Hands Across The Water's Resumption of In-Person Visits and Casework Plan (June 2020)
Overview of Best Practices and Safety Protocols:
Hands Across The Water is taking the necessary precautions to protect the health and safety of our staff and the children and families we serve by implementing new procedures that align with guidance issued by the Centers for Disease Control. Until further notice, Hands Across The Water staff and families are required to adhere to the following guidelines for all in-person interactions.
All parties are advised to take the following precautions to help prevent the spread of COVID-19:
· Wash hands thoroughly for at least 20 seconds, just before entering and prior to exiting an enclosed space, before eating, after use of restroom or any time when you may have come in contact with a contaminated surface;
· When handwashing is not available, use hand sanitizer;
· Wear a mask or face covering over the nose and mouth AT ALL TIMES, even while outdoors or in your vehicle, when in contact with other agency personnel or clients. Staff must wear a mask while in the hallway, restroom or any shared space in the office. Staff alone in their own enclosed office or alone in vehicle are not required to wear a mask.
· Avoid touching eyes, nose, and mouth and mask with unwashed hands;
· Throw used tissues in the trash immediately after use, and then wash your hands or use hand sanitizer; and
· Maintain social distancing guidelines whenever possible during all interactions (parents and children, as well as siblings are NOT expected to maintain distance during an in-person visit)
Prior to an in-person visit, Hands Across The Water staff will wash their hands per CDC guidelines. If staff are traveling outside of the office for a meeting, upon arrival to the destination, staff will wash hands again or use hand sanitizer before interacting with any individuals.
Hands Across The Water will ensure that all staff members meeting in-person with clients, families, or community members have access to personal protective equipment (PPE) as needed. All agency staff will be issued hand sanitizer, at least one disposable surgical, P2.5, KN95 or N95 mask as available, and three cloth masks for their use in the field or in the office. Gloves and face shields will be made available as necessary. Clean gloves should only be worn in situations where staff are cleaning potentially contaminated surfaces or when touching a client/child is inevitable. Gloves should be disposed of properly and hands washed/sanitized immediately after use. The agency will make all efforts to provide all clients and visitors with necessary PPE if they are unable to do so themselves, including cloth masks, face shields if unable to wear a mask and access to hand sanitizer during interactions with agency staff. Additionally, any staff who are transporting clients in their vehicles should maintain as much distance within the vehicle as possible and leave windows open to promote air circulation when possible. Staff providing transportation will be issued disinfectant spray and towels. Staff should follow car disinfecting protocol per CDC guidelines, ensuring that disinfectant spray is used per directions listed on the bottle. Staff utilizing public transportation to commute are encouraged to wear PPE and utilize hand sanitizer while traveling.
After completing any in-person visit, Hands Across The Water staff utilizing PPE are responsible to remove, per CDC guidelines, and dispose of PPE appropriately wash or use hand sanitizer to sanitize their hands. If a staff person is using a cloth mask, the mask must be laundered daily. Visitors issued a mask by HATW may keep the mask for personal use and are asked to launder between visits and use the mask at subsequent visits. Staff or other visit participants who cannot wear a mask due to medical reasons, should inform their supervisor/caseworker as soon as possible in order that HATW can ensure that a face shield can be provided alternatively.
Client Screening
One day prior to any in-person contact, all Hands Across The Water staff person/caseworker will contact the individual/family to complete the HATW COVID-19 Screening Verification Sheet to ensure the following screening questions are asked for each household member prior to in-person contact:
1. Is there any reason you or any of your household members have been instructed to self-quarantine or isolate? If yes, why?
2. Have you or any of your household members had contact with any Persons Under Investigation (PUIs) for COVID-19 within the last 14 days, OR with anyone with confirmed COVID-19?
3. Do you or any of your household member have any symptoms of a respiratory infection (e.g., cough, sore throat, fever (100.4 or above), shortness of breath or difficulty breathing, chills, muscle pain, new loss of taste or smell, nausea or vomiting, diarrhea)?
Caseworker completing the screening must notify all relevant parties (e.g. staff member assigned to supervise the visit, other staff involved in home visit plans, and the program supervisor) of the outcome of the screener questions by 4 PM the day prior to the visit.
