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What COVID-19 Means for Families

As a companion to DODD's guidance about the coronavirus (COVID-19) response, the department has provided explanations about how specific guidance relates to families of Ohioans with developmental disabilities.

General

  • Governor Mike DeWine Executive Order
    • Governor DeWine declares a state of emergency which allows state departments and agencies to better coordinate their response to COVID-19.
    • The order allows state departments and agencies to develop and implement new rules and procedures to protect the lives, health, and safety of people in Ohio.
    • All citizens are asked to follow the advice of the Ohio Department of Health.
  • Having a Meaningful Day during Ohio’s Stay-at-Home Order (DODD)
    • Despite Governor DeWine’s Stay-at-Home Order, people with developmental disabilities can continue to have enjoyable and meaningful days.
    • This resource provides content areas people with disabilities can continue to engage in and suggests specific activities people can do, such as physical activities, arts, creativity, and virtual opportunities.

DODD Messages

  • Guidance: Waiver Visitation
    • Support teams and roommates should talk about if visits should happen now, and safely and responsibly plan for any visits inside the home.
    • Teams & roommates should make visits as safe as possible and follow the public health guidelines, including, but not limited to
      • Educating all residents on
        • The risks of the spread of COVID-19 and what safety precautions to take when meeting with others
        • The importance of face coverings and keeping at least a distance of 6 feet from people they do not currently live with
      • Educating all families/friends of the dangers of the spread of COVID-19 and the potential health impact it may have on the health of residents and staff
      • Encouraging DSPs and visitors coming into the person’s home to always wear a face covering,
      • Frequent cleaning and sanitation of high touch surfaces and shared bathrooms, at least several times per day
      • Encourage the utilization of technology to keep in touch with families and friends
      • Evaluating whether outdoor visitation would be more appropriate for members of the home.
  • Updated Guidance: Phase One Guidelines for ICF/IDD Indoor Visatiion During COVID-19 
    • The Ohio Department of Health (ODH) issued an order permitting Intermediate Care Facilities (ICFs) to allow indoor visitation.
    • DODD has issued guidance to support local families, providers, and teams to implement indoor visitations safely.

      Local team processes are highly encouraged to be the primary way to determine the appropriateness of indoor visitation. Families should work with their local teams to discuss the risks and benefits of indoor visitation.

      Conditions for indoor visitation:

      • The resident’s person-centered planning team has considered all implications for the resident’s physical and mental well-being and decided visits are a good idea
      • ICF’s have considered the facility resident risk levels as a whole and determined visits are reasonable and feasible
      • Residents must be educated on safety precautions and the risks of the spread of COVID-19 when interacting with visitors
      • Providers must educate visitors of the risks of COVID-19 and the potential health impact for their loved one and everyone in the home
      • The Public Health Advisory status of the county where the facility is located and where the visitors live should be considered
    • Families need to understand that facilities must meet the following criteria:

      • Visitors must confirm they have no household members currently in quarantine or isolation status
      • The facility has no residents in isolation or quarantine status in the distinct residential living area where the person being visited resides
      • There are no personnel who have worked in the distinct residential living area where the person being visited resides within the last 14 days who have been diagnosed with COVID-19 or been assigned quarantine status
      • The facility has enough Personal Protective Equipment (PPE) for the resident, the visitor, and the on-going needs of personnel
      • The facility has enough resources and personnel to conduct visits according to the rules for infection control
      • If possible, visitation will take place in a room or building that:
          • Is not currently utilized for other resident activities and has a private entrance
          • Is able and will have all hand-touchable surfaces cleaned between visits
          • Has ventilation that will circulate air during the visitation
          • Has enough space to allow for six-foot social distancing between the resident, personnel, and the visitors
      • Visitors must sign-in and provide contact information
      • Visitors will wash hands or use hand sanitizer upon arrival and before entering the visiting location
      • Visitors must be screened for symptoms upon arrival and before visitation
      • Visitors must wear a face-covering during the visit. A visitor may be required to wear additional PPE (such as surgical masks) based on a resident’s circumstances
      • The resident will preferably wear a face cover and be reminded to not touch their face during the visit
      • Facilities are encouraged to maintain, and in some cases enhance, outdoor and virtual options to augment visitation
  • Outings
    • Since March 13, 2020, by Order issued by the Director of Health, access to intermediate care facilities (ICF) has been restricted to staff and other essential workers.  
      • There has not been a prohibition on residents leaving the facility. Residents of ICFs can continue to work, go to adult day and vocational habilitation programs, attend school, and engage in other activities that are important to them.
    • ICFs who have not already done so should immediately initiate planning for resuming community activities.
      • The planning for each resident should identify the benefits to that resident and the risks to that resident and other residents.
      • The COVID-19 Risk/Benefit Discussion Guide has been modified for this purpose
      • The discussion should include opportunities to:
        • Educate the resident and/or their guardian on the risks and benefits of engaging in the activity.
        • Ensure the activity complies with the Centers for Disease Control (CDC) guidance and Ohio mandates.
        • Engage the team to make a person-centered decision.
        • Identify alternatives activities or ways to participate to minimize risk.
      • Providers should prioritize planning for those residents and families who have already requested opportunities to engage in the community outside of the facility  
      • The team, including the person being supported, and when applicable a guardian, will decide how to move forward. As always, the plan requires the consent of the person or guardian.
      • The Ohio Department of Developmental Disabilities (DODD) expects that all individualized planning will be completed within 60 days.  
    • There is no need to quarantine a resident upon return to the facility after an outing of any type unless the facility learns that a resident may have been exposed* to COVID-19.
      • In the case of exposure, the facility should quarantine that resident following the CDC guidance, local health department guidance, and the additional guidance issued by DODD, including the Long-Term Services and Support Toolkit.
      • *Exposure is generally defined as having been less than six (6) feet from a person who is symptomatic or diagnosed with COVID-19, for 15 minutes or more, and without wearing a surgical level mask.
    • Facilities already under quarantine or isolation must continue to follow the CDC guidance, local health department guidance, and the additional guidance issued by DODD, including the Long-Term Services and Support Toolkit.
  • Guidance: Day Camps and Residential Camps
  • What COVID-19 Standards of Care Means for Families
    • In response to input received from Ohioans with developmental disabilities and their families, the Ohio Department of Developmental Disabilities (DODD), the Ohio Department of Health, and the Ohio Department of Medicaid collaborated to create this guidance about standards of care for vulnerable populations in hospital settings.
  • What LTSS Pre-Surge Planning Toolkit Means for Families
    • The Ohio Department of Developmental Disabilities (DODD), working with the Department of Health, Department of Medicaid, and Department of Aging, created a plan for supporting people in long-term care facilities and homes who may have been exposed to coronavirus (COVID-19). Please do not use this document on its own. Its purpose is to help families understand the Long-Term Services and Supports (LTSS) Pre-Surge Planning Toolkit.

