Oh . Department I. of Health Mike DaWine, Governor Amy Acton, M.D., MPH, Director Jon Husted, Lt. Governor CAMP SAFE OHIO ORDER Re: Director?s Order that Reopens Campgrounds, with Exceptions 1, Amy Acton, MD, MPH, Director of the Ohio Department of Health (ODH), pursuant to the authority granted to me in RC. 3701.13 to ?make special preventing the spread of contagious or infectious diseases? Order the following to prevent the spread of COVID-19 into the State of Ohio: 1. Preamble: The sacri?ces and incredible efforts that Ohioans have undertaken, make it possible to begin to lift the mandatory requirements and restrictions that were needed during the initial phase of the COVID-19 Pandemic. The adjustment of these orders is able to proceed based upon the facts and the science existing at this time in Ohio, however if the situation continues to improve, then more restrictions will be lifted, and if the situation deteriorates additional targeted restrictions will need to be made. While government can set the baseline, it should be understood that these orders set forth the minimum acts that must be taken and if people do more than the minimum to act safely, it will bene?t everyone. 2. Campgrounds to reopen. All campgrounds, including recreational camps and recreational vehicle (RV) parks, are permitted to reopen within the State so long as all safety standards are met. These businesses and operations are encouraged to either reopen or remain open if they have not ceased operation during the prior Stay at Home or other ODH Orders. Businesses and operations shall continue to comply with Social Distancing Requirements as de?ned in this Order, including by maintaining six-foot social distancing for both employees and members of the public at all times, including, but not limited to, when any customers are standing in line. 3. Elderly people and those who are vulnerable as a result of illness should take additional precautions. People at high risk of severe illness from including elderly people and those who are sick, are urged to stay in their residence to the extent possible except as necessary to seek medical care. According to CDC, those at high-risk for severe illness from COVID-19 include people who are sixty-?ve years or older and people of all ages with underlying medical conditions, particularly if not well controlled, including: People with chronic lung disease or moderate to severe asthma; People who have serious heart conditions; People who are immune compromised; People with severe obesity (body mass index of 40 or higher); People with diabetes; People with chronic kidney disease undergoing dialysis; and g. People with liver disease. 1"79 4. Facial Coverings (Masks). Businesses must allow all customers, patrons, visitors, contractors, vendors and similar individuals to use facial coverings, except for speci?cally documented legal, life, health or safety considerations and limited documented security considerations. Businesses must require all employees to wear facial coverings, except for one of the following reasons: Facial coverings in the work setting are prohibited by law or regulation; Facial coverings are in violation of documented industry standards; Facial coverings are not advisable for health reasons; Facial coverings are in violation of the business?s documented safety policies; Facial coverings are not required when the employee works alone in an assigned work area; or There is a functional (practical) reason for an employee not to wear a facial covering in the workplace. H1 Businesses must provide written justi?cation, upon request, explaining why an employee is not required to wear a facial covering in the workplace. At a minimum, facial coverings (masks) should be cloth/fabric and cover an individual?s nose, mouth, and chin. Prior Director of Health Order. The Director of Health Order signed April 30, 2020 that reopened businesses, with exceptions, and continues a stay healthy and safe at home order in the State remains in effect. However, Section 13(g) of that Order is amended to read as follows: g. The Director of Health Order signed March 21, 2020, or as it may be subsequently amended, that closed all indoor family entertainment businesses and venues such as laser tag facilities, roller skating rinks, ice skating rinks, arcades and indoor miniature golf facilities, as well as, adult and child skill or chance game facilities in the State remains in effect. The Amended Director of Health Order signed March 17, 2020, or as it may be subsequently amended, that closed auditoriums, stadiums, arenas, parades, fairs, festivals, bowling alleys, health clubs, ?tness centers, workout facilities, gyms, yoga studios, indoor trampoline parks, indoor water parks, movie and other theatres (excluding drive-in theatres), performance theatres, all public recreation centers, and indoor sports