Governor Mill issues Executive Order to expand healthcare with focus on workforce, alternative care sites
Governor Mills made a major announcement Tuesday afternoon, saying that she has put things in place to help build up the healthcare workforce and to make care more accessible to Mainers.
Alternative care sites will be built at sites including Cross Insurance Arena in Portland, Cross Insurance Center in Bangor. Those could be set up as soon as next week, according to the governor.
Governor Mills says that the Maine National Guard is helping set up those two alternative care sites. In Portland, that site will allow for 100 beds, while in Bangor, 50 beds will be available at that site.
Health care workers will be able to work with licensure modifications and other allowances as stated below.
Statement from the Office of Governor Mills:
"Governor Janet Mills today directed the Maine National Guard and the Maine Emergency Management Agency (MEMA) to work with Maine’s health care systems to open two alternative care sites in Portland and Bangor as part of the State’s preparations to bolster Maine health system capacity in the face of COVID-19.
The Governor’s Office and Department of Health and Human Services (DHHS), including the Maine Center for Disease Control and Prevention (Maine CDC), are partnering with MaineHealth, Northern Light Health, Central Maine Healthcare, MaineGeneral Health, and the Maine Hospital Association on comprehensive surge planning to ensure adequate capacity for the treatment for Mainers with COVID-19. These alternative care sites, which are part of this plan, will free up hospital beds, if needed, to accommodate a potential surge of COVID-19 patients in the coming weeks. This effort is a result of the Mills Administration’s broader partnership with Maine health systems and providers, first responders, and community providers throughout the State to ensure coordination during this fast-moving pandemic.
The effort calls for a total of 100 beds to be set up at Cross Insurance Arena in Portland and at least 50 beds to be set up at the Cross Insurance Center in Bangor as additional capacity for hospitals. Logistical support will come from the Maine CDC, Maine National Guard, MEMA, as well as the Cities of Portland and Bangor and Cumberland and Penobscot Counties. While adequate hospital beds remain available across the State and are the first choice for treating all patients in need of inpatient care, the Governor is taking this step to ensure preparedness in the face of a rapidly evolving situation. The alternative care sites are expected to be set up as soon as next week, and staffed shortly thereafter, should they be needed. The health systems will work with the State on the clinical models and staffing for these sites in the coming days. Further details will be released once the plan is finalized.
“I hope we never need to use these alternative care sites, but we cannot afford to wait to find out. Establishing them now will ensure that, if the need does arise, we will be prepared and Maine people will receive appropriate care,” said Governor Mills. “My Administration will continue to work closely with Maine’s hospital systems to expand our capacity to meet the challenges of COVID-19 and its impacts on Maine people. I continue to urge all Maine people to do their part and stay apart. Doing so will save lives.”
“The Maine National Guard is postured to provide personnel and transportation assets to aid in the initial set up of the alternative care sites,” said Major General Douglas Farnham, Maine’s Adjutant General. “We are prepared to provide additional support to Maine CDC and MEMA as this response continues to unfold.”
“MEMA, the Maine CDC, and the National Guard have spent significant time planning for the rollout of Maine’s first alternative care sites,” said MEMA Director Peter Rogers. “As soon as next week, Maine will be better prepared for any potential surge we may see in the coming weeks. We look forward to further engaging in this important work.”
“Maine’s high-quality hospitals have ably managed the influx of COVID-19 patients to date,” said DHHS Commissioner Jeanne Lambrew. “But this pandemic rivals all others of the last century in its spread and impact. We continue to support Maine’s health care system, as well as our nursing facilities, group homes, home- and community-based providers, and behavioral health care providers, among others, with their ongoing services and care for Mainers with COVID-19.”
“The MaineHealth system is working closely with the Governor and her team to plan for any surge in COVID patients,” said William Caron, CEO of MaineHealth. “That work includes the sourcing of needed supplies and personal protective equipment, resource needs within the four walls of our hospitals, and any external surge capacity that our communities may need. We greatly appreciate the Governor’s leadership during these challenging times.”
“Northern Light Eastern Maine Medical Center has developed a surge plan that will provide care for up to 250 COVID-19 positive patients, and up to 90 other patients (COVID-19 or non-COVID-19) requiring ventilator support,” said Tim Dentry, President and CEO of Northern Light Health. “Additionally, we continue to work with our region’s healthcare partners, and city, county, and state officials on a potential site for additional temporary surge beds if required.”
“Maine hospitals are taking unprecedented steps to prepare for a potential surge of COVID-19 patients who need our care,” said Steven Michaud, president of the Maine Hospital Association. “We have been working hand in glove with state government to fill in potential gaps in capacity and feel comfortable that we can meet the potential demand given the plans being put in place. But staying home and helping us flatten the curve is the key to our success.”
“The City of Bangor has been working closely with the State, local healthcare providers, educational institutions, and social service organizations in order to think creatively should extra hospital space be needed in the coming weeks,” said Bangor City Manager Cathy Conlow. “We are grateful to have the state and community partners that can quickly think outside the box when it comes to keeping our population safe and resilient.”
