A.
Authority to meet extraordinary health care needs.
1. To meet the goal of providing health care and saving lives in response to the potential wave of illness brought on by the COVID-19 pandemic, and to meet the need for additional health care facility beds and technology to treat patients, the undersigned delegates to the Secretary of Health and Human Services authority to waive or modify
enforcement of any legal or regulatory constraints that would prevent or impair any of the following:
a. Increasing health care facilities' licensed bed capacity.
b. Relocating beds from a currently operating hospital, nursing home facility, or adult care home to another hospital, nursing home facility, adult care home, or other physical space.
c. Adding dialysis stations to an existing or approved kidney disease treatment center or hospital.
d. Relocating dialysis stations from a currently operating kidney disease treatment center to another physical space.
e. Acquisition by or on behalf of a hospital of Medical Imaging Equipment (as defined below).
f. Allowing an ambulatory surgical facility to operate as a temporary hospital.
2. Without limiting the foregoing, the undersigned delegates to the Secretary of Health and Human Services authority to waive or modify enforcement of any of the following:
a. Any regulations on licensed bed capacity of adult care homes, including but not limited to I 0A N.C. Admin. Code l 3F .0206 and 13G .0206.
b. Any regulations on licensed bed capacity of mental health, developmental disabilities and substance abuse facilities, including but not limited to I 0A N.C. Admin. Code 270 .0404(e).
c. Any regulations that are related to the provisions listed above.
3. These waivers or modifications must be consistent with the conditions established below. Facilities may increase, relocate, add, or acquire health care resources under this Section only after submitting a request to the Division of Health Service Regulation ("DHSR"), and receiving approval from DHSR under the process described below.
B.
Temporary nature of this Section.
1. This Section allows only temporary increases, relocations, additions, acquisitions, or changes in status of health care resources. All increases, relocations, additions, or changes in status made under this Section's authority shall be allowed only through the duration of the State of Emergency, with an additional 30-day grace period following the State of Emergency. Any equipment acquired under this Section's authority must be returned no later than thirty (30) days following the end of the State of Emergency.
2. The undersigned delegates to the Secretary of Health and Human Services authority to reimpose, during the duration of this Executive Order, any legal or regulatory constraint for which the Secretary has waived or modified enforcement under this Section.
C.
Affirming temporary waiver of hospital and nursing home facility licensed bed capacity. The undersigned hereby affirms the temporary waiver of limitations on hospital and nursing home facility licensed bed capacity granted by DHSR in its March 12, 2020 Memorandum and April 3, 2020 Memorandum. These memoranda allow hospitals and nursing home facilities to request a temporary increase in licensed bed capacity.
D.
Process for requests to temporarily increase bed capacity or relocate beds. Before any increase in licensed bed capacity or relocation of beds under this Section, a request must have been submitted to, and approved by, DHSR. The request shall meet at least the following requirements.
1. The request must be submitted to DHSR in writing (including without limitation e-mail).
2. A request for a temporary increase in licensed bed capacity must specify the number of additional beds requested.
3. A request for a relocation of beds must specify (i) the facility from which the beds will be moved and (ii) the facility to which the beds will be relocated.
4. All requests must include a description of the space that will be utilized, how it will be utilized, and the anticipated duration.
5. All requests must include a certification by an authorized individual that:
a. The request is necessary for the public health and safety in the geographic area served;
b. The physical facilities to be used are adequate to safeguard the health and safety of the patients/residents; and
c. The patients/residents will receive appropriate care and their health and safety will be safeguarded.
E.
Process for requests to add or relocate dialysis stations. Before any increase in dialysis station capacity or relocation of dialysis stations under this Section, a request must have been submitted to, and approved by, DHSR. The request shall meet at least the following requirements.
1. The request must be submitted to DHSR in writing (including without limitation e-mail) by submitting a CMS Form 3427.
2. A request for a temporary increase in dialysis station capacity must specify the number of additional stations requested.
