3/20/20 - Message to Division of Developmental Disabilities' Providers from Director Stark

Helping Families. Supporting Communities. Empowering Individuals.

Friday, March 20th, 2020


Dear Providers,


First, thank you and your staff for all that you are doing to keep individuals with I/DD safe and supported during the COVID-19 pandemic. Your work is appreciated and valued. The Division of Developmental Disabilities would like to continue to support you in your efforts. We are here to help.


Please see below for guidance and direction from the Division.


Questions, Concerns & Support

You should continue to use your local ISC as for any issues as they relate to the individuals you serve. During this time DDD staff will continue working to support our individuals and providers. Our DDD Community Services team, led by Maureen Haugh-Stover, will continue to work with her team, the ISCs and Bureau of Accreditation, Licensure and Certification (BALC) in order to best meet our individual's support needs at this time.


General provider inquiries:


For critical issues that require immediate attention:

jennifer.gentile@illinois.gov or (312) 793-3011


For issues that can be addressed within 24 to 48 hours please send your questions or concerns:

DHS.DDDComments@illinois.gov


Reporting cases of confirmed COVID-19 of your individuals served and/or staff:

jennifer.gentile@illinois.gov


Stay at Home


While the Stay at Home Order has been invoked please be advised that all staff (including Direct Support Professionals (DSP), QIDPs, Aides, supervisors, clinical staff, etc.) of both waiver funded services (including residential Community Integrated Living Arrangements and in-home services) and Intermediate Care Facilities (ICF) for I/DD are considered essential staff. Your staff should continue to go to work.


Please see further guidance: http://www.dhs.state.il.us/page.aspx?item=123118


Restricting residential home activities during Stay at Home Order

  • A screening protocol, including a temperature check, should continue to be applied (or implemented if not currently practicing) for all staff prior to shift start.
  • Families interested in taking their loved ones home should understand that they may be required to have them there for an extended period.
  • In addition to ensuring that stay at home requirements are met, providers must also continue to ensure that social, medical and mental health needs are considered, including:
    • Provision of basic needs like food, medications and laundry.
    • Mental health, faith-based, and social service needs and resources to help pass the time
    • Assistance in accessing television, movies, radio, board/card games, or books
    • Provision of supplies needed for personal hygiene.
    • Support needs, including but not limited to, access to family members and friends by electronic and telephonic means.


Alternative Models of Support

DDD and BALC understand providers may be exploring alternative service delivery methods in order to meet individual's need (such as home consolidation, change of location in extreme emergency, and/or alternative DSP staffing models). Please be advised that individuals receiving services, guardians, and DDD Community Services Team must be consulted and support these alternatives. You will be responsible for contacting the Bureau of Accreditation, Licensure and Certification (BALC) with these requests. Please send them to DHS.BALC@illinois.gov.

It is recommended that staffing ratios be maintained whenever possible, but when not possible, the provider should ensure that BALC is aware and be prepared to discuss ways in which the provider can continue to ensure the health and safety of the individual.

Please note: licensed residential facilities may operate over their licensed capacity only with BALC approval. This will be reviewed on a case by case basis.


Environmental Cleaning and Disinfection

We have received requests for guidance on effective cleaning of site with potential and confirmed COVID-19 contact. The coronavirus (COVID-19) is spread by respiratory secretions (coughing or sneezing) that may remain on surfaces and transmit infection for an unknown period of time. CDC recommendations can be found here: https://www.cdc.gov/coronavirus/2019-ncov/community/organizations/cleaningdisinfection.html


Personal Protective Gear

  • The availability of personal protective equipment (PPE) and other health and safety supplies during the coronavirus (COVID-19) pandemic is having a significant impact on all providers.
  • First and foremost, providers, including intermediate care facilities (ICFs), should always attempt to utilize their open marketplace contacts and suppliers as their first option to order enough supplies to mindfully plan for current and future needs.
  • In the event of an emergency, when providers are unable to locate or secure necessary supplies on their own in the marketplace, providers and ICFs should communicate their health and safety supply needs to their local health department.


Positive COVID-19 Guidance

At this time it is imperative that you continue to follow the Illinois Department of Public Health (IDPH) website to ensure you have up to date information on providing care to an individual with a confirmed case of COVID-19.


IDPH COVID-19 Website:

http://www.dph.illinois.gov/topics-services/diseases-and-conditions/diseases-a-zlist/coronavirus 


To reiterate and reinforce, we recommend:

  • Support individual(s) in their own room (remove roommates) unless both are positive for COVID-19.
  • Contact appropriate medical personnel (primary care doctor) by phone for direction. Do not take individuals to the ER, hospital or doctor's office. Wait for direction from a physician.
  • Only consider relocation of individuals with positive COVID-19 diagnosis to another home if those individuals are also COVID-19 positive.
  • Do not relocate exposed, but currently undiagnosed roommates, to a new home or living environment as they may carry COVID-19.


Regulatory Guidance

Regulatory requirements that are amended will remain consistent with those of other service changes. At this time the below regulatory guidance will remain in effect through April 16th, 2020. DDD will issue further guidance if this dates changes.


Independent Service Coordination Agencies (ISCs)

  • All ISC in-home visits will be suspended.
  • ISC telephonic visits should be maintained and documented.
  • ISCs will do all discovery and personal planning over the phone.


BALC, BQM & RN Surveys

  • All in-person and on-site regulatory surveys (BALC, BQM, Nursing) will be

suspended.

  • Current licenses will be extended through this period.


Office of the Inspector General (OIG)

  • All instances of Abuse & Neglect must continue to be reported to the Office of the Inspector General (OIG) within the 4 hour timeframe. All Abuse & Neglect protocols remain in effect.


Individual Rights

During this time, we recognize that certain individual rights may need to be suspended in order to meet the emergency health and safety needs of the individual, and do not need to be reflected in the Personal Plan. These include:

  • Allowing visitors.
  • Right to choose who to share a bedroom with.

DSP Hiring & Training

DDD is currently working on issuing specific guidance on Direct Support Professional (DSP) and Medication Administration training requirements during the COVID-19 pandemic. The following interim guidance is available:

  • If provider agencies need to share staff, a statement can be accepted from a DSP's primary employer stating that they have required training, including Medication Administration Training, and background checks in order for them to work for a different agency. These employees must still receive person-specific training and site emergency response training. Accepting provider organization should check the Healthcare Worker registry to ensure the person is listed.
  • Staff with no CPR/first aid may provide direct supports as long as at least one other staff person who has current CPR/first aid certification is on site.
  • Staff with lapsed CPR/first aid may provide direct supports alone as long as it was in effect as of 3/1/20.
  • The medication administration training requirements have not changed with the exception that RN Trainers can provide the CBTA over the telephone. All staff who are responsible for administering medication must have medication administration training.


Thank you for all you are doing to keep people safe during these unpredicted times.

Again, we're here to help.


Warmly,


Allison Stark

Director, Division of Developmental Disabilities