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The U.S. Department of Health and Human Services (HHS) has announced it is extending the deadline to August 28 for all dentists to apply for funding through the Enhanced Provider Relief Fund Payment Portal. This deadline applies to:
- Dentists who have directly billed their state Medicaid/Children’s Health Insurance Programs or Medicaid managed care plans for oral health care services
- Dentists who have directly billed health insurance companies for oral health care services, as well as dentists who do not accept insurance and have directly billed patients for oral health care services
Dentists are eligible for these relief funds even if previously receiving Small Business Administration EIDL and/or PPP loans. These have no impact on the HHS relief funds.
For more information on the application deadline extension click here.
The AAPD and ADA recommend that dentists who participate in Medicaid and CHIP programs apply for the Medicaid and CHIP Distribution. A fact sheet is available here.
For dentists who don’t participate in Medicaid/CHIP, the AAPD and ADA recommend application through the Enhanced Provider Relief Payment Portal.
Note that for either application, the same portal is used.
Information on how to apply for either source of funding can be found here.
HHS has updated its FAQs to address common questions, including expanded information on eligibility, application, payment process, and more. HHS also offers webinar recordings, available here. HHS Webinar Recordings
For help with the application process, HHS has set up a Provider Support Line, 866- 569-3522, to assist with questions. The hours of operation are 7 a.m. to 10 p.m. CST, Monday – Friday.
The ADA has also prepared a FAQ for dentists concerning the relief funds, which can be found here. -
The AAPD has joined the Organized Dentistry Coalition in a letter to the leaders of the U.S. Senate and House of Representatives that outlines policy priorities to be included in the next COVID-19 relief package. The letter can be accessed here. This request for important support to dental practices includes:
- Tax credits to small businesses for the purchase of additional personal protective equipment (PPE) and safety improvements
- Temporary and targeted liability protection to small businesses
- Additional flexibility for the Paycheck Protection Program (PPP) loans
- Incentives for health care practitioners to work in health-disadvantaged communities that have been further undermined by COVID-19
In view of the success of previous advocacy efforts, the AAPD predicts a positive step forward in Congressional efforts to combat the challenging effects of the COVID-19 pandemic on pediatric dentistry.
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On June 17, the Centers for Disease Control and Prevention (CDC) updated its Guidance for Dental Settings: Interim Infection Prevention and Control Guidance for Dental Settings During the COVID-19 Response originally released on May 21, 2020. The AAPD and ADA have engaged in ongoing communications with the CDC to help ensure consistency between the CDC guidance, ADA toolkit and AAPD practice re-emergence checklist.
The key points of the update are summarized as follows:
- The recommendation to wait 15 minutes after completion of clinical care and exit of each patient without suspected or confirmed COVID-19 to begin to clean and disinfect room surfaces has been removed.
- The prior recommendation that all elective procedures be postponed has been removed.
- Dental settings have unique characteristics that warrant specific infection control considerations.
- Prioritize the most critical dental services and provide care in a way that minimizes harm to patients from delaying care and harm to personnel from potential exposure to COVID-19.
- Proactively communicate to both personnel and patients the need for them to stay at home if sick.
- Know the steps to take if a patient with COVID-19 symptoms enters your facility.
This updated guidance complements the following CDC guidance documents:
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On June 5, the President signed into law the Paycheck Protection Program Flexibility Act, which will reform the Paycheck Protection Program (PPP) to give small businesses more time and flexibility to use their funds. Advocated by the AAPD and the Organized Dentistry Coalition, the bipartisan legislation passed the House on May 28 and the Senate on June 3. The new act applies to pediatric dentists who have or will receive funds from the PPP — a loan established by the Coronavirus Aid, Relief, and Economic Security Act. This act will extend the following benefits:
- Increase the Paycheck Protection Program loan forgiveness coverage period from eight weeks to 24 weeks
- Defer payroll tax for borrowers
- Deferring Paycheck Protection Program loan repayment for 10 months instead of 6 months
- Allowing borrowers to use 40 percent of PPP funds to pay for non-payroll expenses
- Extending the rehiring deadline for dental practice employees
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Please join the APPD on Tuesday 6/9 at 9:00am (CST) for the upcoming Pedo Teeth Talk, Taking care of Yourself, Your Mental Health and Wellbeing. In this exceptionally important podcast, Dr. Sheela Raja, Clinical Psychologist, and expert on post-traumatic stress, talks with us about doing a survey of ourselves and our well-being, helping us deal with difficult feelings and times, and how to get help for ourselves and others. We ARE all in this together and Dr. Raja is here to help us get through some of the most challenging times in generations. Join us on Tuesday or listen any time after at your convenience. Click here to listen.
