Public Health Emergency Preparedness Hospital Emergency Preparedness

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Public Health Emergency Preparedness Hospital Emergency Preparedness Public Health Division 09/21/2015 Karen Olson, MPH, CHES Hannah Aalborg, MPPA Loni Howard, RN, MSN

Public Health Emergency Preparedness Program Karen Olson, MPH, CHES Public Health Emergency Preparedness Coordinator DHHS Public Health Division, County of Sacramento

Public Health Preparedness Goals Limit death and illness Preserve continuity of essential government and business functions Minimize social disruption Minimize economic losses People are prepared for emerging health threats - people in all communities will be protected from infectious, occupational, environmental, and terrorist threats Center for Disease Control and Prevention, Office of Public Health Preparedness & Response 3

Public Health Emergency Preparedness Pandemic and All-Hazards Preparedness Act Based on standard public health communicable disease control functions with disaster control focus Bioterrorism focus to All- Hazards

Public Health Emergency Preparedness Threats Pandemic Influenza New/Emerging Diseases Climate Change/Vulnerable Communities

Public Health Response 1. Public Health Surveillance and Epidemiology 2. Public Health Laboratory Testing 3. Emergency Public Information and Warning 4. Recommend interventions Distribute Medication Medical Surge Isolation and Quarantine

Public Health Response Planning 1. Planning 2. Training 3. Exercise 4. Evaluate After Action Reports

Medical Health Operational Area Coordinator (MHOAC) 17 Emergency Medical Services Agency Coordination and Communication Partners Emergency Medical Services Agency Environmental Management Department Office of Emergency Services (OES) Regional disaster and medical health coordinator (RDMHC)

MHOAC Functions Roles and Responsibilities Lead Agency Support Agency Coordination of Disaster Medical and Health Resources EMSA Public Health Coordination and integration with fire agency personnel, resources, and emergency fire pre-hospital medical services EMSA Public Health EMD Health surveillance and epidemiological analysis of community health Public EMD status Health Assurance of food safety EMD Public Health Management of exposure to hazardous agents EMD Public Health LEMSA Provision or coordination of vector control services Sac-Yolo Mosquito & Vector Control Public Health EMD Agricultural Commissioner Assurance of drinking water safety EMD DWR Public Health Assurance of the safe management of liquid, solid, and hazardous wastes EMD Sanitation Districts Agency Investigation and control of infectious diseases Public Health EMD

Sacramento County Hospital Preparedness Program and Healthcare Coalition Hannah Aalborg, MPPA Health Program Coordinator DHHS Public Health Division, County of Sacramento

Public Health Emergency Preparedness and Hospital Preparedness Program HPP-PHEP Cooperative Agreement Capabilities-based approach Building upon the strong preparedness foundation already in place Benefits More coordinated and integrated public health and healthcare service delivery system planning and response Improved ability to leverage funding for applicable activities and infrastructure Reduced burden regarding duplicative and conflicting activities and reporting

Healthcare Coalition Member Organizations (HCO) Hospitals (at least 1) Public health EMS providers Emergency Management Mental/behavioral health providers Specialty service providers (e.g., dialysis, pediatrics, woman s health, stand alone surgery, urgent care) Community Health Centers Long-term care providers Primary care providers Tribal Healthcare County Coroner Public safety Private entities associated with healthcare (e.g., Hospital associations) Support service providers (e.g., laboratories, pharmacies, blood banks, poison control) Federal entities (e.g., NDMS, VA hospitals, IHS facilities, Department of Defense) Volunteer Organizations Active in Disaster (VOAD) Faith-based Organizations (FBOs) Community-based Organizations (CBOs) Volunteer medical organizations (e.g., American Red Cross) 10/2012

Healthcare Coalition (HCC) 10/2012 16

Healthcare Coalition (HCC) Health and Human Services Definition of healthcare coalition (HCC): A collaborative network of healthcare organizations and their respective public and private sector response partners that serve as a multiagency coordinating group to assist with preparedness, response, recovery, and mitigation activities related to healthcare organization disaster operations. 10/2012

Healthcare Coalition (HCC) Purpose of HCC Healthcare system-wide approach for preparing for, responding to, and recovering from incidents that have a public health and medical impact in the short-and long-term. 10/2012 Primary Function of HCC Sub-state regional healthcare system emergency preparedness activities involving the healthcare member organizations (HCOs). This includes planning, organizing, equipping, training, exercises and evaluation.

The Common Purpose: To serve as a collaborative network of healthcare organizations to assist with preparedness, response, recovery, and mitigation activities related to healthcare organization disaster operations. California County based, but partner in several ways within the Regions Set up differently than most other states

Five Year Grant Period Working in close collaboration with internal and external subject matter experts (SMEs), ASPR, and CDC developed a set of new performance measures for each year that enable ASPR and its HPP awardees to: Enhance situational awareness Provide technical assistance Support program improvement and inform policy Increase transparency Promote sound stewardship of Federal tax dollars by using the data to assess impact of public funding and ensure that the American taxpayer sees a return on their investment

Health Care Coalitions are groups that integrate, coordinate and organize regional health care preparedness activities and response coordination. They re a key requirement in the 2012-2017 Hospital Preparedness Program (HPP) and Public Health Emergency Preparedness (PHEP) Cooperative Agreements These grants go to local public health agencies, hospitals, long term care facilities, nursing services and other local partners.

Healthcare Coalitions: Assist HCOs within their region to return to normal healthcare delivery operations DISASTER CYCLE Healthcare Coalitions: Address areas in critical infrastructure and key resource allocation planning that decreases the vulnerability of the healthcare delivery system Recovery Response Mitigation Healthcare Coalitions: Integrate with ESF8 to coordinate healthcare organizations priorities and needs to assist incident management with resource and information management during response. Disaster Preparedness Healthcare Coalitions: Follow the steps of the Preparedness Cycle to effectively mitigate, respond and recover from a disaster

Hospital Preparedness and Emergency Management Loni Howard, RN, MSN Emergency Preparedness Coordinator Sutter Medical Center, Sacramento

What is Emergency Management? 4 Phases of Emergency Management Mitigation Preparedness Response Recovery

Why do we do it? Regulations - The Joint Commission - California Department Public Health (CDPH) - Federal (NIMS) Because we need to be prepared - We have a vulnerable population we are responsible for

How do we do it? Based on a Hazard Vulnerability Analysis - Violent Persons, Code Silver, Active Shooter - Mass Casualty Incident(MCI) (medical/infectious) - IT Failure - Flood Based on driving forces ( disaster of the moment )

What do we do? Develop policies and procedures Learn from national standards and other s experiences Train Exercise Re-evaluate

What do we plan for Internal Events - Fire, Infant Abduction, Violent person, Power failure, Water failure External Events - Natural events, Accidents, Terrorism

Hospital Incident Command System Incident Commander Public Information Officer Safety Officer Liaison Officer Medical/Technical Specialist Operations Section Chief Planning Section Chief Logistics Section Chief Finance/ Administration Section Chief

Collaboration with other agencies Coordination with the Hazard Vulnerability Analysis Use of Incident Command System Importance of collaboration from the beginning of the disaster through recovery Understanding coordination with other agencies strengths and limitations

So Are We Prepared All the hospitals in county meet the regulatory requirements Much preparation has been put into place Planning for 96 hour resilience BUT A hospital can not stand up to all major disasters Dependence on Power and Water

Thank You QUESTIONS