It’s been a month since I first wrote about the lack of clarity from DDS about providers’ responsibilities as the District advanced into Phase One reopening. Now we’re in Phase Two, and things haven’t improved much, if at all.
On June 27 D.C. DDS issued guidelines for supporting people under D.C.’s Phase 2 reopening: https://dds.dc.gov/sites/default/files/dc/sites/dds/publication/attachments/DDS%20Phase%20Two%20Re-Opening%20Guidance_0.pdf. Andy Reese, DDS director, has continued to state in the Friday community conversations (https://dds.dc.gov/node/1470236) that, except for some specific DC Health guidance for intermediate care facilities (ICFs) and residential habilitation (group homes), there are no restrictions placed on full participation in D.C.’s reopening by people receiving residential supports, and provider agencies are not empowered to apply such restrictions.
As the Phase Two guidance above indicates, DDS has established an assessment tool, the Community Participation Assessment and Questionnaire, or CPAQ (https://dds.dc.gov/node/1467506), to help identify the supports that individuals need as they consider re-engaging in waiver-supported day services. DDS has repeated over and over that the CPAQ is not intended to restrict people’s movements in the community, but rather to guide the team concerning the types of supports a person needs.
None of the repeated statements on the Friday calls have made any difference. Some providers still seem confused, while some are intentionally disregarding the guidelines. The answer from DDS has been: lots of training, and now a more specific Power Point that is being developed to make things clearer. Maybe this will make a small difference. But more to the point, DDS, at the most senior level, has to put teeth behind the guidelines and insist they are followed. Then, in individual CPAQ meetings and other team deliberations, service coordinators must keep the rights of the person at the forefront of the discussion, with the focus on supports rather than restrictions.
Some of you may read this and think: you can’t prioritize rights over safety! And I agree. Everyone needs to be following guidance found at https://coronavirus.dc.gov/, and Mayor’s Order 2020-063 (https://coronavirus.dc.gov/release/guidance-mayor%E2%80%99s-order-residents-and-businesses) continues to apply. But here’s the thing: there is increasing evidence that the most likely environments for contracting covid-19 are enclosed, air-conditioned indoor spaces. This means that the instinct by some providers to continue confining people indoors - besides the mental-health consequences of isolation - is precisely the wrong reaction. DSPs, however essential, can carry covid into living spaces without knowing it, and members of the general public come and go in apartment buildings’ common areas, potentially bringing the virus with them. And it’s happening: as of July 17, of the 212 covid cases among those DDS supports, 89 of the people were in supported living – the largest single group (77 have been in ICFs) and over 40% of the total.
But providers don’t listen to me, they listen to Andy Reese (firstname.lastname@example.org). What matters here is what DDS is prepared to enforce. And the answer to that is the least clear of all.