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DDD Policy Guidance on Visits to Residential Provider Homes during the COVID-19 Emergency

Coronavirus Disease 2019 (COVID-19) Guidance
For New Jersey Community Providers of Services for
Individuals with Intellectual and Developmental
Disabilities


Topic: Visitors to Homes

Every Community Provider of Services for Individuals with Intellectual and Developmental Disabilities is responsible for daily operations and management of its COVID-19 response and must be prepared to manage daily operations during an emergency or other disruption to its normal routine.

The Division of Developmental Disabilities expects providers of services to adhere to the standards and best practices regarding visitors outlined herein as they prepare for and respond to COVID-19.

Providers Should:
Regularly monitor the situation on CDC's COVID-19 webpage:www.cdc.gov/COVID19
Subscribe to the CDC’s COVID-19 newsletter:
https://tools.cdc.gov/campaignproxyservice/subscriptions.aspx
Regularly monitor the situation on the NJ Department of Health webpage: www.nj.gov/health/cd/topics/ncov


Policy

Individuals may only schedule a visit to the home if the provider determines that it is necessary
for the health and safety of staff or residents. For example, delivery of food, medications and
other critical supplies; the services of medical professionals; or family visits related to critical
medical or behavioral treatment.

All staff, contracted professionals, and visitors must be screened for before entering the
home, including temperature checks. This includes scheduled staff coming onto each shift. A
record of all screenings should be maintained. The only the exception is for first responders 
who are entering the home to address an emergency.

Individuals that are not entering the home, such as those delivering items like food or laundry,
do not have to be screened. The group home manager should establish a designated area
outside the home where deliveries should take place. Staff should maintain the recommended
distance from delivery personnel and wash their hands after handling deliveries.
Staff planning travel to any area that is not a U.S. state or territory shall notify supervisors of
the areas and countries they will be traveling to at least one week before the departure date.
Staff that show signs or symptoms of a respiratory infection at work will be immediately
separated from resident areas and screened for further action.

Individuals that answer “NO” to all screening questions AND have a temperature below 100
degrees will be able to enter the residence.

Individuals that do not clear the screening may not enter the residence, with the exception of
staff who answer “YES” to the Question #2, close contact with COVID-19, solely due to
continuing care for an infected individual in the residence.

Procedure for Entering the Residence - Staff
If, after undergoing screening, staff are permitted to enter the residence, the residential staff
should:
Wash their hands when entering the residence.
Follow Universal Precautions and the guidance of the agency as it relates to preventing
the spread of COVID-19.


Procedure for Entering the Residence - Visitors
If, after undergoing screening, the visitor is permitted to enter the residence, the residential
staff should:
Ask the visitor to wash their hands when entering the residence.
Provide instruction, after washing their hands before the visitor enters the resident's
room, on hand hygiene, the location of handwashing sinks, limiting surfaces touched,
and use of PPE (if recommended by healthcare professional), according to current
residence policy while in the resident's room;
Limit visitor’s movements within the residence to the resident's room (e.g., reduce
walking the halls, avoid going to dining area, etc.); and
Advise the visitor to limit physical contact with anyone other than the resident while in
the residence. For example, practice social distancing with no handshaking or hugging
and remaining six feet apart.

Alternatives to Visits
In lieu of visits, the Department suggests that residential providers consider:
Offering alternative means of communication for people who would otherwise visit,
such as virtual communications (phone, video-communication, etc.).
Creating/increasing listserv communication to update families, such as advising to not
visit.
Assigning staff as primary contact to families for inbound calls and conduct regular
outbound calls to keep families up to date.
Offering a phone line with a voice recording updated at set times (e.g., daily) with the
residence's general operating status, such as when it is safe to resume visits.


Screening Questions
1. Signs and symptoms of a respiratory infection
a. Have you had a temperature over 99.9° within the past 24 hours?
****Verify current temperature and record as directed.****
****The thermometer should be completely sanitized between uses.****
b. Have you had a cough, shortness of breath or difficulty breathing?

2. Close contact with someone who has COVID-19.
Have you or someone you live with had close contact with someone who has tested positive for
COVID-19?
Close contact for healthcare exposures is defined as follows: Being within
approximately 6 feet of a person with COVID-19 for a prolonged period of time.
Examples
Caring for or visiting the person.
Sitting within 6 feet of the person in a healthcare waiting area.
Having unprotected direct contact with infectious secretions or
excretions of the patient.
Examples
Being coughed on.
Touching used tissues with a bare hand.
https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html

3. Travel to an area subject to a Level 3 CDC Travel Health Notice
Within the past 14 days, have you traveled to an area subject to a Level 3 CDC Travel Health
Notice (See Appendix)?
CDC Travel Notices:
https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html

Valuable Resources
The Centers for Disease Control & Prevention (CDC) has published several guidance documents
on infection control and COVID-19. You should review these documents and use them to
identify enhancements in your existing infection control policies and emergency preparedness
plans for epidemics and pandemics. Although these documents are written for healthcare
providers, many of the recommendations are best practices for all providers responsible for the
long-term health and safety of individuals in residential and facility-based services.

CDC Hospital Preparedness Assessment Tool:

www.cdc.gov/coronavirus/2019-ncov/downloads/hospital-preparedness-checklist.pdf

CDC Long-Term Care and other Residential Facilities Pandemic Influenza Planning Checklist:
www.cdc.gov/flu/pandemic-resources/pdf/longtermcare.pdf

Additionally, the Centers for Medicare & Medicaid Services (CMS) is providing updates on its
Current Emergencies page, which includes similar documents on infection surveillance and
control.

CMS Current Emergencies:
www.cms.gov/About-CMS/Agency-Information/Emergency/EPRO/CurrentEmergencies/Current-Emergencies-page

Information for Healthcare Facilities Concerning 2019 Novel Coronavirus Illness (2019-nCoV):

www.cms.gov/files/document/qso-20-09-all.pdf

Guidance for Infection Control and Prevention of COVID-19 in nursing homes:

https://www.cms.gov/files/document/3-13-2020-nursing-home-guidance-covid-19.pdf

COVID-19 Questions and Answers:

Administrators for New Jersey businesses who want additional guidance on how to manage the
risks posed by COVID-19 are invited to contact the Department of Health at 1-800-222-1222 or
via email at
NCOV@doh.nj.gov. Calling the hotline is the best, fastest way to get answers to
your questions about COVID-19. Trained health care professionals are standing by to answer
questions about coronavirus. By email, please allow up to 48 hours for a response.


Previous Article DDD Update 03/16/2020 on COVID-19 Questions and Answers for Individuals, Families and Providers
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