Revised OPWDD Interim COVID-19 Guidance Documents
The Office for People with Developmental Disabilities (OPWDD) published several revised guidance documents in response to changes in approach to COVID-19 precautions at the state and federal levels. The following documents have been reissued:
Interim Visitation Guidance for Certified Residential Facilities: The guidance has been revised to allow fully vaccinated asymptomatic people supported to engage in visitation on- or off-site, even if exposed to COVID-19. The guidance also places visitation limitations only on people currently in mandatory quarantine or isolation. Previously, the limits included those who were in precautionary quarantine.
Interim Guidance Regarding Community Outings for Individuals Residing in OPWDD Certified Residential Facilities: The most notable change in the guidance is the removal of the limit on recreational community outings to one location per day. The language limiting the frequency and duration of community outings to public places was also removed. The guidance creates an exception for vaccinated people supported, allowing them to participate in community outings even if residing in a home with a current confirmed positive or suspected case of COVID-19 (including housemates and employees). Several changes were made to the transportation section. The language requiring that only people supported and staff from the same facility may be transported together was removed. The parties can now be intermingled. The requirements to use directional tape, one-way entering and exiting, and signage on vehicles has also been removed. People supported and staff may now sit near each other and the driver.
Interim Guidance Regarding the Reopening of Day Services Certified by OPWDD: The guidance now allows fully vaccinated people supported to attend their day program even when a member of their household or certified residence is under quarantine or isolation. The requirement for social distancing of at least 6 feet in all directions has been removed, and the language now just requires social distancing. The language requiring adequate space for staff to adhere to social distancing when completing independent tasks and taking breaks has also been removed. Break times no longer need to be staggered to maintain social distancing. Limited revisions were made to the transportation section. The guidance previously prohibited the transport of people who could not tolerate a mask with people other than those in their household. This language has been removed.
Staffing Guidance for Management of COVID-19: The revised guidance removes the expectation for completing health screenings of DSPs and other facility staff at the beginning of each shift and every 12 hours. Screening now must be completed only at the beginning of each shift. The requirement to notify the Human Resources Officer when any travel has occurred within a non-contiguous state has been removed and replaced with only notification to a supervisor. Some subtle changes have been made to expectations to notify the local health department (LHD). Previously, all people supported and staff members who worked in close proximity to a staff member presumed positive with COVID-19 had to contact the LHD. Now, only symptomatic staff have to contact the LHD and notify their supervisor. The OPWDD notification requirements have also been modified. OPWDD now only requires notification for confirmed cases. The guidance clarifies that only unvaccinated people supported and employees should be placed in quarantine. The limitations on staffing assignments for locations with suspected or confirmed cases of COVID-19 have been removed. Changes have been made to the Personal Protective Equipment (PPE) section, including clarification that staff must wear a facemask at all times while at work, regardless of their vaccination status. The guidance clarifies that the use of a cloth facemask or masks with exhalation valves or vents it not acceptable when working with a person infected or presumed infected with COVID-19. Furthermore, a faceshield alone is not an acceptable face covering absent a facemask. N95 masks are not required when providing aerosol-generating procedures when the person is without a known infectious respiratory diagnosis.
DOH Updated Health Advisory: Quarantine for Residents of Non-Healthcare Settings
The New York State Department of Health (DOH) published an updated health advisory regarding quarantine for residents of non-healthcare settings exposed to COVID-19. This document is very helpful in addressing concerns about quarantine of fully vaccinated people living in congregate settings. We have been advocating with OPWDD to push for this revision with DOH in response to concerns expressed by The Arc New York families and Chapters. The guidance explicitly allows an exemption from quarantine for asymptomatic, fully vaccinated people in group homes by applying the definition of non-health care congregate settings to our field.
Non-healthcare congregate setting is defined as an environment where several or more people reside in proximity for extended periods of time. Examples of non-healthcare congregate settings include, but are not limited to, shelters for people experiencing homelessness, and group homes for people with intellectual or developmental disabilities.
As you encounter exposures to COVID-19, you should consider this new advisory when determining if you should be reporting the exposure and if someone is subject to quarantine.
Amendments to Federal Regulations on ICFs
A few changes are being made to the federal regulations outlined in 42 CFR 483. These regulations address the operation of Intermediate Care Facilities (ICFs). The amendments take effect Friday, May 21. Public comments are being received through July 12, 2021.
The two key changes include requirements to offer people supported and staff vaccination against COVID-19, and to educate people supported, staff and the person's representative (parent or legal guardian) about vaccination against COVID-19. The regulations require that the person's medical records include documentation that education was provided.
ICFs must develop policies and procedures to ensure this education is provided. These policies and procedures must be approved by the Chapter's governing body.
The provisions of the amended regulations are a Condition of Participation (COP) and will be included in future surveys of ICF providers.
Chapters with ICFs should read the amendments to the federal regulations closely and share with Administrators and nursing staff.