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DHS COVID-19 PROVIDER GUIDANCE // OCYF

Guidance to Support a Phased Approach to Ongoing Mitigation Efforts Preventing the Spread of the Coronavirus Disease 2019 

Issued: June 5, 2020

Audience

County Children and Youth Agencies, Private Children and Youth Social Services Agencies, Child Welfare Service Providers 

Purpose

Consistent with the Governor’s strategic three-phased approach ( , and ) for reopening the Commonwealth and ongoing mitigation efforts to limit the community spread of the Coronavirus Disease 2019 (COVID-19), the Department of Human Services (Department), Office of Children, Youth, and Families (OCYF) has developed the following operational guidelines for counties, agencies and providers of child welfare services. Pennsylvania plans to proceed with returning to work cautiously. Activities that are not structured around ongoing social distancing, universal masking, or other public health guidance would likely result in a spike of cases and new stay-at-home and closure orders. 

The purpose of this guidance is to ensure child welfare service providers have a shared understanding of expectations for how services will shift and resume as counties transition from one phase to another. As always, all service delivery and decisions shall prioritize child and youth safety. 

The guidance on the following pages builds on and reinforces the guidelines and restrictions defined in the , and phases of the Governor’s reopening plan. 

RED PHASE​

The RED PHASE has the sole purpose of minimizing the spread of COVID-19 through strict social distancing, closures of non-life sustaining businesses and schools, and building safety protocols. 

Work and Congregate Setting Restrictions: 

Social Restrictions:

    • Stay-at-home orders in place;
    • Large gatherings prohibited; and
    • Only travel for life-sustaining purposes encouraged.

YELLOW PHASE​

As the transition from the RED to YELLOW PHASE continues, aggressive mitigation measures to contain the spread of COVID-19 remain in place and there should be few changes in practice or operations. Aggressive mitigation includes strategies restricting social contact to reduce community spread of COVID-19. 

Moving from the RED to YELLOW PHASE includes the following guidelines: 

Visitors in Residential Facilities: 

    • The safest form of visitation remains through the use of video conferencing and telephone calls. This method of visitation should continue where possible. 
    • Exceptions may be provided for immediate family members, if it is determined that the visit is in the best interests of the child’s health and well-being and those factors outweigh the risk of infection. In addition to the exception for immediate family members and contact required to conduct CPS and GPS investigations to ensure child safety, visits by County Child Welfare and Department staff, Behavioral Health Managed Care staff or Juvenile Probation Officers are permitted. For all other visitors, the following conditions must be met: 
          • If the visit is deemed to be necessary, prior approval by the facility director is required; 
          • Consideration must be given to designating a specific location for the visit where safe distance protocols can be met; 
          • If multiple visits are occurring at a facility at the same time, those parties must be maintained at safe distances; o Each visit should be limited to the specific person of the intended visit; 
          • Visitors must be screened using the DOH guidance outlined in the Long-TermCare Facility Visitation Guidance
          • If a person fails the screening, that person may not remain on campus; 
          • Hand washing station(s) and/or hand sanitizer should be easily accessible to visitors; 
          • Visitation areas, especially high touch areas, shall be consistently cleaned and sanitized after each use; 
          • Visitations should be staggered to limit the number of visitors in the facility at one time; 
          • Documentation should be completed for each visit which includes the date, location, time in, time out, the person visited, the person visiting and the person completing the screening; and 
          • If someone is turned away, the provider should make every effort to conduct video conferencing visits; if video conferencing is not available, additional or daily phone contact should be allowed/considered. 
    • All visitors must wear a face mask upon entry, and practice proper social distancing, hand hygiene, and appropriate screening protocols. 
    • Providers should ensure there is a designated family contact for questions/issues related to visitation. Family members, counties and Behavioral Health Managed Care Organizations are to be notified of changes to a provider’s visitation policy related to COVID-19. 

Vendors/Deliveries 

    • Deliveries should be limited when possible to specific non-residential locations, as deemed by the facility, and should minimize contact with people living and working at the facility. 
    • Follow public health guidance, including social distancing, universal masking, and hand hygiene to help reduce the spread of COVID-19. 
    • Daily screening using the guidance outlined in the Secretary of Health worker safety orders should occur. 
    • If an individual fails the screening, the person may not remain on campus and the physical delivery should be refused unless it is an essential item. If the item is deemed essential, appropriate safeguards including cleaning the surface of the item and hand washing with soap and water for a minimum of 20 seconds by anyone who touches the item should be used in the handling of the delivery. 
    • Documentation should be completed for each delivery which includes the date, location, time in, time out, the person receiving the delivery, reason, and the person completing the screening. 

Volunteers and Groups 

    • Volunteers are strongly discouraged from entering facilities and may only do so following all current guidelines for universal masking, social distancing, and health care guidelines, with the expressed written approval of the facility director, and for the sole purpose for supporting the health and well-being of a resident. 
    • While gathering in groups no larger than 25 is permitted in this phase, increased social contact for youth residing in congregate care may expose youth with compromised health conditions to undue risk of exposure to COVID-19. In order to ensure youth in congregate care settings have optimal health conditions, social gathering for youth in congregate care should be limited throughout the transition from the most restrictive to the least restrictive phases. 

Trainings/Meetings 

    • On-Campus 
        • o All trainings and meetings should be held by phone or video conferencing. 
        • o Should a meeting be deemed essential to be in person during this phase, the number of attendees may not exceed 25 and precautions of universal masking, social distancing, and procedures following all public health guidelines must be applied. 
    • Off Campus 
        • All in-person off campus training and meetings should remain prohibited. Aggressive mitigation efforts remain in place. 
        • Telephone or other technology should be used as appropriate to take the place of face-to-face trainings and meetings. 
        • An exception can be made if an in-person training or meeting is deemed to be critically necessary and approved by the facility director. 
        • All trainings and meetings must maintain a policy of allowing no more than 25 attendees. 
        • Each training and meeting that is approved as critically necessary should be limited to the minimum number of staff required and maintain current requirements for universal masking, social distancing, and public health guidelines. The facility director should make such decisions regarding off-campus trainings based on the training need weighed against the potential risk of spreading COVID-19. 
        • A training/meeting form should be completed for each exception which includes the date of the training or meeting, time departed, time returned, attendees, reason, location and person completing the form. Individuals displaying signs of respiratory illness or other symptom based on Department of Health guidance should be prohibited from in-person participation. 

Trips 

    • All trips including staff and residents from the facility should be restricted unless they are medically necessary or ordered by a court. 
    • Each trip should be limited to the specific person and the minimum number of staff required and maintain current requirements for universal masking, social distancing, and public health guidelines. 
    • Documentation should be completed for each trip which includes the date, time departed, time returned, location, reason, attendees, and the person completing the form. This documentation should also indicate if there was contact with anyone who was displaying signs of a respiratory illness or other symptoms relevant to COVID-19.

GREEN PHASE​

While the GREEN PHASE will facilitate a return to a “new normal,” it will be equally important to continue to monitor public health indicators and adjust orders and restrictions as necessary to minimize the risk of spread of COVID-19. 

For agencies that move into the GREEN PHASE, agencies or providers may develop their own modified guidelines to meet specific child population needs. 

Work and Congregate Setting Restrictions:

Social Restrictions: 

    • Visitation may resume subject to the determination of the individual facility which may still limit visitation as necessary based on Department of Health guidance related to risk of COVID-19. 
    • In situations where multiple counties are involved (e.g., a youth is placed in a green county and the visitor is in a yellow county), adhere to the reopening guidance for the county in which the visit is occurring.

The following guidance should be followed in all phases of reopening: 

Report All Confirmed Cases of COVID-19 to OCYF 

For OCYF to be responsive to any provider needs related to COVID-19, timely information from the county and provider community is essential. Staff should follow DOH worker safety orders for evaluation, screening, testing, reporting and communicating with employees when staff or a resident is suspected of having COVID-19. In addition, if staff or a person who received services is suspected to have COVID-19 or has a confirmed case of COVID-19, the appropriate regional office should be notified. 

OCYF Regional Office Contact Information

​Central Regional Office: 717-772-7702
Northeast Regional Office: 570-963-4376
Southeast Regional Office: 215-560-2249
​Western Regional Office: 412-565-5728


Support Best Public Health Practices

The best way to prevent illness is to avoid being exposed to COVID-19. Review orders issued by the Pennsylvania Secretary of Health relating to worker safety and building safety. Individuals should continue to exercise and promote hygiene practices and ensure staff have updated information related to the use of face masks. 

