COVID-19 UPDATE AND RESOURCE CENTER

If you are a patient looking for information, please visit our Patient Resource Page.
As events rapidly develop, the NMDA ​is working to provide you the latest updates and resources for dentists on this page. The New Mexico Dental Association continues to be in touch with the American Dental Association, our Board of Trustees, our members, the public we serve, the state board,  and other stakeholders on how we move forward: safely, financially and legislatively.   We remain dedicated, vigilant and stand ready to provide the best information in the timeliest fashion.

DISCLAIMER:  The content contained herein is informational only and should NOT be construed as legal, professional, financial, tax, insurance, or business advice.

NEWS UPDATES AND PRACTICE INFORMATION

BREAKING: Governor Amends Order (5/7/2020) 


Earlier today Governor Lujan Grisham and Secretaries Kunkel and Scrase gave final approval to reopening guidelines developed by the Dental Advisory Team: CLICK HERE.  These guidelines, along with other supporting documents, will provide the framework on which dentists may gradually resume providing more services.  This will occur through an amendment to the “essential services” order and will be posted on the NM COVID website sometime soon, perhaps later today.  We will send another alert as soon as it is posted.  There are some important things you need to know:
  1. Until the amended order is officially posted by the DOH, the restrictions of the current order will remain in place and enforceable.
  2. Conditions in three northwest counties, McKinley, San Juan and Cibola do not currently meet the state’s requirements to lift restrictions.  There are already gating criteria in place that will allow expansion to these areas when the current conditions improve.  Restrictions in other areas could be reimposed if conditions worsen.
  3. There are a number of requirements that offices must meet in order to reopen more broadly.  This includes having two weeks of PPE on hand and signing a document attesting to the office’s understanding of the guidelines and willingness to comply.  These criteria are identical to those required for the other healthcare providers that started to resume activity last week.
  4. We have been in discussions with the New Mexico Department of Homeland Security to receive needed PPE that we are currently unable to get from dental suppliers.  It may be necessary to make requests through the NMDA and you will probably have to pick up the supplies from a site in your area.  As with all entities seeking these supplies, requests will be limited to essential needs for a two-week period.  We hope to have more details on the process in the next 24 hours.
  5. There will be a great deal of scrutiny during the first couple weeks to make sure that there is no spread occurring and that dental offices are complying.
Our thanks need to go to the members of the Dental Advisory team who met at all hours during the last 7 days to craft and recraft the many documents requested by the administration in support of our restarting.
 
Jennifer Thompson, DDS – General Dentist, Farmington
NMDA President
Michael Sparks, DDS, MS – Periodontist, Albuquerque
NMDA President-elect
Kim Martin, DMD – General Dentist, Las Cruces
NMDA Vice President
David Manzanares, DDS – General Dentist, Albuquerque
NMDA Treasurer
Tom Schripsema, DDS – General Dentist, Albuquerque
NMDA Executive Director

Other DAT Members:
Keon Ahghar, DMD – General Dentist, Roswell
Paul Balderamos, DDS, MS – Prosthodontist, Santa Fe
Lionel Candelaria, DDS, FACS – Oral Maxillofacial Surgeon, Albuquerque
Daniel Clark, DDS – General Dentist, Farmington (PMS)
David Hadley, DDS, MSD – Endodontist, Albuquerque
David Martinez, DDS – Pediatric Dentist, Albuquerque
Ross Mohr, DMD – Orthodontist, Albuquerque
Kelley Hollingsworth-Ryals, DDS – General Dentist, Santa Fe
Charles Schumacher, DDS – General Dentist, Farmington
Joy Trigo, DDS – Pediatric Dentist, Las Cruces

UPDATE: Governors Public Health Order (5/1/2020)

Yesterday, Governor Michelle Lujan Grisham extended the stay at home orders for the state until May 15th.  Additionally, she did not lift restrictions on non-emergent dental care but did lift some restrictions on health care.  To cause further confusion, there was a Q&A posted on the Governors website indicating dentists “may gradually resume non-essential procedures per the Health Department’s guidelines, as can other providers of medical procedures such as opticians and audiologists.” But these guidelines have not been announced and are still awaiting final approval.  NMDA created a Dental Advisory Team to assist the administration with acceptable guidelines to allow dental practices to “gradually resume operations in compliance with guidelines provided by the New Mexico Department of Health.”  We expect the order limiting services will be modified early next week for immediate effect.  We will post the latest information as it is available.  To read the latest public health order, please CLICK HERE.

Watch the NMDA Restart Town Hall On Demand 

If you were unable to join the NMDA Restart Town Hall meeting on Wednesday, April 22, you can now watch it by CLICKING HERE.   The Town Hall featured NMDA president, Jennifer Thompson and Executive Director, Tom Schripsema answered questions and provided additional information regarding NMDA’s  phased restart program proposed to the Governor.  ​The Town Hall helped provide you information on the kind of preparations offices should be making to be ready for seeing more patients and providing more services.  

NMDA Proposed Phased Restart

Please review the documents from April 20, 2020, on the NMDA's proposals for a Phased Restart and a FAQ page concerning relevant issues.  

Governor Extends Public Health Emergency Orders (4/6/20)

On Monday, April 6th, Governor Lujan Grisham extended the order limiting dental services to urgent and emergency care from April 10 to April 30.  She also placed further restrictions on other essential and non-essential businesses.  You can read the order HERE.

New Interim ADA Guidelines: A Message From the NMDA (4/2/20)

Below is a message from NMDA Executive Director Tom Schripsema and President Jennifer Thompson.  If you have trouble reading it, you can CLICK HERE for a PDF.  Additionally, below the message there are important links from the ADA. 

message 4 2 20

ADA Interim Postponement Recommendation Statement
 
Summary of ADA COVID-19 Interim Guidance
 
ADA Interim Guidance for Minimizing Risk of COVID-19 Transmission
 
ADA Interim Guidance Flowcharts for Minimizing Risk of COVID-19 Transmission


NMDA COVID-19 Q&A Town Hall (3/30/20)

If you missed the 3/31 NMDA COVID-19 Q&A Town Hall with Executive Director Tom Schripsema, President Jennifer Thompson and ADA Trustee Brett Kessler, you can watch it on demand HERE. The panel discussed COVID-19 activities in the state, as well as what resources may be available for dentists and practices.  

ADA "What Constitutes a Dental Emergency" (updated 3/31/20)

The ADA has released revised guidelines on what constitutes a dental emergency.  You can read that HERE.

Restrictions on PPE Donations

We have had multiple inquiries from dentists wishing to donate PPE's to facilities in need. The current New Mexico Department of Health order prohibits health care providers from distributing supplies in their inventory.  If there are practices that would like to make a donation, the Association will seek permission on your behalf and coordinate the donation. Please CLICK HERE to access the donation form and  indicate the number of supplies you wish to donate.


New Mexico Department of Health Compliance Reports  3/26/20 The Association has prepared two forms to allow dentists to report compliance with the DOH orders. The first utlilizes the ADA definitions to report what your office will and won’t do to comply with the order. CLICK HERE to fill that form out. The second is for easy reporting of current stocks of PPE. CLICK HERE to report your PPE.  Offices are free to submit their own forms if they wish.  You can complete these forms on your phone, tablet or computer.  They can then be saved and submitted to the Department of Health by CLICKING HERE.  Fill out the required information.  Then, click on the purple "Add File" link to upload your 2 reports. Then hit "Submit."  
DOH Orders Affect Dental Offices 3/25 On 3/25, two new orders came from the Department of Health that very directly impact dental offices.  
The first provides more specific directions about the kinds of services dental offices may perform and creates a penalty for not complying.  Although there are provisions of this bill that require actions by dental offices, at this point dental offices should continue to treat urgent and emergent problems while taking appropriate precautions.  The order clarifies that treatment that cannot be postponed for three months without serious health or dental consequences should be treated, but all other treatment should be delayed until the restrictions are lifted.  (The current order expires on April 10).    CLICK HERE to read the order.

The second order requires offices to inventory certain types of PPE’s and report that to the Department of Health.  CLICK HERE to read the order.

The NMDA is in touch with the Governors office seeking clarification on each order and how to move forward.

Governor Issues Restrictions Including Dental Care 3/23

Governor Lujan-Grisham issued an executive order on March 23 restricting businesses in the state to “essential” services beginning at 8:00 AM on Tuesday, March 24, and will apply at least through April 10. This was accompanied by a DOH order which provided more details.  Dental facilities while providing care for emergencies are consider essential by the order.  Although that is not further defined by the Governor’s order the Board of Dental Health Care will utilize the American Dental Association guidance for both dentists and patients on what constitutes an emergency.  State government has a variety of means to enforce the act including revocation of licenses, citations from law enforcement and civil actions and injunctions.  The Governor called on all New Mexicans to do the right thing on behalf of all citizens.  Businesses that are not on the essential list may not be opened.  Even essential services were called upon to as much as feasible have personnel work from home. 

New Mexico Board of Dental Health Care Issues Advisory
The New Mexico Board of Dental Health Care has issued an advisory message, CLICK HERE to read.

Considerations for Treatment

We know that making decisions for your practice in these trying times is difficult.  We are doing our best to identify information and resources that will be helpful.  We’ve had many questions about what treatment can or cannot be done.  This video is an excellent discussion of how to approach these questions.  Watch the video HERE.  Here are also some considerations:

Dentists have two really important roles to play.  First, we need to use our dental expertise to keep people out of the medical system.  That means taking care of urgent and emergent problems while taking the extra precautions necessary.  Second, our patients and the public need to hear from us in words and action that they need to stay home.  Isolation is the only method of addressing this pandemic and we need to do our part to get it over with as soon as we can.  The health of our economy and our society depend on it.
  1. When determining whether to see a patient as an emergency, ask yourself a few questions:
    1. Could this condition end up in an emergency room after-hours if nothing is done?
    2. If this procedure was delayed 2-3 weeks would it likely cause further problems?
    3. Could I manage this problem for a period of time without direct contact with the patient?
    4. Do I have the necessary PPE’s for myself and staff to safely manage this problem?
    5. Which risk is greater for the patient: contracting the virus by interaction with others or exacerbating a health condition which makes that patient more vulnerable to serious COVID-19 complications?
  2. Current OSHA guidelines treat the risk of COVID-19 spread from any individual the same as that for active Tuberculosis.  If a procedure will produce infectious aerosols you should probably follow enhanced protocols including the use of N95 respirators and negative pressure rooms.  You must either take recommended steps to avoid or eliminate aerosols, use appropriate protective protocols for the aerosol environment or refer to somewhere that can.
  3. Insurers have been encouraged to, and many will accept, the use of DO140 Limited examination for remote encounters during this crisis (more on coding remote visits).  You can help patients manage their problems by gathering as much data as possible remotely and relying on your records to offer good advice for self-management or pharmacological solutions.
  4. Screen patients for active disease over the phone before having a patient come to the office.  An evaluation tool is available on the NMDA website.
Best Practices with COVID-19
On March 20, 2020, the American Dental Association (ADA) teamed up with leading infection control experts from the Organization for Safety, Asepsis, and Prevention (OSAP) to provide the dental community with practical guidance and education as we navigate the challenges COVID-19 is presenting to our profession.  The complete webinar is available to watch and earn 1 free CE credit. You will also find short clips from the discussion for quick answers to your questions. PLEASE CLICK HERE to go to the seminar and resource page. 

ADA Coding and Billing Interim Guidance (3/31/20)
The ADA has developed evolving guidance for coding and billing which will be updated as more information becomes available.  CLICK HERE to read. 

Screening and Referrals
One aspect to providing any care during these outbreak is providing appropriate screening and referrals. Here is a tool that has been prepared for various sources to aid you.  CLICK HERE

Ethics Guidelines
While there are many steps to follow in order to be able to ethically continue to see patients during the Covid-19 pandemic, these principles of autonomy, nonmaleficence, beneficence, justice and veracity are necessary always. HERE to read the ADA's guidelines.

Notifying Patients of Practice Restrictions

As practices begin to restrict the scope of care they will provide it is important to communicate the reasons to patients appropriately and not fuel fears about the virus or the delivery of dental care.  Here are some communications templates that have been shared with us.
 

FINANCIAL AND INSURANCE RESOURCES

"Withstanding the Financial Implications of COVID-19" Town Hall
The NMDA held a special financial town hall  Dan Wicker, CPA, and Partner at Cain Watters & Associates.  He shared the CWA Advisory Board’s collective thoughts on maintaining cash flow, the implications on your personal finances,  preparing your practice and staff for closure, and what recently passed legislation means to you.  You can watch this presentation on demand by CLICKING HERE.  

Below is a series of PDFs answering questions on financial and practice issues:

ADA ADCPA SBA Loan Information Update 4/1/20

CARES Act Small Business Interruption Loans

Financial Obligations to Staff during COVID-19

Vendor Payment Disputes and Access to Stored Patient Data

Renegotiating Payment Terms on Existing Contracts

Contract Obligations during COVID-19 and “Force Majeure”

The Small Business Owner’s Guide to the CARES Act

ADA Summary document on COVID-19 relief loans

Financial Considerations for Practices
Restricting patient care will have a major financial impact on dentists and their staffs.  We have prepared a FAQ page to assist with decision making and available resources, CLICK HERE.

New Mexico Economic Development Department Resources
NMEDD has put together a resource page for businesses impacted by COVID-19.  Please CLICK HERE to visit the page.
 
Insurance Coverage
The New York State Dental Association shared some tips on business insurance coverage issues.  Read the PDF HERE.

SBA Loan Assistance

The Small Business Administration (SBA) has disaster loan assistance programs available for most counties in New Mexico (CLICK HERE). 

Financial Assistance for New Mexico Businesses
We have been in touch with the governors office to emphasize the importance of dental care in fighting the epidemic and supporting dentists during practice restrictions.  They have asked us to share the following resource with our members for businesses that been affected by the pandemic.  Please CLICK HERE to visit the states COVID-19 "Jobs and Economy Page." 


ADDITIONAL LINKS

Managing Stress
CDC guidelines on managing stress and anxiety for individuals and families can be found HERE

CDC Resources 

CDC Resources for Clinics and Healthcare Facilities covering, among other issues: An interim guide for healthcare facilities, steps facilities can take, steps to get your practice ready, and return to work criteria for healthcare workers. 

COVID ACT NOW Web Resource
A team of a team of data scientists, engineers, and designers in partnership with epidemiologists, public health officials, and political leaders, created the website COVID ACT NOW to help understand how the COVID-19 pandemic will affect states.  This tool helps visualize what the impact may be for New Mexico, how much pressure will be placed on our hospitals, and how the various means of intervention could play out over time.  To see New Mexico’s outlook, please CLICK HERE.




 

On March 20, 2020, the American Dental Association (ADA) teamed up with leading infection control experts from the Organization for Safety, Asepsis, and Prevention (OSAP) to provide the dental community with practical guidance and education as we navigate the challenges COVID-19 is presenting to our profession.

The complete webinar is available to watch and earn 1 free CE credit. Below, you will also find short clips from the discussion for quick answers to your questions.

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