Governor extends State Public Health Emergency Declaration Updated Part 1

Today, Gov. Reynolds signed a new proclamation continuing the State Public Health Emergency Declaration. The proclamation orders the closure of schools until April 30th, waiving time requirements as long as school districts put in place a continuous learning plan.

The proclamation also extends closures and limits placed on bars and restaurants, previously identified retail stores, prohibits social gatherings of more than ten people, and continues to ban nonessential and elective surgeries until April 30th.

And it extends and expands the previously granted regulatory relief and other measures until April 30th. Violating any of Governor Reynolds' public health orders is a simple misdemeanor.

All substantive provisions can be read below, and the full text of the proclamation will be posted online later today:

NOW THEREFORE, I, KIMBERLY K. REYNOLDS, Governor of the State of Iowa, by the power and authority vested in me by the Iowa Constitution, Art. IV, §§ 1, 8 and Iowa Code §§ 29C.6(1), 135.140(6), and 135.144 do hereby proclaim a STATE OF PUBLIC HEALTH DISASTER EMERGENCY continues to exist throughout the entire state of Iowa and do hereby ORDER and DIRECT the following:

SCHOOL CLOSURES

SECTION ONE. Pursuant to Iowa Code § 135.144 (13), and in conjunction with the Iowa Department of Public Health and the Iowa Department of Education, unless otherwise modified by subsequent proclamation, I hereby order that all public schools and nonpublic schools, as defined in Iowa Code § 280.2, shall remain closed until and including April 30, 2020, to prevent and control thet ransmission of COVID-19.

SECTION TWO. Pursuant to S.F. 2408, section 13, subsection 2, I hereby waive the instructional time requirements of section 279.10, subsection 1, and the minimum school day requirements of section 256.7, subsection 19, from April 13, 2020, until April 30, 2020, for those school districts and accredited nonpublic schools that adopt a plan for offering continuous learning and submit it to the Iowa Department of Education by April 10, 2020. Consistent with any continuing learning guidance from the Department, such a plan may offer Voluntary Educational Enrichment Opportunities or provide Required Educational Services and must be submitted through the Consolidated Accountability and Support Application (CASA) system.

SECTION THREE. Pursuant to Iowa Code § 29C.6 (6), I continue to temporarily suspend the regulatory provisions of Iowa Code § 256.16(1)(a)(2)(d) and (m) and Iowa Admin. Code rules 281-77.10 (9), 281-79.14(5), and 281-79.14(7), to the extent that they require a minimum number of hours of field experience if the higher education institution providing practitioner preparation program determines that the student has completed sufficient field experience to determine that the student should be recommended for licensure.

SECTION FOUR. Pursuant to Iowa Code §29C.6(6), I continue to temporarily suspend the regulatory provisions of Iowa Code § 100.31, prescribing that not less than four fire drills and not less than four tornado drills be conducted in all school buildings each school year, with not less than two drills of each type be conducted between January 1 and June 30 of each year.

EXTENSION OF BUSINESS CLOSURES AND ORDERS

SECTION FIVE. Pursuant to Iowa Code § 135.144 (3), and in conjunction with the Iowa Department of Public Health, unless otherwise modified by subsequent proclamation or order of the Iowa Department of Public Health, I hereby extend the following orders until 11:59 p.m. on April 30, 2020:

A. Restaurants and bars:

All restaurants and bars shall continue to be closed to the general public except that to the extent permitted by applicable law, and in accordance with any recommendations of the Iowa Department of Public Health, food and beverages may be sold if such food or beverages are promptly taken from the premises, such as on a carry-out or drive-through basis, or if the food or beverage is delivered to customers off the premises.

B. Fitness centers: All fitness centers, health clubs, health spas, gyms, aquatic centers shall continue to be closed.

C. Swimming pools: All swimming pools and spas, wading pools, water slides, wave pools, spray pads, and bath houses, as defined in Iowa Code § 135I.1, shall continue to be closed.

D. Salons: All salons, including all establishments providing the services of cosmetology, electrology, esthetics, nail technology, manicuring, and pedicuring, all as defined in Iowa Code § 157.1, shall continue to be closed.

