Questions Corner: DD Services in the Time of COVID-19

If you are enrolled and receiving DD services, chances are you have felt the shift in those routines, along with everything else. You may be wondering what is allowed, in this new world, and how you can get your needs met. We'd like to help by sharing the information we have currently. Please note that, due to the incredibly fast rate of change in the pandemic situation, change in policy is happening quickly as well. It's important that policy move quickly to keep up with changing needs. However, that pace of change means that what was true yesterday may not be true today. We hope you will have patience with your Personal Agents and providers as they scramble to keep on top of the latest guidance.

Do you have additional questions about what services are allowed? Put them in the comments below, or on our Facebook page. We will do our best to get the answers for you in a future post!

I get regular support from a PSW or DSP to get out and do fun things. Can they still help me with that?

As we all know, Oregonians are all asked to stay at home, for the containment of COVID-19. Leaving for recreational activities is restricted, even if those activities were open and available (which, they are not). But if your need for support is not changed, and your provider is willing to get creative, it is possible for you to explore ways to access your community without leaving your home. For example, if you need help setting up connections with friends, a provider could help walk you through that process, in person or otherwise. If there is a particular activity you are missing, your provider may be able to help you access a virtual version. Do talk with your Personal Agent if you're unsure. Under normal circumstances, we would prefer to have an ISP call out the person's preferences for the way that services are provided before moving ahead with changing them. But, for the time being, in order to keep up with the changing needs, it is okay to proceed in providing the same service indirectly without changing the ISP. The bottom line is: the virtual delivery of services has to be able to meet your needs.A note to our DSA providers: do make sure that you're following ODDS guidance closely on billing for these virtual services. ODDS Policy Transmittal 20-039 makes it clear that you can't mix billing for contingency funding with billing for a modified version of your regular services during the same 30 day period. From the transmittal: "If your agency received contingency funding, your agency may not bill any Employment or DSA services for which the contingency funding was issued during the 30-day period after which your agency received contingency funding. Employment and DSA services should continue to be provided under this guidance and EO 20-12 as possible."

So, what about other ADL/IADLs? Can I get indirect support from my providers to do those as well?

Yes, the same guidance above applies to all ADL/IADL supports that can logically and confidently applied indirectly, or by virtual supports. That means that physical supports like help getting in and out of a bathtub likely cannot be provided this way. But, a provider with a access to technology might be able to help walk you through the steps of safely preparing food for yourself. (Please use caution when proceeding in this way: our medical system is overloaded with the current pandemic, and now is not the time to risk injury or illness.) Cuing a person to walk through daily routines via the phone may be an option to meet your needs. Calling and setting up resources on your behalf, such as securing prescriptions or grocery or household items, is also allowable. It is also now possible for SNAP benefits to be used to purchase groceries and supplies online.This is uncharted territory--we are usually a program that asks for face-to-face support to get things done, in order to ensure that the service matches what the person wants, and to facilitate skill building. But, so long as it's dangerous to put our faces near to the faces of others, we will need to find creative ways to meet needs.

I feel fine, and my provider feels fine. Why can't we go out and see a movie?

This disease is so tricky. Some people who have been infected with it show symptoms in a few days, while others don't show symptoms for a week or two. Still others have been found to have the virus without ever displaying noticeable symptoms. Because of this, we really can't trust how we feel right this moment as a guide for our behavior. Social distancing, or staying 6 feet or more away from other people at all times, while avoiding touching public surfaces, can help contain the disease. But if you've tried to stay distant from more than a couple of people at a time, you know that it's harder than it sounds. So, the safest thing right now is to stay home entirely, or limit outings as much as you can. Try not to go out to group locations (like grocery stores and pharmacies) during peak hours (noontime, right after work hours, etc.).Also, a note about FOMO, or Fear of Missing Out. Are you feeling it? Our minds can trick us into thinking that we are the only ones left out of normal life right now. But the truth is, there are no movies to see. There are no shows to go to. There is no happy hour down the street. Non-essential group gatherings and activities are restricted for everyone right now; it's not just you. Try to remember that you are not missing anything. We will all leave our homes eventually, and re-engage in communal life. But until then, please stay home.

I'm feeling sick. Who should I call?

From the World Health Organization: "The most common symptoms of COVID-19 are fever, tiredness, and dry cough. Some patients may have aches and pains, nasal congestion, runny nose, sore throat or diarrhea. These symptoms are usually mild and begin gradually. Some people become infected but don’t develop any symptoms and don't feel unwell. Most people (about 80%) recover from the disease without needing special treatment. Around 1 out of every 6 people who gets COVID-19 becomes seriously ill and develops difficulty breathing. Older people, and those with underlying medical problems like high blood pressure, heart problems or diabetes, are more likely to develop serious illness. People with fever, cough and difficulty breathing should seek medical attention."If those symptoms sound like what you are dealing with, please call your physician or local health clinic right away. Follow their advice for treatment and testing. If you are tested or asked to isolate, please share that information with your Personal Agent, or ask your PSW to call them. OHSU has developed an excellent website that covers symptoms, testing protocol, and other frequently asked questions.ODDS has published guidance on who should do what in various scenarios related to people contracting COVID-19. These instructions are meant to help ODDS, Case Management Entities (CMEs) such as Brokerages, and paid service providers like PSWs and DSP agency staff know what to do in COVID-19 situations. The instructions for what we should all be doing for you can be found here. For people who receive their services in their home or community, the guidance is on page 4.