Helpful Resources:
Substance Abuse and Mental Health Services Administration National Helpline, 1-800-662-HELP (4357), or TTY: 1-800-487-4889
Anxiety and Depression Association of America
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Many children are at a greater risk for child abuse and neglect (CAN) due to stay-at-home orders. As each state resumes dental care, pediatric dentists are in a unique position to identify CAN. In fact, two to three out of four CAN cases involve trauma to mouth, face, and head. This report by Dr. Homa Amini, DDS, MPH, MS of The Ohio State University and Nationwide Children’s Hospital illustrates a severe case of CAN.
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What to say to families coming back to your practice? This new AAPD resource gives concise positive answers to parent questions about treatment, appointments, dental emergencies and other topics related to the oral health care of their children. It lets families know that even though the office may look a bit different, you continue to provide the highest quality of care possible while keeping children safe and comfortable during the dental visit. You can use the fact sheet in conversations with parents, email it to families, and post it on your website and Facebook page. It can be adopted as is or modified to suit your practice. And don’t forget to share it with your referring dental and medical offices.
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The AAPD Safety Committee is proud to offer its new guide for re-entry into practice uniquely designed for pediatric dentists. This comprehensive online publication will answer many of your most pressing questions to protect patients, families and staff from COVID-19 – including recommendations about personal protective equipment. It will help you prepare for re-emergence in view of the far-reaching effects of the pandemic. Topics:
- Pre-Emergence Processes
- Practice Ramp Up Schedule Considerations
- Situations Unique to the Specialty of Pediatric Dentistry
- Point-of-Care Considerations/Operatory Environment
- Business and Practice Administration Considerations
Follow this checklist to get back to caring for children in ways that are safe for them, their families, your staff and yourselves. Click here to view the checklist.
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The ADA’s Advisory Task Force for Dental Practice Recovery has developed a free toolkit for members offering interim guidance on measures to help protect patients, staff and dentists from COVID-19 as dental practices re-engage in providing the full range of oral health care. The toolkit includes:
- Sample letter to patients
- Guidance on pre-appointment screening
- In-office patient registration procedures
- Reception area preparation strategies
- Chairside checklist
- Staff protection strategies
- Supplies shopping list
To receive a copy, visit this ADA site and fill out the form for a link to the toolkit.
Coming Wednesday: The AAPD Safety Committee will offer its Re-emergence Pediatric Dentistry Practice Checklist: A guide for re-entry into practice for pediatric dentists during the SARS-CoV-2 pandemic. To be located on this website, this comprehensive online publication will answer many of your most pressing re-opening questions. The toolkit and its contents will be discussed in "AAPD Townhall: Sound Science for Reopening Your Practice" to be held Tuesday, April 28, 5:30 PM Central Time. Register here.
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On April 23, the House of Representatives passed a new coronavirus relief bill calling for additional funding for federal loan programs to help dental practices, as well as other businesses, recover from the economic fallout of the pandemic, which was signed into law by the President the following day. The Paycheck Protection Program and Health Care Enhancement Act infuses $370 billion into the Paycheck Protection Program, Economic Injury Disaster Loans, and emergency Economic Injury Disaster Loans grants. Learn more here.
Visit the SBA website here to determine the current status for new applications for the Paycheck Protection Program and the Economic Injury Disaster Loan (including Advances) based on available appropriations funding. Applicants who have already submitted their applications will continue to be processed on a first-come, first-served basis.
The following article summarizes the two Small Business Administration (SBA) loans available to dental practices. View the article here.
Immediately after passage of the CARES Act both ADA and AAPD strongly urged dentists to apply quickly for the SBA EIDL and then PPP loan, because funding was on a first come/first serve basis, and funds might runs out. This was emphasized in the April 1 AAPD podcast of Pedo Teeth Talk where Dr. Joel Berg interviewed Mike Graham, head of the ADA Washington D.C. office.
The AAPD continues to participate in efforts with the ADA to modify the PPP legislation to provide additional funding, streamline the SBA loan application process and allow dental practices to choose the 8-week period for which they can seek loan forgiveness and rehire staff. Learn more about the letter sent by a strong dental coalition consisting of the AAPD and many of our state pediatric dentistry chapters here.
In related news, the AAPD joined a strong coalition of dental organizations in a request for immediate financial assistance for dentists across the country from the Department of Health and Human Services (HHS) and Centers for Medicare and Medicaid Services. The letter strongly recommends that HHS provide immediate access to capital by releasing funding from the CARES Act Provider Relief Fund to dentists that are Medicaid providers and serve as critical access points for oral health care to lower income Americans. Learn more here.
