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Eleventh Community Health Advisory: Coronavirus (COVID-19)
weekly message from the director...
What a week, again. As you know, in the previous two Director’s Messages, I talked about the planning activities that we are undergoing to put together a thoughtful plan of getting back into the office building, and eventually back out into the community. This week we completed our first full draft and will start reaching out to various groups that have a stake in our safe return. Groups like our managers, our labor representatives, our consumers, our families, our providers and so many partners in our community especially our public health authorities, all have an interest in how and at what pace we bring back over 300 people to the local communities. Watch for these focused forums in the coming weeks.

Just in case there is any confusion, I am not a doctor or a health care professional; I am a director of your community based non-profit regional center. These health advisories are not health advice from me (I hold degrees in Psychology and Organizational Development – neither taught me about epidemiology) they are updates on what we’re doing based on the advice of real health professionals. So who are the health professionals guiding us through this unprecedented moment in recent history?

Internally we have we have our own health care professional
·         Claire Lazaro, MSN, RN, NP, PHN, CCRN, FNP-C, VMRC Clinical Director,
·         and her team in the clinical department.

Regionally we have our county public health officials,
·         Maggie Park, MD (San Joaquin),
·         Julie Vaishampayan, MD, MPH (Stanislaus County),
·         Rita Kerr, MD (Amador),
·         Dean M. Kelaita, MD (Calaveras County), and
·         Dr. Eric Sergienko (Tuolumne County)

On the state level we are advised by:
·         Christine L Gephart RN MSN, Deputy Director, Office of Statewide Clinical Services, Department of Developmental Services
·         Dr. Sonia Y. Angell, our Director of Public Health

And Nationally our overriding authorities are
·         Robert R. Redfield, Centers for Disease Control, and
·         Anthony S. Fauci, M.D., NIAID Director, National Institute of Allergy and Infectious Diseases

Governor Gavin Newsom consistently says in his regular updates, he is making decisions based on science and advice he is receiving from health professionals like his HHS Agency Secretary Dr. Mark Ghaly and Public Health Director Dr. Sonia Angell. As one doctor put it this week on NPR, flattening the curve through “stay at Home” orders does not mean we have done something to the virus. He said we are still going to keep seeing confirmed cases until we have a vaccination, but we will have a way to treat them because we are not overloaded with a surge of too many patients in hospitals (as long as the curve bends).

So in the end please know that the health and safety of our employees will dictate our gradual moves back to our buildings and communities, and these moves will be decided upon based on advice from health professionals (not politicians, business leaders, or advocates). We are committed to a very serious mission in support of people with disabilities and their families and we will not make any uninformed decisions that will harm those we are charged with supporting. Finally, our provider community and the thousands of Direct Support Professionals are our most important partners in our system for supporting people with disabilities and their families, they are not able to stay at home where it’s safest, and they are most vulnerable in service to our community.

Thank you again to our health professionals for advising us and steering us through these dangerous times and to the DSPs throughout our system, thank you, you are a critical touch point in a world that is over wise contact free.

Budget Update

On Thursday, May 14, 2020, Governor Gavin Newsom released the state’s May Revision to the January Budget, indicating for the first time the details of the major cuts we all have been worried about since reports have been showing a major downturn in the economy. Many of these cuts are going to be very hard to endure and the Newsom administration is trying to offset them with a combination of revenues and deferrals and the elimination of several expansions in spending. For developmental services we are facing the following proposed cuts (according to the Assembly Budget Committee which will be meeting next Monday at 1 pm):

Developmental Services

1.       Withdraws the Enhanced Performance Incentive Program that was proposed in the Governor’s January Budget, which was proposed to cost $60 million General Fund in 2020-21, 2021-22 and 2022-23.

2.       Withdraws the Enhanced Caseload Ratios for Young Children that was proposed in the Governor’s January Budget, which was proposed to cost $11.8 million General Fund in 2020-21.

3.       Withdraws the Systemic, Therapeutic, Assessment, Resources and Treatment Training for services to individuals with co-occurring developmental disabilities and mental health needs that was proposed in the Governor’s January Budget, which was proposed to cost $2.6 million General Fund in 2020-21.

4.       Withdraws the supplemental rate increases for Early Start Specialized Therapeutic Services, Infant Development Programs and Independent Living services that were proposed in the Governor’s January Budget, which would have cost $10.8 million General Fund in 2020-21 and $21.6 million in 2021-22.

5.       Includes an increase in anticipated federal funds to include additional individuals with developmental disabilities eligible for and enrolled in Medi-Cal and new waiver eligible services, resulting in General Fund savings of $27 million General Fund in 2020-21 and $40 million ongoing.

If the Heroes Act does not pass by the California July 1, 2020 new budget year, the administration is proposing the following massive cuts to developmental services and throughout the health and human system:

Department of Developmental Services

1.       Absent additional and sufficient federal funds that would trigger this reduction off, establishes a cost-sharing program that would result in additional $2 million General Fund in 2020-21 and $4 million ongoing.

2.       Absent additional and sufficient federal funds that would trigger this reduction off, proposes to adjust provider rates and review expenditure trends with a total cut target of $300 million General Fund in 2020-21.
3.       Absent additional and sufficient federal funds that would trigger this reduction off, implements the uniform holiday schedule outlined in Welfare and Institutions Code section 4692, resulting in a cut of approximately $31.3 million General Fund in 2020-21.

4.       Absent additional and sufficient federal funds that would trigger this reduction off, reduces operations budget for Regional Centers, resulting in a cut of $30 million General Fund in 2020-21 and $55 million ongoing.




Have a great weekend.

Sincerely,

Tony Anderson
Executive Director
Valley Mountain Regional Center
Case Management Updates

Asian Americans Focus of VMRC Outreach Campaign
 
News reports indicate that bias against Asian Americans has surged in the nation during recent months. VMRC is planning an outreach campaign to contact our Asian population to survey their concerns during the COVID-19 pandemic. This is an effort to gather pertinent information regarding their experiences and develop a strategic plan to address any issues for those in our catchment area based on the outcomes of the survey. We have identified 1,400 consumers who will begin receiving calls as of Friday, May 15 from our staff—Lue Thao, Service Coordinator and Gabriela Lopez, Cultural Specialist. We are working in conjunction with various community partners and will keep you updated on the progress of our campaign.

Additional Purchase of Service Generated Due to COVID-19
 
For Week 5/4 through 5/8—147
TOTAL— 3/12/20 through 5/8/20— 2,450

·         Respite—1,229
·         PATCH—881
·         SLS—57
·         Personal Assistance—55
·         Medical Supplies—5
·         Day Care—15
·         Crisis—3
·         Bed Hold—1
·         Nursing Respite—4
·         BIS—4
·         ABA—3
·         Supported Employment—1
·         ILS—1
·         Translator—1
·         LVN—1
·         Carryover POS captured by Fiscal during Week 1—189

Cindy Mix
Director of Consumer Services

Clinical Director Updates


What is MIS-C and PIMS?

It was previously thought that the novel coronavirus, SARS-CoV-2, that causes the disease COVID-19, does not cause deleterious effects on children. Most recently, scientists and physicians are learning that COVID-19 can cause a serious health condition in children called Pediatric Multi-system Inflammatory Syndrome, also known as PIMS. [1] Though rare, it can cause harmful, long-term effects on the heart and kidneys of the child. [2] The manifestations are overlapping and similar to Kawasaki Disease, Toxic Shock Syndrome or Isolated Myocarditis. 1,2, [3]  It is important for parents to call the pediatrician when they notice any of the following symptoms: 1

·         Fever that won’t go away
·         Abdominal pain, diarrhea or vomiting
·         Rash or changes in skin color
·         Trouble breathing
·         Your child seems confused or overly sleepy.

