1. United States Department of Health & Human Services Office of the Assistant Secretary for Preparedness and Response Bill Mangieri CBCP, CHEP Region VI Field Project Officer ASPR/OEM/NHPP Healthcare COOP to Recovery In 120 Minutes

2. COOP to Recovery Agenda Review of Common Terminology Review of Federal Guidance for COOP & Recovery Elements of a Viable Healthcare COOP Capability. Review of Healthcare Essential Functions Orders of Succession Exercise Delegation of Authority Exercise Continuity Facilities Exercise Continuity Communications Exercise Essential Records Management Exercise Pre-Incident Disaster Recovery Stakeholder Engagement Post-Incident Disaster Recovery Roles & Responsibilities

3. Business Continuity vs. Continuity of Operations 3 Business Continuity- The ability of an organization to provide service and support for its customers and to maintain its viability before, during, and after a business continuity event. Continuity of Operations- to ensure that Primary Essential Functions (PEFs) continue to be performed during a wide range of emergencies, including localized acts of nature, accidents and technological or attack-related emergencies.

4. Healthcare Sector Disaster Recovery 4 Those capabilities necessary to assist healthcare sector partners affected by an incident to recover effectively, including, but not limited to: Restoration of health care service delivery. Health workforce availability. Rebuilding health care sector community/facility critical infrastructure. Reconnecting a disrupted healthcare supply chain. Restoration of full service availability of the medical/non-medical transportation system. Restoration of healthcare sector information technology and communications systems that support critical business functions. Restoration of healthcare sector administrative & financial systems.

5. COOP & Recovery Federal Guidance 5

6. Health Care Service Delivery Primary Essential Function Definitive Goal: The provision of health care continuity provided in all inpatient and outpatient environments. Emergency Care, Surgical, Dialysis, Lab, Imaging etc. Implications if not conducted: This primary essential function cannot be deferred. Primary Interdependencies: Health Workforce, Critical Infrastructure Recovery Time: 4hrs-96hrs

7. Health Workforce Essential Function Definitive goal: The ability to deploy a credentialed health workforce to provide patient care to support health care service delivery in all environments. Implications if not conducted: will have a direct effect on healthcare service delivery. Primary Interdependencies: Critical Infrastructure Non-Medical Transportation Recovery Time: 12hrs-96hrs

8. Critical Infrastructure Essential Function Definitive Goal: Fully operational critical community/facility infrastructure including power, water, and sanitation etc., to support patient care environments. Implications if not conducted: limited contingency support to health care service delivery. Primary Interdependencies: Healthcare Workforce, Supply Chain, Non-Medical Transportation. Recovery Time: 4hrs-96hrs

9. Healthcare Supply Chain Essential Function Definitive Goal: Full access to the healthcare supply chain including medical & non-medical supplies, pharmaceuticals, blood products, industrial fuels and medical gases, food etc. Implications if not conducted: may need to activate contingency plans for conservation of medical and non-medical supplies. Primary Interdependencies: Non-Medical Transportation, Healthcare Workforce, Critical Infrastructure. Recovery Time: 36hrs-96hrs

10. Medical & Non-Medical Transportation Definitive Goal: Fully functioning medical and non-medical transportation system that can meet the operational needs of the healthcare sector during the response and continuity phases of an event. Implications if not conducted: Ability to provide patient movement to medical surge operations may effect health care service delivery. Primary Interdependencies: Health Care Service Delivery, Critical Infrastructure, Supply Chain, Health & Non-Health Workforce. Recovery Time: 4hrs-72hrs

11. Information Technology & Communications Definitive Goal: Fully functional information technology and communications infrastructure that supports high availability of the healthcare sector’s data management and information sharing capability. Implications if not conducted: healthcare IT support to patient care and incident management support will be effected by the disruption of this essential function. Primary Interdependencies: Critical Infrastructure, Healthcare Workforce, Supply Chain. Recovery Time: 4hrs-72hrs

