1. January 3, 2017 Denver Public Health Denver, CO
MFHCC Meeting
January 3, 2017
Denver Public Health
Denver, CO

2. Welcome and Introductions

3. Agenda Arrive, sign in, grab lunch Welcome & Introductions – Lisa
Review Previous Action Items – Janelle
Overview of New Regulations from Centers for Medicare and Medicaid Services (CMS) – Carolyn Elliott
2016 MFHCC Year in Review – Janelle and Lisa
Upcoming Trainings & Exercises – Janelle and Lisa
Radio Support for Healthcare Facilities – Christine Billings
Member Agency Spotlight: Dispatch Health & Eaton Senior Communities – Christine Greimann & Sarah Schoeder
Recap of The National Healthcare Coalition Preparedness Conference (NHCPC) & International Association of EMS Chiefs (IAEMSC), Dec.12-14, 2016 – Lisa Filipczak, Janelle Worthington and Nicolena Johnson
Agency Updates - All – Lisa
Review New Action Items – Janelle
Networking

4. Review previous action items
Janelle Worthington

5. Review Previous Action Items
Person responsible
Deadline
Contact Christine/Cali if interested in becoming a JCPH or Denver Closed POD.
All
On-going
Janelle or Lisa to sign up for workgroups of interest, including the full-scale exercise workgroup.
Member Spotlight - Janelle and Lisa if you would like to be featured on the website.
Distribute survey to gather feedback about the healthcare coalition merger and to identify training opportunities for 2017.
Lisa & Janelle
11/18/16
DONE
Cali will the Inventory Management System Excel form to all Denver Closed POD partners for confirmation and for POD site records.
Cali Zimmerman
TBD
Janelle

6. Overview of New Regulations from Centers for Medicare and Medicaid Services (CMS)
Carolyn Elliott
CDPHE

7. CMS Preparedness Rule - Hospital Preparedness Program (HPP) Technical Assistance Carolyn Elliott, MPH Healthcare Coalition Coordinator Office of Emergency Preparedness, CDPHE

8. Centers for Medicare & Medicaid Services (CMS) Emergency Preparedness Rule
The Federal Register posted the final rule Emergency Preparedness Requirements for Medicare/Medicaid participating Providers and Suppliers link:
The regulation went into effect on November 16, Healthcare providers and suppliers affected by this rule must comply and implement all regulations one year after the effective date, on November 16, 2017

9. The Good News…
Pages are Public Comments and Responses to the Proposed Rule
This is 82% of the document
CMS received nearly 400 public comments
Most comments centered around hospital requirements, but could be applied to the additional provider and supplier types.

10. Purpose
Rule Purpose: Establishes national emergency preparedness requirements for Medicare/Medicaid providers and suppliers.
Assists providers and suppliers to adequately prepare to meet the needs of their patients, residents, clients and participants during disaster and emergency situations.
Provides consistent emergency preparedness requirements, enhanced patient safety, and a more coordinated and defined response to disasters and emergencies.

11. Major Provisions
The Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers outlines four Core Elements which are applicable to all 17 provider types:
Risk assessment and emergency planning
Policies and procedures
Communication plan
Training and testing
Downloadable documents to assist in the preparation of these four elements can be accessed at:

12. Risk Assessment and Emergency Planning
Requiring facilities to perform a risk assessment that uses an “all-hazards” approach prior to establishing an emergency plan.
This approach is specific to the location of the provider or supplier and considers the particular types of hazards most likely to occur in their areas.

13. Policies and Procedures
Requiring that facilities develop and implement policies and procedures that support the successful execution of the emergency plan and risks identified during the risk assessment process.

14. Communication Plan
Requiring facilities to develop and maintain an emergency preparedness communication plan that complies with both federal and state law.
It is critical that hospitals, and all providers/suppliers, have a system to contact appropriate staff, patients' treating physicians, and other
necessary persons in a timely manner to ensure continuation of patient care functions.

15. Training and Testing
Requiring that a facility develop and maintain an emergency preparedness training and testing program.
Must include initial training for new and existing staff in emergency preparedness
Annual refresher trainings
Must offer annual emergency preparedness training so staff can demonstrate knowledge of emergency procedures.
Must also conduct drills and exercises to test the emergency plan to identify gaps and areas for improvement.

16. 17 Providers and Suppliers
Religious Nonmedical Healthcare Institutions
Hospitals
Ambulatory Surgical Centers (ASCs)
Home Health Agencies
Hospices
Comprehensive Outpatient Rehabilitation Facilities (CORFs)
Inpatient Psychiatric Services
Critical Access Hospitals
Programs of All-inclusive Care for Elderly (PACE)
Clinics, Rehabs, Public Health Agencies as Providers of Outpatient Physical Therapy and Speech-Language Pathology Services
Transplant Centers
Community Mental Health Centers (CMHCs)
Long Term Care (LTC) Skilled Nursing Facilities (SNFs)
Organ Procurement Organizations (OPOs)
Intermediate Care Facilities for individuals with intellectual Disabilities (ICF/IID)
Rural Health Clinics (RHCs)
End Stage Renal Disease (ESRD) Facilities

17. Where is your section? Provider and Supplier Type
Pages in the CMS EP Requirements
Religious Nonmedical Healthcare Institution
Ambulatory Surgical Center (ASC)
Hospice
Psychiatric Residential Treatment Facility (PRTF)
Program for All-inclusive Care for the Elderly (PACE)
Hospitals
States and Long Term Care Facilities

18. Where is your section? Provider and Supplier Type
Pages in the CMS EP Requirements
Home Health Agencies (HHA)
Specialized Providers
Starts on page 611
Comprehensive Outpatient Rehabilitation Facility (CORF)
Critical Access Hospitals
Clinics, Rehabilitation Agencies, and Public Health Agencies: Outpatient Physical Therapy and Speech-Language Pathology Services
Community Mental Health Center
Specialized Services Furnished by Suppliers
Starts on page 633

19. Where is your section? Provider and Supplier Type
Pages in the CMS EP Requirements
Organ Procurement Organization (OPO)
Certification of Certain Health Facilities
Starts on page 638
Rural Health Clinic/Federally Qualified Health Center (RHC/FQHC)
End Stage Renal Disease
Starts on page 643
Dialysis Facility

20. Key Benefits of HCC Membership
HCCs have access to regional risk assessments that could be made available to new providers
HCCs will have access to emergency response plans and plan development expertise to share with new providers, including sample templates and policies and procedures already developed by members
HCCs have access to information sharing platforms (EMResources, WebEOC) available to new providers in order to participate in communication planning
HCCs are currently offering preparedness and response training and exercises that can be helpful in meeting the training and testing requirement

21. What is ASPR TRACIE and how can it help you in achieving all four Core Elements?
In 2006 Congress saw a need for an agency to lead/coordinate America’s response to emergencies and disasters, thus the Assistant Secretary for Preparedness & Response (ASPR) was created in 2006.
ASPR TRACIE is comprised of three complementary domains:
Technical Resources (TR) – a self-service collection of disaster medical, healthcare, and public health preparedness materials, searchable by keywords and functional areas.
Assistance Center (AC) – provides access to Technical Assistance Specialists for one-on-one support.
Information Exchange (IE) – a user restricted, peer-to-peer discussion board that allows open discussion in near-real time.
here is the link:

22. Questions? Contact:
Carolyn Elliott – Healthcare Coalition Coordinator –CDPHE-OEPR

23. MFHCC Resources
Janelle and I will add some resources from the MFHCC website.
Janelle

24. MFHCC Resources
Janelle

25. Metro Foothills Healthcare Coalition - 2016 Year in Review
Lisa Filipczak and Janelle Worthington

26. Metro Foothills Healthcare Coalition Year in Review - 2016
1st meeting held March 1, 2016
Currently 158 members representing 84 agencies
2016 Trainings:
Community Inclusion in Colorado (CICO) Map Project (March and November)
Mass Fatality Training (April)
Continuity of Operations (COOP) (May)
Training and Exercises Planning (May)
Mass Fatality Training (May)
Active Shooter Panel Discussion (June)
Janelle

27. Metro Foothills Healthcare Coalition Year in Review - 2016
2016 Trainings Cont.
Responder Resiliency Training (September)
Medical Countermeasure (MCM) Training (August) and MCM Workshop (October)
Changes to Rules and Regulations Pertaining to Epidemic and Communicable Disease Control (November)
Ebola Tabletop Exercise (November)
First networking event (October)
Distributed and revised MFHCC charter and operational structure documents (December)
Janelle
Need Ideas for networking event

