Gov. Lee opens way for Tennessee National Guard members to work in overburdened hospitals

Staff photo by Troy Stolt / Members of the Tennessee National Guard stand outside the East Lake Courts Community Center where free COVID-19 testing was being offered to residents of East Lake Courts on Thursday, May 21, 2020 in Chattanooga, Tenn.

NASHVILLE - Tennessee's coronavirus surge and its threat to overwhelm hospitals has spurred Gov. Bill Lee to sign a new emergency order granting top officials authority to send trained National Guard members to hospitals to work as nurses, screen patients for COVID-19 and operate ambulances.

The Republican governor's Executive Order 68 says it allows the state to "reduce system capacity strain resulting from COVID-19." Only guardsmen with "appropriate training or skills" would be sent, and that hinges on approval by Maj. Gen. Jeff Holmes, the adjutant general, and state Health Commissioner Lisa Piercey.

Lee's action comes as Tennessee continues to break previous COVID-19 records. Two Southeast Tennessee cities - Athens and Cleveland - are now ranked No. 1 and No. 9 respectively by The New York Times as emerging hot spots, measured by week-to-week population-adjusted change in new cases of the coronavirus.

Lee spokesman Gillum Ferguson said in a statement that "the governor is committed to reducing regulatory barriers to help Tennessee hospitals manage capacity in response to the COVID-19 pandemic, and that's what today's executive order will help accomplish.

"This is in addition to $51 million from the Department of Health in hospital staffing assistance grants available to hospitals for them to hire additional workers," Ferguson said.

Tennessee Senate Minority Leader Jeff Yarbro, D-Nashville, accused Lee of having "failed to take the most basic steps to protect Tennesseans," saying "we are in a crisis where he has to call in the National Guard to deal with overwhelmed hospitals and literally thousands of preventable deaths.

"In what sane universe is a crisis severe enough to call in the National Guard for overflowing hospitals but not severe enough to issue a mask mandate?" Yarbro said of Lee, who has opted to urge rather than mandate statewide mask usage to stop the spread of the virus.

Coinciding with the National Guard deployment to hospitals, Tennessee set a new single-day record for COVID-19 deaths, according to Yarbro.

"Tennessee set a new record for deaths today - breaking the record that was set yesterday!" Yarbro said in his statement. "We need more people to still be living when vaccines are available. We all have to do what we can to keep our families and communities safe."

Doctors in Tennessee's Protect My Care coalition, an advocacy group, called on Lee to "stop ignoring" their pleas for state leadership and urged the governor to go along with White House COVID-19 Task Force recommendations, including a statewide mask mandate.

"Gov. Lee's 'Fend for yourself' approach to the COVID-19 health crisis has failed, so can we now try the approach health experts have said we've needed for months?" asked Dr. Amy Gordon Bono, a Nashville internal medicine primary care physician with a master's degree in public health policy.

Hospitals are at capacity and health care workers "are burning out," Bono warned. "Outbreaks are closing schools and harming businesses. Tennessee is in critical condition, and Gov. Lee's refusal to take responsibility during this health crisis has led to entirely avoidable increases in COVID-19 hospitalizations, deaths, and entirely avoidable school and business closures."

While Lee has issued dozens of coronavirus-related executive orders since the first Tennessee case was recognized in March, he has been castigated by both physician experts as well as Democrats for not acting more aggressively. But the Republican governor has come under increasing criticism and scrutiny from members of his own party in the Tennessee General Assembly who think he's gone too far and are weighing passing time-expiration dates on orders next year that would require the governor to justify extensions.

Here is what the governor's office says his Executive Order 68 does to relieve capacity strain on health care beds, resources, and staffing:

> Permits trained National and State Guard personnel to conduct certain on-site health care support operations, including COVID-19 testing, subject to authorization by the Tennessee adjutant general and commissioner of health;

> Expands the ability of the commissioner of health to approve a facility-specific plan of delegation submitted by a health care facility's chief medical officer to permit licensed health care professionals to perform specific, additional tasks within hospitals and certain psychiatric or behavioral health facilities (Executive Order No. 67 previously authorized this for acute care hospital and emergency department settings).

> Expands temporary, COVID-19-bed-related certificate of need waiver to include home health services;

> Allows for registered nurses to delegate certain practical nursing tasks, including vaccine administration, to certified medical assistants under the supervision of the registered nurse;

> Provides flexibility with respect to staffing non-emergency ambulance transport services;

> Encourages health insurance carriers to provide equivalent reimbursement for in-home hospital care programs to facilitate additional hospital bed capacity.

Contact Andy Sher at or 615-255-0550. Follow him on Twitter @AndySher1.