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SlitLamp provides illuminating e-news for Colorado ophthalmologists. It keeps you in the know on the evolving Colorado health care scene by detailing the latest legislative and regulatory happenings. It also spotlights the information and resources you need for your practice.

 

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Executive Director's Update: Reflections

Posted By Chet Seward, Wednesday, June 17, 2020

Trying to make sense of how life has changed since the last edition of the newsletter feels like a nearly impossible task. I sincerely hope that you and yours are doing ok. To confess, at times I have struggled to see a way through this current/new/next/insert-your-adjective-sans-curse-words-here reality. The other day a friend imparted a simple, yet sticky little bomb of wisdom that has been reverberating around my head. She off-handedly remarked that trying to see a way “through” something isn’t always the right perspective and noted that in order to glean insights from an experience sometimes it’s best just to be “in” it.

In that spirit I am reflecting on:  

  • the death and suffering that the virus has inflicted on too many – directly, indirectly, physically, mentally and emotionally;
  • the quiet, unwavering dedication of physicians and other health care providers to caring for their patients in spite of threats to their health and the health of their families;
  • the devastating economic toll that has been wrecked on the prosperity of individuals, families and neighborhoods;
  • the unequivocal condemnation of racism in all its forms and the cries for social and criminal justice reforms that may finally be answered;
  • the care that ophthalmologists and their teams are taking to re-open their practices to reconnect safely with patients and to preserve and restore vision;
  • the resilient power of community; and
  • the undaunted promise of good science.

For now, that is enough.

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Communicating with patients about your reopened practice

Posted By Chet Seward, Wednesday, June 17, 2020

As Colorado begins to reopen and eye physicians and surgeons across the state take steps to resume providing care after a long pause due to the COVID-19 pandemic, communicating with patients about what they can expect and how they will stay safe is important.

 

CSEPS offers the following key points to emphasize in your pre-visit communications with patients to ensure new care experiences go smoothly. Special thanks to the American Academy of Ophthalmology for resources provided on some of these topics.

 

Depending on your practice situation, topics for communications with patients about what they can expect include:

  • How their safety and the safety of your staff are essential and what you and your team are doing to meet that priority like:
    • No waiting rooms – Having folks wait in their cars or outside to avoid crowding.
    • Restricting the number of people that can be in your practice.
    • Spacing seating in rooms to enable social distancing.
  • How scheduling may be affected given potential backlogs in care and the need to take extra precautions that may reduce the number of surgeries each day.
  • Requiring the use of masks and other prevention measures like asking about whether they may feel ill or taking their temperature. Here’s a video from AAO for patients on how to properly put on and take off masks.
  •  Deep cleaning protocols, between patients along with the availability of hand sanitizer.
  • How you may use different PPE and other materials on diagnostic equipment to minimize the spread of the virus.

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Cornea transplants: Update to FDA policy

Posted By Chet Seward, Tuesday, June 16, 2020

Thousands of patients who need cornea tissue may get the help they need thanks to the research and advocacy efforts by Michael A. Puente, Jr., MD, to drive a changes in outdated FDA policies regarding cornea donation by gay men. Dr. Puente, a pediatric ophthalmologist at CU, worked with CSEPS to craft and help pass a new policy recommendation that was recently adopted by the AAO Council to remedy the problem.

A little-known FDA policy instituted in 1994 prohibits corneal donation by any man who has had sex with another man (MSM) in the preceding five years, even when all infectious disease testing is negative. While the FDA allows organ donation by MSM donors without delay and only requires MSM donors to be abstinent for three months prior to blood donation, MSM corneal donors are still required to be abstinent for five years. This policy was put in place at a time when HIV screening tests were unreliable, yet the policy remains in place today even though modern HIV tests performed on all corneal donors are reliable within approximately a week of HIV exposure. An upcoming publication by Dr. Puente found that this rule disqualifies over 1,600 corneal donations a year from otherwise eligible donors. This is despite the fact that there has never been a reported case of HIV transmission through corneal transplant surgery, even in cases where the donor was retroactively found to have been HIV-positive. With global shortages of corneal tissue and thousands of patients on wait lists for corneas across the world, this policy is depriving patients of vision-restoring surgery.

