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Sixty-Seventh

Community Health

Advisory Coronavirus (COVID-19)

By the Numbers, and a Message on Masks and Vaccinations

While no new cases were reported this week, and the department has stopped requiring daily reporting because the case reports have dropped significantly across the state, we were reminded this week that we are not fully in the clear as we reported a death of one of our consumers who has been suffering with COVID-19 for some time now. This week I took a few of my vacation days to get some of my healthcare maintenance work done (on the occasion of my 55th birthday) and I was reminded that there are still certain places that even vaccinated individuals need to wear their masks. It is definitely a good idea to keep your mask in your pocket in case you find yourself in one of these places like health facilities and waiting room lobbies of all types. During July, VMRC we will be coming back to the building at 25% capacity, and the next month 50%, with some meetings starting to occur in August. Expect to be required to wear your mask in our lobby if you are invited to meet in the building, even when we fully open our buildings to the public on October 1st (all our staff will wear their masks in the lobby). All of our staff will be required to wear their masks in the building, except for at their desks, and the only employees not wearing masks will be the ones who have provided proof of vaccinations to our human resources department and choose to not wear their masks. A final word on the masks and vaccinations… Our regional center recognizes that vaccinations are a personal medical decision and while we will do everything we can to fully inform our consumers and employees about the science related to the vaccinations and do everything we can to get the vaccinations to you if you choose, in the end this is your personal choice. VMRC will not tolerate harassment, bullying or any form of discriminations against individuals who have not been vaccinated for any reason in our workplace or in the course of our daily work.

The Budget

So many big things occurred this week regarding the state budget, and we'll be presenting a thorough overview soon by our public policy committee of the board. Two of the most significant budget items I have been reporting were a commitment from the governor to decrease caseload rations (in the end he chose not to do anything about this in this budget) and increases for the service providers (thankfully he made an increase to their rates this year). The good news is that the governor has made significant budget commitments (subject to accurate budget predictions) in the coming years that increase provider rates each year in the future and a stated intention to decrease the caseload ratios in the future. Here are two sections from the Assembly Budget Analyses (Assembly Budget Committee Deputy Chief Consultant, Nicole Vazquez) that illustrate these actions:

Caseload Ratios

The 2021 Budget Act provides $61.8 million General Fund starting in 2022-23, for a delayed implementation of one year, and on-going to enhance service coordinator ratios at the 21 Regional Centers.

Provider Rates

States findings and declarations of the Legislature related to the implementation of rate increases, based on rate models that were included in the rate study submitted to DDS pursuant to current law, over a five-year period, with the inclusion of a quality incentive program to improve consumer outcomes, service provider performance, and the quality of services. States the intent of the Legislature that, effective July 1, 2025, rates will be uniform within service categories and adjusted for geographic cost differentials, including differentials in wages, the cost of travel, and the cost of real estate. The 2021 Budget Act provides $89.8 million in 2021-22, $346.1 million in 2022-23, $678.7 million in 2023-24, $706.1 million in 2024-25, and $1.233 billion (all General Fund) in 2025-26 for this investment. These amounts are inclusive of the quality incentive program for the fiscal years of 2022-24 through 2024-25, as well as state operations and Regional Center costs.

While we were disappointed and surprised by this outcome, our staff are fully committed to providing our consumers with highest quality person centered service, and we are hopeful for a promise of significant caseload reductions next year.

Tony Anderson

Executive Director

Self-Determination

Effective July 1, 2021, the Self-Determination program is available to all eligible individuals on a voluntary basis with no limit on the number of participants.

To be eligible for the program, you or your family member must:

1. Have a developmental disability and currently be receiving services from a California regional center, or be a new client of a regional center; and

2. Be over the age of three or, if under, be qualified for services through the Lanterman Act; and

3. Live in the community.

Our team is excited to share the following Self Determination orientation training including two in Spanish!!

Friday, July 9, 1pm - 4pm in Spanish

https://zoom.us/webinar/register/WN_5lownrbmRkSf2ohiRegl2w

Saturday, July 24, 10am - 1pm in English with Spanish Translation

https://zoom.us/webinar/register/WN_wMJrxbniQq-CAuoeiVTzRQ

Tuesday, August 3, 9am - 12pm in Spanish

https://zoom.us/webinar/register/WN_5toJdItcRwi5BUoSYR-ZQA

Monday August 9, 2pm - 5pm in English with Spanish Translation

https://zoom.us/webinar/register/WN_YsuFsVbpTPu__8yenueNvQ

Thursday September 30, 2pm - 5pm in English with Spanish Translation

https://zoom.us/webinar/register/WN_GlKCNsZ7RMeVs84yKVdIOg

Early Start

Early Start Remote Services - The requirements of the California Early Intervention Services Act, Title 17, or a child’s Individualized Family Service Plan (IFSP) requiring the delivery of services in-person are hereby waived. This waiver was extended to 8/4/21.

Extension of Early Start Services - the waiver for extending Early Start Service beyond the age of three was extended to 8/9/21. Under this waiver regional centers may consider extending Early Start Services for children who have not been offered an IEP date or FAPE (Free Appropriate Public Education) from the school district.

Tara Sisemore-Hester

Director of Consumer Services - Children

Case Management Update - Adults

Thank you, Dena Pfeifer

Dena is an amazing self-advocate, who has served our community for many years. This year she retires from serving on the VMRC Board of Directors, after 7 incredible years. We are extremely thankful for her contributions to the Board, to VMRC and to the community.

While on the VMRC Board of Directors, Dena has been the chairperson for Consumer Services, a member of the Finance Committee, a member of the Executive Committee, and a member of the Nominating Committee. Dena never says no and is always ready to give her time and energy to VMRC. “Dena was a great board member, but she also went above and beyond, volunteering her time to be a Consumer Services Committee Chair, as well as a member of the Executive Committee, Nominating Committee and Finance Committee. No one person will be able to replace Dena, she is a superstar!” – Doug Bonnet

Dena is also a member of the local Self Advocacy Council 6 (SAC6). She has participated in SAC6 for more than 10 years! She has served as the vice chairperson of SAC6, as well as a member of the goals committee, and the finance committee. She has supported the self-advocacy quarterly area meetings, where up to 500 self-advocates gather to learn, share, and discover information. Dena has been a part of the 57 and counting, Friday zoom chats for self-advocates. Crystal, a fellow SAC6 board member says, “Dena is a really good person and a good listener. She is helpful whenever anyone needs help.”

Dena is committed to fundraising to support the SAC6 and its efforts to serve the community. She has participated on the statewide self-advocacy conference planning committee and attended the conference for many years. She volunteers at the conference and helps with the dating game. Dena attends the annual CHOICES conference and is always ready to host the SAC6 information table. “She is a really good board member for SAC6, and she is also a good advocate. Dena is a good team member for SAC6. She is a sweet person,” shared by Lisa from SAC6.

Dena has given presentations to local community groups, including the Foster Grandparent/Senior Companion presentations, new employee orientation at VMRC, and the California Memorial Project. Dena has volunteered with the State Council on Developmental Disabilities, North Valley Hills office (SCDD) on many occasions. Dena #2 SCDD North Valley Hills shared, “Dena #1 is one of the hardest working self-advocate that I have had the privilege to work with. She takes her role very seriously and always gives her best! Thank you Dena #1 -you are a joy to know!” Dena’s commitment to the community is extraordinary.

Dena has attended the Valley CAPS Plus program in Manteca for approximately 36 years. At CAPS she participates in self-advocacy, has been the past president of the self-advocacy group. Dena is currently the President for the Kiwanis Aktion Club in Manteca. Jessica from CAPS shared this about Dena, “She is always so busy and willing to help out. She stays active in the program.”

I was able to talk with Dena about her experiences and her years of volunteering. Dena says she loves speaking up for herself! During all her years of participating in self-advocacy she has learned how to help people who need help with their self-advocacy skills. Dena’s favorite memory of all these years in self-advocacy are all the committees she has participated in and being with people who appreciate her and her help!

I asked Dena about her advice to new self-advocates. She said the best thing she can tell people is, “Don’t be afraid to ask for help. I’m here to help and people can ask me for advice and for help!”

She wants people to know that working together let’s her help you! She is ready and willing to help. Just ask!

It was an honor to talk with Dena about her journey as a self-advocate. Thank you, Dena!!

