The Arc of Cape May County Coronavirus Response Plan – 4-6-2020

Introduction:

This interim response plan is based on what is currently known about the coronavirus disease 2019 (COVID-19) as of 4/6/2020. The Arc of Cape May County will update this interim guidance as needed and as additional information becomes available. Updates will be highlighted.

CDC is working across the Department of Health and Human Services and across the U.S. government in the public health response to COVID-19. Much is unknown about how the virus that causes COVID-19 spreads. Current knowledge is largely based on what is known about similar coronaviruses.  This plan is based on the CDC most recent data and suggested guidelines.

Corona Virus Definition:

Coronaviruses are a large family of viruses that are common in humans and many different species of animals, including camels, cattle, cats, and bats. Rarely, animal coronaviruses can infect people and then spread between people, such as with MERS-CoV and SARS-CoV. The virus that causes COVID-19 is spreading from person-to-person in China and some limited person-to-person transmission has been reported in countries outside China, including the United States. However, respiratory illnesses like seasonal influenza, are currently widespread in many US communities.

The following interim response plan will be used to help prevent workplace exposures (both employees and program participants) to acute respiratory illnesses, including COVID-19, in non-healthcare settings. The guidance also provides planning considerations if there are more widespread, community outbreaks of COVID-19.

To prevent stigma and discrimination in the workplace, use only the guidance described below to determine risk of COVID-19. The Arc does not make determinations of risk based on race or country of origin and be sure to maintain confidentiality of people with confirmed COVID-19. There is much more to learn about the transmissibility, severity, and other features of COVID-19 and investigations are ongoing. Updates are available on CDC’s web page at www.cdc.gov/coronavirus/covid19

Current strategies for The Arc of Cape May County:

Beginning 3/21/2020 per guidelines by DHS The Arc of Cape May staff is to begin screening staff every shift prior to entering the program. SCREENING FORM needs to be filled out for each staff prior to coming into the program. Follow the directions listed as any temperature 100 or over as well as a yes to any question will mean staff cannot enter the program.

If any staff cannot proceed to work, please inform your director immediately.

Please ensure all your needed items (thermometer, gloves, wipes, etc) are kept by the door to ensure proper follow through with the procedure.

All working staff are required to view the COVID-19 Prevention Video from DHS and acknowledge.

https://www.youtube.com/watch?v=MJ8eeC-tVD4&feature=youtu.be

• We will actively encourage sick employees to stay home:
  • Employees who have symptoms of acute respiratory illness are recommended to stay home and not come to work until they are free of fever (100° F [37.77° C] or greater using an oral thermometer), signs of a fever, and any other symptoms for at least 24 hours, without the use of fever-reducing or other symptom-altering medicines (e.g. cough suppressants). Employees should notify their supervisor and Human Resources and stay home if they are sick.
  • Our sick leave policies are will be flexible and consistent with public health guidance and we will communicate to ensure employees are aware of these policies. We will NOT require employees to find their own coverage if home sick with a fever.
  • Temp agencies that provide The Arc with contract or temporary employees will be contacted to reinforce the need for their employees to stay home if sick.
  • We will request a healthcare provider’s note for employees who are sick with acute respiratory illness to validate their illness or to return to work. It is understood however, that healthcare provider offices and medical facilities may be extremely busy and not able to provide such documentation in a timely way.
  • The Arc will maintain flexible policies that permit employees to stay home to care for a sick family member. Employers should be aware that more employees may need to stay at home to care for sick children or other sick family members than is usual.
• Separate sick employees:
  • CDC recommends that employees who appear to have acute respiratory illness symptoms (i.e. cough, shortness of breath) upon arrival to work or become sick during the day should be separated from other employees and be sent home immediately. Sick employees will be instructed to cover their noses and mouths with a tissue when coughing or sneezing (or an elbow or shoulder if no tissue is available). They will also be instructed to wash their hands frequently.
• Emphasize staying home when sick, respiratory etiquette and hand hygiene by all employees:
  • Posters that encourage staying home when sick, cough and sneeze etiquette, and hand hygieneat the entrance to your workplace and in other workplace areas where they are likely to be seen have been posted in each program location.
  • Employees will be instructed to wash their hands for 20 seconds, often.
  • Hand sanitizer is located in multiple locations in the facilities and in conference rooms to encourage hand hygiene.
  • Visit the coughing and sneezing etiquette and clean hands webpagefor more information.
• Perform routine environmental cleaning:
  • Employees will be reminded to routinely clean all frequently touched surfaces in the workplace, and program locations, such as workstations, countertops, and doorknobs using the cleaning agents (disinfectant wipes, etc) that have been provided.
  • No additional disinfection beyond routine cleaning is recommended at this time.
  • The Arc will provide disposable wipes so that commonly used surfaces (for example, doorknobs, keyboards, remote controls, desks) can be wiped down by employees before each use.
  • Cleaning contractor will be reminded to train all of their employees on the best practices when disinfecting agency workspace and bathrooms.
• Advise employees before traveling to take certain steps:
  • Employees with be provided with the  CDC’s Traveler’s Health Noticesfor the latest guidance and recommendations for each country to which someone  will travel. Specific travel information for travelers going to and returning from China, and information for aircrew, can be found at on the CDC website.
  • When known to us, we will advise employees to check themselves for symptoms of acute respiratory illnessbefore starting travel and notify their supervisor and stay home if they are sick.
  • Employees who become sick while traveling understand that they should notify their supervisor and the Human Resources department and should promptly call a healthcare provider for advice if needed.

• If outside the United States, sick employees should follow obtain medical care or contact a healthcare provider or overseas medical assistance company to assist them with finding an appropriate healthcare provider in that country.  The Human Resources department should be notified so that they can work with our Health benefits provider A U.S. consular officer can help locate healthcare services.

• Additional Measures in Response to Currently Occurring Sporadic Importations of the COVID-19:
  • Employees who are well but who have a sick family member at home with COVID-19 should notify their supervisor and the Human Resources Department and refer to CDC guidance for how to conduct a risk assessmentof their potential exposure.
  • If an employee is confirmed to have COVID-19, employers should inform fellow employees of their possible exposure to COVID-19 in the workplace but maintain confidentiality as required by the Americans with Disabilities Act (ADA). Employees exposed to a co-worker with confirmed COVID-19 should refer to CDC guidance for how to conduct a risk assessmentof their potential exposure.  For program staff, guardians of individuals served will also be provided with information about the possible exposure to their loved one.   All information related to individuals and their health status is considered confidential and must be protected under HIPPA regulations.   No HIPPA information is to be shared.

Planning for a Possible COVID-19 Outbreak in the US

The severity of illness or how many people will fall ill from COVID-19 is unknown at this time. If there is evidence of a COVID-19 outbreak in the U.S., The Arc will plan to be able to respond in a flexible way to varying levels of severity and be prepared to refine their business response plans as needed. For the general American public, such as workers in non-healthcare settings and where it is unlikely that work tasks create an increased risk of exposures to COVID-19, the immediate health risk from COVID-19 is considered low. The CDC and its partners will continue to monitor national and international data on the severity of illness caused by COVID-19, will disseminate the results of these ongoing surveillance assessments, and will make additional recommendations as needed.

Planning Considerations

Communication:  The Chief Executive Officer and /or Compliance and Quality Improvement Director will be the ONLY staff members to communicate with employees and program participations regarding the COVID-19 Virus.   These communications will be frequent and based on information received from either the Department of Health and/or the CDC.   Communications will include:

(a) reducing transmission among staff,

(b) protecting people who are at higher risk for adverse health complications (including program participants

(c) maintaining business operations,

(d) minimizing adverse effects on other entities in their supply chains.

