CHOICE Covid 19 Preparedness Plan posted 6/11/20

Purpose
This Action and Prevention Plan details procedures to prevent and minimize hazards to human health as it relates to the Covid-19 Pandemic. This document is prepared to describe implementation of precautionary and response measures to safely and effectively provide and receive services at CHOICE. We are committed to doing everything we can to protect the health and safety of our participants and employees at CHOICE. Input from our employees and participants is essential in developing and implementing a successful COVID-19 Preparedness Plan. We have involved these parties in this process by conducting surveys and integrating feedback into this plan. Our Preparedness Plan follows Centers for Disease Control and Prevention (CDC) and Minnesota Department of Health (MDH) guidelines and federal OSHA standards related to COVID-19 and addresses:
• Hygiene and respiratory etiquette
• Engineering and administrative controls for social distancing
• Housekeeping – cleaning, disinfecting and decontamination
• Prompt identification and isolation of sick persons
• Communications and training that will be provided to managers and workers
• Management and supervision necessary to ensure effective implementation of the plan
• Serving "at risk" participants

This plan also outlines guidelines and protocols specific to the population we serve as given by the Minnesota Department of Human Services.

Management and employees are responsible for implementing and complying with all aspects of this Preparedness Plan. This plan will be a living document, to be updated as often as new information regarding the pandemic is released. This plan attempts to capture specific actions, prevention plans, and procedures to address emergencies resulting from Covid-19. The provisions of the plan will be implemented on-site and emergency action will be taken during any event that may threaten human health at CHOICE locations or any of the community group employment or enrichment sites where CHOICE employees or participants are employed or in attendance.

Screening and policies for employees exhibiting signs and symptoms of Covid-19.

Employees have been informed of and encouraged to self-monitor at home for the following signs and symptoms of Covid-19: fever (100.4 or higher); new and persistent dry cough; difficulty breathing (can't hold breath for 20 – 30 seconds); or unusual fatigue. When any of these symptoms are present, the employee is to notify their supervisor and not report to work until permitted by their physician/clinic. Employees can go to https://mn.gov/covid19/ to get more information on when and where to get tested.

Employees that may have come in contact with someone who has a confirmed case of Covid- 19 are to call the MDH to determine if they can report to work. Employees that begin to have the signs and symptoms of Covid-19 while at work are to immediately report to their supervisor, clock out, go directly home, and not report to work until permitted by their physician/clinic. Employees with a lab test confirming they have Covid-19 are to inform their supervisor and not report to work for 14-calendar days AND until they are cleared by their physician/clinic. Further, all members of the employee's CHOICE cohort will be notified of exposure to covid-19 and be required to quarantine from the CHOICE program for 14 days. All other participants and employees will also be notified of potential exposure to covid-19 and will be asked to closely monitor themselves for signs and symptoms of illness. Upon learning of a positive case of covid-19 among an employee, CHOICE will close the program for 2 days in order to deep clean and disinfect the building. CHOICE will cooperate with the tracking, notification, and quarantine recommendations provided by the MDH. Employees may be eligible for emergency sick leave. Employees have been informed in writing that if they have symptoms of Covid-19, or other similar conditions, and are seeking a diagnosis, they may be eligible for 80 hours (prorated for part-time employees) of emergency sick leave paid by the company as required by the Families First Coronavirus Response Act (FFCRA). Other eligibility criteria under the FFCRA include the following: (i) have been advised by a healthcare provider to self-quarantine because of concerns related to Covid-19; (ii) caring for another who is subject to quarantine or has been advised by a healthcare provider to self-quarantine because of concerns related to Covid-19; or (iii) need to care for a child(ren) because their school or childcare is closed or unavailable because of Covid-19. All employees have been provided with the form needed to determine eligibility for emergency sick leave and instructed to submit to their Supervisor for verification. Employees have also been informed that once emergency sick leave is exhausted they may be eligible for Emergency FMLA if they continue to need time away from work to care for a child(ren) because their school or daycare remains closed due to Covid-19.

