Tenth Community Health Advisory: Coronavirus (COVID-19)
weekly message from the director...
This week we've been spending a considerable amount of time working to develop a return to the office plan, working with providers on their new approaches to non-residential supports, watching our budget trends now, and studying the data from the state regarding our future budget for next year that starts in less than 60 days.

Planning to Return to the Workplace
The development of the plan for re-entry into our buildings and to the community requires a comprehensive and thoughtful approach that considers everything we can possibly do to ensure our staff remain safe and healthy. Equally as important, our return must not jeopardize in anyway the health and safety of our consumers, our families, Direct Support Professionals, and our entire provider community. Also, Valley Mountain Regional Center is not separate from our local communities, cities, and counties we are closely connected and we must follow the guidelines and recommendations of our health officials in each area. While we'll be driven primarily by state and national policies, our return to the buildings and communities we work in may look a little different in each site depending on the direction from the public health authorities from each county. Here's one of the tools Bud Mullanix, our Director of Human Resources, is using with our insurance carrier to develop our healthy Return to the Workplace.

Here are a couple of examples that we will be basing our policy on from the county specific guidelines where our offices are:
San Andreas Office: Calaveras County Instructions

Each of our provider organizations is and will be also in the process of working with their insurance carriers to put in place workplace safety measures to keep consumers and staff safe while providing services in our region. Next week we'll be meeting with the leadership of CLASP to discuss this and other topics impacting them.

The California Re-Opening Plan - Update on CA Pandemic Roadmap
This week the governor held several press conferences and most of them focused on the state's re-opening planning which culminated yesterday in a slight expansion of the policy. One of the more significant parts of the plan included allowing for Regional Variances (originally localities were not able to be less restrictive than the state guidance). These variances would have to meet a variety of conditions such as: (1) no more than 1 case per 10,000 in the last 14 days, (2) no deaths, (3) able to protect essential workers, (4) adequate testing, 1.5 per 1000 residence, (5) 15 tracers per 100,000, (6) Hospitals need to have capacity for 35% surge and a plan to protect workers with PPE, (7) Vulnerable populations (SNF) must have more than 14 day supplies of PPE, (8) Each county must have an ability to capture data reliably and have an ability to revert back, and other provisions. Starting today clothing stores, florists, bookstores, sporting goods, manufacturing, and warehouses can open with restrictions and the next businesses include offices (workers who cannot telework), seated dining, shopping malls, and outdoor museums.

State Budget
Throughout the week this week there were increased reports on the dramatic impact COVID-19 is having on the state budget. Earlier this year in January the governor said if we had a moderate recession our revenues would drop by $25 billion. Now the recession is expected to be significant and by Wednesday officials anticipated a $35 billion deficit (almost twice the size of our $17.9 billion surplus), and by Thursday the governor started projecting a $54 billion deficit with estimates ranging up to $85 billion. The California Budget of $214 billion is by far the largest in the country, ranked 33 in per capita spending, so a $54 billion deficit represents about 25% of the total budget. As of the beginning of this week the governor reported estimating "depression era" unemployment rates and noted 4.2 million people have now applied for Public Unemployment Assistance costing $10.6 billion and the national unemployment is said to be around 14%. However to help put this in perspective the governor said the 2003 budget deficit as a percentage was actually higher than what they're projecting. In addition to the large budget surplus the governor is also anticipating some federal relief to the states which has occurred during national crisis like this in the past.

I find it helpful to remember that our nation and our state has endured pandemics and major economic downturns in the past and we pulled through together. And most heartening, our community has been periodically hit hard financially but together we pulled through that as well. No economic condition can take away the fact that our community is strong and resilient and we won't retreat from the civil and human rights advances we have achieved over the years, we may advance slower but we will not stop the progress of full participation in the community.

Have a great weekend.

Sincerely

Tony Anderson
Executive Director
Valley Mountain Regional Center
The Latest Directive with a
Department of Developmental Services

DDS is using this latest Directive to provide clarification to the regional centers and the provider community that there have been no changes to the rules for having proof for what is billed to the regional center and this can be reviewed and audited. For the "absences" billing the provider must:

Billing Prior to April 2020
  1. Have a calculation of average number of absences for all claims during the State of Emergency.

April 2020 Billing
  1. The provider must say how they delivered services in alternate locations or remotely (or at least efforts made).
  2. Describe the contacts with consumers regarding their desire/willingness to receive services in alternate locations or remotely and their staff's availability to deliver services.
  3. Explain why the person was absent.
  4. Finally, providers need to show the employee was still on their payroll if billing for absences and if payroll was reduced their bill for absences should be reduced as well.

May 2020 Billing
DDS expects and requires providers to apply for relief funding (i.e., “payroll” loan forgiveness or reimbursement program, including but not limited to, the Paycheck Protection Program, Economic Injury Disaster Loan Emergency Advance Program, etc.) available to any other employer. The reason the department is allowing for payment during absences is that not every provider will be able to access these resources and or avoid financial losses and distress through these channels. These funds are meant to help stabilize this important sector of our support system but are provided as a funding source of last resort. Providers cannot get more money when using relief funding than they would have absent the State of Emergency.

Even though absence funding is available, VMRC and DDS still expect services to be provided to the extent possible in alternate locations or remotely.  Examples include but are not limited to, the following: 
  • Virtually connecting individuals with friends and family, even daily;
  • Delivering activities for individuals to participate in at home (e.g., arts, crafts, etc.);
  • Delivering food or needed supplies;
  • Coordinating individual and/or group remote connections; and
  • Supporting necessary activities away from the home (e.g., grocery shopping, medical appointments, exercise, etc.) while practicing appropriate physical distancing.

"Additionally, nonresidential providers are encouraged to work with their regional center, families and providers of residential and supported living services who may have a need for staffing or support due to consumers spending significantly more time in their homes. Nonresidential providers have an experienced workforce and are uniquely positioned to support consumers where they live. This may be accomplished in a variety of ways, including through cooperative agreements between the nonresidential service provider and the residential or supported living service provider."

As a point of related interest:
Authorization for payment for absences will not end until either the state of emergency ends or DDS informs the regional centers that there is no longer authorization to reimburse under that regulation, whichever comes sooner. 
Clinical Director Updates
(A friendly reminder to all)

The governor has started Stage 2 of the stay at home order modification for our state. This does not mean that the novel coronavirus is gone or that we can go back to previous ways. According to experts and scientists at the Department of Epidemiology and of Immunology and Infectious Disease at Harvard T.H. Chan School of Public Health, their study showed that warm weather did not stop the spread of the novel coronavirus causing COVID-19. 1

Other experts are expecting the virus in the community during the flu season in winter. Please continue to practice social distancing of at least 6-foot apart, frequent hand washing and disinfecting of high touch surfaces. Stay at home if you feel sick and be aware of the symptoms of COVID-19.

The CDC has updated their website yesterday on COVID-19 symptoms. The following may appear 2-14 days after exposure to the virus: 2
  1. ·       Cough
  2. ·       Shortness of breath or difficulty breathing
  3. ·       Fever
  4. ·       Chills
  5. ·       Muscle pain
  6. ·       Sore throat
  7. ·       New loss of taste or smell
Other less common symptoms reported include gastrointestinal symptoms such as nausea, vomiting or diarrhea.

Please remember to call 911 when you have:
  1. ·       Trouble breathing
  2. ·       Persistent pain or pressure in the chest
  3. ·       New confusion or inability to arouse
  4. ·       Bluish lips or face

The California Department of Public Health has released a guidance on the visitation policy of various facilities (attached) including hospitals and emergency rooms that address the need to accommodate people with developmental disabilities and allow them to have support person during their hospital or ER visit. Please feel free to use and share with friends and family.

  1. https://news.harvard.edu/gazette/story/2020/04/covid-19-may-not-go-away-in-warmer-weather-as-do-colds/
  2. https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html

Continue to stay safe and healthy.

Claire B. Lazaro, MSN, RN, NP, PHN, CCRN, FNP-C
Clinical Director
Self-Advocacy Council 6


Lisa Utsey- Self Advocacy Council 6 chairperson invites you to join the SAC6 Friday CHATS!

With so much happening because of the virus SAC6 wants to hear how you are doing and share information so we can all get through this together!

Health and Wellness

Join us on a SAC6 ZOOM CHAT!!
Let’s Check In with each other!
WHEN : Fridays May 8, 2020
TIME : 11:00am-12:00pm
WHERE : ZOOM- computer, tablet, cell phone
 
The next SAC6 CHAT:
  • Friday, May 8, 2020- Update on all things Corona. When does it look like we are going back to program? What will that look like? Can we all ride the bus? Do we need masks?

Join Zoom Meeting on your computer, tablet or phone
 
Meeting ID: 917 7394 4767

Password: 310725 You must enter the Password or you can call in:
TOLL FREE NUMBER TO CALL IN:
  • 888 475 4499 US Toll-free or
  • 877 853 5257 US Toll-free
North Valley Hills Update
Dena Hernandez, Regional Manager
 
SCDD North Valley Hills may have closed its doors during this COVID 19 Pandemic, but our staff are working from home to keep finding ways to work together to support, educate and inform our communities. 

As the days and weeks have passed during this Covid-19 pandemic- we have learned that there are many new SCAMS popping up and we want people to be prepared so that no one falls prey to a scammer!

     Coronavirus Scams & Fraud Alert- 2020
Don’t Get Scammed!!!
BE AWARE!!!!

Please check out the Self Advocacy Council 6, SCDD & VMRC SCAM ALERT info sheet at www.scdd.ca.gov Covid-19 Plain Language Resources- click under FRAUD.

Here is an opportunity to learn more! Click Here

Have a question or concern- feel free to contact me at 209-473-6930 or dena.hernandez@scdd.ca.gov
Disability Rights California (DRC)

Please Join us on a Zoom Webinar to learn about:
Regional Center and Special Education Services and Updates due to COVID-19
Date: Saturday May 9, 2020 Time: 10 am to 11:30 am

If you need a language or reasonable accommodation, please let us know when you register by April 30th
Register in advance for this Virtual Training Webinar at:

After registering, you will get an email with information about joining the Zoom webinar meeting.
Local County Public Health Resources
  1. Amador County (8 known cases May 1, 2020 - no new cases this week)
  2. Calaveras County (13 known cases May 1, 2020 no new cases)
  3. San Joaquin County (581 known cases - 28 deaths May 8, 2020 - 16% increase in cases this week. This is another reduced rate of increase)
  4. Stanislaus County (476 known cases and 19 deaths May 8, 2020 - 46% increase in cases this week. This is an increased rate)
  5. Tuolumne County  (2 known cases May 1, 2020 - last week's two new cases were removed)
  6. VMRC - 3 confirmed consumer cases May 8, 2020 - one new case)
  7. California (62,360 cases and 2546 deaths, May 8, 2020 - 36% increase in new cases this week - increased rate)
  8. National (1,259,777 cases and 75,852 deaths May 8, 2020 - 31% increase in new cases increased rate)