UPDATED June 17, 2020
Update: CARES Act Provider Relief Fund. HHS expects to distribute $15 billion to eligible Medicaid and CHIP providers. The payment to each provider will be at least 2 percent of reported gross revenue from patient care; the final amount each provider receives will be determined after the data is submitted, including information about the number of Medicaid patients providers serve. To learn more or apply: CARES Act Provider Relief Fund.
California is doing a good job of holding the line on the Stay at Home order issued by Governor Newsome in a state of emergency proclamation on March 4, 2020. While the rates of infection and death are trending downward, it’s important that we continue to practice all safety guidance protocols. In this article, you will find links to all the DHCS guidance released for behavioral health, as well as links to the agencies keeping us informed with up-to-date information.
Governor Newsome announced on May 7, 2020, the release of industry guidance to help businesses reduce risk and establish a safe, clean environment for workers and customers. Please see the attached industry-specific checklists and learn more about California’s Resilience Roadmap.
The most recent updates from DHCS include guidance for the SUD Counselor and the requirement to complete AOD registration as stated below.
BHIN-20-016 & BHIN 20-17
Additional Time to Complete Counselor Certification Requirements
California Code of Regulations, Title 9, §13035(f)(1) requires AOD registered counselors to obtain certification as an AOD counselor, from a DHCS recognized certifying organization, within five (5) years of the date of registration.
Under the authority of Executive Order N-55-20, DHCS shall suspend the requirement to complete AOD registration for the duration of the declaration of emergency. DHCS shall extend the AOD registrants’ completion date by the same number of months that the requirement was suspended.
DHCS Guidance During the Pandemic
The Department of Healthcare Services (DHCS) issued several guidance documents during the pandemic regarding all aspects of the delivery and management of behavioral health.
Recently Released DHCS Guidance
- BHIN-20-016 Driving Under the Influence Program and FAQs
- BHIN-20-017-Alcohol and Other Drug Facilities
- COVID-19 FAQ MAT and Telehealth
- IN-20-014 Flexibility for Residential Mental Health Facilities
Previously Released DHCS Guidance
- DHCS Update 3-26-2020
- DHCS COVID-19 Frequently Asked Questions: Driving-Under-the-Influence (DUI) programs
- COVID-19 FAQ Narcotic Treatment Programs updated 031820
- DHCS COVID-19 Frequently Asked Questions: Behavioral Health
- DHCS COVID-19 Frequently Asked Questions: Mental Health Rehabilitation Centers (MHRCs) and Psychiatric Health Facilities
- DHCS COVID-19 Frequently Asked Questions: Narcotic Treatment Programs (NTPs)
- Behavioral Health Information Notice No: 20-009
- Telemedicine and Prescribing Buprenorphine for the Treatment of Opioid Use Disorder
Important Update from DHCS – April 6, 2020
The Department of Health Care Services (DHCS) is providing this update of significant developments this week related to DHCS programs, including guidance related to the COVID-19 emergency.
On April 3, 2020, DHCS submitted to the Centers for Medicare & Medicaid Services (CMS) a request for a waiver under Section 1115 of the Social Security Act and a Disaster State Plan Amendment seeking additional flexibilities to address the health care needs of California during the emergency.
In addition, on April 3, 2020, CMS notified DHCS that it has approved California’s request for a waiver of the broad-based and uniformity requirements related to the State’s managed care organization (MCO) tax, effective January 1, 2020. DHCS is currently evaluating the approval and what, if any, changes will be necessary.
CMS also recently approved the DHCS’ requests for five 1915(c) Home and Community-Based Services (HCBS) Waiver Appendix K amendments, which allow flexibilities during emergency situations that may impact the provision of health care services and California’s ability to meet certain HCBS Waiver requirements. The stand-alone Appendix K amendments are used to advise CMS of expected changes to HCBS Waiver operations or to request temporary amendments to approved Waivers. California received these Appendix K approvals for the period of February 4, 2020, to June 30, 2020, in response to challenges the State faces as a result of the ongoing COVID-19 emergency.