Just yesterday, the Centers for Disease Control and Prevention (CDC) has released a new health advisory regarding this new condition affecting children and adolescents in the United States. 4 This is similar to what experts were previously referring to as PIMS. The CDC is now calling it Multisystem Inflammatory Syndrome in Children (MIS-C) associated with Coronavirus Disease 2019 (COVID-19) [4]

Per CDC, the case definition for MIS-C are below: 4

·         Individual less than 21 years old with fever lasting more than or equal to 24 hours and laboratory evidence of inflammation and clinically severe illness with 2 or more organ involvement (cardiac, renal, respiratory, hematologic, gastrointestinal, dermatologic, or neurological); AND
·         No alternative plausible diagnoses; AND
·         Positive for current or recent SARS-CoV-2 infection or CoVID-19 exposure within the 4 weeks prior to the onset of symptoms

Visitation Policy

There are a lot of hospitals who have “No Visitor Policy” during this pandemic. This affects individuals with developmental disabilities who need a support person with them to help in effective communication, regarding their medical history, medicines they take and symptoms they are experiencing. The California Department of Public Health has issued a guideline that you can share to hospitals, emergency rooms and other facilities. This explains that accommodations for people with disabilities should be made and allow them to have a support person together with them in the emergency room or when admitted in the hospital. Please feel free to print out and bring this with you.

A friendly Reminder

I would like to emphasize that relaxing of the stay at home order to Stage 2 does not mean that the novel coronavirus is gone or that we can go back to previous ways. On a presentation by UCSF Pulmonologist and Geriatrician, Dr. Leah Witt, she is expecting the novel coronavirus to be here even during the flu season and may last longer. [5] Same expectation as other Infectious disease experts. Harvard scientists study showed that warm weather did not stop the spread of the novel coronavirus causing COVID-19. [6] Please continue to practice physical 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. Wear mask or cloth face covering to help protect others.

The CDC has updated their website on COVID-19 symptoms. The following may appear 2-14 days after exposure to the virus: [7]

·         Cough
·         Shortness of breath or difficulty breathing
·         Fever
·         Chills
·         Muscle pain
·         Sore throat
·         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:

·         Trouble breathing
·         Persistent pain or pressure in the chest
·         New confusion or inability to arouse
·         Bluish lips or face

Thank you all for your continued patience and public health compliance during this pandemic. We are all in this together.

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

[2] Morand, A., Urbina, D., & Fabre, A., May 7, 2020. https://www.preprints.org/manuscript/202005.0160/v1
[3] The BMJ (British Medical Journal), April 28, 2020. https://www.bmj.com/content/369/bmj.m1710.full
[4] CDC Health Advisory, May 14, 2020. https://emergency.cdc.gov/han/2020/han00432.asp
Human Resources Update

The senior leadership and HR team has been working very hard to meet a major accountability; “continue to provide services to our consumers and keep our staff, safe and healthy”. In theory, it sounds simple, but in reality it can be stressful. Nonetheless, there is no doubt about the importance and the rewards connected to both. 

Like all of you, our ways of doing things have changed. Instead of meeting in person we are now fully utilizing email, phone and Zoom.  We have been using Zoom to meet with staff, candidate interviews, and various other meetings. Working from home, I believe is being adjusted too. At first, I heard from many staff who were struggling with being home and not in an office environment, and some being alone. I still hear some but it has declined. 

We are working on both today and the future. We are trying to do all we can to accommodate work needs from home, while preparing for when we have moved through the different phases and return back to work. We want to make sure the “Return to Work” plan is thorough, yet easy to understand. 
However, most importantly a document and process that will keep all employee safe, protected, and healthy against Covid-19. 

Lastly we have had staff that have been supporting VMRC from the office. Making sure mail is sent, delivered, distributed to all staff, answering phones, making sure the bills get paid, payroll, and the list goes on. These are jobs that cannot be done from home. This team sometimes feels forgotten, but shouldn’t. What they do and continue to do is critical to the success of the Regional Center and we thank them.

Bud Mullanix
Director, Human Resources
Employment Update

During these difficult times caused by the COVID-19 global pandemic many individuals have lost their jobs in the retail, hospitality, and food service industries (dine-in restaurants). Despite the bleak outlook on the economy there are several companies that are increasing their hiring due to COVID-19 which include; Amazon, Safeway, Wal-Mart, Target, and Costco, and many fast food companies. For more information about finding employment with these companies please go to https://www.indeed.com/ enter in your zip code and see the available jobs closest to your location.

EJ Edmerson
Employment Specialist
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 15, 2020
TIME : 11:00am-12:00pm
WHERE : ZOOM- computer, tablet, cell phone
 
The next SAC6 CHAT:
  • Friday, May 15, 2020- US Census - What is the US Census? Why do I have to complete the US Census? How to fill out the US Census? What if I live in a care home, do I have to fill out the US Census?

