Our Covid Response


COVID-19 Enhancement Preparedness & Response Plan

 

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Approved June 18, 2020

 

Overview

Flint/Saginaw/Port Huron Odyssey House’s behavioral health system has continued to provide services throughout the COVID-19 pandemic albeit many programs have restricted in-person sessions. As a result of the crisis, accessing substance use disorder services has looked different over the past several weeks. As Governor Whitmer begins lifting Stay at Home related orders, our outpatient sites will be able to return to offering clinically appropriate services in a face to face setting. The following is a guide to assist in safely reopening services to mitigate and prevent the spread of COVID-19. For more information about COVID-19 and Michigan’s response, please go to www.michigan.gov/coronavirus

 

Preface

This document is contingent on State and Federal guidelines and may be updated as additional information is released. Check the State of Michigan Website, www.michigan.gov/coronavirus

regularly for any updates and for resources as they become available. Please note that these recommendations do not supersede any rules, laws or locally developed detailed policies/protocols pertinent to the delivery of specialty behavioral health services.

 

 

1. Educational materials and dissemination plan.

 

A. Provide educational materials to staff and consumers regarding COVID-19.

 

https://www.michigan.gov/coronavirus/0,9753,7-406-98178_98281---,00.html

 

Coronavirus

https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html

 

https://www.youtube.com/watch?v=H4EeUx2_9qI

 

https://www.cdc.gov/coronavirus/2019-ncov/downloads/stop-the-spread-of-germs.pdf

https://www.youtube.com/watch?v=9Ay4u7OYOhA&list=PLvrp9iOILTQaJa78zFQ0QgvShQ2HEwHxP&index=5&t=3s

 

Clean Hands

https://www.cdc.gov/handhygiene/pdfs/Provider-Poster-Clean-Hands-Count-508.pdf

https://www.cdc.gov/handhygiene/pdfs/Provider-Poster-Clean-Hands-Count-For-My-Patients-508.pdf

https://www.youtube.com/watch?v=d914EnpU4Fo

 

 

PPE

https://www.cdc.gov/coronavirus/2019-ncov/hcp/using-ppe.html

https://www.cdc.gov/coronavirus/2019-ncov/downloads/A_FS_HCP_COVID19_PPE.pdf

https://youtu.be/of73FN086E8

https://youtu.be/PQxOc13DxvQ

 

Social Distancing

https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/social-distancing.html

 

Social Media

https://www.nimh.nih.gov/health/education-awareness/shareable-resources-on-coping-with-covid-19.shtml

 

Sign Language Videos

 

https://www.youtube.com/watch?v=3KFHhEta68o&list=PLvrp9iOILTQatwnqm61jqFrsfUB4RKh6J&index=2&t=0s

 

Testing

https://www.whitehouse.gov/wp-content/uploads/2020/05/Testing-Guidance.pdf

 

B. Educational materials regarding COVID-19 will be visible throughout the organization.

 

                        Hand Hygiene

                        Respiratory Etiquette

                        Social Distancing

 

 

C. Develop information to distribute for consumers and residents regarding safety and COVID-19.

 

                        Informed Consent

                        Social distancing Consent

 

D. Materials will be made available, e.g., PowerPoint/Video, Hard Copy, Posted throughout the facility, Social Media and/or the agency website

 

E. Materials will be available in English which is the most commonly used language for the population served.  Other languages will be made available as needed.

 

F. Training will be conducted one time with all staff and updates as needed.  Materials will be readily accessible on our training site Odyssey Institute or via links to the Center for Disease Control (CDC) website.  Clients will be provided COVID education during the intake process and as needed thereafter if not compliant with plan

 

 

G. Employee support and wellness

 

                        Trauma Training available on Odyssey Institute

                        Directors will do small check in sessions with staff

                        Will create a guided meditation and add to the Odyssey Institute

 

 

2. Infectious Disease Preparedness and Response Plan.

 

A. COVID-19 response team

Response Team

The Directors have continued to serve as the COVID-19 response team, meeting every Monday and Thursday.  The team continues to develop a response plan to address COVID which aligns with the current legal and contractual obligations and organizational policies and procedures, i.e. The Michigan

Mental Health Code, Accreditation standards, licensing standards, CDC, MDHHS, etc.  The Team will continue to ensure that the organization’s plan aligns with updated state and federal guidance related to COVID.

