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New Executive Order Offers Flexibilities on Testing, Vaccination

The Governor last night issued Executive Order No. 202.82 with new flexibilities related to COVID-19 and influenza testing and vaccination.

HCA is still analyzing the executive order but wanted to flag some key provisions for HCA members.

The order allows non-nursing staff, if they are adequately trained, to do the following: obtain specimens for COVID-19 testing; collect blood specimens for diagnosis of acute or past COVID-19 disease; administer vaccinations against influenza or COVID-19; and “perform tasks, under the supervision of a nurse, otherwise limited to the scope of practice of a licensed or registered nurse to provide care for individuals diagnosed or suspected of suffering from a COVID-19 or influenza infection.”

HCA’s “Home Care Clinician Training for COVID-19 Testing” program has been endorsed by the state Department of Health (DOH) for training of nurses and other professional staff whose scope of practice permits specimen collection. HCA will be seeking clarification from DOH as to whether HCA’s initiative would likewise satisfy the training requirements allowed above for non-nursing staff. We will also be seeking clarification as to what other training requirements may apply to the above provisions, not only for specimen collection but also the administration of vaccines.

The order also allows physicians and certified nurse practitioners to issue a non-patient-specific regimen to nurses, physician assistants, specialist assistants, pharmacists and others to: collect specimens, for purposes of testing; collect blood specimens for diagnosis of COVID-19; and administer vaccinations against influenza or COVID-19.

The order also allows for RNs to administer vaccinations for influenza and COVID-19 without reporting to the attending physician; but they must report, at a minimum, to the New York State Immunization Information System (NYSIIS) or Citywide Immunization Registry (CIR) as applicable. See related story in today’s edition of the Situation Report here.

Also, “insofar as [state regulation] requires a registered professional nurse authorized to administer immunization agents pursuant to a non-patient specific order to be currently certified in cardio-pulmonary resuscitation (CPR),” the order clarifies that “for the purpose of this Executive Order, registered professional nurses must have a current certificate in basic cardiopulmonary resuscitation.” This is consistent with existing regulations as they apply to administration of immunizations, emergency treatment of anaphylaxis, and other tests, treatments and screenings associated with non-patient specific orders and protocols.

The Executive Order includes other provisions with similar flexibilities for other practitioners and settings.

HCA strongly encourages agencies and their staff to read the executive order carefully for the full context and intricacies of each provision. We also encourage members to await further guidance from the state Department of Health (DOH) before acting on any of these new flexibilities.

CDC resources

The U.S. Centers for Disease Control and Prevention (CDC) has provided several resources on the COVID-19 vaccine, including slides from a webinar held Sunday on what practitioners should know about the Pfizer vaccine, and guidance on post-vaccine considerations for healthcare personnel.

DOH Documents

DOH has posted the following additional resources: