There has been an abundance of information coming out about the $2 trillion stimulus package that was passed last week. A lot of the information is confusing and contradictory. The start date to be able to apply for these programs appears to be this Friday April 3rd. There are federal and state programs, but all of them are running through your local banks that are certified SBA banks. Please check with your local institution and get on these quickly as it will be on a first come first serve basis. For many of us in private practice with less than 500 employees, the Payroll Protection Program (PPP) is going to be the best option. Federal Programs from AAO-HNS: PAYCHECK PROTECTION PROGRAM LOAN Paycheck Protection Program Application Form – According to the SBA, lenders may begin processing loan applications as soon as April 3, 2020. Access the loan application now.OVERVIEW OF THE PROGRAM IMPORTANT UPDATES INCLUDE: It is anticipated that not more than 25% of the forgiven amount may be for non-payroll costs.Starting April 3, 2020, small businesses and sole proprietorships can apply for and receive loans to cover their payroll and other certain expenses through existing SBA lenders.Starting April 10, 2020, independent contractors and self-employed individuals can apply for and receive loans to cover their payroll and other certain expenses through existing SBA lenders.Other regulated lenders will be available to make these loans as soon as they are approved and enrolled in the program.BORROWER INFORMATION IMPORTANT UPDATES INCLUDE: The application for borrowers can be found HERE. It is anticipated that not more than 25% of the forgiven amount may be for non-payroll costs.Starting April 3, 2020, small businesses and sole proprietorships can apply for and receive loans to cover their payroll and other certain expenses through existing SBA lenders.Starting April 10, 2020, independent contractors and self-employed individuals can apply for and receive loans to cover their payroll and other certain expenses through existing SBA lenders.You will be required to provide payroll documentation.It is a 0.50% fixed rated and all payments are deferred for six months, however interest will continue to accrue over this period – the loan will be due in two years. No collateral or personal guarantee is required.  What do I need to certify? As part of your application, you need to certify in good faith that: Current economic uncertainty makes the loan necessary to support your ongoing operations. The funds will be used to retain workers and maintain payroll or to make mortgage, lease, and utility payments. You have not and will not receive another loan under this program. You will provide to the lender documentation that verifies the number of full-time equivalent employees on payroll and the dollar amounts of payroll costs, covered mortgage interest payments, covered rent payments, and covered utilities for the eight weeks after getting this loan. Loan forgiveness will be provided for the sum of documented payroll costs, covered mortgage interest payments, covered rent payments, and covered utilities. Due to likely high subscription, it is anticipated that not more than 25% of the forgiven amount may be for non-payroll costs. All the information you provided in your application and in all supporting documents and forms is true and accurate. Knowingly making a false statement to get a loan under this program is punishable by law. You acknowledge that the lender will calculate the eligible loan amount using the tax documents you submitted. You affirm that the tax documents are identical to those you submitted to the IRS. And you also understand, acknowledge, and agree that the lender can share the tax information with the SBA’s authorized representatives, including authorized representatives of the SBA Office of Inspector General, for the purpose of compliance with SBA Loan Program Requirements and all SBA reviews. State and local information from MSMS: Michigan Small Business Relief Program Funding: Information & Application for Michigan Small Business Relief Program Michigan Small Business Relief Program: Grants Michigan Small Business Relief Program: Loans U.S. Small Business Administration: Disaster Assistance in Response to the Coronavirus

These topics are meant to spark conversation and discussion. They are not meant to be rules.I have gotten a lot of calls regarding these issues and I would like the practitioners in the state to provide their views. What are people doing with their office hours? Are you still open? We have reduced our hours by 50% with the other 50% being used for telemedicine appointments. Office visits are meant for urgent/emergent issues and needed post-surgical check-ups. What are people doing with staff? Hours? Payments? We have decreased our staff hours. We are alternating our audiologists and have decreased support staff. We are maintaining health benefits for staff What are people doing about trachestomies? Endoscopic skull base procedures? Mastoid/skull base drilling procdures? Endoscopies? We are implementing testing for SARs-COV-2 prior to performing any needed procedures such as tracheostomies and endoscopic skull base procedures. Flexible endoscopes are being performed only in urgent matters (being careful to use proper PPE) Please post your thoughts and comments. Bob