All “yes” responses MUST be discussed with agency supervisor prior to any modifications being made to visitation plans/casework to problem solve and gather additional information as necessary. Supervisory staff will utilize updated guidance from the Washtenaw County Health Department in decision making. Participants who answer “yes” may be asked to provide documentation that they are advised to self-isolate and/or are seeking appropriate medical care. When in-person contact is deemed to be unsafe or not feasible due to positive response to screening questions or other documented risk factors, HATW staff will work to resolve any unmet needs with all relevant parties (including, but not limited to, clients, agency supervisors, clients’ physicians, therapists, guardian ad litem, attorneys, resource parents/caretakers) to ensure that client case goals, child safety protocols, court orders and policy requirements are met while emphasizing health and safety. When modifications to any visitations of casework are approved by an agency supervisor, the caseworker is responsible for communicating with and providing alternative links and contact information to all parties in timely manner and indicating the following in their case contact:
A COVID-19 screening was conducted on ______ (date) which revealed a risk factor for conducting an in person parent visit at this time. The contact was held via (phone, skype or facetime or other alternative contact).
Employee Screening
In order to comply with Executive Order 2020-97 to implement a COVID-19 symptoms screening process for employees, HATW will require use of the MI Symptoms Web Application
Each employee will need to create an account in misymptomapp.state.mi.us
You will include the workplace, Hands Across The Water and the code is 3860-3839.
All employees must complete this screening daily prior to starting your workday, regardless of the location of your work. If you are planning on an in-office workday or work with clients in the community, this screening MUST be completed prior to your arrival/contact with others. All employees are asked to take their temperatures prior to leaving home. If you do not have a thermometer, HATW will provide one for you.
Hands Across The Water staff that experience symptoms associated with COVID-19 will stay home until they have received clearance from a physician to resume work. Hands Across The Water staff that have contact with anyone who has tested positive for COVID-19 or is suspected to have COVID-19 will be asked to be tested for COVID-19 and will remain home until they have confirmed that they do not have COVID-19 and have completed any recommended isolation/quarantine requirements. If a staff person tests positive for COVID-19, they will immediately report this information to their supervisor and their supervisor will work with Human Resources to coordinate next steps. Hands Across The Water will coordinate with public health officials to ensure that any individuals that have come into contact with a staff person during the period in which they were infectious will be notified properly so that they can seek guidance from a medical professional regarding testing and self-quarantine procedures. Supervisors and Human Resources will utilize guidance from the Washtenaw County Health Department in decision making regarding staff action regarding exposure of illness. Staff who are at high-risk for health complications due to COVID-19 should discuss this with Human Resources who will provide staff with all possible additional safety precautions and accommodations available in order to enable staff to fulfill their job responsibilities. In accordance with Executive Order 2020-36, and any executive orders that follow Hands Across The Water will not discharge, discipline or otherwise retaliate against any employees who stay home or who leave work when they are at particular risk of infecting others with COVID-19.
COVID-19 Positive Contact Protocols
When an employee is identified with a confirmed case of COVID-19, HATW will:
1. Immediately notify the local public health department, and
2. Within 24 hours, notify any co-workers, contractors, or suppliers who may have come into contact with the person with a confirmed case of COVID-19.
Additionally, HATW will notify employees if the agency becomes aware of a client or visitor to agency, or any person who has come in contact with an employee, is identified with a confirmed case of COVID-19.
If you are feeling ill and have at least one symptom of COVID-19 or have been in close contact (within 6 feet for 15 minutes or more) with someone with COVID-19, get tested and stay at home until test results are received.
If it is discovered that an employee working in the office has been diagnosed with COVID-19 the following protocols will be put in place:
· If it has been less than 7 days since the sick employee used the facility, staff will be asked to vacate the office until it is professionally cleaned and disinfected.
· If it has been 7 days or more since the sick employee used the facility, additional cleaning and disinfection is not necessary. Continue routinely cleaning and disinfecting all high-touch surfaces in the facility as directed.
HATW will allow employees with a confirmed or suspected case of COVID-19 to return to the workplace or in-person casework only after they are no longer infectious according to the latest guidelines from the Centers for Disease Control and Prevention (“CDC”) and they are released from any quarantine or isolation by the local public health department or their physician.
DO NOT COME TO THE OFFICE IF YOU FEEL SICK.
Agency/Staff Activities:
In-Person Parenting Time/Sibling Visits
· HATW staff will ensure that screening questions are asked of all involved participants/case members and each participant’s household members prior to in-person contact. If a participant answers “yes” to any of the screening questions, the scenario must be discussed with a supervisor prior to any modification of visits/casework. Participants may be offered an alternate method to participate such as video or phone contact.
