Coronavirus
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What to do if you suspect you have COVID-19 If you are sick with COVID-19 or suspect you are infected with the virus that causes COVID- 19, follow the steps below to help prevent the disease from spreading to people in your home and community. Stay home except to get medical care. You should restrict activities outside your home, except for getting medical care. Do not go to work, school, or public areas. Avoid using public transportation, ride-sharing, or taxis. Separate yourself from other people and animals in your home. People: As much as possible, you should stay in a specific room and away from other people in your home. Also, you should use a separate bathroom, if available. Animals: Do not handle pets or other animals while sick. Call ahead before visiting your doctor. If you have a medical appointment, call the healthcare provider and tell them that you have or may have COVID-19. This will help the healthcare provider’s office take steps to keep other people from getting infected or exposed. Wear a facemask: You should wear a facemask when you are around other people (e.g., sharing a room or vehicle) or pets and before you enter a healthcare provider’s office. If you are not able to wear a facemask (for example, because it causes trouble breathing), then people who live with you should not stay in the same room with you, or they should wear a facemask if they enter your room. Cover your coughs and sneezes: Cover your mouth and nose with a tissue when you cough or sneeze. Throw used tissues in a lined trash can; immediately wash your hands with soap and water for at least 20 seconds or clean your hands with an alcohol-based hand sanitizer that contains at least 60 to 95% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry. Soap and water should be used preferentially if hands are visibly dirty.    Avoid sharing personal household items: You should not share dishes, drinking glasses, cups, eating utensils, towels, or bedding with other people or pets in your home. After using these items, they should be washed thoroughly with soap and water.
Clean your hands often: Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, clean your hands with an alcohol-based hand sanitizer that contains at least 60% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry. Soap and water should be used preferentially if hands are visibly dirty. Avoid touching your eyes, nose, and mouth with unwashed hands. Clean all “high-touch” surfaces every day: High touch surfaces include counters, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets, and bedside tables. Also, clean any surfaces that may have blood, stool, or body fluids on them. Labels contain instructions for safe and effective use of the cleaning product including precautions you should take when applying the product, such as wearing gloves and making sure you have good ventilation during use of the product. Monitor your symptoms: Seek prompt medical attention if your illness is worsening (e.g., difficulty breathing). Before seeking care, call your healthcare provider and tell them that you have, or are being evaluated for, COVID-19. Put on a facemask before you enter the facility. These steps will help the healthcare provider’s office to keep other people in the office or waiting room from getting infected or exposed. If you believe you are sick with the 2019 novel coronavirus call your healthcare provider or call the Washoe County Health District’s Communicable Disease Line at (775) 3282447, this number is available 24 hours a day, 7 days a week. Discontinuing home isolation: Patients with confirmed COVID-19 should remain under home isolation precautions until the risk of secondary transmission to others is thought to be low. The decision to discontinue home isolation precautions should be made on a case-by-case basis, in consultation with healthcare providers and state and local health departments.
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COVID-19
Telehealth Services
Nevada Medicaid currently allows for the reimbursement of telehealth services. This guide has been created to aid providers in Nevada with helpful information regarding Nevada Medicaid Policy for telehealth and includes other resources and links that will help providers to maximize the use of telehealth services.
Telehealth is the use of a telecommunications system to substitute for an in-person encounter for professional consultations, office visits, office psychiatry services, and a limited number of other medical services. Telehealth consists of an “originating site” and a “distant site”. The originating site must be located within the State of Nevada and is the location where the recipient is. The originating site can be reimbursed if they are an enrolled Medicaid provider. If the originating site is the recipient’s home or a location that is not enrolled in Nevada Medicaid, there is no re-
During the response for the COVID-19 crisis, Nevada Medicaid may waive certain policy limitations that are currently identified in MSM Chapter 3400.
imbursement. The distant site is the location of the rendering provider. For reimbursement, this provider must be enrolled with Nevada Medicaid. Additionally, the rendering provider at the distant site must bill using the most appropriate CPT code and a 02 place of service code. Please see the billing guide for telehealth services for more specific information. Services provided via telehealth must fall within the scope of practice of the rendering provider and must be clinically appropriate for delivery via telehealth. These services can include office visits, consultations, assessments, etc. Services that are not allowable within telehealth are those in which there is a need to be in-person such as basic skills training (BST), psychosocial rehabilitation (PSR), group therapy, occupational therapy and physical therapy and medical services which require direct contact with the patient. If a service requires a prior authorization in-person, it will also require a prior authorization via telehealth.
