Hours after Gov. Ron DeSantis spoke out against COVID-19 mandates and vaccines in Jacksonville, Florida hospitals and other health care providers met with state health care officials to flag concerns with new regulations regarding masks. Those proposed rules essentially preclude hospitals, long-term care facilities and doctors offices from requiring patients, visitors and certain staff from wearing facial coverings. At least 29 people attended the rule workshop, either in person or telephonically, on the proposed regulation, a requirement in SB 252, which DeSantis signed earlier this year. Representatives from some of the state’s largest health care associations attended the hearing in person at the headquarters of the state Agency for Health Care Administration (AHCA) to ask questions and register their concerns about the proposed rule.
The changes would apply to all health care settings where “health care providers practice their profession or provide services.” “A hospital’s primary objective is to ensure the safety and protection of our patients and providers. Hospital policies regarding facial coverage are specifically targeted to specific populations,” Florida Hospital Association General Counsel Michael Williams told AHCA officials, adding that facial covering policies “rarely implicate all persons.” Moreover, he told state regulators that the policies are based on several factors, including federal Medicare requirements as well as the requirements laid out by national accrediting organizations. Williams also stressed that the basis for those policies “first and foremost (is) the available scientific evidence and best practices.” Hospitals and other health care providers are allowed to mandate that patients, visitors and staff wear facial coverings, but only under certain conditions.
And health care providers must give all patients and visitors the ability to “opt out” of the requirement. Under the proposed rule only patients and residents in the common area of the health care setting (which the rules don’t define) who are exhibiting signs or symptoms of, or have been diagnosed with, an infectious disease that can be spread through droplet or airborne transmission can be required to wear a mask. Even then, hospitals and health care providers must provide patients with an opportunity to opt out of wearing a facial covering.
The rule requires that the opt out provision be in accordance with what’s known as the Florida Patient’s Bill of Rights and Responsibilities, which was initially passed in 1991. Among other things, the law states that a “patient is responsible for following health care facility rules and regulations affecting patient care and conduct.” The proposed rule doesn’t specify, though, which provision of the Patient Bill of Rights and Responsibilities apply to providers’ policies on facial coverings and masks. Additionally, Florida Senior Living Association Vice President of Public Policy and Legal Affairs Jason Hand told AHCA that the Patient Bill of Rights and Responsibilities didn’t apply to assisted living facilities. Hospitals, long-term care facilities and other health care settings can also require visitors to wear facial coverings.
Visitors who are exhibiting signs or symptoms of an infectious disease or who have been diagnosed with an infectious disease can be required to wear facial coverings. So can people who are visiting a patient who has an infectious disease or who are immunocompromised and, according to their physicians, are at risk from those who don’t wear facial coverings. Visitors can also be asked to wear masks if they are in an area where a sterile procedure is being performed. But, like patients and long-term care residents, visitors must be provided an “opt out.” The visitor opt out language is vaguer than the patient opt out and, according to the rule, only applies if the visitor opt out only applies if “an alternative method of infection control or infectious disease prevention is available.” The proposed rule also limits a health care provider from mandating that their employees wear masks.
Under the proposed rule, only employees who are conducting sterile procedures, working in a sterile area, are with a patient in droplet or airborne isolation, or are engaging in non-clinical potentially hazardous activities that require facial coverings to prevent injury or harm can be made to wear facial coverings on the job. AHCA is taking written comments from the public on the proposed rule through Sept.
14. While the proposed regulation is still being worked on, the requirements in the proposal currently are in effect today. That’s because AHCA based the new regulation on emergency rules issued by the state July 3 addressing the same issue.