I. THE FACTS

The virus that causes COVID-19 spreads in droplets (little sprays of liquid that fly out of our mouths and noses like when we sneeze or cough), or by touching a surface someone else who is infected touched, then touching our faces. If several people touch a doorknob, table or countertop, then it is easy for the virus to spread to many people. COVID-19 is VERY contagious.

Because we have to stay away from people who have COVID-19 but can’t tell if someone has the virus and they may not know themselves, we have to keep 6 feet or 2 metres away from others. The risk of person-to-person infection goes down the further people are away from each other. The bigger the distance, the lower the risk. This is called social distancing and is the best way we can all stay safe.

Sometimes, we cannot stay 6 feet or 2 metres away from other people. That is why it’s important to spend less time close to other people. The longer people are close together, the higher the risk that they can get COVID-19. The more people we are close to and the longer we are close to them, the higher the risk. People who are at high risk need to stay away from as many people as possible and if they are close to others, it must be for the shortest time possible unless the people are wearing Personal Protective Equipment (PPE), like masks, gloves, face shields and gowns.

The risk of infection increases with the number of people who touch the same surfaces, including metal, wood, glass, paper, plastic, cardboard, clothing, towels, doorknobs, equipment, sinks, toilets, touch screens and cell phones. These surfaces must be avoided or cleaned regularly to make sure that the virus does not spread.

II. PREVENTION

There is no vaccine that could help keep us safe (immune) from COVID-19 and no cure if people get really sick. The virus can kill people at high risk. That is why we have to protect them the most. To make sure that all the people who are at risk in British Columbia stay safe, everyone must stay 6 feet or 2 metres away from everyone else, wash their hands often, use hand sanitizer and wear masks or PPE in situations of high risk. COVID-19 may be with us for years, so this will be the New Normal for some time to come.

Until the B.C. government says it’s OK to stop social distancing, washing our hands and using PPE if we’re with people at high risk, everyone in B.C. must follow these guidelines, personally and professionally:

  • No handshaking is the new normal – give air hugs, wave or use other acknowledgments.
  • Practice good hygiene – wash your hands often with soap and water, use hand sanitizers, avoid touching your face and disinfect areas and surfaces around yourself regularly. Take a mini-bottle of hand sanitizer with you in public and a cloth mask, just in case. • Maintain social distance – stay 6 feet or 2 metres away from others.
  • DO NOT go to work if you are feeling ill and have symptoms of COVID (fever, chills, sore throat, trouble breathing, coughing, sneezing). Self-isolate, call in and notify your immediate supervisor, who will tell you to get tested immediately and return only when a COVID test comes back negative and you are cleared for work.
  • Educate yourself about your COVID-19 risks and those of your family or other people you live with.
  • The federal government is prohibiting travel outside of Canada and all but ‘essential travel’ within Canada. If you must leave the country for some reason, you must self-isolate at home for 14 days upon your return and will be unable to work until your quarantine is over. The province is recommending travel in B.C. with social distancing for summer vacations.
  • Keeping socially active is important in our lives to maintain our mental health and stay strong when we need to cope with changes that we cannot control, isolation, worry and all the challenges we face in everyday life. Be sure to stay connected to family, friends, co-workers and others who are important to you by phone, with socially-distanced get-togethers, over social media, Zoom, or by e-mail. Some places of worship, sports and recreation centers are online and may be open – connect and socialize safely.

III. DEVELOPMENTAL DISABILITIES ASSOCIATION POLICIES Stop the spread!

At DDA we will monitor the provincial spread of COVID-19 and Vancouver-Coastal guidelines to adjust and update our policies as required. DDA’s approach to the COVID crisis from the start has been a RISK REDUCTION and RISK MANAGEMENT approach. DDA staff has already implemented most of these policies and procedures because our services were deemed essential and did not close. This approach involves the following steps: 1. Identify risks 2. Develop policies and procedures to inform actions 3. Take action to reduce risks 4. Provide training and support to staff, clients and families about the COVID-19 risk and strategies to reduce risk. 5. Develop conflict resolution and appeal mechanisms.

Because we kept our services operating throughout Phase I, we will not have to change the procedures already in place very much, but we must now formalize and document our COVID-19 Policies and Procedures as we move into Phase III.

