New York State Department of Health HANYS' Nursing Home Emergency Preparedness Webconference June 28, 2007

Emergency Operations Center (EOC) (Central command & control)  Responsible for carrying out principles of emergency preparedness  Ensure continuity of operations of the facility  Responsible for the strategic, or “big picture” of the disaster  Make strategic decisions & leave tactical decisions to lower command  Function is to collect & analyze data, make decisions that protect life & property, maintain continuity, disseminate those decisions to all concerned agencies & individuals  Usually one individual in charge  the Emergency Response Coordinator a.k.a. Emergency Manager

Critical EOC components: 1. Individuals who staff the EOC must:  Be properly trained  Be given the authority to carry out actions necessary to respond to a disaster  Be able to think outside the box (What if) 2. Communication system:  Simple word-of-mouth or sophisticated network  Must provide redundancy to ensure that information & orders can pass into & out of the facility without interruption

Command Post  Area where decision makers can gather  Locate in an area not involved in the emergency  Must have:  Copy of emergency response plan  Copies of MSDSs  Facilities plans, maps and blueprints  Employee lists & contact information  Contact information for local responders & utility/service companies  Radios, telephones & other communications equipment

Emergency Response Coordinator Individual who serves as coordinator of a facility’s emergency operations center A Contact Persons role in the Health Provider Network (HPN) Communications Directory The facility liaison with local/government emergency response systems

The Emergency Response Coordinator should have the authority to:  Assess the situation  Implement the facility emergency management plan  Determine the best response strategy  Secure the facility  Contact local authorities  Interact with local, state & federal agencies  Coordinate an ordered evacuation of the facility if indicated  Requisition needed supplies

Are you in charge?  Depending on the event, the emergency response coordinator might not be in charge for long  Try to anticipate what authorities may require  Keep a list of names, titles and contact information available for all local authorities  Know ICS (Incident Command System)  ICS 100 & 200 are available on line through SEMO

Communications Directory Drills  Roles to be contacted:  Administrator  Designated Pharmacist  Director, Nursing  Director, Patient & Family Services  Director, Safety/Security  Emergency Response Coordinator  HPN Coordinator  HPN Organizational Security Coordinator  Infection Control Practitioner  Medical Director  CHRC AP  24 hour contact [ found in Emergency Contacts (Any Time ) ]

Originally planned for June 2007  To be rescheduled  Goal remains the same:  To ascertain ability of a nursing home to receive information via the HPN through the designated Contact Persons  This is a facility’s chance to update Contact Person information in the Communications Directory  Suggest staging your own drills Communications Directory Drills

Health Provider Network (HPN) Communications Directory NYSDOH  In an emergency, or for routine business, NYSDOH is able to send immediate alerts to contacts, with a generic message on how to receive detailed information about the situation  NYSDOH  NYSDOH relies on facility HPN data accuracy HPN Coordinator (HPNC)  The HPN Coordinator (HPNC) is charged with this role HPN Coordinators  It is advised that there be back-up HPN Coordinators

NYSDOH Duty Officer  DAL sent via the HPN on 6/20/07  Duty Officer contact during non-business hours (5 pm to 8 am, and weekends & holidays)   ‘beeper message’ should include:  Name of facility  Name of ‘caller’  Number of ‘caller’  Reason for call  Note: location

HAN & the Communications Directory are the official NYSDOH directory & alerting system for emergencies

Communications Directory Emergency Office Contacts (Any Time)  24 by 7 Facility Contact-  Director of Nursing  Emergency Medical Supplies Receiving Office  Office of Administrator

Pandemic Influenza Planning Hypotheses:  Hospitals will be beyond maximum capacity  Hospital staff will be overtaxed  Decisions will have to be made at the state level to alter standards of care  Nursing homes have to retain residents normally transferred to hospital  Nursing homes will need to admit sicker residents  Nursing homes will have to surge beyond licensed capacity  Nursing home staff will be overtaxed

Pandemic flu roles of note:  Administrator-  Designated pharmacist-  Director, Nursing-  Director, Patient & Family Services-  Director, Safety/Security-  Emergency Response Coordinator-  HPN Coordinator (s)-  HPN Organizational Security Coordinator-  Infection Control Practitioner-  Medical Director-  Nursing Home Data Reporter  Plant Manager- Note: ‘-’ indicates Communication Directory drill role

Pandemic Flu  CDC has issued a document entitled “Long-Term Care and Other Residential Facilities Pandemic Influenza Planning Checklist”  checklist.html checklist.html  Identifies key areas for facility planning  Much of this has already been accomplished by nursing homes through current infection control planning and implementation

The majority of nursing homes have already established:  A Multidisciplinary Planning Committee  Points of contact with:  Local & state health departments & provider associations  Area hospitals  A written influenza plan that identifies the person(s) authorized to implement the plan (e.g., Medical Director, ICP)  A plan in place for surveillance & detection  A protocol for weekly/daily monitoring of seasonal influenza-like illness (in residents & staff)  A plan to provide education & training to ensure staff, residents & visitors understand basic infection prevention & control measures

Emergency Management Cycle  Mitigation: Taking sustained actions to reduce or eliminate long-term risk to people and property from hazards and their effects  Preparedness: Building the emergency management function to respond effectively to, and recover from, any hazard  Response: Conducting emergency operations to save lives and property  Recovery: Rebuilding communities to function on their own

Emergency Management Cycle

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Katharine Logan Health Systems Emergency Preparedness Office of Health Systems Management Hedley Park Place 433 River Street Troy, New York Phone: Fax: