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Contingency Program

Contingency Program. TRICARE Regional Office (TRO) – South 1330 CST FEB 18, 2008. TRO-South Contingency Officer. Risk Communication, done right… - Prevents problems from arising - Establishes the boundaries of current operations - Eases beneficiaries transition to new-normalcy.

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Contingency Program

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  1. Contingency Program TRICARE Regional Office (TRO) – South 1330 CST FEB 18, 2008 TRO-South Contingency Officer 18 Feb 2009

  2. Risk Communication, done right… - Prevents problems from arising - Establishes the boundaries of current operations - Eases beneficiaries transition to new-normalcy 18 Feb 2009

  3. Purpose • Introduce the TRO-SOUTH/TMA Contingency support efforts • Demonstrate Collaboration Benefits of Regional Office/MCSC in Response to Contingency Event • Address opportunities where marketing assists in the response to contingency events 18 Feb 2009

  4. Contingency Officer(Coast Guard Liaison) TRICARE Regional Office South FEMA Incident Command System Courses • ICS 100 • ICS 200 • ICS 700 • ICS 800 • ICS 300 In addition: HLSMEC, JOMMC, MHAC, USACHPPM RISK Comm., Navy Damage Control Assistant School, Risk Mgmt Courses, HAZMAT, & Shipyard Competent Person CG under the DHS vice DoD: Posse Comitatus does not apply allowing the CG to execute State and Local laws as well as Federal, making the CG the lead Federal Law Enforcement Agency i.e. CG Chief of Staff designated as Lead Officer in Pandemic Flu Response. 18 Feb 2009

  5. TMA Emergency Support Working Group (ESWG) • Plan and coordinate: • Policy actions • Purchased care activities • Education/outreach efforts directly supporting TRICARE beneficiaries impacted by various types of disasters, to include hurricanes, tornadoes, flooding, etc. • Serve as a liaison to the Deputy Director, TMA, ASD (HA), and other members of the HA/TMA leadership, providing: • Timely information regarding actions taken, • Impact of actions, status reports, etc. 18 Feb 2009

  6. ESWG Participants The Working Group is composed of Primary and Alternate representatives from the following HA/TMA offices: • TRICARE Operations, Lead, Health Plan Operations (HPO) • TRICARE Operations, Policy Support SME, HPO • Communication and Customer Service (C&CS), HPO • TMA Aurora, TRICARE Acquisitions, HPO • Force Health Protection/Deployment Health • Office of the Chief Financial Officer (OCFO) • Office of the Chief Medical Officer (OCMO) • TRICARE Regional Office South • TRICARE Regional Office West • TRICARE Regional Office North • TRICARE Dental Program • TRICARE Pharmacy • TMA Privacy Office • TMA Office of General Counsel 18 Feb 2009

  7. California Wild Fires 18 Feb 2009

  8. Waivers • TMA PCM Waiver for Referrals • Eliminates POS Charges • MTF/TRO Initiate in collaboration with MCSC • Signature Dr. Casscells • Pharmacy Waiver • Early Refills • No waiver for Co-Pays • Dental Waiver • Automatic Disenrollment of Beneficiaries due to none payment At this time Waivers are not coordinated together, different POC’s at different Units with different Contract requirements. Thus waivers vary start and stop dates as well as area covered. Key take away is where is information marketed and how can you help get this information out to bene’s when it benefits them most. 18 Feb 2009

  9. Conformed Contract • Section F - Deliveries of Performance (20) Contingency Program Quantity 1: 1 Time of Delivery for 85% of the MTFs within 3 months following the start of option period 1 100% within 6 months following the start of option period I. Update by the 60th calendar day of subsequent option periods. • Section H - para ss, 3rd para Contingency Program: The contractor will develop and implement a contingency program, in conjunction with each MTF, and provide the documented program to the Regional Director for 85% of the MTFs in the South Region within 3 months following the start of option period 1. The contractor will provide documented contingency programs for 100% of MTFs within six months following the start of option period 1. 18 Feb 2009

  10. Conformed Contract Cont. • Para C-7.31. The contractor shall participate in each MTF's Installation Level Contingency Exercise twice each year. The purpose of the exercise is to test the contingency program under a variety of situations and to provide information from which the contractor's contingency program shall be updated. The contractor shall also participate in Regionally Coordinated Table Top Contingency Exercises each year. • Para C-7.32. The contractor shall implement the contingency program at any or all locations with forty-eight (48) hours of being notified by the Regional Director that a crisis exists. 18 Feb 2009

  11. Risk Communication • Is it an objective evaluated in the exercise? • Does the exercise extend out to recovery phase? • Do you have templates or list of information that you would put in communications for different scenarios? You can respond wellto any difficult question or statement on any issue with any stakeholder. K. Fulton & S. Martinez, Communication Articles presented at USACHPPM Advanced Risk Communication Course (2006) 18 Feb 2009

  12. Event Collaboration Timeline • PCM Blanket Waiver • External Resource Sharing • Internal Resource Sharing • Clinical Support Agreements • Media Releases • TMA Emergency Working Group Support • Pharmacy • Coordinate Other MTF Support • Special Needs Evacuation • Media Releases • BENECAT Analysis Starts Communication of Needs & Assessment Projected Hazard Event Affects Normal Operations Actual Hazard Event Affects Normal Operations Efforts to Return to Normal Operations Recovery, Normal Operations or New Normalcy 18 Feb 2009

  13. Disaster Information • HUMANA - http://www.humana-military.com/south/bene/tools-resources/disaster/disaster-recovery.asp • TRO-South - http://www.tricare.mil/trosouth/Disaster.cfm • TMA - http://www.tricare.mil/disasterinfo/default.aspx 18 Feb 2009

