Waiver Requirements - Use of COVID-19 Positive Staff Who Are Asymptomatic or Who Have Mild to Moderate Illness with Improving Symptoms

DHS Logo Original 07/11/2018

Division of Quality Assurance: Assisted Living

Attn: Assisted Living Providers

Waiver Requirements - Use of COVID-19 Positive Staff Who Are Asymptomatic or Who Have Mild to Moderate Illness with Improving Symptoms

This information is to provide information and guidance regarding CDC's healthcare worker crisis staffing plan for assisted living facilities, specifically around the recommendation to let COVID positive healthcare workers, who are asymptomatic or who have mild to moderate illness with improving symptoms, return to work before finishing the recommended isolation. Allowing COVID-19 positive staff to work before meeting conventional return-to-work guidance (link is external) could result in healthcare-associated transmission of the virus. According to CDC guidance, https://www.cdc.gov/coronavirus/2019-ncov/hcp/mitigating-staff-shortages.html, use of staff who are asymptomatic or who have mild to moderate illness with improving symptoms, may be considered as a last resort following the procedures below.

Guidance for Community-Based Residential Facilities (CBRFs) and Adult Family Homes (AFHs)
After exhausting all other opportunities, if the facility still does not have adequate staff to provide the care, treatment, and services to the residents, CBRFs and AFHs should coordinate with their local/tribal public health department (LTHD) and submit a waiver request to the Division of Quality Assurance (DQA), Bureau of Assisted Living (BAL) regional office, to use asymptomatic COVID-19 positive staff who are asymptomatic or who have mild to moderate illness with improving symptoms.

Guidance for Residential Care Apartment Complexes (RCACs)
After exhausting all other opportunities, RCACs should coordinate with their local/tribal public health department (LTHD) regarding the intent to utilize COVID-19 positive staff who are asymptomatic or who have mild to moderate illness with improving symptoms. According to CDC guidance noted above, as soon as the facility feels it has exhausted all resources and still does not have adequate staff to provide the care, treatment, and services to the residents, RCACs should also notify their DQA, Bureau of Assisted Living Regional Office, of the intent to utilize COVID-19 positive staff.

Guidance for Waiver Process
The guidance at: COVID-19: Assisted Living | Wisconsin Department of Health Services describes the steps that must be taken and precautions that must be put into place prior to implementing this practice.

Questions
If you have questions about this information, please contact your Division of Quality Assurance, Bureau of Assisted Living Regional Office.