Please Note: On November 24, 2020, this article was updated with recent changes to the Essential Family Caregiver Program Guidelines. The general rule under the previous Guidelines was that Essential Family Caregivers may only work with Green Unit residents. Under the updated Guidelines, an Essential Family Caregiver who had COVID-19 within the past 90 days and is no longer transmissible may work with residents in other units, although Essential Family Caregivers may work with those in TBP for compassionate care situations even if they have not had COVID-19 within the past 90 days. Further, Essential Family Caregivers who had COVID-19 within the past 90 days do not need to be tested; when 90 days have passed since symptom onset, an Essential Family Caregiver should once again be tested on the same frequency as facility staff.
On Friday, November 20, 2020, the Indiana Department of Health issued a LTC Newsletter reminding long-term care facilities (both nursing facilities and assisted living communities) of the availability of the Essential Family Caregiver Program, which can help supplement care at a time of staffing shortages and assist with socialization of residents, an equally important undertaking during this time. The guidelines for the Essential Family Caregiver Program can be found here and include important protections to help ensure the safety of residents and staff.
We encourage those long-term care facilities that have not yet implemented the Essential Family Caregiver Program to revisit the program to determine if it would be beneficial to the residents, families, and staff at your facility. For those long-term care facilities that have implemented the Essential Family Caregiver Program, we encourage you to market it once again to ensure families know of its availability.
The highlights from the LTC Newsletter are as follows, and importantly, the LTC Newsletter describes how Essential Family Caregivers may continue even when indoor visitation is otherwise restricted, as the services they provide to residents fall under compassionate care as defined by CMS:
- As a reminder, the Essential Family Caregiver Program was launched by the state in June 2020. The program allows a family member or other outside caregiver (i.e., friend, volunteer, private personal caregiver) age 18 or older who provided regular care and support to the resident before the pandemic (at least twice weekly) to supplement the care and support of the resident during the public health emergency. This care and support should occur in the resident’s room only and not in other areas of the long-term care facility.
- The program is still in effect and may be utilized by both nursing facilities and assisted living communities. Essential Family Caregivers should be specifically designated by the long-term facility as such and should only be utilized for residents in a Green Zone; an exception to this requirement is if the Essential Family Caregiver had COVID-19, is no longer transmissible, and is within 90 days of their previous symptom onset date.
- Residents who are on transmission-based precautions (TBP) for COVID-19 should only receive Essential Family Caregiver visits that are virtual, through windows, or in-person for compassionate care situations, with adherence to TBP.
- CMS’s QSO 20-39 allows visitation even when indoor visitation is otherwise restricted (i.e., because of an outbreak or a county is above 10% positivity) for compassionate care situations. Compassionate care situations and Essential Family Caregivers are similar in application and facilities are encouraged to permit and implement these concepts.
- Essential Family Caregivers are permitted to continue even when indoor visitation is otherwise restricted due to outbreak or county positivity above 10%, as the services they provide to residents fall under compassionate care as defined by CMS.
- Long-term care facilities not currently utilizing the Essential Family Caregiver Program are encouraged to revisit the program to determine how it could be implemented at your facility. Essential Family Caregivers can be important supplements to your existing staff resources.
- The following are recommendations to be considered for those long-term care facilities currently utilizing or planning to utilize the Essential Family Caregiver Program:
- Facilities should provide basic infection control and PPE usage training to individuals requesting to be designated Essential Family Caregivers. For example, Section II of the Personal Care Attendant Training could be utilized as a guide.
- Facilities should issue basic guidelines to Essential Family Caregivers to ensure they understand the parameters of the program (i.e., Essential Family Caregivers must wear a mask at all times, Essential Family Caregivers must be tested on the same schedule that facility staff are tested, Essential Family Caregivers should only visit their designated resident’s room, except when utilizing the entrance and exit pathways, etc.). Please note, Essential Family Caregivers who have had COVID-19 within the past 90 days do not need to be tested; when 90 days have passed since symptom onset, an Essential Family Caregiver should once again be tested on the same frequency as facility staff.
- Facilities should consider having Essential Family Caregivers sign a form indicating they understand the parameters of the program and that the designation may be removed if they fail to follow the guidelines.