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Background On September 16 th, 2016, the final rule on Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers was published. This rule affects all 17 provider and supplier types eligible for participation in Medicare. The rule became effective on November 15 th, 2016. Health care providers and suppliers have until November 15 th, 2017 to implement the new requirements and be in full compliance. 2

Who does this affect? 3

17 Supplier Types affected 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 4

Interpretive Guidance on CMS.GOV Surveyor Tool Advanced Copy Emergency Prep Interpretive Guidelines Frequently Asked Questions Documents 5

What work must be done? 6

Emergency Preparedness Checklist Develop Emergency Plans All Hazards Continuity of Operations (COOP) Plan Collaborate with Local or State Emergency Management Agencies Analyze Each Hazard Collaborate with Suppliers/Providers Decision Criteria for Executing Plan Communication Infrastructure Contingency 7

Develop Shelter-in-Place Plans Develop Evacuation Plans Transportation & Other Vendors Train Transportation Vendors/Volunteers Facility Reentry Plan Residents & Family Members Resident Identification Trained Facility Staff Members Informed Residents & Patients 8

Needed Provisions Location of Evacuated Residents Helping Residents in the Relocation Review Emergency Plans Emergency Planning templates Collaboration with Local EM, State, and Healthcare coalitions. Communication with the Long Term Care Ombudsman Program 9

Conduct Exercises & Drills Loss of Resident s Personal Effects. 10

Who will enforce CMS requirements? 11

Compliance: State Survey Agencies (SA), Accreditation Organizations (AOs) and CMS Regional Offices will be involved in monitoring for compliance as is the case with all other requirements for participation in Medicare. CMS does not regulate state and local emergency management agencies. However, facilities may seek to have their plans reviewed by preparedness officials. 12

Where can I find resources? 13

ASPR The U.S. Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response (ASPR) worked closely with CMS in the development of the rule. https://www.asprtracie.hhs.gov 14

CMS CMS has developed a website to assist providers and suppliers in meeting the requirements of the new rule. Website contains resources such as checklists, links to emergency preparedness agencies, planning templates and many other valuable resources. https://www.cms.gov 15

https://www.cms.gov Medicare (Heading): - Provider Enrollment & Certification - Survey & Certification - Emergency Preparedness - Templates & Checklists 16

Kentucky Healthcare Coalitions Reach out to the Healthcare Coalition Coordinators or Healthcare Preparedness Coordinators in your region. 17

Healthcare Coalition Coordinators HCC Region 2 Raymond Giannini Cell: 270-963-1052 Ballard Carlisle Hickman Graves Fulton Kentucky s Regional Hospital Preparedness Program Coalition Coordinators HCC Region 3 Jeffrey Rascoe 270-852-5564 1 Calloway HCC Region 1 Donna Lee 270-444-9625, x-175 Union Trigg HCC Region 5 Stefanie Goff 270-769-1601, x-1039 Henderson Webster Hopkins 2 Christian Daviess Todd 3 Ohio Logan Butler Breckinridge HCC Region 6 Vacant Grayson Warren 4 Meade Allen 5 Hardin Hart Barren HCC Region 4 Janarae S. Conway 270-781-8039 ext. 155 HCC Region 7 Jessica McElroy 859-363-2009 Henry Oldham Jefferson Bullitt Larue 6 Monroe Nelson Shelby Spencer Marion Taylor Adair Owen Woodford Mercer Boyle Casey Grant Wayne 7 Scott Lincoln 15 Harrison Fayette Pulaski 14 Bourbon Mason Robert son Clark Madison HCC Region 14 Amy Tomlinson 606-678-4761, x-1148 HCC Regions 8/9 Jacquelyn P. Campbell 606-674-6396, x-14 Fleming Bath Lewis Rowan Menifee Morgan Powell Wolfe Estill Lee Breathitt Owsley Laurel Whitley 13 Knox 8/9 Clay Bell 12 Leslie Perry Harlan Greenup Carter Elliot Lawrence 10/11 Knott Floyd Letcher HCC Regions 10/11 Gina Porter 606-886-2788 Martin HCC Region 13 Lonnie Saylor 606-337-7046 Pike HCC Region 12 Cory Waddell 606-785-3144 Updated March 3 rd, 2017 HCC Region 15 Dan Satterfield 859-899-4250 18

