Case Management

Case Management developed a group of staff to phone contact with all care homes, ICFs and FHAs twice per week with a set of 10 COVID-19 related questions. All information gathered was sent to a designated QA staff who triaged and forwarded issues to either QA or Case Management for resolution. Information was obtained re: their additional PPE supply needs and devised a list. Staff called to confirm, put together bags of supplies and are in the process of delivering. We received 62 requests from residential providers this week.

Service Coordinators reviewed caseloads for our most vulnerable consumers with highest needs and developed a prioritized list to provide needed PPE supplies. Of 2,500 vulnerable consumers identified, approximately 300 are considered extreme high need and deliveries of PPE are occurring. The remainder of consumers identified will then receive needed supplies and, when that list is exhausted, others requesting supplies will receive, as available.

Phone calls continued to be made to all consumers. Initially, calls completed to those considered vulnerable or 65+, then those losing day services or school programs, and lastly all others. If the consumer/family could not be reached, a letter was sent to them, requesting that they call their SC/PM should they have needs to be addressed. We have been told by families and Service Coordinators that the phone calls are a welcome contact.

IPPs continue to be amended. A total of 1,126 additional POSs were generated due to COVID-19 during the past 2 weeks, the majority of which were Respite or Program Support (PATCH). However, many services such as Supported Living Services (SLS), Personal Assistance, Daycare, Homemaker, Crisis, and Behavioral Intervention Services were also put into place during this time.

Remote meetings are occurring in 95% of cases, leaving only 5% of consumers/families opting to extend IPPs and wait to meet face-to-face.

Our priority has been to make contact and hold meetings in order to ensure needed services are in place.   SCs are scheduling remote meetings either by phone, Facetime, or Zoom. Services are quickly provided if vendorizations are already in place. If vendorization is needed, we are allowing retro-dating so the service can begin immediately, if needed.

Per the DDS Directive pertaining to Regional Center Requests for Placement into Licensed Residential Facilities, VMRC has submitted 16 requests, seeking approval to place consumers for various reasons, but for the most part those being discharged from hospitals or other facilities. We received approval for 15 of those requested.  

We are receiving very positive feedback from families and consumers about Facetime TeleMedicine clinics, also attended by Service Coordinators. This option has been instrumental in avoiding missed appointments and ensuring those services are not interrupted.

Cindy Mix

Director of Consumer Services

Quality Assurance Report

 Packet of Helpful Links, Directives, and Other Resources

The QA team’s focus is to support our vendors by assisting with problem solving and providing technical assistance. Please see attached document intended to provide helpful information to vendors.

 

We are still reviewing Client Rights violations on a case by case basis to determine if the perceived violation is a result of Covid-19 restrictions. If yes, the plan is to have an expanded team meeting (IDT) to come up with a mutually acceptable solution. We are giving Technical Assistance (TA) for issues such as late/incomplete DSP or CEUs - basically the TA gives the vendor three months after DSP and other training have resumed to complete the requirements. We also give TA instead of "Substantial Inadequacies" where feasible without jeopardizing health and safety

 

Claire Lazaro's algorithms for both medical facility discharges and moves between other types of residences have been much needed and valuable resources for us as well as our providers.

Nicole Weiss

Assistant Director 

Quality Assurance...

Intake & Special Education in Our Region

( New Intake Process)

Intake- Referrals have dropped about 35% in Modesto and while less dramatic we're seeing a reduction in our Stockton and San Andreas offices as well.

Update on Special Education services in our region: IDEA regulations have not been relaxed. Local Education Agencies obligation to access, hold IEP meetings and make an offer of FAPE (Free Appropriate Public Education) has not changed during the shelter in place. Service may be held through distance learning while we are in shelter in place. School districts are still making decisions around whether they will hold extended school year services on school sites or through distance learning.

Tara Sisemore-Hester

Assistant Director 

Clinical Services 

Resource Development

Resource Development has modified Residential vendorization protocols in order to increase the residential capacity in all counties- the goal is to have 30 additional private room vacancies by April 15, 2020

Residential Supplemental Support (PATCH) has been increased from $12.12 per hour to $17.19 per hour in an effort to assist Residential service providers with the ability to maintain staffing while consumers are no longer able to attend day program. In addition to this PATCH temporary change we have been given additional authority to help residential providers in need and we've instituted a temporary equivalent for Supported Living services .

Residential Screening continues for all consumers in collaboration with the Department of Developmental Services. All residential placement must be approved prior by the Department. A dedicated e mail group has been established to increase communication to screening team members, clinical support staff and the Dept.

Resource Development has modified Residential vendorization protocols in order to increase the residential capacity in all counties- the goal is to have 30 additional private room vacancies by April 15, 2020

Residential Supplemental Support (PATCH) has been increased from $12.12 per hour to $17.19 per hour in an effort to assist Residential service providers with the ability to maintain staffing while consumers are no longer able to attend day program

Residential Screening continues for all consumers in collaboration with the Department of Developmental Services. All residential placement must be approved prior by the Department. A dedicated e mail group has been established to increase communication to screening team members, clinical support staff and the Dept.

Resource Development has modified the trainings/orientations provided to new and existing vendors. These orientations are HCBS, Day Program, and SLS/ILS and are usually provided on VMRC’s facilities. However, all orientations are now provided through the use of the videoconferencing application/software – Zoom.

Brian L. Bennett

Assistant Director 

Resource Development

Clinic Director Updates

Expectations : Hospital Discharges & Other Placements

FAQs: Discharge Isolation During COVID-19

Algorithm: Discharge from Hospital, etc.

Algorithm: Discharge from Jail, Psych Facility, Family Home, etc .

Aside from the usual consent process, we are also working closely now with Service Coordinators, VMRC surge team, DDS Nurse Consultants. We are working closely with care homes making sure consumers are being monitored for symptoms during the 14 day isolation, ensuring they have isolation procedures in place, talking with them about PPE needs. Regarding their PPE needs, when we discover a need we have been contacting DDS for those that need additional PPE (such as disposable gowns, face shields, masks, gloves, sanitizer, soap). This outreach for the homes is not just limited to those being discharged from hospital, SNF, and ER, but also includes those discharged from jail, behavioral health, psych holds, from home to care home, and from care home to care home (see algorithms above). We are communicating with the residential supports to ensure they will be able to monitor the consumer for symptoms and implement isolation procedure during the 14-day isolation.

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

Clinical Director

Outreach with Our Community Partners and Communications

We have teamed up with the Coalition of Local Area Service Providers (CLASP) and our local SCDD North Valley Hills Office for a supply donation drive. As we speak, supplies are being distributed to our service providers in need. DDS is also helping us with supplies for families in need, and families or caregivers who must isolate individuals for 14 days after leaving a hospital.

 

Each morning we report to DDS on any consumers, staff or vendors that have either had a COVID-19 test, or is showing symptoms of COVID-19.

We now have about 10,000 people signed up to receive updates and information from VMRC if you received this message from someone else click the button below to sign up and follow us on the social application of your preference we're posting something everyday.

Doug Bonnet

Special Assistant to the Executive Director

An Update from Our Fiscal Department

The POS Department (where we pay for services) is making their best efforts working in the office and remotely to maintain processing with increased workload to meet daily deadlines. 

 

We are posting more invoices today to accommodate all the additional services approved due to COVID so vendors will be able to submit billing for additional payments this month.

 

Most communication is done via email instead of by telephone. Hopefully vendors understand this was necessary due to the circumstances and most efficient way for us to handle our workload for consumers and vendors.

Claudia Reed

Chief Financial Officer

Human Resources (VMRC Staff)

The health and safety of our consumers and our staff are of utmost concern for us at VMRC. In addition to all the measures we've mentioned above for our consumers, their families, our providers and our community we have also taken important steps to protect the health and welfare of our staff. Following are a few of the key items to keep them safe:

Bud Mullanix

Director

Human Resources

Valley Mountain Regional Center Coronavirus Update Webpage