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Save eSignature awardee

good morning everyone my name is delight Mel's and I'm one of the training specialists here we're getting reports that there's significant internet connection issues so I'm gonna go ahead and turn my web camera off and if you can hear me please go ahead and type into your questions panel if you haven't connected to your questions panel area if you haven't located it before you can expand the orange box with the white arrow and type into that area so if you happen to have any issues this morning with audio connection we would encourage you to try dialing in if you look at your web controls in the audio area there's a phone number so you can call in if you have any problems doing that or let's say you get kicked out you know like something happens with your internet you can absolutely just click on the same link you use to get into the training today and you'll be able to real aughh in so while I have you all here for a moment and we're testing our web controls what is your three quarantine essentials so this is kind of like an icebreaker if any of you say toilet paper I'm going to be I'm I'm gonna I'm gonna be surprised but I'm looking I'm checking to see it seems like it was it's toilet paper disappointed that you yeah you didn't prepare for that yeah what are your three three essentials it can be food it can be people I have daily walks no dishes and plants yes coffee fresh fruit my dog water food in the phone food nap snacks Coffee cereal and a good book to read hand sanitizer the Internet and coffee hand sanitizers a good one I'll be happy Yoga coffee and my dog come on yo Netflix Hulu and Disney plus hey Chuck that's right fresh air good job Yoga coffee and snacks essentials internet connection don't we all need that my cats my workout machines and home you guys are awesome coffee my dog and Nintendo switch great well Wow we'll say doesn't seem that a machine and I will say that as much as I love my co-workers delight in Cassandra and Kara I like petting my cat all I'm thinking I love my new office mate your coworkers oh right now she's my fluffy office Maiden yeah oh hey Kara we just did a quick little icebreaker of our three quarantine essentials oh that's why you guys were talking about fluffy helpers over to you we are experiencing degraded audio so I turned off my webcam and brief everybody on how to use the audio callin feature you know you can use you can call in and you can come back into the same training with the same link okay if you get disconnected okay awesome I will turn on my my video just for a second just to say hi to everybody and let me work on grabbing the the actual controls here to share my screen let's see I got you change - me me me show my screen all right welcome everybody and I'm glad you're we're all glad you're here we're going to be shared some interesting new information about electronic signatures and I just want to say hello real quick on camera hi everybody it does help for us to have our cameras off when there is you know audio - audio troubles like this and there's a nice big group here so I'll turn off my camera for now and you'll continue to hear us as you know you do have your full training staff here online as well to help us with questions as we go there's no rule saying that the session has to last the entire time but we're happy to have it last as long as up to up to its end an hour and a half in order to help us understand the topic as always we'll do our best to answer your questions during the session and if we can't do that we're we love to get them by text because then we have an opportunity to work with your questions on later and to help us understand a little bit more about how we should be reforming power accuse in order to help you or to help us all understand ok so just as a precaution if you're out there and your audio is not muted you want to go ahead and mute your audio let's keep the phone lines and the audio lines via the computer nice and clean and if you by chance have shared a link with other folks you could sign in if you want using the question area let us know that you're there if you haven't then that's ok you're here and you can see how many folks are in the session with you ok so let's go ahead and talk about signatures and different requirements that are happening at this time it's interesting we've been talking about electronic signatures for quite a while this is from the standpoint of documents that you or a provider if you are a provider of the collective you as the provider role would turn in to senior and Disability Services to request services on behalf of an individual with a waiver or pcs or other documents that are you know other programs that I'm not not specifically naming this pertains to all of the programs and services though all the programs that SDS operates and then by extension services that our providers operate so as we know we have a current Cova 19 state of health state of emergency in Alaska and what we are conveying here is that two things we will now accept electronic signatures on documents that require lethal legal authorization legal authorization that change goes into effect May and we did not put on a specific date on it because as some of us may have worked in progress already and some of us are starting new work and depending on where you are you know with each case or each document that you're working on you can follow this rule after you know it okay so that is why we kind of left it a little open there but may okay electronic signature acceptance continues after the Cova 19 health emergency ends so it let's let's look a little bit at what signatures are what electronic signatures are and when to use when to use them particularly an alternate signature method which is called documentation of attestation and a person who has the authority to sign can attest to their agreement with a document during kovat 19 rather than electronically signing or physically signing now all these methods of course we prefer physical signatures which of course due to social distancing are are most likely not going to happen but that's okay there are ways to get a physical signature without being in proximity to the person signing and with maintaining social distancing and there are ways to use attestation instead so please know before I start and I'll say it again before we start with more info all the documents that have an attestation statement rather than a signature either physical or electronic they will need to be signed they would need to be resubmitted signed either electronic or physical signature after the kovat 19 emergency is declared no longer an emergency so that they will need to be signed and resubmitted so before you know don't worry so much about then that happens because it's not going to be a separate effort to collect documents we're expecting them to be turned in with renewal of the particular plan service plan whatever it may be or an amendment to that plan whatever that whenever that may be so if an amendment happens first after the emergency you know is over then you would turn him in then the person would need to sign a little bit extra extra documents from last the last plan and their current amendment or plan and then when their plan renewal comes up if there weren't any other opportunities to turn them in then you would turn them in with the renewal so you'll need to track them but you won't need to have a separate deadline just for that it'll just go with the regular deadlines that you already have okay so we'll say it again but you we do we will have the attested documents signed at some point through a regular process that you already maintain person will just have some extras to sign so you may want to explain that to people just so they don't say didn't I already do this help them understand what that's about okay so this also stens two documents we have a short list here we haven't listed all the documents but what we when we list them were saying all the documents that would be used to be submitted to SDS support plan amendments release that info provider certification and personal care services timekeeping those are all able to be signed in these methods again attestation is going to is going to be re-signed after covin 19 is over and it's available now for during kovat 19 for all these including qdcs and vo DS we do have a short QA down at the bottom so the requirement for signatures meaning electronic or physical is temporarily suspended due to rules for social distancing and the substitution for that because it's covered 19 at this time is submitting the attestation and it's a sentence a documentation of a conversation that occurred where the person who was the authorizing party tested to their agreement with document okay I'm gonna jump out to my questions and just make sure I get it let's see I don't want to necessarily read them all out right now but I just want to make sure I get your your train of thought here okay guidance on home visit forms I'm I'm thinking that that's what HV means how do we know we won't get get found in an audit in the future without signatures on home visit forms my best answer well let me think about that okay let me let me go back to that and we'll we'll answer a little bit better in the meantime training staff maybe jump out and find a couple of different regs that where we require signatures particularly in the work of of a care coordinator and visits and things like that and and maybe maybe we'll be able to answer that better question says will this document will this document be sent to providers it is in the handouts area of this webinar you can actually download it now and we always email it to you again so whoever's in the webinar will get it we will also have it posted on our website just some time to get those two things done it does take a little bit of time to you know to have it cook if you will and you know create the the email to send to everybody can everybody see my screen okay it should say symbol of intention and things like that I just hope my screens not frozen out there in the world does it say secret yeah okay your screen is moving but you got your mouse hanging over something called star files and so it's like kind of drop-down that's like blocking the first left upper left-hand corner oh you know what that is that's a weird get rid of that thing yeah it's okay guys you know just for the rest of you out there we're often working off of one little laptop screen right now and we're doing magical things that way and you know what I did yeah it's not usual for us I took my audience view panel and stuck it on the upper corner and I didn't even see that because it was covering it I'm very proud of Alaska's internet providers and this kind of um demand that they've had to deal with recently and no nobody's collapsed completely for very long so I think they excellent job yeah yeah us too me too I think that um you know that's why we meet our webinars be for a little longer just in case something happened and you know we have to come back to it but anyway so what's a signature a signature is a symbol of intent please know that we did consult with few experts on signatures in the history of signatures including our r sub r r unit a division law staff that helps us quite a bit more very thankful for them about what a signature is it represents a person or an agency's intention to agree authorize or give permission on a legal document so what can a signature be it could be what we call a wet signature which means just that we physically signed it with a pen a stylus on you know a touch or a little pad that accepts the stylus input or perhaps a touchscreen a stamp which is the same as a physical signature or your finger you know when you sign off on something using your finger that is also a physical signature we do get a lot of questions about stamps obviously it's not the same to use a stamp digitally as it is to use it on paper so there are some thoughts about that since we require a witness anyway with a stamp then when we get more into knowing what electronic signature is there are some options for stamp signers it can be made a signature can also be made electronically through proprietary signature software that has some form of authentication and so I'm going to throw it out there we don't of course you know require or recommend any types of software but common ones it