Health Advisory XIX: VMRC Community Notice

Click Here if You Can't See the Pictures

Nineteenth Community Health Advisory: Coronavirus (COVID-19)

weekly message from the director...

This week we had six more consumers test positive and we learned of two more community staff. Since June 1st we have seen a rapid increase of positive COVID-19 cases representing 85% of all of our cases to date and the regional centers have reported 52% of all the cases statewide came in June. From March through May we only had 5 cases and then all of a sudden we saw 28 more cases. This is a serious health crisis and one thing we've learned is that we cannot let our guard down, we must be diligent with wearing face coverings, staying at least 6 feet apart, washing our hands, and being extra careful if you have a vulnerable health condition.

We are hanging on and holding on to manage the spread within our community thanks to those Direct Support Professionals still showing up every day to help people lead meaningful lives within the restrictions we're all living with right now. The owner operators are also putting in long shifts and living in the homes, and the families who support more adults at home than all the services combined continue to support their adult children at home during a time in one's lifespan when many other parents are experiencing empty nests and retirement. We're all working together to maintain our frayed and worn community network using waivers from bureaucratic rules and enhanced funding, and extensive individualized outreach. We have no idea how long this crisis will last or how long our resources and flexibilities will last, or how long our network of services and supports will hold on, but please know your regional center staff from the new hire all the way through to our senior leadership are all in and fully dedicated to keep the people with developmental disabilities in our region safe and supported.

Provider Feedback on Our Response to During COVID-19

While we were anticipating waiver renewals this week we've been assured that many are forth coming and we'll alert the community as they come in the following days. In the mean time, we really need your help to gauge our efforts to respond to this crisis. So much has changed in the past 4 months and we want to thank you all for your effort and your flexibility. We also want to see how you are doing and how VMRC can best support our service provider community through these times. We have asked Kinetic Flow to conduct this brief ( 10 questions !) COVID Check-In Survey. This survey is being conducted independently by Kinetic Flow and all information is submitted on Kinetic Flow’s website – all responses will be kept anonymous. The survey will close on Tuesday, July 28 ^th at midnight. So, please take the 3-5 minutes to complete this survey. To access the survey, please click on the below link, or copy paste the URL into your browser.

Provider Feedback

http://surveys.kineticflowcorp.com/s3/VMRC-Provider-CCI

Employee Feedback on Our Response to During COVID-19

We have asked a lot of our staff, reorganizing how and where you work, connecting to every consumer we serve to check in on them during this crisis, and asking you to do so many things you've never done before. Well, we want to see how you are doing and how VMRC can best support our staff through these times. We have asked Kinetic Flow to conduct a brief ( 15 questions !) COVID Check-In Survey. The results will help VMRC’s Leadership know how we are doing as a workforce and how VMRC can best support our staff in these uncertain and changing times. The survey will close on Tuesday, July 28 ^th at midnight. So, please take the 3-5 minutes to complete this survey. To access the survey, please click on the below link, or copy paste the URL into your browser.

Employee Feedback

http://surveys.kineticflowcorp.com/s3/VMRC-Employee-CCI

Consumer and Family Feedback on Our Response to During COVID-19

Finally, we have engaged Kinetic Flow to see how the regional center efforts have impacted you. They have already begun this process that includes online surveys targeting over 5000 people in various languages. If you have already received this email please respond so we can use your information to guide our continued response. Again, PLEASE RESPOND to the email and complete the survey, we need to hear from you.

Kinetic Flow

https://kineticflowcorp.org/contact/

Sincerely,

Tony Anderson

Executive Director

Valley Mountain Regional Center

Case Management Updates

Free COVID-19 Advice Line

The Department of Healthcare Services (DHCS) has launched a free, 24/7 Medi-Nurse advice line to answer questions about COVID-19 for anyone who: 1) doesn’t have insurance, 2) is a Medi-Cal beneficiary but doesn’t have a regular doctor or Managed Care Plan to oversee their care. Please click on the below link for more information.

https://files.medi-cal.ca.gov/pubsdoco/newsroom/newsroom_30339_69.aspx

Medicare Part D Access

On July 9 ^th Raj Patel, Pharm.D Ph. D., University of the Pacific – Thomas J. Long School of Pharmacy provided a presentation to VMRC staff regarding Medicare Part D. The presentation included: A Medicare overview, information about prescription drug coverage through Medicare, cost savings through plan reexamination and Medicare Part D plan enrollment.

VMRC currently contracts with University of the Pacific for Medicare Part D plan reexamination and enrollments for VMRC consumers that are Medicare Part D beneficiaries. If you or your family member is a Medicare beneficiary and would like UOP to review your plan annually please ask your service coordinator to submit a Medicare Part D Referral to Special Projects. If you prefer to choose the plan yourself or for your family member please ask your Service Coordinator to inform Special Projects.

VMRC Special Projects staff and UOP work together closely to ensure that consumers have uninterrupted access to their medications. If you have questions about Medicare Part D you can ask your Service Coordinator or contact Katina Richison at (209) 955-3616 or krichison@vmrc.net

Upcoming Self Determination Trainings

Orientation —July 15 from 1-4pm via Zoom. Register in advance for this webinar:

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

After registering, you will receive a confirmation email containing information about joining the webinar. Three (3) CEU offered for vendors who pre-register.

Informational Gathering Series

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

https://zoom.us/j/96393011611?pwd=U05tK2FhWjVxc3luUXQvSUhoNnViZz09 Password: 864928

Get to know local Financial Management Services (FMS), Person Centered Planners and Independent Facilitators

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

https://zoom.us/j/99840286318?pwd=T1A3ZzJSbTRHSzdLeVNVSmJtRVVEUT09

Password: 603333

Get to know some local Service Providers for Self Determination Participants

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

https://zoom.us/j/91079898885?pwd=eHlQN2JqbU1Nd0RUUExRRTJ3R29hQT09 Password: 800817

Reviewing of the VMRC Self Determination budget tool and its implementation in the Self Determination Program

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

https://zoom.us/j/96127663909?pwd=ZVpGeWJ5eDRIbVJiN0xCWEhFMEFrdz09

Password: 380639

Meet some Self Determination Participants and their families for their perspective of how the program works for them

Helpful Tips

The DDS website offers some helpful tips for people with disabilities and caregivers, as well as extra precautions and avoiding scams during the pandemic.

https://www.dds.ca.gov/corona-virus-information-and-resources/

Cindy Mix

Director of Consumer Services

Clinical Update

The following are latest updates regarding COVID-19.

· The World Health Organization (WHO) acknowledges that there is emerging evidence that SARS-CoV-2, the virus that causes COVID-19, spreads via airborne transmission and aerosol transmission. [1] This is after an open letter was published a the Clinical Infectious Diseases Journal supported by 239 scientists in 32 countries provided evidence of the airborne spread of the novel coronavirus. [2]

· With the increase of cases and hospitalization rates in our nation, the professional organizations of nurses, doctors and hospitals have created an open letter to the public urging us all to do our part in stopping the spread of the virus: wear a mask/face covering, keep physical distancing among people not from your own household, and wash hands often.

· Continuous spread and increase in COVID-19 cases could be due to “Silent Spreaders” also known as asymptomatic and pre-symptomatic. [3] Scientists found that existing research show 17.9% to 30.8% of all infections are from asymptomatic ones. If they assume 17.9% are asymptomatic, they found that pre-symptomatic people will account for 48% of transmission while 3.4% of transmission will be from asymptomatic people. Furthermore, if 30.8% of cases are asymptomatic, the team found that 47% would be attributed to pre-symptomatic transmission and 6.6% would be from asymptomatic transmission. [4]

· A lot of people are wondering when they get exposed to COVID-19, what are the chances that they have it? Researchers used data of positive cases at the Cleveland Clinic and were able to identify that those that are male sex, African-American, older age, and has known COVID-19 exposure has higher risk of getting a positive test result. [5] They have also created a free risk calculator that can predict the COVID-19 test result.

· COVID-19 doesn’t just affect your lungs, it also affects your brain. More so, it has shown complications such as ischemic stroke, brain bleed and altered mental status. [6]

· With the scarcity of resources, N95 are being reused in the healthcare setting. How do you properly decontaminate it? Researchers have found that popping N95 in the 1,100 W microwave for 3 minutes with the use of glass container, commercially available mesh and rubber band successfully decontaminates the N95. [7] This is a widely and readily available way of decontamination that can be used by a lot of people.

· The U.S. Environmental Protection Agency (EPA) has tested and approved Lysol Disinfectant Spray and Lysol Disinfectant Max Cover Mist as effective against SARS-CoV-2 on hard surfaces. [8] The EPA is in the process of directly testing other products against SARS-CoV-2.

