MEDICAL SURGE Public Health and Medical System Planning to Promote Effective Response Nora O Brien, MPA, CEM Connect Consulting Services
April 10, 2012 Partnership in Preparedness Conference 2 Presentation Agenda Overview of Healthcare Emergency Preparedness planning Public Health Preparedness Program (PHEP) Hospital Preparedness Program (HPP) Emergency System for Advanced Registration of Volunteer Professionals (ESAR-VHP) Grant Alignment and planning opportunities Healthcare Emergency Management Resources Questions and Answers
April 10, 2012 Partnership in Preparedness Conference 3 Speaker Introduction: Nora O Brien, MPA, CEM CA Primary Care Assoc (01 09), created the Clinic Emergency Preparedness Project Created community health center (CHC)- specific tools, EOP plan, and ICS trainings adopted throughout the country Secured $28 million in emergency supplies, planning, and training Hospital Preparedness Program (HPP ) funding for CPCA and CA CHCs Connect Consulting Services (09- present) Healthcare emergency management firm that works with healthcare organizations in 12 states to enhance their EM programs Serving on CA state projects to exercise the ESAR-VHP program and to create the EF- 8 Public Health and Medical Annex to the CA EOP Center for Domestic Preparedness Instructor (11- present) Teach the Advanced Public Information Officer Course for Hospital and Healthcare Emergencies Masters of Public Affairs, Disaster and Emergency Management (2008); Certified Emergency Manager (2010)
April 10, 2012 Partnership in Preparedness Conference 4 Centers for Disease Control Emergency Preparedness Funding Public Health Emergency Preparedness (PHEP) supports state and local public health departments preparedness programs nationwide to enable public health departments to have the capacity and capability to effectively respond to the public health consequences of not only terrorist threats, also infectious disease outbreaks, natural disasters, and biological, chemical, nuclear, and radiological emergencies. Administered by the Center for Disease Control and Prevention within the US Department of Health and Human Services PEP funds projects such as state and local laboratory enhancements, planning, syndromic surveillance programs, and training of the public health workforce. 5 year grant cycles and the state health departments administer the PHEP grants to the local health departments Department of Health (DOH) is grant administrator for WA
April 10, 2012 Partnership in Preparedness Conference 5 PAHPA Act of 2006 In 2006, the Pandemic and All-Hazards Preparedness Act (PAHPA) established the Assistant Secretary for Preparedness and Response. ASPR s mission areas cover a wide array of preparedness and medical response capabilities, including the National Disaster Medical System (NDMS) its Disaster Medical Assistance Teams (DMATs),the Biomedical Advanced Research and Development Authority (BARDA), the National Health Security Strategy (NHSS), and the Hospital Preparedness Program. ASPR Report on the First Five Years of HPP- ASPR HPP First Five Report
April 10, 2012 Partnership in Preparedness Conference 6 ASPR s Hospital Preparedness Program Administered by the Assistant Secretary of Preparedness and Response (ASPR) within the US Department of Health and Human Services The Hospital Preparedness Program (HPP) is an allhazards preparedness grant program with specific concentration on interoperable communication systems, bed tracking, personnel management, fatality management planning and hospital evacuation planning. HPP funds have also improved bed and personnel surge capacity, decontamination capabilities, isolation capacity, pharmaceutical supplies, training, education, drills and exercises for hospitals, community clinics, long term care agencies, and specialty care providers. 3 year grant cycles and state health departments administer the HPP grants to the healthcare providers their state based upon need and state funding priorities
April 10, 2012 Partnership in Preparedness Conference 7 PHEP and HPP Planning Guidance Alignment CDC PH National Planning Guidelines for Public Health Preparedness Capabilities- 7/11 15 national public health preparedness standards ASPR Hospital Preparedness Program Healthcare Preparedness Capabilities- 1/12 8 healthcare preparedness capabilities Both PH and HC Capabilities are aligned or nested to support overall health preparedness
April 10, 2012 Partnership in Preparedness Conference 8 Public Health Preparedness Capabilities Biosurveillance Public Health Laboratory Testing- Public Health Surveillance and Epidemiological Investigation Community Resilience Community Preparedness - Community Recovery Countermeasures and Mitigation Medical Countermeasure Dispensing Medical Materiel Management and Distribution - Non- Pharmaceutical Interventions Responder Safety and Health Incident Management Emergency Operations Coordination Information Management Emergency Public Information and Warning - Information Sharing Surge Management Fatality Management Mass Care - Medical Surge - Volunteer Management
April 10, 2012 Partnership in Preparedness Conference 9 Healthcare Preparedness Capabilities In January 2012, ASPR released the HC Preparedness Capabilities Planning Document that are aligned in the following 8 areas: Healthcare System Preparedness Healthcare System Recovery Emergency Operations Coordination Fatality Management Information Sharing Medical Surge Responder Safety and Health Volunteer Management
April 10, 2012 Partnership in Preparedness Conference 10 PH and HC Medical Surge Planning FY 2012 Guidance Joint PH and HC Joint Planning Activities Exercise planning and conduct Healthcare coalition planning Implementation of joint capability resource elements and tasks Information technology services Health Alert Networks (HAN) Communication platforms Medical Surge FY 2012 Requirements Planning target is assigned for healthcare organizations to meet surge requirements as follows: The percent of healthcare coalitions that have a coordinated mechanism in place to provide an appropriate level of care to all patients (including pre-existing patients [both inpatient and outpatient], non-disaster-related patients, and disaster-specific patients) that includes providing bed availability for 20% above the daily census within 4 hours of a disaster.
April 10, 2012 Partnership in Preparedness Conference 11 HPP Coalition Projects Since 2007, HPP has funded the development and maintenance of healthcare coalitions on a regional or local level that support preparedness planning throughout the health care delivery system hospitals, primary care, long term care, mental health, etc. In the, the US HHS report on HPP Coalitions outlines each of the project awardees by state that highlights those coalitions efforts to improve medical response coordination As the PHEP and HPP program become aligned in 2012, both grant priorities will shift to support more coalitions building amongst healthcare partners Healthcare Coalitions Five Year Report
April 10, 2012 Partnership in Preparedness Conference 12
April 10, 2012 Partnership in Preparedness Conference 13 PHEP and HPP Grant Alignment Starting in 2012, there will be 1 application submitted by state health departments for both the PHEP and the HPP programs Alignment goals Increase program impact and advance preparedness and response Reduce awardee burden: one-stop shopping ASPR continues to exercise oversight of HPP-specific activities and requirements CDC continues to exercise oversight of PHEP-specific activities and requirements Each remains a stand-alone program in accordance with its authorizing legislation Aligned grant cycles- July 1- June 30 CDC 5 year planning cycles HPP- 3 year planning cycles
April 10, 2012 Partnership in Preparedness Conference 14 PHEP and HPP Grant Alignment HPP PHEP Grant Alignment Process One FOA One Application One Award Awardees Source: ASPR
April 10, 2012 Partnership in Preparedness Conference 15 Alignment Potential Impact on Disaster Planning Communities With less grant administrative burden of two applications, more funding will be available to support overall healthcare system preparedness The emphasis of regionalization on the HPP guidance supports broadening regional definitions Public health and medical preparedness capabilities guidance supports better integration of communities resources Those states with existing regional emergency planning infrastructure will benefit initially
April 10, 2012 Partnership in Preparedness Conference 16 Linkages to Other Disaster Planning Partners PH and HPP FY 2012 Requirements: Integrate preparedness efforts across jurisdictions. Awardees must establish and maintain advisory committees comprised of senior officials from governmental and nongovernmental organizations involved in homeland security, healthcare, public health, and behavioral health to integrate preparedness efforts across jurisdictions and to leverage funding streams.
April 10, 2012 Partnership in Preparedness Conference 17 MEDICAL SURGE PLANNING RESOURCES
April 10, 2012 Partnership in Preparedness Conference 18 CDPH Healthcare Surge Standards and Guidelines Project The 2006-07 CA State Budget provided $5 million in General Funds to develop standards and guidelines for healthcare delivery during surge events. The CA Department of Public Health (CDPH) developed standards such as facility and worker liability, reimbursement, operation of alternate care sites, and surge plan templates for healthcare facilities and communities. Five volumes created for hospitals, alternate care sites, payers, clinics, and long term care agencies Public domain Tools, training and templates are available at: Health care Surge Standards and Guidelines Project
April 10, 2012 Partnership in Preparedness Conference 19 Hospital Surge Capacity Toolkit This toolkit is intended to assist healthcare facilities in thinking through critical issues related to healthcare surge and to create plans to address these needs including: Providing medical surge capacity Patient tracking within the hospital and during patient forwarding activities Requesting resources Establishing alternate care sites Hospital Surge Capacity Toolkit is funded by the National Association of City and County Officials Advanced Practice Center for more visit: APC
April 10, 2012 Partnership in Preparedness Conference 20 Questions or Comments? Nora J. O'Brien, MPA, CEM, Principal Consultant, Connect Consulting Services 1104 Corporate Way, Sacramento, CA 95831 (916) 806-7361 NoraOBrien@me.com www.connectconsultingservices.com