BOSTON — Child care is going to look different as facilities begin to reopen in the second phase of the commonwealth's recovery from the COVID-19 pandemic, but one element of elder care will start getting back to normal under guidelines released on Tuesday.
Commissioner of Early Education and Care Samantha Aigner-Treworgy and Health and Human Services Secretary Marylou Sudders joined Gov. Charlie Baker on Wednesday at his daily press availability.
Aigner-Treworgy laid out a number of the guidelines on child-care programs that were released on Monday.
Sudders explained the rules that will let assisted living facilities to start allowing family members to visit their loved ones — outdoors and while observing the social distancing rules that mark the rest of life in the commonwealth during the pandemic.
"Child care, recreational summer programs and day camps serving youth are all critical components in getting families and the economy back to work," Aigner-Treworgy said.
On Monday, in cooperation with the Department of Public Health, Aigner-Treworgy's office released the minimum requirements for those programs, giving providers time to implement changes ahead of the start of Phase 2 in Baker's plan to reopen the state's economy.
"Child care will look different, and as a former preschool teacher, I want to acknowledge how hard this will be for both our educators and our families," she said. "Some examples of the changes include: Providers will need to scan and screen all staff and children, including health checks, prior to allowing them into the space each day; there will be one point of entry for all families; and families will need to drop children off on a staggered schedule at the door, so we can limit non-essential adults in our childcare facilities.
"Daily activities will need to be redesigned to avoid close contact between children, encouraging social distancing whenever possible."
Child-care facilities looking to open in Phase 2 will need to submit a plan to Aigner-Treworgy's department, and she said additional guidelines will be released in the days ahead. She also noted that the commonwealth will continue to operate the emergency program it implemented for essential workers in order to continue their access to childcare as the rest of the industry gets up and running.
"We understand that social distancing is not easy with toddlers," Aigner-Treworgy said. "There will be many challenges in operationalizing these requirements. And I know there's a lot of anxiety in the field. I assure you our approach is meant to be supportive, not punitive."
Baker later acknowledged a concern that some facilities will choose not to reopen under the more restrictive rules or that facilities will lose revenue because families of families choosing not to return out of concern for children's health.
"We just don't know how people are going to respond to these things, especially in the short term," Baker said.
Aigner-Treworgy said that child-care facilities, like any small business, will struggle as families decide whether to return to the system.
"We have focused the federal funding that we receive toward those providers — about 50 percent of the providers — that are serving that 20 percent of our [at-risk] families," she said. "And we're looking at it in two-month intervals and trying to make sure the requirements and funding that we put in lasts through the summer."
Sudders announced the results of the commonwealth's second round of COVID-19 compliance audits for long-term care facilities and explained the rules that will govern family visitation at those facilities.
"Beginning today, family visitation restrictions at nursing homes, rest homes and assisted living facilities have been eased to allow scheduled, outdoor visits," Sudders said. "While we continue to promote alternative electronic methods of communication … there's nothing, we know, like an in-person visit."
Family visits will be limited to two family members from outside the facility, visitors will be screened, visitors will need to maintain a 6-foot distance from residents and a trained long-term care facility staff member must remain with the visitor throughout the visit, Sudders said. Any resident of a facility suspected of COVID-19 will not be eligible for a visit.
Sudders also shared some good news about the commonwealth's monitoring of nursing homes.
Ninety-seven percent of the commonwealth's 360 facilities have met the requirement to test at least 90 percent of residents and staff for COVID-19 by May 25.
Beginning May 4, the commonwealth began auditing facilities on a 28-point infection control checklist, and last Friday, it completed the second of four rounds of those audits, Sudders said.
In the first round of audits, May 4 to 15, all 360 facilities were audited and categorized either green, yellow or red based on five core competencies; failure to pass one category put a facility in the red.
"Many of the facilities in the red category would have received a high enough score to be in the green if they had not missed that one core measure of competency," Sudders said.
In Round 1, 132 facilities, just more than a third, finished in the red. The second round of audits looked at 230 facilities — including the all 132 failures — and found just 49 facilities, or 21 percent of the sites tested, in the red.
"All facilities in the red and yellow will be audited again within the next two weeks and will continue to receive enhanced supports from us," Sudders said. "Overall, the results of the second round of audits demonstrate encouraging improvement among many nursing facilities.
"The most common missed core competency remains the improper use of [personal protective equipment]. Facilities that consistently have low scores on audits and that we believe may potentially endanger the health, safety or welfare of residents will not be eligible for continued enhanced funding and will be subject to additional consequences, including potential termination of medicaid receivership and other sanctions."
Sudders later clarified that the funding at risk for failing the audits comes from state's $130 million accountability package announced in late April.
Wednesday's press conference, the first for the governor since Monday, covered a variety of topics:
• Baker reiterated his support for demonstrators who have been marching in recent weeks as part of nationwide protests sparked by the death of George Floyd in Minneapolis.
"The murder of George Floyd was a tragedy," Lt. Gov. Karyn Polito said. "It was wrong, and it was an act of racism. We cannot and will not tolerate these injustices. We must listen, learn and make progress in this fight."
• Baker did acknowledge that demonstrations on the scale seen over the last week could heighten the danger of transmitting the novel coronavirus but noted that he had seen widespread use of facial coverings and hand sanitizer among demonstrators.
He also said smaller protests have occurred in the commonwealth throughout the pandemic and he had no plans to use public health as a reason to quelch the demonstrations.
"No one has been arrested, no one has been ticketed, no one has been fined [for violating the public health order limiting the size of gatherings]," Baker said. "I think our view on things like this is First Amendment rights are a balancing act for us in dealing with this pandemic and the contagious nature of it. We certainly appreciate the fact that many of the folks involved in these protests have worn face coverings."
• Although grocery stores and pharmacies continue to be required to set aside at least one hour per day for customers aged 60 and over, Polito said she does not anticipate similar requirements for restaurants or other retail establishments as they open during Phase 2.
"I would not want to be overly proscriptive to restaurants about how to gain the attention of their customers and patrons who want to come back," Polito said. "That might be something that they would consider as an opportunity to have an older population return to a restaurant so they feel comfortable. But I would want to leave that up to restaurant owners to design a program to get their workforce back but also to help their patrons feel comfortable and confident that returning to a restaurant outdoors and indoors makes sense to them."
• Baker indicated an announcement could be made in the next few days about the start date of Phase 2 of the reopening.
"As a reminder, our public health officers will be monitoring data all week to determine when we can start Phase 2," Baker said. "And we plan to be here with you on Saturday to detail the results and when Phase 2 will start."
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