Laurie Jackson |
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Posts: 5
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I am sharing with the permission of Sparky Harlan, the CEO of the Bill Wilson Center in Santa Clara, CA. The following are excerpts from her from the last five and a half days of guiding her agency through the trials of the COVID 19 situation.
March 12, 2020 4:53 P.M.
As a heads up, we are doing more extensive advisement around services, already assuming we have COVID-19 virus within agency. We are not cancelling nonresidential services because our Drop-In Center is key to triaging sick young adults. We have a Santa Clara County doctor who decides to isolate a sick youth in a hotel that we have to pay for 14 days. Do we have the extra funds? No. Anyone with a fever is isolated in hotel or separate room with separate bathroom (like we have that!!)
We have no access to hand sanitizers or wipes within SCC. First level of attack: protect staff. Requirement EVERYONE entering any of our facilities must go directly and wash hands. If you don’t want to wash hands, you leave. Period. We are creating our own solution of bleach and water to wipe down surfaces. Social distancing is key for all services, although we recognize we can’t do that for all services. We are canceling all meetings over 15 people and using Zoom. We are purchasing HIPAA compliant licenses to do remote therapy and case management. We are preparing for SJSU to declare that their 4,000 dorm rooms will close any day now. We expect 200 to become homeless. We hope to get funds to put well youth into Airbnb using our current pilot program with them. However, many hosts are blocking out dates and not renting rooms out.
If you want to see what our County did to respond to the first wave of infections, check out Santa Clara County website Board of Supervisors meeting last Tuesday. March 10. It is recorded on YouTube beginning at 10 am. It is a good overview of what we have to consider before taking action. For example, we are not recommending closing schools, at this moment.
Seattle and Washington State are taking a little different approach although both communities are communicating regularly and working together. Once you are in this, stuff changes rapidly.
I am receiving at least 20 write-ups an hour on agency policies for staff and clients. Take the best out there and think about every building and program you have and design it for your agency. Cut and pasting doesn’t really work. We are sending out an advisory every day to staff now.
March 12, 2020 5:56 P.M.
Below was our first email to All Staff on overall procedures for stopping transmission. We are adding specific policies for each site. We are sending out our policies in small chunks so people will read them and understand them. Our internal policy is many pages long.
Hello everyone,
As we continue to monitor the rapidly evolving spread of Coronavirus, our top priority is the safety and health of our staff. While we are deeply concerned about the burden that social distancing, workplace shifts, and canceled events are placing on the community, we must do all we can to help prevent the virus' spread. Here are some general guidelines that we want to restate to ensure basic prevention:
Staff Guidelines
1. WASH YOUR HANDS! Wash your hands with soap and water as often as possible throughout the day. Ask visitors and clients to wash their hands before and after any sessions. Front desk staff should ask all visitors to wash their hands as soon as they arrive at a BWC location. Avoid touching your face with your hands. Soap and water is still the best method to clean hands. Hand sanitizer should be used only when soap and water is not available. If clients or visitors refuse to wash their hands, they should be asked to leave the facility.
2. STOP HANDSHAKING! Use other noncontact methods of greeting.
3. SOCIAL DISTANCING! Maintain a space of at least 6 feet between you and other people whenever possible.
4. STAY HOME IF SICK! If you have a fever, we ask that you remain at home until 24 hours after the fever has.
5. COVER COUGHS and SNEEZES! Cover your nose and mouth with tissue or use the crick of your elbow to sneeze into if you don't have a tissue available. If you use tissue, immediately throw it out. Wash hands after you sneeze or cough!
6. DISINFECT and CLEAN! Surfaces such as tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks should be wiped down daily.
Supplies
There is a nation-wide shortage of disinfecting wipes, hand sanitizer and other items that are being used to prevent the spread of the virus. BWC has pre-orders ready with our vendors and we have also requested emergency supplies from the County of Santa Clara Emergency Response department. Please check all storage closets in your program/office to ensure that all cleaning wipes and sanitizer are out for everyone to use. While we wait for delivery of these items, our facilities team will be making bleach and water spray bottles that will be distributed to all locations for use to wipe down surfaces (will be delivered to sites by Tuesday next week). Hand sanitizer is only recommended when there is no soap and water available so PLEASE be sure everyone is washing their hands!
Upcoming Information
Specific policies for preventing the spread of the virus at the program level as well as caring for residential clients who exhibit symptoms are being developed as we speak! On Monday, Sparky will be having a discussion with Program Operations meeting attendees to confirm procedures and once finalized, this information will go out to staff. You can expect to see a few emails each week on COVID-19 updates and information as BWC follows recommendations from CDC and the County of Santa Clara.
Let's do all we can to help prevent the spread of COVID-19!
March 14, 2020 11:45A.M.
Do you have a disaster plan in place? Get ready to assign leaders to share these tasks.
You have to be planning in the moment, and short term and long-term. Each CEO will need to make these decisions on their own.
We (really me and my 3 Executive Team members) are taking a strong position to keep 24-7 programs open. We are anticipating needing to go over our capacity of 20 at basic center due to parents going nuts with unruly teenagers and we are at 19 today. Our State CCL has given us permission to do that with just fire clearance. We also only need one staff with the high level FBI and DOJ clearance and we can use trained volunteers or other staff with just DOJ clearance to supplement. Check and ask your CCL ahead of time to prepare. Monday we will get the number of beds over we can have from fire department.
If you have a pre-existing health condition, no matter your age, if you get note from doctor (screenshot of email from Doctor is enough) we will let you work from home. We are not letting anyone over 50 work from home just because our county recommended it.
We are not, yet, sending non essential staff to work from home.
First off, we ran our payroll records for anyone will dependents to get idea how many we may be planning for and also staff over age 50. We have 250 FT and 50 temp employees. We have told our staff with school-age children to call supervisor Monday for direction on what they can do from home. Each person with have a specific plan on what they are expected to do from home, e.g., if you have a caseload of 20 in THP, we will expect calls to clients and notes written up (we have EHR so easier for us). Will be checking in and doing regular supervision on phone with manager. These plans are evolving. Managers will be checking with Supervisors daily on issues and gaps.
We have 400 rent checks we process regularly and weekly checks for over 500 clients. Our auditors require original receipts and we are saying screw that, we will take the audit exception this year, we are accepting screenshots of receipts. Keep the originals until later to provide. I will add this new policy to our Finance Department manual as a new procedure on Monday. Maybe that will satisfy the auditors. All approvals can be done through emails without signatures. We will encourage staff to designate who picks up checks from Admin. Upon entering facility we require washing with soap and water. Our finance staff will remain working.
Daily, sometimes hourly, my tolerance for what I am willing to do changes. I am paying my staff with school-age kids to be home for three weeks and not use their PTO. Are they working? Some will, others will not but they will have work assigned to them. Some might be doing HMIS data entry. I am working with our nonprofit leadership to fight for us to pay them. We are advocating to get what San Francisco did. So far, they are the best.
However, we are anticipating losing at least $250,000 in 3 months even without dealing with whether we meet any outcomes or required services. Our school-based program and mental health services are fee for service. No one is paying us and clients are cancelling appointments. Our annual fundraiser is cancelled for May. We decided not to postpone it because we can’t even get a new venue in fall or whenever. Instead, we are planning for a weeklong donor campaign and doing some live programs and posting of videos. Hopefully, by then people will start thinking about throwing out lifelines to CBOs. Some CBOs are going ahead and selling tables for events in April and May even though they will cancel a week or two before. They will then ask folks to not ask for money back. I can’t do that but up to you.
Make sure you have a line of credit in place for cash flow.
Some of the general COVID-19 messages from CBOs asking for support feel a little self-serving and tacky so be careful what you send to public and donors.
