While the risk of contracting the virus cannot be completely eliminated with safety measures, there are a number of safety measures clients who need a forensic evaluation for court cases during COVID can ask about to help reduce risk.
The world does not stop even as the pandemic drags on and most indicators suggest it will be at least one year, if not longer, before we are free from COVID or vaccinated against it. Court cases continue, and clients may need an evaluation for their court case now, not 1-2 years from now. Or if the case has been bumped, an evaluation can help attorneys work with clients on a settlement now using the evaluation results rather than waiting for a court date. (And if they still can’t settle, at least the evaluations are ready for court.)
Thankfully, we have learned a lot about the virus over the past few months, and there are a number of precautions practices that do evaluations for court can put in place to make the process as safe as possible for clients. Below are questions you or your clients can ask (and the right answers!) to ensure the practice you use is taking every precaution possible, while still providing test results considered reliable and valid.
1. Do you have a specific written process for evaluations during COVID for staff and clients to follow? How is it communicated to clients?
The right answer is: Yes, we have a well-designed, research-informed safety protocol, communicated to clients at scheduling and in writing before the appointment.
For example, at Lepage Associates our protocol in brief is: We are sanitizing test equipment before and after each testing, thus anything a client touches is sanitized twice between use; we have clients and doctors wash their hands and use hand sanitizer just before testing; we require masks and have masks and gloves available for use; and we use a plexiglass barrier when we need to be closer than six feet apart during testing. If a doctor or client has a temperature over 100, or displays any signs of illness, testing is rescheduled. Clients are given this information verbally at scheduling, in writing in a Welcome Letter soon after scheduling, and the day before in a Reminder Email.
2. Do you require everyone (staff and clients) to wear masks and to distance six feet apart? Do you provide masks?
The right answer is: Yes. This is the accepted protocol for COVID-19. (And staff are trained in the awkward world of enforcing COVID protocols!)
This is basic, yet surprising how many places do not require this. There is a difference between suggesting something and requiring it. Thus you might also want to ask if all staff are trained in how to enforce the mask ordinance. In order to have everyone wear masks, a practice must also have masks readily available for anyone who comes in without their own. For example, at Lepage Associates all clients receive an email before their evaluation alerting them they will have to wear a mask, and letting them know we have masks available; at check in, a sign reminds people we require they wear a mask, and just underneath the sign is a box of masks. Staff are trained to politely direct anyone who doesn’t see the sign and put on a mask to do so, and to empathize if they don’t want to while still requiring they do so. Staff and doctors wear masks as well (unless behind a barrier, outdoors, or far apart). For clients who cannot wear a mask due to health reasons, or feel strongly about not wearing a mask, we have created a very nice outdoor waiting area with shade and rain protection.
3. What PPE (personal protective equipment) and sanitizers do you have available for all?
The right answer: Minimally they should have masks and hand sanitizer liberally available for all at check in, and a protective barrier such as a plexiglass shield to be between the doctor and client during any testing that cannot occur with them six feet apart.
Even better is if they also have gloves (adult and child sizes), and additional sanitizing supplies available. Hand sanitizer and cleaning supplies should meet the CDC requirements for protection against COVID-19 (not all do and this is important). For example, at Lepage Associates at check in there is a sign asking clients to sanitize their hands even if they believe they are clean, and hand sanitizer pumps as well as individually wrapped hand sanitizer wipes are available for use. Staff are trained if someone does not notice the signs, to gently prompt them to use hand sanitizer. As noted above, masks are available, as are gloves for anyone who wants them (though gloves are not required). Additionally, all public areas (waiting rooms and restrooms) have COVID-strength cleaning supplies displayed in case in addition to our regular cleaning, a client wants to wipe down a surface they may touch (such as a faucet, door handle or chair).
4. For adults or children who cannot wear a mask due to breathing or sensory issues (or just being a small, fidgety child), are there options other than masks?
The right answer is: Yes. Either outdoor spaces or a plexiglass shield can provide ways to test without the client wearing a mask the whole time. While doing the entire test battery online is not preferred, there are new online protocols during COVID that can be used if needed. (Note the right answer is not that masks can be ignored/not worn, because that puts others at risk in the space. You want to know the space is being protected.)
While not all practices have outdoor space that can work well for evaluations, some do. Outdoors the doctor and client can stay six feet or more apart and remove their masks, and perhaps complete a clinical interview or do a parent-child observation. Indoors, plexiglass barriers provide a way to still ensure a layer of protection without a mask. Clinical interviews can also be done on HIPAA-complaint platforms by doctors adept enough at technology to split their screen so they can still see the client while taking notes. (Phone interviews where the doctor cannot see the client’s facial expressions and non-verbal cues are not recommended.) Many tests designers have okayed the use of online platforms for their tests. However, in evaluations for court it is vital the doctor take the time to proctor the test via video and watch the client take the test to ensure no one else is at the computer taking the test for the client. Not all tests can be done online and the doctor should be well-read on current testing protocols as formally accepted by the test designers (and not something the doctor alone has decided is probably okay to do).
5. With the changes to the testing environment to protect against COVID-19, can you explain to me how my test results will still be considered reliable and valid?
The right answer is: The doctor should be able to provide you with specific information as to the tests you will be taking and how the test designers have approved (or not) changes in standard test administration during COVID-19.
In summary, evaluations for court during COVID-19 can provided with: safety measures ample and enforced, PPE readily available, and a clear understanding by the doctor of any accepted changes to testing protocols to ensure reliability and validity of test results. If you ask these questions of a practice and their answers seem too nonchalant or vague, just call someone else… eventually you will find someone who can provide the forensic evaluations you need. Lastly, several practices are not testing at all during COVID-19, or have limited their testing to online only, so you should be sure a practice is doing evaluations before sending clients their way.