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Coronavirus Response Plan Archived Sections

        


Archived Elements of the Coronavirus Response Plan

What follows are archived sections of the Coronavirus Response Plan. Links here may no longer work or may point back to the plan.

Tap here to return to the current Coronavirus Response Plan.




Historical and Obsolete Information from Previous Versions of The Coronavirus Response Plan


The following sections of this plan are obsolete and no longer in effect. They are included here as a reference.

Update Notification Postings Prior to July, 2021.


February 8, 2021: Vaccinations of staff who chose to participate are now nearing completion in NE Minnesota and are beginning in the Twin Cities. But being vaccinated does not change any of the requirements of this policy. While you are personally safer being vaccinated yourself, you may still have a risk of contracting COVID-19, and you are not safe as a person who might potentially spread the virus (we do not have data or information that tells us that persons who are vaccinated cannot contract and spread the Coronavirus).

You must still wear all PPE and practice social distancing as required by this policy.

We hope that data will show in the long-term that vaccination is effective in preventing spreading of the virus, but at this point, our cautious policy remains in place.


January 29, 2021: Requirements for returning to work after physician-ordered quarrantine are clarified to request that you send us the instructions you received from your physician rather than ask your physician to send them.

Throughout this policy, the requirement of not returning to work until 72 hours symptom-free is changed to "24 hours symptom free without the use of fever-reducing medications" to match current CDC guidelines.

Other parts of this guide are re-organized without significant language changes.


January 27, 2021: Requirements for returning to work following Personal Travel added. Requirements for responsible return to work following risky off-duty activity defined.


January 13, 2021: Close Contact/Exposure is redefined as being within approximately 6 feet (2 meters) of a person with COVID-19 for a prolonged period of time (15 minutes or more in a 24-hour period) whether or not either party is masked.

PPE requirements for direct service are expanded to including use of specific (approved and issued by Accend) masks and eye protection.

Masks and eye protection  will be available in the offices at 101 West 2nd, 1522 East Superior in Duluth, and in Brooklyn Park by (date TBD).

Vistor and in-home services safety and PPE requirements are clarified here.

The policies and procedures in this guide are not optional, rather mandatory, intended to keep you, your family and the people you serve safe. Please review this guide in its entirety again today and follow all of the guidelines.

Nothing in this policy/plan implies that face-to-face services are valued more highly than telemedicine services. Rather, this policy specifically encourages telemedicine services wherever possible.

We ask you to review the current policy in it's entirety today. It starts here.


January 6, 2021: Paid Leaves for COVID-related illness or quarantine, and for family-related leave are clarified to be limited to the totals described in this policy once fully-used, even if subsequent leaves are needed.


January 5, 2021: Facility and General Safety Rules are clarified to include safety guidelines during face-to-face services, and the potential consequence of disciplinary action for failure to adhere to polices, procedures, state laws and government orders is re-emphasized. Please read these sections again in their entirely and ask questions by tapping on the feedback link below.


January 4, 2021:The relief bill signed into law last week extends, until March 31, 2021, the federal tax credits for paid leaves described in our plan.  Offering these benefits is now optional on the part of employers, but we plan to exercise this option. This means these benefits will continue to be available until March 31, 2021 to those who have not exhausted them. 


December 11, 2020:The state recommends that everyone get a COVID test sometime during the current “dial-back” period and before the holidays.

Those of you who’ve had the nasal swab before will probably say, "No way, not unless I absolutely need it!"

Thankfully, there are other options, including the saliva test that you can do at a testing site, or at home. And there are no barriers (financial or otherwise, and you do not need to be experiencing symptoms) to getting a test. Read and follow the instructions here:

No Barrier Testing Information
At Home Testing Information

We recommend this for all of you.


December 3, 2020: Quarantine instructions for illness or exposure have been updated to clarify that your doctor, not Accend advises you on quarantining post-exposure, and that CDC guidelines have shortened their recommended quarantine durations for non-symptomatic individuals.


November 20, 2020: Unpaid leavfes for COVID-related quarantine orders when the employee has previously exhausted federally-funded paid COIVD leave as long as they meet requirements of this policy and all other unpaid medical leave requirements.

Adherence to this policy is required and violations of this policy, state laws, or government orders may result in involuntary termination, depending on circumstances.

Some typos corrected.

For archived sections of this guide, we have added reasons the section was archived.


November 9, 2020: Reminder that workplace exposure is not in itself a qualifier to receive federal paid COVID Leave benefits. Rather, to qualify for paid leave you must have been ordered by a health care provider or government official to quarrantine as per the guidelines found here.

The definition of exposure has been updated to match CDC guidelines of being within 6 feet of an infected and unmasked individual,for a period of 15 minutes or more in a 24-hour period.


November 6, 2020: Reminder and the caution that all staff must adhere to the safety procedures in this guide.


August 4, 2020: Procedures for requesting paid leave under the CARES Act clarified, including what proofs are needed.


August 3, 2020: COVID testing priorities as defined by the Minnesota Department of Health include Accend staff.


July 23, 2020: Screening for COVID symptoms required prior to face-to-face visits.


July 16, 2020: Updates to protocols for illness and exposure of employees. Obsolete sections of this policy are moved to the bottom (historical section) for reference, with annotations.


July 16, 2020: Updates to protocols for illness and exposure of employees. Obsolete sections of this policy are moved to the bottom (historical section) for reference, with annotations.


June 9, 2020: Calling furloughed employees back to work.

Employees who have been furloughed for lack of work can expect calls between now and the end of June to return to work to meet the needs of returning clients and families. When contacting employees for return to work, supervisors will:


May 6, 2020: The temporary waiver of voluntary leave requirements is ended. Going forward, request leave and anticipate review and approvoal for leaves per the usual requirements of our our existing Paid Time Off and Leave policy. The original temporary policy remains visible (indicated by strike-throughs) in this document to demonstrate our commitment to full transparency and a history of changes.


April 30, 2020: Now that supplies for masks are available, using them is required for all staff when providing face-to-face services, and in the office when interacting with others or in common spaces.


April 24, 2020: Question related to partial extended childcare leave benifits answered in FAQs.


April 9, 2020: Changes to Worker's Compensation Law in Minnesota relating to contraction of COVID-19 from an infected individual are summarized below.


April 8, 2020: Options for using 401K savings are available for persons directly impacted financially by the Coronavirus. Cautions for using these benefits are explained in a callout in this section.

*The name of this section has changed since it was announced by email.


April 5, 2020: List of healthcare facilities in our service areas where COVID-19 has been confirmed has been added to the plan. Do not provide face-to-face services in these facilities. Use telemedicine only. Check this list often for updates.

Communication Officers and their contact information listed in FAQ ddSection below.

Link to the Paid Leave Rights Poster added.


April 2, 2020: The Extended Leave Benefits policy has been modified to conform to the temporary regulations released today by the Departement of Labor. The change provides for sick pay seperate from your PTO for up to two weeks of COVID-19-related absence. It also caps most leave benefits at two weeks.

Check back often on this as these regulations are temporary. We'll respond as quickly as we can if things change again.


April 1, 2020:

Social distancing guidelines for face-to-face services is published. Transportation of clients (ridesharing) prohibited until further notice.

Extended paid leave benefit clarification: You are eligible for the extended 10 additional weeks of paid leave only if you have been employed with Accend for at least 30 days.


March 30, 2020: We've created a community recources page for Duluth Community Resources and their status at this time for the people we serve. Check it out here.

We have not found similar clearinghouses or sources for information in the Twin Cities. Let us know if you find one using the feedback link below.


March 29, 2020:

The section of this Plan previously labeled "Temporary Flexibility in FTE Requirements" has been relabeled: "Changes in Salaried Positions, FTE Requirements."

Our plans to move Practitioners and Case Managers to salary-based pay are on hold. Non-supervisory Clinicians will move to hourly-based pay two weeks from today.

Coronavirus-related cancellations will not affect your FTE if your work hours are cut short by them.

Read about those changes here.


March 25, 2020:

Notification of the Governor's Stay At Home Order and some information on what that means.


March 24, 2020: In response to the voices of a very small number of members of our team who for some reason feel we are not complying with requirements for leave and who speak publicly about their opinions, we have added language to the Paid Leaves For Absences Directly-Related to The Coronavirus to assure you that we are in compliance with federal law on this policy.


March 22, 2020:

The effective date for new paid leave benefits is moved up to March 22, 2020 (previously was March 29.) Instructions added for requesting leaves under this policy.

A previous FAQ answer was edited. Where we indicated that we would publish checklists to unstaffed offices for sanitation, we will not. Without a purpose for this checklist other than a reminder this seems unnecessary. Please follow good personal hygiene and infection control procedures at all times in every location where you provide services.


March 20, 2020: New paid leave benefits for persons who are themselves, or whose families are directly affected by the coronavirus.

This section was updated on April 2, 2020.

May 18, 2021: Clarifications added for response to exposure by fully-vaccinated staff. Ride-sharing policy re-defined when the driver and all passengers are full-vaccinated. Some typos corrected in various sections.


May 10, 2021: Some sections were re-ordered and re-worded for clarity and consistency without substantial change in content. The current policy is reviewed for consistency with current guidelines from the Center for Disease Control and the Minnesota Department of Health.

Some previous update announcements were archived but remain available in the archive section at the bottom of this chapter.

Extended deadlines for 401K loans and early distibutions related to COVID-19 are updated.


May 4, 2021: Each employee is eligible for up to 10 days of paid leave related to illness related to to Coronavirus between April 1 and September 30, regardless of whether or not they used COVID leave prior to April 1, 2021.

Eligibility for this benefit is expanded to include situations in which you experience severe side effects from being vaccinated and are unable to work.


April 26, 2021: Changes in policy for fully-vaccinated staff only include:


April 21, 2021: A provision of The American Rescue Plan Act of 2021 announced today by the Biden administration extends additional tax credits to small business for paid time off to employees who miss work to get COVID-19 vaccinations and/or to recuperate from these vaccinations. We plan to implement this benefit.

While we already pay for missed time related to COVID-19 ilness, this new benefit extends to vaccinations and related complications. See the section on Paid Leaves For Absences Directly-Related to The Coronavirus below for more information.

This benefit is also available to persons in the training period (first 90 days of employment.)

To simplify documentation of this new benefit, and track it more easily, we have created a new type of time off: Special Paid Time Off. You will use this type of time off for both COVID-19 illness-related medical leave, leave associated with childcare related to COVID-19 illness, and leaves related to vaccinations and complications.

Unfortunately, the new vaccine-related benefit is available only from April 1-September 30, 2021, so it is not retroactive to anyone who missed time prior to April 1 releated to vaccination. If you did miss time for this reason since April 1 and used paid or unpaid leave for that, contact your Program Manager to change your documentation of the absence and receive payment.


April 5, 2021: The Consolidated Appropriations Act of 2021, signed into law in March, extends until September 30, 2021 the federal tax credits for paid leaves described in our plan.  Offering these benefits remains optional on the part of employers, but we plan to exercise this option. This means these benefits will continue to be available until September 30, 2021 to those who have not exhausted them. 


April 3, 2021: Fully-vaccinated staff have eased resrictions and requirements for domestic travel, including that the need to quarratine after domestic travel is lifted. Fully-vaccinated means that 14 days have passed since your final dose of any of the currenty-available vaccines.


March 9, 2021: Mask requirements are eased for staff members who are fully-vaccinated. Fully-vaccinated means two weeks after your final dose of any of the available approved vaccines. Staff members who are fully-vaccinated may meet one-on-one or in small groups in private offices or meeting rooms if all other persons in the room are also fully-vaccinated. This includes meeting with clients who you know conclusively are also fully-vaccinated.


State (DHS) Updates

This section of this guide will provide you with updates at the state regulatory (DHS) level. DHS is seeking waivers and guidance for more flexible delivery from the federal government for the many of the services we provide, and for protecting the people we serve. Agreement from the federal government is necessary where federal money pays for all or a portion of services. Where they can do so without federal approval, DHS is moving forward with changes.


Changes Affecting Clients and Their Health and Financial Programs


March 23, 2020:

The state has announced their intention to continue enrollment in health care (insurance programs) even if renewal (redetermination) is due. For now, the department is not sending renewal and closure notices to Minnesotans on CHIP, Medical Assistance, and MinnesotaCare while seeking federal approval for this change. 

The commissioner waived certain requirements for economic assistance and housing programs, affecting procedures for applications and interviews, verification, changes to existing applications and reporting. The affected programs include General Assistance, Housing Support, Minnesota Supplemental Aid, the Minnesota Family Investment Program and the Supplemental Nutrition Assistance Program. The changes also reduce barriers for families applying for cash assistance, relieve eligibility workers of after-the-fact verifications, and ensure that participants do not have to repay cash assistance overpayments caused by state, local agency or system errors.

The commissioner waived work requirements for able-bodied adults without children who receive Supplemental Nutrition Assistance Program benefits.


Changes Affecting Service Delivery


March 26, 2020:

Telemedicine may now be delivered by telephone. See the Telemedicine guide for details.


Governor's Order March 25, 2020: Directing Minnesotans to Stay at Home

Some Things You Can Still Do During the Stay-At-Home Order

Guidance for You and the People You Serve

You may still leave home to...

Shop for food, beverages, groceries, hardware, and other supplies to maintain your home.

Pick up take-out food.

Do your laundry.

Get medical care.

Care for others.

Get out of an unsafe situation.

Go to work in a critical sector job.

Move among emergency shelters, drop-in centers and encampments.

Get outdoors for exercise and relaxation while maintaining social distancing.

Travel within or between tribal lands.

On March 25, 2020 the Governor of Minnesota ordered the following:

Beginning on Friday, March 27, 2020 at 11:59 pm through Friday, April 10, 2020 at 5:00 pm, all persons currently living within the State of Minnesota are ordered to stay at home or in their place of residence except to engage in the Activities and Critical Sector work.

On April 8, 2020, Governor Walz extended the stay-at-home order until May 4, 2020.

On April 30, 2020, Governor Walz extended the stay-at-home order until May 17, 2020 at 11:59 PM with some changes.

However, the Governor's Orders also explicitly exclude essential services (Critical Sector work). This includes Community Mental Health. We are asked and will continue to provide services to all the people we serve and who need them

What clients most need from you now is help connecting with resources and supports considering this order. Please continue to provide this essential support.

Thank you all for everything you are doing to support our clients in these difficult times!

Why We Are Staying Open

We are staying open at this time because we have been asked by our Governor to continue to provide these essential and medically-necessary mental health services. (We are a critical sector industry.)

And more importantly, because it is during times like this when many of the people we serve need us more than ever to manage their anxiety, connect them with resources, and stay healthy. This is what we do. We consider our services essential. Thanks to all of you who have demonstrated that you share this value with your words and actions during these trying times.

What We're Doing

Monitoring all developments, making plans, and getting word to you as soon as we can.

Sourcing supplies of sanitation and cleaning supplies.

Enforcing more frequent and stringent cleaning and sanitization protocols.

Obtaining and implementing virtual meeting and training platforms.

We will not allow initiation of new client group services until the outbreak has been contained.

With every plan and decision we make, we are taking into account all staff and your needs, and formulating the most employee-centered plans we can. We hope you see that in the policy modifications and other elements we have published here.

Governor Walz's Executive Order Directing Minnesotans to Stay at Home excludes essential service providers. Among others, community mental health services are defined as essential. We will continue to provide these services, with additional flexibility.

Why was this section archived? We have no intention of updating this guide to include all governor's orders. Please keep abreast of these at: Minnesota Governor's Office Website or the offices of governments in your state.


Temporary Voluntary Leave Requests

This temporary policy waiver ended as of May 6, 2020 as it serves no purpose when work is available and options for providing services via telemedicine and by telephone are so fully supported by our Governor and DHS. From this point on, leave requests should follow the guidelines in our Paid Time Off and Leave policy.

For the duration of the coronavirus outbreak, Accend is waiving some of our requirements for requests for leave, as follows.

Any individual who feels unsafe continuing to work at this time and until further notice may take a voluntary leave up to 2 weeks at a time, with a review at the end of a leave if there is a request to continue it. Employees taking leave for this reason who are eligible to use PTO must use all available (accrued) PTO at the start of the leave. The remainder of the leave will be unpaid.

These are voluntary leaves. During that portion of the leave that is not covered by PTO, the employee must pay the full cost (employee cost and employer match) of any benefits programs in which the employee is currently participating, including health and other insurance benefits.

Employees who are currently receiving matched technology purchases through payroll deductions must pay their portion and the match portion of the equipment in advance of the unpaid portion of leave.

These voluntary leaves are not lay-offs. No one is being asked to take leave, rather we are encouraging you to continue to work and meet the needs of your clients.

These leaves are not medical leaves. If you take a voluntary leave for this reason and are not yourself sick, you will not qualify for our Short-Term Disability insurance.

To request a leave under this temporary policy, contact Human Resources with a written leave request.

Voluntary leaves exclude the leaves that are required of you because you are directly affected by coronavirus as defined the next section below.

Filling Gaps Left By Voluntary Leaves

We will continue to serve clients in spite of absences. Any employee who volunteers to work additional hours will be paid for increased hours and eligible for overtime if necessary. Salary employees who temporarily increase their work hours to fill gaps left by employees taking voluntary leave will be paid hourly to account for increased work hours.

Why was this section archived? We no longer accept voluntary leaves. Your decison to take leave or quarantine is between you and your doctor.


Accelerated Training Opportunities

As of July, we have sufficient work for everyone. Making up lost work with training will no longer be necessary.

Potential pay increases for competencies demonstrated will remain in place.

Lynsee Mattson is currently compiling a list of online, self-study, interactive video, and classroom training opportunities for all staff. If you have cancellations and choose to complete self-directed training during that time, you will be authorized for up to the following total hours of accelerated paid training in quarter 2 of 2020:

FTE - Potential Paid Accelerated Training Hours

1 - 24

0.9 - 21.5

0.8 - 19

0.7 - 16.5

0.6 - 14.5

Training does not increase productivity, but will provide you with paid time and potential opportunities for increases in pay based on competencies demonstrated.

An announcement will come from Lynsee by early next week listing these opportunities. When it comes, the list of options will appear here. Each course will list the total paid training hours associated with it.

Why was this section archived? We have had little participation in competency-based training. It is up to you to use this method to get a pay increase.

Changes in Salaried Positions, FTE Requirements

As of July, we have sufficient work for everyone to return to their previous FTE within the next few weeks. We may return to the plan to salary certain positions in 2021.

Previous plans to move some direct service positions to salary are on hold at this time. Clinical staff who currently salaried and are not supervisory will move to hourly pay staring with the pay period that begins on April 12, 2020.

All direct service staff who have lost clients or who begin to experience cancellations related to the coronavirus should manage their time and schedules accordingly and clock out if they do not have work to do. If you have or anticipate many coronavirus-related cancellations, you have these options:

Ask for additional referrals.

Use PTO to fill short-term gaps.

Complete accelerated paid training (see above).

Fill gaps left behind by coworkers who take voluntary leaves.

Work fewer hours to maintain a higher productivity rate.

Hourly staff members whose IN & OUT Time + Coronavirus-Related Cancellations equal their FTE will not face a reduction in their FTE.

We are asking all of you for cooperation and discipline related to your work schedule, and are putting systems in place to monitor this. These include the following:

Additional Authorization Requirements

When and How to Document Coronavirus-Related Cancellations

Coronavirus-Related Cancellation as a specific note type was discontinued at the end of June

It is essential that you document accurately when your cancellations are coronavirus-related and use the add-on Coronavirus-Related Cancellation to indicate this. Client cancellations are coronavirus-related when:

Requirements for The Narrative in Coronavirus-Related Cancellations

If you use the add-on Coronavirus-Related Cancellation, you must answer the following questions in your Cancellation note narrative:

Why was this section archived? Documentation on reasons for cancellations was and remains poor and inconsistent. There is no way to use this data for any meaningful analysis.


Productivity-Based Pay

Over half of employees were productive enough in Q2 of 2020 to earn bonuses. For the rest, it was difficult to determine if their productivity was affected by the pandemic. We have carried everyone over into Q3 with their previous productivity ratings and will make adjustments as needed according to our policy going forward, during monthly administrative supervision.

An analysis of productivity in the current quarter-to-date indicates that 90% of non-case management* providers studied either:

This tells us we should move forward with the plan to base pay on productivity and competencies earned, to reward and recognize the hard work of the overwhelming majority of staff.

*We did not study Case Management/BHH because these services can be provided by phone and so productivity should not be impacted.

This could change.

The virus outbreak has not affected us in the quarter-to-date, but we do not know how it might affect the final two weeks of Quarter 1, or next quarter.  We will do the following:

Considering the potential for impacts of the coronavirus outbreak on productivity next quarter:

Why was this section archived? For reasons explained in recent memos that discards this method entirely for reasons explained in that memo.


What is a Contact Pod?

You need and deserve healthy and safe social contact.

A "contact pod" is a small group of people with whom you choose to associate with closely during this pandemic. They are trusted family members and friends who share and acknowledge up-to-date medical information to keep one another safe and who, in the context of this trust-based relationshp, choose to associate with a reasonable expectation of safety because of this candor and trust.

This article from Berkley's Greater Good Science Center gives tips on forming and maintaining social contact pods.

Off-Duty Activity

While off-duty, without distance travel, even if not taking paid time off or leave, if you participate in the risky activities described in Domestic Travel above with people who are not in your current social or family circle (or chosen "contact pod") you are also required to follow the restrictions for returning to work described.

This policy does not apply to small family gatherings or gatherings of people in your inner circle (or chosen "contact pod") whom you see regularly.

What This Addition to Policy Means

While we have no control over how you spend your time off-duty, we have a shared responsibility with you to protect your clients and coworkers from your behavioral choices while off-duty. This is mostly an honor system, but we may ask you about off-duty activities if necessary and we will enforce these policies.

For staff who choose to travel on vacation, your choice may require that you request and use up to an additional week or more of PTO followig your trip or event. These requirements do not constitute an order by a medical professional or government agency that qualifies you for paid COVID-19 leave.

Our goal is to protect you, your co-workers and the people you serve.

Why was this section archived? Some of the information was redundant or obsolete based on evolving updates from the CDC given in the policies for traval. Some is also a bit preachy. We trust you all will make responsible choices off-duty.


Testing (if Necessary) When Workers Have Been Exposed To COVID-19

Advocating for Testing for Yourself

The Department of Health as identified employees of Mental Health Clinics as a #2 priority for testing. If you are not fully-vaccinated have had an exposure as defined above, please communicate to your physician that you are a #2 priority for asymptomatic testing as per Minnesota Department of Health guidelines.

It is necessary to read two memos to understand how you have this prioritization. These include the following:

Why was this section archived? Testing now is widely available (and was not when this section was writte. Anyone may now receive a test easily from any of a nmber of testing facilities or by mail.


FAQs

We will also post answers to frequently asked questions below. Frequently-asked means questions that are asked, or that we think might be asked frequently and post our answers here. We will respond individually and personally to other individual questions.


Q: If I must take partial extended leave to care for my children because childcare is unavailable related to COVID-19, am I eligible for leave pay for reduced hours?

A: Yes. You are eligible for 2/3ds of the pay for that portion of the reduced work hours. For example, a person who was a 1.0 (40 hours) must drop to a 0.6 (24 hours) for childcare reasons is eligible for 10.67 hours of leave pay (2/3rds of the reduced 16 hours).


Q: Can I use PTO to supplement parital leave pay and get up to full pay?

A: No. Any PTO taken counts as paid time. To expand on the example above:

You have been full-time (40 hours) but cut down to 0.6 (24 hours) for child care but use PTO for 6 hours per week. This totals 30 hours. Your are now eligible for 6.67 hours of extended paid leave (2/3rds of the unpaid difference.) Keep in mind that you must use PTO during the first two weeks (10 work days) of this leave. Extended leave benefits begin after that.


Q: Can I still do a Covid-19 cancelation note for a client who has a 2 hour scheduled time regularly each week with me? His Board and lodge are only accepting telemedicine. I had a 15 min phone session, and then he wanted to get off the phone.

Do I capture this as a 1 hour and 45 minute cancelation and write a telecommunication note for the 15 min we did communicate for, and then add that client wanted to end call?

A: Yes, that is correct. If your telemedicine visit is cut shorter than the planned visit for reasons such as this, document a cancellation for the balance of the time and use the add-on, explain the details in the narrative.


Q: How are our clients supposed to access food and basic care supplies if we are unable to transport them? It’s not as simple as just riding the bus. I have clients that aren’t able to physically carry their own grocery bags, what are they supposed to do?

A: Thanks for your question. These are difficult times for many. It may be even more difficult to find resources for your clients to use to meet basic needs, and an unfortunate time to be forced to reflect back on what are services are and are not or should have been previously. Your challenge is to identify resources, connect your clients with them, and teach them how to use them.

Case Management is not a transportation or grocery-shopping service. It is a service of:

The question for Case Managers/BHH providers here is:

What have you done as a Case Manager to connect these individuals with the services and supports they need to do their grocery shopping when the barriers are ambulation or physical ability, and then monitoring and coordinating their services (including skills training) to see that their needs are met?

******

ARMHS is not a transportation or grocery-shopping service either. It is a service of (in this case) of:

The question for ARMHS providers here is:

What have you done as an ARMHS to connect these individuals with the services and supports they need to do their grocery shopping when the barriers are ambulation or physical ability, and then teaching them how to use these services, advocate for their needs, and get their needs met?


Q: I am just wondering how I will have clients sign their ICSP’s or Health Action Plans. I know that there is an option for telemedicine to get verbal communication and then have it signed later. Is that something that could be done for ICSP’s, Health Action Plans, and potentially ROI’s?

A: Excellent Question! Not just considering these times.

ICSPs, Health Actions Plans and other Treatment Plan Signatures: Yes, it is fine to go ahead with verbal consent and obtain the signature when possible. Previously, that would have been the first face-to-face contact you have (or anyone has) with them. That is still the case, but we understand it may be delayed. Get the actual signature no later than your first face-to-face (or, with service coordination the first face-to-face visit by other providers).

ROIs: No verbal permission is allowed at this time to release or request health data. We must have an actual signature on a release.

Thanks for your question.


Q: Can we be authorized more than once a week to clean the <unstaffed> office during this time. It is a small space and should only take a small amount of time. How should we document this?

A: We endorse the following with every visit:

No additional documented time (progress note) should be necessary to implement these simple guidelines. These are simple health procedures to follow at any time a few minutes upon arrival and departure from an office location.

Update: Previously we indicated our intentions to provide a checklist for these steps to unstaffed offices. Without such a checklist having any purpose other than a reminder, we will not provide or require you to complete a checklist. We expect that you will follow these procedures with integrity.


Q: I am having a lot of contact with clients via phone, and am wondering if it would make sense to capture that as "telemedicine, phone only" in the event that the phone services is approved?

As of now, I am capturing this time under contact and scheduling. Would there be an opportunity to go back and change the service type (and make it a billable service) if we do get approval for phone service?

A: You're thinking ahead, thanks. We expected word by now on telephone-only delivery of services, but nothing so far. We'd recommend you limit the amount of time spent on the phone only and explore options for approved telehealth for now. We'll let you know as soon as we know anything more.

Update: March 25, 2020: We expect that telemedicine by telephone will be soon be allowed where Telemedicine is allowed.

Update March 28, 2020: Services provided after this (3/28/20) date by telephone are approved as telemedicine. See the telemedicine Guide for more details.

Why was this section archived? The questions in it were aging and have not been updated since early in the plan's development, but remain here for reference.


Paid Leaves For Absences Directly-Related to The Coronavirus


Paid leave remains available until September 30, 2021 and each employee is eligible for up to 10 days of paid leave related to illness related to to Coronavirus between April 1 and September 30, regardless of whether or not they used any or all of 10 days of COVID leave prior to April 1, 2021.


Please look over the following scenarios for types of leave and eligibility for COVID Leave Pay. All COVID Leave pay requires that you are ordered to quarantine by a physician or government official.

Do not ask us for advice on whether or not you should be tested or take leave, or when you should return to work. This advice must come from your health care provider. We do not order quarantines or advise when they can end. To be eligible for leave, you must provide written documentation of your physician's order.

If you request COVID Leave Pay because of an order such as this, you must tell us specifically who gave you the order, when, and the start/end dates or criteria for the leave.

Use the note type Special Paid Time Off for all requests for leave defined as eligible under this policy.

Situation Your Action Leave Type
You have COVID-like symptoms. Contact your doctor for specific instructions. Ask if you should be tested, if you should quarantine, and for how long. If your doctor advises you to quarantine ask for how long. The answer should be one of the following:

Quarantine until the a specific date, or
Quarantine until you have an negative test and are symptom-free for at least 24 hours without the use of fever-reducing medication		 Eligible for COVID Leave pay for up to 10 working days if you cannot work from home.
You have a positive test Contact your doctor for specific advice on quarantining The order should be for a specific time period and until symptom-free for at least 24 hours without the use of fever-reducing medication. Eligible for COVID Leave pay for up to 10 working days if you cannot work from home.
You suspect that you may have been exposed. If fully-vaccinated at the time of the exposure, self-monitor for symptoms. Fully-vaccinated individuals need not quarrantine following potential exposure.

If not fully-vaccinated, contact your doctor for specific advice on testing and quarantining. Follow this advice. It should be one of the following:

Quarantine until the a specific date, or
Quarantine until you have an negative test and have remained symptom-free for 72 hours.		 Eligible for COVID Leave pay for up to 10 work days if you are ordered to quarantine and cannot work from home.
You are experiencing side effects of vaccincation for COVID and unable to work. You must provide us with proof of your vaccination date. Eligible for COVID Leave pay.
You have had a confirmed occupational exposure as defined by this policy. If fully-vaccinated you need not qurrantine and only to self-monitor for symptoms.

You must quarantine for 14 days or until cleared to return to work by your doctor. If the exposure occurred from failure to follow safety guidelines in this policy, this will be noted in your employment record.

Employees who have occupational exposures due to violation of COVID Safety Policies in this section may face diciplinary action.		 If you cannot work from home, and are ordered to quarantine by your physician, you must use Special Paid Time Off.
You are ordered to quarantine because of symptoms or exposure and have exhausted your federally-funded COVID leave benefits. Qurantine as ordered You can take unpaid leave following our unpaid medical leave policies.
You have symptoms of any kind, and have not chosen or been advised to test. Never come to work sick. Return to work when symptom-free for at least 24 hours without the use of fever-reducing medication. Use PTO or unpaid leave if you do not have sufficient PTO (this may affect FTE).
You need time off to get a vaccine, or need time off to recuperate due to the affects of the vaccine. Report to your Program Manager the reason for your need for time off. This time off does not count toward the 10-day limite for COVID Leave related to illness or exposure. Provide proof of your vaccination date and request Special Paid Time Off.

Covid Leave Benefits

The following leave benefits are available to you if you must take leave for the reasons listed. These paid leave benefits are separate from accrued PTO. You will not accrue PTO when taking these benefits.

Cumulative leave benefits under these conditions are limited to the totals described below regardless of the number of occurrences when you request leave under this section. (For example, if you use 10 total FTE-equivalent days of leave during a previous occurrence, you have exhausted this benefit, even if you must take leave again.)

If you qualify for either of the above following of leave, we will continue to pay our match on any health insurance and other benefits programs in which you are currently participating.

Sick Leave for Youself

You are eligible for full sick leave pay for up to 80 hours (full-time) or the equivalent 10 missed work days (part time) if you:

Sick Leave to Care for Others

You are eligible for 2/3rds sick leave pay for up to 80 hours (full-time) or the equivalent 10 missed work days (part time) if you

You may substitute accrued PTO for any or all of a leave for this reason, but are not required to use PTO during this leave.

Extended Family Leave to Care for Children

If you must stay home to care for a child whose school or place of care is closed (or child care provider is unavailable) due to COVID-19 related reasons, other is not available, and you are unable to work from home while parenting.

Leave Related to COVID Vaccination

All employees (including those in the Training Period) are eligible for Special Paid Time off for leaves related to vaccination for COVID and/or recuperatino from complications of the vaccine between the dates of April 1, 2021 and September 30, 2021. Using Special Paid TIme Off for this reason does not count against accrued PTO for any employee.

Procedures for Requesting Leave Under This Section

Use the form Special Request for COVID19 Related Leave for all leaves other than those related to vaccinations.

Submit this form directly to Human Resources (not to your direct supervisor.)

If the reason for leave is that you have symptoms and are being tested, your privacy is assured as described in the leave request.

If You Are Symptomatic

If you are symptomatic, get tested. Follow you physician's orders. If you cannot work from home because of symptoms, you are eligible for paid COVID leave and need only tell us the date you were tested. If your test is negative, you may return to work when you are symptom-free for at least 24 hours without the use of fever-reducing medication.

If You Are Not Symptomatic But Fear You Have Been Exposed

If fully-vaccinated, you need not quarrantine. Self monitor for symptoms.

If not fully-vaccinated, or if you experience symptoms, seek your physician's advice on whether or not you should be tested or self-quarantine. If the advice is to quarantine, you must provide us with the medical professional's or health care official's orders to quarantine to be eligible for paid leave in this case.

Documentation Instructions

For all approved COVID leaves and for time Off related to vaccinations or complications of vaccinations, document your leave using Speical Paid Time Off. Using Special Paid TIme Off for any of the eligible leaves above does not count against accrued PTO for any employee.

Rights Poster

View the poster describing your paid leave rights here.

Unpaid Leave for COVID-Related Quarantine Orders If you Exhaust COVID Leave

Some employees have experienced symptoms or quarantine orders after already having used their full COVID leave pay for a previous incident.In these cases, employees may use prior-authorized unpaid leave for subsequent quarantine orders because of symptoms or exposure.

To be eligible for this, you must still meet all of the requirements for COVID leave above and all other requirements for unpaid medical leave apply, including documentation from your health care provider. Find them here in the Paid Time off and Leaves Policy.

These include, but are not limited to that employees will use PTO for the first three days of leave at least 1/3rd of their accrued PTO at the start of the leave.

Unemployment Benefits for COVID-Related Unpaid Leave

If you request unpaid leave for symptoms or because you have been ordered to quarrantine, and have exhausted your leave benefits, you must follow unpaid leave request procedures found in our Paid Time off and Leaves Policy, including use of accrued PTO described in that policy.

The Minnesota Office of Employment and Economic Development indicates that if you must take unpaid leave for COVID-related reasons, you may be eligible for unemployment benefits for the unpaid portion of that leave. Visit the site to learn how to apply.

 

Why was this section archived? The benefit has expired.


Protocols When Workers Have Been Exposed to COVID-19

Fully Vaccinated Staff

Fully-vaccinated staff who are not symptomatic do not need to quarrantine following exposure unless they have underlying immunocompromising conditions described by The Minnesota Department of health. Also described there are circumstances when some staff may be asked to quarrantine because of exposure to specific strains. You will be informed by the Minnesota Department of Health if that is the case.

If Not Fully-Vaccintated

If you are not fully vaccinated and learn that you have had exposure as defined above with a person who is positive for COVID-19, do the following:


Why was this section archived?This section was archived on October 8, 2021 when Minnesota Department of Health recommendations channged and do not as of this date differentiate between vaccinated and unvaccinated staff for quarrantine guidance.


401K Loan or Early Disbursement Options for Persons Directly Affected By the Coronavirus

*The name of this section has changed for clarification since it was announced by email. This section will be archived on June 25, 2021 when the COVID19-related provisions expire. Hardship loans and distributions remain available for other reasons on 401K as described by the Internal Revenue Service, here.

Due to the COVID-19 outbreak, the Coronavirus Aid, Relief, and Economic Security (CARES) Act was signed into law on March 27, 2020. Provisions of the Act allow Participants to access funds from their retirement plans as loans or as distributions.

Accend has authorized you to exercise these options on our 401K Plan if you meet the requirements.

Think First. Get Financial Advice.

You' probably won't need to use this option.

Before you do, consider all of the other benefits available to you described in this policy and elsewhere. Don't use up your hard-earned retirement if you have other options

Talk to a financial planner. If you are experiencing hardship, our Employee Assistance Program might be an option for financial planning.

To be eligible for a Coronavirus-Related Distribution (CRD) or to take advantage of special loan provisions you must be someone:

Participants can self-certify that they meet one of the above specified conditions for CRDs.

You are not eligible for this option unless you meet one of the above conditions.

Available options:
  1. You may take a distribution through June 25, 2021 from all vested sources up to $100,000. (The deadline was previously December 31, 2020, but was extended by the Consolidated Appropriations Act in December..)
  2. You may take a loan of up to 100% of your current vested balance up to $100,000. (This option is available until June 25, 2021. (Previously 9/23/20.)

*Distributions prior to retirement age on a 401K Plan are typically subject to 1) 10% excise taxes (also called early distribution penalty tax) and 2) 20% income tax withholdings.

The 10% penalty is waived for these distributions.

The mandatory 20% withholding is temporarily waived and you may choose to pay income taxes due on the distribution over the next three years. You do not have to pay the taxes if you replace the funds into a qualifying retirement account (including your Accend 401K or another qualifying account you may own).

If you have a current loan on your 401K account:

If you currently have a loan on your 401K that has a payment due between 3/27/20 and 12/31/20 you may delay payment on that loan for up to one year. Loan repayments that are delayed will need to be re-amortized for accrued interest over the remaining term which may be extended beyond 5 years due to the suspension of repayments.

Why was this section archived?This opton expired on December 31, 2020.


What's the Difference Between Paid Leave for Coronavirus and Worker's Compensation if I Have COVID-19?

The primary differences are these:

Why was this section archived? October 1, 2021: Paid Leave for COVID illness or exposure is no longer available except as PTO.


ADA and HIPAA Concerns Related to Accend's Response as an Employer

Accend will comply with the Departments of Health and Human Services instructions in responding to an reporting infections among our staff. We will ask permission of infected employees to inform others of their status, but without that permission will still adhere to instructions from the state regarding actions needed to prevent an imminent risk of harm to the health, safety, or rights of others we serve or employ.

Why was this section archived? It states the obvious.


What We Ask of You

Do not come to work if you are sick. Remain aware of the symptoms of COVID-19 that are explained here at the CDC Website and do not come to work if you have these symptoms.

While at work, practice all of the personal health and safety guidelines, self-enforce social distancing and avoid gathering indoors in large groups in close proximity to one another, wash your hands frequently and sterilize your work environment.

To protect the residents of healthcare facilities, please do not visit clients in nursing homes or other healthcare facilities without permission from your supervisor and the facility.

Work from home if you can. Inquire about telemedicine delivery of services with your clients and supervisor.

If you have a compromised immune system, seek guidance from your Supervisor/Human Resources about what steps you should take to remain safe.

Our worst enemy for now is fear and the anxiety it brings. Let's work together to keep that enemy at bay. Stay healthy: physically, intellectually, spiritually, and emotionally. Practice good hygiene. Eat a healthy diet, drink lots of healthy fluids, get enough rest, and use the personal behavioral health skills you teach your clients daily.

For reliable, up to date information related to the Coronavirus, and how to keep safe at work and at home, please visit the CDC Website.

Stay calm and use your skills. While we don't know how long this outbreak will last, we will all get through this. Accept the things you cannot change... and also the things you cannot know. This virus will run its course. What that course looks like is unknown.

Why was this section archived? It states the obvious.


Handwashing Procedures

Clean hands frequently throughout the day, especially after contact with others, or with potentially infected services by washing with soap and water for at least 20 seconds, or by using a disinfectant hand sanitizer that contains at least 70% alchohol.

See the guidelines and instructions here for handwashing: CDC Handwashing Instructions.

Generally

Assume that you and everyone you see are potentially infectious..

Wherever possible, screen verbally before seeing individuals in their homes. Do not visit individuals who have symptoms such as a fever, coughing and shortness of breath. Offer telemedicine to these individuals .

When seeing clients in their homes osr any other location indoors or out, maintain a 6-foot distance. In addition use the following precautions:

Why were these sections archived? We think everyone knows this now.


Communicating Exposures and Orders to Quarantine, Requests for Leave Related to Coronavirus

All communication about potential exposure (at work or outside of work) and leaves related to symptoms or exposure must be made to the employee’s Program Manager. Upon receipt, Program Managers will notify Human Resources of any requests for leave or workplace exposure requests. Human Resources will document receipt of physician's orders and other follow-up information, approve or deny requests for leave, or request additional information as needed.

Employees should do as follows:

Why was this section archived? It duplicates the key points in Illness and Exposure of Employees.


Facility and General Safety

Revised Temporary PPE Requirements - October 20, 2021

On October 20, 2021, we re-aligned our safety requirements with those of the Minnesota Department of Health and CDC guidelines that were changed as a result of break-through infections for vaccinated individuals due to the Delta variant.

The new temporary requirements are as follows:

Facemasks

All employees, regardless of vaccination status, must wear facemasks while any work setting in face-to-face contact with others, in offices, client homes, or in the community.

Eye Protection

Staff providing EIDBI services should wear eye protection in situations where they may be serving children who may remove their masks or masks of others.

Eye protection is also encouraged voluntarily at any time by other providers.

Safety When Working With Individuals Served

When working face-to-face with individuals, it is is strongly encourages that they and all other individuals present wear masks, unless they have a medical reason why they cannot, or in the case of some children, they remove their masks for behavioral reasons. It is your responsibility to encourage this behavior. You must still wear a mask and practice social distancing at all times. Masking is still required in all office settings until further notice.

*The above, until April 6, 2022 previously required masking of both staff and clients or declining face-to-face services.

When sharing objects (iPads, technology, etc.) use hand and surface sanitizer safely according to instructions for specific devices. Never spray your keyboard, iPhone or iPad with sanitizer. Rather use alcohol wipese (70%) to sanitize it.

Safety in Client and Family Homes, Group Homes or Congregate Living Facilities

Household Members with a Positive Test or Symptoms

Employees are asked not to visit any group or family residence, including family homes, group homes or other congregate living facilities:

Household Members with Confirmed Exposure to an Infected Individual but Without Symptoms

When a client or a member of a household has had a confirmed exposure to an individual with COVID-19, staff members should not visit the household until 14 days after the exposure incident and then only if all members of the household have remained symptom free since the exposure incident.

Pre-Screen for COVID Symptoms Prior to Face-to-Face Services

Before face-to-face visits with your clients, by telephone if possible, screen for symptoms with the following questions and note that you have done so in your obseration notes.

Have you had any of the following:

If the individual reports any of these symptoms, do not proceed with face-to-face services. Encourage them and offer assistance with seeking medical advice about testing.

Social Distancing Guidelines While Providing Services in the Office Home and Community

Information About The Spread of Coronavirus in Minnesota

This page at the Mn Department of Health contains the most up-to-date information on the spread of COVID-19 in the state, including Health Care facilities.

Do not leave home if you have any cold- or flu-like symptoms.

Offer and provide telemedicine services to the people you serve wherever possible.

Avoid close contact (being within 6 feet) with all people.

Ridesharing (driving with clients in your car) or meeting with them in your car is prohibited indefinitely at this time, as it violates social this distancing policy.

Update to the ride-sharing policy (May 18, 2021):


Update to the ride-sharing policy (Jan 13, 2022):

Ridesharing is again prohibited until further notice.


Illness and Exposure of Employees

Your physician will advise you (not Accend ) on what to do if you have an exposure, symptoms, or illness, how long to quarantine, and when you may safely return to work. Absent advice from your physician, follow the guidance below, or, if the guidance below is more restrictive than that given to you by your physician, follow this guidance also.

Close Contact/Exposure Defined

Close contact/exposure is defined as follows.

Secondary Exposure, However

Exposure is limited to the definition above and does not include exposure to someone else who has been exposed (secondary exposure).

However, if you have a close contact, family member or roommate who has had an exposure event, we ask that you:

This is in part an honor system. We appreciate knowing that your primary concern is the safety of your clients and coworkers and that you will act responsiblty and call if you have questions.

Self-Monitoring and Screening

All employees are asked to self-monitor and not report to work in the office, or provide face-to-face services if the are experiencing any of the following symptoms:

High Risk and Vulnerable Employees

Employees who are at higher risk for severe illness should self-identify and ask for reasonable accommodations to prevent exposure or risk.

 

Protocols For Exposed or Symptomatic Staff and Clients

EIDBI Exception for Exposed Staff

Because of the particularly high risk of exposure unmasked children and child behavior in the EIDBI program protocols for exposed staff are as follows:

Fully Vaccinated and Boosted Staff

Not Fully Vaccinated and Boosted Staff

Exposed Staff

Staff members who are unvaccinated or are more than six months from their first vaccine series and not yet boosted must quarantine for 5 days post-exposure.

Individuals who have received their booster shot do not need to quarantine following an exposure if symptom-free.

Staff members who have tested positive in the past 90 days and have recovered (are no longer symptomatic) should follow the same gudelines as for full-vaccinated and boostered team members.

Testing is strongly encouraged, if available on day 5 for either of the above circumstances.

Symptomatic Staff

If symptoms occur, individuals should immediately quarantine until a negative test confirms symptoms are not attributable to COVID-19, and they are symptom-free.

You may not be able to obtain orders from your physician to quarrantine following exposure as required by unpaid leaves policy. In this case you must simply inform us of the date of the confirmed exposure and follow our guidelines (taken from DHS) for quarrantine.


Protocols When Workers Have Been Tested Positive for COVID-19

If you have a positive test for COVID-19, do the following:

The employee who tests positive for COVID-19 can return when return-to-work (RTW) criteria are met:

Symptomatic employees should stay isolated at home and away from others until all three of these are true:

Asymptomatic employees who test positive after travel, an exposure, or routine surveillance testing should isolate at home for 10 days from their test date and until not experiencing symptoms for at least 24 hours.

No medical exam or additional testing is necessary to clear employees for work once they meet these criteria.

Reporting Exposure to Coworkers and Clients

The investigating nurse will:

Working From Home

Quarantining employees who can work from home is authorized to do so. If you are not sure if you can work from home, ask your supervisor. While working from home, always do the following:

Exposed or Symptomatic Clients

Clients who are unvaccinated or are more than six months from their first vaccine series and not yet boosted should not receive face-to-face services for 5 days following exposure and then only if symptom-free.

Clients who have received their booster may continue to receive face-to-face services following an exposure, if not experiencing symptoms.

Exposed clients who are unable to mask should not receive face-to-face services for at least 10 days, regardless of vaccination status, and then only if symptom-free.

Why was this section archived?It is replaced by simplified and consistent safety, exposure, isolation and work restriction guideleines..