Service Delivery Expectations Tier 2 June 12, 2020 Service Delivery Expectations Tier 2 The Executive Order #86, Encouraging the use of telehealth services during the COVID-19 emergency,” is based on the state of emergency date, as opposed to the stay at home order. The state is working on extending telehealth even when the emergency is lifted, which should be reviewed closely. Thus, providers are authorized and encouraged to use telehealth services when medically appropriate. Upon a determination by a health care provider that an in-person evaluation, examination, or visitation is not feasible due to the COVID-19 pandemic, the use of two-way interactive video technology or other remote participation tools shall satisfy the requirement of an in-person evaluation, examination, or visitation. MDHHS Bulletin Number: MSA 20-36 MDHHS is clarifying that the following temporary COVID-19 Response policies and L letter will remain in effect until further notice. (The end dates of these policies are currently tied to termination of the Governor’s Declaration of a State of Emergency Executive Order 2020-04, COVID.) MDHHS will notify providers and stakeholders when these policies terminate. Face to Face vs. Telehealth Service Delivery in Tier 2 Provider’s COVID-19 Preparedness and Response Plan is submitted to their assigned contract manager related to safety measures to be implemented. Primary Case Holder is responsible to document a chart note in LEO reflecting a review with parents, guardians, individuals and the individuals primary care provider (if appropriate) to ensure that potential risks were discussed and that alternate forms of service provision (i.e. telehealth) were explored to the extent possible. Including use of PPE, social distancing needs and hand sanitation. Documentation on LEO clinical documents will continue related to face to face or telehealth (coding for billing); no changes in current process, including completion of COVID Risk Questionnaire prior to each face to face visit. Contracts and Utilization Management will develop a process for retrospective reviews to support clean claim review process. Questions? Provider agency leadership should contact their Contract Manager. LifeWays Moves to Tier 2 Response Level: LifeWays will Continue to Increase Their Onsite Service Offerings LifeWays Community Mental Health will transition from Tier 3 to Tier 2 on its COVID-19 Preparedness and Response Plan as of 6/15/2020. Tier 2: Increase in amount of staff on-site and increase in the amount of face-to-face activity with use of Personal Protection Equipment (PPE) and Precautions. This means that: Screening protocols will continue, social distancing requirements will continue, telehealth codes will remain active, and group meetings will continue to be held via video. Each department will have a rotating schedule to allow for staff to be on-site at LifeWays buildings. For areas that have more than one desk in a large area and are not able to have six feet distance between them when all are in-house, no more than half of the staff will be permitted to be in each of these areas at a time to ensure following the social distance guidelines of six feet apart are followed. Injections will continue with needed face-to-face activities with use of PPE. Emergency Services will continue providing face-to-face pre-screens for inpatient placement with use of PPE, dependent on hospital policies for outside staff to present in person. Psychiatric evaluations for new patients will continue with use of PPE. Home-based, Outpatient Therapy, Case Management/Supports Coordination, Peer Services, Applied Behavioral Analysis (ABA) Therapy, and Assertive Community Treatment (ACT) Services, Psychiatric Services, Crisis Services and Access Services will begin adding face-to-face visits with those deemed most in need as determined by staff, supervisor and department directors. All face-to-face activity will occur after screening and with use of PPE as well as ability to abide by social distancing rules. COVID-19 is a respiratory illness that can spread from person to person. According to the Centers for Disease Control, reported illnesses have ranged from mild symptoms to severe illness and death for confirmed cases. LifeWays extends appreciation to the community for its flexibility during this time to help ensure the health and safety of its consumers and LifeWays staff. Amid this pandemic, LifeWays encourages everyone to monitor their own physical and mental health. Know the signs of stress and try to recognize it in yourself and your loved ones. If you are struggling with your mental health, you can contact LifeWays Community Mental Health 24/7 at 1 (800) 284-8288.