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117th

Community Health

Advisory

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Weekly Message from the Executive Director

Tony Anderson



By the Numbers



This was a very sad week for us at VMRC. Even though our numbers over all actually went down from 84 to 68, we saw hospitalizations and deaths in our community. There were 49 consumers and 19 direct support professionals who tested positive for COVID this week. Three of our consumers had to be hospitalized this week (two were vaccinated with no booster and one was vaccinated and received their 1 booster) and we suffered the loss of two of our consumers (both were vaccinated and one had received their booster). Finally we had several staff members out due to due direct exposures and positive COVID tests.


The California statewide positivity rate has increased to just 15% and the CDC is reporting over half the cases are the new variant 5 (more information: click here for a Sac Bee article on July 6, 2022)   


Office Building Site Status (June 28th):


  • San Joaquin 14.6% (up .9%) – Exceeds 5% - Remote Quarterly Visit Recommended, Masks in the Office required.
  • Stanislaus 18.5% (up 3.3%) - Exceeds 5% - Remote Quarterly Visit Recommended, Masks in the Office required.
  • Calaveras 16.2% (down .4%) – Exceeds 5% - Remote Quarterly Visit Recommended, Masks in the Office required.


Amador is at 5.8% (down 4%) and Tuolumne is at 15.3 (up 2%).

The Electra Fire Incident


It has been a dangerous and unhealthy week for us in our Amador and Calaveras communities. Our staff in the region have been closely monitoring the status to our consumers and keeping our Emergency Response Coordinator, Aaron McDonald, informed all week. The latest report as of this morning from Aaron is that 4,428 acres have burned, and the fire is at 65% containment. Thankfully, zero structures have been destroyed or damaged, and their have been zero deaths and only 1 injury.

 

The mandatory evacuation continues to decrease in scope allowing many to go back to their homes in certain areas. Certain areas remain under an Evacuation Warnings, so we continue to monitor VMRC consumers, vendors, and staff in these areas. 


Evacuation Information


Amador County Evacuation Information

  • Evacuation orders and warnings remain in place.
  • South of Butte Mountain Road continuing to Hwy 88 and Mt. Zion, west of Hwy 88 and Hwy 26, north of Hwy 26, and east of Hwy 49.
  • The community served by Lower Clinton Road and Butte Mountain Road, the area east of Tabeaud Road and Hwy 88 to Hwy 26, north of Mokelumne River.
  • For more information about evacuation orders in your area please visit: Amador County Evacuation Map 


Calaveras County Evacuation Orders

  • Evacuation orders and warnings remain in place.
  • Evacuation orders are in place for CCU-E051-B, CCU-E052-C, CCU-E024-A, CCU-E026-A, CCU-E025-B. The Evacuation Orders for the following zones have been lifted. CCU-E049-A, CCUE050-A, CCU-E, 051-A, CCU-E052-B.
  • The evacuation order for all residences off Montgomery Lane has been lifted.
  • For more information about evacuation orders in your area please visit: Calaveras County Evacuation Map



Currently we are monitoring 16 consumers down from 53 earlier this week. Of the 16 currently being monitored we have three High Risks Infants, two relocated to an area away from the fire, but we are awaiting contact with the remaining one. The remaining consumers we have either been informed that no assistance is needed or we are awaiting return contact.

 

Power Outages

PG&E continues to be able to restore power in this area. As of 3pm Thursday about 83 VMRC consumers may be without power, including five who are non ambulatory. All Vendor power has been restored and VMRC Community Services Liaisons are in contact with these facilities to see if there are additional needs. 

Our great thanks to Cal Fire Unit Amador El Dorado AEU, all of the additional fire departments assisting, and the Amador and Calaveras County Sheriff Departments for their incredible efforts and work to keep our communities safe.


For up to date information on the Electra Fire:

Click Here

Early Onset Dementia in our Community


Recently one of our parents wrote to us expressing great frustration and pain related to the difficulties and hardship of supporting their loved one who is in the throws of early onset dementia. It was been well documented that people with Down syndrome often experience Alzheimer at a much younger age than the general public.


If you or someone you know are concerned for your loved one and would like more information on things you can do check out the National Down Syndrome Society's Handbook for Caregivers plus if you are a professional supporting someone with IDD and Dementia (family caregivers welcome) click on these links below. 


