As the nation addresses the Coronavirus disease (COVID-19) pandemic, the NAFC understands that Free and Charitable Clinics and Charitable Pharmacies are at the frontlines of community health care needs and concerns.
To help address this pandemic, the NAFC has compiled and regularly updates a list of resources below regarding the disease spread, preparedness, prevention and more for our members.
The NAFC conducted a survey of its members to learn more about the impact of COVID-19 on the organizations and their communities. Visit the link below to learn more and review the survey results in this report.
The NAFC continues to encourage Members of Congress and the Administration to find a solution to the high costs of coronavirus testing for the uninsured and immigrant patient population. Additionally, the NAFC continues to encourage Members of Congress, Federal Agencies and the Administration to identify ways to expand funding to all members of the safety-net who are treating patients in communities across the country. The NAFC will activate our members in letter-writing campaigns if and when it is appropriate.
PUBLIC CHARGE
USCIS announced that the agency will NOT consider “testing, treatment, nor preventative care (including vaccines, if a vaccine becomes available) related to COVID-19” in a public charge determination “even if such treatment is provided or paid for by one or more public benefits.”
NAFC Member Alert – March 26, 2020 - S. 3548, The Coronavirus Aid, Relief, and Economic Security Act (CARES Act) - CLICK HERE TO READ
NAFC Memo to Members - March 30, 2020 - Important COVID-19 Funding Opportunity and CARES Act Update - CLICK HERE
This memo includes:
Information regarding the 100-billion-dollar public health and social services emergency fund in the recently passed CARES Act.
Non-Profit Loans eligibility and requirements included in the recently passed CARES Act.
Additional important provisions under the CARES Act that may impact member organizations, their donors, patients and volunteers.
Trump Administration Acts to Ensure U.S. Healthcare Facilities Can Maximize Frontline Workforces to Confront COVID-19 Crisis - note Stark waivers
At President Trump’s direction, the Centers for Medicare & Medicaid Services (CMS) temporarily suspended a number of Medicare rules so that hospitals, clinics, and other healthcare facilities can boost their front-line medical staffs as they fight to save lives during the 2019 Novel Coronavirus (COVID-19) pandemic on April 9th.
These changes affect doctors, nurses, and other clinicians nationwide, and focus on reducing supervision and certification requirements so that practitioners can be hired quickly and perform work to the fullest extent of their licenses. The new waivers sharply expand the workforce flexibilities CMS announced on March 30. Note especially the following: Blanket Waivers of Sanctions under the Physician Self- Referral Law (also known as the “Stark Law”)
CMS has issued blanket waivers of sanctions under section 1877(g) of the Act. The blanket waivers may be used now without notifying CMS. Individual waivers of sanctions under section 1877(g) of the Act may be granted upon request. For more information, visit: https://www.cms.gov/Medicare/Fraud-and-Abuse/PhysicianSelfReferral/Spotl....
For resources and additional information on 1135 Waivers, please also visit:
NAFC Letter to McConnell Regarding the Third Relief Bill - March 20, 2020 - CLICK HERE
Families USA Coalition Sign-on Letter: FAMILIES USA’S “GIVE FAMILIES AND STATES COVID-19 SUPPORT NOW!” COALITION SIGN-ON LETTER - CLICK HERE
Sample Letter for State Associations: Sample Letter for State Associations to use to contact State Policy Leaders on testing and supplies - CLICK HERE
NAFC Letter to Senate: To see the letter the NAFC asked members to send to their Senators urging them to include legislative language in the Coronavirus Federal Funding Disaster Package that will cover coronavirus testing for the uninsured at 100% and that will make Free and Charitable Clinics and Charitable Pharmacies eligible for federal funds to treat and combat the spread of this virus - CLICK HERE
Telehealth, Telemedicine & Technology
Discounted Telehealth Service for NAFC Members - Updox
The NAFC has partnered with Updox to provide our members with a group discount of up to 50% off on Updox's Telehealth services. Updox will be providing NAFC member organizations with the following three telehealth packages which vary based on the amount of video sessions needed per month by the member organization.
$99 per month/per organization for 400 video sessions
$149 per month/per organization for 1,000 video sessions
$648 per month/per organization for 5,000 video sessions
All packages will include unlimited text messages, unlimited HIPPA compliant text messaging, unlimited users. In addition, due to both ours and Updox's partnerships with Practice Fusion, all packages available to NAFC members will also include the Updox-Practice Fusion integration at no cost to our members using Practice Fusion as their EHR system.
Discounted Telemedicine Services for NAFC Members - Capstone Health Network
The CDC recommends using telemedicine to reduce the impact and spread of the Coronavirus (COVID-19). Capstone Health Network, a NAFC partner, offers an immediate and practical solution clinics can use to implement telemedicine, which includes providers, in order to expand their ability to treat patients during the COVID-19 outbreak, especially individuals who may be afraid to go out in public tor or a clinic for fear of catching an illness.
For more immediate information on a special discounted telemedicine solution for NAFC members, please contact Jeff Roberts at Capstone Health Network by calling (800) 845-7720 or emailing jroberts@capstonehealthnetwork.com.
CareMessage enables free and charitable clinics to reduce no-shows by using text messages and voice reminders to collect appointment RSVPs and fill gaps in care. The platform saves volunteer and staff time spent making phone calls, instead sending personalized text messages to individuals or groups of patients. For more information, please visit www.caremessage.org.
