Operating Independent Living Programs in the Face of Coronavirus: 
A Q&A Session for CILs and SILCs

Presented by Susan Dooha, Tim Fuchs, Sarah Martinez, Paula McElwee, Jeremy Morris, Richard Petty, Marcie Roth, Corinna Stiles, 
and Yomi Wrong
March 20, 2020

TIM FUCHS: This is a Q&A session, for CILs and SILCs this is a very popular call, and I want to thank all of you for taking time, out of your busy week ‑‑ it has been, this week has been quite a busy month hasn't it? So, I want to thank you all for joining us, we really had unprecedented response, to this webinar, and I'm thrilled you were all able to join us as always, we are recording today's webinar, 
Also, you or your colleagues can access it after the fact. So, that will be posted on ILRU's Web site, typically within 48 hours, usually much sooner we're currently in presentation mode as you probably heard, when you joined.
and, please know that, we are going to have plenty of time for questions and answers, today. In fact, it's the agenda for our entire call!  
So, while we do have some housekeeping that we want to go through, and we're going to do, some poll questions, with some of you, you'll have plenty of time, to ask your questions today. I do want to highlight the fact that because we have such a large audience, 800 and 80 some folks registered ‑‑ and 535, already on the line, and counting ‑‑ that we may not be able to get to everyone's questions today, we're going to do our very best, and we do have a process, for answering your questions, if you aren't able to access them ‑‑ ask them ‑‑ excuse me, live on the call!  
So, ILRU has generously offered to field those questions, at their ILRU@ILRU.org e‑mail address and that'll be on our final slide before we close, so I'll remind you all of that, there's a few ways that you can ask questions today: 
We're going to ask that if you're able, that you please use the Q&A tab, in zoom.
So in your menu bar, within zoom, at the bottom of your screen you should see a Q&A tab and you can type your questions out there in the chat feature in zoom, is a helpful way, to chat with others that you see, that you might know. And the list of participants or to share comments with the presenters but please do use the Q&A tab, to ask questions if you're able.
If you're unable to use, and excuse me, I'm going to 'go ahead to slide 3, where we cover had these items, if you're unable, to use, the Q&A tab.
Or if you're only on the telephone today, you may press star 9, to raise or lower your hand. With ‑‑ potentially 800 people on the line, the only way to know that someone has raised their hand is to scroll through the list and look for it. So, I'm going to ask that we please reserve that option for people who need that, for accessibility. So please only use the star 9 to raise your hand, if you're unable to use the Q&A tab, if you're able to use the Q&A tab, we certainly, appreciate that you do that.
You can press star 9 again, it's a toggle to lower your hand and, again, if you have submitted a question, you can trust that we've received it. So because of the large audience today, it's very likely that there will be a lag between, when you ask your question, and when we get to it; the other thing is, we may not get to it on the live call.
but zoom will show us a list of all questions submitted.
And we ‑‑ we will respond to you, in time, via e‑mail as soon as we're able.
A couple of other things I wanted to mention today. If you use captioning, I trust you've already been able to turn that on, in zoom. If you didn't see that when you joined or if you're ‑‑ helping a colleague that hasn't been able to get it on ‑‑ you can go to the more options. And click closed caption or show subtitle, depending on your menu.
either of those will turn it on. If you are only on the phone, or if you prefer to manipulate, your captions, change the font size, the contrast, the color, you may want to use, our full‑screen captions at streamtext.net and that link is right here on slide 3, it's a little bit long, to read out loud, but I'll plug it into the chat right now too, and, again, that is not new, that was sent to you, in the confirmation e‑mail that you received.  So you all should have that, And I will be monitoring ‑‑ there is a chat feature, at Stream text, so some of you who use Stream text frequently might be familiar with that, but regardless, there is a chat feature there, if you log in, I'm logged in there as well.
And you can submit your questions, in that chat, and I'll voice them, for you, during the call. 
>> Okay. 
>> Tim Fuchs: I think ‑‑ oh!  The final thing that I wanted to mention about the housekeeping is just there is an evaluation form for today's presentation.
so, that link was sent to you in the confirmation e‑mail that you received.
with connection instructions, it is also, on the final slide today. When you close today's webinar, the evaluation form will actually open on your computer, so please do fill that out. We would really like to have your feedback on today's call!  
And we take our evaluation data really seriously, we use it all the time to help improve our programs and trainings. All right! So, we've got a big group with us today.
right? We've got a panel, we wanted to be prepared, to respond to all manner of questions, about operating CILs and SILCs in the face of COVID‑19. 
Your moderators today are me, Tim Fuchs from the national council on independent living I'm your host, we also have Paula McElwee, of course, the Technical Assistance Coordinator, for the IL‑NET at Independent Living Research Utilization, ILRU, we also have Richard Petty with us, Richard is Co-Director of ILRU and Director of the IL‑NET project, IL-NET National Training and Technical Assistance Center.
so I want to thank, Richard and Paula for their work pulling this together, and agreeing to moderate today, and then I want to introduce our panelists as well!
I cannot thank our panelists enough for agreeing to do this call, on relatively short notice. And, for setting aside, their busy work, reacting to COVID‑19, to share their expertise, with all of you.
We have Susan Dooha, the Executive Director of the Center for Independence, of the Disabled, CIDNY in New York City. 
Sarah Martinez the Director to Access 2 Independence of the Eastern Iowa corridor.  We have Jeremy Morris, an Executive Director of the Ohio Statewide independent living Council. 
We have Marcie Roth, Marcie, of course, is the Executive Director and CEO of WID and has had a long career in emergency preparedness and response, especially for people with disabilities; 
Corinna Stiles is with us, Corinna, of course, is the Director of the Office on Independent Living at the Administration for Community Living with HHS. 
And last but certainly not least we have Yomi Wrong a former CIL Director, the Berkeley CIL director who is actively engaged in COVID‑19 emergency response both at work and on the grassroots level in California.
Again, to our panelists thank you so much for being with us today, I really do appreciate it! All right. We wanted to start off with some poll questions. So, you know, on your screen, you should see, a question now, for the first poll. That asks, are you working from home? So, we're going to go ahead and give you guys a few minutes to respond.
we've got three of these, and we're curious. How many of you are working from home now? Yes? No, maybe part of the time? If you were only on the phone, I apologize you may not be able to respond to this, it's a way to get a sense from those of you on the computer, how many of you‑all are teleworking currently. Looks like not everybody is able to see that poll, Tim, I don't know if you need to launch it maybe, I'm trying and it won't let me. 
>>Tim Fuchs: That's interesting, I selected let panelists vote and launched it.
it looks like we have 4 votes. Good, good. 
It's not letting me vote either. Well, that's odd. We thought this might be fun to give us a sense of the audience, but some people may not be able to view it and I only see four votes with 600 people on the line. So, let's go ahead and close that. Let me launch this next question and see if it works a little bit better. There we go!  That's the results 
>> Tim Fuchs: 6 out of 600, that voted. I don't think. Not a statistically, valid!  
[LAUGHTER] all right. 
Let's go to question 2, and see if this works any better. Going to launch the poll now, again, my apologies you're only on the phone, if you're on the computer, this one is working great, something changed. So right away, we had over 100 votes, we got about a 3rd of our audience has voted so far. About half our audience has voted. And the ‑‑ and the votes have slowed down. Give me a few more seconds here... and let's see what our results look like here.  Oh, it only captured, it said 279 people voted, and it only captured three votes.  So, the poll results are kind of a bust here, why don't we go ahead and move on?
>>TIM: We thought this would be really neat to do, and ‑‑ something's up, so we'll look into that but let's get to the bulk of our call, the point of this call is to take your questions around operating CILs and SILCs in the face of the pandemic. it has been a harrowing few weeks, and for all of us, we've had to figure out how to adjust our personal lives, our professional lives, and we've got some real questions around KS programs service delivery, funding and how to best support consumers, and people with disabilities while keeping ourselves and our staff, and our communities safe.
So, it really has been a challenge. So I know, that there have been, a ‑‑ a lot of questions coming in, Paula, did you want to start off, with any of ‑‑ the questions, that we have discussed this week or do you want to jump in to the audience questions?
        >> Paula: Let me just ‑‑ say one thing and that is, that, we have different people, with different areas of expertise so as these questions pop up, if you know, who you would like to direct the question to, you can include that in your question. If you're confident that oh, yeah, I need a center director to answer this, or oh, yeah, we're going to put Corinna on the spot for that one, or whatever and so don't be afraid to plug that in but one of the things that I think we need to look at right away is systems advocacy efforts. Because some of the things that we're worried about are not in the center's control and Yomi Wrong, I was hoping maybe you would tell us, what have the advocates in the Bay Area done to make sure people with disabilities have a voice, in the disaster planning and now in the response as we're working on that. 
>> Yomi Wrong: Hi, everybody, I don't know what all advocates are doing.
but I can tell you that here in the east bay, particularly in Oakland, the disability justice culture club, which is, led by five disabled people of color and supported by, at this point about 250 volunteers.
and allies are doing rapid response and mutual aid to disabled folks, homeless populations, seniors, so, what ‑‑ what we're having people do is fill out a Google Doc indicating what their urgent needs are, and then we're matching them with volunteers, I actually received access support yesterday at my house from two volunteers. So the way it works is one of the ‑‑ the lead volunteer gave me a call and we went through some screening questions about my exposure whether I had symptoms, their living situation, and what their exposure has been in the last 7 to 14 days, how many people, that they are actively providing mutual aid with. And how many people that they have potentially come in contact with, that may be symptomatic. And once we have cleared all of those issues and negotiated, you know, working together at safe distances and all of that they came over and did some stuff outside of my house for me yesterday. So, as of yesterday morning, we were helping 40‑plus people in Oakland. That number continues to increase, we're doing grassroots ‑‑ it's very grassroots ‑‑ because we're also partnering with a lot of organizations, that are here in the east bay that we already have relationships with.
so that's key in building out those relationships, so that one organization, or one group does not hold it all. This is sort of the way we work together in a climate crisis. So it's ‑‑ definitely, a very nimble way of providing care, mutual aid, grocery shopping, some ‑‑ you know, all levels of access support using people who are not immunocompromised, and who are feeling well, and have the capacity to assist.
and they're just going to people's homes and getting it done!  
>> Paula McElwee: Wow, what a grassroots as you said, but exciting option as we see some of these questions coming in, what do we do if PCAs don't come to work, that is the kind of response that you've developed there. 
>> Yomi Wrong: Yeah. 
>> Paula McElwee: Is an answer at least in part. 
>> Yomi: Absolutely, as of yesterday afternoon and the number goes up, we've raised disability justice culture club has raised over $15,000 in 24 hours, with like $50 donations, people around the country. 
        >> Paula: Wow!  
>> Yomi Wrong: Very effective use of social media organizing, Venmo, PayPal, buying supplies. The culture club also put together, hundreds of kits of home-made hand sanitizer and other things, distributing those to homeless encampments, distributing those to people's homes. This is the same group that we did kind of the same rapid response around the PG & E shutoffs when our power was cut off in Bay Area, and so this is the model we find works most effectively, because we're meeting people exactly where they're at. And we're not doing it alone, this is really about being in community.
and partnership with other organizations and building relationships of trust over time. And then the funding that we're raising: We actually distributing it to other organizations it's all shared!
       We're giving payments to elders regular monthly payments to elders, from here on out.
until, you know, we don't have the funding anymore. So there's ‑‑ there's so many models out there, and I think that, as ‑‑ CIL directors and folks operating in Independent Living Movement, AND I used to run an independent living center ‑‑ I understand the position that many of you are in, if you can just think outside the box and think of ways to just, stretch yourselves, especially during this emergency, and connect with people, the boots on the ground that are doing the work. Even if the model looks differently than what you're ‑‑ you're used to operate in, I think, that's how it will be effective 
>> Paula McElwee: Wow, Richard, I think you had a question next. 
>> (No audible response).
        >> Paula McElwee: Richard, you're still muted. 
>> Richard: Now can you hear me?
        >> Paula McElwee: There you are. 
>> Richard Petty: And I was going to ask Tim if Susan has been able, to join, and I know, she's been having some technical difficulties. 
        >> Susan: I don't know if you're able to hear me. Paula can you hear me?
        >> Paula:  We can hear you, now, and Susan isn't showing up in the presenters and I think she may be trying to call in. 
>> Richard: Kim may be engaged with that? Let me welcome Marcie, and before we actually proceed, I would just like to acknowledge all of you, throughout the Nation, who – are the linchpins in your community for the Disability Community. Thank you, for what you are doing ‑‑ we know how challenging things are right now and in very difficult times, we know that many of you ‑‑ if not all of you ‑‑ are using a different model of working, different model of being a CIL. 
In these ‑‑ very difficult times; so, it's important that you're there, you're doing incredibly vital work in a very difficult time. I would like to turn to Marcie Roth, with Marcie ‑‑ your extension experience in ‑‑ addressing disaster needs of people with disabilities, working with communities, as they ‑‑.
in states as they address, disasters, this is a different disaster than we've experienced previously, I dare say. And, Marcie, what are some of the best ways, that centers can connect, with local emergency officials and state emergency ‑‑ emergency officials to make sure that there is a Disability Community voice and an understanding of the needs of the Disability Community ‑‑ communities as mitigation work is being done?
       >> Marcie: Well, thank you very much, Richard, and everyone for the opportunity to join you.
in my new role with the world Institute on Disability.
             >>Marcie Roth: (Continuing), communicating with your local emergency managers, and your
      public health professionals, is probably... extremely difficult at this point.  
I know from talking with a number of CIL directors, and disability leaders from across the country, that your efforts to reach out to even when you've had those relationships, in place your ability to reach those emergency managers, the public health folks ‑‑ has not been particularly successful.
in the last few days.
       >>Marcie Roth: (Continuing) I believe that we are going to have to take a shared strategy, in ‑‑ for those of you who are successful, in either, making, or continuing those contacts sharing, those stories, with everybody else, so that we can demonstrate that there are local community, officials, who, are making, the effort to talk with their independent living centers, I think ‑‑ we also, need to be calling out, in our communities, the folks that are ignoring us, marginalizing us. We have a massive... failure across the country, 
In speaking, about the needs and especially, the rights of people with disabilities.
during this public health emergency.
I won't spend a lot of time talking ‑‑ talking right now about the many, many efforts we've made, to help folks to understand, what the rights of people with disabilities are; during disasters.
The obligation, to continue, services, and supports, the truth, that, there are no waivers, to civil rights obligations, despite what some might be trying to do.
And so, it is extremely important, that we are sharing, our experiences, with each other; that we're sharing those promising practices, where we are successfully reaching ‑‑ and communicating, with our public health, and emergency management colleagues.
and that we're, sharing, those stories, where that's not successful.
And, one last point, I would like to make. If people with disabilities, are ‑‑ if our in‑home supports, and our ongoing services, are interrupted, then our ability to maintain our health, our safety, our dignity, our independence ‑‑ are not only going to be, a horrific failure, for us ‑‑ but we will, then, have no choice, but to reach out, into the acute‑care health system for things that really, do not require, acute care and that is the last thing that the acute‑care systems right now need.
       >>Marcie Roth: So let's work very hard together to make sure that the supports and services people need in their home, are prioritized, not just addressed but prioritized it's not just good for us, it's good for the whole community at this time.
       >> Richard Petty: Marcie, thank you for that good guidance. And, Paula, I know that you have a question now from Rhea
>> Paula McElwee; Hello?
        >> Richard: Paula, are you with us?
>> Paula McElwee: Yeah, I'm here, I'm not sure what the question is but let me just state ‑‑ say this, if you're putting in questions right now, we would prefer you to put them in the Q&A, or ‑‑ if you are able to do that, our system is much more, efficient, if you put it in the Q&A, so, to get to that, you go down to the bottom, of your screen, and there's a ‑‑ a Q&A, tab, you can plug your questions in there, some of them are showing up on the chat, some of ‑‑ some of you are raising your hands, and really, that's more effective for us, if you type in the question, if you're able to and use the hand‑raising only for those who are calling in and cannot type ‑‑ or cannot type a question 
>> Richard: Paula, we were going to ask about, ask Sarah Martinez, about, her community partners, who are ‑‑ 
>> Richard: Yeah, for Sarah, absolutely, Sarah, tell us a little bit about your partnerships in the community that make what you're doing to respond, a possibility? 
>> Sarah Martinez: Sure! So, we have been relying on some of our state, and ‑‑ local partners, to help, identify, needs, that exist, and then, to respond to them. So, one of the big ones, we've been utilizing has been our local area agency for aging. They have been great, in identifying, you know, needs, through the aging and disability resource center, that they have. We've been talking to them, about the home meal delivery that they have ongoing, in seven of our 8 counties, and whether they could waive eligibility requirements, to ensure that if there were at risk, and high need individuals that meals could be delivered and they will figure out, funding for those later.
So that's ‑‑ that's just, one example, of ‑‑ you know, relying on our community partners, another example, would be, Vocational Rehab ‑‑ all of their staff, locally, have transitioned to work from home.
and they are no longer, able to do face‑to‑face meetings with their job candidates, who continue to have, a high level of need. And so, we've ‑‑ we've been trying to maintain contact with them, to see, if we can ‑‑ you know, fulfill the things that they're seeing, we're also working on a survey to roll out to the community, you know, brief, five questions that we're going to incentivize, with gift cards, since people are, you know, at risk right now, financially, to identify, what the ‑‑ like, top priorities are, whether it's food insecurity.
Or, you know, basic essentials, things that we can identify to target, and help director our services to. 
>> Paula McElwee: Excellent, that's very helpful. Susan, would you like to tell us what your center is doing with partnerships? That would be very useful 
>> Susan Dooha: Well, we have been working with the mayor's office, for people with disabilities with the Department of Health with our statewide, association, on independent living.
We are getting constant alerts, about changes in laws, changes in programs, and since all of our staff ‑‑ since all of our staff is telecommunicating, we are in a constant information loop to get information out, about what's happening in the community. We're working with other centers to try to elevate people with disabilities, and the discussion, with the state with the Department of Health.
and we're having some successes.
Our initial success, was, in getting the New York City Department of Health and mental hygiene, to post guidance for people who are at higher risk.
of coronavirus, or COVID‑19, COVID; and we have gotten some clarification, and some loosening of guidance, as to how to ‑‑ how to deal with agencies for the duration of the epidemic 
As of today, all offices are completely shut down, so now, everyone is telecommuting and we're working, particularly with agencies in New York City, to try to share information, and guidance, and support one another.
       >> Richard Petty: And, Susan, you've been you have experienced some of the issues that other centers have experienced a little bit later, because of your location; and because, some of the areas, where you're working were hit, hit pretty hard early. How are you operating now as a center?
       >> Susan Dooha: We are completely working remote; everyone is in their homes with equipment that we purchased. Phones, laptops, we're going to be getting everyone printer‑scanners. We have taken all of our phone lines, and worked it out so that they trip over to people's individual CILs. We have all of our existing phone trees for our programs, that are operating as per usual. 
Susan Dooha: We are, getting information, still, out to each other, via e‑mail, and we're going to begin a series of meetings. Friday was our last day! And just in time, because... the state is now closing down operations or asking businesses, and organizations, to close down, their operations. We've been working on this, getting ready for about three weeks.
So, here we are, really, in the thick of the epidemic. We've had several brushes, with COVID‑19, but so far, have not heard that any of our employees, or the people we're working with, are infected.
so we're very lucky at this moment.
       >> Richard Petty: That's good to know, and during the time, that you ‑‑ you were ‑‑ where people were coming to ‑‑ might be out, and about, whether that was a good idea or not ‑‑ if they arrived at your center, what would they have experienced at that point? Would there have been something assigned or somebody who was notifying them, of ‑‑ 
>> Susan Dooha: Yeah, we've had communications out via Twitter, via Facebook, on our Web site, and on our phone lines. We have had signs on the door. We sent out notices, that we were stopping walk‑ins, and face‑to‑face; but how do reach our counselors and how to get help. And all of those routes are active. But I have to say that the epidemic, hit hard and quickly here. And people stopped going out as much. Honestly, so it wasn't as if we were turning away, face‑to‑face, traffic.
We also, stopped going into high‑risk facilities early on because virtually, all of our employees, are in the higher‑risk group. And we did not have equipment, to send them in, we didn't have any protective gear for them. In addition: A number of the entities that we worked with, closed down, to all outsiders and that meant that our long‑term ombudsman ‑‑ long‑term care, ombudsman program could not go into facilities. And we needed to stay in touch with residents by phone, our open doors program that gets people out of nursing facilities ‑‑ has not been able to go in and work with people. So, a lot of the agencies that we travel to, have been really shut down.
