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Thirty-Sixth
Community Health Advisory Coronavirus (COVID-19)
weekly message from the director...

This has been a tremendously difficult week for many of the employees, consumers, families, and community partners whose lives were touched by Wilma Murray, who passed away this week with her loving family by her side. On Tuesday morning one of our staff members came upon Wilma at work after she suffered what we later learned was an aneurism. She was immediately taken to the hospital and received care. We anxiously awaited updates every day from her family and many expressed their love for Wilma and an overwhelming expression of care and compassion for her family. 

There has been a tremendous outpouring of grief and appreciation and acknowledgement of the impact Wilma has had on their lives and careers. Wilma had been with VMRC for over 21 years, and most recently she coordinated our transportation services for our consumers and was a major advocate to increase employment of people with disabilities. For 15 years she was a major contributor helping to organize the CHOICES Conference, our area's signature self-advocate conference, where you could find her at the front registration and all over the event.
 
She has been such an important part of our organization and has impacted the lives of so many of us, not to mention the countless consumers and families who I am sure are forever grateful. Wilma left us way too soon and I, like many others, am still in shock. Everyone knows someone in their work environment that always seems to make those harder work days easier. Wilma was that person for so many people. So many of us are collectively grieving, inside VMRC and throughout our community. Our thoughts turn to her family as we all wish them peace during this time of intense personal grief.

Tony Anderson
Executive Director
Valley Mountain Regional Center

Case Management Update


Person-Centered Thinking and Practices Series Available

The California Department of Developmental Services, in partnership with Support Development Associates, is offering a series of virtual trainings on Person-Centered Thinking and Practices. These trainings will be held via webinar to help assure that key stakeholders, including individuals and their families, providers, and regional center staff are knowledgeable of, and understand the principles and application of person-centered thinking, practices and service planning.

The training titled Person-Centered Practices During Challenging Times will provide information on balancing “important to” and “important for” the consumer during this time of uncertainty, and give participants tools to address this balance while supporting elements of resiliency, including maintaining connections, helping people be and feel safe, and assisting people to have control.

Anyone interested in learning about strategies for continuing person-centered practices in challenging times is welcome to register and attend the training at no cost to training participants. When registering, please provide any needed accommodations.

The trainings will be held on two separate dates. Follow the link to register and participate in the live webinar.

  • Tuesday, November 17, 2020 10:00 AM - 12:00 PM

                   
  • Thursday, November 19, 2020 1:00 PM - 3:00 PM



CDC Guidelines Followed When Considering Site-Based Programming

As some of our day and employment programs may start a soft re-open to their sites on a very limited basis based on approval from public health officials, VMRC is holding planning team meetings with consumers and vendors. The programs will abide by all COVID-19 precautions including staggering of their schedules, requiring ten (10) or less in a room depending on the size of the room, while being socially distanced and wearing masks.

VMRC will follow The Centers for Disease Control and Prevention (CDC) guidelines when reviewing those who may return during the ongoing health crisis. Consumers interested may fall into one of three (3) categories. Those who are considered high-risk will be unable to return at this time, but will have other programming options available to them. Those who might be at risk due to their condition, could return with a doctor’s note. And, the third category includes those with no chronic conditions preventing their return.

The current high-risk category involves those of increased risk of severe illness from COVID-19 and is made up of those with the following diagnoses:  









Individuals with the following conditions might be at an increased risk for severe illness from COVID-19 and would require a doctor’s note:













  • The list of underlying conditions is meant to inform clinicians to help them provide the best care possible for patients, and to inform individuals as to what their level of risk may be so they can make individual decisions about illness prevention. We are learning more about COVID-19 every day. This list is a living document that may be updated at any time, subject to potentially rapid change as the science evolves.

 
Special Ed Training for Parents

The Albany Disability Squad is a group of parents in Alameda County that offers training and support for parents. Parents can go to their website and check the upcoming trainings and register for those of interest. Translation is provided. Upcoming trainings include:

  • November 9—from 7pm- 8:30pm—DREDF’s Special Education Training on How to Read an IEP.

  • November 11—from 6:30pm to 8:00pm— ADS Family Support Group

                        https://albanydisabilitysquad.org/


Participant-Directed Informational Meetings

An online informational event will be held for all self-advocates and family members about Participant-Directed Services. The interactive virtual training will include updates from the California Department of Developmental Services (DDS) and information about this service category followed by a question and answer session. Regional Center staff attended informational sessions this week and will be available to assist with the process.
Participant-Directed Services is an available group of options to increase access and flexibility in service delivery. The choice to access these services through participant direction affords consumers the ability to choose workers (e.g. friends, some family members, etc.) to provide these services.