This plan applies to all DDA staff, clients and work sites and has identified general risks experienced across the community and DDA. Each department has developed additional COVID-19 policies and procedures as applied to their programs. Each worksite has developed policies related to their environments and each individual who they support. All Managers and staff have also signed off on the overall plan. Each Departmental Plan is attached to this plan in an Appendix at each site. Each worksite plan forms an Appendix to the Departmental Plan, which forms an Appendix to this plan. Individual Client COVID Plans are kept as a confidential Appendices to Worksite plans.

Policy #1 General Guidelines

The above general provincial guidelines must be followed by all DDA staff, clients, visitors and the general public. These policies are not optional or negotiable. As we support people in the community, we must also consider how these guidelines impact each individual, their families, networks and staff, then make plans to ensure that risk is minimized for all.

Policy #2 Work Site Guidelines

All staff must follow the social distancing, frequent hand washing and cleaning/sanitizing guidelines required by Public Health at all work sites. Common areas must limit occupancy, workers must be spaced 6 feet or 2 metres apart, work surfaces must be cleaned several times per day (bathrooms, door handles, equipment, etc.) and staff must wash their hands regularly, following directions posted at their worksite. Signs related to COVID safety can be obtained on the B.C. Center for Disease Control website www.bccdc.ca/health-professionals/clinical-resources/covid-19care/signage-posters.

Policy #3 COVID Suspected

Any employee or client who is experiencing symptoms of COVID-19 (coughing, sneezing, fever, chills, muscle aches, shortness of breath, sore throat and painful swallowing, stuffy or runny nose, loss of sense of smell, headache, fatigue, loss of appetite) or who has been in close contact with someone who has tested positive must get tested and return to work only when they receive clearance of a negative test or physician’s note. Clients must stay home and remain isolated until they are cleared for return. Each site will have a ‘sick room’ or private area where people with suspected COVID can isolate until they can get transportation home.

Clients may live in high-risk situations that we cannot control. Staff must encourage all clients to report if they are feeling ill, are hot, or have been in close contact with someone who tested positive for COVID-19. If individuals display symptoms when they arrive or at any time, they must wait in the designated ‘sick’ room or area until they can be transported home or directly to the hospital if onset is severe. ‘Sick’ rooms used by staff and clients who are feeling ill must be thoroughly cleaned and disinfected after each use.

If a DDA client becomes ill with COVID-19 and this is confirmed by a positive test, all staff and other clients who have been in close contact with the individual must go for testing as soon as they are replaced at the worksite. Staff cannot return to work until they receive a negative test result. All staff who work at a COVID-positive site that stays open must wear full PPE. Clients will require frequent monitoring until they receive a negative test result. Individuals who test positive for COVID-19 are not to return to or enter any DDA work site other than their residence, if applicable until they receive a negative test and clearance to return.

DDA has protocols with most Vancouver-Richmond hospitals for client admissions. Each individual’s COVID-19 risk assessment and plan must be included in each client’s medical transfer kit and on the face sheet of their file. Tell the ambulance and hospital staff that you are calling from DDA.

All client COVID-19 illness must be reported immediately to the individual’s family, the DDA Department Director, Public Health, the Public Trustee, if applicable, and for programs operating in commercial buildings, notify building management.

Policy #4 PPE

All DDA employees must wear PPE as appropriate, based on their level of risk of exposure and their personal health risk of extreme illness (age over 60, chronic health conditions, compromised immune systems, etc). All DDA employees who work directly with people who have COVID-19 must wear full PPE at all times.

All staff who require training on COVID safety or PPE use will receive such training before working at DDA sites. Staff are responsible for communicating with and providing training as required to clients, families and related professionals regarding risk prevention and mitigation strategies for each individual. Staff must also ensure their First Aid, Non-Violent Crisis Intervention and other professional training are current. Staff is required to wear face shields, masks and gloves for any close contact like personal care and feeding or if individuals drool or spit. For less intimate tasks and community outings, cloth masks may be used.

Use: Tasks that do not involve contact with others do not require PPE. Activities where a social distance of 6 feet or 2 metres can be maintained do not require PPE. If staff cannot maintain a distance of 6 feet or 2 metres, they require a mask and must regularly wash their hands and avoid touching their faces.

Tasks in a client’s home where there are no confirmed cases of COVID-19 require staff to wear a mask, regularly wash their hands, use hand sanitizer and refer to each client’s COVID-19 risk assessment for any additional requirements. All PPE must be used in combination with other risk reductions strategies. Managers are responsible for ensuring sufficient PPE is available at each site and that staff are aware of their PPE requirements.

Tasks in a client’s home where someone is COVID-19 positive require staff to wear full PPE – a medical mask, gown, gloves, eye protection (face shield or goggles) and disposable slip on shoe protection if a second pair of shoes is not available. Gloves must be changed/discarded after each task and after contact with each individual. Before and after taking masks, eye protection and gloves off or putting on a new set, wash your hands thoroughly with soap and water. Goggles/face shields and masks must be changed if they become wet, soiled or damaged. To ensure personal and family safety, it is recommended that you remove your clothes and wash them when you get home, have a shower and wash your hair.

Since many of the people who we support display and respond to facial cues and gestures, a full face shield may be more appropriate, if possible. If not, consider other methods of communication if wearing a mask. Clients will also need instruction about wearing masks, which can be difficult for some but is necessary during community outings. Infants under age 2 should not wear masks.

Policy #5 Individual Risk Assessment and Plan

All clients supported by DDA must have an individualized COVID-19 Risk Assessment completed at each site. Use the DDA Risk Assessment form and assign a rating of “Go” – Green, meaning LOW RISK, young, healthy people; “Caution” – Amber, meaning people at MODERATE RISK due to age, health concerns, behavioral concerns or who live with others who are at high risk or “Stop” – Red, meaning HIGH RISK for individuals over 50, those with health conditions that make them particularly vulnerable – diabetes, heart, lung, kidney or immune system diseases, obesity, asthma, cancer or others identified by a physician. All staff must be aware of the risk rating for all the clients who they support and communicate this risk level and mitigation strategies to all other staff at the worksite.

Mitigation strategies are creative solutions that balance personal safety (risk) with quality of life (benefit). Those at higher risk will be more limited in their community activities and will require more intensive support to access the activities they enjoy.

How do we keep each person safe but still participating in life?

Each Manager and staff team is responsible for reviewing each individual client’s file and personal circumstances to assess each client’s risk – High, Moderate or Low. All risk reduction and mitigation strategies must be documented on the client’s file and grab and go medical information kit. The level of risk to each individual will be considered while planning all activities inside and outside of a DDA work site.

Policy #6 Worksite Risk Assessment and Plan

Managers and staff have developed an environmental/worksite Risk Management plan for each DDA workplace, including risk identification, risk removal and risk reduction strategies, including risks to social distancing, cleaning standards, visitor procedures and PPE requirements.

What are the risks and how are you going to reduce them?

How are we going to make sure people take the right actions to stop the spread of COVID-19?

Managers and staff will communicate environmental/worksite policies and procedures by using written, visual, verbal and pictorial prompts or nudges to all staff, clients and visitors. All staff will sign off on the DDA plan, Departmental Plan and their worksite plan. Sign off sheets shall be sent to the Department Director and the HR Manager for their personnel files. Copies of our plans may be shared with WCB, Public Health, Licensing, the DDA Joint Health and Safety Committee, the BCGEU or other related public authorities or funders like CLBC or MCFD.

  1. Place any signs and floor stickers at worksites so all staff and clients are constantly reminded of COVID-19 risk reduction and personal safety procedures. Post occupancy limits on each room, indicating how many people may occupy the room based on 6 feet or 2 metres social distancing or consider calculating based on the availability of 5 square metres (15 square feet) of unencumbered floor space per person.
  2. Temporarily suspend all large group activities.
  3. Identify those staff who may work at home, following “Working at Home” policies and WCB guidance. If staff are working from home alone, they must engage in a check-in procedure for their personal safety. Infant Development staff working from home must follow these procedures and any other policies required by their Department. Office and other bargaining unit staff must receive permission from their Director to work at home. Excluded staff may work from home and on-site as long as they practice social distancing, cleanliness and frequent hand washing.
  4. Directors may stagger or change work schedules as necessary and possible.
  5. Physical barriers may be erected to separate people as appropriate.
  6. All visitors, staff and clients will disinfect their hands with gel sanitizer and wash their hands with soap and water regularly afterward when they enter any DDA site. Cleaning or handwashing supplies, soap and paper towels, hand sanitizer and PPE will be available at each site. Ensure that spray bottles of cleaning solution, paper towels and disinfecting wipes are available throughout each site and upon entry to all sites, with a receptionist or other employee designated to monitor safety and ensure people follow proper COVID procedures.
  7. Involve clients and staff in cleaning surfaces – counters, phones, light switches, doorknobs or rails, any commonly touched areas – so they are regularly disinfected. The frequency will depend on traffic but every 2-3 hours is a useful guideline to use. Ensure clients regularly wash their hands and cough or sneeze into their elbows.
  8. If possible, use a cleaning service to do a thorough, deep clean about every month. This will ensure that those areas that may not be accessible to staff can be cleaned and disinfected. Each site will develop a cleaning protocol that is consistent with this policy.
  9. Child Care and Developmental Centers and adult day programs will perform a symptom check of all staff, children and adults upon arrival and use the hand sanitizer station when they arrive and wash their hands right away after entering.

Policy #7 Conflict Resolution

If staff believe they are working in an unsafe environment or in unsafe conditions due to COVID or otherwise, they must report these conditions to their Program Manager or, if unavailable, to the appropriate Assistant Director and/or the Human Resources Manager. Because COVID-19 concerns require a rapid response, the situation will be investigated, corrected immediately and the worker will be informed if it is safe to work or not. If the situation is not resolved to the employee’s satisfaction, an investigation must occur in the presence of the worker and a worker representative from the Joint Health and Safety Committee. If the matter is still unresolved, the worker or employee may contact WorkSafe. Since it will take time for the Joint Health and Safety Committee to investigate, the site Manager may send the employee to work at another site until the issue is resolved. Staff may also appeal to their Department Director, or contact their union representative and file a grievance if still unsatisfied.

If individuals or families believe they or a client are enduring unsafe conditions due to COVID-19 or otherwise, they must immediately bring their concerns to program staff and site management. If such conditions are not resolved, they may appeal to the appropriate Assistant Director or Director for immediate investigation, resolution and identification of options. If they are not satisfied, they may contact Licensing or Vancouver Coastal Health as appropriate.

Policy #8 Transportation

Vehicles that do not have plexiglass barriers between drivers and others must maintain social distancing. Each site manager will evaluate client transportation vehicles including public transportation, determine the individual risk for each client, family and ‘bubble’ in the case of residential services and plan for client mobility accordingly, based on risk level. Those at very high risk should only use DDA van transportation. The interior of each van will be thoroughly cleaned with disinfectant before and after each outing. DDA vans will have plexiglass barriers installed behind the drivers’ seats to offer greater protection against transmission in addition to social distancing, as appropriate and necessary, balancing the need for COVID prevention with the need for vehicle safety. Risk must also be balanced with trips that are necessary to maintain optimal client physical and mental health. For those who are not at high risk, one occupant may be seated per row in a van or in the back seat of a car. Adult clients should wear cloth masks (at minimum) when they leave their homes/site and in all vehicles.

Policy #9 Scheduling

DDA will minimize the number of employees working at multiple sites within DDA and with other employers as much as possible.

Long-term care and group home sites are high-risk areas for transmission of COVID-19. Some employers do not have sufficient PPE and the greater the number of workplaces staff enter and the longer they stay, the greater the risk of transmission from site to site. To further minimize risk, we will attempt to maintain staff teams at sites as they are and minimize the number of relief staff assigned. If COVID-19 is present in a group home or at a site that cannot close, all staff will be sent for testing and they must follow the directives they receive from Public Health (8-1-1). Specific site schedules and site requirements will be adjusted accordingly.

Now that the Province is moving to Phase III, of B.C.’s ‘reopening’ and taking us with them, and as summer weather is approaching, clients should increase their participation in the activities in their individual plans and/or others that are a safer replacement. Regular community businesses and services are ‘reopening’ with their own COVID-19 policies and procedures in place. Community inclusion is all about participation, so we should do as much as possible and be as creative as possible to ensure the people who we support, their families and our communities return to their former rhythms of life to the extent this is possible and as risk levels permit. Higher risk clients may require PPE or other accommodations but there is no reason why everyone cannot get out and about. Those at high risk should continue social distancing, with very careful advance planning while avoiding places with heavy pedestrian traffic or crowds.

Policy #10 Community Inclusion

Staff will maintain activities as recorded in each Individual Client Plan but make necessary adjustments related to individual COVID-19 risk. Outdoor activities and exercise is encouraged.

IV. CONCLUSION

These policies and procedures communicate DDA’s COVID-19 strategies. Department Directors are responsible for the implementation of these procedures and ensuring that these policies and attached Appendices are communicated to individual employees, clients, families and, as appropriate, to the general public. Communications will take place via e-mail, social media, Zoom and by other means in addition to writing directly to our various stakeholders. All staff are responsible for following and implementing these policies and procedures in addition to Department and Worksite policies and procedures. Other non-COVID-19 DDA, WCB, Licensing and other regulatory policies also remain in force.

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