On March 30, 2020, Governor Whitmer issued Executive Order 2020-30, which suspends certain scope-of-practice restrictions for a wide range of allied health professionals. The order lifts restrictions for certain health professionals who are working at their place of employment, are necessary to respond to the COVID-19 crisis, and are performing tasks appropriate to their education, training, and experience as determined by their supervisor.
Specifically, the order provides:
- Physician assistants may provide services without a written practice agreement with a physician.
- Nurse practitioners (advanced practice nurses) and nurse anesthetists may provide care without physician supervision.
- Registered nurses and licensed practical nurses may collect swabs necessary to test for COVID-19.
- Licensed practical nurses may provide nursing care within their education and experience without registered nurse supervision.
In addition to eliminating some supervisory requirements for the duration of the COVID-19 crisis, the order authorizes health-care facilities to use health-professional students to work in any capacity that the facilities deem appropriate to the students’ education and skill set. Medical students, physical therapists, and emergency-medical technicians are authorized to work as “respiratory therapy extenders” and operate ventilators under the supervision of doctors, nurse practitioners, or respiratory therapists. And the order authorizes out-of-state physicians in good standing in their original state to practice in Michigan.
The order also makes clear that health-care providers who provide services related to the COVID-19 crisis are generally immune from civil tort liability pursuant to MCL 30.411. That statute provides that during a state of emergency declared by the governor, health-care providers who provide services “at the request of a state official” are immune from civil liability. Per the order, health-care providers working on the COVID-19 emergency are working “at the request of a state official.” The order extends immunity to students and unlicensed volunteers providing such services. Neither the order nor the statute immunizes health-care providers from liability for gross negligence.
The order endorses an “all hands on deck” policy for health-care providers during the COVID-19 crisis. The State isn’t going to be concerned with the more technical aspects of scope of practice and supervision in relation to allied health professionals. The bottom line is that if allied health professionals are comfortable performing a task, they can perform that task if directed to so by a higher level professional.