Internal Updates Regarding COVID-19

Please check this page regularly as we will be making updates for Community Psychiatry Employees with information regarding the Corona Virus.

April 2, 2020  |  8:13 am

Supporting One Another and Our Communities Through COVID-19

Distribution: All Hands

Summary

– CP’s founder Dr. Mark Levine will begin offering free sessions on “Mindfulness Skills in Times of Crisis” to our people. More information to come.

– We’re building community support content on our website based on our internal Clinical expertise. See our latest blog post from Moe Gelbart, Ph.D.: Managing Children’s Anxiety Amid Our Current Health Crisis

– Reminder: Phone appointments are covered by insurance, but we should make every attempt to schedule video visits.

– CP’s medical carrier, Anthem Blue Cross is covering all costs for COVID-19 treatment and waiving co-pays for telehealth visits. The CDC has launched a Coronavirus Self-Checker to help identify when to stay home and when to seek medical help.

– Reference our Team Page to find most COVID-19 internal communications.

 

Hi Everyone,

 

I’ve been hearing a lot of wonderful stories of teams coming together and going the extra mile in this challenging time. While I always love to hear about our values in action, I am keenly aware of the stress under which many are operating as we navigate new challenges at home in addition to our work. From the bottom of my heart, thank you.

 

How can we support one another at CP?

– Community Psychiatry’s founder, Dr. Mark Levine, has offered to provide our teams with a program “Mindfulness Skills in Times of Crisis” to help us through this time. More information on that program will come in a separate communication.

– Check out Halcyon’s on-demand webinar “Mental Health First Aid Basics” to learn how to identify the signs of someone struggling, connect with people in supportive ways, and guide them to our free EAP resources. www.halcyoneap.com username: cpsych

– Social distancing doesn’t mean we shouldn’t stay connected. Set up Zoom “water-cooler chats” or “coffee dates” with your teams.

 

How can we support our community?

– We continue to build supportive content on our website leveraging our in-house clinical expertise. Check out our latest blog post from Dr. Moe Gelbart: Managing Children’s Anxiety Amid Our Current Health Crisis.

– If you are a clinician and want to contribute – content or otherwise – please let me or Dr. Priyanka know.

– If you have ideas on topics that you would find personally helpful (which means others will, too), please also feel free to share with me and I’ll pass it to the right people.

 

What’s the latest on phone visits for our patients?

– Dr. Priyanka sent a communication on March 20 (attached) letting us know that all insurance companies in California are required to cover both phone and video appointments throughout the COVID-19 emergency. Although phone appointments are covered, we should make every attempt to connect with patients over video.

 

What should I do if I have COVID-19 symptoms?

– Stay home if you are sick and contact the HR team about the new COVID-19 Paid Sick Leave.

– CP’s medical carrier, Anthem Blue Cross, is covering all costs for treating COVID-19 from April 1 through May 31, 2020. You’ll also pay nothing if you have a telehealth visit with a doctor in your plan until further notice (keep an eye on communications Anthem is sending you directly).

– The CDC has launched a Coronavirus Self-Checker to help identify when to stay home and when to seek medical help.

 

April 1, 2020  |  1:40 pm

COVID-19 Leave – What you need to know

Distribution: All Hands

We know that the impact of COVID-19 on our families, communities, and the world is stressful and confusing.  As we continue our regular operations to the extent possible, the health and safety of you and your loved ones remain our top priority.

For this reason, we have developed a policy to explain your right to take time off for certain COVID-19-related reasons.  We also have attached an informational notice, generally explaining your leave rights.  The attached policy is effective on April 1, 2020, and ends on December 31, 2020.  As you read the policy, please remember:

– If you are able to work, we will do our best to make work available to you, subject to the requirements of your job, legal restrictions and obligations, and safety considerations.

– If you or a member of your household are ill or have been exposed to someone with COVID-19, we ask that you do not come to work.  Please utilize the applicable leave and other benefits we provide you to take time off to recover and/or seek medical advice or treatment, if necessary.

– When you request leave under the attached policy, please submit documentation supporting your need for leave.  For example, if you cannot work because your child’s school is closed, please provide the email, letter, or another document that notified you of the closure.

