Tag: Covid-19

On Friday, August 31 the California Department of Developmental Services (DDS) published a new directive, effective September 1, 2020, outlining the policies and procedures for reimbursement of claims for providing nonresidential services using alternative approaches during the COVID-19 State of Emergency.  The stated purpose of the directive is to “permit Alternative Services that meet the individual needs of consumers, sustain the state’s developmental services provider network, and continue receipt of federal reimbursement for services provided to consumers during the COVID-19 State of Emergency.”

The directive is a response to urgent concerns across the state that direct support staff were being laid off and clients were not being reached as a result of continued forced closures of nonresidential services (e.g. day programs, transportation) due to the ongoing public health crisis.

Last week DDS hosted several webinars to clarify the directive and answer questions from families and service providers.  Below are some of the clarifications and answers provided during the presentations; the department will publish more guidance and FAQs soon:

Clients, families, and providers should contact their regional center with any questions, or questions can be directed to the department at [email protected].

State Superintendent Tony Thurmond and Governor Gavin Newsom Providing Updates on Covid-19

The California Department of Public Health on Tuesday published rules for opening school campuses and other programs to small numbers of students with disabilities and other students who need in-person support and services that can’t be met through distance learning.

The guidance applies to groups of children and youth in controlled, supervised, and indoor environments operated by local educational agencies, non profits, or other authorized providers, including, but not limited to, public and private schools; licensed and license-exempt child care settings; organized and supervised care environments, i.e., “distance learning hubs”; recreation programs; before and after school programs; youth groups; and day camps.

The guidance defines a cohort as “a stable group of no more than 14 children or youth and no more than two supervising adults in a supervised environment in which supervising adults and children stay together for all activities (e.g., meals, recreation, etc.), and avoid contact with people outside of their group in the setting.”

The guidance doesn’t specify which students would be eligible, although an accompanying Frequently Asked Questions document states that students with disabilities should be prioritized and English learners, students at higher risk of further learning loss or not participating in distance learning, students at risk of abuse or neglect, foster youth and students experiencing homelessness can be priority groups. They could receive tutoring, counseling, social and emotional services and other help to fully participate in distance learning.

The FAQ also says that the size of the building and school enrollment will determine the maximum number of cohorts and that the number of returning students should not exceed 25% of total enrollment.

The Arc of California is conducting an in depth analysis of the guidance and FAQs is seeking clarification on questions from the offices of Governor Newsom and State Superintendent Tony Thurmond and will publish a more detailed report on Monday in our Monday Morning Memo.

As cases of COVID-19 continue to increase the need for accurate and timely medical information is absolutely critical. People who are uninsured or have Medi-Cal, but no regular source of care, experience significant challenges accessing information and care during this pandemic. Presumptive Eligibility (PE) for COVID-19 was implemented on April 8, 2020 and is available to individuals to seek the necessary COVID-19 diagnostic testing, testing-related services, and treatment services, including all medically necessary care such as the associated office, clinic, or emergency room visits related to COVID-19 at no cost to the individuals.

The California Department of Health Care Services (DHCS)has recently launched a 24 hour/ 7 days a week Medi-Nurse phone line specifically to address questions and concerns related to COVID 19 for people who are uninsured or have Medi-Cal but no regular source of care.

Medi-Nurse services are available in multiple languages to provide information on COVID-19 – symptoms, testing, when, where and how to seek treatment – and how to apply for health insurance if needed. If you, or someone you know, are uninsured or a Medi-Cal beneficiary that does not have a regular source of care and experiencing symptoms that could be COVID-19 related do not delay accessing medical advice. Call 1-877-409-9052 and speak to a Medi-Nurse.

COVID-19 Symptoms include, but are not limited to:

• Fever
• Cough
• Shortness of Breath
• Fatigue
• Muscle or Body Aches
• Headache
• New Loss of Taste or Smell
• Sore Throat
• Congestion/Runny Nose
• Nausea/Vomiting
• Diarrhea

Despite the optimism surrounding California’s re-opening, the number of new COVID-19 cases stubbornly rises. The economy, bolstered by better than expected unemployment numbers, struggles to re-start and gain a solid foothold. Based on what we’re seeing, our recovery will be a long, laborious and expensive process.

As a coalition of statewide and regional associations and organizations representing people with intellectual and developmental disabilities, their families and support staff, we know that our State won’t fully recover unless and until we protect Californians who are most vulnerable at this time.

Thankfully, Governor Gavin Newsom and the Legislature rose to the challenge by protecting Californians with developmental disabilities in this year’s budget. Facing the most challenging deficit in a decade, our leaders preserved funding for the more than 360,000 individuals statewide (as well as their families and direct support professionals) that make-up the disability community.

On behalf of the Lanterman Coalition, we wholeheartedly thank our state elected officials for their leadership when we needed it the most.

However important this year’s state funding may be, it is important that our federal lawmakers advocate for the needs of the disability community during the COVID-19 threat too. In her proposed HEROES Act, Congressional House Speaker Nancy Pelosi prioritized state of emergency funding for our community with several important provisions, and now we need her Congressional colleagues to follow her lead.

Leadership from California state and federal elected officials could not come at a more critical time. Talk of the “new normal” is anything but. For the disability community, this phrase represents a massive understatement. Our community faces significant concerns. Many people with disabilities have pre-existing conditions that place them at greater risk of complications from COVID-19. They also carry greater exposure and transmission risks, particularly for those individuals living in a residential group home setting staffed by frontline direct support personnel.