Regional HPCs 19

Regional Preparedness Coordinators Kentucky Department of Public Health REGIONAL PREPAREDNESS COORDINATORS Kim Yazell Regional Program Supervisor Nicholasville, KY 40356 KimD.Yazell@ky.gov Office: 859-885-4149 x 1029 Cell: 502-229--5573 Fax: 859-887-3683 Tina Massengill (R1) Marshall County HD 307 E. 12 th Street Benton, KY 42025 Tina.Massengill@ky.gov Office: 270-252-2710 Cell: 502-352-8504 Fax: 270-527-5321 Ballard Margaret Hibbs (R3) Green River District 1501 Breckenridge Street Owensboro, KY 42301 Margaret.Hibbs@ky.gov Office: 270-686-7747x3005 Cell: 502-352-3947 Fax: 270-926-9862 Carlisle Fulton 1 Graves Hickman Jim House Branch Manager 275 E Main Street, HS1E-J Frankfort, KY 40621 Office: 502-564-7243 x4034 Cell: 502-382-4722 Fax: 502-564-4387 Calloway Union Trigg Henderson Webster TBA(R2) Interim coverage by Tina Massengill and Margaret Hibbs Lyon County HD 211 W Fairview PO Box 96 Eddyville, KY 42038 Hopkins Christian RPC assigned to KY/TN Bordering Counties 3 2 Daviess Todd Ohio Logan Butler 4 Meade Breckinridge Grayson Warren 5 Allen Jerrod Wright (R4) Monroe County HD 452 East 4 th Street Tompkinsville, KY 42167 Jerrod.Wright@ky.gov Office: 270-487-6782 x 236 Cell: 502-682-4001 Fax; 270-487-5457 Kim Yazell (R15N) 210 E Walnut Street Nicholasville, KY 40356 KimD.Yazell@ky.gov Office: 859-885-4149 x 1029 Cell: 502-229--5573 Fax: 859-887-3683 Joey Riddle North Central; District HD 1020 Henry Clay Street Mike Harmon (R5) Shelbyville, KY 40065 Lincoln Trail District Joey.Riddle@ky.gov 108 New Glendale Rd Office: 502-633-1243 Elizabethtown, KY 42701 Cell: 502-682-4037 MichaelA.Harmon@ky.gov Fax: 502-543-2998 Office:270-769-1601 x 1010 Cell: 502-352-5047 Fax: 270-765-7274 Hardin Hart Barren Jefferson 6 Bullitt Larue Monroe Henry Oldham Nelson Shelby Spencer Marion Taylor Adair Jessica Gover (R14) Lake Cumberland HD 500 Bourne Ave, Suite B Somerset, KY 42501 Jessica.Gover@ky.gov Office:606-678-4761 x1295 Cell: 502-682-4019 Fax: 606-676-9691 Barbara Yates (R7) 1786 Commerce Parkway Lagrange, KY 40031 Barbara.Yates@ky.gov Office: 502-991-0530 Cell: 502-682-3788 Fax: 502-222-8723 7 Grant Wayne Mason Robert son Lewis Greenup Owen Harrison 8/9 Fleming 10 Carter Scott Bourbon Rowan 15N Bath rd Elliott o d fo Fayette Lawrence Clark Menifee Morgan W Powell Martin Mercer Madison Wolfe Estill Lee Floyd Boyle 15S Pike Breathitt Lincoln Owsley 12 Knott 11 Casey Perry 14 Pulaski 13 Laurel Whitley Sandy Glover (R 8/9) Rowan County HD 730 West Main Street Morehead, KY 40351 Sandra.Glover@ky.gov Office: 606-784-8954 ext.135 Cell: 606-359-4908 Fax: 606-783-1443 Knox Clay Rebecca Hardin (R15-S) Boyle County HD 448 South 3 rd St Danville, KY 40422 RebeccaL.Hardin@ky.gov Office 859-236-2053 BB: 502-352-8319 Fax: 859-236-2863 Bell Leslie Harlan Letcher Becki Patton (R13) Laurel County HD 525 Whitley Street London, KY 40741 Rebecca.Patton@ky.gov Office: 606-878-7754 Cell: 502-682-4052 Fax: 606-864-8295 Updated: January 4, 2017 John Hunt (R10) Lawrence County HD 1080 Meadowbrooke Ln. Louisa, KY 41230 JohnM.Hunt@ky.gov Office: (606) 638-0354 Cell: 502-682-4047 Fax: 606-638-3008 Kim Hall (R11) Floyd County HD 283 Goble Street Prestonsburg, KY 41653 Kimberly.Hall@ky.gov Office: (606) 886-2788 ext. 246 Cell: 502-682-4051 Fax: 606-886-9318 Jarrod Crase (R12) Breathitt County HD 955 Hwy 30 W Jackson, KY 41339 Jarrod.Crase@ky.gov Office: 606-666-7732 Cell: 502-682-3849 Fax: 606-666-4601 20