– We are committed to complying with legal restrictions and recommended safety practices related to COVID-19.  If you are concerned that we are not complying with this commitment, please notify your supervisor or Human Resources right away.

– Beyond the attached policy, other resources are available to you if you are unable to work for COVID-19-related reasons.  California employees may visit https://covid19.ca.gov/ for more information. Michigan employees may visit https://www.michigan.gov/leo/ for more information.

– If you cannot work for any of the reasons covered by the attached policy, providing us with as much notice as you can reduces the impact on your colleagues and our patients.

– In this pandemic, circumstances are constantly changing.  So that we can best respond to these changes, please stay in good communication with us, and ensure that we have current, accurate contact information for you.

We appreciate your continued commitment and know that if we work together, we will persevere through these challenging times.

 

March 23, 2020  |  3:16 pm

Personal Resources During COVID-19 Outbreak

Distribution: All Hands

Hi Everyone,

I have been sharing resources in my e-mails to support you all through this challenging time, but I know there is a lot of information and it’s difficult to absorb all at once. This communication is to point out specific resources to help you through concerns you may have around your financial, emotional/mental, or physical health. If you would like more information about any of the below or other topics, please reach out to the HR team or let me know.

 

Financial Health

Stock markets around the world are reacting adversely to the impact COVID-19 is having on travel, consumer behavior, and most importantly global commerce. Our retirement plan advisor, Forest Capital Management (FCM), offers the following guidance:

– From an individual retirement saver perspective, always ensure your own investment elections match your risk tolerance and duration until retirement.

– Remember, making an investment change requires two decisions. When to pull money out of the stock market, and when to put it back in. Human beings are notoriously bad market timers and many people are worse off, in the long term, by making short-term retirement plan investment decisions lead by emotion.

We encourage you to talk to your personal financial advisor or reach out to Forest Capital Management if you have questions or concerns. FCM has also provided a 30-minute webinar: Coronavirus Impact on Retirement Savers.

 

Emotional/Mental Health

Our EAP through Halcyon has many resources to support your emotional and mental health and they put together a full resource page specific to coping with COVID-19 https://www.eaptoolkit.com/coronavirus. You can access services using our code: cpsych

 

Physical Health

If you are covered under Community Psychiatry’s medical plan through Anthem Blue Cross of CA, you should have received communication from them directly regarding getting access to care from home to assess your symptoms.

You can download the free Sydney Care mobile app for a quick and easy way to evaluate your symptoms. You can connect with a doctor through a LiveHealth Online video session or a Virtual Care text session right from your phone. The doctor can evaluate your symptoms, help you understand whether you’re at risk for COVID-19, and let you know whether you need to visit a local health care provider in person for COVID-19 testing. LiveHealth Online is available for members at no extra cost through June 14, 2020.

 

 

March 23, 2020  |  8:55 am

New Patient Appointments – Important Update

Hi all,

I hope everyone is getting used to doing initial evaluations and follow up appointments via telemedicine. We have heard a lot of feedback from our payers and they are letting us know how much they value continued services by all the clinicians at Community Psychiatry. There are a lot of outpatient psychiatry practices that are not able to navigate conversion to telemedicine and it has caused a significant decrease in available mental health services. We are getting calls from our payers and patients asking for new patient appointment availability, both for med management and therapy.

Considering the likelihood that we will be getting an increased number of calls at intake, I wanted to clarify how we will be handling the scheduling of new patient appointments:

– Intake will follow your preferences for new patient limit except for when there is open time in your schedule in the next 2 business days.

– If your schedule has open time in the next 2 business days, then a new patient can be scheduled above your preference. This has always been a policy at CP but we rarely needed to use it. This is one of those times.

– We can exceed your preference by one new patient.

– Intake will do their best to not schedule back to back new patients.

– Intake will continue to align patients with your geographic area unless you have identified yourself as a clinician who is willing to see patients outside of your geographic area.

– Intake will ensure that patients are aware of telemedicine requirements.

I sincerely appreciate the services you are providing to all the patients. Please feel free to reach out to me or Alicia if you have any questions or concerns.