We work a lot with people in homeless shelters, we work with people who are in jail, where the epidemic is hitting hard as well. We work with people ‑‑ a lot who are in nursing facilities, or other group settings. So, it's been very hard, not to be able to check on them, in person, but just stay in touch by phone.
>> Richard Petty: Very good, and thank you, Susan Dooha. And Dr. Corinna Stiles, we certainly know, you've had a very busy week in responding to in fact, more than just a week, by ‑‑ for sure.
in responding to questions from centers and trying to address, concerns, centers are working in a new way, and in a very different time.
       >>Richard Petty: And I would like to ask you: QUESTION:  What has been the most frequent question, you've been receiving and how you've been responding. 
>> Corinna Stiles: Thank you, Richard. Yes, it definitely has been a busy time for us, on the federal level. As it has been on the state level. 
Thank you, to everyone who joined the call today. 
I think this call, today, and the response that we see by the number of participants, is really something that we can point to, as ‑‑ a positive thing, continuing to come out of.
bad situations. 
The way that networks and the states have been rallying around one another, based on the stories that we've been hearing....
the way that, people are changing up how they do business, not just on the state level, but on a federal level ‑‑ are certainly things that I hope, we will continue, to role model, and rely heavily upon.
as we go forward 
As far as the questions that we've been getting from the network: The questions have been mostly around allowability of cost and they have been around, what can services look like, if we are not physically, in a brick and mortar location? And the questions have been around what resources are out there, that can help us? 
And I would say on any or all of those answers: The answers are always... evolving, based on what happens, any particular day and what new information, we have. The guidance that we've been giving out so far, around program and fiscal questions has typically been, bound around how we would typically do business. So, what was allowable before is going to remain allowable. 
What we're seeing, though, is we're seeing some flexibilities out of OMB, the Office of Management and Budget. And we are taking those flexibilities, that we have received just late last night ‑‑ and we're looking at how those flexibilities will apply to the CIL, and ILS programs 
So, for example: How will flexibilities impact the extended purchases for equipment, or the use of telework, or admin leave or anything that is now, being implemented or used in the ordinary course of business that maybe people didn't have to think about before. So, we will be providing additional guidance, beyond today, for sure.
And it will be ongoing guidance as we have the information, we're working hard to put that information out to the network we're also working on a few FAQs ‑‑ most of you may know that we at ACL had provided a couple of FAQs to the Network, over the last few years the first FAQ around disaster response, really was intended to give the network an opportunity to look at building networks within your state, and figuring out ways that you can collaborate, and develop memorandums of agreement within your state, that would specify, steps that centers would take to help people, in either their affected disaster areas; or, in areas that were outside of your approved service area, so that's what that original 2017FAQ, was about based on the responses that we've received from that FAQ: We made some changes to it, under the last leadership.
And it rolled into a policy which, I believe, that is the one that you will see, on our Web site, today, however, what I would say is, we are working at revising, that document. 
>>Corinna Stiles (continuing): And I would strongly encourage, the network wait, to see what the next FAQ version will bring, because we're hoping that we will be able to address many of the questions that have comes to us, as well as questions that continue to come.
so as we're on this call today, all my staff are also on this call ‑‑ we're all taking notes on the questions that we're hearing, the concerns that we're hearing and we will use that information to inform what information we put out, going forward. 
>>Corinna Stiles: If everyone's questions today, for me, aren't answered as Richard mentioned ‑‑ they're tracking questions, they will still come to me, and the office Of Independent Living program staff. 
We also, plan to have our quarterly connection meeting on schedule next Wednesday from 2:00 to 3:00, eastern time, and you will get more information about that through e‑mail, in the next few business days, where we will provide, more information, so as not to take away from your peer support model for this call. I would just strongly suggest that you tune in to that call, as well 
and just keep looking for our e‑mails, and responding to them as you can. 
>>> Richard Petty: Corinna, thank you very much. We know you're here educating for the ‑‑ for the independent living program for centers and for SILCs, and that's appreciated. And, Paula, would you like to ‑‑ present for us?
>> Paula McElwee, I was hoping Jeremy could address on what are the statewide collaborations where the SILC has a role? I know in your state of Ohio, it is one of the hardest‑hit or earliest hit states. 
So, what kinds of things have you been able to do as a network that are helpful in that process?
         >> Jeremy Morris: Hi, everyone, this is Jeremy. You know, it's been a very interesting time, here in Ohio because, you know, it started off very slow but our governor's office, acted, very quickly.
you know, they've been pushing out a lot of changes and they've been making a lot of orders as we've gone through it every day we look, you know, to see what's going to be changing. You know, we have been in conversations with a lot of our state agencies as a SILC, we've tried to maintain, over the last couple of years, you know, good relationships, with those other state agencies. So, with that way right now, in times like this, we know people to contact within those agencies that we can start to work with.
So, you know, for example, our state Department of Medicaid, the Department of Aging ‑‑ talking to our DSC, how are services going to be delivered even just through their own service programs, and how that will impact the centers going forward one of the most important things I think for us that has been happening, is ‑‑ we have been included in all of the communications going out from the governor's office, so pretty much every ‑‑ actually, every day, we are getting updates, directly from the governor's office, that we are able to share out with our council, with the center, directors, so that everyone is getting accurate, timely information of what is happening, because that has been one of the biggest things, and I'm sure everyone has seen it that, you know, there's a lot of, you know, conversations and talk that goes on, but making sure that people, have access to the accurate information AND I really think that's one thing, at least that's one thing we have been at least able to provide to our network and being able to talk with some of those state partners, as some of the policies start changing, you know, we know that we have, individuals, and centers who are impacted by a lot of things going on, making sure that those centers can get connected to the right people, within those agencies so that if there are advocacy issues that we need to be looking at as things continue to progress forward we can be on top of it as we can.
         >> Paula McElwee: That sounds like you're on top of it, as much as any of us are these days, Tim, how about some questions from the audience?
         >> Tim Fuchs: Thanks so much Paula. The very first question came in from Lisa, and Lisa shares one of the most common concerns I've heard from individuals. In this crisis, what can we do if PCAs won't come to work for fear or because of their own sickness, or because of quarantine or lock‑downs? So, Susan, anything that you‑all have done to support, consumers, who are concerned about this? Or, who have been unable to coordinate their personal assistant visits?
        >> Susan: We're grappling with this right now. We don't have a consumer‑directed personal assistance program at our agency so we have not‑borne the brunt of calls from individuals, who have been calling up their agencies, trying to get assistance. And the same thing, with home care agencies. We have got to find a solution, quickly, though, because now that things are shutting down, people will be in their homes, and not ‑‑ not have assistance. Guidance to rely on your neighbors, isn't always really helpful guidance for people living in the community with a disability.
And yet we're thinking about turning to some volunteer efforts; where people are volunteering.
volunteering in response to requests that people are posting. To go and provide assistance, it's far from ideal, because it means, that... people are just matching themselves with people they're not being chosen, they're not being screened.
