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Coronavirus (COVID-19) Health and Safety Guide

ASERT has put together some resources for those with autism and those who care for people with autism relating to the current Coronavirus outbreak.

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Telehealth

The coronavirus (also called COVID-19 or novel coronavirus) spreads easily from person to person, so it’s recommended that people practice something called “social distancing”. This means staying away from other people in order to avoid catching or spreading the virus. It also means that schools, clinics, and offices may close, events may be cancelled, or people may need to work from home.

This can make it difficult for providers to see their patients/clients/ participants in person. The federal government and the Commonwealth of Pennsylvania have made certain changes to regulations and laws to help keep people safe and continue essential services for vulnerable populations during this time. Pennsylvania government is now letting providers use telehealth or telemedicine to see people remotely, even though that wasn’t always allowed before or it required certain technologies.

Service providers must determine if the risk of suspending services is greater than the risk of continuing to provide services. If continuing services is a consideration, the provider must then determine if services can be delivered in a manner that does not unduly increase the risk of exposure to COVID-19.

The Office of Mental Health and Substance Abuse Services (OMHSAS) has issued guidance for the use of telehealth as a delivery method for medically necessary behavioral health services as ordered, referred, or prescribed by a provider or practitioner. This allows services to be delivered effectively while the patient is quarantined, self-quarantined, or self-isolated due to exposure or possible risk of exposure to COVID-19.

What is telehealth?

  • Telehealth is the use of digital information and communication technologies, such as computers and mobile devices, to access services remotely and manage physical and mental health needs.
  • Telehealth allows providers to deliver services so clients can receive supports via technology. It is a convenient and safe way to continue providing services while patients are quarantined, self-quarantined, or self-isolated due to exposure of possible risk of exposure to COVID-19.

Benefits for Behavioral Health providers

  • Maintains communication and support with clients without having to travel to a facility,
    personal home, or be in the community to limit risk of exposure and spread of COVID-19.
  • Provides greater flexibility to safely treat clients, participants and patients.
    • Prior to this announcement, Medicare was only allowed to pay clinicians for
      telehealth services such as routine visits in certain circumstances.
  • Now providers can provide telehealth to anyone not just those who are in rural communities.
  • Qualified providers should inform their patients that services are available via telehealth.

Next steps for providers

  • Providers should consult their agency and determine if they are permitted to provide
    services based on current state and federal regulations.

    • FOR OMHSAS PROVIDERS: However, you will need to complete an Attestation
      Form as required by bulletin OMHSAS-20-02 within 5 days of initiating telehealth.
      When submitting the attestation for RA-PWTBHS@pa.gov for the COVID-19
      state of emergency, please use the subject line “COVID-19 EMERGENCY.”
    • For questions specific to children’s services providers can email:
      RA-PWIBHS@pa.gov

Benefits of telehealth for individuals

  • It’s convenient.
    • Clients/participants/patients will be eligible for telehealth services effective
      March 6, 2020.
    • Patients receive telehealth services from their homes without risking exposure
      to COVID-19.
  • Some services don’t have to stop. Check with your supports coordinators for more information.
  • Slows the spread of the virus and helps to keep more people healthy.
  • Clients/participants/patients can continue to communicate and get support from their providers.
  • Services through telehealth include common office visits, mental health counseling, and preventive health screenings.

What types of technology can be used?

  • HHS Office for Civil Rights (OCR) will exercise enforcement discretion and waive
    penalties for HIPAA violations against health care providers that serve patients in
    good faith through everyday communications technologies.