E. Medical spas: All medical spas, as defined in Iowa Admin Code § 653-13.8(1), shall continue to be closed.

F. Barbershops: All Barbershops, as defined Iowa Code § 158.1, shall continue to be closed.

G. Tattoo establishments: All Tattoo establishments, as regulated by Iowa Code § 135.37, shall continue to be closed.

H. Tanning facilities: All tanning facilities, as defined by Iowa Code § 136D.2(5) shall continue to be closed.

I. Massage therapy establishments: All establishments where an individual is practicing massage therapy as defined by Iowa Code § 152C.1(3) shall continue to be closed.

J. Theaters: All theaters or other performance venues at which live performances or motion pictures are shown shall continue to be closed.

K. Casinos and gaming facilities: All casinos and other facilities conducting pari-mutuel wagering or gaming operations shall continue to be closed.

L. Other nonessential retail establishments:

Bookstores; clothing stores; shoe stores; jewelry stores; luggage stores; cosmetic, beauty, or perfume stores; florists; and furniture and home furnishing stores shall continue to be closed. These establishments may still serve the public through online or telephone sales, delivery, or curb-side pick-up. This closure order does not affect other retail establishments, such as discount stores, grocery stores, or pharmacies that sell these goods in addition to other essential food, medical supplies, and household goods.

M. Senior citizen centers and adult daycare facilities: All facilities that conduct adult day services or other senior citizen centers are hereby closed.

SECTION SIX. I continue to direct all state agencies to coordinate expeditiously in developing plans to mitigate the economic effects of the closings necessitated by this disaster, including potential financial support, regulatory relief, and other executive actions.

MASS GATHERINGS

SECTION SEVEN. Social, community, spiritual, religious, recreational, leisure, and sporting gatherings and events of more than 10 people are hereby prohibited at all locations and venues, including but not limited to parades, festivals, conventions, and fundraisers until 11:59 p.m. on April 30, 2020.

A. A gathering of people inside parked cars, trucks, or other enclosed motor vehicles shall not constitute a gathering of more than 10 people if no more than 10 people are inside each vehicle, all people remain inside the vehicle at all times, and the vehicle remains enclosed with all windows, sunroofs, and convertible tops closed.

B. Planned large gatherings and events must be canceled or postponed until after termination of this disaster.

SECTION EIGHT.

Effective at 5:00 p.m. on April 3, 2020 and until 11:59 p.m. on April 30, 2020, all auctions with more than 10 people present in person are hereby prohibited at all locations and venues, except for livestock auctions that only include food animals, which may continue to operate so long as there are no more than 25 people present in person. People who remain inside parked cars, trucks, or other enclosed motor vehicles shall not be counted in considering the number of people present, provided all people remain inside the vehicle at all times, and the vehicle remains enclosed with all windows, sunroofs, and convertible tops closed.

SECTION NINE. In conjunction with the Department of Public Health pursuant to Iowa Code §§ 29C.18 and 135.35, all peace officers of the state are hereby called upon to assist in the enforcement of the provisions of this Proclamation.

NONESSENTIAL MEDICAL AND DENTAL SERVICES

SECTION TEN.

Pursuant to Iowa Code § 135.144(3), and in conjunction with the Iowa Department of Public Health, unless otherwise modified by subsequent proclamation or order of the Iowa Department of Public Health, I continue to order that until this disaster proclamation expires:

A. All nonessential or elective surgeries and procedures that utilize personal protective equipment (PPE) must not be conducted by any hospital, outpatient surgery provider, or outpatient procedure provider, whether public, private, or nonprofit.

B. A nonessential surgery or procedure is one that can be delayed without undue risk to the current or future health of a patient, considering all appropriate factors including, but not limited to any: (1) threat to the patient's life if the surgery or procedure is not performed; (2) threat of permanent dysfunction of an extremity or organ system; (3) risk of metastasis or progression of staging; and (4) risk of rapidly worsening to severe symptoms.

C. Each hospital, outpatient surgery provider, and outpatient procedure provider shall limit all nonessential individuals in surgery and procedure suites and patient care areas where PPE is required. Only individuals essential to conducting the surgery or procedure shall be present in such areas.

D. Each hospital, outpatient surgery provider, and outpatient procedure provider shall establish an internal governance structure to ensure that the principles outlined above are followed.

SECTION ELEVEN.

A. All dentists and their staff shall refrain from performing elective dental procedures, including: any cosmetic or aesthetic procedures; all routine hygiene; any orthodontic procedures other than those necessary to relieve pain or infection or to restore normal oral functioning; initiation of crowns, bridges, or dentures that do not address or prevent pain or restore normal oral functioning; any periodontal plastic surgery; extraction of asymptomatic non-carious teeth; recall visits for periodontally-healthy patients; and all appointments for high-risk patients, including ASA 2 and 3 patients, unless emergent.

