COVID-19 Resources for Medical Providers

The Maine Osteopathic Association continues to monitor the ongoing spread of coronavirus disease (COVID-19) and will update the resources and information below to the best of our ability, sending important updates to members individually. 

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Keep Up to Date! Call-In Information for Important Recurring Calls for Medical Providers:

Maine CDC Update for Clinicians-- Weekly on Thursdays at 12:30pm: Zoom meeting facilitated by Dr. Stephen Sears, MD.

Topic: MCDC Coronavirus Update for Clinicians

Time: Mar 26, 2020 12:30 PM Eastern Time (US and Canada)

        Every week on Thu, until Jul 30, 2020, 19 occurrence(s)

Join Zoom Meeting

https://zoom.us/j/399715702?pwd=MmNwUUZKa2Nldm1BSmV1SHhHQWJiZz09

Meeting ID: 399 715 702

Password: 348750

        +1 646 558 8656 US (New York)

Other Ongoing Maine CDC Briefings:
Per member request, here is an updated list of all Maine CDC briefings for various stakeholder groups and healthcare providers. CDC staff manage participants via calendar invites from their interested parties lists, so please be sure to let Peggie Lawrence know should you want to be "subscribed" to call updates as the info below may change: Peggie.D.Lawrence@maine.gov.
 

 

Lead

Day of Week

Time

Zoom Link

General Briefing

Nirav Shah, Director, Maine CDC

Monday

1-2pm

https://zoom.us/j/544261659

MCDC Coronavirus Update for Hospitals

Rita Owsiak

Tuesday

11-11:30 am

https://zoom/us/j/687927112

Maine CDC Coronavirus Update for Long Term Care Facilities

Rita Owsiak

Wednesdays

1-1:30 pm

https://zoom/.us/j/570558574

MCDC Coronavirus Update for Clinicians

Dr. Stephen Sears

Thursday

12:30-1 pm

https://zoom.us/j/399715702?pwd=MmNwUUZKa2Nldm1BSmV1SHhHQWJiZz09

Tribal Leaders & Health Centers

Dr. Lisa Letourneau

Friday

11:30-12:15 pm

https://zoom.us/j/6218434986 or tel. +13126266799,,6218434986#

Child Health Providers

Drs. Belisle/Sears/Carmack

Fridays

12:15-1pm

https://zoom.us/j/871527860

Daily Press Conference

Dr. Shah/Governor/Commissioner

Daily

2-3 pm

carried by most major tv outlets live and online

 

Quick Links

Gov. Mills COVID-19 Response Page

US Centers for Disease Control and Prevention

Cleaning and Disinfection of Environmental Surfaces in the Context of COVID-19
[From WHO 05/16/20] https://www.who.int/publications-detail/cleaning-and-disinfection-of-environmental-surfaces-inthe-context-of-covid-19

Clinical Trial Lookup: https://clinicaltrials.gov/
 

Maine CDC

If you have not done so, please sign up for the Maine CDC Health Alert Network HERE

Maine's Emergency Response System Now Activated for Public Questions on COVID-19: Dial 211, or text your zip code to 898-211

If you are a Maine health care professional and have questions about COVID‑19, call: 1-800-821-5821 for quick clinical Q/A

Maine DHHS COVID-19 Resources Page

AOA COVID-19 Resources

FREE AOA OMM for COVID-19 Patients Webinar:https://aoaonlinelearning.osteopathic.org/course/info.php?id=310​

Check the Status of AOA Meetings, Conferences and certification exams 

CMS Updates

COVID-19: Payment for Diagnostic Laboratory Tests

Telephone Evaluation and Management Visits

National Coverage Determination (NCD 30.3.3): Acupuncture for Chronic Low Back Pain (cLBP) (PDF) is available. Learn about coverage of cLBP effective for claims with dates of service on and after January 21.

Events/Calls Coming Up:

MaineCare Updates

MaineCare’s COVID-19 webpage has been updated with new and updated guidance for MaineCare providers. 

MOA Resources

Guidelines for OMM Providers During COVID-19 Pandemic from Stephanie Collins, DO

MOA PPE Guide
The MOA has heard that sourcing the PPE needed for safety in your medical practices has been difficult. Click here for a list of suppliers that have been recommended to us. If you are interested in collaborating with other physicians on group ordering, please contact Amanda Richards, MOA Executive Director at arichards@mainedo.org.


