COVID-19 Information and Resources for Medical Practices

March 16: The Alameda-Contra Costa Medical Association (ACCMA) has compiled the following resources to support our local medical community amid the unprecedented restrictions that have been implemented to mitigate the transmission of novel coronavirus (COVID-19). The ACCMA will continue to provide regular updates. In the meantime, please continue to contact ACCMA with any questions or concerns so that we can be sure we are getting you the information you need: call (510) 654-5383 or email accma@accma.org .

If you have urgent questions and need to speak with somebody tonight, please call Joe Greaves, ACCMA Executive Director, at (415) 987-9639.
Medical Practices Can Stay Open

On March 16, 2020, Alameda County , Contra Costa County and the City of Berkeley (along with Marin, San Francisco, San Mateo, and Santa Clara counties) issued legal orders directing residents to shelter at home for three weeks beginning at 12:01 AM on March 17. The order limits activity, travel, and business functions to only the most essential needs. The guidance comes after substantial input from the U.S. Centers for Disease Control and Prevention (CDC) and best practices from other health officials around the world.
 
The order defines essential activities as necessary for the health and safety for individuals and their families, and includes “health care operations” and specifically states:  
 
  • For purposes of this Order, individuals may leave their residence to work for or obtain services at any “Healthcare Operations” including hospitals, clinics, dentists, pharmacies, pharmaceutical, and biotechnology companies, other healthcare facilities, healthcare suppliers, home healthcare services providers, mental health providers, or any related and/or ancillary healthcare services. “Healthcare Operations” also includes veterinary care and all healthcare services provided to animals. This exemption shall be construed broadly to avoid any impacts on the delivery of healthcare, broadly defined. “Healthcare Operations” does not include fitness and exercise gyms and similar facilities. 
Protecting Your Employees / Workforce Safety

The shelter at home order stipulates that “individuals may leave their residence to work for or obtain services at any ‘Healthcare Operations’.” Accordingly, personnel in medical offices are permitted to leave home to go to work.
 
Physicians are encouraged to follow CDC guidelines to mitigate risk to employees and patients. Please see CDC guidance for healthcare facilities .

On March 12, the CDC published a framework for actions that local and state health departments can recommend in their community to both prepare for and mitigate community transmission of COVID-19 in the United States. Per the CDC, the selection and implementation of these actions should be guided by the local characteristics of disease transmission, demographics, and public health and healthcare system capacity. Please continue to check with local public health departments for local recommendations.

Some of the recommendations that apply to outpatient practices include:

  • Implement changes to visitor policies to further limit exposures to health care personnel (HCP) and patients. Changes could include temperature/ symptom checks for visitors, limiting visitor movement in the facility, etc.

  • Implement triage before entering facilities (e.g., parking lot triage, front door), phone triage, and telemedicine to limit unnecessary healthcare visits.

  • Actively monitor absenteeism and respiratory illness among HCP and patients.

  • Actively monitor PPE supplies.

  • Consider allowing asymptomatic exposed HCP to work while wearing a facemask.

  • Begin to cross-train HCP for working in other units in anticipation of staffing shortages.

  • Cancel elective and non-urgent procedures.

  • Consider requiring all HCP to wear a facemask when in the facility depending on supply.
 
Local public health officials are encouraging employers to allow any employee who can work from home to do so. 
 
Click here  for more information.
Telemedicine Resources

CDC is recommending that physicians utilize strategies to prevent patients who can be cared for at home from coming to your facility potentially exposing themselves or others to germs, like:

  • Using your telephone system to deliver messages to incoming callers about when to seek medical care at your facility, when to seek emergency care, and where to go for information about caring for a person with COVID at home.

  • Adjusting your hours of operation to include telephone triage and follow-up of patients during a community outbreak.

  • Leveraging telemedicine technologies and self-assessment tools.
 
The ACCMA has compiled the following telemedicine resources for physicians needing guidance about telemedicine implementation:

Reimbursement Information

CMA is working to obtain information on payor reimbursement policies related to COVID-19 and telemedicine/telephone appointments. As of now, the ACCMA is aware of the following policy announcements:

Questions/Concerns?

Please contact ACCMA and 510-654-5383 or  accma@accma.org  with any questions or concerns you have. Although we may not currently have an immediate answer to all questions, we want to know the information and resources that you need to continue to provide care for our community during this difficult time.

This information will also be posted online at   www.accma.org/COVID-19  and will be updated frequently. Please check the ACCMA website regularly for updates.