Here are some self-advocacy resources if you are interested in learning more:

https://www.vmrc.net/sac6/

https://scdd.ca.gov/selfadvocacy/

https://www.disabilityrightsca.org/resources/self-advocacy

https://www.dds.ca.gov/consumers/wellness-toolkit/self-advocates/

http://www.aucd.org/docs/add/sa_summits/state%20presentations/CA.pdf

Christine Couch (she, her, hers)

Director of Consumer Services - Adults

Clinical Update

Various Resources

As vaccination advocacy efforts continue, those that are pregnant or planning to get pregnant are not sure if they should get the vaccine or not. Recommendation is to discuss this with your Obstetrician. A good resource is an online tracker that shows how vaccination policies vary by countries all over the world which you may click the link here.[1]

There is now a tool that will help clinicians diagnose Autism Spectrum Disorder (ASD) in children 18 months to 5 years. It is called Cognoa ASD Diagnosis Aid and it is FDA approved.[2]

Shriner’s Hospitals for Children have free Continuing Medical Education for healthcare professionals that focus on developmental disabilities. Below are the details:

[1] Johns Hopkins University. June 28, 2021. https://hub.jhu.edu/2021/06/28/tracker-map-of-vaccine-policies-for-pregnant-women/?mc_cid=35c43180bb&mc_eid=a5c2f72ac3

[2] FDA. June 02, 2021. https://www.fda.gov/news-events/press-announcements/fda-authorizes-marketing-diagnostic-aid-autism-spectrum-disorder

2021 Virtual Provider CME Program

Driven by Excellence in Treatment, Teaching and Research

We are excited to announce our upcoming Virtual Provider Continuing Medical Education (CME) series focused on developmental disabilities, from understanding how to tap into resources to clinical management and new innovations. Our mission is to improve the lives of children by offering outstanding specialty care education programs for medical professionals. Our monthly CME webinars are offered at no cost to you.

Special Invitation for: Pediatricians, PCPs, RNs, School-based Nurses, Physical Therapists

Part One: Advocating Resources for Children with Developmental Disabilities – What Every Pediatric Provider Needs to Know

Presenter: Loren Davidson, MD, Director, Pediatric Rehabilitation Program

Date & Time: July 13, 2021, from 6:00 – 7:00 p.m. PST

Learning Objectives:

· Outline the eligibility criterion for early intervention and services provided for California Children’s Services (CCS) Medical Therapy Program and the Regional Center.

· Gain familiarity with the community resources for therapy, durable medical equipment and available funding.

· Describe the basics of life care planning for a dependent child/family member.

Part Two: Early Identification & Treatment of Hip Dysplasia in Children with Cerebral Palsy– What Every Pediatric Provider Needs to Know

Presenter: Vedant Kulkarni, MD, Orthopedic Surgeon

Date & Time: August 17, 2021, from 6:00 – 7:30 p.m. PST

Learning Objectives:

· Describe the impact of hip dysplasia in children with cerebral palsy and the evidence for early identification through a hip surveillance program.

· Identify strategies for treatment of hip dysplasia depending on the severity of hip displacement.

· Demonstrate usage of the free HipScreen mobile application (www.hipscreen.org) to quantify hip displacement

· Describe how and when to refer a CP patient with hip dysplasia.

Part Three: Management of Gait Abnormalities in Children with Cerebral Palsy– What Every Pediatric Provider Needs to Know

Presenter: Jon Davids, MD, Assistant Chief of Orthopedic Surgery & Medical Director, Motion Analysis Center

Date & Time: September 14, 2021, from 6:00 – 7:00 p.m. PST

Learning Objectives:

· Identify the Gross Motor Function Classification System (GMFCS) for children with Cerebral Palsy (CP).

· Describe the rationale for Single Event Multilevel Surgery (SEMLS) to improve gait in children with CP and discuss the Diagnostic Matrix approach to clinical decision-making for surgery to improve gait in children with CP.

· Compare and contrast the most common surgeries performed to improve gait in children with CP.

· List the use of orthotics and post-operative physical therapy to achieve the best outcomes follow SEMLS.

· Describe how and when to refer a patient with gait abnormalities.

Part Four: Spina Bifida (details forthcoming)

CME Credits

Shriners Hospitals for Children — Northern California is accredited by the California Medical Association (CMA) to provide continuing medical education for physicians. This activity is approved for AMA PRA Category 1 Credit Designation for 1.0 contact hour for the webinars in July and September and 1.5 contact hours for the webinar in August.

SANDIS COVID-19 Tracking Data

DENTAL VAN CLINIC!!!

A FREE mobile dental clinic for Medi-Cal Members, 5-25 years old, at the Modesto area coming on July 18 and 25^th. Please access the link below to register.

Online Booking Link

https://ib4.me/2dZq5Sk

Please continue to stay safe and healthy.

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

Director of Clinical Services

Community Services Update

Important Message about Personal Protective Equipment (PPE)

VMRC’s stock of Personal Protective Equipment (PPE) to distribute is running low. We are completely out of surgical masks and gloves. DDS has informed us that we will no longer be receiving PPE to distribute from them. Their instruction to us is: “As the employer, Service Providers would be required to provide the necessary PPE for their employees."