3. A request to temporarily relocate dialysis stations must specify (i) the facility from which the stations will be moved and (ii) the facility to which the stations will be relocated.
4. All requests must include a description of the space that will be utilized and the anticipated duration.
5. All requests must include a certification by an authorized individual that:
a. The request is necessary for the public health and safety in the geographic area served;
b. The physical facilities to be used are adequate to safeguard the health and safety of the clients; and
c. The clients will receive appropriate care and their health and safety will be safeguarded.
F.
Process for requests to acquire Medical Imaging Equipment. Before acquisition of any Medical Imaging Equipment under this Section, a request must have been submitted to, and approved by, DHSR. The request shall meet at least the following requirements.
1. The request must be submitted to DHSR in writing (including without limitation e-mail).
2. The request to temporarily acquire Medical Imaging Equipment must include information documenting the preparations made for the mobile site location.
3. The request must include a description of the space that will be utilized and the anticipated duration.
4. The request must include a certification by an authorized individual that:
a. The request is necessary for the public health and safety in the geographic area served;
b. The physical facilities to be used are adequate to safeguard the health and safety of the clients; and
c. The clients will receive appropriate care and their health and safety will be safeguarded.
G.
Process for requests for an ambulatory surgical facility to operate as a temporary hospital. Before an ambulatory surgical facility may operate as a temporary hospital, a request must have been submitted to, and approved by, DHSR. Upon approval, DHSR must issue a temporary hospital license and the ambulatory surgical facility operating as a hospital must follow the applicable hospital laws and rules as determined by DHSR. The request shall meet at least the following requirements.
1. The request must be submitted to DHSR in writing (including without limitation e-mail).
2. The request must include a description of the space that will be utilized and the anticipated duration.
3. The request must include an explanation that certifies that:
a. The request is necessary for the public health and safety in the geographic area served;
b. The physical facilities to be used are adequate to safeguard the health and safety of the clients; and
c. The clients will receive appropriate care and their health and safety will be safeguarded.
H.
Relationship to Certificate of Need requirements.
1.
Relocating beds without an immediate Certificate of Need. The undersigned directs DHSR that it may allow a relocation of beds, consistent with the requirements set forth above and without the requirement to first obtain a Certificate of Need, and the undersigned temporarily waives enforcement and sanctions related to that Certificate of Need requirement, under the conditions stated in this Section.
2.
Adding or relocating dialysis stations without an immediate Certificate of Need. The undersigned directs DHSR that it may allow the addition or relocation of dialysis stations, consistent with the requirements set forth above and without the requirement to first obtain a Certificate of Need, and the undersigned temporarily waives enforcement and sanctions related to that Certificate of Need requirement, under the conditions stated in this Section.
3.
Temporary acquisition of medical imaging equipment without an immediate Certificate of Need. The undersigned directs DHSR that it may allow temporary acquisition by or on behalf of a hospital of Medical Imaging Equipment, consistent with the requirements set forth above and without the requirement to first obtain a Certificate of Need, and the undersigned temporarily waives enforcement and sanctions related to that Certificate of Need requirement, under the conditions stated in this Section.
4.
Operation of an ambulatory surgical facility as a temporary hospital without an immediate Certificate of Need. The undersigned directs DHSR that it may allow operation of an ambulatory surgical facility as a temporary hospital, consistent with the requirements set forth above and without the requirement to first obtain a Certificate of Need, and the undersigned temporarily waives enforcement and sanctions related to that Certificate of Need requirement, under the conditions stated in this Section.
I.
Definition. In this Section, "Medical Imaging Equipment" means a mobile Magnetic Resonance Imaging (MRI) Scanner or a mobile Computed Tomography (CT) Scanner.
Section 2. Child Care Facilities for Covered Children
For the reasons and pursuant to the authority set forth above, the undersigned orders as follows:
A.
