Government discussions; COVID-19 and AMA support

March 16, 2020

Dear Members:

The purpose of this letter is to provide you with important information regarding the COVID-19 pandemic.

The COVID-19 pandemic represents an unprecedented public health challenge. During these times of crisis, adhering to the public health direction as a single source of truth is imperative.

The evolving public health policies in place are designed to flatten the curve of infection and prevent exponential growth of COVID-19. This creates an environment where in-person visits and assessments are increasingly inadvisable, except in urgent or emergency situations. AMA staff are talking with Alberta Health about the need for incentives to align physician care with patient needs in this environment. Enabling virtual care with appropriate reimbursement is required.

The bulletin below provides updates on related issues. I hope you find this information useful.

On another issue before I conclude, members will be wondering what is happening with the discussions with government taking place through an appointed working group. I know physicians are feeling pressured as March 31 approaches and we are focused on your needs.

Meetings were held as planned over two days last week. The Board of Directors met subsequently to discuss the results and some additional work is still being done at this time. I will update you as soon as I can.

In your service,

Christine P. Molnar, MD, FRCPC
President, Alberta Medical Association

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AMA COVID-19 UPDATE

March 16, 2020

Keeping yourself healthy

During a pandemic such as COVID-19, physicians may encounter heightened stress and challenges. You may feel fatigue, worry or anxiety. If in distress, please contact the AMA’s Physician and Family Support Program for CONFIDENTIAL help 24 hours a day/7 days a week/365 days a year:

1.877.SOS.4MDS (767.4637)
International: 403.930.0529 (you may call collect)

Compensation

The AMA has been in discussion with government, Alberta Health Services, provincial and territorial medical associations, the Canadian Medical Association, insurance providers and others in seeking ways to support physicians. We have provided information on provisions from the H1N1 pandemic, as well as new arrangements being made in other provinces. Some early information and resources appear below, but more updates will follow.

Physicians have significant worries about what to do if they are not able to work in their normal capacity during the pandemic. This includes questions around their actual clinical work on a daily basis, but also maintenance of their small businesses and responsibilities for practices costs and employees.

Clinical

Alberta Health has reactivated the 03.01AD code for physicians. This is a start to address the need for payments for virtual services required that are related to COVID-19. We know that more virtual services are required to reduce the risk of disease spread by keeping people in their homes and out of doctors’ offices, while enabling patients to receive the necessary services. We are suggesting removal of current restrictions on weekly limits for virtual care codes and expansion of the range of services available via virtual care.

We have assembled resources to help physicians prepare for providing increased virtual care. Find tips for getting started on our Virtual care page.

Information and recommendations with respect to use of Personal Protective Equipment when caring for individuals with suspected or confirmed COVID-19 can be found on the Information for AHS Staff & Health Professionals page of the AHS website. The page includes information about contact and droplet precautions, ordering PPE during COVID-19 and a memo about PPE distribution to PCNs. Note: scroll down the page and type “PPE” in the search box to more easily access PPE information.

• Community physicians, primarily in PCNs, have seen an initial distribution of Personal Protective Equipment, but more will be needed. We are seeking more clarity on what can be expected for delivery and cost.

AHS has launched a self-assessment tool to help people determine whether or not they should be tested for COVID-19: COVID-19 SELF-ASSESSMENT. If you or your office are receiving calls from patients, please encourage them to use the self-assessment tool as a first step.

Assessment Centres are being planned across all Zones of AHS. The Calgary and Edmonton Zones have opened Assessment Centres as of March 7, which are accepting referrals through the Health Link (811) triaging process. Any concerns about travel or symptoms should go through 811 to be triaged appropriately. Each zone is in a different phase of planning with an expectation that centres will be opened based on local need, resources and the evolving situation. Staffing considerations, including physician payment, are part of the planning.

Business

If it becomes necessary to temporarily lay off staff, the Government of Canada has announced that they will waive the one-week waiting period for people who are in quarantine or have been directed to self-isolate and are claiming for Employment Insurance (EI) sickness benefits. The Government of Canada will also introduce enhancements to the Work-Sharing Program to help employers and their workers who are experiencing a downturn in business due to COVID-19. They are exploring additional measures to support other affected Canadians, including income support for those that are not eligible for EI sickness benefits. For more information, please visit the Government of Canada website.

During the crisis you may be asked to join the emergency response effort. This may necessitate work in a different clinical setting (e.g., emergency department) or in a different province where the need is greater. Please click to learn more about your CMPA protection during this COVID-19 pandemic.

We have explored provisions of insurance products common to AMA members in terms of this situation. This includes Commercial Office; Disability and Professional Overhead Expense; Critical Illness and AMA Health Benefits Trust Fund. Most do not cover short term needs in a pandemic situation. We are looking into short term support that may be available through government for physicians financially impacted during the pandemic and will provide details as they become available.

Members covered under AMA HBTF Core Plan please note that due to the Government of Canada's Official Global Travel Advisory, emergency travel coverage through Alberta Blue Cross will not be covered for travel outside of Canada for COVID-19. Unrelated emergency medical treatment will be covered. Members are encouraged to visit the Alberta Blue Cross website for more information or call Customer Services at 1.800.661.6995.

If you have questions about insurance, please contact the AMA’s ADIUM Insurance team at: 1.888.492.3486 or adium@albertadoctors.org.

CPSA Support/Resources

The College of Physicians & Surgeons of Alberta has collected helpful resources for physicians to reference during the COVID-19 pandemic. Check back often for updates.

Official Information/Resources

Alberta Health Services continues to be the primary source for COVID-19 information and hosts clinical resources for all providers, including those in primary care. AHS has developed the first online self-assessment tool for the public in Canada. The public can use this simple questionnaire to determine if they should call 811 for testing arrangements. Visit Ahs.ca/covid for resources.

The Alberta Health website is also a great resource to learn about the developing situation in Alberta, including official updates from the Chief Medical Officer, Dr. Deena Hinshaw, and actions being taken to protect the health of Albertans.

AMA Staff and Organizational Preparedness

While we are in this crisis situation, the AMA will do its best to maintain business as usual. In an effort to be cautious and responsible, as of March 16 we are transitioning all employees to work from home, consistent with our business continuity plan and measures that many public institutions are taking to facilitate social distancing.

Please do not visit our offices, but please reach us by phone or email. For physicians who would have visited our offices during this period, staff will be in touch to offer alternative ways to participate in meetings.

• Email amamail@albertadoctors.org
• Telephone 780.482.2626
• Toll-free 1.800.272.9680