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CalChiro’s commitment to you is that we will do all we can to bring you updates and resources you need during this challenging time. The volume of information continuously being released regarding the COVID-19 pandemic is staggering. We don’t want to seem redundant to other information sources but have decided to err on the side of overcommunication. Special blasts will be sent when necessary and we will use this newsletter to point you towards items that we think you need to see. We have created a dedicated web-page for posting updates and resources regarding COVID-19. We will update this daily as new information becomes available. We have also increased our social media outreach on this topic.

CalChiro is also advocating with state and local officials and regulators to position chiropractors to best serve their community during this crisis. With the various Stay-at-Home directives being placed on many counties, it is important that you are aware how these affect your ability to practice. Each county has its own specific orders that must be followed. CalChiro, along with the Federation of Chiropractic Licensing Boards, believes Chiropractors are essential members of the healthcare community and should be accessible to our patients for visits on a safe basis. We will be making every effort to keep an updated list on our resource page, but please check with your local county for any orders pertaining to your county. Again we are asking all Doctors of Chiropractic to evaluate patients’ need for care on a case by case basis. Please take extra precaution with high risk patients.

Due to the necessary cancellation of in-person events, this week we made our continuing education online courses free to members. We are ramping up our efforts to create new online content which we will roll out as quickly as possible.

Tomorrow, we will be reaching out to compile a database of chiropractors who are interested in volunteering to assist with potential critical care shortages. We are corresponding with government officials to educate them on all that doctors of chiropractic are qualified to do within the scope of practice. This is an excellent opportunity to show our willingness to help as well as shine the light on chiropractic education and qualifications. If you are interested in volunteering, should it be necessary, please watch for this email and get on the list immediately.

Please know that we respect the rights of our members to make clinical decisions to provide services to patients on a case by case basis. If you decide to limit/reduce office hours, we are working on possible telemedicine options to share with you to provide appropriate care to your patients, should you be interested. Let’s all be safe and supportive as we continue to forge ahead in an environment new to all of us as well as continuously evolving. Now is the time to stand together and to do so with compassion. Let us know how we can help.


Warm Regards,
Dawn Benton
CalChiro Executive Vice President, CEO
April 2, 2020
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Members Share Ideas on How They're Staying Safe During
the COVID-19 Pandemic

Earlier this week, we reached out to you, our members, on what you are doing at your practice to stay safe from COVID-19. Thank you to all that participated. Below are some of the responses. And remember, we are in this TOGETHER!
 

Besides waiting room chairs being 6 feet apart, and stepping up disinfecting, we now record all patient and employee temperatures daily. We have also implemented taking each patient's temperature at the front desk when they sign in using a talking, forehead scanner, so that everyone hears the results. It also flashes a green light when patient is within normal range. This reassures them, and us. Remember, the cut-off number is 100.4 degrees. Patients are also given a form to fill out prior to their visit, asking if they have had a cough, fever, sore throat, difficulty breathing or runny nose, today, and then they date and sign it (remember, some meds cause some of these symptoms). We haven't had any positive findings, but if we did, that patient would not even have a chance to sit down before they are rescheduled. Every M.D. would ask these questions and record temps on each visit. Now, so do we, and patients even say "Thank You!"
 

I've extended appointment time allotted per patient so they can get in and out without waiting room time. This also gives us plenty of time to disinfect equipment between patients. Also washing hands before and immediately after each patient!
 

We are taking in no more than three patients at a time. We are also taking temperature on every patient visit and we ask them to give us a brief history, like: 

1. Have you felt sick or had a cough (been around someone who has)
😷  
 

My office has signs on all doors asking patients/clients to reschedule if they are sick and not to bring anyone sick into the office.
 
CalChiro URGENT COVID-19 (coronavirus) Press Release
 
Sacramento, Calif. - March 16, 2020 - The California Chiropractic Association's (CalChiro) understanding around COVID-19 is evolving as announcements continuously and rapidly come in from both our State and National leadership. As always, patient safety is our first concern. Gov. Newsom's recently issued Declaration of a State of Emergency includes the call for all seniors over the age of 65 and residents with chronic conditions to self-isolate at home. Out of an abundance of caution, CalChiro is asking that all California Doctors of Chiropractic cooperate with the following recommendations:
  • CalChiro is asking all Doctors of Chiropractic, to please exercise extreme caution with all patients.
  • CalChiro recommends that non-emergent and non-essential care should be suspended on a case by case basis for the next 14 days.
  • As always, we expect our Doctors of Chiropractic to use excellent clinical judgement, provide the appropriate care and to be available for emergency care and services.
  • As essential health service providers, we understand that many times in-person visits are unavoidable. When appropriate we ask our providers to utilize the technology that is currently available and provide options for remote video or phone appointments as appropriate.
  • Each patient’s situation should be looked at critically and we should be judicial in their treatment.
  • It is important that our patients always have access to non-pharmacological solutions and providers of their choosing.
 
CalChiro does not take these recommendations lightly. We recognize the gravity of these extreme measures and the economic impact of such actions. CalChiro will be advocating on behalf of all Chiropractors in California for economic relief packages. As healthcare professionals, we have a responsibility to continue educating our patients on how to protect themselves and especially the high risk populations around us. CalChiro President Dr. Andrew O. Williams stated, "I am proud of our profession for providing services that circumvent the need for dangerous drugs, especially in this time of crisis."

