Services to support people in isolation and quarantine

A checklist for establishing wrap-around policies and social support services

Checklist

1. Budget

• Determine available budget for provision of wrap-around services and social support; prioritize resources and services that can be provided accordingly. Services and resources should be prioritized based on the needs of cases and contacts.

  • Collaborate with Medicaid to identify potential funding sources for provision of supports.

  • People with fewer resources historically should be prioritized to receive these supports.

2. Support services

• Determine the set of support services and resources that will be made available to cases in isolation and contacts in quarantine.

  • The goal of providing support services and resources is to make it safe, comfortable and easy for people to comply with isolation and quarantine orders. Using escalating social support is the recommended approach to promote compliance (vs. a more coercive enforcement approach that uses punitive measures).

  • Supporting cases in isolation and contacts in quarantine also contributes to alleviate the burden placed on them for the benefit of society as a whole.

• 2.a Core resources

  • For many cases and contacts, a brief interaction may be sufficient, including core resources and hotline support for follow-up. The core resources for all cases and contacts entering isolation and quarantine should include (See Tips to Improve COVID-19 Control Through Better Case and Contact Follow-up):

    • Daily check-in phone calls

    • Instructions on keeping space clean for those sharing space

    • A hotline for counseling, information, social services, and medical support

    • Health education materials

    • Other (as locally relevant)

• 2.b Care package

  Cases and contacts in isolation and quarantine may require social supports for daily living. The care package offered could include:

  • Access to essentials, such as food, medications, laundry, and garbage removal services

  • Access to telehealth and care if ill (See Clinical Consultation for more information.)

  • Transportation and/or access to routine medical care or emergency care

  • Materials, such as a reliable thermometer, masks or face coverings, gloves, hand sanitizers

  • Incentives, such as access to high-speed internet, passwords for on-demand movies, e-books and learning channels, an encouraging note from the mayor

  • Other (as locally relevant):

• 2.c Financial support

  Financial support may be needed to help those in quarantine and isolation to meet basic needs:

  • Stipend from government to those without sick leave or who need to take care of children or other vulnerable dependents

  • For people who are employed, work with their employers to provide support, with possible tax credits

• 2.d Other supports Other supports. Consider the provision of other supports that may be necessary to enable people to adhere to isolation and quarantine requirements, including:

  • Health insurance navigation

  • Medicare/Medicaid assistance

  • Mental health services

  • Substance use services

  • Child care services

  • Transportation services

  • Housing assistance

  • Substitute caregivers (to fill in for the case/contact if they are acting as the primary caregiver for anyone else)

  • Unemployment assistance

  • Legal assistance

  • Negotiation with employers and landlords

  • Small business support (for cases/contacts who are small business owners)

3. Eligibility criteria

• Determine eligibility criteria for the provision of social supports to cases. (See Sample eligibility criteria for social support services)

  • Support should be available to all people regardless of what language they speak, if they have disabilities including blind or deaf, or if they have adequate immigration papers.

• 3a. Eligibility for core resources The core resources should be made available to all cases and contacts entering isolation and quarantine.

• 3.b Eligibility for care package The care package should be offered to cases and contacts entering isolation and quarantine based on need.

  • Cases and contacts are eligible to receive the care package if they do not otherwise have access to the goods or services offered (either they do not have the financial means or cannot safely obtain the goods and services without putting themselves or others at risk).

  • Jurisdictions with available resources may choose to offer the care package to all cases and contacts.

• 3.c Eligibility for financial support. Financial supports should be offered to cases and contacts who:

  • Cannot perform their jobs while in isolation or quarantine and whose employers will not provide adequate paid sick leave

  • Are caregivers (for example, of children or elderly) and cannot provide their caregiving services and do not have access to fill-in support while in isolation or quarantine

  • Other (as locally relevant):

• 3.d Eligibility for other supports Other supports should be offered on an as-needed basis to ensure that cases and contacts can meet their basic needs and to minimize harm and suffering.

4. Support service providers

• Contract with a local care coordination provider or other community-based organization to facilitate social supports for contacts in quarantine and cases in isolation. (See Template scope of work for social support and wrap-around services)

  • Depending on the wraparound services and social support that will be provided along with the landscape of potential service providers in the community, it may be necessary to contract with more than one agency.

  • Funding must cover staffing and resource needs, where these cannot be delivered directly by the jurisdiction.

• 4.a Identify landscape of agencies or organizations that already work in the community providing similar services. This may include health care providers or social services providers, religious groups, food banks, etc.

• 4.b Select and contract with agencies or organizations that can rapidly and effectively provide the needed wraparound services and social support.

5. Private sector engagement

• Consider engaging the private sector to support provision of social support. For example: discounted/free internet, or food deliver services with waived fees.

6. Linkage for cases and contacts

• Ensure the link to social support is made for contacts and cases, as appropriate.

  • Train contact tracing staff to assess an individual’s ability to isolate or quarantine in a safe environment that provides the necessary support (private room and bathroom, adequate food and water, and access to medication) and keeps them away from high-risk individuals.

  • Contact tracing staff should link people with social support and wraparound services based on their eligibility and interest receiving the supports.

  • During daily monitoring of cases and contacts, contact tracing staff should reassess social support needs throughout quarantine and isolation periods.

  • Forms and protocols used by contact tracing staff should include questions and prompts to guide this process.

Implementation Tools

• Tips to Improve COVID-19 Control Through Better Case and Contact Follow-up

• CDC: Self-Isolation and Self-Quarantine Home Assessment Checklist

• Template scope of work for social support and wrap-around services

• Sample eligibility criteria for social support services

• Sample resource directory

• Guidance on Social Support and Referrals

• Reporting Suspected Abuse of Children, Persons with Disabilities, Elders

• Domestic Violence Protocol

• Pathways for Mental Health Referrals

• Immigration Considerations

• Medical Referrals and Follow-up

• Referring Contacts for Testing

LIVING DOCUMENT This playbook is a dynamic, “living” document. Global knowledge pertaining to COVID-19 is rapidly evolving. Feedback and suggestions can be sent to [email protected].