IL-NET T&TA Center presents…

CIL Pandemic Response: CARES Act Funds and Other Opportunities for Innovative CIL Actions-(Dual: Zoom/ST)
MARCH 3, 2021

>> TIM  FUCHS:  Welcome, everyone.  We're going to wait 20 seconds to make sure everyone is connected before we give any content.  So again, if you're just joining us, welcome.  We're going to start in just a few moments.  I want to make sure everyone can see and hear before we start any content today.  Watching that number grow.  We've got a big audience.  Glad you're all here.  All right.  Let's go ahead and start.  I see our audience is still populating.  I want to welcome you all to our latest IL-NET webinar.  CIL pandemic response CARES Act fund and other opportunities for innovative CIL action.  I'm Tim Fuchs on National Council on Independent Living and I'll be your host today.  I just want to walk through some housekeeping and accessibility tips before we get into our content.  So that's where we'll spend the next few minutes together.  
So here on slide 3, we do have both C.A.R.T. captioning and ASL interpreters with us today.  If you haven't turned on the C.A.R.T. captioning yet, you can do that be selecting show subtitle in your closed-caption menu Zoom bar.  If you don't see that, it might be under you're more option in Zoom.  And, you can also follow the same captions at StreamText.net.  That URL is a little too long to read, but it was the same URL shared in the so-called materials email that you received with the PowerPoint ahead of the event.  And so you can check that out there.  I think you guys are familiar with StreamText probably and this allows you to make the font size and change the color contrast and all that.  We are screen sharing today to share the PowerPoint and discussion questions.  
So make sure you're in side-by-side mode.  At the top of your screen, you should see a notice that Tim Fuchs is sharing his screen and there should be a drop down will and side-by-side should be your option.  If you're not seeing that or interpreter clearly, let us know in the chat.  And we'll give you a happened.  Let's see.  I also wanted to talk just a bit about our Q&A.  So we have a panel presentation today.  So we'll be walking through some of our questions, some questions of our own.  But we have plenty of time for audience Q&A.  So you can submit your questions variety of ways.  If it works for you, you can use the Q&A tab right there in Zoom.  It's convenient.  It's easy to use.  You can submit your questions any time you like.  And it will come right to us.  If that Q&A tab is not accessible or convenient for you, you're welcome to email your questions to me at Tim@NCIL.org.  And I've got my Inbox open and I'm happy to voice questions for you.  If you're only on the phone today, you can press star 9 on your keypad.  If you're able to access Zoom and other options, I like to ask that you use them.  Just because it does take some extra time to find folks that have pressed star 9 and have raised their hand and unmute their line.
If you need it as an accommodation, please don't hesitate.  Like I said, you can submit your questions any time.  We're beginning to wait for our Q&A break to address them.  And that will come after we finish our discussion questions.  And, finally, we do have an evaluation form that we like to ask you to fill out.  You guys have probably done this before and we do it for all our IL-NET webinars.  They're quick, they're easy to fill out.  But we really do value your feedback and we take them very seriously and use your comments as we evaluate the project and figure out improvements for the future.  If you have any other questions about access, or technology, let us know in the chat.  We want to reserve our chat for technical assistance, technology assistance.  Any help you all need with accessing the presentation.  And we want to use our Q&A tab and the other options I read for the kind of the content questions if that makes sense.  So if you can all help us with that, we would appreciate it.
Okay.  We've got a great panel today.  I'm here on slide 4.  And we wanted to share our contact information with you all.  So I'm Tim Fuchs, as I've said.  My email is just Tim@NCIL.org.  And each of our panelists have been generous enough to share their connect information.  We have Todd Holloway, Ami Hyten, Jill Jacobs, and Paula McElwee.  These are folks you know very well.  Todd of course is from center of independence in Washington.  And has been a real leader in emergency planning preparedness and response.  Including during the pandemic.  Ami Hyten is Executive Director at Topeka Independent Living Center.  Jill Jacobs is from ECNV from allergy ton Virginia and are Paula McElwee is our technical course coordinator.  So I want to thank all the presenters they've spent for preparing this and beeping with us.  And quickly on slide five, we want to review our objectives for today.  So we are going to discuss and you will learn how CILs can use CARES Act funds and other funding opportunities for CILs that have not spent or -- excuse me, other opportunities for CILs that have not spent or did not receive CARES Act funds.  I am not doing well in my hosting duties today trying to clear my mind a little bit.
Second, how CILs can help with vaccinations and overcoming inequities in vaccine roll outs.  That went better.  All right.
So, we're going to get right to the chase here.  And I'm excited to get into this content.  I have been thrilled to see the registrations come in this week.  We've got over 500 individuals signed up.  I see we've got 350 already online with us.  So I know you guys are dying for this content.  Anyhow, slide six is our first discussion question and I'm going to start with Paula McElwee.  So Paula, here's a loaded question for you.  What exactly can we use CARES Act funds for?  Do you want to try to take a chomp at that?
>> PAULA MCELWEE:  Let me see if I can do that in ten words or less.  [Laughter] You must use the CARES Act funds for something that's COVID-19 related.  And so, what exactly that looks like in your community and where you want to go with that is it depends on what is needed by the people that you serve.  You need to be sure you're serving people who have significant disability, the same people that you serve with your other funds.  And you need to make sure whatever the need is COVID-related.  Once you've looked at those two things, then you can kind of drill down and see if you can make it make sense.  Now, we have a great FAQ from ACL.  If you don't have that, it's going to be posted here for you so you can take a look at that.  But it mentions specific things.  It mentions technology as a specific operational activity.  It mentions PPE supplies to help people stay safe.  It mentions your staff time which is related to the COVID response as being something you can pay for.
And then it answers some other questions.  Now, we've asked people what are you spending it on?  And we've had some really creative answers.  People are looking at what do we need to do to get people out of nursing homes, especially, recently.  Let me see if I can improve this.  I'm trying to improve my sound a little bit.
>> TIM  FUCHS:  Yeah, it is a little bit low.
>> PAULA MCELWEE:  Still fuzzy?
>> TIM  FUCHS:  To be honest, a little bit.  I can hear you, but it's not clear as it typically is.
>> PAULA MCELWEE:  And I've got this really good microphone that is supposed to solve all these problems.  [Laughter] My technology lately has needed some help.  So, I'm sorry.  I hope this is clear enough.  I'll slow down a little bit, make sure it's understood.  And then when I'm off, I fiddle with it a little bit before the next time I talk.  But, Brooke has published you the link to FAQ.  We heard from ACL that they're going to update that.  We're going to have an update on that.  But there really isn't a list of things that money can be spent on so much as that you look individually with the people that you serve, what is it they need to keep safe and healthy during this pandemic?  What is it they need to be connected to their medical services?  What is it they need to be able to access the services of your center?  And some of that really is technology-related.  So, yes, there are centers for purchasing equipment.  Some of it for loaning library, some of it for individuals to keep.  And purchasing minutes or access to wireless, or whatever else is needed for them to be able to access things.
