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Medical Director COVID-19 Discussion Series - Shared screen with speaker view
Flavio Casoy
32:44
Are you having difficulty maintaining staffing on the step down services?
David Walter D.O.
37:37
Getting adequate PPE for residential staff in our kid’s residential units is a big problem in Maine
Sandy Steingard
38:35
and can we address what adequate PPE is? should everyone have masks? surgical vs N95? homemade masks?
tom b
39:08
I can comment on community provider response
Dr. Holly Dubois
39:12
Audio failing often. Can Dr Parks repeat his previous statement please?
Jack Todd Wahrenberger
39:28
yes, we are doing the twice daily screening as well in all residential facilities
Alta DeRoo MD
39:36
Thanks for hosting this today! Some States are partnering DEA and SAMHSA to wave inperson H+P with bupe and instead are allowing this to be done remotely via telehealth. Will there be provision for this respetive to methadone?
e645274
41:35
LA County DMH PPE is sharing the little PPE we do have with our providers. I think this goes a long way in building a network during this crisis.
Ray.Kotwicki
42:00
Our residential facility secured over 200 N95 masks through asking community construction companies and woodworkers for donations via NextDoor.
Manjola Ujkaj, MD, PhD, MBA
42:41
We are keeping the N95 masks for those programs that have had a patient positive for COVID although this one is currently hospitalized.
Aaron Goldman
42:55
How much telehealth can be used realistically in the facilities?
glenn_lippman
43:19
Are any States or local jurisdictions using enforced Isolation or Quarantine for COVID positive individuals without a mental disorder. We are seeing ER's wanting to use the Involuntary Treatment process which we feel is not appropriate if there are no behavioral health symptoms.
rpomm
43:20
I have instituted antibody testing that has been giving great guidance ofr us.
Michael Conn, MD
43:21
For your consideration: https://m.box.com/shared_item/https%3A%2F%2Fstanfordmedicine.box.com%2Fv%2Fcovid19-PPE-1-1
mreid
43:21
CNS Healthcare is a CCBHC in Michigan. Oakland and Wayne County Executive Orders require us to screen everyone who comes in the building. We got PPE from the Oakland County Health Department. Finally yesterday the touchless thermometers we ordered arrive! Adequate access to testing for both staff and persons served is not available per the PCPs we work with.
mgorelick
43:37
GOOD MORNING, THIS IS DR. GORELIK FROM HENDERSON BEHAVIORAL IN FLORIDA, I HAVE A QUESTION.
Geraldine Vallesteros, MD
44:09
How available is Ab testing for COVID 19?
Steven Stout
45:55
There are primary care systems (ours included) that have moved to a process of partitioning outpatient care such that there are a couple of identified clinics that take care of COVID+ patients. We are asking our primary care colleagues if we can use these spaces. Other idea is partitioning our own outpatient clinics such that there is an identified subset of rooms in each building for possible/probable COVID+ patients. What ways have other systems managed this set of issues for outpatients?
Manjola Ujkaj, MD, PhD, MBA
47:22
We are instituting video-enabled offices for hospital discharge patients psychiatric evaluation and intakes that are either possible symptomatic and /or have no access ti their personal video device.
mreid
49:26
I have a question about PPE
cos63
49:28
My ethical dilemma is we have some PPE including N95 masks, but without a proper fit testing, it really doesn't matter what type of mask you have as you will not be protected if the mask does not fit. I don't want staff thinking they are protected because they have an N95. We've been getting our front line staff especially those potentially around any aerosolizing procedures fit tested along the way with the supply we have.
Rob Ipad
49:44
I work with a number of inpatient psychiatric systems in Maine with both units in medical hospital and free standing psychiatric hospital with 100 beds.
mreid
50:17
Michele Reid, I have a PPE question
Rob Ipad
51:21
we have screening but are planning for inpatient Covid positive units for a free standing or psychiatric unit. How are other systems operating Covid positive specif units for acute behavioral health patients that can not be discharged.
Camis Milam
53:12
there is an OSHA video on fitting n-95 masks on line for AAON members. I do not know if it is available otherwise. I will look to see and forward the information to Joe if so. It is long and is intended to train nursing to do testing.
Laxman Nath
53:23
Any suggestions/guidelines regarding facilitation of online and Tele counselling and psychological first aid services
Flavio Casoy
53:27
Dr. Pomm, can you send the details about this test?
Geraldine Vallesteros, MD
55:47
Turn around time for this test is in minutes?
dwrogers
57:13
American Psychological Association has some great telehealth training resources.
Holly DuBois
59:04
Also recommend American Telemedicine Association. Our center has implemented Zoom center-wide. All clients are offered a telehealth or telephone appointment if not able to come to clinic.
Abdulmalek Sadehh, MD
01:00:29
is telehealth possible for inpatient psychiatric units? we are already doing it in the outpatient settings very successfully.
