Screening Stations

There will be a screening station in place at both client entrance and employee entrance of the clinics. All people with the intention of coming inside the building (including staff, patients, and accompanying adults) will be screened upon entering. Each screening will be recorded on log by a staff member.

Screening Criteria

To pass a screening, a person must not have any symptoms or environmental factors related to COVID-19.

Each person's temperature will be taken using a touchless thermometer at the door.

People will be asked if they've traveled to countries known to have wide spread cases of COVID-19 or have been exposed to/in direct contact with someone with COVID-19.

If the person is currently or within the last 14 days experienced the following quantities of symptoms.

If a person does not pass their screening, they will not be able to enter the clinic. It is advised they contact their primary care physician for further directions.

We are excited to announce that we are ready to resume an limited amount of in-person services beginning Thursday, May 7th, 2020!

We have created a comprehensive re-opening plan based on data and best practice:

Phase 1: Preparation 

This phase consisted of obtaining adequate Personal Protective Equipment (PPE: masks, gloves, face shields, gowns) and sanitation supplies (hand sanitizer, virucide, disinfectant). We are increased the quantity of touchless thermometers for screenings. We created new policies and procedures for using PPE, training employees, restricted clinic space, and phasing in employees gradually. We also surveyed select parents on returning in-person services.

Phase 2: Limited In-Person Services Begins May 7th, 2020

See below sections for details.

Phase 3: Increased In-Person Services

The phase includes allowing patients to resume in-person services based on preference, increased quantity of staff returning to clinic, maintaining many of the PPE & sanitizing protocols as phase 2, less restrictions of utilizing clinic space. A date for this phase to begin has not been established.

Phase 4: Primarily In-Person Services

We will resume in-person services in both outpatient and GRHH settings. Our waiting room will re-open and maintain social distance. Staff will be integrated back into the clinic. PPE protocols will be modified as appropriate for the conditions advised by KY government and CDC.  A date for this phase to begin has not been established.

Phase 5: Regular Therapy Services

Services will resume as usual. Telehealth will be utilized for outpatient clients to remove the barrier of distance, illness, and schedule as approved by their insurance company. PPE will be utilized per pre-COVID-19 protocols. Socially distancing, and daily screening will have ended. Equpitment will be on regular sanitizing schedules. A date for this phase to begin has not been established.

Phase 2: Who Can Resume In-Person Services

We are prioritizing patients treated through our outpatient setting who have:

1. Been unable to participate in Telehealth for a technical reason.
   
2. A clinical need for in-person services. This recommendation will be at the discretion of your therapy provider. Please ask your provider if you are interested in resuming in-person services.
   

Phase 2: What to Expect

Our waiting room is closed.

• Our front doors will be locked and there will not be a receptionist working at the front desk.
  
• Your therapy provider will meeting you at the front door. 
• Please wait in your car until they are ready for you.
  
• Please wait for their previous patient to depart from the side walk and/or enter their vehicle before exiting your vehicle to maintain good social distancing.
  
• Allow your child to independently participate in therapy. We are limiting the quantity of people on our building, so unless it's essential for you to accompany your child in treatment, let them participate independently.
  
• If you have a transportation concern, please contact client services at 270-688-8449 to make special arrangements.
  

Screenings

• Every person (clients and staff) with the intention of entering the building will be screened at the door.
  
• Temperatures will be taken and recorded by a touchless thermometer. All temperatures over 100.4F will not be permitted to participate in therapy and/or enter the building. 
• Each person will be asked a services of screening questions as related to COVID-19 symptoms. An adult will need to answer or confirm answers of minors.
  

Patients & PPE

• All people will remove their shoes upon entering the building. Shoes are a cross contaminant.
  
• All people must sanitize their hands immediately upon entering the building with hand sanitizer.
  
• All patients (2yr+) and accompanying adults will be asked to wear masks during treatment.
  
• Patient masks may be surgical or cloth masks.
  
• If you have a cloth mask at home, we ask that you bring this mask.
  
• Here is a video about making a mask.
  
• Sew version kids mask.
  
• No sew kids mask.
  
• Another sew kids mask.
  
• If your child receives speech therapy, you may consider making them a mask with a clear video of their mouth movements like THIS ONE.
  
• Don't forget to wash your cloth masks before/after therapy.
  
•  An adult sized surgical mask will be provided for those who do not have access to masks.
  
• Prepare your child for wearing a mask before your appointment
  
• Watch videos about masks.
• We Wear Masks by Mike McGovern
  
• Read social stories.
• Wearing a Mask Social Story by ASERT
  
• Practice wearing a mask for 30-60 minutes daily.
  
• You may need to begin practicing with 5 minutes and extend time based on tolerance.
  
• Use a timer to practice.
  
• Use a video at a specific length of time to practice.
• If your child refuses to wear a mask, they will not be refused treatment.
  
• They will continue to be offered to try a mask each visit.
  
• Keep practicing at home
  

Staff & PPE

•  Our staff will be wearing the following PPE:
  
• Surgical Masks (cloth masks are not permitted for health care providers to wear)
  
• Gloves
  
• Face shields
  
• No shoes (or designated sanitized work shoes to prevent cross contamination)
  
• Gowns: These will be at the discretion of the therapist for patients who require a high level of physical interaction.
  
• Prepare your child for therapists wearing PPE.
• Seeing Other People Wear Masks.
  
• Wearing a mask and gloves

Phase 2: How To Schedule

Please contact us at 270-688-8449 or Contact@TheraTreePeds.com to schedule your appointment.

TheraTree Familes,

Our promise to our families is alive and moving swiftly with individual communication about how we are addressing COVID-19 in the context of keeping children and families safe while receiving therapeutic treatment. The health and well being of children and families are always of the highest importance to us.

We also understand that the circumstances occurring in our community, state, and world may create fear in parents and children alike. You may have panic and uncertainty. So, we'd like to take this opportunity to create a context around those feelings. It's important to understand that fear does not live off facts. Fear lives and feeds off speculation. We as humans have a tendency to react to what we speculate. However, we as both an organization and health care providers, operate on and make decisions on facts, not fear.

Receiving Therapy

TheraTree is equip and excited to deliver therapeutic services through Telehealth. This is a delivery model we've been working on for weeks - as soon as we knew in-person treatment may not be possible at some point. It's taken a lot of research, planning, action and training. We've been working adamantly to ensure our families have access to therapy services if we reached that critical moment. We first prioritized our most vulnerable clients served to transition to Telehealth. Telehelath is now the only method of delivering therapy services during this time. We have created accessibility to Telehealth across all practice settings we serve.


What is Telehealth?Telehealth is the use of telecommunications technologies to provide health care. Technologies are HIPAA compliant and TheraTree's primary method of providing telehealth is videoconferencing. Telehealth therapy may include evaluations, assessments, consultation, treatment planning, and therapeutic interventions. 



Benefits to Families: Provides opportunities to progress skills sets and overcome barriers such as distance, illness, schedule, and travel. Increases skills and confidence of family members and caregivers. 



What to Expect: Activities will be similar to a typical clinic session. Parent coaching is a key component and can increase home carryover and progress. It's important for the parent or caregiver to be involved during the session to increase effectiveness.


Who Pays for Telehealth:

• This includes Medicaid, MCOS, and Private insurance.
• Self funded and out of state plans may cover Telehealth; we can confirm with your insurance.

• It's important for you to know some information about Non-Traditional Instruction (NTI) as is relates to your child's IEP. Districts must provide IEP services during NTI days.
  
• These services can be adapted to schoolwork packets, online learning, and other adaptions.
  
• Telehealth is the ideal way to provide the required therapy services considering our typical in person delivery model is unavailable.
  

• Access to high speed internet.
• A computer or mobile device with a camera and mic.
  
• Complete Telehealth Consent form (CLICK HERE
)
• Complete Credit Card Agreement (CLICK HERE - if you typically have a payment due for outpatient treatment) 

• Set up your ClockTree Account. A link will be emailed upon transitioning to Telehealth. Please set up your account as soon as possible to reduce technical difficulties. This invitation may go to your spam folder, so check there!
• Watch the orientation video about your first appointment: https://www.clocktree.com/api/1/notificationdocument/730139?content
• After you set up your account, our client services department will then confirm your Telehealth appointment and you'll get an email notification for this.
  
• You can access the Telehealth platform through the appointment confirmation or through this link: Access Telehealth Platform HERE. 

• Log in to your clock tree at least 8 minutes before your scheduled appointment on your device connected to the internet. ProTip: logging in on a mobile device creates endless movement options.

Attendance

With any new process, there will be logistics to work out. Telehealth removes many barriers; especially the ones we're facing currently. We understand this is a swift transition for all of us. Our client services division is working to transition all of our patient's appointments to Telehealth.

Events Since Last Update:

We have all experienced rapid changes of information regarding COVID-19 and our government's response of implementing new processes that effect our daily routines. The following is a series of updates as related to the delivery of our therapeutic services to create a context around the timing of our transition.

On Tuesday 3/17/2020 Kentucky's Governor ordered public-facing businesses to close on 3/18/2020. In this order, health care facilities following CDC guidelines were exempt. In his press conference on 3/18/2020 he stated Occupational Therapy and Physical Therapy should close. This new information did not specify therapy settings or timelines. Therefore, TheraTree sought clarification. Both the Kentucky Occupational Therapy Association (KOTA) and Kentucky Physical Therapy Association (KPTA or APTA KY) immediately requested clarification after the press conference from Secretary Friedlander. Secretary Friedlander then scheduled a meeting for 3/19/2020 to establish which settings the closure applies to and when it should occur. Both KOTA and KPTA then advised therapy members to wait on any closure actions until a specific order has occurred.

After the scheduled meeting on 3/19/2020, the Cabinet for Health and Family Services Office of Inspector General (CHFS OIG) issued it's letter that guides which settings may remain open and which shall close and transition to a Telehealth platform in accordance with DMS guidelines immediately. The letter also stated Telehealth services shall be maximized to the fullest extent possible for patients receiving community based rehabilitative skilled therapy services. TheraTree made the remaining rapid provisions to be in accordance with this official letter and the time line of "immediately". On 3/20/2020 CHFS OIG's letter was revised to identify 3/20/2020 as the date to cease operations and KPTA issued further guidance to cease physical operations by day's end on 3/20/2020.

Fortunately, if our profession has taught us anything, it's to adapt and respond. We've been adapting and responding to ensure the quality of service remains high while we serve our families and take the necessary precautions for everyone. We appreciate the families who are willing to adapt and respond with us by making the last minute schedule changes and learning our Telehealth platform. We are being dealt circumstances unlike we've seen before as an industry, community, and country. The length of time to remain operating this way is unknown. However, we can expect this to be the new normal for much longer than a child without therapy can go before regressing. We are all in this together. Adapt - Respond - Repeat

More Information about COVID-19:

TheraTree recommends the following resources for latest information about COVID-19:

• The Centers for Disease Control and Prevention
• The World Health Organization
• Kentucky Cabinet for Health and Family Services

TheraTree Families,

We have a promise to keep our families updated about how we are addressing COVID-19 in the context of keeping children and families safe while receiving therapeutic treatment. The health and well being of children and families in our community are always of the highest importance to us. Information regarding COVID-19 and our government's response is frequently changing. We continue to monitor the situation daily, if not hourly. At this time (3/18/2020) we have created more options to access services through Telehealth and will continue an option for outpatient services with higher level precautions. Consistent attendance is crucial for progress and to avoid regression. Our experience and research shows it! This is why we've been working tirelessly to make therapy more accessible to you!

Telehealth

This is the recommended delivery of therapeutic services for families who's children or household member(s) have a higher level of health / immune risk. This is also recommended in the event a member of the household has directly exposed to COVID-19 and/or is exhibiting symptoms. 



At this time, our contract home health company has not yet approved the use of telehealth to substitute in person visits. If you are treated in the home health setting and see telehealth as the most appropriate delivery model for you, please call our office at 270-688-8449 to discuss options. 



What is Telehealth? Telehealth is the use of telecommunications technologies to provide health care. Technologies are HIPAA compliant and TheraTree's primary method of providing telehealth is videoconferencing. Telehealth therapy may include evaluations, assessments, consultation, treatment planning, and therapeutic interventions. 



Benefits to Families: Provides opportunities to progress skills sets and overcome barriers such as distance, illness, schedule, and travel. Increases skills and confidence of family members and caregivers. 



What to Expect: Activities will be similar to a typical clinic session. Parent coaching is a key component and can increase home carryover and progress. It's important for the parent or caregiver to be involved during the session to increase effectiveness. For families with co-payments and deductibles, TheraTree has a credit card agreement option for hassle free payments.


