On Tuesday March 10, 2020, the Governor of North Carolina, Roy Cooper, declared a state of emergency to assist our state and local government officials fight the spread of COVID-19, commonly known as coronavirus. At the time, there were only 7 confirmed cases of COVID-19 infections in North Carolina. However, the Mountain Area Community Services, Inc. (MACS, Inc.) leadership team immediately engaged in discussions to create emergency management plans for the people we serve, their families and all direct care personnel and supervisory staff. This leadership team created a three tier response system; Tier one: general guidelines for all personnel of MACS, Inc. to guide daily activities; Tier two: increased levels of precaution and direction of all personnel if/when cases of COVID-19 entered into the Vaya Health catchment area from which all of our services originate; and Tier three: strict regulations and mandates for all personnel should the COVID-19 virus enter into either the MACS, Inc. family of stakeholders or the COVID-19 virus enter into one of the three counties for which we operate.
As you all know, the COVID-19 virus has infiltrated all of Western North Carolina. As of today, Friday March 27, 2020, there are no reported cases within the MACS, Inc. family of stakeholders.
We have implemented the following declarations to all employees and contractors of MACS, Inc. throughout the last 17 days:
Tier One:
The following general guidelines for all employees and contractors of MACS, Inc.:
- Avoidance of close contact with people who are sick.
- Daily conversations, posted flyers to cover coughs or sneeze with a tissue, then throw the tissue in the trash, and posted the CDC flyer titled, “Stop the Spread of Germs”.
- Avoidance of touching eyes, nose, and mouth.
- Increased awareness of regularly cleaning and disinfecting frequently touched objects and surfaces. (e.g., wooden furniture, phones, laptops, tables, door handles, keyboards, cell phones internal vehicle surfaces, etc.).
- Mandatory stay home when you are sick, except to get medical care.
- Vigorous hand washing with soap and water for at least 20 seconds, and regular utilization of effective hand sanitizers
- Increased awareness of mindful distancing, avoiding close space and contact, refraining from handshakes, hugs, etc. Emphasis was placed on keeping distance from large groups and closed / confined areas.
- One-on-one activities were encouraged to take place in the service recipient’s own home or in open air, uncrowded spaces, such as a park, hiking trail, or greenspace.
- Employees and their families who had members that have traveled out of state/country or to large events were encouraged to take all these precautions even more seriously, and consider self-quarantine, if appropriate.
- MACS, Inc. leadership urged all employees and the people whom they serve to focus on credible sources (not social media or most news outlets at this time), and provided contact links to the S. Centers for Disease Control and Prevention (CDC)and NCDHHS for updates regarding COVID-19, and to check these sources regularly.
A flyer of all above mentioned precautions was also provided directly following Governor Roy Cooper’s emergency declaration to all employees, and “slash” messages were posted within the Therap data and communication management system that MACS, Inc. uses internally to document services. Text messages were also sent out to all employees and contractors of MACS, Inc. to ensure thorough communication with service delivery staff, their supervisors, and MACS, Inc. administrators. These employees, in turn, were the primary form of communication with service recipients and their families and/or primary care givers.
Tier two preparations began immediately to further supplement Tier one actions:
- Plans were made to promote “Work from Home” designations for all office site employees.
- Notebook computers were purchased for office site employees.
- Virtual remote log-in capabilities were discussed and planned with IT contractors.
- Information regarding remote access to phone services and messaging were communicated
- “No office visitor” policies were developed.
The following Tier two procedures were actualized within one week of the Governor’s emergency declaration after the first confirmed case of COVID–19 was reported east of Charlotte, NC.
- Visitors were required to wash hands upon entering office space. Effective hand sanitizers were also made available.
- All group events in crowded spaces: particular attention was paid to the MACS, Inc. Day Support Services program in Marion, where all daily group activities were cancelled and replaced with one-on-one service activities in open air spaces outside of groups of ten individuals.
- Regular Temperature checks for all DSP staff and service recipients began within the licensed Day Support Program
- QP staff began to communicate changes in service delivery to periodic participants to ensure low risk events highlighted daily service activities (no groups, no crowed spaces, as little contact with others as possible, and/or home based service delivery).
With cases of COVID-19 being confirmed in Buncombe, Henderson, and now Transylvania County, MACS, Inc. leadership is now implementing the “Tier three response” of our emergency management plan. The following activities were approved to begin immediately to assist in ending the COVID-19 outbreak in Western North Carolina:
- Office sites in Buncombe, McDowell, and Transylvania County began “No Visitor” policies. Signs were posted at all office sites declaring no visitors be allowed within our office sites.
- All re- certification classes scheduled to take place in these office sites were cancelled until further notice (CPR, First aid, Medication Administration, Seizure Management, and NCI plus).
- Qualified Professional Supervisors and office administrators received direction to work from home, and utilize the office sites for limited activities that do not involve meeting in groups of people. (all above plans for remote access supervision of service were actualized).
- QP supervisors will commence with supervisions via telephone / face time / etc.
- DSP staff were approved to provide all appropriate services within the service recipient’s home or staff’s home until further notice. This was approved at the discretion of the primary care giver / guardian / those in authority of the person.
- MACS, Inc. leadership communicated their support for all those (DSP staff, service recipients, and family members) to make the personal decision to intentionally distance themselves from others to avoid COVID-19 infection. QP supervisors and all office managers communicated and provided daily availability to support / discuss / problem solve issues directly related to the desire for people to distance themselves during this time. Issues of possible unemployment, gaps in service delivery, etc. have been problem solved daily and hourly over the last week by the DSP staff, QP supervisors, administrators and owners of MACS, Inc.
- Daily Webinars with County officials, Vaya Health officials, and NCDHHS have been attended by owners and operators of MACS, Inc. to ensure information is being received and communicated.
- HR director has attended local webinar hosted by McGuire, Wood, and Bissette, attorneys-at-law, to ensure employee related matters regarding unemployment compensation are understood and communicated.
- HR Director has researched and studied Families First Coronavirus Response Act to ensure employee related matters regarding leave to care for family situations created by the COVID-19 virus will be attended to in a timely manner.
- Software upgrades have been purchased to allow for remote access meeting of administrators, operators, and direct service supervisors to ensure a constant flow of ever changing information is received and communicated.
- In response to declarations/orders of “Stay Home; Stay Safe” by county officials, mandating that all people stay home unless the sanctions deem otherwise, all personnel of MACS, Inc. were given badges identifying them as essential health care personnel, along with company information, and contact phone numbers, so that MACS, Inc. personnel can move/travel throughout the community as needed to provide necessary services.
The most important thing we at MACS, Inc. have been trying to do is remain alert and connected with each other, those we serve and their families. Please do not hesitate to call your QP supervisor, the managing SQP of your local office, or me directly. Do not hesitate to call for help, assistance, or support. The supervisors, managers and operators of MACS, Inc. are here to offer our assistance, support, and guidance if needed, as we process our concern for the nearly 300 people (service participants and their families, employees and their families, primary care givers, guardians of those we serve, and the contractors that support the folks we serve and our company). We appreciate all of you, and count it a privilege to serve during these challenging times.
Rick Zehr, Vice President
Mountain Area Community Services, Inc.
(828) 460-5774
rzehr@macs-inc.org