12. Healthcare Administrative & Financial Definitive Goal: Fully operational administrative and financial capability including maintaining & updating patient records, adapting to disaster recovery program requirements, safety & security, payroll continuity, supply chain financing, claims submission, losses covered by insurance and legal issues. Implications if not conducted: disrupted administrative and financial essential function will effect patient care records management and may impair ability to transition into short-term and long-term recovery phases of an event without significant restoration challenges. Primary Interdependencies: Critical Infrastructure, Information Technology & Communications, Supply Chain, Healthcare Workforce. Recovery Time: 24hrs-96hrs

13. Orders of Succession Exercise Write down key position titles and their associated successors in the event principal leadership cannot perform authorized duties. Key Position (Position Title) Successor 1Successor 2Successor 3 Leadership Operations Planning Logistics Finance/Admin

14. Delegation of Authority Exercise Write down who has the legal authority to act on behalf of your organization for specific purposes and to carry out specific duties. Authority Position Holding Authority Position Delegated Authority Triggering Conditions Close Facility When conditions make coming to or remaining in the facility unsafe. Represent Agency/ Organization when engaging Govt. Officials When the pre-identified senior leadership is not available. Activate Agency/OrganizationMOU’s/ MAA’s When the pre-identified senior leadership is not available.

15. Continuity Facilities Exercise Identify “Environments of Opportunity” to conduct coalition business when normal host facility is unavailable to conduct operations. Continuity Facility Type of Facility Location of Facility Accommodations ABC HospitalAlternate Site1234 Medical Center Drive, Niceville, USA Hot Site, Identified meeting room with telephones internet access, ham radio access, satellite radio access, 2 desktop computers, laptop connectivity. County EOC Alternate Site 7000 Disaster Way My Town, Gotham City Warm Site, Possible meeting room with telephones, internet access, shared ham radio capability, shared satellite phone capability, No desktop computers, laptop connectivity. Home TeleworkDevolution SiteHome of Record HCC Leadership Warm Site, telephones, internet access, no ham radio, no satellite phone, desktop computers, laptop connectivity

16. Continuity Communications Exercise LandlineEmail Cell Phone Text 700/800 MHz Satellite Phone Ham Radio PagerRunner

17. Essential Records Management Exercise Write down the top 3 types of coalition related essential records you would want access to at all times. Examples: Coalition member POC contact list Coalition member alternative communications contact information Coalition member home phone number Disaster equipment inventory lists Coalition member home addresses Coalition State Health Authority contacts Coalition member organizational leadership contacts Coalition member disaster training records Coalition member organizational vendor lists Coalition member MOU’s/MAA’s

18. Healthcare Disaster Recovery Pre-Incident Stakeholder Engagement Focuses on Collaboration with all Government & Non- Government Partners Awareness, Education, Planning Post-Incident Roles & Responsibilities Focuses on Recovery Efforts of Healthcare Sector Partners Restoration of Essential Functions 18

19. Pre-Incident Disaster Recovery Stakeholder Engagement Write down 3 coalition based examples of pre-incident disaster recovery stakeholder engagement activities. Think of how to effectively engage the following healthcare sector partnerships in healthcare system recovery planning: 1.Individual & Household Healthcare Consumer 2.Healthcare Supply Chain, Critical Infrastructure Partners 3.Professional, Faith-Based, Disaster Recovery Organizations 4.Local Government 5.State Government 6.Tribal Government 7.Federal Government

20. Post-Incident Disaster Recovery Roles & Responsibilities Discussion questions: 1.In what ways can a healthcare coalition advocate for it’s member facilities to support health care service delivery restoration? 2.In what ways can a healthcare coalition advocate for it’s members to receive priority critical infrastructure restoration and reconstruction? 3.In what ways can a healthcare coalition advocate for it’s members when federal disaster recovery program requirements are modified? 4.In what ways can a healthcare coalition advocate for it’s members to determine eligibility for federal and state disaster recovery assistance?

21. United States Department of Health & Human Services Office of the Assistant Secretary for Preparedness and Response Bill Mangieri CBCP,CHEP Region VI Field Project Officer National Healthcare Preparedness Program Office of Emergency Management Assistant Secretary for Preparedness & Response William.Mangieri@hhs.gov Thank You!