Governors across the country continue to leverage their executive authority to stop the spread of the Novel Coronavirus; provide care to those already infected; support front-line health care workers and protect Americans from financial devastation. USofCare is monitoring state executive action and will maintain a resource to highlight the innovative ways Governors are utilizing their authority to address this public health crisis. The examples below are not exhaustive, but rather aim to elevate unique solutions that are worth further exploration and replication.
Maximize and Support the Health Care Workforce
States are continuing to use executive orders and waivers to increase use of telemedicine to relieve in-person volume at hospitals as well as reduce COVID-19 transmission rates. In addition, states are limiting licensing requirements and expanding scope of practice to ensure all medical professionals are able to treat patients within the full scope of their training. Examples include:
- Expedite ability to provide Medicaid waivered services (including home and community-based services) through telemedicine (Ex: Minnesota, 20-12).
- Provide regulatory relief and flexibility to licensing boards in processing health professional clinical licenses, which can help facilitate care delivery across state lines and through telemedicine (MN 20-23).
- Allow telemedicine visits for patients with state-regulated plans to be paid the same as in-office visits for insurance purposes (Texas).
- Expedite licensing of retired physicians who meet certain criteria (Massachusetts).
- Expedite licensing of medical school graduates who have matched as an intern, resident or fellow and consider early graduation of fourth-year medical students (Massachusetts).
- Increase the number of nurses available to support the COVID public health emergency (Wisconsin).
Improve Supply Chain of PPE
States are taking action to address current and anticipated shortages of personal protective equipment for health care workers including shoring up existing resources, utilizing community-driven solutions (like voluntary collection from the public), and issuing executive orders to collect and inventory supplies from other industries. Examples include:
- Preserve supply chain of PPE by ordering inventory of non-hospital medical equipment from business, nonprofits, universities, veterinary clinics and other entities (Minnesota 20-16 and Colorado).
- Relieve weight restrictions for vehicles carrying and delivering necessary items, such as medical supplies, testing and treatment equipment, needed to respond to COVID-19 outbreaks in the state (Michigan 2020-12).
Reduce Transmission and Spread
Executive orders are being used across the county to decrease the risk of community spread in all walks of life including work, school, entertainment, and food supply. Many of these are covered in detail by the National Governors Association and National Conference of State Legislatures. Interesting examples include:
- Stay at Home and Shelter in Place Orders have been enacted across the county in 30+ states. One example is Oregon’s Stay at Home order, which orders residents to stay at home and adds social distancing requirements to various public and private facilities, and outdoor areas. Pennsylvania ordered the closure of all businesses that are not life sustaining.
- An alternative option is limiting public gatherings by a specific number of people. (Kansas Executive Order 20-04 temporarily prohibits mass gatherings of 10 or more.)
- One unique approach taken by Colorado is an executive order that all noncritical workplaces reduce their in-person workforce by 50% unless the employer can show that their employees work 6 feet or more apart from each other.
States are leveraging policies created by the Coronavirus Aid, Relief, and Economic Security or “CARES Act”, and many are taking additional steps to support Americans facing job insecurity.
- Minnesota and other states have suspended evictions during the declared public health emergency (MN 20-14).
- Michigan and Minnesota have provided for additional state-funded small business loans to support business impacted by social distancing and stay at home orders (MN 20-15 , and Michigan).
- Kentucky announced a plan to change parameters for mass layoffs: Any employer with at least 50 employees, who is laying off at least 15 employees, is encouraged to file an unemployment insurance claim on behalf of their employees through an E-Claims process, which is intended to automate and expedite the receipt of benefits for eligible workers.
- The Governor has also announced that state workers would begin helping at food banks.
- Colorado released an order to temporarily suspend requirements to appear before a notary public in person.
Comprehensive Resources on State Executive Orders: