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COVID-19: What to Do

These messages and resources are posted online for use by DFPS Residential Child Care (RCC) contracted service providers. If you have questions or requests, contact us at the DFPS RCC Provider email box.

Message to RCC Providers
July 28, 2020

As you begin preparing for the start of the 2020-2021 school year, DFPS is providing the following guidance to support you in meeting the educational needs of children. The COVID-19 pandemic and its impact on educational settings is very fluid and new information comes out almost daily. The questions and answers provided below is general guidance based on state law and information obtained from the Texas Education Agency (TEA).

It is important to know, however, that there are over 1200 independent school districts in Texas and there will be variations in how each of the district's plan to operate in the fall. You will need to reach out to your district for specific information regarding the type of instruction your district is offering. We are committed to helping you be successful as we all adapt to this ever changing landscape.

Who will decide whether a student receives On Campus or Virtual Instruction?

DFPS is authorized by Texas Family Code, §153.371 to make education decisions on behalf of the children and youth in the agency's managing conservatorship. In most circumstances, DFPS delegates this authority to foster parents or caregivers as the primary Education Decision-Maker. In the event that the Education Decision Maker is not the foster parent or someone at the child's placement, any decisions regarding the child's school setting must be made in consideration of the foster parent's circumstances and wishes.

For a child in the temporary managing conservatorship of DFPS, the caseworker will inform the foster parent and/or Education Decision-Maker of any preferences the parent has regarding the child's educational setting. If disagreements arise, work with your DFPS caseworker and their chain of command.

What is the difference between On Campus and Virtual Instruction?

On Campus means that schools are open and operating normally, students are scheduled to attend school on campus each day (traditional).

Remote Synchronous Instruction – two-way, real-time/live virtual instruction between teachers and students when students are not on campus.

Remote Asynchronous Instruction – instruction that does not require having the instructor and student engaged at the same time. In this method, students learn from instruction that is not necessarily being delivered in person or in real time. This can include recorded lessons provided by instructors.

Will attendance be counted the same as in previous school years and how does this impact families who choose virtual instruction for the child?

Yes, students must attend 90% of the days a course is offered (with some exceptions) in order to be awarded credit for the course and/or to be promoted to the next grade. This requirement remains in force during the 2020-21 school year. In a remote synchronous teaching and learning method, students who are logged in at the teacher's documented official attendance time are marked remote synchronous present for that day, and students who are not logged in at the teacher's documented official attendance time are marked absent.

Asynchronous attendance is measured in a daily frequency. Daily progress is measured via teacher-student interactions, as defined in the approved learning plan; or completion/turn-in of assignments from student to teacher (potentially via email, on-line, or mail).

Who will supply electronics and Wi-Fi access for students?

If virtual instruction is chosen, in most instances, students will be provided access to technology devices, such as iPads, Chromebooks, and Wi-Fi hotspots, to begin their remote learning. Foster Parents will need to inform the school of the need for assistance. Please be mindful that this may look very different depending on the school district, TEA is continuing to work with the districts to overcome any barriers to remote learning.

What is the public health plan in place for students attending on campus instruction?

According to TEA, schools will attempt to have hand sanitizer and/or hand washing stations with soap and water at each entrance and in every classroom. Students, teachers, staff and campus visitors should be encouraged to sanitize and/or wash hands frequently. Schools are required to comply with the governor's executive order regarding the wearing of face masks for students for whom it is developmentally appropriate.

A mask may include non-medical disposable face masks, cloth face coverings (over the nose and mouth), or full-face shields to protect eyes, nose, and mouth. Where feasible without disrupting the educational experience, schools will encourage students to practice social distancing. In the classrooms students are required to be spaced a minimum of six feet apart.

Will schools offer transportation?

Yes, if the school district previously provided you with transportation it will continue to do so, however, schedules and seating arrangements may be modified. Schools are encouraging families to drop students off, carpool, or walk with their students to school to reduce possible virus exposure on buses. Buses will be thoroughly cleaned after each bus trip.

