A04_Appendices.pdf

STATE OF HAWAI I

DEPARTMENT OF HEALTH

KA OIHANA OLAKINO

P. O. BOX 3378

HONOLULU, HI 96801-3378

April 26, 2023

REVISED COVID PREVENTION GUIDELINES FOR KALAWAO COUNTY

Reductions in national and state COVID-19 case counts, hospitalizations, and deaths, in combination with high rates of COVID-19 vaccinations in Kalawao County residents has reduced the threat to public health in the County. This reduction in risk level makes it possible for DOH to retract most COVID-19 restrictions, providing there is cooperation and support from everyone in the settlement.

Effective Monday, May 1, 2023, the new guidelines outlined in this document replace all previous rules, regulations and procedures that were previously implemented by the Department of Health in response to the COVID-19 pandemic. These new guidelines shall remain in effect until modified in writing by the Department and may become more restrictive or less restrictive as conditions and risks change. The Department retains its authority to provide directives pursuant to chapter 326, Hawaii Revised Statutes (HRS).

The Department recognizes and appreciates the many sacrifices patients, staff and other community members have made to prevent illnesses and deaths in our community during this pandemic. During the past two years, COVID-19 has taken the lives of over 1,129,500 people in the U.S, with many more developing long-term health conditions. The toll in long term care facilities has been even more severe. The Department remains committed to ensuring the health and well-being of the residents of Kalawao County and the Kalaupapa Settlement.

As we move forward, the Department asks all individuals present in Kalawao County to help us to reduce opportunities for the introduction and spread of COVID-19 by complying with the

-19 Prevention Guidelines for

Baron Chan Date

Diana Felton, MD Acting Chief Communicable Disease and Public Health Nursing Division State of Hawaii Department of Health

Date

JOSH GREEN, M.D.

GOVERNOR OF HAWAI I

KE KIA INA O KA MOKU INA O HAWAI I

KENNETH S. FINK, MD, MGA, MPH

DIRECTOR OF HEALTH

KA LUNA HO OKELE

In reply, please refer to:

File:

Exhibit A General COVID-19 Infection Prevention Guidelines for Kalawao County

(REVISED 5/1/23)

The Department requests that all individuals in Kalawao County help reduce opportunities for the introduction and spread of COVID-19 in the County by complying with the following community infection prevention guidelines.

A. All visitors and residents arriving in Kalawao County are requested to take steps to help reduce the chance of introducing COVID-19 to the community.

This will help protect the community including residents who are at high-risk of getting very sick from COVID. DOH recommends visitors and returning residents:

1. Take an over-the-counter COVID test within one day prior to traveling to Kalawao County. Please do not travel to the county if the test is positive, you have had recent close contact with someone diagnosed with COVID, or you have symptoms of COVID-19.

2. Avoid close contact with residents of the county for 10 days after arriving and while in Kalawao County if possible. Please make special effort to avoid close contact with county residents who are at high-risk of getting very sick from COVID disease such as those over 50 years old and those who are immunocompromised or have underlying health conditions.

3. Please wear a mask when in close contact with a resident or in communal settings for 10 days after arriving and while in Kalawao County.

B. All individuals within the County of Kalawao are asked to monitor their health daily for any of the COVID-19 symptoms described below:

Fever (100.4°F or higher) or chills

Cough Shortness of breath or difficulty breathing New loss of taste or smell

Sore throat Congestion or runny nose Muscle or body aches Nausea or vomiting Diarrhea

C. If an individual begins to experience any of these symptoms, they are asked to immediately isolate, notify at least one of the following, begin any needed evaluation and follow lation and precautions guidance:

1. Kalaupapa Settlement Administrator Phone: (808) 567-6924 or (808) 567-6928

2. National Park Dispatch Phone: (808) 985-6170

D. If an individual believes they are experiencing a medical emergency of any kind, immediately call 911 or National Park Dispatch at (808) 985- 6170.

E. All individuals within the County of Kalawao are required to continue wearing face masks that cover their nose and mouth when in the Kalaupapa Store or Kalaupapa State Administration Offices.

F. Locations with Continued Access Restrictions:

Kalaupapa Care Home: ONLY patients, designated DOH staff, and others authorized by the Kalaupapa Administrator or Kalaupapa Nursing Supervisor are allowed to enter the Kalaupapa Care Home. All staff present in the Care Home shall comply with any specific infection control directives established by the Kalaupapa Care Home.

Application for Essential Services Provider Permit

To: Administration Office, Kalaupapa Settlement DATE: ___________________

Request permission to have the following person(s) at Kalaupapa Settlement as Essential Services Provider(s) under the sponsorship of our organization ___________________.