· Visits will be outdoors whenever possible (e.g. outdoor play area at HATW office, client home/yard, public park, faith community facilities)
· Visits will limit exposure to unsanitized surfaces, large groups of people and enclosed spaces when determining location (e.g. crowded playgrounds, indoor facilities like McDonald’s Playplace).
· Visits held indoors should be in a well-ventilated space, opening windows if possible and take place in a space as large as possible to enable social distancing when appropriate.
· For visits held indoors, sanitization of all surfaces touched by visit participants prior to and following visit to be done collectively by visit participants whenever possible. Agency clerical staff to sanitize all common areas at the start of each workday prior to commencement of office visits. Deep cleaning of office to take place every Saturday.
· Parents and children over two years old MUST wear a mask or cloth face covering during the visit. If not medically possible, participant must wear face shield. For young children, masks should be worn and encouraged to the extent that it does not lead them to touch their face more frequently or cause them to feel scared.
· Parents, youth to bring own gloves, mask, and/or sanitizer to in-person visit, if available. If not available, agency will provide. Agency personnel may not supervise a visit if participants refuse to comply with wearing of mask, cloth face covering or shield.
· Snacks/toys/activities to be sent to visit by caretaker whenever possible. Agency personnel will provide sanitized toys/activities when caretaker is unable to do so. Toys will be cleaned utilizing the HATW Toy Cleaning Protocol by clerical staff. Plans should be established prior to the visit to ensure safe and appropriate snacks/activities are available.
· Caretakers for youth to transport youth to visit whenever possible to reduce exposure of youth and agency personnel to more adults in an enclosed space.
· Social distancing (6 feet) for adults from different households expected during visit, including agency personnel when possible.
· Visit participants should be limited to essential, court-ordered participants, with a limit of no more than 10 individuals present. Any exceptions to this rule must be submitted to the Executive Director for approval.
· Social distancing between parents and children or among siblings is not expected.
· All participants must wash their hands per CDC guidelines prior to and following the visit, before eating, touching contaminated surfaces and after using the bathroom. When soap and water are not available, participants must use hand sanitizer.
· All visit participants (including children) are advised to change and wash clothes upon return home.
Office Visits/Activities (staff, clients and visitors)
All public entrances to Hands Across The Water offices will have a posted notice asking visitors to read through the three screening questions. If the client/visitor answers “yes” to any of the questions listed, we ask that they not enter the office and contact the appropriate staff member to reschedule their visit/meeting or to conduct the scheduled meeting through video or phone conference. All non-essential visitors will be barred from entering the building, including food delivery personnel, friends or salespeople without an appointment. These visitors may text the staff member who may then meet outside of the building. No visitors will be allowed to wait in the HATW waiting room. Clients with appointments or those who are waiting to transport clients should arrange to communicate via phone/text with the HATW staff person with whom they have an appointment.
The CDC recommends wearing cloth face coverings in public settings. Therefore, individuals entering a Hands Across The Water office will be asked to wear a mask or cloth face covering during their visit. If the visitor does not have a mask, Hands Across The Water will provide it.
Six feet of separation will be maintained by visitors and Hands Across The Water staff whenever possible. All participants will wash their hands per CDC guidelines before and after interactions.
High touch areas such as common spaces shared by staff and visitors will be disinfected regularly by HATW clerical staff and recorded on the HATW High Touch Cleaning Checklist. A deep cleaning/disinfecting of the office will take place each weekend by a professional cleaning crew. HATW staff who conduct work in their office area will be responsible for disinfecting all hard surfaces such as doorknobs, desks, keyboards, phones, mouse, and switch plates in their office personal workstation upon arrival in their office and prior to leaving.
In-Office Staffing Protocols
Staff meetings typically completed in-person at the office such as All Staff, Manager, Team or agency committee meetings should be conducted remotely using Teams videoconferencing. Family Team Meetings, agency orientations, information session and trainings, therapy sessions, case conferences, client interviews, and collateral case contacts should be complete remotely, via video conferencing or telephone whenever possible. If not permitted, or if the client’s needs dictate an in-person meeting, all safety precautions, outlined in the Best Practices and Safety Protocol section of this document should be used.
No more than ten staff and no more than fifteen people total will be permitted in the building at one time though July 15th, 2020. The staff lunchroom or other common areas may not be utilized for staff to congregate. Staff utilizing common areas and shared equipment such as refrigerator, coffee maker, microwave, copiers, drinking fountain, etc. are asked to disinfect any touched surfaces and wash/sanitize hands after use. Staff are expected to remain in their office area alone and to social distance and wear masks when the they in outside of their office space. If staff who share an office are in at the same time, one staff member will be expected to work in another unoccupied space.
