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Dear iBRAIN Community:
I am hopeful you and your family remain healthy and safe. While we have made significant modifications and precautions since the coronavirus crisis emerged, the International Institute for the Brain, iBRAIN, has continued to provide essential services for children who have brain injuries or brain-based disorders.
There are THREE primary constituents who have guided our actions:
The safety of these three primary constituents are paramount to our program, and is not only a priority, it is one of our core values.
Prior to the coronavirus crisis, iBRAIN took very aggressive steps during the regular flu season. All of our staff were mandated to either get the flu shot or wear a face mask throughout the day – no exceptions. We even terminated one staff member who falsified their flu shot documentation and another staff member who continued to be lax in wearing the face mask since they didn’t have the flu shot. Due to this very aggressive action, our program had significantly fewer child and staff absences this school year due to the flu than last year.
As the coronavirus crisis began, we were one of the first programs in the United States to begin staggering staff work schedules to prevent staff from traveling during peak public transit periods. We began taking the children and staff temperatures every day and implementing Centers for Disease Control and Prevention (CDC) recommended guidelines. We installed additional sanitizers throughout the facility and our full-time Registered Nurse closely monitored the children and staff throughout the day. We even had one staff member, who returned from a vacation in Italy, placed on a two-week, work-from-home quarantine.
During the peak of the crisis on March 18th, we initiated Phase I by closing our facility and having all staff work remotely from home. This immediate action protected our kids and their families, our staff and their families and the overall community. Even though we are an essential business, a two-week, “shelter-in-place” directive was the most prudent action to help “flatten the curve” and prevent our health care system from being overwhelmed. During these first two weeks, while initiating remote learning with our staff from their homes, we instituted a daily temperature check for each staff member and a change in health status for their respective households, even on the weekends. Since there was limited testing capabilities, this would provide us with the most information possible to continue to protect the health of our three primary constituents (children, staff and the community). For those students who required 1:1 nursing, those services never stopped.
Our program has always provided remote learning whenever any of our kids were either home or in the hospital. This included, 1:1 direct paraprofessional and nursing support in the home or hospital (when appropriate), as well as two-way, synchronous, academic or related service sessions using FaceTime, Zoom or other platforms that provided two-way video and audio connection. We also provide synchronous translations when needed for families.
On April 2nd, we began Phase II by providing limited, home-based, in-person services, including 1:1 paraprofessional and related services, while continuing to provide additional remote learning and related services. For those kids who needed to be in total isolation, we provided remote learning and related services (we also require a continuous 14-day temp/health check for any child who is in contact with any staff member). Each child’s individualized programming needs were developed in consultation with their parents/guardians based on the individual needs and situation of their child and family. During Phase II, all of our staff were tested for Covid-19, and thankfully, they all came back negative. In addition, our facility had extensive cleanings done throughout.
On May 4th, we began Phase III by reopening our facility, allowing some kids to return part-time or full-time, while still providing home-based paraprofessional services and remote learning for those who have not physically returned. We have continued to provide services based upon the individualized needs and health concerns for each child and their family.
Upon reopening the facility, we have initiated very strict protocols based upon the CDC guidelines. Every person must have their temperature checked BEFORE entering and must be wearing a face mask (if they have a temperature they are sent home to contact their primary care physician and cannot return to work until another Covid-19 test is completed). Social distancing of six feet is required throughout the day, unless when working directly with a child, and a face mask is mandatory. We are staggering our staff’s work schedules to limit the days they are physically commuting to work each week. All of our staff have received the serologic test (to detect Covid-19 antibody) and every month our staff gets a new diagnostic Covid-19 test.
We will likely be in Phase III for an extended period of time.
As many people know, any prolonged period of not receiving academic or related services (i.e., physical therapy, occupational therapy, speech therapy, vision education, etc…) will result in significant regression for our kids. This regression can turn into atrophy and can cause major health complications for our children over time.
Many of our families have limitations in their ability to manage a purely remote learning and related service program at their home. Some parents have work obligations during the day which makes it impossible and some parents are not able to physically handle all of the activities during the school day (since they also have to manage their child the other 16 hours of the day or they may have other children requiring remote learning as well). There is a reason all of our kids have 1:1 paraprofessionals, many have 1:1 nursing and they require a two-person transfer when removing them from their wheelchairs or other activities like preparing them for various services: they need significant support throughout the day!
Besides iBRAIN being an essential business as per New York Governor Andrew Cuomo’s Executive Order, our children have FEDERAL RIGHTS to receive the services in their respective Individualized Education Programs (IEPs). The Individuals with Disability Education Act (IDEA) protects the rights of students with disabilities. As per the United States Secretary of Education, Secretary Betsy DeVos, these federal rights are not modified or changed due to the current coronavirus crisis. State and local educational agencies or school districts are still required to implement their IEPs!
The IDEA also guarantees these services are to be provided in the Least Restrictive Environment (LRE). It is well established that home-based services are considered the MOST Restrictive Environment and solely remote services is the most restrictive manner to deliver those services. Certainly, some children may need to remain at home in greater isolation, but everyone else is entitled to have their services in person as per their IEP!
We will be constantly monitoring the situation and we will make adjustments based on the needs of our THREE primary constituents. If you have any questions, please visit our website, www.iBRAINnyc.org.
All the best,
Patrick B. Donohue, JD, MBA
Founder, The International Institute for the Brain (iBRAIN)
Father, Sarah Jane Donohue