These are answers to questions asked during the Long-Term Services and Supports (LTSS) Pre-Surge Toolkit webinars that originally aired April 21, 2020, led by Janet Winterstein and Ann Weisent.

Q: On page 9 of the toolkit, it lists the temperature as 100.0. I thought the guideline was 100.4. Has this changed?

A: Yes, the guidance from the Centers for Disease Control and Prevention (CDC) has changed to 100.0.

Q: Will we be able to get the slides from this presentation?

A: They are available here.

Q: If the county board has a lease on an empty, community home, and would like to offer it for needed quarantine housing for individuals if the need arises, does the Ohio Department of Developmental Disabilities (DODD) need to do a virtual walk-through for this?

A: If the setting is not currently being used for residential services, yes.

Q: Are providers mandated to use these forms and the LTSS Pre-Surge Toolkit?

A: There is no mandate other than the requirement that a provider ensure the health and safety of those they serve, but it would seem that providers would want to be prepared for possible exposures/diagnosis and the toolkit would be a  helpful resource.

Q: What if we are having trouble getting a call back from the local health department for their assistance?

A: Call the Ohio Department of Health's (ODH) COVID-19 hotline and let them know. Local health departments probably won't be involved unless you have an actual exposure or confirmed case.

Q: Are we going to be getting more personal protective equipment (PPE) soon?

A: The department, provider associations, and private providers are continuously working with available resources to try to acquire PPE.

Q: Is DODD recommending that providers get back to business as usual in May as far as people with disabilities going back into the community for things like going to the library, grocery shopping, movies, non-urgent appointments, and haircuts? Of course it is up to each person and family or guardian to decide what they want to do, but as a provider, should we start offering our full range of community-based Homemaker/Personal Care (HPC) again in May?

A: DODD will communicate guidance to the field as the orders from the governor and ODH change. Make sure that you are subscribed to Memo Monday so that you will receive all future guidance.

Q: Do you still have to use bed hold days if you are the provider providing the service in a different building?

A: Not as long as the building is part of your intermediate care facility (ICF). If the building is not part of the existing ICF's certified space (space that goes through an annual Life Safety Code survey), then you will have to bill bed hold days.

Q: How are we addressing visitors after the May 1 "opening the state"? We have families and guardians who want to visit and take their family members with disabilities home.

A: DODD will communicate guidance to the field as the orders from the governor and ODH change. Make sure that you are subscribed to Memo Monday so that you will receive all future guidance.

Q: If we have a home currently licensed for six, but only have five people living there, are we allowed to still move one person into that location if necessary?

A: Yes.
 

Q: One of the early guidance issued by DODD exempted the four bed limit for unlicensed homes until June 1. Is this not applicable now?

A: The no-more-than-four limit is a state statute, and there is no regulatory authority to exempt or waive that requirement except in a licensed residential setting.

Q: Could you give a brief description of the difference between "isolation" and "quarantine"?

A: Please refer to DODD's companion guidance that goes with the LTSS Pre-Surge Toolkit. Quarantine is to keep known/presumed exposed people away from well people and monitor for symptoms. Isolation is keeping ill people away from exposing anyone else to their illness.

Q: In regard to appropriate areas, what is the space needed for meals/eating for up to 10 people and the 6 feet of social distancing?

A: There is no minimum square footage. Please measure to ensure compliance with the 6 feet of social distancing guidance.

Q: Will there be coordination with DODD getting PPE? Supplies are getting hard to secure.

A: You should coordinate with your local county board and/or EMA for possible PPE resources. If DODD becomes aware of available PPE, the department will work with local partners regarding access to PPE.

Q: What site is the 100 temperature for? 100 axillary and 100 tympanic are very different for example.

A: 100.0 refers to oral or whatever temperature would be equivalent to 100.0.

Q: How does a provider determine if they should isolate or quarantine someone at home or if they should develop a relocation site?

A: Follow the resident journey as outlined in the LTSS document. Home is always the best, but when quarantine/isolation requirements can't be met in the home, you should discuss the appropriateness of a relocation site with your local partners.

Q: Will the state assist providers in getting the mentioned PPE, as most of us are not able to secure the required PPE? Are we to not allow people with disabilities to resume activities until such PPE can be purchased?

A: DODD continues to work with state partners to ensure that the need for PPE by DODD providers is recognized. The department will ensure that resources about available PPE are shared with the field. DODD encourages providers to continue to work with their local partners to secure necessary PPE. Guidance regarding the state's plan for reopening will be coming from the governor's office. All business will need to follow the directives in that plan.

Q: For resuming Adult Day Support services, are people who fall into the vulnerable population guidelines to stay home and not resume?

A: That would be a determination to be made by the person with disabilities, their health care providers, and their team.

Q: Is anyone keeping count of the cases in our community? For instance, how many people being served have been diagnosed? I just want to drive home the urgency to my staff.

A: All positive cases in DODD licensed residential facilities are being shared on the ODH COVID-19 website. 

Q: If we have a site for relocation should arrangements be made to get approval?

A: If you plan to use a site that is not currently a residential setting, you need to contact DODD to have a virtual walk-through of the location completed.

Q: Will there be any guidance for adult day programs?

A: DODD will communicate guidance to the field as the orders from the governor and ODH change. Make sure that you are subscribed to Memo Monday so that you will receive all future guidance.

Q: Is there any place that providers are able to purchase masks?

A: PPE is difficult to locate for all health care professionals. DODD encourages you to work with your local partners to access PPE.

Q: Where did it say the temperature changed to 100.0 F? And when?

A: The most recent guidance from the CDC (as of April 15, 2020) says, “Fever is either measured temperature greater than or equal to 100 degrees F or subjective fever.” (https://www.cdc.gov/coronavirus/2019-ncov/hcp/long-term-care.html)

Q: Where can I find PPE? Especially masks and face shields or goggles.

A: You should reach out to your local county board or council of governments to ensure they know that you have a need. Also, contact your local EMA to share your need. The local EMA is acting as the local contact for PPE.

Q: How is DODD addressing the shortage of PPE for providers?

A: DODD continues to work with state agencies to ensure that the need for PPE in the developmental disabilities field is included in strategic planning for obtaining PPE. 

Q: If a person with disabilities refuses to return to their day program will that be a problem?

A: This is not the subject of this webinar. Please watch for guidance from DODD or reach out to one of the DODD Regional Support staff for your county.

Q: Physical distancing in the home does not mean isolating in their rooms?

A: That is correct.

Q: How far in advance should the virtual walk-through be requested? Can it be requested to be prepared for the possibility of using a site for an isolation facility?

A: As far in advance as possible, but DODD will have them assigned to a reviewer on the same day the request is received. Yes, it should be part of your pre-surge planning so that you are prepared.

Q: In reference to “Tool #1 Patient/Resident population assessment checklist,” is there a guideline for the scores? What is the value that is considered a “higher total score?"

A: The more pre-existing health conditions a person has, the higher risk they have of becoming severely ill. This is not a validated tool. It was provided by ODH to allow "consideration" of cumulative risk factors. It is meant to be used to get a general picture of the population on a scale of lowest risk to highest risk.

Q: If a county board was able to use an old retirement home, would we need a virtual tour?

A: Yes, because it is not currently being used as a residential setting.

Q: Are you aware of any companies that are cleaning N95 masks for ICFs? 

A: Battelle in Columbus is doing the cleaning. You should contact your local health district to find out how to access cleaning.

Q: If a provider for a congregate site gave 30 days' notice a few days before the state shutdown, is a new provider able to transition in given that the state remains with restrictions? 

A: There is no prohibition on starting new services. This needs to be coordinated with the person with disabilities, their team, and the county board.

Q: If a provider gave 30 days' notice a few days before state shutdown, can we move forward with the transition or should the providers wait until the restrictions are lifted?

A: That would depend on where the person is moving to, whether they have had (or anyone where they are moving to has had) a possible exposure, the reason for the termination, whether the termination was appealed, etc. Please feel free to contact one of the DODD staff members on your Regional Support Team to discuss the situation.