State health department orders to licensed settings

Summary

The State health departments did not stop at the stay-home, closure, gathering and mask orders that the State files itemize. Beneath those principal instruments sat a second layer of orders, directives, emergency rules and standing orders, issued by the same departments under the same communicable-disease statutes, that governed who could be tested and where (laboratory and reporting orders in Ohio, Pennsylvania, Delaware, Michigan and New Jersey from March 2020), how the dead were certified and handled (Michigan's death-reporting and bodily-remains orders of April and May 2020; New Jersey's Executive Directive 20-010 on the disposition of remains), what nursing homes, assisted-living facilities, hospitals, home-health agencies, hospices, dialysis centers and surgical centers had to do about staff testing, visitation, PPE and admissions (Florida AHCA emergency rules 59AER20-1 through 59AER21-3; Delaware DHSS emergency orders of May and September 2020 and September 2021; Pennsylvania's hospital-staff and long-term-care PPE orders; Michigan's staff-testing orders for State hospitals, prisons and juvenile-justice facilities; New Jersey's long-term-care testing directives), how pools, aquatic facilities, tanning and body-art establishments, child-care programs, camps and adult day programs could operate (New Jersey Executive Directives 20-022, 20-031, 20-032, 21-003, 21-006, 21-007 and the July 2021 standards), and, from December 2020 to September 2021, who could be vaccinated, in what order, by whom, and under what provider conditions (Pennsylvania's Dec. 14 and Dec. 30, 2020 orders and the Feb. 12, 2021 Vaccine Providers order with its four amendments, the July 26, 2021 Updated Order and the Aug. 13 and Sept. 21, 2021 school-clinic and continued-administration orders; New Jersey Executive Directives 20-035, 20-037, 21-002 and the Department's phase memoranda; New York Executive Order 202.88; Michigan's Interim Prioritization Guidance; Ohio's Director's Journal Entry of Feb. 12, 2021; Massachusetts Orders 2021-3, 2021-5, 2021-6, 2021-7 and 2021-8). By quarter: 2020 Q2 opened with the reporting and testing orders (Michigan Mar. 23, Pennsylvania Mar. 24 and Apr. 1, Delaware Mar. 10 as recited, New Jersey Mar. 16 visitor restrictions and Executive Directives 20-005 to 20-012) and the first long-term-care testing rules (Florida 59AER20-1 to 20-5, Delaware 3201 and 3225 effective June 1, 2020, Pennsylvania's June 9 hospital-staff order); 2020 Q3 added the New Jersey reopening directives for pools, body art, labor and delivery, hospital PPE stockpiles and LTC resumption, Florida's staff-testing rules for nursing homes, assisted living and ICF/DDs, Pennsylvania's Aug. 17 LTC PPE order, and Michigan's staff-testing orders of Aug. 19, Sept. 14 and Sept. 18; 2020 Q4 carried Pennsylvania's Oct. 13 antigen-reporting order, Delaware's Oct. 1 notifiable-disease rule, Michigan's Oct. 6 school-reporting and congregate-care orders, the Florida renewals of Nov. 3-4, New Jersey's LTC point-of-care and standing-order testing directives of Nov. 30 and Dec. 2, and the opening of the vaccine phase regime (Pennsylvania Dec. 14 and Dec. 30, New Jersey Dec. 10 and Dec. 15, Michigan Dec. 11, Massachusetts Dec. 18); 2021 Q1 was the allocation quarter (New York EO 202.88 of Jan. 4 with its $100,000 penalty and one-week administration rule; New Jersey's Jan. 13 and Mar. 11 eligibility expansions; Pennsylvania's Feb. 12 Vaccine Providers order and its Mar. 15, Mar. 25 and Apr. 26 amendments, with allocation-suspension enforcement from Feb. 22; Michigan's Jan. 6 and Feb. 15 prioritization guidance and Feb. 2 standing-orders order; Ohio's Feb. 12 journal entry; Florida 59AER21-1 to 21-3 of Feb. 1-2); 2021 Q2 saw eligibility opened to all persons (New Jersey May 28 memorandum), the Pennsylvania SNF vaccine survey order and its June 23 termination, and New Jersey's June 2021 directives restoring hospital, ambulatory-surgery, adult medical day care and PACE operations under continuing conditions; 2021 Q3, the quarter the Service most often says had no orders, carried Pennsylvania's Updated Vaccine Providers order of July 26 (effective July 28) and its Aug. 13 and Sept. 21 supplements, its Aug. 31 school-testing order, Delaware's nine DHSS emergency orders of Aug. 10 and Sept. 8-10 (effective Sept. 30, 2021) requiring vaccination or testing of staff, vendors and volunteers in hospitals, home-health agencies, hospices, dialysis centers, surgical centers, adult day care, office-based surgery and free-standing emergency departments, California's Guidance for Face Coverings of July 28, 2021 (masks required in health care, K-12, child care, transit, shelters and correctional settings and for the unvaccinated in all indoor public settings), CDPH's AFL 21-34 of Sept. 9 implementing the Aug. 5 health-care-worker vaccination order with a Sept. 30 compliance date, CDPH's Sept. 20 Beyond the Blueprint update requiring vaccination verification or a negative test for indoor mega events of 1,000 or more, and Massachusetts Orders 2021-3 (July 30), 2021-5 (Aug. 20), 2021-6 (Aug. 26), 2021-7 (Sept. 2) and 2021-8 (Sept. 15). These are orders of appropriate governmental authorities within the meaning of the Suspension Clause: each was issued by a State officer exercising a communicable-disease-control statute that authorizes orders binding on persons and businesses, each carried a statutory sanction, and each limited commerce (which laboratories, pharmacies, funeral homes, pools, tattoo studios, nursing homes and vaccine providers could do, for whom and when), travel (entry into facilities) or group meetings (visitation, camps, adult day programs, mega events).