As the national and international response to the growing threat from COVID-19 continues to escalate, our world is changing very quickly.
PECAA is closely monitoring updates and recommendations from public health agencies regarding the global outbreak of the Coronavirus Disease 2019 (COVID-19), specifically as it relates to the optometric industry, and we are actively working to keep our members informed on steps they can be taking to keep their businesses operating as smoothly as possible.
This webpage will continually be updated with new resources and business-related articles as they become available. Feel free to consume the information at your convenience.
*The information provided to you via this webpage should not be taken as medical or legal advice. Please consult the CDC, your local COVID-19 response teams, and human resources professionals as needed.
You may also have your team participate in education and training offered through our PECAA Vendor Partners as you look for ways to keep staff busy over the coming weeks while fulfilling PPP requirements.
Preparing For Re-Opening
Below you will find ideas on how to keep staff productive and busy while you fulfill PPP requirements.
Preparing For Your Financial Future
Paycheck Protection Program (PPP)
New information was released on the Paycheck Protection Program (PPP) and banks are now getting information on how these loans will be processed.
We encourage you to contact your local bank for details. In the meantime, please view the resources below:
Preparing For Your Financial Future
Merchant Processing During COVID-19
Information on the Stimulus Bill
Here is a summary of what we know about the package…
Here is the latest guidance that has been sent to the banks from the SBA.
Banking and Financing
Practices should be reaching out to their financial institutions for potential loan and lease relief programs. We are seeing commercial banks already put in place programs to help practices. PECAA partner Columbia Bank has instituted a 90 day payment deferral plan. Please contact your local lender for further details. There may be opportunities with credit cards and personal loans as well, depending on the institution.
The SBA (US Small Business Administration) has disaster loans available to businesses of all size. Standards have been relaxed this week to help businesses affected by COVID-19. These loans, which can be up to $2 million, are low interest (3.75%) and can be used to pay fixed debts, payroll, accounts payable and other debts that can’t be paid due to the COVID-19 impact. Further information can be found at www.SBA.gov/disaster. While currently only a handful of states qualify, expectations are that this list will grow quickly.
We are hearing that some landlords are willing to provide assistance during the time, particularly if your business has closed. Note that this is not widespread at this time, but worth the question for those who have had to close down. Most landlords are going to want to fully understand how the practice’s business has been affected before reducing rent. Common requests would be for the following information:
- Last two years tax returns
- Bank Statements
- 2019 P&L
- 2020 YTD P&L
Having this information ready to send may help expedite the process and increase the likelihood of a reduction. If your practice is within a one year window of lease renewal, now will be a good time to begin negotiations as they will want to maintain good tenants. Should you have any questions regarding your lease, please contact PECAA partner CARR Healthcare Realty. CARR Healthcare Realty provides a full suite of real estate services exclusively to healthcare providers and at no charge to PECAA members.
The Treasury Department and the Internal Revenue Service are providing special relief in reaction to COVID-19. The filing deadline and payment due date will automatically be extended to 7/15/20. (Note: this is an update from originally only the payment deadline being moved) If you are due a refund, those will be made on a normal schedule based on filing date. The normal 6 month filing extension is still available to those who need. Please contact your accountant or tax professional for full details and any further questions.
Human Resource Materials
*Seek legal council prior to using this templated waiver. We suggest you speak to your insurance provider for business insurance needs.
Where Does Telemedicine Fit In?
A Message From Dr. Paul Karpecki, OD, FAAO, PECAA’s Director of Clinical Education
Finding optimism in situations like this can be difficult but we must try because we will look back on this time as a true time of change but a small blip in the spectrum of time. This is in no way meant to lighten things for those who have lost of suffering family, friends or acquaintances, but to help us put things in perspective. It’s tough and it’s going to get tougher for most of us before we see the light again. As I write this, the CDC recommended the discontinuation of routine examinations (not mandated but a recommendation), which affects most of our profession and optometry practices aren’t truly set up for a situation like this. Most of us can’t afford to close the door for 3-4 weeks and not feel a significant impact. For many optometric practices, its survival mode is the hope that this pandemic doesn’t last too long.
Read the full article to learn how practices can respond to COVID-19 and how telemedicine fits in.
A Message From Teri Thurston, PECAA’s Billing & Coding Advisor
On Thursday March 17, 2020 the Trump Administration announced expanded Medicare telehealth coverage that will enable beneficiaries to receive a wider range of health care services from their doctors without having to travel to a health care facility. Beginning on March 6, 2020, Medicare— administered by CMS—will temporarily pay clinicians to provide telehealth services for beneficiaries residing across the entire country. For the complete news release, please click here.
This expansion has temporarily changed the landscape in how physicians can provide Telehealth and Telemedicine services to patients within their communities. While we await how payers outside of the Medicare and Medicaid program will adjust to these changes, there are a few payers that have already stated they will accept these new expanded telehealth rules during the COVI-19 crisis. To date the major commercial payers (Aetna, Blue Cross Blue Shield, Humana, Cigna, United Healthcare) will be expanding their telemedicine services as well. However, it is strongly recommended to contact your specific insurance payers in your area for coverage details. Keep in mind any State level mandated rules or policies will override these Federal rules.
*Telehealth Billing Codes for Eyecare provided by PECAA’s newest Vendor Partner, EyecareLive!
Create a list of people (employees and/or customers) who the person may have been in close contact with, close contact is defined by the CDC as less than 6 feet physical distance and the main transmission form is through respiratory droplets produced when an infected person coughs or sneezes. CDC provided factors to consider when defining close contact include proximity, the duration of exposure (e.g., longer exposure time likely increases exposure risk), whether the individual has symptoms (e.g., coughing likely increases exposure risk) and whether the individual was wearing a facemask (which can efficiently block respiratory secretions from contaminating others and the environment). CDC states that data is insufficient to precisely define the duration of time that constitutes a prolonged exposure. Recommendations vary on the length of time of exposure from 10 minutes or more to 30 minutes or more. Brief interactions are less likely to result in transmission; however, symptoms and the type of interaction (e.g., did the person cough directly into the face of the individual) remain important.
Notify other employees who have been in close contact with the person with the positive COVID-19 result that it is possible that they may have been exposed to COVID-19. You may also wish to give them the CDC handout above.
The CDC has stated that if the sick person has been in your facility in the last 7 days, you should follow this Deep Cleaning Protocol.
Exercising Compassion Through Leaves of Absence.
If the pregnant individual is not an employee but an immediate family member or residing in the employee’s house, the employee would only be able to take leave under EPSLA reason #4 if the employee is needed to actually care for the pregnant individual because she can’t care for herself. It is not enough for the employee to merely be concerned about bringing COVID-19 home to the pregnant individual. Department of Labor is clear that the pregnant individual must be unable to care for themselves. Reason #4 is the (A) Employee is unable to perform work for his or her Employer; AND (B) The individual depends on the Employee to care for her; AND (C) The individual has been advised to self-quarantine by a health care provider because of a belief that the individual is particularly vulnerable to COVID-19.
Once EPSLA is exhausted, you have a number of choices regarding extending leave if the employee is the pregnant individual:
- Determine if regular FMLA for a serious health condition applies if the health care provider will fill out the health care certification.
- Determine if there is a discretionary unpaid leave of absence under your policies that applies.
- If employee has a short-term disability policy, encourage the employee to apply to see if the situation qualifies for coverage.
- If the pregnant employee is not necessary to carry on your essential business operations (meaning you have enough other staff to cover and won’t need to fill her position) furlough the employee and she can apply for unemployment benefits to see if she qualifies.
- If the pregnant employee is an essential employee and you will have to fill her position if she refuses to work, terminate her employment and the employee can apply for unemployment benefits to see if she qualifies.
Are You Open?
Here are some precautions and best practices to begin implementing in your office:
Communicating With Staff
This is a time where over-communication isn’t a concern.
Use these 6 posters provided by the Centers for Disease Control to educate employees and patients on COVID-19.
Why not post them in your breakroom, waiting room and restrooms?
Communicating With Patients
Craft a statement to your patients and post it in your office, on your website, and on your social media pages. If you have the ability to send it as an e-blast or text it, do that too.
Create patient communication scripts for your staff to use. This will help to support staff when confirming appointments and greeting patients. Draft statements such as, “If you feel you have been exposed, or if you are feeling ill in any way, please reschedule your appointment.” Or “If you have a cough, fever, or experiencing breathing problems, we will reschedule your appointment.”
Emphasize Good Hygiene
- Place posters that encourage staying home when sick, cough and sneeze etiquette, and hand hygiene at the entrance to your workplace and in other workplace areas where they are likely to be seen.
- Provide tissues and no-touch disposal receptacles for use by employees.
- Instruct employees to clean their hands often with an alcohol-based hand sanitizer that contains at least 60-95% alcohol, or wash their hands with soap and water for at least 20 seconds. Soap and water should be used preferentially if hands are visibly dirty.
- Provide soap and water and alcohol-based hand rubs in the workplace. Ensure that adequate supplies are maintained. Place hand rubs in multiple locations or in conference rooms/break rooms to encourage hand hygiene.
- Encourage employees to visit the coughing and sneezing etiquette and clean hands webpage for more information.
- Routinely clean all frequently touched surfaces in the workplace, such as workstations, countertops, and doorknobs. Use the cleaning agents that are usually used in these areas and follow the directions on the label.
- Provide disposable wipes so that commonly used surfaces (for example, doorknobs, keyboards, remote controls, desks) can be wiped down by employees before each use.
Actively Encourage Sick Employees to Stay Home
- Employees who have symptoms of acute respiratory illness are recommended to stay home and not come to work until they are free of fever (100.4° F [37.8° C] or greater using an oral thermometer), signs of a fever, and any other symptoms for at least 24 hours, without the use of fever-reducing or other symptom-altering medicines (e.g. cough suppressants). Employees should notify their supervisor and stay home if they are sick.
- Ensure that your Paid Time Off policies are flexible and consistent with public health guidance and that employees are aware of these policies.
- Do not require a healthcare provider’s note for employees who are sick with acute respiratory illness to validate their illness or to return to work, as healthcare provider offices and medical facilities may be extremely busy and not able to provide such documentation in a timely way.
- Employers should maintain flexible policies that permit employees to stay home to care for a sick family member. Employers should be aware that more employees may need to stay at home to care for sick children or other sick family members than is usual.