MARK SPRINGER SPOKANE REGIONAL HEALTH DISTRICT Partnership with Red Cross and Public Health

Presentation Outline Overview of SRHD and Eastern WA Red Cross Co-Location Agreement Red Cross Shelter Training ACF/Red Cross SOPs The Medical Consultant Challenge Next Steps…

SRHD - Overview SRHD is the lead county in Region 9 Region 9 Health Care Coalition ACF assets include:  2 ACF trailers with 30 cots and 10 E-Beds on each  1 ACF trailer with 40 E-Beds Medical Reserve Corp assets include:  158 credentialed volunteers  22 health care workers  87 mental health workers  49 support staff  Two 30 person teams

Eastern WA Red Cross - Overview 7 chapters (Ellensburg, Kennewick, Okanogan, Spokane, Walla Walla, Wenatchee & Yakima)  Serve 22 counties in Washington & Idaho 2012 snapshot of Red Cross activities  331 disaster responses  1062 disaster victims assisted  15 full time employees  1774 trained volunteers

Alternate Care Facility (ACF) Defined… An ACF may be set up to provide basic medical care during a natural disaster or public health emergency when:  Patients are displaced and cannot be accommodated at a general population shelter due to the complexity of their medical needs; and  The number of displaced persons exceed the normal surge capacity of existing regional healthcare facilities.

Why Co-Location for SRHD? Efficiencies can be realized in ACF planning when co-location is considered.  Facilities – more and new facilities; updated facility surveys  Staffing – large volunteer pool that is familiar with sheltering  Logistical Support – support for feeding and shelter wrap- around services  Experience – Red Cross shelter management staff have experience with running shelters in disaster scenarios Allows families to stay in the same facility. Allows more opportunities for MRC and public health staff to train, exercise and participate in disaster response.

SRHD/Red Cross Co-Location Agreement Each party maintains its own identity as well responsibility for its own policies and financing. Each party will participate in joint planning, training and exercising with respect to co-location. SRHD may provide limited logistical support (trailers, vaccines, medications) as well as staff to support surge of clients with more complex medical needs. Red Cross may provide facilities, shelter management, and non-medical logistical support for ACF activities.

Co-Location Agreement Limitations Limited to Inland NW Chapter of Red Cross and SRHD with plans for Region 9 LHJs. Activation based on community reaching a trigger based on number or percentage of clients who have more complex medical needs. Limited number of shelter facilities that could serve a dual purpose. Red Cross and MRC staff are not committed to other disasters outside of Spokane County.

Co-Location – Training Options

Standard Operation Procedures (SOPs) What are they? What has been developed to date?  Client registration, triage and ACF admission  Transfer clients from the ACF to the general shelter  Working with families split between the ACF and the general shelter  Transfer of DME, medications and medical consumables between the ACF and general shelter  Closure of the general shelter prior to the ACF closure

Side Note – the Medical Consultant This is a role to support the Local Health Officer (LHO) in a disaster where the LHO is not easily available for clinical consultation for providers and staff who are acting under his/her license. This role may:  Act as a prescription authority for an ACF;  Consult regarding patients in isolation/quarantine;  Provide referrals for testing, imaging or specialty consults;  Answer questions regarding clinical care for providers in an ACF. This role should be pre-assigned in a community to a hospital, group practice, or individual provider.

Medical Consultant – Questions? How is liability shared? How are crisis standards of care addressed? How can technology assist with providing information to the medical consultant? Should the consultant be a single individual or be distributed role among a group of providers? How does public health contract for this service? How might this service be regionalized?

Next Steps in Spokane Approval and expansion of co-location standard operating procedures.  Client records  Patient tracking  Role of caregivers and client volunteers Cross training of MRC volunteers  Red Cross Shelter Training Fall table top exercise with SRHD and Red Cross.

Questions For info or questions:  Mark Springer  