New Mexico Register / Volume XXXII,
Issue 20 / October 26, 2021
EXECUTIVE ORDER 2021-059
AUTHORIZING THE SECRETARY
OF THE DEPARTMENT OF HEALTH
TO
ESTABLISH CREDENTIALING AND APPROVAL OF STATE CREDENTIALED
PHYSICIANS AND CREDENTIALED ADVANCED PRACTICE CLINICIANS IN
RESPONSE TO MEDICAL
STAFF SHORTAGES
WHEREAS, on January 30, 2020, the World
Health Organization announced the emergence of a novel Coronavirus Disease 2019
("COVID-19") that had not previously circulated in humans, but has been
found to have adopted to humans such that it is contagious and easily spread
from one person to another and one country to another;
WHEREAS, COVID-19 has been confirmed in
New Mexico since March 11, 2020, when the New Mexico Department of Health confirmed
the first cases of individuals infected with COVID-19 in New Mexico and
additional cases have been confirmed each day since then;
WHEREAS, on March 11, 2020, because of
the spread of COVID-19 , I issued Executive Order 2020-004 declaring that a
Public Health Emergency exists in New Mexico under the Public Health Emergency
Response Act, and invoked my authority under the All Hazards Emergency
Management Act;
WHEREAS, I have renewed and extended
the public health emergency in Executive Orders 2020-022, 2020-026, 2020-030,
2020-036, 2020-053, 2020-55, 2020-059, 2020-064, 2020-073, 2020-080, 2020-085,
2021-001 , 2021-004 , 202 1-010, 202 1-011, 2021-012, 2020-023, 2021-030, 2021
-044, 2021-049, 2021-054 , and 2021-058;
WHEREAS, the public health emergency declaration is
likely to be extended and renewed on an ongoing basis for the foreseeable
future;
WHEREAS, surges in cases of COVID-19
and deaths related to COVID-19 continue to proliferate due to more
transmissible and deadly variants of the virus;
WHEREAS, as of October 15, 2021, the
New Mexico Department of Health reported 263,755 confirmed cases of COVID-19 in
New Mexico and 4,930 related deaths;
WHEREAS, the limitations posed on
non-medically necessary procedures in the past and the hesitance of the general
public to seek preventative and routine medical care during the pandemic has
resulted in a significant subsequent increase in non-COVID related patients
seeking medical care, forcing acute care facilities in the state to expand far
beyond normal capacity;
WHEREAS, New Mexico is in the midst of
an urgent medical crisis which has strained the ability of both institutional
and individual providers to deliver the quality of care New Mexicans due to the
ongoing COVID-19 pandemic;
WHEREAS, the State is now experiencing
a drastic shortage in the number of acute care medical providers available as a
result of high patient censuses and fatigue;
WHEREAS,
this crisis and shortage of medical professionals has created extraordinary
medical circumstances, and it will require providers to change their normal
perspective to a crisis perspective;
WHEREAS, many providers may need to
provide care within the scope of practice of their license but beyond their
normal scope or practice to assist patients in acute care hospital facilities
throughout the state;
WHEREAS, due to the nature of the
public health emergency and the impact on medical resources, the State has
convened a Medical Advisory Team of experts in health, ethics, and law to,
inter alia, address best practices in the treatment and care of New Mexicans
suffering from COVID-19;
WHEREAS, the Medical Advisory Team notified the Secretary of Health
on October 15, 2021, that acute care medical staffing conditions for the
possible implementation of "crisis standards of care" are present
within the State, and that it is appropriate to apply crisis standards of care
in some acute care hospital settings;
WHEREAS, if crisis standards of care
are implemented, healthcare professionals may be asked to assist in in areas
outside their scope of practice to provide medical care in an acute care
hospital setting, or as a triage officer or member of a triage board with
respect to the treatment decisions related to the care of a patient; and
WHEREAS, for these reasons, I find that
it is in the public interest to invoke certain provisions of All Hazards
Emergency Management Act and Emergency Licensing Act to ensure physicians will
not hesitate to respond and provide necessary assistance if crisis standards of
care are brought into effect.
