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Evolving Article: CORONAVIRUS (COVID-19) IN THE CHIROPRACTIC OFFICE

Friday, March 27, 2020  
Posted by: Rachel Wendt
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Quick Link Resources:

Colorado Department of Public Health and Environment COVID-19 Updates
Centers for Disease Control and Prevention/CDC COVID-19 Updates
CDC Reporting Protocols for COVID-19
OSHA Control and Prevention Resources 
OSHA Guide: Preparing Workplaces for COVID-19
Colorado Department of Education School Resources
CMS FAQ Fact Sheet
Gov. Polis Press Releases
Colorado Live Blog Updates on Coronavirus
World Federation of Chiropractic Press Release

DIRECTORY OF LOCAL HEALTH DEPARTMENTS

Resources:

Small Business Disaster Loan Assistance
Disaster Loan Application Form

Webinars:
-COVID-19: What Employers Need to Know About the Families First Coronavirus Response Act
-Strategy for your COVID-19 Response
-SBA Disaster Relief/TaxCredits & Rebates for Chiropractors
-Implementing Telehealth for Chiropractic 

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Editors Note: This article is being constantly updated as new information is made available. Please continue checking this article for updates.

 

In the last few days, our nation and the entire world are coming to terms with the unprecedented health and business impact of Coronavirus. At the CCA, we have never been more acutely aware that many chiropractors operate as solo practitioners or small businesses who may feel more isolated than large group practitioners. 

In addition to providing information updates, the CCA believes it is just as important that we serve as a bridge to remind members that our chiropractic community is strong and that we are here to help in any way we can. The CCA continues to work to stay abreast of developments and to share them with our members.

UPDATE FROM DORA DATES 3.27.2020 AT 9:20AM [UPDATED 3/27/2020 2:55PM]

Regarding the order sent out this morning from the Department of Regulatory Agencies – this order reiterates our messaging yesterday. The Executive Order 009 issued by the Governor’s office “applies to all chiropractic practices and it prohibits any elective procedures”.

 

“No chiropractic procedure should be performed unless:

 

·      There is a threat to the patient’s life if the procedure is not performed;

·      There is a threat of permanent dysfunction of an extremity or organ system if the procedure is not performed;

·      There is a risk of metastasis or progression of staging of a disease or condition if the surgery is not performed; or

·      There is a risk that the patient’s condition will rapidly deteriorate if the procedure is not performed and there is a threat to life, or to an extremity or organ system, or of permanent dysfunction or disability.”

 

As the CCA has previously stated and again reiterated by DORA, unless your patient falls into the categories above, you are “advised to suspend all non-essential healthcare practices at this time”.

 

DORA’s notices further states:

 

“If the practitioner believes that one or another patient meets the narrow categories listed here, then the order and Division of Professions and Occupation’s (DPO) guidance allow for the discretion of the provider to provide a chiropractic procedure in those circumstances.”

 

Be sure to check with your malpractice insurance regarding DORA’s latest notice on coverage for your practice.

 

We understand the Dentists received their own language from the Department of Regulatory Agencies today. Read that language here.

See all updates to the licensees and consumers here.

 

Disclaimer - The Colorado Chiropractic Association is a professional association advocating for the rights of chiropractors and their patients across the state of Colorado. We are NOT a state agency or regulatory body. We are merely informing our membership regarding our understanding of what they are allowed to do during this difficult and confusing time. We are neither requiring nor recommending to you to keep your doors open nor requiring nor recommending to you to close your office at this time as we as an association cannot make this decision for you.  Should you have additional questions or concerns, we encourage you to seek independent legal advice

 

Statement directly below from DORA:


Having trouble viewing this email?View it as a Web page.

CO DORA DPO Color Logo Lock Up

Prohibition on Chiropractic Elective Procedures

Dear Chiropractor Licensee,

The Division of Professions and Occupations (DPO) under the Department of Regulatory Agencies (DORA) has received a number of inquiries concerning the application ofExecutive Order D 2020 009. This email confirms that the Governor’s executive order applies to all chiropractic practices and it prohibits any elective procedure, including any chiropractic procedure, that does not fit within the very narrow categories listed in the order.

In particular, under Executive Order D 2020 009, no chiropractic procedure should be performed unless:

  • There is a threat to the patient’s life if the procedure is not performed;
  • There is a threat of permanent dysfunction of an extremity or organ system if the procedure is not performed;
  • There is a risk of metastasis or progression of staging of a disease or condition if the surgery is not performed; or
  • There is a risk that the patient's condition will rapidly deteriorate if the procedure is not performed and there is a threat to life, or to an extremity or organ system, or of permanent dysfunction or disability.

As is apparent, there are very few, if any, chiropractic procedures that fit within the rubric of these criteria. And as a result, we expect that most chiropractic practices across the state will necessarily halt operations during the emergency. Of course, if a practitioner believes that one or another patient meets the narrow categories listed here, then the order and DPO’s guidance allow for the discretion of the provider to provide a chiropractic procedure in those circumstances.

In summary, we advise you to suspendallnon-essential healthcare practices at this time. We understand that this may cause unfortunate financial difficulties, but it is imperative that we all do our part to stop the spread of COVID-19.

 

Do not reply to this email - this is not a monitored inbox.

CO DORA DPO White Logo Lock Up

 

 

UPDATE ON GOV POLIS STAY-AT-HOME ORDER [UPDATED 3/26/2020 8:00PM]

The Colorado Chiropractic Association is continuing to help our members understand and address the COVID-19 pandemic and remain responsive to updates and changes as this situation continues to unfold.  It is our duty as an association to serve you our members, just as it is your duty to serve your patients and community.  As we continue to get questions from members or requests for additional information from the State, State regulatory agencies, counties and other local jurisdictions, we will continue to evaluate the current status and update you as appropriate.

 

Governor Polis has now issued a stay at home order for the state of Colorado. In addition, many counties and public health authorities have also issued their own stay at home orders. Each order is slightly different, but overall the same concept is there – prevent the spread of COVID-19 by limiting what can and cannot be done at this time, including by those in the health care professions.

 

This stay at home order is also subsequent to Executive Orders (EO) as published by the Governor relating to COVID-19, commencing with EO D 2020 003 Declaring a State of Emergency in Colorado due to the presence of COVID19, and subsequent orders addressing in-person gatherings (005), school attendance (007), suspension of elective medical procedures (009) and a fifty percent reduction in present work-forces in places of business (013), with these EO’s published from March 11th – March 22nd with ongoing enactment.

