Waivers and Modifications: COVID-19 - Minnesota Dept. of Health

Waivers and Modifications
COVID-19

Under the Governor's Emergency Executive Order 20-32, the Minnesota Department of Health has temporary authority to waive or modify regulatory requirements. MDH continues to do regular reviews of potential flexibilities we could authorize to support our regulated entities and Minnesotans throughout the COVID-19 peacetime emergency.

Below is a list of all waivers and modifications currently in effect. This list will be updated as necessary.

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The commissioner temporarily modified certain specified intervals for equipment performance evaluation requirements for health care-based use of x-ray and related technologies. Under current law, facilities are required to have x-ray equipment tested at specified intervals by a service provider. Service providers are being restricted access or are not providing services to facilities due to concerns around personal protective equipment (PPE) and disinfectant supplies, which would be consumed while testing the x-ray equipment. These temporary modifications will allow flexibility for health care-based facilities to use x-ray equipment for clinical use that exceeds the frequency of x-ray equipment testing. Modification for delaying equipment performance evaluation is effective March 13, 2020 and will remain in effect until the end of the peacetime emergency.

Affects Minnesota Rules, parts 4732.0860, Subp. 7, 4732.0865, Subp. 5, and 4732.1100, Subp. 2, Subp. 5 through Subp. 11, and Subp. 12, Item C.

The commissioner temporarily modified the requirements for individuals performing asbestos-related work that are required to renew their annual asbestos certification. Under current law, individuals are required to obtain a renewal training course diploma before the expiration date of their credential. Training course providers have discontinued annual renewal training for asbestos worker, asbestos site supervisor, asbestos inspector, asbestos management planner, and asbestos project designer. This temporary modification will allow individuals to obtain renewal training within 30 days after the termination of the peacetime emergency declared in Executive Order 20-01. This modification is effective, March 13, 2020 and will remain in effect until 30 days after the end of the peacetime emergency.

Affects Minnesota Rules, parts 4620.3300, Subp. 5, item B, Subitem 3a; 4620.3310, Subp. 6, Item B, Subitem 3; 4620.3330, Subp. 6, Item B, Subitem 3; 4620.3340, Subp. 6, Item B, Subitem 3; and 4620.3350, Subp. 6, Item B, Subitem 3.

The commissioner temporarily modified the requirements for individuals performing lead regulated work that are required to renew their annual lead license. Under current law, individuals are required to obtain a renewal training course diploma before the expiration date of their license. Training course providers have discontinued annual renewal training for lead worker, lead supervisor, lead inspector, lead risk assessor, and lead project designer. This temporary modification will allow individuals to obtain renewal training within 30 days after the termination of the peacetime emergency declared in Executive Order 20-01. This modification is effective, March 13, 2020 and will remain in effect until 30 days after the end of the peacetime emergency.

Affects Minnesota Rules, parts 4761.2240, Subpart 5, Item A, Subitem 3; 4761.2260, Subpart 6, Item A, Subitem 3; 4761.2280, Subpart 5, Item A, Subitem 3; 4761.2300, Subpart 6, Item A, Subitem 3; and 4761.2300, Subpart 6, Item A, Subitem 3.

The commissioner temporarily modified the time a certified water supply system operator has to renew their current certification. Under current law, operators are to renew their certificate within three years. Operators typically obtain training hours for renewal by attending in-person training sessions sponsored by professional organizations and the Minnesota Department of Health. These in-person training sessions are not available for operators at this time. These temporary modifications will allow flexibility for water supply system operators to obtain the needed training and renew their certification. Modification for delaying renewal of certification is effective, March 13, 2020 and will remain in effect until the end of the peacetime emergency.

Affects Minnesota Rules, parts 9400.1200.

The commissioner temporarily modified the requirements for individuals working in food establishments that are required to renew their Certified Food Protection Manager credential. Under current law, individuals are required to obtain four continuing education credits in food safety before the expiration date of their credential. Course providers have discontinued face-to-face education classes which has limited the availability of individuals to obtain the continuing education credits. This temporary modification will allow individuals to obtain the continuing education credits within six months after their credential has expired. This modification is effective, March 13, 2020 and will remain in effect until 30 days after the end of the peacetime emergency.

Affects Minnesota Rules, parts 4626.0033, Subp. I (1).

