On July 14, Eastern Idaho Public Health’s (EIPH) Board of Health (BOH) adopted the COVID-19 Regional Response Plan for the eight-county region (Bonneville, Clark, Custer, Fremont, Jefferson, Lemhi, Madison, and Teton Counties). The Plan is stratified by risk levels starting with a Minimal Risk/green level and escalating towards the Critical Risk/red level. Each level has its own metrics and mitigation strategies to reduce the impact of COVID-19. Different parts of EIPH’s region may be at different risk levels at any one time. A copy of the Plan, along with a chart indicating the Risk Level of each county including specific guidance for that level, can be found at www.EIPH.Idaho.gov.

 May 1st, 2020

While we are all grateful to have gone through what Governor Little’s Rebound Idaho plan calls the Initial Stage (before May 1st) without any of our patients testing positive for the COVID-19 virus, that doesn’t mean that the threat is gone. We will continue to align our practices with advice from our Medical Director Dr. Paris, along with the guidelines in the Governor’s Stay Healthy Order for the State of Idaho.  Operationally speaking, that means that we are now moving into Stage 1 (May 1st through May 15th).

Per the medical direction of Dr. Paris, the CAHC will: 

Continue to use the separate entrance for any patient symptomatic or suspect of having the COVID-19 virus.  That means staff will continue the same precautions (including use of PPE) when treating patients admitted to that section of the building.  All patients will be given a mask upon arrival and will be required to wear the mask while at the CAHC.

As always, CEO Steve Rembelski and Dr. Paris will continue to monitor the conditions in the community and adjust clinic practices as necessary.

All of our patients will be screened with questions that will now include the six new symptoms the CDC has officially identified to be added to the existing list of symptoms (fever, cough, and shortness of breath) for the COVID-19 virus.  The additional six new symptoms are:

• Chills
• Repeated shaking with chills
• Muscle pain
• Headache
• Sore throat
• New loss of smell or taste

According to the CDC, these symptoms may appear 2-14 days after exposure to the virus. The CDC is warning that this list of symptoms is not all inclusive and notes that a patient experiencing "emergency warning signs for COVID-19", including trouble breathing, persistent pain or pressure in the chest, new confusion or inability to arouse, or bluish lips or face should seek medical attention without delay.  

COVID-19 Testing:

PCR tests:  These are run to determine if someone is currently infected with the virus.  Nasal swab samples are taken at our health center and then sent to either our reference lab, Quest, or to the Idaho State Lab.  All of these tests completed at the CAHC so far have come back negative.  We still have tests available. Antibody tests (aka serology tests): These are the tests that are done to see if the patient has antibodies in their immune system to fight off the virus.  Antibody tests are generally not used for diagnosis but to give a sense of how widely the virus has spread in a population. These tests are now available from the CAHC and require a blood draw at our site that is sent to Quest for testing. 

Dr. Paris has pointed out that given the unique nature of our community with no diagnosed cases of COVID-19, it is currently difficult to find a way to use this test effectively in Challis. The biggest use of this test is in communities that have had widespread outbreaks.  Consequently, any patient who gets this test will be counseled with the following information pre- and post-testing:

1. This test has been granted emergency use authorization by the FDA, but it is not “FDA approved”
2. This is not a diagnostic test.  PCR tests are used for diagnosis. 
3. A negative antibody test means the patient has likely not been exposed to Covid-19.
4. A positive antibody test means the patient has likely been exposed to Covid-19 or potentially 4 other coronaviruses.  
5.  We cannot infer that a positive antibody test means the patient is immune to Covid-19 or that they cannot get covid-19 again.
6. If patients have a positive antibody test, they should continue to follow social distancing recommendations and the governor’s orders related to Covid-19

Antigen tests:  Not to be confused with antibody tests, these tests look for a specific protein in the patient’s sample to determine if the COVID-19 virus is present.  So far, antigen tests for COVID-19 have proven to be highly unreliable. These are not currently available at the CAHC.

CAHC Update 4-8-20

We’re focused on maintaining the safety of our staff and patients while we remain open to provide care.

We now have telehealth visits available for both your medical and mental health needs.  We also have dedicated staff available during our regular business hours to assist you in navigating you through establishing your appointment for a telehealth visit if you have never had one before. 

Don’t hesitate to call us at 208-879-4351 and let us know how we can help you during this challenging time.

CAHC Update 3-26-20

We know that you, our patient, will continue to have healthcare needs during the next 21 days of Governor Little’s Stay-Home Order.  As an Essential Facility, we will continue stay OPEN. We understand your concerns and want to ensure your safety.  You now have the option to schedule a telehealth visit in the comfort of your own home.   We will continue to remain open as our community’s first line of response for all types of visits as well as emergency care. Please remember that you can always reach us by calling our front desk at 208-879-4351 during regular hours or at 208-879-1111 after hours or through your patient portal.  We are here for you! 

Message from our CEO 

It’s been an extraordinary few weeks for our country and our community as we have begun to confront the challenge of containing the spread of the Corona Virus, also known as COVID-19. During these stressful times it is important that we stay in communication, even as we practice social distancing to slow the transmission of the virus. I’m dedicated to keeping you informed about what actions the Challis Area Health Center is taking to help keep our patients and our community as healthy as possible. 

