Governor Larry Hogan issued a number of emergency orders on Tuesday to address rapidly increasing COVID-19 hospitalizations in Maryland. Aside from declaring a state of emergency, the governor called for the creation of alternate care sites, holds on nursing license expirations, and interstate health care license reciprocity.
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Data from the Department of Health (DOH) shows COVID-19 hospitalizations exceeded 3,000 on Monday, an all-time high that surpassed the state’s prediction of 2,000 during the winter surge’s peak in mid-to late-January 2022. The data also shows nearly 7,000 facilities are utilizing at least 85% of their beds, exceeding the recommended capacity for a hospital to properly staff.
Last week, the Maryland Hospital Association issued a letter requesting that the governor declare a partial state of emergency, citing overburdened health care staff, prompting Hogan to issue a 30-day emergency declaration.
“Hospital personnel are stretched to their limits and we cannot demand more from them.”
A second order allows the Maryland Institute for Emergency Medical Services Systems and State Emergency Medical Services Board to suspend certain licensing or certification restrictions relating to patient screenings and immunization or medication distribution.
Similar to the second order, an additional declaration also lifted certain licensure restrictions for nurses during the state of emergency. Under this order, nursing licenses that would otherwise expire in the next 30 days will be extended until Feb. 3, 2022. Nursing graduates, including those from out-of-state programs, will be allowed to practice registered nursing under appropriate supervision at a health care facility without passing the National Council Licensure Examination.
A key part of this order is the addition of interstate reciprocity, or the ability for health care practitioners licensed in other states to practice at Maryland health care facilities without prior authorization. This flexibility was championed by advocates such as Johns Hopkins Telemedicine’s Rebecca Caninio.
Other provisions of Hogan’s third order include the activation of the Maryland Medical Reserve Corps, restriction of elective surgeries, and issuance of directives to support COVID testing and staffing at nursing homes. It also authorized Maryland Secretary of Health Dennis Schrader to oversee the establishment of alternative care facilities for treating COVID patients. The cost of services at these alternative care sites would be regulated by the Health Services Cost Review Commission, which also directs hospital spending plans under the state’s all-payer model.
Along with the governor’s orders, DOH released a notice on updated eligibility criteria for COVID booster doses, via emergency authorization from the U.S. Food and Drug Administration on Monday. Pfizer-BioNTech booster doses are now available for people aged 12-15 years and immunocompromised children aged 5-11 years. The time frame after the completion of a second and booster dose was also shortened to at least five months.