We have been in communication with the Board of Chiropractic Examiners (BCE) for guidance on practice regulations. As these conversations continue, we will keep you updated. The BCE Website has been updated with a link to COVID-19 Updates from the California Department of Public Health. Any further guidance from the Newsom Administration will also be shared on their website. Regarding the very recent order for residents in certain Bay Area counties to shelter in place, (link: https://www.sfchronicle.com/local-politics/article/Bay-Area-must-shelter-in-place-Only-15135014.php), the BCE is directing licensees with questions about their practices to follow CDC and CDPH guidelines. At this point, the BCE is not aware of either entity requiring any health care providers to close their practices or cease seeing patients. Follow common sense measures to protect your own health and that of your patients.

In order to ensure chiropractic practices are implementing disease mitigation strategies for their local areas, please visit the CDC website for county-specific guidance. Additional information is available at the California Department of Public Health website.

We will continue to push out additional information as it becomes available. Please check our website for updates and information on patient screening. Thank you again for the excellent care that you provide to all patients of chiropractic.
Advice for Chiropractors from the World Federation of Chiropractic
 
To read the full statement, CLICK HERE.

On March 11, 2020, COVID-19 was declared a pandemic by the World Health
Organization (WHO). Chiropractors are primary contact health care professionals
and to protect themselves, their patients and their communities they must stay
current with the latest scientific evidence, information and advice. The global
situation regarding COVID-19 is evolving daily and advice may change over time
pending developments and emerging scientific knowledge. This advice note is
current as of March 17, 2020 and has been produced with advice and guidance
from the WFC Research Committee and WFC Public Health Committee.

Key messages

1. The WFC acknowledges the service of chiropractors around the world in contributing to the health of nations. We recognize that this is a challenging time and that we are in unprecedented territory with regard to the global outbreak and spread of COVID-19. As a worldwide community, the WFC understands that there are many questions being asked of chiropractors and that the situation varies from country to country. In order to support the global efforts of our fellow health professionals it is of critical importance that
chiropractors communicate information to their patients and communities that is scientifically accurate and comes from authoritative sources.

2. Advice communicated to patients by chiropractors and their staff should be based on advice from WHO and official national public health agencies in their country.

3. There is no credible scientific evidence that chiropractic spinal adjustment/manipulation confers or boosts immunity. Chiropractors should refrain from any communication that suggests spinal adjustment/manipulation may protect patients from contracting COVID-19 or will enhance their recovery. Doing otherwise is potentially dangerous to public health.

4. COVID-19 may be transmitted from person to person and may be contracted from surfaces on which the virus is deposited. It is vital that chiropractors, their staff and all visitors to their facilities are scrupulous about personal and clinic hygiene, including the practice of hand washing, respiratory etiquette, social distancing, sanitization of all equipment and surfaces and appropriate use of personal and protective equipment. Chiropractors must comply fully with all government directives in relation to the COVID-19 pandemic, which may include closing clinic facilities.

5. Current evidence is that the elderly and those with co-morbid health conditions are particularly at risk. Care must be taken to minimize potential spread of COVID-19 to these special populations. In areas of confirmed outbreak this may take the form of suspending provision of office-based care to vulnerable individuals in order to prevent transmission. While most fatalities have occurred in the elderly population, it is now known that young people, including children, have died from COVID-19. Those not exhibiting symptoms can still carry and transmit the virus.

6. Chiropractors and their staff should ensure they are familiar with information about COVID-19, which is set out below. They should monitor the WHO website, government directives, advice and guidance from regulators and official sources of public health advice in their respective nations, states and provinces.

7. The elderly and people with underlying conditions must be prioritized. WHO recommends that those with mild disease are isolated and cared for at home. It is important that care-givers take all necessary precautions to protect themselves. This means that the patient and the care-giver should wear medical masks. Patients should sleep in a separate room and use a separate bathroom. One care-giver, who is in good health, should be assigned to care for the patient, and should practice rigorous hand-washing and sanitization procedures as set out below. These measures should continue for 2 weeks after patients have stopped exhibiting symptoms.

8. COVID-19 is spreading to low income countries. It is not known at this stage how it will affect communities with a high HIV-positive prevalence or who are malnourished. Chiropractors working in these communities should be particularly mindful of measures that will help prevent transmission.
An IMPORTANT Message from the FCLB's President
To view the message on FCLB's website, CLICK HERE.

With the concerns about coronavirus (COVID-19), I want to reassure you that the Federation of Chiropractic Licensing Boards (FCLB) is remaining focused on our mission of public health and protection during these unprecedented times.

Our goal is to continue serving our member boards and stakeholders as a centralized and premier resource for information and consolidated services. Knowing there are many questions, our dedicated team at FCLB is ready to provide the support and information chiropractors need to act in the best interests of the public.

The FCLB 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), and local health departments in regard to COVID-19 and their jurisdictional licensing boards’ practice acts, rules, regulations, and policies.

The FCLB affirms that doctors of chiropractic are essential healthcare providers, ready to serve their communities both in daily care and in times of urgent need.

Please know, that as our licensees are in the front lines of patient care, regulatory boards are working diligently behind the scenes to provide the support and information chiropractors need to act in the best interests of the public. I want to reiterate our gratitude to our member boards and your commitment to public protection.

