Is your Facility Prepared for a Community Disaster?

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Is your Facility Prepared for a Community
Disaster?

• Amber Pitts
• Michigan Department of Community Health (MDCH)
  Office of Public Health Preparedness (OPHP)

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Office of Public Health Preparedness

• Developed in 2002 to coordinate development and
  implementation of public and medical health
  management services for preparedness and response
  to acts of bioterrorism, infectious disease
  outbreak and other public health emergencies.

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Key Priorities

• To upgrade state and local jurisdiction
  preparedness for response to outbreaks of
  infectious disease, public health threats and
  emergencies.
• To upgrade the preparedness of the healthcare
  systems and collaborating entities to respond to
  public health and medical emergencies.

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Why is LTC an Important Partner?

• 438 Skilled Nursing Facilities within Michigan
  and 180 Hospitals

• Pre-planning
• Community Relationship Building
• Incorporation into Surge Planning
• Overwhelming Medical Resources
• Self sustainability
• Client well being

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Lessons Learned

• In 2005, Hurricanes Katrina and Rita demonstrated
  how the elderly and disabled are often the most
  negatively affected by the consequences of a
  major disaster.
• The elderly population only accounted for 15 of
  the New Orleans population, but 70 of the deaths
  from Hurricane Katrina.

Source County of Dane, Emergency Management
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Hurricane Katrina Rita

• Even facilities with solid plans were challenged
  by the loss of community infrastructure. Many
  struggled with the fact they would not receive
  outside support for the first 72 hours or longer.
  These disastrous storms highlighted the
  consequences of not integrating long term care
  facilities into community emergency response
  system plans.

Source County of Dane, Emergency Management
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Crawford County Wildfire - May 2010

• Crawford County experienced a well executed
  evacuation plan, utilizing Region 7 medical
  assets such as cots.
• This dynamic response showed a great relationship
  from the local, regional and state perspectives.
  

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Oakwood Annapolis Hospital

• Manor Wayne LTC Facility
• INSERT FROM REGION 2 South

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What is a Disaster?

• A non-routine event that exceeds the capacity of
  the affected area to respond to it in such a way
  as to save lives to preserve property and to
  maintain the social, ecological, economic, and
  political stability of the affected region.
  (FEMA 2006b).

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Questions for the Facilities

• What type of disasters does your facility plan
  for?
• How many facilities have a pandemic influenza
  plan?
• How many facilities have plans to shelter in
  place?
• How many facilities have plans to evacuate to an
  alternate care site?
• Are mutual aid agreements in place?

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Facility Evacuation

• When the disaster is so extreme and it is
  necessary to relocate for the safety for the
  well being of the facilities clients, staff and
  visitors.
• Preferred method if sheltering in place is not an
  option or has been exhausted.

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• Evacuation Plan Considerations

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Evacuation Planning Checklist

• Facility Planning
• Ensure evacuation routes internally and
  externally are known by staff members
• Vendor Contact Information is readily available
  for medical, water, food, transportation
• Alternate Sites are notified and mutual aid
  agreements are signed ahead of time
• Staffing needs at Alternate Care Sites, hospitals
  or other LTC facilities as identified

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Client Needs

• ID bracelets, medications (med cart), MAR (med
  chart)
• Medical Records
• Relocation sites are recorded for family members
• Client Family Contact Information

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NFPA Emergency Evacuation Planning Guide for
People with Disabilities

• Building an Evacuation Plan for
• People with the following impairments
• such as lack of Mobility, Visual, Hearing,
  Speech, Cognitive.

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Available Evacuation Plan Tools

• NFPA Emergency Evacuation Planning Guide for
  People with Disabilities
• http//www.nfpa.org/assets/files/pdf/forms/evacuat
  ionguide.pdf

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Sheltering in Place

• Definition to take immediate shelter - usually
  for just a few hours or for less than 24 hours.
  Local authorities may instruct facilities to
  "shelter-in-place" if there were a chemical or
  radiological contaminants released into the
  environment.
• Shelter-in-place is the preferred option, unless
  the decision is made by the facility
  administrator or supervisor, usually in
  coordination with response agencies, to evacuate,
  consider the circumstances of the incident,
  internally or externally and what is best for
  clients, staff and visitors.

