April 17, 1997

Patricia O'Malley, Esquire
Special Care, Inc.
707 Bethlehem Pike
Erdenheim, Pennsylvania 19038

Dear Ms. O'Malley:

Thank you for your letter of February 13, concerning the applicability of the Bloodborne Pathogens Standard, 29 CFR 1910.1030, for employees who work as companion-sitters in private homes was discussed in detail during a telephonic conversation with a member of my staff, Wanda Bissell, on April 2. This letter will serve to highlight that discussion and reiterate the Occupational Safety and Health Administration's (OSHA) policies on providing the Hepatitis B vaccine.

The companion-sitter occupation is described by you as a "non-health care" service. You provided a list of tasks that employees perform when working as a companion-sitter, personal care attendant and homemaker for the elderly, ill, or disabled persons, such as bathing, feeding, cooking, assisting with walking, light housekeeping, running errands, and providing transportation. You have stated that these workers do not change bandages, nor do they give intravenous injections; however, there may be contact with blood when the employee handles bloody stool or urine or inserts suppositories. The description of a routine day seems to rarely include contact with blood or other potentially infectious materials (OPIM). However, as part of their collateral duties, these employees are expected to provide first aid.

OSHA policy states that designated first aiders are covered under the scope of the standard, however, failure to provide the Hepatitis B vaccine pre-exposure to persons who render first aid only as a collateral duty will be considered a de minimis violation carrying no penalty, provided certain conditions are met. These conditions include the requirement that employers institute a reporting procedure for all first aid incidents involving the presence of blood or OPIM and offer the vaccine to any employee who has rendered first aid in such an incident regardless of the occurrence of an actual "exposure incident" as defined by the standard. All other requirements of the Bloodborne Pathogens standard continue to apply to designated first aiders. This policy does not apply to employees who render medical assistance or emergency response activities on a regular basis.

I hope this has been responsive to your needs. If you have further questions, please feel free to contact Wanda Bissell of the Office of Health Compliance at (202) 219-8036 Ext. 36. Thank you for your interest in safety and health.

Sincerely,



John B. Miles, Jr., Director
Directorate of Compliance Programs



February 13, 1997

John B. Miles, Jr. Director
Directorate of Compliance Programs
U.S. Department of Labor
Occupational Safety and Health Administration
Washington, D.C. 20210

Re: SPECIAL CARE

Dear Mr. Miles:

I enclose a list of the tasks performed by SPECIAL CARE Caregivers to assist your information gathering process. We function under the definitions of companion-sitter provided at 29 CFR 552.6, 29 U.S.C. 213(a)(15).

Please contact my office with any questions, concerns or requests for information. We look forward to your guidance concerning compliance with OSHA requirements.

Sincerely,



Patricia O'Malley

SPECIAL CARE Caregiver task list:

Working in a companion-sitter, personal care attendant, homemaker capacity in the homes of elderly, ill and/or disabled persons, SPECIAL CARE Caregivers can: -provide supportive, hands-on personal care including bathing and toileting assistance -assist with self-administered medications -help with walking, bed-to-chair transfers and wheelchair-bound individuals -perform light housekeeping as part of other services provided -cooking, feeding and meal preparation -run errands, help with shopping -transportation as part of other services provided -provide friendly caring companionship or supervision and guidance if requested