OSHA Withdraws Temporary COVID-19 Vaccine-or-Testing Rule

  • Agency leaves door open to future permanent standard on COVID vaccination-or-testing

The Occupational Safety and Health Administration (OSHA) is withdrawing its emergency temporary standard (ETS) to require all large businesses in the United States to implement a COVID-19 vaccine-or-weekly-testing policy for employees by February 9, 2022.

However, OSHA has decided to propose that the make the temporary standard in to a permanent standard.

“Notwithstanding the withdrawal of the [ETS], OSHA continues to strongly encourage the vaccination of workers against the continuing dangers posed by COVID-19 in the workplace,” the agency said.

OSHA originally published the ETS on November 5, 2021 in the Federal Register and accepted comments through January 19, 2022. However, on January 13, 2022, the United States Supreme Court struck down the ETS, while upholding the narrower Centers for Medicare & Medicaid vaccination rule for health care workers. (See January 13 NAHC Report.)

“Although OSHA is withdrawing the Vaccination and Testing ETS as an enforceable emergency temporary standard,” wrote the agency, “OSHA is not withdrawing the ETS to the extent that it serves as a proposed rule.”

OSHA’s announcement did not indicate when it will finalize a permanent rule, but Labor Secretary Marty Walsh told Politico on Monday that the “Supreme Court opened up a couple of potential different areas which we’ll explore. They talked about assembly line, medical — there’s like three or four general areas that you could read into. We could do something there.”

Previously, OSHA has indicated a number of possibilities for a final rule, such as whether to cover employers with fewer than 100 employees, whether masking should also be required, whether the standard should be strictly vaccination, and others.

“We need clarity on this issue and NAHC strongly encourages both Congress and the Administration to quickly reach a conclusion so that affected health care businesses can focus on providing care,” said NAHC President William A. Dombi. “Infection control in patient care and staffing is an essential responsibility in all of health care. Home care is committed to protecting its patients and its staff from Covid-19.“

OSHA Withdraws Temporary COVID-19 Vaccine-or-Testing Rule

  • Agency leaves door open to future permanent standard on COVID vaccination-or-testing

The Occupational Safety and Health Administration (OSHA) is withdrawing its emergency temporary standard (ETS) to require all large businesses in the United States to implement a COVID-19 vaccine-or-weekly-testing policy for employees by February 9, 2022.

However, OSHA has decided to propose that the make the temporary standard in to a permanent standard.

“Notwithstanding the withdrawal of the [ETS], OSHA continues to strongly encourage the vaccination of workers against the continuing dangers posed by COVID-19 in the workplace,” the agency said.

OSHA originally published the ETS on November 5, 2021 in the Federal Register and accepted comments through January 19, 2022. However, on January 13, 2022, the United States Supreme Court struck down the ETS, while upholding the narrower Centers for Medicare & Medicaid vaccination rule for health care workers. (See January 13 NAHC Report.)

“Although OSHA is withdrawing the Vaccination and Testing ETS as an enforceable emergency temporary standard,” wrote the agency, “OSHA is not withdrawing the ETS to the extent that it serves as a proposed rule.”

OSHA’s announcement did not indicate when it will finalize a permanent rule, but Labor Secretary Marty Walsh told Politico on Monday that the “Supreme Court opened up a couple of potential different areas which we’ll explore. They talked about assembly line, medical — there’s like three or four general areas that you could read into. We could do something there.”

Previously, OSHA has indicated a number of possibilities for a final rule, such as whether to cover employers with fewer than 100 employees, whether masking should also be required, whether the standard should be strictly vaccination, and others.

“We need clarity on this issue and NAHC strongly encourages both Congress and the Administration to quickly reach a conclusion so that affected health care businesses can focus on providing care,” said NAHC President William A. Dombi. “Infection control in patient care and staffing is an essential responsibility in all of health care. Home care is committed to protecting its patients and its staff from Covid-19.“

OSHA Withdraws Temporary COVID-19 Vaccine-or-Testing Rule

Agency leaves door open to future permanent standard on COVID vaccination-or-testing The Occupational Safety and Health Administration (OSHA) is withdrawing its emergency temporary standard (ETS) to require all large businesses in the United States to implement a COVID-19 vaccine-or-weekly-testing policy for employees by February 9, 2022. However, OSHA has decided to propose that the make…

Supreme Court Blocks Biden’s Covid Rule for Biz, Upholds Health Worker Mandate

The Supreme Court handed down a split decision on two Biden administration workplace rules to stop the spread of the novel coronavirus COVID-19, blocking an OSHA rule requiring businesses with at least 100 employees to compel their workers to get vaccinated or wear masks and test negative at least once per week, but upholding a separate rule from the Centers for Medicare & Medicaid Services (CMS) requiring vaccination for about 20 million health care workers.

The OSHA rule would have covered about 80 million workers and administration estimated it would save about 6500 lives in six months.

“Today’s decisions from the U.S. Supreme Court brings home care a step closer to the essential clarity that is needed to determine what is required for compliance,” said NAHC President William A. Dombi in response to the rulings. “The OSHA rule is blocked from implementation and enforcement for the moment. The CMS rule can full take effect for the moment. Both cases return to the lower courts for further adjudication. The Administration has further options option to it. We strongly encourage both Congress and the Administration to quickly reach a conclusion so that affected health care businesses can focus on providing care. Infection control in patient care and staffing is an essential responsibility in all of health care. Home care is committed to protecting its patients and its staff from Covid-19.“

The decision once again laid bare the sharp ideological differences that exist on the court.

“Although Congress has indisputably given OSHA the power to regulate occupational dangers, it has not given that agency the power to regulate public health more broadly,” wrote the court’s six-member conservative majority. “Requiring the vaccination of 84 million Americans, selected simply because they work for employers with more than 100 employees, certainly falls in the latter category.”

The court’s three liberal justice dissented fiercely, writing that the majority was replacing OSHA’s expertise with its own, which lacks the necessary knowledge in public health.

“In the face of a still-raging pandemic,” wrote the dissent, “this court tells the agency charged with protecting worker safety that it may not do so in all the workplaces needed. As disease and death continue to mount, this court… usurps a decision that rightfully belongs to others. It undercuts the capacity of the responsible federal officials, acting well within the scope of their authority, to protect American workers from grave danger.”

NAHC has prepared bullet points to help you understand what these rulings mean for home care and hospice.

OSHA Rule

  • Court majority (6-3) finds that OSHA does not have the authority to issue a broad-based rule that is not specifically focused on occupational hazard affecting workers;
  • Majority views the OSHA rule as more a “public health” action rather than an occupational health one. OSHA does not have public health regulatory authority;
  • OSHA can regulate worker safety “where the virus poses a special danger” because of the employees job functions or workplace. Examples include where the employee is working with the virus or working in a crowded environment;
  • While the Court’s action stops the OSHA rule in its current form, OSHA may consider refining the rule to target certain workers in certain workplaces. This clearly could include health care settings for those entities not subject to the CMS rule.  Such action is not likely to occur quickly but is a strong possibility;
  • States that had been on the fence with respect to employer mandates may now move forward given the limitation on federal power and the Courts direct recognition that states have such power;
  • While the Court suggested that Congress might have the power to enact similar requirements to those under the OSHA rule, it is highly unlikely that such would pass in the current Congress. Earlier, a majority of the Senate opposed the OSHA rule;
  • NAHC recommends that home care companies return to focus on the expired OSHA Healthcare ETS as it may be the next generation of OSHA action as it is more targeted to a specific workplace hazard; and
  • While the OSHA case has been returned to the lower court for further adjudication, it can be expected that OSHA will ultimately lose on the existing rule. A new, targeted rule remains possible with the likelihood that new litigation will follow.

The OSHA rule was originally blocked by lower courts, but a three-judge panel of the U.S. Court of Appeals for the Sixth Circuit reversed the lower court rulings, calling the rule “an important step in curtailing the transmission of a deadly virus that has killed over 800,000 people in the United States, brought our health care system to its knees, and cost hundreds of thousands of workers their jobs.”

The Supreme Court ruling earlier today reverses the Sixth Circuit Court of Appeals decision.

CMS Rule

  • Court majority (5-4) finds clear authority for CMS to require measures, including vaccines, to protect patients and regulate provider staff qualifications
  • “Health and safety” rulemaking authority provides CMS with the ability to address a broad range of issues within its expertise
  • Majority concludes that such authority is inferred for all providers subject to conditions of participation even without express language. e.g. home infusion providers
    • Court explains that there is a provision in the rule that permits severing parts of the rule that are deemed outside of CMS authority
    • This may create an issue for the lower courts to address as the SCt sent the case back for continuing review since it was acting only on the issue as to whether a preliminary stay of the rule should continue
  • NAHC expects CMS will move quickly to bring to rule into enforcement consistent with the recent guidance issued that is applicable to the states where the injunction was not in place
  • NAHC expects that CMS will prevail ultimately in the validity of the rule. As such, we highly recommend that affected providers move forward to full compliance.

CMS released the following statement after the Supreme Court decision, setting compliance dates for the 24 states that had been subject to the injunction against the CMS rule.

As a result of today’s decision, health care providers subject to the Omnibus Health Care Staff Vaccination rule in the 24 states (Alabama, Alaska, Arizona, Arkansas, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Utah, West Virginia, and Wyoming) covered by this decision will now need to establish plans and procedures to ensure their staff are vaccinated and to have their employees receive at least the first dose of a COVID-19 vaccine.

Today’s decision does not affect compliance timelines for providers in the District of Columbia, the territories, and the 25 states where the preliminary injunction was previously lifted. See the guidance released on December 28, 2021, for additional information.

Previously, two federal appeals courts halted enforcement of the CMS rule in 24 states, but it did go into effect in the remaining states.

Supreme Court Blocks Biden’s Covid Rule for Biz, Upholds Health Worker Mandate

The Supreme Court handed down a split decision on two Biden administration workplace rules to stop the spread of the novel coronavirus COVID-19, blocking an OSHA rule requiring businesses with at least 100 employees to compel their workers to get vaccinated or wear masks and test negative at least once per week, but upholding a separate rule from the Centers for Medicare & Medicaid Services (CMS) requiring vaccination for about 20 million health care workers.

The OSHA rule would have covered about 80 million workers and administration estimated it would save about 6500 lives in six months.

“Today’s decisions from the U.S. Supreme Court brings home care a step closer to the essential clarity that is needed to determine what is required for compliance,” said NAHC President William A. Dombi in response to the rulings. “The OSHA rule is blocked from implementation and enforcement for the moment. The CMS rule can full take effect for the moment. Both cases return to the lower courts for further adjudication. The Administration has further options option to it. We strongly encourage both Congress and the Administration to quickly reach a conclusion so that affected health care businesses can focus on providing care. Infection control in patient care and staffing is an essential responsibility in all of health care. Home care is committed to protecting its patients and its staff from Covid-19.“

The decision once again laid bare the sharp ideological differences that exist on the court.

“Although Congress has indisputably given OSHA the power to regulate occupational dangers, it has not given that agency the power to regulate public health more broadly,” wrote the court’s six-member conservative majority. “Requiring the vaccination of 84 million Americans, selected simply because they work for employers with more than 100 employees, certainly falls in the latter category.”

The court’s three liberal justice dissented fiercely, writing that the majority was replacing OSHA’s expertise with its own, which lacks the necessary knowledge in public health.

“In the face of a still-raging pandemic,” wrote the dissent, “this court tells the agency charged with protecting worker safety that it may not do so in all the workplaces needed. As disease and death continue to mount, this court… usurps a decision that rightfully belongs to others. It undercuts the capacity of the responsible federal officials, acting well within the scope of their authority, to protect American workers from grave danger.”

NAHC has prepared bullet points to help you understand what these rulings mean for home care and hospice.

OSHA Rule

  • Court majority (6-3) finds that OSHA does not have the authority to issue a broad-based rule that is not specifically focused on occupational hazard affecting workers;
  • Majority views the OSHA rule as more a “public health” action rather than an occupational health one. OSHA does not have public health regulatory authority;
  • OSHA can regulate worker safety “where the virus poses a special danger” because of the employees job functions or workplace. Examples include where the employee is working with the virus or working in a crowded environment;
  • While the Court’s action stops the OSHA rule in its current form, OSHA may consider refining the rule to target certain workers in certain workplaces. This clearly could include health care settings for those entities not subject to the CMS rule.  Such action is not likely to occur quickly but is a strong possibility;
  • States that had been on the fence with respect to employer mandates may now move forward given the limitation on federal power and the Courts direct recognition that states have such power;
  • While the Court suggested that Congress might have the power to enact similar requirements to those under the OSHA rule, it is highly unlikely that such would pass in the current Congress. Earlier, a majority of the Senate opposed the OSHA rule;
  • NAHC recommends that home care companies return to focus on the expired OSHA Healthcare ETS as it may be the next generation of OSHA action as it is more targeted to a specific workplace hazard; and
  • While the OSHA case has been returned to the lower court for further adjudication, it can be expected that OSHA will ultimately lose on the existing rule. A new, targeted rule remains possible with the likelihood that new litigation will follow.

The OSHA rule was originally blocked by lower courts, but a three-judge panel of the U.S. Court of Appeals for the Sixth Circuit reversed the lower court rulings, calling the rule “an important step in curtailing the transmission of a deadly virus that has killed over 800,000 people in the United States, brought our health care system to its knees, and cost hundreds of thousands of workers their jobs.”

The Supreme Court ruling earlier today reverses the Sixth Circuit Court of Appeals decision.

CMS Rule

  • Court majority (5-4) finds clear authority for CMS to require measures, including vaccines, to protect patients and regulate provider staff qualifications
  • “Health and safety” rulemaking authority provides CMS with the ability to address a broad range of issues within its expertise
  • Majority concludes that such authority is inferred for all providers subject to conditions of participation even without express language. e.g. home infusion providers
    • Court explains that there is a provision in the rule that permits severing parts of the rule that are deemed outside of CMS authority
    • This may create an issue for the lower courts to address as the SCt sent the case back for continuing review since it was acting only on the issue as to whether a preliminary stay of the rule should continue
  • NAHC expects CMS will move quickly to bring to rule into enforcement consistent with the recent guidance issued that is applicable to the states where the injunction was not in place
  • NAHC expects that CMS will prevail ultimately in the validity of the rule. As such, we highly recommend that affected providers move forward to full compliance.

CMS released the following statement after the Supreme Court decision, setting compliance dates for the 24 states that had been subject to the injunction against the CMS rule.

As a result of today’s decision, health care providers subject to the Omnibus Health Care Staff Vaccination rule in the 24 states (Alabama, Alaska, Arizona, Arkansas, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Utah, West Virginia, and Wyoming) covered by this decision will now need to establish plans and procedures to ensure their staff are vaccinated and to have their employees receive at least the first dose of a COVID-19 vaccine.

Today’s decision does not affect compliance timelines for providers in the District of Columbia, the territories, and the 25 states where the preliminary injunction was previously lifted. See the guidance released on December 28, 2021, for additional information.

Previously, two federal appeals courts halted enforcement of the CMS rule in 24 states, but it did go into effect in the remaining states.

Supreme Court Blocks Biden’s Covid Rule for Biz, Upholds Health Worker Mandate

The Supreme Court handed down a split decision on two Biden administration workplace rules to stop the spread of the novel coronavirus COVID-19, blocking an OSHA rule requiring businesses with at least 100 employees to compel their workers to get vaccinated or wear masks and test negative at least once per week, but upholding a…

Supreme Court Casts Doubt on Biden Admin’s Vaccine/Testing Regulations

On Friday, January 7, the Supreme Court debated the issue of whether or not two recent rules from the Biden administration designed to halt the spread of the novel Coronavirus COVID-19 are constitutional, with the rules coming under fire from the court’s six-member majority.

The Court heard the arguments on an expedited basis because one of the two regulations will soon go into effect and the other has been blocked by a lower court. For this reason, a decision from the Court is expected very soon.

COVID-19 hung over the hearing, as two lawyers for plaintiffs challenging the regulations are infected with the virus and made their arguments remotely. Justice Sonya Sotomayor was also remote, as she is a lifelong diabetic and was concerned about virus transmissibility.

The two rules debated during the hearing were:

  1. an OSHA vaccine-or-test mandate for private sector companies that employ 100 or more workers.
  2. a separate CMS vaccine mandate for almost all workers at hospitals, nursing homes and other medical providers receiving federal Medicare and Medicaid funds.

The Occupational Safety and Health Act of 1970 allows OSHA to use emergency rules when “necessary” to protect American workers from “grave danger.” The passage below from the regulation, is likely to be key to the Court’s eventual determination.

Once OSHA has established as a threshold matter that a health standard is necessary under section 6(b) or (c)—i.e., to reduce a significant risk of material health impairment, or a grave danger to employee health—the Act gives the Secretary almost unlimited discretion to devise means to achieve the congressionally mandated goal” of protecting employee health, subject to the constraints of feasibility. See United Steelworkers of Am. v. Marshall, 647 F.2d 1189, 1230 (D.C. Cir. 1981)

A standard’s individual requirements need only be “reasonably related” to the purpose of ensuring a safe and healthful working environment. Id. at 1237, 1241; see also Forging Indus.

The OSH Act in section 6(c)(1) states that the Secretary “shall” issue an emergency temporary standard (ETS) upon a finding that the ETS is necessary to address a grave danger to workers. See 29 U.S.C. 655(c). In particular, the Secretary shall provide, without regard to the requirements of chapter 5, title 5, United States Code, for an emergency temporary standard to take immediate effect upon publication in the Federal Register if the Secretary makes two determinations: That employees are exposed to grave danger from exposure to substances or agents determined to be toxic or physically harmful or from new hazards, and that such emergency standard is necessary to protect employees from such danger. 29 U.S.C. 655(c)(1).

However, Chief Justice Roberts declared that the COVID vaccine/testing mandate is “something the federal government has never done before.” Justices Clarence Thomas, Samuel Alito, Neil Gorsuch, and Brett Kavanaugh sounded even more skeptical about the OSHA rule arguing essentially that Congress would need to enact a law specifically authorizing such a regulation.

The Court’s three more liberal justices, Stephen Breyer, Sonia Sotomayor, and Elena Kagan, strenuosuly objected to the conservatives’ reading, with Kagan calling the current crisis “by far the greatest public health danger that this country has faced in the last century.” Kagan added that “this is the policy that is most geared to stopping all this.”

Lawyers for those challenging the regulation said states could enact their own mandates, but Sotomayor responded that some states have banned mask or vaccine mandates and the relevant statute specifically provides for a national rule to override state laws.

The CMS rule did not seem to provoke as much hostility from the Court’s conservatives, with Chief Justice Roberts noting that the regulation is supported by the principle, long-established in American law, that when the government funds a program it is entitled to attached conditions about how the money may be used. The CMS rule covers Medicare and Medicaid providers, thus making the government’s case potentially stronger, at least in the eyes of the Court.

However the Court eventually rules on the two regulations, what home care and hospice need most is clear guidance and they need it quickly.

“The biggest challenge for home care with the vaccine and/or testing mandates is the lack of clarity on what action must be taken,” said NAHC President William A. Dombi, after following the proceedings. “With varying rulings from lower courts along with conflicting standards on the state level, home care and hospice companies need clear direction from the Supreme Court. The questions and comments by the justices on Friday raise doubts as to whether that guidance is forthcoming. It is apparent that the justices are as divided on these contentious issues as is the Congress and the public.”

Supreme Court Casts Doubt on Biden Admin’s Vaccine/Testing Regulations

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Supreme Court Clears Public Charge Rule, Possible Big Impact on Home-based Care

On January 27, a sharply divided United States Supreme Court narrowly ruled in favor of the Trump administration to enforce a controversial rule that is likely to make it more difficult for poor immigrants to receive green cards. The Department of Homeland Security rule, better known as the “Public Charge,” will allow the federal government…