 

Under Colorado law, chiropractic care is an essential health benefit, and “Health Care Operations” are included as “critical” or “essential” business under the public health orders.  While the State and counties are exempting certain healthcare operations in their orders, certain healthcare providers have been prohibited from seeing patients in certain circumstances and other healthcare providers have been limited to seeing patients for only “essential” procedures. 

Recognizing that the various public health orders can all be read to include chiropractic care in the “critical” or “essential” business category of Health Care Operations, inclusion does not mean business as usual.  Governor Polis’ stay at home order requires critical businesses:

 

to comply with the guidance and directives for maintaining a clean and safe work environment issued by the Colorado Department of Public Health and Environment (CDPHE) and any applicable local health department.  Critical Businesses must comply with Social Distancing Requirements and all public health orders currently in effect to the greatest extent possible.

     

The CCA is not recommending to any of our members that they should either close or stay open.  For those that do decide to stay open, at a minimum, chiropractors should:

·       Comply with all public health orders, social distancing requirements, and CDC recommendations.

·       Continue with patient risk assessment to identify the optimal method of care delivery and prioritize a transition to telehealth services where able.

·       For patient care that is non-essential, meaning it can be delayed or reduced without an anticipated decline in patient health, such a delay or reduction should be considered.


·       For acute patient care, or care which may adversely affect the patient's health if it is postponed, such acute care should be addressed on a case by case basis, and if undertaken must be done in accordance with current public health orders and CDC guidelines.

 

This pandemic has a clear impact on your practices, staff, and families The CCA is actively working to find and encourage resources for impacted chiropractic practices. Federal efforts can be supported here.  As more resources are released in the coming days and weeks, they will be cataloged here: https://www.coloradochiropractic.org/news/493743/Evolving-Article-CORONAVIRUS-COVID-19-IN-THE-CHIROPRACTIC-OFFICE.htm.

 

Stay healthy, remain vigilant, and thank you for your continued support!

Disclaimer - The Colorado Chiropractic Association is a professional association advocating for the rights of chiropractors and their patients across the state of Colorado. We are NOT a state agency or regulatory body. We are merely informing our membership regarding our understanding of what they are allowed to do during this difficult and confusing time. We are neither requiring nor recommending to you to keep your doors open nor requiring nor recommending to you to close your office at this time as we as an association cannot make this decision for you.  Should you have additional questions or concerns, we encourage you to seek independent legal advice

GOV. POLIS STAY-AT-HOME ORDER TO START ON 3/26/2020 [UPDATED 3/25/2020 9:00PM]
Here is the direct link to the statement: https://www.colorado.gov/governor/news/gov-polis-announces-statewide-stay-home-order-provides-update-colorado-response-covid-19

Here is a direct link to the physical order: https://www.colorado.gov/governor/news/gov-polis-announces-statewide-stay-home-order-provides-update-colorado-response-covid-19

Here is a direct link to the FAQ section issued by the Colorado Department of Public Health & Environment (CDPHE): https://drive.google.com/file/d/16nO05S6q0AGBew32r0NYelifwk11uDMO/view

Public Health order here: https://drive.google.com/file/d/1IzfYUaxEf-UFSVAzkY_b9Cf1OMPOdlxH/view

We are continuing to work with our team to provide information to the profession in this time.

GOV. POLIS ISSUES STAY AT HOME ORDER TO START ON 3/26/2020 AT 8:00AM  [UPDATED 03/25/2020 4:30PM]

Dear Colorado Chiropractors -

I assure you that the CCA has been working diligently to monitor COVID-19 in the state of Colorado with our staff, Board, multiple attorneys and lobbying team to provide information for our members.

Gov. Jared Polis issued a statewide stay-at-home order Wednesday afternoon. This goes into effect starting Thursday March 26, 2020. 

The physical order issued today is set to be posted by midnight tonight. The CCA will continue to work with the Board, attorneys and lobbying team to analyze the statewide stay-at-home order once released. We will send further communication once we know more.

As we are receiving a high amount of phone calls at this time, we encourage everyone to continue to check our website first for further announcements. 

Stay healthy, remain vigilant! Thank you for your patience and continued support! 

Rachel Wendt, DC
CCA Executive Director

 

REGARDING LATEST NOTICE FROM DORA ON 3/24/2020 [UPDATED 3/24/2020 6:45 PM]

This notice has been sent to our attorney and lobbyist for review. Please stay tuned. We will send out more information as soon as we know more. We're doing everything we can to get the information to you as quickly as possible.

Original notice from DORA listed at the bottom of this page.

 DENVER STAY AT HOME ORDER ISSUED BY MAYOR HANCOCK [UPDATED 03/23/2020 6:00PM]

COVID-19 clearly presents challenges to our entire medical, business, and personal ecosystems in ways that we have never before seen. Information and recommendations are literally changing hourly, and vary vastly still from state to state and city to city and county to county.  

 

On March 23, 2020, Mayor Michael Hancock of Denver issued a “Stay at home” order effective March 24, 2020 starting at 5:00pm that will run through April 10, 2020 at 5:00pm. The order requires all individuals anywhere in the City and County of Denver to “shelter in place – that is, stay at home. […] All persons may leave their residences only for Essential Actives, Essential Governmental Functions, or to operate Essential Businesses.[…] Essential healthcare operations include “Hospitals, clinics and walk-in facilities…This exemption shall be construed broadly to avoid any impacts to the delivery of healthcare, broadly defined.”. You can read the full order here.

 

We have reviewed the text and concluded that chiropractic clinics are exempted for the delivery of healthcare. Therefore, chiropractic clinics can treat patients and patients can visit your clinic if the chiropractic clinic chooses to remain open.

 

The CCA understands the above applies to the City and County of Denver at this time and encourages all chiropractors to keep an eye on their local government agency for any updates or changes.

 

We do understand similar orders have been issued for the counties of San Miguel, Gunnison, Summit and Eagle. Links to the orders can be found by clicking on the individual county below:

UPDATED 3/23/2020 - 7:30PM

UPDATED 3/24/2020 - 6:00 PM

UPDATED 3/24/2020 - 3:00 PM

 

For a list of all counties with stay at home orders, click here: https://kdvr.com/news/coronavirus/list-all-of-the-colorado-counties-with-stay-at-home-orders/

 

There are 64 counties in Colorado. County Commissioners are responsible for each county. We will continue to update this list as information becomes available. 

