Note: The TCA is working to serve as a connection of timely information to our community. Given the variability of this situation it is important for doctors to stay up to date with the newest guidance and directives. Please see important disclaimer in the footnote and continue checking this page for updates as well as review the CDC recommendations and other links provided on this page for timely information.
BENEFIT NOTE: TCA Members login to access the TCA COVID-19 FAQs, additional resources and informative webinar recordings on topics including, the CARES Act, SBA Loans, Maximizing PPP Forgiveness and Telehealth.
Although the TCA is not and cannot be a primary source on this subject, we want to make our members aware of relevant information which we have been carefully monitoring released by the U.S. Centers for Disease Control and Prevention (CDC), TN Department of Health (TDH) and other authorities on COVID-19.
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.
NEWS: Message from the TN Department of Health
If you are a provider who participates in TennCare and/or Cover Kids, you may be eligible to receive funds from the federal government through the Provider Relief Fund to help support you and the care you are providing during the COVID-19 pandemic.
The CARES Act passed by the U.S. Congress allotted $15 billion dollars to be distributed to support providers who participate in state Medicaid and CHIP programs. TennCare will provide updates as received, but as a reminder, this funding is being administered through a federal program by the U.S. Department of Health and Human Services. Please continue to visit their website or reach out to the HHS contacts for any questions you may have.
To apply, visit the CARES Act Provider Relief Fund Portal at http://www.hhs.gov/providerrelief and choose “For Providers”. This funding is available to a wide array of providers who meet the criteria. Physicians, nurse practitioners, physician assistants, skilled therapists (including respiratory, occupational, speech, and physical therapists), nurses, behavioral health professionals, oral health professionals, pharmacy service professionals, and other providers may be eligible.
UPDATE: The deadline to apply for Phase 2 General Distribution Funding for Medicaid, CHIP, Dental and Certain Medicare Providers has been extended to September 13, 2020.
For more information on who is eligible and how to apply, see the CMS fact sheet online at: https://www.hhs.gov/sites/default/files/provider-relief-fund-medicaid-chip-factsheet.pdf
General Information regarding the CARES Act Relief Fund is available at https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/general-information/index.html
Health Resources & Services Administration Uninsured Program FAQs are available at: https://www.tn.gov/content/dam/tn/tenncare/documents/HRSAFAQsForTennesseeProviders.pdf
TCA Virtual Town Hall – Review of New TBCE Policy & Other Changes
On July 21, 2020, TCA President Dr. Brock Martin, TBCE Vice President Dr. Cole Hosenfeld and TCA ED Tiffany Stevens joined for a Virtual Town Hall to review the newly adopted TBCE COVID-19 policy as well as changes impacting chiropractic licensees. The TCA was pleased to have Dr. Hosenfeld as a guest speaker for the event to offer insights into the policy’s provisions. Dr. Martin and Ms. Stevens also provided the latest news regarding available TCA resources and upcoming events as a further support for licensees.
TCA Members click here to view the video in your Members Only website. TN chiropractic licensees who were unable to participate in the July 21, 2020 Virtual Town Hall may email the TCA@TNChiro.com to request a link to view the video.
Information on Phased Reopening and Related Guidance
TN Gov. Bill Lee continues to release information related to the phased reopening of 89 counties across Tennessee. .
- View the most recently released Tennessee guidelines on the State’s dedicated web page. A printable copy of the “Tennessee Pledge: Reopening Tennessee Responsibly” which includes reopening guidelines can be downloaded here.
- View the most recently released TN Executive Orders issued by Gov. Bill Lee.
- View the latest Governor’s COVID-19 Bulletins
- In his April 27, 2020 COVID-19 Bulletin, Gov. Lee stated: “On Friday (May 1, 2020), elective medical procedures will be allowed to resume so Tennessee nurses and other hospital workers can get back to work. It’s important to get hospitals back online with elective procedures so Tennesseans can safely resume more routine services, including scheduling quality of life procedures. Procedures like routine screenings and joint replacements are included in this first wave.”
- On April 30, the State posted guidance for close contact services, which includes massage-therapy establishments or massage services, enabling these workers to resume business in 89 of the state’s 95 counties on May 6. Please note, the six counties which do not fall under Gov. Lee’s Re-opening plan may have their own requirements for specific businesses/services and you should seek city guidance in these areas.
- TN Close Contact Business Guidance can be found here. The TCA encourages all doctors of chiropractic to review the new guidance issued for Close Contact Businesses in addition to monitoring and adhering to guidance published by the CDC, TN Dept. of Health and other authorities.
- For the remaining six counties, Gov. Lee and the Economic Recovery Group are working directly with local officials and health departments in Tennessee’s major metropolitan areas (Shelby, Madison, Davidson, Hamilton, Knox, and Sullivan counties) as they plan their unique re-open strategies.
