3/13/20 - Message to Division of Developmental Disabilities’ Providers from Director Stark

Friday, March 13th, 2020


Dear Community Providers,


The following is guidance specific to Community Integrated Living Arrangement (CILA) settings, as well as Community Day Service (CDS) settings, which includes day programs, day workshops and day settings, that provide services to both our Home and Community Based Waiver funded participants and our Intermediate Care Facility (ICF/DD) participants. This guidance should supplement the guidance you received on March 5th from IDHS (attached again for reference) and guidance from yesterday, entitled "Guidance for Illinois Department of Human Services Staff & Providers" (also attached).


This guidance below is not intended to address every potential scenario that may arise, as this situation evolves, and may change as circumstances change. We encourage you to make the best decisions in the interest of the individuals you serve, your staff and organization.


We encourage you to continue to monitor local health department guidance and keep in close contact with the Division of Developmental Disabilities. The Division is actively working with Illinois Department of Healthcare and Family Services (HFS) to address the potential avenues of support we can provide to you.


I appreciate all the questions and concerns you continue to send our way. Please address all questions in regards to community based settings serving individuals with I/DD to Jennifer Gentile, Deputy Director of Clinical Services at jennifer.gentile@illinois.gov. Feel free to cc me on these communications.


Thank you. I appreciate all you are doing during this unsettling and constantly changing time. Thank you for keeping the individuals you serve and your staff, safe and supported. Together we will get through this.


Warmly,


Allison

Director, Division of Developmental Disabilities


CILA & CDS General Precautions


I. Precautions

Staff

  1. Implement a screening protocol for staff working in the homes or day settings.
  2. Limit large gatherings.
  3. Clean hands or parts of body that touch others or surfaces with soap and water for at least 20 seconds or an alcohol-based sanitizer, if soap and water are not available.
  4. Increase signage in the home or day setting encouraging hand washing. Be sure to use developmentally appropriate language to explain why new routines are being implemented for individuals being served.
  5. Consider using timers to support individuals to wash their hands for the appropriate amount of time (20 seconds).
  6. Proactively ask individuals if they feel unwell and regularly observe for symptoms of illness, including taking temperatures. Individuals may not proactively report symptoms.
  7. Increase cleaning to surfaces; be sure to clean the items that individuals touch that might not otherwise be routinely cleaned (games, chairs, remotes, boxes that contain games, etc.).


Individuals Served

  1. Discourage or limit attendance at large gatherings. Consider limiting events at agencies, day settings or homes.


Visitors

  1. Limit access to the home or day settings by outside entities/vendors. Consider discouraging family visits; arrange telephone calls, FaceTime or computer skype, as able.
  2. Consider limiting visits to family members/loved ones unless an individual can stay with them for an extended period of time (up to 14 days or longer).


II. Immediate Action for Positive Screening

Staff

  1. Remove individuals served, and other staff, from the immediate vicinity of the staff who screened positive.
  2. Staff should immediately go home and not return to work until medically cleared by their doctor.
  3. Contact local health department.


Individuals Served

  1. Support individual in their own room (remove roommates).
  2. If discovered while in the community or day setting, take the individual to a private room or space, away from other individuals.
  3. Contact appropriate medical personnel (primary care physician, urgent care, etc) by phone for direction.
  4. Contact local health department.
  5. Monitor other individuals for symptoms for at least 14 days.
  6. Individual Service Coordination (ISC) Agency should continue to provide support and service planning via telephone.


Visitors

  1. Visitors should not be allowed at a home or day setting with a positive screening.


III. Confirmed Cases of COVID-19

Staff

  1. Do not allow staff to return to work until they are medically cleared by their doctor.
  2. Day settings should close for at least 14 days (or longer, as you determine) if it has a individual, staff or visitor with a confirmed case of COVID-19.
  3. Homes should isolate any residential settings that have a confirmed case of COVID-19. Individuals should not attend activities outside of the home, including day services or employment.
  4. Work with local health department.


Individuals Served

  1. Support individuals in their own bedroom or space as best as possible.
  2. While you may consider moving the individuals to another home, please be aware that you may be spreading the virus to other locations.
  3. Notify appropriate medical authorities.
  4. Notify appropriate partner agencies with whom the individual had contact.
  5. Work the local health department.
  6. Individual Service Coordination (ISC) Agency should continue to provide support and service planning via telephone.


Visitors

  1. They should be told to leave and contact medical authorities.
  2. If the visitor is at a Community Day Service program/facility, the program should close immediately for at least 14 days.


IV. Physical Location Action for Confirmed Cases

CILAs

  1. Support individuals in their own bedroom or space as best as possible.
  2. Staff home appropriately.
  3. Work with local health department for guidance on cleaning and securing the environment.
  4. While you may consider moving the other individuals to another home, please be aware that you may be spreading the virus to other locations.


Community Day Service Settings

  1. The facility should be closed for at least 14 days (or longer, as you determine appropriate) and all partner agencies need to be contacted.
  2. Work with local health department for guidance on cleaning and securing the environment.