Practice Resources

The Centers for Medicare & Medicaid Services (CMS), Re-opening Facilities to Provide Non-emergent Non-COVID-19 Treatment: Phase 1

AOA COVID -1 Practice Implications (May 7, 2020)

Sourcing PPE
The MOA has heard that sourcing the PPE needed for safety in your medical practices has been difficult. Click here for a list of suppliers that have been recommended to us. If you are interested in collaborating with other physicians on group ordering, please contact Amanda Richards, MOA Executive Director at arichards@mainedo.org.

To Request PPE Resources from the Maine Stockpile:

Providers who want to request PPE from the CDC stockpile can do so via their County Emergency Management Agencies. Here is the contact information for all Maine counties: https://www.maine.gov/mema/ema-community/county-local/county-emergency-management-agencies

Other Practice Resources

Our colleagues in Michigan have shared several resources to help physicians navigate the logistics of re-opening or scaling up during COVID-19. We are sharing them below for our members, with permission and thanks to the "other" MOA!


Reporting

Temporary Updates to the Notifiable Diseases and Conditions List – SARS CoV-2 and COVID-19 Deaths

Background: Reporting of notifiable diseases and conditions is required under 22 M.R.S., Chapter 250, §802 and §822. Failure to report could result in preventable morbidity or mortality. Maine CDC is authorized to advise through publicly noticed Health Alerts the public health need for the temporary reporting of any disease or condition in the state of Maine in order to study and control any apparent outbreak or unusual
occurrence of communicable diseases.


• COVID-19-associated deaths should be reported directly to Maine CDC within 24 hours of the death.
o A COVID-19-associated death is defined as a death resulting from an illness that is clinically
compatible with COVID-19 that is confirmed by an appropriate laboratory test. There should be 
no period of complete recovery between the illness and death. It is not necessary that COVID- 19 be the primary cause of death.

o COVID-19-associated deaths can be reported by phone to 1-800-821-5821 or by fax to 1-800-
293-7534
o Reports should include the patient’s name, date of birth, and date of death

 These changes will remain in effect for a period of one year but may be reassessed at any time.

For more information:
• Maine CDC COVID-19 website: www.maine.gov/dhhs/coronavirus

• Maine CDC notifiable conditions rule: https://www.maine.gov/dhhs/mecdc/infectious-
disease/epi/disease-reporting/documents/notifiable-conditions.doc


Testing

Maine CDC Updates 05/27/2020

  1. Acceptable specimens and collection methods for testing for the SARS-CoV-2 virus
    For initial diagnostic testing for SARS-CoV-2, the virus that causes COVID-19, federal CDC recommends collecting and testing an upper respiratory specimen. While nasopharyngeal (NP) swabs are preferred, there are other options, for example for individuals who are medically fragile and do not tolerate the NP swab.  The following are acceptable specimens for PCR testing:
  2. A nasopharyngeal (NP) specimen collected by a healthcare provider; or
  3. An oropharyngeal (OP) specimen collected by a healthcare provider; or
  4. A nasal mid-turbinate swab collected by a healthcare provider or by patient self-collection when supervised by a healthcare provider (using a flocked tapered swab); or
  5. An anterior nares (nasal swab) specimen collected by a healthcare provider or by patient self-collection when supervised by a healthcare provider or home self-collection (using a flocked or spun polyester swab); or
  6. Nasopharyngeal wash/aspirate or nasal wash/aspirate (NW) specimen collected by a healthcare provider.

Details on how to collect specimens can be found on the federal CDC website https://www.cdc.gov/coronavirus/2019-nCoV/lab/guidelines-clinical-specimens.html.  The Office of the Assistant Secretary for Health (OASH) also has a Fact Sheet on Nasal (Anterior Nasal) Specimen Collection for SAR-CoV-2 Diagnostic Testing (https://www.cdc.gov/coronavirus/2019-ncov/downloads/OASH-nasal-specimen-collection-fact-sheet.pdf).

