Columns / Best Practices

Are you a healthcare provider?

New laws could create EHS practice opportunities

Is an EHS pro also a healthcare provider? The question is relevant because existing and proposed federal and state laws make special provisions for healthcare providers.

Reasonable accommodations

The proposed federal Pregnant Workers Fairness Act, H.R. 5647, introduced to Congress in May 2012, is an example of how healthcare providers may impact the workplace. H.R. 5647 had 112 co-sponsors but did not come out of committee at year end 2012. 

Iowa, Maryland and New York proposed a law similar to federal H.R. 5647 in March 2013.  Although specific language may differ, each of the bills includes the following: “… if the employee requests reasonable accommodations with the advice of the employee’s healthcare provider.”

Within the above bills, to determine reasonable accommodations the healthcare provider would consider if any of the following may be implemented without causing undue hardship to an employer:

  • Changing the employee’s job duties;
  • Changing the employee’s work hours;
  • Relocating the employee’s work area;
  • Providing mechanical or electrical aids;
  • Transferring the employee to a less strenuous or less hazardous position; or,
  • Providing leave.

Healthcare provider is not defined in the bills. This allows for interpretation whether an EHS pro, internal or external to the organization, may satisfy the role.

Healthcare provider

An EHS pro is a part of the healthcare workforce based upon the following:

The U.S. Bureau of Labor Statistics (BLS) Standard Occupational Classification (SOC) system includes the following classifications:

  • Major Group: 29-0000 Healthcare Practitioners and Technical Occupations
  • Minor Group: 29-9000 Other Healthcare Practitioners and Technical Occupations
  • Broad Group: 29-9010 Occupational Health and Safety Specialists and Technicians

The Broad Group breaks down further to 29-9011 Occupational Health and Safety Specialists who:

“Review, evaluate, and analyze work environments and design programs and procedures to control, eliminate, and prevent disease or injury caused by chemical, physical, and biological agents or ergonomic factors. May conduct inspections and enforce adherence to laws and regulations governing the health and safety of individuals. May be employed in the public or private sector. Includes environmental protection officers. Illustrative examples: Industrial Hygienist, Health and Safety Inspector, Environmental Health Sanitarian.”

OSHA health professional

An industrial hygienist is identified as a health professional within OSHA’s 2012 Hazard Communication Standard at 1910.1200(i)(3) as follows:

“In non-emergency situations, a chemical manufacturer, importer, or employer shall, upon request, disclose a specific chemical identity or percentage composition, otherwise permitted to be withheld under paragraph (i)(1) of this section, to a health professional (i.e. physician, industrial hygienist, toxicologist, epidemiologist, or occupational health nurse) providing medical or other occupational health services to exposed employee(s), and to employees or designated representatives.”

Judging competency

Organizations often defer to the advice of a healthcare provider with a medical credential such as MD or RN. Organizations, however, may be hesitant to defer to the advice of an EHS pro, particularly when the pro may not possess a license or certification and hold only a title such as industrial hygienist.  Although the American Industrial Hygiene Association has implemented strategy for title protection, be aware that for the most part anyone may call themselves an industrial hygienist.

One problem is that the healthcare provider title contains the aura of competency where none may exist. Some MDs and RNs have no practical knowledge of workplace hierarchy of controls.

How does an employer determine if an EHS pro acting in the capacity of a healthcare provider is competent to provide advice? Teamwork with medical healthcare providers such as an MD or RN is likely the best answer.

Should the role of an EHS pro as a healthcare provider be promoted? Promotion has its good and bad points. The good point is that promotion may elevate the pro’s prestige and perceived value in an organization’s eye. The bad point is that the pro must live up to expectations as a healthcare provider, whatever these expectations may be.

Further investigation

Individuals with an interest in the area should stay abreast of issue and conduct independent investigation. Investigation may begin with a visit to the U.S. HealthCare.gov http://www.healthcare.gov/news/factsheets/2010/07/health-care-providers.html

Public health and occupational health are slowly merging together. I recognize this trend as a consultant and have added the service mark “Helping employers, help families” to my business cards.

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Recent Articles by Dan Markiewicz, MS, CIH, CSP, CHMM

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