Additionally, included below are useful links regarding telehealth services:
Please see the Nevada Medicaid COVID-19 telehealth response memo that provides information Please see the specific COVID-19 telehealth memo for the most current in- on telehealth allowances during the formation. Additionally, please monitor COVID-19 crisis, under Provider secNevada Medicaid’s COVID-19 webpage tion: www.dhcfp.nv.gov/covid19/ as information may change frequently. Telehealth Resource Center: telehealthresourcecenter.org/who-your-trc/ Questions should be directed to the following email address: dhcfp@dhcfp.nv.gov, please title your email telehealth technical assistance.
Medicaid Services Manual (MSM) Chapter 3400 (linked below) outlines the coverage and limitations of telehealth.
Medicaid.gov Telemedicine Resource: medicaid.gov/medicaid/benefits/telemedicine/index.html Webinars provided by the NFARtec: www.nfartec.org/telehealth-tuesdays/
Medicaid Telehealth Billing Guide: www.medicaid.nv.gov/Downloads/provider/NV_Billing_Telehealth.pdf National Frontier and Rural Telehealth (NFARtec) Education Center: www.nfartec.org/technology-based-supervision-guidelines/ MSM Chapter 3400, Telehealth Services: dhcfp.nv.gov/uploadedFiles/ dhcfpnvgov/content/Resources/AdminSupport/Manuals/MSM/C3400/ MSM_3400_17_07_27.pdf
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Coping and Managing during COVID-19 As more people move toward social distancing and staying home, away from public places, it is normal for many to experience increased stress, distress, and isolation. • Tips For Social Distancing, Quarantine, And Isolation During An Infectious Disease Outbreak: samhsa. gov/sites/default/files/tips-social-distancing-quarantine-isolation-031620.pdf • Social distancing and other mitigation strategies for COVID-19: cdc. gov/coronavirus/2019-ncov/downloads/workplace-school-and-home-guidance.pdf • Centers for Disease Control and Prevention Mental Health and Coping During COVID-19: cdc.gov/coronavirus/2019-ncov/about/coping.html • World Health Organization Mental Health Considerations: who.int/ docs/default-source/coronaviruse/ mental-health-considerations.pdf ?sfvrsn=6d3578af_2
• Substance Abuse and Mental Health Services Administration’s Disaster Distress Hotline: Call 1-800985-5990 or text TalkWithUs to 66746. The Disaster Distress Helpline, is a 24/7, 365-day-a-year, national hotline dedicated to providing immediate crisis counseling for people who are experiencing emotional distress related to any natural or human-caused disaster. People with deafness or hearing loss can use their preferred relay service to call 1-800-985-5990. • Nevada 2-1-1: Call 2-1-1 or go to www.nevada211.org/. 211 provides information and referrals to health, human and social service organizations. Dialing 2-1-1 in almost every part of the United States will connect you to human and social services for your area. • Crisis Support Services of Nevada: 1-800-273-8255; text CARE to 839863 for 24/7 crisis services. • Crisis Text Line: Text HOME to 741741 from anywhere in the US, anytime, about any type of crisis.
• Keeping Your Distance to Stay Safe: • Substance Use Disorder Hotline: 1-800-450-9530; text IMREADY to apa.org/practice/programs/dmhi/re839863. search-information/social-distancing • Managing Anxiety and Stress: cdc. gov/coronavirus/2019-ncov/prepare/ managing-stress-anxiety.html • The White House released additional information regarding ways to slow the spread of the virus: whitehouse.gov/wp-content/ uploads/2020/03/03.16.20_coronavirus-guidance_8.5x11_315PM.pdf.
• Behavioral Health Treatment: behavioralhealthnv.org - A database of behavioral health providers specializing in substance use disorder and co-occurring mental health disorder treatment services.