The commissioner temporarily modified the requirements for individuals working at public swimming pools that are required to renew or obtain their certification as a trained pool operator or lifeguard. Under current law, a trained pool operator must oversee the operation of a public swimming pool and must renew their training certification at least once every 5 years. Under current law, lifeguards at public swimming pools are required to be currently certified. Course providers have discontinued face-to-face education classes which has limited the availability of individuals to obtain or renew their certification. This temporary modification will allow trained pool operators to renew their training within 6 months of the expiration of their credential. Pool operators not currently certified will be allowed to obtain the credential within 2 months of being assigned as the pool operator. This temporary modification will also allow currently certified lifeguards to obtain their renewal certification within 6 months of the expiration of their current certification. This modification is effective, March 13, 2020 and will remain in effect until 30 days after the end of the peacetime emergency.

Affects Minnesota Rules 4717.0650 Subp. 3 and Subp. 5; and 4717.0950.

The commissioner temporarily modified well contractor license renewal requirements. Under current law, to satisfy annual license renewal requirements, well contractors must obtain up to six hours of continuing education contact hours. Third-party vendors, equipment manufacturers, and trade organizations have been postponing or canceling continuing education training events to avoid large gatherings. These temporary modifications will allow well contractors with the flexibility to renew a license obtain the required continuing education contact hours when these training sessions become available. Modifications for delaying license renewal requirements are effective, March 13, 2020 and will remain in effect until the end of the peacetime emergency.

Affects Minnesota Rules, part 4725.1650.

The Minnesota Department of Health (MDH) temporarily waived the statutes noted below that affect hospital licensing, inspection, and fees as well as construction moratoriums. These waivers address the need for hospitals to expand their bed capacity at current sites and alternative care sites to respond to the expected surge in demand from COVID-19. They also allow for the expansion of hospital beds at current sites and alternate healthcare facility sites to respond to the anticipated surge without increasing the hospital licensing fees. In addition, waiving the moratorium on hospital construction; the public interest review process for new construction; and the licensing and inspection of new hospitals will allow health care systems to quickly set up alternative care facilities to respond to the need for additional bed capacity. These waivers will be in place for the period of the declared peace-time emergency and up to 60 days past the end of the emergency.

Affects Minnesota Statutes, secs. 144.122, 144.55.1, 144.551, 144.553; and 144.50 to 144.56.4.

The Minnesota Department of Health (MDH) waived statutes that affect state registration requirements and maximum charge amounts for supplemental nursing services agencies (SNSAs). This allows any in-state licensed health facility regulated by MDH, including hospitals among others, to provide temporary staff in other health facilities that serve residents with COVID-19 without having to be registered as an SNSA. In addition, waiving maximum hourly charges for SNSA services in nursing homes allows the State Emergency Operations Center, in consultation with the Department of Human Services Nursing Home Rates and Policy Division, to set new maximum charge amounts for SNSAs when they are providing staff to work in nursing homes that serve residents with COVID-19. These changes provide flexibility for health facilities assisting other health facilities in finding staff. These waivers will be in place for the duration of the peace-time emergency and up to 60 days past the end of the emergency.

Affected statutes:  Minnesota Statutes secs. 144A.70,  144A.71 and 144A.74.

The Minnesota Department of Health (MDH) waived statutes that affect nursing home facilities' ability to add licensed beds quickly without incurring a financial burden during this pandemic. Specifically, these waivers allow nursing home facilities immediate access to beds, and to use nursing home beds to relocate patients from hospitals or other settings to nursing homes. MDH still requires nursing homes to notify MDH about the bed changes and to ensure adequate and CDC-compliant space to care for COVID-19 residents. This waiver is for the period of the peacetime emergency and up to 60 days past the end of the emergency.

Affected statutes: Minnesota Statutes, secs. 144.122, and 144A.071, subd. 4b.

The Minnesota Department of Health (MDH) waived statutes and rules that affect how deceased persons are held pending disposition. These changes will allow facilities to hold a deceased person longer than the statutory limit (six days for funeral establishments and 24 hours for alkaline hydrolysis facilities and crematories), with proper refrigeration. These changes will also provide facilities with more options for storing deceased persons, such as mobile refrigeration units or coolers located either on or off-site, to increase capacity to store human remains. Waiving these requirements supports the public's desire to put off funerals during this time, and addresses the resulting impact this could have on providers’ storage capacity. These waivers are for the period of the peacetime emergency and up to 60 days past the end of the emergency.

Affects Minnesota Statutes, secs. 149A.90.8; 149A.91.3;  149A.94.1; 149A.941.15 and 149A.95.6.