    • Now, covered health care providers may use online applications that allow for
      video chats, including Apple FaceTime, Facebook Messenger video chat, Google
      Hangouts video, or Skype to see their patients, clients, or participants, even they
      may not fully comply with HIPAA rules. Providers should enable privacy features
      and encryption options that are available in any of these applications.
      Z Providers cannot use public facing technologies (like Facebook Live, Tik Tok,
      or Twitch) to provide telemedicine services. These are not safe.
  • During this state of emergency, telehealth will allow the use of telephonic video
    technology commonly available on smart phones and other electronic devices. In
    addition, telephone only services may be utilized in situations where video technology is
    not available.
  • Providers should make all good faith efforts to make sure the health information of their
    patients, clients, and participants is safe. This means being in a private space, away from
    other people, not disclosing information to others in the household, etc.
  • Providers should tell their patients, clients, and participants of potential privacy risks
    involved in using these technologies.
  • Providers must take responsibility to stay updated with changes to federal and state
    regulations during this time to ensure compliance.

What types of providers can use telehealth?

  • Staff trained in the use of the telehealth equipment and protocols to provide operating
    support and staff trained to provide in-person clinical intervention will not be required
    to be present with the individual while they are receiving services.
  • The practitioner types that can provide services through telehealth will not be limited
    to psychiatrists, licensed psychologists, Certified Registered Nurse Practitioners and
    Physicians.
  • Provider types that can bill for telehealth under Medical Assistance (MA) Fee-For- Service (FFS) will not be restricted to services originating from Psychiatric Outpatient Clinics, Psychiatric Partial Hospitalization Programs, and Drug & Alcohol Outpatient Clinics. BHMCOs may continue to allow billing for any provider type they determine appropriate.
  • Assistants certified in mental health; Licensed Clinical Social Workers; Licensed
    Professional Counselors; and Licensed Marriage and Family Therapists can use
    telehealth services. Other individuals providing necessary behavioral health services
    will be permitted to utilize telehealth for services that are within their scope of practice.

When will the relaxed telehealth rules end?

For 90 days (est. June 15, 2020), or while the valid emergency disaster declaration is authorized by the Governor related to COVID-19 remains in effect, which ever comes first. It is likely that it may be re-issued as appropriate if emergency disaster declaration continues to be authorized by the Governor.

Many agencies are shifting their practice from in person visits to telehealth in order to protect the health of their staff, patients, and the community from the spread of COVID-19. Although it can be difficult to commit to learning and using new technical and community skills. An abundance of research shows us that behavioral health visits by video conferencing are just as effective as being seen face to face!

Are you caring for a person who is making the switch from in person visits to appointments via a telehealth platform? Use this resource as a tip sheet to help prepare a person for their appointment and guide them to having a successful telehealth visit.

  • Your provider will assist you in the transition between in person, face-to-face appointments into using a telehealth platform that their agency has chosen. If video platform is impossible, a phone discussion could also be an option.
  • Choose a space inside your residence that is private and free of distractions and noise
  • If you’re using video, set up your camera about 2-3 feet away from your face. Try and make sure that your face is in the middle of the screen. Make sure that the space has sufficient lighting, so that your provider can see and connect with you easily.
  • Would you like to speak with your provider alone? Or would you like to have a family member or caregiver with you for your visit? If you would like to invite someone to your visit, ask them ahead of time and make sure that they are prepared to be on time.
  • Grab a notepad and a pen so that if is something important to write down, you can do so easily during your appointment.
  • When your visit begins, ask your provider if they can see and hear you clearly. You might need to make some adjustments so that you can communicate back and forth clearly.
  • Review your plan for emergencies and ask your provider how they would like to be contacted in between visits if any issues occur.
  • Do you have any questions for your provider?
  • Do you have any feedback for them about how your visit went?
  • Review what your goals and responsibilities are in between now and your next visit.
  • Review what was accomplished at the visit and talk about what next steps are moving forward.
  • Confirm with your provider and write down the date and time of your next telehealth visit.

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Other downloads

Name Description Type File
Telehealth General Information pdf Download file: Telehealth
Telehealth For Families/Caregivers pdf Download file: Telehealth

This information was developed by the Autism Services, Education, Resources, and Training Collaborative (ASERT). For more information, please contact ASERT at 877-231-4244 or info@PAautism.org. ASERT is funded by the Bureau of Supports for Autism and Special Populations, PA Department of Human Services.