Waiver of enforcement of regulations. To meet the goal of providing health care and protecting the public in response to the COVID-1 9 pandemic, the undersigned delegates to the Secretary of Health and Human Services authority:
1. To waive or modify enforcement of any regulations on child care facility requirements, activities, records, orientation, continuing education, food, and attendance, including without limitation l0A N.C. Admin. Code 09 .0201, .0508, .0510, .0703(c) and (d), .0901,
.1101(a), .1401(a) and (f), . l 402(b), .1709, .1718, .1721(a)(l) and (a)(2), .2318(6), .2504,
.2508, .2830, .3003, and .3005.
2. To waive or modify, by adding additional required health or emergency elements, enforcement of any regulations on child care facility staff qualifications, health and safety training, and sanitation requirements, including without limitation 10A N.C. Admin. Code 09 .0701(a), .0703(c) and (d), .1102, .1720, .1725, and .2401 to .2411, and 15A N.C. Admin. Code 18A .2803, .2827, and .2836.
3. To waive or modify enforcement of any regulations that are related to the provisions listed above.
B.
Guidelines for child care facility operation during pandemic. NCDHHS shall establish certain emergency health, safety and operational guidelines (the ''Emergency Facility Guidelines") for child care facilities that wish to open or remain open. When establishing these guidelines, the Secretary of the Department of Health and Human Services may exercise the authority delegated to her in Executive Order No. 119, Section 1, related to child care regulations. NCDHHS shall issue an Emergency Child Care Provider Application that may be signed by child care facilities attesting to their adherence with the Emergency Facility Guidelines.
C.
Children that may be served. Child Care Facilities approved by NCDHHS to operate under the Emergency Facility Guidelines shall provide child care only to:
1. Children of employees of COVID-19 Essential Businesses and Operations, as defined in Executive Order No. 121; or
2. Children who are receiving child welfare services; or
3. Children who are homeless or who are living in unstable or unsafe living arrangements.
Collectively, these children are referred to as "covered children" in this Section.
D.
Opening or reopening. Child care facilities which have signed the Emergency Child Care Provider Application and which have been approved by DHHS may remain open to serve covered children. Child Care Facilities which are currently closed and wish to reopen to serve covered children shall submit the Emergency Child Care Provider Application prior to reopening.
E.
Requirement to operate only under this Section. Child care facilities shall not remain open except as authorized by this Section.
F.
Implementation. NCDHHS shall develop a detailed process to implement this Section and shall maintain a registry of available child care for covered children.
G.
Temporary nature of this Section.
1. Waivers and modifications under authority of this Section are temporary and shall be effective only for the duration of this Executive Order.
2. The undersigned delegates to the Secretary of Health and Human Services authority to reimpose any regulations, policies, or guidance for which the Secretary has waived or modified enforcement under this Section.
H.
Relationship to Executive Order No. 119. The provisions of this Section supplement, rather than restrict, the emergency authority provided in Section 1 of Executive Order No. 119.
Section 3. Increasing the Pool of Professional Health Care Workers
A.
Regulatory flexibility to expand the health care workforce.
For the reasons and pursuant to the authority set forth above, the undersigned orders as follows:
1.
Authority to meet extraordinary health care needs.
a. To meet the goal of providing health care and saving lives in response to the wave of illness brought on by the COVID-19 pandemic, and to meet the need for additional health care workers to treat patients, the undersigned delegates to each professional health care licensure board the authority to waive or modify enforcement of any legal or regulatory constraints that would prevent or impair the following:
i. Allowing persons to provide care if they are licensed in other states, territories, or the District of Columbia, but not licensed in North Carolina.
ii. Allowing persons to provide care if they are retired or if their licenses are inactive.
iii. Allowing skilled, but unlicensed volunteers to provide care.
iv. Allowing students at an appropriately advanced stage of professional study to provide care.
b. Without limiting the foregoing, the undersigned delegates to each professional health care licensure board the authority to accomplish the goals listed in Subdivision (a)(i)-(iv) above by waiving or modifying any of the following regulations:
i. The regulations on admission and licensure for the practice of medicine, at 21 N.C. Admin. Code Chapter 32.
