CENTERED R E S I L I E N C Y A T C H I M N E Y R O C K V I L L A C M S E M E R G E N C Y P R E P A R E D N E S S R U L E

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1 Issue 3 Summer 2017 UN CENTERED Connecting public health preparedness with real world experiences A MAGAZINE FROM THE CENTER FOR PREPAREDNESS EDUCATION R E S I L I E N C Y A T C H I M N E Y R O C K V I L L A A community devastated by a tornado steps up to help the Chimney Rock Villa Nursing Home evacuate its residents not once, but TWICE. C M S E M E R G E N C Y P R E P A R E D N E S S R U L E Perspective from a local health department on collaboration and outreach efforts. H I D D E N G E M : C E N T E R F O R D O M E S T I C P R E P A R E D N E S S Training America's first responders in rural Alabama. Chimney Rock Villa Nursing Home with roof damage. Photo credit: Nebraska State Patrol

2 UnCentered Contents 03 EDITOR'S NOTES The title UNCENTERED was chosen by our team to describe thinking out of the box or Center, if you will-- uncharted territory from traditional theories and methodologies. 04 DO-TANK PROCESS 05 RESILIENCY AT CHIMNEY ROCK VILLA 07 CMS EMERGENCY PREPAREDNESS RULE 09 SUMMER SAFETY TIPS 11 HIDDEN GEM: CENTER FOR DOMESTIC PREPAREDNESS E L A Y N E S A E J U N G 14 UPCOMING EVENTS 2

3 U N C E N T E R E D M A G A Z I N E Editor's Notes Getting to Know You Again Greetings to old friends, new friends and friends I have yet to meet! It is my turn to share a little about myself, my work and my life. I hope that we will have more opportunities to get to know one another in the coming years. I have been with The Center for almost 14 years. This is the best job ever. So many opportunities to learn, share and meet amazing people from across our state. I enjoy many things about my job. One of my favorite things is visiting the Critical Access Hospitals. I have been to over 60 small hospitals in Nebraska. I only have 2 or 3 to go. I hope to visit those this year. I have a great respect for the part small hospitals, health departments, EMS and other services play in our healthcare system. I worked in EMS for both county and private services before going to DHHS to work in EMS Program. From there I moved to the Center For Preparedness Education. What is one to do after a long hike and with a perfect mountain view, take a selfie of course.. r In my spare time, I do a decent job of growing herbs and cooking with them. I try to have a garden, and if it weren t for squirrels I d do a decent job of that too! I hate squirrels! I have yet to figure out what they could possibly be good for! When I see this rodent running along the top of the fence with one of my tomatoes in his mouth I can t help but try to chase it down and yell at it to give my tomato back! Every year I say this will be my last garden because it isn t worth it. Yet, once again, my plants are in, surrounded by mint, marigolds, and anything else I can find to try to ward off the critters. On to summer preparedness programs! I hope to see many of you at our courses, or connect with you at meetings or webinars. There are still a few spots open in the Hospital First Receiver Instructor Trainer Course. This is a unique opportunity to learn about chemicals and hospital decontamination, then to leave with all of the materials we have developed in the last 10 years. Register on our website. All my best to you for a great summer. And Did I mention that I hate squirrels? If anyone would like some squirrels I know where you could get a few dozen. Give me a call. BARB DODGE DIRECTOR OF HOSPITAL PROGRAMS 3 U N C E N T E R E D M A G A Z I N E

4 Public Health Departments, Hospitals and Long Term Care Facilities participated in the Center's first Do Tank in Kearney. Attendees gained knowledge on the CMS regulation while learning a 3 step problem solving process. The goal of a Do Tank is to generate innovative ground up solutions that encourage creative problem solving. After identifying the What, Who &Why and How (3 step process) attendees created a prototype of their solution using creative everyday tools. 4 U N C E N T E R E D M A G A Z I N E

5 Resiliency at Chimney Rock Villa - The Evacuation of a Nursing Home A story of resiliency in times of disaster. When the tornado hit the nursing home, Administrator Burry knew what she had to do. Call it instinct, planning or preparedness, but what happened next should make any community proud. With the help of first responders and city elected officials, many of whom had damage to their own homes, the 45 residents from Chimney Rock were evacuated to the local high school. But, Ms. Burry knew a second move was inevitable. Within a four hour window, and with the help of Regional West Medical Center, the majority of those residents had been transported to surrounding nursing homes. Community-wide damage assessments are still underway, with an estimated $300,000 damage to the Chimney Rock Villa alone. Ms. Burry hopes to welcome residents back as soon as the repairs and construction are completed. Airal Photo of the Chimney Rock Villa Nursing Home Photo Courtesy of Nebraska State Patrol Hope for the best and plan for the worst, is a motto typically heard in emergency preparedness. By Tonya Ngotel, Center for Preparedness Education June 12th was that day for a small nursing home in Bayard Nebraska when it was forced to evacuate 45 residents due to tornado damage that tore off part of a roof and left mud and debris in its wake. With impending weather looming, Chimney Rock Administrator, Kim Burry, went home to secure her own home, settle her kids in the basement, and return to Chimney Rock to the help the staff weather the storm. Photo Courtesy of Nebraska State Patrol 5 U N C E N T E R E D M A G A Z I N E