Schools have been advised to open windows to allow outside air to circulate in the bus and to consider requiring students and staff to use hand sanitizer upon boarding the bus, but such requirements will be up to the local independent school district. Please check with your district to learn what modifications are being made to their transportation policies and procedures.

Will students be able to receive special education services regardless of settings?

Students are expected to receive special education services outlined in their individualized education program (IEP), regardless of attending on campus or virtual learning. When schools resume, ARD committees should address student-specific needs resulting from the impact of changes to the learning environment.

Schools are to consider ways to use distance technology to the extent possible to provide child find and identify students who may be eligible for special education services, hold initial and annual ARD committee meetings, and/or evaluation/eligibility. COVID 19 does not change any of the special education laws in place. Special education services will look different for every student depending on the type of education setting. If you have any concerns about a child who is receiving special education services please reach out to your regional education specialist for assistance.

Who can I go to for help?

Each school district and open-enrollment charter school is statutorily required to appoint at least one employee to act as a Foster Care Liaison to facilitate the successful enrollment and transfer of records for students in the legal custody of DFPS when enrolling in or changing schools (TEC § 33.904). Foster Care Liaisons also play an important role in advocating for the needs of students in foster care and coordinating with various school personnel and departments to ensure the required supports, practices, and best-practice strategies for serving students in foster care are implemented within the district.

You can contact the school to obtain the name of the foster care liaison or you can go view the foster care liaison information in AskTED.

Additionally, DFPS regional education specialist are available to assist you with navigating these changes and with overcoming any barriers you may have when working with your school district. You can email Education Program Specialist Felicia Penn or locate your DFPS education specialists on the education webpage.

Provider Updates amid COVID-19
June 2, 2020

The coronavirus pandemic has affected us all in many ways, but perhaps none more significant than the inability for our children in conservatorship to see their parent or sibling in person. As you may be aware many of the court orders requiring virtual visitation are set to expire or will expire in June. To that end, unless a court continues to order otherwise, or it is determined unsafe, in-person parent child visits and sibling visits will be resuming during the month of June.

As DFPS begins the process of increasing in-person visits, one of our highest priorities is to ensure that children, parents, and caregivers are supported during this transition. This includes reducing stress, minimizing the impact of the visit procedures established to protect the health and safety of those involved, and focusing on ways to support positive parent-child relationships.

Prior to arranging an in-person visit, caseworkers will call the parent and ask screening questions to determine if there are additional precautions that should be made before the visit. We have emphasized to caseworkers the importance of including the caregiver in the visitation planning to avoid any concerns regarding the child's exposure to COVID-19.

Other changes that will begin in June include reinstating in person visits to children with primary or complex medical needs. Due to the increased vulnerability of these children, DFPS will work with caregivers and facilities to reduce the number of caseworkers visiting. These visits are set to begin between June 15th and July 15th.
With summer upon us, we also wanted to make you aware that when requested, children may participate in summer camps, day camps, and summer vacations. Each request will be considered on a child-by-child basis. When determining whether it is in the child's best interest, caseworkers will consider whether it is a day camp or overnight camp, the location and duration of the camp, and what safety precautions are being taken by the camp. For vacations, in addition to current policy, the caseworker will consider where the family is traveling to, any activities that could impact the child's personal health, and what precautions will be taken to ensure child safety.

We appreciate your ongoing flexibility and willingness to adapt to the many changes that this pandemic has created and are forever grateful for the care and support you provide to the children of Texas.

Message to RCC Providers
May 12, 2020

We are committed to the safety and well-being of the children and families. The importance of our partnership in protecting and nurturing children cannot be overstated.

Beginning May 11, 2020, caseworkers across the state resumed seeing children in person for face to face monthly contact unless a court order is in place prohibiting such contact. We are mindful of the need to minimize the risk of harm to children and caregivers as well as our staff. Caseworkers will be using personal protective equipment and maintaining social distancing during their visits, and will be transparent with questions asked of them related to their personal health as well as submit to temperature scans.

