Home care groups lobby for exemption from ergonomics proposal
Home care groups lobby for exemption from ergonomics proposal
By MATTHEW HAY
HHBR Washington Correspondent
WASHINGTON — Home care representatives are pressing the Department of Health and Human Services (Washington) to exempt home health agencies from its proposed ergonomics program on workplace safety. "This could be worse than OASIS in many respects," warns Ann Howard, executive director of the American Federation of Home Care Providers (AFHCP; Washington).
In addition to the ergonomics regulation, Howard pointed to the potential costs of the Health Care Financing Administration’s (Baltimore) politically correct healthcare requirement that includes 14 provisions for culturally and linguistically appropriate healthcare services and the agency’s latest initiative to prevent abuse in healthcare settings.
"These are third-echelon issues for home care right now, but if and when they actually move to implement them, they become first-echelon issues because they are going to become extremely burdensome, and they are going to be very costly," said Howard. "None of them are in the final stages yet, but all three of them definitely need to be watched." She said all three should exempt home health from the proposed regulations until the prospective payment system is implemented.
In comments submitted to the agency March 1, the American Association for Homecare (AAH; Alexandria, VA) argued that a 1993 circuit court decision and the recent decision by the secretary of the Labor Department to withdraw the "work at home" Occupational Safety and Health Administration (OSHA) policy establish precedent in this area that should prohibit the ergonomics regulation.
AAH also argued that home health agencies should be exempted from the proposed rule based on the same grounds as several other industries, such as construction and agriculture. For example, home care consists primarily of jobs of short duration with visits rarely taking more than one or two hours. Likewise, these visits involve a variety of adverse workplace conditions and involve non-fixed work sites, AAH added.
In addition, home care involves multi-employer work sites and often require the use of temporary workers depending on patient needs. "In order to apply this regulation to home care, it would have to be assumed that the employer controls the environment in which home care professionals work," AAH said. "That is clearly not the case."
The National Association for Home Care (NAHC; Washington) took a similar view. NAHC argued that the proposed standard would increase costs for employers in numerous areas, including start-up and ongoing training and evaluation, education of employees and management, job hazard analysis, MDS management, recordkeeping, and implementing work restriction protections.
NAHC noted that OSHA pegged the cost of implementing the regulation at more than $51 million for the home care industry, which translates into a cost of $3,198 per establishment.
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