Swabs should be placed immediately into a sterile transport tube containing 2-3mL of either viral transport medium (VTM), Amies transport medium, or sterile saline, unless using a test designed to analyze a specimen directly (i.e., without placement in VTM) such as some point-of-care tests (e.g. the Abbott ID Now platform). If VTM is not available, see the standard operating procedure for public health labs to create viral transport medium in accordance with CDC’s protocol. Don't have the swabs or testing kits you need? Request them from your County Emergency Management Agencies. Here is the contact information for all Maine counties: https://www.maine.gov/mema/ema-community/county-local/county-emergency-management-agencies

Providers are reminded to maintain proper infection control and use recommended personal protective equipment (PPE) when obtaining specimens.  This includes an N95 or higher-level respirator (or surgical facemask if an N95 respirator is not available), eye protection (face shield or close-fitting goggles), gloves, and a gown, when collecting specimens.

  1. Reporting of clinician-suspected cases of re-infection 
    Federal CDC, in collaboration with the Emerging Infections Network (EIN, operated by the Infectious Disease Society of America), is trying to determine if patients who have recovered from COVID-19 but who appear to have recurrent infection represent re-infection or intermittent viral RNA shedding.

Any clinician who has identified a confirmed COVID-19 patient who has had clinical recovery for approximately 10 days after symptom onset or diagnosis (if asymptomatic) and who subsequently had any of the following:

  • Two documented negative PCR results followed by a positive result, or
  • Recurrence of symptoms with a positive PCR result, or
  • Positive PCR results for 30 or more days after recovery (without any recurrence of symptoms),

  then please enter a case description using this linkhttps://ein.idsociety.org/surveys/survey/125/

  1. Maine CDC HAN with recommendations for universal testing and retesting in congregate living settings   
    On Saturday May 23, 2020, Maine CDC issued a HAN on Universal Testing in Congregate Living Settings.  The focus of the universal testing guidelines described in the HAN is a change in the recommendation for universal testing after one positive case in congregate living settings whose clients or residents are at significantly increased risk for severe illness and complications from the virus, such as long-term care facilities, shelters for people experiencing homelessness, correctional facilities, group homes, and assisted living facilities. The HAN also contains recommendations on re-testing of staff or residents and when such re-testing is appropriate.

    The full text of the HAN is available on the Maine CDC’s website https://www.maine.gov/dhhs/mecdc/health-advisory.shtml?id=2577694

Current Testing Guidelines for Maine State Lab (via Maine CDC Website)

New as of 5/18/2020 The acquisition of the IDEXX PCR Test Kit enables HETL to process up to 1,000 tests each day.  Training on the new equipment and quality assurance have been completed. Therefore, Maine's Health and Environmental Testing Laboratory (HETL) can now conduct an increased number of tests.

Effective Monday May 18, 2020, the testing priorities and tiers outlined in the March 19, 2020, HAN “Updated Guidance for COVID-19: Prioritization of Testing and Discontinuation of Home Isolation” are rescinded and the following new guidelines are established:


HETL will now test specimens from any person who has one or more symptoms that are consistent with COVID-19.  Testing must be ordered by a clinician.

  • Maine health care providers should use their clinical judgment to determine if a patient has signs and symptoms compatible with COVID-19 and whether the patient should be tested.

HETL will now also test persons without symptoms who may be at risk for spreading COVID-19 to others.  As examples, these may include but are not limited to:

  • Asymptomatic close contacts of confirmed COVID-19 cases in an outbreak setting. For reference, Maine CDC generally defines an “outbreak” as three or more epidemiologically linked cases of a specific disease, and generally defines “close contacts” as individuals who have spent 30 minutes or more within 6 ft of an individual with confirmed COVID-19.
  • Asymptomatic health care workers, including first responders, who have had contact with or exposure to a confirmed COVID-19 case; or
  • Asymptomatic persons tested as part of a sentinel COVID-19 disease surveillance program established by Maine CDC.

In order to maintain laboratory capacity for the activities noted above, HETL will not test specimens collected by congregate facilities that choose to conduct universal testing of their staff and residents when that recommendation has not been approved by Maine CDC.

Maine CDC recommends following the Infectious Diseases Society of America (IDSA) Guidelines on the Diagnosis of COVID-19.  Read the IDSA Guidelines.

Accessing Testing At HETL.  If facility has not previously submitted specimens to HETL, please set up an account with HETL PRIOR to submitting any samples to HETL for COVID testing. To set up an account, please fax the following information to HETL at 207-287-1727: 

  •  
  • Facility name
  • Contact name
  • Facility address
  • Phone number, and
  • Confidential fax number. 