So, we are really hoping for guidance, from our state and city constituencies and frankly gear for the aides, the home care workers the personal assistants, who are going out, they need gloves, masks gowns ‑‑ they need wipes, et cetera. There isn't enough of these things for healthcare workers, at this point, in the city; and so, they're not getting it either.
>> Sarah Martinez: I'm going to echo that because here at access to independence, we do not have a PCA program. And ‑‑ and we haven't been getting any kind of influx of calls from individuals who are concerned about, either their home services, ending; or ‑‑ or they completely stopped.
So, we are ‑‑ we are also anticipating either kind of a grassroots volunteer network, effort needed to address those shortages. I know Iowa Medicaid has pushed out, you know, directives that, the money is there, and that, you know, the services will continue but we ‑‑ providers have been laying people off; and so we ‑‑ we don't know ‑‑ what that's going to look like? So, I am concerned about the volunteer, you know, efforts to address it, but I think that's really the direction we're going to have to go to.
       >> Tim Fuchs: And I know Marcie you had something to share on this too. Do you want to respond briefly?
       >> Marcie Roth: This is Marcie speaking and I do want to point out, that, the centers for Medicare, and Medicaid, 1135, waivers, have been, continually issued in public health emergencies 
Once again, have been issued ‑‑ there are some good things about those waivers.
that bad be used to address, some of the very real concerns that folks are having; however, the 1135 waivers, allow ‑‑ give states permission, to move people from their homes directly into, long‑term care facilities. 
To move people, from emergency rooms directly to long‑term care facilities, and even to move people out of a hospital bed, into a nursing home or institution, and this is incorrect. 
It's a violation of what the department of Homeland Security ‑‑ the department of justice ‑‑ the Department of Health and Human Services ‑‑ have all said, there are no waivers ‑‑ away from microphone) in disasters, the combination of not coming to work, whether because they're sick or they just don't want to, or because they don't have the personal protective equipment; forces [background noise], medical care, as I was talking about earlier, and that ‑‑ call, for ‑‑ Medicare, is ‑‑ [AWAY FROM MICROPHONE] than place people directly into a skilled nursing facility. We have got to collectively say no, to it. And now that our rights are upheld, and we need flexibilities from HHS. 
And those flexibilities need to be giving people, the ability, to pay their family, to pay overtime to self‑determine what their back up plans are and to be able to pay for them, and with the Department of for inclusive disaster strategies ‑‑ a number of flexibilities, we would like to see, 
And in addition to that because one of the options is probable going to include, the use of national ‑‑ medical system, medical reserve corps, and the public health service, we need to be able to provide, that specific training, immediately, so that they understand, what their legal obligations are, 
>>Paula McElwee: And what the self‑determination ‑‑ Marcie, your point is well made, advocacy is the key thing we've got to do, still, and that's true at the local level and it's true with your city or county sometimes, because that's who's declaring you shelter in place, that's who's identifying ‑‑ several questions about are we ‑‑ an essential service or not?
>>Marcie Roth: Well, you need to make sure you are, because your city is making that proclamation, and they are going to include you if they know about you and they're not going to include you if they're not thinking about us, right? 
>>PAULA: So that advocacy, you're so right, at the local county, state level ‑‑ a lot of these declarations are declarations and being made by governors and all of those, and we really do need to make sure we're on top of the rights, and some of the questions had to do with what are we going to do with ourselves? Because we are sitting at home and we don't have the technology to do all that we would have done, pay attention, here's something that you could do: Tim, do you have another question?
        >>Tim Fuchs: I do, we've got about 35 minutes left, and, of course, we do have a long queue of questions, we're going to do our best, I'm actually going to go to the phones now, and open up the line, for Karen in Pennsylvania, Karen, are you there? Karen from Pennsylvania?
>> Karen, do you have a question?
        >>Tim Fuchs: Okay, let's try to go to Carissa, we've opened your line, do you have a question? Let's go back to the written questions then.
Tim Fuchs: So, to our state, and I've heard this from other too, our state has mandated for only essential businesses to be in operation, are we essential? Corinna, any opinion from the feds about, whether or not CILs can argue, they are essential businesses and remain in operation in an event of a lockdown?
        >> Corinna Stiles: Well, certainly, we believe that every center is an essential business. Whether our interpretation meets what's happening on the state level, that part, I don't know. So, I'm afraid, I don't have the ‑‑ the state‑specific answer to that question,
>> Tim Fuchs: Anyone else on the panel ‑‑ I'm not aware of definitions, at the state level, wonder if anyone has anything, otherwise. 
>> Susan Dooha: So.
>> Tim Fuchs: Yeah, Susan. 
>> Susan Dooha: Independent living centers are not designated by the state, as an "essential" provider, or service. And don't ‑‑ don't have special arrangements, so we're ‑‑ having to operate, and stay open, using a telecommuting system. And ‑‑ there you are!
>> Tim Fuchs: Right. 
>> Paula McElwee: That does vary, though, from state to state, and city to city, even so, whether you're in there, or not, you can get in there if you ‑‑ advocate. 
>> Tim Fuchs: So make sure how your center stacks up at the state and local level, but to Susan's point, remember, it doesn't mean ceasing operations; it means finding a way to do your work remotely and we realize that's challenging, but there are some solutions as we're discussing here today.
another interesting question, anyone know guidelines for medical providers testing for COVID‑19, to make those tests accessible to people with disabilities? 
>> No, this is Susan Dooha. We've not heard of such guidance, being issued by the State. By our local Department of Health. And we haven't seen anything like that from CDC, or other authorities.
         >> Tim Fuchs: Okay.

>> Yomi Wrong: I work in healthcare. I work for a large healthcare organization, and my advice is that people start by calling their family doctor or their primary care physician. And first, seeing, if they ‑‑ if they meet the criteria for testing. Many of the healthcare organizations, are setting up respiratory clinics, these are, like, drive‑up clinics outside, of the building, and they're doing testing ‑‑ they're testing people in their cars, testing people under tents, 
Yomi Wrong: I know in my organization, we're making sure that we have video remote interpreting available, in that outside environment. 
So, you can ‑‑ definitely ‑‑ you should be asking about accommodations and talking to consumers about self‑advocacy and starting with their primary care physician describing their symptoms, taking advantage of video visits and telehealth, if they can. 
To, first, be screened before they go and try to get tested, because not everybody will be tested. 
>> Susan Dooha: Right, everybody does need to be screened first; and in New York state, and New York City ‑‑ there are mechanisms for screening. But our difficulty is the supply chain, we don't have enough tests. 
>> Yomi Wrong: Right. 
>> Susan Dooha: So many people are not being tested, although they may merit it.
simply because the scarcity.
        >> Yomi Wrong: Right since we have underlying health issue ‑‑ does not mean you will automatically get tested they're really looking for symptoms, they're looking for the cough, the fever, the other symptoms ‑‑ that are very specific to COVID‑19. 