 

The CCA encourages all chiropractors to stay up-to-date with recommendations and protocols established by the World Health Organization (WHO), the U.S. Centers of Disease Control and Prevention (CDC), local health departments, and the Colorado Chiropractic Board of Examiners rules, regulations, and policies in regard to COVID-19.  Additionally, the CCA encourages chiropractors and patients to follow any specific public health and safety directions from state and federal leaders. 

 

In light of this, we look for common, practical steps we can all take to mitigate the damage to our population. Here are our current recommendations for chiropractors, knowing some of these may change in the days to come.  

TO STAY OPEN OR TO CLOSE:

Please follow the your state, local and federal health authorities in this regard.

 

Disclaimer - The Colorado Chiropractic Association is a professional association advocating for the rights of chiropractors and their patients across the state of Colorado. We are NOT a state agency or regulatory body. We are merely informing our membership regarding what they are allowed to do during this difficult and confusing time. We are neither requiring or recommending you to keep your doors open nor requiring or recommending you to close your office at this time as we as an association cannot make this decision for you. Only the government, either state or federally, can make a mandate. When and/or if there is a mandate by either the state or federal government, we will inform our members and continue to disseminate information to Colorado doctors as it becomes available.

-Colorado Department of Public Health & Environment:

https://www.colorado.gov/cdphe

 

-CDC link:
https://www.cdc.gov/coronavirus/2019-ncov/index.html
 
-Directory of Local Health Departments
https://www.naccho.org/membership/lhd-directory
 
 
Generally speaking, if you choose not to close:

  1. Non-essential visits from patients should very clearly be postponed, and group visits are ill-advised. The primary means of transmission of the coronaviruses is through close personal contact, especially among groups and in spaces that cannot be adequately cleaned and monitored. The more people that pass through your offices, the greater the chances that one will have coronavirus or have come in contact with someone who has coronavirus.
  2. ALL patients should be prescreened by phone, before they come to their appointments, for any signs of illness, and for travel or exposure risks as outlined by public health authorities. No patient should arrive at your clinic ill. If a patient is ill on prescreening, they should remain home or be sent to the hospital if illness is severe. 
  3. Counsel patients by phone regarding health maintenance, sick care, and what to do if they’re feeling they have symptoms of coronavirus. 
  4. Encourage respiratory etiquette – including covering coughs and sneezes. Provide customers and the public with tissues and trash receptacles.
  5. Avoid having patients congregate in the waiting areas. Patients should be taken directly from the entryway to their treatment rooms if at all possible. Ensure social distancing recommendation of 6 (SIX) feet between people is applied to people who are in waiting areas. Many are using “mobile check-in” where the patient will call the office to check-in upon arrival, wait in their car and the office will call them when the doctor is ready to see the patient. 
  6. Stagger appointments so that patients do not overlap and wipe down any surfaces that may have been contacted during the visit with appropriate cleaning products. High volume clinics should decrease their volume if they cannot assure patient separation.
  7. Remove non-essential items that could be vectors for virus transmission from the waiting room, treatment rooms, and other common areas. These are items such as magazines, extra pens, papers, in the waiting area etc. Decreasing the number of points of contact for contaminants will decrease the risk of transmission and make cleaning procedures more effective.
  8. Gov. Polis issued Executive Order D2020 013 on March 22, 2020 –This order requires employers to cut 50% of their in-person workforce. Strategies to execute this order include scheduling your staff in shifts, if you can. All staff must remain 6 (SIX) feet apart when they are working under the same office.
  9. All non-essential services in your office should be halted for the time being.
  10. Per our previous recommendation, the CCA recommends halting all elective massage therapy in your office for the time being. Massage therapists in your office may continue to work if the treatment is part of an active treatment plan as determined by a licensed doctor or for medical treatment as determined by a licensed doctor, however the ultimate decision should be discussed with your current massage therapist.
  11. Maintain regular housekeeping practice, including routine cleaning and disinfecting of surfaces, equipment and other elements of the office. Discourage employees from sharing computers and phones if at all possible.
  12. Promote frequent hand washing for at least 20 seconds by employees and patients.
  13. Detailed guidance on workplace preparedness can also be found from OSHA: https://www.osha.gov/Publications/OSHA3990.pdf

 
IN ALL CIRCUMSTANCES, OBSERVE THE BASICS!

● Avoid close contact with people who are sick. 
● Avoid touching your eyes, nose, and mouth with unwashed hands. 
● Wash your hands often with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer that contains 60%-90% alcohol if soap and water are not available. COVID-19 can transmit through both respiratory droplets and via stool, so careful handwashing is critical. 
● Cover coughs and sneezes with a tissue, then throw it in the trash can. Cough or sneeze into your elbow and not your hand if you do not have a tissue available. If you contaminate your hand and then touch other objects, you will spread the virus. Wash your hands for at least 20 seconds if you cough.


INFORMATION ON INCUBATION FROM PUBMED*

“The median incubation period was estimated to be 5.1 days, and 97.5% of those who develop symptoms will do so within 11.5 days (CI, 8.2 to 15.6 days) of infection. These estimates imply that, under conservative assumptions, 101 out of every 10 000 cases (99th percentile, 482) will develop symptoms after 14 days of active monitoring or quarantine.” Read more on this here

CALL YOUR SENATORS NOW TO ENSURE RELIEF FOR PROVIDERS, INCLUDING CHIROPRACTORS [UPDATED 3/23/2020 9:00AM]

Background: Senators Michael Bennet (D-Colo.) and John Barrasso (R-Wyo.) have introduced the Immediate Relief for Rural Facilities and Providers Act, new legislation to address the impending crisis facing our health care system as the spread of COVID-19 increasingly strains hospitals and providers across the country. Bennet and Barrasso’s new legislation would extend a lifeline to rural hospitals, and all providers and the millions of Americans who depend on them for health care.

Among help for rural hospitals, the Bennet/Barrasso legislation will:

  • Provide Stabilization and Relief for all Providers, including chiropractors with an emergency, one-time grant for all providers and ambulatory surgery centers equal to their total payroll from January 1 - April 1, 2019 
  • Provide Funding for all Physicians and Providers, including chiropractors by authorizing the Small Business Administration to provide low interest loans to providers and ambulatory surgery centers at a 0.25% interest rate that will not accrue until two years after the COVID-19 pandemic has ended.

