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COVID-19: Executive Orders by State on Dental, Medical, and Surgical Procedures

State

Order

Order Text

Date Issued

Date Expiration

AK Health Mandate 5 Required patients, providers, hospitals, and surgical centers to postpone or cancel non-urgent or elective procedures in order help prevent the spread of COVID-19 and thereby decrease the overall impact on the Alaska health care structure, and also to preserve personal protective equipment. March 19, 2020 June 15, 2020
AL   All dental, medical, or surgical procedures shall be postponed until further notice, subject to the following exceptions:
  • Dental, medical, or surgical procedures necessary to treat an emergency medical condition. For purposes of this order, “emergency medical condition” is defined as a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain, psychiatric disturbances, and/or symptoms of substance abuse) such that the absence of immediate medical attention could reasonably be expected by a person’s licensed medical provider to result in placing the health of the person in serious jeopardy or causing serious impairment to bodily functions or serious dysfunction of bodily organs.
  • Dental, medical, or surgical procedures necessary to avoid serious harm from an underlying condition or disease, or necessary as part of a patient’s ongoing and active treatment.
March 28, 2020   5:00 pm on April 17, 2020
AR ADH Directive on Elective Surgeries The following mandatory actions can preserve staff, personal protective equipment (PPE), and patient care supplies; ensure staff and patient safety; and expand available hospital capacity during the COVID-19 pandemic.
  • Procedures, testing, and office visits that can be safely postponed shall be rescheduled to an appropriate future date.
  • Routine dental and eye care visits shall be postponed.
  • Emergent, urgent and care designated as an exception below will continue.
  • Small rural hospitals under 60 beds and critical access hospitals, though strongly advised to follow this directive to maximize resources, are excluded from this directive.
Exceptions to this directive should be made in the following circumstances:
  • If there is a threat to the patient’s life if the procedure is not performed.
  • If there is a threat of permanent dysfunction of an extremity or organ system if the surgery is not done.
  • If there is a risk of metastasis or progression of staging of a disease or condition if surgery is not performed.
  • · If there is a risk that the patient’s condition will rapidly deteriorate if surgery is not done, and there is a threat to life or an extremity or organ system or a threat of permanent dysfunction or disability.
April 3, 2020  
AZ EO 2020 10   March 21, 2020  
CO D 2020 027 As of 12:01 am on March 23, 2020, all voluntary or elective surgeries or procedures, whether medical, dental, or veterinary, are suspended in the State of Colorado until April 26, 2020, at the earliest. A voluntary or elective surgery or procedure means that the surgery can be delayed for a minimum of three months without undue risk to the current or future health of the patient as determined by the guidelines developed by the hospital, surgical center or other treating medical facility. March 23, 2020 April 26, 2020, unless extended further
DC DC Health Rec The District of Columbia Department of Health (DC Health) is recommending that ALL elective medical procedures, non‐urgent hospital and outpatient visits, and non-urgent dental procedures be postponed to preserve health care capacity as our community mitigation strategies work to flatten the epidemic curve.   March 17, 2020  
FL EXECUTIVE ORDER NUMBER 20-72  All hospitals, ambulatory surgical centers, office surgery centers, dental, orthodontic and endodontic offices, and other health care practitioners' offices in the State of Florida are prohibited from providing any medically unnecessary, non-urgent or non-emergency procedure or surgery which, if delayed, does not place a patient's immediate health, safety, or wellbeing at risk, or will, if delayed, not contribute to the worsening of a serious or life-threatening medical condition. Accordingly, all health care practitioners licensed in the State of Florida, including dentists, shall immediately cease performing these elective services.  March 20, 2020 This Executive Order shall expire upon the expiration of Executive Order 20- 52, including any extensions. 
IA  2020.03.26 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. A nonessential surgery or procdure is one that can be delayed without undue risk to teh 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 teh surery or procdure 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 rapidaly worsening to serve symptoms.  March 27, 2020 April 30,2020
IN 20-13 To preserve PPE for health care providers who are battling the COVID-19 pandemic, beginning April 1, 2020, all health care proviers whether medical, dental or other, and health care facilities, whether hospitals, ambulatory surgical centers, dental facilities, plastic surgery centers, dermatology offices adn abortion clinics, are directed to cancer or postpone elective and non-urgent surgical or inasive procedures. An "elective and non-urgent" procedure, for purposes of this executive order includes any surgery or invasive procedure which can be delayed without undue risk to current or future health of the patient as determined by teh patient's treating physician, dentist or health care provider. This prohibition shall not apply to any procedure that, if performed in accordance with the commonly accepted standards of clinical practice would not deplete the hospital capacity needed adn available to cope with the COVID-19 disaster, or utilize any way PPE (exempting gloves). This provision supersedes the non-essential surgical procedure directive in Executive Order 20-04, paragraph 7. April 1, 2020 90 days
KY Cabinet for Health Letter
  1. ALL non-emergent, non-urgent in-person medical, surgical, dental, and any other healthcare practice or procedure must have immediately ceased effective close of business on March 18, 2020.
  2. The Commonwealth of Kentucky relies upon licensed healthcare professionals within the state to exercise their best clinical judgment in the implementation of this restriction.
  3. To assist licensed healthcare professions in the exercise of their judgment, the following guidelines are offered:
    1. Emergent - Any healthcare service that, were it not provided, is at high risk of resulting in serious and/or irreparable harm to a patient if not provided within 24 hours.
    2. Urgent - Any healthcare service that, were it not provided, is at high risk of resulting in serious and/or irreparable harm to a patient if not provided within 24 hours to 30 days.
    3. Non-Urgent - Any healthcare service that, were it not provided, is unlikely to result in any serious and/or irreparable harm to a patient if not provided for more than 30 days. (For example, chiropractic medicine.)
  4. When considering the above guidance, clinicians are urged to consider whether the service provided would still be retrospectively deemed necessary if the patient (or close contact of the patient) were to become infected by COVID-19 as a result and suffer serious and/or irreparable harm as a result.
March 18, 2020  
LA LDH Notice #2020-COVID19-ALL-007 A. The Department hereby directs that any and all medical and surgical procedures SHALL ONLY be performed under the following conditions until further notice.
  1. Medical and surgical procedures are allowed in order to treat an emergency medical condition; for purposes of this Notice, “emergency medical condition” is the definition used in 42 CFR §489.24; such definition states that an “emergency medical condition” is defined as a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain, psychiatric disturbances and/or symptoms of substance abuse) such that the absence of immediate medical attention could reasonably be expected to result in: 1 Dental Providers should follow Section II of this memo. LDH – Provider Memorandum – UPDATE #2, April 20, 2020, Page 3
    1. Placing the health of the individual (or, with respect to a pregnant woman, the health of the woman or her unborn child) in serious jeopardy
    2. Serious impairment to bodily functions; or
    3. Serious dysfunction of bodily organs.
  2. Medical and surgical procedures are allowed to avoid further harms from underlying condition or disease.
  3. Time-Sensitive Medical Conditions:
    1. Subject to paragraph (b) below, medical and surgical procedures are allowed to treat time-sensitive medical conditions, provided that the facility and/or healthcare provider ensure that each of the following conditions/requirements are met; if each of the following conditions/requirements is not met, then the facility/healthcare provider shall not perform any medical or surgical procedures to treat time-sensitive medical conditions:
      1. Each patient undergoing such a medical or surgical procedure shall undergo an appropriate pre-operative clinical evaluation to minimize the risk that the patient has COVID-19; such clinical evaluation shall include appropriate COVID-19 testing, if available;
      2. Each patient undergoing such a medical or surgical procedure shall be required to comply with strict social distancing measures from the time of the pre-operative clinical evaluation through the day of the surgery;
      3. The facility and healthcare provider shall have an adequate and appropriate supply of personal protective equipment (PPE) to treat the patient, as well as treat any other patient, including COVID positive patients, in the facility. At no time shall a facility’s PPE supply to treat COVID positive patient fall below a 5-day supply on hand at the facility. The facility shall not be dependent on the state or other governmental body to supply the 5-day requirement;
      4. There is an adequate supply chain to the facility/healthcare provider for medical equipment, supplies, and medications;
      5. The facility/healthcare provider has adequate medical staff, including surgical, surgical support, recovery, and nursing staff, to meet the needs of all patients;
      6. The facility/healthcare provider shall conduct constant monitoring of hospital, regional, and state resources, as well as ESF-8 reports, indicating coronavirus burden of disease and impact.
    2. Medical and Surgical Procedures to Treat Time-Sensitive Medical Conditions SHALL BE IMMEDIATELY DISCONTINUED upon notice by the State Health Officer, who may consider any of the following criteria in LDH – Provider Memorandum – UPDATE #2, April 20, 2020 Page 4, making a decision to halt or discontinue medical and surgical procedures to treat time-sensitive medical conditions:
      1. Statewide or region-wide ventilator capacity;
      2. Statewide or region-wide ICU bed availability;
      3. Statewide or region-wide med surg bed availability;
      4. The number of new admit COVID-19 cases; and
      5. Any other criteria that the State Health Officer deems appropriate.
March 27, 2020  
MI No. 2020-17 Beginning as soon as possible but no later than March 21, 2020 at 5:00 pm, and continuing while the state of emergency declared in Executive 2020-4 is in effect, all hospitals, freestanding surgical outpatient facilities, and dental facilities, and all state-operated outpatient facilities (collectively, “covered facilities”), must implement a plan to temporarily postpone, until the termination of the state of emergency under section 3 of Executive Order 2020-4, all non-essential procedures (“non-essential procedure postponement plan” or “plan”). For purposes of this order, “non-essential procedure” means a medical or dental procedure that is not necessary to address a medical emergency or to preserve the health and safety of a patient, as determined by a licensed medical provider. March 21, 2020 Until the termination of the state of emergency under section 3 of Executive Order 2020-4
MN Emergency Executive Order 20-09
  1. All non-essential or elective surgeries and procedures, including non-emergent or elective dental care, that utilize PPE or ventilators must be postponed indefinitely.
  2. A non-essential surgery or procedure is a surgery or procedure that can be delayed without undue risk to the current or future health of a patient. Examples of criteria to consider in making this determination include:
    1. Threat to the patient’s life if surgery or procedure is not performed.
    2. Threat of permanent dysfunction of an extremity or organ system, including teeth and jaws.
    3. Risk of metastasis or progression of staging.
  3. Pursuant to Minnesota Statutes 2019, section 12.45, a person who willfully violates paragraph 1 of this Executive Order is guilty of a misdemeanor and upon conviction must be punished by a fine not to exceed $1,000, or by imprisonment for not more than 90 days.
March 19, 2020 Until Rescinded
MS   All licensed health care professionals and all licensed health care facilities shall postpone all surgeries and procedures that are not immediately medically April 10, 2020 April 27, 2020
NC DHHS Letter Effective March 23, 2020, as part of a unified response, I request all hospitals and ambulatory surgery centers suspend all elective and non-urgent procedures and surgeries. Elective and non-urgent procedures and surgeries are defined as any procedure or surgery that if not done within the next 4 weeks would cause harm to the patient. Beginning today, March 20, hospitals and ambulatory surgery centers should institute an explicit, real-time review of all non-time sensitive procedures and surgeries. March 23, 2020  
NE DHH 2020-009 Elective medical and dental surgeries and elective medical and dental procedures are hereby prohibited. For the purposes of this Order, this means a surgery or procedure that is scheduled in advance because it does not involve a medical or dental emergency. Surgeries or procedures that must be done to preserve the patient's life or physical health, but do not need to be performed immediately, are allowed by a case-by-case determination of the medical or dental provider. April 3, 2020  May 4, 2020—Elective surgeries may resume as long as hospitals and health care facilities meet requirements for available bed capacity and have adequate supplies of personal protective equipment (PPE).
NJ EO-19 All “elective” surgeries performed on adults, whether medical or dental, and all “elective” invasive procedures performed on adults, whether medical or dental, are suspended in the State. An “elective” surgery or invasive procedure, for purposes of this Order, is defined as any surgery or invasive procedure that can be delayed without undue risk to the current or future health of the patient as determined by the patient’s treating physician or dentist. An “elective” surgery or invasive procedure does not include the administration of vaccines. March 27, 2020  
NM PUBLIC HEALTH ORDER
  1. All hospitals and other health care facilities, ambulatory surgical facilities, dental, orthodontic and endodontic offices in the State of New Mexico are prohibited from providing nonessential health care services, procedures, and surgeries.
  2. For purposes of this Order, "non-essential health care services, procedures, and surgeries" include those which can be delayed for three (3) months without undue risk to the patient's health. Examples of criteria to consider in distinguishing between essential and nonessential actions include:
    1. Threat to a patient's life
    2. Threat of permanent dysfunction of an extremity, including teeth, jaws, and eyes
    3. Risk of metastasis or progression of staging
    4. Prenatal and postnatal care
    5. Any other factors that will conserve medical resources without creating an undue risk of pennanent harm to patients.
  3. This Order's prohibition on non-essential health care services, procedures, and surgeries is not meant to apply to:
    1. The provision of emergency medical care or any actions necessary to provide treatment to patients with emergency or urgent medical needs
    2. Any surgery or treatment that if not performed would result in a serious condition of a patient worsening (e.g., removing a cancerous tumor or a surgery intended to manage an infection)
    3. The full suite of family planning services.
March 27, 2020 for the duration of executive order 2020-004
NY 202.1 The Commissioner of Health is authorized to direct, and shall so direct, all general hospitals, ambulatory surgery centers, office-based surgery practices and diagnostic and treatment centers to increase the number of beds available to patients, including by canceling all elective surgeries and procedures, as the Commissioner of Health shall define. General hospitals shall comply with such order by submitting COVID-19 Plans to the New York State Department of Health (NYSDOH), on a schedule to be determined by NYSDOH, to accomplish this purpose; March 23, 2020 April 22, 2020
OH Dept Health Order
  1. Non-essential or elective surgeries and procedures that utilized PPE should not be conducted.
  2. A non-essential surgery is a procedure that can be delayed without undue risk to the current or future health of a patient. Examples of criteria to consider include:
    1. Threat to the patient's life if 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
    4. Risk of rapidly worsening to severe symptoms (time sensitive)
March 18, 2020 End of State of Emergency
OK 2020-7 4th Oklahomans and medical providers in Oklahoma shall postpone all elective surgeries, minor medical procedures, and non-emergency dental procedures until April 7, 2020. March 24, 2020 Governor changed order to end April 24, 2020 per announcement on April 15, 2020
OR eo 20-10 Prohibition on Elective and Non-Urgent Procedures
  1. Pursuant to ORS 433.441(3)(a), (b), (d) and (f), ORS 401.168(1), and ORS 401.188(1)-(3), I direct the following actions to conserve PPE and other health care resources for the state's COVID-19 emergency response:
    1. No later than March 23, 2020, all elective and non-urgent procedures across all care settings that utilize PPE, including but not limited to, hospitals, ambulatory surgery centers, outpatient clinics (including community health clinics and student health centers), dental clinics, and veterinary clinics, shall be cancelled, or rescheduled no earlier than June 15, 2020, for the purpose of conserving and redirecting PPE for the state's COVID-19 emergency response.
    2. A procedure or surgery is exempt from the limitations set forth in paragraph l(a) of this Executive Order if a three-month delay in the procedure or surgery would put the patient at risk of irreversible harm. Criteria for determining whether irreversible harm exists include but are not limited to:
      1. Threat to the patient's life
      2. Threat of irreversible harm to the patient's physical or mental health
      3. Threat of permanent dysfunction of an extremity or organ system
      4. Risk of metastasis or progression of staging
      5. Risk of rapidly worsening to severe symptoms (time sensitive)
March 23, 2020 June 15, 2020
PA GUIDANCE ON AMBULATORY SURGICAL FACILITIES’ RESPONSES TO COVID-19 Ambulatory surgical facilities may not perform any elective surgeries or procedures unless the surgery or procedure would preserve organ function or avoid further harms from an underlying condition or disease. March 20, 2020  
SD eo 2020-12 Postpone all non-essential elective surgeries to conserve (and thereby maximize) supplies of personal protective equipment (PPE) April 6, 2020 May 31, 2020
TN  exec-orders-lee25 All healthcare professionals and healthcare facilities in the State of Tennessee shall postpone surgical and invasive procedures that are elective and non-urgent. Elective and non-urgent procedures are those procedures that can be delayed until the expiration of this Order because they are not required to provide lifesustaining treatment, to prevent death or risk of substantial impairment of a major bodily function, or to prevent rapid deterioration or serious adverse consequences to a patient's physical condition if the surgical or invasive procedure is not performed, as reasonably determined by a licensed medical provider. April 8, 2020 April 30, 2020
TX Executive Order No. GA-l5 #3

Beginning at 11:59 pm on April 21 through 11:59 pm on May 8, all licensed health care professionals and all licensed health care facilities must continue to postpone all surgeries and procedures that are not medically necessary to diagnose or correct a serious medical condition of, or to preserve the life of, a patient who without timely performance of the surgery or procedure would be at risk for serious adverse medical consequences or death as determined by a patient's physician. Exceptions now include:

  • Any procedure that, if performed in accordance with the commonly accepted standard of clinical practice, would not deplete the hospital capacity or the PPE needed to cope with COVID-19
  • Any surgery or procedure performed in a licensed health care facility that has certified in writing to Texas HHSC both (1) that it will reserve at least 25 percent of its hospital capacity for treatment of COVID-19 patients, accounting for the range of clinical severity of COVID-19 patients, and (2) that it will not request any PPE from any public source—whether federal, state, or local—for the duration of the COVID-19 disaster. 
April 21, 2020 May 18, 2020
UT STATE PUBLIC HEALTH ORDER All licensed health care professionals and all licensed health care facilities shall postpone all elective surgeries and procedures in accordance with version 3.15.20 of the CMS Adult Elective Surgery and Procedures Recommendations, promulgated by the Centers for Medicare & Medicaid Services on March 18, 2020. March 23, 2020 April 25, 2020
VA  Order of Public Health Emergency Two Prohibiting all inpatient and outpatient surgical hospitals licensed under 12 VAC 5-410, freestanding endoscopy centers, physicians’ offices, and dental, orthodontic, and endodontic offices in the Commonwealth from providing procedures and surgeries that require PPE, which if delayed, are not anticipated to cause harm to the patient by negatively affecting the patient's health outcomes, or leading to disability or death. This does not include outpatient visits delivered in hospital-based clinics. This Order does not apply to the full suite of family planning services and procedures nor to treatment for patients with emergency or urgent needs. Inpatient and outpatient surgical hospitals licensed under 12 VAC 5-410, free-standing endoscopy centers, physicians’ offices, and dental, orthodontic, and endodontic offices may perform any procedure or surgery that if delayed or canceled would result in the patient's condition worsening. Outpatient surgical hospitals are encouraged to work with their local inpatient hospitals to assist with surge capacity needs.  March 25, 2020 April 24, 2020
VT Addendum 9 TO EXECUTIVE ORDER 01-20 B. For Health Care Facilities and Health Care Providers, an emergency management service or response activity, includes, but may not be limited to:
  1. Expedited postponement of non-essential adult elective surgery and medical and surgical procedures, including dental procedures, in the safest but most expedient way possible, as ordered by Addendum 3 of the Executive Order, if elective surgeries and medical and surgical procedures are performed at the Health Care Facility or by the Health Care Provider
  2. Cancelling or denying elective surgeries or procedures or routine care to the extent determined necessary for the health, safety and welfare of a patient or as necessary to respond to the COVID-19 outbreak
  April 10, 2020 Midnight on May 15, 2020
WA AMENDING PROCLAMATION 20-05 20-24 Restrictions on Non Urgent Medical Procedures Examples of procedures to delay include, but are not limited to: most joint replacements, most cataract and lens surgeries, non-urgent cardiac procedures, cosmetic procedures, some endoscopy, and some interventional radiology services. EXCEPTION: The above prohibition does not apply to the full suite of family planning services and procedures or to treatment for patients with emergency/urgent needs (examples of the latter include, but are not limited to, people with heart attacks, strokes, or motor vehicle accidents). Hospitals and ambulatory surgical facilities may perform any surgery that if delayed or canceled would result in the patient’s condition worsening (for example, removal of a serious cancerous tumor or dental care related to the relief of pain and management of infection.) Ambulatory surgical facilities are encouraged to work with their local hospitals to assist with surge capacity needs.  March 19, 2020 May 18, 2020
WV EXECUTIVE ORDER NO. 16-20 All elective medical procedures are hereby prohibited; provided that patients will still have access to urgent, medically necessary procedures like those needed to preserve the patient's life or long-tenn health; and provided that this prohibition applies equally to all types of elective medical procedures performed in hospitals, offices, and clinics throughout the state. The term "elective" includes medical procedures that are not immediately medically necessary to preserve the patient's life or long-term health, except that procedures that cannot be postponed without compromising the patient's longterm health, procedures that cannot be performed consistent with other law at a later date, or procedures that are religiously mandated shall not be considered "elective" under this Order. April 1, 2020