"The people of Cumberland County own the Cross Insurance Arena," said Cumberland County Manager James Gailey. "It's here for them now, to provide comfort and care. We'll do everything we can to support the state and medical communities in making the Arena a safe place for Maine people to heal.”
“Central Maine Healthcare continues to work with our peers, in partnership with State, federal and local governments to make sure our communities are adequately resourced,” said Jeff Brickman, president and CEO of Central Maine Healthcare. “Additionally we are preparing across our system to make sure we have the capacity to care for patients in any surge of this outbreak.”
“Governor Mills bringing this taskforce together to share epidemic modeling, existing resource capacity and to estimate the required resources has helped with statewide transparency in fighting the COVID-19 pandemic,” said Chuck Hays, President & CEO of MaineGeneral Health. “We are confident in the surge plans developed, that collectively as a state, our health care teams are ready to serve the people of Maine. We are all working together to prepare for the surge and are counting on Maine people to self-quarantine and practice social distancing to help flatten the curve. We are all in this together.”
According to modeling, while Maine’s critical care capacity is likely sufficient in aggregate for acute COVID-19 patients under most scenarios, staffing for and geographic distribution of those beds remain focal points. Major hospitals are working on options to augment staffing, transfer patients to other sites, and otherwise maximize existing capacity.
This capacity could be expanded, such as by converting some beds to critical care beds, though new capacity may need to be concentrated in areas where the necessary staff are already available, in light of preexisting workforce challenges. For example, MaineGeneral Health has the capacity to convert up to 30 beds for COVID-19 critical care. Maine Medical Center could convert some of the 64 beds on its new cancer floors to COVID-19 critical care beds. Northern Light Health has developed a surge plan that will provide care to up to 90 additional patients (COVID-19 or non-COVID-19) requiring ventilator support.
The State’s broader response to the pandemic includes providing key supports to health care organizations, such as:
• Personal Protective Equipment: The State is working on three fronts to protect our front-line workers in the fight against COVID-19. First, the Mills Administration continues to request from the Federal government a greater share of the Strategic National Stockpile and other Federal sources of PPE. Second, the Administration is working to procure its own PPE efficiently and effectively. Third, the State is working to produce supplies in Maine. For example, the State has worked with the University of Maine System which has produced over 630 gallons of hand sanitizer so far for over 30 hospitals. The Department of Corrections has produced 1,000 cloth face coverings and 200 gowns for its use.
• Staffing: The Administration is also asking clinicians to sign up for the “Maine Responds” Emergency Health Volunteer System that organizes health care, public health, and emergency response volunteers to respond to emergency situations. Already, approximately 300 have signed up. Nearly half of these anesthesiologists, certified registered nurse anesthesiologists, and respiratory therapists who can help manage a hospital surge.
• Regulatory flexibility: Maine DHHS submitted an 1135 waiver to the federal government that was approved today to give hospitals greater flexibility to rapidly discharge patients to nursing facilities to free up beds, bring on providers from different states, and allocate staff to meet patient needs in this crisis.
• Financial support: DHHS is preparing to take a first step next week to financially support Maine’s hospitals in responding to COVID-19 by making $10 million in supplemental payments to hospitals. This is part of the Administration’s larger effort to support Maine’s health care workers and organizations as they battle COVID-19 and its ripple effects on our residents and health system.
DHHS continues to work to maximize state and federal financial support during the COVID-19 pandemic for a range of providers throughout the state."
The full order can be read here:
"Governor Janet Mills has signed an Executive Order to further expand access to health care for Maine people in the face of COVID-19. The Order takes additional steps to bolster the health care workforce, expand telehealth services, and temporarily alleviate certain licensing requirements, building upon the Governor’s March 20 Executive Order.
“As the demands on our health care system grow, it is critical that we ensure Maine people have access to the health care services they need in the face of COVID-19,” said Governor Mills.
“This Executive Order allows nonresidents and retired Maine health care providers, such as respiratory therapists, to serve Maine people during the pandemic.”
“This action also ensures that Mainers can access a broader range of health care services via telehealth, minimizing in-person visits to comply with physical distancing guidelines” said Department of Professional and Financial Regulation Commissioner Anne Head. Commissioner Head also noted that, “the COVID-19 situation has made it difficult for
licensees to complete some of the steps necessary for licensure, including continuing education. For compassionate and practical reasons, the order waives continuing education requirements for license renewals through March 20, 2021.”
This Executive Order allows:
All health care providers licensed by the Office of Professional
and Occupational Regulation (OPOR), such as psychologists, social workers, and physical therapists to:
o provide their services via telehealth
o have their license expiration dates extended until 30 days following the end of the declared state of emergency, if the license was scheduled for renewal during the state of emergency
o not have to complete continuing education requirements for license renewals that occur through March 20, 2021.
In addition, certain health care providers licensed by OPOR, such as
respiratory care therapists and pharmacists may:
o Receive a temporary license to provide health care in person or through telehealth, with no application fee, if currently licensed in another state
o Reactivate their Maine license immediately, with no application fee, if
retired within the last three years.
The Governor’s March 20 Executive Order applied only to licensed physicians, nurses and physician assistants. For more details including a complete description of the OPOR licensees covered under this order, please refer to the Executive Order.