Encore: Scientists look to people with Down syndrome to test Alzheimer's drugs

People with Down syndrome are sought after for Alzheimer's research studies because many develop it in their 40s and 50s. Most will get it if they live long enough. (Aired on ATC on July 7, 2022.)

Read More




Clinical Update

Claire Lazaro

Clinical Director

COVID-19 Update


The recent rise of COVID-19 cases has been due to the Omicron subvariants BA.2.12.1, BA.4, and BA.5, with the latter amounting close to 54% of cases the past 2 weeks.[1] Subvariants BA.4 and BA.5 are the predominant variant now in the US, South Africa and Europe.[2],[3],[4] Both Omicron subvariant BA.4 and BA.5 have a different characteristic that makes it more contagious and more prone to affecting the lungs.2 There have also been reports that these Omicron subvariants may possibly escape the immunity from previous infection or vaccination.[5],[6],[7] Although experts are still recommending vaccination as the best way to prevent death and severe disease.2 Last week, the FDA Vaccines and Related Biological Products Advisory Committee (VRBPAC) recommended that the vaccine manufacturers include a component of the vaccine that will target BA.4 and BA.5 on the next round of planning for boosters.[8]


The FDA now authorizes state-licensed Pharmacists to prescribe Paxlovid (medicine authorized to treat COVID-19) to eligible individuals with some limitations to ensure appropriate patient assessment and prescribing process.[9] Below is an excerpt from the FDA News Release:9

           When testing positive for COVID-19, patients should first consider seeking care from their regular health care provider or locating a Test-to-Treat site in their area. While this action allows state-licensed pharmacists to prescribe Paxlovid with certain limitations as described below, community pharmacies not already participating as a Test-to-Treat site can decide if or how they will offer this service to patients. 


Patients who have tested positive for COVID-19 and are seeking to determine their eligibility for receiving Paxlovid at locations where prescribing by state-licensed pharmacists is available should bring the following information to ensure that the state-licensed pharmacist has sufficient information to determine their eligibility to receive Paxlovid:


  • Electronic or printed health records less than 12 months old, including the most recent reports of laboratory blood work for the state-licensed pharmacist to review for kidney or liver problems. State-licensed pharmacists could also receive this information through a consult with the patient’s health care provider.


  • A list of all medications they are taking, including over-the-counter medications so the state-licensed pharmacist can screen for drugs with potentially serious interactions with Paxlovid.

Under the limitations outlined in the authorization, the state-licensed pharmacist should refer patients for clinical evaluation with a physician, advanced practice registered nurse, or physician assistant licensed or authorized under state law to prescribe drugs, if any of the following apply:


  • Sufficient information is not available to assess renal and hepatic function.
  • Sufficient information is not available to assess for a potential drug interaction.
  • Modification of other medications is needed due to a potential drug interaction.
  • Paxlovid is not an appropriate therapeutic option based on the current Fact Sheet for Healthcare Providers or due to potential drug interactions for which recommended monitoring would not be feasible.



Paxlovid is authorized for the treatment of mild-to-moderate COVID-19 in adults and pediatric patients (12 years of age and older weighing at least 40 kilograms or about 88 pounds) with positive results of direct SARS-CoV-2 viral testing, who are at high risk for progression to severe COVID-19, including hospitalization or death. Patients in the authorized population who report a positive home test result from a rapid antigen diagnostic test, or a positive PCR test, to their provider are eligible for Paxlovid under the EUA. Confirmation of a positive home rapid antigen diagnostic test with additional direct SARS-CoV-2 viral testing, such as a PCR, is not required. Antibody tests are not considered to be direct SARS-CoV-2 viral tests.


[1] CDC. July 02, 2022. https://covid.cdc.gov/covid-data-tracker/#variant-proportions

[2] Gavi. June 23, 2022. https://www.gavi.org/vaccineswork/how-bad-fresh-wave-covid-19-infections-being-driven-ba4-and-ba5-variants-likely-be

[3] Reuters. June 13, 2022. https://www.reuters.com/business/healthcare-pharmaceuticals/ecdc-warns-new-omicron-subvariants-likely-become-dominant-europe-2022-06-13/

[4] NBC News. July 6, 2022. https://www.nbcnews.com/health/health-news/omicron-ba5-ba4-covid-symptoms-vaccines-rcna36894

