COVID-19 Update – May 1, 2020
N95 Decontamination, Shelter-in-Place Orders, Telephone Appointment Reimbursement

As of May 1, there are 1,636 confirmed cases of COVID-19 in Alameda County and 62 deaths (including City of Berkeley information). As of May 1, there are 907 confirmed cases of COVID-19 in Contra Costa County and 28 deaths. Please check  www.accma.org/COVID-19   for the latest updates.   
Message from Alameda County EMS Agency Regarding the Battelle Critical Care Decontamination Systems

The State of California, in cooperation with our federal partners, is offering the systems as a solution to the N95 shortages impacting California.
 
To participate in the program, complete and return the attached service agreement (an FDA requirement) to the Cal OES POC listed below. Per Cal OES, once the service agreement is received, a 3-digit Battelle code will be assigned to each EMS provider wanting to use the system. Specific details about the process can be found in the Battelle Information Packet attached.
 
Cal OES POC:
 
There are currently two active Battelle Decon System sites ready to receive PPE for decon, a system in S. CA, and one in the Bay Area.
 
So Cal:
Burbank Airport, Hanger 40
2910 Clybourn Ave.
Burbank CA 91505
 
Bay Area:
41320 Boyce Rd.
Fremont CA 94538
 
Please review the attached documents ( Battelle Information Packet and Battelle CCDS Infographic ) for more information. There is no cost to participate in this system. The sending of used and receiving decontaminated N95s is done by UPS which is also at no cost.
Extension of Shelter-in-Place Orders in Bay Area Counties

Earlier this week, seven Bay Area health jurisdictions, including Alameda County, Contra Costa County, and the City of Berkeley, announced that the shelter-in-place order would be extended through the end of May. These new shelter-in-place orders include conditional rules allowing the reopening of certain businesses.
Contra Costa County Issues Standing Order for COVID-19 Testing

On May 1, 2020, Contra Costa Health Services released a standing order authorizing COVID-19 testing of individuals who meet the criteria for testing:

"Any person who meets COVID-19 testing criteria established by the Health Officer, and does not have an order from their personal physician for COVID-19 testing, are authorized to receive COVID-19 testing at any of the COVID-19 test collection sites operated by OptumServe in the County under contract with the State of California (“Testing Sites”). "
Medicare Adopts Telephone Call Reimbursement Rule

Medicare issued another change to telehealth rules on April 30, 2020 with an interim final rule with comment period (IFC). The rule outlines changes to a number of issues including: 1) Advance practice providers ordering and furnishing diagnostic tests; 2) Hospital outpatient departments; and 3) Hospital based clinics billing an originating fee. However, the most significant change for physicians is the new rule regarding payment for Telephone Calls. Medicare will now reimburse telephone calls (99441 - 99443) at the rate of an in-person office E/M service. Read more about the new rule in the article by Mary Jean Sage of The Sage Associates.
Peer Coaching Support Available Through Care 4 Caregivers Now

Care 4 Caregivers Now is accepting applications from health care workers impacted by COVID-19 to receive professional and emotional support in a confidential and virtual setting.

California physicians (M.D. and D.O.), nurses and respiratory therapists providing emergency or intensive services to acutely ill COVID-19 patients can receive coaching sessions from trained peer wellness coaches, available at no cost for up to 30 days.  Sign up here .
Physician Financial Health Survey: Bay Area Survey Results

The COVID-19 pandemic created an unprecedented threat to the viability of physician practices and the California Medical Association reached out to its members to gather information on how the pandemic has affected their practice.

The trend that we noticed in the Bay Area is that 97% of practices are worried about their practices’ financial health due to the financial stress they are experiencing as a result of the COVID-19 public health emergency and virtually all practices (98%) report a substantial decrease in patient volume.

To view the results of that survey, more specifically, the results of the Bay Area please click here .
Temporary CME Waiver for License Renewal

On Monday, March 30, 2020, Governor Newsom issued Executive Order N-39-20, allowing the Director of the Department of Consumer Affairs (DCA) to waive professional licensing requirements due to the COVID-19 State of Emergency.

Under DCA Waiver DCA 20-01 Continuing Education, licenses that expire between March 31, 2020 and June 30, 2020 are provided an extension on the continuing medical education (CME) renewal requirement for six months.

In order to receive the CME waiver at the time of renewal, a physician must submit a complete renewal application and pay the required fees. There are no additional steps. Read more about CME renewal requirements.
COVID-19 Advocacy Priorities:

On April 14 th , the ACCMA held their virtual legislative day where members spoke to legislators about the impacts that the COVID-19 pandemic has had on physicians and their practices. The ACCMA will continue to meet with our legislators in hopes of sharing the results of the CMA Physician Financial Health Survey  and letting them know that, due to this pandemic, more than half of practices have had to lay off or furlough physicians/staff and 65% of practices have reduced physician/staff hours.

ACCMA and CMA will continue to work with the legislator to ensure Practice Sustainability for practices facing permanent closure due to a dramatic reduction in utilization by providing Practice Retention Grants:

  • Commercial and Public Payers have an obligation to ensure an adequate network to provide necessary medical services.
  • COVID-19 is threatening the provider network of health plans and insurers have not taken action to protect current networks despite the continued collection of monthly premiums.
  • Continue Telehealth payment parity for all Medi-Cal patients
  • This solution requires no NEW General Fund spending.

