Homeless People's Network: ARCH Continuum of Care Alert 12/3/97

ARCH Continuum of Care Alert 12/3/97

H. C. Covington

ach1@sprynet.com

Thu, 4 Dec 1997 07:56:18 -0600

This is a multi-part message in MIME format. ------=_NextPart_000_002E_01BD008A.2317EFA0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: quoted-printable H. C. Sonny Covington @ I CAN! America Lafayette - New Iberia, LA 70563-1722 (318) 364-6239 Fax 318-367-9141 ARCH Homeless Network Alert December 3, 1997 OSHA Tuberculosis Standard for Shelters and HCH Projects BACKGROUND:=20 In the October 17 issue of the Federal Register, the Occupational Safety = and Health Administration (OSHA) published its Proposed Standard on = Occupational Exposure to Tuberculosis. The standard directly addresses = employee exposure to Tuberculosis (TB) in hospitals, nursing homes, = homeless shelters, substance abuse treatment facilities and other = workplaces. If adopted, the standard will require shelters and HCH = programs to adopt significant engineering and procedural measures = designed to reduce the risk of tuberculosis infection. The proposed = standard would dramatically affect the provision of services to homeless = people.=20 OSHA anticipates that homeless shelters and substance abuse treatment = centers will use "early identification and transfer procedures for = individuals with suspected or confirmed infectious TB." For these work = settings, employers must [partial list]: a.. make a formal determination regarding occupational exposure to TB = for employees in various job classifications or performing certain = duties;=20 b.. use procedures to promptly identify individuals with suspected = or confirmed infectious TB;=20 c.. mask or segregate such individuals;=20 d.. transfer such individuals to facilities with isolation rooms = within five hours of identification;=20 e.. provide temporary isolation (in rooms with engineering controls = such as negative pressure, direct exhaust or HEPA filtration) if = transfer cannot be accomplished within five hours of identification;=20 f.. provide respirators for employees who enter a temporary = isolation area or who work in an area where an unmasked individual with = suspected or confirmed infectious TB is segregated and awaiting = transfer;=20 g.. assure proper fit and usage of the respirator;=20 h.. provide medical surveillance, including physicals and skin = tests, for employees who are occupationally exposed, and maintain = records of the medical surveillance for 30 years;=20 i.. follow detailed procedures following exposure incidents, which = may include "medical removal" of certain employees and paid leave for up = to 18 months;=20 j.. label segregation and isolation areas and ventilation systems; = and=20 k.. provide appropriate training of staff and maintenance of = engineering controls.=20 =20 The full text of the standard can be found at = www.access.gpo.gov/su_docs/aces/aces140.html or in libraries that = provide the Federal Register.=20 RECOMMENDED ACTION:=20 Because of TB's deadly connection to homelessness and because of the = standard's potential impact on program and facility operations, it is = vital that homeless people, service providers, advocates, funders, = public health authorities and local governments become familiar with = OSHA's proposal and provide comments to OSHA by December 16, 1997.=20 Informal public hearings on the proposal begin on February 3, 1998, in = Washington DC and may occur at other locations around the country. = Written comments and notices of intent to appear at public hearings are = due to OSHA by December 16, 1997. OSHA intends to convene a special = public hearing on "homeless shelters"; parties interested in this = special hearing must so indicate in their notice of intent to appear.=20 Comments on the proposed standard, Notices of Intention to Appear at the = informal public hearings, testimony, and documentary evidence are to be = submitted in quadruplicate to the Docket Officer, Docket No. H=AD371, = Room N=AD2625, U.S. Department of Labor, 200 Constitution Ave., NW, = Washington, DC 20210, telephone (202) 219=AD7894. Comments of 10 pages = or fewer may be transmitted by fax to (202) 219=AD5046, provided the = original and three copies are sent to the Docket Officer thereafter.=20 For more information on the proposed standard and on OSHA's requests for = comments, please read the Health Care for the Homeless Mobilizer or = contact the National Health Care for the Homeless Council at = hch@nashville.net. Please contact the National Health Care for the = Homeless Council if you wish to help develop an appropriate response to = the problem of tuberculosis among homeless people.=20 ------=_NextPart_000_002E_01BD008A.2317EFA0 Content-Type: text/html; charset="iso-8859-1" Content-Transfer-Encoding: quoted-printable <!DOCTYPE HTML PUBLIC "-//W3C//DTD W3 HTML//EN">

H. C. Sonny Covington @ = I CAN!=20 America
Lafayette - New Iberia, LA 70563-1722
(318)=20 364-6239 Fax 318-367-9141

ARCH Homeless Network = Alert

December 3, 1997

OSHA Tuberculosis Standard for Shelters and HCH=20 Projects

BACKGROUND:=20

In the October 17 issue of the Federal Register, the = Occupational=20 Safety and Health Administration (OSHA) published its Proposed Standard = on=20 Occupational Exposure to Tuberculosis. The standard directly addresses = employee=20 exposure to Tuberculosis (TB) in hospitals, nursing homes, homeless = shelters,=20 substance abuse treatment facilities and other workplaces. If adopted, = the=20 standard will require shelters and HCH programs to adopt significant = engineering=20 and procedural measures designed to reduce the risk of tuberculosis = infection.=20 The proposed standard would dramatically affect the provision of = services to=20 homeless people.=20

OSHA anticipates that homeless shelters and substance abuse treatment = centers=20 will use "early identification and transfer procedures for = individuals with=20 suspected or confirmed infectious TB." For these work settings, = employers=20 must [partial list]:

make a formal determination regarding occupational exposure to = TB for=20 employees in various job classifications or performing certain = duties;=20
use procedures to promptly identify individuals with suspected = or=20 confirmed infectious TB;=20
mask or segregate such individuals;=20
transfer such individuals to facilities with isolation rooms = within five=20 hours of identification;=20
provide temporary isolation (in rooms with engineering controls = such as=20 negative pressure, direct exhaust or HEPA filtration) if transfer = cannot be=20 accomplished within five hours of identification;=20
provide respirators for employees who enter a temporary = isolation area=20 or who work in an area where an unmasked individual with suspected = or=20 confirmed infectious TB is segregated and awaiting transfer;=20
assure proper fit and usage of the respirator;=20
provide medical surveillance, including physicals and skin = tests, for=20 employees who are occupationally exposed, and maintain records of = the=20 medical surveillance for 30 years;=20
follow detailed procedures following exposure incidents, which = may=20 include "medical removal" of certain employees and paid = leave for=20 up to 18 months;=20
label segregation and isolation areas and ventilation systems; = and=20
provide appropriate training of staff and maintenance of = engineering=20 controls.=20

The full text of the standard can be found at www.access.g= po.gov/su_docs/aces/aces140.html=20 or in libraries that provide the Federal Register.=20

RECOMMENDED ACTION:=20

Because of TB's deadly connection to homelessness and because of the=20 standard's potential impact on program and facility operations, it is = vital that=20 homeless people, service providers, advocates, funders, public health=20 authorities and local governments become familiar with OSHA's proposal = and=20 provide comments to OSHA by December 16, 1997.=20

Informal public hearings on the proposal begin on February 3, 1998, = in=20 Washington DC and may occur at other locations around the country. = Written=20 comments and notices of intent to appear at public hearings are due to = OSHA by=20 December 16, 1997. OSHA intends to convene a special public hearing on=20 "homeless shelters"; parties interested in this special = hearing must=20 so indicate in their notice of intent to appear.=20

Comments on the proposed standard, Notices of Intention to Appear at = the=20 informal public hearings, testimony, and documentary evidence are to be=20 submitted in quadruplicate to the Docket Officer, Docket No. H371, = Room=20 N2625, U.S. Department of Labor, 200 Constitution Ave., NW, = Washington, DC=20 20210, telephone (202) 2197894. Comments of 10 pages or fewer may = be=20 transmitted by fax to (202) 2195046, provided the original and = three copies=20 are sent to the Docket Officer thereafter.=20

For more information on the proposed standard and on OSHA's requests = for=20 comments, please read the Health= Care for=20 the Homeless Mobilizer or contact the National Health Care for the = Homeless=20 Council at hch@nashville.net. Please=20 contact the National Health Care for the Homeless Council if you wish to = help=20 develop an appropriate response to the problem of tuberculosis among = homeless=20 people.