As everything has moved online.  Their healthcare providers, the services you offer, your independent living classes and peer groups are meeting by Zoom.  How do people access that?  And how do we bridge that digital divide where some of our folks just did not have any access of that sort.  And this is an opportunity for you to establish that.
We've seen food purchased often with in collaboration with food banks.  We've seen really creative things.  One that I just ran across recently was that it was no longer safe or possible for an individual to go to a laundromat.  And so, they were assisted with buying a washer and dryer and getting it hooked up because they needed it in order to stay safe and healthy.  So it's going to be interesting for you to look at this.  But document for each person why did they need it to stay safe and healthy?  And how is it COVID-related?  And that kind of response to each and every one of the things you look at will be very helpful to you.  So, I also would like to mention just before I hand it over, that Sean Barrett from ACL is on the call and he's helping to answer some of the Q&A in the Q&A bar.  So take a look at that as well.
>> TIM  FUCHS:  Thanks, Paula.
>> Hey, Tim.  This is Ami.  If I could add couple of things?
>> TIM  FUCHS:  Yeah, please go ahead.
>> AMI HYTEN:  Hi, folks.  I'm Ami Hyten and my pronouns are she/hers.  I'm an olive complexion woman with hair that is gray and little bit of Black.  Black T-shirt standing in room of white lines.  And so, yes, we'll get that out of the way.  So, one of the things that I think coming from the perspective of Center for Independent Living, one of the hard things for us to get ourselves accustomed to is that before COVID, there have been things that we accomplished using maybe volunteers or community services to accomplish, you know, such as I know there are a lot of groups that build ramps on to homes and help people with those types of modifications.  And it may be the case that during those organizations folks are getting together and they are offering those types of services for free, and so we may find ourselves previously we wouldn't necessarily have paid for that.  But because of the circumstances around and isolation, we may need contracts to provide services.  Because obviously, home modifications keep people remaining safe in their homes.  And help people transition back into those homes.  Both critical parts of responding to this pandemic.  Thank you, Tim.
>> TIM  FUCHS:  Thanks, Ami.
>> Tim, if you don't mind, I want to jump in real quick.  Hi, this is Sean Barrett.  And I want to do a secondary plug for the FAQ that Paula referenced, there's a link in the chat and what have you.  There's a bunch of information in there that was more critical in the first couple of days where people are setting up offices.  But especially questions 8 and questions 15 talk about allow activities.  And sort of some guidelines and some general principles on how to apply those.
The thing I really wanted to point out and hammer home is that presentations like this one, the last one with the election call, also in the chat with Commissioner and myself talking about how people have been using the CARES Act funds.  Those are ideas to stimulate your ideas.  Right?  Nobody knows your consumers needs better than you.  Nobody knows your communities gaps and strengths better than you.  And nobody knows your CILs capacities and gaps better than you.  So it's a combination of those 3 that will lead you to what are the CARES Act funded activities that I can do.  If you hear things about setting up food banks or building a ramp for food bank, that may work for you, but it may not work for you, because you're the only one who really has that expertise that's needed to identify, design, and implement the, really, the things that are super-effective in your area.
>> TIM  FUCHS:  Thank you, Sean.  Let's take a look at our next question.
So, this here on slide 7, what can I be doing to help if I didn't receive CARES Act funds?  Or I've already spent my CARES Act funds?  So there are a lot of part B centers or state funded centers, and some of you may have spent your CARES Act funds.  So Todd, I want to come to you and get your thoughts on what those organizations can be doing if they didn't get CARES Act funds or if those funds are already committed to still be assisting during this mid to late-stage of the pandemic here?
>> TODD HOLLOWAY:  Thank you, Tim.  My name is Todd Holloway.  I'm a light-skinned male.  My pronouns are him/him/his.  And I have gray Brown hair and I'm in one of my home offices.  I'm sure you're all familiar with that.  I am so happy to be able to talk about this today, because I know a lot of you didn't get CARES Act funding.  And those of you who did may be trying to spend what you have and others may be getting ready to be without the funds.
So what I would say is, along the same line of what Sean just mentioned, you are the best determiner of what's going to be the best bang for the buck in the community you live in.  And Paula has been a real tool for us to use at the Center for Independence in Lakewood Washington to ask questions on-the-fly as we go.  And we've done a lot of spending of the CARES Act funding that's really benefited not only our participants, but the entire community.  So with that said, I want to say that something that I say very often, whether it's a pandemic or any other natural disaster, and that is the Civil Rights are not suspended in emergencies and pandemics.  And so, one of the things we can do is that we can continue to remind our other partners, local, state, and federal that that compliance needs to be taking place.  As you've heard Paula mentioned, deinstitutionalization and keeping people out of congregate setting is an enormous responsibility we carry.  And that can be something we can consider and look at as we go forward in the vaccination process.
One of the things I like to tell people is, there's billions of dollars of CARES Act funding out there.  And I'm not talking about two IL center and I'm talking about all of it.  Nobody knows who has what and what is to be spent on even a year in.  So start building those partnerships.
IL centers do a wonderful job of building partnerships with community members.  Sean, I see you come on-screen, so I'm guessing you want to chime in as well?
>> Just real quick.  I want to give you a lot of credit.  I remember talking to you and some of your peers very, very early on in the pandemic.  And you would actually have had previously established relationships with statewide level, excuse me, for a lack of phrase, disaster preparedness type of organizations and we were having conversations about COVID in December or earlier of 2019.
So, you were able to leverage those existing partnerships, what I imagine to some degree what you're referring to now as other funders.  That was it.
>> TODD HOLLOWAY:  Thank you, Sean.  I'm glad you brought that out.  When we're good stewards of funding we do get, and we do produce good work, Congress is a lot more likely to pay attention to us whenever they're handing out money to get good work done in the future.  And that is part of the reason why we got the CARES Act funding we had is that we had done some best practices, and we continue to do some best practices and promising practices.
But these partnerships that I speak of cannot be underestimated.  Again, the FAQs that you have access to with ACL's OILP use those as much as you can.  But work with your partners to find out what you can be doing with them.  The center for independence has been approached by subcontractors and the Department of Health itself within the State of Washington to do some outreach.  And we just were able to, with the subcontracting with the partnership for inclusive disaster strategy who has been at the hand of NCIL friends at the emergency planning subcommittee, we have been able to create a guidance for all of our vaccine sites here in the State of Washington so they have a checklist that they can go through to make sure that everything from registration to the actual process of getting vaccinated is accessible as possible.
