April 6, 2020
On Friday, Governor Lee signed another Executive Order relating to the on-going COVID-19 pandemic and today the Governor made two important announcements pertaining to healthcare and infrastructure.
Executive Order No. 24
On Friday, April 3, Governor Lee signed Executive Order No. 24. The order includes the temporary suspension of selected state laws and rules, as well as other measures necessary to facilitate the response to the COVID-19 crisis. Key provisions include:
- Gives the Commissioner of Health authority to allow post-degree, pre-licensed mental or behavioral health professionals to treat patients through telemedicine under the supervision of a licensed professional.
- Extends payment due date for the professional privilege tax from June 1 to July 1.
- Suspends until July 1 the April 6 deadline for filing applications for property tax relief and tax freezes, so that elderly and other vulnerable populations will not have to visit public buildings to apply.
- Gives the Commissioner of Labor and Workforce Development the discretion to require a terminating employer’s information faster (within 4 days, rather than 7 days) in the unemployment benefits claims process, in order to speed up processing of benefits.
Read the full text of the order here.
Today, the Governor announced a $10 million investment in small and rural hospitals. Citing the financial strain that many small and rural hospitals are facing during the COVID-19 pandemic, the Governor said that these dollars will serve as a bridge until new federal funds are processed. The grant funds will be capped at $500,000 per hospital. Applications are live today and can be accessed here: https://www.tn.gov/ecd/rural-development/small-and-rural-hospital-readiness-grant.
The Governor also announced that $200 Million will be distributed to county and city governments through local support grants. Dollars may be used for road projects, I.T. upgrades, capital maintenance, utility system upgrades, public safety projects, and some disaster-related expenses. The grant amounts are based on population. Each county will receive at least $500,000, while each city or municipality will receive at least $30,000. The allocations for each county can be found here, and the city allocations can be found here. A one-pager with additional information can be viewed here.
April 2, 2020
Governor Lee Announces Stay at Home Order
Today, Governor Bill Lee announced that he will sign Executive Order 23 requiring Tennesseans stay home unless people are carrying out essential activities. This policy shift away from the Governor’s previous urging of citizens to stay home was done after consulting cell phone mobility and traffic data indicating the movement of Tennesseans is trending back toward pre-COVID-19 levels.
In his press conference, Governor Lee stated that an enforcement letter was sent out to law enforcement officials around the state with guidance on how to enforce the order, but ultimately, local governments will determine their own enforcement strategies. The order is effective immediately and will be in effect until April 14. The press release can be found here.
Governor Lee cautioned that April will be a tough month for Tennesseans as COVID-19 confirmed cases and deaths are expected to rise. Preparations are under way as FEMA approved Tennessee’s Major Disaster Declaration that will enable the Army Corps of Engineers to drastically increase the number of hospital beds, which includes transforming large convention centers, such as the Music City Center, into emergency hospitals.
Mayor Andy Berke issued an executive order today for individuals to shelter at their place of residence unless performing Essential Activities, Essential Governmental Functions, or to operate Essential Services Businesses. All public and private gatherings of more than ten people occurring outside a single household or living unit are prohibited, except for the limited purposes as expressly permitted by the order. The full text of the order can be found here.
April 1, 2020
Gov. Lee again had his afternoon COVID-19 briefing. Among other things, he talked about the plans to prepare for the surge of COVID cases and the need for additional hospital beds. He is working with the Unified Command to identify hotels, convention centers and other facilities that can be used. In addition, he asked that former health care workers consider returning to work.
TNCare Waiver Approval
TNCare was approved for a waiver from CMS for a number of federal Medicaid and Medicare requirements that pose issues or challenges for the health care delivery system in all counties in Tennessee. The waiver includes:
- Suspension of Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days
- Provider Enrollment Changes
- Provision of Services in Alternative Settings
Read the full text of the approval letter here.
Tennessee Innovation Crowdsource Platform
LaunchTN, working in partnership with Tennessee’s COVID-19 Unified Command, has unveiled the Tennessee Innovation Crowdsource Platform to engage companies to rapidly connect solutions, resources, and capabilities to major issues facing Tennessee. The platform will allow LaunchTN to organize and evaluate proposals, complete due diligence, and recommend strategies to state procurement specialists for expedited treatment.