Sincerely,
Karlos Boghosian, DC
FCLB President
Guidance on Preparing Workplaces for COVID-19 from OSHA
 
To download the complete guide from OSHA, CLICK HERE.

Steps All Employers Can Take to Reduce Workers’ Risk of Exposure to SARS-CoV-2

This section describes basic steps that every employer can take to reduce the risk of worker exposure to SARS-CoV-2, the virus that causes COVID-19, in their workplace. Later sections of this guidance—including those focusing on jobs classified as having low, medium, high, and very high exposure risks— provide specific recommendations for employers and workers within specific risk categories.

Develop an Infectious Disease Preparedness and Response Plan

If one does not already exist, develop an infectious disease preparedness and response plan that can help guide protective actions against COVID-19.

Stay abreast of guidance from federal, state, local, tribal, and/or territorial health agencies, and consider how to incorporate those recommendations and resources into workplace-specific plans.

Plans should consider and address the level(s) of risk associated with various worksites and job tasks workers perform at those sites. Such considerations may include:

■ Where, how, and to what sources of SARS-CoV-2 might workers be exposed, including:
The general public, customers, and coworkers

■ Sick individuals or those at particularly high risk of infection (e.g., international travelers who have visited locations with widespread sustained (ongoing) COVID-19 transmission, healthcare workers who have had unprotected exposures to people known to have, or suspected of having, COVID-19).

■Non-occupational risk factors at home and in community settings.

■Workers’ individual risk factors (e.g., older age; presence of chronic medical conditions, including immunocompromising conditions; pregnancy).

■ Controls necessary to address those risks. Follow federal and state, local, tribal, and/or territorial (SLTT) recommendations regarding development of contingency plans for situations that may arise as a result of outbreaks, such as:

■ Increased rates of worker absenteeism.

■ The need for social distancing, staggered work shifts, downsizing operations, delivering services remotely, and other exposure-reducing measures.

■ Options for conducting essential operations with a reduced workforce, including cross-training workers across different jobs in order to continue operations or deliver surge services.

■ Interrupted supply chains or delayed deliveries. Plans should also consider and address the other steps that employers can take to reduce the risk of worker exposure to SARS-CoV-2 in their workplace, described in the sections below.
ACA's Latest Guidance on COVID-19
 
The American Chiropractic Association (ACA) has created a resource page with constantly updated information and guidance from the Centers for Disease Control and Prevention (CDC), the Centers of Medicare and Medicaid Services (CMS), and other trusted sources, including an updated fact sheet from WFC, resources for healthcare professionalssmall business administration guidanceoccupational safety, and more.

CLICK HERE to go directly to the ACA's resources page. 
COVID-19: HR Snapshot

Source: California Choice

Question: Given COVID-19, if an employee is out of the office due to sickness, can we ask them about their symptoms?

Yes, but there’s a right way to do it and a wrong way to do it. In most circumstances, employers shouldn’t ask about an employee’s symptoms, as that could be construed as a disability-related inquiry. Under the circumstances, however—and in line with an employer’s responsibility to provide a safe workplace—we recommend asking specifically about the symptoms of COVID-19 and making it clear that this is the extent of the information you’re looking for.

Here’s a suggested communication: “Thank you for staying home while sick. In the interest of keeping all employees as safe as possible, we’d like to know if you are having any of the symptoms of COVID-19. Are you experiencing a fever, cough, and/or shortness of breath?”

Remember that medical information must be kept confidential as required by the ADA. If the employee does reveal that they have symptoms of COVID-19, or has a confirmed case, you should see the CDC’s Interim Guidance to determine next steps. Tables 1 and 2 will help you assess risk and determine what steps, if any, should be taken.
California Requests Federal Government Waiver to Cover Medi-Cal Recipients and Expand Tele-Health Options
 
To read the official press release from Governor Gavin Newsom's Press Office,
CLICK HERE.


SACRAMENTO – Governor Gavin Newsom today announced that the state has asked federal officials to make it easier for California to quickly and effectively provide care to about 13 million Medi-Cal beneficiaries as California works to protect the public from COVID-19.

“To get Californians the care they need during this crisis, we need to change how that care is delivered and communicated,” said Governor Newsom. “By expanding our telehealth options we’re minimizing disruption to our health care system to prioritize care for those who need it most, while providing easier, more accessible options for other Californians seeking care.”

The federal request would ease certain federal rules governing doctors and other health care providers who treat people covered through Medi-Cal, California’s version of Medicaid. It also would loosen rules regarding the use of telehealth and where care can be provided, making it simpler to protect seniors and other populations at high risk for harm if exposed to the virus.

The DHCS letter to the Centers for Medicare & Medicaid Services asked that the rules be waived under Section 1135 of the Social Security Act. President Donald Trump on March 13 declared a national emergency over COVID-19, which allowed DHCS to seek the waiver.
 
DHCS also filed five “Appendix K” waiver requests over the weekend of March 14-15 to ease rules regarding home- and community-based care of certain Medi-Cal beneficiaries. The Department may seek additional waivers if the evolving situation shows they would help to improve care delivery and protect the public.