The individual waiver requests and approval letter are linked below:
- Appendix K Approval Letter
- Appendix K for 1915c Waivers: DDS
- Appendix K for 1915c Waivers: HCBA
- Appendix K for 1915c Waivers: ALW
- Appendix K for 1915c Waivers: HIV/AIDS
- Appendix K for 1915c Waivers: MSSP
DHCS also published additional and/or updated guidance for providers, beneficiaries and the public related to the COVID-19 emergency:
- Joint Guidance on Non-Discrimination in Medical Treatment for COVID-19
- Every Woman Counts Primary Care Provider Information Notice and Telephonic Enrollment Process
- Updated Medi-Cal Fee-For-Service (FFS) Prior Authorization Flexibilities Relative to COVID-19
- Updated Fee-for-Service Pharmacy: Flexibilities for Off-Label/Investigational Drugs in COVID-19-Related Treatment
- Updated Narcotic Treatment Program FAQs
- Behavioral Health Integration Incentive Program Delay
- Presumptive Eligibility in Child Health and Disability Program: COVID-19 Flexibilities
- Hospital Presumptive Eligibility: COVID-19 Flexibilities
- Presumptive Eligibility for Pregnant Women: COVID-19 Flexibilities
- APL 20-007: Policy Guidance For Community-Based Adult Services In Response to Covid-19 Public Health Emergency
Additional updates will be posted to the DHCS COVID-19 resource page.
Clients at Risk – Resources
- Our clients need extra care during times of crisis. Provide your clients with resources they can access telephonically or online including:
The following resource links will also help to keep you updated as you determine how to handle the threat in your practice, business, and life.
California Department of Health
The website provides an overview of the virus, the latest news releases, and the most recent data about cases in California. Additionally, there are many California specific resources such as:
The Center for Disease Control and Prevention
The CDC is in charge of addressing the COVID-19 outbreak in the US. Visit the COVID-19 website to learn about What You Should Know, Situation Updates, and information for specific audiences such as Healthcare Professionals and Facilities. You can also learn what the CDC is doing to address the Coronavirus threat. Available are 10 color handouts to use to address the crisis at your location.
The World Health Organization
Visit the WHO website for daily updates of the Coronavirus throughout the world. On January 30, 2020, the International Health Regulations Emergency Committee of the World Health Organization declared the outbreak a “Public Health Emergency of International Concern.” (PHEIC).
Limit the Spread of Germs and Prevent Infection
Guidance for wearing face masks has been updated.
WEAR A CLOTH FACE COVER
The CDC now advises everyone to wear a cloth face cover when going out in public, such as going to the grocery store or to pick up other necessities.
- The cloth face cover is meant to protect other people in case you are infected. You could spread COVID-19 to others even if you do not feel sick.
- Do NOT use a facemask meant for a health care worker.
- In addition, do NOT place cloth face coverings on young children under age 2, anyone who has trouble breathing, or is unconscious, incapacitated or otherwise unable to remove the mask without assistance.
- Continue to keep about 6 feet between yourself and others. The cloth face cover is not a substitute for social distancing.
- For more information, see CDC guidelines, including how to create your own cloth face cover.
Additionally, practice the following stay-safe guidelines:
- Avoid close contact with people who are sick.
- Stay home when you are sick.
- Cover your nose and mouth with a tissue when coughing or sneezing and throw the tissue away after use. If a tissue isn’t available, cough or sneeze into your elbow, not your hands.
- Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing or sneezing. If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty.
- Avoid touching your eyes, nose or mouth.
- Practice other good health habits. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids and eat nutritious food.
- Disinfect doorknobs, switches, handles, computers, telephones, bedside tables, bathroom sinks, toilets, counters, toys and other surfaces that are commonly touched around the home or workplace.
Governor Newsom Releases Executive Order
On March 4, 2020, Governor Gavin Newsom also issued a new executive order (PDF) further enhancing California’s ability to respond to the COVID-19 pandemic. The Governor’s order:
- Waives the one-week waiting period for people who are unemployed and/or disabled as a result of COVID-19;
- Delays the deadline for state tax filing by 60 days for individuals and businesses unable to file on time based on compliance with public health requirements related to COVID-19 filings;
- Directs residents to follow public health directives and guidance, including canceling large non-essential gatherings that do not meet state criteria;
- Readies the state to commandeer property for temporary residences and medical facilities for quarantining, isolating or treating individuals;
- Allows local or state legislative bodies to hold meetings via teleconference and to make meetings accessible electronically; and
- Allows local and state emergency administrators to act quickly to protect public health.