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OSHA Regulations

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OSHA Regulations & Legal Issues for Evacuation of Health Care Facilities OSHA Training Institute Region IX University of California, San Diego (UCSD) - Extension – PowerPoint PPT presentation

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Title: OSHA Regulations


1
OSHA Regulations Legal Issues for Evacuation of
Health Care Facilities
OSHA Training Institute Region IX University of
California, San Diego (UCSD) - Extension
2
Objectives
  • To describe the current Occupational Safety and
    Health Administration (OSHA) regulations
    regarding evacuation as they pertain to
    healthcare facilities.
  • To describe other regulatory and legal issues
    associated with evacuation.

3
OHSA
  • OSHA's mission is to assure the safety and
    health of America's workers by setting and
    enforcing standards providing training,
    outreach, and education establishing
    partnerships and encouraging continual
    improvement in workplace safety and health.

OSHA Website 2007
4
OSHA 29 CFR 1910
  • General Industry Requirements for Emergency
    Response and Preparedness
  • Includes general requirements for exit routes
  • Medical First Aid
  • Alarms
  • Emergency Action Plans (EAP)

5
Requirements for Exit Routes
  • Permanent free from obstructions
  • Number of exits based on number
  • of employees, occupants
  • Size, arrangement, marking/signage, lighting
    specifications
  • Must lead to an outside area with enough space
    for all participants

6
General Requirements (cont)
  • Medical services first aid
  • Fire extinguishers
  • Employee alarm systems
  • distinctive and perceivablefor emergency action
    or safe evacuation

7
OSHA 29-CFR 1910e Emergency Action Plans
  • EAPs should
  • Address potential expected emergencies
  • Evacuation and Shelter-in-Place
  • Give detailed procedures for employees
  • For operations, rescue and medical duties, Chain
    of Command, evacuation procedures
  • Provide maps with evacuation routes
  • Color coding

8
1910e During an Evacuation
  • Employees must know
  • Type of evacuation
  • Their role in evacuation
  • Safe Areas in Plan
  • Fire Walls, Open Spaces
  • Training
  • Evacuation Wardens scheduled during working
    hours (120)
  • Practice evacuation routes

9
OSHA Evacuation Plans and Procedures eTools
  • www.osha.gov/SLTC/etools/evacuation
  • Develop Implement an EAP
  • Evacuation Plans Procedures
  • Employee Responsibilities
  • Shelter-in-Place
  • Fire Extinguishers
  • Fight or Flee
  • Reporting Emergencies

10
OSHA Evacuation Planning Matrix
  • Worksite Risk Assessment List (DHS)
  • HazMat
  • Provision of essential services
  • High pedestrian traffic volume
  • Limited means of egress
  • High profile site
  • Part of transport system
  • www.llr.state.sc.us.workplace/Full20Report.pdf

11
OSHA Evacuation Planning Matrix
  • Developed in response to terrorist attacks
  • Help assess risk of being a target
  • Risk based on
  • Workplace Vulnerabilities
  • Recognized Threat
  • Anticipated Consequences
  • Specifics for your EAP
  • Safety Security considerations

12
OSHA Emergency Preparedness Guidelines for Floods
  • Types Dam/levee failure, flash, coastal, river
  • Public Warnings Flood Watch,
    Warningactivate plan
  • Workers at Risk Utility, Law, Fire, EMS, other
    outside workers
  • Specific Hazards Electrical, carbon monoxide,
    musculoskeletal hazards, thermal stresses,
    hypothermia, HazMat, fire, drowning, exhaustion,
    dehydration, biohazards, falls from height,
    falling objects, MVAs, burns, structural
    instability and collapse

13
OSHA Emergency Preparedness Guidelines (cont)
  • Earthquakes
  • Hurricanes Winds, tidal surges, flash floods
  • Tornadoes Travel quickly, unpredictable
  • Others Heat or Cold Stress Secondary
  • Explosives, Toxic Chemicals
  • www.osha.gov.SLTC/emergencypreparedness/guides

14
Other Regulations
  • FEMA
  • NIMS
  • PETS Act
  • OES
  • NIOSH
  • The Joint Commission (formerly JCAHO)
  • DHHS

15
Legal Authorities
  • Stafford Act- FEMA/DHS is authorized to
    coordinate Fed agencies, after a POTUS
    Declaration of a major disaster or emergency
  • HHS has lead for health and medical services, can
    activate USPHS CC or NDMS, and maintains the
    Strategic National Stockpile.

16
NIMS
  • Nationwide, standardized approach to incident
    management and response
  • Developed by Homeland Security at the request of
    the President Homeland Security Presidential
    Directive5.

17
NIMS Requirement
  • Requires that federal departments and agencies
    adopt and use NIMS to support state, local,
    tribal entities.
  • Stipulates that federal departments and agencies
    require state and local entities to adopt the
    NIMS as a condition for federal preparedness
    assistance.

18
NIMS Directive for States, Local Agencies and
Tribes
  • State/local/tribes should
  • Complete NIMS Awareness Course IS 700
  • Formally adopt NIMS principles and policies
  • Establish a NIMS compliance baseline
  • Develop a timeframe and strategy for full NIMS
    implementation
  • Institutionalize use of the Incident Command
    System

19
NIMS Requirements for States
  • States are required to
  • Incorporate NIMS into existing training programs
    and exercises
  • Ensure that federal preparedness funding supports
    state, local, and tribal NIMS implementation
  • Incorporate NIMS into Emergency Operations Plans
  • Promote intrastate mutual aid agreements
  • Coordinate and provide NIMS technical assistance
    to local entities

20
NIMS and Evacuations
  • NIMS does not outline specific steps or
    requirements for evacuations.
  • However using NIMS will support a more cohesive
    response among agencies and will support
    assistance in preparedness for evacuations as
    well as any other disaster experience.