Here are some of the specific changes DHCS requested under the 1135 waiver:
  • Streamlined enrollment for health care providers, making it easier to meet the increased need for services and ensure they can be paid.
  • Flexibility allowing providers to be paid for services at a quarantine site or other location where Medi-Cal care isn’t usually offered.
  • Flexibility for telehealth and virtual communications to make it easier for providers to care for people in their homes. Specifically, flexibility to allow telehealth and virtual/telephonic communications for covered State plan benefits, including but not limited to, behavioral health treatment services, waiver of face-to-face encounter requirements for Federally Qualified Health Centers, Rural Health Clinics, and Tribal 638 Clinics relative to covered services via telehealth, allowance for reimbursement of virtual communication and e-consults for FQHCs, RHCs and Tribal 638 clinics and waiver of limitations around virtual/telephonic communications prior to or after an in office visit.
  • Easing rules requiring prior authorization for certain services linked to COVID-19, as well as waiving various utilization controls on covered benefits.
  • Permission to reimburse for “off-label” use of safe and effective medications that have shown promise in treating COVID-19, even if the normally required documentation of that use has not yet been published.
  • Waiving the requirement for a three-day prior hospitalization for coverage of a skilled nursing facility stay to maximize hospital capacity.
  • Changes to allow telephonic or live video interactions for individual with development disabilities.
  • Recognition that COVID-19 testing and any medically necessary follow-up care should be considered as “emergency services” even if they do not occur in a hospital emergency room. These services would be free of cost to all Medi-Cal beneficiaries, even the small percentage whose income places them in a group that normally must pay a share of cost.
  • Expenditure authority related to temporary housing for homeless, as necessary for quarantining, isolating, or treating individuals who test positive for COVID-19 or who have had a high-risk exposure and are thought to be in the incubation period.
  • Expanding presumptive eligibility to people who are over 65 or disabled, allowing hospitals to quickly enroll them into Medi-Cal coverage.

DHCS has requested that most of the changes be made retroactive to January 27, 2020, when the public health emergency declared by U.S. Health and Human Services Secretary Alex Azar took effect.
Department of Industrial Relations - COVID-19 News

DWC Provides Guidance on Medical Evaluations During State of Emergency Period

3/19/2020

The Division of Workers’ Compensation (DWC) appreciates the efforts of the workers’ compensation community to provide care for injured workers during the COVID-19 pandemic. Of paramount importance is that everyone follow all guidance from the Governor as well as federal, state and local public health agencies regarding COVID-19.

After adherence to all public health guidance and orders, DWC encourages all parties to consider creative solutions appropriate to providing care to injured workers. The increased use of telehealth services for medical treatment may be appropriate. The California Business and Professions Code section 2290.5 requires that “…the health care provider initiating the use of telehealth shall inform the patient about the use of telehealth and obtain verbal or written consent from the patient for the use of telehealth as an acceptable mode of delivering health care services and public health. The consent shall be documented.”

DWC is currently evaluating the feasibility of telemedicine for QME evaluations and will continue to do so. The use of telemedicine for a QME evaluation may be appropriate where all parties agree that there is a medical issue in dispute which involves whether or not the injury is AOE/COE (Arising Out of Employment / Course of Employment), and all parties to the action, including the physician, agree to a telemedicine evaluation in order to resolve this dispute. Although DWC is not authorizing any particular course of action, the division recognizes that in this time of medical emergency, creative delivery methods of essential medical treatment and evaluation services may be needed.

DWC realizes that QME appointments may be affected. When cancelling or rescheduling an appointment, please document the reason in the file and inform all parties as soon as possible. Given the current COVID-19 emergency, QMEs that cancel appointments fewer than 6 business days before an appointment may assert that they had good cause to do so. The current state of emergency regarding the COVID-19 pandemic presents serious public health concerns, and parties and evaluators are encouraged to work together to take any action that may be necessary to protect the health of doctors, their staff and injured workers.

Upcoming QME Examination:

The QME examination scheduled for April 18, 2020 will be postponed. The exam will be rescheduled and a new date will be announced.



WCAB Issues En Banc Order Regarding Rules, Office Closure During COVID-19 Emergency

3/18/2020

The Workers’ Compensation Appeals Board (WCAB) issued the following en banc order today:

Pursuant to Governor Gavin Newsom's March 4, 2020 state of emergency in response to the novel coronavirus (COVID-19) and Workers’ Compensation Appeals Board (WCAB) Rule 10370, the Appeals Board is temporarily suspending specific WCAB Rules of Practice and Procedure contained in Title 8 of the California Code of Regulations. This includes Rules regarding dismissals for failure to appear, the timeframe for reports from WCJs and arbitrators, required signatures and witnesses for Compromise and Release agreements, and service by the WCAB by mail and consent for electronic service. All filing deadlines are extended per the DWC's March 16, 2020 Newsline that all district offices are closed for filing from March 17 through April 3.

As of March 19, 2020, the WCAB’s office in San Francisco will be closed. WCAB members and staff will be working remotely during the closure. All practitioners are encouraged to regularly check the WCAB and DWC websites for updates about office closures and filing deadlines.

DWC Temporarily Closing San Jose, Oakland, San Francisco Offices

3/17/2020
 
The Division of Workers’ Compensation (DWC) will temporarily close its San Jose, Oakland and San Francisco district offices to protect the health of the public and our staff and to comply with shelter-in-place orders.

