In-Person Family Time Guidance for Social Workers

Guidance for social workers on in-person family time visits during the COVID-19 pandemic.

In-Person Family Time Guidance for Social Workers

Effective: June 26th, 2020

Updated: January 14, 2021

The purpose of this document is to provide guidelines to safely provide in-person Family Time for children and youth in placement. DCF recognizes spending time with parents, siblings, and family members is a vital part of maintaining and strengthening family and cultural connections for children in care. These guidelines apply whether the Family Time is outdoor or indoors and follow recommendations from the Centers for Disease Control and Prevention (CDC) and the Massachusetts Department of Public Health (DPH) to ensure the safety of all participants and to prevent further spread of COVID-19. Virtual Family Time can support and supplement in-person Family Time. When in-person Family Time cannot occur virtual Family Time should be utilized. The guidance below is the same for indoor and outdoor Family Time unless otherwise noted. 

Scheduling Family Time	The Social Worker should contact the parents and caregiver/provider to schedule a date, time, and location for in-person Family Time. Determine Family Time Location: Try to schedule Family Time in an outside space when possible. If the visit will occur in the Area Office, social workers should talk to their supervisor and/or AAM about where Family Time will occur and procedures for scheduling within the office. If Family Time is occurring indoors, try to limit the participants to those who have been regularly attending Family Time. The limitation will help with new exposure for those attending the Family Time. Determine Family Time Participants: Family Time visits should be limited to no more than 6 participants in total, including family members and children. This limit does not include specialized staff to assist with the visit or the staff supervising the visit. Before scheduling Family Time, social workers should be clear with all participants that they will need to answer screening questions, wear a mask, and follow the guidelines outlined below. Understandably, parents and caregivers may have questions related to these guidelines. It is important to spend time answering questions and ensuring everyone understands the guidelines and expectations. Make sure to coordinate and work collaboratively with caregivers and placement providers to address issues that may arise related to in-person Family Time. If the individual facilitating Family Time identifies issues or concerns during the visit (e.g. adult refusing to wear a mask) it will be important for them to stay in communication and coordinate with network specialists, lead agencies, or the ARC to resolve any concerns.
Conditions that Must Be Met for In-Person Family Time	In order to ensure the safety of everyone involved, the following conditions must be met for anyone attending in-person Family Time: No one is COVID-19+, is in isolation due to being COVID-19+, and has not been instructed by their health care provider that they are ready to leave isolation* No one has been in close contact with someone who is COVID-19+ and is now in quarantine for 14 days. If someone in quarantine** gets tested and the result is negative, they still need to complete the 14-day quarantine and cannot visit until the quarantine period has ended. No one has symptoms of COVID-19: Cough, fever greater than 100.4, difficulty breathing, muscle aches, chills, headache, sore throat, or new loss of taste or smell. If anyone in the child’s foster home has tested positive for COVID-19, the visit must be postponed until the quarantine period for the home has ended. (14 days from exposure to the COVID-19+ person) If the child’s congregate care setting is experiencing an outbreak of COVID-19 (recent concerns include outbreaks of cases, usually >2, among staff or youth), the visit must be postponed. This information is readily available from congregate care teams who are monitoring all outbreaks. If a person tested positive, met the isolation requirement, and continues to test positive, please contact your regional nurse to discuss when the visit may be scheduled. Additionally, children and adults in high risk categories may need to take additional precautions or participate in virtual visits only: For a list of the people the CDC and DPH consider at higher risk of severe illness from COVID-19: CDC People Who Need to Take Extra Precautions If anyone scheduled to attend Family Time has had extended travel internationally or from any state that is not categorized as a “lower-risk state”, they should not attend the visit until they have had a negative COVID-19 test or 14 days have passed since their return. NOTE: This limitation would not apply if the person is traveling from their residence for Family Time, a court appearance, shopping, work, school, or a medical appointment. For further information on exemptions and requirements, see mass.gov/MAtraveler.
Preparing for Family Time	Caregivers should prepare children over the age of 2 for the need to wear a face covering throughout Family Time and let them know their parents will also be wearing one. Depending on the age and developmental stage of the child, you may want to use a virtual Family Time before in-person Family Time for the parent to show the child what they look like with a face mask on. Parents and social workers can prepare for visitation by: Pre-planning activities that can be completed while maintaining social distancing; Gathering and bringing what is needed to participate in the chosen activities, including weather appropriate clothing if the visit is occurring outdoors. For suggestions of age-appropriate activities that can be done outside or inside, from a distance, or separately but together: see the 3 Indoor Family Time Tip Sheet for Social Workers or the Resource Guide of Recreational Areas for Family Time Visits on the intranet. Bringing food in disposable containers only and in portions limited to what the child can eat during the visit as no food will be brought back with the child. Social workers should talk to caregivers after a visit concludes, including precautions they can take after a visit, like hand washing and changing clothes.
Pre-Screening Questions To Ask	All participants should be screened by telephone or video 1 day prior to a visit. If a child is being transported for a visit, screening questions should be asked of the household where the child resides before the transport occurs. All participants will also be screened in person at the time of visit. Screening questions to ask include: Has the individual(s) been diagnosed as COVID-19 positive within the past 14 days? Has the individual(s) been exposed to someone who is COVID-19 positive within the past 14 days? Is the individual(s) exhibiting symptoms that are consistent with COVID-19 such as cough, sore throat, difficulty breathing, nausea, vomiting, diarrhea, new loss of taste or smell, new muscle aches, fatigue, headache, runny nose or congestion, or fever of 100.0 degrees or higher? Have you travelled out of state in the past 14 days? Are you currently waiting for the results of a COVID test? If a parent or child (or their caregiver) answers yes to any of these questions the in-person visit cannot occur and will need to be rescheduled or conducted virtually.
Supplies	The following supplies should be available for the family visit: Disinfecting wipes and/or other disinfecting cleaning products Soap and running water or hand sanitizer Cloth face coverings or disposable masks for all participants to wear. If a participant does not have a mask, one will be provided to them. Gloves (medical grade nitryl or latex)
Transportation to and from Family Time	If possible, the same person should transport the child to each Family Time. Everyone in the vehicle older than two years should wear a facemask/cloth face covering while in the vehicle, except for anyone for whom use of a facemask/cloth face covering would be damaging to their health or anyone who is developmentally unable to use a facemask/cloth face covering. Children should sit in the back seat, utilizing car and booster seats when applicable. No more than two children should be transported together unless they live in the same household. If the weather allows, windows should be opened slightly to support air flow. If this is not possible, set the ventilation system to high in the vehicle and do not recirculate conditioned or heated air. The person providing transportation should bring the child to the agreed upon Family Time location. No one outside of the vehicle should touch the door handles, car seats, or vehicle’s interior. Frequently-touched areas of the vehicle should be wiped down with disinfectant between transportation and after travel. For car seats, buckles and latches should be wiped down before and after transport. Anyone who is self-quarantining due to close contact with a COVID-19+ individual or self-isolating because they are sick, SHOULD NOT provide transportation to Family Time.

