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The scope of this report captures the current structure of existing truck size and weight limit laws from all 50 States and the District of Columbia. This report does not address the interplay of ever-changing case law and its effect on State laws.
This article was originally published March 26, At the beginning of this article series at the onset of the COVID pandemic, states moved with varying speeds in imposing restrictions on individuals and business in stay-at-home orders and orders prohibiting or restricting elective medical procedures. Since late spring, states have moved at different speeds in lifting these restrictions to open the economy and allow elective medical care, while sometimes having to reimpose restrictions. At the current time, states are no longer imposing the more severe stay-at-home mandates or outright prohibiting elective procedures, but instead are putting in place measures meant to address safety concerns while still letting the country get back to work.
As the states have reached a stasis on allowing business and healthcare activities, this will be the final update to this series. Individual State Orders.
We have prepared a succinct state-by-state summary and color-coded map of individual directives and orders that impact healthcare providers and elective procedures. Please click below to expand to view any orders and directives that are applicable to your state.
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This information is recent as of 12 p. ET on October 13,and will be updated regularly. A decision whether a procedure or surgery is elective or should be postponed or canceled under any state directive to do so is a clinical determination that each provider and facility must determine based on the risks and benefits of each case.
In determining whether to proceed with a procedure, providers must take care to heed any executive orders from their states, local governments, or other directives from agencies such as a Department of Health and should consult and consider the CDC and CMS guidelines. As noted above, while no state nor CMS nor the CDC appears to have yet indicated any specific documentation that must be maintained recognizing that in all matters related to COVID, the situation is fluid and ever-changingwe recommend that providers ensure they maintain proper documentation of the risk analysis performed in determining to forward with a procedure or surgery.
McGuireWoods stands ready to assist and has developed and is continuing to develop forms for such purposes. Download printable version. On March 19,Alabama State Health Officer Scott Harris issued an order directing the closure of many non-essential businesses as well as putting in place parameters for the continued operation of certain businesses. The order does not affect healthcare providers and facilities.
On April 3,Harris issued an order requiring all Alabama residents to stay at their place of residence, apart from certain essential activities. The order is effective through at least April 30, Stay-at-Home Update. On April 28, Gov. Kay Ivey announced a safer-at-home order that will be in effect from 5 p. The safer-at-home order recommends that all individuals, and especially vulnerable people, minimize travel, wear face masks when leaving the home and practice disinfecting techniques. Those who have tested positive for COVID will continue to be required to quarantine in their resident for 14 days.
Non-work-related gatherings of 10 or more, or of any size that cannot maintain social distancing, are still prohibited. All employers, unless otherwise excepted, must take reasonable steps to protect their employees by following recommendations such as avoiding gatherings of 10 or more, maintaining social distancing, regularly disinfecting, and facilitating remote work. Retail stores may open, but must limit occupancy to 50 percent and follow social distancing and sanitation guidelines. A of business types considered high-risk may not open, including entertainment venues, athletic facilities and service providers such as salons.
On May 8,Gov. Kay Ivey issued an updated safer-at-home ordereffective May 11 - 22,that allows more businesses to Sexy single 23 Mexico wv 23 and amends restrictions on businesses and individuals. The order rescinds the person limit on gatherings as long as social distancing of six feet is maintained, allows in-person dining as long as social distancing of six feet between tables is maintained, allows the reopening of athletic facilities such as gyms as long as distancing is maintained, and continues to require enhanced sanitation procedures.
Entertainment venues and schools will remain closed.
Hospitals and nursing homes still must restrict visitation and non-essential healthcare personnel, with exceptions for compassionate care visitation. The order provides that entertainment venues such as bowling alleys, concert venues, theaters, tourist attractions such as museums, and playgrounds could open and operate subject to occupancy limits, social distancing and sanitation requirements as of May Further, athletic activities such as team sports could begin on May The order places additional requirements on schools and colleges to operate on June 1.
Child care facilities and day and overnight camps also could begin operations on May Kay Ivey issued an amended safer-at-home order on June 30,which essentially extends until July 31,the prior order that was set to expire on July 3. Kay Ivey issued an amended safer-at-home order on July 15,that included a stateside mask mandate, requiring individuals to wear face coverings whenever in public and in close contact with other people.
Kay Ivey issued an amended safer-at-home order on Aug. Kay Ivey issued her 18th emergency order on Sept.
This order also contained a statewide mask mandate. Elective Procedures. The March 19 order also notes that as of the date of the order, all elective and dental medical procedures shall be delayed. The order does not provide any additional guidance on what constitutes an elective procedure. Therefore, we recommend providers continue to utilize the CMS guidelines.
Elective Procedures Update. Providers are directed to follow any applicable rules promulgated by a state regulatory authority or the Department of Health. Alaska Gov. Mike Dunleavy issued Health Mandate 12effective March 28,which was updated on April 9 to extend the effective date through April 21, It prohibits all in-state travel between communities, whether resident, worker or visitor, unless the travel is necessary to support critical infrastructure or for critical personal needs. Critical personal needs include travel for receiving essential healthcare.