facilities in the State remains in effect. All places of public amusement, whether indoors or outdoors, including, but not limited to, locations with amusement rides, carnivals, amusement parks, water parks, aquariums, zoos, museums, arcades, fairs, children's play centers, playgrounds, ?lnplexes, theme parks, bowling alleys, concert and music halls, and country clubs or social clubs shall be closed. Recreational sports tournaments, organized recreational sports leagues, residential and day camps shall be prohibited. Swimming pools, whether public or private, shall be closed, unless it is a swimming pool for a single household. Social Distancing Requirements. For purposes of this Order, Social Distancing Requirements includes maintaining at least six-foot social distancing from other individuals, washing hands with soap and water for at least twenty seconds as frequently as possible or using hand sanitizer, covering coughs or sneezes (into the sleeve or elbow, not hands), regularly cleaning high-touch surfaces, and not shaking hands. a. Required measures. Businesses and Operations and businesses must take proactive measures to ensure compliance with Social Distancing Requirements, including where possible: i. Designate six-foot distances. Designating with signage, tape, or by other means six- foot Spacing for employees and customers in line to maintain appropriate distance; Page 2 of 11 ii. Hand sanitizer and sanitizing products. Having hand sanitizer and sanitizing products readily available for employees and customers; and ii1. Online and remote access. Posting online whether a facility is open and how best to reach the facility and continue services by phone or remotely. 7. Enforcement. This Order may be enforced by State and local law enforcement to the extent set forth in Ohio law. Speci?cally, pursuant to RC 3701.352 person shall violate any rule the director of health or department of health adopts or any order the director or department of health issues under this chapter to prevent a threat to the public caused by a pandemic, epidemic, or bioterrorism event.? RC. 3701.56 provides that ?[b]oards of health of a general or city health district, health authorities and of?cials, of?cers of state institutions, police of?cers, sheriffs, constables, and other of?cers and employees of the state or any county, city, or township, shall enforce quarantine and isolation orders, and the rules the department of health adopts.? To the extent any public of?cial enforcing this Order has questions regarding what services are prohibited under this Order, the Director of Health hereby delegates to local health departments the authority to answer questions in writing and consistent with this Order, but does not require local health departments to provide advisory opinions to nongovernmental entities. 8. Penalty. A violation of RC. 3701.352 is guilty of a misdemeanor of the second degree, which can include a ?ne of not more than $750 or not more than 90 days in jail, or both. 9. General COVID-19 Information and Checklist for Businesses/Employers. Business and employers are to take the following actions: a. Strongly encourage as many employees as possible to work from home by implementing policies in areas such as teleworking and video conferencing, subject to the discretion of the employer; b. Actively encourage sick employees to stay home until they are ?ee of fever (without the use of medication) for at least 72 hours (three full days) AND have improved for at least 72 hours AND at least seven days have passed since ?rst began. Do not require a healthcare provider?s note to validate the illness or return to work of employees sick with acute respiratory illness; healthcare provider of?ces and medical facilities may be extremely busy and not able to provide such documentation in a timely way; c. Ensure that your sick leave policies are up to date, ?exible, and non-punitive to allow sick employees to stay home to care for themselves. children. or other family members. Consider encouraging employees to do a self-assessment each day to check if they have any (fever, cough, or shortness of breath); d. Separate employees who appear to have acute respiratory illness from other employees and send them home immediately. Restrict their access to the business until they have recovered; e. Reinforce key messages stay home when sick, use cough and sneeze etiquette, and practice hand hygiene to all employees, and place posters in areas where they are most likely to be seen. Provide protection supplies such as soap and water, hand sanitizer, tissues, and no-touch disposal receptacles for use by employees; Page 3 of 11 f. Frequently perform enhanced environmental cleaning of commonly touched surfaces, such as workstations, countertops, railings, door handles, and doorknobs. Use the cleaning agents that are usually used in these areas and follow the directions on the label. Provide disposable wipes so that commonly used surfaces can be wiped down by employees before each use; g. Be prepared to change business practices if needed to maintain critical operations identify alternative suppliers, prioritize customers, or temporarily suspend some of your operations); and h. Comply with all applicable guidance from the US. Centers for Disease Control and Prevention and the Ohio Department of Health regarding social distancing. 10. Sector Speci?c COVID-19 Information and Checklist for Businesses/Employers Covered by this Order. Businesses and employers, whether currently open or reopening, are to take the following actions: a. Campground operators: i. Communicate clearly. Post information throughout the campgrounds and surrounding areas to frequently remind campers and customers to take steps to prevent the spread of These messages should include information about: 1. Staying home if you are sick or do not feel well. 2. Using social distancing and maintaining at least 6 feet between individuals in all areas of the campgrounds and with other campsites. 3. Not gathering in groups. 4. Wearing a mask or face covering when entering buildings or interacting in close proximity to other campers, practicing good personal hygiene including washing hands often with soap and water for at least 20 seconds, using hand sanitizer, refraining from touching eyes, nose, and mouth with unwashed hands, coughing and sneezing into an elbow, etc. It is recommended that, if possible, businesses develop regular communication with campers through a variety of channels (text, emails, social posts, etc.) to clearly communicate the steps your campground is taking to protect campers and stop the spread of COVID-19. Develop an updates website, send emails to campers with additional preventative steps the facility is taking, as well as communicate any changes campers should expect to experience. ii. Maintain public restrooms, showerhouses, and laundry facilities to lower risk of Spread of virus. 1. 2. Ensure there are functional toilets. Clean and sanitize public areas and restrooms in the morning and evening, with increased instances of cleaning and sanitation during peak usage times. Cleaning should be conducted using EPA-registered disinfectants, particularly on high-touch surfaces such as faucets, toilets, doorknobs, and light switches. . Make sure supplies for handwashing, including soap and materials for drying hands, are fully stocked every time the bathroom is cleaned. Page 4 of 11 Provide hand sanitizer where water is not available. Restrooms, showerhouses and laundry facilities should limit the number of users at any one time based on the facility size and current social distancing guidelines. Cleaning and sanitizing public areas and restrooms should occur in the morning and evening, with increased instances of cleaning and sanitation during peak usage times. It is recommended that, if possible, businesses post a cleaning schedule at each location. It is recommended that, if possible, businesses install touch-free entry points at restrooms and other facilities. It is recommended that, if possible, businesses install seat-cover dispensers and motion-sensing faucets, soap, and towel dispensing in restrooms and other facilities. Closures, modi?cations, and limitations. 1. In accordance with current orders, close any nonessential buildings, amenities, and areas where people could potentially congregate, such as pavilions, pools and splash pads, recreation centers, gyms, playgrounds, jump pads/pillows, go-karts, pedal?karts, game rooms, basketball, volleyball, gaga ball, etc. These activities may resume, or restrictions may be eased, when current orders prohibiting such activities are eased or lifted. Snack bars and restaurants must be run in accordance with current orders and guidelines for such establishments. All self-service food stations should be closed or only operated by employees in accordance with the guidance outlined in Responsible RestartOhio for restaurants and bars. RV/Camper water ?lling stations, dump stations, and propane ?lling stations must follow social distancing guidelines. Pumps should be disinfected each day and regularly sanitized multiple times a day based on peak usage (for example, sanitizing should increase with anticipated high-traf?c exit and entry times). Do not allow non-registered campers to visit campsites. It is recommended that, if possible, facilities may determine if masks are required to enter common spaces or may be made available to guests entering common spaces based on the facility It is recommended that, if possible, campgrounds may require campers to sign an agreement to follow guest safety procedures, and if they choose not to follow park guidelines, they may be asked to leave without a refund. iv. Follow all appropriate guidance for customer interaction, retail sales, and equipment rentals. 