Kemp expands government control over COVID-19 “at risk” populations and associated facilities

Gov. Kemp's Executive Order concerning at risk populations and facilities where those individuals reside grants power to the National Guard as well as the GDPH to enforce full control over operations at those facilities. "Community Integration Homes" run by the Georgia Department of Behavioral Health and Developmental Disabilities are also included in the Order.

Calling on emergency powers granted by Georgia Code, Kemp declared nursing homes and other long-term care facilities as “non-essential” businesses and implemented a list of 18 protocols said facilities must follow, including prohibiting visitors and non-essential personnel.


Executive Order 04.08.20.03, titled “Ensuring the safety of employees and residents of nursing homes and long-term care facilities in response to COVID-19,” references Georgia Code sections which “vest the Department of Public Health with the power to segregate and isolate certain individuals with certain communicable diseases or conditions when said individuals’ exposure the general population is likely to endanger the health of others" and “vests the Governor with the power to compel a health care facility to provide services or the use of its facility if such services or use are reasonable and necessary for emergency response. The use of such healthcare facility may include transferring the management and supervision of the health care facility to the Department of Public Health for a limited or unlimited period of time … (and) the power to perform and exercise such other functions, powers and duties as may be deemed necessary to promote and secure the safety and protection of the civilian population.


Stating that the GDPH has “determined that COVID-19 is spreading throughout nursing homes and other long-term care facilities, requiring the implementation of certain restrictions to limit the spread,” Kemp said it “is necessary to authorize actions to monitor, treat, prevent, reduce the spread of, and suppress COVID-19 in nursing homes and long-term care facilities.”


Higher risk populations are defined as “Older adults, people of any age who have serious underlying medical conditions, and "certain other groups” may be at higher risk-level.

Facilities that will be covered by the Order include intermediate care facilities, personal care homes and skilled nursing facilities, nursing homes, inpatient hospice, assisted living communities and all facilities providing assisted living care, community living arrangements as classified by the Department of Community health pursuant to code section 31-2-4(d)(8) and Community Integration homes operated by the Georgia Department of Behavioral Health and Developmental Disabilities.


The Governor also granted the GDPH and the Georgia National Guard the power to issue mandatory directives and guidelines for all included facilities.


All facilities that fall under the order will now be required to comply with a list of 18 protocol. Violation of the order is a misdemeanor. The Governor also granted the GDPH and the Georgia National Guard the power to issue mandatory directives and guidelines for all included facilities.


The state’s Department of Public Health, National Guard and Department of Community Health are authorized to enforce the Order.


Protocols mandated by Executive Order 04.08.20.03:


  1. Adhere to guidelines for non-critical infrastructure businesses issued in Executive Order 04.02.20.01.

  2. Adhere to CDC, Centers for Medicare & Medicaid Services, and GDPH guidance.

  3. Adopt an infectious disease transfer communication protocol with local hospitals.

  4. A positive COVID-19 test result shall NOT be the sole foundation of a decision to send a resident to a hospital for treatment. Any transfers should be based on the medical necessity for hospitalization, including need for respiratory assistance, or other emergent medical needs. All testing strategies should be made in consultation with and facilitated by GDPH epidemiology staff.

  5. Prohibit all visitors and non-essential personnel, except for certain compassionate care situations in accordance with Executive Order 04.02.20.01.

  6. Provide in-room dining services if feasible.

  7. Cancel all internal and external group activities as feasible.

  8. Establish appropriate social distancing infrastructure for residents and employees.

  9. Require all employees to practice frequent hand hygiene.

  10. Implement active screening of residents for fever and respiratory symptoms.

  11. Screen all employees prior to beginning their shift for fever and respiratory symptoms.

  12. Establish a mechanism for employees who work in multiple locations to report any exposure to COVID-19 case in another facility.

  13. To the extent feasible, require employees to self-quarantine for 14 days before returning to work after exposure due to unmitigated close contact with a positive COVID-19 case.

  14. Implement universal and correct use of face masks for all employees.

  15. Use standard, Contact, and Droplet Precautions with eye protection.

  16. Utilize recommended disinfectants for cleaning.

  17. To the extent feasible, cohort residents with symptoms of respiratory infections, including dedicating healthcare personnel to work only on affected units.

  18. To the extent feasible, designate an area in the facility to quarantine patients upon admission for evaluation of their COVID-19 status.

FYI

Georgia Code sections referenced in the Order:

38-3-51(c)(4)

The Governor shall have and may exercise for such period as the state of emergency or disaster exists or continues the following additional emergency powers: To perform and exercise such other functions, powers, and duties as may be deemed necessary to promote and secure the safety and protection of the civilian population.


38-3-51(D)(1)

In addition to any other emergency powers conferred upon the Governor by law, he may: Suspend any regulatory statute prescribing the procedures for conduct of state business, or the orders, rules, or regulations of any state agency, if strict compliance with any statute, order, rule, or regulation would in any way prevent, hinder, or delay necessary action in coping with the emergency or disaster;


38-3-51(D)(4.1)

In addition to any other emergency powers conferred upon the Governor by law, he may: Compel a health care facility to provide services or the use of its facility if such services or use are reasonable and necessary for emergency response. The use of such health care facility may include transferring the management and supervision of the health care facility to the Department of Community Health for a limited or unlimited period of time not extending beyond the termination of the public health emergency;


31-2A-4

Obligation to safeguard and promote health of people of the state: A series of 14 powers, including (11) Enter into or upon public or private property at reasonable times for the purpose of inspecting same to determine the presence of disease and conditions deleterious to health or to determine compliance with health laws and rules, regulations, and standards thereunder.


31-12-4

The department and all county boards of health may, from time to time, require the isolation or segregation of persons with communicable diseases or conditions likely to endanger the health of others. The department may, in addition, require quarantine or surveillance of carriers of disease and persons exposed to, or suspected of being infected with, infectious disease until they are found to be free of the infectious agent or disease in question. The department shall promulgate appropriate rules and regulations for the implementation of the provisions of this Code section in the case of a declaration of a public health emergency.

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