And so, there's a lot of fear out there, I mean, I understand for myself, I've ‑‑ I've been coughing for two weeks but I don't have some of the other symptoms. So, I don't even ‑‑ I don't qualify for testing either. And there are very few tests available. 
I mean, this is ‑‑ the national crisis that we're in, but I would ‑‑ my best advice is to work with your primary care physician.
        >> Tim Fuchs: So, this is Tim, thank you very much. The next question, comes from Darrell: Staffer working from home, how do we continue to draw down on federal Part C dollars? is there any impact on draw‑downs based on remote work?
I'm not aware of any but – Corinna? 
>>Corinna Stiles: This is Corinna. Yeah, I can say that even though, people, are teleworking, in federal government as well; all systems, are still available, and all the usual staff, are still available. So, draw‑downs, from the PSC system, should not be impacted at all. 
Tim Fuchs: Great, thank you very much, oh, they must have meant your staff, I thought they meant their own staff, I think I understand better now. Thanks for confirming Corinna. All right our
next question is also for you, it says: Can the DSC extend Part B beyond 2019, to 2020? CILs are unable to serve consumers because of the pandemic?
        >> Corinna Stiles: I would say that the answer to that question may depend, partly, on the flexibilities that OMB has just issued and how that will relate to the CIL programs and the ILS program. So, as of this minute, I don't know one way or another. 
>> Tim Fuchs: Okay. 
>> Corinna Stiles: But we do have staff, who are actually evaluating those flexibilities while we're on this call, so we are hoping to get something out very soon. 
One thing, that ‑‑ I think I would like to add, you know, as we're talking about centers having staff or SILCs having staff working remotely ‑‑ a question that comes up, quite frequently, and I've seen it in the Q&A, questions here on the site ‑‑ is what happens if the center shuts down? 
And so, there's two pieces to that. You know, are you just closing your brick and mortar and your staff is teleworking so you're still providing services? But you're having to figure out creative ways to provide those services or are you just shut down, door is locked, and everyone is home? 
And you are closed for business in every way, shape, or form? Those are two very different scenarios, on the second scenario, if there are absolutely no services happening, I would strongly suggest that those centers EDs get with their program officers, and talk through those scenarios 
And let us help you, get connected, with other centers or ILRU, who can help you make some assessments, as to what is possible.

And, again, I ‑‑ I just want to keep going, back to something that we've been saying, and something that Yomi Wrong said at the very beginning, is this is an opportunity to be creative in your services. And we are, definitely supportive of that. And would definitely encourage, centers, do something versus, nothing. But we do understand, that there could be, those exceptions, where there ‑‑ it just isn't possible, to be operational or functional.  So, if you ‑‑ if you are in that scenario, please contact your program officer, and we will help you work through that.
        >> Tim Fuchs: Okay, thank you so much. Go ahead.
>>Susan Dooha: This is Susan Dooha; Tim. I wanted to add. In New York, we've been able to get foundations, at least one major foundation, to do, as it did, after September 11th and after hurricane sandy, and make resources available, to nonprofits, including independent living centers that are having additional expenditures for technology, for example. Or to bring on staff, to deal with the surge of demand, and for other purposes as well.  And if there are community foundations that can be tapped, that may be, forward.
        >> Sarah Martinez: We just saw the community foundations of greater cedar rapids in Iowa city announce each $25,000, emergency grants, that they were going to open up, they haven't given us a timeline, but for all nonprofits in the Area, who are providing emergency response, they're going to provide, an application, to access that funding.  
>> Tim Fuchs: Great, you know, I've seen a few more questions regarding, essential services. 
Sherry Burns, shares an interesting example, and it's telling she says their center is operating remotely per federal guidelines from ACL and their own DSC, they're in California, by the way, but some of their programs are actually deemed essential services 
I would assume, on a state or local level, they are contracted homeless provider for people with disabilities, and older adults, so those services are deemed essential, and should continue, 
So, really interesting example, thank you Sherri, AND I also have seen a number of questions as I try to prioritize these and get to as many as we can in the time we have left, regarding, sharing some of the solutions and best practices, that folks have ‑‑ that our panelists have shared or producing additional resources going forward.
and much like Corinna said about the FAQs they're producing and other resources for the IL‑net as well, this is really the first of the resources, that we're ‑‑ we wanted to bring, to you‑all, 
And we've put this ‑‑ webinar together as quickly as we could. But we're looking for other opportunities, for other webinars, or, you know, virtual resources that we can bring to you‑all, along with technical assistance, and any other written resources so just know that, in addition, to, you know, responding to questions, that we don't get to, in the live call today. We will likely, also be bringing additional, webinars, presentations and resources to you, all, that drill down, into some of the solutions that we have talked about today in terms of, you know remote work, equipment, funding those sorts of things. So, we're still figuring some of that out, but I just want to acknowledge knowledge that. All right
let me see... 
Tim Fuchs: (Continuing) what's your outreach look like using social media, tools, to reach to the local Disability Community that may or may not know about our services? 
And, by the way, I heard from the folks at NCIL's emergency preparedness subcommittee today, and they hope that we can help dispel, a myth that's been going around about a social media blackout.
So apparently, there's been some concern, that social media would be closed, or turned off, because of the epidemic, and that is a myth. 
That spread virally so they hoped we could put in a plug today to dispel that myth and say that's not true but for those of you, who do use social media, in your work, how have you pivoted to using social media since you've gone to remote work?
there's, obviously, some opportunities there, 
And ‑‑ I apologize, I don't know who to toss it to, but has anyone had that experience or used those resources to continue, to communicate, with their consumers or provide programs or services?
>>Susan Dooha: Yeah, we're using social media, quite a bit, actually to try to get information, out to people to ask people how they're doing. And so forth and so on. 
>> Sarah Martinez: Anyone who is not on our newsletter, by e‑mail, it's also, being connected, to our social media, so you can access our newsletters, with all the updates on our office response and resources. And then, we're also going to be moving programming, like, video conferencing and we're going to be using, social media, to put out that information, as well. So, people can access, the log‑in information. 
>> Tim Fuchs: Great! All right, good. Excuse me, while I click around, between the ‑‑ the chat, and the ‑‑ and the Q&A. Stacy asks for those centers with significant fee for service contracts with VR, with vocational rehabilitation, or other funders ‑‑ how can we plan, to maintain, our staff from a financial perspective, when the number of our referrals has fallen off drastically? 
>> Tim Fuchs: Anyone ‑‑ any of the CIL directors or others have that kind of funding that are navigating that now, that have some tips for Stacy and others?  
>> Sarah Martinez: I can ‑‑ say that we do have a VR contract for supported employment services that we were having, staff provide. So, we didn't have ‑‑ you know, staff that were.
that were specifically for that programming they're across ILS and supported employment.
our ‑‑ basically all those services, have stopped. And everything has kind of been on pause, we're not getting any referrals; and so, I can't direct anyone on ‑‑ what to do with the loss of income.
but I do know that that has hurt us in terms of, you know, resource development. So, I ‑‑ my heart goes out to you right now.
