Questions and Answers for Staff, Families, and Clients of Children's Residential Facilities: COVID-19
The Minnesota Department of Health (MDH) and the Department of Human Services (DHS) are working together to monitor and respond to the developing COVID-19 situation. Both agencies recognize the immense value that children’s residential facilities offer to children and families in our communities.
Supervised group settings can face rapid spread of COVID-19 among employees, the people who live there, and their families. The questions and answers provided here are intended to help find ways to deliver services that lower the risk of introducing and spreading COVID-19 among unvaccinated people that may live, work, or visit within these settings. This guidance gives providers recommendations about best practices; it does not mandate specific actions.
Staff who are fully vaccinated, at the time they are exposed, do not need to quarantine if they have spent time close to someone with COVID-19 infection. After an exposure in non-health care settings, staff should watch for symptoms for 14 days after their close contact exposure to COVID-19, and get tested if symptoms develop.
In health care settings (including behavioral health treatment settings), staff who have no symptoms and who have had prolonged close contact with someone with COVID-19 infection, regardless of vaccination status, are recommended to be tested immediately and five to seven days after exposure to COVID-19.
Please note, fully vaccinated means two weeks have passed since a second dose of a vaccine that requires two doses, or two weeks after getting a vaccine that requires only one dose.
Staff in non-health care settings who are vaccinated are no longer required to wear facemasks. However, unvaccinated people are still strongly recommended to wear masks in all congregate settings.
For staff who work in a health care setting, including behavioral health treatment, CDC recommends all staff, regardless of vaccination status, wear respirators (e.g., N95 or equivalent), or well-fitting medical-grade facemasks and eye protection during their entire shift (with limited exceptions), as supply allows.
In addition, regulations set by federal regulatory agencies and local mandates may require facemasks, and each health care setting is responsible for understanding and following applicable requirements.
Non-health care congregate settings can determine whether their staff should continue wearing facemasks. Non-health care congregate settings may also choose to tailor policies to address specific, higher-risk situations. For example, facemasks should still be considered if:
- Any staff or residents are unvaccinated.
- Any staff or residents are immunocompromised or at high risk of complications from COVID-19 illness.
- If there are low or unknown vaccination rates among staff or residents.
- If the health care setting is in a county with test positivity rates above 5%.
If a staff or resident has been in the building while infectious with COVID-19 illness in the past 14 days, staff and residents should use personal protective equipment per CDC's Updated Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination and COVID-19 Vaccine FAQs in Correctional and Detention Centers.
More updated information on masking can be found at Recommendations for Wearing Masks.
More information on how to create a well-fitting facemask can be found at CDC: Improve How Your Mask Protects You.
Staff providing care to children with confirmed or suspected COVID-19, in health care or non-health care settings, should wear personal protective equipment, regardless of vaccination status:
- Respirator (e.g., N95 or equivalent)
- Eye protection
If someone living at the facility has COVID-19 symptoms, regardless of vaccination status, find an area to safely isolate them from others and designate staff to care for them. Notify family as soon as possible when their family member is suspected of having COVID-19 or tests positive.
Testing is recommended for all staff, the people who live at the facility, and their family members who show symptoms, regardless of vaccination status. While residents are waiting for their test results encourage them to stay in their rooms or at least 6 feet away from others.
People who have a negative COVID-19 test and who have an alternative diagnosis may resume normal activities based on recommendations for the alternative diagnosis. Residents who test positive for COVID-19 are strongly encouraged to stay away from others, should stay in a private bedroom with a private bathroom, until they meet CDC criteria for Ending Home Isolation for Persons with COVID-19 Not in Healthcare Settings.
Facilities can consider grouping multiple people who test positive in the same shared bedroom if a private bedroom is not available for each. Consider cleaning dedicated bedrooms and bathrooms only as needed (e.g., soiled items and surfaces) to avoid unnecessary contact between people with COVID-19 and others.
For safe administration of nebulizer treatments to clients with suspected or confirmed COVID-19, facility staff can refer to guidance on Aerosol-Generating Procedures and Patients with Suspected or Confirmed COVID-19 (PDF).
Find more information on cleaning and disinfecting community facilities at CDC's COVID-19 Guidance for Shared or Congregate Housing and Cleaning and Disinfecting Your Facility.
Monitoring staff and their symptoms and acting accordingly when staff show COVID-19 symptoms is key to preventing the spread of the virus. Staff members who have symptoms should not report to work. Administrators should consider checking staff temperatures and assessing them for symptoms of COVID-19 before each shift.
If staff show symptoms of COVID-19 during their shift they should:
- Put on a mask, if not already masked.
- Tell their supervisor and leave work immediately to self-isolate at home.