Precautions to take during Family Time

Facemasks/ Cloth Face coverings	Everyone above the age of 2 must wear a facemask/cloth face covering over the nose and mouth, unless the use of a facemask/cloth face covering would be damaging to the person’s health or anyone who is developmentally unable to use a facemask/cloth face covering. Parents can briefly pull down their face covering to remind the child or youth of who they are. Participants may pull down their face coverings for a brief time when eating and drinking. If the child takes off their facemask/cloth face covering they should be encouraged by the adults to keep it on. No visit will be cancelled if the child refuses to keep the facemask/cloth face covering on. If a break from wearing a mask is needed for an adult, do so away from other people and outside. All Family Time participants should follow the CDC guidelines regarding the use of disposable or cloth face coverings, including: Washing hands before putting the face covering on Make sure both mouth and nose are covered Hooking the loops around ears or tying the face covering snugly around the head Refraining from touching the face covering or pulling it down during use Removing the face covering without touching eyes, nose, or mouth and immediately washing hands after removal Washing the face covering between uses and ensuring it is completely dry before using it again.
Maintaining Distance When Possible	Acknowledge that physical contact may be desired by parents and children who have not seen each other for several months, visits should be monitored with risk reduction in mind. Avoid close face-to-face contact and kissing while allowing hugging with faces in opposite direction or hugging legs. Limit close physical contact to less than 15 minutes. Masks should be worn at all times (except children under 2 and others who are unable to wear a mask for medical reasons). Adults should maintain social distancing to the maximum extent possible during the visit. If the visit is in a home/apartment, the largest room should be used if possible, to maximize distance and windows should be open to allow air circulation.
Food	During the visit food should not be shared. All snacks and drinks should be in individual containers so that sharing does not occur. Parents should wash hands or use hand sanitizer before giving a child food. Plastic spoons or forks should be used and disposed of after the visit. If the parent brings a container that cannot be thrown away or if there is extra food, the parent would need to bring the container and food home with them.
Enhanced Cleaning and/or Disinfecting Procedures	Everyone should wash and/or sanitize their hands before putting on a face mask/covering (PPE) and after they take it off. Everyone should wash and/or sanitize their hands right before the in-person Family Time, regularly throughout the visit, and immediately after the visit is done. Everyone should clean frequently touched surfaces, such as car doors, steering wheels, doorknobs, phones, and pens. Toys that cannot be cleaned, sanitized, or washed immediately after Family Time should not be used. Children’s books and other paper-based materials like envelopes are not considered high risk for transmission and do not need additional cleaning or disinfecting. When washing, feeding, or holding young children, adults can protect themselves by: Wearing layered clothing that can be removed after a visit Wearing long hair up off the collar in a ponytail or other up-do. Washing their hands, neck and other places touched by a child’s secretions. Changing the child’s clothes if secretions (e.g., drool) are on the child’s clothes. Changing the adult’s top if there are secretions on it and washing their hands again. Placing contaminated items in a plastic bag or immediately washing them in a washing machine.

* Isolation - The separation or restriction of activities of an ill person with symptoms or with a confirmed diagnosis of a contagious disease from those who are well.

**Quarantine - The separation or restriction of movement of well persons who might have been exposed to a communicable disease while determining if they become ill.