VIRGINIA PRIMARY CARE ASSOCIATION EMERGENCY OPERATIONS PLAN DEVELOPMENT WORKSHOP

1
VIRGINIA PRIMARY CARE ASSOCIATIONEMERGENCY
OPERATIONS PLAN DEVELOPMENT WORKSHOP

• Developing Your Road-Map
• to Disaster Preparedness

David Chaplin, Integrated Fire Life Safety
Solutions VPCA EPR Consultant February 22, 2007
2
General/Emergency Info

• EMERGENCY EXITS
• RESTROOMS
• BREAKS
• FOOD
• CELL PHONES
• EVALUATIONS

3
Workshop Overview
We are all in disaster preparedness together !
4
(No Transcript)
5
Why are we here ?
Getting to know you - How many centers with
3 or more sites ? - How many center Directors ?
Others ? - How many years experience ? lt5 yrs
? gt5 yrs ? gt10 yrs ? gt20 yrs ?
Expectations what are yours ?
6
Why are we here ?
Expectations what are yours ?

• Learning Objectives
• Gain awareness of many aspects of emergency
  management
• Learn how hospitals and public health agencies
  have been preparing
• How community health centers/VPCA can fit-in to
  existing system
• How to develop a comprehensive Emergency
  Operations Plan
• Why it is important that this is accomplished

7
Workshop Overview
We are all in disaster preparedness together !

• Tools you can use
• the Directors Workbook
• the Resource CD
• VPCA EPR web site
• The workshop
• VA version of CA clinic mgmt plan
• CHC-NYS Incident Action Plans
• Final test
• 20 questions on workshop content

8
EPR Activity in Virginia

• VDH EPR
• VHHA
• HRSA grant funding to hospitals (NBHPP)
• VDEM
• OEMS
• VDH / OCME
• Public Safety

9
EPR Activity in Your Community

• VDH District Office
• Hospitals
• Jurisdictional Emergency Services Director
• Public Safety

10
How do VPCA CHCs Fit-in ?

• Dual system of response local/regional state
  level
• Public Health syndromic surveillance
  coordinated response mass prophylaxis ESF-8
  resource mgmt cooperative training
• Hospitals coordinated response RHCCs
  building surge capacity ACC NEHC resource
  mgmt cooperative training
• Juris Emerg Srvcs Dir coordinated response
  resource mgmt

11
How do VPCA CHCs Fit-in ?

• Communications internal external coordinated
  response local comm VDH ECC hospital Med-comm
  EMS center-to-center center-to-satellite
  WebEOC VPCA and (State EOC ESF8).
• Resources stocking sharing transporting
  vendor agreements purchasing procedures
  managing people, time, stuff !
• Licensing and Credentialing sharing among
  Centers MOUs sharing with hospitals and public
  health liability volunteers

12
What Do CHCs Need ?

• All-hazards preparedness plan (EOP)
• Compliance with National Incident Mgmt System
  (NIMS)
• Connection/Coordination with VDH, hospitals,
  jurisdictional ESD
• Staff training and awareness
• Drills Exercises in-house District VDH
  hospitals in your community statewide

13
Developing All-hazards EOP

• Objectives
• Life safety and injury prevention for patients,
  visitors, and staff
• Preserve the ability to deliver prompt and
  efficient medical care during emergencies
• Utilize/Transition to a functional, flexible, and
  scalable chain-of-command and incident management
  system to efficiently and effectively manage
  people, time, and stuff
• Coordinating and cooperating with community
  disaster response

14
Developing All-hazards EOP

• Objectives
• Preserve, maintain, and restore essential
  business services as quickly as possible
  following an emergency or disaster
• Protect center property, facilities, and
  equipment
• Develop sustainability and resilience
• Satisfy applicable regulatory and accreditation
  requirements

COOP
15
Developing All-hazards EOP

• Elements
• Purpose
• A qualified why
• Objectives
• Policy
• A qualified how
• Scope
• When to use the plan, with parameters
• Key Terms
• Unique nomenclature

• Mitigation
• Preparedness
• Response
• Recovery
• Appendices
• Everything else you might need during an
  emergency--within reach !

