The Reopening Plan that follows has been updated to reflect the use of the Unusual Incident Report for those impacted by COVID. As in the past, the areas edited/added have been italicized and underlined so you can easily note the changes.

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Rev. Effective 7/30/2020

COVID-19 Reopening Plan for Family & Children’s Center

Family & Children’s Center is committed to providing a safe and healthy workplace for all our staff and clients. To ensure that, we have developed the following COVID-19 Reopening Plan in response to the COVID-19 pandemic, especially as we prepare for when the safer at home orders lift completely. All of us are responsible for implementing this plan. Our goal is to mitigate the potential for transmission of COVID-19 in our workplaces and communities, and that requires full cooperation among our staff and clients. Only through this cooperative effort, can we establish and maintain the safety and health of our workplaces.

All FCC staff, clients, guests and building tenants are responsible for implementing and complying with all aspects of this COVID-19 Reopening Plan. This plan is aligned with FCC’s Response Plan and will focus on FCC’s practices once the safer at home orders lift completely. FCC has eight (8) sites to be considered. All decisions related to “opening” a building back up to clients and guests or relaxing any protocols implemented because of COVID-19 shall be approved by the President/CEO in conjunction with the Senior Leadership Team. Any changes to the plan shall be communicated via the Depot. Family & Children’s Center is and continues to be an essential business, and has been operational thru the public health emergency. No major changes are likely to occur immediately upon the safer at home orders lifting. The purpose of this Reopening Plan is to reiterate and reinforce implemented protocols and identify and outline any changes to protocols based on the Safer at Home order lifting completely as well as the “new normal” that will exist post safer at home orders.

Our staff are our most important assets. We are serious about safety, health, and keeping our staff working at Family & Children’s Center. Staff involvement is essential in developing and implementing a successful COVID-19 Reopening Plan. We have involved our staff in this process by inviting all staff thru the Virtual Leadership and Town Hall Meetings to offer suggestions and input. Additionally, Directors solicited input from their teams. Finally, we have utilized a Survey to garner input from the Leadership at FCC.

Our COVID-19 Reopening Plan follows most recommendations from the Centers for Disease Control and Prevention (CDC) guidelines as well as the local county health departments and addresses:

hygiene and respiratory etiquette;
administrative controls for social distancing;
client controls and protections for drop-off, pick-up and delivery;
housekeeping, including cleaning, disinfecting and decontamination;
prompt identification and isolation of sick persons;
communications and training that will be provided to managers and staff; and
Management and supervision necessary to ensure effective implementation of the plan.
Specific program modifications highlighted

Exposure Definition:

Throughout this document, references to exposure occurs. The following definition should be utilized. Staff and/or clients exposure shall refer to situations wherein the following three items occur.

Staff and/or clients did not practice social distancing and were less than 6 feet apart for longer than fifteen (15) minutes
Staff and/or clients were not wearing proper PPE
Staff and/or clients were exposed to a symptomatic and/or positive tested person within the past 48 hours.

Screening and policies for employees and clients exhibiting signs and symptoms of COVID-19

Staff have been informed of and are encouraged to self-monitor for signs and symptoms of COVID-19. The following policies and procedures have been implemented to assess staff’s health status prior to entering the workplace and for staff to report when they are sick or experiencing symptoms.

Staff are required to stay at home if sick and should advise their supervisor if not “reporting” to work.
All staff upon entering any facility will continue to complete a health assessment.
Any staff entering FCC’s three main sites shall also have their temperature checked and documented. We recognize body temperature of staff may vary. Any temperature over 100 degrees will be flagged, the employee’s supervisor contacted, and the employee will be turned away from the facility pending further steps.
Temperature checks for clients wherein direct services are being provided is expected
As is part of the FCC Response Plan COVID-19, Staff are required to self-report if they have been exposed to COVID-19 and/or if they have been tested for COVID-19 based on their own symptoms. Staff having been exposed to the COVID-19 virus will be expected to get testing and follow the recommendations from the County health department.
Staff having traveled shall use sound judgement upon their return…If they were traveling to an area considered a “hotspot” or were knowingly exposed to the COVID-19 virus, they are expected to self-identify and get tested. They are further expected to self-quarantine pending the results. They are encouraged to work from home pending test results and then must follow recommendations from the county health department.

FCC has implemented leave policies that promote staff staying at home when they are sick, when household members are sick, or when required by a health care provider to isolate or quarantine themselves or a member of their household. The agency has established Sick Time (HR 510) and FMLA (HR 202) Procedures, and both will always begin with a conversation between an employee and his/her supervisor regarding the need and circumstances to be absent from work. These procedures contain guidelines for the need to attend to personal and/or family member issues. In addition, The Families First Coronavirus Response Act (FFCRA) contains guidelines for economic support in the event of a work disruption directly related to COVID-19. Additional information on the FFCRA can be found at https://www.dol.gov/agencies/whd/pandemic/ffcra-employer-paid-leave and you can get additional assistance from the HR Director.

Employees experiencing symptoms that did not result from an apparent work-related exposure will be directed to their medical provider for testing. Staff will be directed to quarantine and not to return to work pending test results. In the event of positive test employees will follow the directions of their medical provider, and not return to work for at least fourteen calendar days if symptom free (10 days since testing positive AND 3 days of no fever without medication). In the event of a negative result, and the employee did not have exposure to an individual who tested positive, the employee can return to work after being symptom-free for 24 hours. Employees who had a negative test result but did have exposure to an individual who tested positive will not return to work for at least fourteen calendar days if symptom free (10 days since testing positive AND 3 days of no fever without medication).

FCC has implemented a practice for informing staff and clients if they have been exposed to a person with COVID-19 at their workplace and requiring them to quarantine for the required amount of time. A member of the Leadership Team will contact clients (or guardians) to communicate the contact incident, and relay information about the status of the program. Staff who have been exposed at work will be notified in person (or by phone if a live contact is not possible) and also will receive a documented notice in writing which will be placed in their employee file. Staff will be directed to get tested and follow the directions of their medical provider. Regardless of test results, exposed employees will not return to work for at least fourteen calendar days (10 days since testing positive AND 3 days of no fever without medication).

Employees are required to report their exposure status to their supervisor. Employees are also required to report test results to their supervisor and follow the guidelines described above. In all cases, an employee is required to communicate their status to their supervisor before returning to work. Their supervisor will share that information with their Director prior to employee’s return to work. The Director will confer with the HR Director before a return to work if necessary.

An internal unusual incident report form shall be utilized to document any staff or clients that have been tested positive, as well as staff or clients who have been directed to be tested and/or quarantine. The Internal UIR helps FCC to track internal decisions and/or directives given to staff and/or clients as related to COVID. It fosters our ability to be consistent in decisions made related to the health pandemic. The questions below shall serve as guidance when talking to staff or clients

Questions to be considered if COVID-19 exposure exists directly to staff or within our buildings (including clients):

Ensure you have a detailed story:

Who was potentially exposed?
How long ago?
Why do you think they were exposed?
Have you been w/in 6ft of a person diagnosed w/ confirmed COVID-19 infection for greater than 15 minutes?
What is the relationship to our staff/clients or building? Where specifically were they.
How were you advised of the risk?
Was anyone symptomatic?
Provide timeline
Did we/FCC staff follow protocols in place for safety?
Proper PPE?
Proper room/space sanitation
Health Check/Temp upon entering the building?
Complete internal incident report

Contact your supervisor and Director immediately with the full story/details

Advise CEO

Plans for mitigation may include but are not limited to:

Plans for building sanitation
Decisions to be made about potential building closure
Decisions to be made about potential staff isolation/quarantines
Advise Communication department for decision about crisis communication plan, as necessary/appropriate.
Payment for staff- If we request staff isolation or temporarily close the building pay up to (2) days – based on staff’s scheduled hours

Follow the flow chart on the pages that follow for a better understanding of the protocol for testing and symptoms.

All staff receive Privacy and Confidentiality training in Day One Orientation and during program onboarding, including HIPAA requirements, in order to assure the privacy of staff health status and health information. Communication related to positive COVID-19 cases or potential exposure should not include the individual’s identity, other than to a person authorized to receive the information (agency leadership and Human Resources). Any internal communication will be limited to only those that need to know or might be impacted in accordance w/ HIPPA requirements. Any external communications shall be handled by the Director and/or her/his designee. Messaging will be clear and concise. A site leader will relay the appropriate message to the front desk staff to assure the correct response is given to callers regarding the status of the program, client intake, effect on other programs, etc.

Staff are required to provide up-to-date emergency contact information to Human Resources.

If a staff member working in Minnesota is diagnosed with COVID-19, this must be reported to Minnesota Department of Health (MDH) by calling 651-201-5414 or 1-800-657-3504 (Mon. – Fri., 8AM-5PM). This should be done by a member of the Senior Leadership Team.

Screening and policies for when service recipients exhibit signs or symptoms of COVID-19

Monitor service recipients for signs of illness, including using a health screening tool such as this: https://www.health.state.mn.us/diseases/coronavirus/facilityhlthscreen.pdf.
Conduct pre-visit health checks. This may include a phone screening conducted by a staff person for a client prior to arriving for a home visit or a brief survey or questionnaire for out-patient clients sent via email or text that day prior to the appointment, when possible. Otherwise, clients will be screened upon onset of an appointment.
Ensure service recipients know the signs and symptoms of the COVID-19 illness.
Identify criteria for cancelling appointments due to presence of illness or symptoms.
Have protocol if a symptomatic client shows up for an appointment
Ask clients to cancel or reschedule if they are Covid-19 positive or have been in contact with someone who is Covid-19 positive or are living with someone exhibiting symptoms of Covid-19.
Establish protocols based on MDH guidance for when a service recipient exhibits symptoms of COVID-19 or tests positive for COVID-19 to limit exposure.

Handwashing

Basic infection prevention measures have been implemented at our workplaces at all times. Staff are instructed to wash their hands for at least 20 seconds with soap and water frequently throughout the day, but especially at the beginning and end of their shift, prior to and after eating, after using the toilet, or after blowing your nose, coughing, or sneezing. Paper towels and trash-receptacles are placed by the bathroom door so a paper towel can be readily disposed of when operating the door.

Upon entering the building at FCC properties all are expected to use hand-sanitizer dispensers (that use sanitizers of at least 60% alcohol). Hand sanitizer dispensers placed throughout the facilities including near entrances can be used for hand hygiene in place of soap and water, as long as hands are not visibly soiled.

Supplies for handwashing and sanitation will continue to be provided thru the facilities team. Further, staff are required to wash their hands before and after any contact with clients.

Handwashing etiquette signs are posted throughout the facilities.

Everyone is reminded to avoid touching your eyes, nose, and mouth with unwashed hands.

www.cdc.gov/handwashing/when-how-handwashing.html

www.cdc.gov/handwashing

Respiratory etiquette: Cover your cough or sneeze

Staff and visitors are being instructed to cover their mouth and nose with their sleeve or a tissue when coughing or sneezing and to avoid touching their face, in particular their mouth, nose and eyes, with their hands. They should dispose of tissues in the trash and wash or sanitize their hands immediately afterward. Respiratory etiquette will be demonstrated on posters and supported by making tissues and trash receptacles available to all staff and visitors.

www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html

www.cdc.gov/healthywater/hygiene/etiquette/coughing_sneezing.html

Social distancing

Arrivals and departures

At the present time, buildings are not open to the general public. Visitors must call or buzz to get into the buildings for scheduled appointments. Instructions are posted at entrances related to this, including the following:

Not to enter if they are experiencing COVID-19 symptoms;
To wash or sanitize their hands upon arrival;
Screening for COVID-19 symptoms is required prior to or immediately upon entering the program & the buildings;
To wear face-coverings in public/common spaces; and
To adhere to hygiene and social distancing instructions, signage and markings.

Barriers have been installed at front desks to limit contact with visitors in the building.

Steps should be taken to limit use of shared items, such as pens. When these items are shared, they should be disinfected before and after use.

