Recovery Housing and Coronavirus: Frequently Asked Questions

Last Updated: May 26, 2020

Introduction

The global coronavirus pandemic has raised unique questions from recovery housing operators.  There is much information out there, but questions remain on exactly how recovery housing operators should adjust their policies and practices in response.  This document includes frequently asked questions and responses, based on the most recent best practice advice from national, state and local experts.  We will do our best to update this guidance as needed as the situation develops.

We are in unprecedented and uncertain times.  The situation changes rapidly, and it is possible that new recommendations and resources may become available.  Operators must examine information provided by trusted sources, including the Centers for Disease Control and Prevention (CDC), Ohio Department of Health (ODH), and Ohio Department of Mental Health and Addiction Services (OhioMHAS), along with this document and consider the individual needs of their residents. 

Where do I go for accurate information?

The following websites are updated at least daily and contain accurate and trusted information about coronavirus.

Where do I go if I have questions?

  • If you have questions about the coronavirus itself, you should call the Ohio Department of Health at 1-833-427-5634

  • For questions relating to housing and coronavirus contact the Ohio Department of Mental Health of Addiction Services OhioMHAS housing team at COVID19Housing@mha.ohio.gov

  • For questions about behavioral health and coronavirus in general, contact the Ohio Department of Mental Health and Addiction Services OhioMHAS at COVID19BH@mha.ohio.gov

  • For questions about your local response, contact your local health department

What do I do if a resident in my home gets sick?

If a resident becomes ill and starts to show symptoms of possible COVID-19, the resident should call their primary care provider and follow the instructions provided. If  they do not have a primary care provider, you can call a federally qualified health center, or contact your local health department.

If they are having trouble breathing call 911 and inform the operator of the resident’s symptoms if they are symptoms of possible COVID-19.

In some instances, the resident may be asked to go to the hospital, in other cases the resident may be asked to self-isolate. It is important that you help support the resident in completing the instructions provided by their health care professional. 

  • Assist the resident getting to the hospital if that is the recommendation of the health care provider

  • Be sure to call ahead if you are visiting a health care provider

  • If the resident is asked to stay at home and self-isolate, begin isolation protocols

How do I keep other residents in my home from getting sick?  

It is important to remember that many people living in recovery housing often do not have anywhere else to go.  Hospitals and other health care systems are overwhelmed with critical cases.  It is unlikely that a resident will be able to go to a hospital unless they are in need of immediate medical attention.  Treatment centers, shelters and other housing options are also unlikely to be an option.

The following recommendations are provided as ways that recovery housing operators can allow the resident who is ill to have the support they need to get better, keep moving forward in their recovery as well as reducing the risk of illness for the other residents living in the home. 

  • Provide the resident their own bedroom and single bathroom for their own use

  • Ask the resident to clean high-touch surfaces of the bathroom each time it is used

  • Have staff, house manager or other residents bring the resident meals and other supplies to their room for them 

  • Leave any meals, items, or other needs outside the bedroom door. The resident should only open the bedroom door and retrieve items after the person dropping off items has left

  • Allow the resident to participate in house meetings and other activities virtually.  There are many apps and other tools that can be used to help residents keep in connection with others in the home.

  • Allow resident to participate in outside activities virtually.  There are more online and virtual resources becoming available like IntheRooms and the Connections App.  Check the Ohio Recovery Housing Resources Page for the most up to date information about these tools.

  • If the resident needs to go outside, have them notify other residents.  Other residents should go to their rooms while the resident walks through the house and outside to ensure appropriate physical distancing. 

  • The resident should wear a face mask when around other people (including before entering a health care provider’s office). They may have to improvise a face mask using a scarf or bandanna if surgical masks are not available.

  • The resident should clean any doorknobs, light switches or other surfaces touched 

  • If you need personal protective equipment, supplies are limited.  Contact your local Emergency management agency for guidance.

You can reference an example policy for a Level II recovery home provided by Erin Helms, Executive Director of The Woodrow Project and board member for the National Alliance of Recovery Residences and Ohio Recovery Housing.  These procedures are currently in place and working well in the recovery home.

How do we safely welcome visitors to the recovery home?

On May 19, 2020 Governor DeWine issued the "Ohioans Protecting Ohioans Urgent Health Advisory" which will replace the Stay Safe Ohio order that was issued April 30, 2020.  As of this date, Ohioans are no longer ordered to stay at home, but instead are asked to be responsible and consider health risks.

 

Even though the order has been lifted, the coronavirus is still spreading among Ohioans.  Physical distancing is a primary method of preventing spread of this deadly disease.  Recovery homes should discuss these risks with residents and help them decide if it is appropriate to have visitors.  Each recovery home is encouraged to review your existing visitor policies and implement best practices.   

  • If a resident would like to have a visitor, discuss if it is at all possible to have the visit virtually. 

  • Allow residents with limited cell phone minutes to data to use an organization phone or computer to conduct virtual visits

  • If the visit is for peer support or a health care service, contact the provider to determine if telehealth or a virtual visit is an option.