What you need to do:  Call the senate switchboard at 202-224-3121 or find your state senators’ office here and ask them “to include the Immediate Relief for Rural Facilities and Providers Act, sponsored by senators Bennet and Barrasso, in the current Senate COVID-19 relief package.”

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RESOURCES FOR DOCTORS [UPDATED 03/20/2020 7:00PM]
COVID19 & HIPAA NOTICE FROM CMS
ChiroArmor Phone Screening for COVID-19
ChiroArmor "What to know about COVID-19"
ChiroArmor Cleaning Procedure Info Form
ChiroArmor Hand Washing Procedure Form

DORA COVID-19 UPDATES FOR LICENSEES AND CONSUMERS [UPDATED 03/20/2020 6:15PM]

CLICK HERE (link below) for the latest updates for licensees in Colorado:
https://www.colorado.gov/pacific/dora/covid-19-updates-licensees-and-consumers?utm_medium=email&utm_source=govdelivery

MASSAGE THERAPISTS IN THE CHIROPRACTIC OFFICE [UPDATED 3/20/2020 6:15PM]
The public health crisis has generated more questions than answer for medical professionals in Colorado and throughout our nation.  The CCA is doing all we can to stay on top of this rapidly moving pandemic and is striving to keep you informed.

On March 19, 2020, Colorado Governor Polis ordered the Temporary Cessation of All Elective and Non-Essential Surgeries and Procedures and Preserving Personal Protective Equipment and Ventilators in ColoradoRead the full order here.

 

Since Governor Polis’ press release was announced, the CCA reached out to other health care organizations, various state and local agencies, including the Department of Regulatory Agencies (DORA) to share and gather information.  At this time, the CCA recommends that all chiropractic practices who have massage therapy in their office to postpone performing elective massage therapy at the present time.

 

The Colorado Chiropractic Association is in agreement with the Federation of Chiropractic Licensing Boards in affirming doctors of chiropractic are essential health care providers, ready to serve their communities both in daily care and in times of urgent need. Chiropractors, other health care practitioners, and staff are a part of the health care community and have a responsibility for the prevention and mitigation efforts during this pandemic while managing the urgent needs of patients during this crisis. Everyone is at risk for the transmission and contraction of COVID-19. Our top priority must be the health of the public and your patients.

 

The COVID-19 pandemic is a public health emergency and chiropractors have an important role to play. In light of what many expect will be heavy burdens on other segments of the health care system, chiropractors have a special duty to continue to provide the care that patients need, and cannot receive elsewhere. Chiropractors have the ability to prevent patients from treating themselves, self-diagnosing and seeking emergency facilities.

 

The CCA encourages all chiropractors to stay up-to-date with recommendations and protocols established by the World Health Organization (WHO), the U.S. Centers of Disease Control and Prevention (CDC), local health departments, and the Colorado Chiropractic Board of Examiners rules, regulations, and policies in regard to COVID-19.  Additionally, the CCA encourages chiropractors and patients to follow any specific public health and safety directions from state and federal leaders. 

 

The CCA is providing this for informational purposes only. We do NOT have any knowledge of pending or future governmental action that may hypothetically require offices to close. The CCA continues to communicate with state agencies and other officials and the CCA will continue to disseminate information to its members as soon as possible.

 

RESOURCES FOR TELEHEALTH [UPDATED 3/20/2020 5:00PM]

Courtesy of David Klein here is an update: All, Hopefully this article will prove helpful regarding TELEHEALTH and home care https://paydc.com/2020/03/19/telehealth-and-home-care-for-chiropractic-and-physical-medicine-practices/?fbclid=IwAR00PLdPwXrrJasQ9VcKruaxQ3O8jGG9czR0PrbgX0iPbF02bZH6bT5O_8g

 

Zoom has HIPAA compliant software. To learn more, visit https://zoom.us/healthcare

 

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FAKE ONLINE CORONAVIRUS MAP DELIVERS WELL-KNOWN MALWARE  [UPDATED 3/19/2020 12:00PM] 

The U.S. Dept. of Health & Human Services and the U.S. Health Sector Cybersecurity Coordination Center have posted a notice about a malicious website related to the coronavirus.  The website pretending to be the live map for Coronavirus COVID-19 Global Cases by Johns Hopkins University is circulating on the internet waiting for unwitting internet users to visit the website. Visiting the website infects the user with the AZORult trojan, an information stealing program which can exfiltrate a variety of sensitive data. It is likely being spread via infected email attachments, malicious online advertisements, and social engineering. Furthermore, anyone searching the internet for a Coronavirus map could unwittingly navigate to this malicious website. 


We are advised that end users should be warned about this cybersecurity risk and security teams should blacklist any indicators associated with this specific threat. Read the actual notice here.

 

COLORADO HEALTH OFFICIALS BAN PUBLIC GATHERINGS OF MORE THAN 10 PEOPEL WITH SEVERAL EXCEPTIONS [UPDATE 3/19/2020 9:45AM]

The Colorado Department of Public Health and Environment announced Wednesday a statewide ban on public gatherings of more than 10 people. There are several exceptions to the order.

The order goes into effect 12:01 a.m. Thursday. It is set to last for 30 days.

Health officials are implementing the ban in an effort to slow the spread of the coronavirus.

There will be exemptions for grocery and retail stores, airports, bus and train stations, health care facilities, pharmacies and other places where people may be in transit for essential goods and services.

Restaurants following the already-imposed takeout and delivery guidelines will also be exempt.

Office environments, government buildings where essential government services are offered, and factories where at least 10 people are present but social distancing of 6 feet is in effect will also all be exempt.  

“We are acting boldly and swiftly together to protect the health and safety of all Coloradans. The science and data tells us this will get worse before it gets better,” Polis said in a statement. “We are in this together and the state is taking the necessary actions to slow the spread of this disease.”

The governor also suspended in-person learning at all schools from March 23 through April 17.

Finally, the governor suspended all downhill ski area operations through April 6.

_________________________________________________________________

 

IMPACT OF CORONAVIRUS ON THE LEGISLATIVE SESSION FROM CCA'S LOBBYING TEAM [UPDATED 3/18/2020 6:00PM]

On Tuesday March 10th Gov. Polis declared a state of emergency in Colorado over the Coronavirus outbreak. On Friday the Governor urged Coloradans to avoid gatherings exceeding 250 people. Schools, sporting events, concerts and other public events have all been effected.  

