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Elective Procedures

Guide to Resumption of Elective Procedures in Florida

 

Date Elective Procedures can Resume:  Monday, May 4th

 

What Facilities can Resume Elective Procedures: 

Hospitals, ASCs, Physician Offices, Dentists, and Other Health Care Practitioners’ offices

 

Is the Resumption of Elective Procedures Statewide?

While the Governor is taking a slower approach to opening up the economy in South East Florida (Miami-Dade, Broward, and Palm Beach), he did mention that the performance of elective procedures will be opened up statewide.  Unless local officials in those Counties declare otherwise, elective procedures should resume on Monday, May 4th.

 

Conditions under which facilities and offices can resume elective procedures:

 

Section 5.        Medical Procedures

 

Subject to the conditions outlined below, elective procedures prohibited by Executive Order 20-72 may resume when this order goes into effect. A hospital ambulatory surgical center, office surgery center, dental office, orthodontic office, endodontic office or other health care practitioners’ office in the State of Florida may perform procedures prohibited by Executive Order 20-72 only if:

 

A.   The facility has the capacity to immediately convert additional facility-identified surgical and intensive care beds for treatment of COVID-19 patients in a surge capacity situation;

 

B.   The facility has adequate personal protective equipment (PPE) to complete all medical procedures and respond to COVID-19 treatment needs, without the facility seeking any additional federal or state assistance regarding PPE supplies;

 

C.  The facility has not sought any additional federal, state, or local government assistance regarding PPE supplies since resuming elective procedures; and

 

D.  The facility has not refused to provide support to and proactively engage with skilled nursing facilities, assisted living facilities and other long-term care residential providers.

 

The Agency for Health Care Administration and the Department of Health shall utilize their authority under Florida law to further implement and enforce these requirements. This order supersedes the conflicting provisions of Executive Order 20-72.

 

Official Copy of the Executive Order

Click here for the Executive Order

 

Executive Order Frequently Asked Questions:

Click here for FAQ’s from the Governor’s Office.

 

 

Florida Agency for Health Care Administration & Department of Health Guidelines for Re-Opening Health Care Services:

 

Factors for Consideration when Re-Opening Health Care Services

Do you have:

  • Policies and procedures to protect patients and employees
  • Adequate personal protective equipment (PPE) and the ability to maintain needed supply
  • Staff who are trained on the appropriate level and wearing of PPE needed for your type of health care services
  • Employees with up-to-date education and training on COVID-19 risk factors and protective behaviors
  • Sick leave policies that are flexible and consistent with public health guidance
  • Knowledge of the symptoms associated with COVID-19
  • Contingency plan for a potential outbreak in your office
  • Sufficient space and practices to ensure physical distance between employees and patients (i.e., scheduling and intake practices)
  • Regular housekeeping practices, including routine cleaning and disinfecting of surfaces, equipment, and other elements of the work environment

 

Additional Guidance that should be reviewed:

 

CDC: Interim Guidance for Businesses and Employers to Plan and Respond to Coronavirus Disease 2019 (COVID-19)

https://www.cdc.gov/coronavirus/2019-ncov/community/guidance-business-response.html

 

CDC: Re-Opening Businesses with Workers at Risk for Serious Illness

https://www.cdc.gov/coronavirus/2019-ncov/downloads/fs-reopening-america-workers-at-risk.pdf

 

CMS: Recommendations for Re-Opening Facilities to Provide Non-Emergent Non-COVID-19 Healthcare

https://www.cms.gov/files/document/covid-flexibility-reopen-essential-non-covid-services.pdf

 

OSHA: Guidance on Preparing Workplaces for COVID-19

https://www.osha.gov/Publications/OSHA3990.pdf

 

 

CDC Recommendations on Screening & Testing

 

Testing Capacity

• All patients must be screened for potential symptoms of COVID-19 prior to entering the NCC facility, and staff must be routinely screened for potential symptoms as noted above.

• When adequate testing capability is established, patients should be screened by laboratory testing before care, and staff working in these facilities should be regularly screened by laboratory test as well.

 

Discussion

 

There are labs available for facilities and medical practices to contract with to provide laboratory based testing for staff and patients.  The turn around time varies by laboratory. Patients should self-quarantine for the period of time after testing and prior to surgery. The state has testing sites that can be used by the public and the Governor has signed an Executive Order to enable pharmacists to perform testing.  Many hospitals also have testing capacity as well.

 

Other Potential Lab Options:

http://www.healthtrackrx.com/

http://www.dynixdiagnostix.com/

https://www.labcorp.com/coronavirus-disease-covid-19

https://www.questdiagnostics.com/home/Covid-19/

 

 

There are point-of-care tests available however there are reports concerning the accuracy of these tests and the vast majority are operating under FDA Emergency Use Approval only.  FDA has declared these point-of-care tests as highly complex and requires a CLIA License to perform these tests.  Most physician practices and surgery centers are CLIA Waived, not CLIA Licensed. 

 

Physicians should review FDA guidance on the use of the point-of-care tests.  https://www.fda.gov/medical-devices/emergency-situations-medical-devices/faqs-diagnostic-testing-sars-cov-2

 

Are masks required for employees and customers?

The Governor’s Executive Order does not mandate the use of masks. However customers, employees and employers should consult CDC guidance. https://www.cdc.gov/coronavirus/2019-ncov/community/guidance-business-response.html

 

Can I open my business?

Restaurants will be allowed to re-open, with full outdoor seating. Indoor seating will be

allowed at 25 percent of building capacity. On-site sale and retail businesses will be allowed to operate at 25 percent occupancy.

 

If your business is open, it may remain open and should continue appropriate social

distancing and sanitation measures. Also, any activity or work that has been available under the previous order remains available. Businesses should adopt appropriate social distancing and sanitation measures.

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2020 BONES Society of Florida Annual Meeting

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