New York State Department of Health

1. New York State Department of Health HANYS' Nursing Home Emergency Preparedness Webconference June 28, 2007

3. Emergency Operations Center (EOC)(Central command & control) • Responsible for carrying out principles of emergency preparedness • Ensure continuity of operations of the facility • Responsible for the strategic, or “big picture” of the disaster • Make strategic decisions & leave tactical decisions to lower command • Function is to collect & analyze data, make decisions that protect life & property, maintain continuity, disseminate those decisions to all concerned agencies & individuals • Usually one individual in charge • the Emergency Response Coordinator a.k.a. Emergency Manager

4. Critical EOC components: 1. Individuals who staff the EOC must: • Be properly trained • Be given the authority to carry out actions necessary to respond to a disaster • Be able to think outside the box (What if) 2. Communication system: • Simple word-of-mouth or sophisticated network • Must provide redundancy to ensure that information & orders can pass into & out of the facility without interruption

5. Command Post • Area where decision makers can gather • Locate in an area not involved in the emergency • Must have: • Copy of emergency response plan • Copies of MSDSs • Facilities plans, maps and blueprints • Employee lists & contact information • Contact information for local responders & utility/service companies • Radios, telephones & other communications equipment

6. Emergency Response Coordinator Individual who serves as coordinator of a facility’s emergency operations center A Contact Persons role in the Health Provider Network (HPN) Communications Directory The facility liaison with local/government emergency response systems

7. The Emergency Response Coordinator should have the authority to: • Assess the situation • Implement the facility emergency management plan • Determine the best response strategy • Secure the facility • Contact local authorities • Interact with local, state & federal agencies • Coordinate an ordered evacuation of the facility if indicated • Requisition needed supplies

8. Are you in charge? • Depending on the event, the emergency response coordinator might not be in charge for long • Try to anticipate what authorities may require • Keep a list of names, titles and contact information available for all local authorities • Know ICS (Incident Command System) • ICS 100 & 200 are available on line through SEMO

9. Communications Directory Drills • Roles to be contacted: • Administrator • Designated Pharmacist • Director, Nursing • Director, Patient & Family Services • Director, Safety/Security • Emergency Response Coordinator • HPN Coordinator • HPN Organizational Security Coordinator • Infection Control Practitioner • Medical Director • CHRC AP • 24 hour contact [found in Emergency Contacts (Any Time)]

10. Communications Directory Drills Originally planned for June 2007 • To be rescheduled • Goal remains the same: • To ascertain ability of a nursing home to receive information via the HPN through the designated Contact Persons • This is a facility’s chance to update Contact Person information in the Communications Directory • Suggest staging your own drills

11. Health Provider Network (HPN) Communications Directory • In an emergency, or for routine business, NYSDOH is able to send immediate alerts to contacts, with a generic message on how to receive detailed information about the situation • NYSDOH relies on facility HPN data accuracy • The HPN Coordinator (HPNC) is charged with this role • It is advised that there be back-up HPN Coordinators

12. NYSDOH Duty Officer • DAL sent via the HPN on 6/20/07 • Duty Officer contact during non-business hours (5 pm to 8 am, and weekends & holidays) • 866-881-2809 • ‘beeper message’ should include: • Name of facility • Name of ‘caller’ • Number of ‘caller’ • Reason for call • Note: stay @ location

13. HAN & the Communications Directory are the official NYSDOH directory & alerting system for emergencies

14. Communications DirectoryEmergency Office Contacts (Any Time) • 24 by 7 Facility Contact- • Director of Nursing • Emergency Medical Supplies Receiving Office • Office of Administrator

15. Pandemic Influenza Planning Hypotheses: • Hospitals will be beyond maximum capacity • Hospital staff will be overtaxed • Decisions will have to be made at the state level to alter standards of care • Nursing homes have to retain residents normally transferred to hospital • Nursing homes will need to admit sicker residents • Nursing homes will have to surge beyond licensed capacity • Nursing home staff will be overtaxed

16. Pandemic flu roles of note: • Administrator- • Designated pharmacist- • Director, Nursing- • Director, Patient & Family Services- • Director, Safety/Security- • Emergency Response Coordinator- • HPN Coordinator (s)- • HPN Organizational Security Coordinator- • Infection Control Practitioner- • Medical Director- • Nursing Home Data Reporter • Plant Manager- Note:‘-’ indicates Communication Directory drill role

17. Pandemic Flu • CDC has issued a document entitled “Long-Term Care and Other Residential Facilities Pandemic Influenza Planning Checklist” • www.pandemicflu.gov/plan/healthcare/longtermcarechecklist.html • Identifies key areas for facility planning • Much of this has already been accomplished by nursing homes through current infection control planning and implementation

18. The majority of nursing homes have already established: • A Multidisciplinary Planning Committee • Points of contact with: • Local & state health departments & provider associations • Area hospitals • A written influenza plan that identifies the person(s) authorized to implement the plan (e.g., Medical Director, ICP) • A plan in place for surveillance & detection • A protocol for weekly/daily monitoring of seasonal influenza-like illness (in residents & staff) • A plan to provide education & training to ensure staff, residents & visitors understand basic infection prevention & control measures

19. Emergency Management Cycle • Mitigation: Taking sustained actions to reduce or eliminate long-term risk to people and property from hazards and their effects • Preparedness: Building the emergency management function to respond effectively to, and recover from, any hazard • Response: Conducting emergency operations to save lives and property • Recovery: Rebuilding communities to function on their own

20. Emergency Management Cycle

21. Web sites: • www.hhs.gov/pandemicflu/plan/sup4.html • www.cdc.gov/ncidod/dhqp/gl_isolation_droplet.html* • www.cdc.gov/flu/professionals/infectioncontrol/resphygiene.htm • www.cdc.gov/flu/professionals/training/ • www.cdc.gov/flu/professionals/diagnosis/ • www.cdc.gov/flu/professionals/plan • www.cdc.gov/flu/professionals/infectioncontrol/longtermcare.htm • www.pandemicflu.gov/plan/healthcare/longtermcarechecklist.html

22. Katharine Logan Health Systems Emergency Preparedness Office of Health Systems Management Hedley Park Place 433 River Street Troy, New York 12180-2299 Phone: 518-408-5163 Fax: 518-402-8659 E-mail: KML04@health.state.ny.us