We are proud to partner with CareMessage, the largest 501c3 not-for-profit patient engagement organization in the United States. CareMessage focuses solely on the underserved with more than 3.5M active underserved patients reached across ~40 states. In the wake of COVID-19, CareMessage is offering the following:
FREE use of CareMessage for at least 60 days: Through the generosity of major philanthropic donors, CareMessage has released a COVID-19-only version of its texting platform, made available at no cost for 60 days to any health center.
One hour setup: No EMR or PHM integration is required to use this version of the platform and setup takes one hour.
COVID-19 CareMessage Help Center - CareMessage resource space to their help center for best practices when it comes to communicating COVID information to patients and staff/volunteers.
Telehealth Options
Zoom for Healthcare: Video conferencing for telehealth - Zoom for telehealth reliably delivers consistent clinical user experiences, seamlessly integrates into your technology and workflows, and keeps you connected and compliant. With high quality video, even in low-bandwidth environments, organizations can support healthcare teams and patients around the globe.
Doxy.me: doxy.me provides a free video conferencing solution that is compliant with HIPAA and HITECH requirements and incorporates standard clinical workflows such as patient check-in and waiting room into their designs that healthcare providers and their patients experience a familiar and natural visit.
In the wake of COVID-19, Call 4 Health is offering the following to our health center and clinic community: FREE USE of Text & Automated Call software for 60 days! Call 4 Health is offering FQHC's and Free Clinics free access and use of our software for a minimum of 60 days to address COVID-19 with their patients. NO integration, NO long setups! No EMR or PHM integration is required to use this version of the platform and setup takes up to one hour.
Medpod Video Telehealth (from NAFC Partner Henry Schein) - Pricing: 1) Pay per encounter: $50 per provider set up fee - $4 per patient encounter. 2) Unlimited Encounters: $2,750 per year for four providers.
AMA Quick Guide to Telemedicine in Practice - In an effort to keep our health care workers and patients safe amid the COVID-19 pandemic, the American Medical Association (AMA) has designed this quick guide to support physicians and practices in expediting the implementation of telemedicine, so care can continue to be provided to those who need it most.
Notification of Enforcement Discretion for Telehealth Remote Communications During the COVID-19 Nationwide Public Health Emergency - We are empowering medical providers to serve patients wherever they are during this national public health emergency. We are especially concerned about reaching those most at risk, including older persons and persons with disabilities. – Roger Severino, OCR Director Under this Notice, however, Facebook Live, Twitch, TikTok, and similar video communication applications are public facing, and should not be used in the provision of telehealth by covered health care providers.
Office for Civil Rights, U.S. Department of Health and Human Services BULLETIN - HIPAA Privacy and Novel Coronavirus In light of the Novel Coronavirus (2019-nCoV) outbreak, the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS)is providing this bulletin to ensure that HIPAA covered entities and their business associates are aware of the ways that patient information may be shared under the HIPAA Privacy Rule in an outbreak of infectious disease or other emergency situation, and to serve as a reminder that the protections of the Privacy Rule are not set aside during an emergency.
TCI Software COVID-19 Survey Template - TCI Software is offering NAFC Members Free access to its COVID-19 survey template that gives clinic administrators a daily ability to see how the virus is impacting their patient population. The survey can track the number of patients and people within their families who have been tested, diagnosed (positive/negative), and treated (or not), and can be deployed via laptops/tablets, email and/or cellphones. The program runs 24/7 and results are reported in real-time. Clinics can customize their surveys. Administrators can access the results 24/7. The survey template has already been translated into Spanish. The program can be set up within 24 hours.
For more information, or to enroll in the program, simply email a request to COVID19@tcisoftware.com. TCI staff will respond with instructions to set up your access.
Telehealth Toolkit - Resource from the Washington Healthcare Access Alliance and Dr. Angad Singh, University of Washington School of Medicine
Clinical Protocols & Resources
Clinical Protocols from NAFC Members
The NAFC has asked our provider listserv to share sample clinical protocols regarding COVID-19 and we are grateful for the documents that have been shared for your reference and review. Please click on the document title below to access each document.
Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings
This interim guidance has been updated based on currently available information about COVID-19 and the current situation in the United States, which includes reports of cases of community transmission, infections identified in healthcare personnel (HCP), and shortages of facemasks, N95 filtering facepiece respirators (FFRs) (commonly known as N95 respirators), and gowns
Strategies for Optimizing the Supply of Facemasks
These considerations are intended for use by federal, state, and local public health officials; leaders in occupational health services and infection prevention and control programs; and other leaders in healthcare settings who are responsible for developing and implementing policies and procedures for preventing pathogen transmission in healthcare settings
COVID-19 Health Literacy Project - This project created and translated accessible COVID-19 information into 30+ different languages to help all patients know when, and how, to seek care. The materials are created in collaboration with Harvard Health Publishing.
COVID-19 Health Literacy Project - This project created and translated accessible COVID-19 information into 30+ different languages to help all patients know when, and how, to seek care. The materials are created in collaboration with Harvard Health Publishing.
Medical Malpractice and General Liability Insurance
Prior to establishing an open-air COVID-19 screening or treatment clinic, or prior to screening patients in their cars, please contact your medical malpractice and general liability insurance providers to ensure that your insurance protection extends to health care provided outside of your clinic facility.
FTCA
The Health Resources and Services Administration (HRSA) has issued a particularized determination for free clinic providers that clarifies eligibility for FTCA coverage during the COVID-19 pandemic for the provision of qualifying health services by individuals who have been deemed as Public Health Service employees through the Free Clinics FTCA Program. It applies to qualifying health services to prevent, prepare, or respond to COVID-19 (including but not limited to screening, triage, testing, diagnosis, and treatment) to individuals who are established or non-established patients of the free clinic, whether in person at the free clinic, through responsive offsite programs or events carried out by the free clinic, or via telehealth.
