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COVID-19 CBHDA Partner Updates: March 18th

COVID-19 CBHDA Partner Updates: March 18th

Good Morning Directors and Advocacy Partners (Alliance, CBHA, NAMI, Steinberg Institute, CiBHS, CPEHN, Access CA, SEIU, CWDA, CHEAC, Children’s Trust):

Please feel free to forward/share this daily email guidance with key stakeholders. We will continue to provide updates as relevant.

DHCS Guidance
DHCS has clarified several key pieces of guidance for us, outlined below. We welcome feedback/suggestions for additional needs and troubleshooting.

Recognizing the need to deploy county and provider staff to respond to the COVID-19 state of emergency, DHCS Audits and Investigations is suspending all audits scheduled between now and April 17.
The situation is evolving rapidly, so we will communicate with you as we learn more.

Updated COVID-19 information:
The situation is evolving daily, and DHCS is aiming to provide timely guidance. The latest DHCS information on COVID-19 is found on our COVID-19 Response website. We released FAQs and an information notice clarifying BH telehealth policy over the weekend, and we are in the process of publishing updates for NTPs and DUI providers.

Additional clarifications from DHCS:

The extension of our NACT submission deadline to April 17th (for now we have two additional weeks)
Ability to prescribe new patients buprenorphine through telemedicine in lieu of an in-person visit
Flexibility for NTPs to apply for blanket waivers to allow 14-28 days of take-homes, and allow home delivery of methadone
Clarification from the Office of Civil Rights that they will use enforcement discretion regarding HIPAA violations when providers use telehealth in good faith, including guidance about which common tablet and phone apps are appropriate for use. The website lists specific applications by name, and only excludes public-facing apps (like Facebook) from telehealth use.
Clarification that mental health assessments can be done by telehealth or telephone and that SUD initial assessments for DMC-ODS can be done by telehealth or in-person, with subsequent services by telehealth or telephone.

Telehealth and assessments
Medi-Cal in the Specialty Mental Health and Drug Medi-Cal Organized Delivery System allows telephone AND telehealth visits for most services, including mental health assessments.  DHCS was able to clarify that mental health assessments can be done by telehealth or telephone. SUD initial assessments for DMC-ODS can be done by telehealth or in-person, with subsequent services by telehealth or telephone.
See our Information Notice 20-009 for more detail.

Pharmacy 100-day supplies
Other than certain controlled medications, Medi-Cal covers 100-day supplies.  For any pharmacies that do not honor these requests – you can refer them to our pharmacy website where DHCS makes the 100-day policy clear.

State Hospitals/IMD Exclusion
I also wanted to ensure that you all received the notification from the Department of State Hospitals (attached) notifying us that all State Hospital discharges and admissions will be suspended for the next 30 days, effective March 17th.

Outstanding Issues
Provider Relief: One outstanding urgent issue that’s been flagged by several of you is the ability of some of our contracted providers with narrow margins to keep their doors open. We’re working with DHCS and have requested that this get elevated as we’re aware that this is urgent. We will update you as soon as there is news to share on this front. We want you to know that we and the provider associations have been flagging this for the state since late last week. 
Cell phones: Equipment and minutes: We have some possible options for donated cell phone equipment and have also asked the state to weigh in with the large cell phone carriers to see if we can get unlimited plans for our clients who are reliant on tele/phone services. Please stay tuned on this request.

Thank you, and your teams, for the amazing work you all are doing. I am happy to include additional state-level groups on this distribution, or to remove organizations, at your request.

Thank you,

Michelle Cabrera
Executive Director
County Behavioral Health Directors Association of California
2125 19th Street, 2nd Floor
Sacramento, CA 95818

Office: 916-556-3477, Ext. 1108