B. This order does not prohibit the provision of emergency dental services.

C. This order shall be enforced by Iowa Dental Board investigators or their designees who, pursuant to Iowa Code § 153.33(1)(b), shall have the powers and status of peace officers when enforcing this order.

D. The Iowa Dental Board shall provide additional guidance to its licensees pursuant to Iowa Code § 29C.19 regarding the nature and scope of this restriction, to the extent necessary to protect the public health and ensure continuity of services to Iowans.

MANDATORY SCREENING OF HEALTH FACILITY STAFF

SECTION TWELVE. Pursuant to Iowa Code § 135.144(3), and in conjunction with the Iowa Department of Public Health, I continue to order all hospitals, nursing facilities, intermediate care facilities, residential care facilities, hospice programs, and assisted living programs to screen all staff at the beginning of their shift for fever or respiratory symptoms, absence or shortness of breath, new or change in cough, or sore throat, take the employee's temperature, and take any preventative measures based on that screening to prevent the spread of COVID-19 within the hospitals, nursing facilities, intermediate care facilities, hospice programs, residential care facilities, and assisted living programs.

REGULATORY RELIEF TO HEALTH CARE SYSTEM

SECTION THIRTEEN. Pursuant to Iowa Code § 29C.6 (6), I continue to temporarily suspend the regulatory provisions of Iowa Code §§ 135.61 through 135.73 requiring an institutional health facility to obtain a certificate of need prior to operating additional bed capacity. Suspension of these provisions is limited to the duration of this proclamation and is further limited to the provision of medical assistance and treatment of victims of this public health emergency.

SECTION FOURTEEN. Pursuant to Iowa Code § 29C.6(6), I continue to temporarily suspend the regulatory provisions of Iowa Code § 135C.33 and Iowa Admin Code rules 481-50.9(3) & (9) and 67.19(3), requiring a health care facility and assisted living program to complete a criminal history check prior to employment of an individual in a health care facility or assisted living program, to the extent that a health care facility or assisted living program may employ an individual once that criminal history check is submitted, pending completion.

SECTION FIFTEEN. Pursuant to Iowa Code § 29C.6(6), I continue to temporarily suspend the regulatory provisions of Iowa Code § 135C.8 and Iowa Admin Code rules 481-58.3(3)(a), requiring a nursing facility to submit renewal applications at least 30 days in advance of license expiration.

SECTION SIXTEEN. Pursuant to Iowa Code § 29C.6(6), I continue to temporarily suspend the regulatory provisions of Iowa Admin Code rules 481-58.21(6)(d) & 65.17(1)(d), requiring nursing students to administer medications in nursing facilities and immediate care facilities for persons with mental illness only after successful completion of a medication aide course or challenge exam, to the extent the nursing student meets the requirements of Iowa Admin Code rules 481-58.21(6)(d)(1), (2), & (4), and 65.17(1)(d)(1), (2), & (4) and the facility has documentation that it has implemented training and supervision measures to ensure the student's competency in safe medication administration.

SECTION SEVENTEEN. Pursuant to Iowa Code § 29C.6(6), I continue to temporarily suspend the regulatory provisions of Iowa Admin Code rules 481-57.20(1) & 58.23(1)(a), requiring residential care facilities and nursing facilities assist residents to obtain regular and emergency dental services, to the extent those facilities continue to assist residents in obtaining emergency dental services.

SECTION EIGHTEEN. Pursuant to Iowa Code § 29C.6(6) and Iowa Code § 135.144(3), in conjunction with the Iowa Department of Public Health, I continue to temporarily suspend the regulatory provisions of Iowa Admin Code rules 481-57.23(1) & 58.26(1) requiring group activities provided by residential care facilities and nursing facilities.

SECTION NINETEEN. Pursuant to Iowa Code § 29C.6(6) and Iowa Code § 135.144(3), in conjunction with the Iowa Department of Public Health, I continue to temporarily suspend the regulatory provisions of Iowa Admin. Code rule 481-58.47, permitting in-person visits with residents in nursing facilities.

SECTION TWENTY. Pursuant to Iowa Code § 29C.6(6), I continue to temporarily suspend the regulatory provisions of Iowa Code § 231C.3(1)(c) and Iowa Admin Code rules 481-69.22(2) & 481-57.22(3) requiring an assisted living program and residential care facility to update a tenant's or resident's service plan within thirty days of occupancy or admission.

