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What do Direct Service Providers for people with disabilities need to know about COVID-19?

Direct Service Providers (DSPs) include personal care attendants, direct support professionals, paraprofessionals, therapists, and others. They provide a wide variety of home and community-based, health-related services that support people with disabilitiesexternal icon. Services provided may include personal care, activities of daily living, access to health services, and more. DSPs have close and consistent contact with people with disabilities and those providing healthcare support services in day and residential programs for people with disabilities. DSPs are considered to be in the same general risk category as health care personnel. DSPs are essential for the health and well-being of the people they serve. DSPs should be aware of how the coronavirus disease 2019 (COVID-19) spreads, risk factors, and prevention actions.

Here are commonly asked questions that DSPs have about caring for people with disabilities during the COVID-19 pandemic.

How can I protect myself and the people I work with?

As a DSP, your risk of exposure will depend on factors including the setting you work in, the number of people you provide services to, and the spread of COVID-19 in your community. Check with your employer for any specific policies and procedures related to COVID-19 and practice everyday prevention actions when working with clients without suspected or confirmed COVID-19. In addition:

  • When possible, keep at least 6 feet of distance between yourself and others in the home or community setting.

  • Wear a mask when you are at work.

  • Encourage your client to wear a mask.

    • Wearing masks may be difficult for people with sensory, cognitive, or behavioral issues. Masks are not recommended for children under 2 or anyone who has trouble breathing or is unconscious, incapacitated or otherwise unable to remove the covering without assistance.

  • If there is potential that you may be splashed or sprayed by bodily fluids during your work, use standard precautions. Personal protective equipment (PPE) includes a facemask, eye protection, disposable gloves, and a gown.

  • Wash your hands with soap and water: when entering and leaving the home or community setting; when adjusting or putting on or off facemasks; or before putting on and after taking off disposable gloves. If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol. Learn more about proper handwashing.

  • Wear disposable gloves when touching the client (e.g., dressing, bathing/showering, transferring, toileting, feeding), handling tissues, when changing linens or doing laundry. Safely dispose of gloves after use. As noted above, wash your hands before and after taking off disposable gloves. If gloves are unavailable, wash hands immediately after touching the client or handling their belongings.

  • Launder work uniforms or clothes after each use with the warmest appropriate water setting for the items and dry items completely.

  • Monitor yourself for symptoms. Do not go to work or care for others if you develop symptoms.

If you work in the home of an individual with disabilities, also practice these additional prevention actions:

  • Clean and disinfect frequently touched objects and surfaces (e.g., counters, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets, bedside tables), and equipment (e.g., wheelchairs, scooters, walkers, canes, oxygen tanks and tubing, communication boards and other assistive devices).

  • Help the client plan for possible changes in service due to COVID-19.

    • Plan for what to do if you or other DSPs get sick.

    • Create a contact list of family, friends, neighbors and local service agencies that can provide support.

    • Review with the client:

      • How to monitor for symptoms.

      • When and how to contact their healthcare provider. Many healthcare providers have developed new ways to provide healthcare services, such as using telehealth. Help the client find out how those are arranged and any additional information.

  • Help make or update care plans or an emergency notebook.

    • Care plans typically include important information about a person’s medical conditions, how to manage those conditions, how to contact healthcare providers, therapists and pharmacy, information on allergies, medications (names, dosages, and administration instructions), preferences (food and other), daily routines and activities.

    • This information may help the client and new DSPs provide consistent care if the usual provider is unavailable.

  • Plan at least two ways of communicating from home and work that can be used rapidly in an emergency (e.g., landline phone, cell phone, text-messaging, email). Write this information down for both you and the client. Each of you should keep a copy with you.

  • Plan to have enough household items and groceries for a few weeks, at least a 30-day supply of over the counter and prescription medicines and any medical equipment or supplies that might be needed.

    • Some health plans allow for a 90-day refill on prescription medications.

    • Make a photocopy of prescriptions, as this may help in obtaining medications in an emergency.

If you provide services for a client in a community-based setting, such as a group home or day program,

  • Follow any employer, facility, and program guidance for additional precautions related to COVID-19.

  • Encourage the clients you work with to practice everyday prevention actions, if possible, and assist them when needed.

  • Follow everyday prevention actions if there are no known or suspected cases of COVID-19 in the community-based setting where you work.

CDC has also provided guidance for group homes for people with disabilities. Many of the recommendations for COVID-19 preparation and response described in that guidance document also apply to DSPs.

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