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COVID-19 Public Info

COVID-19 Resources for All Chiropractors

Update March 27, 2020


In the last few days, our nation and the entire world are coming to terms with the unprecedented health and business impact of Coronavirus.  At the ICS, we have never been more acutely aware that many chiropractic physicians operate as solo practitioners or small businesses who may feel more isolated than large group practitioners. 

In addition to providing information updates, the ICS believes it is just as important that we serve as a bridge to remind members and nonmembers that our chiropractic community is strong and that we are here to help in any way we can.  The ICS continues to work to stay abreast of developments and to share them with our members.

The following are resources ICS is providing to the chiropractic community. More specific and detailed information and webinars are available to members covering the following topics:

  • HR liability around COVID-19
  • Practice and insurance related issues
  • CDC guidelines and your how to run your practice
  • Unemployment considerations
  • How to keep your practice open and stay compliant
  • Understanding compliance with Emergency FMLA and Sick Leave

LOGIN to access more information. JOIN to become a member.

 

Online Webinar Resources

ICS will be hosting two virtual sessions on the coronavirus for our members. Join us!

Tuesday, March 24th from 12:30 - 1:30 pm  Tuesday, March 31st from 12:30 - 1:30 pm

March 24:
Join from a PC, Mac, iPad, iPhone or Android device:

 

Member Only Recording

Click to see sample of webinar recording

SAMPLE RECORDING

 

March 31:
Join from a PC, Mac, iPad, iPhone or Android device:

 

Members Only

Log In To Member Portal To Gain Access

MEMBER LOGIN

 

 

 

 

 

 

 

 

Presenter: Susan Freed (ICS Legal Counsel)

Ms. Freed will provide an update on the pandemic and share guidance with members on what is known at that point. We will also have time for questions and answers.

 


Proclamation on Additional Restrictions

March 27, 2020

Communities across the country continue to be confronted with the global COVID-19 pandemic. The U.S. now has more confirmed cases than China at this time, https://www.bing.com/covid  This is a staggering reality for our country. In Iowa, cases continue to grow. https://coronavirus.iowa.gov/

Yesterday, Governor Reynolds signed a new proclamation (link on word “proclamation) https://governor.iowa.gov/press-release/gov-reynolds-signs-new-proclamation-continuing-state-public-health-emergency-0) continuing the State Public Health Emergency Declaration. The new proclamation enforces additional restrictions and is asking for strict compliance with regulatory provisions. Compliance will be critical in managing the spread of COVID-19.

While the proclamation does not specifically address chiropractic clinics, essential health care providers are asked to follow CDC and WHO guidelines and Iowa regulatory provisions. Doctors of Chiropractic are essential health care providers and play a vital role in the health care team.  If you have chosen to continue to serve in this important capacity and care for your patients during this pandemic, ICS encourages doctors to review the  tools and resources provided by ICS legal counsel, Susan Freed. Please refer to the webinar to obtain further examples on precautionary measures.

 

Ms. Freed will be holding another webinar for members on Tuesday, March 31, 2020 from 12:30 – 1:30 pm. You may find the information here by logging in as a member. Please join us if you are able. The webinar will be recorded and will also be posted on the ICS COVID-19 Update page.  Following the completion of the meeting, you may find this recording at www.iowadcs.com

As you manage the spread of the virus within your clinic, ICS encourages you to consider the following.

·        Comply with CDC and WHO guidance and screen staff and patients on a regular basis.

·        Ensure proper protocols are in place and are consistently followed. In the event a patient becomes sick with COVID-19, please follow state and federal guidelines.  https://www.polkcountyiowa.gov/health/programs/covid-19/healthcare-covid-19-resources/

·        To stop the spread, Governor Reynolds’ 3-26-2020 proclamation, in support of the CDC guidelines, recommends delay of non-emergency services or care without undue risk to the current or future health of the patient.

·        Build positive public perception by following strict compliance with CDC requirements and Iowa law and regulatory provisions. Illustrating your professional commitment may be demonstrated by putting processes in place such as:

o   Prioritizing patients based on health acuity and only taking essential patients

o   Practicing distancing in waiting rooms by managing patient scheduling

o   Implementing a consistent staff and patient screening process

 

As an essential health care provider, this is the time to demonstrate your commitment to stopping the spread when caring for  your patients.

Thanks for all you do.

 


Financial Resources to Help Your Practice

March 27, 2020

CARES Act

Congress has passed the CARES Act that provides billions of dollars for Iowa hospitals, businesses, workers, and farmers – and authorizes direct payments to Iowans.

The programs and initiatives in the Coronavirus Aid, Relief, and Economic Security (CARES) Act that was just passed by Congress are intended to assist business owners with whatever needs they have right now. When implemented, there will be many new resources available for small businesses, as well as certain non-profits and other employers. The guide below provides information about the major programs and initiatives that will soon be available from the Small Business Administration (SBA) to address these needs, as well as some additional tax provisions that are outside the scope of SBA.

To keep up to date on when these programs become available, please stay in contact with your local Small Business Administration (SBA) District Office, which you can locate here.

Struggling to get started? The following questions might help point you in the right direction. Do you need:

  • Capital to cover the cost of retaining employees? Then the Paycheck Protection Program might be right for you.
  • A quick infusion of a smaller amount of cash to cover you right now? You might want to look into an Emergency Economic Injury Grant.
  • To ease your fears about keeping up with payments on your current or potential SBA loan? The Small Business Debt Relief Program could help.
  • Just some quality, free counseling to help you navigate this uncertain economic time? The resource partners might be your best bet.

Click to Download the Guide


Economic Injury Disaster Loan Program

Small business owners in all U.S. states and territories are currently eligible to apply for a low-interest loan due to Coronavirus (COVID-19). Click here to apply.

Find more information on the SBA’s Economic Injury Disaster Loans at: SBA.gov/Disaster.

The SBA will work directly with state Governors to provide targeted, low-interest loans to small businesses and non-profits that have been severely impacted by the Coronavirus (COVID-19). The SBA’s Economic Injury Disaster Loan program provides small businesses with working capital loans of up to $2 million that can provide vital economic support to small businesses to help overcome the temporary loss of revenue they are experiencing. 

 

Iowa Small Business Relief Fund - Iowa Economic Development Authority - $25,000 max

On March 23, Governor Reynolds announced a new Iowa Small Business Relief Program to provide financial assistance to small businesses and tax deferrals to Iowa businesses economically impacted by the COVID-19 pandemic. The program is NOT first-come, first-served. All applications received by the deadline, March 31 at 12:00 p.m. (noon), will be reviewed for consideration. Please review the required documents before starting the online application. Click here to learn more and apply.

Targeted Small Business Sole Operator Fund - $10,000 max

A fund has been created to support Targeted Small Businesses (TSB) with zero employees that have been economically impacted by the COVID-19 pandemic. The program will process applications in order of receipt of application and submission of all required documents until funds are exhausted. Please review the requirements and eligibility guidelines here before starting an application. Click here to learn more and apply.

 


 

Get Your Clinic Ready for COVID-19

March 26, 2020

America’s medical providers deliver the best care possible and are trusted sources of health information for their patients and the community. CDC is committed to arming them with the accurate and helpful information they need to treat patients with COVID-19, keep other patients and staff safe, and empower patients to protect their own health. Leveraging telemedicine whenever possible is the best way to protect patients and staff from COVID-19. However, when telemedicine is not possible, simple actions can help to reduce the risk of spread and keep people safe.

CDC’s Prepare to Care for COVID-19 is a resource with practical tools clinicians can use to care for patients with COVID-19, and will be regularly updated to help clinicians adapt as the outbreak unfolds. 

Download the PDF Flyer

 


Guidance For Employers Who Do Provide Paid Leave to Employees and Ability To Take Employment Tax Credit

March 25, 2020

IRS came out with guidance and a plan to allow employers who do provide the paid leave to their employees the ability to take the employment tax credit when they submit their payroll taxes monthly and semi monthly rather than quarterly.

Click Here To Access the Davis Brown Resource Page For Employment Tax Credits

 


Massage Therapy Establishment Mandatory Closures

On Sunday, March 22nd, Governor Reynolds signed a new proclamation continuing State Public Health Emergency Declaration. The proclamation closes the following from Sunday, March 22nd, 2020 at 10:00 pm until 11:59 pm on Tuesday, March 31st, 2020: 

  • Salons
  • Medical spas
  • Barbershops
  • Tattoo establishments
  • Tanning facilities
  • Swimming pools
  • Massage therapy establishments – Massage therapists are not allowed to practice after 10pm Sunday evening through 11:59 on March 31. If you have a massage therapist in your office, they need to shut down.

    The proclamation also suspends all foreclosures on residential, commercial, and agricultural real estate property.

 


CDC Information for Clinicians

 

The CDC presented a one-hour live webinar for clinicians on March 5th.    It is now available at no cost on-demand here. The presenters reported on important updates, including recommendations for office protocols for control of the spread of the virus.  The experts recommend similar protocols for other infectious diseases, such as influenza. Aside from the obvious standards for the physical facility and staff (sanitizing surfaces, handwashing, etc.), if a patient presents to the office with symptoms, the patient should be separated from others in the waiting area and masked to prevent the spread of droplets. 
The CDC also discussed how to determine which patients to refer for testing.  CDC recommends using professional judgment to assess the presence of the following factors in presenting patients:
Epidemiological factors such as being in close contact with a diagnosed patient or having been in an area of known community transmission.
Symptoms including:

  • Fever
  • Acute respiratory illness – cough, shortness of breath, difficulty breathing
  • Myalgia
  • Fatigue
  • Persons over 65 years of age
  • Persons with underlying conditions and comorbidities

Physicians are to use their best judgment in assessing patients and refer those for testing as appropriate.  Due to the general scarcity of testing kits, the CDC currently recommends that physicians should refer “persons under investigation” (PUI) to state and local public health laboratories in their areas.  Additionally, the CDC states that “Healthcare providers should immediately notify their local or state health department in the event of a PUI for COVID-19.”  

There has been a concern across the country regarding the availability or non-availability of testing kits. Of course, the availability or non-availability of testing kits should not change physician office protocols for identifying and handling of possibly exposed or infected persons.  In any event, we encourage physician offices to review CDC information daily for updates to their recommendations for in-office procedures.  In addition to evaluating symptomatic patients, many physicians are choosing to screen all patients by asking at each visit if patients fall into any of the following categories per CDC:

  • Recently returned from international travel or from a cruise
  • Have interacted with an infected person
  • Older adults
  • People who have serious chronic medical illnesses such as; heart disease, diabetes, lung disease

https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/high-risk-complications.html

It may be appropriate for some asymptomatic patients to be referred for testing if they have been in close contact with an infected person and/or are positive for some of the other factors (age and comorbidities).

 


CDC Information for Employers

 

The CDC recommends the following strategies for employers to use now.  
The ICS has summarized the strategies here but strongly urges clinic owners to click on the link at the end of this article to review the details provided for businesses by the CDC:

  • Actively encourage sick employees to stay home;
  • Separate sick employees;
  • Emphasize staying home when sick, respiratory etiquette and hand hygiene by all employees;
  • Perform routine environmental cleaning:
  • Advise employees before traveling to take certain steps as outlined in the employer link below;
  • Additional measures in response to currently occurring Sporadic Importations of the COVID-19:

Employees who are well but who have a sick family member at home with COVID-19 should notify their supervisor and refer to CDC guidance for how to conduct a risk assessment of their potential exposure.

If an employee is confirmed to have COVID-19, employers should inform fellow employees of their possible exposure to COVID-19 in the workplace but maintain confidentiality as required by the Americans with Disabilities Act (ADA). Employees exposed to a co-worker with confirmed COVID-19 should refer to CDC guidance for how to conduct a risk assessment of their potential exposure.

 


CMS Release For Providers

 

The Center for Medicaid and Medicare Services (CMS) has issued a number of releases containing information for disease mitigation in specific settings. The following link is a good, detailed strategy for community mitigation based on the level of community transmission:  

https://www.cdc.gov/coronavirus/2019-ncov/downloads/community-mitigation-strategy.pdf.

 As the ICS continues to monitor CDC and other resources, we again encourage members to regularly check CDC and IDPH information in the links below, as they are revised to update the public, healthcare providers, and employers on this rapidly developing issue. 

 


 

Additional Resources

 

Guidance for Businesses and Organizations: 

ChiroArmor Hand Hygiene Policy

 

ChiroArmor Infection Control Policy

 

Patient Handout Flyer

 

Appointments: COVID-19 Phone Screening

 

NCMIC Insurance Company COVID-19 Information


Iowa Department of Public Health Business Guidance 

 
Iowa Department of Public Health FAQ for Businesses 

 
Updates from The Iowa Department of Public Health (IDPH)


Updates from the Centers for Disease Control and Prevention

 

Davis Brown Law Firm Legal Guidance For Employers 

 

Board Recommended Links:

World Federation of Chiropractic Coronavirus PDF


American Chiropractic Association Coronavirus Information



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