  • Temporary Change to Permit Parents to Provide Waiver Services to Their Minor Children
    • DODD is seeking approval from the Centers for Medicare and Medicaid Services (CMS) to temporarily allow a parent of a minor child who is enrolled in the Individual Options (IO) Waiver or Level One Waiver to be employed by an agency and be a paid caregiver for their child or children.
    • This would only be allowed when there is an immediate need, and the regular provider and alternate provider are not available or able.
    • This option is intended to address needs that cannot be met through any other means and is only available throughout the state of emergency
    • Permitting and authorizing a parent of a minor child would be a new authorization in the Individual Service Plan (ISP) and must be determined, by the team, that the child has a need for and would benefit from the waiver service and that it falls within their budget and funding range cap.
  • ODH Order Requires Facilities to Notify Residents, Guardians of COVID-19 Cases
    • The Ohio Department of Health (ODH) order issued April 15 requires that all Ohio Department of Developmental Disabilities (DODD) licensed facilities give notice to residents and guardians within 24 hours of t
    • he first time they have a positive or probable case of coronavirus (COVID-19) within the facility.
    • Notification can be electronic, telephone, or written.
    • The notice should never include the name of the staff member or person with disabilities.
    • The notice requirement is only required for the first time a case is reported. If a second case occurs, or other cases occur in the facility, another notice is not required.
  • Updated Guidance: Adult Day Services Order

    • The stay-at-home order to limit adult day service locations to fewer than 10 people remains in place.
    • The Ohio Department of Developmental Disabilities (DODD) has developed a process, that combines the individual team process at the local level with a state process for providers. 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.
    • Process for People Receiving Services: Person-Centered Team Process
      • 1. The person receiving services, their family or guardian, or ADS, VH, or ICF Day Program tells the service and support administrator (SSA) or qualified intellectual disabilities professional (QIDP) that the person wants to go back to 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 discuss the risks and benefits of the person attending facility-based day services.
      • 3. If the team decides that the person should attend facility-based ADS, VH, or ICF Day Program, the team completes 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.
  • Process for People Providing Services: Provider Assurance Process
    • 1. The ADS, VH, or ICF Day Program, provider completes the Provider Assurance Form.
    • 2. Completed Provider Assurance forms are submitted to DODD and the appropriate county boards of developmental disabilities.
    • 3. DODD and the county board(s) will confirm with the provider their receipt of the forms within one (1) business day.
    • 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.
  • Other Considerations:
    • DSPs must wear a face covering when providing services.
    • People receiving services should wear a face covering.
      • If a person receiving services is unwilling or unable to wear a face-covering, exceptions for medical, functional, or practical reasons should be noted in the person-centered team process and included in the Team Acknowledgment Form for them to receive services.
  • Assisted Living Facilities & Intermediate Care Facilities for Individuals With Intellectual Disabilities
    • Visitors are permitted to have outdoor visitation only
    • All visitors must abide by the facility’s policies and practices:
      • Adhering to limited or scheduled visits for set amount of time during set hours
      • Going through a screening process, which would include temperature taking, a health screening and hand washing/sanitizing
      • Signing sign-in sheets
      • Wearing a face covering
      • Agreeing to minimize physical contact
    • Each facility can determine how to best implement outdoor visitations for their residents in a way that works best for them.
  • Guidance: COVID-19 Prevention and Response for Individual and Family Home Waiver Settings (March 19)
    • These are recommendations to prevent the spread of COVID-19 in individual and family home wavier settings, including checklists, plain language information, and things that can be done to prepare for and prevent COVID-19.
    • This guidance shares recommendations for what to do when someone has been in contact with someone else know to have COVID-19, when someone has symptoms, and when a DSP is being tested or has been tested with results showing they have COVID-19.
  • DODD's Statewide Support Teams Available for COVID-19 Response (March 14)
    • DODD has many employees who are working to help people with disabilities and their families during this pandemic. Employees cover regions of the state and work together. They include:
      • Community Resource Coordinators,
      • the Office of System Support and Standards,
      • Community Life Engagement managers,
      • and dual diagnosis in mental illness and intellectual disabilities liaisons.
  • Guidance: Single Maximum Spending Amount for Level One Waiver
    • There is a temporary single maximum spending amount that will give county boards increased flexibility to meet the needs of people with disabilities using Level One Waivers.
  • Guidance: Environmental Accessibility Adaptations (Home Mods)
    • DODD is asking county boards and providers to place home modification requests on hold, unless the request is needed because there is an immediate risk to health and welfare for the person receiving services.
      • DODD is not denying the request but is unable to support the request, unless it meets the immediate risk to health, safety, and welfare as noted above, and all appropriate documentation is included.
  • Guidance: Waiver Disenrollment
    • Due to the state of emergency, waiver dis-enrollment should only be processed for the following reasons:
      • Voluntary requests (verbal or written)
      • Person moved out of state
      • Person has died
      • Person has spent more than 90 consecutive days in facility (intermediate care facility, developmental center, or nursing facility)
      • Person is incarcerated
  • Guidance: Providers of Waiver-Funded Services
    • Following guidelines of social distancing, providers may limit the delivery of services in community settings when appropriate.
    • Providers may not discharge a person from services only due to the diagnosis of COVID-19.
    • Providers are encouraged to ensure that a person-centered approach to services is maintained by communicating with people receiving services, their families, guardians, and direct support professionals (DSPs) to keep them updated on how they can stay safe during this state of emergency.
    • DODD encourages providers to explore alternative service delivery methods, such as the use of Remote Support or allowing people to receive services in the homes of direct support professionals. People receiving services, guardians, and teams must be consulted and approve these alternatives.
  • Guidance: Independent Providers of Waiver-Funded Services
    • During this state of emergency, independent providers are able to exceed the 60-hour ceiling for providing services, if necessary, to maintain the health and safety of people receiving supports. Independent providers will still require authorization from the service and support administrator (SSA). However, independent providers do not need to wait for the Individual Service Plan (ISP) to be updated or signatures to be gathered. Verbal or electronic authorization will suffice.
  • Public Wi-Fi Hotspot Locations Announced
    • There are places available to visit to get free internet services.
    • A list of hotspot finders and locations by provider is available at innovateohio.gov.
      •  Those without internet access are urged to visit a known hotspot to access the complete list.
  • Prescription Delivery Options Available
    • Many pharmacies are offering delivery options that they may not have provided before.
    • It could be helpful to have prescriptions sent to your home so nobody has to travel out to get medicine during the COVID-19 state of emergency.

Resources

  • How Right Now
    • How Right Now is an initiative to address people’s feelings of grief, loss, and worry during the COVID-19 pandemic. Overall, it aims to increase people’s ability to adapt and be resilient during this time. The How Right Now initiative is funded by the CDC Foundation. 
       
  • Charting the LifeCourse Integrated Star for Social Distancing (March 27)
    • Social distancing is new and hard, but there are many resources and supports you may have available to you that have never been used before.
    • This tool helps you think about what supports you have to live a good life during this period of change.
  • Having a Meaningful Day during Ohio’s Stay-at-Home Order (March 27)
    • Despite the Governor DeWine’s Stay-at-Home Order, people with developmental disabilities can continue to have enjoyable and meaningful days.
    • This resource provides content areas people with disabilities can continue to engage in and suggests specific activities people can do, such as physical activities, arts, creativity, and virtual opportunities.
  • Social Stories (March 20)
    • Explaining to loved ones can be difficult during uncertainty and change.
    • Social stories are a way to help someone understand what is happening and how to regulate their thoughts and feelings, which can have a big impact on their response to change.
    • There are many free resources for learning about and using social stories.

Plain Language, General Info

  • Plain Language about Day Programs Closing (April 2)
    • To prevent spread of COVID-19, new rules have been made to keep everyone healthy.
    • This simple language resource, with pictures, says why programs are closing.
  • Plain Language Information on COVID-19 (March 19)
    • This simple language resource, with pictures, explains what COVID-19 is, how it is spread, what happens if you have it, how to stay healthy, and what to do if some you live with or a direct support professional (DSP) gets sick.
  • COVID-19 Information for Families (March 19)
    • This simple resource shares how to stay healthy, how to plan and prepare for COVID-19, and what to do if someone is sick.