The approved, CSEPS-sponsored Council Advisory Recommendation directs AAO to advocate for the modernization of this 26-year-old rule to shorten the MSM corneal donor deferral period to three months, the same amount of time mandated by the FDA for MSM blood donors. This would follow the example of peer nations such as the United Kingdom, the Netherlands and France, where MSM corneal donors are only subject to three to four-month deferral policies. The Eye Bank Association of America has also endorsed the idea of changing this policy.  The AAO Board of Trustees will discuss the issue at their Jen meeting to determine how the Academy will proceed.

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COVID-19 relief funds for Medicaid providers

Posted By Chet Seward, Tuesday, June 16, 2020

Federal help to weather the COVID-19 pandemic for providers who don’t see Medicare patients is finally on the way. Pediatric ophthalmologists can now seek assistance through grants from the U.S. Department of Health and Human Services, much like their other ophthalmology colleagues who treat Medicare patients who have already received assistance from the Provider Relief Fund. According to AAO, HHS recently added a new, third portal for Medicaid and Children’s Health Insurance Program (CHIP) providers to apply for the funds.

 

In order to be eligible to receive about 2% of reported gross revenues from patient care, providers must have:

  1. Received no payment through either the first or second round of relief and
  2. Billed Colorado Medicaid/CHP+ for services between January 1, 2018, and May 31, 2020.

Expect to submit data attesting to your gross revenues.

 

Don’t wait! Providers will have until July 20 to apply.

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Executive Director's Update: Seeing This Through

Posted By Chet Seward, Friday, April 3, 2020

Chet Seward,
Executive Director

As I look back on the last few weeks and reflect on the COVID-19 pandemic I must confess that I am still a bit dazed and disjointed. At quiet times, late at night, as I peer into the future, I will also say that sometimes I am still a little scared. These emotions are both expected and normal. That’s exactly what I have heard from many CSEPS members like you since the outbreak really took hold in Colorado in March. To be clear, I and my loved ones are ok and it is my sincere hope that yours are too. That said, the phone calls, the texts, the emails from Colorado ophthalmologists have all been important to me not only because of the strengthened personal connections, but also because of the determination and dedication many of you have shown in the face of these trying times.

 

I know that it is tough right now. I also want you to know how grateful we are for your professionalism and your care of patients in need.

 

While looking ahead is a perilous task at this moment, one thing is clear. At CSEPS we are right there with you, your practice and your community. We will see this through.

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COVID-19 response volunteer opportunities

Posted By Chet Seward, Friday, April 3, 2020

Medical professionals and administrators are urgently needed to donate their time to provide free telehealth visits to the hundreds of thousands of currently uninsured and underserved Coloradans. This work will be performed entirely from home, primarily via telephone and/or video calls. Callers will provide their symptoms over the phone, and those who need medical attention will be triaged to a queue for telephone-based care.  

 

The Colorado Covid-19 Innovation Response Team setup by Gov. Polis is specifically looking for volunteers:

  • Medical professionals (Doctors, Nurses, Mental Health professionals)
  • Trained administrators (familiar with SOAP notes, triage, scheduling, etc.)
  • Fluent in English
  • Fluency in a second language is highly desirable
  • Medical professionals must carry active licenses for their profession (retired professionals can reinstate their licenses pursuant to recently updated DORA regulations)
  • Medical professionals must carry malpractice insurance.  COPIC will provide malpractice insurance for volunteer physicians (MD and DO).
  • Volunteers will need a phone and a computer with internet access

 

Even a few hours a week could make a meaningful difference for the people who need it most. Sign up now.

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COVID-19 resources

Posted By Chet Seward, Friday, April 3, 2020

As the COVID-19 pandemic continues to unfold, CSEPS remains focused on providing you with the resources and information you need to safely care for your patients and preserve the viability of your practice.