Please register in advance to attend one of the following events:

  • Saturday November 7, 2020 10:00-11:30 am


  • Tuesday November 10, 2020 5:30-7:00 pm


After registering, you will receive a confirmation email with your link to join the meeting.
Presentations will be in English with simultaneous Spanish, Cantonese, Mandarin, Vietnamese, Tagalog and American Sign Language interpretation. 

For more information or questions, please contact: FamilyInput@dds.ca.gov



Cindy Mix
Director of Consumer Services
Clinical Update


COVID-19 UPDATES

·       Household transmission of SARS-CoV-2 is common and happens within 5 days on the positive patient’s illness onset.[1] Authors of the research are recommending that individuals immediately self-isolate upon onset of COVID-19-like symptoms, at the time of testing due to a high risk of exposure, or at the time of positive result, whichever comes first. And that all household members, including the index patient, should wear masks within shared spaces in the household.

·       People living in the same home are more likely to develop COVID-19 symptoms and test positive, compared to social contacts or work contacts.[2] Risk factors include sharing a bedroom or vehicle or speaking within 2 meters of a positive case for 30 minutes or more. This study emphasizes the value of public health measures of physical distancing, minimizing verbal interactions and testing all household contacts, including asymptomatic ones.

·       An observational study suggests that there is a potential protective role of quadrivalent influenza vaccination on COVID-19 incidence.[3] This enhances the role of flu vaccination during this flu season.

·       One of our community partners, St. Joseph’s Medical Center in Stockton California, has made accommodations for our consumers. If one of our consumers is at their ER, they will make an exception so the consumer can have one advocate with them to help explain their healthcare needs. Please ask the ER nurses and staff to allow an advocate together with our consumer in the ER. If the ER staff decline, you can ask for the ER manager or House Supervisor and express this request.  

·       With the continued increase of COVID-19 cases across the nation, please continue to wear masks, practice physical distancing, wash your hands for 20 seconds and get your flu vaccine now. Let us help restore our community.

[1] CDC Mortality and Morbidity Report. October 30, 2020. https://www.cdc.gov/mmwr/volumes/69/wr/mm6944e1.htm?s_cid=mm6944e1_x
Please continue to stay safe and healthy.

Claire B. Lazaro, MSN, RN, NP, PHN, FNP-C
Director of Clinical Services
Community Services/Quality Assurance Update



During this COVID-19 pandemic, the goal of VMRC is to promote the health and safety of all
the consumers, especially the vulnerable ones with underlying medical conditions and living
in group settings with or without roommates.

When a consumer, living in licensed care or group living arrangements, is going to travel or
go out in outings individually or groups, and care home staff are able to ensure that the
consumer is able to follow all the precautions, the consumer does not have to do the 14-
day isolation. During this time, the following conditions must be met:

• the care home staff will always wear mask per CA State mandate and CDC guidelines

• the care home staff was able to ensure that the consumer had mask on at all times,
covering the nose and mouth, and all precautions were adhered to

• optional to use a face shield or eye goggles as added protection

• practiced more than 6 feet physical distancing

• avoided touching face

• washed hands frequently or used hand sanitizer

• showered immediately and changed clothes upon return to care home

• clothes washed immediately and separately



During this COVID-19 pandemic, the goal of VMRC is to promote the health and safety of all the consumers, especially the vulnerable ones with underlying medical conditions and living in congregate settings.

When a consumer, living in congregate setting, is visiting friends or family members in their homes or other places for a few hours to days, VMRC is highly recommending that consumers will do 14-day isolation upon return to the care home. Please refer to isolation guide with title “DDS Expectations for Consumers Coming back from Hospital or ER or Other placements.”

Similar will be expected when a consumer is working as an essential employee, and lives in congregate setting. The consumer may go to the living area provided that a mask is worn at all times, and he/she is more than 6 feet away from other consumers.

When a consumer, living in congregate setting, is going to an office visit to a primary care provider, doctor visit, dentist visit or laboratory visit, there is a different expectation. Because these settings are controlled environment in such as there is temperature check prior to entry, individuals are required to wear mask at all times inside the building, and chairs are arranged physically distanced with easy access to soap and water or hand sanitizer. If the consumer is able to abide by those safety precautions at all times, and consumer is able to shower and change clothes immediately when he/she returns to care home, the consumer does not have to do 14-day isolation. Clothes should be washed immediately and separately.

Similarly, when a consumer goes out to the community for example, grocery shopping, the consumer does not have to do 14-day isolation when the following conditions are met:

• the care home staff will always wear mask per CA State mandate

• the care home staff was able to ensure that the consumer had mask on at all times, covering the nose and mouth

• practiced more than 6 feet physical distancing

• washed hands frequently or used hand sanitizer, and avoided touching face

• showered immediately and changed clothes upon return to care home

• clothes washed immediately and separately

Further guidance on the document title “In-person Meeting Outdoors / Outside the Home During COVID-19."




When a consumer is discharged from a skilled-nursing facility (SNF), or being discharged from Hospital admission, or from an Emergency Room visit, or from a psychiatric hold, or from behavioral facility, or from home going to a care home, or going to a new care home, please practice the following guidelines from DDS and CDC:

1. Isolate the consumer for 14 days. We will call this Consumer A.

2. Ideally, consumer A will stay isolated in a private room with private bathroom that only this consumer will access.

3. Please separate everything, clothes, eating utensils and others.

4. Please have a dedicated staff to care for this consumer only, if possible.

5. If consumer A is sharing a room with consumer B, please move consumer B to a different room, if possible.

6. The care home may also identify a specific area of the home to consumer A, if that is more feasible.

7. If a private bathroom for consumer A is not possible, please do your best to clean it very well, and disinfect the bathroom every after use of consumer A, including every after shower or bath.

8. An option of providing a bedside commode for consumer A is okay if he/she is comfortable with that.

9. Consumer A may come out of his room to the living area as long as there is no one else out there and wearing mask. If there is another person in the living area, Consumer A should be more than 6 feet away from other individuals and still wearing mask.

10. If all the above conditions are not feasible at the care home, the regional center may look into other options such as surge capacity homes, or hotel with SLS or staff as an example.

11. Regional center should ensure that isolation protocols are in place at each of the care homes.

12. Care home staff are trained to check temperature of Consumer A, at least twice daily, and document this. Care home staff should also monitor for other symptoms of COVID-19 such as fever, chills, cough, shortness of breath or difficulty breathing, fatigue, muscle aches or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea, vomiting, or diarrhea.

13. Care home staff are asked to monitor oxygen saturation, if available, and to seek medical attention if it is 92% or less.1 This is best practice.

14. If any of the above symptoms are recognized, care home staff should contact the primary care provider (PCP) and seek medical attention.

15. Per CA State mandate, care home staff/direct support professionals will wear masks/face coverings while in the care home, whether they are in direct care of a consumer or not. The care home is their work environment.

16. If someone is positive with COVID-19, care home administrator will submit a SIR to VMRC, and isolate the consumer. Testing of other consumers and staff in the care home is highly recommended. The care home staff should monitor the individual with positive result for any symptoms of COVID-19, as well as any other individuals that were exposed. The exposed individual should self-quarantine per CDC guidelines.

Update on the Isolation Plan

1. When discharged from ER/hospital or from parent visit, isolate consumer for 14 days. The reason is we are not sure what type of exposure the consumer had. And continue 14 days because of the incubation period of COVID-19 which is 2-14 days.

2. Based on new CDC guidelines for those with positive COVID-19 result: isolate for 10 days from date of first positive RT-PCR testing if the individual never develop symptoms. If symptomatic, discontinue isolation and precautions 10 days after symptom onset and resolution of fever for at least 24 hours, without the use of fever-reducing medications, and with improvement of other symptoms.

3. Example 1: Consumer A exposed to ER/hospital/family visit, will have 14-days isolation. On Day 11, Consumer A develops diarrhea (covid-19 symptom)  seek medical attention and isolate 10 more days based on CDC guidelines from onset of symptoms.2

4. Example 2: Consumer B has positive test result but has no symptoms  10 days isolation. On Day 9 of isolation, develops headache and body ache (covid-19 symptoms),  seek medical attention and additional 10 days of isolation based on CDC guidelines.

5. For persons with severe illness or severely immunocompromised, isolation will last up to 20 days after symptoms onset; consider consultation with infection control experts.3

6. Severe illness will be classified as those who has been hospitalized due to COVID-19 or COVID-19 related-symptoms.4

7. Examples of severely immunocompromised would be individuals who have weak immune system due to solid organ transplant, blood or bone marrow transplant; has immune deficiencies; or use immune weakening medicines.5

Additional examples are those on chemotherapy for cancer; has untreated HIV infection with CD4 T lymphocyte count of <200; combined primary immunodeficiency disorder; and individuals on long-term steroid use such as prednisone of >20 mg/day for more than 14 days.


COVID-19 Hospital Discharges & other Placement
Revised: 04/02/2020, 04/09/2020, 07/16/2020, 07/20/2020, 08/05/2020, 08/07/2020

1 Academic Emergency Medicine. July 23, 2020. https://onlinelibrary.wiley.com/doi/abs/10.1111/acem.14053
2 CDC. July 22, 2020. https://www.cdc.gov/coronavirus/2019-ncov/hcp/duration-isolation.html
3 CDC. July 22, 2020. https://www.cdc.gov/coronavirus/2019-ncov/hcp/duration-isolation.html
4 CDC. June 30, 2020. https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html
5 CDC. July 17, 2020. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fneed-extra-precautions%2Fgroups-at-higher-risk.html
6 Stanislaus County Public Health Officer. July 20, 2020. http://schsa.org/PublicHealth/pages/corona-virus/pdf/return-to-work-en.pdf


The Community Services Department and
Quality Assurance Team
Early Start Update



Since March of 2020 we have seen a dramatic decrease in the referrals for Early Start services. Early Start referrals are down across the state. VMRC is focusing on outreach to get our Early Start referral numbers up. Take a look at the brochures below to learn more and help us get the word out!

Tara Sisemore-Hester
Assistant Director, Clinical Services
North Valley Hills Update
Dena Hernandez, Regional Manager

 Now more than ever we need to practice self-care- please check out this opportunity to do that from SCDD & Illumination Institute 
Have a question or concern- feel free to contact me at 209-473-6930 or dena.hernandez@scdd.ca.gov
November Personal Protective Equipment Distribution
We have finalized our calendar for PPE Distribution Days for November. 


Friday – November 6, 1pm – 3pm, Valley CAPS Manteca, 1180 N. Union Road, Manteca, CA, 95336

Friday – November 13, 1pm – 3pm, ARC of Amador, 75 Academy Drive, Sutter Creek, CA 95685

Friday – November 20, 1pm – 3pm, UCP, 959 E. Monte Vista Avenue, Turlock, CA, 95382


Thank you to Valley CAPS Manteca, ARC of Amador, and UCP Stanislaus County for hosting us. We wanted to reach some areas that we serve outside of Stockton, Modesto and San Andreas. Also, a very big thank you to SAC6 and SCDD North Valley Hills for being a HUGE help. We couldn’t do this without them!

Please spread the word to families and service providers. Like always, if a family or vendor can not make the event and would like delivery, we will do the best we can to fulfill that delivery request. 

Please have families notify their Service Coordinators, and vendors notify their Community Services Liaisons.

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 October 30, 2020
TIME: 11:00am-12:00pm
WHERE: ZOOM - computer, tablet, cell phone
 
The next SAC6 CHAT:

·    Friday, October 30, 2020 -  Employment Wrap Up - Tony Anderson of VMRC AND Halloween Bingo & Costume Contest with Prizes!
 
Join Zoom Meeting on your computer, tablet or phone
 



Meeting ID:  962 5777 9463

Password: 144334

You must enter the Password or you can call in:
 
TOLL FREE NUMBER TO CALL IN:
·    1-877-853-5257 US Toll-free
 

Five County Data Update
as of November 5, 2020

San Joaquin County
  • 22,556 total positive cases and 494 deaths
  • 7.0 new cases per 100,000 people and 4.0% positivity rate (Substantial/Red....2nd Most Restrictive)

Stanislaus County
  • 18,204 total positive cases and 405 deaths
  • 7.9 new cases per 100,000 people and 4.2% positivity rate (Substantial/Red....2nd Most Restrictive)

Tuolumne County
  • 318 total positive cases and 7 deaths
  • 4.4 new cases per 100,000 people and 2.5% positivity rate (Moderate/Orange....2nd Least Restrictive)

Calaveras County
  • 361 total positive cases and 21 deaths
  • 2.6 new cases per 100,000 people and 1.3% positivity rate (Minimal/Yellow.... Least Restrictive)

Amador County
  • 332 total positive cases and 15 deaths
  • 10.4 new cases per 100,000 people and 2.6% positivity rate (Moderate/Orange....2nd Least Restrictive)

State of California
  • 954,241 total positive cases and 17,833 deaths
  • 7.7 new cases per 100,000 people and 3.3% positivity rate

Valley Mountain Regional Center
  • 204 positive consumer cases and 15 deaths
  • 12 positive VMRC staff cases
  • 1 positive volunteer case
  • 75 positive provider cases and 1 death

Local County, State and National Public Health Resources