The Minnesota Department of Health (MDH) temporarily waived the statute noted below that affects Minnesota’s nursing home bill of rights as it relates to resident notification of transfer and discharge. Waiving the resident notification timeframes related to transfer and discharge in the Health Care Bill of Rights allows facilities to become specialized sites in response to COVID-19 care needs. It gives nursing homes greater flexibility in the transfer and discharge of residents in order to assess and treat COVID-19 patients and meet healthcare requirements. This waiver will be in place for the period of the declared peace-time emergency and up to 60 days past the end of the emergency.

Affects Minnesota Patient Bill of Rights Statute 144.651, Subd. 29.

The Minnesota Department of Health (MDH) administers numerous grants supported by state funds appropriated by the state legislature. These grants provide funding to a variety of grantees, such as Community Health Boards, Tribal Nations, hospitals, individuals and community-based organizations to provide specific services to communities. MDH has temporary authority to provide recipients of state-funded grants with additional flexibility in administration and use of state funds to assist in the response to COVID-19. While many of these specific services will continue, the flexibility is needed to allow grantees to expand their services to support the COVID-19 response.

Affects Minnesota Statutes, sections 144.9512, 144.9513, 145.925, 145.986, 145.928, 144.05, 144.148, 145.9268, 145.929, 145.9269, 144.1503, 62J.692, 145.9268, 145.929

This modification will extend all statewide hospital trauma designations by one year. Typically trauma hospitals are designated for three years, after which they must re-apply for designation and undergo an onsite inspection to verify continued compliance with requirements. The inspections are performed by physicians, surgeons and nurses with subject matter expertise. Inspectors are unable to perform the visits due to the risk of exposure to infected patients. Hospitals are diverting resources that would normally be used to prepare for the onsite visits. With this modification, designated trauma hospitals would undergo reverification of their continued compliance with requirements approximately one year later than they would have otherwise. Extending all designations by one year will avoid the doubling of needed site visits that would happen next year if only this year's designations were extended. This will provide relief for hospitals and free up resources that can be used to address pandemic-related needs.

Affects Minnesota Statutes, section 144.603

The Minnesota Department of Health (MDH) has waived and modified specific regulatory requirements for licensing and practice standards for morticians, interns, and funeral providers. These changes will help providers manage the surge in projected deaths due to COVID-19. Specifically, they allow licensed providers to have their trained, unlicensed employees, or alternatively, hire and have emergency responders remove and transport deceased persons to the funeral homes. They also may hire morticians in good standing from other states and those with emeritus status, provided they have a temporary license issued by MDH. Finally, providers will have extended time to process their renewal applications and fees, while waiving late fees. The waiver also allows interns and morticians who apply by reciprocity to start working before they pass the state exam and the national exam, and to submit case reports on duties related to cremation, alkaline hydrolysis, or other COVID-19 related duties. These waivers are for the period of the peacetime emergency and up to 60 days past the end of the emergency.

Affects Minnesota Statutes, secs. 149A.01, subd. 1 and 2; 149A.20, 149A.30, 149A.45, 149A.50.7, 149A.51.3, 149A.52.6, 149A.53.3, 149A.54.6, 149A.55.3, 149A.70.6, and 149A.90.2.

The Minnesota Department of Health (MDH) modified statutes that affect nursing homes without a layaway bed option, allowing them to quickly add licensed beds without incurring a financial burden. The modification lifts the moratorium on nursing home beds and waives the per-bed licensing fee during the COVID-19 emergency. It allows nursing homes to quickly expand their numbers of beds in order to relocate patients from hospitals or other settings to nursing homes that do not have a layaway bed option. MDH still requires nursing homes to notify MDH about the bed changes and to ensure adequate and CDC-compliant space to care for COVID-19 residents. A condition of this waiver approval would be that newly added nursing home beds be certified for Medicare only and this waiver will not add Medicaid certified beds, assuring that the Medicare benefit is accessed for those dually eligible under both Medicare and Medicaid. COVID-19-affected Medicaid eligible residents without a Medicare benefit can still access the Medicaid service regardless of the bed location on the campus if the nursing facility does not exceed their current Medicaid certified capacity. This waiver is for the period of the peacetime emergency and up to 60 days past the end of the emergency.

Affects Minnesota Statutes, secs. 144.122 and 144A.071.