Some of the key considerations when making decisions on appropriate responses are:

• Disease severity (i.e., number of people who are sick, hospitalization and death rates) in the community where The Arc is located.
• Impact of disease on employees/ program participants that are vulnerable and may be at higher risk for COVID-19 adverse health complications. Inform employees that some people may be at higher risk for severe illness, such as older adults and those with chronic medical conditions.
• Prepare for possible increased numbers of employee absences due to illness in employees and their family members, dismissals of early childhood programs and K-12 schools due to high levels of absenteeism or illness:
  • The Arc will monitor and respond to absenteeism at the workplace. Essential employees will be identified as those who can maintain the core/ essential functions of the department.
  • Director level staff will Cross-train department staff personnel to perform essential functions so that the workplace is able to operate even if key staff members are absent.
  • Essential functions and the reliance on vendors and others and the community will be assessed. Alternative suppliers will be pursued.
• Chief Program Director and Assistant Chief Program Officer with the authority to take appropriate actions outlined in their business infectious disease outbreak response plan based on the condition in each locality.
• Coordination with Cape May County Department of Health and Office of Emergency Management has been established. In addition, The Arc is a fixed facility medication distribution location- in the event that mass distribution of medications is required for program participants and employees.

Plan Update

April 6, 2020

To reduce exposure, employees will be assigned to one on-call program. If there is a need to work in a program that you are not assigned, you will need prior approval. Full time employees intending to work outside of their assigned program, will also need to receive prior approval.

March 31, 2020

Effective March 24, 2020 The Arc of Cape May County will require ALL employees (DSP’s) and visitors to complete a health screening* at the start of their shift or upon visit.

The screening will consist of the following:

The employee/visitor will answer the following questions:

Ask the employee/ visitor if they have had a temperature over 99.9 degrees within the last 24 hours?

Screener to take and record temperature of employee/visitor. Please be sure thermometer has been sanitized and covered before use.  If the thermometer reads 100 degrees or higher, the employee/visitor shall not enter the residence and will leave the premises.

Ask the employee/visitor if they’ve had a cough, shortness of breath, or difficulty breathing.

Ask the employee/visitor if they or someone they live with have close contact with someone who has tested positive for COVID-19.

Ask employee/visitor if they have traveled to area subject to level 3 travel health notices.

If any of the answers on this checklist are yes (excluding working with a person in the program who is positive), the employee/visitor shall not enter the program and must get a doctor’s note before returning.

The Governor announced two revisions to the essential business Executive Order on the 3/30/20 press conference. This goes into effect 3/31/20: • Auto dealerships are permitted to conduct on-line or remote sales • Realtor mays show homes to individuals or members of the same household • Golf courses must remain closed • Breweries and brew pubs are allowed to deliver to homes • Firearm retailers are permitted to operate by appointment only.

Families First Coronavirus Response Act PAID LEAVE ENTITLEMENTS Generally,             employers covered under the Act must provide employees: Up to two weeks (80 hours, or a part-time employee’s two-week equivalent) of paid sick leave based on the higher of their    regular rate of pay, or the applicable state or Federal minimum wage, paid at: •  100% for      qualifying reasons #1-3 below, up to $511 daily and $5,110 total; •  2/3 for qualifying             reasons #4 and 6 below, up to $200 daily and $2,000 total; and •  Up to 10 weeks    more of             paid sick leave and expanded family and medical leave paid at 2/3 for qualifying reason #5             below for up to $200 daily and $12,000 total. A part-time employee is eligible for      leave for             the number of hours that the employee is normally scheduled to work over that period.

1. is subject to a Federal, State, or local quarantine or isolation order related to COVID-19; 2. has been advised by a health care provider to self-quarantine related to COVID-19; 3. is experiencing COVID-19 symptoms and is seeking a medical diagnosis; 4. is caring for an individual subject to an order described  in (1) or self-quarantine as described in (2);5. is caring for his or her child whose school or place of care is closed (or child care provider is unavailable) due to COVID-19 related reasons; or 6. is experiencing any other substantially-similar condition specified by the U.S. Department of Health and Human Services

Letter explaining that essential employees need to travel, in the event a travel restriction is imposed was distributed to all Arc of Cape May Staff.

March 21, 2020

Governor Murphy announces statewide stay at home order, closure of all non-essential retail businesses.

The order also prohibits social gatherings, mandates work from home arrangements for employees when possible, and invalidates conflicting local and county regulations.  

New COVID-19 website is available: covid19.nj.gov.

The website has information that residents, healthcare providers, businesses and organizations, schools, and others will find helpful.

The covid19.nj.gov website also has LIVE updates and announcements, as well as case counts by county.

WHAT IS CLOSED IN NEW JERSEY? (As of 3/21/20)

In an effort to promote social distancing to limit the spread of the COVID-19 virus, the following are closed. 

K-12 public, private and parochial schools  • Universities  • Casinos • Nightclubs • Performing Arts Centers and other concert venues • Racetracks • Movie theaters • Gyms and fitness centers • Indoor malls  • Indoor amusement centers and amusement parks  • All personal-care businesses which cannot comply with social distancing guidelines, including barber shops and hair salons, spas, nail and eyelash salons, tattoo parlors, and social clubs

All non-essential retail businesses Governor Murphy’s March 21, 2020 press release about statewide stay at home order and closure of all non-essential retail businesses may be accessed here: https://nj.gov/governor/news/news/562020/approved/20200320j.shtml

Governor Murphy’s Executive Order further directs the closure of all non-essential retail businesses to the public, with the exceptions of:

• Grocery stores, farmer’s markets and farms that sell directly to customers, and other food stores, including retailers that offer a varied assortment of foods comparable to what exists at a grocery store; • Pharmacies and medical marijuana dispensaries; • Medical supply stores; • Gas stations; • Convenience stores; • Ancillary stores within healthcare facilities; • Hardware and home improvement stores; • Banks and other financial institutions; • Laundromats and dry-cleaning services; • Stores that principally sell supplies for children under five years;

• Pet stores; • Liquor stores; • Car dealerships, but only for auto maintenance and repair, and auto mechanics; • Printing and office supply shops; • Mail and delivery stores.

March 19, 2020 COVID- 19 General Report Guidance was distributed via scomm.

• Effective March 19, 2020, The Arc of Cape May County no longer permits visitors to any

residential program, except in very limited situations. We strongly encourage family

members and friends not to visit their loved one who resides in a residential program. To

help bridge communication, our staff will provide support for people to interact with

friends and family by phone, FaceTime, Skype, etc.

Ensuring the health and well-being of the people who use our services and the staff who

support them are our top priority.

• In initiating this response, The Arc of Cape May County is following the advice of public

health officials who are mandating social distancing to reduce the spread of the virus and

to maintaining the health and safety of the people we serve and the staff who support

them.

• Effective March 19, 2020, the Office of Program Integrity & Accountability or OPIA is

temporarily suspending non-emergency field visits. Unannounced visits will be modified

to telephone calls or video conferencing if available.

• The Field Safety Unit, the unit responsible for incident verification, will use technology

wherever possible. In the event a DDD staff person needs to physically go out to a

residential program, the staff person will follow all screening protocols the Provider has

set in place.

• Routine licensing visits/inspections are currently suspended.
• Effective March 16, 2020, The Arc of Cape May County has closed the Thrift Shop in

Rio Grande.

• On March 13, 2020 the Division of Developmental Disabilities (DDD) mandated the

following:

• Support Coordinators and Division staff will conduct all meetings by video or phone.
• In-person meetings should only occur when necessary for health and safety of the

individual. Routine quarterly and annual visits will be conducted electronically or by

telephone until further notice

• Starting Tuesday, March 17, 2020 all Division-funded, facility-based day services are

closed until further notice

• In all residential settings, community outings that are not for the health or safety of an

individual will be discontinued until further notice

• Based on the directives from DDD, The Arc of Cape May County has initiated the

following actions:

• Support Coordinators will conduct all meetings by video conferencing or telephone. In-person meeting will only occur if necessary, for health and safety of the individual.
• Day Habilitation program (ATC) programing are closed until further notice.
• Day Program staff persons’ have been reassigned to assist the organization in

providing support and service to individuals living in residential services impacted                     by the mandated Day Habilitation program closure.

• In all Residential settings community outings that are not for the health or safety of an individual have been discontinued
• Recreation Programs are cancelled until further notice.
• On March 16, 2020 CMS and NJ Medicaid provided additional information regarding

early prescription medication refills for persons with intellectual and developmental

disabilities (I/DD) who have Medicaid, and for those who are dually eligible for both

Medicare and Medicaid.

• On March 16, 2020, Governor Murphy announced that the State is strongly discouraged
• travel in New Jersey between the hours of 8PM – 5AM for all non-essential and nonemergency persons’.
• Direct Support Professionals (DSP’s) are considered essential staff as their job
• responsibilities provide the assistance necessary to “… prevent an immediate threat to
• life” of the persons’ they provide support to.
• When traveling to or from work between the hours of 8PM – 5AM, DSP staff should
• keep on their persons the Arc of Cape May County work identification badge.
• If necessary, the staff person should be prepared to explain their role as a DSP and
• communicate that their job duties ‘prevent an immediate threat to life’ the persons’ who they provide support to.
• Emergency Travel which identifies why a DSP qualifies as an “Essential Travel and
• Exceptions”

If the public has questions, they should contact the call center: 1-800-962-1253 or 211. Call centers are open 24/7. The call center is not able to diagnose individuals, provide testing appointments or results, or give specific medical recommendations. Callers who need medical advice should contact their healthcare provider. Residents can also text NJCOVID to 898-211 to receive text information to stay informed.

New COVID-19 website that NJDOH has created, covid19.nj.gov. The website has information that residents, healthcare providers, businesses and organizations, schools, and others will find helpful. The covid19.nj.gov website also has LIVE updates and announcements, as well as case counts by county.

For an update of cases by county, the New Jersey Department of Health has set up a dashboard with information: https://www.nj.gov/health/…/topics/covid2019_dashboard.shtml

There have been some questions concerning if a staff member has a family member that been exposed should there be cause for concern about coming in to work. The health department states that there is no evidence that COVID can be transmitted by a third party. If, however the family member exhibits signs or being tested of the virus then there is a cause for concern and the staff should not come into the workplace. In all instances, please keep your supervisor and director informed.

• CDC recommends wearing cloth face covering in public settings where other social distancing measures are difficult to maintain (i.e., grocery stores and pharmacies), especially in areas with community-based transmission. Face covering does not replace social distancing but is another tool to reduce transmission.
• If the public has questions, they should contact the call center: 1-800-962-1253 or 211. Call centers are open 24/7. They may also be directed to the state website: covid19.nj.gov

• Wear a cloth face covering if out in public.
• Practice social distancing (keep a 6-foot space between you and others)
• Discontinue communal dinning.

Important Considerations for Creating an Infectious Disease Outbreak Response Plan

All employers should be ready to implement strategies to protect their workforce from COVID-19 while ensuring continuity of operations. During a COVID-19 outbreak, all sick employees should stay home and away from the workplace, respiratory etiquette and hand hygiene should be encouraged, and routine cleaning of commonly touched surfaces should be performed regularly.

The Arc will:

• Ensure the response plan is flexible and involve your employees in developing and reviewing your plan.
• Conduct a focused discussion (with all Director level staff) or exercise using your plan, to find out ahead of time whether the plan has gaps or problems that need to be corrected.
• Share our plan with employees and explain what human resources policies, workplace and leave flexibilities, and pay and benefits will be available to them.
• Share best practices with other businesses in your communities (especially those in your supply chain), chambers of commerce/ business partnerships, and associations to improve community response efforts.

