Guide for Emergency Preparedness in Primary Health

Based on: Emergency Preparedness Toolkit for Primary Care Providers

Planning Concepts for Natural Disasters

Disclosure

• Impactivo, LLC. which is a social impact firm that works with all health system stakeholders

with a mission to transform health care so that it is more patient centered.

• The materials for the SALUDame Saludable Campaign were developed under a sub-award

from the U.S. Health Resources and Services Administration in Collaboration with

Columbia University.

• The materials for the State Health Innovation Plan were developed under a sub-award

from the Centers for Medicare and Medicaid Services.

• We have no other relevant financial relationships with comercial interests related to the

content of this presentation.

CMS Emergency

Preparedness Rule

Providers and Suppliers that wish to participate in Medicare and Medicaid – i.e.

the nation’s largest insurer – must demonstrate they meet new emergency

preparedness requirements in rule.

Source: http://www.arhealthcare.com/sites/default/files/2017-06/2Understanding_the_CMS_Emergency_Preparedness_Rule_Webinar_final.pptx

Purpose:

To establish national emergency preparedness

requirements, consistent across provider and

supplier types.

Applies to 17 provider and supplier types:

Different emergency preparedness regulations for

each provider type.

Who does it apply to?

INPATIENT OUTPATIENT

• Hospitals

• Critical AccessHospitals

• Religious Nonmedical Health Care

Institutions (RNHCIs)

• Psychiatric Residential Treatment

Facilities (PRTFs)

• Long-Term Care (LTC) / Skilled Nursing

Facilities

• Intermediate Care Facilities for Individuals

with Intellectual Disabilities (ICF/IID)

• Ambulatory Surgical Centers

• Clinics, Rehabilitation Agencies, and Public Health

Agencies as Providers of Outpatient Physical Therapy

and Speech-Language PathologyServices

• Community Mental Health Centers (CMHCs)

• Comprehensive Outpatient Rehabilitation Facilities

(CORFs)

• End-Stage Renal Disease (ESRD)Facilities

• Rural Health Clinics (RHCs) and Federally Qualified

Health Centers (FQHCs)

• Home Health Agencies(HHAs)

• Hospice

• Organ Procurement Organizations (OPOs)

• Programs of All-Inclusive Care for the Elderly(PACE)

• Transplant Centers

Core Elements

Emergency Plan

•Based on a risk assessment

•Using an all-hazards approach

•Update planannually

Policies & Procedures

•Based on risk assessmentand emergencyplan

•Must address: subsistence ofstaff and patients, evacuation, sheltering in place, tracking patients and staff

Communications Plan

•Complies with Federal and State laws

•Coordinate patient care within facility, across providers,and with state and local public health and emergency management

Training & Exercise Program

•Develop training program, including initial training on policies & procedures

•Conduct drills and exercises

Emergency and Standby Power

•Higher level of

requirements for

hospitals, critical

access hospitals,

and long-term

care facilities.

•Locate generators

in accordance with

National Fire

Protection

Association (NFPA)

guidelines.

•Conduct generator

testing, inspection,

and maintenance

as required by

NFPA.

•Maintain sufficient

fuel to sustain

power during an

emergency.

Evacuations

•Home health agencies and hospices must inform officials of patients in need of evacuation

Healthcare needs after disasters

Patients presenting more Social / Basic Needs

Housing and

Infrastructure

Income and

Financial Stability

Environmental

Factors

Health & Healthcare Education

Social &

Community Context

Main challenges in the Health Sector after disasters

1. Changes in the demography of the population

2. Instability in electricity, water and telecommunications networks

3. Patients presenting more social / basic needs

4. Mental health

5. Lack of health providers

6. Maximization of funds

7. Investment in the health sector

Post-Disaster Relief PhasesPHASE 1:

RELIEF

PHASE 2:

RECOVERY PHASE

PHASE 3:

REDESIGN

PHASE 4:

PREPARATION FOR DISASTERS

Time Frame

Right Now

6 months after the date of the

disaster.

Intermediate

1 or 2 years after the date of the

disaster.

Long-term

5 to 15 years after a few weeks

or months from the date of the

disaster.

Continuous Process.

Goal

Short-term strategies to

establish order.

Stabilization. Rebuild for a better future. Reduction and prevention of

emergency risks.

Services Provided

Rescue, medical attention, food,

water, temporary asylum.

Food, water, long-term asylum,

health, health care, return to

schools and work.

Commitment of the local

population in the planning and

reconstruction of the

communities.

Training, creation of policies and

procedures, building

relationships between service

providers and communities.

Media

Large coverage, a lot of

emotional attraction.

Coverage decreases as the first

emergency efforts dissipate.

The coverage decreases. Little coverage, without

emotional attraction.

Five Planning Basics

Preparedness Tip #1:

Know Your Local Team

• Learn about the emergency plans that

have been established in your area by

local government.

• Contact government agencies to see

how you can become a participant in

the planning or response efforts.

Preparedness Tip #2:

Promote a Culture of Preparedness

• Create a yearly plan for trainings and

exercises.

• Schedule staff meetings to share emergency

preparedness efforts at your facility.

• Provide family and individual preparedness

resources to your staff and patients.

Preparedness Tip #3:

Create a Practice Response Team

• Assemble a practice team for responding to

emergencies/disasters. Include key roles such as Incident

Manager, Public Information Officer, Operations Chief,

Planning Chief and Logistics Chief.

• Create a master emergency contact list with contact

information for the practice team, local government

resources and key partners. Update annually.

Preparedness Tip #4:

Assess Your Facility Annually

• Conduct planning with all members of the

team.

• Contact your local emergency management

agency to get local information.

• Use the Hazard Assessment worksheet to

assess your facility for risk.

Preparedness Tip #5:

Support the Needs of Your Staff

• Provide counseling to support the mental

health needs of your staff as they respond.

• Identify areas where staff and their families

can get food, shelter and other basic

needs met. Consider providing resources

onsite for staff and their families.

Source: Emergency Preparedness Toolkit for Primary Care Providers

Responding to an Incident

AAFP: A Practical Guide to Emergency Preparedness for

Office-Based Family Physicians

AAFP: A Practical Guide to Emergency Preparedness for

Office-Based Family Physicians

PMB 140 • 1357 Ashford Avenue

San Juan, PR 00907

(787) 993-1508

Email:

maria.levis@impactivo.com

Web:

www.impactivo.com

References

• AAFP A Practical Guide to Emergency Preparedness for Office-Based Family Physicians

• AAFP Emergency Preparedness

• CDC Medical Office Preparedness Planner

• Disaster Planning as a Practice

• Emergency Care Preparation in Your Office Practice

• Emergency Preparedness Toolkit Primary Care Providers

• Ready.gov Business

• FEMA Continuity of Operations (COOP) Division

• Continuity of Operations (COOP) Planning Workbook Developed by Harford County

Health Department