I.        Pre-Participation Screening:

The Rehabilitation Institute, Inc. (TRI) will require that all staff and individuals, as well as any essential visitors, to be screened prior to entry into the day program site and monitored for signs and symptoms of COVID-19 thereafter.  Individuals who are being picked up by TRI will complete the health screening assessment and be screened prior to entering the vehicle and monitored for signs and symptoms of COVID-19 thereafter. Daily screenings will be documented for all individuals and staff. Documentation will include if the person successfully passed the screening or if the staff was sent home. No personal health information will be recorded. All staff/individual screening documentation will be secured in a locked area. TRI will require individuals and staff to self-report, to the extent they are able, any changes in symptom status throughout the day and identify a contact person who staff and/or individuals should inform if they later are experiencing COVID-19-related symptoms.

The health screening assessment will include the following questions:

1. COVID-19 symptoms in the past 14 days,
2. Positive COVID-19 test in the past 14 days,
3. Close contact with a confirmed or suspected COVID-19 case in the past 14 days and/or
4. Travel from within one of the designated states with significant community spre

Program Management will review the responses every day and document their review.

Any individual or staff exhibiting signs or symptoms of COVID-19 upon arrival will not be allowed to enter the program building. They will be required to return home until they are fever free for 72 hours without the use of fever-reducing medications (e.g. Advil, Tylenol)

If symptoms begin while at the day program, the individual or staff will be sent home immediately upon discovery.  The program will ensure that any one identified as having symptoms (both individuals and staff) will be isolated from well individuals and staff.  Individuals or staff sent home will be provided with instructions to contact their healthcare provider for assessment and required testing. The day program management staff will notify the local health department and OPWDD about the suspected case.

In order for an individual to return to day program after being sent home, they must abide by the following procedure:

1. Individuals sent home from program must consult with their healthcare practitioner prior to returning to the program and provide documentation that they are symptom free.
2. Individuals may not return to or attend the day program while a member of their household or certified residence are being quarantined or isolate

In order for a staff to return to day program after being sent home, they must adhere to the following procedures as they relate to Essential Workers:

1. It is the policy of TRI that if a staff tests positive for COVID-19 AND EITHER OR has COVID-19 symptoms OR did not receive a test, he/she may only return to work if the following conditions are met:
   1. Staff have maintained isolation for at least 7 days after illness onset (i.e. Symptoms first appeared) and have not had a fever for at least 72 hours, without the use of fever-reducing medication, and with other symptoms improving.
2. If a staff has had close contact with a person with COVID-19 for a prolonged period of time AND is symptomatic, the staff will notify the day program management staff and will follow the above protocol for a positive c
3. If a staff has had close contact with a person with COVID-19 for a prolonged period of time AND is NOT symptomatic, the staff will notify the day program management staff and adhere to the following practices prior to and during their work shift, which will be documented by the day program:
4. Regular monitoring: As long as the staff does not have a temperature or symptoms, they should self-monitor consistent with the day program’s health poli
5. Wear a mask: The staff will wear a face covering at all times while in the day program.

• Social distance: staff will continue social distancing practices, including maintaining, at least, six feet distance from ot

1. Disinfect and clean facility spaces: Day Program management will ensure to clean and disinfect all areas such as offices, bathrooms, classrooms, common areas, and shared electronic equipment routinely.

In the event an individual, staff or anyone they reside with are placed on quarantine or isolation, the responsible party (i.e. self, guardian, residence manager etc.) must notify the day program immediately and must suspend attending day program until they are medically cleared to return to work/program.

II.      Social Distancing

All TRI PWW staff will adhere to the Social Distancing guidelines.  At any time that the individuals and staff are indoors, six feet of physical distance will be maintained among individuals and staff, unless safety of the core activity requires a shorter distance or an individual’s treatment plan requires that closer contact be maintained with a staff member.

III. Staffing/Supervision Ratios:

TRI will ensure that groupings of staff/individuals receiving services are as static as possible by having the same group of individuals work with the same staff whenever and wherever possible. When services are being offered indoors, group size will be limited to no more than five (5) individuals receiving services.  This will help prevent crowding in the rooms while ensuring the social distancing guidelines.  When programing outdoors, group size will be limited to no more than ten (10) individuals receiving services.  The restriction on group size does not include employees/staff.