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The Coronavirus Aid, Relief and Economic Security (CARES) Act includes a significant increase in funding of $349 billion to the Small Business Administration (SBA) to guarantee loans to small businesses to help alleviate economic injury directly caused by the coronavirus. These loans may be used to pay for employees’ COVID-19-related sick leave, mortgage or rent, and other overhead expenses. For the latest information from the ADA about these loans and the circumstances in which they must be utilized, click here.
The SBA COVID-19 Economic Injury Disaster Loan (EIDL) is now available to employers in all U.S. states, Washington D.C., and territories. It offers small business owners impacted by COVID-19 the opportunity to obtain up to a $10,000 Advance on their EIDL. To ensure that the greatest number of applicants can receive assistance, Advance amounts will be determined by the number of employees as of January 31, 2020. The Advance will provide $1,000 per employee up to a maximum of $10,000.
Since the EIDL 7(b) loans are awarded on a first-come, first-served basis, online applications should be completed promptly. You will find the updated EIDL Application page here.
The CARES Act also created a new Paycheck Protection Program (PPP) Loan. Starting April 3, 2020, small businesses and sole proprietorships can apply for and receive PPA loans to cover their payroll and other certain expenses through existing SBA lenders. Understanding these options and determining what is best for your practice can be confusing. We strongly encourage that you review this fact sheet prepared by the ADA and Academy of Dental CPAs. In addition, the SBA has released the loan application for the PPP. Comprehensive information from the SBA on loan opportunities can be found here.
Any information you may have seen suggesting that both EIDL and the PPP Loan cannot both be applied for is incorrect. A former draft of the CARES Act would have prohibited this, but last minute negotiations changed that prohibition. Further, the ADA understands that you can roll your EIDL loan into the PPP loan. An EIDL grant/advance of up to $10,000 will be deducted from any loan forgiveness someone receives if they roll the EIDL into the PPP, but not the full EIDL amount. ADA encourages dentists to get both and then roll in the EIDL for better loan terms on any of the remaining balance from the combined loan after receiving assistance.
The AAPD also supports efforts by the ADA to modify the PPP legislation to allow for more flexibility in timing for use of the funds. Click here to learn more.
The U.S. Chamber of Commerce has also provided a Coronavirus Emergency Loans Small Business Guide and Checklist, which can be accessed here.
The AAPD continues to strongly recommend that you should also contact your main practice lender bank for other sources of relief from current loan payments such as deferred payment, interest-only payments, and/or short-term low interest loans. Pediatric dentists have reported favorable outcomes utilizing this approach.
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Information on the COVID-19/Coronavirus changes almost daily and the American Academy of Pediatric Dentistry urges its members to keep current on the evolving science and best practices to protect themselves and the families they care for. The fast spread of this illness and the world’s inexperience with it make staying current even more important:
- Keep abreast of changes in understanding and addressing the virus. This means following the course of the virus every day. Government and professional health organizations provide the most up-to-date and accurate information. Some sites you may find useful are:
- Avoid claims and information from non-mainstream and non-reliable or unverified sources which may provide erroneous and even dangerous advice or recommendations.
- Evaluate the need for precautions and changes in your personal behavior based on sound information. Work, travel, meeting attendance, and other potential sources of exposure are usually addressed in guidance by reliable sources. AAPD will advise its members of changes and precautions related to meetings and other events, based on sound science and best practices in advance. We are looking to the CDC and WHO to provide recommendations on travel. At this time, there are no bans or suggestions not to travel within the U.S. Learn more here.
- Practice-related precautions should follow the advice of recognized authorities. Members should keep abreast of recommendations at the local, state, and national level that relate directly to their individual circumstances. State and county health departments are good sources of information relative to local circumstances.
- This virus has demonstrated the need for personal responsibility in controlling its spread. This means attention to your own risk status, current health, and the health of your family. This is especially important for those who are at greater risk of infection, such as the elderly and those with weakened immune systems. Taking recommended steps to minimize spread of infection while ensuring that you seek and receive the appropriate care is the best advice. Your personal physician and local health authorities remain the best sources of information should you have questions about or require care for suspected infection.
AAPD will closely monitor information as it emerges and when necessary, advise members of changes and recommendations that will protect them, their families and their patients, and help them plan for future events.
AAPD COVID-19 Resources
AAPD has provided additional resources regarding infection control, practice and staff management, emergency care, office closures/limited services and COVID-19 status.