And there's, I want to say mandated, though I'm sure at this point it's a guidance for people working on the sites to look at the training that we created as well.  So that training, and that checklist is being used in a very broad sense.  And now, is more or less going to be standardized in the State of Washington.  And we'll be providing them with the even more documents and guidance as we go forward.  We're at a place in our nation's history where we have an administration that is using terminology we really like right now with the access inequity.  I've heard a lot more of diversity, equity, and inclusion coming out of the White House and Capitol Hill in recent days.  And this is a green light for us to do the hard work that it is that we try and do 365 days a year.  So I want to thank all of the partners that have been doing that work with me.  I encourage you to ask questions when it comes time for Q&A.  Put them in the chat, and I'll be looking at them in a minute.  And I'll leave a little air time here for any one of my co-panelists who want to inject.
>> TIM  FUCHS:  Anybody else have anything else regarding CILs that didn't receive CARES Act funds or already spent them?  If not, that's fine.  Just wanted to give you the opportunity.
>> TODD HOLLOWAY:  This is to do.  Is there still time, Tim?
>> TIM  FUCHS:  Yeah, you've got another minute or so.
>> TODD HOLLOWAY:  Great.  One thing I would like to encourage people too FEMA is fundamentally, well, I should say, they've assigned millions of dollars literally to states to help out with this process.  So I think it's our obligation to make sure there's public assistance dollar that have available that we're encouraging people who can request the state, then request the Federal Government, those dollars are there.  So we need to be diligent in making sure that they're being spent appropriately in each of our states.
The same goes with the Department of Health.  Their CARES Act funds and other funds coming through.  Again, we are partnership that we were able to create in Washington, and I know this is happening in other states as well, including Ami's like California and all across the country.  But just not as much as I like to see is the Department of Health is able to drawdown some of those funds and really draw where that goes to our partnerships, Centers for Disease Control, departments of health, health and human services.  That is key to making sure that if we need resources, they're there and we have the partners ready to work with us to get that job done.  If anybody has any questions about that, and you think of it after this presentation, after today, feel free to connect with me and I will help walk you through that.
>> TIM  FUCHS:  Thank you, Todd.  Okay.  I want to apologize.  And I want to thank Ami and to do for reminding me of our promise to be visually descriptive in these preparations.  So I introduced myself.  My name and title.  But I'm a white guy in my late 30s with very dirty blonde hair.  It gets dirtier every year, I guess.  Also working remotely from the home office with a white background and a lamp that sticks, on this side, right off to the side of my head.  Kind of wish I put that somewhere else.  My pronouns are him/him/his.  Thank you for bearing with me and I'm sorry I didn't do that at the top of the hour.  Okay.  I'm going to go ahead to slide 8.  And this is a big one.  I think a lot of us are here for this question, Ami.  And this is, you know, a multifaceted question.  Shoot, it's hard enough to figure out how you're going to get vaccinated if you can access complicated websites, have a car, or able to get around the community?  And a lot of these processes aren't really being planned for people with disabilities.  So you know, CILs has a huge role here.  And it's not simple.  So what can we be doing at CILs to help with vaccinations in our communities?
>> AMI HYTEN:  Hi there.  This is Ami again.  So you hate to make the first statement directly contradict what Tim said.  But it's simple.  Because my answer to the question is how can we help with vaccines in our communities, we do our job.  We do what we're best at as Centers for Independent Living.  So we can be a resource.  So helping people get information about who is eligible for vaccines?  Who can get those vaccine medications?  Where they sign up to get those vaccinations?  Where they go and when they can go and all of that.  I won't go into too much detail, because I think Jill actually in the next question has some fantastic information to share with respect to helping people get connected to vaccination opportunities.  What else can we do?  As Todd just talked about is we can make sure vaccinations sites are accessible, all vaccination sites are accessible, right?  Accessibility is bread and butter, Center for Independent Living stuff.  And Todd and the emergency response advocates from around the country have done, they have laid this ground work for us.  They started talking about access when we were looking at deploying testing resources.
And so, they've actually have that roadmap for us.  And now, of course, have improved accessibility checklist that Todd was just talking about.  And so making sure that those sites are, you know, that they're accessible and people can get to them.  That folks aren't having to stand and wait in long lines, if there are, there are accommodations.  That's who we are and what we are fundamentally.
Additionally, I would encourage folks to look at the materials and the education, the educational materials that are being distributed.  Make sure that they're being distributed in plain language readily available and accessible.  That they're given in alternative formats.  That you know, when information is being given out to our communities about vaccinations, that that information is being provided in linguistically appropriate formats, including American Sign Language.  So access.  It's pretty fundamental to us.  What are other fundamental things that Centers for Independent Living do?  Oh yeah, we advocate.  So we're in a perfect position to advocate.  How do we use our Civil Rights to help people get accommodation in access and equity in vaccinations?  I keep reminding folks, every single person on Medicaid waiver is, in fact, a person who qualifies to be in an institution.  Everybody who receives home and community-based services on Medicaid waiver is as disabled, as the least disabled person in any institution.
Now, if that waiver beneficiary were, in fact, in that facility, they would have gotten their vaccination along with their morning antacid.  It's our right to get our antacid, to have our showers, to get our shots in the community the same as those folks living in those facilities.
So this may mean we're going to advocate for people on the whole as a group.  Or it may mean that we need to step in and advocate for individuals to get access and accommodations that they need to be able to get the vaccine.  So that may mean we need to advocate for paperwork to become more simple or streamlined.  That means we need to advocate for actual physical assistance at the vaccination sites.  To help people get appointments at specific times around, you know, other sort of health maintenance activities.  Or different locations or reduce exposure to other people so situations don't become problematic.  No one knows our Civil Rights and how to navigate the Civil Rights accommodation provisions better than those of us who are in centers for independent living.  I suppose the final thing that actually I'll touch on is, you know, for Centers for Independent Living, I regard at our center part of our role as a community builder.  And that means that we connect resources in our community to the benefit of the people that we serve.  And so doing things like making sure that the transportation to and from vaccination sites is available.  Whether it is advocating that nonemergency medical transportation be made available.  Or paratransit rides, or public transit rides, or Uber provides accessible rides.  However, that needs to happen in our communities, connecting those resources up and doing the work to make that happen.
Making sure that people have PPE.  So people can safely get to and from.  And making sure that people know what it means to be vaccinated.  That they still will need to exercise social spacing, wear masks, limited exposure.  And continuing to look for those partnerships to support expanded distribution channels, locations, et cetera.  And so, those are just kind of, again, they're core to what we do.  And deploying those for vaccination in our community, there's no more important time for us to be doing exactly what we do and being who we are.
>> TIM  FUCHS:  Thank you, Ami.  Outstanding.  Anybody want to add anything?  I know next question relates to vaccination too, but if any of our panelist want to chime in?  Had.
>> TODD HOLLOWAY:  Hey, Tim, this is Todd.  I just answered a question.  Somebody was referring to people who were being cared for in the community may be getting transitioned into a nursing home for quarantine.  Nursing homes are not quarantine sites.  Quarantine sites are set up completely separate.  And they are individualized sometimes in hotel rooms, sometimes in other facilities that have modular set ups.  But check with your county.  If anybody is referring to a nursing home as a quarantine site, please, question their accuracy on that.
>> TIM  FUCHS:  Okay, thanks for the distinction, Todd.
>> Just add to quickly.  I apologies for not describing myself.  My pronouns are had he/him.  And I am 51-ish older short guy sitting in his chair.  I'm going to use Tim's phrase.  My hair is getting sandier overtime.  That was good.  Or whatever.  And I just want to reiterate.  I just like Ami's comment on this is what you do or what we do.  Everything is in the realm of what you're already doing and what you already have expertise in, and just having to tweak it and focus on the historic pandemic.  So that was great.  Fantastic.
>> TIM  FUCHS:  Great.  Thank you, Sean.  If you come along with me to slide 9.  This is our fourth discussion question here.  And Jill is going to take this one.  So, here on slide 9, you see it says people with disabilities aren't eligible for vaccinations yet, or it should say in a lot of areas, people with disabilities aren't eligible for disabilities yet or the rules are unclear.  How can we get involved in this?  So what can CILs be doing at that systems level to push vaccination priority in the phases that we're all becoming familiar with around the country?  Jill.
>> JILL JACOBS:  Hi, everybody.  I'm Jill.  I am -- my pronouns are she/her/hers.  And I am a white lady, middle aged and I'm wearing Black glasses and Black mask.  I'm currently sitting in a hospital with a family member here.  And I am sitting at a pediatric kitty table and the laptop is balanced on my knee, so it it is jiggle video.
So, this question, people are disabilities aren't eligible for vaccinations yet, or the rules are unclear, how can we get involved in this?  So, yeah, it's different.  First, let's say that access for people with disability seems to different everywhere.  Here in the Commonwealth of Virginia, it is different each from county-to-county from locality to locality.  So it's a challenge.  So if there's anything I can get across how you can get involved, the primary thing you can do is offer solutions, collaborate, reach out to your community, those are really key things you can do.  And, of course, advocate.  So, if there's nothing else you hear today from me, that's what is most important.
So the first thing that we did at ECNV is, and well, first, let me describe ECNV.  We're located in Northern Virginia.  And we serve four counties.  And in those four counties, we have very densely packed urban environments, we have public transportation, we have areas that are suburban with no access or no close access to easy public transportation.  And then we have some Loudoun County with rural environments.  And so, a real -- all kinds of people.  We have every kind of person that you can imagine, we are working with here.
So first thing that we did was, I engaged a dedicated community volunteer.  And that person, we talk every day.  She helps me with writing, with outreach, she picks up the pieces if I suddenly am not available, like that has happened this week.
She is just been a wonderful resource and support in getting these things done.  She makes in roads to network alongside me.  And this particular volunteer has been in the community for quite some time, is very familiar, and has, you know, a real invested interest and the success of people with disabilities.
And the concept is very involved, the concepts of independent living carrying that out.  So that's a key piece for me that we've done.  What we have found is the key issue we have found at every level.  And we're working at local level, state level, county level, and in some cases in Virginia, we have these cities within geographically within counties, but they have completely have their own government.  So they are, we have to work with that level too.
So, the key elements we have identified regardless of what level we're at is that people with disabilities and their caregivers have not been identified as stakeholders, as real key stakeholders, or really at all.  And to there's a lot of lip service, but no real identification and respect, and engagement with us as stakeholders.  And because of that, because we have not been identified this way, even though there may be language around us, or some kind of lip service, we are not engaged in the conversation, the strategy, the planning, and any of that in any meaningful way.  And most importantly, in an emergency environment like this is.  We are not being engaged and involved in the change management process.  Change happen constantly.  I have come to say that Band-Aids, I call it the weekly Band-Aid.  Every week there's a new change and there's a new Band-Aid.  So when things are changing that quickly and you're not seen as a key stakeholder, you have to, every week, start over, start fresh.  And that can become tiring.  And so to work with that, we've advocated.  We have forced ourselves into the stakeholder position.  We've maneuvered ourselves there and have cajoled ourselves there and to be seen and respected.  And we made ourselves the go-to organization in many cases.  And in doing so, people are now seeing us as the go-to organization.  They're coming to us and they're asking questions.  So, we have done that with the Virginia Department of Health, the governor's office, the department of rehabilitative services, delegate, Senators, now the Virginia CIL, VCIL is called.  And local leadership.  And when we talk about local lip, we talk about both formal and informal.  People who are seen as leaders.  So church leaders, community leaders, that way.  So we put ourselves in this position and made ourselves the expert.  And so in doing so, all those levels are coming to us now.
So key thing we're trying to achieve is we would like to have the finger pointing stop.  And so, local points, the county points to Commonwealth of state, and the state points to Federal Government.  We would like to have that stopped and create solutions.  I'm sorry, can you hold on a second?  I have an emergency.  I apologize, guys.
>> TIM  FUCHS:  No, problem, Jill.  We certainly understand.  Does somebody want to pick up in regards to system level approaches to vaccination priority?  And things we can be doing in the community?
>> JILL JACOBS:  Sorry.  I'm back.
>> TIM  FUCHS:  No problem, Jill.
>> JILL JACOBS:  So we want to stop the finger pointing.  So to get to all these goals that we have, what we have done is, we have -- we just offer solutions.  We look at the problems and we offer solutions.  And so everyone we talk to at every level, we presented duties.  We've written a white paper.  And that white paper serves as a framework that identifies clearly.  Includes references, both scientific, legal, and policy references.  And then also personal stories references.  And we offer a few workable solutions.  And then we offer a scaffolding to achieve those solutions.  And that includes things like programs, existing systems, human beings, and resources that are human, resources that are money, resources that are all the kinds of resources there are.  We put together some potential solutions.
And we have been recently really relying on the draft of the document that makes the case for HCVS to be to be treated as high priority recipients.  Anyone who uses how many community services to get those services and identified as risk of institutionalization.  And they're at the same level as anyone in an institution and should have access to the vaccine.  So we use that draft of document and we provide policy language around that and even some documents, so same time as Arlington County and say, here as look you use, that identifies a person in community home-based services because they're eligible for long-term care in an institution.  They qualify.  Let's move along and get over your whatever issues you've got.  Here's your own document.  So we use their own document.  And then we move on to solutions.  And we offer several kind of different solutions.  We have 3 or 4 typical that we talk about but we're open to options.  And we also note in the registration process for the vaccine that the CDC has put together a list that everyone seems to want to use.  And that's awesome.  Everyone trusts the CDC.  But that list, because stakeholders weren't properly engaged at the federal level all the way down follows a medical model.  It has institute and that's in terms of language now not being accessible and you have all things flowing from that when you're using a medical model.  Institutional bias.  Agency-based bias, and non-consumer-directed bias.  And that's important for caregivers getting the vaccines.
So using this kind of language, this kind of terminology has nothing to do with how people with disabilities self-identify.  How they understand or relate to their own disability of condition.  So this is problematic.