KDPH as a resource ESF 8 Health & Medical Coordinator Regional Epis Preparedness Branch Subject Matter Experts 62 Local Health Departments Deliverables for Health Care Coalitions and Local Health Department Preparedness Programs 21

KDPH Subject Matter Experts Staff dedicated to: Epidemiology Health & Medical Emergency Operations Planning, Training & Exercise Cities Readiness Initiative (CRI) Strategic National Stockpile (SNS) KHELPS/MRC 22

KDPH Subject Matter Experts Staff dedicated to: FAN IT Coordination/Communications Systems Local Health Department Preparedness Health Care Coalitions Inventory/Logistics 23

KDPH/LHD Resources Experience with planning, training, exercising COOP plans RPCs/LHDs collaborate with local EM Hazard Vulnerability with ADD and EM SIP Evacuation Transportation assets Family Reunification 24

KDPH/LHD Resources Staff preparedness training plans Communications Drills & Exercises (assembly, quarterly notification, state notification, 24/7) AAR/IP Health Care Coalitions Long Term Care Inventory & Maintenance 25

KDPH/LHD Resources Closed PODs Want to be one? Badging/Credentialing of staff/volunteers Shelter Surveillance Current list of FAN agencies Current list for hospitals/ltcs HCC meetings Patient Tracking HCC communication drills Accreditation 26

LHD Preparedness Training Plan Required Participants 1 staff at each HD Center (Clinic) 1 staff at each LHD/DHD 2 staff from each LHD/DHD Tier 1 Staff Tier 2 Staff Tier 3 Staff Tier 4 Staff Preparedness Staff Classes Lab Specimen Training X ERRT Training X PIO Training X Nuts and Bolts X X X X X IS100.b or IS100.HCb X X X X X Train to Local Plans (Annually) X X X X X IS700.a X X X X X IS200.b X X X X IS800.b X X X X WebEOC Training X X X IS-930 X ICS300 X X X FAN Awareness X X X ICS400 X X HSEEP * HAN Administrator * IS547.a * KHELPS * NEDSS * MDMS * 27

Collaborate & Document! Sign-in Sheets for every meeting Plans (Policies & Procedures not Operating Guidelines) Checklists Drills/TTX/Exercise needs an AAR (2 per year) Real event exempts agency from an exercise for a year (AAR must be written) Sign-in sheets/certificates for staff training 28

Kentucky Emergency Management http://kyem.ky.gov/ Who We Are (Heading): - Area offices - County Directors Ask about county plans, training, exercises & LEPC 29

Questions 30

Contact Information: Rebecca Hardin, CHES Region 15 South Regional Preparedness Coordinator Kentucky Department for Public Health (502)352-8319 Work Cell RebeccaL.Hardin@ky.gov 31