Baker administration issues new emergency orders as Mass. hospitals struggle amid COVID-19 surge

A medical worker at the US Department of Veterans Affairs Boston Healthcare system campus and medical center in West Roxbury, Massachusetts on January 11, 2022.JOSEPH PREZIOSO/AFP via Getty Images

The Baker administration on Friday announced several emergency orders aimed at easing hospital capacity concerns and staffing shortages amid the ongoing COVID-19 surge.

In a statement, the state Department of Public Health said the measures are “intended to ensure acute hospitals can serve those in need of acute care.” The state healthcare system, DPH said, faces a “critical staffing shortage” that’s been a factor in the loss of about 700 medical/surgical and ICU hospital beds.

To assist hospitals amid the staff shortage, DPH said, the agency on Friday issued orders designed to stem unnecessary emergency department visits for non-emergency services; allow qualified physician assistants to practice independently; provide more staffing flexibility for dialysis units; and allow internationally-trained physicians to get a Massachusetts licensure more easily.

Under one order, physician assistants can practice independently without a doctor’s supervision, as long as they’re employed in a provider setting where PAs work together with physicians to provide patient care, and the PA is qualified and practicing within their scope of practice, experience, and training, the statement said.

A second order allows resident physicians to engage in “internal moonlighting,” allowing for flexibility to provide patient care outside their specialized training so they can be redeployed to parts of the health care system with the highest staffing needs, according to the statement.

Another order requires “facilities to expedite credentialing and to facilitate staff transfers across and between hospitals and provider systems to best meet patient care and capacity needs,” the statement said.

A fourth order calls for out-of-hospital dialysis units, including hospitals with outpatient dialysis centers, to “relax staffing requirement levels while maintaining safe patient care by following DPH guidance that otherwise ensures that sufficient direct care staff, who are trained in dialysis care, will be available to meet the needs of patients undergoing dialysis,” the statement said.

And an order relating to doctors trained in other countries calls for “an expedited licensure of foreign-trained physicians by allowing those with at least 2 years of post-graduate training, but who do not have a Massachusetts limited license, to qualify for licensure,” the release said.

State Health and Human Services Secretary Marylou Sudders said in the statement that workforce and capacity issues remain a challenge for hospitals.

“Our healthcare system continues to experience significant workforce and capacity constraints due to longer than average hospital stays, separate and apart from the challenges brought on by COVID,” Sudders said. “Working closely with our hospital leaders, these additional actions by DPH will allow for flexibility to preserve our hospital capacity in the coming weeks.”