The state agency responsible for protecting vulnerable adults has ordered the immediate closure of more than 200 adult day centers across Minnesota, to prevent the novel coronavirus from spreading among thousands of seniors and adults with disabilities who attend the centers each day.

In a letter sent to providers on Sunday, the Minnesota Department of Human Services (DHS) said staffers providing adult day services are not considered "critical sector" workers and are thus required to comply with Gov. Tim Walz's executive order asking Minnesotans to stay at home and limit their movements outside of their homes. About 220 licensed providers received the notice, which ordered them "to immediately close and cease providing those services until authorized to reopen."

Adult day centers offer social activities, meals and a wide range of support services to nearly 11,000 seniors and adults with disabilities across the state, from Mankato to Park Rapids.

Their abrupt closure is expected to put added strain on a social safety net that has already been stretched thin by the coronavirus outbreak. Over the past two weeks, more than two dozen other centers that provide day training and employment services for adults with disabilities have also suspended their operations because of the virus.

With nowhere to go during the day, thousands of seniors and adults with disabilities will be forced to rely on a loose network of families, friends and volunteer providers to offer in-home care during the crisis.

While the closures may be necessary for safety reasons, they will have a "profound effect" on many families that depend on day centers as a respite from caring for their aging relatives, said Joseph Gaugler, a professor who focuses on long-term care and aging at the University of Minnesota's School of Public Health. "These programs play a critical role in the overall fabric of long-term care," said Gaugler, who is working on a national study of day activity centers. "They provide important relief to families that are on the front lines of providing care."

The centers also provide a vital source of social interaction and community engagement for vulnerable adults who might otherwise be isolated at home.

Jeanne Calvit, founder and executive director of the Interact Center for the Visual and Performing Arts, an adult day center where people with disabilities create professional art, said she is "very concerned" about the mental well-being of her clients. More than half the 110 people who come to the center struggle with a mental illness like anxiety or depression, as well as a physical or developmental disability. Calvit said that staff at the center have been calling clients to check in on them and to assure them that they will be opening again once the stay-at-home order is lifted.

"A lot of our artists live in their own apartments, and they tend to self-isolate and won't come to the phone," Calvit said. "We don't necessarily know what's going on with them."

Disability service providers said they are in discussions with the DHS about ways to increase their flexibility to respond to the crisis. For instance, adult day center operators would like the ability to provide care for clients in their homes, and to bill Medicaid for home-based services.

The agency has undertaken a far-reaching review of its regulations and has already modified or removed certain rules that act as a barrier to essential services. For instance, people who are enrolled in public health programs would be allowed to maintain their benefits without having to reapply for them during the emergency.

DHS officials said many of the day centers closed before the stay-at-home order went into effect, but the agency issued the notice because of anecdotal reports that some were still operating. The centers must remain closed through the duration of Walz's order, which ends on April 10.

"Adult day centers provide valuable and needed services, but the challenges of the COVID-19 pandemic require far-reaching steps to protect our communities, particularly older Minnesotans who are most at risk," the agency said in a statement. "We all need to work together over the next weeks and months to reduce the risk of the virus spreading."