) Please see the latest guidance (link) from CDC and OSHA as to preparing workplaces
in this time. Also, here is a presentation from Governor Kate Brown on
(4/24/20) Latest guidance from OHA and the Governor’s Office -
Framework for Restarting Non-Emergent and Elective Proceduresin Medical and Dental Offices
(4/23/20) Governor Kate Brown announced today that she will be lifting her order delaying non-urgent procedures for health care providers, as long as they can demonstrate they have met new requirements for COVID-19 safety and preparedness. Hospitals, surgical centers, medical offices, and dental offices that meet those requirements will be able to resume non-urgent procedures on May 1. The press release of her announcement and the press conference itself are found here:
Please refer to the restrictions and guidance put out by the Governor’s office and the Oregon Health Authority (OHA) to determine how to change or modify your practices.
Cassandra C. McLeod-Skinner, J.D.
Oregon Board of Chiropractic Examiners
530 Center St NE, Suite 620
Salem, OR 97301
(3/26/20) The Oregon Health Authority (OHA) has recently published guidance and FAQs for elective and non-elective procedures referenced in the Executive Order 20-10 issued on 3/19/20. Please go to the following link to access the document:
(3/23/20) The Governor’s Office and the OBCE are not mandating clinic or practice closure at this time. Every licensee must use their own clinical and professional judgment as to whether you are complying with best practices for limiting the spread of COVID-19. Please read the Executive Order carefully.
Governor Brown’s Executive Order 20-12, Stay Home, Stay Safe
Governor Brown has issued Executive Oder 20-12 (link) that orders Oregonians to stay at home, closes specific businesses, and requires social distancing. The purpose of the order is to reduce person-to-person interaction with the goal of slowing transmission of COVID-19/corona virus.
Summary of the EO:
- Non-essential and recreational gatherings of individuals outside of a home or place of residence are prohibited immediately if a distance of six feet between individuals cannot be maintained.
- Individuals are prohibited from patronizing businesses that are closed by this order and from engaging in conduct prohibited by prior EOs or inconsistent with OHA guidance.
- Individuals must maintain a social distance of at least six feet from any person not an immediate member of their family to the greatest extent possible and comply with other OHA guidance.
- Chiropractic clinics/practices/offices are
not listed among the businesses ordered closed and would be considered within the health care and medical exemption of businesses allowed to operate within closed indoor and outdoor malls.
- The closed business list
does include gyms and fitness studios, medical spas, non-medical massage therapy services, and yoga studios.
- Required social distancing is also ordered in certain other types of retail businesses. However, offices that provide health care or medical services are not included within these types of businesses and are encouraged to comply with social distancing guidelines.
- Businesses that have the technology and network ability to facilitate telework/work at home shall do so to the maximum extent possible. When telework/work at home options aren’t available, businesses must designate an employee to establish, implement, and enforce social distancing policies consistent with OHA guidance.
Bottom line: The Governor’s Office and the OBCE are not mandating clinic or practice closure at this time. Every licensee must use their own clinical and professional judgment as to whether you are complying with best practices for limiting the spread of COVID-19. Chiropractic practices and licensees must abide by the restrictions and guidelines indicated by this and other Executive Orders and those from the Oregon Health Authority.
(3/20/20) Neither the Governor’s Office, nor the OBCE, is ordering clinic closures at this time. Please read the order closely to determine if the order applies to your practice and your use of PPE.
Governor Brown’s Executive Order 20-10
Governor Brown has issued Executive Order 20-10 (https://www.oregon.gov/gov/Documents/executive_orders/eo_20-10.pdf) that conserves personal protective equipment (PPE), postpones non-urgent health care procedures, and restricts visitation. “Procedures” and “non-urgent procedures” apply to chiropractic care. The intent and purpose of this order is to conserve much needed PPE and to limit COVID-19 exposure for healthcare practitioners, patients, and the public.
Summary of the EO:
- The order limits all non-essential visitation at hospitals and other health care facilities. This provision is most applicable to chiropractic clinics and family members who accompany patients.
- No later than March 23, 2020, all elective and non-urgent procedures within all healthcare settings (which includes chiropractic clinics)
that utilize PPE shall be cancelled or rescheduled no earlier than June 15, 2020. There are exemptions to this section but they do not apply to chiropractic care. (Italics added for emphasis.)
- All individuals and entities that in other, not healthcare related, industries that utilize PPE are strongly encouraged to cancel or postpone non-essential use of PPE.
- No later than March 27, 2020, any clinics with surplus PPE supplies shall notify the state’s PPE coordinator by calling (971) 900-9952 and arrange for delivery of those surplus supplies to the coordinator. This section does not specifically name chiropractic clinics but it is the Board’s desire that chiropractic clinics participate in this provision. Also, the Board requests that all practitioners or clinics that have extra gloves include them in their surplus PPE delivery.
Please continue to abide by all orders and recommendations made by Governor Brown, the Oregon Health Authority, and the Centers for Disease Control (links provided in earlier notices [below]). As a reminder, our rules allow for telehealth practice (https://secure.sos.state.or.us/oard/viewSingleRule.action?ruleVrsnRsn=249280) and that should not involve any PPE. If you decide to close your clinic or to temporarily not practice, please email the OBCE offices with such information.
The Board determined to issue the following temporary rules, effective March 20, 2020 (Links to
811-010-0083 License Renewal Payment Plans (COVID-19) and
811-015-0024 Continuing Education Requirements for First Year DC Licensees (COVID-19)), in light of the difficulties and hardships that COVID-19 and its restrictions has created on licensees. In summary, the Board is allowing for DC and CA renewal fees to be postponed for 90 days for those experiencing financial hardship and who notify the Board of such. The Board is also allowing for the OTC and Evidence-Based Outcomes CE requirements for first year DC renewals to be postponed until the second year renewal.
Additionally, the Board will suspend its background check requirement for renewing licensees/certificate holders who are experiencing hardship obtaining fingerprint processing from local processing offices that are closed. Please notify the Board office of your circumstance.
NOTICE: False Advertising and Marketing
The Board will be aggressively pursuing advertising and marketing violations, including but not limited to those made online and within social media, and specifically to claims involving COVID-19/Corona Virus. If you, or any licensees you know of, are making claims that they or their clinic can “improve the outcomes of,” “cure,” “prevent,” or in any other way effect patients with COVID-19/Corona Virus or their families, please notify the Board immediately for investigation and possible referral to the Attorney General. Not only are these claims possibly false or fraudulent, they put our public at grave risk.
(3/18/2020) The OBCE doesn’t have any policy or guidelines on temporary office closure or procedures to follow if offices stay open. Per the Governor’s office to date, there are no restrictions specifically directed to health care businesses beyond the 10 or more individuals in one setting.
With the recent call for increased social distancing at the state and federal level, each practice and provider should consider their own practice procedures and policies for continued patient care in an effort to ensure the highest level of safety for patients, staff and providers alike.
Here are some resources to guide you as you determine how you will proceed with patient care in your practices.
Oregon Health Authority’s COVID -19 website and email updates—please use this website to track the latest Oregon guidance on how to deal with the Novel Coronavirus. The site also has a place to sign up for email updates—sign up to get regular email updates from the OHA. The site also has all of the Governor’s Executive Orders related to the virus.
Center for Disease Control (CDC) website—this website has information on what’s happening in the U.S. with the virus, but also has ways practitioners can take care of themselves and recommended infection control procedures. There is also a place on the left hand side of the site to sign up for CDC email updates.
Oregon Governor’s Office—there is a new web page on the Governor’s site specifically addressing the Coronavirus 19. Here’s a link to that page: https://www.oregon.gov/gov/Pages/coronavirus2020.aspx
Oregon Unemployment information—the Employment Department has a specific website for COVID-19 business layoffs, closures and unemployment insurance benefits. Please use this resource for yourselves and your staff.
One other reminder given the changing health care environment. The OBCE allows for telehealth as a means for providing care remotely. Please see OAR 811-015-0066 here:
https://secure.sos.state.or.us/oard/view.action?ruleNumber=811-015-0066 Just an option to allow you to provide some level of services, as the health care environment in Oregon is changing.
Your liability insurance carrier may also have guidance on how to handle patient care given the virus and its potential impacts to your practice and patients. Contact your insurer to see if they have information to help given the global pandemic.
March 16, 2020, Governor Brown issued the following statement regarding a further restriction of events and restaurant closures.
Please see the link and her remarks here: https://www.oregon.gov/newsroom/Pages/NewsDetail.aspx?newsid=36192
A statewide cancelation of all events and gatherings larger than 25 people — exempting essential locations like workplaces, grocery stores, pharmacies, and retail stores. It's additionally recommended that Oregonians avoid gatherings of 10 people or more.
Restaurants, bars, and other establishments that offer food or beverages for sale are restricted to carry-out and delivery only with no on-site consumption permitted.
Food service at health care facilities, workplaces, and other essential facilities will continue.
All other businesses are urged to assess their practices, implement strong social distancing measures, and close their doors temporarily if they cannot put the new guidance in place.” (Emphasis added.)
At this time, no other types of businesses, other than restaurants, bars, and the like, have been restricted but please abide by the social distancing measures and best practices set by the CDC and OHA to protect our public, your patients, and yourselves.
The OBCE itself cannot mandate clinic closures, that lies with the emergency powers of the Governor, but we will provide you with the most up to date information as possible.”