weekly message from the director...
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Two Policy Decisions and Ongoing Work on Expiring Waivers
This week we continued to watch the good work of state level volunteers on various workgroups looking for directions and state policy on issues that so many of us are waiting for these days. The big issues we're waiting on have to do with the end of waivers that are due starting next week such as Health and Safety Waivers for residential/supplemental services, remote meeting flexibilities, and more. The updates that we did receive this week, Extension for Self-Determination Program Local Advisory Committee (SDP) and Grant Encumbrance for Home and Community Based Services (HCBS) projects, and new Policies for Visitations in Community Care Licensed (CCL) Homes and Intermediate Care Facility (ICF) Homes, were welcomed decisions that will be very helpful for many people with disabilities and their families.
Extension of Period to Encumber SDP and HCBS Funds
Last Friday night we got an email from Maricris Acon, the new Deputy Director of Federal Programs at DDS, that "Due to COVID-19 and the resulting stay-at-home orders, the department is extending the time for regional centers to encumber funds" for our SDP Local Advisory Committee and our HCBS grants. This was a welcomed break for many who were rushing to finish encumbering by June 30th and was a recognition by DDS of the difficulty people are having to meet these deadlines during the pandemic. While the SDP committee and VMRC has already identified training for consumers and families, services providers and service coordinators, and potential Independent Facilitators as the focus for these funds the extra time gives us an opportunity to be more specific in our planning. Regarding the HCBS projects we really needed that extension as well because some of the provider agencies who were awarded funds for these special projects have still not returned their contracts signed. We now have until September 30, 2020 to encumber these funds Whew!
New Visitor Policies in CCL and ICF Homes
This decision was one of the most important decisions families and people with disabilities have been waiting for ever since the visitation of family members in licensed homes was prohibited. Families have been longing to see one another and this has caused great anxiety and worry for many. Also many of our service providers who deliver residential services felt caught in the middle between meeting the needs of their consumers and their families while staying compliant with the rules and directives from their licensing and monitoring bodies. We placed the new guidance for visitation on our inside exchange website for our VMRC staff to know, we placed it on the
front page of our public website
and in the
announcements section
, as well as posting on social media and in this health advisory here and below in the Quality Assurance section in greater detail. While there are many conditions and precautions you should read before requesting visits the good news is that visitations are no longer strictly prohibited.
Sincerely,
Tony Anderson
Executive Director
Valley Mountain Regional Center
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Case Management Updates
Asian American Outreach Campaign
As part of our "Outreach to the Asian American Community" campaign we continue making our survey calls completing about 35% of the calls to our 1400 families that have been identified. We are also excited to announce we have started to collaborate with Friends of Children with Special Needs, an advocacy group currently working with other regional centers in the bay area. We recently had a Zoom meeting with Anna Wang, VP of Local Program and Community Relations which allowed us to obtain resources for our Asian American community. If you want to learn more and are looking for resources for you and your family please visit Friends of Children with Special Need’s website:
www.fcsn1996.org
Friends of Children with Special Needs is also happy to invite everyone to a Virtual Live Concert to Celebrate July 4
th
Independence Day, Dream Achievers Band will be performing on July 2, 2020 from 12:30 to 1:00 pm. just follow the link:
http://www.facebook.com/dreamachieversband
Information contributed by Gabriela Lopez, Cultural Specialist and Lue Thao, Service Coordinator
Consumer and Family Notification Calls
Using Everbridge, our mass notification system, VMRC again placed 15,000 plus Wellness Check calls to consumers and their families on June 19. A report generated from your input, documented the request for Service Coordinator call backs. Last week, staff made over 500 calls to those asking for contact, resulting in good information and the provision of services. If you had any difficulty maneuvering the system, but need to talk to your Service Coordinator or a Program Manager, feel free to call or email them. Find their contact information here:
https://www.vmrc.net/wp-content/uploads/2020/06/Staff-Directory-5.27.2020.pdf
Cancellations and Postponements Announced
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Christian Berets has given notice of their decision to cancel their 2020 Camp Season due to COVID-19. Everyone is hopeful and looking forward to next year.
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VMRC has cancelled the in-person San Andreas Person-Centered Thinking Training that was scheduled for July 21 and July 23. The training will be rescheduled in the future, so be on the lookout for new dates.
Ties that Bind
Due to COVID-19 restrictions and socially distancing measures, these sisters missed seeing each other and found a way to have a meaningful visit. Read this heart-warming story and you will find that where there is a will, there is a way.
VMRC Additional Purchase of Service (POS) Generated Due to COVID-19
Our Service Coordinators and Program Managers continue to discuss service needs with consumers and families on an ongoing basis, as well. We have compiled the following statistics to demonstrate the effects of the Coronavirus and services provided solely due to COVID-19.
New POS Authorizations submitted and approved over the past few weeks include—Week 6/8—6/12=77; Week 6/15—6/19=41; and 6/22—6/26=34. The total of new POS and categories are:
TOTAL— 3/12/20 through 6/26/20—2,983
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Respite—1,594
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PATCH—1,011
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SLS—77
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Personal Assistance—68
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Medical Supplies—7
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Day Care—20
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Crisis—4
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Bed Hold—1
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Nursing Respite—5
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BIS—4
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ABA—1
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Supported Employment—1
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ILS—1
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Carryover POS captured by Fiscal during Week 1—189
Cindy Mix
Director of Consumer Services
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Clinical Update
For patients with severe COVID-19 who are on life support (on a mechanical ventilator), the drug Dexamethasone provides the promise of a reduction in the chance of dying (reduced rate of mortality) by up to 1/3, based on the National Institutes of Health (NIH)
[1]
and other studies.
[2]
,
[3]
People with underlying medical conditions are prone to have severe COVID-19. Recently, the Centers for Disease Control and Prevention (CDC) has updated the list of medical conditions that will make people of any age at increased risk for severe illness from COVID-19.
[4]
These are:
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Chronic kidney disease
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Chronic obstructive pulmonary disease (COPD)
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Immunocompromised state or weakened immune system from solid organ transplant
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Obesity (body mass index [BMI] of 30 or higher)
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Serious heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies
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Sickle cell disease
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Type 2 Diabetes mellitus
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Children who are medically complex, who have neurologic, genetic, metabolic conditions, or who have congenital heart disease
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Asthma (moderate to severe)
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Cerebrovascular disease (affects blood vessels and blood supply to the brain)
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Cystic Fibrosis
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Hypertension or High blood pressure
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Immunocompromised state (weakened immune system) from blood or bone marrow transplant, immune deficiencies, HIV, use of corticosteroids, or use of other immune weakening medicines
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Neurologic conditions such as dementia
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Liver disease
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Pregnancy
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Pulmonary Fibrosis (having damaged or scarred lung tissues)
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Smoking
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Thalassemia (a type of blood disorder)
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Type 1 Diabetes mellitus
Individuals with Multiple Sclerosis (MS) that have higher degree of neurologic disability, age and obesity makes them prone to severe form of COVID-19, but no association between the use of MS disease-modifying therapies and COVID-19 severity, therefore reinforcing the current recommendations to continue on those therapies.
[5]
In children 18 years old and younger, severe form of COVID-19 could be seen in those with risk factors such as age less than 1 month, male sex, underlying medical conditions and presence of lower respiratory tract infection signs/symptoms at presentation.
[6]
If you are interested in getting tested, check to make sure you are getting the PCR testing. There are antibody testing of COVID-19 in the community but using this type of test will not tell you if you have the virus early on in the course of the disease.
[7]
Furthermore, the use of an antibody test lack specific clinical indication, and performance of the assays has not been adequately assessed.
[8]
Another testing option being looked at is the use of pool testing. Although this might help remedy the limited number of testing kits, it poses the limitation of possible increase in false-negative results.
[9]
In this time of increased cases in our community, each and every one should practice caution in their everyday encounter. The exposure one acquires from being outside the home, will translate to the people they live with. This is evidenced by the study from The Lancet showing SARS-CoV-2 is highly transmissible in households and older individuals age 60 and above.
[10]
Please continue to wear mask or face covering when you are out of your home, keep 6-foot physical distance from people you don’t live with, and frequently wash your hands with soap and water. We may be tired with COVID-19, but COVID-19 is not tired of us. With our patience and cooperation, we can all get through this together.
Claire B. Lazaro, MSN, RN, NP, PHN, CCRN, FNP-C
Clinical Director
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Early Start Update
UC Davis MIND Institute is having its annual conference on August 7th. This event is free of charge and focuses on women with autism. Please see the link below to register:
Information on Department of Developmental Services Early Start Directive
Local Educational Agencies (LEAs) and Regional Centers across the state are responding to the COVID-19 pandemic in different ways, specific to their regional contexts. Both the California Department of Education (CDE) and the Department of Developmental Services (DDS) recognize that Regional Centers and LEAs adapted to provide services via a virtual/online model in order to prevent and contain the spread of COVID-19, and in order to adhere to state and local stay at home orders. Despite the recent adaptations in service delivery, Regional Centers and LEAs are still required to develop and implement Individualized Education Programs (IEPs), Individualized Family Service Plans (IFSPs), and Individual Program Plans (IPPs), pursuant to state and federal law. This includes ensuring continuity of services for children transitioning from Early Start services to Special Education Services. At this time, the United States Department of Education has not waived or exempted the requirement that an IEP is developed and in effect by the third birthday pursuant to 34 C.F.R. §§ 300.101(b); and 300.124(b).
Recognizing that transition to Special Education Services for children at age three may be delayed as LEAs face challenges related to the COVID-19 pandemic, the DDS has issued a directive waiving requirements of the California Early Intervention Services Act (CEISA), including Government Code 95014(a), mandating early intervention services end at age three. The directive is available for download below and is available on the DDS website at
https://www.dds.ca.gov/rc/regional-center-directives/
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Tara Sisemore-Hester
Assistant Director, Clinical Services
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Community Services Department Update
Community Care Licensing (CCL) has published a “Provider Information Notice” (PIN) 20-23 ASC) which includes essential new guidance in a number of critical areas such as: Testing of new and returning consumers and staff in residential facilities and what to do when the result is negative/positive; Preparing for staffing shortages; Modification of visitor guidelines in care homes, infection control and prevention strategies, including Isolation and quarantine procedures for both consumers and staff; Recommended mitigation measures and re-opening strategies and conditions that must be met in order to begin to ease restrictions related to visitation, communal dining, and activities. Please use the link below to access CCL’s full PIN 20-23 ASC.
On June, 26, 2020, the
State of California—Health and Human Services Agency California Department of Public Health put out an “All Facilities Letter (AFL)” to long-term care (LTC) facilities of Centers for Medicare and Medicaid Services (CMS) and Centers for Disease Control and Prevention (CDC) offering guidance for improving infection control and prevention practices to prevent transmission of Coronavirus Disease, including revised guidance for visitation, allowing LTC facilities to temporarily modify their facility’s visitation policies to protect health and safety of residents, staff and the public. The AFL also updates visitation guidance in order to safely reopen SNFs to visitors. To read the full AFL, use this link:
Patricia Green
Quality Assurance Manager
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