June 19, 2020
The Maine Department of Health and Human Services (DHHS) has proactively completed outreach to a variety of Maine’s congregate living facilities about their infection control policies and practices in response to COVID-19. This work has informed DHHS about the needs of these facilities and how best to support them in protecting the health and safety of their residents and employees.
Across the country and the globe, managing the spread of COVID-19 in congregate living settings, where groups of people reside in close proximity, has presented considerable challenges. The virus is most likely to spread among people who are in close contact with an infected person.
In Maine, approximately 24% of COVID-19 cases are associated with congregate living facilities, including both residents and staff, according to a Maine CDC analysis of the 2,337 COVID-19 cases recorded from March 12 to May 31. This includes facilities that provide some form of assisted care, such as assisted living and group homes. (Shelters for people experiencing homelessness, academic dormitories, and correctional settings are not included).
As previously announced, DHHS began its outreach in April by contacting nursing facilities, in response to the increasing number of outbreaks in those facilities as the outbreak progressed. Nursing facilities, which are both state-licensed and federally certified, are required to have robust infection control policies and emergency staffing plans. The findings led DHHS to issue an emergency rule to further protect the health and safety of Maine's nursing home residents against the spread of COVID-19. The emergency rule ensures that nursing facilities take measures to prevent and are prepared to effectively respond to COVID-19 and that residents and their loved ones are informed and supported.
DHHS went on to conduct similar outreach to other congregate living facilities: assisted living facilities, adult family care homes, residential care homes for older persons, and agencies that provide homes for adults with intellectual disability or behavioral health needs. These more home-like settings assist adult residents with daily living but do not provide a nursing facility level of care or infection control. They are state-licensed, with the exception of certain one- and two-bed group homes. DHHS began requiring licensure of those homes in April 2019 and all are scheduled to be licensed by the end of the year.
In total, DHHS assessed 566 facilities throughout the state over several weeks under this outreach project, using the U.S. CDC’s Infection Control Assessment and Response Program tool. The assessments revealed a wide range of familiarity with and adherence to infection control practices and some areas for improvement. In response, DHHS has initiated greater outreach to these facilities, including through webinars and dissemination of updated guidance. On June 12, DHHS issued a memo (PDF) highlighting proactive steps facilities should consider to prepare for a potential outbreak. The Department is considering further steps to protect the health and safety of residents and employees of these facilities.
Per Maine CDC policy, universal testing is offered at all congregate living facilities with at least one confirmed case of COVID-19.
The survey findings (PDF) represent a snapshot in time. Summaries for each provider type are available below:
- Assisted living facilities (PDF)
- Adult family care homes (PDF)
- Residential care homes for older persons (Appendix C) (PDF)
- Agencies that provide homes for adults with intellectual disability (IDD) (PDF)
- Agencies that provide homes for adults with behavioral health needs:
- Behavioral health PNMIs
- Substance Use Disorder PNMIs
- APS PNMIs (PDF)