Phase 2 Guidelines Released By D.C. Health
During Phase 2, employers will be required to adopt new behaviors and rigorous safeguards to reduce risk for all. This guidance is intended to guide Dental Healthcare Providers (DHCP) in provision of non-emergency dental services during Phase 2. If providing services, the following measures should be implemented to help reduce the risk of COVID-19 transmission among employees, patients, and the community.
CARES Act Provider Relief Fund Expands to Include Dentists
The Provider Relief Fund will distribute $175 billion to hospitals and healthcare providers on the front lines of the coronavirus response. The Fund supports healthcare-related expenses or lost revenue attributable to COVID-19 and ensures uninsured Americans can get treatment for COVID-19. Initially the Fund was restricted to providers enrolled in Medicaid or Medicare. The fund is now open to all providers who want to apply for a Provider Relief Fund payment, regardless of network affiliation or payer contract. HHS is contracting with UnitedHealth Group to facilitate delivery of the funds.
Note that the Department of Health and Human Services has contracted with UnitedHealth Group to administer the Provider Relief Fund payments. Therefore, some steps in the process involve existing UnitedHealth Group tools. Specifically, you'll need to set up an Optum ID in order to access the portal. The process will not involve credentialing or contracting with UnitedHealth Group, and the information you submit will be used to administer the Provider Relief Fund payment.
Other Federal Assistance Programs Remain Available
Paycheck Protection Program (PPP)
The Paycheck Protection Program has resumed accepting applications. The new deadline to apply for a Paycheck Protection Program loan is August 8, 2020.
The PPP is a loan designed to provide a direct incentive for small businesses to keep their workers on the payroll. SBA will forgive loans if all employee retention criteria are met, and the funds are used for eligible expenses. Click here to read more about PPP loan forgiveness.
Small Business Economic Injury Disaster Loan (EIDL)
In response to the Coronavirus (COVID-19) pandemic, small business owners and non-profit organizations in all U.S. states, Washington D.C., and territories are able to apply for an Economic Injury Disaster Loan (EIDL). EIDL is designed to provide economic relief to businesses that are currently experiencing a temporary loss of revenue. EIDL proceeds can be used to cover a wide array of working capital and normal operating expenses, such as continuation to health care benefits, rent, utilities, and fixed debt payments.
- Interest rate of 2.75%, payable over up to 30 years. Can defer initial payments for up to a year.
- Small Business Administration (SBA) loan for up to $2 million, including a $10,000 grant up front. May be used to pay fixed debts, payroll, accounts payable and other bills that can’t be paid because of the disaster’s impact.
- Apply directly at the SBA. Applicants may apply directly online or call 1-800-659-2995.
Updated June 12, 2020
Many of these recommendations may not be new, but are important reminders nonetheless:
- Start by reviewing the CDC Interim Guidance for Businesses and Employers. This will provide guidelines and recommendations that all employers can use to protect their workers and clients.
- Ensure that ventilation systems in your facility operate properly. For building heating, ventilation, and air conditioning (HVAC systems) that have been shut down or on setback, review new construction start-up guidance provided in ASHRAE Standard 180-2018, Standard Practice for the Inspection and Maintenance of Commercial Building HVAC Systems.
- Increase circulation of outdoor air as much as possible by opening windows and doors, using fans, and other methods. Do not open windows and doors if doing so poses a safety or health risk for current or subsequent occupants, including children (e.g., allowing outdoor environmental contaminants including carbon monoxide, molds, or pollens into the building).
- Evaluate the building and its mechanical and life safety systems to determine if the building is ready for occupancy. Check for hazards associated with prolonged facility shutdown such as mold growth, rodents or pests, or issues with stagnant water systems, and take appropriate remedial actions.
Identify where and how workers might be exposed to COVID-19 at work.
Employers are responsible for providing a safe and healthy workplace.
- Conduct a thorough hazard assessment of the workplace to identify potential workplace hazards that could increase risks for COVID-19 transmission.
- Identify work and common areas where employees could have close contact (within 6 feet) with others — for example meeting rooms, break rooms, the cafeteria, locker rooms, check-in areas, waiting areas, and routes of entry and exit.
- Include all employees in the workplace in communication plans — for example management, staff, utility employees, relief employees, janitorial staff, maintenance staff, and supervisory staff.
Engineering controls: Isolate workers from the hazard
- Modify or adjust seats, furniture, and workstations to maintain social distancing of 6 feet between employees.
- Install transparent shields or other physical barriers where possible to separate employees and visitors where social distancing is not an option.
- Arrange reception or other communal seating area chairs by turning, draping (covering chair with tape or fabric so seats cannot be used), spacing, or removing chairs to maintain social distancing.
- Use methods to physically separate employees in all areas of the facilities including work areas and other areas such as meeting rooms, break rooms, parking lots, entrance and exit areas, and locker rooms.
- Use signs, tape marks, or other visual cues such as decals or colored tape on the floor, placed 6 feet apart, to indicate where to stand when physical barriers are not possible.
- Replace high-touch communal items, such as coffee pots, water coolers, and bulk snacks, with alternatives such as pre-packaged, single-serving items.
- Consider using ultraviolet germicidal irradiation (UVGI) as a supplement to help inactivate the virus.
Administrative controls: Change the way people work
- Consider conducting daily in-person or virtual health checks (e.g., symptoms and/or temperature screening) of employees before they enter the work site.
- Clean and disinfect high-touch surfaces
- Follow the Guidance for Cleaning and Disinfecting to develop, follow, and maintain a plan to perform regular cleanings to reduce the risk of people’s exposure to the virus that causes COVID-19 on surfaces.
- Routinely clean all frequently touched surfaces in the workplace, such as workstations, keyboards, telephones, handrails, printer/copiers, drinking fountains, and doorknobs.
- If hard surfaces are visibly soiled (dirty), clean them using a detergent or soap and water before you disinfect them.
- For disinfection, most common, EPA-registered, household disinfectants should be effective as well as diluted household bleach solutions or alcohol solutions with at least 70% alcohol. A list of products that are EPA-approved for use against the virus that causes COVID-19external icon is available on the EPA website. Follow the manufacturer’s instructions for all cleaning and disinfection products (e.g., concentration, application method, and contact time).
- Provide employees with disposable wipes and other cleaning materials so that they can properly wipe down frequently touched surfaces before each use.
- Provide employees adequate time to wash their hands and access to soap, clean water, and single use paper towels.
- Remind employees to wash their hands often with soap and water for at least 20 seconds. If soap and water are not available, they should use hand sanitizer with at least 60% alcohol.
Updated June 12, 2020
Medicaid, CHIP Dental Providers Can Now Apply for HHS Provider Relief Funds
The ADA News (6/9, Garvin) reports that “beginning June 10, eligible Medicaid or Children’s Health Insurance Program dental providers can apply to receive funding from the U.S. Department of Health and Human Services’ Provider Relief Fund Payment Portal,” according to a June 9 announcement from HHS.
More information about eligibility and the application process is available on the HHS CARES Act Provider Relief Fund: General Information page.
Updated June 11, 2020
DCDS Secures PPE Starter Kit From DC Government
PPE Starter Kits were shipped to dentists from DC Health in mid-June. Packages should be delivered to the address listed on your DC dental licence. The kits contain KN90/KN95 masks, earloop masks, disposable gowns and face shields.
Here is a scan of the letter sent from DC Health to DC dentists on the PPE Starter Kits.
If you have question about the packages, please contact the DC Health at (202) 442-5955.
If you did not receive a PPE starter kit, it may be picked up at the DC Health Warehouse at 3335 V Street, NE, M-F 7:30 AM - 4:00 PM
Updated July 17, 2020
Beware of Counterfeit N95/KN95 Respirators and Other PPE
The COVID-19 pandemic and short supply of N95/KN95 masks, other PPE, and test kits combine to create increased potential for counterfeit products. You are urged to exercise caution when purchasing PPE, test kits and other supplies, particularly from suppliers you do not know. The CDC National Personal Protective Technology Laboratory (NPPTL) provides additional information about N95 masks and alternatives permitted during the pandemic (FDA Emergency Use Authorization (EUA)). NPPTL also provides information on counterfeit respirators. The NPPTL page also includes the following statement:
NIOSH has recently received new information from Stakeholders across the United States regarding products from China claiming to meet GB2626 and EN149. Assessment results confirm that some of these products have poor filter efficiency and are of poor quality. NIOSH is working closely with the FDA to align Emergency Use Authorizations to communicate the point of use testing results.
TDSC recently released two resources that provide guidance on this topic:
N95 Respirator FDA Authorized Cleaning Process
The FDA authorized Battelle to employ its Critical Care Decontamination System™ (CCDS). The CCDS can be used to decontaminate N95 masks (healthcare and industrial) that are not cellulose based. There is a CCDS facility in DC, and the decontamination service is being provided to healthcare personnel at no charge. Here is the form to request the Battelle CCDS service. Additional information on this program is provided below under “Additional Resources.”
The FDA Establishment Registration & Device Listing enables you to look up manufacturers who are registered to sell medical devices, including PPE, in the United States. If you search for “ORW” under product code as shown in the screenshot below, you will be provided with a list of manufacturers that registered with the FDA to sell KN95 in the United States. The presence of a manufacturer on the list is not a guarantee; searching for the manufacturer on the list should be a minimal check performed. The FDA has a toll-free information line open 24 hours a day where you can ask questions about COVID-19 Diagnostic Tests, and COVID-19 device shortages, including all Personal Protective Equipment for masks and respirators: 1-888-INFO-FDA.
Updated April 17, 2020
DCDS Webinar Recordings Available
Critical Business Decisions in the Era of COVID-19: Employees and Insurance (April 7)
Crisis Management for Dentists – Cash flow, credit and other resources (March 26)
These webinars were presented for informational purposes only to assist you and your business during the COVID-19 pandemic. Because of the short time frame required to organize this program, it is not possible for these webinars to be recognized under ADA CERP, therefor no CE will be provided.