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Updated Guidance: Adult Day Services Order

Coronavirus (COVID-19) has disrupted the personal and professional lives of all Ohioans. Health and well-being have been the primary focus when deciding how to best respond during this state of emergency. Adult day service providers who serve large groups of people have been affected significantly by restrictions on group size. Restrictions put into place on March 23, 2020, through the Ohio Department of Health (ODH) Order, remain in place until rescinded by the director of ODH or until the governor ends the state of emergency.

After the order was issued, many providers found ways to comply with the order and deliver services in these smaller settings, in homes, or virtually. Some providers voluntarily chose to close their businesses. Many of these providers may be looking at ways to reopen and continue to operate smaller group services.

During this state of emergency, small group service settings, defined in the order as a single location where no more than 10 people, including staff, are present in a confined space, can be an important option for people with disabilities and their families. The Ohio Department of Developmental Disabilities (DODD) has developed a process, in conjunction with stakeholders, that combines the individual team process at the local level with a state process for provider assurance. When these congregate settings are deemed necessary by the individual and their team, this process will promote the health and safety of people receiving services, their families, and the direct support professionals (DSPs) who support them.

This is the first of many phases to ensure the health and safety of Ohioans with developmental disabilities as services are being provided in innovative ways that are both meaningful and safe for all persons involved. This process applies to all facility-based Adult Day Support (ADS), Vocational Habilitation (VH), and Intermediate Care Facility (ICF) Day Program providers, regardless if services were discontinued after the order was issued.

The person-centered team and the provider assurance processes can happen concurrently. There is no order in which they must be completed.

Person-Centered Team Process

  1. The person receiving services, their family or guardian, or ADS, VH, or ICF Day Program provider notifies the service and support administrator (SSA) or qualified intellectual disabilities professional (QIDP) that the person wishes to resume facility-based services.
  2. A team, which consists of the person receiving services, their family or guardian, day service and residential providers, and SSAs or QIDPs, will work together using the Risk/Benefit Discussion Guide to inform the conversation about the risks and benefits of the person attending facility-based day services under the order.
  3. If the team determines that the person should attend facility-based ADS, VH, or ICF Day Program, the person receiving services, their family or guardian, and the SSA or QIDP complete the Team Acknowledgment Form and corresponding Risk/Benefit Discussion Guide.
  4. The Team Acknowledgment Form is submitted to the ADS, VH, ICF Day Program, or Transportation provider by the SSA or QIDP.

At the time the SSA or QIDP receives a request from the person, parent or guardian, or provider that someone would like to attend facility-based ADS, VH, or ICF Day Program, the SSA or QIDP has seven (7) business days to complete the Risk/Benefit Discussion Guide and outline the plan for resuming facility-based services.

The above steps must be completed for each person requesting to resume facility-based services. The SSA or QIDP, through the team process, may need to revise the person’s plan to reflect current conditions, services, and outcomes. Providers who maintained services throughout the state of emergency are expected to have maintained documentation that outlined the new service arrangements with the team.

Facility-based services may not be the wish of every person or the desire of every team. The team should consider, any time in the process, alternative ADS, VH, or ICF Day Program options for service delivery, including virtual or in-home services.

Provider Assurance Process

  1. The ADS, VH, or ICF Day Program, provider completes the Provider Assurance Form. If facility-based ADS, VH, or ICF Day Program services are provided in multiple settings, a separate form must be completed for each setting.
  2. Completed Provider Assurance forms are submitted to DODD (via email: OSSAS@dodd.ohio.gov) and the appropriate county board(s).
  3. DODD and the county board(s) will confirm with the provider their receipt of the forms within one (1) business day.
  4. The Office of System Support and Standards (OSSAS) will complete a virtual walk-through of the setting(s) with the provider within 48 hours of receiving the provider assurance form.

This process only needs to be completed once per setting. Providers can resume their facility-based services once their assurance documentation is submitted to DODD and the appropriate county board(s), and they have received a confirmation email from both. For providers who have maintained services throughout the state of emergency, those services may continue, but the Provider Assurance Form must be completed and submitted to continue services. Any questions about the setting can be answered during the virtual walk-through with OSSAS. If the provider needs to arrange a virtual walk-through later than 48 hours, OSSAS will accommodate the request.  

Once a person’s team completes the person-centered team process, and their chosen provider has completed the assurance process, services may begin for that person.

Other Considerations

DSPs must wear a face covering when providing services. Providers play an essential role in educating people receiving services on the health benefits of wearing a face covering and the role they play in preventing the spread of disease. People receiving services should also wear a face-covering to prevent the spread of COVID-19 to DSPs and others attending day services.

If a person receiving services is unwilling or unable to wear a face-covering, exceptions for medical, functional, or practical reasons should be documented in the person-centered team process and included in the Team Acknowledgment Form for them to receive services.

The ODH order directs necessary provider personnel and participants at ADS or VH buildings to be screened for COVID-19 or its symptoms each time they enter the facility. To protect families and housemates, DODD is asking that participants also be screened when leaving services. Providers should use the ADS, VH, and ICF Day Program COVID-19 Symptom Monitoring Log for these purposes.

This process begins with the person’s choice to resume services and is bolstered by a team discussion of the risk and benefits of that decision. Safety is ensured by the provider taking all necessary measures to decrease the spread of COVID-19 and keeping all who are in their setting as healthy as possible.

Information and Resources

DODD support teams are available and consist of staff ready to help county boards and providers. 

DODD has set up a dedicated web page for department communications and links to helpful resources that will advise people with disabilities, their families, service providers, direct support professionals, county boards of developmental disabilities, and the community at large. 

For specific questions about COVID-19 and additional information and resources, DODD urges you to use the Ohio Department of Health’s call center. Call 1-833-4-ASK-ODH (1-833-427-5634), or visit coronavirus.ohio.gov.