Transcript of “Rights Here, Rights Now – Episode 12: “COVID19”

Produced by the disAbility Law Center of Virginia.                                                            

[INTRO]:                      The information provided on this podcast does not, and is not intended to, constitute legal advice. Instead, all information, content and materials available are for general informational purposes only.

Welcome to Rights Here, Rights Now, the podcast about disability, advocacy, and activism. I’m your advocate host, Ren Faszewski

And I’m your advocate host, Virginia Pharis. Every two weeks, we dig into relevant issues, current events, and avenues for self-advocacy.

‘Cause someone has to!

It might as well be us!

[REN]:                          Welcome to Rights Here, Rights Now- The podcast about disability, advocacy, & activism.

I'm your Advocate host, Ren Faszewski.

[VIRGINIA]:                 And I'm your Advocate host Virginia Pharis.

 

[REN]:                          So Virginia, today we have something of a pretty special episode.

[VIRGINIA]:                 Yes. We are-We're still recording remotely, but we were able to dial in the manager of our *Communities* Unit, Erin Haw, who was one of my mentors when I first started DLCV.  She is awesome and she is going to be talking to us a little bit about DLCV’s response to the covid-19 crisis. And what we’ve been doing that’s important for facilities.

[REN]:                          And obviously, like, on our website, we’ve been doing updates for the virus as we get information, but I think that this is good to kind of explain what DLCV is doing with our advocacy work? And yeah, Erin who is advocate extraordinaire, doing all the Community stuff- But VIRGINIA, you *forgot* that you’re supposed to be talking to us about institutions!

[VIRGINIA]:                 [Laughter] Yes, for better or for worse, I will be giving the institutions perspective, of that Unit, and sort of what we’re doing to respond to the crisis, but- before we jump in- let’s check out disability in the news.

 

Students in Hasbrouck Heights New Jersey have taken online learning to a whole new level recently. Over a dozen middle and high school students have been using 3D printers while at home to create face masks for the areas local hospitals. These students, all with disabilities, had been using 3D printers in the classroom prior to the quarantine, but when schools in the area shut down teachers had the great idea to deliver the 3D printers to the students homes. Shane Miller, the STEM coordinator for the district, dropped off 3D printers at over a dozen homes and gave quick tutorials to the families. Since then, students have been printing masks all day every day for local hospitals and new 3D printers have even been donated so more students can participate. New Jersey Governor, Phil Murphy, applauded these students at a news conference recently, expressing his gratitude for their selflessness acts during this time.

[REN]:                          All right! And now, we’re ready to get into it. Thank you so much to Erin for joining us today.

*ERIN HAW ENTERS*

[ERIN]:                         Hello! Thanks for having me!

[REN]:                          It is always a blessing to have one of the [our] most Senior and excellent advocates ever enter into the podcast….zoom meeting?? Is that what we’re going to call it?

[Pause]

[REN]: [Continued]      So, we have some really important stuff that we’re going to talk about today. Let’s just dive right in. So, what are some of these things, systemically, that DLCV is doing to track COVID 19 responses in the community?

[ERIN]:                         That’s a great question. And we’re really focusing on a number of great efforts right now. The first big one that I’ll highlight for you, is the one that we’re doing around our [specific] CRIS DATABASE. For people who are listening and who maybe don’t know what that is...Under state law, we have access to a lot of incident reports, for people with all sorts of disabilities who live in *Licensed Residential Settings* and also receive services from Licensed community based providers like day programs and those sorts of things. And so, we have had this information for a long time, and we do a lot of training and tracking around these reports- for incidences or cases of abuse and neglect, for all kinds of reports. Over the last few weeks we’ve really spent a lot of time developing a more “COVID 19 focus” trending, tracking, analysis and follow up process. So our wonderful CRIS team reviewers are identifying reports, um, in 3 broad areas. The first one is going to be individuals in licensed programs who have suspected COVID 19. And the other big area is going to be people who’ve *confirmed* COVID 19, and the third big group that we’re kind of trending and tracking are people who don’t *have* COVID 19, but the people who haven’t been able to access services *because of* COVID 19. So, we’re tracking this data, identifying patterns and trends whenever we can, and then we’ve also developed a provider survey tool, which allows us to reach out to those providers that are *having* the identified issues- so either, securing specific testing for their residents, or specific issues within that community. Then, we ask them [specifically] 1. What issues they’re having and 2. What might actually help them resolve some of those issues, some of that. So, we’re still in the early stages of those surveys, but those’ll be some good tools.

[REN]:                          Clearly, we’re tracking it. Is there any sort of like- how people are responding to the crisis? Or like, how providers are managing how the crisis is **happening** within their facilities?

[ERIN]:                         I think that’s the piece that we’re trying to get at with the provider services//surveys. So [for instance] the incident reports that we get, a lot of times, with these providers, are *REQUIRED* to report to the state. And it’s just like, “Hey, Johnny was presenting with some symptoms...we took him to the doctor, and the doctor diagnosed him with COVID 19.” Something like that. 

And that doesn’t really help us to understand, that like, well, where is the group home that Johnny resides, making sure that the other residents are safe? Is the group home provider having trouble accessing PPE? What are the bigger implications here that we should know about? And be doing something about? Because we have a much more direct relationship of communication to state leadership than some of these much smaller providers have. So, again, we’re still in the early stages of the provider surveys, but I think that’s going to be a really meaningful tool for us to have- it’s a better understanding of what’s going on in the community and then follow up. 

[REN]:                         Is there particular areas...that we’re really trying to figure out about how they’re being impacted? Like, I know that there’s been talk about “Telehealth” and “Direct Testing-” And how that can impact the disability community??

[ERIN]:                         Absolutely! Yes, that is something that we are looking at really closely, not just in the context of the CRIS surveys, but in the overall service system. So, we are aware that individuals who’re blind & some of our constituents who have physical disabilities that might make it difficult say, for them to drive themselves are having a hard time accessing the drive through testing sites, and so, you know we’ve been exploring you know, what are the different accommodations, that the sites need to *provide* to our constituents. And if, the testing site for whatever reason isn’t going to be a viable option, then what is the alternative. That should be provided to people. So something we’ve heard about, that’s been happening to people, in some parts of the state is-

We don’t know but we’re following up on this **more** is that local health departments and different health care providers are going to people’s **homes** to offer testing *there*. I think that, the problem right now is (at the time that we’re recording this episode) is that there’s not a consistent, state-wide, practice for that. And so, if one of our constituents is blind and isn’t able to drive, and doesn’t have a family member that can drive them, then, Northern VA has a provider that is willing to come to their house and test them? That’s great, but then, say, does a similar situation exist for say, a constituent who lives instead (say) in Southwest, VA? We are still exploring that, but it is a concern. And on the Telehealth side, we, of course think Telehealth is a great option for a lot of people right now, it helps to slow the spread of some of those CV19 outbreaks, *but,* a number of our clients over the years have struggled to obtain the needed effective communication accommodations, in traditional doctor’s offices, and that is certainly something that could make Telehealth challenging as well. So, basically, we still have our attorneys and advocates providing individual case services to folks who might be calling in to us. If somebody’s deaf and hard of hearing, and then needs an ASL INT. to access their telehealth services or some kind of other effective communication *and they aren’t getting that,* then they can contact our offices, for basically, just foremost to know their rights, but also just so they aren’t being denied, at least, their basic healthcare.

[Pause]

[VIRGINIA]:                 So Erin, I’ve been hearing some rumblings about changes or, like, some, even **LACK OF** changes to like, Medicaid Waivers, and Medicaid overall, that sort of thing. Can you tell us what you know about that?

[ERIN]:                         Absolutely! And this is something that is changing every day. So, I will encourage people that are listening to this, that if you want the most up to date information, to please check out our COVID 19 website. Check out our Facebook Page, or give us a call, b/c the information I’m sharing right now, is what’s happening *NOW* at the **time of recording.**

So, [um] Virginia, like a number of other states, requested, very early on in this pandemic, some flexibility around their Medicaid programs from the Federal Gov’t. And the Federal Government approved that. So, right now, in Virginia, people who have Medicaid, don’t have to pay any Co-pays for their medications. They aren’t at risk of being **DISENROLLED** basically. For failing to send in a form. There’s kind of a moratorium in place to make sure that people can have consistent access to healthcare during the pandemic. So that’s great! And that benefits Medicaid beneficiaries...generally. The area where we’re very concerned and where we’ve done some sort of extra advocacy work, is around APPENDIX K. These are for our home and community based service waivers. So in Virginia, we have a number of what we call Medicaid waivers, that essentially offer an alternative to Institutional Care. For people with disabilities. So we have a CCP+ Medicaid Waiver, which is an alternative to Nursing Home Care, & then we have 3 DD disabilities waivers, which are an alternative to what we call ICF, or Intermediate Care Facilities. And these waivers are introduced by **thousands and thousands** of Virginians, and a lot of these people, because they’ve chosen these waivers, want to remain in their own homes, they want to remain with their families, they wanna remain-- But to be able to do that *safely* they need people who can come in and meet their needs. Whether that is related to tube feedings, or medication administration, or people need to be coming into their homes to work with them. But, the problem that we’re having right now is that, understandably, a number of the people who are typically employed to *provide* those services, either, themselves are sick, so they're having to quarantine at home or not go anywhere, or are concerned about going into a lot of different peoples’ **homes,** and then potentially picking something up in those settings, and then potentially getting sick themselves, or their family members getting sick. And so, you have a lot of individuals. And so you have a lot of people with Medicaid waivers right now, wanting that flexibility and at the same time, wanting to be with family, having that conversation about who can be their paid caregiver, **during a pandemic** And Virginia can’t get that permission (or grant that permission??) to CMS, which is our federal agency. And unfortunately [again] Virginia has really been dragging their feet, as far as getting that approval for Appendix K. So, how basically we ended, was that the Governor, said he would do that as soon as possible. [Um] 25 States, have actually already submitted and had their requests approved. So there’s really no reason for Virginia to...to wait around on this any longer. Every day that we go without those enhanced flexibility for Medicaid Waivers, they are at risk at being placed in an institution. Which, I think, we’d all agree, is not a great thing, at anytime! We would all agree. Right now, and I know we’ll get into this later, on the institutional side of things, but right now, it is very, very dangerous, to be in an institution. People are **VERY** at risk at contracting COVID-19 in those settings!

[REN]:                          Yeah, what-what...you’re saying makes a lot of sense! I’ve previously spoken on the podcast that my niece is disabled and uses a CCC+ Waiver, and luckily half of my family is quarantined right now so they have six adults! So they’re pretty lucky in that regard, that right now they have a lot of hands on deck. But not everybody’s like that. So I’m sure, um, a lot of our constituents are hoping that we get an answer from the governor soon. Speaking of MONEY, obvi everyone’s been talking about, you know, the stimulus checks, and all this money that is supposed to be coming people’s way, and how is any of this different? How is this going to affect any of our folks in this community?

[ERIN]:                         That’s such a great question! And yet again that’s another area where the information is trickling down from the federal to the state level everyday. So, again, um, if you are listening to this, and you are worried about how a stimulus check might affect **YOUR OWN** benefit, I would encourage you to reach out to us by phone, or to check the resources on our website for the most current information. Which we- as we know right now- we have resolved a couple of issues- we AS IN THE COLLECTIVE we- have resolved a couple of issues that we knew were a problem initially. So, a number of our constituents, who are on Medicaid, also receive SSI benefits.  And, because they receive SSI benefits, they typically don’t file a FEDERAL TAX return. So there were some initial concerns as: “Would they be included in the stimulus package at all?” In fact, I think there were some updates to that. Just yesterday, there were updates from the IRS and SSI about how people who don’t typically file a tax return can get that money. So that’s good.

[Continued]

                                    The concern, though, that it’s still in Virginia is around the impact of enhanced unemployment insurance? On people’s benefits. Whether that might be: an SSI benefit, a Medicaid benefit, a section 8 housing voucher benefit, like all of these main tested services that are available, through a combination of Federal and state programs...I think that *that’s the thing* we’re still having to devote a lot of time and attention to, and it’s an understanding-

[Continued]

If I need my Medicaid, if I’m a person with a DD and I need my Medicaid, to remain in the community, to remain **outside** the walls of an institution, and I’m employed- not *gainfully employed* but employed, then what is that extra money going to do to these other services that I really, really need?? So I don’t know if we have great answers to that as of our recording today, but it’s something that we’re actively tracking and will be looking into further. Thankfully, at least, my understanding is that the stimulus checks are not going to be counted *FOR A YEAR* as income, for people on SSI, or people who use SSI benefits, so that’s good. But there’s just a few issues surrounding unemployment insurance that we’re still figuring out.

[VIRGINIA]:                 So, within the communities Unit, are y’all doing anything to mitigate the effects of, COVID 19 and COVID 19 precautions with the ability to access other services, like crisis services and other medical services? Because I imagine those have been impacted a lot.

[ERIN]:                         Absolutely! We have a fairly robust ADA practice. So as I mentioned earlier, individuals who have a hard time accessing their health care services, because their health care services are not accessible, we are able, in most of those cases, to provide some short term assistance. For individuals who live in our community, so like, individuals who reside in group homes, specifically, for example, who might have some behavioral health support needs, have noticed that they might not have the kind of *full, necessary, access that’s required at this time.* And I think most people listening know this, but our services at DLCV are kind of twofold. First, is the client advocacy, where we’re jumping into the disability rights directly with a client, and going to meetings, and getting a timely resolution to that issue. But then there’s this other sort of, oversight, watchdog, investigative arm of what DLCV does. And so, for these cases that we’re starting to hear about, through APS, through the CRIS database, or from people just calling our office where people’s rights are being violated and they’re not getting the services that they need. That that’s being **harmed** in some way. That’s resulting in neglect, abuse, unnecessary institutionalization. And every time that we do that, we obviously have the person that we’re advocating for, like, **their best interests in mind** but we’re also looking for that systemic angle as well. Where, if we can, use that to get change and systemic angles across the board. That is what we have done and what we’ll continue to do around this.

[Pause]

[REN]:                          Yeah. Certainly, this situation highlights some of the fractures in the system that we’re already aware about, but magnifying those issues. So, that’s a lot for communities, and we’re developing this. And, you know, I’m sure we’re going to change and we’re going to get updates in te future, but I’d say, let’s take a little step to the left, and talk about how this is affecting folks in institutions. And so my advocate host, Virginia Pharis will now be my interviewee, and Erin, feel free to jump in as a host!!

[Shift]

[REN]:                          All right, so, Virginia, is dLCV still monitoring at these places, institutions, during this outbreak?

[VIRGINIA]:                 Yes, absolutely yes. The way that we are monitoring looks a little bit different than it did, you know, a month ago. We are doing our best to keep our clientele safe by limiting in-person visits—

 

[REN]:                          Well, I know as a member of this unit that there are other ways of contacting them. You know, by phone, or speaking through a supervisor, that-

[VIRGINIA]:                 Well, yeah! We see the leadership of DLCV be met with the leadership of DVBS (??). Um. That talk about hospital monitoring and to explain our access and authority, and **demand** that we have continued access to the large institutions. We’re not visitors, we’re advocates. And, we do still have ways to maintain access to our clientele. For instance, um, we can set up video calls with our clients within the institutions, we are OF COURSE accepting phone calls, and you know, I would encourage anyone who knows a situation with a person with a disability to, you know, DON’T ASSUME. Because, there is more to monitor than ever with this going on.

[REN]:                          So, you know, I know that we **definitely** want people to continue to reach out to us during this time. But, you know, I’m sure there are a lot of people who would ask: *Why?* You know, why is it still important that we have access to institutions during this time??

[VIRGINIA]:                 Well, first and foremost, peoples’ rights don’t stop just because there’s a global pandemic happening. People’s rights may look a little bit different, but, laws are still in place, human regulations are still in place, and folks with disabilities should still be able to exercise their rights, even during these strange and unprecedented times. Additionally, folks in congregations- institutions- are at a MUCH HIGHER RISK for COVID-19 specifically in these spaces. Like, you can’t use the practice of social distancing in a place like that, where it may be too isolating-- you know, to get within 6 feet of somebody else, and you know, the day room is only 12 feet wide.

[Wow.]

[REN]:                          Hmmm, yep.

[VIRGINIA]:                 And you know, we have to make sure, even under these circumstances, that institutions are making access to these rights as easy as possible!

[REN]:                          Since, you know, since these pandemic measures and Quarantine measures started, is- you know- is-are there specific issues that DLCV has been seeing, you know, in these institutions?

[VIRGINIA]:                 Yeah, you know, there’ve been blimps that we’ve had to- you know, there was an issue at one state hospital where you know, folks learned that they would not be getting packages from loved ones {YES! THOSE CALLS}. Because of you know, cross contamination. But, you know, obviously, there are ways around that, and people do have the right to receive mail. And luckily we were able to work with these institutions. You know, also for instance nursing homes, many of them are freezing their admissions right now, so things may not be available to them when they get out of these institutions, but we still want to make sure that people AREN’T CONFINED to as little a space as humanly possible for any length of time, so-

[Pause]

[VIRGINIA]:                 For the most part, you know, people who are looking to move into assisted living, into, you know, small independent nursing homes, things like that, they’re not seeing the same level of restrictions.