While in the office, employees are discouraged from using other worker’s equipment. Hand sanitizer will be located at the copiers. Please clean hands prior to touching the machines. When one person is using the copy machine, please wait outside the room for your turn. Remember to stay six feet apart. Masks are required at all times in the office, except when a staff member is alone in an enclosed office with the door shut.
In-Home Family and Child Visits
One day prior to a Hands Across The Water staff person making a home visit, the staff person will contact the individual/family to share home visiting protocol and will ensure that the HATW COVID-19 Screening Verification Sheet is completed and that any “yes” responses are discussed with program supervisor prior to any proposed modification to the casework plan as described in page 2-3 in this document.
Due to the need to ask screening questions prior to the visit occurring, unannounced visits should not be conducted unless there is concern regarding child’s safety or well-being until further notice.
Risk during an in-person home visit should be reduced by a staff member requesting that the homeowner open windows when possible, limiting the number of people in an enclosed space at one time and limiting the touching of items within the home. Weather permitting, staff should conduct as much of the visit as possible outdoors, if the setting also allows for appropriate privacy. Depending on the nature of the visit, HATW staff may be required to inspect your home to ensure it meets safety standards for an assessment, or in accordance with foster care or licensing rules. The length of time spent in the home to complete the necessary inspection should be limited and all participants should observe social distancing.
All persons present in the home will be asked to wear a mask or face shield, which can be provided to household members by HATW staff, if necessary. HATW staff are required to wear a mask or face shield while conducting home visits.
Court
Hands Across The Water staff who are required by their job responsibilities to attend court hearings will do so remotely when possible and offered by the jurist/county of jurisdiction. When in-person appearances are necessary, staff will be required to wear a mask or face covering, maintain social distancing to the extent possible.
Hospital/Medical Visits
Should a Hands Across The Water staff be required by their job responsibilities to visit hospitals or other medical offices, the staff member will follow guidelines and procedures as indicated by the facility at all times, including the use of PPE.
Placement/Replacement
Prior to each placement or replacement of a child into a family home setting, caseworkers must inform caregivers of the child’s health status. Staff are required to ask the three screening questions of all household members in the child’s current home or placement and the child’s prospective home/placement(s).
In cases where placement must occur and someone in the removal household has COVID-19 or symptoms, caseworkers must inform the prospective placement setting, without providing identifying information. If the child has symptoms at the time of placement or subsequently develops symptoms, the child’s parent or placement caregiver should contact the child’s physician. If anyone in the child’s removal household or prospective home reports symptoms, advise the individual to contact their health care provider.
Drug Screens
Drug screen testing sites have processes in place to ensure that safety precautions are followed for clients being tested (clients must call the site when they arrive and will be told when they can safely enter). That process must be shared by staff so that clients are aware. If there is an identified need for Michigan Department of Health and Human Services (MDHHS) staff to administer a test, consultation must occur between the worker and supervisor to ensure proper safety precautions are taken.
The MDHHS drug screen contractor, Averhealth, developed a brief training providing guidance for the steps to be followed during the resumption process, including safety precautions at substance use testing sites. County directors received these training communications to distribute to frontline staff. Reviewing the training material and other subsequent messaging will ensure that workers have enough knowledge and adequate tools for the resumption of testing.
Drug screening should only occur if worker, client, tester and public safety are not put at risk. Any staff member conducting a screening must wear PPE, including a mask, face shield and gloves, disposing of all PPE properly and washing hands thoroughly afterward. Clients must be asked the three COVID-19 screening questions before being tested.
If screening cannot be completed based on health concerns of staff or clients, screening must not be conducted. A client’s inability to complete the random screen due to health or safety reasons related to COVID-19 shall not be viewed as non-compliance.
Implementation Timeline/Rollout of In-Person Casework - Program Specific
All screening and safety protocols outlined under in this document should be followed to the extent possible for all in-person activities outlined below.
FOSTER CARE – In-person parenting time and sibling visits to begin June 8th. All children on caseload to be seen in-person, but outdoors, at their place of resident for monthly foster home visits to be completed between June 13th- June 30th. Resumption of normal casework/in-home visitation on July 1st. At least part of the visit must be done in the home for any circumstance where the caseworker has not previously assessed the home or if there are questions or concerns about safety.