 
The Executive Committee of the Colorado Legislature met this afternoon at 4pm. They have prepared two bipartisan resolutions, one to recess starting Saturday March 14 through March 30 at 10:00 am. The other requesting legal guidance from the Colorado Supreme Court whether the constitutional requirement that the legislature only meet for 120 days in general session needs to be consecutive days or not.

During the two week recess, House and Senate staff will be doing an assessment of legislative work that has to be completed before they adjourn sine die. This will allow House and Senate leadership to have a list of outstanding items to consider when they come back into session.

Legislative Leadership has also waived all of the deadlines for the introduction and passage of the budget and the School Finance Act. Taking a two week recess will allow the JBC and their staff to really take time to assess the impact on the budget and the revenue forecast. To that end the Joint Budget Committee will still be hearing the March revenue forecast on Monday March 16th, as well as finishing figure setting and comebacks by EOD Wednesday March 18th. 

 

We will continue to monitor the situation and will inform you of any changes as we hear them.  Please feel free to let us know if you have any questions.

_________________________________________________________________

 

CCA OFFICE [UPDATED 3/17/2020 5:30PM]
The CCA office remains open, although some of our staff will be working remotely. We are committed to assisting our members and serving your needs. If you have a question, please call the office at 303-755-9011 or send us an email at CCA@ColoradoChiropractic.org. We urge you to keep checking the “Latest New” post on our homepage for the latest updates on COVID-19 as it relates to the state of Colorado.

IMPACT OF CORONAVIRUS ON SCHEDULED CCA EVENT PROGRAMS [UPDATED 3/17/2020 5:30PM]
President Trump recently announced coronavirus guidelines, recommending that all Americans avoid group gatherings of more than 10 people. CCA continues to monitor the rapidly changing situation related to the spread of COVID-19. We understand that concerns for health, safety, and the impact on meeting attendance, among other issues, are affecting our members.

The CCA is looking at hosting the April 11, 2020 PPE remotely and will have registration open for that specific event shortly. We are continuing to monitor the state of Colorado and will post updates to each event as we move forward. 

HIPAA REMINDER - COVID-19 FROM NCMIC [UPDATED 3/17/2020 10:00AM] 

Original article here from NCMIC

While social media is blowing up with so called “facts” about the Coronavirus, something that every clinician needs to remember is that following HIPAA  guidelines is paramount.

As an example, when an Ohio case was announced yesterday, I received a call from a friend telling me that the man testing positive lives about three miles from a family member.  Unless that individual or his family member shared that information, this type of information should not be out in “air waves”. Let’s be clear, the 18 Protected Health Information (PHI) identifiers include:

•             Names

•             Dates, except year

•             Telephone numbers

•             Geographic data

•             FAX numbers

•             Social Security numbers

•             Email addresses

•             Medical record numbers

•             Account numbers

•             Health plan beneficiary numbers

•             Certificate/license numbers

•             Vehicle identifiers and serial numbers including license plates

•             Web URLs

•             Device identifiers and serial numbers

•             Internet protocol addresses

•             Full face photos and comparable images

•             Biometric identifiers (i.e. retinal scan, fingerprints)

•             Any unique identifying number or code

HIPAA has a special guidance section for what information and to whom that information can be released during an emergency situation. You can review these guidelines at: https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/decision-tool-overview/index.html  

Office of Civil Rights

Always remember the Office of Civil Rights (OCR) is very clear in their message:  there needs to be a balance between protecting the privacy of patient PHI (protected health information) and the appropriate use and disclosure of information to protect the public.

 

X-RAY REGULATORY REQUIREMENTS DURING COVID-19 [UPDATED 3/17/2020 5:15PM]

COVID-19 Extensions for Certification Evaluation of Radiation Machines and Facilities Subject to 6 CCR 1007-1 Part 02 and 06

In the interest of preventing transmission of COVID-19 the Colorado Department of Public Health and Environment is exercising regulatory flexibility and providing an extension to the requirements for select radiation machine and facility certification evaluations. 

For those radiation machines and facilities that require an initial certification evaluation within 90 days of use as per Section 6.6.1.2 the department is providing an additional 90 days for the completion of the initial evaluation.  Please note, the requirements of 2.5.1.5 and 2.5.1.6 still remain in force and an evaluation of those machines prior to being used to perform any human examination is still required.

Radiation machines and facilities that are due for a certification evaluation, as per Section 2.5 of the Regulations, during the months of March, April, May and June of 2020 shall be granted a 6 month extension to complete that evaluation.

Please feel free to contact the X-ray Certification Unit with any questions at 303-692-3448 
or via email at cdphe.hmxraycomments@state.co.us.  

 

This information is also posted on the website at: https://www.colorado.gov/pacific/cdphe/xray

ADVERTISING [UPDATED 3/17/2020 11:30AM]

Note also, the CCA strongly recommends that our members exercise extreme care in advertising at this time and refrain from making claims that are not substantiated by peer-reviewed, empirical evidence.  Regulators are on high alert for the exploitation of the pandemic and may view as grounds for license suspension any claim that certain treatments can prevent or cure COVID-19 until more is known about the virus. We do understand the federal government, including the FTC and FDA are on high alert at this time.

While we understand that each business has the right to make their own decisions when it comes to advertising, we would like to highlight Rule 1.12 from the Department of Regulatory Agencies for those docs who may not be familiar. Find the full list of Statute, Rules and Policies here.

1.12 Misleading, Deceptive, False, or Unethical Advertising

A. Chiropractors are responsible for the content of their advertising.

B. The following types of advertising constitute misleading, deceptive, false, or unethical advertising pursuant to sections 12-215-115(1)(h), (o) and (5):

1. The misleading use of a claim regarding board certification or of an unearned or nonhealth degree in any advertisement or any claim that is likely to cause confusion or misunderstanding as to the credentials, education, or licensure of a healthcare professional;

2. Advertising that has the effect of intimidating or exerting undue pressure;

3. Advertising that uses unsubstantiated testimonials;

4. Advertising that creates an unjustified expectation or guarantees a cure;

5. Advertising that offers gratuitous services or discounts in a manner that is deceiving to the public;

6. Advertising of free or discounted x-ray services; or

7. Advertising that is otherwise misleading, deceptive, or false.

8. It must be clear to the public that the advertisement is from a doctor of chiropractic.

C. At the time any type of advertisement is placed, the chiropractor must possess, scientifically valid research that would substantiate the truthfulness of any assertion, omission, or claim set forth in the advertisement. Scientifically valid research includes applied research, basic research, and field-initiated research in which the rationale, design, and interpretation are soundly developed in accordance with principles of scientific research.