Infectious Disease Outbreak Response Plan:

• For program participants and employees who have increased risk are those who have underlying respiratory issues and/or compromised health; In the event of an outbreak, these individuals will be separated from others. Employees will be asked to self-quarantine; Program participants will be isolated in their bedrooms unless other guidance from health practitioners is provided. If needed our “Shelter in Place/Lockdown” policies will be activated to separate individuals who are symptomatic, from those who are not.
• Employees who work in a home with symptomatic individuals will be quarantined along with the individuals, unless transported to the hospital.
• Human resources policies will be reviewed to ensure policies and practices are consistent with public health recommendations and are consistent with existing state and federal workplace laws. Non-Exempt will be paid for hours worked and/or PTO can be used, if there is a need to be absent from work.
• Policies and practices, such as flexible worksites (e.g., telecommuting), conference calling and flexible work hours (e.g., staggered shifts), to increase the physical distance among employees and between employees and others will be observed – if state and local health authorities recommend the use of social distancing strategies.
• For employees who are able to telework, supervisors will be encouraged to have employees to telework instead of coming into the workplace until symptoms are completely resolved. Information Technology Department will assist to ensure that the information technology and infrastructure needed to support multiple employees who may be able to work from home.
• Identify essential business functions include:

• • Finance, managing cash and reserves in the event that there is a financial need
  • Billing – to ensure ongoing financial resources
  • Purchasing – to ensure adequate supplies and food for programs
  • Maintenance – only priority projects will be completed (those projects that must be completed to ensure the health, safety and welfare of individuals served and employees)
  • Programs –If needed, Employment programs will close, and employment staff will be reassigned to support group homes
  • Technology – ongoing monitoring to ensure infrastructure intact
  • Human Resources – will monitor the health of employees and provide guidance on sick/ leave policies

• Our Disaster plan will be set into motion as per that plan. Sheltering in place and alternate location schedule policies will be activated as needed.   The Executive Staff will trigger this response.  Executive Staff will maintain contact without local health officials to identify these triggers.
• As directed by the Chief Executive Officer, The Arc will communicate information to business partners on our infectious disease outbreak response plans and latest COVID-19 information.  We will anticipate employee fear, anxiety, rumors, and misinformation, and plan accordingly.  Assistance in coping with fear and anxiety related to COVID-19 is available to employees through their health insurance plans, the department of health in your county, the Health Advocate resource on The Arc’s Resources page of the employee database, and the newly published video from Health Advocate on the Resources Page entitled “Tips To Keep Emotions in Check in Response to Coronavirus.”  The agency is prepared to help staff locate additional resources when needed.
• Local conditions will influence the decisions that public health officials make regarding community-level strategies; The Arc will take the time now to learn about plans in place in each community where they have a business.
• If there is evidence of a COVID-19 outbreak in the US and or in NJ, The Arc will cancel all business travel to additional countries per travel guidanceon the CDC website.

• Travel restrictions may be enacted by other countries which may limit the ability of employees to return home if they become sick while on travel status.

Screening and Protection:

• As per agency policy, employees must be physically able to perform their job functions and must be free of communicable diseases.
• If there is evidence of a COVID-19 outbreak in the Cape May County or adjacent Counties, The Arc will screen employees prior to entering the work site and at the end of their work shift. This will include at a minimum, taking each employees temperature and screening for coughing and shortness of breath.  Each screening will be recorded and maintained in the Human Resources department.  Any Employee with any of the (3) symptoms screened will be asked to go home immediately and contact their health provider.  Any individual served that displays any of the (3) symptoms, will be quarantined in their bedroom while further instruction from their health care providers and The Cape May County Department of Health and The Cape May Office of Emergency Management are contacted for guidance.
• For employees working with quarantined individuals, The Arc will provide personal protective equipment (PPE) along with instructions on how to use/ wear the PPE.

If the there is evidence of an outbreak in the immediate area (Cape May and the adjacent Counties), group events, gatherings and meetings will be reassessed and possibly cancelled.

This plan and related policies will be updated as new information is gathered.  Updates to this plan will be highlighted to ensure changes are easily identified.

Plan date: 3-12-2020

Revision dates:  3-23-2020

Revision dates:  4-6-2020