Resuming Visits In Congregate Living Settings
Ministry of Children Communityand Social ServicesResuming Visitsin CongregateLiving Settingsontario.ca/coronavirus
ResumingVisits inCongregateLivingSettingsIntroductionOn April 23, 2020 the government released its COVID-19Action Plan for Vulnerable People. The Action Plan includedlimiting non-essential visitors in congregate living settings, asan important step to reduce exposure and prevent the spreadof COVID-19.On May 28, 2020, the Ministry of Health Guidance:Congregate Living for Vulnerable Populations was releasedand provided further recommendations that congregate livingsettings develop policies that limit non-essential visitors.It was also recommended that an operational definition of“essential visitor” be defined in policy, which could include “aperson performing essential support services, such as healthcare services, a parent/guardian, a person visiting a very ill orpalliative resident, or a maintenance worker”.Further guidance was provided from MCCSS via memo to allfunded congregate living settings: An essential visitor is generally a person (including acontractor) who performs essential services to supportthe ongoing operation of a service agency or is a personconsidered necessary by a service agency to maintain thehealth, wellness and safety, or any applicable legal rights,of a resident. Who is considered an essential visitor and the way inwhich the visit is exercised (e.g. in-person, virtual) maychange depending on whether there is an active outbreak,the nature of the congregate living setting, the individualsserved, as well as advice provided by a local public healthunit. Agency employers should take careful consideration asto when and whether an in-person visitor is truly vital tomaintain the health, wellness and safety of a resident. Thisshould include whether the support or care provided bythe visitor can be reasonably, safely, and fully assumed byagency staff.2
Resuming Visitsin CongregateLiving Settings For residents under the age of 18, employers should take allmeasures to ensure ongoing visitation rights are maintainedin compliance with requirements under the Child, Youth andFamily Services Act, 2017. Consideration should be given tousing virtual visits. A log of all essential visitors who are given entry, with whomthey visit, and/or what areas of the residence they occupyshould be maintained. All visitors are to be actively screened for COVID-19symptoms, to maintain infection prevention and control(IPAC) standards and to wear masks for source protection.For congregate living settings in adult Developmental Services,Violence Against Women, Anti-Human Trafficking, andIntervenor Services sectors, Ontario Regulation 177/20 underthe Emergency Management and Civil Protection Act requiresthat recommendations of the COVID-19 Guidance: CongregateLiving for Vulnerable Populations be followed.Although the direction on non-essential visitors does not placea blanket prohibition on all visitors, it is intended to greatlylimit entry into the congregate living setting to help preventtransmission of COVID-19 and to protect residents and staffduring the outbreak. The role that families, visitors and lovedones play in providing caregiving and emotional supports isimportant in the quality of life for those living in congregateliving settings. To support visits while protecting residents andstaff, the ministry is proposing resumption of personal visits,provided they take place outdoors and are guided by thefollowing principles:9 Safety: Any approach to visiting in a congregate livingsetting must consider, balance, and meet the health andsafety needs of residents, staff, and visitors, and ensure risksare mitigated.3
9 Emotional Well-being: Allowing visitors is intended to supportthe emotional wellbeing of residents and their families/friends,through reducing any potential negative impacts related tosocial isolation. Homes must make every effort to ensure thatvisits are meaningful and equitable by scheduling visits of asufficient duration and maintaining the visiting schedule. Anycancellations should be due to extraordinary circumstances.9 Equitable Access: All individuals seeking to visit a residentbe given equitable visitation access, consistent with residentpreference and within reasonable restrictions that safeguardresidents.9 Flexibility: The physical/infrastructure characteristics of thecongregate living setting and/or nearby public space, andits current status with respect to staffing, and any other keyfactors must be considered.Visitors should consider their personal health and susceptibilityto the virus in determining whether visiting is appropriate. Whereit is not possible or advisable for in-person visits homes shouldcontinue to provide virtual visiting options.As the COVID-19 outbreak evolves across the province, thedirection regarding visits will be adjusted as necessary keepingthe safety, health and emotional wellbeing of residents and staffas the priority.Entrance by essential visitors necessary to the ongoing operationof the home (e.g. maintenance workers) can continue at thediscretion of the agency.4
CongregateLiving SettingRequirementsCongregate Living Setting RequirementsThe baseline requirements for the congregate living settingmust be met prior to the home being able to accept anypersonal visitors:1. The setting must NOT be currently in outbreak.2. The congregate living setting has established:a) Procedures for the resumption of visits and aprocess for communicating these procedures withresidents, families, visitors and staff, including butnot limited to infection prevention and control(IPAC), scheduling and any setting-specific policies.i. This process must include sharing aninformation package and educating visitorson IPAC, masking, physical distancing ofa minimum of 2 metres (6 feet), and otheroperational procedures such ensuring visitors’agreement to comply. The setting’s policymust include an approach to dealing withnon-adherence to policies and procedures,including the discontinuation of visits.b) Protocols in place to maintain the highest of IPACstandards prior to, during and after visits.3. A dedicated outdoor area has been identified wherevisitors can meet with loved ones, that allows for aminimum of 2 metres (6 feet) physical distance. The areamust be thoroughly disinfected after every visit.4. Staff must be available to transfer residents out of and intothe congregate living setting and remain within visualcontact of the visitor and resident for the full durationof the visit. Any concerns regarding the visit must bedocumented.5
5. List of visitors should be maintained and available forrelevant\appropriate staff members to access.6. A schedule must be created that allows for:VisitorRequirementsa.b.Maximum of 2 visitors at a time per resident.Time-limited visits, but not restricted to less than 30minutes.c.d.At minimum one visit per week per resident.Staffing and space capacity (or appropriate nearbypublic space) to maintain safety of residents, staffand visitors.e.Enhanced cleaning in between visit space use.7. Visitor RequirementsAll visitors must adhere to the following:1. Must pass active screening every time they are on thepremises and attest that they are not experiencing any ofthe typical and atypical symptoms of COVID-19. Theyshould not be allowed to visit if they do not pass thescreening.2. Attest to home staff that the visitor has tested negative forCOVID-19 within the previous 2 weeks and subsequentlynot tested positive. The home is not responsible forproviding the testing.3. Comply with the congregate setting’s IPAC protocols,including proper use of face masks.a.Visitors should use a face covering at all times. Thismay include a cloth mask while maintaininga minimum of 2 metres (6 feet) physical distance.Visitors are responsible for bringing their own facecovering.b.Visitors must maintain a minimum of 2 metres (6feet) physical distance from the resident for the fullduration of the visit.c.Visitors must adhere to protocols for hand hygieneand respiratory etiquette.6
4. Gifts are permitted, only if in accordance with existingpolicies and procedures of the setting, and only if they canbe easily cleaned and disinfected (e.g. hard surfaces, originalpackaging).5. At no time may the non-essential visitor enter to congregateliving setting.Any non-adherence to these rules will be the basis fordiscontinuation of visits.7
Resuming Visits . in Congregate . Living Settings For residents under the age of 18, employers should take all measures to ensure ongoing visitation rights are maintained in compliance with requirements under the Child, Youth and Fami
B3. study because you were once diagnosed with a cancer, leukemia, tumor, or similar illness. How many of the visits to the doctor indicated in question B2 (during the 2 year period) were related to this previous illness? None 7-10 visits 1-2 visits 11-20 visits 3-4 visits More than 20 visits 5-6 visits . Please! Do not mark below this line .
chronic disease patients Risk stratified patient population Two-step risk stratification process for all empanelled patients Alternative to traditional office visits, e.g., e-visits, phone visits, group visits, home visits, and/or alternate location visits. Empanelment Two-step risk stratification process for all empaneled patients
2,988 Dental Visits 1,286 Eye Care Visits 26,938 Medical Visits 1,591 Mental Health Visits 1,015 HIV Visits 1,838 OB Visits Downtown Clinic - 48% 108 Cowardin Ave., Richmond, VA 23224 Western Henrico Clinic - 41% 8600 Quioccasin Rd., Richmond, VA 23229 Chesterfi eld Clinic - 11% 2619 Sherbourne Rd., Richmond, VA 23237
COVID-19 is a new disease, and information about community spread, mitigation strategies, and treatment approaches are evolving. Congregate living facilities serve people who are highly vulnerable to the disease's most catastrophic outcomes, and staff members report to work with their own vulnerabilities.
COVID-19 and the Delivery of Primary Health Care Services in 2020: Health Center Patient Visits. Health centers provided . 114.2 million patient visits . in 2020, a . 7% decrease overall . from 2019. Not all services were impacted equally: Mental Health visits increased by . 15.1% ( 1.8 M visits) Medical visits decreased by . 3.8% (-3.1 M .
1/16 Guide for Resuming On-Campus Operations www.EduRiskSolutions.org Guide for Resuming On-Campus Operations In these unprecedented times, schools and colleges continue to struggle with how to provide educational services during the COVID-19 pandemic. When it comes to decisions about re
Checklist for Resuming Clinical Research The following checklist outlines actions to consider for resuming clinical research. This checklist is meant as guidance for assessing safety for clinical studies and sites. When working at non-UMB clinical sites
Grade 5-10-Alex Rider is giving it up. Being a teenage secret agent is just too dangerous. He wants his old life back. As he lies in the hospital bed recovering from a gunshot wound, he contemplates the end of his career with MI6, the British secret service. But then he saves the life of Paul Drevin, son of multibillionaire Nikolei Drevin, and once again he is pulled into service. This time .