​DHS COVID-19 PROVIDER RESOURCES // ODP​

ODP Announcement 20-047:
Facilitating Personal Relationships When Visitors are Restricted in Residential Settings

Updated: April 17, 2020

Audience

Providers of Residential Habilitation and/or Life Sharing services and all interested stakeholders

Purpose

To outline guidance for residential providers to develop policies for managing visitors while facilitating personal relationships between each individual and persons of their choosing

Discussion

Policies and Procedures for Visitation 

As stated in ODP Announcement 20-027, COVID-19 Operational Guidance, the requirements for allowing visitors was suspended (providers may prohibit/restrict visitation in line with CMS recommendations for long term care facilities). The modification of this right is not required to be justified in the Individual Support Plan (ISP). 

In alignment with the requirements under Governor Wolf’s Stay at Home Order, Residential Habilitation and Life Sharing providers can develop policies and/or procedures that:

• Prohibit individuals from receiving visitors in the home 
• Prohibit individuals from returning to the home if they choose to visit others outside of the home 

Residential Habilitation and Life Sharing providers should notify relatives and other individuals designated by the individual of the visitation policies and/or procedures being implemented by the provider. 

Several considerations should be taken when developing policies/procedures related to visitation and communicating with anyone interested in visiting individuals receiving residential services:

• Individuals and their family or friends can choose to have the individual visit the home of the family or friends. When this occurs, providers must communicate their policy/procedure regarding whether the individual will be allowed to return to the home, whether the individual will be required to be quarantined by the residential provider for a period of time or whether the individual will be required to remain with the family or friends through the remainder of the COVID-19 emergency.
• If the individual will remain with the family or friends through the remainder of the COVID-19 emergency, the provider (and ISP team if possible and necessary) should determine how the individual’s needs will be met. Some options to consider are sending residential staff to the home for periods of time to provide needed services to the individual, discussing whether family and friends are willing to support the individual without payment and all of the requirements associated with rendering a waiver service or whether the provider can support hiring and training the family or friends to render residential services. Another option is temporarily discontinuing residential services (but not removing the residential authorization[s] from the ISP) and adding services such as Companion or In-Home and Community Support to the ISP. Regardless of the option decided on, the individual will remain enrolled in the waiver.
• When an individual will remain with family or friends, the provider must assist the individual with packing enough items such as clothing, medication, basic medical records, and any necessary personal items. The provider must also continue to communicate with the individual and family/friends while the person is away from the Residential Habilitation or Life Sharing home to verify if additional items are needed by the individual. The provider must cooperate with the family if the individual needs additional items such as clothing or medications, in order for the individual to receive those items in a timely manner.
• When an individual will remain with family or friends, the provider must ensure that the individual has the right to return to their home once the COVID-19 emergency has ended at the latest. Providers can develop policies that allow individuals to return sooner.
  
• Whether the provider has resources to support individuals to go for walks with family or friends while meeting social distancing requirements of being 6 feet or more apart.
• For providers that allow hospice care in the home, the provider may require limiting visitors to one at a time or for next of kin. The provider may also require use of personal protective equipment during the visit
  

Ongoing Communication Facilitation 

Residential Habilitation and Life Sharing providers (including Life Sharing hosts) are responsible to facilitate ongoing communication between individuals, family members, friends, and anyone else the individual chooses to communicate with during the COVID19 emergency. Unless otherwise indicated by the individual, the expectation is that communication with family and friends is supported on a regular and routine basis for each individual. 

The provider must offer assistance to the individual to communicate with friends and family, when needed. The provider may need to assist the individual with learning new ways to communicate with the people he/she has relationships with. The provider should be creative in ways that assists the individual to remain in contact with family and friends and feel comfortable with the method of communication. A few examples include:

• Arranging a meeting that occurs between an individual or family/friends viewing each other through a window or glass door, so that social distancing guidelines are implemented
• Using technology such as FaceTime, Skype, Zoom meetings, Facebook Messenger, etc.
• Promoting communication through telephone calls, email, writing letters, texting, sending photographs or videos, or the use of virtual assistant technology (ex. Amazon’s Alexa or Google Home)
  

Homes that have access to the internet are expected to offer the individual access to a computer for the use of technology. If the individual resides in his or her own home and doesn’t have internet access, the provider should assist the individual to access an existing account for free of charge or determine if there is a reasonable accommodation that can be made. The provision of internet services is included in the room and board regulations for a Residential Habilitation or Life Sharing Home that isn’t owned by the individual. 

In homes that provide services to more than one individual, ODP acknowledges that access to items such as computers, smart phones or tablets may need a schedule; so that everyone has access to the preferred method of contact. Program specialists, Direct Support Professionals or Life Sharing hosts should collaborate with individuals and family/friends in order to plan available time to communicate.