During the declared emergency, can deemed free clinic health care practitioners conduct screenings, triage and related services of patients in vehicles located within the free clinic’s parking lot?
In responding to the declared emergency, deemed free clinic health care practitioners may provide screenings, triage, and related services, including initial consultations to patients or to individuals that intend to become a patient of the free clinic. These activities may be conducted inside the free clinic site(s) (this includes all sites that appear in an approved free clinic deeming or redeeming application) or outside of the free clinic site(s) (e.g. to patients in their vehicles in the free clinic parking area). Free clinics may also utilize telehealth to facilitate the delivery of health center services. All contact with current free clinic patients or patients that intend to become patients of the free clinic, must be appropriately documented in writing. Also see Policy Information Notice 2011-02, Free Clinics Federal Tort Claims Act (FTCA) Program Policy Guide, and the free clinic website at https://bphc.hrsa.gov/ftca/freeclinics/index.html
Health Department Directories
The resources below link to health departments in all 50 states, 8 US territories and freely associated states, and the District of Columbia. Please contact the health department in your state to gain a better understanding of where you should send any patients that have coronavirus symptoms.
Employee COVID19 & Return to Work Protocols - Resource from the Greenville Free Medical Clinic in Greenville, SC - CLICK HERE
COVID-19 CRISIS RESPONSE WORKBOOK - FREE & CHARITABLE CLINICS EDITION - Prepared by Next Stage on behalf of NCAFCC - The purpose of this crisis response workbook is to provide free and charitable clinics a framework for working with staff, volunteers, board members and community leaders to both react to the near-term realities facing their clinics as well as prepare for what is to come in the future. CLICK HERE
Emergency Management Plan - The NAFC has developed an emergency management plan document that you can fill out with your contact information to personalize for your organization: CLICK HERE
NAFC Office Procedures - NAFC continues to monitor this situation closely and if/when appropriate will utilize the following protocols, which were approved by the Board under our disaster plan. CLICK HERE
Americares COVID-19 Planning Resources:
COVID-19 Response Plan Template designed for CHCs and FCCs
Checklist that can be used to assess existing emergency plans
Online training
One-on-one consultations
The Americares Preparedness Team has developed a plan template and checklist to assist health centers and clinics in planning their response to the COVID-19 pandemic. To access the template and checklist, along with links to register for free online trainings based on the documents, please visit: https://www.americares.org/what-we-do/emergency-programs/resources-for-clinics-health-workers/
Informational Webinars
Government lending to small businesses (including non-profits) during COVID-19—Why? How? And will it work? On Tuesday, April 14, the Hutchins Center on Fiscal & Monetary Policy at Brookings convend a virtual panel to discuss the shape, scale, and economic rationale for the small business lending program; the administrative challenges it poses to lenders, small businesses, and government; and the possibility that it will prove to cost far more than the initial $349 billion allocation.
COVID-19 & Nonprofit Response: Health, Fundraising, and Risk Assessment - The Non-Profit Times - Nonprofit leaders are scrambling to keep services operational, not just open, during this worldwide pandemic. The NonProfit Times has assembled health professionals, fundraising experts and risk management authorities to provide guidance during a one-hour webinar. This webinar features NAFC President & CEO Nicole Lamoureux and NAFC Board Member Dr. Bobby Kapur.
“Coronavirus Disease 2019 (COVID-19) Update—What Clinicians Need to Know to Prepare for COVID-19 in the United States” - During this COCA Call, clinicians will learn what they can do to prepare for COVID-19 including identifying persons under investigation, applying infection prevention and control measures, assessing risks for exposures, optimizing the use of personal protective equipment supplies, and managing and caring for patients (inpatient and at home).
“Outbreak of 2019 Novel Coronavirus (2019-nCoV)—Interim Guidance for Clinicians” - During this COCA Call, clinicians will learn about the current epidemiology, infection control and prevention recommendations, specimen collection and testing, and clinical management for patients with 2019-nCoV infection.
“Prepare Not Panic: COVID-19 CDC Update and the Health Center Response” - On Friday, March 6, 2020, the National Association of Community Health Centers hosted the webinar in collaboration with the Centers for Disease Control and Prevention Coronavirus Response Task Force.
Laboratories Certified to Perform High Complexity Testing under CLIA prior to Emergency Use Authorization for Coronavirus Disease-2019 during the Public Health Emergency
“Don’t Let Pathogens Hang Out in Your Facility: An Integrated Decontamination Plan for Hard/Soft Surfaces in Healthcare Settings” with Clorox Healthcare”
NAFC Partner Offers Telemedicine Solution to Help NAFC Members Deal with COVID-19 - Join the NAFC for an informational webinar presentation from one of the NAFC's newest partners, Capstone Health Network. The CDC recommends using telemedicine to reduce the impact and spread of the Coronavirus (COVID-19). Unfortunately, few clinics are currently set up to provide telehealth services. Capstone Health Network, an NAFC partner, offers an immediate and practical solution clinics can use to implement telemedicine in order to expand their ability to treat patients during the COVID-19 outbreak, especially individuals who may be afraid to go out in public tor or a clinic for fear of catching an illness.
NAFC Partners - Donated and Discounted Services and Supplies
Discounted Medical Supplies
Henry Schein Medical – limited discounted products for NAFC members may be available such as gowns, gloves, etc. This changes by the hour as well, and there may be limitations on amounts of products purchased at a time due to shortages.
