Policy Number: 4-E2. This Policy Applies to: The agency. I. Definition and Scope:

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1 Policy: Emergency Preparedness and Response Plan Section: Disaster and Emergency Date: 01/09/2003 Date(s) Revised: 04/02/2004; 04/10/2008 Number of Pages: (12) Policy Number: 4-E2 This Policy Applies to: The agency I. Definition and Scope: A. This plan defines an emergency as a crisis situation whose area of effect and intensity are severe enough to significantly disrupt one or more programs and possibly also the ability of Pathway Homes as an agency to respond. Possible scenarios include but are not limited to catastrophic weather events (e.g. hurricane, snow or ice storm), industrial accidents (e.g. release of toxic chemicals), or acts of terrorism. B. A detailed set of instructions can not be given for the many variables and unpredictable circumstances surrounding emergency scenarios. Instead, this plan will identify a set of prioritized guiding principles to be followed by all employees in response to an emergency situation. By their nature, any such situation will call upon the preparation, initiative, flexibility, and good judgment of each employee to best implement these principles and adapt them to particular circumstances. II. Goals of Emergency Response: A. The primary goal in any emergency situation shall always be to preserve the life and ensure the ongoing safety of individuals being served and employees. B. Pathway Homes will strive to minimize the negative impact, both physical and psychological, of emergency conditions on individuals being served. C. Pathway Homes will strive to preserve the assets that allow this agency to fulfill its mission, including physical structures, vehicles, equipment, vital records, and supplies.

2 Page 2 D. Pathway Homes will strive to maintain the greatest continuity of care possible for all individuals being served. E. Pathway Homes will in its emergency response respect the human rights, dignity, and free will of individuals served. III. Principles of Emergency Response: A. Preparation - The foundation of any emergency response will be the preparation for emergency situations which occurs at all Pathway Homes programs on an ongoing basis. This includes training, stocking adequate emergency supplies, and maintaining accurate records such as emergency phone trees. These preparations are described in more detail in Appendix A. B. Authorities - To the greatest extent possible, employees and individuals served shall seek out and follow the emergency response instructions of the appropriate governmental and emergency authorities. In a true emergency situation, employees and individuals served should directly follow the instructions given by such authorities, and should not wait for confirmation from Pathway Homes management or staff. C. Priorities - Steps in the response to some specific types of emergencies can be found in Appendix B, but in all cases Pathway Homes staff will prioritize the goals listed in this plan in the making of critical emergency response decisions. Staff will immediately take whatever steps necessary to ensure a safe environment for individuals being served and render first aid if needed. Ongoing staff response may require prioritizing more important goals over lesser ones: for example, the evacuation of individuals from likely danger may be required even if it is disruptive to their ongoing continuity of care, the abandonment of significant personal property may be necessary to ensure the safety of an individual, the dignity of an individual may be unavoidably violated if not to do so would create a negligent risk of injury or harm, etc.

3 Page 3 D. Evacuate or Shelter In - The principal response to an emergency situation is likely to be one of two steps: evacuation or sheltering in. Unless specific instructions to evacuate are given or immediate threats to health and safety require it, the default response will be sheltering in. Sheltering in will follow the procedures described in Appendix C, evacuation will be subject to the instructions of relevant authorities and the Agrab and go@ guidelines in Appendix C. E. Program Staffing - Employees of intensive or 24 hour programs on duty during an emergency situation are expected to remain on duty until relieved by other appropriate staff. Employees of intensive or 24 hour programs not on duty are expected to arrive for their shifts as scheduled. Employees of other clinical programs are expected to make direct contact with assigned individuals immediately. All supervisory employees (MHCIII and above) are expected to report immediately to their respective programs to direct operations. Any clinical employee unable to fulfill their responsibilities is to notify their supervisor immediately of their situation and to remain available for other duties that may be assigned. In the event of an emergency during scheduled work hours administrative staff shall immediately secure computers, monies and files. Administrative and support staff, as well as interns, students, and volunteers, will call the main office or work site prior to reporting for work, and should not report to the main office or work site during off hours. Leadership team will make the determination of need for any change in work schedule or office hours. F. Communication - In order to best allocate limited resources as well as give reports to higher authorities, it is vital that communication be maintained during an emergency. Communication requires a two way flow of information between individuals being served and programs and the senior Pathway Homes management. Supervisors will have primary responsibility for coordinating communication. All clinical managers and designated administrative personnel are responsible for carrying agency cell phones and for ensuring those cells phones are functioning properly to allow for emergency communication when needed. These individuals are responsible for the initial implementation of the agency s emergency preparedness plan and for disseminating information to the rest of the agency.

4 Page 4 Each clinical manager will gather information about their program(s) and individuals served and report the status to Pathway s Leadership team, and ensure that all relevant information and instructions are received by the staff and individuals served within their program(s). IV. Steps in Emergency Response: In coping with the chaos inevitable during a genuine emergency, all employees should prioritize their activity and remind themselves to continuously ASC: Assess, Secure, and Communicate. A. Assess - During this step employees should gather information about the nature of the emergency and the status of all assigned individuals, evaluate possible threats to health and safety, and choose a course of action in keeping with the goals and principles listed above. This may vary from a few seconds to see who is hurt to many hours spent tracking down and speaking with everyone on a caseload. The time available will depend upon the situation, but the goal will always be to speak directly with ALL individuals in each program and accurately assess the current status and potential risks for each person. B. Secure - During this step, employees will carry out the course of action chosen to ensure the safety and well-being of individuals served and staff. This could be anything from administering first aid to assisting individuals in relocating to a safer location. As time passes the activities needed to secure a situation will likely change: for example, sheltering in may initially require covering doors and vents with plastic, but after a day, securing the situation may mean rationing bottled water and providing supportive counseling to individuals served. C. Communicate - During this step staff will communicate their assessments and actions to supervisors, and will keep individuals served informed of the current situation and plans. Supervisors will coordinate communication between programs and leadership team. If phone service is unavailable supervisors will physically travel, or delegate a staff person to do so, as soon as it can be safely done to receive updates and report to Pathways leadership team. In a

5 Page 5 situation requiring physical travel to relay information, each program should aim to report in at least every morning, in order to allow an overview of the agency and coordination between programs. V. Recovery: The goal of recovery from an emergency situation is to restore the normal functioning of Pathway Homes programs as quickly as possible while mitigating the effects of the crisis on individuals served and staff. The immediate priorities of emergency recovery are as follows: A. Pathway Homes shall notify the family or emergency contact person for each individual served that has been affected by an emergency, and the local human rights advocate if appropriate. B. Pathway Homes shall notify DBHDS of any emergency/disaster within 72 hours of the incident. C. Pathway Homes shall ensure that individuals served continue to receive those services necessary to maintain the health, safety and well-being of each individual. D. Pathway Homes shall ensure that any physical site affected by an emergency/disaster is assessed and deemed safe for occupancy.

6 Page 6 APPENDIX A All Pathways-operated sites shall maintain readily accessible emergency/disaster supplies to include: # Fully stocked First Aid Kit # Water (3 gallons per person) # Canned/non-perishable foods (3-day supply) # Batteries # Plastic and duct tape # Paper supplies and utensils # Manual can opener # Flashlights # Battery-operated radio # Utility knife # Tool kit # Particulate face masks # Emergency Preparedness manual # Smoke detectors # Fire extinguishers # Buckets with lids All residents shall have an emergency phone numbers list prominently posted near telephones. The list shall include: # On-call Pathway Homes staff # Hospital/ambulance/rescue squad # Local mental health center emergency services # Poison Control # Local fire and police substations # Emergency utilities access -A1-

7 Page 7 All Pathway Homes staff shall receive initial and annual training in Emergency Preparedness procedures to include: # Implementation of training for residents # Conducting monthly Emergency Preparedness drills # Sheltering-In procedures # Location of utility shut-off valves and breaker box # Evacuation procedures # Response during non-work hours # Communication and reporting procedures # Community resources # CPR and First Aid # Use of fire extinguishers # Monitoring and replacing Emergency Preparedness supplies #Accessing emergency medical information for individuals receiving services # Recognizing and responding to Workplace Violence # Therapeutic Options of Virginia All individuals receiving services shall receive initial and annual training in Emergency Preparedness procedures to include: # Review and use of Emergency Preparedness manual # Use of the emergency phone tree # Location and use of the Emergency Preparedness supplies # Location of utilities shut-off valves and breaker box # Sheltering-In procedures # Evacuation procedures # Community resources

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9 Page 9 APPENDIX B In the event of fire: 1. Small, manageable fires shall be extinguished with a fire extinguisher. 2. Larger, unmanageable fires shall result in immediate evacuation of all individuals from the premises and a call to Staff shall account for all persons present at the program at the time of the incident. 4. Staff shall notify appropriate supervisors and complete an adverse incident report. In the event of severe injury or illness: 1. Render the appropriate first aid and call Staff shall notify appropriate supervisors and complete an adverse incident report. 3. Staff shall notify the family or emergency contact person of any injuries incurred by individuals served. In the event of acts or threats of violence: 1. Direct all individuals to a secure, non-threatened area. 2. Utilize appropriate techniques to defuse or minimize the lethality of situation. 3. Immediately call Notify appropriate supervisors In the event of a missing person: 1. Staff shall search places frequented by the individual served. 2. Staff shall call known family and friends of the individual. 3. Staff shall notify appropriate supervisors. 4. Staff shall contact the local police to file a missing persons report.

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11 Page 11 In the event of a bomb threat: 1. Engage the caller in conversation for as long as possible; noting details about voice, speech patterns, and background noises. 2. If possible, have another person call 911. If you are alone, call 911 immediately after the call is over. 3. Begin evacuation of the building using emergency evacuation procedures. 4. Staff shall notify appropriate supervisors. In the event of a suspicious package: 1. Leave the package alone. Do not touch, examine or move the object. 2. Clear all persons from the immediate vicinity. 3. Call Staff shall notify appropriate supervisors. In the event of severe weather: 1. Tornado - Assemble all individuals present in the lowest level of the house in an interior door frame, away from windows. 2. Lightening Storm - Keep all individuals away from running water and electrical conductors. Unplug televisions, radios and other small appliances. 3. Flooding - Remain in the house/facility unless local authorities advise evacuation. 4. Severe Snowstorm - Remain indoors, unless the environment becomes unsafe. In the event of disruption in utilities: 1. Interruption in Gas Service - If a gas odor is detected or the carbon monoxide detector sounds, individuals shall immediately evacuate the premises and call 911. Staff shall notify appropriate supervisors in the event of a prolonged gas outage that may impact the health and safety of individuals served. Shut-Off Valve Location: -B2-

12 2. Loss of Electricity - Staff shall first locate the breaker box. If the outage is not fuserelated, staff shall notify the power company. Staff shall account for and reassure all individuals served. Staff shall notify appropriate supervisors in the event of a prolonged electrical outage that may impact the health and safety of individuals served. Breaker Box Location: Page Loss of Water/Water Leaks - In the event of a significant water leak, staff shall locate shut-off valves and turn off the water at the source of the leak to minimize excessive damage. In the event that staff need to shut off the water, staff shall immediately contact the office manager and appropriate supervisors. In the event that there is no water service for other reasons, staff shall immediately notify the water company. In the event of a prolonged water service interruption that may impact the health and safety of individuals served, staff shall notify the appropriate supervisors. Main Water Shut-Off Location: 4. Loss of Phone Service - Staff shall identify which specific line is out of service and notify the phone company. Staff shall ensure that individuals of the program are notified of the outage and directed to the accessible, functioning line to utilize in an emergency. In the event that any phone line is out of service, staff shall notify appropriate supervisors.

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14 Page 14 APPENDIX C SHELTERING-IN-PLACE PROCEDURES Shelter-in-Place is defined as remaining indoors for your protection. Everyone is to go indoors immediately. Gather your emergency preparedness supplies, and make sure the radio is working. Go immediately to an interior room without windows or, at least, a minimum number of windows. In the case of a chemical threat, an aboveground location is preferable because some chemicals are heavier than air, and may seep into basements even if the windows are closed. SPECIFY YOUR SHELTERING-IN-PLACE LOCATION: TAKE THE FOLLOWING ITEMS TO THE IDENTIFIED SHELTERING-IN LOCATION: # All persons on-site at the time # All medications that may be needed # All emergency phone numbers # All Emergency Preparedness supplies # Additional Comments/Site specific instructions: WHEN ALL NEEDED SUPPLIES ARE IN THE SHELTERING-IN LOCATION: # Close all windows, exterior doors and fireplace dampers # Turn off all fans, heating, and air conditioning systems Breaker Box Location: # Wet some towels and jam them in the cracks under the doors # Tape around the doors, windows, exhaust fans, and vents # Use plastic garbage bags to cover windows, outlets, and heat registers # Close the window shades, blinds or curtains if you are told there is a danger of explosion

15 # Stay inside and keep listening to your radio or television until you are told all is safe or you are told to evacuate -C1- Page 15

16 Page 16 EVACUATION PROCEDURES EVACUATION WILL OCCUR WHEN: # The site you are at becomes unsafe to remain in, OR # The authorities have ordered an evacuation of your geographical location LISTEN TO THE RADIO FOR INSTRUCTIONS GRAB AND GO In the event that evacuation is necessary, gather the following items in a pillow case: # Medications # Any Medical Supplies # Hygiene Items: - toothbrush - toothpaste - hairbrush or comb - feminine hygiene products - deodorant # Cash on hand # Change of clothes # House keys # Identification & insurance card # Emergency phone numbers -C2-