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States Lifting Bans on Elective Procedures [COVID-19]

Posted on: May 01, 2020

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While the COVID-19 pandemic has caused certain states to ban hospitals and other medical facilities from performing elective procedures, we are now seeing some of these bans starting to lift.  Originally intended to help dedicate resources to fighting the virus, the bans will no longer be in effect in the following states. Read on for details:

Please note: This information was last updated on 5/28/2020. However, state protocol is constantly changing, so we will continue to make updates to this page. 

Alabama:


Beginning on April 30th, dental, medical, or surgical procedures may proceed unless the State Health Officer or his designee determines that performing such procedures would unacceptably reduce access to PPE or other resources necessary to diagnose and treat COVID-19. 


More Information


Alaska:

Alaska has taken a phased-approach to lifting the ban on elective surgeries and procedures, as follows:

  • Effective April 20th, health care facilities are able to resume low-risk, routine-type services that require minimal PPE by complying with specific requirements outlined in the mandate. Some examples of the procedures contemplated include: annual physical exams, prenatal appointments, and routine dental cleanings.
  • Effective May 4th, health care facilities are able to resume elective surgeries and procedures if delay is deemed to cause significant impact on health, livelihood, or quality of life AND the specific conditions outlined in the mandate are met (see link below at Section II for specific conditions). Some examples of the specific conditions include: (1) the facility has adequate PPE on hand and (2) capacity at the facility can accommodate both an increase in both COVID-19 hospitalizations and increased post-procedure hospitalizations. 

More Information 

Arizona:

Arizona's stay at home order has been extended to May 15th. 

However, beginning on May 1st, hospitals, dental offices, and other healthcare facilities are still permitted to resume elective surgeries and procedures if they can show they've implemented certain safety measures (see specific measures below). Prior to resuming elective surgeries, however, facilities will need to receive approval from the Department of Health Services.

  • Demonstrating greater than a 14 day supply of PPE;
  • Ensuring adequate staffing and beds;
  • Testing patients prior to surgery and all at-risk health care workers;
  • Ensuring appropriate discharge plans for patients being transferred to nursing care facilities, including diagnostic testing for COVID-19;
  • Implementing a universal symptom screening process for staff, patients, and visitors;
  • Establishing an enhanced cleaning process for waiting areas; and
  • Prioritizing the restart of elective surgeries based on urgency.

More information

Arkansas:

Certain non-essential out-patient procedures are able to resume beginning on April 27th. In accordance with the Arkansas Department of Health's directive, elective procedures (including dental, eye, nasopharyngeal, chest surgery, and colonoscopy) shall be limited as follows:

  • Only outpatients with no plans for overnight stay.
  • An American Society of Anesthesiologists rating of I or II. If II-rating, their disease process should be well controlled.
  • No contact with known COVID-19 patients during the past 14 days.
  • Patients must be asymptomatic for COVID-19 per ADH guidelines.
  • Start with a small initial volume of cases and increase incrementally as PPE availability and number of statewide occurrences dictate.
  • Each institution must have an ample supply of PPE for resuming elective procedures while maintaining a reserve should there be a resurgence of the virus.
  • For an asymptomatic patient to be a candidate for a procedure, he/she must have at least one negative COVID-19 NAAT test within 48 hours prior to the beginning of the procedure.
  • Small rural hospitals under 60 beds and critical access hospitals are excluded from the requirements of the directive. 

More Information 

California:


California's Governor Newsom announced on April 22nd during a press conference that restrictions on essential non-emergency surgeries (for example, tumors, heart valves, and chronic disease) are lifted and health care facilities are able to resume scheduling these procedures.

On April 26th, the California Department of Public Health issued an announcement regarding certain considerations and guidelines for resuming elective procedures. Some of the considerations include prevalence of COVID-19, PPE supply, others specific to the setting (e.g., outpatient, dental, skilled nursing facility, etc). 

More information

Colorado:

Under an executive order from Gov. Jared Polis effective April 27, voluntary or elective medical and dental surgeries and procedures may resume if facilities are following required safety protocols. Facilities performing these procedures must develop a plan to reduce or stop voluntary or elective surgeries and procedures “if there is a surge” of COVID-19 infections in the county or municipality in which they are located. The state’s health department will determine the conditions that constitute a surge. 

More information

Connecticut:

On May 20, Nuvance Health hospitals and ambulatory care centers in Danbury, New Milford, Norwalk and Sharon, Connecticut opened for elective surgeries and endoscopy procedures as the region observes a decrease in the rate of new COVID-19 infections and in accordance with Governor Ned Lamont’s executive order. One of Nuvance Health’s most notable safety measures is mandatory COVID-19 testing for patients scheduled for a surgical procedure. 