 

Priyanka

March 20, 2020  |  6:13 pm

What a week…

Distribution: All Hands

All:

It is hard to imagine that just 10 days ago, our world was a completely different place.  I have been on calls and in meetings, seen remarkable email traffic and spoken with many of our team again and again where I have been amazed at what you have been able to do – all with one overarching goal and approach:  taking care of patients come first, even before ourselves.

In just a week, you have moved more than 90% of our visits to telemedicine.  Our offices are still operating, even when people are away.  Our payers are responding to our requests and we have gotten them to flex some of their most restrictive policies.  This is nothing short of astonishing.  And it took everyone – providers navigating new ways of working, charting, managing patients; front and back office teams working together and simply doing what needed to be done, often without needing to be asked; managers scrambling to make fast decisions, navigate absences and trying hard to keep the information flow going.

And we are all feeling the effects of the crisis in our own homes – uncertainty about the virus, taking care of kids, worrying about our loved ones.

I wish I were coming with a soothing message of the end is in sight, but we are a ways from that.  But I do want to express my gratitude for all you are doing – for your commitment to quality care, for being willing to be there for our patients, and for your selflessness, your compassion and your support of one another.  It has been good to see this team in action and it gives me great confidence we can weather whatever comes next.

To each and every one of you, thank you.

Ken

March 20, 2020  |  9:22 am

UPDATE: CP Approach to Shelter in Place Orders

Distribution: All Hands

Hi Everyone,

We want to keep you updated on the steps we are taking to respond to and limit potential exposure to the rapidly changing COVID-19 situation while continuing to serve the needs of our patients.

Meeting the needs of patients

In just five days, we have converted almost 80% of our visits from in-person to telemedicine.  This is a tremendous service to our patients who need us now, more than ever.  This took flexibility, hard work and the kind of cross-functional, cross-office cooperation that shows us at our best.

It has allowed us to work toward dramatically reducing exposure in our offices as we have reduced the traffic in our waiting rooms, worked toward social distancing, and been diligent to have our own people stay home if they have symptoms.  It has also allowed us to keep working in places where we need people in our facilities to keep functioning.

COVID-19 Task Force

We have a Task Force working throughout each day focused on safeguarding our people, protecting our patients, and maintaining the health of our business.  Changes are happening quickly, and we are using notes like these to keep you up to date on the latest.

Should I come into the office?

Unless you are exhibiting symptoms or need to stay home to care for family members, you should report as usual to your normal work location.

What about locations under shelter-in-place or other public health orders?

As a healthcare provider, we are considered an essential business, which means all of our offices are exempt from any state or county public health orders directing residents to shelter in place and businesses to cease all activities. This includes our non-clinical offices whose services support the provision of direct patient care.

Is there an option to work from home? 

At the moment, some people can work from home, but many cannot.

Our next priority is to have all provider offices operating without any patient traffic (100% virtual, with limited exceptions) by Monday, March 23.  We are also working to accommodate our team members who are considered high-risk under CDC guidelines or need to work from home to care for a child due to school and/or daycare closures.  Lastly, we may be able to transition more of our team to remote operations under certain conditions outlined below.

We expect all these measures to be temporary, but we are not sure how long we will need to work this way.

Why can’t everyone work from home?

At the moment, we do not have the equipment or systems needed to have all employees work from home and many of our people do not have a setting at home that allows for their work to continue remotely.

We have ordered more laptops and will be adding access points (VPN), Zoom licenses, and bandwidth to help, but that will take time.

What are the requirements for working remotely?

For all of our teammates, in order to work remotely, you must be able to assure continued compliance with federal and state privacy regulations, have a space that is conducive to work and to private communications where you are not interrupted or distracted by other concerns (family members, pets), and have stable access to high-speed internet.  Our providers are already operating under guidelines that assure these work requirements and we will soon publish those requirements for non-clinical team members.

What are we doing to keep our offices healthy?

Clinical locations:

Transition as many patients as possible to telemedicine appointments

Screen for symptomatic patients

Remove magazines and toys (hard to clean)

All locations:

Stay home when sick

Practice social distancing measures amongst those working in the offices (i.e., maintain a physical space of at least six feet between you and others in the office)

Wipe down frequently touched surfaces at least every two hours

Increasing cleaning frequency and depth in both our suites and in common areas

What resources can I access for self-care during this stressful time?

We’ve posted a blog on our website “Tips for Managing Anxiety and Stress During the Coronavirus Outbreak”

Reach out to our EAP provider, Halcyon, if you need someone to talk to or to explore their online resources

www.halcyoneap.com username: cpsych

HR can help with questions on leave/sick pay/PTO and outside resources

Thank you to you all for your hard work to care for our patients and each other during this unprecedented and difficult time.

March 20, 2020  |  6:00 am

Telephone Appointments

Hello everyone,

The California Department of Managed Health Care is now requiring all health insurance plans to reimburse for telemedicine visits, whether delivered by video or phone during the current COVID-19 emergency.  While we now expect to get reimbursed for all visits, we must maintain clinical standards in doing so, and we should only schedule phone visits in circumstances where video visits are not possible.

 

Please ensure you are following the below clinical guidelines:

We should make every attempt to schedule video visits with our patients as it allows for better assessment capability and meets the standard of care.

At this time, we believe conducting initial psychiatric evaluations by phone to be suboptimal and recommend use of telemedicine for initial evaluations.

That said, we should prioritize getting follow up patient care in whatever way patients can access it rather than delaying the care if there is a barrier to video visits.

For phone visits, documentation should be done in our regular follow up templates in NextGen and your notes should reflect that the visit was rendered via telemedicine, whether done by video or phone.

For phone telemedicine, please document that a phone visit was conducted and that video was not available given the circumstances.

Documentation for telemedicine visits, whether rendered via video or phone, should mirror documentation for visits rendered in-person. You are still responsible for selecting the appropriate CPT code for telemedicine visits based on time or level of service criteria.

We have made significant changes in the way we practice over the last few days and I’m glad to see that we are seeing support from our payers to increase access to care. I hope this eases some of the concerns raised in recent days about not being able to see all patients through this difficult time.

 

As always, please reach out to me if you have any questions or concerns.

Priyanka

March 17, 2020  |  5:09 pm

Important Legal Guidance Related to COVID-19

Distribution: All Providers
Copied: Entire Company
From: Laura Ashpole

Below please find important legal guidance on a few topics impacting your practice during the current COVID-19 outbreak.

Prescribing Controlled Substances Via Telemedicine

Today, the DEA published new guidance making clear that because the Secretary of Health and Human Services has declared COVID-19 a public health emergency, DEA-registered practitioners may issue controlled substance prescriptions to patients for whom they have not conducted an in-person medical evaluation, as long as the prescription is issued for a legitimate medical purpose in the usual course of professional practice by a practitioner engaged in treating the patient via telemedicine. This means that effective immediately you may prescribe clinically indicated Schedule II-V controlled substances to patients you see for an initial evaluation or follow-up visit via telemedicine, regardless of whether you’ve previously seen the patient in-person. As long as COVID-19 remains designated a public health emergency by the Secretary, this exception to the in-person medical evaluation requirement under the Ryan Haight Act applies.

Consent to Telemedicine

Per CA law, consent to telemedicine can be obtained verbally or in writing, as long as the patient’s practitioner documents that consent to telemedicine was obtained. This means that patients are not required to sign our Consent to Telemedicine form before being seen by you via telemedicine and can provide their verbal consent to telemedicine instead, as long as you document this in the patient’s chart.

HIPAA Confidentiality

As a health care provider, you are a mandated reporter of cases or suspected cases of certain diseases, including COVID-19. This means that in the event you learn that a patient of yours has tested positive for COVID-19, you are required by CA law to immediately report this information to the patient’s local health department by phone. In the event you are required to make such a report, please also be sure to complete an incident report form and submit to IncidentReporting@cpsych.com.

If you have any questions regarding the above legal guidance or any other legal questions related to COVID-19, please call or email me directly.

Best,
Laura Ashpole, General Counsel

March 16, 2020  |  7:15 pm

New Patient Evaluations via TM

Hi all,

It has been the most activity-filled day for all our clinical and operations teams. As we make a move towards minimizing exposure to COVID-19, our front office staff has made significant progress in accommodating requests for converting in-person patient appointments to telemedicine. Please take a moment when you can to recognize their efforts.

