Home health agencies provide nursing and other therapeutic services for millions of people across the country in their homes or in other congregate settings such as assisted living and rehabilitation facilities. There are about 4,000 home health agencies in the U.S., with close to a hundred in New York City alone. Patients in these settings depend on home health aides to deliver various aspects of care, as well as to support the activities of daily living such as feeding and bathing. Some may be unable to leave their homes to receive medical care, which underscores the importance of home health aides for the continuity of care.
Because of the nature of the services provided by home health aides, particularly in private residences, they and their patients face unique vulnerabilities when it comes to COVID-19. For example, infection prevention and control in the home is typically not a central focus, as it is in health care facilities. In addition, home health aides may not have the same depth of knowledge and training in this area as many primary health care workers do. Perhaps the biggest vulnerability, however, is the social nature of the home environment, which very often leads to both home health aides and their patients lowering their guard when it comes to infection prevention measures. And while the heightened vulnerability to disease transmission in home settings is always a concern, the risks are of course even higher during a pandemic—especially with a disease like COVID-19 that is passed through respiratory droplets.
To address these vulnerabilities and identify opportunities for enhancing infection prevention and control by home health agencies, the Health Care Facilities Team of the NYC Test & Trace Corps, in collaboration with the New York State Department of Health, hosted a webinar in April entitled “Ensuring the Safety of Home Health Agency Staff and Their Patients during the COVID-19 Pandemic.” The session, which attracted representatives from about 200 home health agencies, provided up-to-date guidance on infection control practices tailored to home health aides and explored the role of home health agencies in contact tracing, introducing opportunities to work more closely with NYC Test & Trace in these efforts. It also addressed such topics as how to maintain social distancing in a home setting, the most effective use of personal protective equipment (PPE), proper hand hygiene and best practices for cleaning equipment (e.g., glucometers, BP cuffs, thermometers). In addition, information was provided about the wide variety of resources Test & Trace has available, including testing, vaccination, food delivery and free hotel stays for infected individuals who are unable to safely separate at home.
The presentation, which you can view and download here, was very well-received, with a large number of participants taking part in the Q & A session that followed. The Test & Trace Health Care Facilities Team is currently engaged in other specialized outreach, including with dental and other private medical practices, working to involve these providers in its efforts to stop the spread of COVID-19.