LaunchTN is seeking proposals from companies that have an existing solution or one that can quickly pivot to address immediate challenges due to COVID-19. For more information and to register your business, click here.
Solicitations for proposals will be actively updated as the needs of Tennesseans evolve. Visit this page to find descriptions of open solicitations and specific details on needs and how to submit your proposal. Solicitations are listed by category and there is an opportunity to submit proposals to challenges not listed in existing solicitations.
Tennessee Chamber Launches TN Creators Respond
The program was created to help connect manufacturers with the capability of producing personal protective equipment and needed medical supplies with hospital systems and medical centers in need. Amid a nationwide shortage of testing, N95 masks, and other tools healthcare providers need to protect themselves and their patients against the spread of COVID-19. The program’s website is putting together manufacturers who want to help and health care providers who need supplies.
March 30, 2020
This afternoon, Governor Bill Lee issued Executive Orders No. 21 and No. 22, both aimed at combatting the COVID-19 crisis.
Executive Order No. 21 mandates a state-wide shutdown of all businesses and organizations who perform close-contact personal services such as barbers, massage spas, and nail salons. The Order also closes entertainment and recreational gathering venues such as night clubs, concert venues, and bowling alleys. The order is effective immediately and will stay in effect until April 14. The full text of the order can be viewed here.
Executive Order No. 22 urges Tennesseans to stay at home, except for when engaging in Essential Activity or Essential Services. The Order requires that businesses or organizations that do not perform Essential Services shall not be open for access or use by the public. A list of Essential Activities and Essential Services are included with the order in Attachment A. The order is effective at 11:59pm on March 31 and will stay in effect until April 14. The full text of the order is attached.
Most major metropolitan areas in Tennessee had issued stay at home orders and shut down nonessential businesses previously. (See prior updates.) The full text of the order can be viewed here.
In other news, the Department of Revenue has issued an additional guidance extending the due date to June 15th for the business tax that would be originally due April 15. That guidance joins the prior extensions of both the franchise and excise tax as well as the Hall income tax to June 15th as well. Click here for more information.
On March 26, 2020, Tennessee Governor Bill Lee signed Executive Order No. 20, with immediate effect. Executive Order No. 20 amended and significantly expanded the health care specific sections of Executive Order No. 15, dated March 19, 2020, which has been previously summarized and posted on our COVID-19 website.
As more fully summarized here, Executive Order No. 20 specifically addresses following areas: Licensing under Tennessee Code Annotated, Titles 63 (Professions of the Healing Arts) and 68 (Health, Safety and Environmental Protection); Investigations and Inspections by the Department of Health; Investigations and Inspections by the Board of Pharmacy; Pharmacy Technicians- Ration to Pharmacists; Medical Laboratory – Onsite Visit; Emergency Medical Services; Certificates of Need for Involuntary Commitment; Telehealth and General Suspension to Effectuate Order. The full text of Executive Order No. 20 can be found at https://publications.tnsosfiles.com/pub/execorders/exec-orders-lee20.pdf.
March 23, 2020
On March 23, 2020, Governor Bill Lee issued Executive Order #18, which restricts medical facilities from performing non-emergency procedures in order to conserve essential items needed to facilitate the response to COVID-19.
Effective at 12:01 a.m. on March 24, 2020, the following restrictions will be in effect until 12:01 a.m. on April 13, 2020:
- Dental service providers in the State of Tennessee shall not perform any non-emergency dental or oral procedures.
- All hospitals and surgical outpatient facilities in the State of Tennessee are prohibited from performing procedures not necessary to address a medical emergency or to preserve health and safety. The order provides examples of what procedures are included and excluded from the prohibition.
Additionally, non-hospital healthcare providers impacted by this Order are requested and encouraged to provide necessary personal protective equipment in their possession and not required for the emergency care exempted in the Order.
