Evacuation to and from Nursing Homes in an Emergency

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Evacuation to and from Nursing Homes in an
Emergency
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Introductions

• Name
• Title
• Agency
• Area of the State
• Why you are here

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Objectives

• Identify types of disasters in Idaho
• Understand basic preparedness
• Knowledge of Laws affecting nursing homes
• Identify evacuation considerations
• Describe need for Continuity of Operations Plans
• Ability to write an emergency evacuation plan

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Disasters in Idaho
Mackay Hotel

• Flooding
• Wildland Fire
• Earthquake
• Landslide/Mudslide
• Power Outage
• Severe Weather/Winter Storms
• Tornados/Micro Downbursts
• Hazardous Materials
• Nuclear Incident
• Volcanic Eruption/Ash
• Terrorism/WMD
• Civil Disobedience

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(No Transcript)
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Disaster Responsibility
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Response
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Preparedness is key!

• Ensure that staff, residents and their families
  feel safe
• Teamwork and communication are critical
• Have a plan

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Emergency Kit

• Be prepared for 4-7 days
• Gallon of water per person per day
• Non-perishable food
• Warm Clothes/Bedding
• Flashlight, battery operated radio, batteries
• First Aid Kit
• Sanitation Supplies
• Tools/Supplies
• Special Items

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Emergency Preparedness for the Medically Fragile

• In preparing for a disaster, people with special
  medical needs have extra concerns.
• What might be some of your residents special
  medical needs?

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Laws

• 42 CFR, Section 483.470
• Idaho Code Title 39, Chapter 33
• IDAPA, Title 3, Chapter 2
• IDAPA, Title 3, Chapter 22

Add Notes
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Business Continuity

• Personnel
• Are they available
• Do their families need them
• Medication
• Doctors
• Records
• Generators
• Resources

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GAO Report

• Who is responsible for deciding to evacuate
  hospitals nursing homes?
• What issues administrators consider in deciding
  to evacuate?
• What federal response capabilities support the
  evacuation?

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Break
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Evacuation or Shelter in Place

• Considerations
• Safety
• Stress
• Medication
• Disorientation
• Increased Staff to evacuate
• Transportation

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Communication

• NOAA radios
• Families
• Staff
• Memorandums of Understanding
• Receiving facility

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Transportation

• Transportation contractors
• Contracts for mass evacuations
• Commandeered buses and ambulances
• Local emergency Management

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People Who Can Help

• Family, friends, and neighbors
• Discuss disaster plans
• Fire department
• Power company

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Caring for Staff is important too!

• Without conscious attention to self-care,
  caregivers' effectiveness and ultimately their
  health will suffer.

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Be on the Alert for Signs of Stress

• Common Physical/Behavioral Reactions fatigue,
  loss of appetite, difficulty falling asleep,
  restlessness, headaches, changes in sleeping,
  increased blood pressure, changes in eating
  habits, increased susceptibility to colds, flu,
  infection, change in libido, changes in smoking
  habits, changes in alcohol and drug consumption.
• Common Emotional Reactions feeling helpless,
  overwhelmed, inadequate, fragile, vulnerable,
  unable to cope or go on, increased mood swings,
  decreased motivation, feeling burned out, crying
  more frequently and easily, isolation, changes in
  communication patterns and other relationship
  dynamics, withdrawal.
• Common Cognitive Reactions confusion, difficulty
  making decisions, difficulty problem solving,
  memory blanks, having ambiguous feelings,
  questioning why this happened in a world that is
  supposed to be safe, difficulty concentrating or
  paying attention.

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US Senate Special Committee on AgingConcerning
Hurricane Katrina/Rita

• AHCA/NCAL members have participated in an
  unprecedented effort to coordinate an
  overwhelming demand for emergency assistance
  and more than 900 of our member facilities have
  responded with help, across the full spectrum of
  long term care needs.
• The level of civil preparedness did not come
  close to matching the level of destruction.

