Updated: May 18, 2020
(see the attached PDFs below for the Informed Consent form and printable guidelines)
As states begin to lift their “stay-at-home” orders in phases, many early intervention (EI) practitioners are anxious to ‘get their hands on’ their clients again. But before going back to direct care, EI practitioners should consider the following:
During Early Phases of “Opening Up America Again,” Consider Resuming In-Person Sessions Only for the Following Reasons:
The client’s family has NOT been compliant or participating with telehealth sessions.
The client has not made progress with telehealth service delivery.
The client needs direct, in-person care from the EI practitioner to reach the established IFSP goals.
Determining if an In-Person Session is Necessary
Before resuming in-person sessions, you should first check and follow your state guidelines to determine if direct in-home services are allowed or if any criteria must be met.
Determining the service delivery mode of in-person sessions or teletherapy sessions should be a joint decision of the EI practitioner and the client’s family.
Clients and EI practitioners who are high-risk for complications to COVID-19 should continue remote services when appropriate and make careful considerations prior to resuming in-person sessions.
EI practitioners should ask themselves, “Does the client’s services require face-to-face contact or can sessions be continued remotely?” Err on the side of safety.
When determining the service delivery mode, EI practitioners should document the decision-making process.
Review Health and Behavior Risks
Assess the health of the client to determine if their health status puts them at higher risk of contracting COVID-19.
Assess the behaviors of the client and family to determine whether their behaviors (i.e. contact with the public, shopping, use of personal protective equipment, etc.) put them at higher risk of exposure to COVID-19.
Establish Guidelines for In-Person Sessions
If you decide to see a client in their home or community setting, consider protecting yourself and/or your agency with an informed consent document (see sample EI Informed Consent Form below).
Discuss the risk of exposure to the COVID-19 with your clients and document their understanding of those risks and their agreement to proceed with in-person care.
Establish expectations and policies with the caregiver prior to resuming in-person sessions.
Schedule appointments with extra time between sessions to allow for handwashing, disinfecting, and sanitization.
Prior to each session, conduct pre-screening phone calls to confirm that no one in the family/household has a fever, shortness of breath, cough, or has been exposed to anyone demonstrating signs of COVID-19.
Ask family members to wash their hands thoroughly prior to the session and to avoid touching their face during the session.
Limit the number of people present for the session (i.e. do not allow siblings or extra family members to attend).
Be sure to have personal protective equipment available during sessions (i.e. extra gloves, masks, sanitizer, disinfectant wipes, etc.).
When returning to the client’s natural environment, you may want to consider “Front Porch Sessions” or “Carport Sessions” rather than going inside the home.
If the session must be inside the home, request the family open windows or increase ventilation if possible.
Minimize contact during the session and comply with “physical distancing” (at least 6 feet apart) as much as possible during the session.
Implement a “no-touch” policy and avoid direct physical contact with clients and their family members.
Use disinfected items and toys from the client’s natural environment for session activities. If you must take toys/equipment to the session, take extra care to disinfect before and after each use.
Carry pre-packed PPE kits in a sealable bag to each session. When leaving an in-person session, seal all used disposable PPE in the bag for disposal.
Clean all equipment and personal items outside the home prior to leaving.
To capture signatures at the end of each session on paper or tablet, you may ask the signer to wear gloves. Disinfect the tablet or pen thoroughly after each use. If allowable by your early intervention program, record a “verbal consent” signature instead of a direct contact signature.
Document all precautions taken before, during, and after the session in each session note.