In addition to scheduling our existing patients, there is a significant need to continue seeing new patients. We take care of a very vulnerable population and they are at a significantly increased risk at this time. If we refuse to see new patients then they do not have anywhere to turn as all resources are scarce and primary care/urgent care/emergency rooms are filling with patients with symptoms of flu. I would strongly encourage all our clinicians to not limit seeing new patients via TM. I would also ask for your help in opening your schedule to patients that are outside of your geographic location for TM. While evaluating new patients via TM, there are two important factors to consider, in addition to completing an evaluation as usual:

Consent for TM appointments and consent for treatment: You can obtain verbal consent for these and document in your note.

Controlled substance prescriptions: due to the Ryan Haight Act we cannot prescribe controlled substances to a patient that has not been evaluated in person at least once. The intake team can do their best to advise patients about this before scheduling and patients will need to be understanding of this restriction.

We have received reports from several clinicians who have been seeing new patients via TM in the last few days and have not faced any significant issues so far. Please let me know if you are willing to see new patients regardless of their geographic location in California. Your willingness to help out is greatly appreciated.

Sincerely,
Priyanka

March 16, 2020  |  4:47 pm

CP Approach to Shelter-in-Place Orders

Hi Everyone,

Earlier today six Bay Area counties (Alameda, Contra Costa, Marin, Santa Clara, San Mateo, San Francisco) implemented a Shelter in Place order restricting access to non-essential services. Since healthcare operations, including mental health services are considered essential, our offices will remain open in those counties. We will, however, be working to move all patients in those offices to telemedicine as quickly as we can. This will take some time to achieve, and our goal is to transition all patients in those offices to virtual visits within a week.

In order to accomplish this, we ask all providers and staff to report as usual tomorrow. If you are unable to come into the office due to childcare or personal health concerns, please reach out to your supervisor or Regional Medical Director to discuss potential accommodations as required.

We are in the process of updating our website to include an announcement to our patients about the switch to telemedicine.

Resources

San Francisco Shelter in Place Order

Personal Well-being

Halcyon Employee Assistance Program
User name: cpsych

California wage replacement options: California EDD

Health Information

California Department of Public Health

Centers for Disease Control and Prevention

World Health Organization

March 13, 2020  |  3:00 pm

Working together in uncertain times from Ken Kelly, CEO

Hello CP:

Community Psychiatry has a long history of coming together during challenging times like the ones we face today with the coronavirus (COVID-19) pandemic. Truly, it is in these moments when we are at our best – taking care of patients and one another with excellence and compassion.

The situation with COVID-19 is rapidly changing, and we have assembled a Task Force to focus on delivering on our promises, managing through the changing environment, and assuring good communication. The Task Force has prepared business continuity plans should one or more of our offices be faced with an exposure from an individual diagnosed with the virus. This will include shifting patients to telemedicine, providing phone consultations for patients in urgent situations, and making more laptops and equipment available to facilitate remote work for both providers and non-clinical staff. We started that today with a temporary closure in our Davis office where we are seeing patients only through telemedicine through 3/18/20.

All travel outside of our team’s home areas is canceled until further notice. You are encouraged to evaluate your personal travel plans as well and if you need any supporting documentation from us to make changes, let us know.

We are committed to transparent and frequent communication to you all. I have asked Heather Prowd, Executive Director of People, to manage internal and patient-facing communications and our Medical Director, Dr. Priyanka, to communicate with all of us on clinical matters.

I’d like everyone to do the following now:

Practice good hygiene as described in several previous communications – hand washing, frequent cleaning of surfaces, making sure patients and staff have access to hand gels and cleaning supplies.

If you have symptoms (cough, sore throat, fever) – stay home. We have liberalized our leave policies, and no one will be penalized for missing work for COVID-19 related absences.

Pay increased attention to emails from Heather, Dr. Priyanka and your leaders. They will provide up to date guidance as this situation evolves.

Take care of one another. I know many of us feel the stress of the current situation, and I also know we do great things when we work together compassionately.

My thanks for your care on behalf of our patients. You really are making a difference.

Ken
CEO, Community Psychiatry

March 13, 2020  |  1:55 pm

Davis office to be telemedicine appointments only until Wednesday, March 18

We learned on March 12 that two of our team members were directly exposed to an individual who tested positive for COVID-19 while attending a conference. The individual who tested positive has never been in our office, but we closed the office for cleaning and are only seeing patients over telemedicine through March 18.

March 13, 2020  |  1:44 pm

Coronavirus Precautionary Measures from Heather Prowd

Hi Everyone,

As you are likely aware, the World Health Organization (WHO) classified COVID-19 as a pandemic earlier this week. According to the CDC “A pandemic is a global outbreak of disease. Pandemics happen when a new virus emerges to infect people and can spread between people sustainably. Because there is little to no pre-existing immunity against the new virus, it spreads worldwide.”

The spread is at different stages across the US, so the approach in each community varies. On the whole, the overarching goal is to slow the spread of COVID-19 through social distancing (such as canceling large events and closing schools) and practicing good hygiene. We have received many reports of school closures yesterday and today and remain committed to flexibility in accommodating needs to care for children. Please work directly with your supervisor to discuss your options.

COVID-19 Preparedness – Your Action Required

A survey will go out shortly to collect information from you regarding your ability to work from home and making sure we have updated contact information for everyone. Please complete the survey as soon as possible as the information you provide helps us make the necessary arrangements to support working from home where it is required.

What should I do if I think I’ve been exposed to COVID-19 and/or I have a fever, cough, or shortness of breath?

Notify your supervisor and do not come into the office.

If you have symptoms of COVID-19, the current CDC and Department of Health guidance is to call your medical provider for triage so that they can receive you with appropriate precautions in place if you do need to come into the office. Most people will be asked to stay home unless their symptoms worsen and require medical attention.

Will my insurance company cover testing for COVID-19?

Our insurance carrier, Anthem Blue Cross of CA, sent a message out to all employees recently that all costs associated with testing for COVID-19 will be covered without co-pay or deductible. With that said, available tests are limited right now and are being reserved for individuals who are showing symptoms and who are high-risk. If you do not have symptoms, it’s highly unlikely you will be tested.

What are the risks associated with COVID-19?

From the CDC:

The complete clinical picture with regard to COVID-19 is not fully known. Reported illnesses have ranged from very mild (including some with no reported symptoms) to severe, including illness resulting in death. While information so far suggests that most COVID-19 illness is mild, a report out of China suggests serious illness occurs in 16% of cases. Older people and people of all ages with severe underlying health conditions — like heart disease, lung disease, and diabetes, for example — seem to be at higher risk of developing serious COVID-19 illness.

How should we handle sick patients?

Patients and/or caregivers should be asked upon check-in whether they have traveled outside of the country within the last 14 days or have any recent fever or respiratory concerns? If yes, immediately convert the appointment to telemedicine or reschedule to a future date.

Scripts for triaging patients and re-directing them, if needed, were distributed earlier this week (see attached).

Our website was updated this morning with a notice to patients to convert to telemedicine if they have concerns around COVID-19.

Make sure that the “Cover Your Cough” sign is posted and tissue and hand sanitizer are available in the waiting room

How should we handle sick employees?

Supervisors have been advised to be very flexible with the attendance policy, both in relation to employees who are sick, have a sick family member, or have school or daycare closures.

Sick employees should stay home until they are fever-free for at least 24 hours without the use of fever-reducing or other symptom-altering medicines. Employees should notify their supervisor and stay home if they are sick.

Hygiene Reminders

If you have a cough or are sneezing, you should cover your nose and mouth with a tissue (or an elbow or shoulder if no tissue is available).

Wash your hands frequently with soap and water for at least 20 seconds.

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.

No additional disinfection beyond routine cleaning is recommended at this time.

What if I have plans to travel out of the country?

Please inform your supervisor and Human Resources if you intend to travel to a country under travel advisory by the CDC so that we can plan appropriately for your return by following guidance from the CDC.

EAP Support

If you are feeling stressed or anxious about COVID-19 and need someone to talk to, please contact our EAP provider Halcyon at 888-425-4800 or access them online at http://halcyoneap.com/ with the user name: cpsych. They offer this tip sheet on Stress During Infectious Disease Outbreaks.

Additional Links to CDC Information

How does Coronavirus spread?