Please find information on the different “colored circles” that are associated with all items on the Henry Schein website. Each line item will have a color. If an items has a Green Circle - it will arrive the Next Day if ordered by 4:30PM, local warehouse. If an item has a Yellow Circle, the item is Backordered and will be delivered once available. If it has a Red Circle, the item is discontinued. If the circle is half green and half yellow, there is a 2-5 day delivery time. If the circle is Blue, the item is considered a non-stocking item, will have additional fees and is not returnable.
Please note, for any current Henry Schein Medical customer, orders may sometimes be canceled or placed on backorder due to COVID-19. Clinics are able to run a report on the Henry Schein Medical website that will show items that have been Canceled or are currently on Backorder regardless of the order entry method. For a detailed walk-through on how to run this report, please watch this 3 minute video: https://player.vimeo.com/video/402920111?quality=1080p
You can also find information from Henry Schein Medical on their Coronavirus (COVID-19) Update webpage that has a list of additional resources for healthcare professionals: http://www.henryschein.com/coronavirus.
Provista GPO – Limited number of vendors have mostly gowns available. To connect with one of the vendors, please email – tbirk@provistaco.com. Also, you can check out their COVID-19 site for more information and supply updates: https://www.vizientinc.com/covid-19
Mail Order Pharmacy Partner - RxOutreach
Rx Outreach is the nation's largest, non-profit, fully licensed, mail order pharmacy and Patient Assistance Program (PAP). Missioned to provide affordable medication to the underserved, Rx Outreach partners with the NAFC and hundreds of clinics and organizations across the U.S. to provide a crucial health safety net for those who battle both illness and poverty.
Rx Outreach offers more than 1,000 medication strengths at affordable, transparent prices as well as free home delivery. NAFC members have access to a dedicated clinic team, free pharmacist consultations, and a clinic portal to efficiently manage patient enrollment, orders, and refills. Rx Outreach serves people regardless of their citizenship status or whether they are insured, uninsured, or under-insured.
As a NAFC member benefit, Rx Outreach offers $5 off the first medication order for new clinic patients and a 5% discount on all medications. Additionally, in gratitude for their service to those in need, all employees and volunteers of NAFC member organizations are automatically eligible for Rx Outreach affordable medication program. Since 2010, Rx Outreach has saved patients more than $662 million on their prescription medications.
Patient Assistance Program (PAP) for Prescription Drug Recovery Software - WebPAP™
For NAFC members needing Medication Access Programs, we have a product which can address this urgent need for the member clinics, for Patient Assistance Program (PAP) for Prescription Drug Recovery Software - WebPAP™. Our clients include many of the Free and Charitable Clinics who are members of NAFC, CHC Clinics, Hospitals and FQHC clinics.
Our clients have successfully processed over 1 million applications with our WebPAP™ software and their patients have received over $1.02 Billion in FREE medications (based on average wholesale price (AWP) in value, with our Patient Recovery software. I believe this would be a huge value add for member clinics of the NAFC. We are also offering a 20% discount to all new customers who sign up between now and September 1, 2020 off our MSRP software licenses to NAFC Members, to help in these trying times.
The technology deployed in WebPAP™ software empowers clinics to quickly identify and qualify patients who are either un-insured, under-insured, or medically indigent. A process which took 72 hours or more, by clinics can now be completed in minutes!
WebPAP™ can be used efficiently and effectively to qualify the patient for needed medications at No cost or substantially reduced cost to the patient. Securing PAP aid can be extremely challenging. We help successfully manage the ever-evolving PAP complexities by providing PAP recovery software and services from start to finish.
DIRECT RELIEF: To learn more or to become a partner with Direct Relief, please visit: https://www.directrelief.org/apply/ or download their partner application, HERE. To download their application to be a part of their Non-Prescription Support Program, please click HERE. To learn more about Direct Relief's emergency preparedness efforts, please click HERE
NAFC Direct Relief Grant Application - $1 Million from Direct Relief to help NAFC members in good standing with operational support, telehealth/telemedicine and medication access. GRANT APPLICATION CLOSED -The announcement from Direct Relief’s CEO can be viewed here: https://www.youtube.com/watch?v=BuKHEZhGkP8&feature=youtu.be
COVID-19 Planning Resources: The Americares Preparedness Team has developed a plan template and checklist to assist health centers and clinics in planning their response to the COVID-19 pandemic. To access the template and checklist, along with links to register for free online trainings based on the documents, please visit: https://www.americares.org/what-we-do/emergency-programs/resources-for-clinics-health-workers/
Institute for Healthcare Advancement
With the healthcare system possibly becoming overwhelmed it can become a challenge to get the medical attention you need for your child. By utilizing our “What to do when your child gets sick” book, it can help alleviate a lot of the burden from our healthcare services for urgent and vital situations. It will help you make sound decisions on how to care for your child if they get sick at home or to determine if it is truly an emergency and for them to go see a doctor. The book includes what to do for fever and colds. It would be important more than ever now for parents to have a copy of this book with schools being shut down and children being at home.
In addition to English and Spanish, the book also comes in Chinese, Korean, Vietnamese, Arabic, and Burmese. They are all written at a 3rd to 5th grade reading level making it easy to understand.
NAFC COVID-19 Rolling Funding Application - As the NAFC receives and continues to develop funding opportunities for our members for COVID-19 responses, we are opening up this application for funding as opportunities become available. To learn more and to apply, please visit: https://www.emailmeform.com/builder/form/Ct01X8FW49ewj4pbkmaS
Funding Opportunities for Coronavirus Relief - Candid.org has compiled a list of funds specifically established in the wake of coronavirus. The list focuses on funds hosted at U.S.-based foundations that serve nonprofits.