[5] The New England Journal of Medicine. June 22, 2022. https://www.nejm.org/doi/full/10.1056/NEJMc2206576

[6] Cell. June 8, 2022. https://www.cell.com/cell/fulltext/S0092-8674(22)00710-3?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0092867422007103%3Fshowall%3Dtrue#secsectitle0040

[7] Nature. July 5, 2022. https://www.nature.com/articles/s41586-022-05053-w

[8] Reuters. June 29, 2022. https://www.reuters.com/business/healthcare-pharmaceuticals/us-fda-advisers-meet-discuss-design-future-covid-vaccines-2022-06-28/

[9] FDA. July 6, 2022. https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-pharmacists-prescribe-paxlovid-certain-limitations

The ARC and Vaccination

Sharing this information on vaccines from The Arc.


Why Get a COVID-19 Vaccine and Booster?



Getting a COVID-19 vaccine and booster can help protect you from getting sick, prevent you from becoming seriously ill, and limit the spread of the virus. Getting vaccinated is a choice we all get to make—but for many people with disabilities there is a greater risk of death from COVID-19, so vaccines are especially important.

 

Visit thearc.org/covid to hear Lynsay, George, Jackie, and others explain why they chose to get the vaccine.


Protect yourself and others by getting the safe and effective COVID-19 vaccine and booster shot.


LEARN MORE


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Case Management Update - Children

Tara Sisemore-Hester

Director of Consumer Services - Children


Update CA Budget- Governor Newson signs CA Budget


June 30th, Governor Newson signed a $308 billion plan into law. Some of the highlights include cost of living relief, fuel refunds, investment in K-12 education, pay down state debt and plastic recycling, etc.

Other Trailer Bills SB188 click here Developmental Services:

 

REGIONAL CENTER SERVICES

 

Direct Support Workforce Crisis: to solve an acute crisis in regional center services due to the inability for state funded service providers to hire and retain direct support professionals (DSPs).  

o Accelerate by one year the implementation of the Department of Developmental Services’ Rate Study, bringing increased partial provider rates on January 1, 2023 instead of July 1, 2024. .

 

Family Fees: Elimination of all fees on families that utilize regional center services, including the Annual Family Program Fee and the Family Cost Participation Program.

 

Access, Equity, and Inclusion: Grants to regional centers and community-based organizations to reduce disparities and increase equity within the developmental services system.

 

Early Start Eligibility reduced to 25% from 33% level- quarterly reviews to be required (implementation not defined)

·    #40 - Caseload for Early Start Service Coordinators

 

·    Expands eligibility to the State Preschool Program by guaranteeing 24-months of Early Learning and care to all 3- and 4-year-old children with exceptional needs and expanding eligibility to all families with incomes at the state median, and increases provider rates for 3-year-olds, children with exceptional needs, DLLs, and supporting early mental health 

 

 

Resources:

 

ECE Technical Resources and Tool Kit: Updated COVID-19 click here

Revised Early Start brochure click here

 

The 2022-23 Budget: Update on Home- and Community- Based Services Spending Plan (ca.gov)

 

Frequently asked Early Start Rate Model Questions: Rate Reform: Rate Model Implementation Frequently Asked Questions - CA Department of Developmental Services

 

DDS Quality Incentive Work Group Presentation 6/23/22- https://www.dds.ca.gov/wp-content/uploads/2022/06/QIPWorkgroupMeeting062322.pdf

 

 

You are Invited:

 

July 14-July 15th - CA Interagency Coordinating Council Meeting - click here

 

July 14th: DDS Task Force meeting

Thursday, July 14, 2022

3:00 p.m. - 4:00 p.m.

Via Zoom

Presented in English

With Live Spanish & ASL Interpretation

 

Register Here

 

 

July 27st- 10:00-12:00 Quality Incentive Program workgroup: Quality Incentive Program Workgroup Meeting - CA Department of Developmental Services.


Thank you,

Fran Chasen and Annie Cox

IDA Policy Co-Chairs


Meet Liz!

And Michelle!

