The early months of this COVID-19 crisis already feel like a blur, as we were all riding the “corona coaster” together. Many regions that were spared some of the worst conditions in the spring are being hit heavily during these late summer months, so here’s a quick summary of the COVID-19 response so far to highlight the most helpful resources for ACEP members.
Explore This IssueACEP Now: Vol 39 – No 08 – August 2020
Wellness and Support
ACEP wants you to be able to seek help if you are suffering from depression and PTSD without concerns about its impact on your licensure or hospital credentials, so we developed a strong and impactful statement opposing such obstacles that was signed by more than 40 medical societies and advocacy organizations, including the American Medical Association, the National Alliance on Mental Illness, and the Federation of State Medical Boards. This initiative has moved to phase two, in which we and our partners reach out to individual state licensing boards and have meetings with hospital associations and hospital systems to try to remove these obstacles and barriers for our members.
In late 2019, ACEP launched the Member Assistance & Wellness Program as a new member benefit, providing for three free counseling or wellness sessions with a professional, along with the option to receive legal assistance.
The Physician Wellness Hub was launched in June. Designed to help you find the right support, the Hub has options for peer support, crisis counseling, or addressing your stress at the source (financial, legal, personal, clinical, or workplace).
To address the tough economic impact this pandemic has had on our members—and medicine as a whole—ACEP compiled the COVID-19 Financial Survival Guide.
ACEP forged new relationships with consumer companies and called upon existing health care partners to step up and support ACEP members in truly unique and meaningful ways:
- We led the call for free and discounted rooms for emergency physicians to protect themselves and their families with Marriott and Hilton.
- We partnered with GrubHub on a virtual benefit concert resulting in $250,000 in free meals for ACEP members.
- We partnered with Amazon Business to get members unrestricted, hospital-level access to cleaning and other supplies that support their personal safety.
- We partnered with multiple companies that provide our members generous discounts and freebies in support services—including food, child and pet care, and other travel support.
Federal and Regulatory Progress
ACEP’s Advocacy team developed a comprehensive and evolving list of needed policy changes related to workforce protection and mobility, access to care, personal protective equipment (PPE), liability shields, and frontline financial support. We sent this list to all members of Congress and policymakers, and chapters have used it for state-level advocacy.
On April 28, we coordinated 474 members from 45 states to hold 306 legislative meetings during Virtual Hill Day to discuss COVID-19 policy priorities in lieu of our normal Leadership & Advocacy Conference.
ACEP President Bill Jaquis, MD, FACEP, participated in a small White House meeting with the vice president and key senior Trump administration officials to help inform the administration’s pandemic response.
On the regulatory side, we sent several letters to Alex Azar, secretary for the Department of Health and Human Services (HHS), outlining specific changes and regulatory waivers that would protect emergency physicians and other frontline health care staff while increasing patient access to care.
Our advocacy efforts kicked off a quick cascade of significant changes for emergency medicine:
Pushing for PPE
ACEP’s grassroots campaign generated more than 120,000 letters to members of Congress, urging them to prioritize PPE for frontline personnel and to release PPE in the Strategic National Stockpile. This was one of our most successful grassroots efforts ever!
After discovering some hospitals were sanctioning staff for wearing donated or self-purchased PPE, ACEP discussed this problem with The Joint Commission (TJC), sharing firsthand accounts we had solicited from our members. TJC then issued a statement of support for allowing staff to bring their own standard face masks or respirators to wear at work.
ACEP is also addressing this problem with the American Hospital Association, Centers for Disease Control and Prevention (CDC), the Occupational Safety and Health Administration, the Centers for Medicare & Medicaid Services (CMS), and the Food and Drug Administration. ACEP is also working with GetUsPPE.org to connect private industry with hospitals and clinicians in need.
Expanding Access to Care Through Telehealth
When initial CMS guidance was unclear about how emergency physicians could deliver telehealth services, ACEP was in constant contact with CMS and successfully advocated for two major policy changes.
- The ability to perform medical screening exams via telehealth has helped protect emergency physicians from unnecessary exposure to the virus and preserved limited supplies of PPE.
- The addition of ED E/M codes on the approved list of Medicare telehealth services enables emergency physicians to be appropriately reimbursed for the care they provide.
Expanding Liability Protections
ACEP continues to actively work to secure immunity from liability. During his White House meeting, Dr. Jaquis explained to Vice President Mike Pence and the other Trump administration officials about the need for such increased liability protections, and ACEP is working directly with Congressional lawmakers to include liability protections in future COVID-19 legislation.
A lot of the liability movement will happen on the state level, so we also provided a template letter asking for full immunity to every state chapter. By July, 16 states and Washington, D.C., had included strong liability protections for frontline health care practitioners in either an executive order or legislation. Another eight states expressed a belief that existing statutes related to emergencies created such protections.
Seeking Federal Financial Support for Our Members
ACEP has consistently pressed for emergency physicians and other frontline health care workers to be prioritized during the distribution of stimulus funding. ACEP sent four letters to the Trump administration and to Congress requesting financial support so emergency physicians can treat patients, maintain readiness, and be fully prepared for further patient surges.
We continue to track new waves of funding from the Provider Relief Fund created in the CARES Act and are keeping our members apprised of announcements. We continue to be in constant contact with HHS to reiterate our concerns.
As part of our focus on small, independent groups, we created resources on financial options to sustain them through COVID.
Supporting Physician Mental Health
ACEP is actively supporting several pieces of legislation that prioritize mental health for both health care workers and patients. ACEP worked closely with legislators on the development of the Dr. Lorna Breen Health Care Provider Protection Act, introduced in late July. Learn more about Dr. Breen on p. 11, and see the latest on this legislation and other ACEP-supported bills related to mental health at acep.org/Breen-bill.
While we press for COVID-related progress, other factions are trying to slide one-sided, insurer-favored surprise billing legislation into the response packages. ACEP is pushing back, explaining that now is not the time to introduce divisive surprise billing legislation into the debate about how to respond to the pandemic.
Information Sharing and Communications
In late January, we sent our first all-member Coronavirus Clinical Alert. ACEP coordinated webinars with Washington state physicians who were some of the earliest to experience the COVID-19 surge and connected them with legislators to explain the situation firsthand.
In response to the need to rapidly share COVID-19 experiences, ACEP created the COVID-19 Community on the EngagED platform and extended its availability to the international audience. As of mid-June, the forum had 3,987 participants from 90 countries, with 642 conversation threads and 2,799 discussion posts. The COVID-19 Community alerted ACEP to issues we needed to tackle:
- PPE shortages and lack of hospital support for the use of self-purchased or donated PPE
- COVID-19 being used as a negative factor during custody disputes
- Confusion over regulatory policies
Daily summaries of the COVID-19 Community soon became unwieldly. That led to development of the Field Guide for COVID-19 Care in the Emergency Department. This definitive clinical guide is a frequently updated living resource. By July, this guide had more than 125,000 views, it had been independently translated into five languages, and it had been cited by more than 170 prominent online resources, including the CDC, the National Institutes of Health, and the COVID-19 Healthcare Coalition.
The Clinical Alerts grew into the COVID-19 Center, a robust resource library that organizes more than 400 webinars, articles, podcasts, videos, and more by clinical topic. By July, the COVID-19 Center had more than 1 million views. The most accessed page is ACEP’s statement standing with our members against emergency physicians’ having their jobs threatened.
At the same time, ACEP’s public relations team was sharing your frontline experiences with the public. Externally, ACEP or ACEP chapters have been mentioned in COVID-related media stories more than 10,000 times in national and local print, online, and broadcast news outlets since March—a 500 percent increase over 2019.
Ms. Grantham is ACEP’s communications manager.