Seventeenth Community Health Advisory: Coronavirus (COVID-19)
weekly message from the director...
A Bad Week for the Numbers

This week we saw the most reporting of positive COVID-19 cases than we have seen in the previous four months combined. The largest increase was people with disabilities growing by more than triple. In addition, we received news of a second VMRC staff person and a second Direct Support Professional working with people with disabilities. We closed our office building in Stockton for 48 hours upon learning of the positive test result of a staff person who was in the building. We did this to follow recommendations of health officials as proper protocols for work place exposure. While the numbers are still relatively small, the rapid rate of growth is alarming, especially when you consider the regional rate of hospitalizations and the state’s record setting positive reports. People with developmental disabilities do not automatically have a vulnerable health condition but according to our records we serve over 2500 individuals who do have some form of a vulnerable health condition and we must do everything possible to secure their health and safety and the health and safety of all our consumers that we are charged with serving. 

The State Budget Update

On Monday of this week, we started getting updates on a budget deal between the legislature and the governor and it was hopeful. As a reminder, the governor had proposed major cuts to developmental services including $300 million reduction to services and rates for providers and $30 million to regional centers operations (both general funds portions). These cuts were to be in place if the federal government did not provide state and local financial relief estimated at about $14 billion. 
 
There were vast cuts throughout Health and Human Services in the governor’s budget but the legislature passed a dramatically different budget.
 
For developmental services, it is probably the best possible budget we could have gotten in this economic climate, as there are no cuts to our services or operations and there are increases for growth and for a few service rates such as Independent Living and Early Start Services. Thank you to everyone who followed our calls for advocacy as well as other group’s efforts to advocate for a state budget that preserves the services and supports for people with developmental disabilities and their families. Check out this great report by Marty Omoto , of California Disability Community Action Network for many more details in developmental services and across Health and Human Services.


The latest directive from the Department of Developmental Services (DDS) centered on providing some regulatory relief for people using the Self-Determination Program (SDP), and Family Home Agency (FHA) model. While applicants and staff in these service models must still get a criminal background clearance, the requirement for submitting fingerprints is suspended through July 31, 2020. This is in recognition of the shortage of available fingerprinting services.
If you are in an area where you can get fingerprint-based background checks then you should go ahead and do it using Live Scan, otherwise submit the Department of Justice Form BCIA 9010-COVID-19 to get a name-based criminal background check.


Sincerely,

Tony Anderson
Executive Director
Valley Mountain Regional Center
Case Management Updates

Overview of Resources for Basic Needs during COVID-19

The recent increase in COVID-19 cases in the VMRC catchment area has brought about an increase in need for basic necessities. Food, health, housing and financial security are top priorities for our consumers and families. Many state agencies are offering additional assistance and extensions for those needing assistance. Here is a summary of some resources that may be of help during this difficult time:

·          FOOD

o  No one will be cut off from CalFresh food stamp benefits at this time. If you get CalFresh, you may get extra CalFresh benefits on your EBT card to help buy food during the COVID-19 pandemic crisis and extensions are available.  https://wclp.org/wp-content/uploads/2020/05/COVID_19-CalFresh-Bump-CAFB-CFPA-WCLP-CWDA-2-002.pdf

o  Families with children enrolled in CalFresh, CalWORKs, Medi-Cal or foster care should have received a P-EBT card by mail before May 22. If you did not and your children are eligible for free or reduced-priced school meals, you can still apply up until June 30th.  https://ca.pebt.org/en/?fbclid=IwAR0FcRkIA8qAZVRjZ5NUV0Q84dwkQxfWCigp3WuQaTrWqEzQdyrMUe4meMs

o  Restaurant delivery service is available for older Californians and those considered high risk. Information and sign-up details for interested participants and restaurants are available. https://covid19.ca.gov/restaurants-deliver-home-meals-for-seniors/

o  The California Department of Education has posted  a list  of all school districts and locations offering grab-and-go meals during the COVID-19 school closure. They’ve also created  an app  to help families locate meals. https://www.cde.ca.gov/nr/ne/yr20/yr20rel14.asp

o  California households receiving SNAP food stamp benefits (CalFresh) can now purchase groceries  online  through a USDA pilot program. https://wclp.org/pilot-program-for-california-snap-calfresh-online-food-purchases-to-begin-next-week-ufcw-and-western-center-on-law-poverty-applaud-steps-and-urge-further-action/

o  Full Cart is a program of the nonprofit Feeding Children Everywhere. This virtual food bank partners with generous donors to cover the cost of the food and ship groceries directly to your door.  https://fullcart.org/?gclid=EAIaIQobChMI7sTaxrWe6gIVZRh9Ch3JwwlaEAAYBCAAEgKBHvD_BwE

o  The Coalition of Mexican Americans Organization (COMA) is having a free food giveaway for field workers on Sunday, June 28, 2020 from 2-6 PM at the Mexican Heritage Center & Gallery, 111 S. Sutter St. Stockton, CA 95202. Free COVID-19 testing will also be available. For more information go to: file:///C:/Users/cmix/AppData/Local/Microsoft/Windows/INetCache/Content.Outlook/7LICQMZ8/COMA%20Food%20Giveaway.pdf

o  The Presentation Food Pantry located in Stockton has been instrumental in the donation of over 200 food bags to VMRC’s neediest consumers and families. The most recent donation occurred on June 20, with deliveries taking place in all of our five counties. VMRC’s Cultural Specialist Gabriela Lopez coordinates this wonderful effort. The next delivery is scheduled for July 16.

·         HEALTH

  • Testing (when available) and treatment for COVID-19 is covered at no cost for all Californians. 

  • COVID-19 testing is already free for the majority of Californians with private insurance or Medi-Cal. Testing and treatment will not be used against anyone in a Public Charge analysis.


  • Applications for Medi-Cal will be accepted without proof of income documentation during the COVID-19 crisis. This is also true for those seeking to renew existing coverage. Your Medi-Cal will not be cut off if you are unable to provide paperwork right now.

  • Everyone is encouraged to seek care if they are sick, regardless of income or immigration status.

·          HOUSING



·         FINANCIAL SECURITY

  • An executive order has been issued to allow current recipients of safety net programs in California (CalWORKs, CalFresh, In-Home Supportive Services, Medi-Cal, and Cash Assistance for Immigrants) to continue receiving them without interruption during this time.


  • Governor Newsom announced an executive order requiring the exemption of federal, state, or local government financial assistance from debt collection and garnishments in response to the COVID-19 pandemic.

  • Governor Newsom signed an executive order restricting water shutoffs for homes and small businesses while the state responds to the COVID-19 pandemic. The order also directs water agencies to restore water to those who had it cut off.

  • To ensure households keep essential Lifeline wireless and home phone service, the California Public Utilities Commission has temporarily suspended its rule requiring people with low-incomes to re-enroll in the Lifeline program. This will allow hundreds of households to retain service during the pandemic.
 
Five-County Transportation Updates

There have been a few changes in transportation services due to directives, local requirements and safety protocols. Wilma Murray, our Transportation Manager has developed the following service outline for the five-county area during this time. Recent updates are highlighted:

Amador County (ARTS) ph # 209-267-9395 or 1-877-704-4297

Regular Fares are being charged. Service is available Monday thru Friday. Currently, masks are recommended – not required

Dial A Ride is operating as usual. No changes – full operation. Reduced fixed route service - “Micro Transit”  Limited service for Jackson, Sutter Creek and Upcountry. All other routes are on an On-Call Basis. Riders can call at least 24 hours in advance of need and ARTS will do their best to accommodate. This change is in effect thru 7/3/202. Full service resumes on July 6, 2020. Rides will be free that week.                    

Visit the website for more info and updates. www.amadortransit.com .

Calaveras Transit ph # 209-754-4450

Rides are free of charge. Service is available Monday thru Friday. No weekend service. Masks are required. Regular service has been suspended but CTC is providing on-demand service with ¾ mile deviation of normal routes. Riders need to call ahead to schedule rides.
This will remain in effect until further notice.

Visit the website for more info and updates: www.calaverasconnect.org

Tuolumne County Transit – ph #209-532-0404

Rides are free of charge. Service is available Monday thru Saturday. At this time, masks recommended.
Regular fixed route is eliminated and Dial A Ride service – open to all – is being provided. Riders need to call the reserve trips. 

Visit the website for more info and updates: www.tuolumnecountytransit.com

Ceres Transportation – ph #527-4991

Service is now run thru Modesto MAX and Modesto Dial A Ride. Rides on the regular fixed route (CAT) are free thru July 31st. Dial A Ride fares are enforced. Modesto MAX and Modesto Dial A Ride tickets must be used starting July 1 st .
Website is not updated with COVID-19 information. Call for updates.

Modesto MAX ph # 209-521-1274

Normal full service, Monday thru Sunday, has been restored as of May 18 th . Rides are free thru July 31 st . Masks are required.
New Commuter service from Modesto to the Stockton Transit Center, with a stop at the Manteca Transit Center, starts on July 1 st . There will be 3 northbound routes leaving Modesto at 6:30 am,. 10:30 am and 5:00 pm and 3 southbound route leaving Stockton at 7:30 am, 11:30 am and 6:00 pm. Cost is $5 for a 1-wy ride and $7 for a round trip. 

More information to follow or check the website.  www.modestoareaexpress.com


Modesto Dial A Ride ph # 209-527-4900

No service changes or reductions. Regular service, hours and fares are being charged. Masks are required.

Stanislaus Regional Transit  Ph # 800-262-1516

Resumed full normal schedules, effective June1st. Rides are still free on regular fixed route thru July 31st. Shuttle service and ADA services are regular fare. Masks are required.  www.srt.org

Turlock Transit ph #209-668-5600

Rides are free of charge. Masks are required. Fixed Route and Dial a Ride* services are running Monday-Saturday 9 am to 7 pm. *DAR special hours for senior citizens: 7am -9am Monday –Saturday.            

Visit the website for more info: www.turlocktransit.com

San Joaquin Regional Transit District (SJRTD) ph # 209-943-111

Rides are free of charge on fixed route. Regular fares are being charged for Dial A Ride and VanGo! Masks are required. Regular fixed route is running on weekend schedules 7 days a week.

VanGo! is operating 6am – 8pm 7 days a week. VanGo should be used for rides going out of the Stockton city limits only. Proposed service changes will be announced soon.
Dial A Ride: Regular service hours and fares are still in place. Service is only available for rides within the Stockton city limits. Some commuter routes are running. Check website for times and routes. www.sanjoquinrtd.com

Lodi Transit Grapeline (regular bus routes) and Vineline (ADA/DAR) ph #209-333-6806
Regular Fares are being charged for all rides. Masks are required. No Sunday service for regular or DAR services.  Monday thru Saturday service is on a reduced schedule for 8:30am – 4:30 pm. Express routes are suspended until further notice.

Visit the website for updates: www.lodi.gov/469/Transit

Manteca Transit ph 209-456-8888

Rides are free of charge until further notice. At this time, masks are recommended but not required. Regular routes and Dial A ride are running Monday thru Saturday. DAR is limited capacity (medical priority) on Saturdays. 

Visit the website for updates: www.mantecatransit.com

Tracy Tracer ph # 209-831-4287

Regular fares are being charged for all services. Masks are required. No change in service hours for regular bus or Dial a Ride. Temporarily suspension of commuter peak service routes E,F &G. 
              
Visit the website for updates: www.ci.tracy.ca.us/index.cfm?navid=178

For our contracted transit providers : All have developed tentative plans to address COVID-19 directives for health and safety as well as inclusion of any local County health directives and adjust those requirements as updates are given. This will allow for quicker start-up once specifics are available for re-opening of day programs.

SDP Informational Zoom Series Offered

VMRC’s Self Determination Program (SDP) is progressing well. Through remote meetings, we have been able to move forward with our goals. And, this time next year all consumers and families interested in the program can opt to participate. To better equip everyone with the information and knowledge to make the decision of whether to participate or continue accepting traditional services, the Self Determination team made up of Elizabeth Diaz, Tania Candelaria, David Narbona, Michele Poaster and Angelique Shear will provide an Informational Zoom Series. 

There are currently four different sessions scheduled, one during each upcoming month. The first one will introduce the local FMS providers, Person Centered Planners and Independent Facilitators. The second session will highlight people and community agencies providing services to individuals in the SDP. The third session will be an overview of the VMRC SDP Budget Tool and how it is used, explaining the difference between the Certified Budget and Spending Plan. The final session of the series is going to be a parent panel of individuals who are participating in different phases of the SD Program. This series is open to anyone who would like to attend via Zoom.

o  Part 1: Friday July 31, 2020 10:00 AM – 12:00 PM
Password: 864928

o  Part 2: Monday August 24, 2020 1:00 PM - 3:00 PM
Password: 603333

o  Part 3: Tuesday September 8, 2020 10:00 AM – 12:00 PM
Password: 800817

o  Part 4: Wednesday October 14, 2020 10:00 AM – 12:00 PM
Password: 380639


IHSS Virtual Training on July 2

VMRC is offering an IHSS webinar via Zoom on Thursday, July 2 from 9am to 11am for VMRC staff and families. Maria Iriarte, an attorney for Disability Rights of California will present the information. Please join us.   


