Update to Information on Coronavirus (COVID-19) for Family PACT Providers

March 27, 2020

The Department of Health Care Services (DHCS) continues to closely monitor the emerging COVID-19 situation, and encourages Family PACT providers to stay updated on COVID-19 developments. As the number of confirmed COVID-19 cases in California rises, it is critical that Family PACT providers assess their office policies and follow recommended safety procedures and protocols from the federal Centers for Disease Control and Prevention (CDC) and California Department of Public Health (CDPH) to help prevent spread of the virus.

Preparedness Strategies

Family PACT providers should share current COVID-19 information and discuss preparedness strategies with their staff. To enhance the health and safety of Family PACT provider offices, DHCS encourages Family PACT providers to adhere to the CDC’s and CDPH’s recommendations to prepare for COVID-19. Some helpful preparedness strategies include but are not limited to the following:

  • Screen patients and visitors for symptoms of acute respiratory illness (e.g., fever, cough, difficulty breathing) before entering your healthcare facility.Providers can refer to the following resources on the CDC’s Guidelines for patient screening and Infection Prevention and Control Recommendations for more information.
  • Ensure proper use of personal protection equipment (PPE)
    Healthcare personnel who come in close contact with confirmed or possible patients with COVID-19 should wear the appropriate personal protective equipment.
  • Encourage sick employees to stay home
    Personnel who develop respiratory symptoms (e.g., cough, shortness of breath) should be instructed not to report to work. Ensure that your sick leave policies are flexible and consistent with public health guidance and that employees are aware of these policies.
  • Encourage adherence to the CDC’s recommendations, including but not limited to the following steps, to prevent the spread of illness:
    • Avoid close contact with people who are sick.
    • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
    • Avoid touching your eyes, nose, and mouth.
    • Clean and disinfect frequently touched objects and surfaces.
    • Stay home when you are sick, except to get medical care.
    • Wash your hands often with soap and water for at least 20 seconds

Family PACT providers can also find helpful resources to download, print, and display in their clinics and offices to educate their patients on preventive best-practices and to enhance awareness of COVID-19. These resources are available in select threshold languages. Buttons and badges, videos, and news links can also be found on the Communications Resources page of the CDC website.

Please note that if you suspect a possible COVID-19 case, DHCS asks that you please report it immediately to your local health jurisdiction.


Family PACT providers may utilize existing telehealth policies as an alternative modality for delivering Family PACT covered services when medically appropriate, as a means to limit patients’ exposure to others who may be infected with COVID-19, and to increase provider capacity.

Client Enrollment and Re-Certification

To slow the spread of COVID-19, during this emergency, Family PACT providers may enroll and recertify clients through telehealth or other virtual/telephonic communication modalities.

Utilizing telehealth or telephonic modalities:

  • Family PACT providers may complete the Client Eligibility Certification (CEC) form (DHCS 4461) and Retroactively Eligibility Certification (REC) form, if applicable, on behalf of the applicant/client.
  • The provider is required to complete each field on the CEC (DHCS 4461) form and REC form (DHCS 4001) on behalf of the client based on the applicant/client’s response(s). The CEC form (DHCS 4461) or REC form (DHCS 4001) must not be prepopulated.
  • A provider must obtain verbal consent to sign the form on behalf of the client and should note “Information and consent captured verbally by “(provider or designee’s name)” in the signature field on the CEC form (DHCS 4461) or REC form (DHCS 4001). A witness signature is not needed.
  • Following the discussion between the provider and applicant/client, the provider may utilize electronic signature services, such as DocuSign, to obtain the applicant’s/client’s signature on the CEC form (DHCS 4461) and REC form (DHCS 4001). Providers opting to capture signatures electronically should assure that they are in compliance with California Government Code Section 16.5 and with California Code of Regulations (CCR) Title 2, Division 7, Chapter 10.
  • The provider or designee must sign the CEC form (DHCS 4461) and REC form (DHCS 4001).
  • The CEC form (DHCS 4461) and a copy of the REC form (DHCS 4001) must be maintained in the client’s medical file.

Due to the nature of telehealth and telephonic modalities, the provider must arrange for the client to receive their HAP card/number to ensure a client has continued access to pharmacy, laboratory services, or other Family PACT covered benefits. Options may include, but is not limited, to in-person pick up of the HAP card or mailing the HAP card to the client’s address. If the HAP card is mailed to the client’s address, the provider must receive the express consent of the client to mail it, and must ensure that the address is verified.

Client Eligibility forms may be accessed on the Family PACT website at California Family PACT websiteForms tab on the “Providers” web page

Additional Resources

Any questions regarding this notice may be directed to the Telephone Service Center (TSC) at 1-800-541-5555, Monday through Friday, 8:00 a.m. through 5:00 p.m. except holidays.

For general Medi-Cal information, you can visit the Medi-Cal website, and for COVID-19 specific information, please visit DHCS’ COVID-19 Response webpage, which also includes guidance specific to Medi-Cal FFS pharmacy benefits.

For additional COVID-19 information and resources, providers are encouraged to review the following resources: