Healthcare Preparedness in South Dakota or, How I learned to Stop Worrying and Love CMS Preparedness Rules

Andy Klitzke Hospital Preparedness Program Coordinator South Dakota State Department of Health 605-773-4412 Andy.Klitzke@state.sd.us Jan Clites Partnership Coordinator South Dakota Healthcare Coalition

Objectives for today’s presentation Describe the structure, functions, and members of the SD Healthcare Coalition including points of contact for technical assistance on preparedness, response, and recovery activities. Discuss activities required under the new CMS Preparedness Rule and how they apply to individual facilities Identify local, county, and state partners in preparedness.

What is a Healthcare Coalition?

A Healthcare Coalition is: A network of healthcare organizations and their respective public and private sectors response partners

Why do Healthcare Coalitions exist?

So who are we? Four (4) regional planning groups that supports healthcare organizations and communities through planning, organizing, equipping, training, exercising, evaluating, and networking Hospitals Long Term Care Clinics Home Health Services Mental and Behavioral Health Services FQHC’s Public Health Emergency Management EMS/EMS-C Volunteer Agencies National Guard Nation Weather Service SD Fusion Center

Where are we located?

Contacts for each regional coalition Region 1 Coalition: Andy Klitzke 605-773-4412 Andy.Klitzke@state.sd.us Region 2 Coalition: Alexandra Little 605-626-2227 Alexandra.Little@state.sd.us Region 3 Coalition: Samantha Hill 605-367-4510 Samantha.Hill@state.sd.us Region 4 Coalition: Carol Taylor 605-367-7496 Carol.Taylor@state.sd.us

What is our Mission. The mission of the Coalition is to enhance What is our Mission? The mission of the Coalition is to enhance statewide relationships for Healthcare Emergency Preparedness and Response

What is our vision? The vision of the Coalition is to significantly improve coordination of healthcare resources among and within the coalition.

Our Core Values: PARTNERSHIPS: effective relationships through a coalition exists to support healthcare organizations and save lives PREPAREDNESS: planning is based on a foundation of all-hazards approach from mitigation through recovery EXCELLENCE: members are recognized for their expertise and experience in emergency planning and response as related to healthcare needs

Our Structure: One (1) statewide healthcare coalition comprised of four (4) regional healthcare coalitions for planning and responding to an event A Governing Board comprised of the Regional Chairperson and at least one additional representative from each Region; the Executive Director; and SD DOH representative(s). Committees and workgroups with member representatives from each Region and organized under the umbrella of the SDHC Membership shall be open to all organizations that provide or support health services within the State that wish to work collaboratively on emergency preparedness and response activities.

Our work is based on Health Care Preparedness and Response Capabilities Capability 1 – Foundation for Health Care and Medical Readiness – build strong relationships; identify hazards and risks; plan, train and exercise Capability 2 – Health Care and Medical Response Coordination – share and analyze information, share resources and coordinate strategies Capability 3 – Continuity of Health Care Service Delivery - provide uninterrupted, optimal medical care to all populations Capability 4 – Medical Surge – sustain the ability to care for an increased volume of patients that exceeds normal capacity

Five Year Grant Period Working in close collaboration with internal and external subject matter experts (SMEs), ASPR and CDC developed a set of performance measures for 2017-2022 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 his or her investment.

The Fabulous CMS Preparedness Rule

Applies to 17 Provider Types Four Core Activities What we know: Applies to 17 Provider Types Four Core Activities Emergency Plan Policies and Procedures Communications Plan Training and Testing

17 Provider Types Hospitals Religious Nonmedical HCO’s Ambulatory Surgical Centers Hospices Psychiatric Residential Treatment Facility All-Inclusive Care for the Elderly Transplant Centers Long-Term Care Facilities Int. Care Facilities For Individuals w/ Intellectual Disabilities Home Health Agencies Comprehensive Outpt. Rehab. Facilities Critical Access Hospitals Outpt. PT & Speech Pathology Services Community Mental Health Centers Organ Procurement Organizations Rural Health Clinics Federally Qualified Health Centers End-Stage Renal Disease Facilities

Develop Emergency Plan Develop an emergency plan based on a risk assessment. Perform risk assessment using an “all-hazards” approach, focusing on capacities and capabilities. Update emergency plan at least annually.

Develop Policies and Procedures Develop and implement policies and procedures based on the emergency plan and risk assessment. Policies and procedures must address a range of issues including subsistence needs, evacuation plans, procedures for sheltering in place, tracking patients and staff during an emergency. Review and update policies and procedures at least annually.

Develop Communications Plan Develop a communication plan that complies with both Federal and State laws. Coordinate patient care within the facility, across health care providers, and with state and local public health departments and emergency management systems. Review and update plan annually.

Develop Training and Testing Program Develop and maintain training and testing programs, including initial training in policies and procedures. Demonstrate knowledge of emergency procedures and provide training at least annually. Conduct drills and exercises to test the emergency plan.

What we don’t know: Implementation Guide expected…….soon, so we don’t know what the test questions will be

Resources ASPR’s Technical Resource, Assistance Center, Information Exchange (TRACIE) https://asprtracie.hhs.gov/ Yale New Haven Crosswalk for all 17 Provider Types https://www.ynhhs.org/emergency/insights/library .aspx Local and industry partners SD Healthcare Coalition Members

How Does The Healthcare Coalition Help You With CMS Preparedness Rule Compliance?

How can we partner together? Source: Kansas Regional Preparedness Training 2012

Healthcare Coalitions offer a whole community approach to planning

Healthcare Coalitions can offer: Tools Resources Best Practices

Healthcare Coalitions may be able to provide some funding Each Regional Coalition has funding available to address preparedness gaps in their region and can combine efforts statewide. Target systematic gaps. Training Equipment It doesn’t hurt to ask.

Healthcare Coalitions can help you exercise your plans Examples of organizational exercises Members can serve as facilitators and/or evaluators Members can serve as participants to allow for inclusion of community Members can help connect you to partner agencies

Questions??? Concerns??? Stinging Rebuttals???