Meeting ID: 930 0164 7188        Password: 2020



Vote in 2020

Voter Registration is available through your VMRC Service Coordinator. Each year at the annual planning team meeting, Service Coordinators are asking individuals and/or families if they would like to register to vote. This is because Valley Mountain Regional Center is considered a Voter Registration Agency (VRA). In 2012 SB 35, authored by now Secretary of State Alex Padilla, was passed to codify the National Voter Registration Act (NVRA) into state law. 

NVRA has two major aspects related to voter registration: maintaining accurate voter rolls through list maintenance and ensuring every eligible citizen has the opportunity to register to vote through the Department of Motor Vehicles (DMV) and designated NVRA Voter Registration Agencies (VRAs). NVRA is often referred to as Motor Voter, because it requires DMV offices to offer customers an opportunity to register to vote when they apply for or renew their driver licenses or state ID cards, or change their addresses. Under the NVRA, many other state government offices, also known as VRAs, and private entities under contract with those offices are also required to offer people the opportunity to register to vote. This means that VMRC is required to offer voter registration services and assistance each time a person starts services, has an annual review or changes their name or address. 

We will also provide you any assistance in completing the voter registration cards and mail them in for you (if you would like). If at any time you would like to register to vote please contact your Service Coordinator who can provide you with a voter registration card and/or assist you in completing it. Since this is an election year, this is the perfect opportunity to register. Make your voice heard!     https://www.sos.ca.gov/elections/voter-registration/nvra/



Cindy Mix
Director of Consumer Services

Clinical Update

This week, the U.S. Food and Drug Administration (FDA) has released warning to all consumers not to use hand sanitizers manufactured by Eskbiochem due to the product containing Methanol, a toxic substance that can cause nausea, vomiting, headache, blurred vision, blindness, seizures, coma, and death when exposed in substantial amounts. [1] These products are:

·         All-Clean Hand Sanitizer (NDC: 74589-002-01)
·         Esk Biochem Hand Sanitizer (NDC: 74589-007-01)
·         CleanCare NoGerm Advanced Hand Sanitizer 75% Alcohol (NDC: 74589-008-04)
·         Lavar 70 Gel Hand Sanitizer (NDC: 74589-006-01)
·         The Good Gel Antibacterial Gel Hand Sanitizer (NDC: 74589-010-10)
·         CleanCare NoGerm Advanced Hand Sanitizer 80% Alcohol (NDC: 74589-005-03)
·         CleanCare NoGerm Advanced Hand Sanitizer 75% Alcohol (NDC: 74589-009-01)
·         CleanCare NoGerm Advanced Hand Sanitizer 80% Alcohol (NDC: 74589-003-01)
·         Saniderm Advanced Hand Sanitizer (NDC: 74589-001-01)

The FDA has revoked the Emergency Use Authorization (EUA) that allowed Chloroquine and Hydroxychloroquine to be used to treat hospitalized patients with COVID-19, when a clinical trial was unavailable, or participation in a clinical trial was not feasible. [2] FDA has determined that both drugs aren’t likely to be effective in treating COVID-19 and the risks outweigh the possible benefits. 2 Furthermore, the National Institutes of Health (NIH) has stopped the clinical trial to evaluate the safety and effectiveness of Hydroxychloroquine. [3] The study showed that although the said drug does no harm, it also provides no benefit to hospitalized patients with COVID-19. 3

FDA has also warned health care providers about the drug interaction when they co-administer the drug Remdesivir with Chloroquine or Hydroxychloroquine because it reduces the anti-viral activity of the drug Remdesivir. [4]

On a lighter note, the drug Remdesivir, who got an Emergency Use Authorization (EUA) by the FDA to be used to treat hospitalized patients with COVID-19 when administered intravenously, will now start human trials for an inhaled version (nebulization) of the drug. [5] When this becomes successful, it will pave the way for easier use and administration of the drug outside of the hospital setting.

Recently, the Centers for Disease Control and Prevention (CDC) has updated the symptoms of COVID-19, adding gastrointestinal symptoms such as nausea, vomiting and diarrhea. Evidence now shows that patients presenting with gastrointestinal symptoms may transmit SARS-CoV-2 (the virus that causes COVID-19) via fecal-oral route due to the presence of viral RNA in stool. [6] Knowing the possibility of fecal-oral route mode of transmission, does the act of flushing the toilet add to the spread of the virus? With the use of computational fluid dynamics, scientists have determined that, indeed, flushing the toilet can cause an alarming degree of upward transfer of virus particles (40-60%) reaching above the toilet seat, that could lead to a large-scale virus spread. [7] To reduce the spread, the scientists recommended putting the toilet lid down before flushing, cleaning the toilet seat before use because floating virus particles may have settled there, and to wash hands carefully after flushing. 7

