HCAOA The Voice Summer 2020

10 HCAOA The Voice necessary, we’ve worked with the state to ensure that unem - ployment claims are met and paid out.” Additionally, home care agencies have found some relief in the Paycheck Protection Program, which was issued as part of the CARES Act in March. The PPP offers forgivable SBA loans to small businesses who can keep their staff on payroll and work - ing, and at press time, both houses of Congress had passed a bill that offered small businesses like home care agencies additional flexibility in deploying funds from that program. “Despite our operating revenues being down, [the PPP] has allowed our company to continue to pay our fixed business expenses plus maintain paying our internal staff their full salaries and benefits,” said Takemura. Well-prepared agencies like Bayada have even been able to pick up the slack where competitors have pulled back care. “In the most extreme case, an old client called us in because their agency wasn’t going to come,” said Needham. “Our Clinical Manager, Roslyn Foreman, went above and beyond, coordinating with our client services manager to find caregivers for that client, in the midst of the initial rush of the pandemic, in the course of a day.” The Road Ahead Both Takemura and Needham agree that caregivers and the industry at large need wider protections as the country recovers from the first wave of COVID-19. “We definitely need some form of hazard pay,” said Needham. “At the moment, depending on the state you operate in, caregivers are incented to head to deliver care in partnership with a facility given that those facilities can offer more money than an in-home client.” “The home care industry needs acknowledgement as an essen - tial part of the larger health care continuum,” said Takemura. “On a more specific level, we need better collaboration with hospital/rehabilitation discharge planners as it relates to the COVID-19 client. For example, we have had to request for retesting prior to discharge to ensure that the home care plan reflects the client’s current COVID-19 status.” While overall daily cases are down from the peak in March, home care agencies should still maintain their preventive protocols. “With spring arriving, there’s perhaps a sense of optimism that COVID-19 is behind us and a return to our ‘new normal’ is within reach,” said Takemura. “New Yorkers, who we serve at SelectCare, and Americans in general, must keep in mind that COVID-19 continues to be a threat; therefore, relax - ing on social distancing restrictions and face mask mandates with the warmer weather increases risk for infection.” Whatever happens over the summer, caregivers will be a linchpin of the nation’s efforts to keep care in the safest place: the home. “The response of our caregivers has been magnificent,” said Needham. “We’ve been able to take care of a lot of people during this time. Our front line workers have been able to step up and carry out their cases and shifts.” A Sample COVID-19 Playbook “The first and most critical step was to put information out there regard- ing our specific plan of action to get ahead of the crisis,” said Takemura. “Decisiveness and overcommunication was the key to mitigating fears and anxieties. We created a general outline of steps taken that helped us protect employees and clients focused primarily on infection control, education, and safety.” The specific needs of your agency will vary, but in general the following items will be vital to any public health crisis: ▪ Education on identifying symptoms suggestive of COVID-19 ▪ Education on self-monitoring and plan for whom to contact if the employee and/or client develop symptoms suggestive of COVID-19 • Education on immediate action to be taken if the employee develops symptoms suggestive of COVID-19 while on duty ▪ Enhanced screening practice: ALL employees are screened for suggestive symptoms of COVID-19 prior to start of shift ▪ Reinforcement and promote handwashing upon arrival to work and throughout shift ▪ Education on cleaning and disinfecting high-touch surface areas • Confirmation of disinfectants in the home ▪ Review of risks incurred if they continue to work while symptom- atic to general public ▪ Distribute N95 masks, surgical masks, and gloves at minimum to all employees • Strictly enforce mask mandate while on duty • Additional PPE provided to those with suspected or confirmed COVID-19 • Evaluation and confirmation of PPE competency donning/doffing ▪ Confirmation of thermometers in the home • Distribution of thermometers were provided if needed ▪ Consideration for home care for the suspected or confirmed COVID-19 client is contingent on the RN assessment as to whether the residential setting is suitable for home care, if appropriate caregivers are available to provide safe and effective in-home care, and available inventory of PPE • Employees who are actively working with suspected or confirmed COVID-19 clients cannot be assigned to other clients ▪ Implement alternate travel plans for caregivers as needed • Prior to the MTA implementing Essential Service Plan system wide, we saw a significant reduction of commuters including transit workers and police presence with an increase in homelessness; essential personnel, especially women, were increasingly vulnerable to targeted harassment and assault ▪ Suspension of routine in-home nursing supervisor visits • Implementing use of remote technology in place of in-person visits FEATURE ARTICLE >> continued from previous page