PLEASE NOTE: Light Blue italicized writing is AMTA-MD Comments and suggestions. Black Text is the Health Department Amended Directive from Secretary of Health Neall.
B. Resumption of Elective and Non-Urgent Medical Procedures – Conditions
All licensed healthcare facilities and healthcare providers may resume elective and non-urgent medical procedures and appointments at 7:00 A.M., May 7, 2020 provided all of the following measures are in place:
Licensed Massage Therapists are considered Health Care Providers by statute and it is interpreted that they can return to work – if following all the additional guidance below. RMPs are not included in this guidance.
I. Healthcare providers licensed under the Health Occupations Article shall exercise their independent professional judgment in determining what procedures are appropriate to perform, which appointments should occur, and which patients to see in light of widespread COVID-19 community transmission.
This means that LMTs may decide for themselves what is safe and what procedures are required for safety (in addition to those required and listed below.) This does not force us back to work, it allows us to return to work.
II. Any licensed healthcare facility or healthcare provider resuming elective and non-urgent medical procedures in a healthcare setting shall have at least one week’s supply of PPE for themselves, staff, and as appropriate, for patients.
- Note: PPE requests to any State or local health or emergency management agency will be denied for elective and non-urgent medical procedures.
- Note: The healthcare facility or healthcare provider must be able to procure all necessary PPE for its desired services via standard supply chains.
- Note: For hospitals with COVID-19 patients, MDH will determine a daily PPE per patient use rate for PPE requests.
- Note: “Healthcare setting” means: (1) the office of a healthcare provider licensed under the Health Occupations Article; or (2) a healthcare facility as defined in § 19-114 of the Health-General Article.
III. Social distancing requirements must be strictly maintained in all settings where people must wait in order to minimize direct contact between individuals within the healthcare setting and use of non-traditional alternatives is encouraged (e.g., call ahead registration; waiting in a car until called).
There are many sources for good ideas on how to manage this within the massage setting, see our links below.
IV. All healthcare workers, patients, and others must be screened for COVID-19 symptoms upon arrival for shift or visit. Staff must stay home if they are showing COVID-19 symptoms.
V. All healthcare facilities and healthcare providers must plan for and implement enhanced workplace infection control measures in accordance with the most current CDC guidelines: https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control.html
- Note: All healthcare providers and staff shall wear appropriate face coverings, to include cloth face coverings, surgical face masks or N-95 masks, respirators, and/or face shields.
- Note: Patients should wear a face covering whenever possible.
There is also a lot of good information about what Personal Protective Equipment is helpful and important in a massage setting with Masks being required, and face shields, gloves, and gowns or changeable clothing highly suggested.
VI. Any healthcare facility or healthcare provider who is unable to provide PPE for themselves, staff, and patients where appropriate shall immediately restrict operations to urgent and non-elective procedures and appointments.
We must have sufficient PPE for everyone to be open.
C. Certification and Other Matters
I. A healthcare facility’s managing authority or the responsible healthcare provider shall certify to MDH via secretary.health@maryland.gov that all of the above conditions for resumption of elective and non-urgent medical procedures have been met prior to resuming operations. A copy of this self-certification notice shall be posted prominently in the facility for the attention of patients and staff.
The LMT or the Health Care Facility must certify to the state that these conditions have been met and post that certification on site.
II. Complaints about a healthcare facility’s implementation of these measures may be directed to the Office of Health Care Quality at
https://health.maryland.gov/ohcq/Pages/Complaints.aspx. A healthcare provider’s failure to comply with the terms of this order shall be considered to constitute unprofessional conduct, and written complaints about such failures may be directed to the appropriate health occupation board.
III. MDH does not construe the immunity provisions in Pub. Safety Art. § 14-3A-06 or Health Gen. Art. § 18-907 to apply to a healthcare provider or facility performing non-COVID-19 related procedures or appointments.
This guidance from the MDH does not provide immunity or protection from any lawsuits.
6. Personal Protective Order Conservation
Subject to availability, all healthcare providers are required to immediately implement the U.S. Centers for Disease Control and Prevention’s Strategies to Optimize the Supply of PPE and Equipment, to include, but not limited to:
A. Use facemasks beyond the manufacturer-designated shelf-life during patient care activities.
B. Implement limited re-use of facemasks. The healthcare provider must not touch the outer surfaces of the mask during care, and mask removal and replacement must be done in a careful and deliberate manner.
C. Prioritize facemasks for:
I. Provision of essential surgeries and procedures;
II. During care activities where splashes and sprays are anticipated;
III. During activities where prolonged face-to-face or close contact with a potentially infectious patient is unavoidable; and
This is one concern for Massage settings – extended time with close contact
IV. Performing aerosol generating procedures, if respirators are no longer available.
D. Exclude healthcare providers at higher risk for severe illness from COVID-19 from contact with known or suspected COVID-19 patients.
A reminder that returning to work for those in high-risk categories might not be the best choice at the moment. There are provisions for this within the unemployment rules, although we certainly cannot guarantee coverage.
