GUIDANCE: USE OF FACE COVERINGS BY PHYSICIANS

Effective November 13, 2020, the Iowa Board of Medicine adopted the following guidance (provided by the Federation of State Medical Boards (FSMB)) for the use of face  coverings by physicians and other healthcare providers while providing in-person medical care during the COVID-19 pandemic.

“Wearing a face covering is a harm-reduction strategy to help limit the spread of COVID-19, especially since physical distancing is not possible in health care settings. When seeing patients during in-person clinical encounters, physicians have a professional responsibility to wear a facial covering for their own protection, as well as that of their patients and society as a whole.”

Iowa Board of Medicine - Face Mask Advisory

Upon reviewing the considerable emerging evidence from clinical, laboratory, and case reports, the Iowa Board of Medicine joins the Center for Disease Control (CDC) in recommending the use of masks in public areas as a means of preventing infected individuals with, and without symptoms from spreading coronavirus to high-risk individuals.  The specific recommendations are…

• CDC recommends that people wear masks in public settings and when around people who don’t live in your household, especially when other social distancing measures are difficult to maintain.
• Masks may help prevent people who have COVID-19 from spreading the virus to others.
• Masks are most likely to reduce the spread of COVID-19 when they are widely used by people in public settings.
• Masks should NOT be worn by children under the age of 2 or anyone who has trouble breathing, is unconscious, incapacitated, or otherwise unable to remove the mask without assistance.
• Masks with exhalation valves or vents should NOT be worn to help prevent the person wearing the mask from spreading COVID-19 to others (source control).

In addition, the Board of Medicine would like to encourage all physicians and support staff to train individuals on proper face mask use including children as they return to school.   Masks do not replace social distancing especially for high risk individuals who should take extra precautions in public spaces.

COVID-19 – EMERGENCY PROCLAMATION

(Effective November 10, 2020)

Governor Kim Reynolds issued an Emergency Proclamation due to COVID-19 extending the following temporary provisions from Tuesday, November 10, 2020, until Thursday, December 10, 2020, at 11:59 p.m.

1.No Iowa Medical License Required: A physician may practice medicine/telemedicine in Iowa without an Iowa medical license on a temporary basis to aid in the emergency, if a physician holds at least one active medical license in another United State jurisdiction, and all medical licenses held by a physician in other United States jurisdictions are in good standing, without restrictions or conditions. 

2.Telemedicine and Telehealth Services:  All rules which establish preconditions, limitations, or restrictions on the provision of telehealth or telemedicine services in Iowa, including the use of audio-only telephone transmissions, continue to be suspended.  All rules which require face-to-face interactions with health care providers, and impose requirements for residential and outpatient substance use disorder treatment and for face-to-face visitations, continue to be suspended. 

3.Emergency Medical License - Medical School Graduates:  An individual who has graduated from an accredited medical school but has not obtained an initial Iowa medical license may seek an emergency medical license from the Board.  The Board may grant an emergency medical license if it determines that the individual has completed sufficient education.  An individual who has been granted an emergency medical license, shall practice in accordance with any guidance provided by the Board.

Application for an Emergency Medical License: If a medical school graduate would like to apply for an Emergency Medical License they should go to the Iowa Board of Medicine’s website and use the Resident license application and indicate that they are applying for an Emergency Medical License.

4.Lapsed or Expired Iowa Medical Licenses: A physician whose Iowa medical license lapsed or expired in good standing within five (5) years of the date of the Proclamation may provide medical care and treatment of victims of this public health emergency for the duration of the Proclamation. 

5.Continuing Medical Education (CME) Requirements:  All requirements for in-person continuing medical education and all deadlines and other requirements for continuing medical education that are unable to be satisfied due to the health emergency, are temporarily suspended during the period of this health emergency. If a licensee is unable to complete the required continuing medical education required for renewal of their Iowa medical license due to the health emergency, they should note that on their next renewal application. 

6.License Renewal Requirements:  All license renewal requirements and deadlines continue to be temporarily suspended during the period of this health emergency. If a licensee had an active Iowa medical license on March 22, 2020, the expiration date will be automatically extended for the duration of this health emergency.

7.Criminal Background Checks:  All criminal background checks required for initial licensure continue to be temporarily suspended during the period of this health emergency due to a temporary lack of fingerprinting services due to potential exposure to COVID-19. 

8.In-Person Notarization:  All requirements for in-person notarizations for licensure and other purposes are temporary suspended during the period of this health emergency due to potential exposure to COVID-19. 

9.Medical Spas:  A medical spa, as defined in Iowa Administrative Code Section 653-13.8(1) may reopen or remain open to provide medical aesthetic services, but only if the medical spa complies with the requirements for performing procedures that utilize personalized protective equipment (PPE) below.