SECTION TWENTY-ONE. Pursuant to Iowa Code § 29C.6(6), I continue to temporarily suspend the regulatory provisions of Iowa Code § 231C.8(1) and Iowa Admin. Code rule 481-67.13(1) requiring an assisted living program to submit any additional or rebuttal information to the department within two working days of an exit interview at the conclusion of a monitoring evaluation or complaint investigation.

SECTION TWENTY-TWO. Pursuant to Iowa Code § 29C.6(6), I continue to temporarily suspend the regulatory provisions of Iowa Admin. Code rule 481-67.5(2) requiring a person administering medications in an assisted living program have, at a minimum, passed a medication manager course and examination. Suspension of this provision is effective on April 15, 2020, the date upon which that rule becomes effective.

SECTION TWENTY-THREE. Pursuant to Iowa Code § 29C.6(6), I continue to temporarily suspend the regulatory provisions of Iowa Admin. Code rule 481-69.29(5) & (6) requiring a new program manager and delegating nurse in assisted living programs complete an assisted living management class and/or an assisted living nursing class within six months of employment.

SECTION TWENTY-FOUR. Pursuant to Iowa Code § 29C.6(6) and Iowa Code § 135.144(3), in conjunction with the Iowa Department of Public Health, I continue to temporarily suspend the regulatory provisions of Iowa Admin. Code rule 481-57.11(6) requiring a residential care facility employee have a physical examination no longer than twelve months prior to beginning employment, to the extent it is not feasible for a facility to obtain the required physical examination prior to beginning employment.

SECTION TWENTY-FIVE. Pursuant to Iowa Code § 29C.6(6) and Iowa Code § 135.144(3), in conjunction with the Iowa Department of Public Health, I continue to temporarily suspend the regulatory provisions of Iowa Admin. Code rule 481-57.11(6) requiring a residential care facility screen and test an employee for tuberculosis pursuant to 481-Chapter 59 if it is not feasible for a facility to do so, to the extent the facility continues to perform and document sign/symptom review of new health care workers and residents and places the health care worker or resident on a callback list to test as soon as possible.

SECTION TWENTY-SIX. Pursuant to Iowa Code § 29C.6(6) and Iowa Code § 135.144(3), in conjunction with the Iowa Department of Public Health, I continue to temporarily suspend the regulatory provisions of Iowa Admin. Code rules 481-57.19(3)(c) & 64.4(9)(b) requiring a person administering medications in a residential care facility and intermediate care facility for the intellectually disabled to complete a department-approved medication aide course and pass a department-approved medication aide exam, to the extent the person has successfully completed a state-approved medication manager course and passed a state-approved medication manager exam to administer medications.

SECTION TWENTY-SEVEN. Pursuant to Iowa Code § 29C.6(6), I continue to temporarily suspend the regulatory provisions of Iowa Admin. Code rule 481-57.22(1) requiring a residential care facility provide orientation within twenty-four hours of admission, to the extent the facility must continue to provide a review of the resident's rights and the facility's evacuation plan.

SECTION TWENTY-EIGHT. Pursuant to Iowa Code § 29C.6(6), I continue to temporarily suspend the regulatory provisions of Iowa Code § 135C.36 and Iowa Admin. Code rules 481-56.2 & 67.17, requiring fines for a health care facility or assisted living program, to the extent those fines may be issued in suspension.

SECTION TWENTY-NINE. Pursuant to Iowa Code § 29C.6(6) and Iowa Code § 135.144(3), and in conjunction with the Iowa Department of Health, I temporarily suspend the regulatory provisions of Iowa Admin. Code r 641 - 136.2(2) related to trauma data registry reporting by trauma care facilities within certain timeframes. I hereby direct the Iowa Department of Public Health to provide additional guidance to trauma care facilities regarding the effect of this suspension.

SECTION THIRTY. Pursuant to Iowa Code § 29C.6(6) and Iowa Code § 135.144(3), and in conjunction with the Iowa Department of Health, I temporarily suspend the regulatory provisions of Iowa Admin. Code r 641 - 137.2 and 137.3 related to initial and continuing trauma education requirements for trauma team members. I hereby direct the Iowa Department of Public Health to provide additional guidance to trauma care facilities and trauma team members regarding the effect of this suspension

Government : Governor extends State Public Health Emergency Declaration Updated Part 1

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