Children with primary/complex medical needs will continue to be completed virtually unless there is a safety concern. For children who are placed in general residential operations or other residential facilities, DFPS recognizes the need to minimize the footprint and number of visitors by coordinating with the facility, and will develop plans to limit staff to only a few individuals.

We appreciate your flexibility and creativity during this time of crisis and are forever grateful for the care and support you provide to the children of Texas.

Message to RCC Providers
May 6, 2020

Effective May 1, 2020, DFPS resumed all in-person unannounced 24-hour awake night supervision monitoring visits. DFPS will no longer conduct any virtual visits to facilities or homes with more than six children.

All DFPS night staff will wear Personal Protective Equipment (PPE), including masks and gloves, will maintain social distancing of 6ft, will ensure personal handwashing or use of hand sanitizer, and will clean and disinfect any materials used during the visit, including cell phone, tablet, pens, etc. There are multiple options for obtaining signatures, as well, to avoid any unnecessary contact.

Staff will continue to ask screening questions to ensure we have up to date information related to COVID-19. Residential contractors may continue to conduct verbal health assessments of DFPS staff prior to entry into the facility, but must allow DFPS staff to enter as they are taking precautionary measures to minimize the spread of COVID-19.

Please contact your contract manager if you have any specific questions or concerns. If you have general questions or concerns, please send them to the DFPS RCC Provider email box.

Message to RCC Providers
April 24, 2020

To ensure that the educational needs of children are being met, DFPS caseworkers are collecting specific information via SurveyMonkey on all children in Permanent Managing Conservatorship (PMC) placed in licensed care. The questions in the survey are related to educational instruction and the child's access to virtual platforms (e.g. Zoom) and internet connectivity. Much of the information the caseworker may already know, but you may be contacted by the caseworker for some of this information. Because caseworkers must complete these surveys by Wednesday, April 29, 2020, please plan to respond to them as quickly as possible.

We are requesting that Child Placing Agencies please alert your foster parents about these forthcoming calls. We will also be in touch with General Residential Operations regarding the children in their care.

Message to RCC Providers
April 23, 2020

Thank you for all you are doing during this challenging time. This guidance provides an update to the direction provided on March 24, 2020 entitled Residential Contracts Updates related to COVID-19.

As a reminder, telehealth is not an option at this time for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) checks. We continue to monitor the situation and work with HHSC on the issue. Below is additional information related to completion of the 3-Day Medical Exam, Texas Health Steps/EPSDT exam, and the CANS Assessment. We hope this eases the administrative burden on providers so that you can continue to accept new admissions and focus on child safety during this critical time.

The three parts of the 3-in-30 are being managed differently.

3-Day Medical Exam

There is no change. Please continue to obtain the 3-Day Medical Exam within 3 business days of removal. This is an opportunity to have a child new to DFPS conservatorship be seen by a health care provider and for the new caregiver to have information about the child's health. These medical visits are very important.

If the medical provider contacted says that he or she cannot see a child for this purpose during the COVID-19 health crisis, the caseworker can reach out to the Well Being Specialist in your region for assistance or have the caregiver contact the Superior Member Help Line at 866-912-6283. The Help Line is available 24/7 and has options for Spanish speakers. When a new removal occurs, and the child has had significant exposure or is known positive to COVID-19 that requires quarantine or isolation at the time of removal, a telemedicine option for the 3-day medical is acceptable. These children, if clinically stable, should not be brought into a health care environment due to the risk of transmission. Please consult with STAR Health, the child's medical provider and/or the local health authority for further guidance.

CANS Assessment

There are telehealth options for CANS Assessments for all children in foster care. Some current CANS assessors have shifted to telehealth, so check with them first. Pathways/Mosaic is available statewide as a CANS telehealth alternative if there are no CANS assessors with whom you ordinarily work who are providing telehealth.

As a reminder, if there are concerns about the child's mental or emotional health and behavioral health services are needed, a CANS assessment is not required first. The Superior Member Help Line (866-912-6283) can assist with locating a CANS assessor or with obtaining behavioral health services.

