COVID-19 Resurgence Guidance for Protective Services
The Pennsylvania Department of Aging (PDA) continues to recognize the COVID-19 pandemic may have a long-term impact on our consumers and on standard operating policies and procedures within protective services (PS). This document provides guidance to Area Agencies on Aging (AAAs) to assist them in making decisions regarding modifying operations in response to a resurgence of COVID-19 cases in their planning and service areas (PSAs).
The health and safety of older adults and the aging network remains the primary concern; therefore, PDA stresses the importance of continuing to follow the Centers for Disease Control and Prevention (CDC) guidance and Pennsylvania Department of Health (DOH) guidelines for mitigating the spread of the COVID-19 virus.
PDA previously provided specific guidance and risk mitigation strategies for in-home, face-to-face visits for purposes of conducting investigations, assessments and other essential activities in accordance with Governor Wolf's strategic phased reopening plan for Pennsylvania. However, as counties across Pennsylvania experience upticks in positive cases and increased community spread, it may be necessary for AAAs to return to more restrictive mitigation strategies to protect the health and safety of their staff and the older adults they serve.
PDA recognizes circumstances involving this virus can change quickly and will continue to evolve in the coming months. Therefore, PDA is allowing AAAs the local discretion to make decisions to return to more restrictive mitigation strategies, on an as-needed basis. In making the decision to return to more restrictive mitigation strategies, the AAA shall utilize relevant, available data pertaining to their PSA but also consider the nature of the allegation and the categorization given to each Report of Need (RON) in deciding if an in-person visit is required.
PDA acknowledges these are challenging and unprecedented times for the AAAs and staff. The Department will support the decision of the AAA in returning to more restrictive mitigation strategies when the decision to do so is based upon relevant data, compliance with the initial guidance provided and most importantly, the health and safety concerns of older adults and staff.
AAAs may choose to fully return to the strategies outlined in the PS Guidance for Older Adult Face-to-Face Visits (PS COVID-19 Guidance 6-20) which, at a minimum, includes:
- Conducting PS investigations and assessments remotely, off-site and not face-to-face, unless the allegations on the Report of Need (RON) include the immediate or potential risk of self-neglect, serious bodily injury, serious physical injury, sexual abuse, or death. If the allegations contain the risk of any of these possibilities, a face-to-face visit may be conducted after consulting with PDA PS staff. The use of the COVID-19 Consumer Health Screening Tool will be required in these instances.
- If an off-site investigation reveals significant concerns, regardless of the type of allegations reported, a face-to-face visit may be conducted after consultation with PDA PS staff. A well-check conducted by a local police department may also be requested to determine if urgent support is needed through a face-to-face visit.
- When the AAA identifies there is a need to conduct a face-to-face visit and has consulted with PDA PS staff, the PS Caseworker shall consider the allegations on the RON, such as physical abuse or caregiver neglect, when determining if the older adult should be contacted before or only at the time of the face-to-face visit.
- When contacting the older adult by telephone before the face-to-face visit, the PS Caseworker shall discreetly notify the older adult of the allegation and explain the need for the face-to-face visit. While on the call with the older adult, complete the Community or Facility COVID-19 Screening Tool for Protective Services (Screening Tool).
- The outcome of the Screening Tool will determine if a face-to-face visit with the older adult is to be conducted. When no symptoms are present, a face-to-face visit is to be completed; however, when symptoms of COVID-19 are present or older adult/household/residency is positive for COVID-19, a face-to-face visit should not be done.
- Explore alternatives when/if conducting an in-home visit, such as, conducting the meeting on the porch or through a screen door.
- Having staff conduct a self-evaluation as to their own health condition and comfort level the day of the visit when a visit is deemed necessary.
- Providing appropriate documentation in SAMS as outlined in the guidance.
AAAs may choose to implement a "hybrid" version of the mitigation strategies outlined in the Yellow and Green Phases of the PS Guidance for Older Adult Face-to-Face Visits (PS COVID-19 Guidance 6-20).
A "hybrid" version may include any of the following strategies:
- Conduct face-to-face PS visits for all PS allegations when the older adults and others in the residence report no current symptoms of COVID-19 per the Community or Facility COVID-19 Screening Tool for Protective Services (Screening Tool).
- The outcome of the Screening Tool determines if a face-to-face visit with the older adult is to be conducted. When no symptoms are present, a face-to-face visit is to be completed; however, when symptoms of COVID-19 are present and/or older adult/household/residency is positive for COVID-19, a face-to-face visit should not be conducted.
- Complete the majority of the investigation and/or assessment by telephone to minimize the amount of time spent in an older adult's home. The Department advocates for seeing an older adult in their home environment to accurately assess the living conditions and to validate functional abilities and the need for protective services, even if the home-visit is brief in nature.
- Conduct in-home visits with existing consumers where the AAA is familiar with the older adult and their home environment and feels confident that a home visit could be conducted safely. For example, this may include knowing the home is conducive to social distancing, the older adult will be compliant with wearing a mask, and the only individuals present in the home would be those known to the AAA.
The AAA shall maintain appropriate documentation in SAMS as outlined in the guidance when assessments are conducted telephonically. When conducting in-home visits, the AAA shall continue to follow CDC Community Guidance and PA Department of Health guidelines.
AAAs wishing to return to more restrictive mitigation strategies shall contact their assigned Protective Services Specialist via email to provide:
- Strategies the AAA will be implementing for their PSA, such as telephonic assessments
- Date of implementation
- Any additional pertinent information
For questions or technical assistance with mitigation strategies, AAAs should contact their assigned Protective Services Specialist via email.
Where can I find more information about COVID-19?
Visit the PA Department of Health COVID-19 page for the most up to date information regarding COVID-19. Additional information is also available on the CDC website and through the Centers for Medicare & Medicaid Services (CMS).