Policy and Procedure: Visitation Guidelines for State-Operated Developmental Centers

Adopted: 02/23/21; Revised: 03/29/22, 02/08/22, 01/25/22, 01/04/22, 12/21/21, 12/01/21, 11/10/21, 08/10/21, 06/16/21, 04/06/21, 03/25/21

Policy

The Illinois Department of Human Services, Division of Developmental Disabilities recognizes the right of all persons served in State-Operated Developmental Disability Centers (SODCS) to receive regularly scheduled visits. Visitation by family members, friends, and guardians is extremely important to the health, happiness, and well-being of persons served. Following Illinois Department of Public Health's Updated Interim Guidance for Nursing Homes and Other Long-Term Care Facilities and Programs, DDD has developed the following policy and procedure to ensure safe visitation during the COVID-19 pandemic. This policy and procedure is consistent with IDPH Long term care guidance updated on January 18, 2022, and CMS guidance updated November 12, 2021. The Illinois Department of Human Services (IDHS) is working tirelessly to address and contain the threat that the recently widespread Omicron COVID-19 variant is posing to our staff, residents, and patients. Therefore, until further notice, we are adopting the following visitation guidance at all IDHS facilities.

Procedure

  1. ALL SODCS may have visitation for all residents.
  2. During high to substantial county transmission levels, both the resident and the visitor must wear well-fitted masks and maintain social distancing for the entire visit.
  3. SODCs in outbreak status may have indoor visits for residents in affected buildings. Indoor visits for those in isolation/quarantine can occur as determined in conjunction with the guardian or resident requests. Outdoor visits are not recommended for those in quarantine or isolation. 
  4. Facilities should not limit the frequency of visits, length of visits, number of visitors allowed (unless maintaining social distancing) or require that visits be scheduled. 
  5. When a facility has a new COVID 19 positive case, affected areas will be tested two days after exposure. 
    1. Exposed Up to Date asymptomatic Residents not in isolation/quarantine may continue indoor visits in designated visitation spaces, private rooms or common areas. Outdoor visits are allowed (if feasible). Both resident and visitor should wear source control (well-fitted masks, add eye protection if county has high to substantial transmission. Visits in the resident's room may take place unless it is a shared room and resident's roommate is not up to date with COVID-19 vaccination, or immunocompromised (regardless of vaccination status).
    2. Exposed Not Up to Date Residents that are in quarantine (not isolation) are allowed indoor visits preferably in their room or if they have an unvaccinated, not up to date or immunocompromised roommate, in a private site on the affected area. Both the resident and the visitor should wear source control (well-fitted masks, add eye protection if county has high to substantial transmission) and maintain physical distancing. Visitors must be counseled about the risks of COVID-19 and the reason for the resident's quarantine status.
    3. Residents in isolation can have visits in their private rooms. Visitors must be counseled about the risks of COVID-19 and wear full PPE which includes a surgical or KN 95 mask, eye protection, gown and gloves. Visitors are encouraged to call ahead of visiting to inquire about the status of their resident and the area which they will be visiting. 
  6. This fact sheet will be provided to guardians and printed copies made available at the visitor's lobby. Visitors are required to comply with the facility's visitation policy. If a visitor refuses to follow the facility's policy during the visit, then staff may end the visit.
  7. Outdoor visitation is preferred to indoor visits, weather permitting. Outdoor spaces include under a canopy or tent if at least two sides of the tent are open to allow air flow. Residents in isolation will not be eligible for outdoor visits.
  8. No visitors under the age of 18 will be allowed to visit. 
  9. Visitation hours when staff are available for screening of visits and administering tests will be determined by each facility and posted on every home/cottage/unit/living area.
  10. Testing: While not required, visitors are encouraged to be tested for COVID-19 within 48 hours of visitation. Alternatively, they may call the Visitation Coordinator for an appointment to be tested upon their arrival.
  11. Visitors will be screened on arrival. (see Section II.4).
  12. In the event that a resident is ill on the day of the visit, the scheduled visitation will need to be rescheduled.