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We are excited to announce the following self determination orientation opportunities:

 

Monday, August 8, 2022 1PM-4PM English with Spanish Translation

https://us06web.zoom.us/webinar/register/WN_LO75PDOzRWSAzwZCOSkl_A

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Case Management Update - Adults

Christine Couch

Director of Consumer Services - Adults

California to Become First State to Offer Health Coverage to All Undocumented Immigrants

 

“This will represent the biggest expansion of coverage in the nation since the start of the Affordable Care Act in 2014,” said Anthony Wright, executive director of Health Access California, told the Associated Press. “In California we recognize (that) everybody benefits when everyone is covered.” This is indeed a victory!

https://www.tierradelsol.org/



Join the Tierra’s Summer Webinar Series! Understanding Alzheimer’s in Individuals with Down Syndrome

PDF Version of Flyer Here

Hello, July and Welcome to Disability Pride Month! This article is borrowed from the organization, Parents and Friends, Inc. located in Fort Bragg, California!

 

On July 26, 1990, the Americans with Disabilities Act was signed into law, paving the way for inclusive change. We recognize this important date and invite you to recognize Disability Pride Month with us…"It is about proudly owning our identities and not pleading for acceptance, more leading the way, and feeling included within society."

 

You can read more in this Forbes article, https://www.forbes.com/sites/carolinecasey/2022/07/04/disability-pride-month-july/?sh=25a975236f93&fbclid=IwAR2BV9WnHL_MplQqL1Wm7TYarCnBiPoT-hRrAvGkPwZakQDzlf6jNE_wmZQ

 

The Disability Pride flag has a black background and diagonally across the flag are five zigzag lines colored blue, yellow, white, red, and green. The lines are considered to be a lightning bolt and each color represents something unique about the disability community. The flag was created to encompass all disabilities and was designed by Ann Magill member of the disability community. The black background represents the suffering of the disability community from violence and serves as a color of rebellion and protest. The lightning bolt represents how individuals with disabilities must navigate barriers and demonstrates their creativity in doing so. The five colors represent the variety of needs and experiences: Mental Illness, Intellectual and Developmental Disabilities, Invisible and Undiagnosed Disabilities, Physical Disabilities, and Sensory Disabilities.





Community Services Update

Brian Bennett

Director of Community Services


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HCBS Compliance Assessments – Validation and Remediation Process Announcement


DDS in cooperation with Regional Centers is preparing for the implementation of the HCBS Final Settings Rule by assessing vendor settings that provide services to more than one individual in the same setting. This includes providers of residential, day program and employment programs. Between January and August of 2020 vendors were asked to complete an HCBS compliance self-survey. Then in 2021 DDS contracted with Public Consulting Group (PCG) to complete a full HCBS assessment for a representative sample of regional center vendors. VMRC had 60 providers who received this full assessment. Those reports have been received back from DDS and were emailed to providers on May 2nd, 2022.


DDS has released a directive to regional centers on the validation and remediation process that our vendors with eligible service codes will need to complete. Emails will be sent to providers to advise whether they are to complete the validation process or the remediation process. Vendors will have 30 days to complete the process that they are assigned to complete. Validation forms and supporting documents are due to VMRC no later than June 30th, 2022. Remediation plans and supporting documents are due to VMRC no later than July 22nd, 2022. You have until March 17th, 2023, to complete the work you outline in your remediation plan including receiving updated IPP information from Service Coordinators. 


DDS Assessment Validation and Remediation Forms


  VMRC hosted two trainings on the validation and remediation process on May 31st and June 3rd, 2022. Providers can access the Power Point Presentation below and includes the updated due date for vendors assigned to remediation:  


HCBS Validation and Remediation Training for Vendors

     

              VMRC will also be hosting virtual office hours for our vendors to drop in via Zoom to ask questions related to the validation and remediation process. The three links below will take you to the zoom session.


Monday’s from 2:00-3:30pm through July 18th


Wednesday’s from 10:00-11:30am through July 20th


Friday’s from 1:00-2:30pm through July 22nd



               Please do not wait to get started on your validation and remediation plans. An email will be sent to providers advising them of what step of the process, validation or remediation, they will be starting on. All documentation must be submitted electronically through email. Paper copies and handwritten documents will not be accepted. Your vendor # must be included in the file name of every document you submit, documents that are not named with the vendor number will be rejected. 