So, for California’s disability community, adjusting to the “new normal” with modified programs that minimize exposure to COVID-19 and keeps our most vulnerable safe necessitates significant – and costly – changes.

As families and caregivers eye the future, efforts to provide quality of life and, in many cases, life-sustaining support will look much different as we implement many new safety protocols for our community. These mandates will have a major economic impact to disability service providers as they modify services, reduce in-person day program ratios and maintain social distancing. Some of the pandemic-related operational costs will include personal protective equipment, additional sanitation practices, more frequent transportation with lower ratios, increasing staff wages for those working on the front lines, testing equipment, new technology to facilitate remote services, and other modifications that aren’t yet known.

As this public health crisis continues to evolve, these modifications will remain in place until we achieve what Governor Newsom has described as “herd immunity” or until we discover a vaccine or viable treatment. It could take months to fully resume programs as they were before the pandemic.

As our state grows accustomed to these changes, it will be critical that we ensure continuity of care for individuals with disabilities. State and federal support is not only necessary, it’s essential for support staff to provide critical support services to Californians with disabilities.

The Legislature and Governor will re-evaluate the budget in August when the depth of our economic recovery, federal relief and the tax receipts are known. In the meantime, our community cannot wait given that we face an uncertain future. It’s essential that the federal government – the president and Congress – step up to help now.

Sacramento has done its job. As has Speaker Pelosi. Now it’s time for the U.S. Senate to focus its attention on issues that truly matter in July when the U.S. Senate resumes session and will be making critical decisions about emergency relief funding to the disability community during the pandemic.
We must do everything possible to minimize the impact of this outbreak on those with disabilities, and we urge our federal leaders to work to ensure any final bi-partisan agreement on the next COVID assistance legislation includes the provisions in the House bill.

On behalf of the more than 360,000 Californians with disabilities and their families, thank you Governor Newsom, the California Legislature, and our federal elected officials for your leadership. The funding decisions you make to protect vital support services and keep our community whole speak volumes about your priorities.

Visit TheLantermanCoalition.org to learn more about how you can become an advocate for those with developmental disabilities.

Jordan Lindsey, Executive Director, The Arc of California and Chair, The Lanterman Coalition

About The Lanterman Coalition – www.thelantermancoalition.org

The Lanterman Coalition is a coalition of statewide and regional associations and organizations representing people with intellectual and developmental disabilities, their families and the workforce. It works to uphold the principles of the The Lanterman Act by advocating on behalf of Californians with developmental disabilities. Under this Act, the person with a developmental disability is entitled to receive services that enable the individual to live a more independent and productive life in an inclusive community.

The California Office of Emergency Services (Cal OES) hosts an Access and Functional Needs Leadership call every week to discuss critical issues for people with AFN, their families, friends, and services providers. This week on the call, Cal OES highlighted a partnership with LISTOS California, the State Council of Developmental Disabilities, and the Department of Developmental Services to provide accessible and accurate information for people with intellectual and developmental disabilities. The materials include corona virus safety tips, self-care-tips, making a plan, and creating a health profile. These downloadable info-graphs are available in several different languages at: https://www.listoscalifornia.org

WASHINGTON, D.C. – June 9th, in response to the first federal complaint challenging discriminatory hospital “no-visitor” policies, the Office for Civil Rights (OCR) at the U.S. Department of Health & Human Services announced a resolution making clear that federal law requires hospitals and the state agencies overseeing them to modify policies to ensure patients with disabilities can safely access the in-person supports needed to benefit from medical care during the COVID-19 pandemic. Read The Arc’s full press release here.

Highlights from the hospital policy announced by OCR and Connecticut include that it:

• Requires all hospitals and other health care facilities to allow designated persons (family members, staff, or others) to support any disabled patient that may need such support;
• Requires hospitals to provide available personal protective equipment (PPE) to support persons to keep them safe;
• Includes procedures for screening support persons for COVID-19 symptoms and for supporters to safely take breaks and leave and re-enter the hospital; and
• Encourages hospitals to mitigate the risk associated with support persons supporting COVID-19-positive patients.

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WASHINGTON, D.C. – June 12th, The same office, the Office for Civil Rights (OCR) at the U.S. Department of Health & Human Services (HHS), finalized their ACA Section 1557 Rule which removes discrimination protections from LGBTQ people seeking health care and health insurance. Specifically, the rule redefines “sex discrimination” as only applying when someone is being discriminated against on the basis of their assigned sex at birth.

Under the new rule LGBTQ people, especially transgender people, can be denied medical care on the basis of their gender with no federal legal protection. This rule goes beyond the ability for providers to refuse gender transition related care. Doctors can refuse to treat transgender patients altogether.

How are these rules related?

The resolution clarifying that hospitals must allow in-person support for people with disabilities will undoubtedly save lives during the COVID-19 pandemic. Yet there are many in the disability community who are also transgender people. Many of whom have complex medical needs which are now at risk of going unmet. While the fact sheet issued by HHS’s OCR on ACA Section 1557 rule specifies that it protects individuals with disabilities, the rule itself removes transgender people with disabilities from this protection.

UPDATE:

Unlike many states California has regulations in place at the state level which protect transgender people’s access to health care. Medi-Cal also has specific protections in place for transgender patients. Click here to view an interactive map which shows which states do and do not have these protections.