Technology & Other Requirements: Families must have access to high speed internet and a computer or mobile device with a camera and mic. Families must sign a consent form for Telehealth services. There will be a link sent upon scheduling a telehealth appointment which will give families access to the telehealth portal. Please set up your portal as soon as possible to reduce technical difficulties. 



Complete Telehealth Consent form HERE

Complete Credit Card Agreement HERE
Access Telehealth Platform HERE

TheraTree's Enhanced Precautions:

We have updated our precautions to keep clients, families, and our staff healthy while receiving in person outpatient intervention.

• Introducing Curb-Side: 

• Beginning Thursday 3/19/2020 our waiting room with be closed. 

• Your therapy provider will meet you at our main entrance to check in your child. 

• If you have a payment, you can establish a credit card agreement or call the office before your appointment to skip line at reception. 

• If you utilize public transportation, please see reception for options. 

• If you have additional questions, please call us at 270-688-8449, email us at contact@theratreepeds.com, or ask your therapy provider at curb-side.

• We've removed all fabric based intervention tools from use and the environment. 

• As a reminder, our previously established precautions are 

• Both clinicians and children will wash hands and/or utilize hand sanitizer upon entering and exiting the treatment area.

• Hand washing is a prioritized goals for children who have difficulty with hand washing.

• Staff is reminding patients to avoid touching eyes, nose, and mouths during sessions.

• Our staff is cleaning AND disinfecting frequently touched surfaces / toys during and in between treatment sessions. This includes tables, doorknobs, light switches, countertops, pens, handles, toilets, faucets, and sinks.
• Our clinic is professionally cleaned and sanitized on a regular basis with an increased priority to disinfect all surfaces in the clinic. 

• Alternative social gestures to high five, hugs, and hand shakes.

Attendance:

Continue to follow the CDC recommendations of if a person has a fever or respiratory symptoms such as a cough or shortness of breath AND has traveled to an affected geographic area, OR had direct contact with someone with COVID-19 to not come into the office.

Please notify our office immediately if you, your child, or an immediate family member have:

• Traveled to an affected country outside of the USA; identified by the CDC and/or WHO.

• Been directly exposed to COVID-19 and are under a self-quarantine due to this exposure.
• A confirmed case of COVID-19.

Please keep in mind that we have a cancellation policy to cancel your appointment 24 hours in advance. Please do not bring a sick child to therapy. Consider telehealth as an alternative. If you should have a question regarding this policy, please do not hesitate to contact our office. Please note that during this time we will be doing our best to make accommodations for rescheduling make-up sessions.

More Information about COVID-19:

TheraTree recommends the following resources for latest information about COVID-19:

• The Centers for Disease Control and Prevention
• The World Health Organization
• Kentucky Cabinet for Health and Family Services

TheraTree Community Engagement:

At this time, we have postponed community events that engage the public in person. We will announce via social media when these events will be rescheduled to.

This message is intended to inform our TheraTree community about how we are addressing COVID-19 in the context of keeping children and families safe while receiving therapeutic treatment. The health and well being of children and families in our community is of the highest importance; after all, that is why we are here in the first place!

Information regarding the prevalence of COVID-19 is frequently changing. We have assessed and continue to monitor the situation daily, if not hourly. At this time (3/11/2020) we have determined that it is safe and in the best interest of the families we serve to continue to provide services with enhanced precautions.

• All patients will wash hands when arriving, prior to entering treatment spaces.
• Hand sanitizer will be made available in the waiting area.
  
• Both clinicians and children will utilize hand sanitizer upon entering and exiting the treatment area.
  
• If you have a preferred hand sanitizer due to skin sensitivity, please bring this with you.
• For children who have difficulty with hand washing, this will be a prioritized goal for them. Hand washing is a daily life skill addressed by Occupational Therapy, and is especially important during times of health concern.
  
• Staff is reminding patients to avoid touching eyes, nose, and mouths during sessions.
  
• Our staff is cleaning AND disinfecting frequently touched surfaces / toys during and in between treatment sessions. This includes tables, doorknobs, light switches, countertops, pens, handles, toilets, faucets, and sinks.
• Our clinic is already professionally cleaned and sanitized on a regular basis. An increased priority will be made to disinfect all surfaces in the clinic. 
  
• High five, hugs, and hand shake alternatives: How about an elbow bump, thumbs up or a "raise the roof" instead?

Attendance: