This document provides suggestions and resources for family members and caregivers of children and youth with special health care needs. We understand that families and caregivers are facing unique challenges and stresses during the COVID-19 pandemic. See the end of this document for a list of resources to support families and caregivers. These resources were last updated on March 17, 2021.

As more people are fully vaccinated, it is still very important to wear well-fitted masks, practice physical distancing, wash hands frequently, and adhere to other prevention measures.

COVID-19 in Children

• Children can get sick from COVID-19 and spread the virus to others. Most children have no or mild symptoms, but some can become severely ill and even die.
• According to the Centers for Disease Control and Prevention (CDC), current evidence suggests that children with certain underlying medical conditions and infants (age <1 year) might be at increased risk for severe illness from COVID-19. Most children who have developed severe illness from COVID-19 have had underlying medical conditions.
• Children with medical complexity, with genetic, neurologic, metabolic conditions, or with congenital heart disease might be at increased risk for severe illness from COVID-19.
• Similar to adults, children with obesity, diabetes, asthma or chronic lung disease, sickle cell disease, or immunosuppression might also be at increased risk for severe illness from COVID-19.
• Talk with your doctor if you have questions about your child's risk of developing severe illness.  

Face Masks

• Everyone in California is required to wear a mask when outside of their home with limited exceptions.
• Well-fitting masks help protect others as well as the person wearing the mask. The mask should cover both the nose and mouth in order to provide protection. For more information on mask type, fit, and filtration see CDPH Face Masks Tips and Resources
• According to the American Academy of Pediatrics, masks can be safely worn by nearly all children 2 years and older with special health care needs, with rare exceptions.
• Children under 2 years and anyone else who is unable to take the mask off on their own should not wear one, as well as anyone where a mask could obstruct breathing.
• If you are unsure if masks are appropriate for your child, talk to your doctor.
• Tips to help your child become more comfortable wearing a mask can be found here.
• Family members may consider wearing masks at home to help protect those that may be at increased risk for severe illness from COVID-19.
• In addition to other preventive measures, wearing a well-fitted mask is key to the safe return to school, childcare, and other group settings.
• For additional information, visit these webpages on COVID-19: Caring for Children and Adolescents with Special Health Care Needs and Common Misconceptions about Kids & Masks.

Medical Visits

• It is important that your child continues to receive the healthcare they need.
• Doctor's offices and clinics have protocols in place to keep your child safe during in-person visits.
• You can also check with your doctor, including all specialists and other providers (e.g., physical or occupational therapy) to see what needs may be met with a phone or video appointment.
• The American Academy of Pediatrics recommends keeping routine well-child care and immunization appointments for all children and adolescents. 
• If you do need to take your child to a medical appointment, call ahead. Many offices and clinics have new guidelines for in-person care and they change often.
• If your child has a medical emergency and needs to go to the hospital, call ahead to see if admitting practices or locations have changed. Ask if you can avoid being admitted through the Emergency Department. 

Medication and Supplies 

• You may be able to get a 90-day supply of medication at one time to cut down on unnecessary trips out of the house. Your pharmacy may also mail prescriptions or offer drive-through pick up. Ask your provider or pharmacist about options.
• Many health insurers, including Medi-Cal, have made it easier to access prescription refills during this time. Ask your health plan or provider for details.
• Talk to your doctor about getting extra supplies, including any medical equipment, technology and nutrition support.  

Home Health Visits

• Home health care, private duty nursing, and respite care may be an essential part of your family's routine. While you might not be able to postpone visits for your child or conduct them over phone or video, try to minimize the number of people who come into your home. 
• Check with the company or organization that provides home health services about what precautions they are taking to prevent the spread of COVID-19, and how you can help keep your child and those around them safe and healthy. 
• Anyone providing care or therapy for your child should wear a well-fitted face mask at all times and keep at least 6 feet of distance, when possible.
• To prevent possible transmission of COVID-19 when a visitor is present, improve ventilation in your home by opening windows and doors, if possible. For additional information see CDPH Guidance for Ventilation of Indoor Spaces here.
• Keep up routine good hygiene habits that your family likely already practices: wiping down high-touch surfaces and washing hands frequently. Visitors in your home should wash their hands upon arrival and before leaving.
• If you have concerns about getting the care you need, reach out to your child's health care provider, local Family Resource Center, or local Public Health Department for help. 

Food

• Many school districts are providing to-go meals for kids while schools are closed.
• The California Department of Education has created a mobile app, "CA Meals for Kids", to help students and families find meals during COVID-19-related school closures. The link to access the app is in the resource table below.  
• Many grocery stores have created specific hours during the day for those at greater risk.
• Consider ways of getting food brought to your house through social or commercial networks. Grocery delivery options can be found here.  
• If your child relies on a special diet and/or formula, call ahead to your pharmacy or grocery store to ask when deliveries are expected.

Family Wellbeing and Mental Health 

• As a caregiver or family member, consider what your contingency plan will be if you get sick. Your local Family Resource Center, local Public Health Department, or care coordinator/social worker (if you have been assigned one) can provide support and suggestions to help. 
• Prioritize your mental health. Reach out to your health care provider if you need help managing stress and anxiety. Two 24/7 helplines are provided in the resource table.
  
• Helpful tips for managing stress for your child and your family.
  
• If you are experiencing domestic or family violence or have any concerns about you or your loved one's safety, please reach out for help.
  
• The pandemic has affected many people financially. Find important information on relief, including unemployment insurance, eviction protection, and food assistance.
  

Communication

• Continue to talk with your child about what is happening. Open discussion can help reduce fear.
• Reassure your child that they are safe, while letting them know it is okay to feel upset.
• Limit your child's exposure to news and social media coverage of the pandemic. Children may misinterpret what they hear and become stressed or frightened by something they may not understand.
• Maintain routines, connect with family and friends virtually, and build family time into the schedule.
• There are many kid-friendly resources to help you talk to your child about COVID-19-related topics. See resource list below.

Returning to School

• The Governor of California announced plans to continue and expand safe in-person instruction in early Spring 2021. For more information, visit the Safe Schools Hub.
• As your school district prepares for in-person classes, discuss the best and safest school options with your family, your doctor and school staff, such as school nurses and special education teachers. Your child's Individualized Education Program (IEP) and 504 plans can be implemented or updated based on the educational setting.
• Review your school's plans for reopening to understand what steps will be taken to reduce the spread of COVID-19.
• Children at higher risk for severe illness may need extra accommodations to stay safe.    
• Changes in school routines can be stressful. Be sure to talk to your child about any changes to their daily routine.

COVID-19 Vaccine

• Per CDC Guidance, caregivers, family members, and young people with special health care needs who have been fully vaccinated should continue to wear masks, practice physical distancing, and adhere to other prevention measures when visiting with unvaccinated people who are at increased risk of severe COVID-19 or people who have an unvaccinated household members at increased risk.
• Distribution of COVID-19 vaccines began in December 2020.  
• The Pfizer-BioNTech vaccine can be given to people 16 years and older. The Moderna vaccine and the Johnson and Johnson/Janssen vaccine can be given to people 18 years and older.
• At this time, there are no COVID-19 vaccines available for children younger than 16 years of age. Further research is planned or underway that will provide more information on the use of the vaccine in children younger than 16 years.
• For up-to-date information on when COVID-19 vaccines are available for specific groups of people in California, please visit the California COVID-19 Vaccine webpage.     
• For more information on your county's vaccine plan, see the Local Public Health Departments resource below.          

Key resources are offered in the table below. 

More resources specifically for families are available on the Center for Family Health's COVID-19 Resource Page.