>> Tim Fuchs: Go ahead, Susan. 
>> Susan Dooha: You know, our services that we provide for VR consumers are at a standstill because we're not getting referrals. We're fortunate that we did not depend on fee‑for‑service‑income to pay for staff and salaries. And my heart goes out to those of you who have staff that are tied to the fee‑for‑service income, it really does!  
>> Paula McElwee: One of the things you need take a look at as centers is what is your state and community doing because there are have been a number of governors this morning who have announced, creative ways to help small businesses. And you are a small business.
Typically, you would qualify for that ‑‑ for that help, I've seen some states that are freeing up city and county ‑‑ CDBG funds, community development block funds, within 24 hours, so you need to analyze, what this is costing you, and look at whether or not there are some solutions in your community for that it's going to vary, again, state to state, town to town ‑‑ but keep your eyes and ears open because there are things happening. 
>> Sarah Martinez: In Iowa, unemployment insurance became available recently for people who are laid off or had changes due to COVID‑19, and I know that they were also going to be providing financial assistance to employers to help either pay partial wages or kind of maintain staff. So, maybe through your Department of Labor workforce development 
>> Tim Fuchs: Okay, thanks good tips. All right. This next question, comes in from Ann, and Ann says: And I know you guys have heard this, you probably have experienced it ‑‑ many of our consumers are getting calls from their providers canceling all nonemergency appointments, so no new appointments Yes.  No new appointments have been made, offices ERs everybody's turning ‑‑ you know, canceling all nonessential appointments and even closing their doors (Tim Fuchs) so for a center, what are some tips to help allay the fears of consumers and staff, frankly for medical access needs, and also, ways to advocate, for better access for those you know, non-COVID-19 medical needs that are more essential than a ‑‑ a doctor's office might realize? Prescriptions and other services? 
Yomi Wrong, I was wondering if you could take a first stab on this based on your work in the community, and if others want to chime in, I would be happy to do that. Sorry you cut out at the very end of it, I didn't hear the last part of what you said. 
>> Tim Fuchs: Sorry about that. So, for folks who are having appointments cancelled, right? With so many non-COVID-19 medical appointments being turned down by hospitals and doctors’ offices what are the best ways to both allay consumer fears, and also to advocate for access, to those services, when they're more essential than a doctor's office might realize?
        >> Yomi Wrong: So, I'm just going to go back, again, to working with your care team. Using, like, video visits, Telehealth.  And, I mean, in my organization, we are de‑escalating certain clinics because we're really focused on COVID, and we're trying to reduce exposure to our staff as well.
But, just the other day, I worked with the imaging team around some accommodations for an MRI that could not be rescheduled, and the patient did not want to walk through the entire clinic. And then have possible exposure and so we managed to get her through a side door. So, if you have a hospital system that you are a part of ‑‑ work with their ADA coordinator, reach out to them. Find out what accommodations you can get, what you should do, if you feel like you need an essential ‑‑ medical appointment, and if you were able to, please take advantage of telehealth, and video visits, because that is, the way a lot of noncritical care is being delivered right now.
       >> Tim Fuchs: Great. Thanks, Yomi Wrong. 
       >> Yomi Wrong: So, I've seen a lot, too, about equipment, the cost of equipment.
Smaller and less resource centers that are concerned that they can't, you know, do, you know, video, or ‑‑ or Zoom, or what not or certainly, even if you're CIL can't or your consumers can't. So, I just want to encourage people to remember the telephone is there and that lower‑tech, options are available, and that everyone is dealing with the same situations. So certainly, there are going to be some systems, some bureaucracies that aren't willing to adjust, maybe not in the short time, anyway short‑term. 
But please remember to use those low‑tech options and to advocate that people make exceptions given the unprecedented nature of this epidemic.
>>Tim Fuchs: So, Corinna, I ‑‑ I don't even see it ‑‑ I can't find it again, but I know a question came in a few minutes ago, about the SPIL deadline so SILCs are dealing with the fact that everybody's ‑‑ some folks are on ‑‑ on lockdown or quarantine, others are at very least, responding to the CDC ban to not meet in groups, it's difficult to set up meetings. It's certainly not reasonable to set up public meetings.  So should folks expect, the ‑‑ the SPIL to be due, on the original date or is there consideration of pushing that deadline back?
         >> Corinna Stiles: I think you might not be seeing some of the answers because they're going to the answer tab. Tim while you've been talking I've been answering questions so it might be on the other tab. 
>> Tim Fuchs: Thank you very much. 
>> Corinna Stiles: Sorry about that. More generally, the SPIL timeline and deadline are set in statute. So currently, all timelines that are established will stay in place.  Again, as I said earlier, that is the guidance, right here, right now, this minute at 4:18 pm Eastern Standard Time.  Anything is subject to change on a daily basis. We are definitely monitoring that. We are also, currently, developing, a ‑‑ a webinar specifically around all things SPIL that we will be collaborating with ILRU on in the next couple of weeks; and we hope to get out at some point, in April probably towards the middle of April. So, all SPIL questions will definitely be answered at that time. 
We also have a draft of some guidance that we will be putting out in the next few business days, that will answer questions, like, how are we going to deal with public meetings? And what are the requirements? And hopefully, we can provide some alternatives to how you can go about doing that kind of business. 
I know ILRU is definitely working on pulling materials together that will help in that process, as well. So, the short answer is yes, as of today. The due date will remain the same; however we are, always monitoring what's happening and what's available to people so it could change as we go forward, but it's not likely; but we will definitely, do, everything possible, to give the states what they need, and the networks what they need, so that they can meet their obligations and meet timelines.
       >> Tim Fuchs: Okay, great. Maria, has a question for Marcie, she asks, how do you propose, that we get our officials, to work on assure ‑‑ ensuring individuals with disabilities have ongoing care during this time? So, in Ohio, we ‑‑ we've reached out to Department of directors, for ‑‑ Medicaid, and ‑‑ and ‑‑ developmental disabilities, but they're not getting back to us. So, what can you recommend in terms of advocacy to get a response, and ‑‑ and, you know, raise a level of importance for people with disabilities, in that work? 
>> Marcie Roth: Thanks for asking that question, maybe somebody else, needs to mute their phone. You cut out, go ahead. 
>> Richard Petty: No! If this is a question that Marcie might be able to take? Is Marcie with us?
>> Marcie Roth: I am, and I'm on!  Can you hear me?
        >> Tim Fuchs: Yeah, yeah, go ahead. 
>> Richard: Yes.
>> Marcie Roth: This is an ongoing frustration and when I was at FEMA, we had the opportunity to work, you know through the regional disability integration specialists and at FEMA headquarters to bring emergency managers and disability organizations together. I know that in some of the regions, some of the disability integration advisors, are continuing to do that.  Unfortunately, at FEMA headquarters, they are at the Office of Disability Integration and Coordination is no longer making those critical connections. The partnership for inclusive disaster strategies ‑‑ I'm sure would be happy, to work with you, on some strategies, for identifying, ways to begin to build those relationships. And, with NCIL as well ‑‑ they are all working on some strategies. I've been doing a lot of training and providing technical assistance, including in Ohio with the independent living centers ‑‑ through a very innovative grant that the SILC went after and successfully won. So, there are, some ‑‑ you know, we ‑‑ there are a number of things that we can be doing, to improve this. And the NCIL emergency management, committee, is a great tool for that. 
