health and human services preparedness program

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Health and Human Services Preparedness Program

FY 2012-2013 GrantRound I Mandatory Workshop

August 2012Joint Session

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FY 2012-2013 HHS GrantRound 1 Agenda FY 2012 Grant Overview (1 hour)

Grant Amount & Directives Grant Participation Requirements (3 steps)

Step 1: Letter of Intent, NIMS Compliance, Mandatory Meeting Step 2: Spending Process & Timeline Step 3: Site Visits

Frequently Asked Questions

Other Topics (45 minutes) SNS Request Process – Mini Drill (Region 4 Only) MCI - ESF 8 Portal Tabletop (Region 1 Only)

Announcements (15 minutes)

FY 2012-2013 Louisiana Grant AllocationDistribution of Louisiana’s HHS Grant

DISPOSITION AMOUNT SPLITState Level (Administrative) $1,857,500.00 0.3593Distribution to EMS and Hospitals $3,310,889.00 0.6406

Total $5,168,389.00 1.00

Distribution to Hospital and EMS Providers

*75% of the grant must be use to benefit the field. The remaining 11% is in the administrative project to cover ESAR-VHP, Bed Tracking systems (ESF 8 portal), and the State PPE and Pharmaceutical caches.

FY 2012-2013 FY 2011-2012 DIFFERENCE SPLITEMS $844,607.78 $ 884,888.33 $40,280.55 0.2551

Hospitals $2,466,281.22 $ 2,583,901.67 $117,620.45 0.7449

Total $3,310,889.00 $ 3,468,790.00 $157,901.00

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Grant Distribution & Monitoring Process

2012-13 HPP Grant Awarded

July 1

*Allocation Model Developed & Approved by Advisory Board

August-Sept 2012

Participation Agreement Developed

September - Nov 2012

Participation Agreements Mailed

Oct 2012 - Jan 2013

Signed Participation

Agreements & Budget Proposal

Due

Nov - Feb 2012

*Facilities submit required documentation for

reimbursement as required by Participation Agreement on one

of the three deadlines

March, April or May 2013

*HPP grant staff review documentation for acceptable purchases and required

documentation.

Mar – June 2013

*HPP grant staff submits request to accounting

department ;

Accounting submits request invoice to DHH

Mar – June 2013

Unspent Funds Reallocated (Reallocation 2)

June 2013

Once funds received from DHH, LHA

distributes grant dollars

Sept 2013

Unobligated Funds Reallocated

(Reallocation 1)

Apr- Mar 2013

Regional Rounds meetings to

discuss 2012-13 grant requirements

are held

August 2012

*Site Visits for 2010-11

Begin

Nov 2012


End

March 2013

*Green = Documentation in binder

**Blue = Monitoring Activities

Internal Participation Agreement Tracking Process Begins*

Spending & Documentation Review Process

LEVEL – ONEA. FCC/TSP requirementsB. Interoperable Communication SystemC. Bed-Tracking System (ESF 8 Software)D. ESAR-VHP SystemE. Fatality Management Plans* (panflu)F. Hospital Evacuation Plans/ Shelter in PlaceG. Partnership/Coalition development

(CRI and Non-CRI areas)

LEVEL – TWOA. Alternate Care Sites (ACS)B. Mobile Medical AssetsC. Pharmaceutical CachesD. PPEE. Decon

Over-Arching

A. NIMS – 14 elements / extensive reporting

B. Needs of At-Risk Populations

C. Education and Preparedness Training

D. Exercises, Evaluation and Corrective Actions

- MRC, CRI inclusive***

- At-risk population planning inclusive***

What they don’t say; but imply:

• EMS

• Isolation*

• Lab

• SurveillanceAdditional Considerations:• MRC• Critical Infrastructure Protection

Old Grant Directives (FY 2011-12)

New Grant Directives (FY 2012-13)

ESAR-VHP (LAVA)

PPE, Pharmaceutical Cache, Decontamination Capabilities

Surge, Alternate Care Sites, Crisis Standard of Care, Shelter in Place and Evacuation Plans

Bed Tracking, Communication Systems

Fatality ManagementConduct Hazard Vuln. Analysis

NIMS, At Risk Population, Training & Education, Exercises and Drills, Mobile Assets

FY 2011-2012

Volunteer Management

Responder Health & Safety

Medical Surge

Information Sharing

Fatality ManagementHealthcare System Recovery

Healthcare System PreparednessFY 2012-2013

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14

10

6

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1Capability

“Same Goals, Different package”

Changes in Grant Directives

Alignment of Public Health Emergency Preparedness (PHEP) and Hospital Preparedness Program (HPP) grants

Development of Coalitions

Capabilities based planning and implementation (8 capabilities)

More integration into ESF 8 network as response component.

What do you need to do to participate?

