Rocky Mountain Region COVID-19 Healthcare Update (CO, ID, MT, NE, NM, UT, WY)

Healthcare Essential Businesses

Essential Procedures

PPE

Relaxation of Licensing Requirements

Visitation to LTC

Telehealth

• Hospitals, clinics, and walk-in health facilities
• Medical wholesale and distribution
• Pharmacies
• Medical supplies and equipment manufacturers and providers, including durable medical equipment technicians and suppliers
• Blood banks

• Expired April 26, 2020

• DORA will waive licensing requirements and rules to allow for late renewals, reinstatements, and reactivations of the volunteer nurses and other qualified licensed providers from out of state

• Allow for clinical instruction to continue via simulation, ensuring continued training and an accessible workforce
• Suspends current requirements that no less than 16 hours of clinical instruction occur under the direct supervision of an RN or LPN

• Allows physicians who are not licensed in CO to provide medical care in an emergency if the services are free of charge
• Allows physicians licensed and lawfully practicing medicine in another state or territory without restrictions to provide occasional services in Colorado. The physician must not have a regular practice in CO and have medical malpractice insurance.

• Suspension of C.R.S. § 12-240-107(5)
• Suspends the requirement that all licensees designated in § 12-240-107(3), C.R.S., must confine themselves strictly to the field for which they are licensed and to the scope of their respective licenses

• Suspension of requirements for endorsement under C.R.S. § 12-240-110(1)(d)(I)(C), C.R.S., which requires active practice for at least five of the immediately preceding seven years.
• Suspension of requirement under § 12-240-118(1), C.R.S., that requires a physician to have been on inactive status for not more than two years prior to receiving a pro bono license

• Suspension of Colorado Medical Board Rules 120 and 410 requiring demonstration of continuing competency for licensure, reinstatement or reactivation for physicians and physician assistants

• Relaxes and suspends certain statutory requirements surrounding telehealth to make it easier for patients to receive care via telehealth

Healthcare Essential Businesses

Essential Procedures

PPE

Relaxation of Licensing Requirements

Visitation to LTC

Telehealth

• Hospitals,
• Clinics,
• Dentists,
• Pharmacies,
• Pharmaceutical and biotechnology companies,
• Other healthcare facilities,
• Healthcare suppliers,
• Home healthcare services providers,

Out-of-state physicians and PAs do not need an Idaho license to practice in Idaho during COVID-19

Guidance for Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19) in Residential Assisted Living Facilities

All facilities should restrict visitation of all visitors and non-essential health care personnel, except for certain compassionate care situations, such as an end-of-life situation in which case visitors are assessed on case by case basis.

Healthcare Essential Businesses

Essential Procedures

PPE

Relaxation of Licensing Requirements

Visitation to LTC

Telehealth

• Expired on April 26
• Essential businesses still open

• hospitals;
• clinics;
• dental offices; pharmacies;
• public health entities, including those that compile, model, analyze and communicate public health information;
• pharmaceutical, pharmacy, medical device and equipment, and biotechnology companies (including operations, research and development, manufacture, and supply chain);
• licensed medical cannabis dispensaries and licensed cannabis cultivation centers; reproductive health care providers;
• home Health Care services providers;

While many Montana healthcare providers have voluntarily ceased elective and non-essential procedures, there has been no state-mandated requirement to do so.

N/A

The Montana Department of Labor & Industry has implemented a COVID-19 Emergency Healthcare Registration for out-of-state healthcare licensees requesting to actively work in Montana for a defined period of time. The Department will evaluate home state license(s) according to licensing regulations in Montana, to verify it is currently active, unrestricted, and in good standing, and issue a registration to work in Montana. The registration is only valid until the current emergency directives are rescinded.

N/A

Four major health insurance companies operating in Montana have voluntarily expanded their coverage of telehealth services to aid in the state’s response to the virus known as COVID-19, but there has been no state mandate to do so.

Healthcare Essential Businesses

Essential Procedures

PPE

Relaxation of Licensing Requirements

Visitation to LTC

Telehealth

• Bars gatherings of more than 10 people in Douglas, Sarpie, Cass, and Washington Counties of Nebraska through April 30, 2020

• Elective medical and dental surgeries and elective medical and dental procedures are prohibited.

• Surgeries or procedures that must be done to preserve the patient’s life or physical health, but do not need to be performed immediately, are allowed by a case-by-case determination of the medical provider

N/A

• Waives specific statutes and regulations arising from the Health Care facility Licensure Act, the Assisted Living Facility Act, the Nebraska Healthcare Certificate of Need Act, and Nebraska Revised Statute §71-6039(c), § 71-6039.01(3), and § 71-6725(4) which could impair Nebraskans' ability to receive care and treatment in licensed hospitals and health care facilities during the COVID-19 state of emergency

• Waives specific statutes and regulations to access needed healthcare practitioners in Nebraska for thirty (30) days from March 21, 2020

• Temporarily allows individuals who are actively licensed in a U.S. state or territory other than Nebraska to practice in Nebraska without needing a Nebraska license. The license in the other state must be active, in good standing and free from disciplinary action

• Restrict all visitation except for certain compassionate care situation, such as end of life situations or hospice; and

• Nebraska statutes, including but not limited to N.R.S. § 38-1,143, currently authorize any credential holder under the Uniform Credentialing Act to use telehealth in establishing a provider-patient relationship

• Out-of-state providers who work in Nebraska pursuant to Executive Order 20-10, Coronavirus, Additional Healthcare Workforce Capacity, are authorized to use telehealth under the same statutory provisions that permit Nebraska health care providers to use telehealth

• Health care providers are not required to obtain a patient’s signature on a written agreement prior to providing telehealth services.

• Nebraska Medicaid will abide by any federal guidance issued related to HIPPA approved or allowable technologies.

Healthcare Essential Businesses

Essential Procedures

PPE

Relaxation of Licensing Requirements

Visitation to LTC

Telehealth

• Non-essential means procedures which can be delayed for 3 months without undue risk

• Does not apply to emergency medical care, surgery that if not performed would result in a serious condition of worsening, and family planning services

• Restricts health care providers and medical suppliers with an inventory of PPE from reducing its inventory via selling, distributing, etc. without prior approval from NWHD

• Permits the New Mexico Department of Health (NMDOH) to allow Canadian nursing professionals who are licensed and in good standing to work in any New Mexico healthcare facility during the Pendency of the COVID-19 pandemic

• Can request a graduate permit if you are new to the nurse/APRN role or a temporary license if you are endorsing an APRN license or a LPN/RN license from California (RN only), Michigan, and Pennsylvania
• Nurses currently licensed to practice as a RN or LPN in a jurisdiction of the United States may practice in New Mexico without making application for a New Mexico license for a period not to exceed 30 days
• Employers can consider loosening the requirement for new hires to hold permanent licenses prior to the first day of work during the COVID-19 pandemic

Physicians

• Provides temporary license to individuals who can provide proof of medical school graduation, passing the USMLE tests, and two years of post-graduate training
• Waives the remaining documentation requirements such as work verification, recommendation letters, specialty board

• Applicant must certify they cannot obtain the remaining documentation or documentation will be delayed because of COVID-19

• Authorizes emergency funds for the Aging and Long-term Services Department to assist in relief efforts during the state wide public health emergency due to COVID-19

• Prescribing controlled substances still must be medically appropriate, well-documented and continue to conform to NMMB pain rules
• NMMB encourages applicants to access this licensure type if the focus of the medical practice will remain telemedicine in nature

Healthcare Essential Businesses

Essential Procedures

PPE

Relaxation of Licensing Requirements

Visitation to LTC

Telehealth

• Healthcare providers with privileges while practicing at hospitals or ambulatory surgical facilities

• Healthcare providers required to wear face shields or goggles that seal around the eyes when performing procedures that create an aerosol

• Screen each individual entering healthcare facility for temperature and symptoms of individual and those in individual’s household

• To follow guidance issued by Centers for Medicare and Medicaid Services, Center for Clinical Standards and Quality.

Healthcare Essential Businesses

Essential Procedures

PPE

Relaxation of Licensing Requirements

Visitation to LTC

Telehealth

(Third continuation of Statewide Public Health Order #2 dated 4/28/2020; Second dated 4/3/2020; Original order 3/20/2020.)

Exclusions include healthcare facilities (hospitals, medical facilities, home health agencies, personal care agencies, hospices, adult family homes, mental health centers, and pharmacies), alcohol and drug treatment centers, and long-term care and assisted living facilities.

N/A

N/A

• No disciplinary action will be taken against persons practicing as CNA, LPN, RN, or APRN without the required licensure when acting to protect a patient’s health or safety

• Primary care trained and certified APRNs may provide low risk treatment services to acute care patients as an interdisciplinary team member.
• Emergency intubation and ventilation support within the scope of practice of an RN with facilities to offer additional clinical training and oversight for these interventions
• RNs may perform a nursing history and physical, screening and assessment exams with facility inservice required
• CNA I can perform the eight skills offered in the level II curriculum under the delegation of a nurse after being oriented by the facilities in the skills
• RNs may be unable to obtain provider orders in specific settings (ie. school, community). The RNs will use their best clinical judgement to provide emergency treatments and make all attempts to post-rectify orders.

• Physicians and physicians assistants not licensed to practice in WY must apply for the exemption and then be approved by the WY Board of Medicine and State Health Officer

• Allowing WY licensed physician assistants to practice under emergency supervision of a WY licensed physician not previously approved as their supervisor

N/A

• Physicians licensed in another state may provide services via telehealth to a WY resident if there is already an established physician-patient relationship, but may not provide care that treats a new diagnosis if patient was not seen face-to-face for it in your home state.