On March 29, 2020, Michigan Governor Gretchen Whitmer issued Executive Order 2020-30 (“E.O. 2020-30”) temporarily lifting certain licensure and scope of practice restrictions for health care professionals practicing at health care facilities in response to the COVID-19 public health emergency. E.O. 2020-30 contains the following provisions, which are effective immediately through the end of the COVID-19 public health emergency.
1. Temporary Suspension of Scope of Practice Restrictions. All provisions of Article 15 of the Michigan Public Health Code (“Code”), relating to scope of practice, supervision and delegation are temporarily suspended to the extent needed to allow:
- a licensed, registered or certified health professional;
- working as an employee or contractor in a “designated health care facility;”
- to provide medical services necessary to support the designated health care facility’s response to the COVID-19 pandemic;
- that are appropriate to the professional’s education, training and experience, as determined by the designated health care facility in consultation with its medical leadership (such tasks are referred to in this summary as “Medical Services”).
“Designated health care facility” is defined to include all health facilities licensed under the Code (e.g., hospitals, freestanding outpatient surgical facilities, nursing homes, hospices and hospice residence, homes for the aged, HMOs, and county medical care facilities), state-operated outpatient and veterans facilities, and state-owned surgical centers, as well as any entities used for surge capacity by these listed facilities. A designated health care facility is referred to as a “Facility” in this summary.
E.O 2020-30 gives the following non-exclusive list of specific examples of how the scope of practice restrictions are suspended:
(a) Physician’s Assistant. A physician’s assistant (PA) may provide Medical Services without physician delegation/supervision or a written practice agreement, without criminal, civil or administrative/licensure penalties for lack of a written practice agreement.
(b) APRNs and CRNAs. An advanced practice registered nurse (“APRN”) (i.e., nurse practitioner, certified nurse midwife, clinical nurse specialist) and a certified registered nurse anesthetist (“CRNA”), may provide Medical Services without physician supervision without criminal, civil or administrative/licensure penalties for lack of supervision.
(c) COVID-19 Test Ordering by Nurses. A RN or LPN may order nasal and throat swabs specimen collection from an individual suspected of being infected with COVID-19 for testing.
(d) LPNs. A licensed practical nurse (“LPN”) may provide Medical Services without physician supervision without criminal, civil or administrative/licensure penalties for lack of supervision.
(e) Pharmacists. A licensed pharmacist may provide Medical Services for routine health maintenance, chronic disease states, or similar conditions without physician supervision without criminal, civil or administrative/licensure penalties for lack of supervision.
2. Use of Students. Facilities may allow students enrolled in health professional licensure programs to provide Medical Services at the Facility, without need for a clinical affiliation agreement.
3. Respiratory Therapist Extenders. A Facility may allow medical students, physical therapists and emergency medical technicians to volunteer or work in the Facility as “respiratory therapist extenders” under the supervision of physicians, respiratory therapists (“RTs”) or APRNs, to assist RTs and other health care professionals in the operation of ventilators or related devices and provide Medical Services.
4. Permits Out-of-State Licensure for Health Professionals. Permits health professionals who are licensed in good standing in other states or United States territories to practice in Michigan without criminal, civil or administrative/licensure penalties for lack of Michigan licensure. Any license subject to limitation in another state/territory is subject to the same limitation in Michigan.
5. Permits Controlled Substance Distribution by Out-of-State Licensed Drug Manufacturer/Wholesalers. Permits drug manufacturers or wholesale distributors of prescription drugs licensed in good standing in other states or United States territories to temporarily distribute and ship controlled substances into Michigan to a hospital or to a licensed manufacturer or wholesale distributor. Any license subject to limitation in another state/territory is subject to the same limitation in Michigan.
6. Use of Volunteers. Subject to any conditions set by the Director of the Michigan Department of Health and Human Services, a Facility is temporarily authorized to use qualified volunteers or personnel affiliated with other Facilities, and to adjust the volunteers’ and personnel’s scope of practice as though they were affiliated with the Facility using the volunteers and personnel.
7. Rights and Immunities for Students and Volunteers. Unlicensed volunteers or students at a Facility who perform activities in support of the Michigan COVID-19 pandemic response are considered “personnel of a disaster relief force” under the Michigan Emergency Management Act (“Act”), and are entitled to the same immunities and rights provided to state employees under the Act when providing such services.
8. Protection from Liability for Health Professionals and Facilities. Licensed health professionals and Facilities that provide medical services in support of the Michigan COVID-19 pandemic response are not liable for any injury sustained by a person by reason of those services, regardless of how, under what circumstances, or by what cause the injuries are sustained, unless the injury is caused by the health professional’s or Facility’s gross negligence, as defined in the Act.
9. Suspension of Health Professional License Exams, Fingerprinting, Continuing Education. E.O. 2020-30 temporarily suspends all laws and rules that require, as a condition of licensure, certification or registration for any health professional, or for renewal of same, any of the following:
(a) An exam that has been canceled while the emergency declaration is in effect;
(b) Fingerprinting, to the extent that in the judgement of the Director of Licensing and Regulatory Affairs, fingerprinting locations are substantially unavailable due to COVID-19 related closures; and
(c) Continuing education while the emergency declaration is in effect.
10. Continuation of BCLS, ACLS, First Aid Certifications. Current and valid certifications for basic life support, advanced cardiac life support and first aid shall remain in effect during they emergency declaration, even if otherwise due to expire during the emergency.
11. Delay of Telecommunication Training Suspended for 60 Days. Deadlines for completing training or continuing education required under the Michigan Administrative Code for telecommunicators and trainees employed by primary public safety answering points are delayed by 60 days.
12. Suspension of Facility Employee Fingerprinting Requirement. All employee fingerprinting requirements that are a condition of licensure or certification for hospitals, nursing homes, county medical facilities or psychiatric hospitals are temporarily suspended.
Full text of Executive Order 2020-30 is available here.