More Information

District of Colombia:

The District of Columbia Department of Health (DC Health) is recommending that ALL elective medical procedures, non‐urgent hospital and outpatient visits, and non-urgent dental procedures be postponed to preserve health care capacity . More Information

Florida:


As of May 4th, elective surgeries and procedures are allowed to resume.

 More Information

Georgia:

As of April 20th, elective surgeries and procedures are allowed to resume.

More information

Idaho:

While Governor Little announced a 4 stage plan to reopen Idaho, his original stay-at-home order did not prevent doctors and hospitals from performing nonessential surgeries and other procedures, but instead was a decision made by hospitals and medical clinics. It will be up to each health provider to decide when to resume offering those services. 

More Information


Illinois:

Beginning on May 11th, hospitals may begin to perform non-essential procedures so long as certain specific criteria have been met. 

More Information 


Indiana:

On April 21st, as part of a revised stay-at-home order, Gov. Eric J. Holcomb loosened restrictions on elective surgeries, stating that hospitals can conduct medically necessary procedures, including determining cancer diagnoses and cardiac issues, provided sufficient personal protective equipment, staff and other supplies are available for the COVID-19 response.

More Information

Iowa:

Iowa’s ban on non-essential procedures and surgeries will be lifted for certain healthcare facilities effective as of April 27th at 5:00 am. Specifically, hospitals and outpatient surgery/procedure providers who meet the below requirements may conduct: (1) in-patient surgeries and procedures that, if further delayed, will pose a significant risk to quality of life and (2) any outpatient surgeries or procedures. 

  • A hospital or provider must have (a) adequate inventories of PPE and access to a reliable supply chain without relying on state or local government PPE stockpiles to support continued operations and respond to an unexpected surge in a timely manner and (b) a plan to conserve PPE consistent with guidance from the CDC and Iowa Department of Public Health;
  • A hospital or provider must have a plan for timely COVID-19 testing of symptomatic patients and staff to rapidly mitigate potential clusters of infection and as otherwise clinically indicated. Providers must comply with any relevant guidance related to testing requirements for patients and staff issued by the Iowa Department of Public Health, the CDC, or a provider’s professional specialty society. For scheduled surgeries patients should have a negative COVID-19 test performed within 48 hours of surgery date. If a COVID-19 test is not available, a hospital or provider should consider alternative methods to determine the patient’s probability of COVID-19. If the patient has symptoms of fever, cough, or low oxygen saturation, then postponing the surgery is recommended. 
  • A hospital must continue to accept and treat COVID-19 patients and must not transfer COVID-19 patients to create capacity for elective procedures.
  • A hospital must reserve at least 30% of intensive care unit (ICU) beds and 30% of medical/surgical beds for COVID-19 patients.

Aside from the above, the remainder of the original proclamation banning non-essential or elective surgeries and procedures as well as elective dental procedures will expire on April 30th. Accordingly, unless the original proclamation is extended again or a new one is issued, all elective surgeries and procedures and all elective dental procedures are able to resume beginning on May 1st. 

More information

Kentucky:

Beginning on April 27th, health care practitioners can resume non-urgent/emergent health care services, diagnostic radiology and lab services in: (1) hospital outpatient setting, (2) health care clinics and medical offices, (3) physical therapy settings, chiropractic offices, and optometrists, and (4) dental offices with enhanced aerosol protections. This is considered phase 1 of Kentucky's health care services reopening. Elective surgeries and procedures will be addressed at a subsequent phase. 

More Information


Louisiana



On May 14, Gov. Edwards formally declared that Louisiana will enter into Phase One of its Roadmap to a Resilient Louisiana on Friday, May 15, when the Stay at Home order will be lifted and more businesses will be allowed to open with strict social distancing, enhanced sanitation and required masks for employees helping the public.The order specifies that Louisianans should still stay at home as much as possible to avoid unnecessary exposure to COVID-19. People who are at a higher risk of severe illness from COVID-19 should still stay at home unless they are traveling outside of the home for an essential activity, like obtaining food, medicine or medical care.

More Information

Maine



Elective procedures can resume starting May 1st, but you must meet certain requirements. Criteria is based on need.