1. 2. Install barriers and protective shields where needed to safely distance staff and customers. Post a revised occupancy number in retail or rental areas in accordance with any current order to minimize crowding where necessary. Mark ?oors inside buildings for 6 foot standing areas or one-way traf?c. Clean and disinfect hi gh-use areas like door handles, keypads, counter tops, etc. multiple times a day, as often as possible. Page 5 of 11 10. Sanitize all rental equipment after each use, using EPA?registered disinfectants. Arrange any seating areas, tables, chairs, etc. (indoors and out) at safe distances from each other. If safe distances are not achievable, or regular sanitizing of these areas is not possible, barricade or remove seating areas. It is recommended that, if possible, businesses regularly provide customers with up-to-date information about COVID-19 and related business procedures and policies. Communicate the importance of practicing preventive actions. It is recommended that, if possible and where available, businesses use online solutions for reservations, waivers, or payment. It is recommended that, if possible, businesses install touch-free entry points to stores, check-ins, or buildings. It is recommended that, if possible, businesses create self-sanitizing stations by making hand sanitizer, soap and water, or effective disinfectant available to the public at or near the entrance of facilities and at any locations where people have direct interactions and near high-touch surfaces. v. Maintaining Distance in outdoor spaces. 1. 2. In areas of concern, mark 6 foot spacers at popular or high traf?c areas to help campers and customers visualize safe distancing. In areas with a lot of cross traf?c, direct pedestrian traf?c to enter/ exit these locations in speci?c ways or indicate one?way traf?c wherever possible. b. Employees and Vendors i. Be as ?exible as possible with staff attendance and sick-leave policies. Remind staff to stay at home if they are sick. Isolate and send home anyone who exhibits fever, cough, or shortness of breath. 1. Employees must perform a daily assessment prior to reporting for work. Per the CDC, include cough, shortness of breath, dif?culty breathing, fever, chills, repeated shaking with chills, muscle pain, headaches, sore throat, and new loss of taste or smell. Require employees to stay at home if and perform daily assessment requirements before returning to work. Following recommendations in current orders, employees must wear clean masks and gloves when indoors and interacting with guests and other employees. Employers should provide proper PPE including masks and gloves to staff and de?ne proper use when interacting with customers, as well as the expectation to keep these items clean (for example, change gloves frequently). Allow ample opportunities for employees to wash and sanitize their hands. Business/campground vehicles, golf carts, keys, tools, break rooms, bathrooms, and other common areas must be cleaned and disinfected at the end of each shift, or for non-assigned items or equipment after an employee completes use and prior to another employee using the item. Page 6 of 11 c. Campers ii. iv. 10. ll. 12. 13. 14. Wherever possible, implement staggered employee entry, work in assigned teams, vary arrival and departure, and stagger breaks to avoid interaction or grouping among staff. It is recommended that, if possible, businesses encourage third-party delivery staff to wait outside or in non-congested areas practicing social distancing guidelines. Encourage third-party delivery staff to wear face coverings. It is recommended that, if possible, businesses educate on proper use, disposal, and maintenance of face coverings. Enhance education on proper use of gloves, per code. It is recommended that, if possible, health checks may include temperature assessments, questionnaires, employee self-checks, screening apps, or other tools. Update ?les with log of ?health checks.? It is recommended that, if possible, businesses conduct assessments over the phone for employees who were ill and planning to return to work. It is recommended that, if possible, as employee rehiring begins, businesses consider virtual interviewing and on?boarding. It is recommended that, if possible, businesses reinforce education per current food safety code about when to wash hands. Post health department handwashing posters at sinks and stations. Set times for periodic handwashing. It is recommended that, if possible, employees avoid switching tasks to reduce cross contamination concerns. Increase handwashing if changing tasks is necessary. It is recommended that, if possible, businesses appoint an employee safety team or point of contact to identify safety concerns, suggest additional safety or sanitizing measures, and make ongoing improvements to safety plans. Make sure all employees know who is on this team and how to contact them. This team can be responsible for training, developing, and distributing information regarding updated protocols, answering questions, and displaying information. It is recommended that, if possible, businesses regularly provide staff with up-to?date information about COVID- 9 and related business procedures and policies. Communicate the importance of practicing preventive actions. Only one family household may occupy each site, with a pre?determined limit for any campsite (always ten people or fewer). Use social distancing and maintain at least six feet between individuals from other households in all areas of the campgrounds and with other campsites. Do not gather in groups. Practice self-contained camping when possible. It is recommended that, where possible, stay home if you are sick or do not feel well. Page 7 of 11 vi. It is recommended that, if possible, campers wear a mask or face covering when entering buildings or interacting in close proximity to other campers. vii. It is recommended, if possible, campers practice good personal hygiene including washing hands often with soap and water for at least 20 seconds, using hand sanitizer, refraining from touching eyes, nose, and mouth with un washed hands, coughing, and sneezing into an elbow, etc. It is recommended that, if possible, campers bring trash bags, food, and supplies. Plan to carry in and carry out trash and other items. 11. Duration. This Order shall be effective at 12:01 am. on May 21, 2020 and remains in full force and effect until 11:59 pm. on July 1, 2020, unless the Director of the Ohio Department of Health rescinds or modi?es this Order at a sooner time and date. 9 is a respiratory disease that can result in serious illness or death, is caused by the 2 virus, which is a new strain of coronavirus that had not been previously identi?ed in humans and can easily spread from person to person. The virus is spread between individuals who are in close contact with each other (within about six feet) through respiratory droplets produced when an infected person coughs or sneezes. It may be possible that individuals can get 9 by touching a surface or object that has the virus on it and then touching their own mouth, nose or eyes. On January 23, 2020, the Ohio Department of Health issued a Director?s Journal Entry making COVID- 19 a Class A reportable disease in Ohio. On January 28, 2020, the Ohio Department of Health hosted the ?rst statewide call with local health departments and healthcare providers regarding On January 30, 2020, the International Health Regulations Emergency Committee of the World Health Organization declared the outbreak of 9 a public health emergency of international concern. On January 31, 2020, Health and Human Services Secretary, Alex M. Azar II, declared a public health emergency for the United States to aid the nation?s healthcare community in responding to On February 1, 2020, the Ohio Department of Health issued a statewide Health Alert Network to provide local health departments and healthcare providers with updated guidance for COVID-19 and revised Person Under Investigation (PUI) criteria. On February 3, 2020, the Ohio Department of Health trained over 140 personnel to staff a call center for 9, in the event it was needed. On February 5, 2020, the Ohio Department of Health began updating and notifying the media of the number of PUIs in Ohio every Tuesday and Thursday. On February 6, 2020, the Ohio Department of Health updated all agency assistant directors and chiefs of staff on COVID-19 preparedness and status during the Governor?s cabinet meeting. On February 7, 2020, the Ohio Department of Health and the Ohio Emergency Management Agency met to conduct advance planning for Page 8 ofll On February 13, 2020, the Ohio Department of Health conducted a Pandemic Tabletop Exercise with State agencies to review responsive actions should there be a pandemic in Ohio. On February 14, 2020, the Ohio Department of Health held a conference call with health professionals across the state. The purpose of the call was to inform and engage the healthcare community in Ohio. Presentations were provided by the Department of Health, Hamilton County Public Health, and the Ohio State University. On February 27, 2020, the Ohio Department of Health and the Ohio Emergency Management Agency briefed the directors of State agencies during the Governor?s cabinet meeting regarding preparedness and the potential activation of the Emergency Operations Center. On February 28, 2020, the "Governor DeWine, Health Director Update COVID-19 Prevention and Preparedness Plan" was sent to a broad range of associations representing healthcare, dental, long-term care, K-12 schools, colleges