Facial Covering Policy

SCOPE:
This policy applies to the University of Miami Health System (“UHealth”), any person that is a hospital employee, volunteer, student, resident, independent contractor, vendor, member of the Board of Hospital or Health System, or any other person who provides any care, treatment, or other services (including clinical staff and physicians) and/or patients at any of the University of Miami Hospital and Clinics.

PURPOSE:
To ensure the health and safety of our patients, employees, and visitors, facial covering will be required under certain circumstances, such as when a patient, visitor, or employee is exhibiting signs or symptoms of or has a diagnosed infectious disease that can be spread through droplet or airborne transmission.

This policy applies to all individuals two years of age and older listed under Section I titled “Scope.” Facial covering and other personal protective equipment recommendations and/or requirements or policies may be reviewed and reassessed with national and state standards as well as state and federal laws, rules, requirements, and regulations in the event of a community or other outbreak.

The standards and protocols in this Policy will govern in the event that UHealth encourages or requires the use of facial coverings at any of its locations. Unless otherwise noted, all other UHealth policies, procedures, and guidance that encourage or require the use of facial coverings are subject to the standards, protocols, and provisions herein.

This Policy does not apply to the use of personal protective equipment that are recommended and/or required for chemical or physical hazards that might require such equipment to prevent physical injury or harm in accordance with industry or other prevailing standards.

DEFINITIONS:
1. Common area – any area in a health care setting where patients are not treated, diagnosed, or examined.
2. Employee – for purposes of this policy only, any person under employment or contract of a health care setting, including health care practitioners, administrative staff, maintenance staff, aides, contractors, students, and volunteers.
3. Health care setting – any place where health care practitioners and/or health care providers practice their profession or provide services. For the sake of brevity only, the term “health care setting” may be referred to here as “Hospital.”
4. Patient – any person receiving a service from a health care practitioner or health care provider.
5. Sterile area – a location where surgery is conducted or where procedures that require aseptic techniques are performed.
6. Sterile procedure – an aseptic procedure with the goal of minimizing the risk of microbial contamination to reduce the rate of invasive or surgical site infection.
7. Visitor – any person in a health care setting who is not an Employee or Patient of the Hospital.
8. Facial covering – any cloth or surgical face mask, a face shield, or any other facial covering or material that covers the mouth and nose.

POLICY:
In certain circumstances, UHealth requires Employees, Patients, and Visitors to use facial coverings.

As to a Patient --
In the event that Hospital requires the use of facial coverings, a Patient may be required to wear a facial covering in the common areas of Hospital if the Patient is exhibiting signs or symptoms of or has a diagnosed infectious disease that can be spread through droplet or airborne transmission.

As to a Visitor --
In the event that Hospital requires the use of facial coverings, a Visitor may be required to wear a facial covering if the Visitor is:

Exhibiting signs or symptoms of or has a diagnosed infectious disease that can be spread through droplet or airborne transmission;
In any sterile area of Hospital, including where surgeries or procedures that require aseptic techniques or sterile procedures are performed;
In an in-patient or clinical room with a Patient who is exhibiting signs or symptoms of or has a diagnosed infectious disease that can be spread through droplet or airborne transmission; or
Visiting a Patient whose treating health care practitioner or provider has (i) diagnosed the Patient with or confirmed a condition affecting the immune system in a manner which is known to increase the risk of transmission of an infection to the Patient from others without signs or symptoms of infection; and (ii) determined that the use of a facial covering is necessary for the Patient’s safety.

As to an Employee --
Employees should avoid entering the Hospital if they are sick. Employees who are sick should contact their immediate supervisor and the Employee and Student Health Hotline at (305) 243-ONEU. Employees will be required to wear a Food and Drug Administration-certified medical/surgical mask (ASTM F2100) or a National Institute for Occupational Safety and Health-approved respirator if they are:

Conducting sterile procedures,
Working in a sterile area,
Working with a Patient whose treating health care practitioner has diagnosed the Patient with or confirmed a condition affecting the immune system in a manner which is known to increase risk of transmission of an infection from employees without signs or symptoms of infection to a Patient and whose treating practitioner has determined that the use of facial coverings is necessary for the Patient’s safety,
With a Patient on droplet or airborne isolation, or
Engaging in non-clinical potentially hazardous activities that require facial coverings to prevent physical injury or harm in accordance with industry standards.

UHealth reserves the right to require the use of facial coverings at the Hospital in other circumstances consistent with national and state standards and state and federal laws, rules, requirements, and regulations.

Opt out --
Under the Florida Patient Bill of Rights and Responsibilities contained in Section 381.026, Florida Statutes, “[a] patient in a health care facility has the right to retain and use personal clothing or possessions as space permits, unless for him or her to do so would infringe upon the right of another patient or is medically or programmatically contraindicated for documented medical, safety, or programmatic reasons.”

In the event that Hospital encourages or requires the use of facial coverings, then Visitors, Patients, and Employees may opt out from wearing facial coverings as follows:

If an alternative method of infection control is available, Patients and Visitors may opt out of any existing facial covering requirements by notifying a health care practitioner or provider of their decision to opt out of the requirement, and such request will be reviewed consistent with Hospital’s infection control procedures.
Employees may opt out of any facial covering requirements by submitting a request via Workday, which request will be reviewed by the Employee and Student Health Department.

Notwithstanding the opt-out provisions herein, in the event that Hospital requires the use of facial coverings, the following exclusions shall apply:

If there are no alternative methods of infection control or infectious disease prevention, a Patient may not opt out of any facial covering requirements in the following circumstances:

A Patient who has been diagnosed or is exhibiting signs or symptoms of an infectious disease that can be spread through droplet or airborne transmission is in the common area of Hospital;
Opting out has been identified by a health care practitioner or provider as being medically or programmatically contraindicated for medical, safety or programmatic issues; or
Opting out would otherwise infringe on the rights and would risk the safety or health of other Patients, individuals or staff/employees of Hospital.

If there are no alternative methods of infection control or infectious disease prevention, a Visitor may not opt out of any facial covering requirements in the following circumstances:

The Visitor has been diagnosed or is exhibiting signs or symptoms of an infectious disease that can be spread through droplet or airborne transmission;
Opting out would otherwise infringe on the rights and would risk the safety or health of other Patients, individuals, or staff/employees of Hospital; or
There are no alternative methods of infection control or infectious disease prevention.

An employee may not opt out of any facial covering requirements if the employee is:

Conducting a sterile procedure, including aseptic procedures or surgeries that call for practices that minimize the risk of microbial contamination to reduce the rate of invasive or surgical site infection;
Caring for a Patient or being present while sterile procedures are being performed, including aseptic procedures or surgeries;
Working in a sterile area of Hospital, including where surgeries or procedures that require aseptic techniques are performed;
With a Patient who is on droplet or airborne isolation;
Working with a Patient whose treating health care practitioner or provider has diagnosed the Patient with or confirmed a condition affecting the immune system in a manner which is known to increase the risk of transmission of an infection to the Patient from others without signs or symptoms of infection; and (ii) whose treating practitioner or provider has determined that the use of a facial covering is necessary for the Patient’s safety; or
Engaging in potentially hazardous activities that require a facial covering to prevent infection, injury or harm in accordance with national, state, and industry standards, and state and federal laws, rules, requirements, and regulations.

Hospital reserves the right to consider other exclusions from the opt-out provisions in order to comply with applicable state and federal laws, rules, requirements and regulations.

DISPLAY AND PUBLICATION
UHealth shall make this policy accessible from the home page of its website. In addition, this policy will be displayed in the lobby of the Hospital.

REFERENCES

Fla. Stat. § 408.824 (SB 252)
Fla. Stat. § 381.026 (Florida Patient Bill of Rights)
Fla. Admin. Code 59AER23-1 (Definitions Rule)
Fla. Admin. Code 59AER23-2 (Standards Rule)
OSHA Rules

Bloodborne Pathogens (29 CFR 1910.1030)
Personal Protective Equipment (29 CFR 1910. 132)
Respiratory Protection (29 CFR 1910. 134)

Conditions of Participation Infection Control Worksheet
Joint Commission

CDC Prevention strategies for Seasonal Influenza in Healthcare Settings: Guidelines and Recommendations.