- Tell facility leadership who they were in contact with, what equipment they used, and where they were in the facility throughout their shift and two days before their symptoms started.
Staff who have COVID-19 symptoms should be evaluated by their primary care physician, who may recommend testing for COVID-19. Staff who test positive for COVID-19 should not be allowed to work while they are sick. More information about returning to work can be found at CDC: Return to Work Criteria for Healthcare Personnel with SARS-CoV-2 Infection.
We recommend that staff should self-monitor for symptoms and get re-evaluated if symptoms recur or worsen. If staff test negative for COVID-19, or were not tested but have an alternative diagnosis, facilities should allow staff to return to work per the organization’s standard guidance, returning no sooner than 24 hours after their fever ends and symptoms improved.
Children's residential facilities are recommended to follow Interim Guidance for Discharge to Home or New/Re-Admission to Congregate Living Settings and Discontinuing Transmission-Based Precautions (PDF).
Family visits are essential to the well-being of people living in children’s residential facilities, yet they provide an opportunity to bring COVID-19 into the facility. It is important to screen visitors for symptoms and potential close contact with COVID-19 before they enter the facility. Ideally, the screening should include taking the person’s temperature and asking these questions:
- Do you have symptoms of COVID-19, including fever, cough, shortness of breath, chills, headache, muscle pain, sore throat, fatigue, congestion, or loss of taste or smell, or other less common gastrointestinal symptoms of nausea, vomiting, or diarrhea?
- In the past 14 days, have you been identified as a close contact of someone who has tested positive for COVID-19?
- In the past 14 days have you been in contact with someone who had symptoms of COVID-19 and who is waiting for COVID-19 test results?
It is recommended that visitors be prohibited from entering the building if:
- They have a measured fever or seem to have a fever.
- They answer “yes” to any screening question.
Visitors who are fully vaccinated and showing no signs or symptoms can be exempt from these criteria.
Children's residential facilities may create their own policies and procedures to limit disease transmission when visitors are in the facility. Visit CDC's Interim Public Health Recommendations for Fully Vaccinated People and Updated Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination.
Home visits are essential to properly plan for the transition of services soon, yet they could provide an opportunity to bring COVID-19 into the facility. Before allowing a home visit, facilities should assess potential risks to the person planning to go home and to the people living in the home, and discuss expectations.
Before the person returns to the facility after their home visit, ask about their health and any known contact with a person with COVID-19 during the home visit.
If it is suspected that an unvaccinated person who lives in the facility had close contact with someone who has tested positive for COVID-19, they should stay away from others for 14 days (quarantine). If a person is fully vaccinated they do not need to stay away from others.
Children's residential facilities who provide transportation to their clients may refer to guidance found in Guidance for Facilities Providing Transportation Services during COVID-19 (PDF) and CDC: Protect Yourself When Using Transportation.
There may be times when staff members need to physically intervene with someone who has COVID-19 in order to protect people’s health and safety. These situations are particularly challenging because they can arise with little to no warning. to reduce the risk of contact with COVID-19 associated with these interactions MDH and DHS recommend:
- Encouraging vaccination of all staff and residents.
- Review techniques for avoiding restrictive procedures, including relationship building, de-escalation techniques, avoiding power struggles, etc.
- Wear well fitted masks and other appropriate personal protective equipment.
- Make sure staff know where personal protective equipment is stored throughout the facility so it is readily available if needed for an escort or restraint.
- Regardless of vaccination status, wear the following during physical contact with people who have tested positive for, or are suspected of having COVID-19, or who have had known contact with COVID-19 in the past 14 days:
- Gloves, gown or coveralls.
- N-95 or higher-level respirator (surgical facemasks are an acceptable alternative if respirators are not available).
- Eye protection (goggles or a face shield that fully covers the front and sides of the face).
- Clean and disinfect any equipment or belongings that may be contaminated. This is especially important after any close physical contact with someone who lives at the facility who has tested positive or is suspected of having COVID-19.
- Use an EPA-registered household cleaning spray or wipe. Follow instructions on the product label.
- Contain and throw away used personal protective equipment and wash any clothing that may be contaminated. Avoid shaking the clothes.
- Follow existing procedures for contact with bodily fluids. For further information CDC: Cleaning and Disinfecting Your Facility.
- CDC: Cleaning and Disinfecting Your Facility
- CDC: COVID-19 Guidance for Shared or Congregate Housing
- CDC: Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic
- CMS: Guidance for Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19) in Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IIDs) and Psychiatric Residential Treatment Facilities (PRTFs) (PDF)
- COVID-19 Toolkit: Information for Long-Term Care Facilities (PDF)
- Evaluating and Testing: COVID-19
- COVID-19 Prevention Guidance for Certified Child Care, Youth Programs, and Camps (PDF)
- Masking Recommendations for Child Care