1. NYCHCC: BP3 REVIEW MARC JEAN, MPH OFFICE OF EMERGENCY PREPAREDNESS AND RESPONSE NYC DEPARTMENT OF HEALTH AND MENTAL HYGIENE

2. DISCLAIMER STATEMENT “This project was supported by Cooperative Agreement Number 1U90TP000546-01 from the Assistant Secretary for Preparedness and Response (ASPR). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of Centers for Disease Control and Prevention and/or ASPR.” 2

3. OVERVIEW  Background  Purpose  Our Priorities  NYCHCC Organizational Chart  Big 5 Categories  Phased Approach  Analysis  Key Findings  Proposed Recommendations/Next Steps 3

4. PURPOSE 1)Establish a baseline of the NYCHCC 2)Provide a snapshot of the coalition work from 2014-2015 3)Inform the preparedness work for BP5 and beyond 4)Identify promising practices that we could adopt for future coalition development 4

5. OUR PRIORITIES Increase preparedness of healthcare system for all hazards. OEPR Goal #1: Increase preparedness of healthcare system for all hazards. BHSR Strategic Priorities Priority 1Healthcare Sector Integration Into Jurisdictional Health/Medical Planning and Response Priority 2 Coalitions as Drivers of Facility Preparedness and System-Level Response Priority 3Strengthening Facility Preparedness and Resiliency 5

6. THE NYCHCC …is a collaboration of health care and non-health care partners …is organized in support of the citywide incident management structure …is to prepare for and respond to an emergency, mass casualty or catastrophic health event …is to increase the NYC health care system’s capacity to protect New Yorkers during emergencies. 6

7. NYCHCC ORG CHART NYCHCC Subject Matter Expertise Network/Systems Advisory Group Bronx Brooklyn ManhattanQueens Staten Island 7

8. BIG 5 CATEGORIES Assess Plan TrainExercise Communications/ Situational Awareness 8

9. BP3: ENGAGEMENT  Investing in coalitions as drivers of facility- and system- level preparedness  Building on prior coalition work, 17 funded coalition groups  Incorporated the following five capabilities (the “Big 5”) in their planning and designing of BP3 deliverables  Creating a commonality of health care emergency preparedness city-wide 9

10. THE APPROACH Phase 1 Collected and reviewed all coalition SOWs from BP3 Coded by key words list Summarized and re-tagged all deliverables by Big 5 Categories Phase 2 Reviewed all coalition deliverables from BP3 to confirm what was completed and listed deliverables by Big 5 Categories Phase 3 Performed 1 st level of analysis on deliverables to describe results, trends, and reach Phase 4 Performed 2 nd level of analysis on deliverables to describe depth of deliverables 10

11. IN ORDER TO DO THIS, WE… Phase 1 Proposed Work  Collected all coalition-related SOWs and entered deliverables into matrix “as-is”  Summarized all deliverables  Developed Word Clouds for each Big 5 Categories to build a key words list  Re-tagged deliverables to Big 5 Categories based on key words list Phase 2 Completed Work  Through Salesforce, compared proposed vs paid out deliverables  Identified completed work in matrix Phase 3 Analysis  Using Excel, enumerated coalition activities (count, value)  Administered survey to coalition point-of-contacts for membership composition and reach 11

12. SCOPES OF WORK 12

13. WORD CLOUDS  Image composed of words used in a particular text or subject, in which the size of each word indicates its frequency or importance  Used to develop key words list and retag the deliverables based on findings 13

14. ASSESS n=97 14

15. PLAN n=143 15

16. TRAIN n=116 16

17. EXERCISE n=86 17

18. COMM/SIT AWARENESS n=87 18

19. SCOPES OF WORK MATRIX BIG 5ASSESSPLANTRAIN SME Coalition Completed in DOHMH and NYC EM Mapping Project Participated in the New York City Healthcare Coalition Leadership Council and Emergency Preparedness Symposiums; Attended ACF Sector ESF-8 Quarterly Readiness Meetings Participated in ACF Emergency Preparedness Webinar and Audio Conference Series; Organized Annual NYC ACF Emergency Preparedness Meeting; Participate in the Long-Term Care Emergency Management Program and Advisory Board Borough Coalition Risk Assessment Working Group; Risk Assessment Tool; Analyzed and prepared a summary Drafted charter; Risk Assessment Work Group; Developed guidelines and CONOPS for a Staff Support Center (SSC) Social Work Disaster Response Team (SWDRT) provided input to SSC guidelines; Attended the Bill Lane Social Work Disaster Mental Health Conference Network/Systems Coalition Inventory of ambulatory care assets and capabilities for members Drafted charter; developed list of required resources needed to execute strategies; developed protocol to expand SNF bed capacity; Developed plan outline to use ambulatory care members; Developed training program for non-hospital members Trained supervisory staff on bi- directional communication protocols; Trained non-hospital coalition members 19

20. MATRIX BY VALUE & COMPLETION$3K $10K $3K $4K 20

21. FINDINGS  Deliverables  Allocation of Tagged Activities by Count  Allocation of Tagged Activities by Value  Other Findings  Current “Reach” of NYCHCC  Coalition By the Numbers 21

22. DELIVERABLE SUMMARY Number of Contracts Executed in BP322 Total Number of Deliverables160 Value of All Coalition Work in BP3 (total)$1.4M Number of Deliverables/Coalition (median)9 Completed Work in BP3 (total)98% n=160 Proportion of Deliverable Activities by Coalition Type, FY14-15 22

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28. OTHER FINDINGS  SME coalitions tend to have multiple contracts  ASSESS: 23% coalitions developed and implemented a risk assessment tool (including all borough coalitions)  PLAN: 53% drafted a coalition charter describing structure and governance  TRAIN: All SME coalitions completed an in-person training  EXERCISE: 56% completed at least one operations-based exercise  COMM/SIT AWARENESS: 80% revised/completed communications protocol 28

29. HHC – 11H, 5N, 6P Montifiore – 4H, 22P NYP -10H, 3N, 24P, 3S NSLIJ – 21H, 3N, 34A, 450P, 3S, 1O MediSys – 2H, 1N, 12P MSHS – 294 Practices Network 7 1 PDC – 55H, 4N 3 NHTAs – 173N 4 ACFTAs – 77A 20PCNs, 297P 106DC TBC – 10H, 2N, 2O SI COAD – 2H, 22O BEPC – 7H, 5N, 1O NYcHRC – 192H, 20N, 900P, 5O borough (Queens) City Gov’t 29

30. BY THE NUMBERS NYCHCC comprises…  All NYC hospitals  90% of all nursing homes  80% of ACFs  City and state trade associations  Nontraditional healthcare preparedness partners  CBOs, FBOs, Academics, Associations, Pharmaceutical Providers, Environmental Contractors, Medical Equipment Providers, Mobile Medical Units, etc. Membership goes beyond NYC Estimated total reach = >2,000 members 30

31. PROPOSED RECOMMENDATIONS  Develop coalition membership profiles  Indicate coalition status throughout the development cycle and ensure current structure supports movement through this cycle  Build a formal annual assessment tool  Consolidate the number of contracts 31

32. NEXT STEPS  Strengthening the 5 Core Capabilities while focusing on training and exercises  Building out the overarching NYCHCC structure to include a place for all participating organizations and individual members  PHASE 4: Promoting, at every opportunity, the sharing of promising and best practices 32

33. QUESTIONS? Marc Jean, MPH CDC Preparedness Field Assignee Office of Emergency Preparedness and Response NYC Department of Health and Mental Hygiene E: MJean7@health.nyc.govMJean7@health.nyc.gov O: 347-396-2709 33