STEP ONE (1)

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Step One (1)


July 1


August-Sept 2012




Oct 2012 - Jan 2013



Due

Nov - Feb 2012

*Facilities submit required documentation for





documentation.

Mar – June 2013


department ;


Mar – June 2013


June 2013



Sept 2013


(Reallocation 1)

Apr- Mar 2013



are held

August 2012


Begin

Nov 2012


End

March 2013




Step 1

Step One (1):

Complete and submit the following documents to HHS Grant Staff: Letter of Intent NIMS compliance worksheet

Attend Rounds mandatory meeting in August 2012.

Letter of Intent

To participate in grant process, facilities must: Must be completed and signed by

CEO/Director indicating you wish to participate Must be returned by August 31, 2012 Critical Information in Letter of Intent

NIMS worksheet Send representative to mandatory meeting.

Comments & Suggestions are welcome

NIMS Compliance

‐Adopted the Louisiana Emergency Response Network Plan OR possess a Mutual Aid Agreement, MOU or MOA with hospitals, EMS providers and/or other healthcare organizations.

‐Participated in regional planning, exercises, and/or trainings w/other agencies

Participate in interagency mutual aid (MA) and/or assistance agreements

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Revised plans to incorporate NIMS principles.Revise and update emergency plans to incorporate NIMS

3

Purchased equipment to support NIMS such as IC vest, command center set‐up, etc

Grants and cooperative agreements support NIMS

2

‐Adopted NIMS statement

‐Identified ICS personnel and placed ICS language in plans.

Adopt NIMS throughout the healthcare organization

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Action TakenActivity

NIMS Compliance (Cont’d)

Use and adopted the ESF 8 portal for the use of communicating to State Level personnel

Ensure processes, equipment, & communication facilitates the collection and distribution of consistent and accurate information with partners

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Use Incident action sheets or has identified roles and responsibilities for each ICS position in plans.

Promote and integrate, as appropriate, NIMS concepts and principles

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Identified the appropriate personnel to take the course and is tracking compliance

Implement ICS‐800 course6

Identified the appropriate personnel to take courses and is tracking compliance

Implement ICS‐700, ICS‐100 and ICS‐200 courses

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NIMS Compliance (Cont’d)

Discuss or has statement of common and consistent terminology practices in plans.

Apply common and consistent terminology including the establishment of plain language communications standards.

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‐Established a JIC and JIC is mentioned in facility’s plans.

‐ Discuss role of PIO in plans

Adopt the principle of Public Information (PI), facilitated by the use of the Joint Information System (JIS) and Joint Information Center (JIC) ensuring that PI procedures and processes gather, verify, coordinate, and disseminate information during an incident or event.

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‐Identified and uses IC Org. Chart.

‐Use ICS incident action plan or discuss the role of each ICS position in plans.

Manage all emergency incidents, exercises, and preplanned events with consistent application of ICS organizational structures, doctrine, processes, and procedures

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NIMS Compliance(Cont’d)

Summary The List of Action Items is NOT an exclusive list.

Your facility may meet the NIMS Implementation Activity in another way.

Review ALL plans to ensure NIMS principles are met, including environment of care plan. Incorporate plans into one or mention where (what plan) the principle can be found.

Document, Document, and Document Compliance

Mandatory Rounds Meeting

Please sign the attendance list, including your contact information.

If you are representing more than one (1) facility, please sign in by both facilities.

If you do not attend meeting or sign in, facility will NOT be included in allocation model and awarded funds.

If your facility has NOT decided whether they wish to participate, you are encouraged to at least complete Step 1 so that funds can be allocated to your facility. Funds can later be declined.

STEP TWO (2)

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Step Two (2)


July 1


August-Sept 2012




Oct 2012 - Jan 2013



Due

Nov - Feb 2012

*Facility submits required documentation for





documentation.

Mar – June 2013


department ;


Mar – June 2013


June 2013



Sept 2013


(Reallocation 1)

Apr- Mar 2013



are held

August 2012


Begin

Nov 2012


End

March 2013




Step 2

Step Two (2):

Identify gaps and develop plan of action on how grant goals will be met & how funds will be spent. (Budget Proposal)

Submit signed Participation Agreement, Budget Proposal and other requested documents.

Spend funds and submit the Acceptable Documentation of Proof of Payment as indicated in Participation Agreement.

Continue participation in HHS Emergency Preparedness activities Radio Roll Call Regional and State Drills Regional Meetings ESF 8 Portal Activities

Acceptable Grant Documentation

Acceptable Documentation of Proof of Payment includes the following:

Receipts stamped “Paid” along with the “check number” and “date paid”.

Copies of the corresponding check(s) used to pay invoice/receipt.

Invoice(s) indicating items have been paid with a credit card. Credit card payments must be accompanied by the credit card statement and proof of payment of the credit card statement.

