Health Advisory XV: VMRC Community Notice

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Fifteenth Community Health Advisory: Coronavirus (COVID-19)

weekly message from the director...

We made it through another week slowly but surely working through so many questions. Our community of people with disabilities, their families, and their service providers are turning to Valley Mountain Regional Center to tell them when families can visit loved ones in licensed homes again, how many people are getting sick, when can day programs reopen and under what conditions, when do all the temporary COVID-19 response rates and flexibilities end, what do we do with so many waivers that are expiring in June, and so much more.

Here is what we learned this week:

Family Visits in Licensed Settings ( Directive March 23, 2020 – no deadline )

We have been informed that state officials have been working hard on easing this prohibition, which requires guidance from the Department of Developmental Services (DDS) and the CA Department of Social Services (CDSS). Community Care Licensing, a program of CDSS, is preparing to send a “ Provider Information Notice ” (known as a PIN) to all licensed providers and others who have signed up to receive these notices ( sign up here ) explaining a change to this policy.

How Many People in our IDD Community are Getting Sick?

Every day Doug Bonnet reports to DDS whether or not we have experienced an exposure or positive diagnosis of COVID-19, and by the end of the week we report to you the weekly number (it’s at the end of the Health Advisory). Since we consistently get questions about this, it seems people are not aware that DDS also reports the collective number from all the regional centers and puts it on their Data webpage for COVID-19 . Out of the 354,156 people served 450 have tested positive for COVID-19 which is an increase statewide of 60 people since June 4, 2020. Also we get questions about the distribution of positive cases across ethnicity and DDS reports that as well. According to the reports the following groups are over represented proportionately: Black/African American by 2%, Hispanics by 3%, and Caucasian by 8%. In addition DDS reports on distributions by regional center, diagnosis by residence type, and deaths by residence type.

When Can Day Program Sites Reopen and Under What Conditions (DRAFT PLAN June 10, 2020)

On Thursday of this week one of the subgroups of the Developmental Service Task Force met and focused on the issue of re-entry into day programs and several other settings and services. To review the materials and other information from the DS Task force visit their webpage . Of additional significance, DDS said the state was targeting the end of June for stopping the “absence payments” which allows regional centers to pay non-residential providers when the consumer is absent from the program because of COVID-19 Stay at Home Orders.

DDS says the transition will need to take place in phases and while they have been working through logistics with ARCA and the California Disability Services Association, discussions with consumers and families will be part of the decision-making process going forward. To view the document overview of the policy being considered click on the DRAFT PLAN June 10, 2020 above . VMRC has also been advised that Community Care Licensing will publish a PIN in the next few days regarding their expectations and requirements for reopening licensed day programs (see directions for receiving these PIN notice in the “Family Visitation” section above).

When do all the Temporary Rates and Flexibilities End? (Waiver Extensions June 8, 2020)

On June 8 ^th of this week we received another directive from DDS extending several deadlines for various waivers of rules related to service locations, provision, billing, and temporary rates. This Directive includes the following extensions:

1. Prohibition Against Use of Day Program for ARFPSHCN, ICF (nursing and continuous nursing) – ends July 10, 2020

2. Early Start (In-Person eligibility and remote services), - ends July 10, 2020

3. IPP Remote Meetings – ends July 10, 2020, extended to July 16, 2020

4. Health and Safety Temporary Rate Adjustment for Residential/Supplemental Services – ends July 10, 2020, extended to July 16, 2020

5. Absence Payments for Non-Residential Services. – ends July 16, 2020

6. Regional Centers Public Meeting can be remote or postponed - extended to July 16, 2020

7. Temporary 4731 40 day timeline from 20 days - extended to July 16, 2020

8. Postponing of certain audits and program reviews extended to July 16, 2020

9. Home and Community-Based Services (HCBS) Self Assessments The requested completion date for provider HCBS self-assessment has been extended to August 31, 2020.

10. Suspension of DSP certification Training extended to July 16, 2020

11. Streamlined eligibility process and presumptive eligibility - extended to July 23, 2020

12. In-Home Respite Workers relaxed on requirements for CPR and First Aid - extended to July 23, 2020

13. Suspension of the Family Cost Participation Program and the Annual Family Program Fee - extended to July 23, 2020

14. Addition to the list of Participant Directed Services – extended to July 28, 2020

15. Absence Payments for Residential Services – extended to July 14, 2020

16. EBSH/CCH Registered Behavior Technician Certification Requirement waived – extended to July 14, 2020

17. Consecutive Days worked Requirements Waived for Competitive Integrated Employment (CIE) Incentive Payments – extended to July 14, 2020

18. The Directive mandating regional centers to request approval for residential placements was rescinded on June 8, 2020

There is much more work to do to ensure our service system does not collapse around us, to make sure our families are getting the supports they need to sustain themselves during this crisis, to protect and support our staff so they can work the mission of VMRC, and ensure people with IDD in our community have the opportunities they need to part of their communities and to not slip backwards in their access to a life they choose. #AllTogether

Have a great weekend.

Sincerely,

Tony Anderson

Executive Director

Valley Mountain Regional Center

Case Management Updates

VMRC Additional Purchase of Service (POS) Generated Due to COVID-19

Service needs can continually change and, as members of your planning team, we are diligently trying to help meet those needs. We have compiled the following statistics to demonstrate the effects of the Coronavirus and services provided solely due to COVID-19. Each week the numbers grew until a few weeks ago when they started to decline. Statistics show an increase in service needs again last week. Our total of additional purchases and the categories used during the pandemic look like this:

TOTAL— 3/12/20 through 6/5/20—2,831

· Respite—1,498

· PATCH—967

· SLS—73

· Personal Assistance—62

· Medical Supplies—7

· Day Care—18

· Crisis—4

· Bed Hold—1

· Nursing Respite—5

· BIS—4

· ABA—1

· Supported Employment—1

· ILS—1

· Carryover POS captured by Fiscal during Week 1—189

CalFresh Issues Emergency Allotments

California will be issuing Emergency Allotments (EA) to current CalFresh recipients for May & June 2020 . The Emergency Allotment for May will be issued on June 14 and for June, it will be issued on July 12 to bring their CF benefits up to maximum amount allowable based on household size. Per Food and Nutrition Service (FNS), households already receiving the maximum allotment are not eligible to receive an emergency allotment. Get details or look at your status at: https://ca.p-ebt.org/en/

Census Data is Vital for Federal Funds

The Census Bureau has identified people with disabilities as a hard-to-count population which means they are at a greater risk of being under counted. Census data affects funding and representation for people with disabilities. So, we need to make sure that you are ready to be counted in the 2020 Census. Allocation of more than $675 Billion in federal funds is at stake. We ask that families and service providers assist consumers and access your regional center Service Coordinator if additional help is needed. Group home and facility administrators have the important task of making sure everyone in the home is counted for the census. The Census Bureau helps those administrators respond to the census on behalf of residents.

Group Home Info: English or Spanish / Español

Videos in: English, ASL, and Spanish.

To get more help: becounted@disabilitycounts2020.org

Want to Track the Status of Your Stimulus Check?

If a consumer is eligible for a stimulus payment, they can use the IRS web portal “Get My Payment” to track their money. Here’s the process:

1) Go to the IRS Get My Payment page to check the status of your economic impact payment-- https://www.irs.gov/coronavirus/get-my- payment .

2) Enter your Social Security number (SSN); your date of birth; your street address, and ZIP.

3) On the next page, the portal will show your payment status, whether it’s been scheduled, and the method used for payment (check, card, or direct deposit).

4) Normally, SSI recipients have a $2K limit. With the $1200 stimulus check, the balance limit is now $3200. This means you cannot go over $3200 (with the $1200 stimulus) and you have one year to spend the additional $1200 received in stimulus money.

Self-Determination Program Update

The Self-Determination Program (SDP) is a new voluntary option and an alternative to traditional regional center services. SDP will be available to all consumers in June of 2021. VMRC is involved in the soft roll-out of 110 participants at this time and COVID-19 has not stopped our efforts. If you are interested in learning more about the program, we are offering several informational trainings via Zoom.

Please register in advance for both the July 15, 1-4 pm or the August 27, 1-4 pm webinar:

https://zoom.us/webinar/register/WN_YpdsqVxJRRCvkCvDvPefuw

https://zoom.us/j/92307979966pwd=emhZcjA4WEtWcFF2T09uak1kRzlEUT09 A

Flyers will be posted on www.vmrc.net

Additionally, a Zoom presentation and virtual Meet & Greet is scheduled for July 31 from 10 am to 12 pm related to Financial Management Service (FMS), Person-Centered Planning (PCP) and Independent Facilitator (IF).

Join us at:

https://zoom.us/j/96393011611?pwd=U05tK2FhWjVxc3luUXQvSUhoNnViZz09

Password: 864928

Other presentations being planned include SDP Service Providers (vendor and non-vendor) in August; Family Stories (successes and barriers) in September; and Budgets/Spending Plans (the differences) in October. Stay tuned as more information is coming your way.

Cindy Mix

Director of Consumer Services

Clinical Updates

To VMRC Family,

With the office starting the slow re-opening for staff, I would like to personally thank you all for your patience, understanding, and cooperation in the adjustments we need to implement and follow. The temperature checks, wearing of face coverings, physical distancing, one directional flow in the stairwells and door, and staggered shifts. These modifications in work routine are difficult, uncomfortable, and inconvenient. Nevertheless, these are necessary in order to ensure your health and safety at work. Your well-being is our priority - for you to be able to go home safely to your own families. Each one of you is important. You are valued as an integral part of the VMRC team, and a precious resource to the consumer and families you serve.

Continue to stay safe and healthy,

Claire B. Lazaro, MSN, RN, NP, PHN, CCRN, FNP-C

Clinical Director

Early Start Services

Our Early Start Service Coordinators continue to contact families to check in with them regarding needs and monitor children’s progress. Most services continue to be held through distance learning and parent coaching. We have gathered input from our vendors regarding what’s working with remote services and have shared it with the California Early Start Interagency Coordinating Council hoping that it helps others in the provision of virtual learning.

Intake

VMRC Intake numbers continue to be low in all of our counties with the exception of Stanislaus. We are looking at ways to do outreach and working with our community partners to assist us. Child find is important because we know that early intervention is vital. Two possible reasons for the low number of referrals could be school closures and very few visits to physicians. In terms of eligibility determinations, we are able to conduct file reviews for some perspective consumers and find them presumptively eligible for services if we have enough documentation. Those consumers found presumptively eligible will be re-evaluated for continued eligibility within a year.

OT Clinic

During this time our OT clinics continue to be held remotely. This has worked well for the most part as providers are able to see consumers in their natural environment.

Autism Diagnostic Services

Most of our autism diagnostic evaluations are being done remotely if it is appropriate for the individual as confirmed by our Psychologist vendors. However, there are a couple of vendors who conduct evaluations in person.

Tara Sisemore-Hester

Assistant Director

Clinical Services

Mental Health Awareness and COVID-19

“When we are no longer able to change a situation – we are challenged to change ourselves.”

(Victor E. Frankl)

May was Mental Health Awareness month, and its significance is underscored by the changes we have all been forced to make in order to keep ourselves safe and help flatten the curve in response to the COVID-19 pandemic. This includes a recognition that while sheltering in place and social distancing plays an important role in the fight against the COVID-19 pandemic, it is not without unintended circumstances for an already vulnerable population - those who struggle with mental illness. Although change of any type is not without uncertainty, this dramatic change in lifestyle and interaction has also brought about feelings of isolation, despair, and anxiety. As a result, mental health experts across the country have begun to express concerns with respect to a potential increase in mental health symptoms, alcohol and drug use, domestic violence, and suicide. For example, according to a recent Kaiser Family Foundation poll, 56% of respondents reported that worry or stress related to the outbreak has led to at least one negative mental health effect. In a recent study conducted by McKinsy & Co. they found that 35% of Americans surveyed felt anxious or depressed with regard to COVID-19, and many reported increases in dysfunctional coping strategies, such as binge drinking and illicit drug use.

If reading those stats has added to your own feelings of anxiety and uncertainty, multiply that by 10 or more and you’ll begin to understand how these uncertain times feel to those struggling with a mental illness.

Now, add to this the changes and feelings of uncertainty that individuals with a developmental disability with and without a mental illness may be experiencing, as well as the added stress to families and caregivers.

Social distancing does not mean social isolation - we can all still be there for each other!

Regardless of our circumstances, while we may be stuck indoors, it is important that we all practice self-care during Mental Health Awareness month and beyond by implementing some of these tips and passing along to family and friends:

· Strive for normalcy by establishing a routine. Get up, take a shower, get dressed, work out, eat healthy, make daily virtual “dates” with the people you love—your mind may be telling you to stay in bed and not do anything, but this will only make things worse.

· Another coping skill is what experts call “fake it to you make it.” Basically, read or watch or do something that is the opposite of how you are feeling. Keep in mind, “laughter is good medicine.” So, don’t binge watch those movies that make us feel down. Watch something funny and lighthearted instead. Focus on positive topics, and distract yourself from feelings of loneliness, sadness, and uncertainty.

· In addition to regular exercise, reading a good book, playing a video game, or picking up a new hobby, can all be helpful distractions.

· In a world of easy access, news overload can make anyone spiral. Limiting your access is important to well-being.

· One last tip, if you know someone with a mental illness, now is the time to step up and make sure you are helping them in whatever way you can. Reach out—whether it be video, phone, text, or social media—to check in and be an active part of their support group.

“The isolation, the fear, the uncertainty, the economic turmoil - they all cause or could cause psychological distress.”

Devora Kestel, Director of the World Health Organization’s (WHO) Mental Health Department

Barbara Johnson, Psy.D.

Clinical Psychologist

A Message from our Employment Specialist

We are happy to be members of Chambers of Commerce in each of our 5 counties. Through those partnerships we have had the privilege to work side by side with other local community organizations and businesses. The African American Chamber of Commerce of San Joaquin (AACCOFSJ) has been a prominent organization in San Joaquin County and the Greater Stockton area for over 30 years. We are glad to be able to highlight a local organization during the COVID-19 global pandemic and encourage each of our 5 counties to continue to support your local organizations. Below is a PDF if you are interested in joining or learning more about the African American Chamber of Commerce.

African American Chamber of Commerce of San Joaqin (AACCOFSJ)

Enos Edmerson

Employment Specialist

Personal Protective Equipment (PPE) Update

Over the last week we were able to team up with our Self Advocacy Council Area 6 (SAC6) and the California State Council on Developmental Disabilities (SCDD) North Valley Hills Office to distribute PPE to our vendors and families. We hit each office with a drive through distribution day for 3 hours. Thank you to SCDD for the supplies and the muscle, and thank you to SAC6 for helping out as well!

We would like to announce that next week, we have 2 more PPE distribution days coming:

Thursday, 06/18/20, from 9:00 AM - 12:00 PM at VMRC Stockton Office, 702 N. Aurora Street, Stockton, CA 95202

and

Friday, 06/19/20, from 9:00 AM - 12:00 PM at VMRC Modesto Office, 1820 Blue Gum Avenue, Modesto, CA 95358

Distributions do not require a registration or RSVP, simply drive up, stay in your vehicle and our team will supply you with surgical masks, face shields and hand sanitizer!

Doug Bonnet

Special Assistant to the Executive Director

Human Resources Update

In response to the recent events in Minnesota and across the U.S., Magellan has opened a 24-hour toll-free crisis line (US only) accessible to the public, regardless of whether or not they are Magellan members. The situation with COVID-19, in addition to the unrest in communities across the country, has sparked an unprecedented level of stress for many individuals. Magellan is available to help as individuals who call the hotline will speak directly to a masters-level, certified licensed mental health clinician.

The toll-free number to access free, confidential counseling services is 1-800-327-7451 (TTY 711).

Magellan’s confidential mental health crisis line is offered free-of-charge to the community to assist individuals as they try to cope with feelings of fear, sadness, anger and hopelessness related to these difficult times. Crisis line callers may also seek information and guidance to other available resources, such as community-based support. You are welcome and encouraged to share this toll-free number with friends or extended family members who are not covered by the EAP. Full press release is attached.

As a reminder, we have developed a central location for crisis communications resources. The resource page, www.magellanhealth.com/crisiscommunications , includes four Magellan tip sheets available to download, and links to resources on the Ready.gov website, such as guides and videos for nearly 30 different types of traumatic events. This resource page can also be shared publicly.

As always, please remind your employees, team members and family members that they may contact the Employee Assistance Program for support anytime, 24/7/365. Please don’t hesitate to reach out if we can further assist in any way. Stay healthy, be well and mind your mental health!!

www.magellanhealthcare.com/covid-19

www.MagellanAscend.com

www.MagellanHealth.com/mymh

Bud Mullanix

Director, Human Resources