Holly DuBois
01:00:55
@Dr. Sadehh I believe it is. I have consulted for inpatient units in the past very successfully.
mgorelick
01:01:33
HERE AR HENDERSON BEHAVIORAL WE ARE DOING TELEHEALTH WITH THE CRISIS UNIT PATIENTS.
Heather Fretwell
01:01:34
@DuBois do you use the typically inpatient billing codes? Or are there Telehealth codes for inpatient rounding?
Tom Young MD
01:02:08
We are using digital tools from Nview Health screeners. MINI interviews and monitoring sales to access the increasing number of folks accessing the increasing numbers with anxiety and depression
cgrigg
01:03:15
yes, we do telehealth regularly to our acute hospital
Holly DuBois
01:03:24
@Fretwell my email is: holly@availtelemed.com Feel free to contact me there :)
Sara Coffey
01:04:12
OSUCHS is offering a COVID ECHO Program every MWF at 8:30am CST helpful up to date information which ranges from Oklahoma specific to national updates from our Medical team if others might be interested in signing on. Link https://health.okstate.edu/echo/index.html
cgrigg
01:04:33
we receive a day rate for inpatient, but we code under TH codes, just so we know how the servie was provided.
Laxman Nath
01:04:51
Thanks all, the discussion was very insightful for me. I will surely share it here in Nepal
Geraldine Vallesteros, MD
01:06:19
Will send it to Lindsi!
Billina Shaw
01:06:20
I have a question about telehealth intakes. How are people handling issues around the signing of consents, etc.?
cgrigg
01:06:41
we get verbal and document
Aaron Goldman
01:06:57
In AZ, consent are waived, and they are documented as verbal accepted due to COVD
Sandy Steingard
01:07:01
I am sewing in my spare time!
dwrogers
01:07:10
We get telehealth consents via DocuSign or verbal consent
Billina Shaw
01:07:37
Thank you all....
jace angelly
01:07:38
In Washington state are wavier lets us just get verbal agreement with date and time as noted into assessment and notes
glenn_lippman
01:07:48
Are any States or local jurisdictions using enforced Isolation or Quarantine for COVID positive individuals without a mental disorder. We are seeing ER's wanting to use the Involuntary Treatment process which we feel is not appropriate if there are no behavioral health symptoms.
Dr. S
01:08:13
could they put the slide again please
Stephen Mandler
01:08:28
Regarding Childrens protocol from Flavio, my email is smandler@orchardplace.org thanks you
Heather Fretwell
01:09:05
We are participating in the FDA guidelines for deferral of clozapine blood draws, after the first 6 month of therapy, for stable patients. Our hospital pharmacy is dispensing medication for our patients on this basis.
Laxman Nath
01:09:57
Can you send that slide seems very helpful here as there is almost no mask in market.
Lindsi DeSorrento
01:10:30
Geraldine has shared the slide with me so i will send it out to the group after the call. Thank you!
Holly DuBois
01:11:15
Is anyone using the Athelas fingerstick device for CBC testing? We have not implemented yet but it is being widely marketed throughout Texas and California
Geraldine Vallesteros, MD
01:11:37
I sent the slide to Lindsi re: HOUSEHOLD Materials Effectiveness to filter 1 micron particles
Dr. S
01:11:45
we are looking into athelas
Camis Milam
01:11:49
we are using it in NW Washington, but have suspended testing for now
cos63
01:12:05
spoke with REMS yesterday and nothing new from them
Heather Fretwell
01:12:16
http://www.fda.gov/media/136317/download
Dr. S
01:12:35
we wanted to run a pilot before we used it just to compare efficacy
Heather Fretwell
01:13:01
We’ve been sharing this article with local pharmacies as well:
Heather Fretwell
01:13:02
https://www.ncbi.nlm.nih.gov/pubmed/16595571
Camis Milam
01:13:26
if you work with Genoa pharmacy, they continue to fill prescriptions whether or not you have done testing
Lindsi DeSorrento
01:14:33
- SUD Office Hours: Today from 3 - 4 ET- https://zoom.us/webinar/register/WN_bCnC7mFMRzSfmBB37Dhirw- Children & Youth Office Hours: Tuesday 4/7 3 - 4 ET- https://zoom.us/webinar/register/WN_ZvoY-zurTP6KJ6sLpaQPYg
Manjola Ujkaj, MD, PhD, MBA
01:14:38
https://www.fda.gov/media/136317/download
angelapinheiro
01:14:45
Michigan pharmacies are asking for a letter if clozapine draws are delayed
e645274
01:15:58
Thank you for inviting me today!
glenn_lippman
01:16:24
Great session...great seeing some colleagues face to face again !
DrTracyMullareMD
01:17:11
Will you please forward that quote with the references? Thank you!
carolynyoung
01:19:50
Thank you - great session.
Tskale
01:19:51
Excellent meeting. Thank you!
Dani Spano
01:19:53
Thank you!
Dr. S
01:19:55
thanks
cgrigg
01:19:59
thanks
mgorelick
01:20:04
AWESOME, BE SAFE AND BE WELL