      

Designated Site Supervisors will be responsible to implement, monitor and report COVID-19 control 

 Strategies developed under this plan. 

 

Name

Designee

Department

Kimberly Shewmaker

Ronald Brown

Corporate Compliance (unsafe working conditions)

Joe Klobuchar

Annette Banks-Cash

Accounting and Billing

Jacqueline Blair

Bridget Pilcher, Shanta Smith, Kristine Dunn

Flint Residential

Neva Johnson

Carmen Davis, Zakiya Long and Chelsey Seymour

Medical Department and Detox

Tonya Evans

Elizabeth Reyes

Saginaw Residential

Tonya Evans

Amanda Poppiti

Saginaw Outpatient/Housing

Ronnie Tyson

Kenneth Jones

Flint Adult Outpatient

Ronnie Tyson

Andra Tyiska-Johnson

Flint Adolescent outpatient

Ronnie Tyson

Kenneth Heuvelman

Port Huron Outpatient and Recovery Housing

Andrea Horton

Ashley Seeback

CIC Admission and Flint Recovery Housing

 

 

General Infection Control

 

·         Staff are not to come to work if they are sick

·         Clients will not come to services if they are sick

·         Hand hygiene (hand washing for 20 seconds with soap and warm water or hand saitizer that contains 60 to 95% alcohol).  Hand sanitizer is avaialble at each location for staff and clients, as supplies allow.

·         Appropriately covering cough and sneezes

·         Avoid touching eyes, nose and mouth

·         Increased cleaning and disinfection stategies have been implemented for environmental mangement for COVID-19.  Thorough cleaning will be conducted at the end of each business day to ensure all areas are disenfected according to CDC guidelines.

https://www.cdc.gov/coronavirus/2019-ncov/community/clean-disinfect/index.html

https://www.cdc.gov/coronavirus/2019-ncov/community/disinfecting-building-facility.html

https://www.epa.gov/sites/production/files/2020-04/documents/disinfectants-onepager.pdf

·         Regularly (minimally every 2 hours) cleaning and then disinfecting frequently touched surfaces, like doorknobs, keyboards, cell phones and light switches, etc.

·         Use resources available at: www.michigan.gov/coronavirus

·         Employees should self monitor for fever twice daily

 

Infection Control with face to face encounters:

 

·         Clients with acute respiratory illness should be identified at check-in and placed in a single room with the door kept closed, as feasible.  In residential/housing these clients should be isolated to a room by themselves, as feasible.

·         Prevent transmission of respiratory infection by adhering to respiratory hygiene/cough etiquette at the first point of contact with any potentially infected person.

·         Offer a disposable surgical mask to persons who are coughing and provide tissues and no-touch receptacles for used tissues

·         Ill persons must wear a face covering when in service areas

·         Employees assessing a client with influenza-like or other respiratory illness should wear disposable surgical mask, non-sterile gloves, gown and eye protection to prevent exposure

·         Clients and behavioral healthcare workers should perform hand hygienen after possible contact with respiratory secretions and contaminated objects/materials

·         All able Staff and clients who are at least 2 years of age and physically able will be required to wear face coverings when they are within six feet of another person.    

https://www.youtube.com/watch?v=JwPWdkbyizw

·         When in close contact (within 6 feet for greater than 10 minutes) with PUI or people with COVID-19, the workforce must wear gowns, gloves, face covering, goggles/face shields during said contact. 

·         Minimize hand to hand transmission of paperwork and supplies e.g. provide client with a pen to keep when documents need to be signed, staff will wear face coverings and gloves during the intake process, scan all signed documents immediately and sanatize areas along the way.  Place in file area as soon as scanned.  COVID positive admissions paperwork is conducted with full PPE for staff, transported to CIC in plastic ziplock baggies, scanned, then the area is sanitized. COVID staff maintain social distancing from admission staff.  Nighttime check list from recovery housing is transported in ziplock baggies, scanned then placed in shred box.

·         Measures to monitor successful implementation of an infectious disease plan

Checklist: Posters hand washing and social distancing at all entry points, clients and staff wearing face coverings when within 6 feet of each other and in common areas, hand sanitizer readily available for staff and clients, people adhering to social distancing

 

 

 

 

 

3. Policy on Workplace Controls and Safe Practices

 

·         Procedures for working from home

o   Each component director will determine if it is feasible for an employee to work from home and what that work from home schedule will be.  Staff that have been approved to work from home were set up with remote access to Odyssey Village and provided training on the use of telehealth platforms e.g. zoom, Lifesize, FaceTime, telephonic, etc. in order to work remotely.  Directors may ask for a verbal or written log of daily activities completed while working from home.  The COVID Response Team will determine when face to face services can resume at each location and reduce working from home. 

·         Social distancing policy

o   Telehealth will be utilized whenever clinically appropriate and will be individualized for each client.

o   Office protocol will be for all able staff and clients to wear face coverings when within 6 feet of another person including while in common areas.

o   Face to Face Group sessions will adhere to social distancing as feasible based on facility size and will comply as feasible with the guidelines set up by the World Health Organization (WHO) 3 feet or the Center for Disease Control (CDC) 6 feet.

o   The admissions department has 4 rooms that are being utilized for intakes and sanitized after each client.  Lobby area is set up with chair 6 feet apart and sanitized after each client. 

o   Health Monitoring Unit is being utilized for new admissions to residential/housing until COVID test results are received or they have been monitored for 14 days.

o   Outpatient will assess risks vs. benefits with each client related to face to face services and determine how services will be provided e.g. telehealthy only, combination of telehealth and face to face or face to face only. 

o   Home based services (EWSS/EPP)

o   Transportation of clients will include only utilizing each vehicle at 50% capacity, each person must wear a face covering and the vehicle should be sanitized after each use.

o   Health screening will be conducting in a manner and space that promotes social distancing.

 

·         Procedures for identifying level of risk of exposure among employees, visitors, vendors and consumers.

 

o   Health screening will be conducted on all individuals entering the facilities that do not reside there.  This screening includes questions about respiratory health (e.g. new cough, trouble breathing, shortness of breath or wheezing) or any of the following: chills, new muscle aches, sore throat, diarrhea, new loss of sense of smell or taste.

o   Each person’s temperature will be taken and must be below 100 degrees Fahrenheit.

o   Any person having a positive response will not be allowed to enter the facility and the following should protocols should be followed:

o   Must receive clearance from a primary care provider to return to work, complete a COVID-19 test that is negative or quarrentine for 14 days before returning to work/services.

o   If a person has been in close contact (within 6 feet for greater than 10 minutes) with a person who is positive for COVID-19 or who is presumtive postive for COVID-19 and did not utilize PPE, they should quarentine for 14 days and be tested for COVID-19.

o   Returning to work or services after a positive COVID test will follow CDC guidelines:

Symptomatic COVID Positive Persons:

·         Symptom-based strategy

Ø  At least 3 days (72 hours) have passed since recovery defined as resolution of fever without fever reducing medications and improvement in respiratory symptoms (e.g. cough, shortness of breath); and,

Ø  At least 10 days have passed since symptoms first appeared

OR

·         Test-based Strategy

Ø  Resolution of fever without fever reducing medications and

Ø  Improvement in respiratory symptoms (e.g. cough, shortness of breath), and

Ø  Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 RNA from at least two consecutive respiratory specimens collected > 24 hours apart (total of two negative specimens).

 

Asymptomatic Positive Persons:

·         Time-based Strategy

Ø  10 days have passed since the date of their first positive COVID-19 diagnostic test, assuming they have not subsequently developed symptoms since their test. 

·         Test-based Strategy

Ø  Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 RNA from at least two consecutive respiratory specimens collected > 24 hours apart (total of two negative specimens).

 

*Special Note for repeat positives: Per GCHS and MDHHS, If a patient is receiving a second positive result after 10 days from the first positive results collection date, whether it be serology or PCR, then the patient will not need to re-isolate, a second investigation will not have to be performed, and no contact tracing will be needed. The patient may return to work at that point. The assumption is that the repeat results will be considered the same course of illness if over 10 days from the first positive result’s collection date. If a patient receives a negative test in between positive tests, then the assumption is that the negative was a false value, and that the patient was positive through the whole course of testing. The same instructions as noted about repeat positives should be followed in this case.

 

o   Any client in Detox/Residential and housing who tests positive COVID-19 will be offered placement in Medical Recovery Housing until they have 2 negative COVID-19 test or meet the Guidelines listed above.

o   Outpatient clients would be required to meet guidelines above before face to face services can continue.  Telehealth will be offered during quarrentine.

o   For those with symptoms: at least 10 days from the onset of symptoms must have passed, symptoms must be reducing and no fever for 3 days without fever reducing medication.

o   For those who are asymptomatic: quarantine for at least 10 days.

o   Anyone (staff or client) who tests positive for COVID antibodies without a COVID test must quarrentine for 14 days or provide a negative COVID test.

o   Non-patient visitors and vendors will be limited to those who are needed to conduct our business.

o   Client visitors will comply with Executive Order 2020-108.

o   https://www.apaservices.org/practice/news/in-person-services-covid-19

 

·         All employees and clients must stay home if they are sick.

o   Sick employees and clients will be required to comply with CDC guidelines

o   All those who are sick must comply with the CDC guildelinies listed above.

o   All employees and clients are expected to notify their supervisor or counselor if they are sick, if they have been exposed to a person who is COVID-19 positive or presumed to be COVID-19 positive and/or if the indivudal tests postive to COVID-19.

o   80 hours of Emergency Paid Time Off (EPTO) has been added to our full time employees benefit package

 

·         Procedures for PPE

o   Personal Protective Equipment (PPE): The use of gowns, gloves, surgical face covering, goggles and face shields is crucial for employees and people who are taking care of someone in close settings.  With supplies of PPE equipment being limited the agency has agreed to prioritize in the following way:

 

Ø  Staff working with individuals who are positive for COVID-19 (face covering, goggles/face shield, gown, gloves, client must wear facemask)

Ø  Staff working with people under investigation of COVID-19 (face covering, goggles/face shield, gown, gloves, client must wear facemask)

Ø  Staff working with individuals showing signs of respiratory infection (e.g. cough, sore throat, fever or shortness of breath).  (face covering, goggles/face shield, gown, gloves, client must wear facemask)

Ø  Admission staff who are conducting intakes and/or searches (face covering and gloves)

Ø  Detox and Health Monitoring staff (face covering and gloves)

Ø  Staff who are conducting monitoring at the screening stations (face covering and gloves)

Ø  Anyone cleaning must wear gloves

Ø  Anyone collecting specimens (e.g. blood, urine) must wear gloves

Ø  All able employees and clients must wear a face covering when in six feet of another person.

Ø  Those who cannot wear face coverings due to medical conditions must adhere to the respiratory hygiene and social distancing.