Program staff will take additional measures to prevent congregation in lobbies, hallways, and limit density in elevators.  When programming indoors, communal dining will not be allowed.  Individuals can either eat in their respective rooms or go outside for snacks.  Shared food and beverages will not be allowed. All individuals and/or their guardians will be educated that any food being brought from home should require limited preparation at the day program site (i.e. heating in microwave) and be packed appropriately.

1. Program Without Walls Schedule

TRI will be offering two service blocks of time during which day services opportunities will be offered. Services will be offered from 8:00am to 12:00p and 1:00p to 5:00p. This will allow individuals and the family members the flexibility to select a time that best accommodates their needs.

Initially, TRI will include reintegrating men and women that currently reside in the community with their families. TRI staff have reached out to the families and most of them have expressed that they are interested in returning to day activities. Some families have expressed an interest in transporting their family members and others have requested that TRI provide the transportation.

It is the goal of TRI to increase our capacity in Phase II by 20-25%.  During this phase, we will continue to re-integrate the individuals living in the community.  This will allow the individuals and family members to assess how phase I was operationalized as well as exploring opening of additional community resources that our men and women can participate in.

V. Personal Protective Equipment Guidelines

All staff will wear an appropriate face mask or covering at all times at work, consistent with all OPWDD guidelines, unless medically contraindicated. TRI has provided each staff with cloth masks coverings. However, if at any point, there is a need for higher degree of protection, day program management has ample supply of N95 masks and will provide them to the staff.

The teams will work with each individual and provide education on the importance of wearing PPE especially masks in the community as tolerated. TRI has secured ample supply of the following items:

• KN 95 Facial Masks
• Surgical/Disposable Masks
• Goggles
• Face Shields
• Gowns
• Shoe Guards
• Gloves
• Hand Sanitizers
• Disinfectant wipes
• Infrared Thermometers
• Pulse Oximeters

1. Proper Cleanliness and Sanitation guidelines:

When programming outdoors, where bathrooms are not readily accessible, each staff will carry alcohol-based hand sanitizer containing at least 60% alcohol with them at all times. They will encourage the individuals to use the hand sanitizer after each activity and encourage them to wash hands with soap and warm water upon returning to a hub site.

Emphasis will be placed to limit the sharing of objects, such as electronic equipment, arts and craft materials, touchscreens, as well as the touching of shared surfaces; or, require staff to wear gloves (trade-appropriate or medical) when in contact with shared objects or frequently touched surfaces; or, require workers and individuals to practice hand hygiene before and after contact.

 

VII.        Transportation

TRI will utilize its vehicles to transport the men and women participating in PWW.  The team has also reached out to the family members and some have expressed interest in transporting their respective family members to and from day program.  The vehicle fleet has been modified to ensure compliance with social distancing guidelines and safety practices.  The modifications include plastic barriers behind each row which will reduce the chance of spread. With the modification to the vehicles, we will be able to transport 1 passenger in each row.   This will be in line with the recommendation of 50% reduced capacity to maximize social distancing and reduce COVID-19 transmission risks.

Staff, and the driver must wear face- coverings at all times in the vehicle. Staff who cannot medically tolerate the use of a face covering should not be assigned to transport individuals at this time. Individuals will be encouraged to wear masks to the extent they can medically tolerate one.

After each trip is completed, the interior of the vehicle will be thoroughly cleaned to reduce COVID- 19 transmission risks.

Where appropriate and safe, windows should be rolled down to permit air flow.

 

VIII.        Tracing and Tracking

Day program services management will notify the local health department and OPWDD immediately upon being informed of any positive COVID-19 test result by an individual or staff at their site.

In the case of a staff or visitor testing positive, day program services management staff will work with the local health department to trace all contacts in the workplace and notify the health department of all staff, individuals and visitors who entered the facility dating back to 48 hours before the staff began experiencing COVID-19 symptoms or tested positive, whichever is earlier, but maintain confidentiality as required by federal and state law and regulations.

Staff who are alerted that they have come into close or proximate contact with a person with COVID-19, and have been alerted via tracing, tracking or other mechanism, will be required to self-report to their employer at the time of alert and shall follow all required protocols as if they had been exposed at work.

1. Employee Training:

All TRI staff have participated in required COVID-19 trainings before they work with the individuals. These trainings include:

• Centers For Disease Facts about COVID
• Hand Hygiene
• Appropriate use of Personal Protective Equipment
• Infection control
• Role of the DSP