In an effort to share effective practices supporting people with intellectual/developmental disabilities (I/DD) through the COVID-19 pandemic, Together for Choice spoke with representatives from two service providers—St. Louis Center in Chelsea, Michigan and BrightStone in Franklin, Tennessee. Both organizations have been remarkably successful keeping their clients safe while simultaneously continuing to support their ability to thrive in their daily lives.
St. Louis Center
St. Louis Center’s (SLC) 63 residents live on a gorgeous campus in southeastern Michigan. They provide residential, employment, and day services to children and adults, including seniors. Since closing their day program in mid-March in response to COVID-19, SLC has not lapsed in providing their residents excellent services. They have since resumed a limited amount of their previous activities to provide residents with more opportunities while continuing to remain vigilant of potential dangers.
A resident works in one of SLC's on-campus gardens.
The children who live at SLC continue to attend summer school remotely through July. As of today, local schools do not have a definite plan to either return to school in-person or continue virtually in the fall. SLC’s residents attend virtual classes in conference rooms with staff present to provide additional support. To supplement video lessons, students head to SLC’s spacious gym where they can play games and sports to stay active after classes.
SLC successfully maintains person-centered services for all residents through the pandemic. When work and day programs were closed during the shelter in place, staff still offered the widest possible selection of what to do each day. For some, this could mean recreational activities like playing games or going on walks; others will choose to work in one of SLC’s many beautiful gardens or on other campus projects to satisfy their desire to work. Recently, SLC’s sheltered workshops, supported employment, and volunteer programs like Meals on Wheels have reopened in a limited capacity for residents who are able to maintain social distance, wear masks, and otherwise follow public health guidance.
Despite anxiety early on, SLC’s residents have maintained good mental health overall. According to COO Deana Fisher, the initial change in routine was difficult, particularly for residents with autism who rely on consistency in their days. SLC’s dedicated staff increased the services offered including counseling and occupational therapy as the shelter in place began, particularly for high-risk groups like their aging residents. SLC additionally received an influx of community support, including donations of hand sanitizer from Ugly Dog Distillery, weighted blankets for people with high sensory needs, and letters of support for their residents from local schools and churches.
Michigan has been able to relax some of their preventative policies, thus allowing SLC to provide more options to residents on how they can spend their time. SLC also recently began allowing residents’ families to visit campus and for residents to visit their families’ homes. Visits still require diligence, including designating an on-campus “clean room” reserved for indoor visits, and the room is thoroughly sanitized before and after visits. SLC’s administration furthermore ensures safety by providing agreements for families to follow public health guidance as closely as possible. Residents who engage in risky behavior while at home, such as attending a family gathering, must then isolate for two weeks before reintegrating into their on-campus home. SLC’s careful blend of safety measures and relaxed policies allows their residents to maintain a high quality of life even through the current extreme circumstances.
The number of Tennessee’s confirmed COVID-19 cases climbed in July as the state began to relax laws around social distancing, coupled with only a recommendation, rather than a legal requirement, to wear masks in public. As a result, positive cases in group homes for people with I/DD are staggeringly high in the state. In stark contrast to the recent spike, BrightStone in Franklin, Tennessee has successfully avoided any positive cases among their students. Their success is thanks to their creative, critical thinking and strict adherence to public health guidance—all while still supporting a slow, careful reopening of their facilities.
A class of BrightStone students pose for a picture before the COVID-19 pandemic.
After the pandemic came to the U.S. but before states began sheltering in place, BrightStone formed a COVID-19 advisory team and re-opening task force. The two groups consist of board members, staff, and physicians. They work together to determine policies around closing BrightStone’s in-person services, how to safely re-open, and reevaluating extant company policies such as how to return to work after an illness.
The advisory team and task force temporarily closed in-person programs on March 11, moving online to stream via Facebook Live. Since it began, V-BST (Virtual BrightStone) has been hugely popular among students, as well as former students and other members of the greater Franklin community that BrightStone has welcomed to participate.
While sheltering in place, BrightStone began surveying students and families about when they would feel comfortable returning to in-person programs. Once the order expired and the instances of COVID-19 (temporarily) slowed, BrightStone decided to reopen its program in a very limited capacity. The task force worked individually with students wanting to return to determine if they could effectively social distance, wear a mask, and consistently follow other safety measures at BrightStone. Unfortunately, due to the high incidence of COVID-19 in Tennessee group homes, in addition to the difficulty of coordinating strict safety precautions between multiple agencies, BrightStone is not yet allowing group home residents to return. For those able to return safely, they must pass a health screening every time they enter BrightStone’s facilities. Instead of their typical six-hour work day, there are two, two-and-a-half hour shifts with an hour in-between for staff to sanitize the spaces. While V-BST continues, the in-person classes offered focus exclusively on job skill development instead of movement-based programs. In order to sensitize everyone to wearing masks for prolonged periods, classes are structured with short breaks outside (sheltered from weather, if necessary) every 20-30 minutes for everyone to remove their masks from a safe distance. All of BrightStone’s safety practices are shared with staff, students, and families in a live document that is updated as their policies adapt to the world around them. Importantly, while BrightStone critically examines every opportunity to minimize transmission of the virus, they also ensure their community’s understanding and acceptance of the risks inherent to returning to work.
In addition to constant vigilance of a virus outbreak among the BrightStone’s vulnerable population, students’ mental health is also of serious concern. While some students had few issues adjusting to the shelter in place order, others face increased levels of depression and anxiety, along with increased maladaptive behavioral symptoms like physical aggression. BrightStone’s CEO and founder, Brenda Hauk, counseled many students and their families to navigate the difficult, emotional process of leaving group homes to live with family, then returning to group homes after two to three months. For those struggling emotionally while remaining in family a home, the worst fear is that they will developmentally regress while not receiving in-person services. Thus far, the fears seem unrealized; while the numbers are still small and anecdotal, Hauk says that students recently experiencing depression and anxiety show marked improvements in their mental health shortly after resuming in-person classes. While their primary concern will always be students’ and staff’s safety, BrightStone’s creativity in developing an alternative model of their programs has shown a significant benefit in other aspects of quality of life for the people they support.
Jonathan Neidorf (Assistant to the Board)