The Division’s headquarters office, which includes the Medical Unit, Return-to-Work Supplement Program, Uninsured Employers Benefit Trust Fund and Legal Unit, will also close temporarily. Staff will work remotely and are available by phone at 1-800-736-7401.

DWC is closely monitoring the situation and will update the public of any changes. DWC and WCAB announced March 16 (see below) that they are limiting court appearances to protect the health and safety of our staff and the community, in accordance with numerous public health orders suggesting that public gatherings be limited.


To read the DWC's official press release on their website, CLICK HERE.
DWC and WCAB Announce Modified Hearing Calendar & Filing Update
 
3/16/2020
 
To read the DWC's official press release on their website, CLICK HERE.

The Division of Workers’ Compensation (DWC) and the Workers’ Compensation Appeals Board (WCAB) are committed to protecting the health and safety of our community and staff while performing our legislative and constitutional duties. We are in communication with the California Department of Public Health (CDPH) and the Office of Emergency Services to ensure that we have the most up-to-date information available during this unprecedented COVID-19 crisis.

We are limiting court appearances to protect the health and safety of our staff and the community, in accordance with numerous public health orders suggesting that public gatherings be limited.

Scheduled Hearings

March 17 through March 20: DWC will only hear expedited hearings at the district offices. DWC will continue all other hearings and send parties notice of new hearing dates within the next five business days.

March 23 through April 3: DWC will continue to hear expedited hearings for parties that appear at the district offices. DWC will also hear status conferences, mandatory settlement conferences and priority conferences via CourtCall only. If all parties do not appear via CourtCall the case will be continued and notice will be given. All other hearings will be continued. No trials or lien conferences will be heard during this time.

Filings

March 17 through April 3: DWC’s district offices will be closed for filing purposes. Accordingly, all filing deadlines are extended to Monday, April 6 (see California Code of Civil Procedure Section 12(a); 8 California Code of Regulations Sections 10600 and 10605; and WCAB Significant Panel Decision Pa’u v. Department of Forestry, et al.: (2019) (ADJ 9159725, ADJ 7757931, ADJ 9640668).

DWC will not accept walk-through documents or walk-in filings until the district offices reopen for filing purposes. Workers’ Compensation Judges will focus on reviewing settlement documents and ruling on petitions submitted by the parties during the closure. Parties may utilize the Electronic Adjudication Management System to file documents online. Parties may also mail settlement documents or petitions to the district office where the case is filed. Refer to the district office page for e-mail and other contact information.

These changes are based on the best information currently available and are subject to change without notice as circumstances change. Although we will endeavor to provide updates regarding hearings, filing or office closures, parties, attorneys and hearing representatives should also check the DWC and WCAB websites for updates.

To read the DWC's official press release on their website, CLICK HERE.
COVID-19 Updates from the Johns Hopkins Center for Health Security
 
Our experts are closely following and analyzing updates on the Coronavirus outbreak and resources will be routinely updated.

CLICK HERE to see the most current news from Johns Hopkins.
COVID-19 Updates from CalChamber Advocacy
 
Coronavirus (COVID-19) continues to dominate the news, raising concerns among individuals and for our economy. This page provides links to CalChamber, federal, state and local resources.

CLICK HERE for updates. 
Governor Newsom Issues New Executive Order Further Enhancing State and Local Government’s Ability to Respond to
COVID-19 Pandemic

 
To read the full press release, CLICK HERE.

SACRAMENTO – Governor Gavin Newsom today issued a new executive order further enhancing California’s ability to respond to the COVID-19 pandemic.

The Governor’s order:

  • Waives the one-week waiting period for people who are unemployed and/or disabled as a result of COVID-19;
  • Delays the deadline for state tax filing by 60 days for individuals and businesses unable to file on time based on compliance with public health requirements related to COVID-19 filings;
  • Directs residents to follow public health directives and guidance, including to cancel large non-essential gatherings that do not meet state criteria;
  • Readies the state to commandeer property for temporary residences and medical facilities for quarantining, isolating or treating individuals;
  • Allows local or state legislative bodies to hold meetings via teleconference and to make meetings accessible electronically; and
  • Allows local and state emergency administrators to act quickly to protect public health
The full executive order can be found here.

Last night, Governor Newsom and state public health officials announced that gatherings should be postponed or canceled across the state until at least the end of March. Non-essential gatherings must be limited to no more than 250 people, while smaller events can proceed only if the organizers can implement social distancing of 6 feet per person. Gatherings of individuals who are at higher risk for severe illness from COVID-19 should be limited to no more than 10 people, while also following social distancing guidelines.

“Each of us has extraordinary power to slow the spread of this disease,” said Governor Newsom in announcing the state’s new policy last night. “Not holding that concert or community event can have cascading effects — saving dozens of lives and preserving critical health care resources that your family may need a month from now. The people in our lives who are most at risk – seniors and those with underlying health conditions — are depending on all of us to make the right choice.”
Let Your Voice Be Heard!

