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HHSC has released guidance to HCS and TxHmL providers on preparing for COVID-19. This guidance was released to help reduce the risk of spreading infection to the individuals served by these waivers.
Similar to the guidance prohibiting non-essential visitors in nursing homes and other institutions, HHSC has mandated HCS and TxHmL providers prohibit visitation from non-essential personnel. Given that many group homes serve medically fragile individuals, it is necessary to take strong precautions to prevent the spread of COVID-19 among this population. Essential personnel are any one of the following:
- providers of essential services, such as direct care workers, contract doctors and nurses, home health and hospice workers, emergency medical services (EMS), and persons operating under the authority of the Local Intellectual and Developmental Disability Authority (LIDDA);
- persons with legal authority to enter, such as law enforcement officers, Disability Rights Texas (DRTX), ombudsman, and HHSC surveyors;
- Department of Public Safety (DPS) personnel; and
- family members and loved ones of residents at the end of life
While non-essential visits are restricted, providers should take steps to provide alternate means of communication for people who would otherwise visit. Facetime and other forms of video or telephone conferencing are excellent alternatives to promote ongoing contact between individuals and their loved ones.
Screening of Essential Visitors
Essential visitors may be allowed in unless they are experiencing any of the following:
Program providers must take precautions and screen all visitors to ensure they do not meet the above criteria. While present in the home, all essential visitors must wear a facemask. Providers are required to have personal protective equipment (PPE) available at all locations where services are provided. If they are unable to obtain PPEs for reasons outside their control they will not be cited, but they must contact the local and state public health agency to notify them. Providers must follow national guidelines for optimizing their current supply, or identify the next best option to care for the program providers.
HHSC is requiring all providers to post visible signage to address screening criteria detailed below prior to allowing access to residents. This signage should also include language discouraging visits, reminding non-essential visitors that visits are currently limited to essential personnel. These signs must remain up until further guidance is issued by HHSC. When essential personnel are present, providers must adhere to the following:
- temperature checks must be conducted and hand sanitizer made available prior to entry;
- program providers must disinfect the area after the visitor leaves;
- visitors must be screened prior to entrance to determine if they are essential- family members and loved ones visiting residents at the end of life are considered essential, but they must be restricted to a specific room to protect others in the residence.
HHSC encourages providers to set up a phone line that is updated at a set time (e.g., daily) with information on the provider's status and information on when it is safe to resume visits (if available).
Protections for Residents
Program providers must actively and consistently monitor residents for potential symptoms of respiratory infection. Nurses must be immediately notified of any individuals who begin exhibiting symptoms such as cough, fever, or shortness of breath. Nurses must then immediately notify the individual's physician. Providers must also ensure all host homes, three-person, and four-person residences are equipped with:
- soap;
- commercially produced hand sanitizer;
- and any other disinfecting agents to maintain a sanitary environment.
Providers must not use home-made hand sanitizer. Finally, within residences provider staff must ensure the following precautions:
- limiting physical contact, such as handshaking and hugging;
- reinforcing strong hygiene practices for individuals and staff, such as proper hand-washing, covering of coughs and sneezes, and the use of hand sanitizer when soap and water is not immediately available;
- practicing social distancing;
- using gloves when supporting individuals;
- regularly disinfecting all high-touch surfaces such as counters, doorknobs, and telephones.
This is not an exhaustive list of precautions. Program providers must maintain documentation as proof of compliance.
Any questions about the HHSC guidance letter should be directed to the Policy, Rules, and Training Section by email or call (512) 438-3161.
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