NOW, THEREFORE, I, Michelle Lujan
Grisham, Governor of the State of New Mexico, by virtue of the authority vested
in me by the Constitution, the All Hazards Emergency Management Act, and the
laws of the State of New Mexico do hereby ORDER
and DIRECT as follows:
1. Pursuant to the authority vested in
me by NMSA 1978, Section 12-10-4 (2007), and in accordance with NMSA 1978,
Sections 12-10-4, -11, and -13 (2007), the New Mexico Department of Health is
hereby directed to undertake all steps necessary to credential physicians and
other licensed healthcare providers with authority under New Mexico law to
provide medical care independently and
not under the supervision of a physician (i.e., "advanced practice
clinicians") who are providing care to a person in an acute care hospital
setting, or when the physician serves as a triage officer or member of a triage
board with respect to the treatment decisions related to the care of a person.
Such physicians shall be identified as "Credentialed Physicians." Such advanced practice clinicians shall be
identified as "Credentialed Advanced Practice Clinicians." For
purposes of this Order, "physicians" include medical doctors and
doctors of osteopathic medicine. For purposes of this Order, "advanced practice
clinicians" include certified nurse practitioners (licensed by the New
Mexico Board of Nursing in accordance with NMSA 1978, § 61-3-23.2 (2014)),
certified registered nurse anesthetists (licensed by the New Mexico Board of
Nursing in accordance with NMSA 1978, § 61-3-23.3 (2014)), clinical nurse specialists (licensed by the Board of
Nursing in accordance with NMSA 1978, § 61-3-23.4 (2014)), and certified nurse-midwives (licensed by the Board
of Nursing pursuant to the Nursing Practice Act and licensed by the Department
of Health as a certified nurse-midwife pursuant to NMSA 1978, §
24-1-3(V)
(2017) and NMAC 16.11.2).
2. The Secretary of the Department of
Health (the "Secretary") shall designate physicians as
"Credentialed Physicians" and advanced practice clinicians as
"Credentialed Advanced Practice Clinicians" based upon findings that:
(1) the physician/advanced practice clinician services will materially further
the State interest in public health and welfare and (2) the physician/advanced
practice clinician possesses the requisite skills and background necessary to
provide care during the pendency of the existing health emergency. The
Secretary may weigh and consider any additional factors the Secretary deems
appropriate given the operative facts and circumstances.
3. "Credentialed Physicians"
and "Credentialed Advanced Practice Clinicians" shall only be
considered public employees for purposes of the Tort Claims Act to the limited
extent and in the limited circumstance in which
such Credentialed Practitioners provide medical care outside of their non11al
and privileged scope of practice, and/or are serving as a triage officer or
triage board member, in a hospital acute care setting. See
NMSA 1978, §§ 41-4-1 to -27; §§ 12-10-4, - 11, -13.
4. The directives contained in paragraphs 1-3 within this Order become
effective and may be invoked only after the Secretary, upon consultation with
the New Mexico Medical Advisory Team, declares that it is necessary for the
State to recognize that conditions requiring the potential implementation of
crisis-level standards of care are present.
I FURTHER ORDER and DIRECT as follows:
1. This Order supersedes any previous orders,
proclamations, policies, or directives to the extent they are in conflict.
2. This Order shall take effect on October 18, 202
1, and shall remain in effect until November 17, 2021.
ATTEST: DONE
AT THE EXECUTIVE OFFICE
THIS
18TH DAY OF OCTOBER 2021
/ S /
MAGGIE TOULOUSE
OLIVER WITNESS
MY HAND AND THE GREAT
SECRETARY OF
STATE SEAL
OF THE STATE OF NEW MEXICO
/ S /
MICHELLE
LUJAN GRISHAM
GOVERNOR