FROM: __________________ TO: ___________________ STAYING AT:________________________________ Date of Arrival Date of Departure

Tag# Name of Guest Age (if a minor)

____ ________________________________ Print Name of Sponsor Phone

____ ________________________________ Sign Sponsor Name(s)

Above request is granted, Permit issued on ___________________, SUBJECT TO RULES & REGULATIONS

GOVERNING KALAUPAPA SETTLEMENT AND REVOCABLE.

Administrator, Kalaupapa Settlement

By signing, you as a sponsor assure that all Rules & Regulations are followed. Please be sure that all your guests have read and understand the Rules of the settlement as shown on Attachment B. You understand the responsibility of sponsoring these individuals to enter and remain in the Settlement during the dates specified and the penalties for sponsors and their guests where rules are not followed. Sponsor understands that Permit Application is to be submitted three (3) BUSINESS days prior to arrival.

I/We as Essential Service Provider(s) have read and understand all instructions for visitors and agree to follow them as a condition for permission to visit Kalaupapa Settlement. I/We hereby acknowledge receiving a copy of The Rules and Regulations, including Attachments A, B, C and D. If I will be driving I will provide a copy of my driver’s license.

PRINT SIGN FULL BUSINESS EMERGENCY

NAME NAME ADDRESS PHONE #

Revised 3/11/2022

ARRIVAL

DATE

Sponsors should have a copy of Rules & Regulations, if not it is the responsibility of the sponsor to request a copy from the Administration office. FAILURE TO ABIDE BY THE RULES & REGULATIONS ARE IMPOSED UPON BOTH THE SPONSOR AND GUEST (S). FIRST OFFENSE SIX (6) MONTHS SUSPENSION. SECOND OFFENSE NINE (9) MONTHS SUSPENSION. THIRD OFFENSE ONE -TWO (1-2) YEAR SUSPENSION. Additional sanctions may be made at the discretion of the Kalaupapa Administrator.

TRAVEL BY: PLANE TRAIL OCEAN

michael.casey Highlight

SPONSORS: ONLY RESIDENTS OF KALAUPAPA MAY SPONSOR GUESTS.

GUESTS/VISITORS: All visitors must present some type of photo identification

REGISTRATION:

MAXIMUM STAY:

HOSTS/SPONSORS:

VISITATION OF

MINORS:

PHOTOGRAPHY:

HOSPITAL:

RESTROOMS:

VISITOR’S QTR’s:

Upon sign-in at the State Administration Office (i.e., Driver’s License, State ID, etc.)

ALL ID’s MUST HAVE BIRTH DATE ON THEM.

Registration at the - State of Hawaii - Administration Office is required of “ALL” guests. Guests are required to sign the Department of Health permit upon entering the Settlement and obtain a copy of Rules if sponsor has not provided them a copy. Anyone visiting the Settlement without a sponsor and signed permit is TRESPASSING and subject to legal action.

NO VISITOR is allowed to visit Kalaupapa Settlement more than thirteen (13) days in a calendar quarter. The maximum stay for each guest is limited to seven (7) days and (6) Nights at the Visitor’s Quarters/ Wilcox.

Unescorted walking or riding beyond settlement property is strictly prohibited. Guests must be in the company of their sponsor at all times when outside the airport terminal area and the cattle guards beginning at the road to Kalawao (where the pavement ends and dirt road begins).

Children under the age of sixteen (16) are not permitted in Kalaupapa Settlement.

Photographs of patients may NOT be taken without their written permission. This includes their property. Permits may be picked up at the State of Hawaii Administration Office.

THERE ARE NO MEDICAL SERVICES AVAILABLE TO VISITORS AT

KALAUPAPA

Public restrooms are located at the Airport Terminal, the Administration Building, Lion’s Club “Ocean View Pavilion, National Park’s Kalawao Pavilion.

Check-In 2:00PM, Check-Out 12:00 Noon Please inform Administration staff if you will need an early check-in and/or late check-out time. If you fail to notify Staff, our Housekeepers have the right to gather all your personal belongings and set it aside so that they may proceed with their duties. Please DO NOT REMOVE any items from Visitors Quarters, Wilcox or Cottages.

ATTACHMENT B

INSTRUCTION FOR APPLICATION FOR VISITOR PERMIT

RULES & REGULATIONS GOVERNING ALL VISITORS TO KALAUPAPA SETTLEMENT

IF YOU ARE GOING TO BE DRIVING DURING YOUR VISIT IN KALAUPAPA, WE ASK YOU TO USE EXTRA CAUTION SINCE MANY OF OUR RESIDENTS HAVE VISUAL AND HEARING IMPAIRMENTS. ON OCCASION

DEER AND WILD BOAR ARE IN THE SETTLEMENT. PLEASE BE CAREFUL AND CAUTIOUS!