Ø  https://www.youtube.com/watch?v=ylrqilC3YmY

Ø  https://www.youtube.com/watch?v=JwPWdkbyizw

 

 

4. Programming Implementation.

 

·         Develop criteria for telehealth vs. in-person programming.

o   Directors will determine the work from home schedule which will influence telehealth vs. in person services.

o   All staff and clients will be required to stay home if they are sick.  If sickness includes respiratory illness they will need clearance from their primary healthcare provider, and negative COVID-19 test result or have completed the 14 day quarantine.   All illness must be reported to the employee’s supervisor or the client’s counselor.  All cases must be reported to the Compliance Officer (Kim Shewmaker).

o   Any staff or client who is determined to be or suspected to be positive for COVID-19 must follow CDC guidelines listed above.

o   Anyone (staff or client) who has been in close contact (within 6 feet for greater than 10 minutes) with a person who is positive for COVID-19 or suspected as such shall follow the guidelines above.

o   Direct contact such as handshakes hugs must be avoided between all parties.

o   An individual plan shall be developed with each client to determine if they will receive telehealth, a combination of telehealth and face to face services or all in person services and will consider the following factors:

Ø  The individuals health risks

Ø  Risk to exposure (i.e. do they live with someone who works in healthcare or other high risk services).

Ø  Medically able to wear a face covering

Ø  Will transportation to and from services pose a risk for the individual

Ø  Will office based services pose a risk or be beneficial to the client

Ø  Client preference

 

Residential and detox Program

o   All staff and clients will be required to wear face covering

o   All new clients being admitted will be required to complete a COVID-19 test

o   All new clients will be placed in the Health Monitoring Department until test results are received or 14 days has passed.

o   Residential clients are assigned to group cohorts.  Each group will have group services with and attend medication, meals, etc. 

o   Whenever possible any full house meetings will be in an area where social distancing can occur

o   Visitation policy will comply with Executive order 2020-108.

o   https://www.michigan.gov/whitmer/0,9309,7-387-90499_90705-530534--,00.html

 

Outpatient Programs

o   All staff and clients will be required to wear face covering

o   In all waiting room areas, chairs will be set up to maintain the 6 feet social distancing (X’s will placed on the floors as a visual que for the 6 feet space).  Other chairs will be removed from the area.

o   Food service will be limited to sack lunches that will be delivered to each group room

o   Transportation services will be provided whereby seating will be utilized at 50% capacity and each vehicle will be sanitized after each transport

 

Home or Community Based Services (WESS and/or EPP)

o   Services will be provided outdoors whenever possible.  Parent Advocates will bring gloves, a mask or face covering, and/or sanitizer to the visit and make such available as needed to the service recipient.

o   Adults that are able must wear a mask/face covering during the visit as with any attending children 2 years of age or older.

o   Parenting advocates will sanitize hands both immediately prior to and following each face to face visit. Visits will be scheduled in a manner to allow the parenting advocate sufficient time to wash hands between services.

 

 

Prevention Services

o   Currently being provided through telehealth only,

 

·         Include considerations for preventing community spread.

 

·         Establish guidelines for individual and group programming.

 

Guidance for groups:

o   Review Group protocol with each participant prior to the group start date in participant’s own language.

o   Screening protocol health evaluation will be conducted for entering the building, including temperatures (staff, contractor, visitor, or client)

o   Clients will not be penalized for missing group but are required to notify counselor about reason for absence and anticipated length of absence.

o   Consider implementing more extensive screening and infection control procedures for groups such as:  

§  Group size will be limited based on size of group room to ensure safety of consumers and to adhere to federal and state guidelines.

§  Group schedules will be expanded to evening hours when needed to ensure for safety.   

§  Chairs, sofas and other seating in the group meeting space are arranged to permit at least 6 feet of space between any two participants.  Wherever possible only furniture that can be sanitized will be used. 

§  Clients will be assigned to a group room and only those assigned and the group facilitator shall be permitted entry.

§  All group participants must comply with site guidance concerning occupancy limits in restrooms and in any common areas, including smoking areas, near the meeting room or space.

 

o   Procedures for physical distancing include:

§  All group participants always wear cloth face coverings in the group and in moving through the site in which the group takes place.   (Face covering will be on hand for consumers who forget or do not have a mask.)

§  All group participants sign in using their own pens or using a pen that is sanitized between users, or electronically using personal devices or devices that are sanitized between users.

§  No food or drink is served within the meeting and no sharing of food/drink/cigarettes/etc. is permitted

§  Hand sanitizer, tissues and trash cans are available to the public at or near the entrance and exits of the facility.

§  Counselors/Recovery coaches and clients will be required to wear face coverings during any individual sessions.

 

5. Plan for employee support.

·         Provide emotional support/ mental health resources to staff as well as to consumers, i.e. EAP materials and Michigan Coronavirus Website Emotional/ Mental Health Resources: https://www.michigan.gov/coronavirus/0,9753,7-406-98178_99557---,00.html

 

·         Ensure ongoing support of staff who are continuing to work in facilities and returning to the workplace after working remotely.

 

        Each Component Director will lead small group discussions with staff related the

        pandemic and how it is effecting them.

 

·         Develop guidance for travel and staff that use either their own vehicles or agency vehicles for transporting.

 

        Non-essential travel is prohibited at this time. 

        When transporting client’s the staff will only allow 50% capacity in each vehicle and the vehicle shall be sanitized after each transport. 

 

·         Provide emotional/mental health screening and resources to staff and clients

 

        Each Component Director will lead small group discussions with staff related to the

        pandemic and how it is effecting them.

        Mental health Screening is completed on clients entering the program and staff are required to assess ongoing mental health conditions of our clients.

 

·         Enhance suicide prevention screening for clients

 

        Mental health screening is completed on clients entering the program and staff are required to assess ongoing mental health conditions of our clients.

        https://suicidepreventionlifeline.org/

       

·         Support staff by providing training on respecting opposing viewpoints

 

        Each Component Director will lead small group discussions with staff related to the

        pandemic and how it is effecting them.

 

       

Additional Resources

·         State of Michigan Coronavirus website: www.michigan.gov/coronavirus

·         Michigan Coronavirus Website Emotional/ Mental Health Resources:  https://www.michigan.gov/coronavirus/0,9753,7-406-98178_99557---,00.html

·         CDC Coronavirus Managing Stress webpage: https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html

·         OSHA Guidance on Preparing Workplaces for COVID-19:   https://www.osha.gov/Publications/OSHA3990.pdf

·         CDC Interim Guidance for Businesses and Employer Responding to Coronavirus Disease 2019 (COVID-19): https://www.cdc.gov/coronavirus/2019-ncov/community/guidance-business-response.html

·         Training and Technical Assistance Related to COVID-19 (PDF): https://www.samhsa.gov/sites/default/files/training-and-technical-assistance-covid19.pdf 

·         Tips For Social Distancing, Quarantine, And Isolation During An Infectious Disease Outbreak (PDF):  https://www.samhsa.gov/sites/default/files/tips-social-distancing-quarantine-isolation-031620.pdf

·         White House, CDC, FEMA: https://www.coronavirus.gov/

·         Great Lakes Addiction Technology Transfer Center Network https://attcnetwork.org/centers/great-lakes-attc/home

·         Guidance on PPE recommended to minimize chances of exposure:  https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html

·         Instructions for the proper use of PPE: https://www.cdc.gov/coronavirus/2019-ncov/hcp/using-ppe.html

·         Re-opening Facilities to Provide Non-emergent Non-COVID-19 Health care: Phase I https://www.cms.gov/files/document/covid-flexibility-reopen-essential-non-covid-services.pdf

·         U.S. Department of Labor Coronavirus Resources: https://www.dol.gov/coronavirus

·         University Hospitals Healthy Restart Playbook: https://www.uhhospitals.org/university-hospitals-healthy-restart

·         SAMHSA Resources and Information: https://www.samhsa.gov/coronavirus

 

 

 

 

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