Tuesday, May 19, 2020

Hi Everyone,

The Maryland Department of Health has issued an Amended Directive stating that Licensed Massage Therapists working in Health Care Facilities may reopen. An email from the Maryland Board of Massage Therapy Examiners arrived this evening - do check your email.

AMTA-MD has read through the Health Department Amended Directive and added notes and explanations to make this situation more understandable. All will be found below, scroll down.

We would also like to be clear that we are here in support of all of our members. This news from the Secretary of Health does not require a return to work, it allows a return to work with very strict requirements. Some will feel comfortable returning to work, others not. There will be no value judgment from AMTA-MD on that, we simply suggest that everyone make their choices based on science and data, and hope nobody chooses based on financial need alone.

Please read on for more details and to reach out with any questions you have after reading the information below.

Best wishes,

Amelia

Amelia Mitchell, LMT, LLCC, BCTMB

Board Member and Government Relations Chair

for

David Madon, Mark Hamilton, and Chelsea Adams-Cook

Your AMTA-Maryland Chapter Board

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.

The full text can be found here: Amended Directive May 19, 2020

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.

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

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 [email protected] 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.

LMTs are licensed health care providers, so the office of an LMT is a Health Care Facility and LMTs may return to work there.

 

A Spa, Franchise, Club, Gym or other type of facility, if not owned and run by an LMT would not qualify as a Health Care Facility so it is questionable at best if an LMT employed there would be allowed to return to work. These spaces will generally fall under the unfortunate category of “Massage Parlor” or “Massage Services” or Gyms and Health Clubs, all of which are currently closed due to Governor Hogan's Executive Order of May 13, 2020.

 

An LMT who was a sole proprietor and rented space in a Spa, Salon, Club, or Gym etc. could return to work as their space when they are renting would be a health care facility.

 

And to reiterate, RMPs are not allowed to work in a Health Care Facility, so they cannot return to work under this guidance. RMPs can only work in places as listed above that would not qualify as health care facilities, and cannot reopen at this time.

 

What if I can't return to work because I am in a high health risk category or I am unable to get childcare - will I lose my unemployment benefits?

While we cannot guarantee your unemployment, we are aware that there are provisions in the unemployment law that allows for some individuals to remain on unemployment even if their job becomes available. We hate to even have to tell you this, you will need to contact the Maryland Unemployment offices for more information specific to your situation.

I am an LMT and I work at a Spa or a Franchise, does this mean they can reopen?

In general, a spa or a franchise is not a Health Care Facility. At this time under this limited guidance, only LMTs who work in a Health Care Facility may return to work. So no, there is nothing in this that would allow a spa to open or to allow you to return to work there.

Why can't RMPs also go back to work?

RMPs, due to the difference in licensing and education are not considered health care providers and are not included in this Amended Directive.

AMTA Reopening Resources: https://www.amtamassage.org/about/news/covid-19-resources-for-massage-therapists/#reopeningresources

FSMTB: More information about reopening and safety details:

https://www.fsmtb.org/

CDC Infection Control Guidance for Healthcare Professionals about Coronavirus (COVID-19) https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control.html