FOOD:

LIBRARY:

SPEED LIMITS:

There are no restaurants in Kalaupapa so it is necessary for guests to provide their own food, beverages and sundry items.

All visitor trash/garbage must be packed out when visitors leave Kalaupapa.

Visitors may purchase a soda, candy or bag of chips per day at the Kalaupapa Store, but shopping for groceries is PROHIBITED. Sponsors must provide for their visitors.

The library is NOT open to the public. Please have your sponsor check with National Parks Office if you wish to use Library resources. Removal of materials from library is strictly prohibited.

15 MPH Hospital Zone and Unit Homes Drives 25 MPH within the Settlement 35 MPH outside the Settlement

**Please move onto the shoulder of the road when there is oncoming traffic.

HUNTING:

CAMPING:

USE OF NATURAL

RESOURCES:

NO ANIMALS:

Visitors are NOT PERMITTED to hunt. Visitors are NOT PERMITTED to carry firearms. Visitors may only accompany approved resident hunters after registering with Administration Office.

Camping is NOT ALLOWED anywhere.

Visitors of patient residents, visitors of employees, and short-term volunteers may only fish with poles. No NET fishing by any guests will be allowed. State and Federal fish and game rules must be respected. Visitors MAY NOT take any marine life on behalf of patient, employee residents or resident volunteers, or exercise their privileges. No Opihi picking. Any violations of the Kalaupapa fishing policy or fish and game rules will result in the visitor being declared unwelcome and banned from future visits to Kalaupapa. No fishing equipment or the cleaning of fish is allowed in any building.

Harvesting and removal of sea salt is to be done under the supervision of sponsor. Please only take what YOU need. Be mindful of others.

No diving tanks or scuba allowed. No surf boarding or boogey boards. No diving off the pier.

No animals of any species are allowed in the settlement. Service animals are an exception with proper documentation present at check-in as proof. All Service animals must be properly identified with Vest and paperwork.

NO LITTERING: Please be respectful of this Makanalua Peninsula. Do your part to maintain the pristine beauty, as a steward for the ‘aina (land) and all that lives and

ATTITUDE:

NO TRESPASSING: Trespassing onto personal property is strictly prohibited. This Includes: any fruit, vegetable or flower picking.

ANY VIOLATION OF THESE RULES GOVERNING ALL VISITORS WILL RESULT IN DISCIPLINARY

ACTION AND SUSPENSION OF VISITATION AND SPONSORSHIP PRIVILEGES.

VIOLATIONS OF THE KALAUPAPA FISHING POLICY SHOULD BE REPORTED TO THE KALAUPAPA

SETTLEMENT ADMINISTRATOR IMMEDIATELY FOLLOWING THE ALLEGED VIOLATION.

VIOLATIONS OF THE KALAUPAPA FISHING POLICY MAY BE REPORTED UP TO THREE (3) MONTHS AFTER THE ALLEGED DATE OF THE INCIDENT. ANY VIOLATION AFTER THAT TIME WILL NOT BE

INVESTIGATED.

Revised 3/14/22 grows here.

Honor and respect the history of those who once lived here and Especially for those who still reside here and call this special place “Home”

ATTACHMENT C

INTERIM MODIFICATIONS - COVID-RELATED

RULES & REGULATIONS GOVERNING ALL VISITORS TO KALAUPAPA

SETTLEMENT

Effective March 16, 2022

Applications will be accepted beginning Wednesday March 16, 2002, but the earliest date that approved visitors will be permitted to ARRIVE is Monday, March 21, 2022.

Each Sponsor is only allowed to sponsor up to four (4) guests at a time. As a Sponsor you are required to be with your visitors/guests outside of Settlement boundaries.

The Department will allow a maximum of twenty-five (25) sponsored guests in Kalawao County/Kalaupapa Settlement, at any given time during these interim modifications. The Kalaupapa Administrator will work with all sponsors to resolve any conflicts.

NO UNVACCINATED GUESTS WILL BE PERMITTED All guests must provide documentation of their COVID-19 vaccination status prior to their arrival. If the sponsored visitor cannot provide documentation that they will be “fully-vaccinated” against COVID-19 on the date of their planned arrival to Kalawao County/Kalaupapa Settlement, their application shall be denied. ("Fully vaccinated" in these interim modifications means that at least two weeks have passed since the individual received at least two doses of the Pfizer or Moderna vaccine, or one dose of the Johnson & Johnson vaccine.)