The right way to wash your hands

CDC Situation Summary (updated frequently)

March 10, 2020  |  3:00 pm

Update to telemedicine policy in response to COVID-19

Hello Everyone,

Effective immediately and for the next 60 days, any patient who wishes to be seen via telemedicine, and whose provider identifies it as clinically appropriate, can do so without any prior insurance verification required. We are confident that our payors will support covering telemedicine visits in light of concerns around COVID-19. Late appointment cancellations related to COVID-19 will not be assessed cancellation fees.

We are updating our scripts for appointment reminder calls and our patient check-in process to screen for patients who have fever, cough, or shortness of breath and/or who have traveled out of the country in the past 14 days. We intend to move high-risk patients to telemedicine or reschedule their visits past their potential isolation/self-quarantine dates. A separate e-mail with scripts and decision trees for how to route patients based on their responses will be sent directly to office team members.

We are also working on updating our phone systems and website to include messaging to the community about our response to COVID-19.

Lastly, our COVID-19 Task Force is working through contingency planning to continue serving our patients should any of our locations be exposed to individuals diagnosed with COVID-19, including any of our own employees. If you have any concerns about potential exposure, please contact the Human Resources team and/or file an incident report immediately.

March 6, 2020  |  3:00 pm

Coronavirus Precautionary Measures

Hi Everyone,

As the community spread of COVID-19 increases in California and the state experienced its first COVID-19 death, we are getting more questions from our front office and provider teams about procedures related to interacting with sick or potentially sick patients in the offices. We have a task force assembled to meet on Monday, March 9 to further refine our short- and long-term risk mitigation strategy and will share an update with you all on Tuesday. In the meantime, we ask that you review the below information to help keep our offices healthy and to keep any stress related to COVID-19 at bay to the extent possible.

How widespread is COVID-19 in the US?

As of today, the US has 260 confirmed cases of COVID-19 with 14 deaths confirmed. Remember, while COVID-19 has a high transmission rate, the vast majority of people affected recover fully.

CDC’s current risk assessment as of March 3, 2020 is as follows

For most of the American public, who are unlikely to be exposed to this virus at this time, the immediate health risk from COVID-19 is considered low.

People in communities where ongoing community spread with the virus that causes COVID-19 has been reported are at elevated, though still relatively low risk of exposure.

Healthcare workers caring for patients with COVID-19 are at elevated risk of exposure.

Close contacts of persons with COVID-19 also are at elevated risk of exposure.

Travelers returning from affected international locations where community spread is occurring also are at elevated risk of exposure.

How should we handle sick patients?

**Additional information to come next week

Please add the following advisory in reminder calls:

If the patient or caregiver bringing patient to the appointment has traveled outside of country within last 14 days or has any recent fever or respiratory concerns, they should convert to a telemedicine appointment or reschedule to a future date.

Patients and/or caregivers should be asked upon check-in whether they have traveled outside of country within last 14 days or have any recent fever or respiratory concerns? If yes, immediately convert the appointment to telemedicine or reschedule to a future date. Make sure that the “Cover Your Cough” sign (attached) is posted and tissue and hand sanitizer are available in the waiting room

Hygiene Reminders

Sick employees should stay home until they are fever free for at least 24 hours without the use of fever-reducing or other symptom-altering medicines. Employees should notify their supervisor and stay home if they are sick.

Sick employees may be sent home. If you have a cough or are sneezing, you should cover your nose and mouth with a tissue (or an elbow or shoulder if no tissue is available).

Wash your hands frequently with soap and water for at least 20 seconds.

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.

No additional disinfection beyond routine cleaning is recommended at this time.

What if I have plans to travel out of the country?

Please inform your supervisor and Human Resources if you intend to travel to a country under travel advisory by the CDC so that we can plan appropriately for your return by following guidance from the CDC.

EAP Support

If you are feeling stressed or anxious about COVID-19 and need someone to talk to, please contact our EAP provider Halcyon at 888-425-4800 or access them online at http://halcyoneap.com/ with the user name: cpsych. They offer this tip sheet on Stress During Infectious Disease Outbreaks.

Additional Links to CDC Information

California Department of Public Health

Centers for Disease Control and Prevention

World Health Organization