View the full text of the order here: https://publications.tnsosfiles.com/pub/execorders/exec-orders-lee18.pdf
Governor Lee announced today that he was creating a COVID-19 Unified Command. This effort will be lead by Commissioner Stuart McWhorter, who will be leaving his post at the Department of Finance and Administration in order to lead this joint command. The COVID-19 Unified Command will “streamline coordination across the Tennessee Emergency Management Agency (TEMA), Tennessee Department of Health and Tennessee Department of Military. Retired Brig. General Scott Brower will serve as the chief of staff for the operations.
Click here to read the press release announcing the creation of this new joint command.
On March 23, Memphis Mayor Jim Strickland declared Executive Order 3 of 2020 regarding the, “Safer at Home directive and closure of nonessential services and businesses.” The order is effective beginning at 6:00 pm on March 24, 2020, through midnight April 7, 2020.
The order requires City of Memphis residents to stay in their homes unless they are engaged in essential activities. This means that all mass gatherings of more than 10 people and all business activity, unless deemed essential, are prohibited. The order also prohibits all travel, including by public transit, unless it is necessary for an essential activity. The order further mandates that those who partake in essential activities outside their homes maintain six-foot social distancing whenever possible.
Activities that are deemed as essential are described as:
- Activities or tasks essential to the health and safety of themselves or their family members.
- Obtaining necessary services or supplies for their household or to deliver to others.
- Engaging in outdoor activities if individuals comply with social distancing.
- Performing work to provide essential products and services at an essential business or to carry out activities permitted by the order, including minimum basic operations.
- To perform payroll and other critical administrative functions for any business.
- To care for a family member or a pet in another household.
Minimum Basic Operations are described as:
- The minimum necessary activities to maintain the value of the business’s inventory, ensure security, process payroll and employee benefits, or for related functions.
- The minimum necessary activities to facilitate employees to work remotely.
A thorough, but not exhaustive, List of Essential and Nonessential Services was provided by the City of Memphis and can be found here.
The full text of the Executive Order can be found here.
March 22, 2020
Nashville’s Mayor, Jon Cooper, announced Sunday morning Order No. 3 closing all nonessential businesses. The “Safer @ Home Order” is an attempt to flatten the curve and to prevent the spike of cases that would be otherwise forthcoming.
Meharry’s Dr. Hildreth, an Epidemiologist by training and Vanderbilt’s Dr. Balser both appeared with the Mayor to support the order and to explain its need.
This order will be in place for 14 days but will allow delivery of goods in a safe manner.
On Sunday, March 22, Tennessee Governor Bill Lee signed Executive Order 17 calling for businesses across the state to utilize alternative business models beginning at midnight on Monday, March 23, 2020 until midnight April 6, 2020.
The Executive Order prohibits social gatherings of 10 or more people and implements these mandatory business interruptions until April 6:
- Bars and restaurants are to exclusively offer drive-thru, take-out, or delivery options. These establishments will be allowed to sell alcohol by take-out or delivery (with the purchase of food) in closed containers to those who are age 21 and up.
- Gyms and fitness centers are to temporarily suspend in-person services.
- Visitation to nursing homes, retirement homes, and long-term care or assisted-living facilities is now limited to visits involving essential care only.
Further, the order encourages all Tennessee business owners to seriously consider adjusting their business practices to comply with recommendations from the President and CDC, including implementing telework when possible. The order does not mandate sheltering in place.
This is Lee’s fourth Executive Order pertaining to the COVID-19 pandemic, with the first order released on March 12, 2020. This order is the first to include mandates to curb the spread of the virus. See the full Executive Order here.
March 20, 2020
Late yesterday, Governor Lee conducted his daily 3:00 Press Conference and Update regarding COVID-19 and discussed his just released Executive Order #15. The order is extensive and is heavily focused on the health care industry. Many provisions in statutes and rules are suspended along other necessary measures to facilitate the treatment and containment of COVID-19.