 

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QUESTIONS FROM MEMBERS [UPDATED 3/16/2020 10:30AM]

The following are the most common questions we are receiving in the CCA office at this time:

  • “Essential services”:  whether services of chiropractors are deemed to be “essential services” that may remain open in the event that the government declares that all businesses close:  At this time, we do not know which governmental branch may make such a declaration or what the guidelines will be.  If and when a “close order” happens, we will carefully review and update this information.
  • Closing of offices:  at this time, the CCA recommends that doctors use their best professional judgment, applying relevant guidelines, such as those of the CDC and the White House Coronavirus Task Force, to determine whether to close offices. 
  • Offices remaining open:  for offices that remain open, the CCA recommends:

· Apply all CDC guidelines regarding the screening of patients who call with concerns that they may be infected with Coronavirus (see link below) and refer the patient to their county health department;

· Reschedule staff and patients so that no more than 10 persons are in the office at a time;

· Conduct “pre-screening” of staff at the beginning of the shift and prior to any patient contact, using CDC guidelines for assessing the presence of symptoms and risk, and sending staff home or referring for testing where appropriate.  The CDPHE recommends these steps for nursing facilities, and the CCA believes this is a prudent practice in physician offices;

· Apply all CDC guidance and standard of care regarding infection prevention (see links below), including using disposable surgical gloves for each patient and regular disinfection of patient surfaces and facilities;

· Suspend restrictions on cancellations and do not apply penalties for cancellations and no-shows;

· Begin to plan for the possibility of remote employment; i.e., consider whether some of your staff, such as billers, could work from home.

· There is no general order or algorithm to determine whether health care offices should close at this time.  However, the CCA recommends closing any office that does not have staff or resources to maintain strict CDC disinfecting protocols, social distancing, and other prevention tools. Chiropractors may want to review their release to assist in deciding whether to remain open or temporarily close. It is ultimately your business decision to close. We will continue to monitor updates from Gov. Polis as it relates to the closure of business.

  • Cancellation of events:  based on the White House Coronavirus Task Force guideline to cancel events with more than 10 people, the CCA strongly suggests chiropractic offices should cancel all such events, such as health fairs or informational seminars, for the foreseeable future.
  • Home office visits: The CCA recommends first, you should check your insurance contract to see if this is covered outside the physical chiropractic office. Second, you should check with your malpractice insurance to see if a visit is covered at a remote office. Third, you should be cautious on the patient's symptoms and all persons in the home prior to entry as well as practice and follow all CDC guidelines on proper protocol as it relates to disinfecting and protecting all chiropractic equipment used.
  • Liability: Example: Am I liable if I come in contact with COVID-19, continue to treat patients asymptomatically, then unknowingly infect a patient with COVID-19? The CCA recommends practitioners should closely monitor and follow their State / County / City / Legislative and Regulatory (DORA) recommendations and directives. NCMIC like most agencies has an exclusion for communicable diseases.  In other words, if someone sues you for giving them ANY communicable disease, there is no coverage under your malpractice policy. Please check you malpractice coverage.


MARCH 16, 2020 [UPDATED 3/16/2020 10:00AM]

Colorado Gov. Jared Polis declared a state of emergency on March 10 in response to recent cases of COVID-19 in the state.

The new strain of coronavirus began popping up in the United States in February. On March 5, the first case was announced in Colorado. As of Tuesday morning, Polis said three new cases of COVID-19 have been confirmed in the state, bringing the total number to 15.

On March 15, 2020, the Colorado Department of Public Health and Environment (CDPHE) following Centers for Disease Control and Prevention (CDC) guidance, recommends that event organizers (groups or individuals) cancel or postpone in-person events that consist of 50 people or more. The CDPHE request can be found here.

 

CMS RELEASE FOR PROVIDERS [UPDATED 3/16/2020]

On March 12, 2020, the Centers for Medicare & Medicaid Services (CMS) posted Frequently Asked Questions (FAQs) to the Medicaid.gov website to aid state Medicaid and Children’s Health Insurance Program (CHIP) agencies in their response to the 2019 Novel Coronavirus (COVID-19) outbreak. CMS is taking this action in its continuing efforts to protect the health and safety of providers and patients, including those who are covered by Medicaid and CHIP.

A press release with further information can be found here: https://www.cms.gov/newsroom/press-releases/cms-publishes-first-set-covid-19-frequently-asked-questions-faqs-state-medicaid-and-childrens-health

The COVID-19 FAQs for State Medicaid and CHIP agencies can be found here: https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/covid19/index.html

These FAQs, and earlier CMS actions in response to the COVID-19 virus, are part of the ongoing White House Task Force efforts. To keep up with the important work CMS is doing in response to COVID-19, please visit the Current Emergencies Website. 

 

The Center for Medicaid and Medicare Services (CMS) has issued a number of releases containing information for disease mitigation in specific settings. The following link is a good, detailed strategy for community mitigation based on the level of community transmission:  https://www.cdc.gov/coronavirus/2019-ncov/downloads/community-mitigation-strategy.pdf.

 

As the CCA will continue to monitor CDC and other resources, we again encourage members to regularly check CDC and CDPHE information in the links below, as they are revised to update the public, healthcare providers, and employers on this rapidly developing issue. 

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TEMPLATE LETTER FOR PATIENTS [UPDATED 3/13/2020]

 

Also, the CCA is making available to our members a template letter for our doctors to send to their patients regarding the COVID-19 virus (coronavirus).  The letter explains the steps you are taking in your offices to protect your patients, as well as your recommendations for measures your patients should take outside of the office. The template will need to be tailored to reflect your individual office procedures and policies. The template letter can be found here.


On March 11, 2020, the World Health Organization declared COVID-19 a pandemic, the first to be caused by coronavirus.  The WHO director said hope remains that COVID-19 can be curtailed, and he urged countries to take action now to stop the disease.

The CCA has been carefully monitoring the CDC and other information on the COVID-19 (coronavirus 2019).  Although the CCA 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, the State of Colorado, and other reliable sources.  The spread of this virus has particular implications for chiropractic offices, as both health care providers and as employers. 

The COVID-19 outbreak is rapidly evolving, and information is constantly changing.  For that reason, the CCA strongly recommends that chiropractors stay up to date with guidance issued by the U.S. Centers for Disease Control and Prevention (CDC).  The CDC has provided a number of links (end of the article below) to general information about the virus, as well as information for healthcare professionals and businesses.  CDC updates these sites continually as information becomes available.   The Colorado Department of Public Health and Environment (CDPHE)) has also created a webpage (end of the article below) with coronavirus updates, including statistics on persons under investigation and positive cases in Colorado.  The CDPHE page contains links to other recommendations, such as ways to reduce community spread and guidance for businesses, travel, and households.

CDC INFORMATION FOR CLINICIANS [UPDATED 3/13/2020]

The CDC presented a one-hour live webinar for clinicians on March 5th. It is now available at no cost on-demand here.  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, handwashing, 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:
  • Fever
  • Acute respiratory illness – cough, shortness of breath, difficulty breathing
  • Myalgia
  • Fatigue
  • Persons over 65 years of age
  • Persons with underlying conditions and comorbidities

 

CDC INFORMATION FOR EMPLOYERS [UPDATED 3/13/2020]

The CDC recommends the following strategies for employers to use now.  The CCA has summarized the strategies here but strongly urges clinic owners to click on the link at the end of this article to review the details provided for businesses by the CDC:

  • 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.
  • 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.

 

 

EXTERNAL LINKS

General Information on Coronavirus (COVID-19)

Healthcare Professionals

Businesses

Colorado Department of Public Heath & Environment Coronavirus Updates

NCMIC Resources

 

CO-HELP is Colorado’s call line for the novel coronavirus (COVID-19). People who have general questions about COVID-19 can call CO HELP at 303-389-1687 or 1-877-462-2911, for answers in many languages, or email them at COHELP@RMPDC.org for answers in English.

 

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NOTICES FROM THE DEPARTMENT OF REGULATORY AGENCIES:

 

 

 

 

Friday, March 13, 2020

Dear Healthcare Professional:

The Division of Professions and Occupations has assembled theattached documentdetailing existing provisions and exemptions that can be used to bolster the healthcare workforce as part of the state’s ongoing efforts to combat the spread of Coronavirus.

This guidance will allow individuals in the healthcare field who hold licenses in other states, who have an inactive license, or who have allowed their license to expire in Colorado to immediately resume work within their scope of practice, provided their out-of-state, inactive or expired license is/was in good standing.

These measures will bolster the workforce’s ability to test, treat and care for patients amid this growing crisis by augmenting the number of qualified professionals while creating the ability to backfill positions, as necessary.

The temporary licensure provisions are part of an emergency directive from Gov. Jared Polis to provide support to a taxed healthcare system.

Healthcare providers who are being called upon to assist in caring for patients, but who are wondering if they can lawfully practice without a current Colorado license, should consider the attached exemptions before resuming work in the field, and should contact the Division with questions.

Please monitor your email for communications regarding any future regulatory measures aimed at combating the spread of COVID-19 in Colorado.

 

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Friday, March 13, 2020

Dear Licensee,

The Division of Professions and Occupations (DPO) is actively assessing daily events related to the spread of COVID-19 in our state. The Division understands that many of our licensees are on the front lines of identifying, monitoring and caring for patients, or could come in contact with those who have become ill, and wants to ensure that each of you are equipped with the latest information to combat the spread of the virus while ensuring your safety on the job.

The Division currently is in the process of conducting assessments of its program areas and customer service functions to identify where additional resources may be needed or redirected. Potential action to address requests and concerns regarding Division and Board services are under review. Considerations include expedited licensure, telehealth policies and rules, ongoing and potential virtual public meetings and other external events. We appreciate your patience as these assessments continue, and will be sending updated communications if and when they are required.

In the meantime, we would like to stress the importance of continually checking for updates from theCenter for Disease Controland our stateDepartment of Public Health and Environment. CDPHE’s call line (303-389-1687 or 1-877-462-2911) is available with information in multiple languages.

CDPHE is providing ongoing information specific tohealthcare agencies and providers, and has set up a specific provider hotline (303-692-2700 weekdays from 8:30-5:00 pm and 303-370-9395 after hours and weekends). We encourage you to consult these and other resources, and to reach out with questions or concerns.

We truly appreciate all you are doing for Coloradans at this time, and will do all we can to ensure that you have the necessary tools and information to continue your work.

With regards,

 

Ronne Hines Director, Division of Professions and Occupations

 

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EDO Logo


NEWS RELEASE

For Immediate Release: March 18, 2020

Media Contact

Jill Sarmo
P: 303-204-1766
Jillian.Sarmo@state.co.us
www.dora.colorado.gov

DORA releases emergency measures for healthcare professional licensing in response to COVID-19

 

DENVER -In response to the recent COVID-19 developments anddirectives given by Governor Polis, the Division of Professions and Occupations under the Department of Regulatory Agencies (DORA) will expedite licensing to increase workforce capacity to address this emergency. This includes the temporary suspension of the application of laws, rules and policies that will allow the State to expand its testing capacity for Coronavirus and ensure ongoing business continuity in the delivery of healthcare services.

“This virus will put a strain on our systems and healthcare worker heroes on the front lines of this battle. In order to quickly scale up our healthcare workforce capacity, I directed the Colorado Department of Regulatory Agencies to cut through the red tape on licensing our medical professionals so that medical professionals with licenses in other states can practice immediately in Colorado,”said Governor Polis.

“DORA divisions have been working diligently to address the many questions and concerns of Colorado professionals in the healthcare industry, and we are thrilled that so many people have already stepped up to answer Governor Polis’s call for assistance,”stated DORA Executive Director Patty Salazar.“Our divisions will continue to explore ways that we can do our part to address this crisis in the coming days and weeks, and we want both our licensees and Colorado consumers to know that we are here to help.”

The emergency measures include key provisions for renewal waivers, expedited licensure, waiver of supervision requirements, and expanded scope of practice for select health care providers such as physicians, physician assistants, nurses, pharmacists, pharmacy technicians, and respiratory therapists, including, but not limited to:

  • Waiving licensing requirements and rules to allow for late renewals as well as reinstatements and reactivations during the emergency period of volunteer nurses and qualified licensed providers from out of state;
  • Waiving limitations on clinical instruction via simulation;
  • Expanding scope of practice for physician assistants and nurses;
  • Expanding opportunities for telemedicine;
  • Allowing pharmacists to administer vaccines.

The full list of emergency measures can be viewedhere.