can be things like DocuSign and some of the Adobe sort of the free download Adobe there are formats of Adobe that you can buy which have an electronic signature ability within the document to sign and so with that when that happens what it is is there's a little bit of authentication that occurs for example in Adobe it's pretty simple you can sign physically using your mouse or you know if you have a touchscreen you can you can use a stylus or something like that and then you can store it and you can use it again if you have it stored you can use that signature again and just plop it on to the document that is a little form of authentication of course DocuSign has its own format which I'm not prepared to explain but something that has the the intent piece of it within it which is pretty common nowadays so those are two examples so electronically okay so we also always encourage signatures to be completed with social distancing and here are some examples printing a document physically signing and skiing inning you could send it as an attachment as an attachment in a secure encrypted email which is DSM okay you can send DSM to non DSM emails and you could send them kind of a little mini account that is encrypted which is just a conversation an email string between you and that non DSM email that exists for 15 days so you can have a back-and-forth of attachments that contain pH I that type of thing we say encrypted email because these documents always contain pH I and that's just you know how we want it done like that has to be done like that to comply with HIPAA if we're using email of course you could physically mail documents back and forth and then if by chance someone had an opportunity to be near enough to the person within six feet to get a physical signature it could be done so we are saying that what's not off the table if it can be done it could be done you know wearing a mask and six feet of social distance and sanitizing objects that you know your you use hand sanitizer than hand on the document maybe you wear gloves you know that type of thing it's not fully spelled out here but if you had the chance to collect a physical signature you could do so let me go to my questions and just make sure I got it you all right I think I got good questions there we'll come back to those the the signature electronic signature software if it includes an opportunity for a person to type using a font of their choice you know like whatever they pick or whatever it is and the software that just is the default that is also accepted so the signature can be you know the person's original mark or in an electronic signature or it could be a typed in signature which comes from that process the person has agreed to sign through that DocuSign or adobe or something else similar and they're choosing to type it in so that is where I was trying to think it through with the stamp signers that their witness can sign on using their they could type in for that they could type in their name and they could they could say you know they they're witnessing the person you know they could authenticate that person's signature by either typing in the person's name on their behalf and then putting in their own name you know you could make a note that says they usually sign with a stamp since the stamp is a considered wet signature you know you could certainly use the electronic part and they're their witness can help them you know get get a signature typed in okay okay so they the choices are there for social distancing sign II okay during Koga 19 emergency declaration providers recipients and representatives may use a documentation of attestation to show their agreement and or authorizing documents filed with senior disability services so what's an attestation we do have listed here the methods for authors authorizing a document at a station how do you do it so a care cord or a provider would we have to get the document to the person so that they can read it or their person who helps them can read it okay so the authorized signer right so we send it by a secure encrypted email fax or mail like I know a lot of people don't have fax at home but it could happen maybe you're sending it to a provider who's still working in the office maybe one person's working or something like I don't know but if there's a fax you could use it you would you can call on the phone or perhaps use a video chat if you prefer to review the document with the person and then you ask do you understand agree consent to and authorize this document the recipient of representative can verbally consent agree or authorize the document you know if people need assistance to talk on the phone if a person uses another way other than a phone call to normally communicate you know their their rep you know we realize that many people don't physically sign their own plan okay so they have a representative if there's another way that that representative communicates as an accommodation like TTY or something like that that's okay to a care coordinator or provider documents the interaction in their service notes it's very important to keep a good service note as to when this happened and what you did and why during kovat 19 okay a digital signature or a wet signature same thing for these purposes a care coordinator provider sends in PDF form and you know just one second I'm gonna grab my list here of attendees and please if you could make sure that you're on okay thank you sorry it's all good so a digital or wet signature we send the document in a non editable format to the person a digital document like PDF using secure email the representative or recipient draws types or places their signature on the signature line using whatever methodology Mouse stylus or finger or touchscreen or key keyboard you can type however it is however it works to indicate their consent agreement or approval and the date of approval they fill that in to so they put in their signature in those formats and the D send it they send it to you you send it via this is how it happens okay care coordinator can send documents for review for review via secure email DSM an agency representative responds to the same email string care coordinator updates the signature line for the agency on an original PDF on the original PDF and the care coordinator saves the email string to PDF and retains it for your records so the conversation that you're having you know changing sending the document back and forth for review those things are what you keep on record for your interaction between a provider and/or a person so we don't want those submitted with with documents we want you to keep those on file and we want you to have accurate documentation in your service notes as to what you talked about did on the person's behalf as as a care coordinator would normally do for what what should you send to SDS for an attestation a care coordinator or provider would use direct secure messaging to email SDS the documents with a recipients alternate signature that add as attestation is called alternate signature as well attach the documents that were attested by the client representative we're just using verbally as the default there but you know if a person uses another method to attest then they for accommodation that could that could happen includes the following the body of the email I've reviewed the following documents with client representative and then a list of the titles attached and the dates of attestation and the statement the recipient rep has agreed consented to and approved the attached documents and an example is here so it says I've reviewed the following documents with Papa Pete Bo peeps father than the list there's only two and Papa Pete verbally agreed consented to and approved the attached documents that is what's written in the email and then on the actual document it the signature line has this verbal attestation of Papa Peep Bo peeps father via call for one twenty twenty I know it says four but we were previously accepting these out of stations before May anyway so we are just giving you a format to use here because we're kind of getting a lot of statements that are sort of all over the place and that's okay I mean we know it wasn't you know we were all kind of trying to think this through but this is what your attestation is going to look like you're going to send us an email you're gonna take care of business using DSM and review process of the document that the person's attesting to they have to know what they're attesting to so they have to get it they have to have time to review it then they indicate to you that they agree verbally or they buy accommodation methods then you send us a list with a statement i that i've reviewed the following documents with this person and then the statement recipient rep has agreed and then a list okay so that's what we want to see and then on the document it looks like that and these are available during the time of kovat nineteen emergency declaration okay the the attestation czar available during the time of Kovan nineteen emergency declaration electronic signatures and of course wet signatures to include stamps are available from now on okay not ending ANCOVA nineteen's end so a digital wet signature looks like this a person can use digital tools to draw their signature in this little example here is pretty cool and make it a little bigger you can kind of see that this is a little example from Adobe the person can choose they just click on draw and then it gives them a way to draw their signature even if it looks like a little scratch or squiggle lots of times they do look like that with those digital tools and folks are not familiar with them but that's okay then they can save their signature and they can apply it to the line okay so that would be a function of Adobe right there if that's that that is what works for the person you zoom out a little bit they place the signature on the document enter the date and save it and then send it back they can send it back with the DSM that you have extended to them or they could mail it or fax it back possible okay the providers who are signing a document similar methodology if it's going to be you know how would how would we have a provider filled a provider entry here a care coordinator would send the document for a review via DSM the agency would look at the document respond to the same email string with the statement on behalf of the agency my agency I certify the previously attached documents are true and correct and then on the signature line a care coordinator would enter the wording that you see here certified by DSM at 9:35 a.m. on the date and the person and the agency okay so this is how we're documenting you know our planning meetings and our interactions with I'm generically calling them planning meetings but you could also interact you could also use this methodology and proof of interaction with teams for you know talking about services or determining the appropriateness of services or any of the the updating that you do and helping that you do with agencies to the care coordinator would do with an agency that helps you know move the service forward or make it happen okay let me go to my questions you hey all right looks good we'll get to those in a bit what do we not accept okay so what do we not want to see we do not what what will we send back as incomplete or insufficient if you will documents that are missing signatures so missing a signature means there's no signature or if there's a legal guardian they have not signed even if the client has signed for themselves okay so legal guardian they need to sign if they don't sign throughout the document you know and there that it's the same person then that's gonna be missing found to be missing okay power of attorneys can sign people who are there they're their current active guardian definitely needs to sign we don't accept screenshots of partial pages so that little picture there is like like if I was to you know use my snip tool or copy and paste a little bit of a document and and say they signed it here's just their signature we need to see the whole document and needs to be assembled so that we can tell that the person knew what they were signing written confirmation which is sent by unsecured email documents must be included as an attachment in a DSN so don't send us unsecured emails with these things and then finally documents that reuse signatures from something previously