HEALTHCARE DISASTER PLANNING FORUM Meeting Summary February 4, 2010

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1 HEALTHCARE DISASTER PLANNING FORUM Meeting Summary February 4, 2010 Present: (26) partners attended representing; 4 th Street laser Surgery, Alliance Medical Center, Auxiliary Communication System, Blood Bank Redwoods, CDPH/EPO, County Sonoma/Public Health, Creekside Convalescent Hospital, Friends House, Healdsburg General Hospital, Kaiser Santa Rosa, Palm Drive Hospital, Sonoma Valley Community Center, Sonoma Valley Hospital, Spring Lake Village, St. Joseph Healthcare System, Sutter Medical Center, West County Healthcare. ACCOMPLISHMENTS since last meeting: H1N1 Influenza event collaborations RESOURCES for Healthcare Partners: Public Health website for Healthcare Disaster Planning Forum resources: county.org/ph/ CAHAN contact County CAHAN Administrator, at CAHAN@sonoma county.org EMSystem contact Kent Coxon, Coastal Valleys EMS Agency, , kcoxon@sonoma county.org GETS/WPS/TPS sign up at HAM Radio MedNet contact Ann Cadgene, Public Health Preparedness, , acadgene@sonoma county.org problems contact Jeremy Nichols, Aux. Communications Systems, Jeremy@cds1.net ACRONYMS see last pages Action Items and Updates: Clinical facilities that are administering free vaccinations will inform PH to post on H1N1 website. Not Done Public Health Preparedness will post Kaiser s information about free HICS Trainings to its website Did not receive information to post. Public Health Preparedness will research and obtain a CBRNE Training DVD and post it on their Public Health website. Not Done Committee members will start planning for the Earthquake drill in May. Public Health will try to schedule a TTX on Evacuation and Shelter in place Scheduled 5/21/10 Kent Coxon will run a HAVBED report and send to Kim for minutes Not done Kim Caldewey will find out the GETS fee associated with TPS. See below GETS has NO FEE~ Hospitals/Clinics/Skilled Nursing Facilities please call Connie Or cvarela@sonoma county.org Wireless Card (WPS) $10 set up fee. Monthly fees depend on cell phone company. Not all wireless companies have WPS (AT&T and Verizon do). Kim Caldewey will look into the number of facilities we have in Sonoma County that would participate in facility staff training. DONE Contracts in process for 14 facilities H1N1 Update AAR H1N1 AAR Lessons Learned -Kim Plus Delta Kaiser Drive through clinics worked well Public Health Drive through vaccine clinics did not work well due to traffic problems and gas fumes Kaiser stockpile of N95 respirators was beneficial Sutter & Kaiser symptom segregation was imposed in Emergency Rooms Restrictive hospital visiting policy Developed in collaboration with infection control practitioners and Public Health, was appreciated by hospitals By monthly conference calls good. Good information and up to date Kaiser had a CDPH audit they were the piloted West County Health Center increase hand gel. Lots of media information to cts. CB called requesting vaccines. This took lost of staff time Healdsburg shortage of seasonal flu vaccine. People still want the seasonal vaccine Difficult to get the same message to all partners and keep it all on the - 1 -

2 facility for H1N1 and were told that they were same page. doing the right thing such as stockpiling mask masks. They are still vaccinating patients Healdsburg kept HEPA filters in their ER Don t have a good list of all providers in the community and their contact information. To notify staff, facilities, and implement guidelines, we need office mgrs. contact information, Palm Drive had their Isolation unit located adjacent to ER. They took over for lab usage. Vaccinated 860 on Flu Shot Saturday 12/5/2009 HDPF was good. We knew that we were getting the supplies that we could. It wasn t competitive and everyone had the same or similar supplies. Creekside saw less flu this year. MH patient contracted H1N1. They isolated and had zero spread. The SNF had zero H1N1. Spring Lake Village had zero cases. Used signage for ILI. Admissions screened visitors and used Discharge Planners. Kaiser still vaccinating. PH vaccinated 477 at Santa Rosa Junior College. Healdsburg vaccinated 50 on 1/23/2010 SRMH IC nurses track patients that are positive for H1N1 using the Mask Task Force. They had to switch respirator models and be retrofitted for the ProTech Mask mid stream. Patient tracking was still accurate. Healdsburg phone staff used scripts in answering H1N1 questions. This was more effective than they realized. Vaccine seems as effective as regular flu. No one had H1N1 patients who had been vaccinated. EMS heard that law enforcement was frustrated that they weren t part of the 1 st Responder community getting vaccinated. Better communication with Law enforcement on this would be good CDC Lots of information daily; alerts were sent frequently, PH shared information frequently with schools, web updates continued. Very hard to keep up PH Created a Public Health Alert bulletin board for facilities are the effective? Rumor control and conspiracy theories staff felt the cheapest masks were being bought at Kaiser. N95 Respirators learned which ones are good and which ones are not II. Collaborative Discussion: PHER Phase IV Funding for H1N1 Vaccines. Caifornia Primary Care Assn. (CPCA) will reimburse clinical fees associated with administering the H1N1 vaccine to encourage federally funded clinics to continue vaccinating.. This will encourage federally funded clinics to continue vaccinating. Kaiser provides free vaccinations to their Kaiser members Healdsburg Hospital and clinics are requesting a ten dollar donation and won t refuse to vaccinate. Trainings for partners 2010 HICS for SNF s, Clinics, and Hospitals Training TBD This training will be held at each facility There will be staff reimbursement for training time We will develop a training product to accommodate all facilities. This may take two years. Hospital Evacuation Tag Training 05/07/2010 Training CD is being developed We could train ourselves on using tags These tags were developed by the Evacuation Task Force last year There is a bar code on the tag and we would need scanners. HPP funds could purchase for Sonoma facilities HCDPF could develop policy in using evacuation tags Mass Fatality Planning Workshop 04/21/

3 Training to learn about county mass fatality planning (in process) Workshop will include hands on practice with body bags Participants will go home with a plan template and preliminary plan for their facility Registration opens 3/15 space is limited CEU s will be offered N95 Fit Test Training HPP funds used to contract a trainer until 6/30/10 Palm Drive Hospital wants another on site training. CBRNE Training Facilities want to do a DVD training at their facility PHP will research for a CBRNE Training in a DVD and post it to the PHP website. Exercises/Drills Memorial Hospital commented that they wrote their H1N1 activities into an AAR and was able to count it as an exercise. Earthquake Drill Committee members decided to drill in May and planning meetings will start. St. Joseph Healthcare System is planning on drilling. The scenario will be a fire in the facility and will include field and hospital command coordination as well as patient players. Kaiser Hospital will not drill in May Flood Drill Kaiser is exercising a Flood Drill on 4/24/2010 Bomb Drill The County and EMS will drill in concert with Golden Guardian in May, 2010 HCDPF will not participate IED Exercise The State will exercise on 11/18/2010 using an explosive device scenario Kaiser will not drill in this exercise because IED is not one of the top HVA s. Med Net Drill May start next week FCC has given us verbal agreement to resume and we are awaiting written confirmation Currently, we have 42 facilities and 103 operators in our net Evacuation and Shelter in Place Exercise Public Health will look into planning a TTX Scheduled for May 21, 2010 Mass Fatality Planning Exercise see above Mass Fatality TTX This is scheduled for May 27, 2010 EMSystems Polls EmSyst Polls Skilled Nursing Facilities Polls 115 requests sent out and two have replied training is needed Clinics Polls No one has replied training is needed Hospitals Going well and on schedule Communication GETS/WPS See HCDPF Agenda for the FCC website. From website: Transmission Augmentation and Restoration GETS uses the following NCSmanaged capabilities to provide improved connectivity and network management service during times of crisis. o o Wireless Priority Service (WPS) provides nationwide priority access/egress into GETS through commercial wireless services. FEE: $10 to set up, then wireless service monthly fee, determined by individual service. Telecommunications Service Priority (TSP) provides for priority installation and restoration of emergency telecommunication services. See website for more information. Committee recommends testing GETS once in awhile HPP Grant - 3 -

4 HPP funds for Equipment and Supplies We have $297,000 in this fund to pay for PH surge, vaccinations, healthcare workers, and supplies. The forum needs to decide how we want to spend this. We have $75,000 for the Mass Fatality consulting group (update $42,500 budgeted for the consultant) We are budgeting for some SAT phones HPP Funds for Alternate Care Site: Contracting a consultant We have money set aside to pay for a consultant to write an ACS plan, but one is not available. We need to decide what to do with the $102,000 in this fund. Questions presented to the Forum: Do we have needs in the H1N1 program? Do we need training in HICS? Do facilities have tools for evacuation, rescue and extraction? Kaiser has these tools Sonoma Valley has jaws of life and search and rescue, but they require training Do we want to do a Comm. Network Training with practicing MDs? Do we want CAHAN drills? Do we want to do Hospital Emergency Preparedness Team training? This is a Federal Training Program RESIG has a large training room Do we want to provide Facility Staff Trainings? PH has funds that could pay for hourly salary need to decide the dollar amount according to size of the facility need contracts in place, Kim will look into the number of facilities. H1N1 Grant Spending Suggestions Hospital Surge Tents Fire Marshall Permits Tents have to be set up and inspected Hospitals do not have any surge tents RCHC to bring clinics back into the emergency planning they did preparation work electronic medical records took clinic time hire a contractor to do site visits at clinics to get them on track need gap analysis to determine cost Comments get suggestions from the clinics to determine their need many clinics never participated in the HCDPF We need to assure that the entire community is ready. Ann Baechler met with SNFs in a piloted project. SNFs saw the benefit and they met 100% of their deliverables. Was there a similar outcome with the clinics? Anyone willing to contact the clinics? Kim offered to follow up. Next Meeting May 20, 2010 Thursday 9:30 am to 12:00 pm 475 Aviation Blvd, Santa Rosa, CA - 4 -

5 ACRONYMS ABAHO Association of Bay Area Health Officers ACS Auxiliary Communications System (i.e.: Ham Radios), organized through County DES ACS Alternate Care Site (government authorized ACS, as opposed to alternative locations planned by hospitals where they can move their patients) AAR After Action Report BT bioterrorism CAHAN California Health Alert Network (Internet based notification, alerting, and information sharing system used by State and local health departments, run by State) CAHF California Association of Health Facilities, education & advocacy for long term health care CCLHO California Conference of Local Health Officers CD Communicable Disease (also, Communicable Disease Unit of Public Health, usually called Disease Control or CD ) CDC Centers for Disease Control and Prevention, Atlanta, Georgia CDPH California Dept of Public Health CERT Community Emergency Response Team, neighborhood based disaster response teams trained (usually by fire depts. or Red Cross) in triage, light search & rescue, sandbagging, fire suppression, etc CHA California Hospital Association COPE Citizens Organized to Prepare for Emergencies, a Santa Rosa program similar to CERT CPCA California Primary Care Association, for not for profit community clinics DC Disease Control (as in Disease control Unit of Public Health, usually called Disease Control or CD DES Dept of Emergency Svcs, Sonoma County agency, not to be confused with State OES DHCV Disaster Healthcare Volunteers of California DMAT Disaster Medical Assistance Team DMORT Disaster Mortuary Operational Response Team DOC Department Operations Center, an emergency ops center at the department level ED Emergency Department of a hospital EDIS EMS Emergency Medical Svcs, we have Coastal Valleys EMS Agency, which covers Sonoma Napa Mendocino EMSA Emergency Medical Svcs Authority, California state agency EOC Emergency Operations Center (County Op Area) EOP Emergency Operations Plan EPO Emergency Preparedness Office, under the CDPH HCC Hospital Command Center (hospital EOCs) HEPA filter High Efficiency Particulate Air filter HICS Hospital Incident Command System, a hospital based ICS HO Health Officer HPP Hospital Preparedness Program (federal funds for hospitals and health facility partners for emergency planning and response, formerly HRSA) HRSA Health Resources Services Administration (federal funding for health center emergency planning, now called HPP) HVA Hazard Vulnerability Assessment I&Q Isolation & Quarantine IAP Incident Action Plan, used to plan activities during a disaster IC Infection Control ICS Incident Command System, an organizational structure used to command and coordinate people from different areas or agencies, doing different tasks, all in a coordinated response to a disaster JAS Job Action Sheet (same as position checklist) - 5 -

6 JCAHO Joint Commission on Accreditation of Healthcare Organizations (regulates hospitals), pronounced JAY co, now simply called The Joint Commission JIT or JITT Just in Time Training Logs Logistics (in the ICS organization structure) MCI Mass casualty incident MHOAC Medical Health Operational Area Coordinator MOC Medical Operations Center, San Diego s model for a health and medical center managing resources and implementing actions during a disaster MOU Memorandum of Understanding MPU Medical Planning Unit, concept in the planning stages for Sonoma County, similar to MOC MRC Medical Reserve Corps (Public Health registered volunteers) N 95 Respirators that filter 95% of airborne particles, the N stands for Not resistant to oils NIMS National Incident Management System, national standards and guidelines for managing disasters NPI Non pharmaceutical interventions, such as school closure or use of masks during pandemic flu OASIS OES Office of Emergency Svcs, a CA state agency, not to be confused with Sonoma County DES Ops Operations (in the ICS organization structure) PAHO Pan American Health Organization PAPR Powered Air Purifying Respirator (face mask with battery powered blower to move air through filters) PH Public Health PH DOC Public Health Division Operations Center (in Sonoma County, we call the DOC a Surge Center: PHN Public Health Nurse PHP Public Health Preparedness PIO Public Information Officer POD Point of Dispensing, aka mass dispensing site PPE Personal Protective Equipment (includes masks/respirators, gloves, goggles, booties, gowns, etc) PSAP RCHC Redwood Community Health Coalition, organization of community clinics in Sonoma, Marin, Napa, and Yolo. RDMHC Regional Disaster Medical Health Coordinator (an MD) RDMHS Regional Disaster Medical Health Specialist (carries out plans set by the RDMHC) REDCOM Redwood Empire Dispatch Communications (central dispatch for all Fire and EMS except Petaluma and Cloverdale) RIMS Response Information Management System (online messaging system between local EOCs and State, used during emergencies to report status and request resources from outside the local area SEMS Standardized Emergency Management System, California system for managing emergencies and coordinating resources and information to and from local areas to regional areas to the State SNF Skilled nursing facility SNS Strategic National Stockpile (CDC stockpile of meds and medical supplies and equipment) SUASI Super Urban Area Security Initiative, a coalition of UASI cities (San Francisco, Oakland & San Jose) who gathered with 10 Bay Area counties to apply for Homeland Security funds as a region, on the premise that disasters in urban areas will have major impacts to neighboring areas SOC State Operations Center - 6 -

7 TTX Tabletop exercise UASI Urban Area Security Initiative, US Dept of Homeland Security program and funds to prepare urban areas considered as potential terrorist targets for disasters WHO World Health Organization VOAD Voluntary Organizations Active in Disasters, a national program coordinating Salvation Army, Red Cross, and many other organizations during disasters. In Sonoma County, the VOAD is run jointly by Red Cross and Sonoma County Volunteer Center