STATE OF WASHINGTON



center31912900STATE OF WASHINGTONDEPARTMENT OF SOCIAL AND HEALTH SERVICESAging and Long-Term Support AdministrationHome and Community Services Divisioncenter1836420HCS MANAGEMENT BULLETIN00HCS MANAGEMENT BULLETINPO Box 45600, Olympia, WA 98504-5600H20-109 Policy & ProcedureDecember 28, 2020TO:Home and Community Services (HCS) Division Regional Administrators Developmental Disabilities Administration (DDA) Regional AdministratorsArea Agency on Aging (AAA) DirectorsFROM:341757015684500Bea Rector, Director, Home and Community Services DivisionShannon Manion, Director, Division of Field Services, Developmental Disabilities AdministrationSUBJECT:Health and Safety obligations for Individual Providers (IPs) including:Requirements to wear a face mask while in a client’s home; and N95 mask and Fit-Testing for Individual Providers (IPs) PURPOSE:To inform HCS/AAA/DDA staff about previous and upcoming information provided to Individual Providers regarding safe care practices during the COVID-19 outbreak, specifically related to wearing face masks and about N95 mask distribution, fit-testing, and one-time payments for IPs for fit testing when working with clients with aerosol generating procedures. BACKGROUND:Individual Providers (IPs) have an obligation to perform their duties in a manner that does not compromise the health and safety of any DSHS client. This includes a requirement to wear a face covering when out of their home and in their worksite, including when in the home of a DSHS client. They must also comply with COVID-19 work site-specific safety practices as outlined in the Governor’s “Safe Start” Proclamation 20-25.4, the guidelines set forth by the Washington State Department of Health and safety guidance provided by DSHS. (See attached).Workers caring for clients with the following Aerosol Generating Procedures (AGP) have additional requirements for wearing fit-tested N-95 masks. CPAP or BiPAP?Nebulizer?High flow oxygen therapy?Respiratory therapy?Suctioning?Tracheostomy care?Ventilator/Respirator N95 masks were distributed to IPs who are caring for clients with AGPs. Each shipment contained the following communications: (See attached)Fit-Testing LocationsCDC Fit-Testing FAQDon and Doff N95Fit-Testing WarningWHAT’S NEW, CHANGED, OR CLARIFIED:Individual Providers will receive additional written safety information and reminders regarding the requirement to wear face coverings/personal protective equipment when they are at their worksite.Individual Providers caring for clients identified with Aerosol Generating Procedures (AGP) have already received N-95 masks and instructions for fit testing. They will receive a one-time payment for fit-testing in January of 2021.ALTSA and DDA will be developing a FAQ document to respond to additional questions that have been received. In addition we will continue to post communications when guidance from Department of Health (DOH) and Center for Disease Control (CDC) are revised.Individual Provider postcard and DOH home care guidance (see attachments below) will be placed in the IPs contracting packets.ACTION:Effective Immediately: IP Contracting Staff: During contracting sessions, HCS/AAA/DDA contracting staff must remind IPs of the requirement to wear a face mask when they are in a client’s home. Contracting staff should remind IPs that if they are caring for a client with AGP there is a requirement to wear an N-95 mask and remind them of provider resources related to fit-testing and a one-time payment for fit testing. (See attached). Include the IP postcard and DOH home care guidance documents in IP contracting packets.Case ManagersIf case managers receive calls or questions from clients or IPs about face masks, including N-95 masks, provide information and reminders that IPs are required to wear a face mask when they are in a client’s home, and that fit tested N-95 masks must be worn by providers caring for clients with AGP. If there are issues with fit-testing, additional information will be provided in the FAQ that is being developed. If alternative brand N95s are needed, the IP may contact the Incident Management Team at one of the contacts listed below. Refer the client and IP to publications about these requirements as appropriate and inform them of a one-time January payment for fit testing.Identification of IPs who are providing services to clients with AGP will be done on a routine basis to identify new IPs that have not been issued a shipment of N95s or a one-time fit testing payment. This process will be managed at headquarters at this time.RELATED REFERENCES:Washington State Department of Social and Health Services Individual Providers (IPs) Guidance for Providing Safe Care During the COVID-19 Outbreak(S):\s\sCONTACT(S):Dawn Williams, Incident Management Team (IMT)Dawn.williams@dshs.Hannah Thompson, Incident Management Team (IMT)Hannah.thompson@dshs.Rachelle Ames, Care Management Unit Manager, HCS(360)725-2353rachelle.ames@dshs.Stacy Graff, Individual Provider and Administrative Hearing Program Manager, HCS(360) 725-2533stacy.graff@dshs. Jaime Bond, State Plan Services Unit Manager Phone: 360-407-1567 Jaime.bond@dshs. Melissa Randles, Individual Provider Program Manager Phone: 360-407-1515 Melissa.randles@dshs. ................
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