Our statewide behavioral health association and statewide residential services association had both executive committee members on a call last night. They are setting up Google docs to start posting sample plans and policies from the large CBOs for smaller ones to get help with. They are taking some of the President’s directive to HHS and hope to clarify what can be billed with telehealth. Each of the 52 counties in CA have different rules.
But we don’t have HIPAA compliant telehealth software in place nor the money for it. For example, Zoom charges $200/month per person. Can you share one license? Possibly, I am trying to get it paid for now by begging software provider. Zoom is waiving fees for their basic services.
GoToMeeting and other software vendors are offering free services for small businesses so check online if you need to add capacity for remote work.
It is raining here and I need a hike anyway and then going to work. We have the largest homeless adult shelter and cold weather family shelter that is taking a firm position and announced no new clients until further notice. They are also telling volunteers to stay away and no longer taking donations of food or goods. They are sending nonessential staff home. My guess is they expect our county to have isolation shelters in place next week.
I am frustrated because I think our county has been slow compared to other communities. And, frankly, just like what we get from HUD, youth shelters are lower on their priority list. We have been told to text our needs to one disorganized county employee because they don’t have time to take our call. I am in the dark with what county is doing except we are told to wait until they make announcements.
At least SJSU called me personally to tell me they will not shut their 4000 dorm rooms down. Monday they will announce what plans are, which are still confidential so not sharing. I would suggest you look at it for your local colleges with dorms because it will be a humane approach. They are making sure to keep us informed. However, we are being inundated with panicked SJSU students that say they are homeless.
I am going to walk into our county emergency center tomorrow to get answers.
I will continue to share my diary with you! On a personal note, I live alone in a three-bedroom house, so I moved two college students (a couple) into my house last night and they are keeping my fridge stocked and feeding me in exchange for free rent. I am continue my commitment to provide housing to those who need it.
In Community Solidarity,
March 15, 2020 3:45 P.M.
Some software companies are stepping up to offer limited time free access to their services. More will be posted as they step up.
https://www.openforbusiness.org/
March 16, 2020 7:00 P.M.
Ok, this is the new reality on “shelter in place” rules. Homeless shelters are essential services but most counseling is not. 25% of my staff has school-age kids, has a preexisting medical condition, or is 65 and over, all reasons to work from home. My staff went into panic mode after the 1 pm press conference telling everyone that they need to be home by midnight. We explained that is not us. Our county is arranging washing stations, food delivery, cash assistance to homeless services. THEY ARE REQUIRING HOMELESS SHELTERS TO BE 24-7. Not sure how they enforce that if folks don’t have staff to cover. Our Sheriff Dept. just announced they are suspending all life-scan appointments although we have three shelter staff that need them now to be able to work. It is an extremely fluid time and just when you make one decision you have to change it and regroup. However, there does seem to be this sense of “make it work” for at least some folks. Others it is doing business as usual (like the State). However, our state monitor did give us 3 months to do a budget modification and just giving us our grant that is starting April 1. We are booking lots of Airbnb rooms for our homeless youth.
March 17, 2020 3:36 P.M.
We are so in the midst of this we cannot take the time to actually write this down. With the “shelter in place” and orders of who should stay home, staff who said they would stay onsite to work are now wanting to stay home. Some can work remotely but not shelter stay. They are all very scared. It is not a lock down but I had to stop staff from bolting out the door yesterday at 1 pm even though it wasn’t in place until midnight.
Main decision for you all will be what is your policy for staff who need to be home but cannot do their job remotely? Do you force them to take PTO? We are saying they will be paid without using PTO for the three week order. But now we worry there will be a rush for others to say they need to be home. We will decide what our policy is after that. Every 15 minutes we have another group of staffing issues we are addressing. We cancelled all PTO, we are not letting our key directors leave the area. We are making sure we have Finance staff remaining to write checks. We are lining up volunteers to cook and package meals to deliver. We don’t have staff who can take time to cook anymore. We have written new finance policies for documentation. It is basically, “Covid-19 Disaster Plan Policy”, “Whatever the CEO decides is what we are allowed to do.” That is my written policy for now. |
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