Note: TCA Members login to access additional resources and informative webinar recordings on topics including, the CARES Act, SBA Loans and Telehealth. Please see important disclaimer in the footnote and continue checking this page for updates.
Although the TCA is not and cannot be a primary source on this subject, we want to make our members aware of relevant information that has been published by the CDC, TDH and other authorities. The Tennessee Chiropractic Association affirms that Doctors of Chiropractic are essential health care providers who are ready to serve their communities, both in daily care and in times of urgent need, such as the current COVID-19 pandemic. The TCA has been carefully monitoring information released by the U.S. Centers for Disease Control and Prevention (CDC), TN Department of Health (TDH) and other authorities on COVID-19.
The TCA continues to be a resource for updates to the profession regarding important developments throughout this crisis. View the recently UPDATED Profession-wide TCA Doctor Privilege Newsletter (April 3, 2020).
For Healthcare Professionals
- CDC Clinical Information on COVID-19
- TN Dept of Health COVID-19 Information
- Triage and Assessment
- NEW 4/5/20 — CDC Recommends wearing Cloth Face Coverings in Public Settings Where Other Social Distancing Measures are Difficult to Maintain & How To Video for Making Masks
- Risk Assessment for Healthcare Personnel with Potential Exposure in a Healthcare Setting to Patients with Coronavirus Disease
- Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease in Healthcare Settings
- Department of Health and Human Services (HHS) FAQs on Telehealth and HIPAA during the COVID-19 nationwide public health emergency
- Informational Videos on COVID-19
- U.S. Government Response to Coronavirus
- CMS COVID-19 Partner Page
- Medscape article highlighting strategies for handling this crisis properly.
- TN Governor Daily Bulletins
- TN Dept of Health Notification (Sent 3/20/2020)
- Report a Case
- The Tennessee Department of Health offers a COVID-19 Public Information Line at 877-857-2945, with information available daily from 10 a.m. to 10 p.m. Central Time.
- Self-care advice for health-care providers during COVID-19
The COVID-19 outbreak is rapidly evolving, and information is constantly changing. For that reason, the TCA strongly recommends that physicians stay up to date with guidance issued by the CDC and TDH. We have provided a number of links (below) to general information about the virus, as well as information for healthcare professionals and businesses. The CDC and TDH updates these sites continually as information becomes available.
The CDC presented a one-hour live webinar for clinicians on March 5th. It is now available on demand, at no cost at: https://emergency.cdc.gov/coca/calls/2020/callinfo_030520.asp.
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, hand washing, 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:
- Acute respiratory illness – cough, shortness of breath, difficulty breathing
- 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. The CDC is aware that testing kits may be in short supply, but they report that more may be made available soon through a private company. In any event, the potential testing kit shortage did not change CDC’s recommendations for testing referrals as outlined above.
Although it was not part of the CDC webinar, 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 above categories. 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).
TCA Gold Corporate Member ChiroHealthUSA is offering a variety of webinars on topics related to the COVID-19 crisis.
TCA Gold Corporate Member OUM Chiropractor Program has posted resources to assist doctors during the COVID-19 crisis.
TCA Silver Corporate Member NCMIC has developed a number of resources to help you handle the impact on your practice, staff and patients.
The TN Board of Chiropractic Examiners (TBCE) has notified licensees of serious concerns regarding any advertisements making claims regarding chiropractic spinal adjustments/manipulation and immunity to the flu or coronavirus. The TCA encourages doctors to review TN statute (T.C.A. 63-4-101) and rules (0260-02.02) as they pertain to advertising (0260-02.20).
- Governor Lee’s Executive Order 21, Executive Order 22, Executive Order 23 and Executive Order 25 regarding Essential Activity and Services (updated 4/9/20)
- U.S. Dept. of Homeland Security Advisory – Essential Critical Infrastructure Workforce includes Chiropractors (added 3/31/20)
- CDC Interim Guidance for Business and Employers
- Informative Law Resource on COVID-19 (posted by Fisher Phillips firm-should not be construed as legal advice for any particular fact situation)
The CDC recommends the following strategies for employers to use now. The TCA has summarized the strategies here but strongly urges clinic owners to review the details provided in the CDC Interim Guidance for Business and Employers:
- 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. Additionally, on April 7, 2020, the CDC changed their recommendations for Critical Infrastructure Workers Who May Have Had Exposure to a Person with Suspected or Confirmed COVID-19 and now allows exposed workers to return to work sooner. Although this new guidance is primarily for non-healthcare related essential workers, it provides additional guidance for your office.
- 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.
TCA will continue to monitor CDC, TDH and other resources, but we encourage members to regularly check the links provided, as they are revised to update the public, healthcare providers, and employers on this rapidly developing issue.
