COVID-19

COVID-19 PrEP-AP enrollment

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The California Department of Public Health has issued instructions regarding the Pre-Exposure Prophylaxis Assistance Program (PrEP-AP) to minimize exposure to COVID-19 and maintain coverage.  For clients with expiring eligibility or expired eligibility back to March 1, PreP-AP is extending eligibility for 90 days to June 30, 2020.

However, for clients in a Gilead Assistance Program, Gilead is not extending eligibility.  Clients enrolled with expiring eligibility should submit a re-enrollment application with income documentation to Gilead prior to their eligibility ending to avoid a lapse in coverage.

If clients are unable to obtain their medication or submit a re-enrollment application before their eligibility expires, Gilead can provide the pharmacy override on a case-by-case basis.  If Gilead does not allow a medication dispense, PrEP-AP may approve an override on a case-by-case basis.

Clients enrolled in Gilead’s Patience Assistance Program and Copayment Assistance Program can receive up to a 90-day fill of medication as long as there is eligibility throughout the 90 day time period.  Clients in Gilead’s Copayment Assistance Program can only receive a 90 day dispense if their insurance allows for a 90-day prescription fill.  Pharmacies must contact Gilead to get an override code.  This is in effect until April 30, 2020.

Clinical providers are encouraged to consider converting PrEP to virtual if their agency has the capacity.  PrEP-AP can reimburse telemedicine using the same billing code as for an in person visit. Providers are encouraged to reach out to client to inform them that in-person appointments are changing to telemedicine.

Providers are also asked to postpone services that require person-to-person interaction but will maintain access to in-person visits when needed based on the client’s symptoms such as acute HIV or a sexually transmitted infection.  Laboratory testing for people on PrEP with good adherence and no symptoms can usually be postponed for 3 months.  (Management Memorandum 20-08, March 20, 2020.)

COVID-19 ADAP enrollment

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The California Department of Public Health has issued instructions regarding the AIDS Drug Assistance Program (ADAP) to minimize exposure to COVID-19.  For clients with expiring eligibility or expired eligibility back to March 1, ADAP is extending eligibility for 90 days to June 30, 2020.

New or lapsed clients can enroll over the phone.  New or lapsed clients will be required to provide documentation of eligibility.  Workers can email the client so the client can respond with enrollment and supporting documentation.

ADAP will now have early medication refills and has extended the dispense quantity to 90-day fills.  (Management Memorandum 20-06, March 16, 2020.)

COVID-19 CBAS services

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The California Department of Aging has issued guidance about changes to Community-Based Adult Services (CBAS) because of COVID-19.  CBAS centers have temporary flexibility to reduce day center activities and to provide services in the home, telephonically or by videoconference, including professional nursing care, personal care services, behavioral health services and therapeutic activities.  CBAS center may provide physical therapy and occupational therapy at the beneficiary’s home.

CBAS centers can provide for home-delivered meals in the absence of meals provided at CBAS centers, and may continue to provide transportation services.

Centers can provide individual in-center services such as individual meetings to receive services, indivuduals comont to the center to pick up supplies, meals, receive wound care assistance or receive assistance with a shower.  Participants assembling and receiving services in groups of more than one or being served in the same space at the same time is prohibited.  (All Center Letter 20-06, March 27, 2020.)

COVID-19 APS investigation and visits

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The California Department of Social Services (CDSS) has issued information about modifying Adult Protective Services investigations and monitoring visits because of COVID-19.  Face-to-face investigations continue to be required when an elder or dependent adult is imminent danger or immediate or 10-day in-person response is necessary to protect the individual’s health or safety.  Counties may collect and review information by phone prior to a home visit.

30-day in person monitoring visits remain mandatory unless the written visitation plan justifies why it is not necessary to visit the client once every 30 days and it is approved by a supervisor.  The mandatory visits can only be substituted by telephone calls with supervisor approval.  (Program Manager Letter, March 13, 2020.)

COVID-19 IHSS submission of SOC 873 during COVID-19 response

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The California Department of Social Services (CDSS) has issued guidance regarding an exception to IHSS applicants submitting the SOC 873 Health Care Certification prior to authorization of IHSS services.

Counties can consider all new IHSS applicants who are unable to obtain a SOC 873 from their licensed heath care provider because of COVID-19 to be considered at imminent risk of out of home placement and therefore have good cause for not submitting the SOC 873 prior to authorization of services.  These applicants should have good cause to submit the SOC 873 up to 90 days from the date it is requested by county.  Counties may authorize IHSS services pending receipt of the SOC 873 for 90 days from the date of the county request for applicants who meet all eligibility requirements.  (ACIN I-28-20, March 30, 2020.)

COVID-19 IHSS social worker overtime and outreach

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The California Department of Social Services (CDSS) has issued guidance regarding social worker outreach and overtime.  CDSS will augment IHSS administrative fund to support social worker overtime.  Social workers’ primary work during overtime should be initial face-to-face assessment, answering and returning phone calls, assessments because of a change in condition or circumstances that would increase hours and assistance with provider enrollment.

In addition, IHSS and Adult Protective Services social workers should identify and outreach to program recipients who may need additional support during the COVID-19 emergency.  Counties should prioritize recipients who are most at-risk for outreach.  For example, recipients who are over 80 years old, living alone, or do not have an active provider can be prioritized.  Counties will receive funding for these activities.  (ACL 20-30, March 30, 2020.)