Nursing Homes: Integration into planning

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Nursing Homes Integration into planning

• Don Sheldrew
• Minnesota Department of Health
• Office of Emergency Preparedness
• 625 Robert St., St. Paul, MN 55164
• 651-201-5738
• Don.sheldrew_at_health.state.mn.us

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What do we know about nursing homes and
preparedness

• Very little
• Typically prepare for floods, fire, other natural
  disasters
• Corporate and regional involvement?
• What would happen if events were larger scale in
  terms of supplies, transportation, other
  sheltering?

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What do nursing homes know about hospital,
clinic, EMS plans?

• Very little
• Regional activities
• NIMS
• PPE
• Decon
• MACs..

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What if?

• We needed to support each other..
• Needed to communicate but spoke a different
  language?
• We were going after similar resources?
• We had things that could help but the other
  didnt know?
• There were concerns about the plans of the other
  and no conversation?

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Nursing Home Preparedness

• Overall, preparedness efforts have dramatically
  increased as the result of many factors since
  9/11 and Katrina.
• Populations such as the elderly present unique
  psychological and medical needs

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Nursing Home Preparedness

• Nursing homes traditionally are not considered in
  preparedness efforts as most efforts go towards
  hospitals and first responders
• Regional integration has been poor nationally
• Understanding their capacity is limited

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National Concerns

• Little bioterrorism knowledge
• Little decontamination knowledge
• Varied level of local or state involvement
• Concerns about personnel, space, generators,
  specialty care and what hospital plans are
  regarding NHs

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National Concerns

• Concerns after Katrina liability, judgment,
  regulations, documentation
• Food, water, pharmaceuticals
• Concerns about what role is expected of them, if
  any augment healthcare, accept infectious
  patients, Red Cross

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National Concerns

• Rules and regulations
• Need education types of disasters, PPE, NIMS,
  Communications, PFA
• Agency for Healthcare Research and Quality
  Nursing Homes in Public Health Emergencies
  Special Needs and Potential Roles
• May 2007

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Process

• 2002 OEP Established
• Federal grants / HRSA Hospitals, EMS, Clinics
• Regional Approach differences/ similarities
• 2004 Behavioral Health
• 2007 Adding in Long Term Care (MN),
  specifically skilled nursing facilities

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Work Plan

• Convene nursing home subcommittee to assess the
  current level of emergency preparedness,
  including policies and procedures, facilities,
  equipment and supplies, training, interoperable
  communications and staffing.

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2007 Work plan

• Integrate nursing homes into regional healthcare
  system preparedness planning committees,
  including ACS subcommittees.
• Include nursing homes in trainings, drills and
  exercises.

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Developing LTC Subcommittees

• Other regional long term care facilities
• Regional hospital groups
• LPH
• Emergency Management
• Others

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Partnering Opportunities

• Minnesota Health and Housing Alliance (MHHA)
• Care Providers of Minnesota
• Others MN HomeCare Association

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Meet and Greet Activities

• All regions have or will have an initial meet
  and greet get together to discuss the purpose
  and need.
• Assessments have or will be distributed and are
  being looked at to determine strengths and needs
• All regions have either met or are in process of
  setting that up

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Bolster knowledge

• Develop relationships
• Understand plans local and regional
• Reduce uncertainty with knowledge
• Develop plans that can augment and support each
  other where possible.

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Increase capacity

• Knowledge
• ICS JAS
• Equipment where indicated
• Increase preparedness
• Connect to regional resources
• Many done by 6/08

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Early Assessment Returns

• Staff / Family Preparedness huge concerns
  regarding staffing during crisis
• Training staff in emergency procedures
• Participating in drills and exercises -local and
  regional

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Early Assessment Returns

• Regional planning relationship development
• Selecting and purchasing appropriate equipment
  ex. NOAA radios, PPE
• Better evacuation planning more partners

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Early Assessment Returns

• Implementation of an ICS
• Formalizing mutual aid agreements
• Credentialing
• Patient tracking
• Community concerns

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Partners

• MHHA and Care providers Applied for funding to
  conduct training for LTC regarding
• NIMS
• Information specific to LTC and ICS
• Development of Job Action Sheets
• Others as identified

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Where are we going?

• Continue building capacity determining needs
• Discussions currently ongoing with MN HomeCare
  Association, adding in other types of LTC
  providers once skilled nursing facilities are
  firmly on board
• Uniformity where possible
• Continued building

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Questions