HETL will contact your facility with confirmation of receipt of the information. 
Once an account is established, specimens can be forwarded to HETL.

Testing forms and information on acceptable swabs and transport media are found on HETL's website. Download the information and forms.


Financial Relief

FINANCIAL RELIEF PROGRAM UPDATES May 22, 2020
 

New COVID-19 Provider Relief Fund FAQs
The Department of Health and Human Services (HHS) recently updated its frequently asked questions (FAQs) in response to questions about the $50 billion of the Provider Relief Fund allocated for general distribution to Medicare facilities and providers impacted by COVID-19. The FAQs provide clarification about eligibility, terms and conditions, and attestation. To be considered for additional Provider Relief Fund general distribution payments, providers must accept the HHS terms and conditions and submit revenue information by June 3, 2020. 

Paycheck Protection Program Forgiveness Application Released

The Treasury Department and Small Business Administration recently released the loan forgiveness application for the Paycheck Protection Program (PPP). This application must be completed to apply for forgiveness of a PPP loan and submitted to the lender who approved the loan. Borrowers are eligible for loan forgiveness for the following costs: payroll costs paid and payroll costs incurred during the eight-week Covered Period and certain nonpayroll costs including mortgage obligations, rent obligations and utility payments; the nonpayroll costs cannot exceed 25 percent of the total forgiveness amount.

 

Governor Mills Extend State Income Tax Payment Deadline to July 15, 2020 (March 26, 2020)

The U.S. Small Business Administration has released information about financial relief for small businesses, including private practices. For SBA Coronavirus Relief Options, click here.

Paycheck Protection Program Loan FAQs

Paycheck Protection Program Information Sheet

For additional guidance related to unemployment benefits and COVID-19, visit www.maine.gov/labor/covid-19 provided by the Maine Bureau of Unemployment.

Frequently Asked Questions – Layoffs and Unemployment Compensation in Maine (Bernstein Shur)
Newly Enacted Federal Paid Leave Law: Families First Coronavirus Response Act (Bernstein Shur)


Credentialing/Licensing

Many states have eased licensing requirements to allow more physicians to help meet the growing healthcare needs of the pandemic, including Maine (see below information regarding Gov. Mills' Executive order affecting physician licensing) Contact the Maine Board of Osteopathic Licensure for more details.
Website: https://www.maine.gov/osteo/ Phone: (207) 287-2480 Email: osteo.pfr@maine.gov

 

The DO Board also has an emergency COVID-19 locum tenens license – issued for 90 days for now. Click Here for more info. Please tell your colleagues that may be interested!

 Other Important Licensing Note: Gov. Mills Executive Order Keeps DO/MD Licenses from expiring or needing to be renewed for 30 days after the declaration of the emergency (including CME requirements): It Also:

  • Allows the expedited licensure (at no cost) of qualified retired physicians and physician assistants to provide assistance for the duration of the emergency;
  • Allows the expedited licensure (at no cost) of qualified physicians and physician assistants licensed in other jurisdictions to provide assistance for the duration of the emergency;
  • Suspends the requirement of supervision or collaboration for nurses and physician assistants for the duration of the emergency;
  • Maximizes the use of telemedicine and telehealth and eliminates the need for some in-person patient visits for the duration of the emergency by: Allowing voice-only technology to be used; and Suspending any laws or rules related to state medical record privacy and HIPAA that would interfere with the use of telemedicine and telehealth technology.

AOA Announces One-Year Extension of Board Eligibility -- April 9, 2020


Health & Wellness Resources

FrontLine WarmLine

Maine FrontLine WarmLine is a call-in system to help Maine health care workers and first responders manage the stress of serving on the front lines of the fight against COVID-19. The FrontLine WarmLine is available to clinicians and first responders from 8am to 8pm, 7 days a week by calling (207) 221-8196 or 866-367-4440. Text capability will be added soon.