It is anticipated the suspension of these laws and rules, particularly as they apply to out-of-state practitioners, shall last until the expiration ofExecutive Order D 2020-003, or unless additional directives are received by the Governor.

For healthcare professionals seeking to get involved, Governor Polis has just announcedHelpColoradoNow.orgas a website for those Coloradans hoping to volunteer or assist in the COVID-19 response in a variety of ways.

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The Department of Regulatory Agencies (DORA) is dedicated to preserving the integrity of the marketplace and is committed to promoting a fair and competitive business environment in Colorado. Consumer protection is our mission. Visitwww.dora.colorado.govfor more information or call 303-894-7855/toll free 1-800-886-7675.

 

 

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 Colorado Department of Regulatory Agencies sent this bulletin at 03/23/2020 11:03 AM MDT

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Personal Protective Equipment Needed for COVID-19 Response

Dear Licensee:

The following is a communication that the Division of Professions and Occupations at DORA is distributing on behalf of Colorado Governor Jared Polis. Please note, DORA is not currently accepting or distributing these items, and all contributions as well as requests for PPE will need to adhere to the instructions outlined in the Governor's letter, below.

Thank you for all you are doing in our state's time of need.

Respectfully,

Ronne Hines

Director, Division of Professions and Occupations


ALetter to Colorado Healthcare and Health Services Professionals from Governor Jared Polis

As the State of Colorado comes together to respond to Conoravirus disease 2019 (COVID-19) we are faced with a shortage of Personal Protective Equipment (PPE) for our health care workforce. As you know from your own experience, without this protection, our health care workforce is unable to perform their critical duties and our health care system can not operate at the capacity we need in this crisis.

Today, I am reaching out to you because I need your help to save the lives of our fellow Coloradans. I am requesting that you review all of the PPE in stock in your offices.

Specifically, we are looking for information regarding the quantity of the following pieces of equipment:

  • Eye protection and goggles
  • Face shields
  • Surgical masks - with shields
  • Surgical masks - without shields
  • N95 masks
  • Non-sterile gloves
  • Sterile gloves
  • Disposable gowns
  • Biohazard bags
  • Anesthesia machines
  • Ventilators, whether in use for medical care, animal care, or research.

I am asking for you to keep the bare minimum amount of supply you need to conduct essential or life saving functions, and contribute the remainder to our state's COVID19 response.

If you have small quantities of supplies to contribute, between 1-25 boxes of personal protective equipment (i.e., six boxes of protective eye glasses) we ask that you donate these supplies to yourlocal public health department,local community health center, community clinic, or local hospital.

If you have more than 25 boxes, or the pieces of larger equipment such as anesthesia machines or ventilators, we ask that you fill outTHIS FORM, so we can determine if these items are needed in our state’s emergency supply. Once we receive your form entry, we will follow up with you to determine next steps.Please completeTHIS FORMby Friday, March 27 at noon.

Thank you in advance for your cooperation with this request. Working together, we can get through this crisis.

If you have questions about this request please reach emailPPE@state.co.us.

Sincerely,

Jared Polis

Governor


Find Your Local Public Health Department


Find Your Local Community Health Center


How to Request PPE

If you or your organization are experiencing a shortage or outage of personal protective equipment (masks, gloves, gowns, etc) to conduct essential or life saving functions during this crisis, please reach out to your local emergency manager or local public health department. These entities are connectedto the state's emergency operations center through their local/Tribal emergency operations center, and are the best contact for your request. Thank you for your work serving Coloradans during this difficult time.

 

Find Your Local Community Emergency Manager

 

 

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 Colorado Department of Regulatory Agencies sent this bulletin at 03/24/2020 5:14 PM MDT

 

 

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FAQ for Healthcare Professionals Now Available

Dear Licensee:

The Novel Coronavirus (COVID-19) has impacted healthcare professionals across Colorado in unprecedented ways. For DORA, the pandemic has created myriad questions and scenarios to address on an ongoing basis, along with an increased need for timely, accurate information for our licensees.

We are listening and responding to the issues that have emerged within this rapidly changing landscape, in concert with the Governor’s Office and other state agencies. And we want to ensure that we continue to distribute information that provides clarity within this unpredictable environment.

To that end, DORA has created aCOVID-19 FAQ for Healthcare Professionalsto help distill, amplify and further define information provided over the last week.

We are cognizant that there are questions still unanswered, and are working to provide those in the future. Many of you have written to us with specific topics, which we continue to analyze and respond to in as timely a manner as possible. Please continue to check your email andDORA’s COVID-19 informational websitefor further updates as they become available.

We also want to express our gratitude to the many formerly licensed professionals or out-of-state licensees who, to date, have offered their services and healthcare knowledge for combatting the Coronavirus as volunteers. Those interested in signing up to volunteer can visithttps://cohealthvol.nationbuilder.com, where efforts to place workers with facilities in need will now be coordinated.

Thank you.

 

EMAIL FROM DORA 3/27/2020 9:20AM

 

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Prohibition on Chiropractic Elective Procedures

Dear Chiropractor Licensee,

The Division of Professions and Occupations (DPO) under the Department of Regulatory Agencies (DORA) has received a number of inquiries concerning the application ofExecutive Order D 2020 009. This email confirms that the Governor’s executive order applies to all chiropractic practices and it prohibits any elective procedure, including any chiropractic procedure, that does not fit within the very narrow categories listed in the order.

In particular, under Executive Order D 2020 009, no chiropractic procedure should be performed unless:

  • There is a threat to the patient’s life if the procedure is not performed;
  • There is a threat of permanent dysfunction of an extremity or organ system if the procedure is not performed;
  • There is a risk of metastasis or progression of staging of a disease or condition if the surgery is not performed; or
  • There is a risk that the patient's condition will rapidly deteriorate if the procedure is not performed and there is a threat to life, or to an extremity or organ system, or of permanent dysfunction or disability.

As is apparent, there are very few, if any, chiropractic procedures that fit within the rubric of these criteria. And as a result, we expect that most chiropractic practices across the state will necessarily halt operations during the emergency. Of course, if a practitioner believes that one or another patient meets the narrow categories listed here, then the order and DPO’s guidance allow for the discretion of the provider to provide a chiropractic procedure in those circumstances.

In summary, we advise you to suspendallnon-essential healthcare practices at this time. We understand that this may cause unfortunate financial difficulties, but it is imperative that we all do our part to stop the spread of COVID-19.

 

Do not reply to this email - this is not a monitored inbox.

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