COVID-19 POLICIES
INFORMED CONSENT & PATIENT AGREEMENT
Updated August 2022
Step By Step Pediatric Therapy, Inc.
COVID-19 POLICIES
SBSPT staff, volunteers, visitors, and clients must go through COVID screening on a daily basis during working hours. In order for SBSPT staff, volunteers, visitors, and clients to be present for therapy and/or on office grounds, the following must be met:
- Body temperature less than 100.4 degree
- Free from related symptoms or a negative COVID test or doctor’s note stating symptoms are non-contagious.
- No recent or possible exposure to COVID. HOWEVER, PERSONS WHO ARE VACCINATED, DO NOT NEED TO QUARANTINE, UNLESS THEY DEVELOP SYMPTOMS. THEY NEED TO TAKE A COVID TEST 3-5 DAYS AFTER EXPOSURE AND MONITOR SYMPTOMS FOR 2 WEEKS.
COVID MEASUREMENTS FOR BOTH IN PERSON CLINIC AND IN PERSON HOME SESSIONS
- SOCIAL DISTANCING:
- Clinic: social distancing will be enforced as much as possible. Limiting the number of people per room as necessary; ideally no more than 2 clients, 2 therapists, and 2 parents per room at a time (space permitting). Parents, siblings, and other visitors will be asked to wait in the waiting room if social distancing cannot be established.
- Client’s Home/School/Other Settings: social distancing will be enforced as much as possible. Limiting the number of people per room as necessary; ideally only the therapist, client, and a parent/caregiver if possible. Providing therapy outside if social distancing cannot be established inside the home or if poor ventilation is detected.
- PERSONAL PROTECTIVE EQUIPMENT:
- Mask: masks must be worn at all times except for children under the age of 2. Children 2 years old and older must wear a mask except when eating or drinking. If a child is not able to tolerate wearing a mask, the therapist must work toward the goal of wearing one.
- Gloves: gloves must be worn during feeding therapy and when bodily fluids are present (ie. excessive drooling)
- Gowns: gowns must be worn when bodily fluids are present (ie. excessive drooling).
- HANDWASHING: SBSPT staff, volunteers, visitors, and clients must wash their hands before and after each session for at least 20 seconds. If handwashing is not available, a hand sanitizer must be used.
- TOYS/EQUIPMENT/COMMON AREA: Toys, equipment, and common areas must be sanitized before and after each use with an EPA approved disinfectant. The use of porous toys is discouraged. Feeding tools must be washed and sanitized before and after each use. It is recommended that parents provide personal feeding tools to be used during feeding therapy.
- REPORTING AND MANAGEMENT PLAN: CDC and local government guidelines on reporting and management will be followed. https://www.cdc.gov/coronavirus/2019-ncov/your-health/quarantine-isolation.html
Step By Step Pediatric Therapy, Inc.
COVID-19 INFORMED CONSENT
I, the undersigned parent/caregiver, on behalf of my child, hereby acknowledge that I have been advised of the risks, benefits, and alternatives identified below with respect to COVID-19 and the current pandemic-related changes to my child’s participation in the services, treatment, and care provided by Step-By-Step Pediatric Therapy, Inc. and its personnel and providers (hereafter “SBSPT”). I have had the opportunity to discuss the risks identified below, to ask SBSPT my questions, and to receive answers to my satisfaction. By signing below, I acknowledge the following on behalf of myself and my child.
1. Risk of Exposure:
I understand that, despite SBSPT’s reasonable efforts to follow public health guidance on reducing the risk of exposure, due to the nature of the testing available at the present time, it is only possible to mitigate, not eliminate, the risk of exposure. I understand that in-person consultations, services, and/or treatments performed at this time, despite my own efforts and those of SBSPT, may increase the risk of exposure to COVID-19. In other words, even following best practices, it is possible for me and my child, SBSPT, or healthcare personnel to be unaware that we are contagious even without symptoms, raising the possibility of infection. I am aware that exposure to the novel coronavirus (SARS-CoV-2) and persons with COVID-19 can result in severe illness, intensive therapies, extended intubation and/or ventilator support, life-altering changes to one’s health, and even death.
2. Current Safety Protocols:
I understand that infection control and safety protocols may change at any time in response to public health guidelines, and that there is a risk that further research will lead to the conclusion that current practices are insufficient and created risks that might have been avoidable if I had waited for my child’s participation in SBSPT’s in-person services or treatment.
3. Telehealth
I understand SBSPT may use telehealth before, during and/or after treatment to reduce the number of in-person meetings and the accompanying risks of COVID-19 infection. I will need access to, and familiarity with, the appropriate, working technology for my child and me to participate in the services provided by SBSPT, with a risk of technology interruptions. I also agree that my child and I are responsible for timely attendance, and that I remain responsible for adhering to SBSPT’s “Third-Party Funders,” “Parent Presence,” and “Attendance” policies.
Step By Step Pediatric Therapy, Inc.
COVID-19 PATIENT AGREEMENT
- I, the undersigned parent/caregiver, on behalf of my child, hereby agree by my signature below to the following conditions of my child’s treatment by Step-By-Step Pediatric Therapy, Inc. and its personnel and providers (hereafter “SBSPT”). I understand I must honestly disclose this information to avoid putting myself, my child, and others at risk.
- I agree to cooperate and comply with, before, during, and after my child’s participation and treatment, for my child’s protection as well as my own and SBSPT’s, all COVID-19-related compliance and infection control protocols communicated by SBSPT. I agree on behalf of my child to cooperate whether or not I personally agree and feel such COVID-19 procedures and/or preventive measures are necessary.
- I agree to disclose to SBSPT any symptoms I am experiencing or have experienced within the past fourteen (14) days that may be related to COVID-19.
- I agree to disclose to SBSPT any symptoms that may be related to COVID-19 that I am aware of as experienced by myself, my child, and/or anyone with whom I have had prolonged, close contact. This includes both family members living with me and any other person or instance through whom or which I may have been exposed to the virus.
- I agree to be tested and/or have my child tested upon SBSPT’s request, at my own expense and regardless of any prior testing, and that the results of that testing must be satisfactory to SBSPT, before my child may continue to receive in-person services or treatment.
- I agree to follow all COVID-19 recommendations by the CDC and state and local public health authorities, and confirm that I, my child, and all persons living with me for the past 14 days have followed all personal hygiene, social distancing and other recommendations, and that adhering to such recommendations is required by CDC.
Based on the above, I certify that I have read the foregoing COVID-19 Informed Consent and COVID-19 Patient Agreement, had opportunities to ask questions, agree and accept all of the terms above, and voluntarily consent as noted above on behalf of me and my child. I also specifically consent to the uses and disclosures of my child’s health data necessitated by telehealth, including but not limited to videoconferencing, recording and storage of videoconferences, email, text messages, and other digital communications exchanged in the course of care.