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Zirpoli: Grateful for direct support professionals, for whom social distancing with clients is not possible

Last week, the Maryland Department of Health issued guidelines to medical laboratory directors, local health officers, and health care providers regarding COVID-19 testing priorities. Priority A includes “Hospitalized patients, who should be tested by the most expeditious means available.” Priority B includes “Symptomatic Emergency Medical Service Personnel, healthcare workers, and law enforcement personnel.”

Priority C includes “Symptomatic patients in nursing homes, long-term care facilities, or in congregate living facilities housing individuals who are medically fragile.” Priority D includes, “Symptomatic high-risk unstable patients whose care would be altered by a diagnosis of COVID-19.”

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Thousands of direct support professionals in Maryland's group homes who are caring for citizens with intellectual and developmental disabilities should fit into Priority C which includes, “in congregate living facilities housing individuals who are medically fragile.”

Group homes for people with developmental disabilities are licensed differently than nursing homes, but in reality, they are small nursing homes with many of the same characteristics and risks, especially when it comes to COVID-19. Like nursing homes, group homes are monitored by the State of Maryland under the Office of Health Care Quality. Unlike nursing homes, group homes are supervised and monitored by the Maryland Developmental Disabilities Administration.

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Like nursing homes, group homes in Maryland have residents living in close proximity to each other and a revolving stream of direct care staff coming and going into the homes to cover three shifts per day, seven days per week. Like nursing homes, many residents of group homes are medically fragile and have multiple physical disabilities associated with their primary diagnosis of intellectual and developmental disabilities.

Like other essential employees, group home employees must balance home and work life in order to provide for their families at home and the clients where they work. While the agencies running these homes try to limit who comes and goes into each home, especially given COVID-19, covering three shifts across seven days in a home where clients require one-on-one care requires a team of workers.

Like the brave and dedicated direct care providers in hospitals and nursing homes, the direct support professionals in group homes risk their own health, as well as the health of their family members, to report to work each day. And many of them are working without significant protective gear that larger institutions are able to secure.

The Arc of Carroll County, Flying Colors of Success, and Target Community & Educational Services (Target), all based in Carroll County, manage a total of 25 residential group homes for adults with disabilities within the county. Other agencies, like Penn-Mar, based in Pennsylvania, also have homes in Carroll County. I serve as the CEO of Target which serves as the internship site for our Human Services Management graduate program at McDaniel College which I also coordinate. We currently have 17 graduate students who live in and manage Target’s group homes while they attend classes — now online — at McDaniel College.

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Under normal circumstances, the two-year, live-in graduate internship is life-changing. While none of my graduate students signed up for a pandemic, they have risen to the occasion and are managing their homes like professionals. All of our clients across all of our county agencies are locked down in our homes because many of them are medically fragile. We understand that COVID-19 would likely be deadly for many of the people we serve. We also understand that one positive case would quickly run through a home and this is why these clients and staff must be a priority for COVID-19 testing.

I’m frequently asked, “Have your clients gone home?” While many of our other programs have closed for dozens of our clients, for the individuals living in our group homes, they are home.

The staff at our homes come to work instead of staying at home with their families. They are dedicated to our clients’ wellbeing and they do it because they care. The direct care working relationship is intimate and trusting. In our line of work, “social distancing” is not possible. Our staff bathe, toilet, dress, and feed many of our clients. Touching and holding are as important as breathing when walking with a client, guiding a client in a walker, or pushing a client in a wheelchair.

I know I speak for my fellow agency directors when I thank the community volunteers who have been and continue to make masks and secure other supplies so that staff doesn't add to their risk by shopping. It takes a village, but our direct support professionals are leading the way.

We are grateful.

Tom Zirpoli is coordinator of the Human Services Management graduate program at McDaniel College. His column appears on Wednesdays. Email him at tzirpoli@mcdaniel.edu.

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