More information 

Maryland



Gov. Hogan said elective medical procedures, including dentistry, that have been on hold for weeks will be allowed beginning Thursday. (May 7) 

More Information


Massachuetts

All hospitals are to adhere to guidance published by the Massachusetts Department of Public Health regarding the scheduling, cancellation, and performance of non-essential elective invasive procedures. The guidance recommends that providers use their clinical judgment on a case-by-case basis and consider the preservation of the patient's life and health. The guidance does not apply to the cancellation or delay of life sustaining care.

More Information


Nebraska:

Elective surgeries and procedures are allowed to resume beginning on May 4th under certain guidelines, as follows:

  • Hospitals can resume elective surgeries if they maintain 30% general bed availability, 30% ICU bed availability, 30% ventilator availability, AND have a two-week supply of necessary personal protective equipment (PPE) in their specific facility.
  • Procedural guidelines for resuming elective procedures will be at the discretion of the hospital or health clinic.

More information

Nevada:


Nevada hospitals will begin to schedule medically necessary outpatient and low acuity inpatient surgeries as of May 4. Nevada hospitals will provide medically necessary procedures based on an established plan to safely phase-in procedures based on:

• Clinical judgement
• Established guidelines
• Sufficient availability of personal protective equipment
• Flexible policies permitting immediate response to any COVID-19 surge
• Alignment with established guidelines developed by the Centers for Disease Control and other regulatory agencies.

More Information


New Hampshire



 The reopening plan released Friday (5/1), which Sununu dubbed “Stay At Home 2.0,” allows health care facilities to begin resuming elective and other time-sensitive procedures on May 4. Employees and patients will be screened for coronavirus symptoms before being allowed to enter any facility, and all providers are asked to monitor their levels of PPE to ensure adequate supplies. 

More Information 

New Jersey:



On March 23, 2020, Governor Murphy issued Executive Order No. 109, which suspended all “elective” surgeries performed on adults, whether medical or dental, and
all “elective” invasive procedures performed on adults, whether medical or dental, effective March 27, 2020, at 5:00 p.m. An “elective” surgery or invasive procedure, for
purposes of this Order, is defined as any surgery or invasive procedure that can be delayed without undue risk to the current or future health of the patient as determined
by the patient’s treating physician or dentist. Executive Order No. 109 remains in effect until further notice. Therefore, dentists are not permitted to resume “elective” surgeries and invasive procedures for adult patients until further notice, notwithstanding the reference to April 20 in the Board’s Advisory.


More Information



New Mexico:

All hospitals and other health care facilities, ambulatory surgical facilities, dental, orthodontic and endodontic offices in the State of New Mexico are prohibited from providing nonessential health care services, procedures, and surgeries.

More Information


New York:

Hospitals in certain counties in New York can resume performing elective outpatient treatments beginning on April 28, 2020. ( so long as the hospital capacity is over 25 percent for the county and there have been fewer than 10 new hospitalizations of COVID-19 patients in the county over the past 10 days) 

There are some additional conditions, as follows:

  • If a hospital is located in a county eligible to resume elective outpatient treatments, but that hospital has a capacity under 25 percent or has had more than 10 new hospitalizations in the past 10 days, that hospital is not eligible to resume elective surgeries.
  • If a county or hospital that has resumed elective surgery experiences a decrease in hospital capacity below the 25 percent threshold or an increase of 10 or more new hospitalizations of COVID-19 patients, elective surgeries must cease.
  • Patients must test negative for COVID-19 prior to any elective outpatient treatment.  
  • Restrictions on elective surgery will remain in place in Bronx, Queens, Rockland, Clinton, Yates, Westchester, Albany, Richmond, Schuyler, Kings, New York, Dutchess, Sullivan, Ulster, Erie, Orange and Rensselaer Counties.

More information



North Carolina:

The North Carolina Department of Health and Human Services issued a letter on March 20, 2020, requesting that effective March 23, 2020, all hospitals and ASCs suspend all elective and non-urgent surgeries and procedures. These are defined as “any procedure or surgery that if not done within the next four weeks would cause harm to the patient.” The letter also notes that hospitals and ASCs, starting on March 20, 2020, should institute an explicit, real-time review of all non-time-sensitive surgeries and procedure.

More Information




Ohio:

As per the Governor’s announcement on April 27, 2020, dental offices are permitted to open on May 1, 2020 to provide dental services. Dental healthcare providers are advised to exercise the utmost caution and strictly adhere to infection control protocols and guidelines from the CDC to maintain a safe environment and to minimize patient-to-patient contact. 

More Information  

Oklahoma:

As of April 24th, Governor Kevin Stitt will allow any procedure for conditions that are not life-threatening — and which would have the potential for increasing disease or death if not provided — to be performed.

