New Executive Order Extends Waiver Authority for CDPH and EMSA

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On Aug. 16, Gov. Gavin Newsom signed an executive order reinstating certain authorities that had been granted to state government agencies early in the pandemic, but were withdrawn on June 11, 2021. Specifically, yesterday’s order does the following for two key provisions related to hospitals that were set to expire Sept. 30, 2021:

  • Authorizes CDPH to suspend licensing requirements found in the Health and Safety Code and Title 22 for general acute care hospitals, acute psychiatric hospitals, skilled-nursing facilities, and other facility types. However, the order newly and explicitly states that CDPH “shall not waive licensing requirements governing facility staffing ratios, except for individual facility waivers otherwise authorized by law.” Existing law authorizes CDPH to approve program flexibility requests for individual hospitals, including on staffing ratios; that authority remains unchanged by the executive order. The authority for CDPH to issue statewide blanket waivers, such as the space waiver in All-Facilities Letter 20-26.9, was set to expire Sept. 30, is now extended..
  • Authorizes the Emergency Medical Services Authority (EMSA) to allow out-of-state health care personnel to practice in California. (See EMSA’s COVID-19 website and scroll down to “Authorization of Out-Of-State Medical Personnel” for details.) 

Instead of expiring Sept. 30, these will now be in place until Dec. 31, 2021. CHA had advocated for extension of both authorities. CHA had also recommended that they be extended as soon as possible to provide certainty, particularly with respect to out-of-state personnel, given the need to secure contracts with traveler nurses and other staff to respond to the current surge.

Related to health care, the executive order also:

  • Authorizes CDPH to waive professional licensing and certification requirements and amend scopes of practice for certified nursing assistants, home health aides, nursing home administrators, and certified hemodialysis technicians.
  • Authorizes EMSA to add to optional scopes of practice for paramedics without first consulting with a committee of local EMS medical directors.
  • Authorizes EMSA to suspend licensing, certification, and training requirements for emergency medical technicians and paramedics and allows them to practice in any setting — including hospitals. EMSA has provided details in this memo and fact sheet
  • Authorizes the Department of Social Services (DSS) to waive licensing requirements for day care facilities, community care facilities, and residential care facilities for the elderly. DSS has allowed temporary employer-sponsored childcare without a license, provided certain conditions are met. DSS has issued guidance.

The authorities outlined above will remain in effect until Dec. 31, 2021.