6 UNMC's Student Response Team A College of Public Health Student Organization Our Mission Our mission is to promote future public health leadership by providing students with hands-on training and experiences in outbreak response and emergency preparedness. Who We Are We instruct students on specific roles in public health, medical, and volunteer response to a disaster or public health emergency and train to deploy in Nebraska and Western Iowa. What We Do Epidemiology Outbreak Team: Assist local health departments with outbreak investigation and control Points of Dispensing (POD) Assistants: Support public health emergency response coordinators with mass dispensing or immunization clinics The 2016 UNMC Student Response Team as they prepare to host a Preparedness Fair. Article Submitted By: Angelia Wimberly, UNMC Student Response Team President Digital Response Team: Assist volunteer agencies in systematic monitoring of social media. Contact Us: cophstudentresponse@unmc.edu 6 U N C E N T E R E D M A G A Z I N E

7 Centers for Medicare and Medicaid Services (CMS) Emergency Preparedness Rule by: Randy G. Fischer, Emergency Preparedness Coordinator,Lincoln-Lancaster County Health Department In this ever changing world of the preparedness industry, we are faced with a large amount of policy changes, regulations, funding requirements and world political threat issues just to name a few. In 2013, the Centers for Medicare & Medicaid Services (CMS) proposed new emergency planning and preparedness regulations that would affect 17 different provider types. Since then, those providers sat tight to see just What exactly are those new regulations and how are we going to meet them? Being actively engaged in the preparedness and planning industry practically from its recognized inception, these providers, including myself, knew that the regulations could take affect at any time, just when and how, no one really knew the answer. In early 2014 Lincoln-Lancaster County Health Department (LLCHD) held its first meet with Long Term Care and Assisted Living facilities in Lancaster County on how to be prepared for these regulations. The health department developed templates, plans, and other tools for those providers to utilize in order to meet the regulations and requirements that had been proposed. Since that time, the health department has been requested to speak on the CMS regulations across the state and provide assistance in putting facility plans together. As many of you know, the regulations became final in September 2016 and will take full effect on November 15, LLCHD has teamed up with several organizations across the state to provide the training and planning templates needed. Some of those organizations are Nebraska Health Care Association, Leading Age Nebraska, Southeast Nebraska Health Care Coalition, Rural Region One Medical Response System, as well as many local health departments. In the final regulations, CMS has outlined 4 core elements that are needed in a required preparedness plan for each facility. Each of these components have been outlined and developed in the templates provided by LLCHD. 4 Core Elements 1. Risk Assessment & Planning 2. Policies and Procedures 3. Communications Plan 4. Training and Testing 7 U N C E N T E R E D M A G A Z I N E

8 (CMS) Emergency Preparedness Rule, continued Currently LLCHD works with others across the state for emergency planning and preparing. By doing this with the facilities, LLCHD has learned that they have become a critical partner in a community response, if the need should arise. These facilities have the skills and expert staff that are valuable in the health care setting. I encourage others to reach out to the 17 provider types to provide guidance, assistance etc. Please note and realize that the rest of the 17 are now documented partners in public health, get to know them, their capabilities and their role in the plan before a disaster occurs. LLCHD will continue to reach out to the other providers on the list to provide templates, guidance and assistance in, not only meeting the requirements of CMS, but to be a partner facility. We at LLCHD do our best to stay ahead in this preparedness industry and we find that this effort has provided great dividends in relationships and learning. With that, we are seeing results in better preparing our communities as a whole for the unfortunate inevitable. Facilities Impacted by the Emergency Preparedness Rule 1. Hospitals 2. Religious Nonmedical Health Care Institutions (RNHCIs) 3. Ambulatory Surgical Centers (ASCs) 4. Hospices 5. Psychiatric Residential Treatment Facilities (PRTFs) 6. All-Inclusive Care for the Elderly (PACE) 7. Transplant Centers 8. Long-Term Care (LTC) Facilities 9. Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) 10. Home Health Agencies (HHAs) 11. Comprehensive Outpatient Rehabilitation Facilities (CORFs) 12. Critical Access Hospitals (CAHs) 13. Clinics, Rehabilitation Agencies, and Public Health Agencies as Providers of Outpatient Physical Therapy and Speech-Language Pathology Services 14. Community Mental Health Centers (CMHCs) 15. Organ Procurement Organizations (OPOs) 16. Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) 17. End-Stage Renal Disease (ESRD) Facilities 8 U N C E N T E R E D M A G A Z I N E