Effective immediately, and while supplies last, we still will be able to provide N95 masks, face shields, surgical gowns, and hand sanitizer, however, VMRC should not be your sole source of PPE. If you are requesting PPE for consumers that you serve, please limit it to consumers that are currently receiving services on site at your program. Orders will be filled within 5-10 business days, again, while supplies last. Consumers and families will still be able to order PPE themselves, for themselves, while supplies last.

Quality Assurance

VMRC’s Quality Assurance Team has resumed In-Person On-Site annual Quality Assurance Reviews AND unannounced visits to licensed settings.

Day Program Providers who have modified your Community Care Licensing APPROVED COVID Mitigation Plan or Community Based Day Program COVID Mitigation Plan must submit the modified plan to your Community Services Liaison

Resource Development

Please remember that for any/ all changes to a provider’s services and/or program design should be done by submitting an email to vendorchangerequest@vmrc.net. Changes include New Administrator or Consultant or changes to processes, forms no longer used or new forms added. All requests will be reviewed and cannot be implemented until approved.

VMRC has awarded the SWIM Community Resource Development Plan grant project to Christine Donlin - Christine has over 25 years of experience providing swim lessons to persons with intellectual and developmental disabilities. VMRC is excited to work with Christine to bring opportunities to consumers in all five VMRC counties.

Weekly Service Provider Informational Session hosted by VMRC’s Community Services Department EVERY FRIDAY at 9:00 a.m. to learn about important changes and trends:

Join Zoom Meeting

https://zoom.us/j/99862863596

Meeting ID: 998 6286 3596

HCBS Training for Day Program and Employment Providers July through September

HCBS Training for Residential Providers July through September

Brian L. Bennett

Director Of Community Services

Free Conference Opportunity July 16th-18th, 2021 for Professionals, Providers, Parents, and More!

The Equity, Diversity, and Inclusion in ABA Special Interest Group is hosting a LIVE Virtual Event.

Check out this unique conference dedicated to highlighting Equity, Diversity, and Inclusion in the field of Applied Behavior Analysis and beyond. The conference will be streamed for free and fees will only be charged for those who want to earn BACB CEUs.

Learn from a diverse group of speakers with presentation topics ranging from the RBT/Mentee Experience, OBM, Diversity in ABA Business Ownership, Health & Fitness, Diversity in Academia, Growing Up with Autism, Working in a Multidisciplinary Team, and much more!

Take your learning deeper with workshops about Cultural Responsiveness, Presentation Skills, & Going Beyond Self-Care as a helping professional.

Earn up to BACB 22 CEUs while broadening your knowledge and wisdom!

Workshops - Friday, July 16th

Cultural Responsiveness as a Path to Social Justice
Presentation Zen
Beyond Self-Care: Cultivating Radical Self-Acceptance Among Helping Professionals

Presentations - Saturday & Sunday, July 17th & July 18th

You do not need to be a BCBA, BCaBA, or RBT to attend this event. This diverse conference is open to anybody interested in Diversity, Equity & Inclusion in ABA.

MORE INFO and Registration can be found at the link below:

https://www.eventbrite.com/e/equity-diversity-inclusion-virtual-conference-tickets-157148335903

Speakers and Topics are highlighted daily at:

https://www.facebook.com/EquityinABASIG

For any questions regarding the conference, please contact VMRC Board Certified Behavior Analyst, Liz Herrera Knapp LKnapp@VMRC.net or (209) 955-3652.

Liz Herrera Knapp, M.A.

Board Certified Behavior Analyst (BCBA)

North Valley Hills Update

Dena Hernandez, Regional Manager (209) 473-6930

After a lengthy and insightful discussion, Senate Bill 639 by Senator María Elena Durazo passed the Assembly Committee on Human Services on 6/30/21 with a 6-1 vote and now heads to the Assembly Appropriations Committee.

SCDD is co-sponsoring this civil rights measure with Disability Rights California and Legal Aid at Work. This bill will stop California employers from paying workers with disabilities less than the minimum wage.

Thank you to the numerous supporters who called during the hearing today to support SB 639. We will continue to work with the legislators until the bill is signed by the Governor. More information about the bill and disability employment in California can be found at scdd.ca.gov/sb639.

#CALeg #SB639 #SubminimumWage

Assemblymember Lisa Calderon