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DHS COVID-19 PROVIDER RESOURCES // ODP

ODP Announcement 20-109: Guidance for Providing the Life Sharing Service During the COVID-19 Pandemic

Posted: December 1, 2020

Audience

Life Sharing Agencies, Life Sharing Host Homes, and all other interested parties 

Purpose

The purpose of this document is to:

    • Provide recommendations to enable Life-Sharing agencies to assist host homes with understanding and applying the guidance
    • Provide recommendations relating to individual participation in facility-based Community Participation Support and other community-based activities during the COVID-19 pandemic
    • Explain what host home household members and substitute care providers should consider during the COVID-19 pandemic and clarify expectations for agencies to support host homes in managing COVID-19 related situations.
    • Clarify what is meant by “suspected to have COVID-19” and “diagnosed with COVID-19.”

Discussion

Although Life Sharing agencies and host homes are subject to regulatory and programmatic requirements, host homes operate very much like private residences.

It is essential that Life Sharing agencies provide adequate support to host homes in preventing the spread of COVID-19 and addressing COVID-19 related issues and events.

On November 3, 2020, ODP released an updated version of Announcement 20-066, Guidance for Visitation in Residential Settings (ODP). Life Sharing agencies are reminded that the guidance in Announcement 20-066 applies to licensed and unlicensed host homes. Agencies are strongly encouraged to adopt the guidance and assist host homes with understanding and applying the guidance.

Participation in Facility-Based Community Participation Support

If an individual or household member has COVID-19, is waiting for COVID-19 test results, or is experiencing symptoms of COVID-19, the individual may NOT go to a Community Participation Support (CPS) facility.

      • If an individual with COVID-19 goes to a CPS facility, this significantly increases the risk of COVID-19 infections both at the CPS program and throughout the community services system
      • There have been several cases where individuals receiving Life Sharing services who had or were suspected to have COVID-19 participated in facility-based CPS and exposed their peers and facility staff to the virus
      • The other exposed participants and staff may then expose their housemates, family, and friends to the virus

Immediately upon discovery that an individual or household member has COVID-19, is waiting for COVID-19 test results, or is experiencing symptoms of COVID-19 and has attended a CPS program, the Life Sharing agency should contact the CPS facility. The information is essential to help the CPS facility make decisions about how to keep peers, peers’ families, program staff, and program staff’s families safe from the spread of COVID-19. When making decisions about preventing the spread of COVID-19, the CPS provider is required to keep identifying information confidential.

ODP recognizes that many individuals are eager to return to CPS facilities, and not being able to do so can be difficult.

      • Agencies and host homes should remind individuals that refraining from attendance helps protect other people, and
      • Pursue alternative means to offer individuals the opportunity for interaction with peers, such as exploring the possibility of remote CPS.

Life Sharing agencies are reminded that they are responsible for providing all necessary supports to host home providers who are unable to meet individuals’ needs due to COVID-19. This includes, but is not limited to, sending agency staff to the host home providers as needed.

Participation in Other Community-Based Activities

In addition to participating in formal day activities such as CPS services, individuals who receive the Life Sharing service frequently engage in informal community activities such as extended or overnight home visits with family members and friends. If an individual or host home household member has COVID-19, is waiting for COVID-19 test results, or is experiencing symptoms of COVID-19, participating in home and overnight visits will expose the individual or individual’s family and friends to the virus.

As is the case with CPS facility attendance, ODP recognizes that individuals are eager to participate in in-person visits with friends and loved ones, especially during events such as birthdays and holiday celebrations. Nevertheless, agencies and host homes must consider both the potential that the individual will expose others to COVID-19 and the potential that the individual will be exposed to COVID-19 by family and friends.

Agencies and host homes should attempt to minimize the emotional distress to both individuals and their families and friends by emphasizing the benefits of refraining from visits that may expose the individuals and others to COVID-19. This includes explaining that refraining from visits helps protect everyone, and that not participating in visits now helps stop the spread of the virus, which can expedite controlling the virus so visits may resume.

Please see “Facilitating Personal Relationships When In-Person Visits are Restricted” in Announcement 20-066 for guidance on alternatives to in-person visits.

Considerations for Host Home Household Members and Substitute Care Providers

Life Sharing agencies and host home households must also consider the potential for exposure between the individual and other household members in the host home who do not receive the Life Sharing service.

Host home household members should examine risk factors in their own everyday lives such as potential exposure at their jobs and at community activities in which they engage that are not part of the Life Sharing service. If these activities present a high risk of COVID-19 exposure, the host home household members should strongly consider refraining from those activities, if possible. If the host home household members must participate in activities which present a high risk of COVID-19 exposure, they should consider whether the individual who is receiving services should be temporarily relocated to an alternative living arrangement to protect other household members and the individual from exposure to the virus.

Informal substitute care arrangements are also a regular part of Life Sharing service provision. People who provide substitute care should also examine risk factors in their own everyday lives, such as potential exposure at their jobs and at community activities in which they engage that are not part of the Life Sharing service. If these activities present a high risk of COVID-19 exposure, the substitute care provider should strongly consider refraining from those activities, if possible. If substitute care providers must continue participating in activities which present a high risk of COVID-19 exposure, the substitute care provider should consider not providing substitute care during the pandemic.

Clarification: When an Individual or Host Household Member is Suspected to Have COVID-19

A person is suspected to have COVID-19 when:

      • The person has been tested for COVID-19 due to symptoms or contact with a person with COVID-19 and is awaiting test results;
      • The person is experiencing symptoms of COVID-19;
      • The person has been in close contact with a person who tested positive for COVID-19 positive or is suspected of having COVID-19; or
      • The person has been in close contact with another person who meets the criteria in (1)-(3) above.

Close contact is defined as being within 6 feet of person who tested positive for COVID-19 for a cumulative amount of at least 15 minutes within a 24-hour period starting from 2 days before illness onset (or, for asymptomatic individuals, 2 days before a test specimen is collected) until the time the infected person is isolated. Any contact with a COVID-19 positive person where the length of contact time is not known should be considered “close contact.”

The host home should contact the Life Sharing Agency immediately when the individual or anyone residing in the host home is suspected to have COVID-19 as clarified above. The Life Sharing agency is responsible for discussing what type of support is needed with the individual and host home. The Life Sharing agency can also provide assistance and guidance as outlined in the “Life Sharing Agency Expectations” section below.

Clarification: When an Individual or Host Home Household Member is Diagnosed with COVID-19

A person is considered to be diagnosed with COVID-19 when:

      • A COVID-19 test was performed and the results are positive for the virus, or
      • A health care practitioner determines that the person has COVID-19 even if a test is not performed.

The host home should contact the Life Sharing agency immediately when the individual or anyone residing in the host home is diagnosed with COVID-19. The Life Sharing agency is responsible for discussing what type of support is needed with the individual and host home. The Life Sharing agency can also provide assistance and guidance as outlined in the “Life Sharing Agency Expectations” section below.

Expectations for Life Sharing Agency

In addition to the expectations for Life Sharing agency involvement described throughout this document, agencies are also expected to remain in regular contact with each host home to provide the most up-to-date COVID-19 related information and to offer support in areas such as:

      • Applying the policies and procedures developed as recommended in Announcement 20-066;
      • Securing necessary personal protective equipment, and
      • Meeting individuals’ needs when household members are too ill to care for individuals receiving Life Sharing services.

While ODP intends to support Life Sharing agencies to cope with COVID-19 through technical assistance and support, agency actions or inactions that may or do contribute to the spread of the COVID-19 virus may result in enforcement action.

Contact

Life Sharing agencies are strongly encouraged to contact ODP with any questions about managing COVID-19 related situations. Questions may be sent to RA-PWODPEMRGNCYRSPRQ@pa.gov or to Ronald Melusky, Director, Division of Program Operations, at rmelusky@pa.gov.