 

Nationally, CSEPS continues to partner closely with the American Academy of Ophthalmology who has an excellent site. Rather than reinventing the wheel and filling up your inbox with even more email, we are collaborating locally with the Colorado Medical Society (CMS) and other state specialty societies to compile more state-specific resources. CMS has a nice set of information broken down by relevant areas including general questions, telehealth, care protocols, PPE, testing, workforce and financial support. There is also a secure physician-only discussion board that has rich dialogue and practical advice from doctors across the state on issues related to current practice and the COVID response.

 

Besides current problems relating to COVID testing and the availability of personal protective equipment (PPE), CSEPS staff has fielded a number of questions from members centered on Governor Polis’ executive order pausing voluntary and non-essential surgeries and procedures,  and practice viability issues given the striking downturn in patient visit volume. This useful list from AAO will help ophthalmologists determine what is and isn’t essential as they work to comply with the executive order (also see this FAQ from DORA). The recently passed CAREs act to help stimulate the economy in the wake of the COVID-19 outbreak had important components that can aid your practice with keeping staff on payroll using a Small Business Administration loan that can be forgivable. Get details here and here. In addition to suspending the 2% sequestration cuts to Medicare payments from May 1 until Dec. 31, Medicare also announced accelerated, advanced payments to physicians due to the effects of the COVID-19 pandemic. This program might also be a way to weather the financial storm in your practice, but be aware these advance payments must be paid back within a certain time period. Read the fact sheet here.

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CSEPS co-sponsors COVID town hall featuring Sens. Bennet and Gardner

Posted By Chet Seward, Friday, April 3, 2020
Sen. Michael Bennet
Sen. Cory Gardner
CSEPS co-sponsored a special, physician, virtual town hall by the Colorado Medical Society that focused on the recently enacted $2 trillion CAREs act. Colorado U.S. Senators Michael Bennet and Cory Gardner presented detailed information about the bill and fielded questions from physicians, emphasizing their recent work to ramp up delivery of PPE and expand testing especially for health care workers. Both senators repeatedly thanked physicians like you and other clinicians for your service during the pandemic. They encouraged physicians to contact their offices and welcomed the opportunity to serve as a resource. The program ended with a status update from Colorado Department of Public Health & Environment Chief Medical Officer Eric France, MD, MPH, who reported that as of 4/1/2020 Colorado had 3,342 positive case reported, with 620 hospitalized and 80 deaths. Modeling suggests that Colorado can expect peak surge during the second or third week of April. Dr. France reported that current data indicate that social distancing may be having a positive impact on flattening the curve.

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Stressed because of COVID?

Posted By Chet Seward, Friday, April 3, 2020

Whether you’re on the frontlines or sidelined and deeply concerned about the viability of your practice given mandatory closures because of the COVID-19 pandemic, the truth is that the level of anxiety and stress permeating the health care system right now is amazing. CSEPS encourages you to remember and prioritize your wellbeing. If you or a colleague are struggling, then consider calling the new COVID-19 Care Line by the Colorado Physician Health Program (CPHP). Call the Care Line at 720-810-9131, you will be linked with a physician peer who will listen and discuss stresses associated with the COVID-19 crisis and caring for those suffering from the disease. This free service is not treatment, but rather an opportunity for peer support in a confidential environment. Get more information here.

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Calls for COVID expanded liability protection

Posted By Chet Seward, Friday, April 3, 2020

CSEPS joined the Colorado Medical Society and other state and county medical societies in a letter to Gov. Polis strongly advocating for a new executive order that would provide liability immunity protections for confirmed, potential and suspected COVID-19 cases. Ophthalmologists and other physicians have answered the call all over the state to help with the response to the pandemic. The letter calls for the extension of those same protections for physicians who are operating under crisis standards of care or who are providing care outside of their normal practice location or outside of their primary practiced specialty or sub-specialty in response to workforce surge needs during this public health emergency. Read the letter here.

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