The partnership, WID, and the ‑‑ the promising practices, that, some of ‑‑ you‑all, can share, with each other, might be, able to ‑‑ cut through that log jam.
one last point: It would be wonderful if the leadership from the federal agencies, would issue, if all they can do is recommendations, something that would reinforce, the imperative, that the local emergency managers, are working, with, the disability organizations. 
>> Tim Fuchs: All right. thank you, Marcie! All right, so Sam asks, if ‑‑ if someone with a disability is ‑‑ advised to have a COVID‑19 test and they cannot get themselves to a medical facility to do that ‑‑ any options for in‑home testing?  And then what would that look like? Susan or others, is that something that you've heard anything about in your ‑‑ in your community discussions?
Looks like we may have lost Susan, I'll reach out to her, anyone else aware of anything like that? 
>> Richard Petty: That's going to be so highly local, in response, and ‑‑ and, you know, I would ‑‑ I was looking at Sam's question, while we were talking and, thinking Sam, it may be at the very best to talk with those who recommended that you have that test. And find out what path you have, to get either ‑‑ transit or door to door, support to get to where that test is and then, you also, will want to call or reach out, another way, to some of the local urgent care, and through the hospitals in your Area, and find out what options they have for you, and encourage them through your Center for Independent Living in your Area ‑‑ to find, to create options, so that ‑‑ that ‑‑ it is possible, within your Area. And I expect you're experiencing, and want to know what to do pretty quickly for yourself, if you've been told that. And so, trying to find shat options there are right now, for you by reaching out to the entities that I've ‑‑ that I've mentioned.  And Marcie, you may have a quick answer to that too. 
>> Marcie Roth: I think, again, [AWAY FROM MICROPHONE] the reality is that there are aren't the testing resources yet there are some, online. 
And, we also ‑‑ need to make sure that if those come online, that they are, in fact, going to be available to people. If there's going to be a cost involved, how long it takes to get them read 
So, I think, wherever possible, if somebody needs, to get tested, the focus needs to be on making the kinds of arrangements, that will enable them, to be tested, in an existing ‑‑ path, 
Again, I think it was talked about earlier by Yomi Wrong working with your trusted healthcare providers is probably going to be your best bet.
>> Tim Fuchs: Thanks. And Scott shared in the chat that Everlywell is supposedly producing an in‑home test, that is not an endorsement by any means, so proceed cautiously, I agree with Marcie and Richard's advice that you focus first on getting people ‑‑ to a medical facility, where they can get tested but just be aware of that. I want to go to this question ‑‑ 
Yomi Wrong: I want to add to that. I wonder what centers are doing around working with paratransit? I mean, I was shocked, that, even last week, our local paratransit, we're still doing shared rides, they said that they were cleaning the vans, and the buses in between trips but they had not cancelled shared rides, so that's exposure. 
>> Tim Fuchs: Yeah. 
>> Yomi Wrong: This is good advocacy, systems change work that centers can be doing, there's a lot that centers can be doing right now from the phone, from the computer, from working from home ‑‑ to advocate that the systems that our consumers rely on, step into this moment. I mean, it's ridiculous ‑‑ nobody should be in a shared‑ride situation right now.
        >> Tim Fuchs: Yeah, no kidding!  So, Sarah, I'm going to come to you: The next question that I want to tackle, is ‑‑ from John, and John says, you know, we're working remotely. And we've got some real concerns about HIPAA and confidentiality. As you‑all have gone to remote work, do you have any simple, or low‑cost solutions, for ways that people, can handle that kind of confidential information as they share it from their home offices? 
>> Sarah Martinez: Yeah, so we are doing our best ‑‑  [LAUGHTER] in this regard, because, you know, everything has been happening so quickly. We even had to buy two laptops to make sure that our staff could all transition, to work from home by Monday. So, there are staff that have, small children or, family members who live at home with them.  That, that may you know, pop in the background. We can't ensure that a kid isn't going to bust through, you know a door and not want to come say Hi, to mom or dad. So, we are creating kind of a ‑‑ a release of information, for teleconferencing that we can't guarantee, 100%, that, no one else, will hear that information so that our consumers can agree, that if they're comfortable, with this platform, that we have their permission 
>> Tim Fuchs: Okay, good.  Yeah, as someone working from home, with small children, I had to talk with my five‑year‑old to tell him that he couldn't come through the door for this webinar, the way he did with a couple of meetings yesterday and it looks like at 4:30, we've achieved that so, yeah, it is ‑‑ it's a new time, for all of us, isn't it? Well, hey, it is the end of our time together and you don't need to point out to me how many questions remain in the queue!  So, I want to thank you for your patience with us as we've answered as many of these as we can and in case you joined the call, later, I want to just reiterate two things. First, if you didn't get an opportunity, to ask your question today, ILRU has generously offered to collect those questions at ILRU.org. If you submitted your question today and we didn't have time to get it ‑‑ we'll save you the trouble.  We'll be collecting those from the chat and the Q&A tabs, and we will respond to you‑all. So, that may take us some time, but we'll do our best to get back to those, questions; I want to go ahead ‑‑ we've been on this, Q&A slide for some time, I want to highlight, the link to our evaluation form, before we close. 
Now, this isn't a live link, but this was in the confirmation e‑mail that you received. And when you close the webinar today, it should actually come up on your computer screen so that page should already be open.  If it doesn't work or you don't see it or you're on the telephone, again, it was in the confirmation e‑mail that was sent to you.  If you're participating with somebody else today, although I guess it's less likely now that no one's in the office, huh?? Old habits die hard, anyway we do hope that each of you will participate in this evaluation and will submit your feedback to let us know what you think or what we might be able to do better. Here, on slide 7 as I just mentioned, is the offer from ILRU, so ILRU@ILRU.org, if you didn't get a chance to ask your questions send it there, we will pull all those, and respond to you by e‑mail, I want to thank our panelists again, this has been, outstanding, I know it's been short notice, and I really appreciate you‑all taking time out of your busy schedule to share your expertise and your experience with us.
And to all of you on the phone, thank you for the same.  Again, this is the first, of a number of resources we're planning to put together. And so, we're all in this together, and we will be in touch, and if you have requests or suggestions, for other resources that you‑all could use, please don't be shy about letting us know, because we were certainly listening. With that we'll go ahead and close the call.
Don't forget that this archived presentation will be available on ILRU's Web site, within 48 hours, usually, sooner. That is business days by the way, and so look for that. You can review it, or share it with colleagues, whatever you see fit.
I hope you‑all have a wonderful afternoon; we'll talk to you soon! Take good care!