So, we're working to change that in Virginia with the registration process.  We have the statewide registration process.  And then each locality has their own version, but they all flow from that same language, that lingo, so we're working to change that so that people with disabilities can recognize themselves when they go to register for vaccines as they move through the vaccine process, as they ask questions.  And we are working to educate people so they know how to respond to those question and recognize the language the CDC use and what that actually is called in our world for people with disabilities.  So we offer some kind of cheat sheet vocabulary that kind of stuff.  But in the meantime, while we're waiting to try to get that changed, we have worked diligently to make sure that all the entities that provide services to disabilities, so for example, the community service boards that gets services to every person with intellectual or developmental disability, we have been working with each county to make sure those consumers, case managers through the consumer service board are given clear direction from their leadership about how a person with disability can get through these registration processes.  So it's broken down into plain language.  It offers guidance.  It tells people with disabilities where you fit in these weird words like neurologic, like where you fit in.  That sort of thing.  So we offer those tools.  And we have been working with the community service boards to get that information directly to people.
The two key issues we've identified when you're looking at access to vaccines are people with disabilities and the fact that who use HCVS, and people, let's see.  Consumer-directed caregivers for people with disabilities.  They have been left out of the whole process of accessing the vaccine.  And that's because of this bias that exist that agencies provide, home healthcare agencies for example, provide that kind of care.  So when a consumer-directed caregiver goes to register, it says are you a person who provides care to someone who is elderly or has a disability?  You click Yes.  And the next screen says, who is your employer?  So at that point, it's a stopping point.  If you can't answer, it sends you right back to the beginning and you can't get through.  So on that end, consumer-directed caregivers is what we've been working on.  We work with SEIU.  And we have worked with every entity up the chain.  And we have worked with counties individually ECNV has become a pathway, a conduit.  To caregivers can go through us and we identify as the "employer" we call ourselves the "employer pathway" and we just created a Survey Monkey.  We gather that information every day, and it passes up the chain.  We send it directly to Arlington County.  And so they have the information they need and people get vaccines that way.
In this way, in one county, we helped probable approximately 600 people, caregivers, access the vaccine.  That's just in one county.  We're working with other counties in other ways.  So another example is in Loudoun County.  But when it came to people with disabilities, we started getting heard there.  So what we recommended to the Department of Health director there was what about if we create clinics?  If we can bring people in the community together and create clinics, will you allot vaccine to us?  When I will you allot medical staff to us?  Will you allot the logistics and scheduling to us?  And we will be a conduit and we'll put out a survey monkey and reach everyone we serve and we will pull all that for you and other entities to support you guess in the process.  And they said yes, sure.  So we're working on getting two clinics open in Loudoun County.  Something that's particularly exciting about this, we're working with groups of people who to my knowledge never worked together before.  Latinx Community, the East Asian Community, rural community, because Loudoun has a lot of rural elements.  Rural tan club is offering us space and Black churches.  So they're coming together to make this happen.  So it's a really positive way for us to all serve and solve this problem together.  And it is an opportunity to recognize that we have a lot in common.  We all want to make sure we survive, that our family members survive.  So that's the way we're achieving that.  And just on different things and different places.  I could go on forever about the kinds of every place in Alexandria and come up with processes and move through the services and change process at the state level.  We worked closely with the department of rehabilitative services.  And that's been recently very successful.  And we've been invited to come and speak to the governor and secretary of human services now.  And most thing I can say, what I can says is to just come up with to identify the problems, to backup the problems you've identified with, you know, data, to create some solutions, and to utilize all, everything at your fingertips to help solve problems.  Come up with creative solutions.  At the end, I'll be happy to email to Tim or whoever the white paper we've created that we've utilized.  So, I hope that's helpful with everybody.
>> TIM  FUCHS:  Thank you, Jill, thank you for your work and laying it out for us.  If there's handouts like that.  I can't promise for folks in ILRU, but we can probably add it to the training webpage where we're going to archive the webinar.  All right, we're going to move ahead to slide ten.  And I'm going to talk to you, by the way, before we transition to our Q&A break after this question, I'm going to talk about some of the additional resources we have like the recorded webinar.  I saw few questions about that, you'll be able to access that and some other ongoing resources that that's coming up before the Q&A break.  Here on slide ten, we're seeing early data.  This is becoming clearer, unfortunately, that vaccination rates are lowest in communities of color and among people of color.  And other areas that have been hardest hit by COVID-19.  And that's really troubling.  So Ami, I wanted to come to you and just talk about what CILs can do to help reverse this trend?
>> AMI HYTEN:  Thank you, Tim.  So this is Ami again.  And, yeah, as Jill leaves her response talking about the data, I think it's important for you guess to sort of take a time out and set the stage here.  Because at the outset, we have to recognize that CDC, which is where most of the data comes from has not been requiring states to report racial data with respect to COVID.  And so, in the world of data, people, data means everything.  Data drives policy.  Data drives programs.  Data drives funding.  And so not having any data means that the experiences of folks aren't in the driver's seat for policies, for programs, for funding.  And this lack of data, the way that it doubles over on itself, the way that people then point to nothing demonstrates a problem because there is no data, because the data wasn't collected in the first instance, that is a prime example of the type of structural racism that has led to the inequities that sort of under gird this question.  So the good news is that even though the CDC itself was late to the party, some states began the process of collecting racial data notwithstanding.  And at this point in time, there looks like there's about 23 states who have been reporting racial data.  And based on those 23 states, to go back to what Tim alluded to.  White people in those states are being vaccinated at twice the rate of Black people in those states.  Even though Black people in those same states are 1.4 times are as likely to contract COVID, and 2.8 times, almost 3 times as likely to die from COVID.
And so, it's important for us to recognize, again, as a matter of structural bias, the same type of institutions that we're used to fighting in the disability world that create the institutional bias, that means that people in certain buildings get access to things that people who aren't in those building get access to.  It's the same kind of dynamic that works itself out in our racially marginalized communities.  It may mean that the fancy CVS in an affluent neighborhood newly built with a refrigerator and all the bells and whistles may receive a whole bunch of dosages of vaccine than the CVS that's located in a Midtown or downtown location that would be convenient for people in more racially marginalized communities to get to.
Additionally, the history of medical trauma and abuse for marginalized communities, in particular, Black communities cannot be overstated.  Black and Brown folks have good reason, historical reason to feel in this case what feels like a rushed medical advancement and deployment.
So how do we fix it?  We have to get vaccines to where people are at.  So the release of the single dose Johnson & Johnson vaccine is going to be a source of tremendous progress in this area.  And so my Center for Independent Living for example, started working, just sort of soon as we found out this is going to be an option, started working with our local Meals on Wheels and state nurses association and their volunteer groups to try to put together a program that would use the client-based of the meals on wheels program to create an entree for nurses to be able to go into the home and give people vaccinations sort of alongside their very starchy lunch.  Much in the same way Jill was talking about sort of the efforts in Virginia.  You know, sort of looking at these creating these partnerships, what we're trying to do is set the program up and go to the state and try to get the certain number of vaccines sort of dedicated to those types of programs.
Similarly, my Center for Independent Living has a partnership with a number of our local mutual aid groups, including our local Black Lives Matter organizers.  And we're actually working with them to set up, to propose setting up a vaccination site that is an event that runs alongside and ongoing food distribution event that organization holds.  Again, with the help of our state nurses association.
The critical piece is to be creative.  CARES Act funds could be used to pay for refrigerated delivery of vaccine doses, for handling, for accessible space, for PPE, those funds are available and at this point in time, there's really next to transitioning people, this is the next best way to deploy those and get those funds in the community.  It's important to recognize people who know someone who has been vaccinated are more likely to take the vaccine themselves.  And that's exactly why my Center for Independent Living didn't just set an event up in the building.  That's why we set out with trusted community members in marginalized communities sore they can use the same peer-to-peer model that we use in the disability world.  It works in other places as well.  It works in the community.  And we recognize that, that value of the model as we try to make sure underserved communities and marginalized communities are getting access to the vaccine.  We need to consider other barriers.  Immigration status of people.  Or the immigration status of other people living in other people's homes may feel less likely to sign up for a vaccination.  You have to provide a lot of personal information and a lot of data associated with that.
And so, again, with the idea of trusting, focusing on the use of trusted community members, we're working on ways to encourage participation amongst people in immigrant communities, and in communities where, you know, where folks and undocumented folks tend to be.  You know, looking at the paperwork itself, how little paperwork -- how little information can you get people -- can you collect from people to still be able to make sure that they can access the vaccine and minimize barriers in that way as well?  Both as a matter of language access, and to assuage concerns about people being potentially po filed.  Two last things.  One thing is, and in the webinar that happened in health equity, there was actually an epidemiologist from Harvard who had great information, again, about the data and lack of data.  And one of the things they pointed to in the work they're doing is that we may not have racial data.  But we have data that is adjacent to racial information.  And so, if we know that there are certain places that are hotspot, and those hotspots tend to be more closely associated with marginalized populations.  So for example, we have a factory here in Topeka where we know that a large number of people in our Hispanic community work.  It's called Reasor.  Who got food poisoning probably came from Reasor's.  And we know there's a large population of folks associated with that hotspot, because it was, of course, a hotspot.  Like meat processing plants, much like schools and daycares in certain locations.  And so advocating to target vaccinations to bring vaccinations on-site to those types of hotspot locations, it was a bit much higher probability that you're going to get more engagement and participation from the people who are being affected in those communities.
The final thing is, the unsaid thing here is this.  In the interest of promoting equity and addressing racial inequity associated with the greater infection and exposure risk of folks, and the lack of access to vaccines, we, as Center for Independent Living, we as director, we as employees, we may need to stand down.  We may need to let other people lead.  And for the first time in many of our lives in a Center for Independent Living, we actually have money.  We have resources.  And we have, which gives us that ability to stand down, to let other trusted members of the community to lead and make sure people are comfortable and are safe, and feel okay about taking those vaccinations.
And in the meantime, we can play the role of Daddy Warbucks.  We can deploy the resources and organize the logistics that allow those people to successfully, when they make in roads with those communities to get the shots in people's arms to the greatest extent available.  And that is the best way to ensure that our communities are well served and to promote equity.  And that's, I don't know, I think that's all I have.  I don't know if anybody else has anything.
>> TIM  FUCHS:  That's heck of a start.
>> JILL JACOBS:  I do have a comment.  I'll just describe myself again.  I'm the same white lady but now I'm in a hallway with IV machines behind me.  So regarding data, I would like to say that it is possible for CILs to take, kind of been take bit of a control with that data.  Hold on, I need to move out of the way of the x-ray machine.
To sort of take control of the data by offering yourselves up as experts or pathway or conduit.  So for example, in the case where we have offered obviously up as a pathway, people with disabilities and caregivers to register for the vaccine, we use a Survey Monkey which is a really simple tool and it's great at creating presentations.  And now we have data, and we now own the information that's come to us and we use that data, we use those metrics to post our agenda.  That's all I have to say about that.
>> TIM  FUCHS:  Thank you.  These inequities that we're seeing are troubling and tragic, and it's important to have concrete steps that we can take.  And so, Jill and Ami, nice job and I appreciate you all addressing that.
I want to move to our audience Q&A.  I told you at the beginning of the call, in the announcement, we have plenty of time for questions.  I want to mention things before we go there.  So first of all, as your questions have rolled in, at least on the Q&A tab?  And in the chat.  I want to thank our panelist for addressing those.  We've got a massive audience today.  Over 350 connected live.  We had over 500 registered.  So I was worried about getting to all your questions, which is something we always strive to do.  So I want to thank our panelist for doing that, for responding to those questions in writing.  But we do have plenty of time for audience questions.  And we'll go there next.  I want to do plug couple of up coming events that relate close to this content.  We have talked about and alluded to transition in emergency relocation from congregate setting right now during the pandemic, because that is so important.  I mean, it's literally life or death.  And the only reason why we've not gotten into more detail on that today, because we have a presentation coming up next Thursday entirely about that.  In fact, that announcement is going to roll into your inbox here, if not later this afternoon, and then first thing tomorrow morning.  So be on the lookout for that.  It's actually under the same title.  It's part of the short series that we're offering on COVID.  So you'll see it under the CILs pandemic response.  And it's emergency relocations and transitions for CILs.
And so, be on the lookout for that.  There's a third too.  So we actually heard from the folks at CDC that wanted to talk about some of the ways the CDC could and wanted to support CILs right now during the pandemic.  And so, that one is forthcoming.  That one is down the road, maybe a few weeks away, but look for that announcement.  We're going to do our best to get through all your questions today.  I want to remind you as we transition to the Q&A break, you can submit your questions in the Q&A tab in Zoom.  If that doesn't work for you for any reason, you can email me at Tim@NCIL.org.  And if you're on your phone today, you can press star 9 on your key pad.  If you are logged into Zoom for asking questions, I like to ask that you do that.  I want to reserve the star 9 and raised hand feature for folks whom those other options are not accessible.
Lastly, I just want to mention some of the ongoing resources.  So, one of the nice things about IL-NET is we're not going anywhere.  I hope today's presentation was helpful.  But we're a training and technical assistance project, so any questions we don't finish today or any questions that come up for you, please do reach out to us.  Paula and I are happy to be your lightening rods for questions.  I think you guys know us.  You know our emails.  My email is very simple.  It's just Tim@NCIL.org.  And all of our email addresses are on the, I think it's the third slide in the slide deck that you received by email when you registered.