Bruce Yarwood, Acting President CEO of
American Health Care Association National
Center for Assisted Living
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Yarwood Suggestions

• Emergency communications
• Facility disaster plan evaluations
• Mutual support plans
• Interoperable electronic health records
• Interaction/coordination
• Supply storage capacity

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Evacuation Planning
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Evacuation Plans

• Local/Tribal Emergency Operations Plan
• State of Idaho Emergency Operations Plan
• National Response Plan
• Emergency Support Function (ESF) 1
• Transportation

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Nursing Homes

• Basic Plan to evacuate out of the building
• Evacuate or shelter in place
• Memorandum of Understanding (MOU)

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Pre/post event

• Flooding
• Wildland Fire
• Earthquake
• Landslide/Mudslide
• Power Outage
• Severe Weather/Winter Storms
• Tornados/Micro Downbursts
• Hazardous Materials
• Nuclear Incident
• Volcanic Eruption/Ash
• Terrorism/WMD
• Civil Disobedience

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Sheltering or Long Term Housing

• Relocated
• 3 days
• A Week
• A Month
• A Year
• Care in a shelter
• Space in another facility
• Staffing in another facility
• Your staff ability to locate in shelter or
  another facility

Talk to Sharon Duncan
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Housing Evacuees Considerations

• Transportation
• Evacuee Basic Needs
• Medical Support
• Psychological Support
• Social Support
• Financial
• Discharge
• Death

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Planning as an organization

• A well thought-out plan
• A plan with checklists for key personnel
• Teamwork
• Maintain
• Exercise

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Summarize

• Types of disasters
• Basic preparedness
• Laws
• After catastrophic disaster reports
• Business continuity
• Things to consider for patients
• Things to consider for staff

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Break
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Writing an Evacuation Plan
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Documents to Include

• Dated title page
• Promulgation Document
• Forward or preface
• Record of changes
• Record of Distribution
• Table of Contents

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Purpose

• Broad statement of what the plan is meant to do
• A synopsis of the plan

Scope

• What needs to be included
• What will the audience find in the plan

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Policies

• Authorities and References
• The legal bases for emergency operations,
  including
• Laws, statutes, and ordinances.
• Executive orders.
• Regulations.
• Formal agreements.
• Pertinent reference materials (including related
  plans of other facilities or suppliers).

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Policies

• Assignment of Responsibilities
• Define the staffs responsibilities
• Limitations
• Acknowledge contingencies
• Set boundaries
• Mutual aid
• List agreements with other organizations

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Situation and Assumptions

• Situation
• Hazards addressed by the plan
• Relative probability and impact
• Vulnerable critical facilities
• Population distribution
• Relationships with other facilities
• Maps

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Situation and Assumptions

• Assumptions
• What is assumed to be true
• Staff is familiar with the EOP and will execute
  their assigned responsibilities
• If needed, assistance will be available
• Executing the EOP will save lives and reduce
  damage

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Concept of Operations

• When the EOP will be activatedand deactivated
• Alert levels
• Sequence of actions before, during, and after an
  event
• Forms necessary to request assistance

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Responsibilities

• List of staffs general responsibilities
• Assigned by section and position.
• Identifies shared responsibilities and specifies
  which section has primary responsibility and
  which have supportive roles.

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Maintenance, Training Exercise

• Describes the planning process
• Identifies the planning participants
• Assigns planning responsibilities
• Describes the revision cycle (training,
  exercising, review of lessons learned, revision)

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Evacuation Plan

• Plan for
• Evacuating your facility-complete or partial
• Evacuating before an event with warning
• Evacuating after an event has occurred
• Receiving evacuees from another facility
• Receiving those that need a facility that were
  not previously in a facility

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• IBAPP Grant Goals

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Advance preparation can reduce fear and anxiety
during any emergency, and will certainly help in
the hours and days following an event.

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