16
Developing All-hazards EOP

• Working with the template
• Mitigation
• Risk assessment / Hazard Vulnerability Assessment
  (HVA)
• ID potential emergencies that may adversely
  affect Center operations or the demand for
  services
• Prevent a predictable event from occurring
• Minimize the severity and impact of the disaster
• Anticipate consequences, and act before it
  happens
• Limiting and confining the damage
• Activities occur before and after a disaster
  strikes

17
Developing All-hazards EOP

• Mitigation measures include
• Hazard Vulnerability Analyses
• Define your Centers emergency/disaster response
  role
• Building Code
• Building-use regulations (Fire Code)
• OSHA regulations
• JCAHO certification
• Liability and insurance coverage

• Tax incentives and disincentives
• Zoning and land use management
• Sharing of resources.
• Preventive health care.
• Public education.

18
Developing All-hazards EOP

• Working with the template
• Mitigation
• 1.1 Introduction
• 1.2 Hazard Vulnerability Analysis
• 1.3 Hazard Mitigation
• 1,4 Risk Assessment
• 1.5 Insurance Coverage
• 1.6 Center Emergency Response Roles

19
Developing All-hazards EOP

• Working with the template
• Preparedness
• Most important phase of disaster prep
• Develop plans to save lives and lessen severity
• Minimize damage and enhance your response
• Build organizational capacity to manage
  emergencies
• Improve effectiveness and efficiency of emergency
  response
• NIMS adoption and implementation
• Command Management
• Preparedness
• Resource Management
• Communications Information Management
• Supporting Technologies
• Ongoing Management and Maintenance

20
Developing All-hazards EOP

• Preparedness efforts include
• Develop maintain EOP
• Developing a Continuity of Operations Plan (COOP)
• Developing patient surge plans
• Developing staff roles responsibilities
• Train staff utilize drills exercises for
  evaluation
• Develop emergency contact list and call-back
  list
• Adopt/Implement ICS or HICS as a management tool
• Emergency exercises and training with outside
  agencies
• Emergency communication systems

21
Developing All-hazards EOP

• Preparedness efforts include
• Warning systems (plugging-in to incoming and
  developing outgoing messages)
• Develop agreements (MOUs) with other agencies for
  emergency/disaster response
• Evacuation planning
• Public information and education
• Develop Disaster Medical Resources plans
• Development of resource inventories, personnel
  contact lists, and mutual aid agreements
• Develop vendor agreements for emergency
  suppliesin writing
• Develop a disaster mental health plan

22
Developing All-hazards EOP

• Working with the template
• Preparedness
• 2.1 Introduction
• 2.2 Emergency Operations
• 2.3 Incident Command System
• 2.4 Integration with Community-wide Response
• 2.5 Roles and Responsibilities
• 2.6 Initial Communications and Notifications
• 2.7 Continuity of Operations
• 2.8 Center Patient Surge Preparedness
• 2.9 Disaster Medical Resources
• 2.10 Disaster Mental Health
• 2.11 Public Information / Risk Communications
• 2.12 Training, Exercises, and Plan Maintenance

23
Developing All-hazards EOP

• Working with the template
• Response
• Incident-driven incident management activity
• Must establish response priorities
• Life safety patient care
• Contain the hazard, if possible
• Protect critical infrastructure, facilities,
  vital records and data.
• Support the community response
• Restore essential services/Return to normal
  operations ASAP
• Provide crisis information to staff, patients,
  partners in response
• Provide emergency assistance for casualties
• Reduce the probability of secondary damage
• Proper response can speed recovery

24
Developing All-hazards EOP

• Working with the template
• Response activities may include
• Declaring a disaster mode of operations
• Activating public warning systems
• Notifying public authorities, including the
  hospital
• Mobilizing emergency personnel and equipment
• Establishing a Center Command Center
• Establishing your Emergency Mgmt
  Organization(page 30)

25
Developing All-hazards EOP

• Working with the template
• Response activities may include
• Establishing communications
• Providing emergency medical assistance
• Develop situation/status report on resources
• Establish Liaison/Public Info Officer/Crisis
  Communications
• Establish security for all
• Mental health response
• Volunteer management
• Internal vs. External emergencies

26
Developing All-hazards EOP

• Working with the template
• Response
• 3.1 Introduction
• 3.2 Response Priorities
• 3.3 Alert, Warning, and Notification
• 3.4 Response Activation and Initial Actions
• 3.5 Emergency Management Organization
• 3.6 Emergency Operations Center Operations
• 3.7 Medical Care
• 3.8 Acquiring Response Resources
• 3.9 Communications
• 3.10 Public Information / Crisis Communications
• 3.11 Security
• 3.12 Mental Health Response
• 3.13 Volunteer / Donation Management

27
Developing All-hazards EOP

• Working with the template
• Response
• 3.14 Response to Internal Emergencies
• Damage Assessment
• Hazardous Materials Management
• Evacuation Procedures
• Decision on Center Operational Status
• 3.15 Response to External Emergencies
• Local vs. Widespread Emergencies
• Weapons of Mass Destruction
• Bioterrorism Response
• Reporting
• Potential Indicators
• Infection Control
• Patient Placement
• Mass Prophylaxis

28
Developing All-hazards EOP

• Working with the template
• Response
• CHC-NYS Incident Action Plans
• Table of Contents
• Establishing ICS
• Evacuation General, Earthquake, Flood
• Virginias Tiered System Response to Four
  Scenarios
• Pandemic Influenza
• Explosive Mass Casualty Incident (MCI)
• Hazardous Material Event (Chemical/Radiation
  Exposure)
• Weather-related Natural Disaster

29
Developing All-hazards EOP

• Working with the template
• Recovery
• Returning to Normal Operations (ASAP)
• Begins concurrently with response activities
• Could also require a lot of resources and time
• Varies according to severity and impact of the
  emergency
• Develop current situation/status report and gap
  analysis while in the Response Phase

30
Developing All-hazards EOP

• Working with the template
• Recovery activities may include
• Develop current situation/status report and gap
  analysis
• Develop procedures and timeline for ending
  emergency responsean orderly transition
• Establish employee support system-physical
  psychological
• Inventory damage and loss
• Restock / Re-supply

31
Developing All-hazards EOP

• Working with the template
• Recovery activities may include
• Document Document Document everything !
• Cost / Loss recovery
• Restore services
• After-action report and evaluation

32
Developing All-hazards EOP

• Working with the template
• Recovery
• 4.1 Introduction
• 4.2 Documentation
• 4.3 Inventory Damage and Loss
• 4.4 Lost Revenue Through Disruption of Service
• 4.5 Cost / Loss Recovery Sources
• 4.6 Psychological Needs of Staff and Patients
• 4.7 Restoration of Services
• 4.8 After-Action Report
• 4.9 Staff Support

33
Developing All-hazards EOP

• Working with the template
• Appendices
• A JCAHO Standards EC 4.10 and 4.20
• B Emergency Management Acronyms
• C Emergency Management Glossary
• D Hazard Assessment Tool
• E Clinic Response Roles and Requirements
• F Emergency Response Teams/Emergency Ops Center
  Positions
• G Emergency Management Training and Exercises
• H Emergency Procedures
• I American Red Cross / Office / Auto
  Preparedness
• J Contact Lists

34
Developing All-hazards EOP

• Working with the template
• Appendices
• K Communications Systems
• L Location of Alternate and Referral Facilities
• M Mental Health Coordination Checklist
• O Emergency Operations Center Forms
• P Emergency Operations Center Procedures
• Q Managing Volunteers and Donations
• R Bioterrorism Agents
• S Damage Assessment and Cost Estimation Forms
• T Casualty Care Forms
• U Clinic Emergency Management Legal Issues

35
Developing All-hazards EOP

• How to use the template
• Purpose to help develop your customized EOP
• Just the beginning
• Must be adapted to your needs, your environment,
  available resources, existing plans (in-house),
  and community response plans (including VDH and
  hospitals)
• Edit and insert CHC-NYS Incident Action Plans,
  where appropriate
• Include regulatory and accreditation requirements
• Emphasizes coordination with government EM
  agencies
• NIMS compliance and the ICS (or HICS)
• Uses an all-hazards approach
• Requires active implementation and maintenance
  efforts
• Establishes two-tiered disaster response for
  centers and VPCA

36
Developing All-hazards EOP

• HRSA-defined Six-tiered response
• Individual assets
• Regional healthcare assets RHCCs
• Jurisdictional Incident Management
• State assets
• Regional state assets EMAC agreements
• Federal assets

37
Developing All-hazards EOP

• Working with the template
• The Resource CD
• List of Counties and Hospitals
• NFPA 1600 Standard on Disaster/Emergency
  Management and Business Continuity Programs 2004
  ed.
• Virginia CHCs and Hospitals HRSA Geospatial
  Data Warehouse Mapping Tool
• Planning and Preparedness for VPCA
• Directors Workbook Table of Contents
• Four Phases of Emergency Management Folder
• Preparedness folder
• VAMC - Emergency Mgmt Principles and Practices
• Resources and Training Folder

38
Summary and Evaluation

• Its
• Emergency Preparedness
• Jeopardy !