Source Centers for Disease Control and
Prevention
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Facility Notification to Shelter in Place

• Facilities will be notified by
• Reverse 911 recorded message
• Emergency Alert System (EAS) through the radio or
  television
• Community Sirens
• News media
• Weather Radios such as NOAA

Sources American Red Cross Centers for Disease
Control and Prevention (CDC)
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• Shelter in Place Planning Considerations

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• Implement Lockdown Procedure for all doors and
  windows
• Assess the need to turn off all facility
  mechanical systems such as fans, heating and air
  conditioning systems
• Advise Staff, Clients and Visitors of facility
  procedure
• Conservation of resources
• Assess Staffing Needs for next 24 hours
• Assess location of Staff, Clients Visitors,
  possible relocations within facility due to
  hazards to interior rooms

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Shelter in Place Resources

• Red Cross Fact Sheet
• http//www.nationalterroralert.com/readyguide/shel
  terinplace.pdf

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Are you Aware of the Following Available
Resources?
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Michigan Health Alert Network (Mi-HAN)

• Enhancing connectivity of Local Health
  Departments, Hospitals, EMS Agencies, Long Term
  Care, Rural, Migrant, Federally Qualified and
  Tribal Health Centers. Professional health
  organizations and other partners. Over 400
  licensed users on the system.

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Statewide Bed Resource Tracking System
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Pharmaceutical Caches

• Local/Regional Caches
• Antibiotics, antivirals, nerve agent antidotes,
  burn surge supplies, etc.
• Statewide Deployable Caches
• MEDDRUN/CHEMPACK
• Standardized caches of medications and medical
  supplies to treat from 100 1000 patients,
  focusing on nerve agent antidotes and other
  biological or radiological events.
• Strategic National Stockpile (SNS)
• Comprised of pharmaceuticals, vaccines, medical
  supplies, and medical equipment to augment
  exhausted local and state resources.

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Michigan Transportable Emergency Surge Assistance
(MI-TESA) Medical Unit
40-bed MI-TESA Medical Unit
100-bed MI-TESA Medical Unit
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Ventilator Capacity

• There are currently state and regional cache
  stockpiled of the LTV 1200 portable ventilators.

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Michigan Volunteer Registrywww.mivolunteerregistr
y.org
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Past ASPR / CDC Cooperative Agreement Activities

• In 2005 OPHP distributed 1,870 to LTC facilities
  to purchase computers, through Health Care
  Association of Michigan (HCAM).
• These monies were awarded with the requirement
  that each long-term care facility would purchase
  a computer and printer for the purpose of
  receiving public health emergency alerts through
  the Michigan Health Alert Network (Mi-HAN).
• Purchase of this equipment would enable the
  long-term care provider community to be an active
  partner in the 24/7 public health emergency
  alerting network.

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Statewide Long Term Care (LTC) Workgroup

• First met in March 2007
• Representatives from
• Health Care Association of Michigan (HCAM)
• Michigan Association of Homes and Services for
  the Aging (MAHSA)
• Michigan County Medical Care Council
• Long-Term Care Commission
• Michigan Office of Services to the Aging (OSA)
• NADONA
• TEACH
• Region 2 South LTC Workgroup
• MDCH/OPHP
• MDCH Bureau of Health Systems, Division of
  Nursing Home Monitoring

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Michigan LTC Preparedness Toolkit

• Continuity of Operations Plan (COOP) Planning
  Template
• Local, Regional, State Contact Information
• Hazard Vulnerability Assessment
• Sample MOAs
• Guidelines for Employees
• Pandemic Influenza Q A
• Pandemic Influenza Planning Checklist
• Evacuation Checklist
• http//www.michigan.gov/documents/michiganprepares
  /LTCToolkit_225004_7.pdf

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Michigan LTC - DVD Project

• Facility Emergency Plan
• Sheltering in Place
• State Resources
• Exercises
• Emergency Kits for Residents
• Community Health Emergency Coordination Center
  (CHECC)
• Finalize and mailed to LTC - 10/1/08

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Mather Lifeways - PREPARE

• PREPARE Learning Module Topics (Train-the-Trainer)
  