and universities, business, public transit, faith?based organizations, non-pro?t organizations, and local governments. On March 2, 2020, the Ohio Department of Health activated a Joint Information Center to coordinate COVID- 1 9 communications. On March 5, 2020, the Ohio Department of Health hosted the Governor?s Summit on COVID-19 Preparedness, a meeting with the Governor, cabinet agency directors, local health department commissioners, and their staff. On March 6, 2020, the Ohio Department of Health opened a call center to answer questions from the public regarding COVID-19. On March 9, 2020, testing by the Department of Health con?rmed that three (3) patients were positive for COVID-19 in the State of Ohio. This con?rms the presence of a potentially dangerous condition which may affect the health, safety and welfare of citizens of Ohio. On March 9, 2020, the Ohio Emergency Management Agency activated the Emergency Operations Center. On March 9, 2020, the Governor Declared a State of Emergency in Executive Order 2020-01D. On March 11, 2020, the head of the World Health Organization declared COVID-19 a pandemic. On March 11, 2020, testing by the Ohio Department of Health con?rmed that one (1) more patient was positive for COVID-19 in the State of Ohio. On March 1 1, 2020, the Ohio Departments of Health and Veterans Services issued a Joint Directors? Order to limit access to Ohio nursing homes and similar facilities. Page 9 of 11 On March 15 2020, the Ohio Department of Health issued a Director?s Order to limit access to Ohio?s jails and detention facilities. On March 15, 2020, the Ohio Department of Health issued a Director?s Order to limit the sale of food and beverages, liquor, beer and wine to carry-out and delivery only. On March 15, 2020, the CDC issued Interim Guidance for mass gatherings or large community events, stating that such events that consist of 50 or more people should be cancelled or postponed. On March 16, 2020 the Ohio Department of Health issued a Director?s Order closing polling locations for the March 17, 2020 primary election. On March 17, 2020 the Ohio Department of Health issued a Director?s Order for the management of non- essential surgeries and procedures throughout Ohio. On March 17, 2020 the Ohio Department of Health issued an Amended Director?s Order to limit and/or prohibit mass gatherings and the closure of venues in the State of Ohio. On March 19, 2020, the Ohio Department of Health issued a Director?s Order closing hair salons, nail salons, barber shops, tattoo parlors, body piercing locations, and massage therapy locations. On March 21, 2020, the Ohio Department of Health issued a Director?s Order closing older adult day care services and senior centers. On March 21 2020, the Ohio Department of Health issued a Director?s Order closing family entertainment centers and internet cafes. On March 22, 2020, the Ohio Department of Health issued a Director?s Order that all persons are to stay at home unless engaged in essential work or activity. On March 24, 2020, the Ohio Department of Health issued a Director?s Order that closed facilities providing child care services. On March 30, 2020, the Ohio Department of Health issued an Amended Director?s Order that closed all schools in the State of Ohio. On April 2, 2020, the Ohio Department of Health issued an Amended Director?s Order that all persons are to stay at home unless engaged in essential work or activity. On April 30, 2020, the Ohio Department of Health issued the Stay Safe Ohio Order that reopened businesses, with exceptions, and continued a stay healthy and safe at home order. Multiple areas of the United States are experiencing ?community spread? of the Virus that causes COVID- 19. Community spread, de?ned as the transmission of an illness for which the source is unknown, means that isolation of known areas of infection is no longer enough to control spread. Page 10 of 11 The CDC reports that people are most contagious when they are most (the sickest) however some spread might be possible before people show although that is not the main way the virus spreads. Mass gatherings (10 or more persons) increase the risk of community transmission of the virus COVID- 1 9. Accordingly, I hereby ORDER that campgrounds may reOpen or continue to operate as set forth in this Order. This Order shall remain in full force and effect until 11:59 pm. on July 1, 2020, unless the Director of the Ohio Department of Health rescinds or modi?es this Order at a sooner time and date. To the extent any public of?cial enforcing this Order has questions regarding what services are prohibited under this Order irector of Health hereby delegates to local health departments the authority to answer ques on 'n writing and consistent with this Order. .i I, . at?) tU-t if May 20. 2020 Amy Actb?n, MD, MPH Director 01 Health Page 11 of 11