Provider Alerts

COVID-19 Guidance for NEMT and NMT Providers
The Department of Health Care Services (DHCS) continues to closely monitor the emerging 2019 COVID-19 situation, and is providing information to all non-emergency medical transportation (NEMT) and non-medical transportation (NMT) providers as a reminder of federal Centers for Disease Control and Prevention (CDC) and California Department of Public Health (CDPH)recommended safety procedures and protocols to help prevent spread of COVID-19.

General COVID-19 Information

The CDC currently estimates that the incubation period for COVID-19 ranges from 2 to 14 days. Symptoms may include fever, cough and shortness of breath, although some people may not have any symptoms. Seniors and people with underlying medical conditions such as heart disease, lung disease or diabetes are at a higher risk of developing severe complications. The CDC has also issued interim guidance for Emergency Medical Services (EMS) systems, including EMS transport and cleaning EMS vehicles after transporting a person suspected of having COVID19. See the CDC web page for Interim Guidance for EMS Systems and 911 Public Safety Answering Points (PSAPs) for COVID-19 in the United States
(https://www.cdc.gov/coronavirus/2019–ncov/hcp/guidance–for–ems.html).

Please note that COVID-19, like the majority of human coronaviruses, are most commonly spread from an infected person to others via droplets in the air through:

• Uncovered coughing and sneezing
• Close personal contact, such as touching or shaking hands
• Touching an object or surface with the virus on it, then touching your mouth, nose or eyes before washing your hands
• Rarely, fecal contamination with coronavirus present

Preparedness Strategies – Medi-Cal NEMT and NMT providers
Medi-Cal NEMT and NMT providers are encouraged to share current COVID-19 information and discuss preparedness strategies with their staff. To enhance the health and safety of your organization, as well as help protect yourself, your clients and others, DHCS recommends all NEMT and NMT providers adhere to the CDC’s* and CDPH’s# recommendations (see links at bottom of this Alert). Providers should take note of the simple steps below, which may help to prevent the spread of COVID-19 at home and at work:

DHCS Guidance for NEMT and NMT Providers: COVID-19
April 15, 2020 

• Clean frequently touched surfaces and objects, including door handles and seat belts, before transporting another client. Wear disposable gloves during cleaning and then dispose after each use.
• Have facemasks available for patients to wear if a client is sick or is caring for someone who is sick.
• Air recirculation in both compartments should be turned off, in order to maximize air changes that reduce potentially infectious particles in the vehicle.
• Open outside-air vents in the driver compartment when transporting clients.
• Wear a single pair of disposable patient examination gloves and change gloves if they become torn or contaminated, in addition to changing gloves between rides.
• Wash your hands often with soap and water. Use alcohol-based sanitizers (at least 60 percent alcohol) when you cannot wash your hands.
• Avoid touching your eyes, nose or mouth with your hands.
• Stay home when you are sick.
• Cover your mouth with a tissue when you cough and/or sneeze and dispose of the tissue immediately.
• Get plenty of rest, drink fluids, eat healthy foods and manage your stress.

If you suspect a possible COVID-19 case, DHCS requests that you report it immediately to your localhealth jurisdiction(https://www.cdph.ca.gov/Pages/LocalHealthServicesAndOffices.aspx).
 
Additional Information Resources, COVID-19:

• List of CDPH COVID-19 Guidance Documents (https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Guidance.aspx) 
• CDC COVID-19 response (https://www.cdc.gov/coronavirus/2019–ncov/index.html)
  en Español (https://espanol.cdc.gov/coronavirus/2019ncov/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F201 9–ncov%2Findex–sp.html) 
  中文 (https://chinese.cdc.gov/coronavirus/2019ncov/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F201 9–ncov%2Findex–Chinese.html)

 Follow CDPH Twitter for the latest COVID-19 information (https://twitter.com/CAPublicHealth) 
____________________________________________________________________________________________________________________
Access to Care for People with Disability
The Departments of Health Care Services (DHCS), Public Health (CDPH), and Managed Health Care (DMHC) issued guidance (see below for 4/1/20 joint bulletin) related to non-discrimination in medical treatment for the Novel Coronavirus 2019 (COVID-19). 
                                                                                      
The State of California understands that people with disabilities are concerned that medical providers might consider an individual’s disability status when determining which patients to treat if hospitals or other health care facilities experience a surge of patients needing life-saving care. This joint bulletin reminds health care providers and payers that rationing care based on a person’s disability status is impermissible and unlawful under both federal and state law.
The departments will closely monitor and assess appropriate next steps to ensure the safety of Medi-Cal beneficiaries, health plan enrollees, medical providers, and California communities in general. 

4/1/20: Joint Bulletin – Medical Treatment for COVID 19, 3.30.20 1 http://sharepoint.hpsj.com/sites/compliance/Projects/2020%20COVID-
19/Joint%20Bullletin%20-
%20Medical%20Treatment%20for%20COVID%2019%203.30.20%201.pdf  
Guidance related to non-discrimination in medical treatment for COVID-19.  The guidance covers March 28 federal guidance, California’s equal access to health care services requirement, treatment of Medi-Cal members, and the American Medical Association Code of Medical Ethics.
3/30/20: Guidance on Non-Discrimination in Medical Treatment for Novel Coronavirus
(COVID-19)
http://sharepoint.hpsj.com/sites/compliance/Projects/2020%20COVID19/Guidance%20on%20Non-
Discrimination%20in%20Medical%20Treatment%20for%20Novel%20COVID19%2020200330.pdf  

From page 1, last paragraph:  
* CDC’s Recommendations –  https://www.cdc.gov/coronavirus/2019-ncov/hcp/steps-to-
prepare.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019ncov%2Fhealthcare-facilities%2Fsteps-to-prepare.html 

# CDPH Recommendations – https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Immunization/ncov2019.aspx