The order, among other things, waives some health care Tennessee licensure requirements, expands scope of practice for some providers without additional supervision, waives some CON requirements for expansion of hospital beds, allows pharmacists to fill 90 day maintenance prescriptions without proper authorization, urges insurance companies to cover telemedicine for COVID19, and waives the renewal or expiration of driver licenses for 6 months. More specifically, it does the following:
- Section 2 – Provides the Commissioner of Health the authority to permit health care professionals living in another state to practice in TN without a TN license. Forms will be posted on the Department’s website.
- Section 3 – Permits pharmacists to dispense maintenance prescriptions without authorization for up to 90 day for maintenance purposes, as necessary to respond to and prevent the spread of COVID-19. State restrictions on opioid prescriptions remain in place.
- Section 4- Permits home health visits by professionals who do not meet TN licensing requirements. (Necessary as a result of Section 2).
- Section 5 – Relieves nurse practitioners that have certificates of fitness from (1) certain filing requirements with the Board of Nursing, (2) chart review requirements, and (3) requirements for physician visits to remote sites.
- Section 6 – Relieves physician assistants from same requirements summarized in Section 5.
- Section 7 – Extends expiration date of facility and health care professional licenses for 3 months.
- Section 8- Permits pharmacists and pharmacy techs to process prescriptions remotely including from residences, subject to HIPAA compliance. This section does not alter regulation of pharmacy facility, recordkeeping or medication storage or dispensing.
- Section 9 – Permits the Commissioner of Health to allow unlicensed individuals to work as medical lab technologists for corona virus research, provided the individuals are employed by a medical laboratory and working under the supervision of the medical laboratory director, and further provided the individuals are postdoctoral fellows in a biological science.
- Section 10 – Suspends CON requirements for hospitals to add new beds or diagnostic facilities in order to respond to COVID-19.
- Section 11- Permits the addition of testing sites for COVID-19 without prior approval by the Medical Laboratory Board; laboratories must notify the Board of alternate sites.
- Section 12 – Permits construction of temporary structures in response to COVID-19 without plans review; structures will be subject to safety inspections.
- Section 38 – Permits telemedicine services by pain management clinics and for nonmalignant chronic pain.
March 19, 2020
Governor Lee’s Administration is now providing a daily update to Tennesseans on the COVID-19 virus and has created a website specifically for Tennessee COVID-19 Updates. The impact on state government continues to evolve daily and there have been major shifts that impact how the public interacts with state government.
The Lee Administration announced that over 15,000 state employees are currently working from home using the Alternative Workplace Solutions program through March 31st. This is a sizable portion of total state employee workforce, and the state is readying equipment so another 8,400 employees can telework by week’s end. Lee also noted that 37 percent of Tennessee State Employees are unable to perform their roles using Alternative Workspace Solutions. Further, state employees have been instructed to cease all non-essential business travel through March 31.
Vendors that work with state government have also seen changes as more and more meetings are held remotely or are canceled altogether when at all possible.
Lee also announced assistance for small businesses. Noting that 94 percent of Tennessee businesses have fewer than 50 employees, Lee said that any small business or nonprofit impacted by COVID-19 can apply for low interest loans of up to $2 million.
The General Assembly is working feverishly to pass a budget this week, shelving all other legislative matters unless it is deemed “essential.” The State of Tennessee had expected a large surplus of revenue that could have been spent on many key initiatives. When Governor Lee first released his proposed budget in January there was over a billion dollars of non-recurring dollars and approximately nine hundred million recurring dollars budgeted to be spent. Given the expectation that future state tax revenues will take a large dip in the coming months due to COVID-19, the Governor’s Office and the Legislature are negotiating a budget that is scaled down considerably. Governor Lee unveiled his budget amendment on Wednesday, March 18 with nearly a billion dollars in new funding from the original proposed budget shelved for the year.
The General Assembly is expected to pass a budget no later than Saturday, March 21 and then take a recess to reconvene potentially in June. Depending on the impact of COVID-19, the Legislature could possibly take up other legislation and budget items in June, subject to revenue projections. This is obviously a fluid situation, and there is an expectation that there will be changes to this plan as the state learns more on what the impact to COVID-19 is on the state.
Below you will find links to the Governor’s Executive Orders and other notices related to COVID-19: