How to ensure worker safety during in-person interactions with families?
The Play
Lower the risk of child welfare workers becoming infected with COVID-19 while working with families in-person.
Who Can Do This
Anyone can use the recommendations from the Centers for Disease Control and Prevention (CDC) for going out and interacting with other people, and agencies can use them to implement responsive protocols that facilitate safe meetings between child welfare workers and families.
Cost
Mostly free, but some cost considerations include the purchase of alcohol-based hand sanitizer and a multi-layered mask for workers, as well as families. The cost increases if there must be direct contact with a potentially COVID-19 positive person, since that requires providing more costly personal protective equipment (PPE), such as face shields, respirators, gowns, and gloves.
Timeframe
Individual protection strategies can be implemented immediately by child welfare workers. It may take a couple of weeks for agencies to develop a large-scale protocol, though it could be sooner depending on the existing policies they already have in place.
Difficulty
Medium. Many of the CDC recommendations have now become commonly known best practices for dealing with COVID-19. However, there are some factors that may increase difficulty, such as transporting a COVID-19 positive youth or designating a COVID-19 safety officer to a job site.
The Problem It Solves
Child welfare workers have not been able to regularly engage with foster youth and families in-person since the beginning of the COVID-19 pandemic.
How To Do This
1. Designate a safety officer.
Safety officers are responsible for developing protocols regarding testing, notification of COVID-19 status, and documenting any instances of possible contamination or outbreaks of COVID-19 due to work-related activities at job sites. Child welfare workers should notify the safety officer of any possible exposure to COVID-19 that may have occurred at a job site, as well the names and location of possible exposure. The safety officer is responsible for communicating any outbreaks or contamination to local public health officials.
2. Provide employee training on COVID-19.
Provide a paperless documentation solution for reporting contamination risk and provide training for all employees on the reporting process. Train on preventative strategies about COVID-19, including exposure risk, how it spreads, at-risk groups, etc. Provide information on testing solutions and expectations. Take the time to outline the agency’s institutional response to COVID-19 and its leave policies should an employee contract COVID-19. Implement virtual and in-person training options.
3. Provide PPE and training on hygiene and safety practices to all employees.
PPE, such as masks and gloves, should be provided to all employees. Training on the proper use of PPE, disinfection of vehicles, safe transportation of youth, safe residence entry, and safe meetings should also be provided.
4. Evaluate whether to alter or halt group or visitation activities.
Use state guidelines to determine the appropriate visitation strategy. When interacting with clients or conducting visitations in person, consider all factors that contribute to increasing COVID-19 exposure risk (e.g., number of individuals involved, whether or not they are high risk, meeting location, transportation arrangements, safety guidelines, etc.). See our “How to safely reopen in-person visitations?” play for more information.
5. Enforce safety guidelines for shared workspaces.
Workplaces should enforce the following guidelines:
Consider staggered or rotating shifts for staff reporting to work (see example from Alabama).
Conduct frequent cleaning and disinfection of commonly used spaces or commonly touched items such as: employee break rooms, meeting rooms, toys and games, playground equipment, rest areas, sink handles, door and refrigerator handles, light switches, desks, chairs, keyboards, mouses, and other similar spaces or objects.
Require face coverings.
Screen employees for symptoms at regular intervals.
Additionally, workers should:
Stay away from other people as much as possible.
Wear a cloth face covering over their nose and mouth around other people.
Keep their distance and cover their coughs and sneezes.
Monitor their symptoms for warning signs, including trouble breathing.
Notify their supervisor and stay home if they have symptoms.
Follow CDC guidelines for returning to work.
Follow CDC precautions for employees with sick family members.
6. Enforce safety guidelines for visiting residences.
Before entering a residence for work, conduct a COVID-19 awareness pre-entry assessment. This could include asking if anyone in the building has been diagnosed with COVID-19 or is currently experiencing symptoms, as well as asking that ill people be moved to another area of the building.
Additionally, workers should:
Inform all occupants that you will be practicing safe social distancing.
Ensure everyone wears a cloth face covering.
Put on their cloth face covering outside of the home prior to entry.
Ask that pets also be moved if there are any.
Wear face covering and gloves when handling items like clothing, medicines, and toys.
Practice good hand washing hygiene.
7. Enforce safety guidelines for transporting youth.
When transporting children who do not have COVID-19 or COVID-19 symptoms, workers should:
Place children on the seat farthest from the driver
Avoid using the recirculated air option.
For children who are COVID-19 exposed or positive, workers should identify available non-emergency medical transport options for them.
If no alternative non-emergency vehicle is available and it is necessary to transport a passenger with confirmed COVID-19 symptoms or potential exposure:
Workers must wear an N-95 respirator or face mask and eye protection such as a face shield or goggles (as long as they do not create a driving hazard).
Ensure the child (over the age of 2 wears) a face mask or cloth face covering as well, unless they have trouble breathing, is unconscious, incapacitated, or otherwise unable to remove the mask without assistance.
If the worker must provide any sort of assistance to the sick child, they should also wear a gown and gloves.
Additionally, efforts to disinfect vehicles used for transportation must be taken. The CDC guidelines for cleaning and disinfection of non-emergency vehicles recommend using disposable gloves when cleaning and disinfection of commonly touched surfaces. Diluted bleach can be used on hard, non-porous surfaces, while fabrics, leathers, and other vehicular surfaces require particular cleaners and processes. Electronic surfaces such as touch screens should be cleaned using 70% isopropyl alcohol.
8. Create and implement a symptom-based strategy that promotes recovery, healing, and reintegration.
For child welfare workers who have been exposed to COVID-19, the following should be observed before reintegration:
At least 3 days (72 hours) have passed since recovery defined as resolution of fever without the use of fever-reducing medications and improvement in respiratory symptoms (i.e., cough, shortness of breath);
At least 10 days have passed since initial symptoms appeared;
Resolution of fever, improvement in respiratory symptoms, and negative results from an FDA emergency use authorized COVID-19 molecular assay for detection of ribonucleic acid (RNA) from at least two consecutive respiratory specimens collected at least one day apart.
Who’s Already Doing This?
Since the CDC and the Children’s Bureau just recently released their collaborative recommendations in mid-June, many states are still in the process of reviewing the guidelines and planning out implementation.
Resources
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