9 Be Safe This Summer Some Tips to Keep You and Your Family Safe This Summer Did You KNOW: Emergency departments report that approx 20,000 children ages 14 and younger receive traumatic brain injuries from playground related accidents. (Source; National Safety Council) From there have been more then 11,100 injuries from distracted walking... involving cell phone usage - put that phone down. (Source: National Safety Council) 8,900 home fires are started by grills each year, on average. 75% of U.S. households own at least one outdoor BBQ, drill or smoker. (Source: NFPA) Lightning can strike as far as miles away from the parent thunderstorm. Most lightning deaths occur when people are caught outdoors in the summer months. (Source; National Weather Service) 1 ounce of sunscreen, enough to fill a shot glass, is considered the amount needed to cover the exposed areas of the body (Source: American Academy of Dermatology) Do you have a picture that depicts Nebraska's preparedness? Maybe you are a budding author? Here's your opportunity to shine. Calling All Authors and Photographers The Center would like to highlight your exercise, drill, training or real event in our next issue. Submit articles, pictures or ideas by September 1, 2017 to center@preped.org or call (402) U N C E N T E R E D M A G A Z I N E

10 A Snap Shot in Time - 15th Annual Preparedness Symposia Staff and Friends of the Center for Preparedness Education Enjoying the 15th Annual Preparedness Symposia Participants of the Immersion Course enjoy a celebration commencement at the end of the 2017 Symposia Participants display the number of years they have attended the symposia. 10 U N C E N T E R E D M A G A Z I N E

11 Hidden Gem: The Center for Domestic Preparedness (CDP) by: Debra Robinson, Planning & Training Specialist, Nebraska Emergency Management Agency Police, Fire, EMS, Emergency Management, Public health we are all being asked to do more with less and to leverage every dollar and training is often the among the first things to be sacrificed to save money. A number of years ago I was fortunate enough to come across some federal training sites that provide free training to first and emergency responder disciplines, such as emergency management, law enforcement, fire services, EMS, government leaders, Hazmat, healthcare, public health, public safety and public works from local, state and federal governments. Did I happen to mention it is FREE? Yes, the U.S. Department of Homeland Security fully funds training at the Center for Domestic Preparedness (CDP) for these public entities and also trains private entities on a feefor-service basis. There are actually a number of these federal schools available. I will address some of these training options in future editions of this publication. As a trainer, I try to make sure that I am taking full advantage of the most up-to-date training that is available. My job actually requires me to take many of the courses offered through the CDP and other training centers, so I can speak from my first-hand experience, both having attended many trainings and as an instructor for some of their courses- they are top notch! Facilities at the CDP are designed to support the various classes offered in different disciplines and specialties. For example, the Noble Training Facility (NTF) is a former Army Hospital that is now used to provide training for healthcare and public health for responses to chemical, biological, radiological, nuclear and explosive (CBRNE) and mass-casualty incidents (MCIs). It is the only hospital facility in the US that is dedicated to training medical/healthcare officials and personnel in disaster preparedness and response specifically related to terrorist attacks and MCIs. 11 U N C E N T E R E D M A G A Z I N E

12 Hidden Gem: The Center for Domestic Preparedness, continued The Advanced Responder Training Complex (ARTF) includes a variety of venues that first and emergency responders encounter every day in a specifically designed training environment. The training uses these common business and industrial sites as the backdrop for scenarios involving terrorist activities and/or MCIs. Responders no longer have to imagine how they would deal with situations in specific environments because they get the opportunity to train and respond in those environments. The site even includes an indoor street scene with a town center, subway, and a rail car that can all be used in various exercise scenarios for different disciplines and specialties. The Chemical, Ordnance, Biological and Radiological Training Facility (COBRATF) is the only civilian training program that features the ability to safely train and exercise in a toxic chemical and biological environment. We train hard and with great care in simulated environments, but there is nothing like training with live agents like VX, Sarin and Anthrax. It takes your preparedness and training to a whole new level! If you are interested in the training opportunities being offered at the CDP, you can visit their website at cdp.dhs.gov. Once on the site you can register for your FEMA student identification number (FEMA SID) which is required for all trainings, preview course descriptions and schedules and submit your application for training. Costs for travel, food and housing are completely covered by the U.S. Department of Homeland Security. The only costs to public entities are their regular salaries and backfilling positions (if/as needed) while participants attend the training. Kids' Corner Are YOU the Master of Disaster? Q: How much water should be in your shelter kit? 12 a: 1 gallon per person for 3 days Find out at U N C E N T E R E D M A G A Z I N E

13 S A V E T H E D A T E S A V E T H E D A T E 1 6 T H A N N U A L E M E R G E N C Y P R E P A R E D N E S S S Y M P O S I A April 11 & 12, 2018 Gering, Nebraska S A V E T H E D A T E May 8 & 9, 2018 Omaha, Nebraska J O I N U S O N A N E D U C A T I O N A L A D V E N T U R E I N

14 UPCOMING EVENTS SUMMER 2017 The Center for Preparedness Education J U L Y A U G U S T S E P T E M B E R Hospital First Receiver Instructor-Trainer Course HavBed Drill HCC Workshop For more information, upcoming events and training resources check out our website at preped.org or call HavBed Drill HCC Workshop Center for Prepardness Edcuation Staff from left to right: Tonya Ngotel, Beckie McCaw, Barb Dodge, Elayne Saejung, Leslie Scofield, Gary Gorby MD, Sharon Medcalf PhD 14