at tnorth@ambulance.org or 202-486-4888 should you have any questions.
- Prevalence of PTSD and common mental disorders amongst ambulance personnel: A systematic review and meta-analysis. Soc Psychiatry Psychiatr 2018;53(9):897-909.
- ALmutairi MN, El Mahalli AA. Burnout and Coping Methods among Emergency Medical Services Professionals. J Multidiscip Healthc. 2020;13:271-279. Published 2020 Mar 16. doi:10.2147/JMDH.S244303
- Stanley, I. H., Hom, M. A., & Joiner, T. E. (2016). A systematic review of suicidal thoughts and behaviors among police officers, firefighters, EMTs, and Clinical Psychology Review, 44, 25–44. https://doi.org/10.1016/j. cpr.2015.12.002
- Doverspike D, Moore S. 2021 Ambulance Industry Employee Turnover Study. 3rd Washington, DC: American Ambulance Association; 2021.
OSHA Withdraws the Mandatory Vaccination & Testing Emergency Temporary Standard (ETS)
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EMT Reid Needs a Kidney! Living Donor Sought
URGENT: Fellow first responder Reid Cappel is in kidney failure and needs a kidney transplant. A living donor is his best chance at survival.
For years, Reid Cappel has selflessly served his New Jersey community as an emergency medical technician. Now, it is his turn to ask for a lifeline from his fellow public health and public safety professionals. Help Reid find a living kidney donor, so that he can get back to doing what he does best: caring for others.
Anyone who is healthy and eligible to be a kidney donor can give Reid the gift of life. A donor does not have to be a direct match, can live anywhere in the US, and will have access to donor protections and resources. EMS Gives Life, a nonprofit organization for first responders, by first responders, will provide guidance to our EMS, fire, and police brethren who are considering living donation.
All inquiries will be held in complete confidence. There is no commitment required to learn more. Meet Reid and learn more about living kidney donation at www.emsgiveslife.org/Reid.
Annual OSHA Workplace Illness and Injury Reporting
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Jan 5 | EMS360: Fatigue Risk Management in EMS Webtool Demo
Fatigue Risk Management in EMS: Project Summary and Webtool Demo
OSHA and CDC Updates
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EMS360: Fatigue Risk Management in EMS Webtool Demo
Fatigue Risk Management in EMS: Project Summary and Webtool Demo
6th Circuit Lifts the Injunction on the OSHA Vax & Testing Rules
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Support & Counseling for Medics
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NIOSH Seeks Public Comment on Interventions for Work-Related Stress Through November 26
The National Institute for Occupational Safety and Health (NIOSH), part of the Centers for Disease Control and Prevention (CDC), is seeking public comment on current evidence-based, workplace and occupational safety and health interventions to prevent work-associated stress, support stress reduction, and foster positive mental health and well-being among the nation’s health workers, including first responders and EMS clinicians. The NHTSA Office of EMS is committed to working with our Federal partners to prioritize efforts that address the high rates of stress, burnout, depression, anxiety and suicide among members of the EMS community. This request for information is an opportunity to make sure your voice is heard.
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NIOSH invites comment on best practices, promising practices or successful programs related to providing stress prevention and mental health services to health workers, including but not limited to employee assistance programs, screenings, supervisor trainings, workplace policies, talk therapy, mindfulness, peer support and mobile apps.
Comments and responses may be submitted here through Friday, November 26, 2021.
New Guidance on COVID-19 Workplace Safety for Federal Contractors
This week, the Safer Federal Workforce Task Force released new guidance on COVID-19 workplace safety protocols for Federal contractors and subcontractors. On September 9, President Biden signed Executive Order 14042, Ensuring Adequate COVID Safety Protocols for Federal Contractors, which directed executive departments and agencies to ensure that all federal contractors and subcontractors comply with all guidance published by the Task Force. These workplace safety protocols will apply to all covered contractor and subcontractor employees in covered contractor workplaces even if they are not working on Federal Government contracts.
Overview of Workplace Safety Protocols for Federal Contractors and Subcontractors
Pursuant to the guidance issued this week, and in addition to any requirements or workplace safety protocols that are applicable because a contractor or subcontractor employee is present at a Federal workplace, Federal contractors and subcontractors with a covered contract will be required to conform to the following workplace safety protocols:
- COVID-19 vaccination of covered contractor employees, except in limited circumstances where an employee is legally entitled to a medical or religious accommodation;
- Compliance by individuals, including covered contractor employees and visitors, with the Guidance related to masking and physical distancing while in covered contractor workplaces; and
- Designation by covered contractors of a person or persons to coordinate COVID-19 workplace safety efforts at covered contractor workplaces.
The guidance provides details regarding who is included under these new rules. Under the latest guidance, a “Covered Contractor Employee” means any full-time or part-time employee of a covered contractor” working on” or “in connection with” a covered contract or working at a covered contractor workplace. This includes employees of covered contractors who are not themselves working on or in connection with a covered contract, except for those employees who only perform work outside the United States or its outlying areas. This means that all ambulance service employees, who perform work related to or in connection with the contract, such as dispatchers, human resource and billing personnel, training staff, etc. are subject to the new requirements. This includes employees working from remotely or from home, who are performing work in connection with the contract.
Under the guidance, a “Covered Contractor Workplaces” are locations controlled by a covered contractor at which any employee of a covered contractor working on or in connection with a covered contract is likely to be present during the period of performance for a covered contract. This includes those workplaces such as ambulance stations, administrative offices, etc.
Vaccination of Covered Contractor Employees
Covered contractors must ensure that all their covered employees are fully vaccinated for COVID-19 unless the employee is legally entitled to an accommodation. Covered contractor employees must be fully vaccinated no later than December 8, 2021. The guidance detailed that vaccination is required of all employees, even if they have previously been infected with COVID-19.
Proof of COVID-19 Vaccination
Under this guidance, the contractor or subcontractor must review the covered employee’s documentation to prove vaccination status. The guidance identifies the list of acceptable documents an employee can furnish to prove vaccination, including:
- Copy of Immunization Record from a healthcare provider or pharmacy
- Copy of the COVID-19 Vaccination Record Card (CDC Form MLS-319813_r, published 9/3/2020)
- Copy of Medical Records documenting the vaccination
- Copy of Immunization Records from a public health or State Immunization Information System
- Copy of any other official documentation verifying vaccination with information of:
- Vaccine name
- Date of administration
- Name of healthcare professional or clinic site administering the vaccine
*Digital copies of these records are acceptable (jpg, scanned PDF, etc.)
The guidance specified that a signed attestation by the employee is not acceptable proof of vaccination. Additionally, the guidance stated that recent COVID-19 antibody tests do not satisfy the requirements under these rules.
Masking and Physical Distancing While in Covered Contractor Workplaces
Covered contractors must ensure that all individuals, including covered contractor employees and visitors, comply with published CDC guidance for masking and physical distancing at a covered contractor workplace. The guidance provided more details on these masking and physical distancing requirements. These include requiring unvaccinated individuals to mask indoors and in certain outdoor settings regardless of COVID-19 transmission levels. Contractors are required to monitor the community transmission levels on the CDC COVID-19 Data Tracker County View website on a weekly basis.
COVID-19 Coordinator Designation
Covered contractors must designate a person or persons to coordinate implementation of, and compliance with, these workplace safety protocols at covered contractor workplaces. Their responsibilities to coordinate COVID-19 workplace safety protocols may comprise some or all of their regular duties. This individual can be the same person who is designated under other state or local COVID-19 safety requirements.
Finally
The guidance makes it clear that the rules applicable to all federal contractors and supersedes any state or local rules or regulations that are contrary to these provisions. That means that any rules that prohibit mask or other COVID-19 related safety mandates, or otherwise contradict the rules under this guidance will not excuse a federal contractor’s obligations under these rules.
The guidance will be finalized by the Office of Management & Budget in the coming days. In the meantime, if you have any questions or need assistance, contact the AAA at hello@ambulance.org.
EMS.gov | Information About COVID-19 for EMS Systems and Clinicians
From EMS.gov
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HHS | $103mm for Healthcare Workforce Resiliency and to Address Burnout
202-690-6343
media@hhs.gov
HHS Announces $103 Million from American Rescue Plan to Strengthen Resiliency and Address Burnout in the Health Workforce
Today, the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced the availability of an estimated $103 million in American Rescue Plan funding over a three-year period to reduce burnout and promote mental health among the health workforce. These investments, which take into particular consideration the needs of rural and medically underserved communities, will help health care organizations establish a culture of wellness among the health and public safety workforce and will support training efforts that build resiliency for those at the beginning of their health careers.
“The Biden-Harris Administration is committed to ensuring our frontline health care workers have access to the services they need to limit and prevent burnout, fatigue and stress during the COVID-19 pandemic and beyond,” said HHS Secretary Xavier Becerra. “It is essential that we provide behavioral health resources for our health care providers – from paraprofessionals to public safety officers – so that they can continue to deliver quality care to our most vulnerable communities.”
Health care providers face many challenges and stresses due to high patient volumes, long work hours and workplace demands. These challenges were amplified by the COVID-19 pandemic, and have had a disproportionate impact on communities of color and in rural communities. The programs announced today will support the implementation of evidence-informed strategies to help organizations and providers respond to stressful situations, endure hardships, avoid burnout and foster healthy workplace environments that promote mental health and resiliency.
“This funding will help advance HRSA’s mission of developing a health care workforce capable of meeting the critical needs of underserved populations,” said Acting HRSA Administrator Diana Espinosa. “These programs will help to combat occupational stress and depression among our health care workers as they continue their heroic work to defeat the pandemic.”
There are three funding opportunities that are now accepting applications:
- Promoting Resilience and Mental Health Among Health Professional Workforce – Approximately 10 awards will be made totaling approximately $29 million over three years to health care organizations to support members of their workforce. This includes establishing, enhancing, or expanding evidence-informed programs or protocols to adopt, promote and implement an organizational culture of wellness that includes resilience and mental health among their employees.
- Health and Public Safety Workforce Resiliency Training Program – Approximately 30 awards will be made totaling approximately $68 million over three years for educational institutions and other appropriate state, local, Tribal, public or private nonprofit entities training those early in their health careers. This includes providing evidence-informed planning, development and training in health profession activities in order to reduce burnout, suicide and promote resiliency among the workforce.
- Health and Public Safety Workforce Resiliency Technical Assistance Center – One award will be made for approximately $6 million over three years to provide tailored training and technical assistance to HRSA’s workforce resiliency programs.
To apply for the Provider Resiliency Workforce Training Notice of Funding Opportunities, visit Grants.gov. Applications are due August 30, 2021.
Learn more about HRSA’s funding opportunities.
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