STATE ADOPTION - All children on caseloads to be visited in person, but outdoors, at their place of residence, between June 13th and June 30th. Ability to visit children residing in CCIs may be restricted due to regulations of specific CCI, please check with CCI regarding ability to visit youth outdoors. Resumption of normal casework/in-home visitation for all cases on July 1st. At least part of the visit must be done in the home for any circumstance where the caseworker has not previously assessed the home, or if there are questions or concerns about safety.
FOSTER HOME LICENSING – Any in-home visits needing to be completed for the purposes of initial licensure, special investigations/evaluations, and any annuals/renewal due prior to June 30th should begin on June 13th.
Monthly relative in-home visits should begin June 30th.
Visits in relation to annuals and renewals due after June 30th may delayed until July 1st.
At least part of the visit must be done in the home for any circumstance where the caseworker has not previously assessed the home or if there are questions or concerns about safety.
BEHAVIORAL HEALTH
Telehealth sessions may continue with all clients through June 30th
Clients who have previously declined/are unable to participate in telehealth and are in need of services may begin in-person sessions June 13th.
IN-HOME
All clients on caseload should have at least one in-person visit between June 13th and June 30th, then full resumption of in-person services beginning July 1st.
INTERNATIONAL/INFANT ADOPTION
In-home adoption assessments and post placements to begin June 13th. For assessments, 3 visits may be done virtually or outdoors (not at HATW office) and final visit must be in the home. Post-placement/post adoption visits should begin in-person on June 13th. At least part of the visit must be done in the home for any circumstance where the caseworker has not previously assessed the home or if there are questions or concerns about safety.
Communication and Dissemination of Information and Monitoring:
This plan will be reviewed and modified as necessary on a monthly basis by Human Resources and the Executive Director. The plan and any subsequent modifications will be communicated with staff through email and reviewed with supervisors as needed. The plan and any subsequent modifications will be made available to clients via email and given in hard copy to clients without email. Additionally, this plan will be posted in the agency lobby with copies available upon request and will be posted on the agency website for review.
Safety protocols including screening questions and agency rules/procedures regarding hand washing, cleaning/disinfecting of surfaces, face coverings and social distancing will be posted throughout the office.
All staff working in the office are required to receive Supervisor permission and to reserve that time on the In-Office Calendar. At least one on-site supervisor will be present at all times when employees are present in the office to provide guidance and ensure adherence to the agency plan. A manager, supervisor or designated employee will be trained in supervision of the agency plan, monitoring and reporting any concerns about staff or agency safety to Human Resources when necessary.
It is each employee’s responsibility to review and adhere to all items, including training videos, set forth in this plan. Any questions should be brought by a staff member to his/her supervisor or Human Resources.
Overall adherence to the plan will be monitored by the Executive Director and Human Resources. Unsafe working conditions should be reported immediately to Human Resources.
Resources
Staff should regularly check https://www.cdc.gov/coronavirus/2019-ncov/index.html for updated information from CDC and http://michigan.gov/coronavirus for updates from MDHHS. Additionally, the following resources may be helpful:
Cleaning and Disinfecting https://www.cdc.gov/coronavirus/2019-ncov/community/clean-disinfect/index.html
Personal Protective Equipment (PPE) https://www.michigan.gov/coronavirus/0,9753,7-406-98178_98156---,00.html
Mask Wearing 101: How to Properly Use & Re-use a Mask https://www.youtube.com/watch?v=JwPWdkbyizw
Prevent Getting Sick https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/index.html
High Risk Populations https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-at-higher-risk-old.html
MI Safe Start: A Plan to Re-Engage Michigan’s Economy https://www.michigan.gov/documents/whitmer/MI_SAFE_START_PLAN_689875_7.pdf
Michigan Communication Webpage https://www.michigan.gov/coronavirus/0,9753,7-406-98178_98281---,00.html
CDC Guidance Businesses and Workplace https://www.cdc.gov/coronavirus/2019-ncov/community/organizations/businesses-employers.html
What you should know about COVID-19 to protect yourself and others: https://www.cdc.gov/coronavirus/2019-ncov/downloads/2019-ncov-factsheet.pdf
Steps to help prevent the spread of COVID-19 if you are sick
https://d1ocufyfjsc14h.cloudfront.net/sites/default/files/sick-with-2019-ncov-fact-sheet_2.pdf
Symptoms of Coronavirus (COVID-19)
https://www.cdc.gov/coronavirus/2019-ncov/downloads/COVID19-symptoms-11x17-en.pdf