[1] Geneva (Reuters). July 7, 2020. https://www.reuters.com/article/us-health-coronavirus-who-airborne/who-acknowledges-emerging-evidence-of-airborne-spread-of-covid-19-idUSKBN2482AU

[2] Clinical Infectious Diseases Journal. July 6, 2020. https://academic.oup.com/cid/article/doi/10.1093/cid/ciaa939/5867798

[3] CNN. July 7, 2020. https://www.cnn.com/2020/07/07/health/covid-19-silent-spreaders-wellness/index.html

[4] Proceedings of the National Academy of Sciences of the United States of America (PNAS). July 6, 2020. https://www.pnas.org/content/early/2020/07/02/2008373117

[5] CHEST. June 10, 2020. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7286244/

[6] The Lancet Psychiatry. June 25, 2020. https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(20)30287-X/fulltext

[7] American Society for Microbiology. June 30, 2020. https://mbio.asm.org/content/11/3/e00997-20#skip-link

[8] CNN. July 7, 2020. https://www.cnn.com/2020/07/07/health/epa-lysol-disinfectant-covid-19-trnd/index.html

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

Clinical Director

Quality Assurance Update

Now that some COVID-19 restrictions are being eased, we know your residents are anxious to see their family members and friends after months of quarantine. We also know that contact with family and friends is critical to human well being. Thus, CCL and CDPH have recently provided additional guidance on visitations:

Adult and Senior Care Home Vendors should follow the CDSS June 26, 2020 PIN 20-23 ASC which provides updated guidance to Adult and Senior Care (ASC) licensees related to modification of visitor guidelines and guidance for vigilant adherence to infection control and prevention practices to prevent the transmission of COVID-19 in ASC facilities. Using the following link, you can access the full list of PINS: https://www.cdss.ca.gov/inforesources/community-care-licensing

ICF Vendors should follow the CDPH June 30, 2020 AFL 20-22.3 which authorizes LTC facilities to temporarily modify their facility's visitation policies in accordance with CMS and CDC COVID-19 guidance when necessary to protect the health and safety of residents, staff, and the public.

Children’s Care Home Vendors should follow the combined All County Information Notice (ACIN) No 1-50-20 and CCL Provider Information Notice 20-12 CRP PIN 20-12-CRP which addresses the California Department of Public Health’s (CDPH) current guidance regarding protective measures to prevent and minimize the risk of exposure and transmission of COVID-19 and how the guidance may be incorporated into a county’s current practice and work with caregivers, and how children’s residential facilities and home-based caregivers can use the guidance to ensure the health, safety, and well-being of the children/youth in care. Using the link below, you can access the full list of ACINs and PINs:

https://cdss.ca.gov/inforesources/community-care-licensing/policy/provider-information-notices/childrens-residential

In the event you encounter conflicting guidance, it’s best to go with the most stringent guidance.

In addition to the above guidance, VMRC’s QA Department would like you to keep the following recommendations in mind when arranging a resident‘s visit with family and friends to ensure a safe and enjoyable experience.

· Set up a comfortable visiting area, preferably outside, with seating that is 6 feet apart.

· During extreme heat, schedule visits in the morning or evening to take place in shady areas.

· Some residents may have a difficult time refraining from touching or hugging their loved ones, so consider having these visits either through a window or a gate.

· Visits can also take place at a local park, if preferred.

· Be sure to have staff available to monitor the visit while still allowing for the resident’s privacy.

· Schedule visits in such way as to reduce the numbers of people visiting at any one time.

· Set up a visitor binder for sign in and sign out located outside the front entrance.

· Visitors may bring food and activities to share with their friend/relative; but out of abundance of caution should avoid bringing food or activities for others who live in the home.

Lastly, ongoing screening is essential to safe visiting. Make sure to have protocols in place for assessing for signs of illness and exposure from visitors, prior to visitations. The referenced guidance also provides helpful direction on the need for infection prevention and control which will help keep everyone safe.

If you have questions, please contact your QA Liaison. If you do not know who your Liaison is, contact Kioti Fleming, Senior Office Technician/QA at kfleming@vmrc.net , or call 209-955-3287.

Human Resources Update

I have had several employees ask me about Tracing. What is it? what does it mean? More importantly, what does it do? So for VMRC, tracing is very important, should someone test positive for Covid-19. Tracing means that HR talks with the person to find out when they may have been exposed, and then we work with them to gather a list of those people they may have been around at work. With the list in hand, HR and the person infected will notify those who may have been exposed.

We ask those staff to self-quarantine for 14 days and to notify their doctor of any symptoms or go directly and get tested. At the same, time if the individual who has tested positive has come to one of our offices, we close down for 48 hours to have professionals come in and clean the entire building. There are many other things we do behind the scenes to make sure everyone stays safe. I mainly want all of you to know that should an employee test positive, that leadership is on top of it to keep us all safe. Please be safe, stay happy and stay healthy.

Bud Mullanix

Director

Human Resources, Safety, Security, FGP & SC Program

North Valley Hills Update

Dena Hernandez, Regional Manager

Many people are worried and concerned about getting back out into the community safely with all the uncertainty of Covid-19. While no one knows when that will be, here are two booklets from the organization called Autism and Intellectual Disabilities of Pennsylvania called Roadmap Back Into the Community for Self-Advocates, Parents & Caregivers. While there are some resources specific to Pennsylvania- much of the info can be personalized just for you or your loved one. Find complete info and other resources at www.aidinpa.org

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