Grants Plus Crisis Grant Funding Opportunities - Deadline - Rolling: Our team is tracking emergency grant opportunities that are being released by funders across the country to help organizations recover and respond to the crisis. Visit our Crisis Grant Funding Resources List frequently, as we will continue updating it as we learn of new funding opportunities.
The COVID-19 Health Coalition The COVID-19 Healthcare Coalition is a private-sector led response that brings together healthcare organizations, technology firms, nonprofits, academia, and startups to preserve the healthcare delivery system and help protect U.S. populations. https://c19hcc.org
This coalition developed a Vulnerable Population Dashboard that takes into consideration medical risk, social risk and health care resource risk. It was put together by MITRE. https://c19hcc.org/resource/vulnerable-population
In this time of stress, anxiety and fear, the Headspace app is offering a collection of meditation and mindfulness content for healthcare providers, workers/businesses, teachers and caregivers. Click the above link to learn more.
Headspace is providing free subscriptions to US healthcare providers working in public health settings: If you work in healthcare or know someone that does, please visit or share this link with instructions on how to claim your free subscription through the end of 2020.
As the nation addresses the Coronavirus disease (COVID-19) pandemic, the NAFC understands that Free and Charitable Clinics and Charitable Pharmacies are at the frontlines of community health care needs and concerns.
To help address this pandemic, the NAFC has compiled and regularly updates a list of resources below regarding the disease spread, preparedness, prevention and more for our members.
Advocacy & Policy Telehealth/Telemedicine Clinical Protocols & Resources
Malpractice & General Liability Insurance Health Dept Directories
Disaster, Stay at Home, Return to Work Plans Webinars
NAFC Partner Resources Funding Opportunitues
Community Statements & General Info Stress, Loss and Grief Resources
Coronavirus Updates and Resources
For the most up-to-date status of COVID-19 and available informational resources, please visit the CDC website: www.coronavirus.gov
FIND RELATED NEWS STORIES ON THE NAFC PUBLIC CORONAVIRUS WEBPAGE - https://www.nafcclinics.org/Coronavirus
NAFC BLOG - March 12, 2020 - Coronavirus – A Perfect Storm for the Medically Underserved: https://www.nafcclinics.org/content/coronavirus-–-perfect-storm-medically-underserved
The NAFC conducted a survey of its members to learn more about the impact of COVID-19 on the organizations and their communities. Visit the link below to learn more and review the survey results in this report.
ADVOCACY & POLICY
Uninsured Testing Cost
The NAFC continues to encourage Members of Congress and the Administration to find a solution to the high costs of coronavirus testing for the uninsured and immigrant patient population. Additionally, the NAFC continues to encourage Members of Congress, Federal Agencies and the Administration to identify ways to expand funding to all members of the safety-net who are treating patients in communities across the country. The NAFC will activate our members in letter-writing campaigns if and when it is appropriate.
PUBLIC CHARGE
USCIS announced that the agency will NOT consider “testing, treatment, nor preventative care (including vaccines, if a vaccine becomes available) related to COVID-19” in a public charge determination “even if such treatment is provided or paid for by one or more public benefits.”
For more information: https://www.uscis.gov/greencard/public-charge
CARES ACT
Trump Administration Acts to Ensure U.S. Healthcare Facilities Can Maximize Frontline Workforces to Confront COVID-19 Crisis - note Stark waivers
At President Trump’s direction, the Centers for Medicare & Medicaid Services (CMS) temporarily suspended a number of Medicare rules so that hospitals, clinics, and other healthcare facilities can boost their front-line medical staffs as they fight to save lives during the 2019 Novel Coronavirus (COVID-19) pandemic on April 9th.
These changes affect doctors, nurses, and other clinicians nationwide, and focus on reducing supervision and certification requirements so that practitioners can be hired quickly and perform work to the fullest extent of their licenses. The new waivers sharply expand the workforce flexibilities CMS announced on March 30. Note especially the following: Blanket Waivers of Sanctions under the Physician Self- Referral Law (also known as the “Stark Law”)
CMS has issued blanket waivers of sanctions under section 1877(g) of the Act. The blanket waivers may be used now without notifying CMS. Individual waivers of sanctions under section 1877(g) of the Act may be granted upon request. For more information, visit: https://www.cms.gov/Medicare/Fraud-and-Abuse/PhysicianSelfReferral/Spotl....
For resources and additional information on 1135 Waivers, please also visit:
For questions please email: 1135waiver@cms.hhs.gov
COVID-19 Emergency Declaration BlanketWaivers for Health Care Providers - /sites/default/files/summary-covid-19-emergency-declaration-waivers%203%20updated%204%209%2020-508%20%28002%29.pdf
Letter Writing Campaigns
National Council of Nonprofits Sign-on Letter: Urgent Nonprofit Policy Priorities in Reforms to CARES Act - July 13, 2020 - https://www.councilofnonprofits.org/sites/default/files/documents/nonprofit-community-letter-7-13-2020.pdf
NAFC Letter to McConnell Regarding the Third Relief Bill - March 20, 2020 - CLICK HERE
Families USA Coalition Sign-on Letter: FAMILIES USA’S “GIVE FAMILIES AND STATES COVID-19 SUPPORT NOW!” COALITION SIGN-ON LETTER - CLICK HERE
Sample Letter for State Associations: Sample Letter for State Associations to use to contact State Policy Leaders on testing and supplies - CLICK HERE
NAFC Letter to Senate: To see the letter the NAFC asked members to send to their Senators urging them to include legislative language in the Coronavirus Federal Funding Disaster Package that will cover coronavirus testing for the uninsured at 100% and that will make Free and Charitable Clinics and Charitable Pharmacies eligible for federal funds to treat and combat the spread of this virus - CLICK HERE
Telehealth, Telemedicine & Technology
Discounted Telehealth Service for NAFC Members - Updox
$99 per month/per organization for 400 video sessions
$149 per month/per organization for 1,000 video sessions
All packages will include unlimited text messages, unlimited HIPPA compliant text messaging, unlimited users. In addition, due to both ours and Updox's partnerships with Practice Fusion, all packages available to NAFC members will also include the Updox-Practice Fusion integration at no cost to our members using Practice Fusion as their EHR system.