ii. The regulations on admission and licensure for the practice of nursing, at 21 N.C. Admin. Code Chapter 36.
iii. The regulations on admission and licensure for the practice of midwifery, at 21 N.C. Admin. Code Chapter 33.
iv. The admission and licensure regulations for the social worker profession, at 21 N.C. Admin. Code Chapter 63.
v. The regulations on admission and licensure for the practice of respiratory care, at 21 N.C. Admin. Code Chapter 61.
vi. The admission and licensure regulations for the pharmacy profession, at 21 N.C. Admin. Code Chapter 46.
vii. The regulations on admission and licensure for the practice of speech language pathology/therapy, at 21 N.C. Admin. Code Chapter 64.
viii. The regulations on admission and licensure for the practice of psychology, at 21 N.C. Admin. Code Chapter 4.
ix. The regulations on admission and licensure for the practice of clinical mental health counseling, at 21 N.C. Admin. Code Chapter 53.
x. The admission and licensure regulations for substance use disorder professionals, at 21 N.C. Admin. Code Chapter 68.
xi. The regulations on admission and licensure for the practice of occupational therapy, at 21 N.C. Admin. Code Chapter 38.
xii. The regulations on admission and licensure for the practice of physical therapy, at 21 N.C. Admin. Code Chapter 48.
xiii. The regulations on admission and licensure for the practice of recreational therapy, at 21 N.C. Admin. Code Chapter 65.
xiv. The admission and licensure regulations for the profession of interpreters and transliterators, at 21 N.C. Admin. Code Chapter 25.
xv. The admission and licensure regulations for the profession of nursing home administrators, at 21 N.C. Admin. Code Chapter 37.
xvi. The admission and licensure regulations for the profession of assisted living administrators, at l0A N.C. Admin Code 13F .1701.
xvii. The admission and licensure regulations for the perfusionist profession, at 21 N.C. Admin. Code Subchapter 32V.
xviii. Any regulations that are related to the provisions listed above.
c. In each case, the professional health care licensure board shall have the authority to allow or not allow, in its discretion, these waivers or modifications, and the board shall have the authority to impose conditions on any persons authorized to provide care under this Subsection.
2.
Posting waivers and modifications. Each professional health care licensure board shall document such waivers and modifications in writing and post them on their respective websites.
3.
Guidance on training and qualifications. The professional health care licensure boards shall provide guidance on the training and qualifications necessary for their licensees to be ready to address workforce shortages in essential health care services needed to properly manage this State of Emergency.
4.
No reduction in existing waiver authority. Nothing in this Subsection shall limit the existing statutory waiver authority of any board.
5.
Temporary nature of this Subsection.
a. Waivers and modifications under authority of this Subsection are temporary and shall be effective only for the duration of this Executive Order.
b. The undersigned delegates to each professional health care licensure board the authority to reimpose, during the duration of this Executive Order, any legal or regulatory constraint for which the board has waived or modified enforcement under this Subsection.
6. This Subsection supersedes the first paragraph of Section 16 of Executive Order No. 116. Any persons licensed in other states, territories, or the District of Columbia who are providing health care services under the authority of the first paragraph of Section 16 of Executive Order No. 116 may continue to provide those services through April 15, 2020, unless otherwise authorized by a professional health care licensure board under the authority delegated in this Subsection.
B.
Utilizing the Emergency Management Assistance Compact ("EMAC").
For the reasons and pursuant to the authority set forth above, the undersigned orders as follows:
1.
EMAC requests. The State Director of Emergency Management shall identify resources that are available for response to Emergency Management Assistance Compact ("EMAC") requests. EMAC requests shall be coordinated through the State Director of Emergency Management and shall be fulfilled once authorized by the State Director of Emergency Management.
2.
