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State Facilities Admission Protocols

Updated: April 10, 2020

The COVID-19 coronavirus is a respiratory disease that can result in serious illness or death, is caused by the SARS-CoV-2 virus, which is a new strain of coronavirus that had not been previously identified in humans and can easily spread from person to person. The virus is spread between individuals who are in close contact with each other (within about six feet) through respiratory droplets produced when an infected person coughs or sneezes. Itmay be possible that individuals can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose or eyes. 

On March 6, 2020, Governor Wolf issued a disaster emergency declaration in response to the presence of the COVID-19 coronavirus in Pennsylvania.i The declaration and subsequent orders issued by the Governor and Secretary of Health directed wide-ranging efforts to slow the rate of spread of the virus and included, amongst other things, closures of non-essential businesses, stay-at-home restrictions for individuals statewide, and direction to avoid unnecessary travel and social distancing.ii The Department of Human Services (DHS) recognizes that this is a very stressful time for the entire community and that mental and behavioral health challenges and the need for services will continue. Indeed, for many, we may see an increase in service needs across the state because of the circumstances we currently find ourselves in. The individuals served by the state hospitals and state centers generally have chronic medical illnesses which increase their risk and as such, we need to make sure we protect that population as much as possible. Similarly, adjudicated youth in Youth Development Centers and Youth Forestry Camps (YDCs/YFCs) are at a higher risk of contracting COVID19 and can have compromised immune systems as well. To ensure protection of the vulnerable populations cared for in our state facilities, and the staff who care for them, with the authority conferred by the Governor’s March 6, 2020 Proclamation of Disaster Emergency, and in consultation with the Pennsylvania Department of Health (DOH), DHS is issuing this directive for procedures that must be followed at a minimum for admission of an individual to one of our state facilities: 

    1. Individuals are required to be screened for COVID-19 and provide documentation prior to admission to state operated psychiatric hospitals, the long-term care facility (South Mountain Restoration Center), state centers, and YDCs/YFCs. Screening guidance is available from the U.S. Centers for Disease Control and Prevention (CDC) and Centers for Medicare and Medicaid Services (CMS), as well as from DOH. Screening should include taking the individual’s temperature and asking questions about exposure to COVID-19 and the presence of respiratory symptoms (new or worsening cough, sore throat, shortness of breath). For the purposes of this screening, a fever is a temperature greater than or equal to 100.0 degrees. Any individual who meets screening criteria for indication of infection but does not have documentation of a negative test result for COVID-19, may not be admitted. Additional guidance on testing can be found at the Department of Health website.  
    2. A medical clearance attestation from a physician within 72 hours prior to the requested admission date is acceptable for admission if the individual was screened with a negative result. If there was a positive screening, regardless of a COVID-19 test result, the individual must not be admitted until 7 days have passed since symptom onset, and 3 days (72 hours) after the resolution of fever without fever reducing medicines and improvement of other symptoms. 
    3. If an individual has had a close contact with someone suspected to have, or diagnosed with, COVID-19, the individual should quarantine for 14 days from the last time they had contact. Quarantine should begin immediately without waiting for final test results. Close contact is defined as being within 6 feet for a period of 10 minutes or more during the period 48 hours before symptom onset to isolation. Admission to a facility should not occur until after the 14- day quarantine is complete.

This protocol entails minimum requirements and is subject to change. In line with existing expectations and practices, the level of care needed should be carefully considered before admitting an individual to ensure the least restrictive setting is being utilized at all times and that residential services are necessary for the treatment and safety of an individual. 

Additional guidance for infection prevention and control from DOH can be found here, and CDC guidance for patients with suspected or confirmed COVID-19 in healthcare settings is available here. 

This Directive shall take effect immediately and remain in full force and effect until the disaster emergency declared by Governor Wolf is no longer in effect. With the Governor’s authorization as conferred in the disaster emergency declaration issued on March 6, 2020, all state regulatory statutes, regulatory provisions, policies, or rules that would impose an impediment to implementing this directive are suspended. Those suspensions will remain in place while the proclamation of disaster emergency remains in effect. 

1The Governor issued the Proclamation of Disaster Emergency pursuant to 35 Pa.C.S. § 7301(c) of the Emergency Management Services Code. 

iiThe Secretary of Health issued her orders pursuant to her authority under the Disease Prevention and Control Law (DPCL), 35 P.S. §§ 521.1 et seq. and sections 532(a) and 1404(a) of the Administrative Code, 71 P.S. § 532; 71 P.S. § 1403(a).