Dear Foster Parents and Foster Parent Providers:
Over the past few weeks, our state and federal governments have taken unprecedented measures to reduce the spread of the novel virus that causes Coronavirus Disease 2019 (COVID-19) and to address the progressing public health concerns. Even during these trying times, the Maryland Department of Human Services (DHS), Social Services Administration’s (SSA) mission of helping families stay stable, safe and healthy guides us as we act to protect not only the safety of our children, youth and families, but of our foster and kin caregivers as well. As a valued caregiver and partner in our work, we deeply care about your health and well-being. We will ensure that you have as much up-to-date information as possible about Maryland’s response and how it affects your role moving forward.
SSA is utilizing internal and external expert resources and consulting with other states to develop our processes. For example, the SSA Child Welfare Medical Director Dr. David C. Rose, a board-certified pediatrician and an experienced public health professional, has been consulting with staff as questions arise. Additionally, we are following guidance provided by the Maryland Department of Health (MDH), as they consult with the Centers for Disease Control and Prevention (CDC), relative to COVID-19.
The circumstances of COVID-19 are evolving and recommendations will change in the coming days and weeks. To provide a trusted, truthful source of information, the MDH maintains a website, at coronavirus.maryland.gov, which is updated daily. There you will find facts about the current situation in Maryland and useful guidance and links.
The following Q&A is based on the information we have available to us at this time; I hope that you will find it useful.
What is Coronavirus Disease 2019 (COVID-19) and how does it spread?
- COVID-19 is caused by a new respiratory virus that has not caused illness in humans before. After becoming infected, a person can develop symptoms within 14 days, which have included a mild to severe respiratory illness with fever, coughing, and shortness of breath.
- According to the CDC, the virus is spread mainly from person-to-person, between people who are in close contact with each other (within about 6 feet).
- Spread is from respiratory droplets produced when an infected person coughs or sneezes, close personal contact such as touching or shaking hands, or touching an object or surface with the virus on it; the virus that causes COVID-19 can remain on certain surfaces for up to 72 hours.
Who should be most cautious?
The vast majority of people recover from this infection and most people will have mild or moderate symptoms. However, older adults, anyone with pre-existing health conditions (diabetes, heart disease, and lung disease) or weakened immune systems are at higher risk of getting very sick. If you are part of the higher risk groups, you will need to exercise additional caution to reduce your exposure to others, including visitors in your home or regularly scheduled appointments for your foster child(ren). You can learn more about what steps you can take if you are in a high-risk category on the CDC’s website here.
How does COVID-19 impact children?
Based on available information, children do not appear to be at higher risk for COVID-19 than adults. Children at all ages are susceptible to COVID-19, but adults make up most of the known cases to date. Symptoms in children (cold-like symptoms, such as fever, runny nose, and cough) are generally less severe than those of adults; however, young children, particularly infants, appear to be more at risk for more than mild disease. Additional information on COVID-19 and Children can be found here.
What should I do if I think my foster child or someone in my household is sick and I am worried it may be COVID-19?
Stay home and call your healthcare provider immediately to discuss symptoms and next steps; older patients and people who have severe health conditions or have weakened immune systems should call early, even if their illness is mild.
The conditions below might indicate an increased risk of having COVID-19:
- Sick with fever (higher than 100.3o F) or newly developed respiratory illness such as cough, shortness of breath, or sore throat
- Recent international travel (within the past 14 days) from COVID-19-affected geographic areas
- Close contact (within six feet for a prolonged period) with a person diagnosed with COVID-19 in the past 14 days
COVID-19 can only be diagnosed with a laboratory test. There are no specific criteria to determine which groups qualify for testing and neither MDH nor any local health department is collecting samples for testing. A healthcare provider can order COVID-19 testing where it is clinically needed. When you speak with your provider, he/she will provide you with further guidance on whether testing is called for. If you or a household member is sick enough to seek care in an emergency room, you should call before you go so that they can prepare for your arrival.
As a general rule of thumb, when someone in your household is sick, you can take these measures in addition to talking with your healthcare provider:
- Keep the sick person in a separate, well-ventilated room, apart from other people and pets as much as possible.
- If a separate space is not available, keep a distance of at least six feet between the sick person and those who are well.
- Separate utensils and glasses/cups should be used by the sick person and not shared with others.
- A sick person who is coughing or sneezing should wear a mask when around other people. If the sick person cannot wear a mask, the caregiver should wear a mask when providing direct care to that person. The bathroom should be cleaned every day using a household disinfectant according to the directions on the label. Gloves should be worn while cleaning.
- Provide the sick person with a separate bathroom if available and a trash bag within reach.
- Limit activities outside the home until the sick person is feeling well for at least one day.
- Limit outside visitors.
What should caregivers be doing to reduce the risk of spreading COVID-19?
Limit and screen visitors to your home and exercise caution when taking children to regularly scheduled appointments.
You likely have caseworkers and service providers coming to your home and appointments
scheduled in the community for your foster children. To reduce the likelihood of spreading COVID-19, we recommend limiting the number of visitors to your home and using alternative communication methods for appointments, like FaceTime, or other tele-medicine services whenever possible. We are encouraging our staff to utilize these communication methods as well in their work with children and families.
We encourage you to screen any visitors to your home for any of the conditions below, whether they are your family, friends, or a provider for your foster child(ren):
- Personal or household sickness with fever (higher than 100.3o F) or newly developed respiratory illness such as cough, shortness of breath, or sore throat;
- Close contact with a person diagnosed with COVID-19 in the past 14 days?
Practice universal precautions and good daily hygiene.
- The CDC does not recommend that people who are well wear a facemask to protect themselves from respiratory illnesses, including COVID-19. You should only wear a facemask if a healthcare professional recommends it. A facemask should be used by people who have COVID-19 and are showing symptoms, or, if the sick person cannot wear a mask, the caregiver who is providing direct care to that person. This is to reduce the risk to others of becoming infected.
- Wash your hands often with soap and water for at least 20 seconds, especially:
▪ After going to the bathroom;
▪ Before eating;
▪ After blowing your nose, coughing, or sneezing; and
▪ Upon entering and exiting your home.
- If soap and water are not available, use an alcohol-based hand sanitizer with at least 60% alcohol.
- Cover a cough or sneeze with a tissue and dispose of tissue.
- Don’t touch your eyes, nose or mouth without first carefully washing your hands.
- Properly clean all frequently touched surfaces (such as doorknobs, railings/banisters, faucet handles, kitchen areas and countertops) on a regular basis using everyday cleaning products.
- Avoid sharing dishes, drinking glasses, eating utensils, or towels.
- Wash dirty dishes in a dishwasher or, if by hand, with warm water and soap.
- Wash laundry in a standard washing machine with warm water.
- Do not shake dirty laundry or “hug” dirty laundry to your chest to carry it.
Avoid unnecessary out of state or international travel and avoid large gatherings or crowds.
- Limit out-of-state travel.
- Do not host or attend gatherings, avoid crowds and practice social distancing (keep a distance of six feet from others).
Develop an Emergency Preparedness Plan for your household
- Keep an adequate supply of water, food, and pet food in your home. If you or your family members take prescription medications, contact your healthcare provider, pharmacist, or insurance provider about keeping an emergency supply at home. If you need assistance in obtaining medication for your foster child, contact your child’s ongoing caseworker or supervisor.
- Talk to caregivers about backup plans in the event a primary caregiver becomes ill or childcare closes. Talk to your caseworker if you are concerned about childcare.
- Create an emergency contact list of family members, friends, neighbors, healthcare providers, employers, and others.
- Keep a working thermometer and medication for fever (ibuprofen [Motrin, Advil], acetaminophen [Tylenol]) on hand.
- Plan for childcare as schools continue their temporary closing.
- Ask about your employers’ preparedness plans, including sick‐leave policies and telework options.
What is DHS doing to reduce the risk of spreading COVID-19?
DHS is following all directives put in place by Governor Hogan and adopting the following precautionary measures for the foreseeable future:
- All DHS offices will be closed to the public effective Wednesday, March 18, 2020
- Discontinuing out-of-state work-related travel for our staff. We are encouraging foster/kin/institutional caregivers to do the same.
- Postponing all statewide events and meetings and encouraging smaller meetings to occur by conference call or web-based technology. As a foster parent, this means foster parent support groups, foster care reviews and other meetings will likely occur by phone or web-based technology.
- Non-essential staff are working remotely with only mission critical employees reporting on a minimal basis.
- Preferentially using web-based technology like WebEx and FaceTime in place of routine, scheduled in-person home visits.
- Implementing new procedures for sibling and parent visits, and screening procedures for new out-of-home placements.
What should I do if I have questions about my foster child, including questions about visitation?
Ideally, DHS wants to encourage in-person parent-child visitation to the extent possible, in order to preserve the child-parent bond. Weekly parent-child visits and monthly sibling visits should continue but also may be conducted by videoconferencing and other virtual communication and teleconferencing tools; siblings and parents visits may occur at the same time and Family Support Workers can assist with parent-child visits as appropriate. If in-person visits are going to occur, our staff will be asking COVID-19 screening questions beforehand and they will follow required procedures if exposure or symptoms are identified. If the visit must be cancelled or missed, please ensure that the child knows that the disruption is due to the pandemic and is beyond the parent’s control.
The monthly caseworker visits requirement remains in place, but these visits can be conducted by videoconferencing and other visual communication tools. Local departments of social services will be designating specific visitation days, as much as possible, to reduce the amount of traffic in buildings. We recommend reaching out to your child’s caseworker or their supervisors if you have questions about visits.
What should I do if I have questions about my foster child’s childcare?
DHS and the local departments of social services will assist resource parents in identifying alternative sources of childcare due to schools and childcare program closures. In addition, we encourage resource parents to utilize their own support to secure alternative daycare arrangements as needed. Reach out to your child’s caseworker or supervisor if you have questions about childcare.
Are there resources to assist me in talking to my foster child(ren) about COVID-19?
When children and youth watch news on TV about an infectious disease outbreak, read about it in the news, or overhear others discussing it, they can feel scared, confused, or anxious—as much as adults. As adults, we may be more capable of managing these feelings, yet our children may be less equipped. Even though you may be concerned yourself about this coronavirus, it is important to model calmness. Children are keenly aware of their parents’ behaviors and often mirror them. Here are a few helpful resources on talking to children about COVID-19:
Michelle L. Farr, LCSW-C, LICSW
Executive Director, Social Services Administration