Out-of-state licensees; telehealth. For the pendency of the State of Emergency: (i) a health provider licensed, registered, or certified in good standing in another United States jurisdiction (or reinstated pursuant to emergency action) may apply for an emergency license with the appropriate North Carolina licensing board and, if deemed eligible and licensed, may deliver services in North Carolina, including through any remote telecommunications technologies (telehealth), provided those services are within the provider's authorized scope of practice in such other jurisdiction; and (ii) any restrictions under North Carolina state law restricting the use of telecommunications technologies (telehealth) by a health provider licensed in North Carolina, whether through a standard license or emergency license, have their enforcement waived.
3.
Deemed licensed. Pursuant to N.C. Gen. Stat. § 166A-45, when assistance is requested by North Carolina, any person who holds a license, certificate, or other permit issued by another United States jurisdiction evidencing the meeting of qualifications for professional, mechanical, or other skills shall be deemed licensed, certified, or permitted by this state to render aid involving skill to meet the declared State of Emergency, subject to any limitations and conditions the undersigned may prescribe by executive order or otherwise.
Furthermore, any requirement for a license to practice any professional, mechanical, or other skill shall not apply to any emergency management workers as defined in N. C. Gen. Stat. § l 66A- l 9.60(e) who shall, in the course of performing the workers' duties as such, practice such professional, mechanical, or other skill during a state of emergency.
4. The provisions of this Subsection 3(B) supplement, rather than restrict, the persons and types of health care practice that are authorized under Subsection 3(A) above.
5.
Limitation of liability.
a. Pursuant to N.C. Gen. Stat. § 166A-46, officers and employees and emergency management workers as defined in N.C. Gen. Stat.§ 166A-l 9.60(e) are considered agents of the State of North Carolina for tort liability and immunity purposes; and no officers, employees or emergency management workers rendering aid in North Carolina pursuant to the Compact shall be liable for any act or omission occurring as a result of a good faith attempt to render aid or as a result of the use of any equipment or supplies used in connection with an attempt to render aid. For the purposes of this Executive Order, "good faith" does not include willful misconduct, gross negligence, or recklessness.
b. All persons participating in a response authorized by the State Director of Emergency Management to an EMAC request shall be considered state emergency management workers as defined in N.C. Gen. Stat. § 166A-19.60(e) for the purposes ofEMAC.
6.
Temporary nature of this Subsection.
a. Actions under authority of this Subsection are temporary and shall be effective only for the duration of this Executive Order.
b. The undersigned delegates to the State Director of Emergency Management the authority to reimpose, during the duration of this Executive Order, any legal or regulatory constraint for which the Director has waived or modified enforcement under this Subsection.
C.
Limitation of liability under N.C. Gen. Stat. § 166A-19.60.
N.C. Gen. Stat. 166A-19.60(e) defines "emergency management workers" as follows:
As used in this section, the.term "emergency management worker" shall include any full or part-time paid, volunteer, or auxiliary employee of this State or other states, territories, possessions, or the District of Columbia, of the federal government or any neighboring country or of any political subdivision thereof, or of any agency or organization performing emergency management services at any place in this State, subject to the order or control of or pursuant to a request of the State government or any political subdivision thereof. The term "emergency management worker" under this section shall also include any health care worker performing health care services as a member of a hospital-based or county-based State Medical Assistance Team designated by the North Carolina Office of Emergency Medical Services and any person performing emergency health care services under G.S. 90-12.2 [recodified as G.S. 90-12.5].
For the reasons and pursuant to the authority set forth above, the undersigned orders as follows:
1. All persons who are licensed or otherwise authorized under this Executive Order to perform professional skills in the field of health care are hereby requested to provide emergency services to respond to the COVID-19 pandemic and, to the extent they are providing emergency services, therefore constitute "emergency management workers" to the extent allowed under N.C. Gen. Stat.§ 166A-19.60(e).
