Monday, Jan 10, 2022

Prepare for Cal/OSHA changes effective Jan. 14

As CDA explained in an email sent to members Jan. 7, the guidance being issued by multiple federal, state and local agencies remains confusing and complicated, and the confusion and disruptions are expected over the next several weeks until the current omicron surge wanes.

What we know
CDA is committed to providing members the most up-to-date and accurate information as it becomes available. Here is what we know right now:

• Cal/OSHA: On Dec. 16, Cal/OSHA approved a revised emergency temporary standard that will replace the current standard on Jan 14. The readoption of the ETS was necessary for Cal/OSHA to continue enforcing COVID-19 safety rules into 2022. The agency is expected to consider and adopt a permanent COVID-19 regulation this year.
• The ETS was initially the source of some confusion as it included more restrictive return-to-work criteria than were being released by other authorities. These more restrictive requirements were quickly reduced when it was recognized that they were inconsistent with the return-to-work guidance issued by CDPH (as is required by the December 2020 executive order requiring Cal/OSHA to be consistent with CDPH).
• CDPH: Within the last 10 days, the California Department of Public Health has begun to release quarantine and return-to-work guidance. So far, this guidance has been specifically for the public and for health care personnel working in acute care environments and permits shortened quarantine periods for fully vaccinated and boostered individuals based on various scenarios. While this action suggests how CDPH is viewing quarantine and return-to-work guidance, CDA has confirmed that the All Facilities Letters guidance released so far do not apply to dental practices.

What that means for dentistry is that we do not yet have updated or specific return-to-work guidance from CDPH for dental practices. However, CDA is working with the state dental director, Jay Kumar, DDS, MPH, to obtain the needed guidance, which is currently under review, though no release date has been announced.

In anticipation of guidance being released, dental practices are advised to continue utilizing existing return-to-work protocols for COVID infection and exposures. CDA offers several resources to assist with navigating the current environment, including the Reporting Symptoms/Positive Test for COVID-19 Flowchart. Please note that we anticipate the new CDPH guidance in the coming days and resources will be modified accordingly.

We also know that other elements of the Cal/OSHA Emergency Temporary Standards that go into effect Jan. 14 do still apply. Practice owners are advised to document all changes they are making to attempt to comply with these standards as soon as practicable. Please continue reading for additional information on what you can do now to comply with these ETS requirements.

What we are working on
As noted above, CDA is working closely with the state dental director to understand CDPH’s process for issuing return-to-work guidance for dentistry and to ensure members have clear direction on what they must do to practice safely and in compliance in California.

However, we also anticipate additional shifts in regulatory guidance as governmental entities respond to new information and mounting questions from the public and health care providers. CDA will continue to keep members up to date as information becomes available.

Information that will help you right now
CDA members are encouraged to review the following information and implement policies and procedures as appropriate:

• At this time, the best practices for reducing SARS-CoV-2 transmission in the dental office include full vaccination with booster as soon as eligible and mask-wearing for all staff at all times while in the office (no break-room exceptions), including the use of respiratory protection by staff providing clinical care.
• Dentists are reminded that the most stringent guidance always applies to their practice, whether it is local, state or federal. CDA offers a resource to assist member compliance with local public health orders.
• CDPH quarantine guidance for the public with SARS-CoV-2 infection includes wearing a mask for 10 days and isolating until symptoms are resolving and no fever is present. Dentists should follow these guidelines for determining when a patient can resume dental care.
• When determining employee exposure, “close contact” is defined by Cal/OSHA as being within six feet of an infected person for a cumulative 15 minutes or more over a 24-hour period, except if an individual is wearing a properly fitted respirator such as an N95.
• While PCR tests are more sensitive in determining if someone has contracted COVID-19, antigen tests are preferred for clearing someone for return to work because PCR tests are so sensitive that they may continue to give positive test results long after a person is no longer shedding the virus.
• Review the existing COVID-19 resources and information on cda.org for information on managing employees, infection control, PPE, testing and vaccination confidence.
• Begin preparations for complying with the Cal/OSHA Emergency Temporary Standards which take effect Jan. 14. Specifically, employers should be aware of the following changes which are unlikely to be affected by upcoming CDPH guidance:
  • Employers must make COVID-19 testing available at no cost and during paid time to all workers who had a close contact with a COVID-19 case in the workplace, regardless of workers’ vaccination status and even if they are asymptomatic.
  • Revised definition of “COVID-19 test” specifies employers or a telehealth professional must observe the test and results if worker uses at home a test with self-read results.
  • Revised definition of “face covering” as a solid piece of material without slits, holes or punctures and should not let light pass through when held up to a light source.
  • Employees who are exempt from wearing a face covering due to a medical condition and who cannot wear a nonrestrictive alternative must be six feet from all other persons and either be fully vaccinated or test weekly for COVID-19 during paid time.
  • Employers must make additional changes to their Injury and Illness Prevention Plan COVID-19 addendum based on the above-noted bullets as well as the specific return-to-work criteria (once available).

What you can expect from us
We will ensure that all information shared is as accurate and useful as possible. We are working to reduce the confusion in the government guidelines and create tools to help practices manage workplace infection, staffing questions and patient management.

We will provide updated tools and resources to assist compliance with the Cal/OSHA ETS and CDPH guidance once the dental-relevant guidance is issued. Please watch for additional information in the CDA newsroom and through CDA’s social media channels.