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COVID-19 Partner Updates: March 22nd

COVID-19 Partner Updates: March 22nd

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

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

Counties and CBOs Request SB 89 Funds to Stabilize Public Behavioral Health Safety Net
Today, CBHDA, CBHA, and the Alliance requested the Administration request $100 million to stabilize the county behavioral health safety net due to impacts related to COVID-19. Please find the letter to HHSA and DHCS, attached. This funding would be used by county behavioral health to stabilize our providers who are facing COVID-19 related fiscal hardship, address any immediate increase in demand for services related to COVID-19, and lift up new services, as needed. The Administration will need to weigh this request among many others for the SB 89 funding, however, we would appreciate individual and association letters of support addressed to the Administration as well as the legislature for this important funding which will be needed to ensure the viability of our public behavioral health safety net.
CLICK HERE to read the Entire Request.

Troubleshooting On-the-Ground and In-the-Moment
In partnership with the various provider associations, we’ve agreed to try to troubleshoot provider and county problems with each other. If you are having a local issue with a specific county, please ask your provider association to reach out to CBHDA to see if we can troubleshoot the issue in real-time. A lot is changing rapidly. Many of the rules that we typically operate under are being altered in major ways. CBHDA has been working hard to ensure our membership is fully informed. Those messages don’t always make to each of our thousands of county behavioral health workers, so we’d ask patience, and high-touch communication. If you are not reaching resolution at the local level, please reach out to me to request coordination on a solution through CBHDA. Sometimes it’s a matter of educating our county behavioral health members, sometimes it’s a matter of educating your members, and sometimes, it’s a matter of joint advocacy to see if we can remove barriers standing in the way of safeguarding the wellbeing of our clients.

Newsom Administration Clarification of Essential Workforce
(CLICK HERE to read the entire document).
Following Thursday night’s state Stay at Home order, the administration faced a wave of questions and confusion from various sectors about who is and is not considered “essential.” New guidance, out yesterday, confirms that behavioral health workers, are, in fact, considered part of the essential workforce who may continue to work during this order. The clarification is attached and can be found here as well.

Excerpts of how our workforce is defined:

“Workers in other medical facilities (including Ambulatory Health and Surgical, Blood Banks, Clinics, Community Mental Health, Comprehensive Outpatient rehabilitation, End Stage Renal Disease, Health Departments, Home Health care, Hospices, Hospitals, Long Term Care, Organ Pharmacies, Procurement Organizations, Psychiatric, Residential, Rural Health Clinics and Federally Qualified Health Centers, cannabis retailers)." Pg 1

“Behavioral health workers (including mental and substance use disorder) responsible for coordination, outreach, engagement, and treatment to individuals in need of mental health and/or substance use disorder services." Pg 2

CDSS Issues COVID-19 Guidance Related to Child Welfare Services
Late last night, CDSS issued a new All County Letter clarifying roles and workflows for child welfare during the COVID-19 crisis. This includes everything from welfare checks, to court processes, and CFTs. The full ACL is attached. CLICK HERE to read the letter.

COVID-19 Homelessness Hotel Effort
The Administration and the Legislature appropriated $150 million to work to immediately shelter homeless individuals as they are at higher risk for contracting COVID-19. Approximately $50 million of those funds will be used to lift up hotels, motels and trailers to house individuals experiencing homelessness, as they are at extremely high risk due to their underlying health conditions. CBHDA is working to ensure that county behavioral health is being brought in to ensure coordination around the behavioral health needs of the individuals who will be getting newly sheltered through these efforts.

California 1135 Waiver Amendments Requested
CLICK HERE to read the entire Waiver Request.
An 1135 waiver is a special waiver option for states from the Federal Government for the waiver of Medicaid rules for the duration of a national emergency. The state issued a request to the federal government late last week, seeking amendments to our original 1135 waiver request. Several behavioral health issues were included in that request (attached). This summary is not exhaustive, and it is important to note that none of this goes into effect until the federal government approves it. If approved, the request is for these provisions to be applied retroactively to January 27, 2020. Among the revisions requests, the state’s asked for:

  • A temporary waiver of the IMD exclusion during this crisis. This is important as we expect that inpatient hospital beds may be converted to deal with the COVID-19 crisis and we’re already experiencing a number of providers of all types (hospitals, Department of State Hospitals and community residential) refuse new admissions. We will continue to have clients who require higher levels of care, and expect to see individuals in psychiatric emergency as this public health crisis unfold, and are mindful of the need to maximize existing capacity wherever possible. (p. 5)
  • A request to allow for expanded use of individual SUD counseling via telehealth for State Plan counties. Currently, individual counseling is restricted in State Plan counties. The state is requesting a waiver of this restriction. (p. 5)
  • HIPAA flexibility: In order to support the expanded use of telehealth, the state is requesting authority for state to decline to impost penalties for HIPAA noncompliance, consistent with existing federal guidance (p. 3)

ICU Bed Capacity, By County
Kaiser Health News posted a new database showing ICU bed capacity by county throughout the US. That resource can be accessed here.

Enterprise Vans Available for Essential Services Please see the attached notification from Enterprise Van Services of the availability of their fleet to assist with “essential services,” FYI only.


CDPH COVID-19 Daily Update, By the Numbers

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