• The NAMI Warmline: Call or text 775-241-4212. The NAMI Warmline is a stigma-free, non-crisis, phone service you can call or text to speak one-on-one with a NAMI WNV CARES operator. The Warmline is staffed by trained peers in recovery, who provide support to peers by telephone. The Warmline provides confidential support when we want to talk to someone. The Warmline gives you a peer’s perspective on how to find support in the community by phone, text, or video. Knowing someone cares can motivate us to carry on in recovery when there is anxiety. • Foundation for Recovery Warmline: 1-800-509-7762. Our peer support specialists will continue to see peers at our recovery community centers. We encourage anyone who has access to a phone or computer to consider seeing peer specialists through tele-recovery supports (over the phone or video session). A full directory of our peer support specialists with emails and phone numbers may be found here: forrecovery.org/meet-ourteam/ • Children’s Mobile Crisis Response Team: If your child is experiencing a mental or behavioral crisis contact the Division of Child and Family Services Children’s Mobile Crisis Response Team. More information also can be found at knowcrisis.com. - Northern Nevada: (775) 688-1670, Monday – Friday 8 am – 8 pm and Saturday/Sunday 8 am – 6 pm - Rural Nevada: (702) 486-7865, Monday – Sunday 9 am – 6 pm - Southern Nevada: (702) 486-7865, Monday – Sunday 24 hours
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Essential versus Non-Essential Business The Nevada Health Response Center (NHRC) released the COVID-19 Risk Mitigation Initiative Wednesday, March 18, 2020, which includes a list of all essential and non-essential businesses. Essential services and sectors include, but are not limited to:
• Fire services, law enforcement agencies, emergency medical services & public safety agencies • Healthcare services • Businesses or organizations that provide food, shelter, or critical social services for disadvantaged populations • Utilities as defined in NRS Chapter 704 • Trash collection • Home maintenance/repair services • Auto repair services & trucking service centers • Grocery stores, supermarkets, hardware stores, convenience & discount stores • Pharmacies, healthcare operations, & biomedical facilities • Post offices & shipping outlets • Gas stations & truck stops • Banks & financial institutions • Veterinary services & pet stores • Laundromats & dry cleaners • Food processing • Agriculture, livestock & feed mills • Logistics & Supply Chain Operations: Warehousing, storage, distribution, and supply-chain related operations • Public transportation • Essential stays in hotels, commercial lodging, dormitories, shelters, and homeless encampments • Child care centers and daycares operating in accordance with requirements set forth by their licensing authorities and COVID-19 guidance • Charitable food distribution sites, including the meals being distributed to
our students in wake of the school closings, along with grocery stores, should remain fully open and operational. • Food services for healthcare facilities and other essential facilities should remain open. Any buffet or food stations used in charitable food distribution settings should transition to boxed meals or served through gloved staff members or volunteers. Other businesses, including but not limited to legal services, business and management consulting, professional services and insurance services are encouraged to have employees work remotely or telecommute.
Non-essential services and sectors include, but are not limited to:
• Entertainment & hospitality, including but not limited to strip clubs and brothels, casinos, concert venues, arenas, auditoriums, stadiums, large conference rooms, meeting halls, and cafeterias • Recreation and athletic facilities, including but not limited to community and recreation centers, gyms, health clubs, fitness centers, yoga, barre and spin facilities • Beauty and personal care services and facilities, including but not limited to barber shops, beauty, tanning, waxing hair salons, and nail salons and spas • Retail facilities, including shopping malls except for pharmacy or other health care facilities within retail operations. Retailers are encouraged to continue online operations with pickup and delivery.
• Restaurants throughout Nevada, in addition to pubs, wineries, bars, and breweries that include meals provided by a full kitchen should be reduced to serving food only in a drive-thru, takeout or delivery capacity. No dine-in at food establishments should be allowed until further notice. This also includes food courts, coffee shops, catered events, clubs, bowling alleys, and other similar venues in which people congregate for the consumption of food. • Pubs, wineries, bars, and breweries that do not include meals provided by a full kitchen should close.
Gaming
The Governor announced that all gaming machines, devices, tables, games, and any equipment related to gaming activity will be shut down. Restaurants and bars located within gaming properties will be subject to the same restrictions as those outside of gaming establishments.
Cannabis
Licensed cannabis stores and medical dispensaries should only remain open if employees and consumers strictly adhere to the social distancing protocol. The Nevada Health Response Center is encouraging consumers to use delivery services and not congregate in stores.