For an overview: https://info.updox.com/hubfs/2020%20Campaigns/202004_NAFC-Overview.pdf
To connect with Updox and access discounted NAFC pricing: https://info.updox.com/nafc
Discounted Telemedicine Services for NAFC Members - Capstone Health Network
For more immediate information on a special discounted telemedicine solution for NAFC members, please contact Jeff Roberts at Capstone Health Network by calling (800) 845-7720 or emailing jroberts@capstonehealthnetwork.com.
Webinar: NAFC Partner Offers Telemedicine Solution to Help NAFC Members Deal with COVID-19 - https://attendee.gotowebinar.com/recording/414603150779401474
CareMessage
We are proud to partner with CareMessage, the largest 501c3 not-for-profit patient engagement organization in the United States. CareMessage focuses solely on the underserved with more than 3.5M active underserved patients reached across ~40 states. In the wake of COVID-19, CareMessage is offering the following:
To learn more or get started with this free solution, please reach out directly to CareMessage through this link. If you are already using a texting platform, CareMessage has made its entire COVID-19 message library free and available to any safety net provider. Access it here.
COVID-19 CareMessage Help Center - CareMessage resource space to their help center for best practices when it comes to communicating COVID information to patients and staff/volunteers.
Telehealth Options
Additional Telehealth/Telemedicine/Technology Resources
Protocols & Information from NAFC Members
Clinical Protocols & Resources
Clinical Protocols from NAFC Members
The NAFC has asked our provider listserv to share sample clinical protocols regarding COVID-19 and we are grateful for the documents that have been shared for your reference and review. Please click on the document title below to access each document.
General Clinical Resources
COVID-19 Health Literacy Project - This project created and translated accessible COVID-19 information into 30+ different languages to help all patients know when, and how, to seek care. The materials are created in collaboration with Harvard Health Publishing.
Medical Malpractice and General Liability Insurance
Prior to establishing an open-air COVID-19 screening or treatment clinic, or prior to screening patients in their cars, please contact your medical malpractice and general liability insurance providers to ensure that your insurance protection extends to health care provided outside of your clinic facility.
FTCA
The Health Resources and Services Administration (HRSA) has issued a particularized determination for free clinic providers that clarifies eligibility for FTCA coverage during the COVID-19 pandemic for the provision of qualifying health services by individuals who have been deemed as Public Health Service employees through the Free Clinics FTCA Program. It applies to qualifying health services to prevent, prepare, or respond to COVID-19 (including but not limited to screening, triage, testing, diagnosis, and treatment) to individuals who are established or non-established patients of the free clinic, whether in person at the free clinic, through responsive offsite programs or events carried out by the free clinic, or via telehealth.
The Free Clinic PD can be accessed from the link above or from the FTCA Free Clinic website: https://bphc.hrsa.gov/ftca/freeclinics/policies.html
Questions should be directed to Health Center Program Support: By phone: 877-464-4772, option 1; or Online: http://www.hrsa.gov/about/contact/bphc.aspx
Frequently Asked Questions Regarding FTCA, HRSA and COVID - Answers to how COVID Reimbursement may impact Free Clinics FTCA status can be found on this page, along with links to important policy announcements policy guides - https://bphc.hrsa.gov/emergency-response/coronavirus-frequently-asked-questions
During the declared emergency, can deemed free clinic health care practitioners conduct screenings, triage and related services of patients in vehicles located within the free clinic’s parking lot?
In responding to the declared emergency, deemed free clinic health care practitioners may provide screenings, triage, and related services, including initial consultations to patients or to individuals that intend to become a patient of the free clinic. These activities may be conducted inside the free clinic site(s) (this includes all sites that appear in an approved free clinic deeming or redeeming application) or outside of the free clinic site(s) (e.g. to patients in their vehicles in the free clinic parking area). Free clinics may also utilize telehealth to facilitate the delivery of health center services. All contact with current free clinic patients or patients that intend to become patients of the free clinic, must be appropriately documented in writing. Also see Policy Information Notice 2011-02, Free Clinics Federal Tort Claims Act (FTCA) Program Policy Guide, and the free clinic website at https://bphc.hrsa.gov/ftca/freeclinics/index.html
Health Department Directories
The resources below link to health departments in all 50 states, 8 US territories and freely associated states, and the District of Columbia. Please contact the health department in your state to gain a better understanding of where you should send any patients that have coronavirus symptoms.