To view CMA’s full advocacy priorities, please click here. As a reminder, you can contact your legislator by sending them a message, by clicking here .
HIPAA Compliant E-Signature Companies

Mary Jean Sage, of The Sage Associates, has compiled a list of companies that physicians can use when looking for a HIPAA Compliant E-Signature Company. Most physicians may be able to use the e-signature company that comes with their EHR/PM system, however other e-signature company options are available.

Most of the companies on  this list  have websites where users can watch a demo and obtain pricing.
CMA and CDPH Guidelines for Reopening CA Health Care System

The California Medical Association has released  guidelines for reopening California's health care system , which were developed by a task force comprised of practicing physicians from different parts of the state and different sized practices.

The California Department of Public Health has released  guidelines on resuming California’s deferred and preventive health care  for physicians, hospitals, dentists, and skilled nursing facilities.

Click here  for a comparison grid showing a side-by-side rundown of CMA’s guidelines for reopening the health care system in California vs. the guidelines released by the California Department of Public Health, as they pertain to physicians.
CDC COVID-19 Resource Tool for Clinicians

The Centers for Disease Control and Prevention (CDC)'s " Prepare to Care for COVID-19" is a resource clinicians can use to care for patients with COVID-19. This resource contains practical tools for treating COVID-19 patients and will be regularly updated to help clinicians adapt to the ongoing COVID-19 crisis.
ACCMA & CMA COVID-19 Resource Toolkits
 
The ACCMA has put together a free toolkit of resources that address the day-to-day needs of East Bay physicians of all career stages and in all modes of practice, from food and grocery delivery services to exercises that can be done at home. Click here to access and download the toolkit.

To help physicians understand the rapidly evolving personnel and other employment-related issues during the COVID-19 public health emergency, the California Medical Association has published the  CMA COVID-19 Toolkit for Physician Employers . This resource is free to all and available on CMA’s COVID-19 resource page,  cmadocs.org/covid-19 .
Intuit Aid Assist - Financial Assistance Resource

Intuit Aid Assist  is a free service that allows businesses, self-employed, contractors, and others to understand and access different business relief programs. Individuals and businesses can complete a loan eligibility assessment to see if they qualify for any federal funding programs.
Alameda & Contra Costa County Recruiting Physicians for COVID-19

East Bay physicians can support COVID-19 response efforts through paid and/or voluntary service opportunities through the Alameda County, Contra Costa County, or the State of California. Please visit accma.org/COVID-19 and scrolling to "COVID-19 Volunteer Opportunities" for application instructions.
Tips for Physicians to Protect Themselves and Their Families During the COVID-19 Pandemic
 
Click here for tips on what to do before going to work, at work, and after work/coming home to protect yourself and your family. Tips include how to create a hot zone (contaminated area) near your home entrance and how to take care of your skin. Courtesy of the TPMG Diablo Health and Wellness Team.    
Upcoming Webinars
May 5, 2020 | 12:15 - 1:15 PM
Presented by the California Medical Association

Centers for Medicare and Medicaid Services (CMS) Regional Chief Medical Officer Ashby Wolfe, M.D., will provide an overview of the CMS response to COVID-19. Dr. Wolfe will review existing CMS waivers and flexibilities supporting patient care during the pandemic, with a particular focus on flexibilities that impact physicians. She will discuss 1135 waiver authority, the difference between blanket and individual provider waivers, and an overview of existing telehealth, care by phone, workforce and laboratory testing flexibilities.
May 8, 2020 | 12:15 - 1:15 PM
Presented by the California Medical Association

In this webinar, we will review how the COVID-19 public emergency has changed how we care for patients with opioid use disorder. The webinar will also review new state and federal flexibilities to help patients stay safe and access care. Presenters will share how physicians are adapting to the challenges of the epidemic in opioid treatment programs and office settings. We will also here how the California Department of Health Care Services (DHCS) has responded to the emergency to help transform the safety-net behavioral health treatment system from one predominantly dependent on in-person group visits to one that can deliver services by telephone and telehealth.
May 12, 2020 | 12:15 - 1:15 PM

This webinar will build on CMA's telehealth webinar from March 26, 2020, focusing on the updated telehealth and privacy flexibilities granted by federal and state governments over the past four weeks. Presenters will discuss recent expansions of telehealth use, state and federal privacy waivers, and updates to telehealth billing guidelines. 
Available On-Demand

This one-hour, on-demand webinar led by Linda Hawes Clever, MD, MACP, offers practical, creative, and effective remedies to deal with the crush on personal and professional lives during the COVID-19 pandemic. It contains strategies, resources, and suggestions for handling physician wellness, as well as addressing questions and answers, as we listen and see the ingenuity, guts, and devotion with which we are addressing the harrowing challenges we all face as a profession, community, and nation. Discover how to reduce personal stress and learn healthy ways to contend with the impact of COVID-19.
Questions/Concerns?  

Please contact ACCMA at 510-654-5383 or [email protected] 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.