All individuals within the County of Kalawao are to wear face masks that cover their nose and mouth in all indoor settings in Kalaupapa Settlement. This requirement does not apply when individuals are within their personal residences and in the presence of only members of their immediate household.

All individuals within the County of Kalawao shall maintain at least six (6) feet of physical distance between themselves and other individuals in Kalaupapa Settlement.

Indoor social gatherings of up to five (5) persons are permitted as long as the indoor space allows for all of the individuals involved to maintain the recommended six (6) feet of physical distance while indoors. If a gathering cannot meet the six feet minimum spacing requirement, organizers are asked to work with the Kalaupapa Administrator to develop an alternative plan.

The requirement to wear face masks and maintain physical distancing of at least six (6) feet, does not apply when individuals are within their personal residences and in the presence of only members of their immediate household.

Individuals are NOT REQUIRED to wear face masks while in outdoor settings in Kalawao County, but should maintain at least six (6) feet of distance between themselves and others.

Individuals in the County of Kalawao shall monitor their health daily for COVID-19 symptoms. Any individuals experiencing symptoms of COVID-19 shall immediately notify Kenneth Seamon, Kalaupapa Administrator at (808) 567-6924, or National Park Service dispatch at (808) 985-6170.

ATTACHMENT D

INTERIM MODIFICATIONS - COVID-RELATED RULES & REGULATIONS

GOVERNING ESSENTIAL SERVICES PROVIDERS IN KALAUPAPA SETTLEMENT

Effective March 16, 2022

The Kalaupapa Settlement Administrator can review and approve requests from government organizations that have administrative or statutory responsibilities in Kalawao County and seek to sponsor individuals who are designated by those organizations as necessary to perform essential work duties in the County. For purposes of these interim rules and regulations, “essential work duties” are those services that are vital to the health and welfare of the Kalawao County community, including, but not limited to health care, law enforcement, food, waste and wastewater, transportation, communications and information technology, food services, environmental services, utilities, and others as deemed necessary by DOH.

The Department's Kalaupapa Administrator will determine the acceptable maximum total number of essential services providers that will be allowed to be present in the County at any time and will work with all sponsors to resolve any scheduling conflicts. Permit approvals will be based on a variety of factors, including, but not limited to: the need for the services, the availability of housing/transportation for the workers and the ability of the sponsoring organization to provide adequate oversight - and any required COVID testing - for the sponsored workers while they are in the County.

All sponsors of Essential Services providers are required to complete an "Application for Essential Services Provider Permit." Sponsors must include documentation of the COVID-19 vaccination status for all individuals they are proposing to sponsor with their application.

If a sponsored Essential Services provider is not “fully-vaccinated” against COVID-19 (see definition in Attachment C) on the date of their planned arrival to Kalawao County/Kalaupapa Settlement, that individual will be further required to:

• prior to arrival - provide documentation of a certified, laboratory-conducted, negative COVID-19 test that was conducted within 72 hours prior of their Kalawao County/Kalaupapa Settlement arrival, and

• upon arrival - complete a COVID test conducted in Kalawao County by an approved staff member of their sponsoring organization (this is a responsibility of sponsorship), and

• during their stay - if required by the Department, complete any additional COVID tests conducted in Kalawao County by an approved staff member of their sponsoring organization.

Approved Essential Services providers that are NOT "fully-vaccinated" will ONLY be allowed to travel to their designated work sites, and shall be restricted to specified housing quarters and defined outdoor areas during their non-working hours. If Individuals that are NOT "fully-vaccinated" shall have no contact with any residents of the County, except as approved by the DOH Administrator. Should one or more individuals of any group of approved essential service workers NOT be "fully-vaccinated," the Department shall consider the entire group to be unvaccinated, and will place these same restrictions on ALL members of the group during their stay.

All individuals within the County of Kalawao are to wear face masks that cover their nose and mouth in all indoor settings in Kalaupapa Settlement and maintain at least six (6) feet of physical distance between themselves and other individuals in Kalaupapa Settlement. This requirement does not apply when individuals are within their assigned residences and in the presence of ONLY members of their immediate group of approved Essential Service Providers.

Individuals are NOT REQUIRED to wear face masks while in outdoor settings in Kalawao County.

Individuals in the County of Kalawao shall monitor their health daily for COVID-19 symptoms. Any individuals experiencing symptoms of COVID-19 shall immediately notify Kenneth Seamon, Kalaupapa Administrator at (808) 567-6924, or National Park Service dispatch at (808) 985-6170.

Visitor Permit 2019 (Fillable PDF) (2)

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