Healthcare operations also include veterinary care.
The order goes into effect April 24, and includes five attachments addressing specific types of businesses, such as non-essential public-facing businesses generally, retail businesses, restaurant dine-in services, personal care services and non-essential non-public-facing businesses. Each of these attachments acts as a modification of a prior health mandate and allows the category of businesses to operations if they meet all listed requirements.
These requirements include measures to address social distancing such as specific restrictions on the of customershygiene protocols, staffing measures such as employee screening, and cleaning and disinfecting requirements. Under phase three, all businesses, religious houses of worship, libraries, museums, recreational activities, and sports activities could reopen at percent of capacity.
The phase three plan also continues to include guidelines for specific business types, including retail, child care, camps, mass transit, personal services, restaurants, fitness centers, swimming pools and entertainment venues. While Gov. Dunleavy issued Health Mandates and on March 19,requiring the postponement of all elective dental procedures for a period of one month and the postponement or cancellation of all elective or non-urgent medical procedures for a period of three months.
Regarding dental procedures, the mandate recommends the following actions:.
Regarding medical procedures, elective and non-urgent medical procedures include pre-scheduled surgeries that are deemed non-essential but does not apply to surgical cases coming through the emergency room or to existing hospitalized patients. Mike Dunleavy issued Health Mandate 15 on April 15, providing that procedures that require minimal protective equipment may on April 20 if providers continue to follow guidance regarding the provision of telehealth whenever possible, maintain physical barriers, require masks for all patients, screen all patients for COVID symptoms, minimize aerosolizing procedures, and test all patients for COVID if they have an emergent or urgent need for a procedure.
Providers may continue to provide urgent or emergent procedures but also must follow the enhanced screening and safety measures noted above. Therefore, surgeries are allowed to proceed if a delay would cause a ificant impact to the health, livelihood or quality of life of a patient. All patients undergoing such procedures should be tested for COVID within 48 hours of the procedure and the procedure delayed, if possible, for any positive Sexy single 23 Mexico wv 23. The health mandate also provides that non-emergent surgeries and procedures, defined as those that cannot be postponed beyond eight weeks without posing a ificant risk to quality of life, may on May 4, if the following conditions have been met:.
Doug Ducey issued Executive Ordereffective March 31 through April 30,ordering all individuals to limit their time away from their place of residence except for conducting essential activities, employment in essential functions, and to obtain services provided by an essential business. As with other states, the order to limit time away from home does not apply to seeking healthcare services or employment in healthcare.
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On April 29, Gov. The order still directs all residents to limit their travel except for essential activities including healthcarebut sets Sexy single 23 Mexico wv 23 staggered approach to how businesses ly classified as non-essential may operations. As of May 4, non-essential businesses that engage in the sale of goods may operate through delivery services, window services, walk-up services, drive-thru services, curbside delivery, and by appointment, while following requirements for social distancing.
As of May 8,non-essential retailers may operate and offer goods in-store as long as guidelines are followed. On May 4, Gov. Doug Ducey issued an additional, updated executive orderproviding that as of May 4, additional businesses such as barbers and cosmetologists may operations if they follow guidelines such as requiring appointments and face coverings. Further, as of May 11, dine-in services may with limited capacity, social distancing and required sanitation protocols.
Doug Ducey issued an executive order rolling back prior reopening of businesses and imposing other restrictions.
The order prohibits organized events of more than 50 people and requires the closure of bars, indoor gyms and fitness clubs, movie theaters, and water parks and tubing operators. On July 23,Gov. The updated order will stay in place and continue to be reviewed every two weeks. Under the orders, mass gatherings of more than 50 people are prohibited, and the following businesses must continue to pause operations: bars with a series 6 or liquorindoor gyms, indoor movie theaters, water parks and tubing operations. Ducey issued Executive Ordereffective March 21,ordering that all non-essential or elective surgeries including elective dental surgeries that utilize PPE or ventilators not be performed at any state d healthcare facility or by any state d healthcare provider.
On April 22, Gov. Ducey issued Executive Order to allow elective surgeries to on or after May 1 for those providers that have requested and received an exemption from the Arizona Department of Health Services from the prior executive order requiring the postponement of elective procedures. Providers and facilities must demonstrate that they can meet minimum criteria that includes the following:.
Further, any hospital, facility or provider that obtains such an exemption from the prior prohibition will not be eligible to request or receive PPE from the state or county health departments. Elective Procedures Updates.
State governors’ “stay-at-home” and prohibition on elective procedures orders
As the of COVID cases in Arizona continues to rise and the Arizona Department of Health noted that hospital bed capacity was at 83 percent under Executive Orderelective procedures must cease if capacity exceeded 80 percent the Arizona Department of Health issued a letter directing hospitals to fully activate their emergency plans.
Further, the letter directed hospitals to be judicious and reduce or suspend elective procedures to ensure sufficient hospital bed capacity for both COVID and non-COVIDrelated care. Facilities that had d elective procedures but are now affected by staff shortages or insufficient bed capacity must suspend elective surgeries immediately.