As of 3/23/2020, Clinical is strongly discouraging clients from coming into the office or being seen in person.

We are helping staff and clients use a video app called Hangouts Meet as much as possible to continue services. If someone cannot participate in telehealth, we will continue some services with the approval of Clinical Director. Anyone coming into the office will be screened to reduce the risk of passing on an infection.

Clinical Solutions offices will be closed to clients. Clinical Solutions will be open on a modified schedule from 11-3 pm Monday -Friday and an on-call representative outside those hours for emergency situations only.

Please contact your PRP counselor or PRP/Therapist to discuss options. We will do our best to find a way to get you the services you need!

> https://play.google.com/store/apps/details?id=com.google.android.apps.meetings
> https://itunes.apple.com/app/hangouts-meet/id1013231476
The main app that we are using is called Hangouts Meet. It will protect your privacy and offer the ability to continue services.

You have the option of phoning into the meeting via a phone call. Once the meeting is created, a pin is generated that an individual may call into an 1800 number and put in the pin number to access the meeting.

We are asking clients the following questions:

• Has the client/household member had a fever, cough, or body ache?
• Has the client/household member traveled out of state, particularly on an airplane in the last 14 days?
• Has the client/household member had a known exposure to Coronavirus?
• If yes to one of the above, we are going to encourage telehealth or explore other options for services. If there is little risk of infection, then in-person services are likely still an option.

Telehealth is Therapy and PRP services provided that use both audio and visual components. If using this option, Clinical Solutions staff would send a link to the client/guardian to start the session. It cannot be just a telephone call at this time. The client must be present for sessions, except for some family sessions per agency policy.

Use the Hangouts Meet application and have the client or parent download it via the app store or Google Play.
Your clinician or counselor will send you a link depending on the app/platform they are set up to use: Hangouts Meet

Please contact your PRP/Therapist to discuss. Please contact your PRP/Therapist or our office to discuss. We are going to do our best to come up with a way to get people the services they need! If there is inadequate Wi-Fi/data connection, the counselor must end the service if the service cannot be ethically and reasonably provided. Counselor should make efforts to have a secondary means of continuing the service.

Clinical Solutions has a Telehealth Consent Form. Clients must acknowledge and provide verbal consent to all items on the form in order to proceed with telehealth services. Clients can access on www.csolutionsmh.com

Clinical Solutions shall not force or coerce a client/guardian to sign a consent. During a state of emergency, particularly if a client may have been exposed to a contagious illness, Clinical may elect to deny in person services. If telehealth services are denied, Clinical Solutions shall follow discharge procedures and provide client with referrals and final medication management services according to policy.

If unable to utilize a backup platform, clinician shall follow up with a phone call. The phone call cannot count as part of a billable service.

Telehealth services may be contraindicated for more serious symptoms, such as psychosis, suicidality, or homicidally. If a client presents with a more serious symptom, the clinician must consult with a supervisor regarding appropriateness for telehealth and other options. Clinical will work with the clients and treatment team to develop a plan.

If a client has a mental health emergency during a session, safety precautions must still be taken, which include:

• Contacting the local crisis response team
• Contacting emergency services
• Advising the client to seek psychiatric evaluation at local hospital. If hospitals are closed for evaluations due to states of emergency, advise for the client to be assessed at a local walk in or crisis center.
• If due to a state of emergency, no emergency services are accepting clients with psychiatric emergencies, clinician must contact supervisor or Director to safety plan.

During the state of emergency of 2020 due to COVID-19, telehealth services are permitted for both Medicaid and Medicare clients, but must be in compliance with all other policies and procedures regarding services. For clinicians who are not Medicare paneled, a paneled prescriber must be on-site with the clinician to provide an incident to.
Once the state of emergency is over, we may have to end telehealth services. At this point, the State of Maryland has indicated telehealth is only temporarily covered by your insurance.

Clinicians are required to review Telehealth Ethics included on the Credible Home Page> Forms and Documents> Telehealth. Clinicians are reminded that services must be provided as clinically indicated and only in ways that provide appropriate and high-quality care.

• One of the best things you can do is to wash your hands and have children practice hand washing skills. Here is a great resource for how to wash hands appropriately from the CDC:
• https://www.cdc.gov/coronavirus/2019-ncov/about/coping.html

• CDC has suggestions for both adults and children. Follow this link:
• https://www.cdc.gov/coronavirus/2019-ncov/about/coping.html
• One of the best things you can do is to focus on the things you can control, such as handwashing and using your coping skills.

• Information is starting to come out. 211 may be able to offer some options. Contact your PRP/Therapist to get information that Clinical Solutions may be aware of.

We welcome feedback- it helps us make our services even better or helps us clear up any miscommunication! We are working hard to make changes in this very tough situation. We know we won’t be perfect and will find it helpful to hear your concerns.
Please talk with your PRP/Therapist first. If you still are not satisfied, feel free to call the office to discuss with the PRP/Therapist’s supervisor. If you still have concerns you are welcome to submit a grievance in writing to the director. Please see our Grievance Policy in Helpful Information for more details.

• Montgomery County Crisis Center 240-777-4000 1301 Piccard Drive Rockville, Maryland 20850
• As of March 23, 2020, Montgomery County Energy Assistance and Rental will be accepting applications via telephone only. Clients can contact these offices at the telephone numbers listed below:
• Montgomery County Energy Services 240-777-4450 website: dhs.marylandgov/office-of-home-energy-programs
• Montgomery County Rental Assistance  240-777-4400