21
Pet Evacuations
  • PETS Act of 2006 as an Amendment to the Stafford
    Act
  • Grants FEMA authority to provide assistance for
    individuals with pets and service animals, and
    the animals themselves, following a major
    disaster.

Helicopter transport of victims and pets with a
DMAT disaster responder.
22
Community Opinion and Evacuation Consequences
  • Post Hurricane Katrina
  • 49 percent of all adults say they would refuse to
    evacuate ahead of a disaster if they could not
    take their pets with them
  • 61 percent of pet owners would be likely to
    refuse an order to evacuate
  • 24 percent of non-pet owners would refuse to
    leave.
  • Report from the nationwide Zogby Interactive
    Poll 3,185 adults polled September 13 to 15, 2005

23
Pet Transportation Standards Act (PETS)
  • Requires local and state emergency preparedness
    authorities include plans for pets and service
    animals in disaster plans to qualify for FEMA
    grants
  • Authorizes federal funds to help create
    pet-friendly emergency shelter facilities
  • Grants FEMA authority
  • to assist states and local communities in
    developing disaster plans to accommodate people
    with pets and service animals

24
Office of Emergency Services (OES)
  • Emergency Services Act
  • State responsibility for disaster mitigation
  • Mutual aid from outside state/area
  • Declaration of local emergency provides
    additional immunity from liability for the public
    entity and its employees
  • CA Gov Code 8657 extends ESA immunities to
    disaster service workers

25
National Institute of Occupational Safety and
Health (NIOSH)
  • Emergency Management Guide for Business
    Industry
  • Alarm Systems
  • Hurricane Response

26
The Joint Commission (formerly JCAHO)
  • EAP
  • Assignment of staff
  • Evacuation procedures
  • Patient transfers
  • Communications
  • UtilitiesSentinel Event alert
  • Drill requirements

27
Dept of Health and Human Services
  • Emergency Medical Treatment and Active Labor Act
    (EMTALA)
  • Health Insurance Portability and Accountability
    Act (HIPAA)
  • Secretary of DHHS permitted to temporarily waive
    these requirements for healthcare providers in an
    emergency area

28
Good Samaritan Laws, Etc.
  • Good Samaritan Laws in all states
  • The US Volunteer Protection Actof 1997 (42
    U.S.C. 14501 - 14505)
  • CA Gov Code 8657
  • Immunity to healthcare providers responding
    during an emergency
  • Some states place higher burden on plaintiffs for
    cases regarding provision of care during an
    emergency

29
ESAR-VHP
  • Emergency System for Advance Registration of
    Volunteer Health Professionals
  • Public Law the Public Health Security and
    Bioterrorism Preparedness and Response Act of
    2002
  • Each State and Territory to establish a
    standardized, volunteer registration system.

30
ESAR-VHP System Aims
  • Readily available verifiable information about
    the volunteers identity, licensing,
    credentialing, accreditation, and privileging in
    hospitals/ medical facilities.
  • State ability to quickly identify better
    utilize health professional volunteers in
    emergencies disasters.
  • Sharing of these pre-registered credentialed
    health care professionals across State lines
    even nationally.

31
Legal Issues
  • Certain states can require staff designated as
    Emergency Service Personnel to stay at work
    during an general evacuation order
  • Employer must provide adequate emergency shelter
  • Legal cases from Katrina
  • Neglect
  • Euthanasia

32
Legal Issues
  • NYTimes.com By Jane Gross August 18, 2006 
  • DHHS Report Calls for Tighter Rules in Nursing
    Home Evacuations
  • all emergency plans met the requirements of
    federal and state law94 of nursing homes have
    these
  • But it found that the plans had rampant
    deficiencies especially in ensuring the safe and
    comfortable evacuation of residents with complex
    needs

33
Summary
  • Need to have specific procedures for evacuation
    for your facility
  • Emergency Action Plan
  • Need to include provisions for pets
  • Laws providing for immunity when responding in a
    disaster situation
  • Can vary by State

34
References
  • California Office of Emergency Services. Legal
    Guidelines for Flood Evacuation. 1997.
  • Davis Davis, PC. The Legal Angle Electronic
    Newsletter Hospital staffing during a hurricane
    evacuation. Spring 2006.
  • FEMA. National Incident Management System. SEMS
    Advisory Committee Meeting, Mather, CA March 24,
    2005. Slide Set
  • Zogby International. Americans make disaster
    plans for pets,too! Interactive polls ZOGBY
    International New York. October 14, 2005

35
References
  • Pesik N, Keim ME, Iserson KV. Terrorism and the
    Ethics of Emergency Medical Care. Annals of
    Emergency Medicine. 2001. 37642646.Davis
    Davis, PC.
  • US Dept of Labor OSHA. General industry (29 CFR
    1910) requirements for emergency response and
    preparedness. www.osha.gov
  • US Dept of Labor OSHA. Evacuation Plans and
    Procedures. www.osha.gov/SLTC/etools/evacuation/ev
    ac.html

36
References
  • US Dept of Labor OSHA. Evacuation planning
    matrix. Matrix to provide employers
    withplanning considerations and on-line
    resources that may help employers reduce their
    vulnerability to a terrorist act or the impact of
    a terrorist release. www.osha.gov/dep/evacmatrix/
    index.html
  • US Dept of Labor OSHA. Emergency Preparedness
    and response Safety and Health
    Guides.http//www.osha.gov/SLTC/emergencypreparedn
    ess/guides/index.html
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