NONESSENTIAL OR ELECTIVE SURGERIES AND PROCEDURES

SECTION EIGHT.  Pursuant to Iowa Code§ 135.144(3), and in conjunction with the Iowa Department of Public Health, unless otherwise modified by subsequent proclamation or order of the Iowa Department of Public Health.  This emergency proclamation expires on Thursday, December 10, 2020, at 11:59 p.m.:

A.     A hospital, outpatient surgery provider, or outpatient procedure provider may conduct inpatient surgeries and procedures that, if further delayed, will pose a significant risk to quality of life and any outpatient surgeries or procedures if the hospital or provider complies with the following requirements:

(1)   A hospital or provider must have:

(a)  Adequate inventories of personal protective equipment (PPE) and access to a reliable supply chain without relying on state or local government PPE stockpiles to support continued operations and respond to an unexpected surge in a timely manner; and

(b) A plan to conserve PPE consistent with guidance from the CDC and Iowa Department of Public Health;

(2)   A hospital or provider must have a plan for timely COVID-19 testing of symptomatic patients and staff to rapidly mitigate potential clusters of infection and as otherwise clinically indicated. Providers must comply with any relevant guidance related to testing requirements for patients and staff issued by the Iowa Department of Public Health, the CDC, or a provider's professional specialty society. For scheduled surgeries patients should have a negative CO VID-19 test performed within 72 hours of surgery date. If a COVID-19 test is not available, a hospital or provider should consider alternative methods to determine the patient's probability of CO VID-19. If the patient has symptoms of fever, cough, or low oxygen saturation, then postponing the surgery is recommended.

(3)   A hospital must continue to accept and treat COVID-19 patients and must not transfer COVID-19 patients to create capacity for elective procedures.

(4)   A hospital must reserve at least 10% of intensive care unit (ICU) beds and 10% of medical/surgical beds for COVID-19 patients.

(5)   The total number of medical/surgical and observational beds used for the non-essential surgery or procedure must be no more than 50% of the number of beds that were used on average during the month of September 2020

(6)    A hospital or provider that begins conducting surgeries or procedures as authorized by this paragraph but is no longer able to satisfy all these requirements must cease conducting such surgeries or procedures except as authorized by paragraph B. All hospitals and providers shall have a plan in place to monitor compliance and a transition plan to reduce or suspend procedures and surgeries as necessary. 

B.     Except as provided in paragraph A, all nonessential or elective surgeries and procedures that utilize PPE must not be conducted by any hospital, outpatient surgery provider, or outpatient procedure provider, whether public, private, or nonprofit.

C.     A nonessential surgery or procedure is one that can be delayed without undue risk to the current or future health of a patient, considering all appropriate factors including, but not limited to any: (1) threat to the patient's life if the surgery or procedure is not performed; (2) threat of permanent dysfunction of an extremity or organ system; (3) risk of metastasis or progression of staging; and ( 4) risk of rapidly worsening to severe symptoms.

D.     Each hospital, outpatient surgery provider, and outpatient procedure provider shall limit all nonessential individuals in surgery and procedure suites and patient care areas where PPE is required. Only individuals essential to conducting the surgery or procedure shall be present in such areas.

E.     Each hospital, outpatient surgery provider, and outpatient procedure provider shall establish an internal governance structure to ensure that the principles outlined above are followed.  

F.     The hospital or provider has taken steps to ensure compliance with the Department of Public Health’s PPE Shortage Order issued on April 25, 2020.

“Personal protective equipment” or “PPE” includes protective clothing, gloves, face shields, goggles, facemasks, respirators, gowns, aprons, coveralls, or other equipment designed to protect the wearer from injury or the spread of infection or illness.

Please use the link below to see the Governor’s Emergency Proclamation.

https://governor.iowa.gov/press-release/gov-reynolds-signs-new-proclamation-continuing-state-public-health-emergency-11

Please contact Kent M. Nebel, J.D., Executive Director, at 515-281-7088 or kent.nebel@iowa.gov if you have any questions or concerns.

The offices of the Iowa Boards of Dentistry, Pharmacy, Nursing and Medicine will be closed to the public until further notice.

The Iowa Boards of Dentistry, Pharmacy, Nursing and Medicine announced March 20, that its offices at 400 SW 8th Street in Des Moines, will be closed to the public until further notice.  Board business will continue to be conducted even though public access to the building is restricted. 

The Boards continue to work and serve the public during this public health emergency.  For anyone wishing to drop off paper applications, requests or related items, the Boards have provided drop boxes at respective entrances for the public to use. Phone numbers and email addresses for Board contacts are posted on the entrance doors if you need assistance.  General contact information for each of the Boards are listed below:

Medical Board: 515-281-7088
(for licensure inquiries please email licensure@iowa.gov)
(for general inquiries please email ibm@iowa.gov)

Dental Board: 515-281-5047; IDB@Iowa.gov
Pharmacy Board: 515-281-5944; amanda.woltz@iowa.gov
Nursing Board: 515-281-3255

The Boards and its respective staff will be responsive and address all communications during this time.  This closing to the public is an effort to prevent the spread of Covid-19.