Texas Health Steps/Well Child Checks (also known as EPSDT)

As completion of an EPSDT/Texas Health Steps exam is a federal and state requirement, DFPS cannot waive it. Please attempt to identify a Texas Health Step checkup STAR Health provider continuing to provide care for children in-person. The Superior Member Help Line (866-912-6283) can assist in determining if this is an available option with a STAR Health provider.

In-person Texas Health Step checkups should be prioritized especially for newborns, infants, and young children to stay current on recommended vaccines and developmental surveillance when available through local provider capacity. While some health care providers have limited capacity to provide well visits at this time, many practices have instituted policies to maintain well visits for young children.

If routine, in-person Texas Health Steps checkups are unavailable for older youth, obtain the checkup after the crisis is concluded. As noted above, if HHSC modifies policy to allow telehealth/telemedicine options for the Texas Health Steps exam, DFPS will provide further guidance as it becomes available.

During this unprecedented time, we ask that you document your efforts in obtaining the EPSDT. This documentation is not intended to be burdensome to you or physicians. Documentation is sufficient if it provides the date of call, the name of physician contacted to obtain an EPSDT check, and that an EPSDT could not be obtained. Please maintain this in the file for those children that will have an EPSDT check pended until the time a physician becomes available.

To be clear, it is not necessary to obtain documentation from medical providers when they are unable to complete EPSDT checkups due to COVID-19. DFPS understands the significant challenge the virus poses, and will keep that in the forefront when testing for Quarter 3 remedies in June 2020. As the COVID-19 impact lessens and we get closer to the review period, we will provide information on how these assessments will be handled.

Dental Exams

For urgent or emergency dental issues, please continue to access dental health care as previously done, and follow dental health professional recommendations.

For ongoing routine dental checkups, the requirement for six-month healthy checks are suspended until further notice.

Sharing Information

We will continue to make every effort to keep you updated and to share information as we have it. We know you are committed to doing the same. Please inform your contract manager of any variance your facility may have been granted by HHSC Residential Child Care Licensing so that we can take the appropriate steps.

Thank you again for your commitment to serving children. We recognize and greatly appreciate the additional effort that is required to continue serving children and youth during this trying time. We are particularly grateful to those providers who have continued to accept new placements and quickly identified ways to quarantine youth to prevent placement moves and provide continuity of care. Please continue to let us know how we can help. Contact us at the DFPS RCC Provider email box.

Message to RCC Providers
March 24, 2020

Thank you for all the much needed support and care you continue to provide to children and families.  Your health and well-being are of utmost importance to us, as are the continued services you provide to our DFPS children, youth, and families. We want to share our plans for conducting the essential function of monitoring with you.  In order to maintain progress on key issues, we have been mindful to balance the challenges you are facing in the current environment, and have modified activities as follows:

  • Background Checks, Emergency Behavior Intervention training, and Trauma Informed Care training reviews will not be completed for the second quarter of the current fiscal year.
  • The PACES system will be released for the quarterly monitoring beginning in April, however only Early and Periodic Screening, Diagnostic and Treatment (EPSDT) assessments will be tested. Converting to an electronic system instead of email and excel spreadsheets should minimize the amount of time spent by both parties.
  • Office visits for EPSDT checks are suspended until further notice.  A contractor must attempt to find a Texas Health Step checkup option using telehealth. The Superior Member Help Line (866-912-6283) can assist if this is an available option with a STAR Health provider. You are reminded to follow the instructions for claiming an exception when an EPSDT via telehealth cannot be obtained which remains consistent with an in-office checkup.
  • The majority of work performed during on-site monitoring will now be completed by desk review. Interviews will be conducted virtually when possible.
  • On-site physical plant inspections for existing contractors and contract applicants may be conducted dependent on the status of the facility.
  • Annual on-site facility monitoring performed by Youth for Tomorrow will be conducted by desk review and through virtual interviews.
  • Unannounced 24-hour awake night supervision monitoring visits will be suspended until further notice. The monitoring will be announced with consideration given to the status of the facility relevant to COVID 19.

 Because of their importance, several critical activities will not be modified. They include the following:

  • The quarterly verification and gathering of each contractor's Sexual Abuse Caregiver Training log will go forward as usual.
  • DFPS will continue to gather internal data for the Safe In Care remedy and other performance measures resulting in incentives.
  • Non-telehealth (in person) Texas Health Step checkups should be prioritized for newborns, infants and young children especially to stay current on recommended vaccines and developmental surveillance, when available through local provider capacity. While some health care providers have limited capacity to provide well visits at this time, many practices have instituted policies to maintain well visits for young children.

Contract staff are informed of the need to cooperate with verbal health assessments that your agency may be conducting prior to accessing the facility.

We are asking that you contact your contract manager if your facility should go on quarantine.

Please contact HHSC Residential Child Care Licensing with any waiver or variance requests around ratios or licensing questions.

Please contact your contract manager if you have any specific questions or concerns. If you have general questions or concerns, please send them to the DFPS RCC Provider email box. We will post this email on our Coronavirus Resources webpage, and we will periodically update it with general questions that we receive in the provider mailbox. We will of course also continue to provide you additional information and guidance as it becomes available.

Resources

Texans, no matter where they live, can dial 2-1-1 or (877) 541-7905 and select option 6 to get information and referrals to COVID-19 social services, including testing, community clinics, unemployment benefits and more. Dial 2-1-1 to find information about local community resources such as financial assistance for utilities or rent and food pantries, housing assistance, crisis counseling, utility payment assistance, and senior services.

Message to RCC Providers
March 13, 2020

Thank you for all you do for children and families. We stand with you as you continue to deliver much needed support and care for those we serve. Many of you have reached out with good questions regarding COVID-19 (Coronavirus). As the situation continues to evolve, we wanted to provide some information and answers.

While DFPS has suspended all non-essential work travel through April 30th, including in-person trainings and gatherings of 100 people or more, we are still seeing clients and visiting people's homes. In determining how your agency is going to respond to COVID-19, we encourage you to follow the instructions of your local health authority and your agency's policy. We understand you may have questions and we are working diligently to develop guidance to help you navigate providing services while ensuring your health. Your health and well-being are of upmost importance to us, as are the continued services you provide to our DFPS children, youth, and families. The following information may be helpful:

  • Stay in close contact with local jurisdictions regarding safety protocols to ensure a coordinated approach to service delivery.
  • Continue to meet contact requirements as defined by your contract.
  • When planning for or at the time of a foster home visit, if a child or family member reports being sick, service providers must plan for alternate arrangements to maintain continuity of services until all members of the household are well (e.g. at least 24 hours with no fever, vomiting, etc.)
  • To prevent stigma and discrimination, do not make exposure risk determinations based on race, ethnicity or country of origin.
  • Ensure confidentiality of people with illness and confirmed COVID-19.
  • Wash hands or use hand sanitizer before and after home or office visits in addition to washing hands frequently.
  • Limit physical touch (e.g. – shaking hands) with others.
  • Offer to share information with the foster family about available community resources, information and referral networks, hotlines, etc.
  • If it is believed that any of these decisions will have a detrimental effect for a child, youth or family, please elevate the concerns as appropriate.
  • If it becomes necessary to modify the method of service delivery, in response to direction from your local public health official, you must notify your contract manager.

Answers to Your Questions

Where would we seek guidance related to how to care for kids in a quarantine environment?
Please visit the CDC website. It is a great source of information and provides guidance.
What is expectation and/or protocols if a child, caregiver and/or staff person is diagnosed with COVID?