  • Discuss potential risks with residents.  Discuss with residents the populations who are high risk and remind them that these populations are recommended to take additional precautions.

  • Remind residents that having visitors not only increases their risk, but also the risk of anyone else in the household

  • Allow residents to offer feedback and discuss any changes to your visitor policy in light of COVID19

If a resident chooses to have a visitor - the following best practices can be incorporated into your formal visitor policies to help residents have visitors while reducing the risk of spread of disease.

  • Include in your formal policy that all visitors should be screened for symptoms of COVID-19, including fever (100.4 or higher), dry cough, sore throat, or shortness of breath.  Visitors should also be asked if they have been around anyone who has tested positive or has shown symptoms of COVID-19 in the past 14 days.  

  • At all times, everyone should practice appropriate physical distancing of being six feet apart from any other person

  • Visitors should wash or sanitize their hands upon arrival

  • If at all possible, conduct the visit outside, on the porch or in the backyard

  • Establish a room in the house that is designated for visitors in case visits can not be performed outside.   

  • Clean this room before and after the visitor leaves

  • Do not allow other residents in this room while the visitor is present

  • Anyone participating in the visit should wear a mask that covers the nose and mouth

  • Have an extra supply of masks or face coverings for any visitors who do not have their own.

How can residents safely leave the home for nonessential purposes?

On May 21, 2020 Ohioans are no longer being ordered to stay at home.  However, the Protecting Ohioans Urgent Health Advisory strongly recommends that Ohioans stay at home as much as possible.  Specific populations who are identified as being higher risk are cautioned that the should be especially careful.  

We all know it is safer to be at home.  The following best practice suggestions for helping residents choose to stay at home.  

  • Remind residents of any current or existing policies around leaving the home, such as curfews and similar policies.  

  • Discuss risks of COVID19 with residents.  Remind residents that older adults and those with specific health conditions are at increased risk.

  • Discuss recommendations in the Urgent Health Care Advisory with residents and how all Ohioans are encouraged to take steps to protect themselves and each other

  • Work with residents to reduce trips outside of the home. 

    • Contact any health care, treatment or peer support providers and see if services can be received via telehealth. 

    • Work with residents to create weekly shopping lists to reduce trips to the grocery store

    • Allow resident with limited minutes on their phones to use the organization phone or computer to connect with others virtually

    • Create a space in the home where residents can have privacy to participate in telehealth, virutal recovery supports, or even have private conversation with friends and family without leaving the home

  • Continue offering any additional activities or strategies that you implemented during the stay at home order to encourage residents to choose to stay at home

  • Discuss with residents' any ideas or strategies that they have to make the idea of staying home more appealing

If a resident does need or chooses to leave the home, the following strategies can be used to help reduce risk.

  • Remind the resident that they are still required to participate in appropriate physical distancing whenever they leave the home

  • Remind the resident that they should wash their hands often when they are not at home

  • Remind the resident to avoid high touch surfaces in public areas, such as handrails or elevator buttons

  • Provide masks or cloth face coverings for all residents to wear when outside the home.  

  • Assist the resident in finding transportation other than public transit.  If residents must use public transit they should

    • Maintain Six Feet of distance from other passengers​

    • Avoid touching the handrails and other surfaces

    • wash their hands or use hand sanitizer as soon possible after using public transportation

  • When residents return to the home they should

    • remove their shoes 

    • wash their hands

    • Promptly shower or bathe 

    • Clean all frequently touched surfaces 

    • Where possible, residents can store a change of clothes in a laundry room or other area.  This can allow them change prior to entering the home.  Residents can also immediately go to their room to change if there is no private place to change upon entering the home.

  • Remind residents that gatherings of 10 or more people remain prohibited.   

What if our recovery home only has one bathroom?

Some homes are smaller, and only have one bathroom that is shared by all residents.  There are still steps homes can take to reduce risk in these environments.

  • Ensure the bathroom has soap, paper towels and disinfectant cleaner

  • Use disposable paper towels to avoid shared items.  If paper products remain difficult to get in your area, ensure each resident as their own cloth towel to use, and that it is washed frequently

  • Empty trash cans regularly, wear gloves when emptying cans

  • Do not place items on shared surfaces (for example, do not place toothbrushes on the sink)

  • Provide each resident a caddy so they can bring personal items into the bathroom and then remove them when not in use

  • Clean the restroom before and after each use.  Post a checklist of surfaces to be cleaned each time to serve as a reminder

  • Do not use the restroom immediately after someone else has used it.  Wait a reasonable amount of time to enter, clean and use the restroom.

I have a resident who has lost their job, how do we support them?

As businesses are forced to close to reduce the spread of disease, many people are losing their jobs, including recovery housing residents.  There are resources available.

  • Residents can apply for unemployment online at www.unemployment.ohio.gov or call 1-877-644-6562 or 614-387-8408 M-F 8 a.m.-5 p.m.

  • There are many people applying for unemployment at this time. You are encouraged to use the website as wait times on the phone are very long.

I am unable to buy enough supplies at the store, what do I do?

