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CPF Newsletter
COVID-19 Update April 3
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Coronavirus Resources for Practices and Providers
TN Dept of Health: Coronavirus HQ - Guidance for Healthcare Providers and Public - New Data Updated Daily 2 PM
WEBINAR EDUCATION
CPF has hosted webinars on Employment Law in the Coronavirus Landscape, Real Estate Strategies in an Unstable Market, and Adapting to Telehealth as a Community Practice aimed at helping members manage the COVID-19 outbreak. Find those links and more below:
CPF Webinar: Employment Law w/ Baker Donelson Attorney Kim Vance
CPF Webinar: Real Estate Strategies w/ Ken Jorgenson of CARR Healthcare Realty
CPF Webinar: Adapting to Telehealth as a Community Practice w/ VUMC Telehealth Director Amber Humphrey
All CPF Video Education
The TN Dept of Health has been holding weekly Friday webinars to give updates. Find all recordings and register for the next one at the link:
TDH Friday COVID-19 Webinars
The Pediatric Management Institute (PMI) has been holding webinars on The Business Impact of COVID-19 on Pediatric Practices to discuss financial and operational issues pediatric practices are facing.
PMI Business Impact Webinar - Part 1 (March 19)
PMI Business Impact Webinar - Part 2 (March 26)
PMI Business Impact Webinar - Part 3 (April 2) Featuring Dr. Suzanne Berman)
TNAAP is holding a webinar on Wednesday, April 8 at 6:30 PM that will provide guidance on how to implement telehealth. Telehealth experts Suzanne Berman, MD, and Sue Kressley, MD, will be featured as guests. 
Register for 4/8 TNAAP Telehealth Webinar
BUSINESS RESOURCES
Comparison of Different Disaster Relief and Stimulus Options: Economic Injury Disaster Advance Loans (EIDL) vs PPP
Coronavirus Emergency Loans Small Business Guide and Checklist: US Chamber of Commerce
Paycheck Protection Program (PPP) Information Sheet for Borrowers
PPE Loan Forgiveness Chart
PPP Application Form
Small Business Administration (SBA) Disaster Loan Assistance: APPLY HERE
The TN Dept of Economic and Community Development is offering daily webinars to assist with SBA-loan related inquiries, along with many other resources, including guidance on filing for unemployment.
TN Dept of Economic and Community Development Webinars and COVID-19 Guidance
TN COVID-19 Unemployment for Employers
EXECUTIVE ORDERS
TN Gov. Bill Lee has decreed multiple executive orders regarding emergency proceedings for every branch of the government and the delivery of health care. Find all executive orders at the link:
View All TN Executive Orders Related to Coronavirus
TESTING UPDATE 4/1
TDH provided the following testing update on April 1:
  • Testing has expanded significantly via both commercial and state lab availability over the last several weeks and turnaround time is improving although it is still significantly longer than is ideal. TDH continues to urge prioritizing testing for the sickest and most at-risk patients and to quarantine when appropriate. 
  • As diagnostic capacity expands to office-based point-of-care tests, TDH reminds providers that any confirmed cases of COVID-19 must be reported immediately to 615-741-7247.
  • Regarding testing of uninsured patients, a step-by-step guide to be reimbursed by TDH for these tests when ordered from commercial labs is linked below:
TDH Billing and Reimbursement Process for COVID-19 Testing for Uninsured Patients
SITE OF CARE (ASSESSMENT AND TESTING)
TDH continues to encourage patients to seek care first from their usual site of care and to enable providers to accommodate that need. Shortages of PPE, of testing supplies, and of testing site availability are increasingly common.

TDH is looking for every opportunity to fix those issues but permanent solutions are not immediately available and TDH needs your help in addressing shortages by implementing strategies to conserve PPE and by putting procedures into place to minimize unnecessary tests

Providers do NOT need to consult with public health before sending a test to a commercial lab. Providers are advised to prioritize testing highly symptomatic and not asymptomatic individuals.
TDH: Guidance on Testing Decision-Making
CDC: COVID-19 ICD-10 Codes
AAP: Critical Updates on COVID-19
Barton Schmitt: COVID-19 Exposure Telephone Triage Protocols
PPE SUPPLY REQUESTS
The TN Emergency Medical Agency (EMA) and local EMA agencies are now coordinating both donations of PPE and requests for PPE or supplies (including testing materials). Contact information for the local EMA entities coordinating these requests can be found at the link:
Regional EMA Contact Info for PPE Donations and Requests
PPE OPTIMIZATION STRATEGIES
The CDC and TDH have provided guidance on PPE conservation:
CDC: Strategies to Optimize the Supply of PPE and Equipment
TDH: PPE Conversation Guidance
TDH: Extended Use of N95s
TDH: Extended Use and Re-Use of Facemasks
TDH: Extended Use and Re-Use of Eye Protection
TELEHEALTH
There has been a rapid expansion in reimbursement opportunities for telehealth, now including home-based telehealth coverage by nearly every plan in the state during this time of public health response. 

Guidance from TDH: Please utilize teleheath and telephone triage as much as possible for both sick and well patients. This is critical to minimize public exposure to illness and to optimize capacity for routine and emergent care. Utilization of telehealth and telephonic management should be optimized in all settings.
VHAN: Telehealth COVID-19 Quick Reference Coding Guide
AAP Webinar: Telehealth COVID-19 Guidance
AAP Guidance: Telehealth Payer Policy in Response to COVID-19
TMA: Telehealth Guidelines
TNAAP: COVID-19 Telehealth Coding Guidance
TNAAP: COVID-19 Telehealth Guidelines By Payer
TennCare Guidance on COVID-19
CALLS FOR CLINICAL STAFFING
Clinical staff looking for employment are needed to care for COVID and non-COVID patients as hospitals put plans into place to increase their capacity. TDH is converting the volunteer medical mobilizer into a tool that registers clinical/non-clinical volunteers and those clinicians and staff seeking employment. 

Those who have availability to help meet growing staffing needs can register at the link below:
COVID-19 Emergency Preparedness Volunteer Mobilizer
ISOLATION GUIDANCE FOR CASES
The CDC has adjusted recommendations for isolation of cases at home to be for at least 7 days (not 14), including afebrile and feeling well for at least 72 hoursThe TN Dept of Health has adapted this recommendation as well.

Note: Contacts should still remain quarantined for 14 days following last exposure.
CDC: Guidance for Persons with COVID-19 Under Home Isolation
TDH: Guidance for Releasing Cases and Contacts from Isolation and Quarantine
PUBLIC HEALTH MONITORING CHANGES
Public health staff are changing their monitoring protocol to include:
  • Making initial contact with lab confirmed cases
  • Conducting a thorough interview to identify close contacts
  • Ensuring that the cases understand the requirement to remain isolated
  • Contacting close contacts to explain their exposure, and the recommendation to remain home for 14 days following their exposure
Following the initial interview, public health will no longer actively check in with the patient (or contacts) each day, but rather ask the case to get in touch with their provider if they need medical care and public health if they have exposure, isolation, or quarantine questions.
NEWBORN NURSERY GUIDANCE
The TN Dept of Health does NOT recommend early (<24 hours after birth) discharges for newborns. Further guidance can be found at the link:
TDH: COVID-19 Update for Pediatric Providers Caring for Infants in the Newborn Nursery






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Cumberland Pediatric Foundation · 5141 Virginia Way, Suite 230 · Brentwood, Tennessee 37027 · USA