We’ve been hearing from many members, eager to join the long list of chiropractic advocates who congregate in Sacramento each year for one important purpose – to advance the chiropractic profession, patient care and quality of life for Californians. Well now is the time – sign up today to attend the California Chiropractic Association (CalChiro) Legislative Day 2020 to be held June 2, 2020, at the Sheraton Grand Sacramento Hotel where you will meet with your legislator(s) or their key staff in her/his Capitol office, learn about CalChiro’s political agenda and recent developments affecting chiropractic, hear about the California Legislature, including background information and the latest updates and network with your peers.

For more information go to: https://www.calchiro.org/legislative-day-2020-0. Registration includes lunch and reception. *Early Bird Discount taken at checkout.

 
Legislative Day 2020 Agenda

8:00am: Registration Opens Sheraton Grand Sacramento Hotel
9:30am: General Session
12:00pm: Lunch
1:15pm: Group Photo State Capitol Steps
1:30pm: Legislative Appointments State Capitol
4:00pm: Networking Reception with invited Legislators Sheraton Grand Sacramento Hotel
Register Here
An Update from the Managed Care & Insurance Committee

The Managed Care & Insurance Committee (MCIC) has participated in discussions related to communication to CalChiro members of the Covoid-19 virus and its effect on the health care delivery system, and public and personal safety. The MCIC has also offered information and language related to any Telehealth discussions to ensure doctors of chiropractic are included as a category of provider in any legislative/regulatory enactment, or Executive Order.

The MCIC is in the process of reviewing draft trailer bill language for two health related proposals in the Governor’s budget – the Office of Health Care Affordability, and Health Care Payments Data System. Briefly, the language includes provisions outlined in the Affordable Care Language (for example, Medical Loss Ratio).

The Health California for All Commission has cancelled its April 2020 meeting and at this time there is no anticipated date to reschedule. The next meeting is currently scheduled for June 2020. CalChiro representatives will continue to monitor the Commission’s activities and participate as appropriate.
ABN Form Update
 
Some of you may have noticed that on the Medicare Advanced Beneficiary Notice (ABN) form, there is an expiration date of March 2020. As there is no new ABN form in the works for now, providers should continue to use the current form.
District Officers and House of Delegates Nominations
 
The California Chiropractic Association (CalChiro) is calling for volunteers for District Officers and House of Delegates (HOD) members. As a member of CalChiro, your voice is important and getting involved with your local district is a great way to make sure it is heard. If you are a member in good standing and are looking for a way to get more involved with your local CalChiro district, now is the time!

CalChiro has a new leadership opportunity for our members, as we are launching our first ever House of Delegates (HOD).

For information on HOD, read the welcome message from the HOD Chair.

The responsibilities of a member of HOD are as follows:
  • Review all mailings from the House of Delegates Chair.
  • Attend and provide input at all delegate conferences, caucuses, and informal House of Delegates meetings.
  • Register and attend the CalChiro Fall Conference; in 2020 this will be October 16-18 in San Diego, California.
  • Attend the Open Forum at the CalChiro Fall Conference (when applicable).
  • Attend the Delegate Caucuses at the CalChiro Fall Conference (when applicable).
  • Attend all meetings of the House of Delegates at the CalChiro Fall Conference.
  • Solicit input from CalChiro members.
  • Discuss proposals and formulate positions in preparation for CalChiro HOD meetings.
  • Attends House of Delegates meeting at the annual meeting, open hearings, regional meetings, and Caucus meetings.
  • Travel required: 3 days at Delegate meetings per year.
  • If you have an interest in helping shape the future of CalChiro,
The application deadline is Friday, April 30, 2020. If you have any questions about qualifications or the application process, please contact Kelley Smith.

Please submit an application.
Member Benefit of the Week - We're Here For You!

Even though some of us are working from home and practicing social distancing, that doesn't mean our community can't stay connected and informed. CalChiro is here for you with resources and programs to help you continue your work (and learning) with as little interruption as possible.

Although some of our face-to-face CE events might be postponed or canceled, we have many online learning opportunities that you can take advantage of. In response to the current COVID-19 pandemic, we want to ensure our members have access to our CE21 on demand continuing education library for FREE (or at a discounted rate)! For those programs that are not free, use code WELOVECALCHIRO for a $10 discount.


This platform allows you to purchase any On-Demand program directly from your CE21 account, watch it on your own time and then have a CE certificate generated automatically and stored directly to your CE21 account.

View our entire On-Demand Library here: https://calchiro.ce21.com/

Current CalChiro members, who have not previously logged in, will need to click the Forgot Password link in order to create your CE21 account. The email address will be the same email associated with your membership.

CalChiro is working with the CA Board of Chiropractic Examiners (BCE) on extending the max 12 hours distance learning CE hours to 24 hours. We will report once we have the answer from the BCE.

Questions? Please contact Kayleigh Carey at kcarey@calchiro.org.

FREE ChiroHealthUSA Webinar
 
CalChiro is always striving to bring you as much knowledge as we can. We have strategic partnerships that help bring our members new and exciting resources. One of those partnerships is with ChiroHealthUSA and one of the great benefits they offer our members is free webinars.

On Tuesday, March 24, 2020, ChiroHeatlhUSA will be hosting a webinar that will cover Revenue Cycle Management. Being a physician, practice manager, biller, or chiropractic assistant means you know every step to providing care and reimbursement in the office. Policies and procedures on billing, conflict resolution, and collections all begin at the front desk. We will explore policies and procedures at the front desk that will decrease patient drop out and increase collections. Dr. Mario Fucinari is a practicing chiropractor, Certified Professional Compliance Officer, author and national speaker on policies and procedures in compliance. This class is perfect for the doctor, staff, and billers. Learn crucial front desk procedures for patient intake, and get step-by-step procedures for the front desk to avoid costly billing and collection errors.

