Clarification on Executive Order 2020-147 (Masks)

CLARIFICATION ON EXECUTIVE ORDER 2020-147 (MASKS)

The Michigan Association of Chiropractors is a professional association advocating for the rights of chiropractors and their patients across the state of Michigan. We are NOT a state agency or regulatory body. We did not create this order. However, it is our responsibility to inform you regarding these regulations and potential ramifications to your license to practice your profession should you choose not to abide by them. And, please know, we are advocating for you every day!

We have consulted with an attorney regarding the Executive Orders discussed below and feel confident that the information provided is the most complete, current, and relevant available at the time this was written.

In a Frequently Asked Questions document from the State of Michigan after the release of Executive Order 2020-147, they state: “No business… may provide service to a customer or allow a customer to enter its premises, unless the customer is wearing a face covering as required by this order.” It is our best judgment that this expansive wording would definitely include chiropractic offices.

Additionally, chiropractic offices are bound by Executive Order 2020-145, which outlines “Safeguards to protect Michigan’s workers from COVID-19.” Section 9 of Executive Order 2020-145 deals with outpatient health-care facilities, including clinics, primary care physician offices, dental offices, and veterinary clinics. Executive Order 2020-145 states these facilities must:

(a) Post signs at entrance(s) instructing patients to wear a face covering when inside.
(b) Limit waiting-area occupancy to the number of individuals who can be present while staying six feet away from one another and ask patients, if possible, to wait in cars for their appointment to be called.
(c) Mark waiting rooms to enable six feet of social distancing (e.g., by placing X’s on the ground and/or removing seats in the waiting room).
(d) Enable contactless sign-in (e.g., sign in on phone app) as soon as practicable.
(e) Add special hours for highly vulnerable patients, including the elderly and those with chronic conditions.
(f) Conduct a common screening protocol for all patients, including a temperature check and questions about COVID-19 symptoms.
(g) Place hand sanitizer and face coverings at patient entrance(s).
(h) Require employees to make proper use of personal protective equipment in accordance with guidance from the CDC and OSHA.
(i) Require patients to wear a face covering when in the facility, except as necessary for identification or to facilitate an examination or procedure.
(j) Install physical barriers at sign-in, temperature screening, or other service points that normally require personal interaction (e.g., plexiglass, cardboard, tables).
(k) Employ telehealth and telemedicine to the greatest extent possible.
(l) Limit the number of appointments to maintain social distancing and allow adequate time between appointments for cleaning.
(m)Employ specialized procedures for patients with high temperatures or respiratory symptoms (e.g., special entrances, having them wait in their car) to avoid exposing other patients in the waiting room.
(n) Deep clean examination rooms after patients with respiratory symptoms and clean rooms between all patients.
(o) Establish procedures for building disinfection in accordance with CDC guidance if it is suspected that an employee or patient has COVID-19 or if there is a confirmed case.

“Cannot Medically Tolerate a Face Covering”
As we said in the email announcing Governor Whitmer’s order, we believe that as a physician-level health care professional licensed under Michigan’s Public Health Code, a chiropractor can use his or her clinical judgment regarding whether a patient “cannot medically tolerate a face covering,” and is therefore exempt from this requirement. Examples of conditions that should be considered include, but are not limited to, asthma, COPD, post-traumatic stress disorder, severe anxiety, autism, cerebral palsy, etc.

If it is your clinical judgment that a patient cannot medically tolerate a face covering, we highly recommend thoroughly documenting that fact in the patient’s record. Keep in mind: This is not guaranteed to absolve a health care professional of potential consequences if found to be in violation of the Executive Order.

Potential Consequences – Know Your Risks
Executive Order 2020-147 states that “a willful violation of this order is a misdemeanor, but no term of confinement may be imposed…” This means that the maximum penalty for a violation of the order is a $500 fine.

More importantly for the purposes of a licensed health care provider, however, is this: “A department or agency that learns that a licensee is in violation of this section will consider whether the public health, safety or welfare requires summary, temporary suspension of the business’s license to operate…”

In other words, your license to practice – at least temporarily – could be at risk should you be found to have violated Executive Order 2020-147.

This document is information only and is not intended to be construed as legal advice regarding any specific matter or situation. Legal advice may be given only on the basis of specific facts relayed by a client to an attorney.