Expansion of Scope of Practice to Provide Assistance in Responding to COVID-19 Chiropractors
On May 6, 2020, Governor Tom Wolf signed an Order of the Governor of the Commonwealth of Pennsylvania to Enhance Protections for Health Care Professionals (the "Executive Order"). Its purpose is to afford health care practitioners protection against liability for good faith actions taken in response to the call to supplement the health care provider workforce battling COVID-19.
During the course of the pandemic and the disaster declaration associated with it, the Wolf Administration has used its authority under the declaration to suspend a number of regulations and regulatory statutes. The effect of several of the suspensions is to expand the scope of practice and to relax the supervision requirements for numerous health care licensees, allowing these professionals to perform acts they would not otherwise be authorized to perform in the ordinary course of their practice.
More specifically, as set forth in the Executive Order, "temporary suspension[s] of portions of 63 P.S. §§ 42.2, 271.2, 422.2, 625.101-625.1106, and 49 Pa. Code §§ 18.502, 18.509, 25.702, 25.709, 33.208" have been granted "to provide opportunities to trained health care practitioners, not currently on the front lines of the pandemic response, with the opportunity to assist in response efforts if they so desire. The expansion of the scope of practice of Dentists, Oral Surgeons, Athletic Trainers, Chiropractors and Podiatrists would permit MDs and DOs to delegate certain practices to these practitioners to support the efforts to expand the response needed in hospitals, emergency departments, nursing homes and longterm care facilities during the COVID-19 disaster emergency." For chiropractors, the effect of these suspensions is as follows:
Chiropractors may perform the following tasks for the duration of the emergency declaration: triaging; history taking; screening; discharge procedures; taking vital signs; administering tests such as nasal swabs and other COVID-19 tests; providing wound care and infection prevention; making differential diagnosis; ordering testing and directing treatment on patients with neuromuscular skeletal complaints; performing telehealth for acute and chronic neurological and musculoskeletal conditions to prevent further deconditioning; assisting with treatment and education for patients who in normal circumstances would be admitted to a hospital to be watched overnight, but now are sent home (for example, a patient with possible signs of a stroke, flareup of a neurological or orthopedic conditions); assisting in activities of daily living such as bed changes, feedings, baths, and the like and providing basic care in long-term care facilities (e.g., assisted living residences, personal care homes, "nursing homes") and performing other tasks lawfully delegated by an M.D. or D.O.
A licensee's obligation to competently perform their duties consistent with their level of training, education and experience is a guiding principle that is both constant and unwavering. Neither the Executive Order nor the temporary suspensions alters that obligation. Moreover, when performing tasks to aid in the COVID-19 response that are outside of their normal scope of practice, licensees (and those working towards licensure) shall not undertake any activity for which they are not already licensed or authorized to perform without first obtaining the appropriate training and support to perform those tasks competently.
The Executive Order shall remain in effect for the duration of the disaster emergency.