[REN]:                          Mhhhmm.

[VIRGINIA]:                 You know, so that’s good! We are seeing, as for levels of treatment, for instance in a lot of state hospitals, you know- treatment groups are being suspended!! And you know, what if, for a lot of people, you know, the only treatment that they receive is their medication! You know, and now, with that being suspended, that’s affecting them.

[REN]:                          Hmmm.

[ERIN]:                         Right.  

[VIRGINIA]:                 So, you know, we really want to encourage anyone who that might be happening to please give us a call--

[REN]:                          Right.

[VIRGINIA]:                 Because we are trying to monitor that. As of the time of this recording, and, of course, this could even change in the time before/after this podcast’s release, but there have been at least 4 staff members at different state hospitals that have tested positive for COVID 19. Luckily, this appears to only be at one institution, but we’re still monitoring it VERY CLOSELY.

[REN]:                          So yeah, it does sound like there are quite a few things that are particularly impacted because of COVID 19, like you said. I think one of the things we really need to highlight, in conclusion, is that, in communities and institutions, these are peoples HOMES, and that even with the need to put protective measures in place and make sure people are safe, people have certain rights **in their home** and it doesn’t matter if that home is an institution or a nursing home, people have those rights, and they SHOULD NOT be impacted. So that’s really what we’re doing to make sure that yes, PEOPLE ARE PROTECTED, but also that people’s rights are not being infringed during this time.

[ERIN]:                         Yes, please get in touch with us! And I just wanted everybody listening to know that there’s a couple of ways that you can do that. But we’re still actively manning our phones and our intake system. So those are still good & folks can call us at 1800….on a MWF. Also, if you have access to the internet, people can go to dLCV.org/get-help, and there’s a little form that you can fill out to get assistance from our office.

                                    [Pause.]

And that’s not to say that we’re still not looking at everything else going on. So, please don’t hesitate to call us about something NOT RELATED to COVID 19, because we’re still looking at that too! We are doing a lot of work there on COVID 19.

[REN]:                          Well. Erin, and Virginia, thank you so much for being here and chatting with me. Everything will change next week so we’ll have you on again next week- No, I’m kidding! But anyways, thanks for being with me.

[VIRGINIA]:                 And now, **for a DLCV highlight.**

Beth is a high school sophomore who has a hearing impairment and some intellectual disabilities.  Beth’s father contacted dLCV because they had met with DARS about pre-Employment Transition Services, but they had never gotten any follow-up from DARS. dLCV participated in two meetings for Beth. In the first meeting, we advocated for her to do a career interest inventory using pictures instead of words. DARS provided this resource for Beth. In the second meeting, Beth picked careers that fit her interests (based on pictures). Because of our advocacy, Beth was able to receive the services that she needed. She now has been able to pick careers based on her interests, and she is moving in the right direction vocationally. Beth’s dad is grateful there are new ways to communicate with his daughter and her new ability to have options.

[REN]:                          So once again, Erin, thank you so much for taking the time to chat with us. She is a font of knowledge, and we are so blessed to have her. And Virginia I love having you once again as my host and my interviewee//GUEST.

[VIRGINIA]:                 This is a weird time Ren, I don’t know if you’ve noticed but this is a weird and scary time. We’re all just doing our best and trying to be good and kind to one another. So…

[REN]:                          I think that is the best we can strive for and DLCV is continuing it’s work in this very strange time we’re living in. So, thank you all for listening to this episode of Rights Here, Rights Now! - brought to you by the Disability Law Center of Virginia. We’re available on Apple Podcasts, Spotify, where ever you get your podcasts!

[VIRGINIA]:                 Don’t forget to subscribe and leave us a review. If you need assistance or want more information about DLCV, and what we do, visit us online at www.dlcv.org.

[REN]:                          You can also follow us on twitter at @disabilitylawva and you can always share us with your friends.

[VIRGINIA]:                 Until next time, I’m Virginia Pharis.

[REN]:                          And I’m Ren Faszewski. And this has been…--

[VIRGINIA AND REN]: “Rights Here, Rights Now!” End of transcript.