 

Fitness Apps with free trial periods: 

Amanda Recommends-- "Unlocking Us" Podcast Channel by Brene Brown

Other Opportunities

Ten Percent Happier Meditation App: Free Access for Teachers, Healthcare, Grocery, and Food Delivery Workers
We want to deeply thank and recognize essential workers all over the world who are responding to the COVID-19 pandemic. If you are a teacher, healthcare, grocery, or food delivery worker and are not currently subscribed to Ten Percent Happier, we would like to support you by offering free access to the app.Visit https://www.tenpercent.com/care for more information.

Headspace is Offering all US Healthcare Professionals Who Work in Public Health Settings Free Access Through 2020. Headspace is an app that teaches you how to meditate. We’re offering all US healthcare professionals who work in public health settings free access to Headspace Plus through 2020. You’re here for them, we’re here for you. What’s going on right now is a challenge for everyone. But you, our healthcare professionals, are particularly overburdened. Headspace wants to be here for you and support you as best we can. Helping you be kind to yourself, and your own health, during this difficult time. If you are a healthcare professional, you can redeem your subscription using your National Provider Identifier (NPI) and email address. Or, if you are a nurse and you don’t have an NPI, you can provide your organization information to verify your credentials.



Calling all DO's in the greater Portland area! 

Vagabond Coffee Car is looking to Deliver FREE Cold Brew or Iced Chai to your door as a thank you for being an Essential Worker and doing EVERYTHING you can to keep us safe during the pandemic!

Click on the link below to sign up!

https://forms.gle/nnF9DyRVxQXS74Tb9

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Get Help for you and your family from UNE Students-- Have you heard about Maine COVID Sitters?:

Maine COVID Sitters are volunteering to provide childcare, pet services, and household support to those on the front line of the COVID-19 pandemic. 

A little bit about how our program works: we are a group of health care professional students (DO, MD, PA, dentistry, pharmacy, etc) in and around Portland, Maine, modeled after the MN CovidSitters. Using this intake form you can identify your needs, may they be child care, pet walking, grocery or pharmacy runs. You will then be connected with a  “pod” of 1-5 students who will provide support solely to your family. This is done to distribute the responsibilities evenly among students who still have academic requirements, and promote social distancing in accordance with CDC guidelines. You will then be able to coordinate with your pod to get the services that you require. Please know that we are students and not certified childcare providers, nor are these services affiliated with our respective institutions. 

We encourage you to share this information widely, so we will be able to reach any and all health care workers that need a helping hand.  We are attaching a document of frequently asked questions to address any concerns you may have. If you have any additional questions or concerns, you can contact us at maineCOVIDsitters@gmail.com


Ways to Volunteer for Retired DOs and other Healthcare Workers:

New York Governor Cuomo Urgently Seeks Qualified Health Professionals https://coronavirus.health.ny.gov/get-involved-how-you-can-help

Medical Professionals-- Register for Maine Responds to Assist on the Front lines:
Maine Medical Reserve Corp
Maine Responds-- Emergency Health Volunteer System

Governor Mills Launches New Online Resource Outlining Ways Mainers Can Help Mainers During COVID-19 Pandemic
March 27, 2020
In response to the extraordinary generosity of Maine people, businesses, and organizations looking to help during these challenging times, Governor Janet Mills today launched a new online resource, coronavirus.maine.gov/mainehelps, to outline ways in which Maine people can support efforts to combat the COVID-19 pandemic. 

 


Tell Your Story:

MOA Open Response Form- Tell us how COVID-19 is impacting you, your practice and your patients.

The AOA is also collecting stories from DOs to advocate nationally and provide the support you need.

A Note from the New England Osteopathic Heritage Center (April 14, 2020)
We are living in historically significant times. While the official response to the COVID-19 pandemic will
be documented through governmental and organizational records it is important that individual voices
are recorded as well. The New England Osteopathic Heritage Center is looking to collect materials that
document the personal experiences of osteopaths during this time; these might include photos, videos,
journals, narratives, artwork, video diaries or any form of expression that speaks to you. The NEOHC is
equipped to preserve any format physical or digital. Your contributions will help to inform future
researchers, osteopaths and students. For more information or to donate materials please contact
Zachary Enright, zenright@une.edu.


And Don't forget... your MOA is always here for YOU!

Please give us a call if you have questions or need help finding resources.

207-623-1101

Amanda Richards, Executive Director
arichards@mainedo.org

Claire Berger, Office Manager & Membership Coordinator
cberger@mainedo.org