______________________________ MEETING THE DISASTER CHALLENGE ENHANCING COMMUNITY CLINIC

1
______________________________ MEETING THE
DISASTER CHALLENGEENHANCING COMMUNITY CLINIC
HEALTH CENTER PREPAREDNESS AND RESPONSE
____________________________________________
THE WILSON GROUP
GLOBAL VISION CONSORTIUM

• Clinic Emergency Preparedness Project (CEPP)
• California Primary Care Association
  (CPCA),Emergency Medical Services Authority
  (EMSA)

2
WELCOME CLINIC EMERGENCY PREPAREDNESS
PROJECT _________________________________________

• ATTENDEES
• Emergency Planners
• Clinicians
• Administrators
• Clinic Consortia Staff

• STATEWIDE PARTICIPATION
• June 18, 04 - San Francisco Training
• June 24, 04 - Eureka, Rural Northern Coast
  Training
• June 29, 04 - Pasadena, Los Angeles County
  Training

3
MEETING THE DISASTER CHALLENGE ENHANCING
COMMUNITY CLINIC HEALTH CENTER PREPAREDNESS
RESPONSE___________________________________

4

• INTRODUCTION
• _________________________________
• OVERVIEW
• ? Goals Objectives
• ? Agenda
• ? Project Background
• ? Review of Handouts

5
ENHANCING COMMUNITY CLINIC HEALTH
CENTER PREPAREDNESS RESPONSE
Building a Foundation of Capabilities Tools,
Templates, Plans, Supplies, Training
Commitment Leadership
Mandates/Legislation
New Goals, Roles
MEETING THE DISASTER
CHALLENGE
Risk Threat/ Lessons Learned
Collaboration, Partnership
OTHER DISASTERS
EARTHQUAKE
TERRORISM
6
TRAINING GOALS BUILDING THE BRIDGE ______________
___________________
External PARTNERS
CLINIC Internal Staff

• Government
• Hospitals / Community
• Corporate(Business)
• Schools
• Utilities

• Clients / Staff / Volunteers
• ERT
• EOC
• Emergency Planning Committee
• Director

Joint Mission No Lag Time No Gaps
7
A THREE LEVEL EMERGENCY MANAGEMENT APPROACH TO
PLANNING
CLINIC EOP TEMPLATE Identify Essential
Functions, Revise Plans, Identify New Roles,
Create SOPS Delegation of Authority Lines of
Succession
PROVIDE ENHANCED CLINIC CAPABILITY Intensive
Support - Communications EOC- Coordinated,
Intensive, and Sustained Plans for Training
BUILD A PLANNING FOUNDATION State, Regional,
Operational Local Jurisdiction Partner
Teams (Support Operational Area, State, Federal
Plans Initiatives)
8
PLANNING FOR EMERGENCY OPERATIONS
INTEGRATING STRATEGIES

• PLANNING
• ASSESSMENTS, RECOMMENDATIONS REVIEW
• Directed at Leadership, Supporting Agencies,
  Partners

PLANNING FACILITATING PARTNERSHIPS NETWORKS
Access to Information From State, Regional,
Operational, Local Jurisdictions
REVISIONS OF EXISTING PLANS INTEGRATED EOP
TEMPLATE

• EOC RESPONSE PLAN
• SOP ENHANCEMENTS
• SEMS
• Alternate Communication
• Information Flow to Local Jurisdictions, Regions,
  State

• PLANNING TRAINING EVALUATION
• Consistent With Legislation
• State OES Policies Laws

9
NEW CLINIC RESPONSE CAPABILITY

• Facilitates Rapid Disaster Response
• Immediate Response to Clients Staff
• Timely Activation Efficient Decisions
• Organizes Community Efforts
• Strengthens Coordination with Government
• Facilitates Access to Mutual Aid to Supply
  Personnel
• Promotes Community Self-Sufficiency Decision-
  Making

10
GOALS / OBJECTIVES _________________________
___

• Minimize Community Clinic Losses
• Prevent Further Casualties Losses
• Rescue / Recovery
• Provide Triage Medical Operations
• Evacuate Injured
• Open Communications

• Reduce Property Loss
• Minimize Clinic Interruptions
• Minimize Life Style Impact
• Minimize Impact From Disaster
• Less Stress on Community

11

• TRAINING OBJECTIVES
• _______________________________________
• Participants Will
• Understand Basics of Emergency Management
  Clinic Roles
• Understand How to Use Templates, Power-point
  Presentation Other Tools
• Understand Strategies for Initiating, Developing
  Sustaining Clinic Emergency Management Program

12
CLINIC EOP TRAINING Provides Realistic
Solutions _____________________________________

• Increased Response Effectiveness Risk Reduction
  
• Access To Resources How To Maximize Resources
• Staff with Military or Police Background
• Executive Directors
• Staff Person at Consortia Level
• Operations Staff (who are more available than
  clinical staff)
• Community-Wide Emergency Response Coordination
• Clinic Leverage in Community Response Plans

13
PROJECT BACKGROUND How Clinics Became
Involved ________________________________________
14
PROJECT BACKGROUND How Clinics
Became Involved __________________________________
________________
- CPCA Emergency Preparedness Planning Nora
OBrien, CPCA Regional Advocate - CA EMSA Grant
Funded Project Cheryl Starling, EMSA
Bio-Terrorism Coordinator

• CLINIC EMERGENCY PREPAREDNESS PROJECT
  (CEPP)
• To Increase Clinic Preparedness in 3
  Pilot Regions of State
• San Francisco
• Rural Northern Coast
• Los Angeles County

15

• EMSA / CEPP Partnership
• CLINIC TEMPLATE TRAINING
• - Joint Effort Developing Deliverables
  Objectives
• __________________________________________
• To Establish / Strengthen Relationships With
  Local Disaster Planning Community.
• Develop a Template All Hazards Emergency
  Preparedness Plan.
• Identify Clinic Emergency Best Practices
• Develop a Risk Communication Template.

16
CEPP FACILITATESDeliverables
Objectives_______________________________________
_______

• Address Mental Health Issues in Disaster Response
• Involve CCHC Personnel in Drills Exercises
• Define Roles of CCHC Consortia in Disaster
  Response
• Create Train-the-Trainer Curriculum
• Determine Civil Liability Issues CCHC Personnel
  Disaster Response

17

• RISK, THREAT, LESSONS LEARNEDUnexpected Roles
  For Clinics
• _________________________________________________
  

• CLINIC CONSORTIA EMERGENCY RESPONSE
• SUCCESSES CHALLENGES

18
CLINICS RESPOND _______________________________
________________ TERRORISM Changing Face
of Disaster Risk 9/11 --------------------
EARTHQUAKES Northridge 1/17/94 Loma Prieta
9/17/89
19
____________________________________________
THREATS CHAOS
EMS PUBLIC HEALTH SYSTEM IN TURMOIL
Hospital Closures Evacuations
People in the Park
CLINIC
Transport Provider Delays
20
SCENARIOS
WHAT IF.... ... Event Destroys Clinic
Community Partners? Clinic Buildings - Closed
for Normal Business Activities As Result of
Catastrophic Event? ... Event Creates Mass
Casualties Including Clinic Employees? ...
Extensive Fires Flooding Occurs Near Clinics
With No Access to Community Resources?
21
CLINIC IMPACT

• MAJOR THREAT IMPLICATIONS
• Lack of Coordination County, City, Clinics
• Limitations in Clinic Disaster Plan
• Does not address coordination of personnel,
• supplies, resources within county.
• Limitation in Identifying Accessing Clinic
• Resources in County / Operational Area

22
EXTENDED MEDICAL RESPONSE
REALITY _________________________________
_____________
Week 1
Week 2
Week 3
Week 4
Week 5
Week 6
Incident Impact
Convergence on Hospitals, Clinics
Environmental Health Demands
Public Health Demands
Mental Health Demands
POTENTIAL EVENTS
EOC Closures
Sewer Disruption
HAZMAT
Clinic Evacuation
Water Power Loss
Vendor Problems
People In the Park
Hospital Evacuation
Aftershocks
Communicable Diseases
EMS Disruption
Debris Dead Bodies
Search Rescue
Secondary Incident
Infectious Diseases
Federal Response
23
REALITY MUTUAL AID - Over Time Delays
Day 1
Day 2
Day 3
Day 4
Day 5
Day 6
Evacuation of People
72 hours or longer
Resources/ Supplies In
Nurses/ Physicians
Mobile Vans
EOC Support
Military Resources
Self-Sufficiency Window
24
WHAT WE HAVE CHAOS
WHAT WE NEED COHESIVENESS
25

• DISASTER RESPONSE CLINIC LESSONS LEARNED
• CHALLENGE OF NEW ROLES - Experience
  Highlights
• ___________________________________________
• San Ysidro, San Diego Fires
• North East Valley Health Corporation - Northridge
  

26
CRISIS CHALLENGES CLINIC IMPACT
__________________________________
Loss of Staff by Injury / Death
Loss of Operational Capacity
Threat of Hospital Evacuation -
Loss of Credibility With Public/Clients
Limited Documentation Reimbursement Issues
Loss of Public Health Safety
27
LESSONS LEARNEDEMERGENCY IMPACT
Clinics__________________________________________
_

• INFLUX of PATIENTS -
  Congregate at Clinic
• ______________
• Regular patients will report to familiar location
• County or hospitals may send non-acute patients
  to clinics in emergency
• Patients may delay visiting doctor until very ill
  (could be unwitting carriers of biological agent)

Community Expectations
28
The Local ChallengeYou are on the front line.
WARNING
29
KEY EMERGENCY MANAGEMENT CONCEPTS_______________
___________________________
EOP TEMPLATE INTRODUCTION
BUILDING A FOUNDATION FOR
EMERGENCY RESPONSE /RECOVERY
____________________________________

CRISIS / EMERGENCY MANAGEMENT PHASES

EMERGENCY PREPAREDNESS COMMITTEE

EOP / ICS / SEMS
EOC / ERT / IM
OPERATIONAL AREA
30
(No Transcript)
31
CLINIC EMERGENCY OPERATIONS PLAN
___________________________________

• GOALS, OBJECTIVES POLICY
• MITIGATION - Assessment Tools
• PREPAREDNESS - Key Clinic Roles
  Responsibilities Continuity of
  Operations Resources/ Integration
• 
  Community- Wide Response
• Training Maintenance
• RESPONSE - Initial Actions
• Emergency Management Organization
  EOC Management Operations
• RECOVERY - Recovery Tools,
  Restoration Critical
• Services, Documentation After- Action
  Reports

32
KEY CONCEPTS Emergency Management Cycle -
Standardized____________________________
RECOVER Financial Relief, Restoration
MITIGATION Codes, Standards, Designs, Best
Practices
Mitigate
Recover
Prepare
PREPAREDNESS Risk Management, Evaluate
Positions Set Goals, Plans, Drills, Build on
Existing Resources
Respond
RESPONSE Activation of Additional Resources,
Temporary Shelter Support, Coordination,
Communication
33
EOP TEMPLATE INTRODUCTION KEY TERMS

• CEPP Clinic Emergency Preparedness Project
• EOP Emergency Operations Plan
• EOC Emergency Operations Center
• ICS Incident Command System

34
EOP TEMPLATE INTRODUCTION KEY
TERMS _________________________________

• EMERGENCY PREPAREDNESS COMMITEE (EPC)
• Guides development maintenance of clinics
  emergency management program development of its
  emergency operations plan
• EMERGENCY RESPONSE TEAM (ERT)
• Consists of clinic staff who will fill core
  positions of EOC manage clinics emergency
  response

35
EOP TEMPLATE INTRDUCTION KEY TERMS

• ALTERNATE SITES/FACILITIES
• - Locations other than primary facility where
  clinic operations will continue during an
  emergency
• EMERGENCY OPERATIONS CENTER (EOC)
• Location at which management can coordinate
  department activities during an emergency.
• Managed using ICS
• EOC may be established in primary clinic facility
  or at an alternate site.

36
INTRODUCTION KEY TERMS _______________________
_______

• MULTI-HAZARD APPROACH
• Evaluates all threats including impacts from all
  natural man-make disasters, including
  technological threats, terrorism, state of
  war.