approved so I wouldn't go and get a screenshot or a snip of somebody's signature from previous year and paste it on to today's document that is not the same as allowing a person to authorize using the software that allows the electronic signature okay so copying and pasting onto a document from something else that's previously authorized separately outside of the DocuSign or Adobe or or similar software that is not accepted because that is not giving the person a chance to to authorize it between all these methods there should be a way to get that done okay so common questions what if I take a picture of the whole signed page you could do that we we may accept the picture file of a physically signed document right as long as it's clear we need to be able to read it it needs to be legible in terms of not full of shadows it needs to not include the computer screen and the computer that you're taking a picture of we have received pictures that were done on somebody's phone of their computer sitting on its desk with a document on the screen we can't read it because it's just a picture of a computer with a document on it no matter how hard we try we can't tell exactly what that is so it needs to be the only the document needs to be the only thing that the pictures of and so there there is software or apps out there that will you know take a nice picture of the document just the entire document so you can explore that if you are using a phone to do those things alright nothing takes away the DSN part you know there's no nothing takes away HIPPA and storing of documents and things like that we're just giving options and answering the question what if multiple providers sign different pages and the signatures are not all on the same page go ahead and turn in all the separate pages we'll accept them as long as all the required signatures are there what if I'm missing just one signature should I turn it in no everybody needs to sign a document the document before submission okay so don't send in incomplete in terms of signatures incomplete materials can electronic signatures be used on VOD verification of diagnosis and QDC qualifying diagnosis certification forms yes the medical professionals diagnosing professionals may use electronic signatures and finally in our thought process we we wanted to answer this we thought it might be a common question why must we go back and collect signatures on the attestation x' so what we're trying to do is prevent misuse of attestation x' during the emergency health declaration a signature is always the best way to tell that the person authorized a service reviewed a document and signed and since this is not a physical signing or even an electronic signing with some sort of intent around it it's a documentation of a conversation which indicated intent then we're gonna need a signature like I said before this is not a separate effort to turn them in on a certain date after covent it is a separate effort where you'll turn them in the next available amendment or perhaps renewal of the person's plan whatever that may be okay so the person's going to sign a little extra and you're going to track that and the responsibility for the original intent of the signature in terms of all these methods the responsibility for that is with is with the the person who's offering the the methods to sign that would be the provider whether they're the care coordinator or a different service provider okay so I am going to go down to our questions and just kind of view them a little bit here and I'm gonna get myself reconnected with my with my list of people and all that good stuff I apologize for the for the strange you know silent periods but they're kind of like a feature of webinars I'm going to go ahead and tackle our questions I will start at the beginning of them thank you to my staff for jumping in and answering them and I'll read them out two's for the benefit of everybody here okay if we get an e-signature like DocuSign will we eventually have to get an original signature the answer to that is no if you use an e-signature if a person uses DocuSign or adobe or a similar proprietary software that has some kind of albeit simple method for them to sign within it or enter their name and a typed font intentionally within it then that's a signature and we will accept it you will not go back and have to get an original signature it's considered an original signature from now until you there isn't on and end date to that to the e signature okay question says agencies are required to do monthly visits for family habilitation would this fall under the same guidelines as care coordinator visits there isn't a requirement in our regulation for formats of signatures on visits there's a requirements and documentation regulation and appropriate content for service notes if your agency's practice is to require a signature then that's your agency's practice so you know if you're you know if you're doing visits virtually or by phone call instead and you need to have a document that will show your service note and show that you're you're complying with the regulatory requirement for what the service is and what you're doing and what you talked about and the methodology that you you know by phone or video chat that type of thing and then if have a person verified by signature then you'll have to extend an opportunity to them that your agency determines okay question says if nothing is available is an email attached stating provider client care coordinator agrees to the action within the support plan allowable the answer is you don't have to send SDS the email but you need to put a statement in the signature area that the agreement was made through the email on a specific date and you keep that in your records we we always say you know it's easy to turn it into a PDF and keep it on file okay that kind of keeps it out of your piles of emails if you will okay if my fax is wireless can I still send documents of all kinds yes do providers of PCs services send email in addition to uploading to harmony for renewals nothing is different about PCs and renewals okay though Kara it's Sina and I would say that's just about exactly the same question you just answered about do we have to send an email chain with our harmony documentation know or or DSM documentation no no it's alright look your providers and you have your own responsibilities it's not on SDS we need to see in a station at test station can't speak that's a station or an e-signature of some sort it's on your agency's responsibility make sure you're keeping that documentation mmm-hmm good thank you the next question says what if the legal rep doesn't have email we can do verbal attestation over the phone yes it is fine to do verbal attestation just remember you will have to collect their signature later you will have to collect a signature when code 19 emergency is over at the next available amendment or renewal okay next question presumably the attestation email would not be a part of submissions that occur via harmony harmony correct the email string you save that in your records and it should be good because it has times and days and things like that in it you can convert it to whatever file format you want to keep it to in so it's not just always an email kept out there that you have to search you know search for store it any way that your agency stores it is your responsibility to store it for future research purposes or remembering what you did and when that is we don't need to see the email chain unless for whatever reason we may ask but that's a very custom key specific so no we don't want to see that turned in that is for you to keep okay if documents have already been submitted with out of stations on the forms does a care coordinator or agency have to go back and submit a DSM with the sample at a station from the consumer legal rep no do not go back and do work you have already done go forth from this day with the document that you see before you and the download that you have done of it or when you get it in email go forth and do this in the future out of stations are valid during kovat 19:00 these signatures are valid now and ongoing and of course the wet signatures are always valid hang on I'm looking at the question and I'm reading okay awesome um let me scroll down a little bit more the long one okay would this be a good strategy under these guidelines collect a digital signature image but instead of reusing that on multiple documents each use of the digital signature acts like a stamp and that a unique assigned pin is collected via telephone or other method which authorizes their use of this signature image um no I mean I that I couldn't really say what you're describing is the methods that would exist within a software that allows people to apply an e-signature so we're not including you know your your internal creations and that however you know again a signature is a verification of their it's an intent so we're not we're not asking for or poor you know proposing that we would store signatures of people and apply them each time with some kind of other way a person needs to have a document and apply a signature within ten so that's gonna be a physical signature that's going to be software like that and that's gonna be attestation until kovat nineteen is over in either case any case the provider takes responsibility that the person is signing a document that they understand and that authorizes services so you know I guess the consequence is there is that if you you know receive an audit where that can't be shown accurately to somebody who doesn't know story and doesn't understand you know exactly what's happening then it could be a finding you know or like hypothetically I guess our hypotheticals are coming in but if they can't tie it together or if there's other circumstances that show that people were not aware of authorizing services then that's going to be findings all that stuff is going to be not part of what's accepted in the Medicaid programs at all we have to give them person a way to authorize a document what we're saying here is key signatures on using software that has some kind of a intent structure to it okay the handout is gonna be on the website it's not on there right now but it'll get there a couple questions on that we are a SME provider our PCA is allowed to sign our work orders after the services are performed if the recipient is unable nobody should sign for someone else the recipient needs to sign or give authorization for these things that can be done through these methods on you need to connect with a care coordinator over these things okay so they're they're gonna be helping with these situations as long as the waivers you know paying for it of course have the care coordinator help out home visit forms I've seen some home visit forms that included a PCA signature yeah I mean people who are with the person there might be part of contributing to a home visit collection of information could be okay different I mean I don't want to digress off of signatures it's important to remember that a signature is intent and so if we're developing other things that are not already currently accepted ways that your average person would be sign something then there's there's a lot of aftercare I guess you would have to do for that with begin because of that it's extra work and it's also exposing to you know things that don't comply okay so okay that is our presentation do you have any other questions I guess I got to the bottom of the questions there what other questions about signatures do you have concerns thoughts everybody this is Cena and I just kind of wanted to point out something you care this but just popped in at the very bottom might be very clear that you understand that attestations are being accepted during this emergency declaration time however east signature is is a intended to go continue on we're going to continue to accept electronic signatures in the format the carriage is described going on it's not just during this emergency time it's it's from now until the foreseeable future until it changes right now we don't imagine that it's going to change okay I'm also we've had a lot of questions about the signature and I just want to draw attention to the signature on service notes and whatnot that's in a larger Medicaid reg set than then what SDS governs so you really need to be looking into the Medicaid program regulations set instead of just looking at SDS as requirements because we know that true and there are questions about you know can we get this person to sign can we get that person to sign this is not a presentation about who is the authorized signer this is about the authorized signers ability to provide a signature either through electronic signature software or physical signature as always ordering code 19 out of stations that's what this is scene is right there's a bunch of other regulations that we should all operate under we do all operate under Medicaid overarching regulations which are starting at 7 a a C 105 that series there's a bunch of those so you can take a look at you know notes and and signature requirements on notes and things like that they're more questions well behavioral health get on board with accepting electronic signatures as well you know good question I'd have to take a look it's my understanding I could be out of you know it's my understanding that they do but I'm not sure I mean don't write in and comment to me hey Kara they don't you know I get it I get it but let's check into that for you okay let's check into that I do know that our our wonderful Guardians our OPA guardians are aware of this so that might really help we're hoping that this helps electronic signatures and of course out of stations will help because there's just a lot of kind of a flurry of work that we're doing to try to help people right now but we're hoping that the East signatures is going to be helpful and save save you some time and help our providers you know even medical providers sign so that's a quick and easy one kind of you know hopefully yeah I would say we've all seen a VOD or QDC with the doctors electronic signature mm-hmm now they're good yeah yeah it applies to all STS forms ro eyes questionnaires rates and responsibilities yes everything everything e signatures are accepted on everything and that's perpetual attestation czar only accepted during kovat nineteen and of course what signatures are accepted at any time okay other questions thoughts concerns when you're talking about having documents resigned after the pandemic I just want to be clear is that just for documents that do not have electronic signatures only the attestation does it apply to ICAP documents as well it applies to everything so whatever document that you have that's been attested to by the signer rather than assigned or physically signed you'll have to get them signed again well not again but you'll have to get them physically signed and just keep it you know turn it in and that will be at the next available opportunity meaning amendment or renewal of plan not a separate deadline for that maybe even the same person you know maybe maybe the same people so at least it's not you know searching out other people that aren't perhaps you know the same people that go to for the renewal other thoughts questions concerns last call we don't have to continue we can you know we can be finished it's okay to you can always send your questions thoughts and concerns to SDS training at Alaska gov SDS training at alas dot gov and we'd be very happy to respond to them and include them on our FAQ s we're really hoping that this is helpful to you we kind of just got you know was laughing about it with my team we kind of just got launched into the 21st century it with the e-signature so we know it's different but we're really you know excited about this and we're you know since its ecig matures are accepted ongoing you know it's worth it to if you're not already using easting that your simple software would be worth it to you know maybe investigate what you could do it's up to you you know you're the provider it is up to you I have guardians who have given me permission to send documents via non secure email of a collected attestation this way if I have permission from them to use the method should I proceed it's a little bit off topic your question really is about you know can I send non secure emails to people if they say it's okay my best answer to that is nothing it nothing prevents HIPPA from being in enforced okay my best suggestion here is I would practice with my Guardians since they have email and say hey I have a way to make sure that your documents are sent with my special encrypted email and I need you to use it because it protects your information and it protects the person's information we had a whole separate training on how to do that and why I truly believe that when we send non secure email that a person's information is is very much at risk of being being stolen and we do have a separate training about that and why but I would do my best to reach out to them and have them start using that a similar example maybe not so similar but you know like like when you get a loan from a bank online or when you buy a house and they do all that or buy a car you can do all that stuff online now they only use secure email they have their own you know methodology where you're told to use it and that's the way it works because of the sensitive nature of the work that they're doing with you same type of thing same type of thing people's information is private should be kept private people join the programs with that understanding I know people may want something you know but I believe that if we reach out and kind of educate people on how to do it that it could be done okay any other thoughts or questions about signatures formats ecig matures out of stations okay alright so I don't see any others coming in I will go ahead and close our our session I really want to thank you for being here and talking about this great topic with us and also for the wonderful work that you do and I hope everybody is healthy and safe and having on you know a good Friday and we'll catch up with you at our next opportunity and we we really thank you for everything that you do I will go ahead and close our session if you have additional questions please email at SDS training at Alaska gov and look for my email or one of our team members emails to come to you with the attachment that we shared at the document we shared okay so we're always happy to interact have a great rest of the day and a wonderful weekend and we'll see you online bye for now