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 will be hosting its Regional Advisory Committee Meeting on Tuesday, May 26, 2020 from 6pm to 8pm on Zoom. Our featured speakers will be Aaron Carruthers- Executive Director of the State Council on Developmental Disabilities, Tony Anderson- Executive Director of Valley Mountain Regional Center, Lisa Culley- Executive Director of Family Resource Network and Members of the Self Advocacy Council 6.

Here is how to join us:
Join Zoom Meeting

Meeting ID: 965 9450 9503
Password: 816511
One tap mobile
+16699009128,,96594509503# US (San Jose) 13462487799,,96594509503# US
+(Houston)

Dial by your location
       +1 669 900 9128 US (San Jose)
       888 475 4499 US Toll-free
       877 853 5257 US Toll-free
Meeting ID: 965 9450 9503
Find your local number: https://zoom.us/u/adJ7QDpGoF
 
Have a question or concern? Feel free to contact me at 209-473-6930 or dena.hernandez@scdd.ca.gov
Disability Rights California (DRC)

Upcoming Webinars:

COVID-19 Employment Training Series - Services to Help You Keep Your Job - May 19, 2020

Has your employment been impacted by COVID-19? Have your hours been reduced? Have you lost your job? Are you an essential worker concerned about safety? Disability Rights California invites you to attend a web-based training series for people with disabilities.
We will discuss: Where can I get help to keep my job?... Register Here

Mental Health Awareness Series - Disability Benefits and Work Incentives Under Title XVI - SSI - May 21, 2020

Many people who receive SSI benefits fear they will lose their SSI benefits if they return to work. This myth prevents many from seeking employment. Discover opportunities to avoid deductions to your SSI checks through Disability Benefits and Work Incentives Programs... Register Here


If you need a language or reasonable accommodation, please let us know when you register.

After registering, you will get an email with information about joining the Zoom webinar meeting.
Family Resource Network
Lisa Culley, Executive Director

Hi Families! Family Resource Network wants you to know that there are staff in the office working and are available to connect with any family who may need assistance. If you'd like to speak to another parent about any issue you may have with someone who understands the journey and some of the frustrations or joys you may be facing at this difficult time, please call us. All staff members are the parent or family member of a child or adult with a special need! If you are having troubles with virtual learning, feelings of isolation, with basic needs, or anything else, please call us! Someone is in the office Tuesday - Friday, from 8:30 am to 2:30 pm, and other times as needed. If you reach our voice mail, please leave a message with a time that is convenient for one of us to return your call.

Unfortunately, at this time, our office is closed for in-person visits, and our activities and events are on hold, but we are available by phone or email. Our phone number is 209-472-3674, and FRN's email is FRNfamilies@frcn.org . We also have a Facebook page-"Family Resource Network-Stockton". Please visit and like our page for resources, information, and activities to keep your kiddos active. We hope to hear from you soon! Please remember, you are not in this alone, we will get through this difficult time together, and we will grow and be stronger when we are on the other side of this pandemic! 
Local County Public Health Resources
Amador County - 9 known cases as of May 15, 2020 - 1 new case this week

Calaveras County - 13 known cases as of May 15, 2020 - no new cases this week

San Joaquin County - 644 known cases and 31 deaths as of May 15, 2020 - 63 new cases and 3 new deaths this week

Stanislaus County - 537 known cases and and 23 deaths as of May 15, 2020 - 61 new cases and 4 new deaths this week

Tuolumne County - 2 known cases as of May 15, 2020 - no new cases this week

VMRC - 5 confirmed consumer cases as of May 15, 2020 - 2 new cases this week

VMRC Staff - 1 known case as of May 15, 2020 - no new cases this week

VMRC Volunteer - 1 known cases of May 15, 2020 - no new cases this week

VMRC Providers - 3 known cases as of May 15 - no new cases this week

California - 74,959 cases and 3052 deaths as of May 15, 2020 - 36% increase in new cases this week - increased rate

National - 1,419,863 cases and 85,974 deaths as of May 15, 2020 - 31% increase in new cases increased rate