Screening and policies for participants exhibiting signs and symptoms of Covid-19

Participants and their homes have been informed of and encouraged to self-monitor for the following signs and symptoms of Covid-19: fever (100.4 or higher); new and persistent dry cough; difficulty breathing (can't hold breath for 20 – 30 seconds); or unusual fatigue. When any of these symptoms are present, the participant/home is to notify CHOICE immediately and not come to the program until permitted by their physician/clinic. Participants and their families/caregivers can go to https://mn.gov/covid19/ to get more information on when and where to get tested. Participants that may have come in contact with someone who has a confirmed case of Covid-19 are to call the MDH to determine if they can attend the program. Before participants enter a CHOICE vehicle or when participants arrive to the program if not utilizing CHOICE transportation, DSPs will conduct a manual screening to look for signs and symptoms of Covid-19. This screening will include taking a temperature with a touchless thermometer, visually observing for any symptoms and completing an Illness Questionnaire (see attachment, exhibit A) regarding symptoms. If a participant displays any signs or symptoms of illness, they will NOT be permitted to enter the CHOICE vehicle or building. Participants that may have the signs and symptoms of Covid-19 while at the program will be isolated from others until they can be picked up, and instructed to not come to the program until permitted by their physician/clinic. Participants with a lab test confirming they have Covid-19, or a member of their household has tested positive for Covid-19, are not to report to the program for 14-calendar days AND until they are cleared by their physician/clinic. Further, all members of the participant's CHOICE cohort will be notified of exposure to covid-19 and be required to quarantine from the CHOICE program for 14 days. All other participants and staff will also be notified of potential exposure to covid-19 and will be asked to closely monitor themselves for signs and symptoms of illness. Upon learning of a positive case of covid-19 among a program participant, CHOICE will close the program for 2 days in order to deep clean and disinfect the building. CHOICE will cooperate with all tracking, notification, and quarantine recommendations provided by the MDH.

Handwashing

CHOICE has implemented a schedule for frequent handwashing throughout the program day. All employees and participants will wash their hands at the beginning and end of their shift/scheduled day, prior to any mealtimes, and after using the restroom. Employees have been instructed to wash their hands for at least 20 seconds with soap and water frequently throughout the day. Posters demonstrating these techniques have been placed throughout the building. Staff and participants will be expected to follow handwashing procedures as detailed by the CDC: https://www.cdc.gov/handwashing/when-how-handwashing.html. Participants will be reminded, and supervised when appropriate, to wash their hands for at least 20 seconds with soap and water frequently throughout the day, but especially at the beginning and end of their day, prior to any mealtimes, and after using the restroom. CHOICE will provide hand sanitizer (greater than 60% alcohol) at all locations and in all CHOICE vehicles. This can be used for hand hygiene in place of soap and water if needed as long as hands are not visibly soiled. Employees and participants will be encouraged to use their knuckle, elbow, or covered hand when contacting high touch areas (i.e., light switches, door knobs, handles, keypads).

CHOICE seeks to limit visitors to only those with necessary business at CHOICE. Any visitors (except those dropping off or picking clients up at the doors) will be required to wash their hands immediately upon entering the facility. Hand sanitizer will be provided to each mobile crew that can be used when soap and water is not reasonably available.

Personal Protective Equipment (PPE)

CHOICE, Inc. requires all staff, participants and necessary visitors to wear a mask at all times (except when eating lunch). It is strongly encouraged that staff and participants provide their own mask to ensure fit and reduce un-necessary waste. CHOICE reserves the right to not permit the use of a mask that it feels, in its own determination, is inappropriate and/or compromises the health and safety of others. CHOICE encourages employees, participants and necessary visitors to launder or replace disposable masks frequently. CHOICE will provide masks for participants, employees and necessary visitors if needed. Other Personal Protective Equipment (PPE) including gloves and face shields will also be provided for employees to use when assisting participants with hygiene cares or whenever requested. CHOICE Program Directors and Administrative Team Members will ensure that a sufficient inventory of disinfectant, sanitizer for food and hard surfaces, soap, and tissues are in stock and distributed to employee and participant areas as needed.

Respiratory Etiquette

Employees and participants have been instructed to cover their mouth and nose with their sleeve or a tissue
when coughing or sneezing and to avoid touching their face, in particular their mouth, nose, and eyes, with their hands. Tissues should be disposed of in the trash and hands washed or sanitized immediately afterward. Respiratory etiquette is demonstrated on posters and supported by making tissues and trash receptacles available to all employees and participants. Staff will frequently remind and train participants on the above respiratory etiquette. Participants that cough or sneeze into their hands will be directed to a sink and supervised as needed to wash their hands for at least 20 seconds with soap and water.

Social Distancing

To help ensure social distancing strategies can be implemented in the facility, CHOICE is limiting occupancy to no more than 50% of the licensed capacity or a maximum of 50 people at a time, including staff, whichever is smaller. Currently, capacity numbers are as follows:

Eden Prairie: 50
Maple Grove: 50
Minnetonka STARS: 23

CHOICE has re-arranged seating areas to maximize the space between persons receiving services with at least six feet between seats. Whenever possible, CHOICE has arranged seating so that chairs are turned in the same direction (rather than facing each other) to reduce transmission caused from virus-containing droplets created when people talk, cough, or sneeze. CHOICE has created and posted visual aids (tape and stickers on the floors and walls) to illustrate traffic flow and appropriate spacing to support social distancing. For the short-term, participants are not permitted to walk throughout the building without staff support. Also for the short-term, CHOICE will deliver services in shifts, with a maximum duration of three hours throughout the day for each person receiving services. CHOICE will document the start and end time of each shift and the staff who worked those shifts, and will clean and disinfect the facility between shifts.

Employees are not permitted to use another employee's personal desk, mobile device, tablet, PPE or other work tools and equipment that could be duplicated. CHOICE participants are not permitted to share or touch another participant's PPE, personal belongings, food, mobile (or other) device, or any other equipment or supplies. Each CHOICE participant will have a designated chair and table spot for their use only. Participants will also be provided with a bin or box to keep personal belongings. CHOICE strongly encourages participants bring only necessary items (i.e. purse or bag, water bottle, phone or technology device) in order to limit the transfer of germs. Each bin or box will also be stocked with program supplies and for each participant's personal use. All employees and participants must maintain a distance of 6 feet between each other at all times, except in cases when it is necessary for an employee to physically assist a participant for a health, hygiene or safety reason. Employees will remind participants to practice physical distancing and bring disinfectant as needed to clean touch points they have contacted. Whenever possible and when it is agreeable with participants, team meetings will be hosted by conference call or using a virtual platform like Zoom or Google Meet.

For sanitary reasons, CHOICE strongly recommends that no food be consumed in the CHOICE building. Employees and participants who need a snack for a health or wellness reason, OR employees who work a shift that spans a meal time will consume food at their desk, office or designated area (while maintaining a 6 food distance from others) whenever able. Before and immediately following the consumption of a snack, employees are to disinfect surfaces where food was consumed. CHOICE asks that all participants and employees bring a personal water bottle with their name clearly written on it. Until further notice, tours for prospective clients are not permitted.

Cohorts
To further reduce the spread of germs, CHOICE will create and maintain consistent cohorts of the same staff and persons receiving services. Per the new licensing requirements put forth by the Minnesota Department of Human Services, service delivery will consist of no more than a period of 3 consecutive program hours. These 3 hours do not include transportation to and from the program. Cohorts will consist of 10 or fewer people, including staff. Typically, a cohort will be 2 staff and 8 participants. Cohorts will be maintained throughout the program day and will also be maintained during the programming week whenever possible. CHOICE will limit cohorts to a designated program area as much as possible to further attempt to reduce germs. If a cohort does move to a different location, both the location the cohort came from as well as the location the cohort is going to will be cleaned and disinfected. Cohorts will arrive and depart through separate entrances at separate times. Participants will be asked to remain in their transportation vehicles until a CHOICE employee performs a screening and Illness Questionnaire. If the participant passes screening, they can proceed to the entry for their specific cohort.

A sample schedule with sample departure and pick up times is as follows (*this is subject to change as needed):

a. Cohort 1
i. Arrive at 8:15
ii. Enter through separate entry
iii. Wash hands in specific area
iv. Programming activities in designated area
v. Bathroom break at 9:30 (staff should wipe all touch points with Clorox wipe when their group is done)
vi. Leave at 11:15
b. Cohort 2
i. Arrive at 8:25
ii. Enter through separate entry
iii. Wash hands in specific area
iv. Programming activities in designated area
v. Bathroom break at 9:50
vi. Leave at 11:25
c. Cohort 3
i. Arrive at 8:35
ii. Enter through separate entry
iii. Wash hands in specific area
iv. Programming activities in designated area
v. Bathroom break at 10:10
vi. Leave at 11:35
d. Cohort 4
i. Arrive at 8:45
ii. Enter through separate entry
iii. Wash hands in specific area
iv. Programming activities in designated area
v. Bathroom break at 10:30
vi. Leave at 11:45

Housekeeping

Prior to the arrival of participants, CHOICE Program Directors and Administrative Staff will ensure that disinfectant, sanitizer for food and hard surfaces, soap, tissues and necessary PPE are distributed to the staff and participant areas. Regular housekeeping practices have been implemented including routine cleaning and disinfecting of work surfaces, program equipment, restrooms, program areas and meeting rooms. Frequent cleaning and disinfecting (at least twice per day AND as needed) with sanitizer will be conducted in high-touch areas such as phones, keyboards, screens, light switches, door handles, copy machines, etc. Cleaning and disinfecting of the overall program will also take place twice per day (in between a schedule change of cohorts and after all program participants leave for the day) AND as needed. CHOICE staff are responsible for sanitizing their desk and work area prior to leaving for the day. All CHOICE staff, program directors and administrators will be responsible for cleaning and maintaining the program buildings.

Transportation and Offsite Activities

CHOICE will not be able to transport all participants in our vehicles to and from our programs while maintaining proper social distancing. Should CHOICE transport individuals, a revised transportation schedule to maintain physical distance between participants and much as possible will be implemented. CHOICE will create "sub cohorts" that consist of 1 staff to 4 participants for the purpose of transportation. Two such sub cohorts will be combined together to create a full cohort of 10 people when in the building and doing any outdoor activities at CHOICE. Passengers in a CHOICE vehicle are to sit one to a seat whenever possible with not more than 2 sharing a bench seat. Company vehicles will be cleaned by the driver with disinfectant at the end of each use. All drivers and passengers must wear a mask at all times while in a CHOICE vehicle. Vehicles will comply to a staggered drop off and pick up protocol that eliminates or reduces contact with other cohorts (see "Cohorts" section above). Vehicles will line up in marked areas in the parking lot and the persons in only one vehicle at a time will be allowed to enter and exit the building. Before participants enter a CHOICE vehicle, Staff will conduct a manual screening to look for signs and symptoms of Covid-19. This screening will include taking a temperature with a touchless thermometer, visually observing for any symptoms and completing an Illness Questionnaire (see attachment, exhibit A) regarding symptoms. If a participant displays any signs or symptoms of illness, they will NOT be permitted to enter the CHOICE vehicle.

CHOICE will limit attending offsite activities to only those activities where staff can reasonably ensure we will have the space and means to support clients to practice physical distancing when engaged in these activities (such as outdoor activities).

Communications and Training

All CHOICE employees will be trained on this plan before reporting back to work and sign off that they understand and
will follow its procedures. Prior to resuming participant services, the plan will be revised based on any new guidelines and information from appropriate government and local authorities as well as the suggestions of frontline employees directly supporting clients to best ensure it reflects practical procedures. Employees will continue to receive company updates via email, video meetings and in person meetings when it is possible to maintain proper social distancing. This plan will be certified by the Executive Director, posted on our website (www.choicejobs.org) and on the employee/participant bulletin board and sent to participant homes as requested.

Serving "At Risk" Participants
Pursuant to Emergency Executive Order 20-55, "at-risk persons ... are strongly urged to stay at home or in their place of residence except to engage in necessary activities for health and wellbeing ... " At-risk persons are defined in paragraph 2 of the Order as follows: Consistent with guidance issued by the Centers for Disease Control and Prevention ("CDC"), "at-risk persons" include people who are:
a. 65 years and older.
b. Living in a nursing home or a long-term care facility, as defined by the Commissioner of Health.
c. Any age with underlying medical conditions, particularly if not well controlled, including: i. People with chronic lung disease or moderate to severe asthma. ii. People who have serious heart conditions. iii. People who are immunocompromised (caused by cancer treatment, smoking, bone marrow or organ transplantation, immune deficiencies, poorly controlled HIV or AIDS, or prolonged use of corticosteroids and other immune weakening medications). iv. People with severe obesity (body mass index (BMI) of 40 or higher). v. People with diabetes. DHS-7313D-ENG 6-20 DHS-7313D-ENG 6-20 vi. People with chronic kidney disease undergoing dialysis. vii. People with liver disease.

Exhibit A – CHOICE Illness Questionnaire

STAFF/ PARTICIPANT SCREENING

For the safety and security of our employees and all those we serve, EVERYONE must answer the questions below
in order to enter a CHOICE vehicle, building, or community site.

1. Have you been within 6 feet for 10 minutes or more of someone diagnosed with Covid-19 in the last 14 days?

2. Do you live with someone who has been diagnosed with Covid-19 and is under quarantine?

3. In the last 3 days, have you experienced any cold or flu-like symptoms, including: fever at or above 100.4 degrees F, cough, sore throat, respiratory illness, or difficulty breathing (trouble holding your breath for more than 20 seconds)?

4. Does this individual currently have a temperature at or above 100.4 degrees F? Yes/No

*If yes, this individual is NOT permitted to enter a CHOICE vehicle, building or community site. Please immediately report this temperature to the guardian or group home of the participants and to the CHOICE Program Director.

Questions must be answered each time you enter a CHOICE vehicle, building, or community site.