IAYT would like to remind its members and friends that the best sources of reliable public health information remain the World Health Organization and the U.S. Centers for Disease Control and Prevention. The U.S. National Institutes of Health publish general information as well as data on the progress of clinical trials.
The CDC's Resources for Clinics and Healthcare Facilities offers guidance yoga therapists may want to consider. Local health departments may be able to offer business-specific advice.
In addition, many individual facilities such as nursing homes and hospitals, where yoga therapists may work, have implemented specific protocols they expect employees and contractors to follow.
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Continuing Work with Clients
We believe that helping people to continue their practices as they are able is an appropriate support during uncertain times.
The research listed here on yogatherapy.health, IAYT's website for the public, may be useful. Under the headings "Immune function" and "Stress" you'll find just a few of the high-quality studies that demonstrate yoga's relevant effects.
Community, whether in person or not, is also important to optimal health. If you or clients are in quarantine or practicing social distancing, virtual visits may be an option for staying connected. This Yoga Therapy Today article introduces online yoga therapy, and this post covers the basics of working with several virtual platforms. We've listed our best additional practical tips below.
Yoga therapists may want to verify whether online class/session delivery is covered by their liability insurers, as individual policies vary. IAYT has learned of policies that specify two-way video, signed waivers from clients, location in the same country, and other requirements for sessions to be covered.
- Be willing to serve as—calm!—tech support.
- Logging out of and closing the program (e.g., Zoom) and rejoining a session often fixes problems; if that doesn't work, guide people to restart their devices.
- Close all other tabs in your internet browser and ask clients to do the same; you may also need to close all other programs to speed processing time.
- For one-to-one sessions, you can mute the audio on Zoom (or Skype) and use your phone (on speaker or with headphones) for the audio; this prevents timing lags and is a great backup if the client can't get their sound to work.
- Make sure clients' devices—and yours—are plugged in. Live-streaming depletes battery power quickly.
- Short practices (10–20 minutes or less) and audio-only recordings also useful, especially for those without broadband internet access.
- Zoom is one of several possible platforms for two-way video. The company maintains an extensive library of tutorials that yoga therapists and clients may find helpful for getting started. Read about some Zoom security practices here.
- Doxy is one HIPAA-compliant option for virtual sessions. (See below for more on HIPAA.) As with other online tools, it works better (or not at all) with certain web browsers, so be sure you know these parameters for yourself and to share with clients.
- Don't forget the heart-centered aspects of yoga as therapy. This video is a lovely reminder that your offerings need not be polished to perfection. Additional ideas for remaining fully present with clients include weighting your lap with a sandbag when you're not moving, mindfully sipping water or tea, and creating rituals to ground yourself before sessions.
- These tip sheets offer starting points for
Of course, not everyone has access to online sessions. If you are able to share your talents or donate to communities in need in some other way, please consider doing so, while so many are facing serious challenges to meet basic needs.
For U.S. Practitioners
As a professional association, IAYT cannot determine when it will be
safe for yoga therapists to resume in-person visits (or tell them to
stop holding them). Reopening decisions must take into account
a multitude of factors, including clients' and your own comfort levels.
In the United States the official guidance varies by state and county,
so the following may be helpful.
In the United States, the CDC sets cleaning and disinfecting guidelines.
Because every jurisdiction is different and will have varied
guidelines and pacing for reopening (and potentially periodic
re-closing), individual practitioners and businesses will next have to look
to their state and local regulations and guidance. (For California,
e.g., start with https://covid19.ca.gov/)
Once reopening that includes your category of business (e.g., "gyms" or
"professional services") is underway, each individual/business will
need to determine whether they are able to meet the requirements for
space between people, surface disinfection, mask-wearing, etc.
Reopening guidance from the CDC is here; that page also links to a “decision tree” to help businesses determine
whether they can safely reopen.
This comprehensive article from Gary Kissiah, attorney and director of the Integral Yoga Institute in San Francisco, offers essential points to consider.
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The COVID-19 Economic Injury Disaster Loan Program from the Small Business Administration (SBA) may be able to provide assistance for business owners, including those who are self-employed or independent contractors who don't typically qualify for aid such as unemployment benefits.
Find the official information on the Coronavirus Aid, Relief, and Economic Security (CARES) Act here.
As of July 6, 2020, the Paycheck Protection Program (PPP), which is part of CARES, has reopened. Many yoga therapists—including those who are self-employed, sole proprietors, or independent contractors—are eligible to apply for these funds, which may be forgivable (i.e., function as a grant rather than a loan, provided certain criteria are met). The new deadline for application is August 8, and working with a smaller local or regional bank may be helpful.
Individual states and counties are also offering grant and loan programs, so check your state's department of labor/commerce website. The U.S. Chamber of Commerce has a guide for small businesses.
Local banks may have programs as well—you can find out what your bank is offering through the American Bankers Association. If you already work with a loan officer or SBA lender, consider consulting with them as soon as possible so you can begin gathering the documentation you'll need for possible loans.
Mortgage and student loan relief may be available. Communicate with your lender—don't just stop making payments.
Access applications only through trusted websites such as that of your own bank or a government agency.
Please consult with your accountant or financial advisor for individualized advice. The types of loans and grants available to you vary based on your business structure, and you will need to consider your long-term business and financial situation when deciding what assistance to seek. IAYT is not able to answer questions on these programs.
What About HIPAA?
The Health Insurance Portability and Accountability Act (HIPAA) is just one of the laws that governs the way healthcare providers in the United States handle sensitive data. Additional regulations at both state and federal levels regulate online privacy and security. Regardless of where you are in the world, professional ethical standards, including IAYT's Code of Ethics, also apply to virtual interactions. For instance, can others in your space see or hear what a client is saying to you?
It is IAYT's understanding that yoga therapists are not HIPAA "covered entities" unless they are submitting HIPAA-covered transactions. (The official guidance, from the U.S. Centers for Medicare & Medicaid Services, is here.)
The situation is a bit more complicated for C-IAYTs who also hold healthcare licenses. Those individuals would generally be practicing under the highest standard required by their licensure, regardless of the setting in which they are providing services and regardless of how the yoga therapist describes those services (e.g., psychotherapy vs. yoga therapy).
However, the U.S. Department of Health and Human Services has announced that it will not impose HIPAA-related penalties on providers who offer telehealth during the COVID-19 pandemic:
"A covered health care provider that wants to use audio or video communication technology to provide telehealth to patients during the COVID-19 nationwide public health emergency can use any non-public facing remote communication product that is available to communicate with patients. OCR is exercising its enforcement discretion to not impose penalties for noncompliance with the HIPAA Rules in connection with the good faith provision of telehealth using such non-public facing audio or video communication products during the COVID-19 nationwide public health emergency. This exercise of discretion applies to telehealth provided for any reason, regardless of whether the telehealth service is related to the diagnosis and treatment of health conditions related to COVID-19."
Even in the absence of clear governmental regulations, ethical principles require C-IAYTs to maintain clients' privacy and confidentiality, except where otherwise mandated by law (e.g., if you have reason to believe that a client is planning to harm themselves or someone else). IAYT recommends that C-IAYTs investigate and understand the applicable laws in the specific jurisdictions in which they practice.
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