If claiming sales taxes that are not listed on the invoice/receipt, documentation supporting your tax percentage should also be submitted.

Spending Timeline (FY 2012-13)

Acceptable Documentation of Proof of Payment must be submitted by one of the following deadlines in order to receive reimbursement.

Deadlines: To Be Determined

Note: Acceptable Documentation must be dated between July 1, 2012 to May 31, 2013.

For not spending all funds, please send letter along with documentation indicating this.

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Facilities can submit the following toward their 10% match (In-Kind Contribution Worksheet):

In Kind Staff Time Sign-in sheets, meeting agenda/summary/minutes and/or AAR

must be submitted. “In-Kind Staff Time” tab must be completed showing the pay rate

per employee.

Mileage to attending Emergency Preparedness meetings – Mapquest directions calculating the mileage, the travel

authorization or vehicle request form, and the participant’s reimbursement check should be submitted;

Mileage summary should only reflect a maximum reimbursement of 0.51 per mile (per state travel guidelines), although the reimbursement from the organization may be greater;

10 % MatchIn-Kind Contribution Worksheet

On-Campus Meeting Space Based on the amount you would normally charge for use of the

space or what another location within your region would charge for a room that size.

Rental cost must be reasonable. Thus a written quote from a privately-owned building within the same locality must be submitted.

On-campus Storage Space Must include square footage, cost per square foot, and total

cost Rental cost must be reasonable. Thus, a written quote from a

privately-owned building within the same locality

10 % Match (Cont’d) In-Kind Contribution Worksheet

Grant Management System

Grant Management System will be integrated in ESF 8 portal by October 2012. There will be a single sign on.

“Grant Manager” will be added to list of positions/roles in ESF 8 portal so that users can gain access to system

Grant Management System

Grant Management System has been redesigned. New system will be operational by October 2012.

New system has same look and feel as ESF 8 portal.

Signed Participation Agreements & Budget Proposal must be uploaded to system.

Expenditure process the same but system is easier to maneuver.

Training/webinars dates for system will be sent out later.

STEP THREE (3)

Step Three (3): Site Visits Site visits increased from 5% to 20% of facilities. Site visits usually

occur sometime between November – March. 55 hospitals 11 EMS providers

Every hospital and EMS provider will be visited over the next 5 years regardless of whether they participated in the last grant cycle.

Site visits are more comprehensive than in the past. In addition to grant purchases, HHS grant staff will be reviewing and confirming: NIMS compliance Survey responses Compliance with Participation Agreement Surge planning – i.e. beds, pharmaceuticals, PPE, etc

If a “red flag” is found in site visit, corrective action measures will be taken. Corrective action measures includes: No longer eligible to receive grant funds until measures have been met Return a portion grant funds received Provide justification as to why measure cannot been met

Frequently Asked Questions

Grant Directives / FAQsWho “owns” the items purchased with grant funds (ownership of the items especially as it relates to inventory taxes, insurance and storage costs)?INDIVIDUAL PURCHASES

Any item purchased with HHP grant funds is deemed to be a federal asset. However, the purchaser of the equipment shall retain the title to the equipment and is

responsible for the purchase and payment of all inventory taxes, insurance, and/or storage costs associated with items purchased with HHP Grant funds.

REGIONAL ASSETS Purchases that have been made on behalf of the region (i.e. western shelters, mass

fatality trailers, etc.) are “owned” by the purchaser but are deemed to be a regional asset and are available for use by other members of the region upon request.

As a best practice, it is prudent for regional assets to have a written agreement or Regional MOU that addresses at a minimum: storage of the asset, activation of the asset, and notification protocols. If applicable, a written process for leasing and insurance should also be included in the document.

Grant Directives / FAQs

What responsibility does the provider have to make purchases available to the State and under what circumstances?

The equipment shall be used to meet local, regional and state medical surge needs and can be used for training, drills and response activities related to mass casualty incidents and other local, regional and/or state disasters.

The State along with the Grant PI may request and direct the use of grant purchased equipment in a state or parish declared emergency.

As a working policy, equipment purchased with grant funds should be used to provide “for the greatest good” for the citizens of Louisiana.

What is the process for the disposal of purchases – unusable,expired, broken or lost?

Sell and use proceeds for another allowable HHS grant project (ex: larger storage trailer)

Dispose of equipment/supplies and make a record including the date and reason for doing so (ex: batteries, pharmaceuticals)

Donate it to another eligible recipient

*When disposing of equipment, in either way mentioned above, facilities should have a record including the disposal date and reason for the disposal of equipment/supplies.



What are the provider replacement obligations for expired, broken, or lost items? Provider should develop internal procedures to maximize the ongoing

availability of assets funded with grant funds through rotation, maintenance procedures, etc.