28. Metro Foothills Healthcare Coalition Year in Review - 2016
Thank you for hosting us for a member Field Trip:
Arvada Fire Protection District
Clear Creek EMS
Clear Creek Public & Environmental Health
Colorado Ambulatory Surgery Center Association (CASCA)
Denver Health Paramedic Division
Denver Water
Gilpin Ambulance Authority
Gilpin County Public Health
Jefferson County Sheriff’s Office of Emergency Mgmt.
Mental Health Center of Denver
Porter Hospital
St. Anthony Hospital
St. Joseph Hospital
Janelle and Lisa visited 13 different organizations during These visits are very helpful so we can see the capabilities, facilities, challenges and opportunities for our member agencies. We want to continue site visits in 2017, so please contact us if you’d like to give us a tour or meet at your facility.

29. Metro Foothills Healthcare Coalition Annual Survey
Lisa
Lisa Filipczak and Janelle Worthington

30. MFHCC Survey:
Survey sent in November/December of 2016 to all 158 members
Received 48 responses
= 30.4% response rate
Thank everyone who participated. We would like to share some high level results with you for a few key questions.
We will now look at responses to 6 of the questions.

31. MFHCC Survey:
87.5% either strongly agreed or somewhat agreed that the MFHCC fulfilled its mission.

32. MFHCC Survey
We received feedback on the annual survey that members would like to receive more information and examples of best practices. We will ask agencies to think about compiling and sharing examples of best practices going forward. This could be oral reports or information posted on our website, etc.

33. MFHCC Survey:
- One interesting comment here noted that, “We don't get the same details of what's happening in each jurisdiction, and in each facility. It's now more formal – more presentations, than conversations.” We always leave time for agency updates and we encourage people to come better prepared to share stories, news, updates, staffing changes, industry updates, etc. We admit that sometimes we run out of time at the end. We will ensure that we still dedicate 15 minutes for this at the end of every meeting. We have also implemented quarterly networking events in order to allow for more informal gatherings.
- For this and other slides, there are some responses as “unsure” or “neither agree or disagree.” Those replies were written by new members who refrained from responding or felt unable to comment.

34. MFHCC Survey: No one said the MFHCC is not beneficial!
Top response = networking = 80%
2nd response = new relevant information= 68%
61% training and exercises
49% Opportunity to present/share information
27% meeting grant deliverables
10% Other

35. MFHCC Survey:
95% either strongly agree or somewhat agreed that they are satisfied with the facilitation of the MFHCC

36. MFHCC Survey:
We included this question because we devote a great deal of time to updating the website. We want to make sure the content is valuable to our members. If you have any feedback or suggestions about the site, please let us know.
Read off:
19% have never visited the site – so there is more opportunity to make the content timely and relevant to our members
69% have visited 1-3 times

37. MFHCC Survey – Requested Topics for 2017:
Thanks for your responses! The Advisory Group met today to start planning for topics and trainings for We will work to prioritize the top requested topics. Since the survey was anonymous, if there are any topic areas that you would like to present on, let us know. If you were either not able to add input or have additional suggestions, let us know.
The advisory group met with us today to review the most

38. Changes to MFHCC Meetings:
NEW - Agency spotlight presentation
Addition to Operational Structure:
Beginning in January of 2017 and whenever possible, a member agency will be featured. This allows the MFHCC to learn more about its members, and provides the agency an opportunity to share its mission and programs and what support they could give or might need during an emergency.
Agency Updates – Continue to dedicate 15 minutes to each meeting for important updates and discussion by all members
- Based on the survey feedback, we will implement this starting this month. If you are interested in giving a brief presentation, please contact Janelle and Lisa. This will also be an opportunity to share best practices.
- The second bullet goes back to the feedback received on the annual survey that members would like to hear timely announcements by each agency. Please make a renewed effort to come prepared with announcements related to your agency, discipline, customers, county, etc.