2. Therefore, the undersigned intends that all such emergency management workers should be insulated from civil liability to the maximum extent authorized by N.C. Gen. Stat. § 166A- l 9.60, except in cases of willful misconduct, gross negligence, or bad faith.
Section 4. Public Health
For the reasons and pursuant to the authority set forth above, the undersigned orders as follows:
A. Waiver or modification of enforcement of regulations. To meet the goal of providing human services during the COVID-19 pandemic, the undersigned delegates to the Secretary of Health and Human Services authority:
1. To waive or modify, in order to provide necessary relief to restaurants continuing to provide carry-out, delivery, and drive-through services, the expiration date of transitional food establishment permits under 15A N.C. Admin. Code 18A.2659(b) issued from January 1, 2020 to June 30, 2020 for 180 days.
2. To waive or modify, in order to ensure there are sufficient analysts permitted to conduct breath alcohol tests, the expiration date of analyst permits under 1OA N.C. Admin. Code 41B .0302(a) otherwise set to expire from March 10, 2020 to June 30, 2020 for twelve
(12) months.
3. To waive or modify enforcement of any regulations that are related to the provisions listed above.
B.
Temporary nature of this Section.
1. Waivers and modifications under authority of this Section are temporary and shall be effective only for the periods listed above.
2. The undersigned delegates to the Secretary of Health and Human Services authority to reimpose any regulations, policies, or guidance for which the Secretary has waived or modified enforcement under this Section.
Section 5. Mental Health, Developmental Disabilities and Substance Abuse Services
For the reasons and pursuant to the authority set forth above, the undersigned orders as follows:
A. Waiver or modification of enforcement of regulations. Health care remains an essential service during this State of Emergency, including mental health and substance use disorder treatment services and support services for individuals with intellectual and/or developmental disabilities ("MH/DD/SAS" services). In order to help protect the health and well-being of North Carolinians by allowing access to MH/DD/SAS services and MH/DD/SAS facilities during this State of Emergency:
1. The undersigned delegates to the Secretary of Health and Human Services authority to waive or modify enforcement of any MH/DD/SAS regulatory constraints that would prevent or impair any of the following:
a. Continued provision of MH/DD/SAS Services.
b. Providing MH/DD/SAS Services via real-time, two-way audio and/or video teleconferencing ("Telehealth").
2. Without limiting the foregoing, the undersigned delegates to the Secretary of Health and Human Services authority to waive or modify enforcement of any of the following:
a. Regulations on minimum periodic retraining and demonstration of competence requirements for non-restrictive and restrictive interventions, including without limitation lOA N.C. Admin. Code 27E .0107, 27E .0108, 28D .0209, and 28D
.0210.
b. Regulations on minimum program teaching requirements for non-restrictive and restrictive interventions trainers, including but not limited to 10A N.C. Admin. Code 27E .0107(i)(7) and .0108(i)(l0).
c. Regulations on requiring that Associate Professionals must have individualized supervision plans upon hiring, including but not limited to 10A NCAC 270
.0203(t) and 10A NCAC 270 .0204(t).
d. Regulations setting minimum hours per week for licensed professionals at Residential Treatment Staff Secure Facilities, including but not limited to 10A
N.C. Admin. Code 270 .1705(a).
e. Regulations setting requirements for the direct service ratio at Adult Developmental and Vocational Programs (ADVP) for Individuals with Developmental Disabilities, including but not limited to 10A N.C. Admin. Code 270 .2303(d).
f. Regulations, including but not limited to N.C. Admin. Code 10A NCAC 28D
.0102(c), setting requirements for annual exams to the extent that they require delivery of non-essential medical services.
g. Regulations setting requirements for multiple staff members to be in the presence of the client at all times, including but not limited to l0A N.C. Admin. Code 270
.1402(b).
h. Regulations setting a maximum date after which an adolescent may not remain in a day treatment facility for children and adolescents with behavioral or emotional disturbances, including but not limited to l0A N.C. Admin. Code 270 .1403.
1. Regulations regarding factors for determining program compliance for purposes of take-home eligibility, including but not limited to lOA N.C. Admin. Code 270
.3602(6).
J. Regulations setting the ratio of certified drug abuse or substance abuse counselors to clients, including but not limited to 10A N.C. Admin. Code 270 .3603(a).
k. Regulations regarding conditions for determining levels of take-home eligibility, including but not limited to l0A N.C. Admin. Code 27G .3604(f)(l).
1. Regulations regarding the minimum frequency for the conduct, and program staff observation of, random testing for alcohol and other drugs on each active opioid treatment client, including but not limited to requirements set forth in 10A N.C. Admin. Code 270 .3604(h).
m. Regulations setting limitations on the class session schedule at drug education schools, including but not limited to l0A N.C. Admin. Code 27G .3903(e)(5).
n. Regulations on routine drug screens, staffing, minimum operational hours and days per week, and minimum service hours per week at Substance Abuse Intensive Outpatient Programs, including but not limited to 10A N.C. Admin. Code Subchapter 270, Section 4400.
o. Regulations on routine drug screens, staffing, minimum operational hours and days per week, and minimum service hours per week at Substance Abuse Comprehensive Outpatient Programs, including but not limited to 10A N.C. Admin. Code Subchapter 270, Section 4500.
p. Regulations limiting cumulative provision of private home respite services, including but not limited to l0A N.C. Admin. Code 27G .5101(b).
q. The requirement set forth in l0A N.C. Admin. Code 27G .5601(g) defining "F" designation facility as a facility in a private residence which serves no more than three adult clients whose primary diagnosis is mental illness, to the limited extent necessary to also allow for service of minor clients whose primary diagnosis is mental illness in this setting.
r. Regulations establishing specific time frame requirements for the steps of the non Medicaid appeals process, including but not limited to l0A N.C. Admin. Code Subchapter 271.
s. State MH/DD/SAS administrative rule prov1s1ons requiring that services, assessments, interviews, consultations, counseling, crisis or emergency responses, or other client contacts be provided in-person or face-to-face in connection with delivery of MH/DD/SAS Services, including but not limited to l0A N.C. Admin. Code 27G .1705(a), .3602(8), .3805(3), .3807(b), .4003(c)(2), .4403(a), .4503(f),
.5703(c), and .6102(b).
t. State MH/DD/SAS administrative rule prov1s1ons requmng MH/DD/SAS Services to be furnished in a group setting, including but not limited to 10A N.C. Admin. Code 27B .040l(a), .3401, .3602(8), .3603, .3701(a), .4101, .4501, and
.5401(a).
u. State MH/DD/SAS administrative rule provisions requiring day/night treatment facilities for substance use disorders to provide services at the facility or program site setting, including but not limited to 10A N.C. Admin. Code 270 .2301(d).
v. State MH/DD/SAS administrative rule prov1s1ons requiring substance abuse treatment programs to operate in a setting separate from the client's residence, including but not limited to 10A N.C. Admin. Code 27G .4403(a) and .4503(a).
w. State MH/DD/SAS administrative rule provisions that require adult developmental and vocational programs for individuals with developmental disabilities to provide a majority of services and activities on the program site premises, including but not limited to l0A N.C. Admin. Code 27G .230l(d).
x. Any regulations that are related to the provisions listed above.
3. These waivers or modifications must be to the extent clinically appropriate and in accordance with appropriate mitigation measures in effect during the COVID-19 pandemic.
B. Temporary nature of this Section.
1. Waivers and modifications under authority of this Section are temporary and shall be effective only for the duration of this Executive Order.
2. The undersigned delegates to the Secretary of Health and Human Services authority to reimpose any regulations, policies, or guidance for which the Secretary has waived or modified enforcement under this Section.
Section 6. Health Services Licensure
For the reasons and pursuant to the authority set forth above, the undersigned orders as follows:
A. Program of All-Inclusive Care for the Elderly ("PACE") entities to provide in-home