37
Cornerstones of California Response
STANDARDIZED EMERGENCY MANAGEMENT SYSTEM
(SEMS) Four Major Elements

--------------------------------------------------
-

• INCIDENT COMMAND SYSTEM (ICS)
• MULTI-AGENCY OR INTER-AGENCY COORDINATION
• CALIFORNIAS MUTUAL AID SYSTEM
• OPERATIONAL AREAS

38
EOP TEMPLATE INTRODUCTION KEY
TERMS _________________________________

• STANDARDIZED EMERGENCY MANAGEMENT SYSTEM (SEMS)
  
• Mandatory System Established by Government Code
  Section 8607 (A) for Managing Response of
  Government Agencies to Multi-agency
  Multi-jurisdiction Emergencies in CA
• Incorporates Use of ICS

39
EOP TEMPLATE INTRODUCTION KEY
TERMS __________________________

• OPERATIONAL AREA
• An intermediate level of state emergency
  organization, consisting of county all
  political subdivisions within county area.
• Clinics will coordinate their disaster response
  with
• MEDICAL HEALTH OPERATIONAL AREA COORDINATOR
  (MHOAC)

40
EOP TEMPLATE INTRODUCTION KEY
TERMS ______________________________

• STANDARD OPERATING PROCEDURES (SOPs)
• Pre-identified operating procedures that are
  basis for how organization operates
• SOPs - used routinely for day to day operations
  operations response to emergency situations
• SOPs are presented in form of checklists or Job
  Action Sheets

41
3.5 EOP TEMPLATE - EOC ORGANIZATIONICS
Chart ROLES FUNCTIONS ________________________
___________

42
EMERGENCY OPERATIONS PLAN Emergency Operations
Center ______________________________ 3.5.1
EOP TEMPLATE COMMAND STAFF      Manages
coordinates emergency response         
         SAFETY OFFICER (RISK MANAGER)         
        Ensures all emergency response operations
conducted in safe manner          SECURITY
OFFICER                  Provides security for
all facilities.  Controls personnel access to
facilities in accordance with policies
established by the EOC Director.
43
OPERATIONAL AREA Funnels Information Access
for Mutual Aid___________________________________
____________
FEDERAL FBI, FEMA
STATE REGION EOC
City EOCs
CLINICS
Operational Area EOC
Clinic Field Sites
Private Sector Vendors
Hospitals
Community at Large
Transport Provider EOCs
Special Districts
Fire Depts.
44
COMMUNICATION INFORMATION
FLOW _____________________________________________
______
City EOCs
CLINICS
Staging Areas
MEDICAL OPERATIONS
HEALTH CARE
Federal/State/Region OES/EMSA
Hospitals
EOC OPERATIONAL AREA (County)
Ambulances
Mutual Aid Counties
Special Districts
Fire
Police
Private Vendors
Schools
Nursing Facilities
Utilities
Community Resources/ General Population
Red Cross
45
CLINIC EOC ACTIVATION EVOLUTION _________________
____________________
Operations Logistics Planning Finance
EOC DIRECTOR/IM
CLINIC EOC ACTIVATION
ERT Deployment
Alert/Notification ERT
ERT Mobilization
46
EOC PLANNING Health Care Situation
Analysis
HOSPITALS/ CLINICS
TRANSPORT PROVIDERS

• ___________
• ___________
• ___________
• ___________

EVACUATION AREAS

• ___________
• ___________
• ___________
• ___________

• ___________
• ___________
• ___________
• ___________

STAGING AREAS
FBI INSTRUCTION

• ___________
• ___________
• ___________
• ___________

• ___________
• ___________
• ___________
• ___________

RED CROSS SHELTERS
MUTUAL AID RESOURCE REQUESTS

• ___________
• ___________
• ___________
• ___________

PRESS RELEASES

• ___________
• ___________
• ___________
• ___________

• ___________
• ___________
• ___________
• ___________

47
VISUALIZE INFORMATION PATH
State Emergency Operations Center (EOC)
Regional EOC
Operational Area EOC
Local Jurisdiction EOC
Clinic EOC
Command Management/ IM /EOC Director
Operations
Planning
Logistics
Finance
Command Posts
48

III. USING CLINIC TOOLS TEMPLATES
_____________________
EMERGENCY PREPAREDNESS

BUILDING A
FOUNDATION __________________________________
EFFECTIVE RESPONSE
RECOVERY
The Wilson Group Global Vision Consortium
49
PREFACE HOW TO USE THIS TEMPLATE

• PURPOSE
• Assist clinics to develop maintain emergency
  management programs to guide their response to
  all emergencies
• Fill-in-the-blank format
• Includes planning language, procedure, policies,
  forms
• Tools can provide a jump-start
• Provides useful resources to refine or extend
  program Builds on capability

50

• PREFACE HOW TO USE TEMPLATE
• Template emphasizes coordination with
  government emergency management.
• _______________________________________________
• Clinics to coordinate preparedness response to
  emergencies with MEDICAL/HEALTH OPERATIONAL AREA
  COORDINATOR
• Contact information for local officials
• Standard emergency management system (SEMS)
  concepts

51

• PREFACE HOW TO USE TEMPLATE
• TEMPLATE REQUIRES ACTIVE IMPLEMENTATION EFFORT
• _______________________________________________
• Read template
• Appoint EMERGENCY PREPAREDNESS COMMITTEE
• Set priorities create work plan
• Recognize importance of training, drills update
  plan information

52
PREFACE HOW TO USE THIS TEMPLATEREGULATORY
ACCREDITATION REQUIREMENTS_____________________
___________

• Developers of template took into account
  environment of care Standards of Joint Commission
  on accreditation of healthcare organizations.
• However, use of template does not guarantee that
  plans programs based upon it will meet JCAHO or
  government regulatory requirements for clinic
  emergency preparedness.

53
PREFACE HOW TO USE THIS TEMPLATE_______________
_______________

• Specifically, we recommend that clinic leadership
  initiate development of their emergency
  management program.
• Read this template
• Appoint an EMERGENCY PREPAREDNESS COMMITTEE to
  manage development of their emergency program
• Set priorities create work plan for developing
  plans preparing staff
• Recognize importance of training, drills,
  keeping plan info. up-to-date
• Clinic need to work with consortia to develop
  program

54
PREFACE HOW TO USE THIS TEMPLATE

• TERMINOLOGY
• Given diversity of clinic community roles
  organization, it was not possible to develop
• a single template that would apply completely to
  organizational, operational
• environment of every clinic.
• CLINIC Full Range of Non-profit Community
  Clinics, Free Clinics, Heath Centers
• CLINIC CONSORTIA County Based or Regional
  Association of Clinics

55
EOP TEMPLATE UMBRELLA BASIC PLAN
___________________________________

• Used Before, During After Disasters
• Easy to Use Readable
• Answers Questions
• Who should use plan?
• When should EOP be used?
• Why should EOP be used?

56
EOP TEMPLATE INTRODUCTION -
POLICY_________________________

• Clinic able to respond to disaster, suspected
  case of bio-terrorism or other emergency that
  protects health safety of patients, visitors,
  staff, coordinated with community-wide response
  to large scale disaster.
• All employees know prepared to fulfill duties
  responsibilities team effort to provide best
  possible emergency care in any situation.
• Each supervisor - each level of organization will
  ensure employees aware of responsibilities.
• Clinic will work in close coordination with
  civil authorities health care providers to
  ensure community-wide coordinated response to
  disasters.

57
EOP TEMPLATE INTRODUCTION -
SCOPE_____________________________

• Within plan, DISASTER - any emergency event which
  overwhelms or threatens to overwhelm routine
  capabilities of Clinic
• ALL-HAZARDS EOP - emergency management program
  designed to respond to natural man-made
  disasters.
• Plan describes POLICIES PROCEDURES - to
  mitigate, prepare for, respond to, recover from
  emergencies.
•      CCR Title 22 Disaster plan complies with
  California Code of Regulations, Title 22,
  Division 5, Section 78423 Disaster Plan.
•     JCAHO Development / implementation of plan
  complies with sections of JCAHO Environment of
  Care standards related to emergency preparedness.
  Refer to Appendix A for checklist of JCAHO
  requirements.

58
EOP TEMPLATE 1.1 MITIGATION

• Clinic - undertake HAZARD MITIGATION activities
  to lesson severity impact of potential
  emergency.
• Mitigation begins to identify potential
  emergencies that affect organizations
  operations or demand for services, followed by
  implementing strategy that supports perceived
  areas of vulnerability within organization.
• During mitigation phase, Director staff will
  identify specific internal external hazards
  take steps to reduce level of threat they pose by
  mitigating hazards or reducing their potential
  impact on clinic.

59
EOP TEMPLATE I.
HAZARD MITIGATION ______________________________

• Clinic will conduct survey of facilities at least
  annually or following disaster that damaged
  clinic facility complete structural /
  non-structural hazard mitigation checklist in
  APPENDIX D.3
• Based on results of hazards assessment, clinic
  will establish a plan priorities for mitigating
  structural non-structural hazards

60
EOP TEMPLATE MITIGATION1.2 HAZARD
VULNERABILITY ANALYSIS

• Clinic will conduct hazard vulnerability analysis
  to identify opportunities to minimize losses in
  disaster focusing on emergencies that may occur
  within facility as well as external to facility
  in surrounding community.
• Tools for conducting vulnerability analysis are
  provided in APPENDIX D.
• Clinic will re-visit hazard vulnerability
  assessment yearly to address new concerns
  challenges.

61
EOP TEMPLATE MITIGATION - 1.2 Refers to
D.1 HAZARD VULNERABILITY ANALYSIS Sample Human
Events

62
EOP TEMPLATE MITIGATION HAZARD VULNERABILITY
ANALYSIS PROCESS

• Multiply ratings for each event in area of
  probability, risk preparedness.
• Total values, in descending order, will represent
  the events most in need of organization focus
  resources for emergency planning.
• Determine value below which no action is
  necessary.
• Acceptance of risk is at discretion of
  organization.

63
EOP TEMPLATE MITIGATION -1.2 Refers to D.1 THE
WORKSHEETS

• Worksheet 1 HVA Site Tool (3 pages)
• Used by most clinic facilities for California
  region.
• Worksheet 2 Could be used in other states,
  depending upon geographical or geological area.
•  

Note Joint Commission (JCAHO) says that you do
not have to prepare for an event that will not
have an effect upon your facility.
64
EOP TEMPLATE MITIGATION -1.2 Refers to
Appendix D.2
65
1. 2 Refers to Appendix D.2
66
EOP TEMPLATE MITIGATION - 1. 2 Refers to
Appendix D.2
67
EOP TEMPLATE MITIGATION - 1. 2
Refers to Appendix D.2
68
EOP TEMPLATE MITIGATION - 1. 2
Refers to Appendix D.2
69
EOP TEMPLATE MITIGATION1.4 RISK
ASSESSMENT_______________________

• Hazard Vulnerability analysis will assess
  likelihood of disasters their likely severity.
• Clinic will identify hazards that could not be
  eliminated determine their likelihood of
  occurrence severity of their consequences.
• Assessment of remaining risks will influence
  emergency response roles clinic adopts for itself
  preparation required to meet roles.

70
EOP TEMPLATE MITIGATION1.5 INSURANCE
COVERAGE________________________________

• Chief Financial Officer of clinic will meet with
  insurance carriers to review all policies
  understand facilitys coverage for relocation to
  another site, loss of supplies equipment,
  structural nonstructural damage to facility.
• Determine value of insurance for clinic.
• CFO will assess clinic coverage for floods or
  earthquakes.
• If coverage is absent or inadequate, clinic will
  evaluate if it is financially sound to acquire
  it.
• Clinics located in special flood hazard areas
  must have flood insurance to be eligible for
  assistance.

71
EOP TEMPLATE MITIGATION1.6 CLINIC EMERGENCY
RESPONSE ROLES

• Based on findings of risk assessment, clinic will
  take following steps to define disaster
• response roles for which it should prepare
• Assess pre-disaster medical care environment
  role clinic performs in providing health services
• Assess clinic resources including availability of
  staff to respond ability of clinic to survive
  intact.
• Discuss findings with MEDICAL HEALTH
  OPERATIONAL HEALTH COORDINATOR
• Obtain community input
• Obtain input from clinic staff especially medical
  nursing directors, safety officer, Chief
  Operating Officer
• Present recommendations to Board of Directors for
  ratification

72
EOP TEMPLATE MITIGATION 1.6 CLINIC
EMERGENCY RESPONSE ROLES

• Clinic may play variety of roles in responding to
  disasters including
• Providing emergency medical care,
• Providing temporary shelter expanding primary
  care services to meet increased community needs
  created by damage to other health facilities
• Clinic may provide mental health services to
  disaster victims serve as conduit for
  information dissemination to affected communities
• Refer to APPENDIX E for list of potential roles
  planning preparedness requirements for meeting
  those roles
• As part of mitigation program, clinic will
  identify response roles it will prepare to
  perform following a disaster
• Decision will involve input from clinic
  management staff, clinic Board of Directors,
  community government emergency officials

73
EOP TEMPLATE Application of Concepts OVERVIEW
TABLE OF SECTIONS Introduction
1. Mitigation 2. PREPAREDNESS
3. Response 4. Recovery 5.
Appendices
74
EOP TEMPLATE PREPAREDNESS
EMERGENCY PREPAREDNESS Rationale________________
______________
STAFF PATIENT SAFETY COMMUNITY
PATIENT CARE RESPONSIBILITY
LICENSING ACCREDITATION MANDATES
BUSINESS IMPERATIVE
75

• EOP TEMPLATE PREPAREDNESS
• 1 INTRODUCTION

• Preparedness activities build organization
  capacity to manage effects of emergencies should
  one occur.
• During this phase, clinic Director, EPC staff
  will develop operational capabilities improve
  effectiveness of clinics response to
  emergencies.
• Specifically, EPC will
• Develop/update emergency plans including
  Emergency Operations Plan
• Develop update agreements with other community
  medical providers with civil authorities
• Train emergency response personnel
• Conduct drills exercises

76
EOP TEMPLATE PREPAREDNESS ___________________
___________________

• 2.2 EMERGENCY OPERATIONS PLAN
• EOP is an all hazards plan that will guide
  staff to provide for an efficient systematic
  response to any type of disaster.

