Harbor Hall’s office-based opioid treatment (OBOT) program is a medically managed program that provides treatment services to persons with opioid use disorders. Please listen to this radio message by Peter Bucci, Clinical Director.

COVID-19 policy Addendum 1

Date: April 27, 2020

POLICY:

Harbor Hall is committed to mitigating the advancement of COVID-19 in any way that is within our control.  The CDC guidelines of social distancing and the Governor of Michigan Executive Orders has required Harbor Hall to take actions to isolate at risk, and our most vulnerable populations as best we can.  The purpose of this policy is to set forth standards of practice and strategies that will enable Harbor Hall to protect our residents, staff and the community as we begin to slowly reestablish operations.

BACKGROUND: 

There has been many changes that have occurred with the COVID-19 issues and the response to it on an almost daily basis.  Harbor Hall has developed and activated a COVID-19 Mitigation Response Plan.  We have complied with all of the orders of the State of Michigan in order to do our part to mitigate the problem.  We have worked in conjunction with the Northern Michigan Regional Entity, Mid-State Health Network, Northwest Michigan Public Health Department and the Recovery Centers of Michigan to address a variety issues.

The below policy is to establish procedures as Harbor Hall begins to reopen at a reduced rate as normal operations resume.

General Building Security:

1. All exterior doors will remain locked at all times.
2. Door bells will be installed to alert staff of visitors.
3. Admin areas will have plexiglass barriers to protect staff
4. Entrance log will be maintained, logging in and out of all visitors that will include temperature
5. Ensure adequate supply of PPE is available for visitors and staff
6. Ensure adequate supply Hand sanitizer is available for all visitors and staff.
7. Ensure adequate supply of CDC COVID-19 questionnaires at the main entrance

Access to buildings:

Residential: 

1. All exterior doors will remain locked at all times.
2. Entrance to the facility will be through the main entrance only for visitors located on the south side of the building.
   • Staff may enter through the “Staff Only entrance” on the North side of the building.
   • All staff are to report to have temperatures taken at the beginning of shift.
3. Anyone entering the building must have their face covered.
4. Staff will have donned appropriate PPE to greet visitors.
5. All visitors/guests entering the facility must answer the CDC guideline questions.
6. Hand sanitizer is to be used by all visitors/guests prior to entering the building.
7. Temperature will be taken of all visitors/guests prior to entering the building.
   • Temperature of visitors will be logged in the visitor sign-in/out log
8. The general rule is: only one visitor/guest is to be in the administration area at a time, social distancing is to be maintained.
   • During admission of a new resident that may be extended to include one escort who will follow the same procedure for access above.
9. Maintain the social distancing guidelines in all areas of the building.

All Outpatient sites including OBOT:

1. All exterior doors will remain locked at all times.
2. Entrance to the facility will be through the main entrance only.
   • All staff are to report to have temperatures taken at the beginning of the shift.
3. Anyone entering the building must have their face covered.
   • Each client WILL provide their own face mask and staff will have a face mask made available to them if needed.
   • If a client does not have a face mask upon arrival at the building, they will be refused face-to-face services.
   • If refused face-to-face services, the clients will be asked to call for a teletherapy appointment with their counselor.

It’s important that the clients are aware of these requirements in advance.

4. Staff will have donned appropriate PPE to greet visitors.
5. All visitors/guests entering the facility must answer the CDC guideline questions.
6. Hand sanitizer is to be used by all visitors/guests prior to entering the building.
7. Temperature will be taken of all visitors/guests prior to entering the building. Temperature of visitors will be logged in the visitor sign-in/out log
8. The general rule is: visitors/guest are to maintain 6’ in the administration area and in group rooms.
9. Maintain the social distancing guidelines in all areas of the building.

Screening:

Screening for appropriateness for services and placement at all sites and all services will be conducted over the phone or through Zoom as appropriate.

Admission/Intake Residential:

1. Intake begins at screening, CDC approved questions asked in addition to the normal screen.
2. Upon arrival, client and family will be screened again. This will now include Temp check for clients and family, sanitize, and isolate in front office until full check-in is complete.
3. Once check-in is complete, client will be escorted to room which will be in 200 to 203. Those ten rooms will be sectioned off. The entire front area will be blocked from “cleared” client use. This area includes the music room, old stairs, and upper bathroom. Tape marking the floor in the upstairs and downstairs to denote limited areas.
4. Isolated clients will be checked for symptoms twice daily.
5. Isolated clients will wear a mask when outside of their room at all times.
6. Isolated clients will collect their food at 12 and eat in their room
7. Isolated clients will smoke either at separate times or off porch and away from other house members.
8. Options for separate group schedule, otherwise clients will only attend Psychotherapy group and the one PM lecture.
9. Isolated clients will remain in isolation for a minimum of 7 days or until cleared by the MD

Outpatient Services:

Drug Testing:

1. Drug testing will commence as soon as possible once we are able to do so safely.
2. Clients and staff will wear face masks during the drug testing procedure.
3. Gloves may be worn by staff if deemed necessary.

Therapy/Counseling Sessions:

1. When allowed to conduct face-to-face group therapy sessions, the group size may be limited depending on the Governor’s orders, social distancing practices and group room size.
   1. The group size is to be limited to 10 or less clients, clinical staff will break the large group number up into smaller sized groups to accommodate the Governor’s order at that time. This may require the facilitation of more group therapy sessions each week.
   2. OP Petoskey can also open up the upstairs main group rooms to one large room vice two smaller rooms. This will allow us to service more clients in a group setting while maintaining social distancing practices.
2. For individual face-to-face therapy and assessment sessions, social distancing practices will be in effect along with the wearing of face masks for staff and clients alike.

OBOT/Primary Care:

1. There is currently a back log of potential OBOT/Primary Care clients waiting for services.
   1. All of the precautions mentioned above will be in effect for the OBOT/Primary Care program.
   2. Continue with the standard screening process to see who qualifies and who does not qualify for the OBOT program.
   3. Clients will be brought in at an expected rate of 6 per day and will be intermingled with the current client caseload.
   4. Inductions will take place as scheduled but no later than 2 pm, Monday through Thursday.
   5. Existing clients will be seen up to 4 pm, Monday through Thursday.
   6. Clients will be scheduled on a first come-first served basis starting at 8:30 am and ending at 2 or 4 pm depending on whether the appointment is an induction or not.
   7. The schedule will be filled for all appointment slots for Monday before moving to Tuesday and so on. Appointments WILL NOT be scattered throughout the day/week but rather back-to-back each day.  We will do our best to accommodate a client’s desired appointment time and date but our schedule of the next available appointment time and date will prevail.
   8. Clients will be required to schedule their next appointment before they leave the OBOT office.
      1. Scheduling will be in the downstairs office to schedule those appointments.
      2. Appointments will be scheduled to include a 15 minute timeframe that is built into the appointment. In other words, if a client has a 2 pm appointment, they will be scheduled, and told to be at the appointment at 1:45 pm.

• This extra 15 minutes will allow for check-in, drug testing, social distancing, etc. If a client is more than 15 minutes late for their scheduled appointment, they will be scheduled for the next available appointment which MAY NOT be that same day.

Telemedicine/Teletherapy:

Telemedicine/Teletherapy will continue for those as appropriate and as directed by the State of Michigan or Northern Michigan Regional Entity.