LANSING — The Michigan Department of Health and Human Services (MDHHS) has issued an emergency order that updates requirements for residential care facilities to allow for indoor visitation.

Emergency order under MCL 3332253 expands and updates such requirements as a means of protecting the public and containing the spread of COVID-19.

MDHHS Director Robert Gordon said the goal is to allow visitation while remaining low risk.

“As we grapple with both colder weather and rising cases, our task is to increase access to visitation in ways that do not increase the spread of the virus,” he said. “Visitation is a substantial source of risk.  This order provides a plan for visitation that mitigates risk and continues necessary protections in facilities across the state.”

The order does continue to limit communal dining, internal and external group activities.

The visitation rules are linked to the risk level of the county as outlined on the MI Safe Start Map.

Indoor visitation will now be allowed in areas where the risk level is A, B, C or D, as long as the facilities have had no new cases involving residents or staff. Indoor visitation is still not allowed in a county labeled as a risk level E, which means there is an average daily cases/million greater than 150 or a positivity rate greater than 20 percent.

Indoor visitation will also not be allowed if the local health department has determined it to be unsafe.

Outdoor visitation will still be allowed as long as there are six feet between all persons and adequate protection from weather elements.

The county’s risk levels and types of visits will determine if COVID testing prior to entry is required.

All visitors will be required to wear a mask at all times and maintain six feet from residents. If a visitor is providing medical support and services or end of life visits may have physical contact with the resident if that resident is not COVID positive.

Chief Medical Executive Dr. Joneigh Khaldun said that she is still concerned.

“This is a delicate balance of trying to prevent the further spread of the virus while still allowing for family members and friends to visit their loved ones in residential care facilities,” she said. “I remain concerned about the increase in case levels across the state, so it will be vitally important that the order be followed closely in order to keep the facilities safe and prevent the spread of the virus.”

Facilities are allowed to impose reasonable time limits on visits and visits will be by appointment only, with only two persons per scheduled visit. Health evaluations will also be required to enter the facility and facilities must restrict anyone with fever or symptoms of the virus from entering.

Violation of the order is punishable by a civil fine of up to $1,000 and may also be treated as a misdemeanor punishable by imprisonment for up to six months, a fine of up to $200, or both.

The order goes into effect Monday Oct. 26.