We are committed to keeping our patients safe by: 

• Enhancing our cleaning and infection control practices in the clinic. We are using hospital-grade disinfectants to clean all hard surfaces in the building. Our staff are supplied with wellness items such as gloves and cleaning wipes to ensure public surface areas are disinfected. We removed non- essential items from the waiting rooms and exam rooms to minimize transmission surfaces. We have established safe, isolated areas for evaluation and treatment of patients suffering from respiratory illnesses or exhibiting flu-like symptoms. We have established new protocols for patient management that should reduce the risk of sick patients spreading the illness to other patients and our staff. 

• Implementing Telehealth visits. If you don’t need to be at the clinic to be treated for your health problems, we are now providing the option for telehealth visits with our providers. These visits can be conducted by telephone or by using Apple FaceTime, Facebook Messenger Video Chat, Google Duo or Skype. You can make an appointment for a telehealth visit by calling our front desk at 208- 879-4351. This service will be available to our established patients only, so if you haven’t established care with us and want to do so, call us so that we can help you. 

• Meeting all your healthcare needs. We know that our patients will have other healthcare needs during the corona virus outbreak. We have appointment times available every day to make sure that we can connect with our patients to address their chronic needs. We also remain open as our community’s first line of response for emergency care not related to the corona virus. Please remember that you can always reach us through your patient portal too. 

• Providing accurate and up-to-date information. We encourage you to go to our website: www.cahcinc.com for the latest details on the virus. We are regularly posting information from our clinic, along with links to the CDC and State of Idaho’s websites. We want you to stay safe and informed. 

Despite the challenge presented by the corona virus, I want to reassure that we remain committed to our mission to provide quality healthcare to our community. I am inspired by the resilient spirit I see demonstrated every day by our staff, our patients and our community. Thank you for your continued support as we navigate this challenge, and I hope everyone remains healthy and safe. 

                                                                                      Sincerely, 

                                                                                      Steve Rembelski CEO 

                                                                                       3/24/20 

OUR PROTOCOLS FOR PATIENTS 

3-20-20

If you or someone you know is suffering from a respiratory illness and is concerned about having the COVID-19 virus, please call us first before you come to the Clinic so that we can better help you address your health problems.

HOW TO CONTACT US:

If you are calling between the Clinic’s business hours (8:00 am to 5:30 pm), dial 208-879-4351. 

-or-

You can also call our Careline at 208-879-1111.  A provider is available 24/7 to speak to you.  

TREATMENT PROCESS:

You will be asked questions by a nurse and/or a provider, who will be following the most current guidelines from the CDC to evaluate your symptoms.  They may recommend that you come to the CAHC to be seen.  If so, please follow the instructions posted on the front door of the clinic.  You will be asked to call a number that will get you to the nurse. You will be admitted through a separate entrance of the clinic, given a mask and taken to a safely isolated exam room. One of our providers will evaluate you and recommend treatment appropriate to your symptoms.

LAB TESTING:

We currently have a limited number of COVID-19 testing kits supplied by our reference lab, QUEST Diagnostics.  The testing is performed in California and the current turnaround time for test results is approximately five days.  Our providers are following the CDC guidelines for testing, which includes testing for Influenza A before testing for COVID-19.  

NOTE: At this time we do not have enough tests to provide testing to patients who do not meet the CDC criteria.

COVID-19 Public Statement

On March 13th, Governor Brad Little signed an emergency declaration to prevent the spread of coronavirus in Idaho. The main objective of the Governor’s measure and other preparations are to protect vulnerable populations (i.e. elderly and health-compromised) and to preserve healthcare resources.  The Challis Area Health Center, along with the North Custer Hospital District, share the Governor’s objective to providing the best care possible to our local population throughout the duration of this national healthcare emergency.

The CAHC began preparing for the possibility of a pandemic last year when we participated in training exercises with Eastern Idaho Public Health.  We have continued our preparedness work with EIPH by serving as active members of the EIPH Regional Healthcare Coalition. We also sponsored a local training facilitated by EIPH staff on March 11th which was attended by representatives from the Clinic, the EMS, the Custer County Sheriff’s Office, the Coroner’s Office and the School District.  We also participated in several recent conference calls designed to keep providers in our entire region up to date on developments.

As the only Federally Qualified Health Center serving Central Idaho, we have also been working closely with our partners from the Idaho Primary Care Association. The IPCA is disseminating information and resources that the Health Resources and Services Administration (HRSA) is directing specifically to Health Centers to help us address the COVID-19 outbreak.

We have been working diligently to prepare to respond to the needs of our community during this challenging time.  We share our residents’ desire to have testing for COVID-19 widely available as soon as possible. For the time being, we are dealing with the same restrictions on availability of testing supplies and delays in processing that are affecting other healthcare facilities around Idaho and the rest of the country.  As the national supply of testing materials grows and we receive more kits from Quest, our private reference lab, and from the State Bureau of Labs, we will let the community know about expanded testing opportunities.

Finally, we have implemented internal processes to meet the CDC standards of infection control and prevention.  Patients who come to the clinic with symptoms of a respiratory illness will see signs posted with instructions on how to proceed in receiving treatment in the CAHC building.  We will do our best to keep all of our patients safe while receiving care, whether it’s for the COVID-19 virus or other medical needs.  We are offering the option of a Virtual Visit through our Careline (208-879-1111) for those patients who would prefer to speak with a provider over the phone rather than come into the Clinic.

We are committed to keeping our community informed as this situation evolves and will provide updates as we have them.

Issue Date: 3/16/20

Contact:  Kate Taylor

  Public Information Officer

  Phone: 208-879-3023