COVID-19 Update
March 30, 2020

COVID-19 Notifications and Contact Tracing Process
Over the past two weeks, we have been pursing relief for providers regarding the Office for People With Developmental Disabilities (OPWDD)'s Contact Tracing Process, which included an onerous Contact Tracking Form and initiated an involved process any time a provider notified the Justice Center (JC) or OPWDD of a staff or individual being placed under quarantine or isolation. This reporting requirement significantly increased administrative burden at a time when resources are extremely strained.  We advocated with the OPWDD Deputy Commissioner for the Division of Quality Improvement (DQI) on the need for urgent relief and a revised process. We are happy to report progress on two major fronts:
  1. Precautionary Quarantine Relief Going forward, the only quarantine/isolation reports that need to be made to OPWDD/JC regarding COVID-19 are instances where the Local Health Department or a medical professional directs precautionary or mandatory quarantine or isolation. Instances where providers or individuals self-quarantine without such an order no longer need to be reported. Since most precautionary quarantine is self-imposed, this should drastically reduce the number of reports that must be made to oversight entities.
     
  2. Contact Tracking Form Relief OPWDD has accepted our recommendation and agreed to discontinue the use of the Contact Tracking Form. In its place, providers will be asked for basic information by the JC call center and/or OPWDD Incident Management Unit (IMU) when making a notification. This information will be recorded and uploaded to the Incident Report Management Appliation (IRMA) by the JC/IMU. Following this initial contact, providers will be asked to inform IMU of any parties who may have come into contact with the individual supported or staff under quarantine/isolation. The final step will be to provide any updates pertaining to test results and quarantine/isolation status if and when they occur.

    Two options will be available for providing these updates. OPWDD is revising IRMA to include fields to capture information pertaining to the updates. Once these revisions are completed, Chapters will be able to enter the information directly into IRMA. Alternatively, Chapters may send updates via email to IMU through the dedicated mailbox. We have requested that OPWDD include a specific set of criteria for the emails so Chapters know what information to provide.
These changes should significantly reduce the amount of time spent on reporting. We have requested updates to the notification instructions and associated guidance, and OPWDD has agreed to schedule a WebEx on these changes. We will continue to provide updates on the changes as they become available.

Thank you to everyone who provided feedback on their experiences with the reporting process. Your input was exceedingly helpful to our advocacy efforts. 
 
OPWDD Return to Work and Release from Home Isolation Guidance 
OPWDD has published three important documents: two on returning employees to work, and one on releasing individuals from home isolation. As confirmed COVID-19 cases continue to increase, this guidance is critical for Chapters facing staffing challenges.  
  1. OPWDD's "Health Advisory: COVID-19 Release From Home Isolation" details protocols to be followed when deciding to release individuals from home isolation. This advisory is based on the Centers for Disease Control (CDC) non-test based strategy. Immunocompromised individuals should only be released from home isolation based on the CDC guidance.
     
  2. The "Protocols for Essential Personnel to Return to Work Following COVID-19 Exposure or Infection" establishes eight specific conditions under which essential personnel who have been exposed to, or have a confirmed or suspected case of COVID-19, can return to work. 
  3. OPWDD's "Updated Protocols for Personnel in Clinical and Direct Care Settings to Return to Work Following COVID-19 Exposure or Infection" establishes similar conditions specific to clinical and direct support professionals. Additional requirements include assigning staff to lower-risk individuals and maintaining self-isolation when not at work. 
The conditions in these documents reflect the CDC crisis strategies to mitigate staffing shortages, and align with the March 28 New York State Department of Health (DOH) Health Advisory. We consulted with OPWDD on the implementation of these protocols. They advised that if there are any challenges presented by the Local Health Departments (LHD), we should reach out to OPWDD. Please contact us if you experience any challenges when implementing these protocols.
 
Executive Orders  202.12 and 202.13
The Governor has signed two new Executive Orders since March 28.  EO 202.12 focuses on rescheduling elections planned for June and permits one support person to be present for a patient giving birth during this public health emergency.  EO 202.13 addresses the background check process for current employees of OPWDD providers seeking employment at a different OPWDD provider. The EO does not waive the provider requirement from checking the Staff Exclusion List prior to hiring a new employee. We are hopeful this will bring much-awaited relief and expedite access to staff during this public health crisis. However, clarification is needed regarding the details of the order. We will update you with further guidance as soon as it's available. 

Article 16 Clinics Closure Info
On March 26, OPWDD's Director of Statewide Article 16 Clinics sent directions on the notification process necessary when a voluntary provider of an Article 16 Clinic decides to temporarily close a site. The directions also address the requirement for a Certificate of Need (CON) when permanently closing a clinic.
 
OPWDD Guidance on Health Checks
OPWDD's March 25 "Staff Guidance for the Management of COVID-19" includes a requirement for health checks of staff in Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) and individuals living in a residential facility certified or operated by OPWDD who have been identified as having a suspected or confirmed case of COVID-19. The health checks include monitoring of heart and respiratory rate. Unfortunately, the guidance document does not detail acceptable ranges of rates or protocol for responding to concerns. We reached out to OPWDD's  Director of Nursing and Health Services for guidance. At this time, OPWDD is advising that providers focus on the temperature and symptoms assessment aspects of the health checks. OPWDD is seeking additional information on heart and respiratory rates from the New York State Department of Health. We will send additional updates as more information becomes available. 
 
Statement on Right to Access Medical Treatment
The Arc New York Signed on to the TASH Statement on the Right to Access Medical Treatment to assert that a diagnosis of I/DD should not be an indicator to withhold full access to medical care. The U.S. Department of Heath and Human Services (HHS) also issued a Bulletin on Civil Rights, HIPAA and the Coronovirus Disease, which clearly articulates that, " ... persons with disabilities should not be denied medical care on the basis of stereotypes, assessments of quality of life, or judgments about a person's relative 'worth' based on the presence or absence of disabilities. Decisions by covered entities concerning whether an individual is a candidate for treatment should be based on an individualized assessment of the patient based on the best available objective medical evidence." All people with disabilities and other vulnerabilities are encouraged to keep a copy of the bulletin with them to share with medical professionals, should they need to seek treatment for COVID-19.

FEMA Webinars
The Office of Disaster Recovery at the Division of Homeland Security and Emergency Services is holding virtual applicant briefings to discuss federal funding from the Federal Emergency Management Agency (FEMA) that may be available under the COVID-19 major disaster declaration. The briefings will provide guidance on eligibility standards for applicants under a FEMA disaster grant, and what types of activities are reimbursable under this current declaration. Details, dates and registration links can be found here.

CDC Infographic on Optimizing PPE
The CDC has published a simple infographic for healthcare professionals on how to optimize the supply of personal protective equipment. 
 
Johns Hopkins University & Medicine Resource Center 
John Hopkins University has developed an excellent Coronavirus Resource Center on their website. The site includes articles on the latest research. We have added this resource to The Arc New York COVID-19 Resource page and recommend that Chapters share as well. 

This and all related updates will be cataloged on  The Arc New York COVID-19 Resource Page   for future reference. Please contact us if you have questions regarding any of this information.

 
CONTACT: 
Josh Christiana , Associate Executive Director for Quality, Compliance & Chapter Relations

This email was sent to:
  • President Jack Kowalczyk 
  • Board of Governors 
  • Chapter Presidents
  • Executive Directors 
  • Chief Operating Officers
  • Chief Financial Officers  
  • HR Directors 
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  • Quality & Compliance Staff 
  • Joint Committee on Quality & Compliance 
  • Guardianship Coordinators 
  • State Office Staff