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 (see https://www.butlersnow.com/2020/03/gov-lee-releases-executive-order-15-with-focus-on-health-care/).
As more fully summarized below, 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.
Licensing Requirements under Tennessee Code Annotated, Titles 63 (Professions of the Healing Arts) and 68 (Health, Safety and Environmental Protection)
- Extends deadline for an initial license applicant to pay application fees, including any state regulatory fee, originally due to the Department of Health between March 12, 2020 and May 18, 2020, until June 17, 2020. Fees already collected will not be refunded. Payment schedules for licenses and fees shall return to their original schedules in subsequent (Section 7.1)
- Provides that application documents do not need to be notarized. Instead, the license applicant may declare, certify, verify, or state under penalty of perjury that each document submitted in support of his/her application is a true and correct copy of what it purports. Such declarations, certifications, verification, and statements must be signed and (Section 7.2)
- Gives the Commissioner of Health the authority to grant a license, certificate, or registration to a healthcare professional, such as a retired healthcare professional, who has been out of practice for a period of time without requiring that individual to demonstrate continued competency or submit to an interview before a licensing board or other licensing authority, provided that the individual satisfies all other requirements for licensure, certification, or (Section 7.3)
- Suspends the requirement for individuals to complete or submit proof of completing continuing education requirements or to otherwise demonstrate continuing competence as a condition of reinstating a license, certification, or registration. (Section 7.4)
Department of Health Inspections and Investigations
- Gives the Commissioner of the Department of Health the authority to suspend any required onsite inspections of laboratories to the extent necessary to allow laboratories immediately begin testing for COVID-19. (Section 7.5)
- Suspends requirement for Department of Health to conduct inspections and investigations of a licensee. However, the Department of Health retains the authority to conduct any inspection or investigation when, in the Department’s sole discretion, the public health, safety, or welfare necessitates such inspection or (Section 7.6)
- Suspends requirements for Department of Health to inspect the following entities applying for licensure:
- pain management clinic if the applicant clinic will be physically located in the same location as another licensed pain management clinic where patients have been seen within the thirty (30) days preceding the submission of the application. (Section 7.7)
- facilities if the applicant facility is physically located in the same location as another licensed facility where patients have been seen within the thirty (30) days preceding the submission of the application. (Section 7.9)
- medical laboratory if the applicant laboratory is physically located in the same location where another licensed medical laboratory was located within the thirty (30) days preceding the submission of the new application. (Section 7.10)
- veterinary facility if the applicant veterinary facility is physically located in the same location as another licensed veterinary facility was located within the thirty (30) days preceding the submission of the new application. (Section 7.12)
In instances where the Department of Health elects to not inspect an entity applying for applying a license as described above, any provisions requiring such entity to be inspected are also suspended.
- Suspends requirement for Department of Health to conduct inspections of licensed pain management clinics at least every two (2) years in order to give the Commissioner of Health the discretion to extend the applicable inspection deadline when conducting an inspection would not be appropriate given the risks associated with COVID-19. (Section 7.8)
Department of Health Inspections and Investigations
- Suspends requirement for Board of Pharmacy to conduct inspections of license applicants with physical locations in Tennessee, including pharmacies, manufacturers, outsourcing facilities, oxygen suppliers, or wholesalers/distributors and warehouses provided by a Third Party Logistics Provider, if the applicant is physically located in the same location as another Department of Health licensee was located within the thirty (30) days preceding the submission of the new application. (Section 7.11)
Pharmacy Technicians – Ratio to Pharmacists
- Suspends restrictions regarding the ratio of pharmacy technicians to pharmacists. All statutes and rules regarding the supervision of a pharmacy technician by a licensed pharmacist remain in full force and effect, including, but not limited to, the requirement that a licensed pharmacist supervise, direct, and verify the accuracy of all pharmacy technician functions pursuant to Tenn. Comp. R. & Regs. 1140-02-.02(9). (Section 8.1)
Medical Laboratory – Onsite Visits
- Suspends requirement that a medical laboratory director make certain periodic in-person, onsite visits to the facilities the director oversees, so long as the director utilizes other technological means of maintaining and exercising (Section 9.1)
Emergency Medical Services (EMS)
- Enables the Emergency Medical Services Division of the Department of Health to utilize all licensed emergency medical services (EMS), EMS vehicles, and EMS personnel during the COVID-19 pandemic, as follows:
- Suspends the Department of Health’s obligation to annually inspect each ambulance service and emergency medical service and the vehicles of such services, except that newly licensed ambulance services, emergency medical services, and vehicles must still be
- Delays the expiration of any EMS service or vehicle license or certificate in good standing set to expire between March 12, 2020, and May 18, 2020 for three (3) months from the current expiration date.
- Delays the expiration of any EMS personnel license or certificate in good standing set to expire between March 12, 2020, and May 18, 2020 for three (3) months from the current expiration date.
- Allows any Emergency Medical Technician student, Advanced Emergency Medical Technician student, or Paramedic student who has successfully completed a Board-approved written exam to practice on a level that is commensurate with the level of examination that the student has successfully completed; provided that any such student shall, at all times, be supervised by a licensee in the same field who holds an unencumbered license at or above the level of the student.
Certificates of Need – Involuntary Commitment
- Allows the issuance of a certificate of need under Tennessee Code Annotated, Section 33-6-404, for the emergency involuntary commitment of a person with a mental illness or serious emotional disturbance based upon a telephone assessment of such person by a mandatory pre-screening agent designated pursuant to Tennessee Code Annotated, Sections 33-6-104 and 33-6-427, if the following conditions are met:
- The mandatory pre-screening agent is not reasonably able to conduct an evaluation in-person or via readily available telehealth services; and
- The mandatory pre-screening agent determines in the agent’s professional judgment that conducting the assessment via telephone with the person is clinically appropriate.
- Allows telehealth or telemedicine services to be provided by any provider licensed under Title 63, regardless of the provider’s authority to diagnose. This suspension does not otherwise alter or amend any licensee’s scope of practice or record keeping requirements. (Section 38.1)
General Suspension to Effectuate Order
- Suspends any state or local law, order, rule, or regulation that would limit the application of this Order. (Section 41.1)