If diagnosed with COVID-19, communicate with a health care provider about next steps, including self-isolation. Importantly:

  • Stay at home until instructed to leave: Patients with confirmed COVID-19 should remain under home isolation precautions until the risk of secondary transmission to others is thought to be low.
  • Talk to your healthcare provider: The decision to discontinue home isolation precautions should be made on a case-by-case basis, in consultation with healthcare providers and state and local health departments.
Where can we get hand sanitizer? What about other types of personal protective gear such as gloves and face masks
Please keep checking stores to restock, however, the best method for preventing the spread of COVID-19 is handwashing. Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing. The CDC does not recommend that people who are well wear a facemask to protect themselves from respiratory diseases, including Coronavirus. Facemasks should be used by people who show symptoms of Coronavirus to help prevent the spread of the disease to others. The use of facemasks is also crucial for health workers, and people who are taking care of someone in close settings (at home or in a health care facility).
Can orgs get an allowance/waiver for face-to-face visits, ratios, etc.? Can we facilitate use of zoom, video conferencing for parent and/or caseworker visits, etc? What about ensuring the health of folks who are not “within our control” such as CASA, legal, families, etc but who do have access to children?
At this time, there are no waivers for face to face visits with family members. This is a federal requirement and a very important part of the work you do for children. If this changes, we will advise you at that time. While there are no changes now, if you would like, you can begin to strategize about alternative methods for contact like zoom, video conferencing, etc. DFPS is in communication with the Administration about federal requirements.
At the House Public Health Committee meeting, one of the witnesses mentioned a concern over the supply chain for medications produced in China. That brings to mind whether any of the medications we administer in our programs could be subject to possible supply interruption. Is there a list of the medications presenting this concern?

The Vendor Drug Program (VDP) is closely monitoring the formulary for medications sourced in China and will disclose any shortages. As of now, HHSC did not see many on the formulary that were made in China. Specifically, HHSC provided the following guidance:

"HHSC is monitoring potential shortages of drugs that the Food and Drug Administration (FDA) has identified on its website. Currently there is no shortage of any drugs used to prevent, test, or treat COVID-19. HHSC also has an established drug shortage notification process that manufacturers use to notify HHSC of any shortages. Should a shortage occur, HHSC will identify and announce possible alternatives.

VDP will share with the MCOs all information regarding drugs shortages. MCOs have prior authorization data and the most recent claims data to identify members that will (have) to have alternatives authorized."

Are there any travel precautions we should take or restricted forms of travel (i.e. air)?
Please follow all CDC guidelines regarding travel. Also, we cannot stress enough reviewing the DSHS website for information.
Are there any restrictions on out of state travel due to the coronavirus?
Again, please follow CDC guidelines and avoid those destinations identified.
A DFPS caseworker told me that travel is halted for children in care until further notice statewide, is this true?
No, aside from the CDC guidelines regarding travel, at this time travel has not been restricted.
Can we discontinue family visits due to coronavirus?
No. Family visits cannot be discontinued. We do not have any information that warrants not having parent-child visits at this time, given their importance. If public health officials provide directions that necessitate changes to parent-child visits we will certainly follow those. That being said, there may be instances where we move to Skype or Zoom visits in the case of a primary medical needs child for example, or if an adult has underlying health concerns, etc. The work you do as providers is critical and must continue. Family visits are important to both children and their parents. Please follow the direction of your local health authorities and we will continue to share information with you regarding any changes.

The Administration on Children, Youth and Families has provided information to address and mitigate the spread of COVID-19. For local assistance, please see the listing of Coronavirus Disease 2019 (COVID-19) Local Health Entities. Check the DSHS website for the latest details and what Texans need to know about COVID-19.

March 13, 2020, Superior Health Plan began calling all caregivers of children and youth on to inquire about whether the caregiver has any pharmacy needs, authorization issues, or challenges getting the child or youth in to see a doctor. If they need assistance, the STAR Health member services 1-866-912-6283 will help them. The calls will continue through the weekend and are estimated to take about 3 days to complete.

Please contact your contract manager if you have any specific questions or concerns. If you have general questions or concerns, please send them to the DFPS RCC Provider email box. We will post this message on our DFPS Coronavirus Resources webpage, and will periodically update it with general questions we receive in the provider mailbox. We will, of course, also continue to provide you additional information and guidance as it becomes available.