https://www.cdc.gov/publichealthgateway/healthdirectories/healthdepartments.html
Disaster, Work from Home and Return to Work Plans
Employee COVID19 & Return to Work Protocols - Resource from the Greenville Free Medical Clinic in Greenville, SC - CLICK HERE
COVID-19 CRISIS RESPONSE WORKBOOK - FREE & CHARITABLE CLINICS EDITION - Prepared by Next Stage on behalf of NCAFCC - The purpose of this crisis response workbook is to provide free and charitable clinics a framework for working with staff, volunteers, board members and community leaders to both react to the near-term realities facing their clinics as well as prepare for what is to come in the future. CLICK HERE
Emergency Management Plan - The NAFC has developed an emergency management plan document that you can fill out with your contact information to personalize for your organization: CLICK HERE
NAFC Office Procedures - NAFC continues to monitor this situation closely and if/when appropriate will utilize the following protocols, which were approved by the Board under our disaster plan. CLICK HERE
Americares COVID-19 Planning Resources:
The Americares Preparedness Team has developed a plan template and checklist to assist health centers and clinics in planning their response to the COVID-19 pandemic. To access the template and checklist, along with links to register for free online trainings based on the documents, please visit: https://www.americares.org/what-we-do/emergency-programs/resources-for-clinics-health-workers/
Informational Webinars
Government lending to small businesses (including non-profits) during COVID-19—Why? How? And will it work? On Tuesday, April 14, the Hutchins Center on Fiscal & Monetary Policy at Brookings convend a virtual panel to discuss the shape, scale, and economic rationale for the small business lending program; the administrative challenges it poses to lenders, small businesses, and government; and the possibility that it will prove to cost far more than the initial $349 billion allocation.
COVID-19 & Nonprofit Response: Health, Fundraising, and Risk Assessment - The Non-Profit Times - Nonprofit leaders are scrambling to keep services operational, not just open, during this worldwide pandemic. The NonProfit Times has assembled health professionals, fundraising experts and risk management authorities to provide guidance during a one-hour webinar. This webinar features NAFC President & CEO Nicole Lamoureux and NAFC Board Member Dr. Bobby Kapur.
“Coronavirus Disease 2019 (COVID-19) Update—What Clinicians Need to Know to Prepare for COVID-19 in the United States” - During this COCA Call, clinicians will learn what they can do to prepare for COVID-19 including identifying persons under investigation, applying infection prevention and control measures, assessing risks for exposures, optimizing the use of personal protective equipment supplies, and managing and caring for patients (inpatient and at home).
“Outbreak of 2019 Novel Coronavirus (2019-nCoV)—Interim Guidance for Clinicians” - During this COCA Call, clinicians will learn about the current epidemiology, infection control and prevention recommendations, specimen collection and testing, and clinical management for patients with 2019-nCoV infection.
“Prepare Not Panic: COVID-19 CDC Update and the Health Center Response” - On Friday, March 6, 2020, the National Association of Community Health Centers hosted the webinar in collaboration with the Centers for Disease Control and Prevention Coronavirus Response Task Force.
Laboratories Certified to Perform High Complexity Testing under CLIA prior to Emergency Use Authorization for Coronavirus Disease-2019 during the Public Health Emergency
“Don’t Let Pathogens Hang Out in Your Facility: An Integrated Decontamination Plan for Hard/Soft Surfaces in Healthcare Settings” with Clorox Healthcare”
"Healthcare and Public Health Legal Preparedness: 2019 Novel Coronavirus (2019-nCoV)”
NAFC Partner Offers Telemedicine Solution to Help NAFC Members Deal with COVID-19 - Join the NAFC for an informational webinar presentation from one of the NAFC's newest partners, Capstone Health Network. The CDC recommends using telemedicine to reduce the impact and spread of the Coronavirus (COVID-19). Unfortunately, few clinics are currently set up to provide telehealth services. Capstone Health Network, an NAFC partner, offers an immediate and practical solution clinics can use to implement telemedicine in order to expand their ability to treat patients during the COVID-19 outbreak, especially individuals who may be afraid to go out in public tor or a clinic for fear of catching an illness.
NAFC Partners - Donated and Discounted Services and Supplies
Discounted Medical Supplies
Henry Schein Medical – limited discounted products for NAFC members may be available such as gowns, gloves, etc. This changes by the hour as well, and there may be limitations on amounts of products purchased at a time due to shortages.
Updated list of Personal Protective Equipment (PPE) that is available and in stock for purchase from Henry Schein Medical. This list of PPE is being updated every business day by 9am EST. https://docs.google.com/spreadsheets/d/1htH2LvoxBxYQVQOHt0tmPZuVsTJ_7T3mNMWlEJu0X-g/edit?usp=sharing
Please find information on the different “colored circles” that are associated with all items on the Henry Schein website. Each line item will have a color. If an items has a Green Circle - it will arrive the Next Day if ordered by 4:30PM, local warehouse. If an item has a Yellow Circle, the item is Backordered and will be delivered once available. If it has a Red Circle, the item is discontinued. If the circle is half green and half yellow, there is a 2-5 day delivery time. If the circle is Blue, the item is considered a non-stocking item, will have additional fees and is not returnable.
Please note, for any current Henry Schein Medical customer, orders may sometimes be canceled or placed on backorder due to COVID-19. Clinics are able to run a report on the Henry Schein Medical website that will show items that have been Canceled or are currently on Backorder regardless of the order entry method. For a detailed walk-through on how to run this report, please watch this 3 minute video: https://player.vimeo.com/video/402920111?quality=1080p
You can also find information from Henry Schein Medical on their Coronavirus (COVID-19) Update webpage that has a list of additional resources for healthcare professionals: http://www.henryschein.com/coronavirus.
Provista GPO – Limited number of vendors have mostly gowns available. To connect with one of the vendors, please email – tbirk@provistaco.com. Also, you can check out their COVID-19 site for more information and supply updates: https://www.vizientinc.com/covid-19
Mail Order Pharmacy Partner - RxOutreach
Rx Outreach is the nation's largest, non-profit, fully licensed, mail order pharmacy and Patient Assistance Program (PAP). Missioned to provide affordable medication to the underserved, Rx Outreach partners with the NAFC and hundreds of clinics and organizations across the U.S. to provide a crucial health safety net for those who battle both illness and poverty.