As of the publication of this document, we are starting to see basic supplies such as toilet paper and cleaning products be restocked in stores.  However, be prepared that stores may have placed limits on the amount that you can buy at one time to reduce hoarding.  Also, be prepared that certain items, such as thermometers, are going to be extremely difficult to find.  Each store is managed differently, and these strategies might not work at all stores, but some operators have had success using the following strategies.

  • Call ahead, if possible, and ask to speak to the store manager or business account manager.

  • Explain that you are a housing provider, and that you need to purchase supplies for all the residents in your home.

  • Ask how many supplies you will be permitted to purchase.

  • Bring your Ohio Recovery Housing certificate or other documentation with you to demonstrate that you are purchasing supplies as an organization.  The capacity of your home is printed on the certificate. 

  • Contact your local Emergency management agency for guidance on supplies such as masks.  

  • Contact your local ADAMH Board and/or health department for direction and support if all other sources for obtaining needed supplies have been attempted and exhausted.

  • Contact business that may currently be closed, such as beauty salons, restaurants and other establishments to see if they have cleaning supplies they are not using while closed

  • Post on Facebook or other social media that you are in need of supplies or are looking for places to purchase supplies locally, your community may respond with either donations or places where you can go 

  • Check out this list of potential resources

How do I support residents who are experiencing anxiety or sadness during this time?

This is a stressful time for all people, and it is not uncommon for people to be overwhelmed and experience anxiety and sadness.  The CDC has provided resources on managing stress and anxiety during this time.

  • Everyone should continue with any existing mental health treatment plans.  Many providers are offering services via telehealth, contact the provider to learn more about how to continue to receive any treatment services.

  • If a resident needs help immediately, you can contact the Disaster Distress Hotline at 1-800-985-5990

  • They can also use the Crisis Text Line.  Text the keyword “4hope” to 741 741 to be connected to a Crisis Counselor

  • They may also call the OhioMHAS help line at 1-877-275-6364 on Monday – Friday, 8:00AM – 8:00PM

General best practice strategies include

  • Taking breaks from watching or reading news stories or social media 

  • Encouraging everyone to stick to a routine as much as possible

  • Engaging in physical activity, such as taking a walk (remember physical distancing!)

  • Connecting with others virtually, talking to friends and family about how you are feeling

  • Engaging in enjoyable activities 

  • Talking to other recovery housing operators to get ideas about group activities and projects for residents to do

What can we do to prevent a relapse during this time?

Relapse is always a concern in recovery homes.  This concern is raised during this time of crisis as residents experience increased anxiety, sadness and disruption in routine.  Suggestions for creating an environment that is supportive of recovery and decreases relapse include

  • Connect with your local treatment providers to learn about available services, including telehealth options, in case they are needed.

  • Be sure to talk to your local treatment providers about any resources that may be available to you should a resident experience a relapse.

  • Have any residents who are currently engaged in treatment contact their treatment provider to make arrangements so they can continue with any existing treatment plans under telehealth or other options.

  • Refer to the Ohio Recovery Housing Best Practice Guidance on Preventing and Addressing Relapse in Recovery Housing.  This document contains information on developing and updating recovery plans that include relapse prevention.

  • Go over the recovery and relapse prevention plans with each resident.  Make changes and updates to adapt for a new schedule, goals, and options.

  • In-person recovery meetings have been cancelled, but residents can still engage in virtual recovery meetings using online tools and apps like IntheRooms and the Connections App.  Check the Ohio Recovery Housing Resources Page.  Please also see resources listed by the Office of National Drug Control Policy. As we learn about new tools and resources, we will post them there.

  • Many residents may not be able to engage in regular work and volunteering.  Help provide residents resources for virtual job training and virtual volunteer opportunities so they can remain engaged in these activities. 

  • Residents may have limited minutes on their phone, allow them to use the organization’s phone or computer to connect with peers, family and friends.

  • If a resident were to experience a relapse, and treatment services or other options are not available, connect the resident to their primary care provider or to a federally qualified health center.

What are some ideas of things residents can do from home to keep busy and avoid boredom?

As with any other household, residents may be looking for positive activities to do, especially residents who normally would engage in work, school or volunteer activities that have been cancelled.  Suggestions to reduce boredom include:

Conclusion

These are challenging times, and the decisions that recovery housing operators need to make are difficult.  It is normal to feel stress, anxiety and sadness during this time.  Recovery homes are critical parts of the continuums of care for people with substance use disorders, they are also critical parts of or neighborhoods and communities.  By being thoughtful, supportive and reasonable during these times, you will be demonstrating to your residents and your communities the core values of recovery housing, and further demonstrating how recovery housing is a critical asset for any neighborhood or community.

Disclaimer

This frequently asked questions guide is not intended to replace the advice of legal counsel or serve as medical recommendations or clinical guidance for substance abuse disorder treatment professionals.  It is based on best practice guidance that has been provided up to the date of publication.  The exact implementation of these responses will vary depending on the exact structure of your home and the Level of Support available in your home. 

Ohio Recovery Housing | 35 E. Gay Street, Suite 401 | Columbus, OH | 43215

614-453-5133 |  info@ohiorecoveryhousing.org