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    COVID-19 Department Directives and Practice Matters

    GOVERNOR'S ORDERS, MDH Order, guidance, and letters

    01/29/2021 COVID-19 Update

               SUMMARY of Governor's Orders    
    1. Reiterates that health care providers who already have statutory authority to administer vaccines can administer the COVID-19 vaccines

    2. Expands the scope of practice of licensed health care providers to allow them to administer COVID-19 vaccines with appropriate training

    3. Authorizes all other individuals to administer COVID-19 vaccines after receiving appropriate training and under reasonable supervision 

    4. Since some COVID-19 vaccines require dilution before being administered, the order also authorizes licensed health care providers to prepare (dilute) the vaccine after receiving training 

            Adds daily vaccine reporting requirements on vaccinations of staff and residents via CRISP
    1. Requires nursing homes to appoint a vaccine point of contact to address coordination of vaccines with CVS/Walgreens to track staff and resident vaccinations
    2.  Adds in a technical note exempting EMS/OHCQ surveyors from testing requirements for entry in to a nursing home per CMS guidance 
    MDH Order- Amended Various Healthcare Matters:( see attachments for documents)
    • Requires all hospitals to submit a pandemic plan to the Health Secretary that includes strategies to expand hospital bed capacity. Plans due by Dec 8, 2020. 
    • If hospitals statewide reach a total of 8,000 hospitalizations (COVID and non-COVID) or greater, hospitals will be required to expand their staffed bed capacity by 10% of each hospital’s physical bed capacity within seven calendar days. 
    • The same mechanism will be activated at 9,000 and at 10,000 statewide hospitalizations of all patient types
    • Hospitals will have the flexibility to create additional bed capacity in whatever way makes the most sense for each hospital, including transferring patients to alternative sites, reducing elective and non-urgent procedures, and bringing on additional staffed bed capacity.
    • Advises hospitals and nursing homes that they should use the Maryland Board of Nursing’s March 2020 flexibilities to use unlicensed individuals as health care extenders and to perform nursing support tasks with appropriate training and supervision.

    • Suspends the COMAR requirement for a practicum for community health worker students and allows a CHW student to substitute it with employment as a CHW 

    • Recommends that hospitals use their community health workers to extend care.

    • Tells hospitals that they should use the Hospital Association’s Chesapeake Registry to fill their staffing needs

    • Recommends cancelling non-essential time off for staff through January 31, 2021 and that hospitals look at addressing staff barriers to work

    1. Governor to Med School Deans: asking them to create flexibilities in their programs to allow students to work/volunteer in hospitals and nursing homes

    2. Governor to Nursing Programs: asking them to create flexibilities in their programs to allow students to work/volunteer in hospitals and nursing homes

    3. MDH to Hospital CEOs: directing them to use the Chesapeake Registry, MDMedNow, and MD Board of Nursing licensing flexibilities to enhance hospital staffing per notice

    4. MDH/MSDE to local school superintendents and health officers: asking them to identify any school nurses or other county level staff so that they can help with county COVID activities

    CHANGES IN CME REQUIREMENTS-Effective Immediately

    Please be advised that the Board has recognized the hardships and safety issues ensued by the COVID-19 pandemic, and based on those concerns, has changed the CME requirements ONLY for the duration of the 12-1-2019 through 12-1- 2021 accrual window, which covers the 2022-2023 licensure renewal cycle.

    ALL 50 CME's may be attained online or in person, including the CPR for the non-lapsing certification, HOWEVER, 25 of the CME's, must be specific to podiatric medicine. CPR re-certification may be included as part of this specific CME accrual category.

    Below you will find the laws guiding the Board's decision:
    1. The Board is mandated to follow the Governor's Executive Order and its own Code of Maryland Regulations and statute.
    2. The in-person requirements are waived to provide consistency with the Governor's Executive Orders that limit all public face-to-face contacts to only those essential needs, in an effort to mitigate the risk of exposure to the coronavirus.
    3. A waiver of the continuing education requirements in light of catastrophic events such as this pandemic would require an executive order or a statutory change.
    4. The Executive Orders do not authorize the Board to waive actual continuing education requirements. They do allow for an accommodation in the interest of the health, safety and welfare of the public, which is what the Board has put in place, effective immediately.

    Staffing Message:

    During this unprecedented crisis, our health care workers on the front lines need reinforcements.

    The state of Maryland is adding to its medical reserve corps, and is also collecting information from health care providers looking to volunteer, or for contract positions. You can get more information at https://mdresponds.health.maryland.gov/

    We thank all health care providers for their interest in serving during this historic emergency.


    With respect to the 3/23/2020 Secretary's Directive and Order on Various Health Care Matters, the language in paragraph 5 regarding provision of services states: 'medical procedures that are critically necessary for the maintenance of health for a patient.' Determination of what this mean is something that is within each practitioner's clinical judgment as each individual patient's/client's case. The individual practitioners need to make that call.

    NEW: Governor's Executive Order about closures:

    A Board is not authorized to provide licensees with legal advice regarding the definition of essential businesses. Please refer to the Governor's Executive Order, the CISA list of essential businesses, the following guidance from the Office of Legal Counsel and the following Directive Order (#6) published by Secretary Neall below for guidance:


    Number: COVID19-04
    Date: March 23, 2020
    Re: Order of the Governor of the State of Maryland, Number 20-03-23-01, dated March 23, 2020, Amending and Restating the Order of March 19, 2020, Prohibiting Large Gatherings and Events and Closing Senior Centers, and Additionally Closing All Non-Essential Businesses and Other Establishments

    2. Businesses, Organizations, and Facilities That May Remain Open. The following is a non exhaustive list of businesses, organizations, and facilities that are included in the federal critical infrastructure sectors. The Order does not require these businesses, organizations, and facilities to close.

    The Healthcare and Public Health Sector includes, but is not limited to:

    i. Hospitals.
    ii. Healthcare systems and clinics.
    iii. Offices of health care providers, including physicians, dentists, and pharmacists.
    iv. Physical, occupation, and speech therapists.
    v. Behavioral health facilities and professionals, including psychologists, mental health counselors, and substance abuse counselors
    vi. Rehabilitation facilities.
    vii. Diagnostic facilities, including radiology, imaging, and laboratory facilities.
    viii. Health plans, payors, and billing companies.
    ix. Funeral homes and crematoriums.
    x. Senior living facilities, including independent living, assisted living, and skilled nursing.
    xi. Manufacturers and distributors of medical equipment and supplies.
    xii. Medical cannabis growers, processors, and dispensaries.
    xiii. Home health care companies. xiv. Pharmacies.


    Pursuant to Md. Code Ann., Health-Gen. §§ 2-104, 18-102, 18-103, 18-205, 18-902, 18-904, and Public Safety § 14-3A-03

    I, Robert R. Neall, Secretary of Health, finding it necessary for the prevention and control of 2019 Novel Coronavirus (“SARS-CoV-2” or “2019-NCoV” or “COVID-19”), and for the protection of the health and safety of patients, staff, and other individuals in Maryland, hereby authorize and order the following actions for the prevention and control of this infectious and contagious disease under the Governor’s Declaration of Catastrophic Health Emergency:


    Hospital Contingency Plans

    All licensed hospitals shall implement the medical staff plans required by COMAR to grant temporary disaster privileges. The plans shall remain in effect for the duration of the catastrophic health emergency.

    Elective and Non-urgent Medical Procedures - Licensed Health Care Facilities

    Pursuant to the Executive Order of March 16, 2020 relating to various health care matters and in accordance with the guidance issued by MDH and posted on its website at coronavirus.maryland.gov, all licensed hospitals, ambulatory surgical centers, and all other licensed health care facilities shall cease all elective and non-urgent medical procedures effective at 5 p.m., Tuesday, March 24, 2020 and not provide any such procedures for the duration of the catastrophic health emergency.

    Elective and Non-urgent Medical Procedures - All Health Care Practitioners

    Pursuant to the Executive Order of March 16, 2020 relating to various health care matters and in accordance with the guidance issued by MDH and posted on its website at http://coronavirus.maryland.gov, all providers of health care licensed, certified, or otherwise authorized under the Health Occupations Article shall perform only medical procedures that are critically necessary for the maintenance of health for a patient. All elective and non- urgent medical procedures and appointments shall cease effective at 5 p.m., Tuesday, March 24, 2020 and shall not be performed for the duration of the catastrophic health emergency.

    1. For Medicaid-related Coronavirus updates, visit mmcp.health.maryland.gov.
    2. For questions about the Coronavirus, visit coronavirus.maryland.gov.

    Due to the 'Emergency Declaration' from Governor Hogan, regarding COVID-19; Please be advised that the office will be closed until further notice, therefore the preferred method of contact is through email. Board staff will continue to check voicemail and emails regularly.

    Please email any verification requests or inquires to Elizabeth.Kohlhepp@maryland.gov or Eva.Schwartz@maryland.gov.

    Response times may vary. Your patience and cooperation are appreciated during this unprecedented occurrence.