The following precautions should be exercised regularly by youth and staff: 

    • Wash hands often with soap and water for at least 20 seconds especially after being in a public place, or after blowing noses, coughing, or sneezing; 
    • Use a hand sanitizer that contains at least 60 percent alcohol if soap and water are not readily available. People should cover all surfaces of hands and rub them together until they feel dry; 
    • Avoid touching eyes, nose, and mouth with unwashed hands; 
    • Wear a face mask or other face covering when sharing space with co-workers or the public; 
    • Cover mouths and noses with a tissue when coughing or sneezing or use the inside of their elbow; 
    • Clean AND disinfect frequently touched surfaces daily. This includes tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks; and 
    • Stay home if sick. 


Review Agency Back-up Plan and Infection Control Procedures

All counties, agencies and providers must: 

    • Continue to review internal infection control protocols and emergency back-up plans for events in which a provider does not have adequate staffing to meet individuals’ health and safety needs; 
    • Evaluate staff adherence to provider infection control protocols; 
    • Evaluate capacity to implement emergency back-up plans in the event staffing is impacted by COVID-19; 
    • Seek guidance from OCYF regional offices when circumstances arise that are not included or addressed in emergency back-up plans. 

For questions or technical assistance related to emergency back-up plans, counties, agencies and providers may contact the appropriate regional office. 

Contact OCYF Before Making Any Changes to Business Practice

County child welfare agencies, foster care agencies, adoption agencies and providers should contact OCYF as soon as possible before making any changes to their business practices in response to COVID-19. Examples of changes in business practices include, but are not limited to: 

    • Suspending services at a service location or temporarily closing programs. 
    • Reducing or eliminating the provision of placement for children or youth in a program. 
    • Closing county offices. 

OCYF is closely monitoring the changing landscape as counties transition from the red into yellow and yellow into green phases and will provide additional guidance on a caseby-case basis should unique conditions arise. County children and youth agencies, foster care agencies, adoption agencies and providers should continue to provide workforce updates and identify service barriers to OCYF. 

Document Actions Taken and Maintain Evidence for Those Actions 

As counties transition to a new phase, county children and youth agencies, foster care agencies, adoption agencies and providers should continue to document any changes to their operations and expenses incurred related to operations as a result of COVID-19 and maintain evidence to support why the changes were made. Doing so will help demonstrate the basis for an action, support any changes that may need to be made and substantiate submitted claims for services rendered in an alternative manner due to a COVID-19 outbreak. 

OCYF will continue to provide technical assistance regarding the evidence that should be maintained when counties or providers contact OCYF. The evidence that should be maintained includes, but is not limited to: 

    • Orders or notices from local authorities 
        • Example: County Health Department A imposes a restriction on public gatherings of more than 10 people, forcing Provider B to close its vocational program for one week. Provider B should retain the official notice from County Health Department A as evidence to support the closure. 

As the COVID-19 pandemic continues, the Department is aware that some providers may struggle with adequate staffing. Despite this challenge, the facility remains responsible for providing adequate care and maintaining a safe environment for residents. The Department will continue to uphold its regulatory responsibilities but will not cite a facility based solely on a request for assistance from federal, state, or local resources. The Office of Children, Youth, and Families expects facilities to reach out for assistance during this unprecedented time. 

Stay Informed

The Department continues to monitor information from DOH and the CDC. Guidancedeveloped by the Department will be updated as additional guidance becomes available. Over time, information will continue to be shared and disseminated to address questions and concerns as they arise and new information on COVID-19 as it develops. We encourage you to continue to consult these resources for updates on COVID-19, information on staying healthy, and updates on the situation in Pennsylvania. 

    • COVID-19-specific information can be found at: 
    • `DOH holds regular press briefings to announce the latest efforts and updates on the commonwealth’s response to COVID-19. Counties, foster care agencies, adoption agencies and providers may watch a free live stream of the regular briefing at https://pacast.com/live/doh
    • One of the most important steps you can take to stay informed about our program is subscribe to our Listservs. Important announcements, including announcements about COVID-19, are regularly sent over the Listservs. 
        • Please email ra-DPWOCYFNet@pa.gov to request subscription to the OCYF Listserv, if you are not already subscribed. 

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