- Click here to view the TN Attorney General opinion stating the Governor’s emergency powers preempt the authority of local health departments to issue restrictions in response to the coronavirus pandemic. (added 4/28/20)
We encourage you to monitor your county and local releases pertaining to guidelines as they evolve. The following sites may provide information, in addition to other county, metro and local sources:
- Shelby County website: https://www.shelbycountytn.gov/3627/28231/Coronavirus-Info City of Memphis website: (https://covid19.memphistn.gov/news/)
- Madison County website: https://www.madisoncountytn.gov/
- Nashville Metro & Davidson County website: https://www.asafenashville.org/
- Hamilton County website: http://www.hamiltontn.gov/
- Knox County website: https://knoxcounty.org/index.php#
- Sullivan County website: https://sullivancountytn.gov/
Federal guidance can be found online here:
- White House Opening Up America Again guidelines
For Healthcare Professionals
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.
- CDC Clinical Information on COVID-19
- TN Dept of Health COVID-19 Information
- TN Dept of Health – Resources for Healthcare Providers
- NEW 8/26/20 — TN Dept of Health Q&A from 8.7.20 Webinar
- NEW 8/24/20 — TN Dept of Health Infographic on Isolation and Quarantine Release
- NEW 5/4/20 — CDC Reopening Guidance for Cleaning and Disinfecting Workplaces, Businesses
- NEW 4/30/20 — TN Close Contact Business Guidance which includes massage-therapy establishments or massage services
- 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
- Use of Cloth Face Coverings to Help Slow the Spread of COVID-19 (Poster PDF)
- 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 (updated May 18, 2020)
- TN Dept of Health Triage and Assessment
- 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 Dept of Health Notification (Sent 3/20/2020)
- Report a Case
COVID-19 Public Information Number 877-857-2945 or 833-556-2476 – Available 10 a.m. – 8 p.m. Monday – Friday and 10 a.m.- 4 p.m., Saturday and Sunday.
- Self-care advice for health-care providers during COVID-19
OSHA’s General Duty Clause, Section 5(a)(1) of the Act, requires an employer to protect its employees against “recognized hazards” to safety or health which may cause serious injury or death. While there is no specific regulation dealing with COVID-19, it is the General Duty Clause which mandates that you must act to protect your employees.
You are obligated under OSHA to develop a written plan to protect your employees from this risk. The plan assessing the “hazard” should include, but is not limited to:
- Training employees with regard to the hazard
- Revisiting the procedures utilized with personal protective equipment (PPE)
- Recording (logging) any illness which are occupationally related
- Documenting all efforts and training on this hazard
The TCA has developed a Sample COVID-19 Preparedness and Response Office Plan as a benefit to TCA Members – LOGIN for access.
More information from OSHA:
- OSHA COVID-19 Guidance
- Workplace Risk Exposure poster (added 4/28/20)
- Guidance on Preparing Workplaces for COVID-19
Advertisements & Claims
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).
Webinars & Other Profession-Related Resources
The TCA has posted informative webinars for TCA Members online via your tnchiro.com login. These on-demand videos are posted on the “Videos and Webinars” tab.
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.
- U.S. Dept. of Homeland Security Advisory – Essential Critical Infrastructure Workforce includes Chiropractors (added 3/31/20)
- 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 7/14/20)
The Paycheck Protection Program (PPP) provides cash-flow assistance through 100% federally guaranteed loans to small employers who keep paying their employees during this emergency.
Congress and the President extended the deadline for PPP loans to August 9, 2020. This means that if you have not previously been approved/received a PPP forgivable loan, you can still apply. There are over $130 billion remaining of these forgivable loans. Remember, the loan is only 1% and the requirements for forgiveness are not a stretch (see information below, including the newly broadened forgiveness rules passed by Congress in early June).
For information on the Paycheck Protection Program, Economic Injury Disaster Loans and other relief provisions, also see the below links.
- Main Paycheck Protection Program site (added 4/3/20)
- TCA Members can access a TCA PPP Forgiveness FAQs with Flexibility Act update (revised 6/3/2020) via your tnchiro.com login.
- 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)
The U.S. Treasury Department and the Internal Revenue Service announced distribution of economic impact payments 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. Also, see Recovery Check Frequently Asked Questions.
- View the State of Tennessee’s dedicated web page for Small Business Resources.
- Provider Relief Fund CARES legislation – All facilities and providers that received Medicare fee-for-service (FFS) reimbursements in 2019 are eligible for this initial rapid distribution. Providers have 45 days from the date they received a payment to attest and accept the Terms and Conditions or return the funds. Providers that do not log into the provider portal and accept the Terms and Conditions after 45 days of receipt will be deemed to have accepted the Terms and Conditions. ALERT: On May 20, 2020, the U.S. Department of Health and Human Services (HHS) is reminding eligible providers that they have until June 3, 2020, to accept the Terms and Conditions and submit their revenue information to support receiving an additional payment from the Provider Relief Fund $50 billion General Distribution. TCA Members may find information on the Provider Relief Fund – HHS Medicare Stimulus Package including details on the attestation to terms and conditions in the FAQs on COVID-19 via your Member 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 firstname.lastname@example.org 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
- 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
- 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.