Visitors

  1. Although not required, Visitors are encouraged to contact the Center prior to visitation for the health status of their resident and if needed to schedule testing.
  2. Visitors should allow time for checkpoint screenings and testing if requested, prior to visitation.
  3. Visitors will be allowed access to locations designated for the visit, not to other areas of the facility. 
  4. All visitors must enter the facility through a checkpoint location and will be screened using a CDC symptom checklist and have their temperature taken. Any visitor that answers "yes" to any question will not be allowed to visit. 
  5. Visitors that have been exposed to a positive case within the past 10 days: Not up to date visitors that have been exposed to an individual who is suspected or known to be COVID-19 positive within the last 10 days are not allowed to visit. Visitors that are up to date with COVID-19 vaccinations and had close contact with a positive case are allowed to visit as long as they remain asymptomatic and wear appropriate PPE. Visitors that have had COVID -19 in the prior 90 days are allowed to visit.
  6. Visitors will not be allowed to visit who have tested positive for COVID-19 in the last 10 days or who are currently displaying COVID-19 like symptoms. Visitors must follow the quarantine and isolation guidance for LTC residents; the shortened CDC time periods for the general public do not apply. This means that a visitor must be in isolation for 10 full days after a positive test, or 10 days of quarantine if a close contact of a COVID-19 positive individual, regardless of vaccination status.
  7. We encourage all our visitors to be up to date with vaccination but understand that some visitors may not be vaccinated or up to date. All visitors regardless of vaccination status, will be required to wear a mask at all times (add eye protection and social distancing if the county has a high to substantial transmission) during the visit with the resident even when they are in the resident' room.
    1. If the resident and visitor are up to date, close contact with source control (wearing masks) is permissible, only if the county transmission level is not high to substantial. 
    2. Visitors should physically distance from other residents and staff in the facility, wear mask and perform hand hygiene frequently.
    3. All must remain masked at all times during the visit.
  8. Visitors who are not up to date with COVID-19 vaccinations and choose to visit a COVID-19 positive resident need to wear appropriate PPE and maintain a distance of 6 feet or more away from the r3esident while visiting. Visitors who are closer than 6 feet for a cumulative total of 15 minutes or more over a 24 hr period without wearing appropriate PPE are considered EXPOSED or a close contact to a positive case. If wearing appropriate PPE and was 6 feet or more away from the resident, then the visitor is NOT considered to be exposed.
  9. Visitors who are not up to date with COVID-19 vaccinations will be considered exposed to a positive case (even if the case is the resident they are visiting) and should quarantine per community guidance and not visit a long-term care facility for 10 full days from the last exposure (with the date of the last visit being day 0)
  10. Visitors will be asked to provide their name, address, telephone, and email address (if available) prior to visitation. This information along with the date and time of the visit will be retained according to current visitation log retention policy and may be made available to state and local health departments for inspection and, as needed, for contact tracing. This information must be retained for at least 30 days.
  11. Upon entry, all visitors will be asked to notify the Center Director or designee if they develop symptoms of COVID-19 within 3 days after visiting.
  12. Any visitor displaying observable symptoms of COVID-19 like illness will not be permitted on campus.
  13. Visitors must self-disclose any contact with a COVID19 positive person within the last 10 days and anyone who has had such contact will be prohibited from visiting.
  14. In the event that a resident is ill, the visitation will be rescheduled.
  15. All visitors must use hand sanitizer upon arrival at the center and throughout the visit, as needed.
  16. Visitors must use hand sanitizer and/or wash their hands prior to interaction with the resident. 
  17. If the resident is not up to date or the county transmission level is high to substantial the Visitor should remain 6 feet apart from the resident during the visitation.
  18. Residents or visitors in the designated visitation area, must remain at least 6 feet from others.
  19. Facilities should offer well-fitting mask or other appropriate PPE, including KN95 masks (if available). Visitors should not wear facility provided N95's, however they may bring and wear their own N95's.

Staff Members

  1. Visits can occur in large rooms that allow for adequate social distancing. The visitation space should be measured to determine the number of residents and visitors that can be accommodated at one time in that areas with at least 6-foot separation between residents and their visitors. Facilities will post the maximum number of residents and visitors that can occupy the area.
  2. Visitation may also occur in private rooms or bedrooms, as determined by the facility, that can accommodate the visitor and the single resident only. This option or outdoor visitation is preferred during high to substantial county transmission levels.
  3. If possible, visitation rooms should have a window open to allow for ventilation.
  4. Signage will be posted to remind visitors about six-foot separation, face covering, and hand hygiene.
  5. The room must be equipped with hand sanitizer and have an EPA registered List N Disinfectant available for use.
  6. When the resident returns to the home/cottage/unit/living area they will thoroughly wash their hands. 
  7. A staff member will supervise visitation areas with multiple stations. Staff members will wear face masks and face shields and maintain social distancing of six feet from visitors.
  8. Staff will remind families that zero-physical contact of any kind with the resident will be allowed for those residents that are not up to date. During low to moderate transmission levels only, for fully vaccinated residents that have physical contact with their visitor, both the visitor and individual will be reminded to sanitize their hands after the contact.
  9. The visitation room or designated visitation space in a large area must be thoroughly disinfected after each visit, prior to another use of the room/area. Allow for 15 minutes of time following each disinfection before the next use of the room. The visitation room should contain only non-porous furniture that can be effectively cleaned and disinfected. No furniture with porous properties (cloth coverings, wood, etc.) should be present in visitation room.

Visitation

Outbreak Status

Indoor/Outdoor**/Home Visits

**if feasible for the facility

Indoor in Private Room
NON- Affected area- no outbreak. All residents, well-fitted mask must be worn by all visitors (if county has high to substantial transmission, eye protection is also to be worn and use social distancing)
Affected area in outbreak- for close contact not up to date residents, well-fitted mask must be worn by visitor (if county has high to substantial transmission eye protection is also to be worn and use social distancing), visitor must be counseled about risk X
Affected area- Up to date, asymptomatic resident well-fitted mask must be worn by visitor (if county has high to substantial transmission add eye protection and use social distancing), visitor must be counseled about risk X
Residents in isolation due to symptoms or positive COVID test-well-fitted mask (Kn95 or surgical), eye protection, gown and gloves must be worn by visitor, visitor must be counseled about risk, and use social distancing X

References

Updated Interim Guidance for Nursing Homes and Other Long-Term Care Facilities and Programs; March 22, 2022.  https://dph.illinois.gov/covid19/community-guidance/long-term-care.html

Centers for Disease Control and Prevention (CDC). Interim Infection Prevention and Control Recommendations to Prevent SARS-CoV-2 Spread in Nursing Homes; February 2, 2022. https://www.cdc.gov/coronavirus/2019-ncov/hcp/long-term-care.html

https://www.cms.gov/files/document/qso-20-39-nh-revised.pdf CMS Nursing Home Visitation-COVID 19; revised March 10, 2022