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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.
  • Guidance: ICF Visitation
    • Visits for people in ICFs are challenging because of the number of vulnerable people living together, and the number of staff needed to make sure visits are done safely
    • Visitors are permitted to have outdoor visitation only
    • Providers need to:
      • Decide how to best implement outdoor visitations in a way that works best for them.
      • Carefully consider resident’s physical and mental well-being when determining when to allow facility and personal visitation
      • Evaluate to ensure the visit is going to be emotionally beneficial
        • Take into consideration if the individual has indicated a desire to have visitors, and if the individual being visited will be able to wear a mask (facial covering)
      • Develop a visitation policy that includes, at a minimum: limiting visits, creating a screening process for visitors, and using sign-in sheets to track visitors
        • The sign-in sheets must contain confirmation that each visitor provided identification, a phone number, and address
      • Educate residents on the risks of the spread of COVID-19 when interacting with visitors and the appropriate/applicable safety precautions
      • Educate families/friends of the risks of the spread of COVID-19 and the potential health impact for their loved one, staff and all residents of the home
      • Have enough personnel available to check visitors in, take temperatures (both resident & visitor), do health screening (visitor), and monitor visits
      • Make sure visits take place in distinctly separate outdoor areas so that groups are distant and not able to comingle
      • Assure visitors do not take people off the grounds unless approved by the provider in advance
      • Advise visitors in advance that access to the residential living area will not be granted for any reason (e.g., restrooms), so the visitor needs to plan accordingly
        • Facilities that can offer restrooms in non-residential buildings that are not in use by residents at the time of visitation, may consider accompanying visitors to and from those locations as needed. Those areas must be thoroughly cleaned after visitation before use by residents.
      • Have contingency plan need in place to address potential adverse weather conditions
        • Consider the temperatures and making areas of shade available, especially taking into consideration medication-related sun sensitivity
      • It is preferable for visits to be contact-free. If contact does occur, it is recommended that the individual wash hands thoroughly and change clothes when returning indoors. Items such as wheelchairs or other touched items need to be cleaned and disinfected
      • Make hand sanitizer available to visitors and individuals before and during the visit
      • Continue to maintain, and in some cases enhance, virtual visitation options to augment visitations.(Face Time, Skype, and Zoom, etc.)
  • Visits need to be:
    • Prescheduled with the provider and notify the visitor of the length of time available for the visit
    • Include screening of visitors for temperature and symptom reporting, and hand sanitizing
    • Limited in group size based on the space available to maintain social distancing, including the individual and any staff needed to assist
    • In structured settings that encourage social distancing and are supervised to address any misuse of wearing facial coverings or lack of cooperation with social distancing
    • Conducted in an outdoor location where surfaces and furniture will be cleaned and sanitized before and after the visit
    • Limited to the individual and their visitors in an outdoor location of their own that will not be entered or used until cleaned after the visit
    • Planned to avoid anything that would require removing the visitor’s masks (such as eating)
    • Planned in accordance with visitation guidelines required by the provider to maintain the health and safety of all residents
    • Planned to avoid sharing items such as balls, games, or craft supplies
  • Visitors need to:
    • Agree to sign-in, have temperature taken, complete a health screening & wash hands/use hand sanitizer upon arrival.
    • Agree to wear face coverings
    • Agree to minimize physical contact when possible as decided as necessary by the team.
    • Agree to follow visitation guidelines required by the provider to maintain the health and safety of all residents.
    • Understand the health risks of COVID-19 and the importance of taking steps to minimize exposure for all the residents of the home.
    • Agree to potential cancelation or reschedule of visits on short notice depending on the availability of staff, or the health status of any resident in the home or weather conditions
  • 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.