Rx Outreach offers more than 1,000 medication strengths at affordable, transparent prices as well as free home delivery. NAFC members have access to a dedicated clinic team, free pharmacist consultations, and a clinic portal to efficiently manage patient enrollment, orders, and refills. Rx Outreach serves people regardless of their citizenship status or whether they are insured, uninsured, or under-insured.
As a NAFC member benefit, Rx Outreach offers $5 off the first medication order for new clinic patients and a 5% discount on all medications. Additionally, in gratitude for their service to those in need, all employees and volunteers of NAFC member organizations are automatically eligible for Rx Outreach affordable medication program. Since 2010, Rx Outreach has saved patients more than $662 million on their prescription medications.
For more information about Rx Outreach or the NAFC partnership, visit www.rxoutreach.org/NAFC or contact the clinic team at 314-627-6221 or clientservices@rxoutreach.org.
Patient Assistance Program (PAP) for Prescription Drug Recovery Software - WebPAP™
For NAFC members needing Medication Access Programs, we have a product which can address this urgent need for the member clinics, for Patient Assistance Program (PAP) for Prescription Drug Recovery Software - WebPAP™. Our clients include many of the Free and Charitable Clinics who are members of NAFC, CHC Clinics, Hospitals and FQHC clinics.
Our clients have successfully processed over 1 million applications with our WebPAP™ software and their patients have received over $1.02 Billion in FREE medications (based on average wholesale price (AWP) in value, with our Patient Recovery software. I believe this would be a huge value add for member clinics of the NAFC. We are also offering a 20% discount to all new customers who sign up between now and September 1, 2020 off our MSRP software licenses to NAFC Members, to help in these trying times.
The technology deployed in WebPAP™ software empowers clinics to quickly identify and qualify patients who are either un-insured, under-insured, or medically indigent. A process which took 72 hours or more, by clinics can now be completed in minutes!
WebPAP™ can be used efficiently and effectively to qualify the patient for needed medications at No cost or substantially reduced cost to the patient. Securing PAP aid can be extremely challenging. We help successfully manage the ever-evolving PAP complexities by providing PAP recovery software and services from start to finish.
Additional information can be viewed on our web site: www.medicationadvocate.com
Disaster Relief Partners
DIRECT RELIEF: To learn more or to become a partner with Direct Relief, please visit: https://www.directrelief.org/apply/ or download their partner application, HERE. To download their application to be a part of their Non-Prescription Support Program, please click HERE. To learn more about Direct Relief's emergency preparedness efforts, please click HERE
N95 MASKS AVAILABLE TO CURRENT DIRECT RELIEF PARTNERS - For those organizations that are already current partners with Direct Relief, you will be receiving information from them on how to request masks. https://www.directrelief.org/2020/03/protective-gear-bound-for-approximately-1000-u-s-health-centers-and-clinics-fighting-covid-19/
NAFC Direct Relief Grant Application - $1 Million from Direct Relief to help NAFC members in good standing with operational support, telehealth/telemedicine and medication access. GRANT APPLICATION CLOSED - The announcement from Direct Relief’s CEO can be viewed here: https://www.youtube.com/watch?v=BuKHEZhGkP8&feature=youtu.be
AMERICARES: Please contact: uspartnerships@americares.org
COVID-19 Planning Resources: The Americares Preparedness Team has developed a plan template and checklist to assist health centers and clinics in planning their response to the COVID-19 pandemic. To access the template and checklist, along with links to register for free online trainings based on the documents, please visit: https://www.americares.org/what-we-do/emergency-programs/resources-for-clinics-health-workers/
Institute for Healthcare Advancement
With the healthcare system possibly becoming overwhelmed it can become a challenge to get the medical attention you need for your child. By utilizing our “What to do when your child gets sick” book, it can help alleviate a lot of the burden from our healthcare services for urgent and vital situations. It will help you make sound decisions on how to care for your child if they get sick at home or to determine if it is truly an emergency and for them to go see a doctor. The book includes what to do for fever and colds. It would be important more than ever now for parents to have a copy of this book with schools being shut down and children being at home.
In addition to English and Spanish, the book also comes in Chinese, Korean, Vietnamese, Arabic, and Burmese. They are all written at a 3rd to 5th grade reading level making it easy to understand.
For more information, please contact Andrew Pong: APong@iha4health.org or visit www.iha4health.org.
Funding Opportunities
NAFC COVID-19 Rolling Funding Application - As the NAFC receives and continues to develop funding opportunities for our members for COVID-19 responses, we are opening up this application for funding as opportunities become available. To learn more and to apply, please visit: https://www.emailmeform.com/builder/form/Ct01X8FW49ewj4pbkmaS
Coronavirus Aid, Relief, and Economic Security (CARES) Act: Coronavirus Emergency Loans Guide and Checklist for Small Businesses and Nonprofits - Prepared by U.S. Chamber of Commerce - https://www.uschamberfoundation.org/sites/default/files/C3_COVID_EmergencyLoanGuide.pdf
COVID-19 Grant Opportunities
Community Statements & General Information
The COVID-19 Health Coalition The COVID-19 Healthcare Coalition is a private-sector led response that brings together healthcare organizations, technology firms, nonprofits, academia, and startups to preserve the healthcare delivery system and help protect U.S. populations. https://c19hcc.org
This coalition developed a Vulnerable Population Dashboard that takes into consideration medical risk, social risk and health care resource risk. It was put together by MITRE. https://c19hcc.org/resource/vulnerable-population
Stress, Loss and Grief Resources