Social distancing will continue to be implemented in the workplace through the following administrative controls:

Teleworking will continue to be permitted as their position allows
Flexible Work hours will continue to be supported
Staggered shifts as needed is allowable
Sharing of office space is cautiously allowed. Specifically, in all FCC sites… any shared office space shall be reviewed by supervisors to determine measures to social distance, where possible, and when not possible, what measures shall be put in place or continue to support health and safety.
Use of agency vehicles is prohibited, where possible. Programs shall review protocols to encourage clients to come to their services. When this is not possible, use of agency vehicles is allowable, but all those in cars shall wear masks. Clients shall sit in the back passenger side to be in line with social distancing. Weather permitting, car windows are to be opened.
When staff use an Agency vehicle for any reason, staff are expected to sanitize the car prior to and after each use. Specifically, staff shall receive at the time they pick up the vehicle keys materials to clean the car for use.
PPE (Masks) is required for staff and HIGHLY ENCOURAGED for clients when meeting directly with providers, especially when social distancing is a challenge.
As of 5/29/2020- In-Person Consent Forms are being required for all clients being seen directly/ face to face. As of 7/13/20, this form has been edited to include safety measures and expectations as well.
Meeting directly with clients is permissible but social distancing is an expectation. Direct meetings w/ clients shall have the ultimate approval by the Director
Telehealth platforms will continue to be encouraged and is the preferred method of client contact. This assumes telehealth laxed requirements continue.
Staff, visitors and clients are prohibited from gathering in groups larger than 10. Any public group space that might be utilized should be cleaned and sanitized before and after each use.
Staff and visitors are prohibited from gathering in confined areas and from using other staff’ personal protective equipment,

Whenever possible, consider having groups or individual sessions outdoors if safe to do so and client confidentiality can be facilitated. Encourage participants to spread out. Avoid outdoor areas that are densely populated.

Phones, computer equipment, desks, offices or other personal work tools and equipment should NOT be shared whenever possible. If not possible, Cleaning and sanitizing equipment is an expectation before and after each use.
Masks are now required by employees in all public spaces at all FCC sites. (6/22/2020)
Face to Face contacts will continue to be kept at a minimum. All programs seeing clients directly will review their protocols w/ the Directors.
Telehealth remains the preferred platform to see clients.
Clients may not be required to wear a mask during programming…However, clients who are known to engage in risky behavior may be required. See the Director.
For the minimal number of clients entering our buildings, for appointments/meetings, they will be required to wear masks until they enter their program space.
Masks will be required by staff seeing clients directly even while in programming when social distancing is a challenge. In other words, programs like R-YNC, Day Treatment, HH, Safe Visitation and YH wherein multiple clients are present and ‘groups” occur, staff will be required to wear a mask.
Clients will be encouraged to wear masks
Providers may use their judgement when requiring our youngest clients to wear masks enroute to their programming space.
Sanitation expectations continue to be required.
As necessary, Common areas and other areas of congestion should be marked to provide for social distancing of at least 6 feet.
As necessary, provide for physical distancing in restrooms or limit capacity. Mark off areas for where to wait to use the restroom.
As necessary, rearrange seating spaces to maximize the space (at least 6 feet apart) between people.
Hold meetings remotely whenever possible.
In residential services, staff should not enter residents’ rooms as much as possible to reduce potential for cross-contamination, unless required for supervision.
Community drinking stations and water foundations should not be available. Instead, encourage staff and clients to bring their own water bottles.

Face coverings-additional items

Face coverings are an important piece of mitigating the spread of the virus, but are only effective if it can stay in place without being pulled on or touched by the person wearing it or others. Within this context, the provider, staff members, and volunteers should wear face coverings during the work day as much as possible.
When providing services in the home provide employees with face coverings, gloves and hand sanitizer
When providing services in the office provide employees with face coverings.
Provide trainings for appropriate ways to put on and take off and disposal procedures of protective equipment Consider providing infographic sheets of this to employees
For in-home or out-patient services ask any client or family member who intends to be in the same room while the session is occurring to wear a face covering.
For groups that are longer in duration (4-5 hours per day) please consider breaking up group times or using a combination of in-person and virtual meetings to accommodate those with difficulty wearing masks for an extended period of time.
Face covering guidance is available here: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html

Housekeeping

Regular housekeeping practices that follow state and CDC guidance have been implemented, including routine cleaning and disinfecting of work surfaces, equipment, and areas in the work environment, including restrooms, break rooms, lunch rooms, meeting rooms, etc. Frequent cleaning and disinfecting will be conducted in high-touch areas, such as phones, keyboards, touch screens, controls, door handles, elevator panels, railings, copy machines, etc. Any use of shared public spaces/equipment should be sanitized both before and after each use.

Each facility has a documented sanitation schedule and checklist, identifying surfaces/equipment to be sanitized, the agent to be used, and the frequency at which sanitation occurs.

The use of shared supplies (e.g. arts and crafts, office supplies) that cannot be sanitized will be minimized, and a method should be established in each facility or program to keep used items separate from clean items.

When washing towels, bedding, and other items, use the warmest appropriate water setting and dry items completely.

Ventilation

Whenever possible, maximize the amount of fresh air being brought in, limit air recirculation and ensure ventilation systems are properly used and maintained. Take steps to minimize air flow blowing across people. In vehicles, avoid having air recirculated.

Communications and training

This Reopening Plan was initially communicated via the Depot to all staff 5/14/2020, due to the unexpected Safer at Home orders lifting because of the WI Supreme Court ruling. Necessary training was imbedded inside this Reopening plan. Instructions will be communicated to clients about social distancing and how their services will be delivered. This COVID-19 Reopening Plan has been approved by Family & Children’s Center management and will be updated as necessary.

Clients and their parents/guardians, legal representatives, and case managers will be notified that this plan is in place and provided with the parts of this plan that are relevant to them, including related resources.

For in-home clients, communicate to clients in advance of the visit what the agency and staff will do to protect the client and employees of the agency allowing enough notice for clients and employees time to prepare for additional precautions.

Staff with concerns about this plan should contact their supervisor, coordinator, or director.

Specific program modifications:

The specific program modifications relates to all changes to implemented program protocols because of COVID-19. This section of the plan is fluid and will be updated as protocols change as the Safer at Home orders lift and FCC discerns changes are necessary. As has been indicated, initially, programs will operate, as has been the norm during this public health emergency. FCC will monitor the situation closely and will make edits and advise the workforce via posts on the Depot. It is expected that Supervisors/Coordinators/Directors monitor their programs and make recommendations for program modifications. These changes may include but are not limited to:

Opening up residential beds
Continued use of telehealth
R-YNC reopens their doors to programming
How to handle staff and/or clients testing positive for the COVID-19 virus
Etc…

All certified programs in Minnesota, including, ARMHS, CTSS, Hiawatha Hall, Outpatient and Treatment Foster Care are all compliant with this plan.

Approved by:
Tita Yutuc, LCSW, LICSW
President/ CEO

Original Date: 5/14/2020

Re-approved- 7/22/2020

Appendix A – Guidance for developing a COVID-19 Reopening Plan

General

CDC Coronavirus (COVID-19) – www.cdc.gov/coronavirus/2019-nCoV

MDH Coronavirus – www.health.state.mn.us/diseases/coronavirus

State of Minnesota COVID-19 response – https://mn.gov/covid19/

Businesses

CDC Resources for businesses and employers – www.cdc.gov/coronavirus/2019-ncov/community/organizations/businesses-employers.html

CDC General business frequently asked questions – www.cdc.gov/coronavirus/2019-ncov/community/general-business-faq.html

MDH Businesses and employers: COVID-19 – www.health.state.mn.us/diseases/coronavirus/businesses.html

Minnesota Department of Employment and Economic Development (DEED) COVID-19 information and resources – https://mn.gov/deed/newscenter/covid/

DLI Updates related to COVID-19 – www.dli.mn.gov/updates

Federal OSHA – www.osha.gov

Some helpful ideas from the Department of Health (MDH):

Visitor and Employee Health Screening Checklist (PDF)

CDC: Reducing the Spread of COVID-19 in Workplaces

- Ensure that emergency contact information for service recipients is up-to-date.
- Establish communication protocols for positive COVID-19 cases or potential exposure and ensure that an individual’s identity is not disclosed, other than to a person authorized to receive the information.
- Notify MDH and follow their direction if a service recipient is diagnosed with COVID-19.

COVID-19 Update 7/30/2020

COVID-19 Reopening Plan for Family & Children’s Center

Exposure Definition:

Screening and policies for employees and clients exhibiting signs and symptoms of COVID-19

Handwashing

Respiratory etiquette: Cover your cough or sneeze

Social distancing

Housekeeping

Ventilation

Communications and training

Specific program modifications:

Appendix A – Guidance for developing a COVID-19 Reopening Plan

General

Businesses

Handwashing

Respiratory etiquette: Cover your cough or sneeze

Social distancing

Housekeeping

Employees exhibiting signs and symptoms of COVID-19

Training