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California Launches Health Corps, Loosens Rules for Medical Professionals Amid Coronavirus
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Source: Los Angeles Times, by Melody Gutierrez
Gov. Gavin Newsom issued an urgent call for healthcare workers to join the state in caring for an expected surge of COVID-19 patients while announcing an executive order to expand the services medical professionals can perform in their jobs.
Newsom said he believes the state can add 37,000 healthcare workers by asking recently retired providers, those in the process of getting a medical license in the state and students enrolled in medical or nursing schools to apply to the newly created California Health Corps.
“We need you,” Newsom repeatedly said, aiming his comments at healthcare workers. “We’ll help you with your relicensing, we’ll help you with the protocol and processes to get you up and running and get you out the door so that you can support the needs of people in California.
New York Gov. Andrew Cuomo announced a similar effort calling on retired healthcare workers, medical students and mental health workers to sign up to help care for residents, with that initiative drawing 40,000 volunteers last week.
Newsom said Monday he is hopeful that “with this effort we will see a surge of individuals” who can help in California.
“The next few weeks are going to be critical,” Newsom said.
Dr. Mark Ghaly, California’s secretary of health and human services, said the state’s modeling suggests California will need 50,000 new hospital beds by mid-May.
“We project that we will need that towards the second half of the month of May,” Ghaly said. “So we are very busy trying to build towards that.”
Newsom declined to say how many people his administration believes are infected with the virus based on the state’s existing models.
“It’s a dynamic model and it’s radically different, I can assure you, than it was just four or five days ago,” Newsom said. “And if we had a model that I could more confidently say, based on all of these conditions and everything being static, then we would provide it to you, but I can assure you we are running those models in real time.”
The urgent need for healthcare workers comes as the death toll from the coronavirus in California rose to 142 and the number of confirmed cases surged to more than 6,800. Experts say the number of confirmed cases is expected to rise in the coming weeks, the result of the highly contagious nature of the virus as well as expanded testing efforts.
Between Friday and Monday, the number of California patients hospitalized with COVID-19 in intensive-care beds nearly tripled to 597 from 200. The number of hospitalizations has nearly doubled, from 746 to 1,432. On Sunday, the Navy hospital ship Mercy, which is docked at the Port of Los Angeles, began receiving patients who do not have COVID-19 in an effort to reduce the strain on hospitals treating those who do have the disease.
Newsom’s executive order allows the state Department of Consumer Affairs to waive licensing requirements and change the scope of practice of healthcare professions through June 30. The department is ordered to work with each licensing board to determine what those changes will look like. The few details available as to what scope of practice changes will be made left many unsure of the effect.
“Other states have issued more specific executive orders regarding extension of license expirations and expanded scope of practice for clinical staff,” said Joanne Spetz, an associate director of research at Healthforce Center at UC San Francisco, which produces supply and demand forecasts on registered nurses in the state. “Until we have more details on which specific requirements are waived by the state agencies, it’s hard to say how much of an impact the executive order will have.”
California was facing shortages of healthcare workers even before the pandemic, with the California Future Health Workforce Commission urging the state to invest in doctor training programs and grant nurse practitioners more autonomy.
The commission, created by healthcare, education and business leaders and co-chaired by UC President Janet Napolitano, wrote in a report last year that the state needs to invest $3 billion over the next decade to increase the number of nurses, doctors and in-home caregivers to meet the needs of the state’s aging baby boomer population. In addition, more than one-third of the state’s doctors and nurse practitioners are reaching retirement age.
Among the recommendations from the commission was allowing nurse practitioners to work independently of doctors. California is one of 28 states that require nurse practitioners to work under a doctor’s oversight, with previous legislative efforts to ease those restrictions failing amid concerns from the powerful doctor’s lobby, the California Medical Assn.
Newsom acknowledged the complicated history behind the scope of practice changes, particularly with nurse practitioners, and said the administration would provide “temporary flex in that space.”
The governor’s executive order also calls for the California Emergency Medical Services Authority to ease restrictions on paramedics in the state. Dr. Sandra R. Hernández, a physician and president of the California Health Care Foundation, said those changes could allow paramedics to use their respiratory training outside of an ambulance.
Hernández said that while the details of the executive order are still unclear, the changes to expand the scope of practice of medical professions can increase the state’s ability to care for the sick
“It’s a very important step to allow health workers to do what they are training to do,” Hernández said. “Full scope is absolutely the right thing to do.”
Newsom said the state hopes to tap nursing school students to help with the crisis, but details about that process were unclear. Nursing students were encouraged to apply to the California Health Corps to begin working in hospitals, but one of the most pressing questions for those students has yet to be answered.
Nursing schools across the state have pleaded for weeks with Newsom and the Board of Registered Nursing to change licensing requirements so that an estimated 10,000 nursing students could graduate in the coming months.
California requires nursing students to spend most of their clinical education in hospitals providing supervised care for patients, but the coronavirus outbreak has caused hospitals to restrict access to prevent the spread of COVID-19.
That meant thousands of nurses across the state were no longer able to complete hospital rotations required to graduate.
While the schools asked for graduation leniency, other states have already begun awarding temporary emergency licenses to nurses.
The Idaho Board of Nursing announced an apprentice program this month to move nursing students into hospitals and a temporary emergency license for students who are nearing graduation. The Texas Board of Nursing also relaxed its rules on how many hours nursing students must work in hospital training rotations.
On Monday, California nursing schools said they were left wondering what changes will ultimately be made to help their students.
“We applaud Governor Newsom’s efforts to add to the healthcare workforce and absolutely agree that time is of the essence in taking action against COVID-19,” said Dr. Robyn Nelson, the dean of nursing at West Coast University, in a statement. “This urgency is why we are left disappointed that there is still no clear pathway forward for the thousands of nursing students who can no longer move forward with their education.”
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