The variation in disease behavior among those that had COVID-19 has prompted scientists to study the genetic association of the virus. 8 They have found that patients with blood type A have 45% higher risk of COVID-19 related respiratory failure than those with other blood groups. [8] And those with blood type O have a 35% lower risk of developing COVID-19 related respiratory failure. 8

With the knowledge of these new findings, and the current increase in cases and hospitalization rates, I implore you all to please continue to practice physical distancing of 6 feet or more when you are around people that are not members of your household, wear mask/face covering when you go out of your home, wash your hands thoroughly for 20 seconds, or use hand sanitizer with at least 60% ethyl alcohol (ethanol), and avoid touching your face. To date, there is still no approved medication or vaccine that can fight CVOID-19. But with all the above precautions and behavior modifications, we can all get through this together.

[7] American Institute of Physics (AIP). June 16, 2020. https://aip.scitation.org/doi/10.1063/5.0013318
[8] The New England Journal of Medicine. June 17, 2020. https://www.nejm.org/doi/full/10.1056/NEJMoa2020283



Claire B. Lazaro, MSN, RN, NP, PHN, CCRN, FNP-C
Clinical Director
North Valley Hills Update
Dena Hernandez, Regional Manager

The current public health crisis has brought a lot of fear and uncertainty among all of us but especially among people with developmental disabilities who often rely on caregivers and different programs to complete their daily activities.
It has been our pleasure to collaborate with  Listos California California Department of Developmental Services  and  California Governor's Office of Emergency Services  to produce these COVID-19 tips so that we can empower people with intellectual and developmental disabilities and their caregivers to turn fear and uncertainty into assurance and knowledge.

Have a question or concern- feel free to contact me at 209-473-6930 or dena.hernandez@scdd.ca.gov
Self-Advocacy Council 6

Lisa Utsey - Self Advocacy Council 6 chairperson invites you to join the SAC6 Friday CHATS!

With so much happening because of the virus SAC6 wants to hear how you are doing and share information so we can all get through this together!

Health and Wellness

Join us on a SAC6 ZOOM CHAT!!
Let’s Check In with each other!
WHEN : Friday June 26, 2020
TIME : 11:00am-12:00pm
WHERE : ZOOM- computer, tablet, cell phone
 
The next SAC6 CHAT:
  • Friday, June 26, 2020 - Mental Health Awareness and How are you Taking Care of Yourself

Join Zoom Meeting on your computer, tablet or phone

https://zoom.us/j/97738109956?pwd=cXZRSithYURkbHNRcmJWZE9tdDF4QT09
 
Meeting ID: 977 3810 9956

Password: 102738
You must enter the Password or you can call in:

TOLL FREE NUMBER TO CALL IN:
  • 888 475 4499 US Toll-free or
  • 877 853 5257 US Toll-free

Local County Public Health Resources
Amador County - 20 known cases as of June 25, 2020 - 8 new cases this week, 0 current hospitalizations, 6 new cases in the last 14 days, 20% of ICU beds available, 88% ventilators available

Calaveras County - 29 known cases as of June 25, 2020 - 3 new cases this week, 0 current hospitalizations, 10 new cases in the last 14 days, 92% of ICU beds available, 100% ventilators available

San Joaquin County - 2884 known cases and 49 deaths as of June 25 , 2020 - 957 new cases and 2 new deaths this week, 122 current hospitalizations, 1398 new cases in the last 14 days, 34% of ICU beds available, 83% ventilators available

Stanislaus County - 1871 known cases and and 38 deaths as of June 25, 2020 - 549 new cases and 3 new deaths this week, 102 current hospitalizations, 1009 new cases in the last 14 days, 42% of ICU beds available, 74% ventilators available

Tuolumne County - 15 known cases as of June 25, 2020 - 6 new cases this week, 0 current hospitalizations, 2 new cases in the last 14 days, 83% of ICU beds available, 100% ventilators available

VMRC - 21 confirmed consumer cases as of June 25, 2020 - 15 new cases this week

VMRC Staff - 2 known case as of June 25, 2020 - 1 new cases this week

VMRC Volunteer - 1 known case as of June 25, 2020 - no new cases this week

VMRC Providers - 5 known cases as of June 25, 2020 - 1 new cases this week

California - 197,589 cases and 5751 deaths as of June 25, 2020

National - 2,452,567 cases and 125,796 deaths as of June 25, 2020