Upcoming Home and Community Based Services (HCBS) Trainings for Vendors


The HCBS Final Settings Rule applies to all vendors who provide services in a setting that serves more than one regional center consumer. The intent of the Final Settings Rule is to ensure that people with developmental disabilities receive services that integrate them fully into the community to the same degree as people without developmental disabilities. It ensures quality of life! They also ensure that the residential settings that services are received in are home environments rather than institutional environments. All settings must optimize and enhance choice rather than regimenting it. The HCBS Final Settings Rule protects consumers rights including the right to privacy, dignity, respect and freedom from coercion and restraint. The Final Settings Rule goes into effect March 17th, 2023, all providers with the service codes listed below, must be compliant by that date.

 

VMRC will continue hosting trainings for Residential Providers, Day Type Services Providers and Employment Services Providers. Service providers under the following service codes are strongly encouraged to sign up for one of the trainings provided. It takes time and effort to implement these requirements. Eligible service codes are Residential: 096, 113, 904, 905, 915, 910, 920; Employment Services: 950 and 954; Day Type Services: 028, 055, 063, 475, 505, 510, 515, 855

 

The attached flyers have registration links on them for the following trainings. You must register to take the training. Once you have registered you will receive a link for the zoom session on the date you have chosen. For attendance purposes please have each staff taking the training register with their own contact information including their email address. Any last-minute changes to the scheduled trainings will be communicated to the registered individuals by email at the email address they have provided.

 

HCBS Trainings for Residential Providers



July 12th, 2022, 10:00am – 11:00am 

 

HCBS Trainings for Day Type and Employment Services


July 12th, 2022, 2:00pm – 3:00pm 


Contact Anna Sims, SCSL, HCBS Program Evaluator with questions: (209) 955-3353, asims@vmrc.net


HCBS for Residential Providers April through July



HCBS for Day Program and Employment Providers May through July



Please notice that VMRC has extended our request for proposal deadlines – see links for VMRC 2021-2022 Community Resource Development Plan projects- each project has $150,000 in startup funds available



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Community Care Licensing has released a new Provider Information Notice 


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On September 2, 2022, from 10-11:30 am VMRC and CAPTAIN (California Autism Professional Training and Information Network) will host a webinar related to the use of Visual Supports- participants will receive 1 CEU



Prior registration is required – see flyer and register HERE: 






North Valley Hills Update

   Dena Hernandez, Regional Manager (209) 473-6930


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Program Development Grants (PDG) Cycle 45

Request For Proposals

Due July 27, 2022!


Did you know that the State Council on Developmental Disabilities administers grants to community-based organizations to fund new and innovative program development projects? That is how important projects like "Let's Work!" are funded.

 

Program Development Grants (PDG) provide funding for new ways of serving Californians with developmental disabilities and are part of an overall strategy for systemic change. With Cycle 45, the Council is seeking project proposals in the areas of education, employment, health & safety, and housing.

 

The proposals are due on July 27, 2022.

 

If you are interested in submitting a proposal and/or would like more information about Cycle 45 grants, please visit SCDD’s grants webpage at: Program Development Grants | SCDD (ca.gov).


How to connect to SCDD through Social Media

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Family Resource Network (FRN) Update

Lisa Culley, Executive Director


Is your child turning 3 soon? Join FRN for a parent workshop on Building Bridges: Transitioning Your Child From the Early Start Program! Learn about the process of advocacy, what's happening during the months leading up to your child's 3rd birthday, the Individual Education Plan (IEP) process, and ongoing services available through VMRC. You will walk away from this training with knowledge that will give you a great foundation for the next stage of parenting your child with special needs. Attendees will receive a Building Bridges workbook to complete as you prepare for your child's transition. Spanish interpretation will be available. Register by clicking the link on the flyer, calling the FRN office at 209-472-3674 or by email at FRNfamilies@frcn.org

PDF Version Flyer Here

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Self-Advocacy Council 6 (SAC6)

 



Come Learn About Tools to Reduce Stress with Crystal Enyeart & Christine Couch

 



WHEN: Friday, July 8, 2022


TIME: 11:00 AM -12:15 PM


WHERE: ZOOM - computer, tablet, cell phone


Join Zoom Meeting


https://us02web.zoom.us/j/89907214323?pwd=pDEN3RRhvLbnSYz-vl8JqaP5SlL4K2.1


Meeting ID: 899 0721 4323


Passcode: 347236


PDF Version of the SAC6 Flyer Here


Also - VMRC Update by Tony Anderson, Executive Director, and Mental Health Tip of the Day by Dr. Dave!


Local County, State and National Public Health Resources

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