The Minnesota Department of Health (MDH) has temporarily waived or modified certain statutes that affect investigations, background studies, and enforcement activities for the Maltreatment of Minors Act (MOMA) and the Vulnerable Adults Act (VAA). Included in the modifications are timeframe requirements for completing maltreatment investigations, investigation-related notices, requests for reconsideration, data request processes, and notice of investigation results and fines. In addition, the Office of Health Facility Complaints will be prioritizing investigating allegations of egregious maltreatment. Finally, invoicing of fines is suspended. These modifications will allow the MDH Office of Health Facility Complaints (OHFC) to prioritize investigations of allegations of egregious maltreatment that could result in serious harm or death, while also prioritizing COVID-19-specific support to providers and vulnerable adults. This waiver will be for the period of the peacetime emergency and up to 60 days past the end of the emergency.

Affects Minnesota Statutes 626.556 and 626.557.

The commissioner temporarily waived the requirements for accredited environmental laboratories that are required to obtain an onsite assessment on a 24 month schedule, and modified the definition of inspection to include remote inspections. Under current law, laboratories are required to obtain an onsite assessment every 24 months. Accredited environmental laboratory facilities and commissioner approved assessors are delaying onsite inspections due to limiting facility access or travel restrictions that have been implemented because of COVID-19. This temporary modification will allow accredited environmental laboratories to schedule onsite or remote assessments no later than 30 days after the termination of the peacetime emergency declared in Executive Order 20-01. This modification is effective, March 13, 2020 and will remain in effect until 30 days after the end of the peacetime emergency.

Affects Minnesota Statutes 144.98, Subdivision 13. (a) and Minnesota Rules, 4740.2010, Subpart 24.

The Minnesota Department of Health (MDH) Health Regulation Division (HRD) has temporarily modified and delayed certain requirements for licensing, certification, and registration of occupations regulated by the Health Occupations Program. These health occupations include speech language pathologists, audiologists, hearing instrument dispensers, doulas, body art technicians, and body art establishments. The statutory modifications and delays will allow current licensees in good standing to practice during the COVID-19 peacetime emergency while protecting public safety. MDH will temporarily cease licensing activities for practitioners that are not supporting COVID-19 in health care facilities and critical access hospitals. This will allow existing staff to support MDH in other critical areas during the COVID-19 peacetime emergency.

Affects Minnesota Statutes, chapter 146B, sections 148.511 to 148.5198, sections 148.995 to 148.997, and chapter 153A.

The commissioner has temporarily waived service obligation requirements for recipients of the Health Professional Education Loan Forgiveness Program to practice in their field as a condition of ongoing eligibility. As a result of the COVID-19 pandemic, many of the participating health care professionals have not been able to meet the required service obligation hours due to temporary furlough, reduced hours, schools transferring to long distance learning, or the inability to transfer to a telehealth operation during the Executive Order 20-32. MDH has provided assurance that their funding would not be in jeopardy due to COVID-19. From March 23, 2020 through May 17, 2020, MDH has waived the required service obligation in this year’s contract term, if needed as a result of Executive Order 20-20, based on documentation provided. For awardees with school-aged children unable to work from March 16-20, 2020, MDH waived the requirements if sufficient documentation was provided. Requirements have also been waived if an awardee cannot work due to isolation from exposure to, or testing positive for, COVID-19, or due to caring for a family member who is sick with COVID-19, or whose regular care-givers are in isolation or sick with COVID-19, when sufficient documentation is provided. Under normal guidelines, Loan Forgiveness participants are required to practice for a minimum of three years in a designated rural area or in an underserved urban community. Participants in the Loan Repayment Program are required to practice for a required 2-year service obligation.

Affects Minnesota Statutes 144.1501.

The commissioner extended current certifications and compliance enforcement of health information exchange entities operating in Minnesota. Under current law, entities providing health information exchange services in Minnesota for clinical transactions must apply for a certificate of authority to conduct business in the state, and apply for recertification annually thereafter. Certifications and compliance processes may be extended, allowing current state-certified health information exchange entities to continue providing essential services during the pandemic, with certification resuming on a revised delayed schedule. The commissioner has also authorized a six month suspension of enforcement and exception provisions related to health care administrative simplification requirements.

Affects Minnesota Statutes 62J.498 through 62J.4982 and 62J.536 Subd. 2a and 2b.

See more at Minnesota Department of Human Services (DHS): Waivers and modifications.

Updated Friday, 26-Jun-2020 10:26:15 CDT