More Information

Oregon:

Elective surgeries and procedures are allowed to resume beginning on May 1st as long as certain criteria are met. There are two separate "frameworks" that outline the specific criteria for hospital and ambulatory surgical centers on the one hand and medical and dental offices on the other.

More Information



Pennsylvania:



Beginning on April 27th, ambulatory surgical facilities (ASFs) may begin performing elective surgeries and procedures if the ASF makes an affirmative decision that it is able to do so without jeopardizing the safety of patients and staff or the ASF's ability to respond to the COVID-19 emergency.

More Information


Rhode Island



PROVIDENCE, R.I. (WPRI) — Rhode Island Governor Gina Raimondo announced Monday all Rhode Island hospitals have submitted plans on how they will safely resume non-critical procedures and surgeries.In her Friday briefing, Gov. Gina Raimondo announced it was time for Rhode Island hospitals “to get back into the business” of performing some non-critical surgeries. The governor said this was due to Rhode Island not hitting a surge in hospitalizations, the anticipation the state’s new field hospitals will not be needed, and to bring back a key source of revenue to hospitals. The governor said Friday the allowance of some of the procedures starting to be rescheduled again is an example of what it will be like to reopen the economy in stages. 

More Information



South Carolina



Gov. Henry McMaster's spokesman, Brian Symmes, said Thursday morning that the Republican governor is working with the South Carolina Hospital Association to "determine when and how hospitals can gradually resume elective surgeries while keeping South Carolinians safe." (Apr 17th). This comes after House Minority Leader Todd Rutherford of Columbia called for hospitals to resume elective procedures. According to DHEC, more than 5,000 hospital beds are currently available in South Carolina. However, the bed-utilization rate has crept up from 50.7% to 54.7% in just three days. 

More information


South Dakota

South Dakota does not have a stay-at-home order. Some elective procedures occurred through March and April, and on May 31st healthcare providers will be allowed to begin performing all nonessential, elective surgeries, which they have been asked to postpone to preserve personal protective equipment.

More information


Tennessee:

Tennessee resumed elective procedures in phases starting Friday, May 1. This comes as hospitals have been conserving resources during the COVID-19 pandemic to address a potential surge in patients.


Dr. Wendy Long with the Tennessee Hospitals Association called bringing back elective surgeries a "cautious return." The association worked with the state's Unified Command on the future return of elective surgeries to make sure hospitals are methodical about prioritizing their resources. (https://fox17.com/news/local/t... )

 More Information  

Texas:

Beginning on May 1, the only COVID-specific limitations on practicing medicine/dentistry include:  

(1) All licensed health care professionals shall be limited by and must comply with any emergency rules promulgated by their respective licensing agencies dictating minimum standards for safe practice during the COVID-19 disaster; and

(2) All hospitals licensed under Chapter 241 of the Texas Health and Safety Code shall reserve at least 15% of its hospital capacity for treatment of COVID-19 patients.

More Information

Utah

On April 21, the executive director of the Utah Department of Health issued a state public health order, which allows some elective medical procedures to resume. Each hospital and surgery center in Utah must follow the protocols developed by the Utah Hospital Association

More information

Vermont

As of May 15th, The state's healthcare providers will be allowed to return to performing nonessential or elective procedures.

More Information


Virginia

Elective surgeries are allowed to resume as of May 1st.

More Information

Washington

On March 19th, Governor Inslee announced his original order which stopped all non urgent medical and dental procedures. On April 13th, he issued new guidance in how his initial order should be interpreted.

The original order applied to all procedures not expected to “cause harm to the patient” if delayed for three months. It did not define “harm.”

The new guidance leaves assessment of harm up to the individual clinician, saying providers should consider how a patient’s illness or injury is causing pain and dysfunction in daily life.

More Information


West Virginia


As of April 28th, Healthcare providers that have applied to the state's Office of Health Facility Licensure and Certification and received approval may resume elective surgeries.

More Information

Wisconsin

Wisconsin has not yet prohibited elective surgeries. Guidance from the Wisconsin Department of Health, DPH Numbered Memo 2020-14 does recommend that dental practices postpone all elective and non-urgent care treatment.

More information 

Wyoming



While the Wyoming Department of Health and Governor’s Office did not prohibit elective procedures through statewide orders, hospitals and providers were encouraged to follow guidance from CMS and CDC that recommended suspending these procedures in order to preserve PPE and protect Wyoming’s hospital capacity during the outbreak. The Department of Health is recommending that hospitals and providers follow the current CMS guidelines with respect to resuming elective procedures. The guidelines below are meant to assist in these decisions.

More Information

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