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Provider Return to Face to Face (F2F) Services Policy

Objective:
The health and safety of our providers and the children we serve continues to remain our highest priority during the pandemic. By prioritizing such, this policy supports CTP’s mission to provide the highest quality services, utilizing the latest in research to help our clients achieve their fullest potential.

CTP Designated Point of Contact to Assist During the COVID-19 Pandemic
The designated point of contact when CTP resumes F2F services are called the Return to Work (RTW) Coordinator / COVID-19 Representative. They will serve as the providers first point of contact.

Guideline Revisions – Living document
The CDC understanding of COVID-19 and the pandemic in general is continuously evolving. As such new developments and understanding will be continuously incorporated in this policy on an as needed basis.
Revisions will be communicated to all providers through CTP communication emails or through the designated point of contact or through the CTP leadership team.

Return F2F Services Considerations
There are several factors to consider before returning to F2F Services. The key factors include:

  1. Identify those at high risk
  2. Identifying those infected or showing symptoms of COVID-19
  3. Providers with care-taking responsibilities
  4. Providers who are uncomfortable or unwilling to return to provide face to face services

Factors Affecting Return to Face to Face Services

1) Identifying high risk providers

As defined by the CDC, adults of any age with the following conditions are at increased risk of severe illness from the virus that causes COVID-19:

  • Cancer
  • Chronic kidney disease
  • COPD (chronic obstructive pulmonary disease)
  • Down Syndrome
  • Heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies
  • Immunocompromised state (weakened immune system) from solid organ transplant
  • Obesity (body mass index [BMI] of 30 kg/m2 or higher but < 40 kg/m2)
  • Severe Obesity (BMI ≥ 40 kg/m2)
  • Pregnancy
  • Sickle cell disease
  • Smoking
  • Type 2 diabetes mellitus

2) Providers who test positive, have been potentially exposed or show symptoms or combined symptoms for 24 hours or more, that may be attributed to having COVID-19 within the past 14 days

Provider must cancel all F2F services immediately and notify the CTP COVID-19 Representatives by email within 24 hours after you have self-identified being infected with COVID-19, are suspected to have COVID-19, have potentially been exposed to individuals who are ill with COVID-19 or display symptoms or combination of symptoms of COVID-19 as indicated by the CDC:

  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea

Tested Positive with COVID-19:
Contractors must immediately cancel all F2F services until directed by CTP to resume F2F services and contact the CTP COVID-19 Representative within 24 hours. Contractor should quarantine and be in isolation at home for 14 days to monitor symptoms. The contractor will require a retesting negative result OR a doctor’s note OR have no fever for 24 hours without the use of fever-reducing medications and other symptoms of COVID-19 are improving, before returning to any F2F services.

Providers potentially exposed to COVID-19 or showing symptoms or combined symptoms for 24 hours or more:
Cancel all F2F services until directed by CTP to resume F2F services.

  • If provider is unvaccinated, they should quarantine at home for 14 days to monitor for any new signs or symptoms.
  • If a provider was exposed but has been fully vaccinated and meet all 3 criteria according to the CDC (see definition of “fully vaccinated” below in section COVID-19 Vaccination) and provide proof of vaccination to CTP, F2F services may continue uninterrupted pending approval from the CTP team.
  • A provider will not be able to provide any F2F services unless during the quarantine period they show a negative test for COVID-19 within the 14-day quarantine period OR at the end of the 14- day quarantine period, they remain fever free for 24 hours without the use of fever-reducing medications and other symptoms of COVID-19 are improving to return to any F2F service(s).
  • A provider is encouraged to take the COVID-19 test to check for their COVID-19 status where possible instead of quarantining for 14 days to limit the amount of disruption of F2F services. The COVID-19 test must occur on day 5 or later from the exposure date.

3) Providers with care taking responsibilities.

Providers who must care for child/ren or care for a loved one. Providers who have to care for child/ren, under 18 years of age, whose school or child care provider is closed or unavailable for reasons related to COVID-19 or child/ren 18 years of age or older and incapable of self-care because of a mental or physical disability, may take the following step:

  • Provider may continue to provide virtual services, if applicable, at their supervisor’s discretion and if the school allows virtual services for their specific caseload.

Providers who have to care for an immediate family member or someone who regularly resides in their home or where their relationship creates an expectation that they care for the person in a quarantine situation, and that individual depends on them for care during the quarantine, may take the following step:

  • Provider may continue to provide virtual services, if applicable, at their supervisor’s discretion and if the school allows virtual services for their specific caseload.

4) Providers who are uncomfortable or unwilling to return to provide F2F services
Providers who are uncomfortable or unwilling to return as a provider of F2F services.

  • Each situation will be evaluated on a case by case basis.

Additional Considerations Related to F2F Services
We are monitoring Federal, CDC, State, Local and Department of Education guidelines in consideration of providing F2F Services. If a school requires sessions to be held virtually despite the return to work color coding system, CTP will follow the school guidelines. If the school’s requirements remain stricter than changes from the CDC, Federal, state or DOE level, CTP will continue to follow the school mandates.

The status of services is subject to change. CTP will follow the directive as mandated by the State and Pennsylvania Department of Education and the respective school.

If a family refuses face to face sessions, the provider will communicate the refusal to CTP and a CTP representative will immediately contact the respective school.

For any other concerns related to COVID-19 and the health and well-being of the provider in the F2F environment, reach out to the CTP RTW Coordinator/ COVID-19 Representative.

Prior to and During each F2F Session

  1. The day before every appointment, the provider will send an email or call the family reminding them of the appointment and discuss the following below with the family:
    • After self-evaluation and no COVID-19 like symptoms are identified, the provider will let the family know they are symptom free and are able to provide service. Provider will inquire if the client or other people in the F2F environment are showing any signs of COVID-19 or have been in contact with anyone who is showing signs or confirmed to be infected or not.
    • Provider will also follow any state (see below in travel section) and school specific guidelines.
    • Provider will inform the family that all people in the F2F environment are required to wear a mask or face covering during the session as it is mandated by PA Health Secretary, effective 11/20/2020
  2. Providers should evaluate themselves regularly and an hour before providing services to determine if they are experiencing any COVID-19 symptoms and use temperature checks to make sure they do not have a temperature of 100.4 or higher, without using any fever reducing medication.
    Note:
    ➢ Do not have face mask on 15 minutes before temperature check.
    ➢ An hour before seeing a client, you must have a temperature below 100.4 degrees (not aided by fever reducing medications).
    ➢ Temperature checks are subject to CTP video confirmation at random times.
    ➢ Temperature monitoring will be reported to CTP as designated.
    ➢ CTP will also check for confirmation of no combined COVID-19 like symptoms.
  3. If the provider tests positive for COVID 19, has been potentially exposed or experienced any COVID-19 symptoms within the past 14 days or if they are otherwise sick, they should do the following
    • Notify CTP RTW Coordinator/ COVID-19 Representative immediately within 24 hours afte information is obtained.
    • Complete the CTP Incident Report form.
    • Cancel the appointment(s) with all in-person Face to Face the client(s).
    • Communication will then be sent to respective school and provider.
    • Follow Steps to Address the Factors Affecting Return to F2F Services above.
    • If a provider was exposed but has been fully vaccinated, (based on the criteria set forth in the CDC’s definition of “fully vaccinated” below in section COVID-19 Vaccination) and provides proof of vaccination to CTP, F2F services may continue uninterrupted pending approval from the CTP team.
    • Follow COVID-19 procedure. See policy under F2F Service Considerations: Contractors who test positive, have been potentially exposed or show symptoms or combined symptoms for 24 hours or more, that may be attributed to having COVID-19 within the past 14 days
  4. If client or other people in the F2F environment tested positive, confirms they are showing signs and symptoms and/or infected with COVID-19, the provider should do the following:
    • Notify CTP RTW Coordinator/ COVID-19 Representative immediately within 24 hours after the information is obtained.
    • Complete the CTP Incident Report form.
    • Cancel the appointment(s) with all in-person Face to Face client(s).
    • Communication will then be sent to respective school and provider.
  5. If client or other people in the F2F environment declines to wear a mask or face covering during the session, then the provider will do the following:
    • Complete the CTP Incident Report form. See incident report process directions.
    • Session may occur ONLY if applicable reason not to wear face mask is provided and there is a prior written approval and everyone in the F2F environment are in agreement for service to continue F2F.
    • Cancel the appointment(s) with that particular client unless you have prior written approval and agree to provide services with people who are declining to wear mask(s) in the F2F environment.
    • When canceling appointment, follow the normal session cancellation process while inputting “Person in F2F environment declined to wear mask” in notes section.
    • The next step will be communicated by the CTP team to both the school and provider

COVID-19 Vaccination
A fully vaccinated Contractor that meets the CDC requirement below and submits proof of vaccination to the CTP COVID-19 Representative or produces a negative COVID test result taken at least 5 days after exposure may be exempt from the 14-day quarantine requirement. The next action to take will be communicated by the CTP team to the contractor.
According to the CDC, a fully vaccinated person must meet all 3 criteria mentioned below:

  1. Individuals who are at least two weeks passed the date they received the second dose of a two-dose vaccine or one dose of a single-dose vaccine.
  2. It has been less than three months since their final dose of the vaccine.
  3. Individuals who do not have symptoms of COVID-19 after the exposure.


As of March 8, 2021, per the CDC, fully vaccinated people should continue to:

  • Take precautions in public like wearing a well-fitted mask and physical distancing. • Wear masks, practice physical distancing, and adhere to other prevention measures when visiting with unvaccinated people who are at increased risk for severe COVID-19 disease or who have an unvaccinated household member who is at increased risk for severe COVID-19 disease.
  • Wear masks, maintain physical distance, and practice other prevention measures when visiting with unvaccinated people from multiple households.
  • Avoid medium- and large-sized in-person gatherings.
  • Get tested if experiencing COVID-19 symptoms.

Expectation of F2F Environment from the CDC

  • Prior to each session, verification that the client’s and other people in the F2F environment’s temperatures are below 100.4 degrees and they are not displaying COVID-19 like symptoms.
  • Environment for F2F service should follow the CDC guideline regarding using Personal Protective Equipment (PPE). Client and other people in the F2F environment should use PPE. *
  • Face coverings must be worn by all people in the F2F environment as required by the order mandated, effective11/20/2020, by the PA Department of Health, with some exceptions. ** Masks can be removed to eat or drink.
  • Work areas are sanitized.
  • Social distancing (maintain a six feet distance) practices are followed by all persons in the F2F environment while providing services.
  • Frequent handwashing and/or use of hand sanitizer should be utilized at the start of each sessions and as needed

*If a student’s disability or anyone in the F2F environment is unable to follow environmental expectations, a meeting should be held and an individual plan with all parties in agreement should be developed.

**Exceptions to face covering requirement: Individuals who cannot wear a mask due to a medical condition including those with respiratory issues that impede breathing mental health condition or disability; Individuals who will be unable to remove a mask without assistance; Individuals who are under two years of age; Individuals who are communicating or seeking to communicate with someone who is hearing impaired or had another disability where the ability to see the mouth is essential for communication.

Reasons Leading to Cancellation of Sessions

  • Failure to obtain confirmation of temperature below 100.4 degrees and/or absence of COVID-19 like symptoms or infection of the client’s or persons who would come in contact with the provider prior to the start of services may lead to a cancellation of session.
  • If a person in the F2F environment who would come in contact with the provider, has a fever of 100.4 after temperature has been taken and/or other COVID-19 like symptoms or infection, the session should be cancelled.
  • Failure of F2F environment to follow CDC guidelines, (see above Expectation of F2F Environment from the CDC) may result in the cancellation of the session.

Providers should complete the CTP Incident Report form and contact CTP RTW Coordinator/ COVID-19 Representative

CTP will provide reported information to the respective school.

Personal Protection Equipment (PPE)
All providers are required to perform the following and utilize the following when providing F2F services and follow school specific guidelines.

  • Temperature Checks
  • Face Coverings
    ➢ if using face mask, a new mask must be worn before each F2F session
    ➢ if using a face shield, wipe mask with disinfectant wipes before each F2F session
  • Hand sanitizer
  • Disinfectant wipes
  • When applicable, gloves

*Note: Some schools may require the use of both a face mask and face shield. Please check the school’s applicable Health and Safety Plan for the specifics.

Providers are required to follow personal hygiene and social distancing measures:

  • Wear face covering during face to face sessions as required by the CDC.
  • Carry along hand sanitizer for use in F2F environment and keep in a safe location to ensure client’s safety.
  • Discourage handshaking and encourage the use of other noncontact methods of greeting.

Travel

All providers must report personal travel outside of Pennsylvania that occurred within the past 14 days to the Return to Work (RTW) Coordinator / COVID-19 Representative. Contractors should also report planned future trips outside of Pennsylvania.

Provider to complete the incident report if they or anyone in the F2F environment traveled outside of Pennsylvania.

Anti-discrimination and harassment
It is an unfortunate part of our hyper politicized environment, that bad behavior is at times evident. CTP will not tolerate discriminatory or harassment behavior towards our clients or providers. Any such behavior should be immediately reported to the RTW Coordinator/ COVID-19 Representative.

Simultaneously, if CTP receives a report of such behavior on the part of our providers, that behavior will also be immediately communicated, and action will be taken.

Frequent Communication, Updates
This pandemic is an evolving environment. New findings and new guidance are reported frequently. As such, this policy will be updated frequently. To the extent that this policy is changed, a communication will go out referencing the changes to all affected persons.

Mental Health
As noted by CDC officials, mental health has been a concern from the beginning of the pandemic. That concern has grown now that lockdown continues to be extended. Many of us are exhibiting effects of the shutdown as we encounter such pressures as home schooling, shortened school sessions, working from home, not being able to exercise, limited human contact, and loss of friends and family members due to COVID-19, just to name a few.

If you are experiencing any issues that may affect your performance in providing services to clients, contact the CTP RTW Coordinators/COVID-19 Representatives for support and guidance.

Additional Information
In addition to the steps outlined above we recommend all employees review all CDC guidelines and local and state requirements/regulations/recommendations. Below are some links to the CDC website and Pennsylvania state government. Please also look at your county specific guidelines for details regarding your local government.