Also we are going to archive this webinar.  So that will be on ILRU webpage.  Give us 48 hours.  It usually goes up sooner than that.  But it will be up in 48 hours.  So and you want to review the presentation or share it with a colleague, you'll be able to do that.  And we'll also post the materials there as well.  Okay.  So those are just some things I want to mention.  Leather get to your questions.  So again, I'm going to do my best to get to all of these.  And if we do run out of time, again, you can always reach out to us and we'll answer it.  We'll be happy to answer them by email.  First question from Mariah.  It's important to collect the right data with the right methods and analysis.  Engaging with economic partners or working with public health researchers who may be already on staff at CILs would be a good way to address those concerns.  Great session, Mariah.  And for me personally, the first place I learned about inequity and vaccine roll out, and it was unfortunately no surprise was in The Washington Post.  So to Ami's point by this not being collected by the CDC, the media is looking at the issue.  So you might be able to find articles there.  You probably have.  And if they're not in your community, maybe you can write an op-ed or be the source.  Interested in nationwide Google of work.  Everyone is dealing with their CARES Act funds.  So that is something we looked into.  NCIL sent out a survey about what people were using the CARES Act funds for.  And I don't have that data handy, but I can ask some of my colleagues about how that information will be disseminated.  Anonymous ask is there an opportunity to build planning and goals for response and recovery in terms of the pandemic by using funs from the CARES Act?  For instance, if CILs need to establish emergency planning and design programming to support the response?  Todd, I'm going to come to you because you're in the position of emergency planning.  I know this is an allowance fund issue.  I'm curious if you have thoughts on how people can use this to prepare for the next disaster or pandemic?
>> TODD HOLLOWAY:  Thank you, that's a great question.  Yes, we have folks that we partner with 365 days a year that are also members of the NCIL emergency planning subcommittee who can assist you with that.  What we did in the State of Washington, we set up a training so that all of our centers along with our state Independent Living Council did some training to, not only be prepared, but to have a comprehensive, you'll hear referred to as a coupe, which is a CO, basically a Continuity of Operation plan.  And every center in the State of Washington has a comprehensive continuity of operation in place.  And the gap analysis how we do that was critical in getting to that point.  Hey, Sean.
>> Another thing I would add is one thing I think on our quarterly call that might be weaving in as we go along is, y'all are neck deep in this right now, so I'm not trying to add on.  But what are the lessons that you learned that can inform the next time something God forbid happens?  And one thing that is worth paying attention to, what are the groups I'm working with now that I wish I had known two years ago?  And I mentioned earlier, Todd and some people in Washington have relationships with state level disaster people well before anybody knew what COVID is.  Look around, who are the people you're working with and who are the organizations helping you and partnering with and really think I'm going to get to know those people now.  So next time it happens, we were talking about this the other day.  You're sitting in your office, and instead of going, oh my God, who do I help to help with this?  Your answer is I'm going to get Bill on the phone.  That's the goal.
>> TIM  FUCHS:  Thank you Sean and Todd.  Next question is about housing discrimination.  There's so many secondary issues from the pandemic.  And this is one of them.  So anonymous and how can we amidst of this pandemic tackle this?  And I apologize, I'm not sure who has expertise in this.  Anybody want to comment on this around housing discrimination?  I think all those secondary issues we're seeing from people who are hard to contact during the pandemic.
>> PAULA MCELWEE:  I might add a thought.  I didn't describe myself.  I'm a lady, gray hair, white, and I'm wearing a Black turtleneck.  And one of the things I'm seeing, all the issues that have been issues for us before are just magnified by this pandemic.  Housing being one of them.  It's always been an issue.  We have trouble finding affordable accessible housing for the people we serve anyway.  And now we're in a situation where, you know, it's hard to get a hold of people.  It's hard to take a tour of a place and hard to do things you need to do.  Absolutely, if you can work on getting people out of the, wherever they are now that's a group setting or institutional setting, they need a place to go to.  We have seen some temporary housing as a stopgap because they need to get out of there.  And we need to have a place for them to go.  Of course, if they had a home, that's easy.  If they have a home and make it accessible now.  But that's not true with most of our folks.  So this is just one of them though.  Transportation, hasn't that been magnified?  Public transit shutdown and people can't get to where they want to get, or it's greatly reduced.  All our issues are the same issues, except the pandemic magnifies them.  I think Ami has something to say.
>> AMI HYTEN:  Sorry, yes, so this is Ami.  So the question itself was about helping people assert for housing rights.  And I mean, so if it were me, and given what Paula has said, what we know to be true.  Here in Topeka, one of the hotspots was the administrative office of our Housing Authority.  It would be open for two days, and then it would shutdown for two weeks.  And that happened basically all last summer.  And so, as a general rule, you know, when we're advocating for fair housing, we begin by going to the local level.  We begin by filing those complaints and seeking redress at the local level.  From my perspective, we don't actually have time for those niceties right now.  Because you know, as Paula again mentioned, as a matter of losing housing, that is seriously problematic.  You know, given the circumstances that we're in.  And so if it were me, to try to communicate with the local housing authority or local fair Housing Authority.  Did not receive a timely response, and then I would directly, there's an online portal for HUD fair housing and equal opportunity housing office, do not past go and do not collect $200.  I would do directly go to that portal and file a complaint and are request immediate intervention.  All of those online portals are still open.  And folks, you know, we don't, like I say, our Civil Rights don't sort of take a backseat in this time.  They actually become more important.  And so, requiring that those system respond to those complaints is a completely reasonable response.  I don't know.  Anybody else?
>> TIM  FUCHS:  Thanks, Ami.  Okay.  Here's a question from Moriah.  And this dovetails with what people are feeling with roll out of vaccine.  It seems like in our region, vaccines are going to Walgreens and other pharmacies with few going to doctors or hospitals especially in rural areas.  This is resulting in challenges for consumers who would be better served by getting a vaccine from their doctor than trying to get to a Walgreens or other venue for vaccines.  Any advice on how to overcome that barrier?
This really gets at, I think, personally, I mean as in urban guy living in the city, that I think the particular rural challenges of getting to the vaccine, and what that means, what that looks like.  So anybody want to speak to Moriah specific question and some of those tough nuts around, you know, the rural transportation and getting to the vaccine right now?
>> TODD HOLLOWAY:  Tim, this is Todd.  One of the things that we're trying to do here.  And this is something I encourage all of you to do is much one-on-one outreach as possible.  Get together with your partners and let them know nobody can figure out for the life of them how this eligibility process works.  We have something called phase finder in Washington State.  Nobody can figure that out.  So a lot of people are actually missing their opportunity.  They actually qualify and they don't know it.  So my suggestion is to work with folks and get a hole of your local vaccine task force and ask if people are showing up.  Maybe if they don't necessarily fit in the phase finder and get the vaccines that way.  That's what I'm encouraging our participants to do.  If you have the capability to get to a site, consider these things.  And then we go a little bit above and beyond what the local statewide recommendations are.  Simply because there's vaccines sometimes leftover at the end of the day.  And people don't know what to say to really realize that they are eligible for the vaccine.  And the other thing I would say very quickly is that you have Disability Rights, you have protection advocacy in your state, work with them.  The fact that they're just now getting around to the equitable issues for people with disabilities in accessing functional needs is little late in the game obviously.  We all know that, but work with them to see what other things can be done from a legal standpoint to help out.
>> TIM  FUCHS:  Thanks, Todd.  Okay.  We have a few more minutes left if you all have other questions, we'll be happy to take them.  Again, you can type them in the Q&A tab in Zoom.  You can email me at Tim@NCIL.org.  If you are on the phone, you can press star 9 or raise your hand.  Tim@NCIL.org.
>> Tim, I would add to the things Todd and Ami talked about.  And I think everybody said this.  But you can literally use CARES Act funds that have staff that do nothing but sit around all day, not sit around, working hard all day helping people navigate these systems.  They can be online or working through website or making phone calls.  Here's a tally of hey, here's three CVS spots that have spots.  Absolutely allowable and access for the CARES Act funds.
>> TODD HOLLOWAY:  Thank you for saying that.  I just found a video that is going to be our partners and some for our fee-for-service folks to literally tell them we're here to do that.  And I gave the good news on the coalition call today in Washington State, they're all our partners.  And probably the calls will come to the Center for Independence, we're going to share the wealth with all of them.  Because you're absolutely right, Sean.  We have a huge digital divide.  We have a lot of folks that can't figure this out whether they have a disability or not.  And it's their obligation to be sitting down with them and helping them with the one-on-one steps that it takes to get through this process.  It's not easy.  Folks have myriad of different barriers to being able to understand and get registered for, and get the vaccine, and get a ride there, and get home.  So it's all very cumbersome.  So this is where IL centers can really shine.
>> TIM  FUCHS:  Thanks, Todd.  Okay, great.  I just want to mention couple of things while I'm waiting to see if we have any more questions.  First of all, I mentioned resources.  I'm going to say NCIL and ILRU have extensive COVID resources on our website.  So I encourage you to check those out.  Our link was in the chat.  And I wanted to talk about the chat for a minute.  I always strive to voice the activity from the chat on these webinars.  It's been going a mile a minute.  It would be much more than I could voice here.  But I want to thank the folks at ILRU who have offered to post that chat history along with the archive of the webinar.  So whether you we were the able to access it live or whether like me, it's just hard to keep up with all the contents.  That will be posted something you can review that on the view on-demand page.  And so we've got couple of more minutes here.  Anonymous is asking can you refresh our memories on CSR documentation for CARES Act?  Paula, can I toss that to you?
>> PAULA MCELWEE:  So any time the CARES Act expense is going to help a specific person, it would be recorded in the specific record in the same way you would record any service provided.  Most of you have a way to capture that through the CARES Act report, and you will have to pull PPR information and CARES Act information at the end of the fiscal year so you can report on what you've done.  But you would record it in the same way that you would record other things.  So we suggest you use an abbreviated intake process.  That's where the person still validates that he have a significant disability.  That you would help them write a goal.  Because your goal might be, their goal might be to reduce food insecurity, to find personal attendants who will come in during the pandemic.  There may be several things that are there that are their goals, but you would still have a goal.  And you document it in the same way you document anything else.  Now, when it's an expense to make your services more accessible during COVID, so it's actually not one consumer, but it's for your global services, you would document that in the bill that you have and why it was COVID-related.  And make sure you separate that out in the funding so it's clear that you paid for it with CARES Act funds.
But as far as your records, it's very much the same.  Just do kind of what you did, only keep it as simple as you can just because of the volume.  A lot of you have served many more people.  I've heard people say two or three times as many people do in COVID is what they were serving before.  So we do understands if you keep it clear and simple.  But you do need that documentation.
>> TIM  FUCHS:  Great, thank you, Paula.  Okay.  All right.  Anonymous is asking anyone have input or experience with utilizing a mobile unit approach to reach rural areas and such?  I don't know if any of our panelist do, feel free to let me know.  I know big one here is Atlantis in Denver area and I have to catch up how they used COVID-19.  And they would be great to ask about that.
>> AMI HYTEN:  This is Ami.  It's a great point, and to be honest with you, that was sort of what precipitated me reaching out to our state nurses association.  Aside from the fact they're very active and have been active in advocating vaccine equity in distribution.  You know, quite frankly, my sort of idea came from the knowledge that I had that there are actually mobile mammogram units.  And I was like, hey, if you can put a mammogram machine on a truck and drive it around and provide mammograms in that kind of format, why in the world couldn't we do a similar thing with vaccine?  So, I mean, going back to sort of some of the advocacy strategies that Jill talked about, you know, one of my favorite is sort of taking something that looks like what we want it to be and saying if you can do this, why can't you do this other thing that we want you to do?  And so, again, yeah, I defer to Atlantis probably because of their reach and breadth of knowledge.  But definitely look at other ways these types of services have been deployed in your communities.  And advocate that you know, we do more of the same.  That we replicate success.  In the chat, Howard has something about capital district in Albany.  So thanks, Tim.
>> TIM  FUCHS:  Thanks, Ami.  Yeah, capital district around Albany has used local ambulance to services to deliver in home vaccine services.  Well, there's look like that more we could talk about.  I have logged this presentation.  But we are out of time.  I have just enough time to wrap us up here.  Meg was asking if we were tracking misinformation, not through any formal process, but if you are aware of some we love to follow-up on.  I also want to acknowledge, thank you to Brooke and Sharon who posted those COVID resource pages from our websites in the chat.  Again, to make them easier to find.  And I neglected to mention APRIL.  I feel like everybody has a COVID resource page on their websites.  But those from, you know, NCIL and APRIL and IL.  As we close here, I just want to leave you with couple of points.  Please fill out the evaluation.  I hope this has been helpful.  But we are always very open to feedback if things we can do better, we make the evaluation short as we can.  And we take those comments seriously.  And we use that information.  So please fill that out.  When I close the webinar, it will actually pop-up on your screen.  So if you're only on the phone, or if you need to run, that same link was September to you in that materials email you got yesterday or today with the PowerPoint.  So please do fill it out.  Secondly, like I said, we're not going anywhere.  
So this is a TA project too.  So reach out to us if you have ongoing questions or lingering questions or if you need clarity around these issues.  And don't forget we have those upcoming events.  Next Thursday, announcement is on its way.  You're going to get it any minute for the emergency relocation and transition during COVID.  And then the CDC one will be forthcoming in a few weeks.  So be on the lookout for those.  I want to thank all of our panelist, Ami, Todd, Paula, you've done a fantastic job.  I want to especially thank Jill.  I wish you were here to hear this.  She had to run.  But joining this webinar to be a resource for us during a family emergency is above and beyond and I want to give her my deepest thanks for doing that.  With that, it's 4:31 in the East Coast.  I want to thank you, all, for joining us.  Thanks for the great turnout.  Keep the questions coming.  I hope you all have a wonderful afternoon and we'll talk to you soon.  Bye-bye.