39. Upcoming Trainings and Exercises
Lisa Filipczak and Janelle Worthington

40. Trainings and Exercises
Jan 6 (In Person) & Jan 9 (Virtual Meeting) CDPHE Crisis Standards of Care Stakeholder Meetings
Jan. 18 – “Disaster Behavioral Health Education: Education Fact Sheets to Enhance Preparedness and Response” Webinar, 9am, MST
Offered by National Center for Disaster Medicine and Public Health. Details in minutes and website.
Jan Joint Criminal-Epidemiology Investigations Workshop by CDPHE and the FBI, Greeley, CO, 8:30 am – 4:00 pm
Trauma Informed Care – Determine member interest
- If you are aware of any upcoming trainings and conferences, please send the details to Janelle and Lisa. If you have something unique to your discipline, let us know as we may not be aware of those opportunities. All trainings can be shared with MFHCC members and posted on the MFHCC website.
- CDPHE is seeking input into developing Crisis Standards of Care. They’re looking for participants that can engage in discussion at a policy level and critical decision making surrounding an event that might lead to Altered/Crisis Standards of Care.  Janelle ed the Crisis Standards of Care flyer in December.
- CDPHE and Denver Office of the FBI workshop focused on how law enforcement and public health work together to respond to potential bioterrorism or other events that require information sharing. Some of us have participated in this and found it valuable and interesting. A few flyers are up front.

41. Trainings and Exercises
Public Health Emergency Dispensing Exercise (PHED EX) – June 2017
Workgroup divided into two groups:
1. Denver PHED EX Workgroup
2. Jefferson/Clear Creek/Gilpin PHED EX Workgroup
Communications workgroup
Will meet to review draft plan and eventually test it
-Thank you to members who completed the PHED EX spreadsheet. We submitted details about resource requests to CDPHE.
- PHED EX next steps – We will reach out to people that signed up for PHED EX workgroup. If you would like to be involved with the communications workgroup, please us.

42. Radio Support for Healthcare Facilities
Christine Billings, Emergency Response Coordinator
Jefferson County Public Health

43. 800Mhz Radios - FAQs
If I am a Healthcare facility, who should I talk to when I have issues with my radios? 
Healthcare facilities having problems (i.e. connectivity, programming, etc.)  with their radios can contact Greg Stasinos of CDPHE or the entity which initially programmed their radios.
Where can I buy radios, and where can I have them programmed?
There are several vendors statewide who sell Motorola radios and can program them too. In order to not endorse or identify specific vendors, CDPHE (Greg Stasinos) would be happy to provide a list of contacts if needed. 
Does CDPHE do any type of support for the radios?
CDPHE allows hospitals to use their Hospital Preparedness Program (HPP) funding to purchase the radios and the CDPHE OEPR can provide training on 800Mhz radios upon request (again, contact Greg Stasinos).  

45. Member agency spotlight – Dispatch health & Eaton Senior Communities
Janelle Intro
Christine Greimann, Clinical Engagement Manager, Dispatch Health
Sarah Schoeder, Wellness Director, Eaton Senior Communities

46. Dispatch Health/Eaton Senior Communities

47. Recap of the nHCPC and IAEMSC conferences Washington, DC – Dec
NHCPC = National Healthcare Coalition Preparedness Conference
IAEMSC = International Association of EMS Chiefs
Lisa Filipczak
Janelle Worthington
Nicolena Johnson, Chief Paramedic, Clear Creek EMS

48. Conference Takeaways Lisa Janelle Nicolena
Lessons learned from Orlando Pulse Shooting
Situational Awareness for HCCs
Janelle
Involving State Department & Consulates
Changes with capabilities, funding requirements, and regulations. We will keep you updated about them as they relate to the MFHCC.
Nicolena
Presentation overview

49. Agency Updates - Lisa
Please mention brief updates you would like to share with the entire group
Include your name and agency name
High level reports applicable to various agencies
Updates requiring in depth discussions may transition into workgroups

50. Agency Updates Epidemiology Update Hospitals
Public/Environmental Health
EMS Provider
Emergency Management
Long Term Care
Mental/ Behavioral Health
Outpatient Medical Services (Example: community health center, clinic, dialysis, etc.)
Other HCC Partner (Example: education, private, federal entity, coroner, etc.).

51. Agency Updates
Public Health 24/7 Emergency Contacts Now Posted on our Website:
Denver Public Health 24/7 duty officer phone: (303)
Jefferson County Public Health (JCPH) Emergency Preparedness Response On Call 24/7 phone: (303)
To be used by any MFHCC member to report a facility issue, request assistance or alert the coalition that assistance might be needed.

52. Review New Action Items
Janelle Worthington

53. Thank you! Networking