  14. Humana Website 18 Feb 2009

  15. Threats and Vulnerabilities 18 Feb 2009

  16. 2008 Hurricane Season 18 Feb 2009 Source: http://www.cpc.ncep.noaa.gov/products/outlooks/figure1.gif

  17. The 2008 hurricane season had activity at well above-average levels. 2008 Hurricane Season 18 Feb 2009

  18. Key Points of 2008 Hurricane Season • 2008 became the first year on record with five consecutive months of a storm at major hurricane intensity (July – November). • Six named storms in a row (Dolly through Ike) made U.S. landfall. This breaks the old record of five named • No hurricanes made landfall along the Florida Peninsula and East Coast. This marks the third year in a row with no hurricane landfalls along this portion of the U.S. coastline. 18 Feb 2009

  19. Hurricane Ike Primarily Affected PSA 0196 and 006410 Sept 08 PSA – Prime Service Area 18 Feb 2009

  20. MTF CO Fills Out Waiver Request Faxes/Emails to TRO-S 210-292-3222 Fax TRO-S drafts Memo, Reg. Dir. Signs FWDS to TMA CONTINGENCY OFF Routes for Signature Approval Copied to Region and MTF Determine Media Releases

  21. Example of TRICARE South Approved Blanket PCM Waiver Referrals in Response to Hurricane Ike and Gustav Pink Bounded Area Area – Identifies GUSTAV/IKE Affected Area where PCM waiver was in effect until 26 Sept 2008 YellowBounded Area – Identifies IKE Affected Area where PCM waiver was in effect from 13 Sept 2008 until 31 Oct 2008 Blue Bounded (Green Shade) Area - Identifies IKE Affected Area where PCM Waiver is in effect from 13 Sept 2008 until 20 Sept 2008 18 Feb 2009

  22. Decision Making Geographic Scope and Length of Waiver Remains Subjective • Is Facility Affected? • Is Staff Affected? • Are Beneficiaries in the Area (Demographics)? • Does Infrastructure affect Return of Staff or Beneficiaries? 18 Feb 2009

  23. 2009 Hurricane Season Predicting a somewhat above-average Atlantic basin tropical cyclone season in 2009. Predicting an above-average probability of United States major hurricane landfall. 18 Feb 2009

  24. Historical Trends 18 Feb 2009

  25. 19 June 2008 NOAA Report 18 Feb 2009 Source: http://www.noaanews.noaa.gov/stories2008/images/climatetable.jpg

  26. Other Regional Risks • High Probability Low Consequence • Power Outages • Industrial Accidents • Winter Storms • Low Probability High Consequence • Pandemic/Epidemic • Terrorist Attack • Airline Crash • Industrial Accident • Earthquakes 18 Feb 2009

  27. Earthquakes Primary difference between Earthquake and Hurricanes is notification time. The ability to reduce consequence by evacuation and emergency crew stand up. 18 Feb 2009

  28. Consequences of Major Earthquake in SC • About 20 out of 108 hospitals will be incapacitated, mostly within the tri-county area, where most of the casualties will occur. • About 800 bridges will be rendered unusable, thereby preventing first responders who try to reach victims. A number of sea island communities, such as the Isle of Palms, Sullivan's Island, and Hilton Head Island, whose only connection to the mainland is a bridge, may be cut off from all transportationexcept by boats or helicopters if the bridge fails. • Substantial damage to power production and distribution facilities, resulting in power outages lasting days to weeks. After Hurricane Hugo in 1989, for example, some neighborhoods had no electrical power for a month. • Significant disruption of water lines. Over 500 major water pipeline breaks are expected. Homes may not have water for periods ranging from weeks to months. • Damage to communication facilities, chiefly to large, poorly secured equipment. Disruption of telephone and television service may last for days to weeks. Emergency radio broadcasts will probably be the first to provide disaster-related information • Vastly greater destruction of life and property.This is due to the enormous population growth since 1886 and the lack of earthquake-resistant building construction standards until the last few years. • At least 900 fatalities, compared to 124 known deaths in 1886. • At least 8,000 serious injuries, compared to 140 known serious injuries in 1886. • Approximately 45,000 total casualties (dead and injured), compared to approximately 500 in 1886. • More than 200,000 people displaced, with 60,000 requiring short-term (under 90 days) shelter, compared to 40,000 in 1886. • At least $200 billion in total economic losses from damage to buildings, interruption of businesses, and damage to transportation and utility systems, compared to approximately $100 million in 2006 dollars in 1886. About 77 percent of the losses will occur in the Charleston-Berkeley-Dorchester region. • Significant damage to more than 200 schools and over 100 fire stations. Because of insufficient seismic building code standards and the age of the majority of buildings, the majority of structures in the State, specifically schools and fire stations, are vulnerable to damage. 18 Feb 2009

  29. Summary • Know the threats to your facility • Know your stakeholders needs • Know where the information can be found • Anticipate communications needed • Remember - exercise collaboration is part of the preparation, be involved • Review and evaluate risk communication/beneficiary outreach • Think out side of the box vice defaulting towards normalcy ITS NOT THE PLANS ITS THE PEOPLE 18 Feb 2009

  30. Questions & AnswersTraining OpportunitiesHomeland Security Medical Executive Course HLSMEC http://www.dmrti.army.mil/courses.htmlUS Army Risk Communication Course http://chppm-www.apgea.army.mil/risk/default.aspxForce Health Protection Conference http://www.pdhealth.mil/education/detailsFHP.asp 18 Feb 2009

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