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Providers question cost, value of OSHA standard

THE OCCUPATIONAL SAFETY AND HEALTH Administration has proposed a plan it says will save $9 billion by reducing work-related injuries. But the proposal, which would require certain employers to implement formal ergonomics programs, could force many long term care providers to squeeze thousands of extra dollars out of already strained budgets.

"It seems to us that OSHA is putting a very expensive cart before the horse to go ahead with this standard without basing it on sound scientific principals," said a spokesman for the Assisted Living Federation of America. ALFA, along with the American Health Care Association, and the American Association of Homes and Services for the Aging, opposes the proposed plan.

Under the proposed ergonomics program standard, employers whose workers perform manual handling jobs would be required to establish a basic ergonomics program for those jobs that includes training, ongoing analysis and reporting, and evaluation. In cases where an employee has sustained a documented work-related musculoskeletal disorder, the employer would be required to implement a more expanded ergonomics program.

"We believe the ergonomics standard, as it stands now, would have significant operational and economic implications for the long term care industry," says an AHCA spokesman. Opponents of the plan cite high start-up costs, excessive and time-consuming paperwork requirements, and a lack of understanding on OSHA's part of the complexities of lifting human patients as opposed to inanimate objects.

The average estimated start-up cost for a long term care facility to implement an ergonomics program meeting OSHA's requirements is $3,000, according to Marsha Greenfield, public policy attorney for AAHSA. The annualized cost of compliance per establishment is estimated at $14,000. "Nursing homes would probably have to purchase lifting equipment and hire outside consultants to comply with the program," Greenfield says. "These are up-front expenditures that are not reimbursed by government payors."

Additional costs would be incurred in order to comply with ongoing record keeping requirements. And a "medical removal protection requirement" contained in the standard could require employers to compensate injured employees over and above what is currently covered under worker's compensation plans.

But it isn't just the cost of compliance that concerns Greenfield and others who say the program guidelines are inadequate for the long term care industry. "We have to look at each resident individually, and develop a care plan for that resident. Some residents may require assistance in order to move from one place to another, but not actual lifting. You can't just go out and buy box-lifting equipment. It's just not that simple," she says.

Greenfield believes the industry can address the problem of work-related injuries without OSHA's mandate. Many providers have implemented special training and ergonomics programs. "OSHA's own statistics show that these programs have already reduced injuries," says Greenfield.

The standard won't take effect until early 2001, according to an OSHA staffer. At press time in early January, AHCA had requested a 60-day extension from the February 1 deadline for comments.
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Publication:Contemporary Long Term Care
Date:Feb 1, 2000
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