1. Don Sheldrew Rachel Mockros
Central Minnesota Healthcare
Coalition
Looking behind and ahead
Don Sheldrew Rachel Mockros
Long time coming – Increasing partners

2. Purpose Mission statement
The Central Minnesota Healthcare Preparedness Coalition serves our communities in collaboration with other partners to coordinate emergency preparedness, response and recovery activities.

3. Hospital Preparedness Program Health Care Coalition
Definition:
Collaborative network of healthcare organizations and their respective public and private sector response partners
Multi-Agency Coordinating group that assists emergency management, local and regional partners with activities related to healthcare organization disaster operations
Has mitigation, preparedness, response, and recovery roles
NOT a command and control function

4. Healthcare Preparedness Program(HPP) Evolution
Facility-based equipment purchasing approach
HPP funding was disbursed directly to hospitals for establishing regional partnerships and purchasing equipment and supplies, including personal protective equipment, mobile medical units, and pharmaceutical caches.
Development and Strengthening of HCCs and Healthcare Capabilities
HPP funding focuses on the development of HCCs and support of their members. Awardees disbursed funds to promote health care capabilities.
2017 and Beyond
HCCs operationalized to respond
HPP funding will focus on operationalizing HCCs for effective response by optimizing their membership, as well as population and geographic coverage.

5. Health Care Coalition Response Functions
Promote situational awareness
Facilitate resource sharing/coordination
Facilitate information sharing
Facilitate coordination of incident response actions among member organizations
Promote efficient interface of member organizations with jurisdictional authorities
Support the request and receipt of assistance from local, State and Federal authorities
We do not take command and control

6. Hospital Preparedness Program Funding
Enables health care systems to save lives during emergencies that exceed day-to-day capacity of health and emergency response systems.
The only source of federal funding that supports regional health care system preparedness
Promotes a sustained national focus to improve patient outcomes, minimize the need for supplemental state and federal resources during emergencies, and enable rapid recovery.
Prepares the health care system to save lives through the development and sustainment of regional health care coalitions (HCCs) that incentivize diverse and often competitive health care organizations with differing priorities and objectives to work together.
Hospital Preparedness Program Funding
Bottom Bullet – Day to day competition

7. Current Grant Funding Defines the parameters of the grant
Provides clear expectations and priorities
Intended to ensure focus on the Health Care Preparedness and Response Capabilities
Health Care Coalition focused

8. Funding Flow Federal Congress
Assistant Secretary of Preparedness and Response (ASPR)
State
States – Minnesota Department of Health (MDH)
Regional
Regions – Central Region
Local
Local Partners - Hospitals

9. HCC Core Membership – Enabling HCC Response
While HCCs should have diverse membership, there are four core members that must be present.
Community Partners
Academic Institutions
Non-profits
Volunteers
Elected Officials
Fire Departments
Police Departments
Long Term Care
Skilled Nursing Facilities
Hospice Care
Hospitals
Public Health Departments
Outpatient Facilities
Primary Care
Specialists
Health Care Coalition (HCC)
Health Centers
Rural Health Centers
Community Health Centers
Local Government
Emergency Medical Services
Home Health Agencies
Emergency Management Agencies
Behavioral and Mental Health
Centers and Agencies
Physicians

10. Where We Are At Currently
Why Participate?
Mandated
Money
Motivated by Value
Where We Are At Currently
RACHEL
We participate in emergency preparedness activities for many reasons and it is up to each facility to determine what motivates them to do the work.

11. Mandates and Compliance
Requirements:
Joint Commission
CMS – in place November 15, 2017
HPP/PHEP grant requirements
Impacts:
Sets minimum standards across board
May not understand the value – could feel like very detailed work to meet uncertain of outcomes
Burdensome
Just doing enough to barely be compliant – to appease the surveyors
Failure to meet requirements can impact status and funding

12. Financial
“The future of the 22 mature, well established TX HCCs is currently at risk due to federal NHPP funding cuts.”
(NACCHO, 2014)
Sources:
ASPR (assistant secretary for preparedness and response) - Hospital Preparedness Program Grant
CMS Emergency Preparedness Rule – reimbursement tied to compliance
Individual healthcare facilities
Other??
Impacts:
Financial investment = Training and exercises → enhanced response capacity and capability
Activities tied to funding parameters → not all HCC members needs are met
Decreased funding = decreased ability to conduct core coalition planning and exercise functions, staff impact = less collaboration and sharing of resources and practices

13. Value Motivation Value-Added Concepts (High Functioning Coalition):
Commitment, shared goals and ideas
Coordinated response
Information sharing and situational awareness
Technology adjuncts
Impacts:
Some degree of continuity despite funding changes or loss
Relationship building
Common operating picture
Adaptation and innovation
Sustainment
Value Motivation
What does it mean to be motivated by value and work as a coalition?
High functioning coalition – members are committed, have common goals and objectives, capability to coordinate response and direct efforts to meet the common good of all the members
We currently are operating as a high functioning coalition
By continuing with a high functioning coalition we are able to work towards sustainment

14. Health Care Coalition (HCC) Sustainability
Sustainability planning is a critical component in HCC development
Strong governance mechanisms, constant regional stakeholder engagement and sound financial planning form the foundation to continue HCC activities well into the future
Health Care Coalition (HCC) Sustainability
Our mindsets on how to sustain coalitions are starting to shift from how can ASPR support us to how can we support ourselves. We approaching a phase of developing sustainment strategies that may or may not include grant funding. By moving towards supporting ourselves, sustainment is not only achieved, but greater engagement by it’s members, greater stake in decisions that are made, and strategic planning based on the needs of the coalition and financial resources.

15. What Does All This Mean for Executives?
Understanding and influence
Ultimate responsibility for compliance
Provide support and tools for staff doing the work
Identify resources (staff, equipment, space)
Promote effective and efficient work processes (i.e. collaboration, information sharing, coordination, resource sharing, etc.)
Participation during practice opportunities
What Does All This Mean for Executives?
As the coalition continues to evolve to a more sustainable model, it is important for Executives to understand the purpose, vision and goals of the coalition. Executives can influence this work in may ways, at the facility level, at the coalition level, and through trade associations,
Responsibility!
We understand that emergency preparedness and safety may be assigned to someone other than yourself in your facility, please do assure those staff have the tools and support necessary to do the work reasonably. Assure that proper FTE’s are dedicated to at minimum be compliant and at maximum be fully engaged with the coalition.
We believe that by being an active member of the coalition, your facility will be able to more effectively and efficiently meet the emergency preparedness and safety needs in a more efficient and effective manner.
When an event impacts your facility, the Executive team will ultimately be responsible for some major decisions. Practice with your team so when you do need to respond and manage an event, it becomes more seamless.

16. Looking Ahead Where Do We Want To Go?
Planning for a Self Determined group
Increased ability to provide for facility and coalition level needs
Determine important items at the coalition level
Plan for funding outside of the Federal parameters
Planning for long term functioning
Maintain and augment structures that work for us
We want to move towards a group that has greater influence in meeting the needs of our coalition. With this we intend to better meet the goals and objectives of each of your healthcare facilities.

17. Looking Ahead / Next Steps
Brainstorming on what sustainment looks like
Understanding of needs
Development of value added tools and resources
Development of future coalition model
Discussion on best ways to accomplish goals
Begin minimizing need of Federal funds
We will be continuing to brainstorm with coalition members to best define the direction we should go in and when.

18. Questions Don Sheldrew Donald.Sheldrew@centracare.com 320-255-5967
Rachel Mockros