In response to continuing COVID-19 developments, the Division of Professions and Occupations (Division), under the Department of Regulatory Agencies, has taken steps to implement Executive Order D 2020 020 issued by Governor Jared Polis. The Executive Order, issued on April 1, 2020, temporarily suspends certain statutes to expand the use of telehealth services due to the presence of Coronavirus Disease (COVID-19) in Colorado.
A large amount of provider-related guidance regarding telehealth is addressed on the Telehealth for Providers page, created by the Colorado Department of Public Health and Environment (CDPHE) in light of the Executive Order. However, DORA recognizes that our licensed professionals may have some lingering questions about how to undertake telehealth during the COVID-19 crisis.
Here is information that may prove helpful.
1. Which DORA-regulated professions fall under Executive Order D 2020 020?
Executive Order D 2020 020 explicitly mentions suspension of statutes related only to mental health and veterinary services providers. Nevertheless, the following healthcare professions also are able and encouraged to use telehealth in treatment of patients for the duration of this health emergency. Please note that, with the exception of veterinarians, providers must meet the definition outlined in Colorado Revised Statutes §10-16-102(56), which includes those “licensed or otherwise authorized to furnish healthcare services” as defined in §10-16-102(33).
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Acupuncture
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Addiction Counselor
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Advanced Practice Nurse
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Athletic Trainer
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Anesthesiologist Assistant
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Audiology
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Certified Nurse Aide
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Chiropractic
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Dental
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Direct-Entry Midwife
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Hearing Aid Provider
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Licensed Practical Nurse
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Marriage and Family Therapy
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Massage Therapy (if performed in a healthcare capacity, as ordered by a physician)
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Medical
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Naturopathic Doctor
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Nursing
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Nursing Home Administrator
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Occupational Therapy
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Optometry
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Osteopath
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Pharmacist
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Pharmacy Intern
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Pharmacy Technician
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Physical Therapy
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Physician
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Podiatry
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Professional Counselor
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Psychology
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Psychiatric Technician
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Registered Psychotherapy
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Respiratory Therapy
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Social Work
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Speech-Language Pathology
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Surgical Assistant and Surgical Technology
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Veterinary
2. What if telehealth is not sufficient to address the needs of my patients? Can I still conduct in-person appointments?
The professions listed above must still adhere to the mandates in Executive Order D 2020 027 (the amended version of Executive Order D 2020 009) prohibiting elective, non-emergency procedures**, as well as the social distancing requirements in Amended Public Health Order 20-24.
Governor Polis issued this Order to prioritize essential health care services, to help ensure access to necessary personal protective equipment (PPE) and other medical supplies, and to promote safe personal distancing to reduce putting individuals at great risk of contracting COVID-19.
We are asking all healthcare professionals to assess the essential need to provide services on a conservative, case-by-case, patient-by-patient basis to ensure compliance with the Order. To make an assessment, providers need to consider that the only procedures or surgeries that are permissible under this Order are those that address the following:
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There is a threat to the patient's life if the surgery or procedure is not performed;
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There is a threat of permanent dysfunction of an extremity or organ system of the surgery or procedure is not performed;
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There is a risk of metastasis or progression of staging of a disease or condition if the surgery or procedure is not performed; or
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There is a risk that the patient's condition will rapidly deteriorate if the surgery or procedure is not performed and there is a threat to life, or to an extremity or organ system or of permanent dysfunction or disability.
**Note: Rural and critical access hospitals are exempt from Executive Order D 2020 027, but are strongly advised to comply on a voluntary basis. Rural and critical access hospitals are, however, directed to comply with CDC guidelines for PPE preservation. Please refer directly to the order for further clarification in this area.
3. What insurance considerations must I be aware of before offering telehealth services?
The Division of Insurance within DORA has compiled a comprehensive list of questions and answers specific to recent emergency measures and allowances for private, commercial health insurance plans made according to Executive Order D 2020 020. View the Insurance FAQ on Telehealth Services for these considerations.
Note: Links to Colorado Healthcare, Policy, and Financing (HCPF) and Centers for Medicare and Medicaid Services (CMS) are provided in the above document with guidance for public insurance.
4. Can I continue providing services to people who may now be residing outside of Colorado (i.e. college students who returned to out of state homes) without getting in trouble?
Yes, as long as you hold an active license in the state of Colorado and have an existing relationship with a patient or client that was initiated in Colorado, Colorado will permit you to continue to provide telehealth services to clients who are temporarily residing in other states due to COVID-19. However, because the patient is residing in another state, you may want to contact that state’s licensure board to ensure similar allowances have been made there.
If you are aware of individuals who have returned home to Colorado and are hoping to continue receiving care from a provider who resides in a different state, Colorado is allowing this during the COVID-19 state of emergency. However, the out-of state provider should consult with his/her home state licensure board to ensure that similar allowances have been made there.
5. If I have a question that wasn’t addressed here, where can I go to get an answer?
General questions and concerns about telehealth/telemedicine licensure and practice requirements can be sent via email to DPO@state.co.us.
