APFC recommended Guidelines for Resuming in-person behavior health services
Approved 5/22/2020
In an effort to protect those who receive behavioral healthcare services from harm and to promote a recovery environment that puts their safety first, with regard to Covid-19, we respectfully recommend adherence to the following:
Per CDC Guidelines
** Facility Maintenance
- Clean & disinfect everything especially frequently touched surfaces.
- This includes tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks.
- Use detergent or soap and water to clean dirty surfaces prior to disinfection. Then, use a household disinfectant.
- Limit & designate entrances to permit temperature taking and assure wearing of masks
** temperature checks
- Before providing/receiving services check temperatures ideally with a scanning thermometer (before entry into the building) and send home anyone with a temperature of 100.4 or above.
** encourage or require face masks
- Provide face masks: Assure that everyone covers their mouth and nose with a face mask or cloth face cover when in public or meeting with others. If providing cloth face masks, assign them to individuals and teach them how to use & maintain them (do not collect, clean and redistribute).
- Post sign on entrance door stating : Welcome! For Your Safety & Ours, Face Masks or Coverings are (Encouraged or Required), Thank You
- Individuals could spread COVID-19 to others even if they do not feel sick.
- Face coverings should not be placed on young children under age 2, anyone who has trouble breathing, or is unable to remove the mask without assistance.
- The face mask is meant to protect other people from you, it will not protect you from them.
** social distance
- Keep 6 feet between yourself and others.
- The cloth face cover is not a substitute for social distancing.
- Keeping distance from others is especially important for people who are at higher risk of getting very sick.
- Arrange common areas to support social distancing (remove or mark chairs not to be used).
- Follow CDC Guidelines for group meetings and seating areas.
** promote & educate all about frequent hand washing
- Wash hands often with soap and water for at least 20 seconds especially after you have been in a public place, or after blowing your nose, coughing, or sneezing.
- If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands and rub them together until they feel dry.
- Avoid touching your eyes, nose, and mouth with unwashed hands.
** know who is at risk
Based on what we know now, those at high-risk for severe illness from COVID-19 are:
- People 65 years and older.
- Homeless population.
- People of all ages with underlying (pre existing)medical conditions including:
- Chronic lung disease or moderate to severe asthma
- Serious heart conditions
- Immunocompromised
- Severe obesity (body mass index [BMI] of 40 or higher)
- Diabetes
- Chronic kidney disease undergoing dialysis
- Liver disease
Per governor ducey’s executive order
https://azgovernor.gov/executive-orders Order 2020-36 5/12/20
STAY HEALTHY, RETURN SMARTER, RETURN STRONGER replaces Stay Home, Stay Healthy, Stay Connected
- Phase in return based on the recommendations by the CDC and health experts through May and June
- Increase testing to return in May while maintaining strong physical distancing
- Balance public health & returning stronger
- Gradual & phased in
** individuals
- Vulnerable individuals should remain at home
- Individuals in these households should avoid returning to work where distancing is not practical
- Precautions should be taken to isolate from vulnerable residents
- All Arizonans should continue to physically distance
- Social settings where appropriate distancing is not practical should be avoided unless precautionary measures are observed and CDC guidelines are followed
** businesses
- Develop and implement appropriate policies, in accordance with Federal, State and local regulations and guidance, and informed by industry best practices, regarding:
- Social distancing and protective equipment
- Temperature checks
- Testing, isolating and contact tracing
- Sanitation
- Use and disinfection of common and high-traffic areas
- Business travel
- Do not allow symptomatic people to physically return to work until cleared by a medical provider
** employers
- Continue to ENCOURAGE TELEWORK, whenever possible and feasible with business operations.
- If possible, RETURN TO WORK IN PHASES.
- Close COMMON AREAS where personnel are likely to congregate and
interact, or enforce strict social distancing protocols. - Minimize NON-ESSENTIAL TRAVEL and adhere to CDC guidelines regarding isolation following travel.
- Strongly consider SPECIAL ACCOMMODATIONS for personnel who are
- members of a VULNERABLE POPULATION.
** Recap **
- Vulnerable individuals should remain at home
- All businesses and services to follow CDC guidance, implement protocols
- Continue to encourage telework
- Continue to physically distance
- Avoid large gatherings
- Schools remain closed
- In-person visitations to nursing homes prohibited
** REMEMBER TO DO YOUR PART
- CONTINUE TO PRACTICE GOOD HYGIENE
- Wash your hands with soap and water or use hand sanitizer, especially after touching frequently used items or surfaces.
- Avoid touching your face.
- Cover your cough or sneeze, cough into a tissue, or the inside of your elbow.
- Disinfect frequently used items and surfaces as much as possible.
- Strongly consider using face coverings while in public, and particularly when using mass transit.
- PEOPLE WHO FEEL SICK SHOULD STAY HOME
- Do not go to work or school.
- Contact and follow the advice of your medical provider.
Please note from 5/16/20 Governor Ducey Executive Order
#5: Any business whether for-profit or non-profit, institution, profession or entity that physically operates in this state and services the pubic or is an employer shall develop, establish and implement policies based on guidance from the CDC, Department of Labor, Occupational Safety and Health Administration (OSHA) and ADHS to limit and mitigate the spread of COVID-19 including the following:
- Promoting healthy hygiene practices;
- Intensifying cleaning, disinfection and ventilation practices;
- Monitoring for sickness;
- Ensuring physical distancing;
- Providing necessary protective equipment;
- Allowing for and encouraging teleworking where feasible;
- Providing plans, where possible, to return to work in phases; and
- Limiting the congregation of groups of no more than 10 persons when feasible and in relation to the size of the location.
ADHS Guidance
- Follow Governor Ducey’s Executive Order and CDC Guidelines
- Vulnerable employees should perform tasks with the least amount of customer contact.
WHITE HOUSE GUIDANCE
https://www.whitehouse.gov/wp-content/uploads/2020/04/Guidelines-for-Opening-Up-America-Again.pdf
FDA Food Safety Guidelines
Includes No Self Serve:
- Water fountains should be covered up and not in use.
- Water dispensers should also not be used and covered up. Bottled water should be used instead and only handed out by employees in PPEs.
- Self serve Coffee stations would need to be omitted or modified to be served by employees with PPEs.
- Food service would be prepackaged and only served by food handling certified employees in PPEs.
- ATM/Credit card machines covered in plastic and disinfected and replaced frequently. (FDA, restaurants)
- Computers should not be used by members. Unless a cleaning and disinfecting protocol is used rigorously including wipeable covers on keyboard and mouse. (FDA, restaurants, high traffic areas)
- Hand sanitizer station at all entry and exit points.
APFC ADDITIONAL GUIDELINE RECOMMENDATIONS
** Temperature Monitoring
- The CDC considers a person to have a fever when he or she has measured temperature of 100.4°F (38°C).
- Before you take your temperature: Wait 30 minutes after eating, drinking, or exercising. (CDC)
- Wait at least 6 hours after taking medicines that can lower your temperature, like (CDC):
- Acetaminophen, also called paracetamol
- Ibuprofen
- Aspirin
- Note: Scanning thermometer is best practice as it does not require physical contact and subsequent disinfecting.
** educate staff & members
- Provide employee education and adherence to CDC guidelines policies and procedures prior to reopening to the public.
- POST and provide education on these new policies and procedures for families/members.
- Telehealth should be prioritized for vulnerable individuals.
- Smoking and any outdoor areas would need to comply with the same in facility policies and procedures regarding maintaining a minimum 6 foot distance from others.
** transportation
- Sanitize vehicles before & after each use
- Take temperature of perspective passenger before loading and ask if they have a cough or have been exposed to anyone with Covid-19
- Require masks for all drivers and passengers
- Distance passengers to best ability
- Limit # of passengers
** Face Mask Use & Care
- Put on and remove face masks touching only the strings or loops, do not touch the front of the mask.
- Disposable masks: Do not re-use, dispose of safely.
- Cloth masks: Wash with soap/detergent and let sit in the sun (sunshine kills viruses). Have two masks to alternate and always have a clean one.
** Gloves
- If gloves are worn, it is imperative that the wearer know how to take them off safely so as not to contaminate themselves when removing them.
- As with any biohazard material, gloves must be safely disposed of.
** Members With Concerns: Steps You Can Take
- Express your concerns to your provider.
- Notify your Health Plan Office of Individual and Family Affairs (OIFA) Team of your concerns and for support. https://www.azahcccs.gov/AHCCCS/Downloads/OIFA_Administrators.pdf
- Contact the AHCCCS Office of Individual and Family Affairs (OIFA) Team: https://www.azahcccs.gov/AHCCCS/HealthcareAdvocacy/OIFA.html
- Utilize APFC (https://azpeerandfamily.org/) for guidance and support.
- Call Member Services at your Health Plan, express your concern, and ask to file a grievance.
- Contact your County Health Department, or the Arizona Department of Health Services at 844-542-8201.
Find your local health department here:
https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=AZ