Financial Resources (updated 4/3/20)
The U.S. Treasury Department and the Internal Revenue Service announced that distribution of economic impact payments will begin in the next three weeks and will be distributed automatically, with no action required for most people. However, some seniors and others who typically do not file returns will need to submit a simple tax return to receive the stimulus payment. For more information click here.
- Coronavirus Aid, Relief and Economic Security Act (CARES ACT) – Recovery Check Frequently Asked Questions
The Paycheck Protection Program provides eight weeks of cash-flow assistance through 100% federally guaranteed loans to small employers who keep paying their employees during this emergency. For information on the Paycheck Protection Program, Economic Injury Disaster Loans and other relief provisions, also see the UPDATED Profession-wide TCA Doctor Privilege Newsletter (April 3, 2020).
- Main Paycheck Protection Program site (added 4/3/20)
- Small Business Paycheck Protection Program one-pager (added 4/3/20)
- Fillable Application for Use in PPP Loan Preparation (added 4/3/20)
- Paycheck Protection Program FAQs for Small Businesses (added 3/31/20)
- Find a Nearby Lender Eligible to Issue a Loan Under the Paycheck Protection Program (added 4/4/20)
- TCA Members can access a CARES Act/PPP Overview updated April 6, 2020 via your tnchiro.com login.
- NEW Small Business Relief Provisions Aimed at Healthcare Providers (added 3/31/20)
- Families First Coronavirus Response Act Information:
• US DOL INFO
• SESCO FFCRA EXPLANATION
- Employers Prepare to Provide Paid Sick Leave and FMLA under New Legislation (effective 4/2/2020)
Do you have questions about the federal paid leave requirements related to the Coronavirus? View the U.S. Labor Department’s Fact Sheet for Employees here. General questions and answers here. (added 4/3/20)
Small Business Support
Tennessee has been approved for Economic Injury Disaster Loan assistance from the U.S. Small Business Administration. Tennessee small businesses and nonprofit organizations that have suffered economic injury as a result of COVID-19 are eligible to apply for disaster loan assistance of up to $2 million per applicant.
Small businesses who are ready to explore these efforts should visit www.SBA.gov. Additional information can be found here. Applicants may also call SBA’s Customer Service Center at (800) 659-2955 or email email@example.com for more information on SBA disaster assistance.
A TCA Member Webinar on these loan options is viewable
via the Members Only Home Page and clicking on the Videos & Webinars icon.
TN RESOURCES FOR THOSE AFFECTED BY COVID-19
The Department of Human Services is offering several programs and services to assist Tennesseans impacted by COVID-19.
Temporary Assistance for Needy Families (TANF): This emergency cash assistance program will provide cash payments to families significantly impacted by the COVID-19 emergency. Beginning March 26, families are able to apply online for up to two months of emergency cash assistance if they were employed as of March 11th and they’ve lost employment or at least 50% of their earned income as a result of the pandemic. It will provide between $500 and $1,000, depending on household size, to qualifying families. Applicants can complete the application process online here.
Expanded Unemployment Relief
The Tennessee Department of Labor will extend unemployment benefits to employees who suddenly find themselves out of work as businesses temporarily cease operations during the pandemic or to those who are quarantined by a physician for COVID-19 and are temporarily away from their job. For information and resources you can access it here.
The department is suspending certain regulations so those who are approved will get paid more quickly. Tennesseans are encouraged to apply online here.
- TN Department of Labor and Workforce Development: JOBS4TN.gov
- TN DOL Questions and Answers
- TN.gov Small Business Resources
- Presidential Executive Orders: https://www.federalregister.gov/presidential-documents/executive-orders/donald-trump/2020
Mental Health Resources
- TN Mental Health Resources and Crisis Services
- National Alliance on Mental Illness (NAMI) COVID-19 Information and Resources
Ways to Help Our Communities
- TCA Partners with Smile Tennessee to Help Provide PPE for Needy TN Facilities
- American Red Cross Blood Donations Needed
Other Helpful Links
- WFC Advice for Chiropractors – Updated
- Learn About COVID-19
- CDC Guidelines for Travel
- Preventing COVID-19 Spread
- World Health Organization Q & A on COVID-19
- Johns Hopkins University Interactive Map of Global Impact
- Just For Kids: A Comic Exploring The New Coronavirus
The information provided in this article and on this website does not, and is not intended to, constitute legal, medical, financial, or other professional advice. All content and materials available in this article and on this site are for general informational and educational purposes only. The TCA regularly reviews new developments, and the guidance we provide represents information believed to be current and accurate at the time of posting. However, due to rapid changes in some of the content, the TCA does not guarantee that all of the information in this article and website constitutes the most up-to-date information.