Revenue Cycle Management
Tuesday, March 24, 2020
11:15AM PST
Cost: FREE
CLICK HERE FOR MORE INFO AND TO REGISTER
F4CP News and Resources
Billboard #3 Goes Up Thanks to CalChiro Monterey Bay District & F4CP
Last week, the Foundation for Chiropractic Progress (F4CP), along with CalChiro's Monterey Bay District and Dr. Randal Jones, placed another eight-week billboard in the Fresno, CA market. 

Once again, thank you to Dr. Jones and the entire Monterey Bay District for continuing to spread the chiropractic message. We appreciate you!

Be A F4CP Ambassador!

The Foundation for Chiropractic Progress (F4CP) has launched an Ambassador Program, which entails an Ambassador, or group of Ambassadors, from each Group Member State Association to serve as feet on the ground promoting the value of chiropractic care in local communities.
 
State Ambassadors spearhead the F4CP’s marketing campaigns to further promote the value of chiropractic care at the grassroots level. The F4CP provides the Ambassadors with patient education and community outreach materials to market chiropractic effectively throughout their State. As a special thank you, all Ambassadors receive a complimentary Gold Membership with the F4CP for their active engagement.
 
If you’d be interested in becoming an Ambassador, please email F4CP Marketing Manager Megan Gilson at megan@f4cp.com for more information.

 
F4CP's Collaborative Opportunities

Last year, the F4CP submitted a statement to the National Academy of Medicine to enroll as an organization in support of their Opioid Collaborative. The Foundation then sent statements to other organizations who also enrolled in the Action Collaborative to see how we could work to move the needle forward for nonpharmacological care.
 
In response, the Foundation began establishing relationships with organizations in many different professions, including but not limited to yoga therapists, nurse practitioners and more. 
 
The Foundation worked with the International Association of Yoga Therapists to create and place an ad in Yoga Therapy Today, featuring the F4CP’s National Find-A-Doctor Directory, which includes your contact information as a Group Member.
 
In addition, the F4CP’s Executive Vice President Dr. Sherry McAllister was invited to record a chiropractic presentation at Johns Hopkins University – School of Nursing, which is now being presented in the curriculum to Nurse Practitioners. In addition, the F4CP is placing a series of ads in the Journal for Nurse Practitioners, with the call-to-action showcasing Dr. McAllister’s presentation on the ad. Johns Hopkins also built her presentation into their core curriculum.
 

F4CP LinkedIn Articulator 
4 Reasons Why Women Are Making a Big Impact in Chiropractic

By Dr. Sherry McAllister

In its 125-year history, chiropractic has been a male-dominated profession, like most others in the healthcare industry. Times, however, are changing. The number of women doctors of chiropractic (DCs) has more than doubled since 1991 to nearly 32% of the profession, according to the National Board of Chiropractic Examiners’ (NBCE) Practice Analysis of Chiropractic 2020.

This report, released in February, is published every five years and based on an in-depth survey of DCs from around the country. In every report since 1991, women have made steady gains in the profession. In the last report, based on a 2015 survey, women comprised 27% of the profession, which is a five-point increase. If this pace continues, women will make up the majority of DCs in less than 20 years.

As a woman who is also a DC and deeply involved in the industry, I feel I have a unique understanding of the reasons for this diversity trend, which, by the way, is both great for patients and great for the industry. Here are some of the reasons:

1.    Women prefer same-gender doctors. According to the NBCE study, women make up the majority of chiropractic patients at 57%, a figure which has remained largely the same since 1991. In years past, there was little choice over the gender of the doctor. Now that the profession and all of healthcare is more diverse than in decades past, women, who feel strongly about this choice, are discovering they have greater opportunity to seek care from a woman doctor. A consumer survey with more than 7,600 respondents showed that 46% of women prefer a female doctor, while only 23% of men said they preferred a male doctor. Meanwhile, only 6% of women said they preferred a male doctor.

2.    Gender-specific problems. One of the main reasons for this preference, in my experience and those of colleagues, is a perception among women that someone of the same gender will simply better understand their body. There is some evidence behind this judgment, as well. A 2018 study based on a review of heart attack patients admitted to Florida hospitals over 20 years found a higher mortality rate among women patients who were treated by male physicians, while women and male patients experienced similar outcomes with women doctors. Women patients also tend to be more comfortable with a woman doctor for discussing health problems involving the more intimate areas of their body and feel a male doctor may not relate to these gender-specific problems.

3.    Flexibility. Nearly two-thirds (64%) of DCs work as sole practitioners, according to the NBCE. Such an arrangement offers schedule flexibility that women DCs prefer. A flexible schedule enables women doctors more time to raise families while still maintaining their practice. In fact, the latest report shows 45.7% of women DCs practice part-time compared to only 35% of men.

4.    Youth. Women DCs are on average younger than their male colleagues. More than half (53%) of DCs younger than 30 years old are women, while more than 70% of doctors age 50 to 59 years are men. As more male DCs retire, the younger women doctors will fill their ranks. This sets up a cycle where younger women aspiring to become a doctor have same-gender role models and mentors, which, in turn, grows the number of women in the profession.

To continue reading this article on LinkedIn, CLICK HERE
Christmas decorations in March? Self-isolaters share photos of their homes bedecked in festive lights as they try to 'spread cheer' in neighbourhoods locked-down because of coronavirus
DailyMail March 18, 2020
Creative self-isolaters have come up with a new way to spread a little cheer without leaving their homes - digging out their festive lights. While bringing out the yuletide decorations in March might seem a little bizarre, the #lightsforlife movement is gathering momentum on social media, with lock-downers sharing their snaps of their twinkling homes. One dad admitted that he'd fished out the string of lights to try and entertain his bored son while others said the sight of light in locked-down neighbourhoods offered a message of hope and inspiration to people feeling overwhelmed by the pandemic.
Survey highlights unmet patient-provider demand for drug-free pain management methods
MCMA March 2020
The results of a Quest Diagnostics nationwide survey of physicians highlights an unintended and unfortunate consequence of the nation’s opioid epidemic: fear to treat patients taking opioids. More than eight physicians out of 10 (81%) admitted in the survey that they are reluctant to accept patients currently prescribed opioids, and 83% agreed that treating patients with chronic pain is much more challenging in light of the opioid crisis.
Denying care to patients suffering from chronic pain is not the answer, regardless of whether they take opioids. We have learned that there is no single solution to this public health crisis, which kills more than 130 Americans per day. Rather, physicians, health systems, governments, public health officials and other stakeholders must consider a multimodal approach that includes prescription limits, education, expanded rehabilitation resources and other tools at our disposal to help prevent opioid use disorders.
This 15-Second Stretch Can Help You Stop Slouching While You're Working From Home
Popsugar March 17, 2020
If you've never worked from home before, the transition can be challenging. Unless you have a comfortable home office (or even better, a standing desk), you may find yourself slouching over your computer from your couch or bed, which can cause neck, shoulder, and back pain. One thing that can help? Good, old-fashioned stretching. An Oregon-based chiropractor shared a video with a very simple 15-second stretch to help improve your posture, no matter your circumstances. While sitting down, hold your palms out in front of you and turn them face up. Swing your arms out to your sides; roll your shoulders back so your shoulder blades are pressed together, then drop them as you continue squeezing. Pull your head back so you feel like you're giving yourself a double chin, and hold this position for 15 seconds.
Working from home? Here’s how to make your setup more ergonomic
NY Post March 16, 2020
The coronavirus could end up being a real pain in your neck. While most city dwellers don’t have in-home offices to spread out in while they work from home for the foreseeable future, there are still ways to be smart about your spine from 9 to 5. When it comes to non-COVID-19 consequences, “the brunt of the non-infected population’s symptoms will be in their lower backs and necks,” a Manhattan-based chiropractor tells The Post. He says it’s likely a bad setup could result in “tech neck” — the headaches and spasms you get from too much hunching. But there are ways to make sure you don’t end up in the doctor’s office when the self-quarantine is over.
Do you have the right mindset to grow your chiropractic practice?
Chiropractic Economics March 16, 2020
Opening your own chiropractic clinic can be incredibly empowering. But it can also be a source of uncertainty. There is a push-pull common among chiropractors: You love the clinical component, and you love helping people, but the business part can feel foreign to you. Even though you have in-depth knowledge of your domain and your clientele, it can be intimidating to start a business without a business degree or any previous experience. Growing a business is difficult and risky, even with that experience. But like Tony Robbins says, if you’re not growing, you’re dying – you must expand your business and adapt to the economy if you are to be profitable in an ever-evolving market.
B.C. chiropractors warned about 'inappropriate' claims on COVID-19
CBC March 14, 2020
A handful of B.C. chiropractors marketing supplements or spinal manipulations they suggest will build immunity to the novel coronavirus face investigation for "inappropriate" advertising. Chiropractors are not trained in either treating or preventing infectious disease, and there is no scientific evidence that chiropractic techniques can be used to treat infections of any kind, according to the College of Chiropractors of B.C. But CBC has learned the college is looking into online posts and email advertisements from at least three chiropractic clinics that make claims about preventing COVID-19.
Chiropractic discount plan: know the rules or else
Chiropractic Economics March 13, 2020
Nothing stirs up emotions in a conversation quite like the wildly debated topic of offering discounts in your chiropractic office. My team and I have all been challenged, and even yelled at, when answering a question about a chiropractic discount plan, especially when the answer wasn’t exactly what the doctor or chiropractic assistant (CA) wanted to hear.
It’s OK if you are confused about what you can and can’t do about offering discounts in your practice. Although it seems counter-intuitive, the rules and regulations were apparently not written to provide clarity, just confusion. Why? Because the rules and regulations surrounding discounts are dictated not by one entity, but by just about every entity in our practice. This includes our boards of examiners, our provider agreements, state and federal rules on anti-kickback and anti-inducement, Medicare, and ultimately, the Office of Inspector General (OIG).
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Established in 1928, the California Chiropractic Association is a not-for-profit organization supporting thousands of doctors of chiropractic and students across California.
Visit 
www.calchiro.org or call 916.648.2727.

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