• Module 1 Special Considerations of Older Adults
  in a Disaster
• Module 2 Psychological Needs of Older Adults in
  a Disaster
• Module 3 What Providers Need to Know About
  Biological/Chemical Agents
• Module 4 Leading and Communicating in LTC
  During a Disaster
• Module 5 Surveillance and Infection Control
• Module 6 Tabletop Exercises
• Module 7 Participating in Local, State-Wide, or
  Federal Response
• Module 8 Effective Disaster Planning for LTC
• Funded project complete in Gaylord, Lansing
  Troy During 2008
• For more information, contact
• http//www.matherlifeways.com/re_prepare.asp

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Emergency Preparedness Grants Pilot Project

• Funds could be used to purchased items such as
  evacuation equipment, client go-kits, personal
  protective equipment (PPE), travel, training and
  exercises. Funding was awarded in amount up to
  10,000.
• Deadline for submission was April 3, 2009
• 133 facilities submitted applications and 130
  were funded.
• Funding was distributed to 100 facilities spent
  by September 30, 2009 and the other 30 facilities
  spent by March 30, 2010.

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How to Get Involved in Community Emergency
Preparedness Planning?

• Participate in the Regional Bio-Defense Network,
  monthly meetings
• Take advantage of federal preparedness funds
• Build relationships and partnerships ahead of
  time.
• Knowing your available resources and plans.
• Exercises and Trainings with community partners.

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Cooperative Agreement (CA) Funding
ASPR CA
CDC CA
Local Health Departments
Regional Initiative
Medical Control Authorities
Other Local/Regional Partners
Healthcare Partners
Coordinate State/Local/Regional Planning
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Regional BT. Coordinators
Region 1 Region 5 Mark Malcuit Bob
Dievendorf Region 1 BT. Coordinator Region 5
BT. Coordinator 5020 Northwind Dr. 1000 Oakland
Dr. East Lansing, MI 48823 Kalamazoo, MI
49008 Office 517-324-4404 Office
269-337-6549 d1rmrc-mwmalcuit_at_sbcglobal.net
dievendorf_at_kcms.msu.edu    Region 2N Region
6 Rick Drummer Jamie Crouch Region 2N BT.
Coordinator Region 6 BT. Coordinator 2032 E.
Square Lake Road, Ste. 200 1675 Leachy St. Suite
308B Troy, MI 48085 Muskegon, MI
49448 Office 248-828-0180 Office
231-728-1967 Rickdrumrs_at_aol.com jcrouch_at_mcmca.org
   Region 2S Region 7 Amy Shehu Mary
Fox Region 2S BT. Coordinator Region 7 BT.
Coordinator 6754 Brandt Street 2434 Silver Fox
Trail, Suite A Romulus, MI 48174 Gaylord, MI
49735 Office 734-728-7674 Office
989-731-4975 AShehu_at_2South.Org region7btc_at_gmail.c
om    Region 3 Region 8 Jim Brasseur
Joshua Burt Region 3 BT. Coordinator Region 8
BT. Coordinator 1600 N. Michigan Ave. 420 West
Magnetic Street Saginaw, MI 48602 Marquette,
MI 48955 Office 989-583-7938 Office
906-225-7745 btdregion3_at_gmail.com Joshua.Burt_at_mgh
s.org
8
7
6
3
2N
1
5
2 S
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Future Cooperative Agreement Activities for 2010
- 2011

• Expanding the use of Long Term Care facilities on
  the Michigan Health Alert Network (MI-HAN),
  currently 64 of facilities are on the HAN.
• Statewide planning for resource tracking during
  an event.
• Statewide and Regional conferences on Emergency
  Preparedness and specific topics pertaining to
  long term care.
• Creation of statewide training and learning
  modules for long term care specific staff.

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Additional Contact Information

• Local Emergency Management
• http//www.michigan.gov/documents/msp/LocalDir_ext
  ernal_320561_7.pdf
• Local Public Health, Emergency Preparedness
  Coordinators
• http//www.malph.org/page.cfm/108/

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Questions?

• Amber Pitts
• pittsa_at_michigan.gov
• 517-335-8150