DECLARATION OF EMERGENCY DIRECTIVE 011
WHEREAS, on March 12, 2020, I, Steve Sisolak, Governor of the State of Nevada issued a Declaration of Emergency to facilitate the State's response to the COVID-19 pandemic; and
WHEREAS, on March 13, 2020, Donald J. Trump, President of the United States declared a nationwide emergency pursuant to Sec. 501(6) of the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C. 5121-5207 (the "Stafford Act"); and
WHEREAS, pursuant to NRS 414.070(6), the Governor may exercise the power "[t]o authorize providers of emergency medical services and providers of mental health services who are not licensed, certified or registered, as applicable, in this State but hold a license, certificate, registration or similar credential in good standing in another state of the United States, the District of Columbia, the Commonwealth of Puerto Rico or any territory or insular possession subject to the jurisdiction of the United States to practice their profession within their scope of practice as if they were licensed, certified or registered, as applicable, in this State for the amount of time necessary to assist in responding to the emergency or disaster;" and
WHEREAS, pursuant to NRS 414.070(7), the Governor may perform and exercise such other functions, powers and duties as are necessary to promote and secure the safety and protection of the civilian population; and
WHEREAS, NRS 414.110(1) provides that all functions under Chapter 414 and all other activities
relating to emergency management are hereby declared to be governmental functions. Neither the State nor any political subdivision thereof nor other agencies of the State or political subdivision thereof, nor except in cases of willful misconduct, gross negligence, or bad faith, any worker complying with or reasonably attempting to comply with this chapter, or any order or regulation adopted pursuant to the provisions of this chapter, or pursuant to any ordinance relating to any necessary emergency procedures or other precautionary measures enacted by any political subdivision of the State, is liable for the death of or injury to persons, or for damage to property, as a result of any such activity.
WHEREAS, NRS 414.110(2) provides that any requirement for a license to practice any professional,
mechanical or other skill does not apply to any authorized worker who, in the course of performing his or her duties as such, practices that professional, mechanical or other skill during an emergency or disaster.
WHEREAS, NRS 414.110(3) defines "worker" to include without limitation any full-time or part-time paid, volunteer or auxiliary employee of this State, of any political subdivision thereof, of other states, territories, possessions or the District of Columbia, of the Federal Government, of any neighboring country, or of any political subdivision thereof, or of any agency or organization, performing services for emergency management at any place in this State subject to the order or control of, or pursuant to a request of, the State Government or any political subdivision thereof; and
WHEREAS, Nevada must be prepared to expand its health care workforce to protect its citizens who require emergency care and services and ensure all critical medical resources are available to identify and treat those impacted by COVID-19 during this emergency;
WHEREAS, Article 5, Section 1 of the Nevada Constitution provides: "The supreme executive power of this State, shall be vested in a Chief Magistrate who shall be Governor of the State of Nevada;" and
NOW, THEREFORE, by the authority vested in me as Governor by the Constitution and the laws of the State of Nevada and the United States, and pursuant to the March 12, 2020, Emergency Declaration,
IT IS HEREBY ORDERED THAT:
April 1, 2020 Declaration of Emergency Directive 011
||The waiver of licensing provision of NRS 414.110 is hereby invoked. Professional licensing boards regulating providers of medical services shall temporarily waive certain licensing requirements to allow the practice of currently unlicensed skilled medical professionals during the pendency of the COVID-19 crisis. For the purposes of this Directive, a provider of medical services includes all categories of skilled personnel deemed necessary by the Governor's COVID-19 Medical Advisory Team to augment and bolster Nevada's healthcare workforce to the levels necessary to combat this pandemic, including without limitation, medical doctors, physician assistants, nurse practitioners, advanced practice registered nurses, registered nurses, licensed practical nurses, emergency medical technicians, advanced emergency medical technicians, respiratory care practitioners, paramedics, pharmacists, pharmacy technicians, medical students, nursing students, medical laboratory directors or technicians, and licensed or certified behavioral health professionals.
||The waiver and exemption of professional licensing requirements shall apply to qualified providers of medical services during this declared emergency who currently hold a valid license in good standing in another state, providers of medical services whose licenses currently stand suspended for licensing fee delinquencies, providers of medical services whose licenses currently stand suspended for failure to meet continuing medical education requirements, and providers of medical services who have retired from their practice in any state with their license in good standing. These waivers and exemptions shall not apply to persons whose licenses have been revoked or voluntarily surrendered as a result of disciplinary proceedings.
| SECTION 3:
||The Chief Medical Officer is authorized to approve the wavier and exemption of professional licensing requirements for any provider of medical services who has received training in another country but is not currently licensed in the United States, subject to verification of their credentials.
| SECTION 4:
||Individuals seeking waiver and exemption of professional licensing requirements are required to notify the applicable Nevada licensing board or agency and provide any requested information. Any medical facility as defined by NRS 449.0151, laboratory, or pharmacy employs or contracts with a provider of emergency medical services who is not licensed in Nevada during this declared emergency must ensure that the provider has notified the applicable Nevada license board or agency.
| SECTION 5:
||The Chief Medical Officer and, to the extent necessary, the appropriate professional licensing board shall expedite the processing and final disposition of all applications to practice under the terms of this Directive.
| SECTION 6:
||A provider of medical services during this emergency is authorized to supervise students in their profession to provide any emergency medical services as is appropriate to the student's knowledge and skill level without further licensure or certification.
| SECTION 7:
||All providers of medical services in the State of Nevada are authorized to practice outside the scope of their specialization, within the limits of their competency, to the extent necessary to augment and bolster Nevada's healthcare system during the COVID-19 crisis.
| SECTION 8:
||The Governor authorizes the Chief Medical Officer or his designee to review and approve the Crisis Standards of Care Guidance for COVID-19 promulgated by the State of Nevada Department of Health and Human Services, Division of Public and Behavioral Health, and the Governor's COVID-19 Medical Advisory Team.
| SECTION 9:
||All regulatory requirements for providers of medical services that are not compatible with the applicable Crisis Standards of Care approved by the Chief Medical Officer during this declared emergency will be suspended.
| SECTION 10:
||All providers of medical services related to COVID-19 are performing services for emergency management subject to the order or control of and at the request of State Government and shall be afforded the immunities and protections set forth in NRS 414.110, subject to the same exclusions therein.
| SECTION 11:
||All licensing fees assessed on providers of medical services by the State of Nevada or professional licensing boards shall be waived for all persons applying to practice in the State of Nevada pursuant to this Directive, for the duration that this Directive shall be in effect. Providers of medical services currently licensed by the State of Nevada may, at their election, delay submission of outstanding licensing fees for the period this Directive shall be in effect, except that no person who has paid the fee prior to the date of this Directive shall be entitled to a refund thereof by virtue of this order. No license for a provider of medical services shall be suspended for nonpayment of licensing fees while this Directive is in effect, and for a period of 60 days thereafter.
| SECTION 12:
||No license for a provider of medical services shall be suspended for any administrative reasons, including without limitation, continuing education requirements while this Directive is in effect, and for a period of 60 days thereafter. This restriction shall not be construed to prohibit the suspension or revocation of licenses for reasons that jeopardize patient health, including without limitation, incompetency or malpractice.
| SECTION 13:
||This Directive shall remain in effect until specifically modified or terminated by a subsequent Directive promulgated pursuant to the March 12, 2020 Declaration of Emergency to facilitate the State's response to the COVID-19 pandemic.