COFAR blog

The Department of Developmental Services appears to be leaving it up to its residential providers to impose family visitation restrictions in light of the latest surge in COVID-19 cases in the DDS system.

This appears to have resulted in inconsistencies and contradictions among visitation policies among different providers, and potentially overly restrictive policies on testing and quarantines in some cases.

The last time DDS appears to have updated its visitation guidance was September 23, prior to the current COVID surge.

I sent an email query on Monday (November 30) to DDS Commissioner Jane Ryder, asking whether she intends to update the Department’s September 23 guidance on visitation, and whether some standardization of requirements for indoor visits and quarantines might be necessary. I haven’t yet received a response to my query, which was also sent to the DDS ombudsman.

Indoor visits banned, contradicting DDS guidance

At least three providers have recently banned indoor visits entirely by family members, and enacted varying requirements for testing and quarantining group home residents who were taken by family members home for Thanksgiving and other visits.

One provider is banning all visits of group home residents to their family homes until further notice.

The September 23 DDS guidance permits indoor visits by family members and allows off-site visits by residents.

The same provider, however, has not allowed any indoor visits since March, according to a family member. The provider has also sharply limited outdoor visits, and, as noted, banned out-of-group home visits.

In a directive issued last week, a second provider stated that visits to its group homes would only be permitted outdoors or via Zoom or Facetime.

Another provider stated that on-site visitation was being suspended until further notice “due to rising COVID rates nationally and in the state.”

Contradictory directives on quarantines after off-site visits

Different providers appear to have adopted widely varying policies on quarantining residents after the residents have left group homes even for short visits

One provider allows off-site visits by residents, but has lately required a three-day quarantine of any resident who is taken out of the group home.  Another provider now requires a 14-day quarantine for any resident taken out of state.

As one family member said, however, it is very upsetting to residents to be subjected to multi-day, in-room isolation after returning to a group home, and it results in “very little benefit.”

The September DDS guidance does not require quarantines if residents are taken off site, but states only that they must be monitored for 14 days after returning to their group homes. Quarantines are required only if the resident shows symptoms.

Providers have different requirements on testing after off-site visits

Providers similarly appear to have contradictory policies regarding COVID testing after off-site visits.

One provider has required that residents taken off site receive a negative COVID test less than 48 hours before returning to a group home or other DDS-funded setting.

Two other providers, however, appear to require residents taken off site to wait a minimum of 72 hours between getting tested and returning to the group home.

One of those providers requires the resident to remain at the family home for 14 days before even getting the test. Even if the test is negative, the provider’s directive states that the resident must remain in isolation in the group home for an additional 72 hours and then needs a second COVID test.

Staff don’t appear to be subject to similar restrictions

As we have reported, the biggest jump in COVID infections in the DDS system, in terms of absolute numbers, appears to be among staff.

The number of COVID-19 positive staff in all provider-operated group homes (in DDS and other agencies in the Executive Office of Human Services) rose by more than 100% in the two-week period ending November 11.  Yet, it is clear that staff regularly go in and out of group homes without the need for quarantines, in particular, unless they are symptomatic.

We have long suspected that the biggest risk to residents in the DDS system does not come from family members who visit them either outdoors or indoors under controlled conditions, but from staff who face few such restrictions.

We think DDS needs to reassess where the risks in the current COVID surge really lie, and to adjust their guidance accordingly. The burden imposed by restrictions on visits should not fall disproportionately on the families and the residents themselves.

Moreover, that updated guidance should be followed by all providers.