However, in incidents in which an asset may be used (events or trainings), become broken, lost or expire, the provider should identify and maintain an inventory of these items to be replaced with future grant funds.

The provider is responsible for maintaining records regarding the status of items purchased with HHP grant funds including those expired, broken or lost. Records for property and equipment acquired with federal funds shall be retained for 3 years. However, purchasers are encouraged to keep records for at least 7 years.


What assurances are there of replacement grant funds?

There are no guaranteed assurances that the HPP grant funds will continue.

However, the Health and Human Services (HHS) Assistant Secretary’s Office of Preparedness and Response (ASPR) has indicated that grant funds will be available with a match requirement of at least 10% for the following 3 to 5 years.


Who determines the appropriate use of funds?Is there an approval process?

The Participation Agreement provides organized material from thegrant guidance and cost directives manual.

A budget proposal is submitted to HHS Grant Staff PRIOR to purchases being made so that any “problems” can be flagged and grant dollars redirected if the proposal identifies a project that may be at-risk for being unallowable by grant guidance.

If requested item is not listed on Participation Agreement, purchaser must obtain approval from the HHS Grant Staff prior to purchase.


Who determines the appropriate use of equipment? Can purchase(s) be used on a daily basis?

Non-Disposable Equipment over $1,000 Equipment such as radios, trailers, ventilators, spine boards and/or generators are some

examples of non-disposable equipment that may be used on a daily or frequent basis to maintain operability.

Pharmaceuticals should not be used on a daily basis but set aside for readiness upon being formally activated by the State. Please note that for pharmaceuticals (surge cache) should not be used on a daily basis, but the cache should be rotated to ensure an updated cache is available for surge.

Disposable Material under $1,000 Disposables such as gloves, gowns, masks should be handled similarly to pharmaceuticals. The

purpose of the grant is to ensure medical caches are available for a surge event. If these materials are used on a daily event, it defeats the purpose of the grant and having a surge cache.


Can the purchases be used to respond to an in-state event? Is there an approval process?

Yes, equipment can be used to respond to an in-state event.

For regionally-owned purchases like trailers or tentage, the purchaser should notify their regional partners that the trailer/tentage is being used in their region for a specific regional purpose; or alternatively, that the region’s trailer/tentage is being moved to another region.


Can purchases be used to respond to an out-of-state event? Is there an approval process?

Yes, HPP purchased equipment can be used to respond to an out-of-state event.

However, approval must be sought from the State as movement of an HPP asset to an out-of-state event will require an Emergency Management Assistance Compact (EMAC).

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What spending restrictions exist?Absolutely cannot:

New Construction Antivirals Vaccines Subscription Charges Personnel Cost (Except for Match Requirement)

Must receive written permission from HHS prior to expenditure: Retrofitting that will take longer than 60 days Security Equipment Vehicles Trailers/Storage Shed purchases Leased warehouse space



How long must the provider keep grant documentation? What on-going documentation is required for the provider to keep?

Records should be retained for a minimum of three (3) years from the date of submission of the final expenditure report or date of the submission quarterly or annual financial report. Facilities are, however, encouraged to keep records for at least seven (7) years.


What should be included on the awardee’sproperty records and inventory list? A description of the equipment;

Manufacturer’s serial number, model number, federal stock number, national stock number, or other ID;

Source of the equipment, including the award number;

Whether title vests in the recipient or the Federal Government (proportionate share); Acquisition date and cost;

Percentage of HHS’s share in the cost of the equipment;

Location and condition of the equipment and the date the information was reported; Unit acquisition cost; and

Ultimate disposition data, including date of disposal and sales price or the method used to determine current fair market value where a recipient compensates the HHS awarding agency for its share.


If my recipient receives HHS grant funding, does my recipient need to submit a financial report to the Legislative Auditor? Yes. Any not-for-profit or for-profit recipient that is subject to the open

meeting laws and derives any portion of its income from payments received from any public agency or body OR any not-for-profit recipient that receive or expend any (from the first dollar) local or state assistance including grants, loans, transfers of property, awards, and direct appropriations from state or local public funds will be required to submit an annual financial report to the Legislative Auditor no later than six months after your entity’s fiscal year end. (La. R.S. 24:513).

Financial report may consist of an audit, review, or a compilation engagement.

Questions??

Hospital Grant StaffAsha Green ([email protected]) Kendra Powell ([email protected]) Lauren Barleycorn ([email protected]) 9521 Brookline AvenueBaton Rouge, LA 70809Office: (225) 927-1228Fax: (225) 927-1230

EMS Grant StaffSawazi A. Daniel ([email protected]) Louisiana Bureau of EMS7173 Florida Blvd., Suite ABaton Rouge, 70806Office: (225) 342-6138Fax: (225) 925-3832

health and human services preparedness program

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