77
EOP TEMPLATE PREPAREDNESS 2.4.6 ACQUIRING
RESOURCES

• Clinic will develop procedures for augmenting
  supplies, equipment personnel from variety of
  sources
• Prior agreements with vendors for re-supply
• Stockpiles of medical supplies
• Operational Area assistance to clinics
• From other clinics, hospital or other health
  providers
• Consortium coordinated clinic assistance to
  clinics

78
EOP TEMPLATE PREPAREDNESS 2.4 INTEGRATION WITH
COMMUNITY-WIDE RESPONSE

• Clinic will notify civil authorities of emergency
  impacting clinic coordinate response to
• community-wide disasters with medical health
  response of Operational Area. See
• APPENDIX J.3 disaster contacts - agencies
  individuals
• 2.4.1 COORDINATION WITH GOVERNMENT RESPONSE
  AGENCIES
• Clinic will ensure response - coordinated with
  decisions actions of civil authorities
  medical care agencies involved.
• To ensure coordination, clinic staff will
• A. Meet with Operational Area officials to
  define clinics role in emergency response
• Determine which response roles - expected by
  officials which are beyond systems response
  needs or clinics response capabilities.
• See APPENDIX E clinic response roles /
  responsibilities for potential clinic roles.

79
EOP TEMPLATE PREPAREDNESS 2.4 INTEGRATION
WITH COMMUNITY-WIDE RESPONSE b. Participate
in planning, training exercises sponsored by
medical response agencies. c. Develop
reporting communications procedures to ensure
integration with Operational Area
response. d. Define procedures for requesting
obtaining medical resources for evacuating /
transporting patients. NOTE In some area,
clinic consortium will coordinate completion of
these tasks while in others, clinics will be
responsible for taking initiative in completing
these tasks.
80
EOP TEMPLATE PREPAREDNESS 2.4 COORDINATION

• OPTIONS FOR MUTUAL ASSISTANCE
• Information Sharing
• Referral / diversion of patients to nearby
  clinics
• Provision of space support
• Provision of medical supply, pharmaceutical
  clinical/non-clinical staff support
• Examples referral /diversion of patients to
  nearby hospitals

81

• EOP TEMPLATE PREPAREDNESS 2.4.3 COORDINATION
• 2.4.3.2 LIMITATIONS
• During area-wide disaster, patient transfers
  access to ambulances may need to be coordinated
  through medical/health authorities of operational
  area, overriding other agreements.
• Developing arrangements for receipt / referral of
  disaster victims requires
• planning
• Alert Notification
• Sharing of medical information
• Patient Tracking
• Contingencies that impact ability of either party
  to meet terms of agreement

82
EOP TEMPLATE PREPAREDNESS 2.4.4 RELATIONSHIP
TO CLINIC CONSORTIUM

• Clinic Clinic Consortium Will Define Emergency
  Response Relationship
• In PREPAREDNESS PHASE, Consortium role could
  include
• Resource acquisition including grant funding,
  group purchasing shared equipment
• Training technical assistance
• Coordinated planning
• Exercise coordination
• In RESPONSE/ RECOVERY PHASES, Consortium role
  could include
• Information gathering dissemination to other
  clinics or 0perational Area
• Resource acquisition

83
EOP TEMPLATE PREPAREDNESS 2.4.4 RELATIONSHIP
TO CLINIC CONSORTIUM

• Public Information
• Technical Assistance
• Financial Recovery Assistance
• Although clinic consortia- not expected to play
  central operational role in coordinating
• disaster response of clinics, they can provide
  services including
• Nature of emergency
• Impact of emergency on clinic operations
• Current operational status of clinic
• When clinic expects to become fully operational
• Clinic resource needs

84
EOP TEMPLATE PREPAREDNESS 2.4.4 RELATIONSHIP
TO CLINIC CONSORTIUM _____________________________
_______________
C. Clinic reporting to clinic consortium does
not take place of reporting to medical / health
authorities of Operational Area, which should
occur first if operational area EOC is
open. D. Clinic reporting to clinic
consortium does not necessarily constitute a
request for resources or other assistance.
85
EOP TEMPLATE PREPAREDNESS 2.5.1 CLINIC
DIRECTOR RESPONSIBILITIES _______________________
____________

• Ensures program constantly in state of readiness
• Provides guidance policy direction response and
  recovery
• Main roles
• Acts as bridge to outside world  
• Disseminates information
• Acts as spokesperson
• Activates the EOP by assigning the IM / EOC
  Director

86
EOP TEMPLATE PREPAREDNESS ROLES
RESPONIBILITIES______________________________

• 2.5.1 CLINIC DIRECTOR
• is responsible, directly or through delegation,
  for development of EOP for directing response
  to emergencies
• Execute development implementation of disaster
  plan
• Assign staff duties responsibilities based on
  job action sheets. See APPENDIX.
• Activate clinics emergency response
• Develop criteria for direct evacuation of
  staff, patients, visitors
• Ensure continuity of care maintenance of
  medical management of all patients in care of
  clinic during a disaster.

87
EOP TEMPLATE PREPAREDNESS 2.5.2 MEDICAL
DIRECTOR________________________________________

• Directly or through delegation, will have
  following emergency responsibilities
• Serves as leader co-leader of ERT
• Assigns clinical staff to medical response roles
  (triage, treatment, decontamination)
• Provides clinicians with updates from CDC
  Health Department on standards for detection
  diagnosis, treatment of chemical
  bio-terrorism agents
• Contacts local health department to determine
  local system for bio-terrorism updates.
• Monitors ltname of local systemgt for updates.
• Determines clinical staffing needs in cooperation
  with the Nursing Director.

88
EOP TEMPLATE PREPAREDNESS 2.5.3 - NURSING
DIRECTOR

• May be assigned following roles
• Monitors for Bio-Terrorism
• Provides clinicians with updates from CDC NHD
  of standards or detection,diagnosis, treatment
  of chemical Bio-Terrorism agents
• Determines clinical staffing needs in cooperation
  with Medical Director
• Performs other duties delegated by Medical
  Director or IM consistent with training scope
  of practice

89
EOP TEMPLATE PREPAREDNESS 2.5.5 ALL
CLINIC STAFF

• TAKE FOLLOWING STEPS TO FACILITATE RESPONSE TO
  CLINIC EMERGENCIES BY ITS STAFF WHEN THEIR HOMES
  FAMILIES MAY BE IMPACTED
• PROMOTE STAFF HOME EMERGENCY PREPAREDNESS (See
  Appendix I).
• IDENTIFY CHILDCARE RESOURCES LIKELY TO REMAIN
  OPEN FOLLOWING A DISASTER

90
EOP TEMPLATE PREPAREDNESS 2.5.5 - ALL CLINIC
STAFF

• All Clinic staff shall
• Familiarize themselves with evacuation procedures
  routes for their areas. See APPENDIX H 1.1
• Become familiar with emergency response
  procedures for fire, HAZMAT other emergencies.
  See APPENDIX H Section 3.14
• Understand role responsibility in clinic plans
  for response recovery
• Participate in training/exercises
• Make suggestions on how to improve planning
• Prepare family home for disasters

91
EOP TEMPLATE PREPAREDNESS 2.5.5 Refers to
APPENDIX F.3 EMERGENCY RESPONSE/RECOVERY TEAM
JOB ACTION SHEETS

• LIST OF POSITIONS
• Clinic Director
• Incident Manager
• Public Information Officer
• Legal Counsel
• Liaisons
• Safety Officer
• Security Officer
• Operations Section Chief
• Planning Intelligence Section Chief
• Logistics Section
• Finance Administration Section

92
EOP TEMPLATE PREPAREDNESS 2.5.5 Refers to
Appendix F.3 EOC JOB ACTION SHEETS CLINIC
DIRECTOR

• Line of Authority
• Line of authority flows from Clinic Executive
  Director then to Incident Manager, finally to
  the Section Chiefs in the EOC.
•  
• Responsibility and Duties
• Clinic Executive Director EOC Incident Manager
  should confer during major emergencies, providing
  guidance policy direction for emergency
  response recovery strategy assessment,
  including
• Identifying operations still at risk
• Establishing clinic operations restoration
  priorities
• Authorizing expenditure of funds for emergency
  acquisitions for additional personnel
  expenditures, as needed

93
EOP TEMPLATE PREPAREDNESS 2.6 INITIAL
COMMUNICATIONS NOTIFICATIONS___________________
_________________

• Clinic will compile/maintain internal contact
  list for staff
• Name, position title, home phone, cell, pager,
  preferred method of contact during off hours.
  Refer to APPENDIX
• List will be kept off-site on key employees
• List should be treated as sensitive because of
  personal contact info.
• Clinic should distribute laminated wallet-sized
  cards with contact info. for key staff.
• Clinic will compile/maintain external contact
  list. Refer to APPENDIX (utilities, repair)
  (hospitals/clinics,media)

94
EOP TEMPLATE PREPAREDNESS 2.6.2 EXTERNAL
NOTIFICATION

• Clinic will compile maintain external contact
  list of phone numbers of key
• vendors, stakeholders, resources, emergency
  response agencies.
• APPENDIX J.2___ lists routine emergency
  contact numbers for basic support services for
  clinic operations (e.g., utilities, repair
  services, etc.)
• APPENDIX J.3___ lists contact information for use
  - response to disasters (e.g., government
  response entities, nearby hospitals clinics,
  media, etc.)

95
EOP TEMPLATE PREPAREDNESS 2.6.2 Refers to
APPENDIX J.2 CONTACT LISTS VENDORS / FUNDING
SOURCES / COMMUNITY LIAISONS

• Clinic Consortium
• Electricity
• EMS Provider
• Fire Service
• Gas or Propane
• Information Technology Support
• Law Enforcement
• Medical Supply and Equipment
• Vendor
• Repair
• Maintenance
• Telephone
• Equipment Provider
• Equipment Repair
• Service Provider

96
EOP TEMPLATE PREPAREDNESS 2.6.2 Refers to
APPENDIX J.3 CONTACT LIST DISASTER RESPONSE
OFFICIALS

• County EOC
• Med/Health Op Area Coordinator
• Division of Epidemiology Bio-terrorism Emergency
  Number
• CDC Emergency Response Office
• Nearest Hospital Emergency Department
• Nearest Clinic / Medical Group
• Local EMS Agency
• Health Department (general)
• Name of Countygt County Medical Society
• Name of Countygt Office of Emergency Services
  Director
• Amateur Radio
• Media Television
• Media Radio
• Media Newspaper

97
EOP TEMPLATE PREPAREDNESS 2.6.3 PRIMARY
COMMUNICATIONS

• Refer to APPENDIX K.1 for list of communications
  resources available to clinic.
• Primary means - local telephone
• If telephone fails, clinic staff will notify
  provider by whatever means available including
  telephones in another area, cell phones,
  messenger, E-Mail, or pay phones
• Clinic will keep change for pay phones in its
  disaster supplies
• Clinic has installed standard telephone jacks
  that bypass electronic phone system.
• Jacks - used for fax machines for telephones
  that do not require electricity to operate.

98
EOP TEMPLATE PREPAREDNESS 2.6.3 Refers to
APPENDIX K.1 COMMUNICATIONS EQUIPMENT
INVENTORY

• Clinic Phone System
• Fax Machines
• Analog telephone jacks
• Analog telephones
• Cellular telephones
• Satellite telephones
• Computer
• Email
• Telemedicine
• Videoconference camera and video-monitor
• Radio-based
• Amateur Radio
• Handheld radios
• Other Radios
• EMS Ambulance
• Hospital Status Radio
•  

99
EOP TEMPLATE PREPAREDNESS 2.6.4 ALTERNATE
COMMUNICATIONS METHODS___________________________
__________

• In addition to telephone, clinic maintains radio
  communications equipment.
• Refer to APPENDIX K.2 for procedures for
  operating county specific radio/communications
  system.
• Radio - located in clinic area used by trained
  staff.
• Clinic maintains Amateur Radio System or
  alternate communication system - located in
  clinic area used only by trained staff.
• Clinic maintains Amateur Radio System or
  alternate communication system - located in
  clinic agreement with local Amateur Radio group
  to respond to clinic when requested.

100
EOP TEMPLATE PREPAREDNESS 2.6.4 ALTERNATE
COMMUNICATIONS TOOLS_____________________________
_____________

• Amateur radios, FAX, Cell Phone, Internet/E-Mail,
  Public Pay Phones, Voice Messaging. See APPENDIX
  for communication resource list.
• HANDHELD RADIOS (WALKIE-TALKIE) for internal
  communications in both routine emergency
  situations
• If telephone radio communications are
  unavailable, RUNNER will be employed to take
  messages to from Clinic appropriate agencies
  rendering assistance.
• Clinic EOC - provisions for receiving TELEVISION
  RADIO broadcasts to remain up to date on
  official GOV. announcements

101
EOP TEMPLATE PREPAREDNESS 2.7.2 ALTERNATE
FACILITIES

• Identify/use existing facilities if possible
  Consider creative alternatives
• Ensure sufficient space equipment
• Provide reliable logistic support services
• Ensure ability to sustain operations for 30 days
• Consider pre-positioning assets resources
• Ensure appropriate physical security access
  controls

102
EOP TEMPLATE PREPAREDNESS 2.7.1 CONTINUITY
OF OPERATIONS

• POLICY Clinic will maintain or restore services
  to community as rapidly as possible following
  emergency that disrupts services.
• As soon as safety of patients, visitors, staff
  has been assured, clinic will give priority to
  providing or ensuring patient access to medical
  care.
• GOALS Completing following tasks increases
  likelihood that emergency will not disrupt clinic
  operations, if disruption occurs, operation can
  be restored.
• Protect essential facilities, equipment, records,
  assets
• Reduce or mitigate disruption to operations
• Identify designate principals support staff
  to e relocated succession delegations of
  authority for execution of Plan
• Facilitate decision-making through establishment
  of lines of succession delegation

103
EOP TEMPLATE PREPAREDNESS 2.7 COOP
___________________________________
104
EOP TEMPLATE PREPAREDNESS 2.7 COOP
On-Going Requirements

• Essential Functions Personnel, Equipment,
  System and Space Requirements
• Successor Plan, Delegation of Authority, and Team
  Assignments
• Primary Secondary Contact Lists
• Primary Alternate Site Vulnerability Analysis
• Deployment Information Storage Locations
• Transportation Alternate Facility Activities
  Equipment Systems
• Emergency Operating Records
• COOP Maintenance Team
• Vendor List

105
EOP TEMPLATE PREPAREDNESS 2.8.1
PREPAREDNESS SURGE

• Clinic Director, Nursing, /or Medical Director
  will review Op Area plans
• How surge capacity will be increased
• Patient transportation policies/procedures
• Procedures for augmenting medical care - Op Area
  plans for accessing distributing contents of
  National Pharmaceutical Stockpile
• Develop surveillance process to provide early
  indications of potential for patient surge that
  may result from Bio-Terrorism (appointment
  patterns, walk-in clinic utilization, news
  report, groups of patients ill at same time)

106
EOP TEMPLATE PREPAREDNESS 2.8.1.5 SURGE
PATIENT FLOW SITE PLANNING

• Periodically review patient flow identify areas
  on clinic grounds that can be converted to triage
  sites patient isolation areas
• Evaluate appropriateness of use of cafeteria,
  break rooms other spaces for patient holding or
  treatment areas
• Designate sites available for isolating victims
  of a chemical/bio-terrorist attack
• Ensure triage isolation sites should have
  controlled access
• Store cots, blankets for holding shelter

107
EOP TEMPLATE PREPAREDNESS
2.9.2 PHARMACEUTICALS / MEDICAL SUPPLIES /
MEDICAL EQUIPMENT Clinic will determine level of
medical supplies pharmaceuticals to stockpile
will stockpile only those items likely to use in
response or in day-to-day operations. All stored
items will be rotated. Clinic will identify
primary secondary sources of medical supplies
pharmaceuticals develop estimates of expected
time required for re-supply in disaster
environment. NATIONAL PHARMACEUTICAL
STOCKPILE NOTE IN BIO-TERRORIST EVENT, IF
MASS QUANTITIES OF PHARMACEUTICALS ARE NEEDED,
COUNTY WILL REQUEST MOBILIZATION DELIVERY OF
NATIONAL PHARMACEUTICAL STOCKPILE THROUGH CA.
CDC HAS ESTABLISHED NATIONAL PHARMACEUTICAL
STOCKPILE (NPS)
108
EOP TEMPLATE PREPAREDNESS 2.9.2.3 NATIONAL
PHARMACEUTICAL STOCKPILE

• In Bio-terrorist event, if mass quantities of
  pharmaceuticals are needed then Op Area (Co.)
  will request mobilization delivery of National
  Pharmaceutical Stockpile (NPS)
• CDC has established NPS as repository of
  antibiotics, chemical antidotes, life support
  med, IV adm., life support meds, IV sets, airway
  maint.
• Clinic leadership should be informed of local
  level plan what role, if any, they might be
  expected to play in distribution of assets

109
EOP TEMPLATE PREPAREDNESS 2.9.2.4 PERSONAL
PROTECTIVE EQUIPMENT

• Clinic will take measures to protect its staff
  from exposure- infectious agents hazardous
  materials
• Clinic will obtain maintain a minimum of PPE
• CDC OSHA have determined that in event of a
  Bio-Terrorist attack
• Healthcare workers will have access to be
  trained on use of personal protective equipment.
• Licensed medical personnel support personnel
  are assigned to respond to care for victims of
  WMD

110
EOP TEMPLATE PREPAREDNESS 2.9.2.4 RESPONSE TO
BIO-TERRORISM EVENT

• Suggested PPE for level C
• N95 HEPA mask
• TYVEK Coverall with hood and booties
• TYVEK booties
• Face shield
• Nitrile Gloves
• Protective equipment is located in ____________,
  will be accessed by _______________ or
  ____________ when ______________.

111
EOP TEMPLATE PREPAREDNESS 2.10 Mental Health

• Clinic Administrator will establish DISASTER
  MENTAL HEALTH COORDINATOR. See APPENDIX M for a
  checklist of actions for the Mental Health
  Coordinator
• Develop an internal clinic mental health
  disaster response plan
• Serve as member of Emergency Preparedness
  Committee ERT
• Coordinate with local jurisdiction Operational
  Area (county) to identify community resources
  define procedures for implementation

112

• EOP TEMPLATE PREPAREDNESS
• 2.10.1 MENTAL HEALTH PREPAREDNESS
• ___________________________________________
• e. Coordinate local jurisdiction Operational
  Area (county) for community resources
  procedures for access to resources
• f. Develop maintain resource list of community
  mental health resources to augment response of
  clinics mental health team. Establish MOUs when
  possible.
• g. Identify mental health disaster communication
  needs
• h. Work with clinic PIO to develop info.
  (brochures, PSAs, etc.) used in response
• i. Acquire maintain following resources stored
  with other disaster supplies labeled Mental
  Health Supplies
• Contact information for disaster mental health
  resources updated annually
• Master copy of one or more brochures with
  information about typical survivor responses to a
  disaster with Clinic or Mental Health Agency
  contact phone numbers

113

• EOP TEMPLATE PREPAREDNESS
• 2.10.1 MENTAL HEALTH PREPAREDNESS
• A limited amount of brochures for immediate use
• Culturally appropriate brochures in several
  languages of clinics service populations
• Basic office supply go box with pens, paper
  clips, tape, note pads available to staff
• Paper, crayons other items for children
• Cell phone or calling cards available for staffs
  use
• Disaster forms to document contacts
• Copies of local resource directory agency
  directory for referrals

114
EOP TEMPLATE PREPAREDNESS 2.10.2 REFERS TO
APPENDIX M MENTAL HEALTH COORDINATOR
RESPONSIBILITIES
P R E P A R E D N E S S

• Assume role of Clinic Mental Health Coordinator
• Develop internal Clinic Mental Health Disaster
  Response Plan
• Coordinate with Local Jurisdiction Operational
  Area (County)
• Identify mental health disaster communications
  needs
• Promote mental health clinic preparedness
• Promote clinic awareness of importance of mental
  health prevention / awareness

115
EOP TEMPLATE PREPAREDNESS 2.10.2 REFERS TO
APPENDIX M MENTAL HEALTH COORDINATOR CHECKLIST
P R E P A R E D N E S S

• Establish maintain comprehensive city
  county-wide mental health resource list
• Use emergency information management
  communications systems
• Develop mental health resource list
• Coordinate with local mental health officials
  mental health managers
• Coordinate with mental health facilities to
  develop disaster preparedness

116
EOP TEMPLATE PREPAREDNESS 2.9 DISASTER MEDICAL
RESOURCES ________________________________________
_____

• 2.8.1 PERSONNEL
• - Clinic will rely on existing staff for response
  to emergencies.
• - MEASURES TO BE TAKEN TO ESTIMATE STAFF
  AVAILABILITY
• Identify clinical staff with conflicting practice
  commitments
• Identify staff with distance other barriers
  that limit their ability to report to clinic
• Identify staff likely to be able to respond
  rapidly to the clinic
• Clinic will develop roster of bi-lingual staff by
  language

117
EOP TEMPLATE PREPAREDNESS 2.11 PUBLIC
INFORMATION / RISK COMMUNICATIONS

• INCIDENT MANAGER will appoint PUBLIC INFORMATION
  OFFICER (PIO) to coordinate release of clinic
  information internally externally to media
  community.
• PIO will ensure development of disaster public
  information plan to guide clinic information
  disseminaiton response to media community
  inquiries following disasters.
• PURPOSE OF PLAN - to ensure information is
  communicated to communities served by clinic to
  communicate
• Information on nature status of emergency
• Appropriate actions for protection, seeking
  health care services obtaining needed
  information
• Reducing anxiety among community members
• Information on status of clinic its ability to
  deliver services

118
EOP TEMPLATE PREPAREDNESS 2.11 PUBLIC
INFORMATION / RISK COMMUNICATIONS

• Plan will include provisions for
• COORDINATION WITH OPERATIONAL AREA PUBLIC
  INFORMATION OFFICER
• Ensure most up-to-date information to ensure
  consistency of information released.
• Address information needs of clinics publics
  when providing information stakeholders
  include community, patients, staff, volunteers
• Provisions for employee meetings, internal
  informational publications, press releases
  other programs intended to disseminate accurate
  information regarding impact deal with
  misinformation.

119
EOP TEMPLATE PREPAREDNESS 2.11 PUBLIC
INFORMATION / RISK COMMUNICATIONS

• Clinic will incorporate disaster preparedness
  information into normal
• communications education program for staff
  patients including
• Home family preparedness. See appendix I for
  guidelines
• Information on clinic emergency preparedness
  activities
• Information dissemination channels include
  newsletters, pamphlets, health education
  in-service education classes internet postings

120
EOP TEMPLATE PREPAREDNESS 2.12 Refers to
Appendix G PURPOSE OF TRAINING

• Training for members of the ERT ensures
• Know role responsibilities
• Possess skills knowledge needed to perform
  respective functional responsibilities
• Understand disaster management processes to
  achieve effective coordination / communications

121
EOP TEMPLATE PREPAREDNESS 2.12.1.1 EMPLOYEE
ORIENTATION

• Instructed how to assist patients staff in
  evacuation of premises.
• Instructed in location use of oxygen (licensed
  staff)
• Shown location use of medical emergency
  equipment (medical staff staff trained on AED).
• Instructed on emergency codes used in clinic, how
  called initial actions. (See APPENDIX H.2
  emergency code examples).
• Instructed on actions to be taken during fire
  other emergency drills.
• Annual training updates on emergency
  preparedness, including elements of plan

122
EOP TEMPLATE PREPAREDNESS 2.12.1.2 CLINICIAN
BIO-TERRORISM TRAINING

• Medical Nursing staff will receive training on
  procedures to treat respond to patients
  infected - Bio-terrorism agent.
• Recognition of potential epidemic or
  bio-terrorism events
• Information about most likely agents, including
  possible behavioral responses of patients
• Infection control practices
• Use of personal protective equipment
• Reporting patient management
• Behavioral responses of patients to biological
  chemical agents

123
EOP TEMPLATE PREPAREDNESS 2.12.1.2 CLINICIAN
BIO-TERRORISM TRAINING
B. Staff training will include - Roles
responsibilities in bio-terrorism event -
Information skills required to perform their
assigned duties during bio-terrorism event -
Awareness of backup communications systems used
in bio- terrorism event - Location / how to
obtain supplies during bio-terrorism
event. C. Staff physicians will receive
updates as new information becomes
available. D. Mental Health Team training
124
EOP TEMPLATE PREPAREDNESS 2.12.2 DRILLS
EXERCISES

• 2.12.2.2 Exercises should include response
  issues in scenarios
• Clinic evacuation
• Bio-terrorism
• Mental health response