What Healthcare Agencies Need to Know
By law in Florida, healthcare agencies are tasked with the responsibility of developing a Comprehensive Emergency Management Plan (CEMP) in the event of an internal or external disaster. To assist plan developers, home healthcare agencies, and by association their staff and clients, the Polk County Health Department has launched “Operation in the Know” seminars.
Denise Heady, the department’s regional vulnerable population consultant, is the instructor for these seminars. She sat down with Central Florida Doctor magazine to answer questions and share with agencies what they need to know.
Central Florida Doctor (CFDr): What is the “minimum” requirement by law for a Comprehensive Emergency Management Plan (CEMP)?
Denise Heady: The “minimum” requirement by law for a Comprehensive Emergency Management Plan for home healthcare agencies (home healthcare agencies, home medical equipment, hospice, and nurse registries) is for the agency’s management to write a document that ensures staff and clients know what to expect in regards to communication, response, and recovery on behalf of the agency, are captured in the Agency for Healthcare Administration (AHCA). AHCA has put together mandated forms for each type of agency, which are planning templates.
The forms capture the following areas:
– Basic demographics
– Primary and alternate emergency contacts
– Concept of operations (when and how to activate the CEMP)
– Delegation of authority (who can activate the CEMP)
– Emergency roles and responsibilities
– Notification of staff and clients
– Operational procedures (services provided) and training for before, during, and after an emergency or disaster
– Patient education regarding special needs shelter and assisting with special needs shelter registration for each county served
– Training procedures
CFDr: What classifies as an “emergency” under a CEMP?
Heady: Webster’s New Compact Desk Dictionary and Style Guide defines an emergency as “a sudden, generally unexpected occurrence demanding immediate action,” so for a home healthcare agency “any general unexpected occurrence that has the potential to disrupt service to the agency providing care and services to clients would seem to be a reasonable classification.”
CFDr: How can a home healthcare facility go “above and beyond” to create a CEMP for its staff and clients?
Heady: The Comprehensive Emergency Management Plan (CEMP) is a resource and guide written by the agency’s management for the staff and clients on what to expect during— and how to respond to and recover from— an emergency or disaster. A well-written plan is brief, concise, but thorough, to the point that if the most junior person in the agency activated the plan, there would be little or no confusion as to what steps to take to ensure a positive outcome. In addition to a well-written plan, agencies should make time to have the staff become familiar with the contents of the plan before an emergency strikes, as well as encourage staff members to suggest or recommend improvements.
Another way to go “above and beyond” when creating the CEMP, would be to talk with community partners, such as those you can find in the local health and medical coalition, which is made up of local health and medical community partners to gain insight as to how other partners would respond to a request for assistance in an emergency.
CFDr: How can home healthcare providers, physicians, owners, and staff help ensure that CEMPs are followed in the event of an emergency?
Heady: Provide staff and clients with a plan that is brief, concise, and to the point, so areas can be quickly implemented with ease before, during, and after an emergency. The main goal is to write a realistic plan that accurately reflects the agency’s capabilities and intentions. Then continuously train and exercise the plan internally with staff and externally with community partners, so all players are familiar with the procedures and those they may be depending on to respond.
CFDr: How does “Operation in the Know” help developers of a CEMP have a plan for incident-specific hazards?
Heady: The “Operation in the Know” CEMP Seminars are designed to walk developers through the CEMP templates to gain a greater understanding of what is required for disaster planning. Also, plans should take an “All Hazards” approach because the basic plan of action is similar in most cases, and have checklists or appendices that address the uniqueness of a particular type of emergency.
CFDr: Are there additional training or educational courses for CEMP planners?
Heady: Federal Emergency Management Administration (FEMA) and the Florida Department of Emergency Management (FDEM) have planning templates and resources to assist with plan development for personal, family, and organizations. Also, check with the local community college for class offerings. Another resource for planning is the health and medical coalitions both locally (within each county) and at the Regional Domestic Security Task Force (RDSTF – 4) Tampa Bay area. Theses coalitions provide a community approach to planning for emergency response.
At the coalition meetings, representatives from various health, medical and community partner agencies engage in discussions and collaborations on disaster preparedness concerns. The coalitions consist of the full spectrum of the health and medical community, such as hospitals, nursing homes, long-term care facilities, home healthcare agencies, primary care providers, specialists, emergency medical service, and public health, just to name a few. In addition, community partners that work closely with the healthcare industry also participate. Building relationships before an emergency occurs yields better outcomes because each partner has increased understanding of the capabilities and challenges of those working to resolve an emergency. For example, special needs clients may need assistance with transportation to evacuate out of the area or to a special needs shelter. By discussing the challenges faced by the client and or the community, partners have the opportunity to resolve issues before a disaster occurs.
CFDr: How can a CEMP planner at a healthcare facility do a risk analysis on the plan?
Heady: The agency can conduct a risk analysis by exercising the plan to find the gaps or weaknesses so the areas can be improved. When doing an exercise, ensure follow-up is conducted by putting together an “after action report,” which describes the exercise scenario, lessons learned, and provides recommendations on how to improve the procedures or processes to make the plan realistic and functional.
CFDr: What’s your advice for continued training on the CEMP for staff?
Heady: When training staff on the use of an agency CEMP, make it realistic and complete. Train on the plan in small, meaningful segments, perhaps during staff meetings or scheduled recurring training. Then ask for feedback from your staff, who can add to the planning portion by providing what works and does not work in reality.
CFDr: Is there any other information you’d like to share about the process of developing a CEMP?
Heady: Plan for the worst case scenario and hope for the best outcome. The plan is a resource and guide on how the agency intends to react to an emergency. However, keep in mind that a plan is a starting point to the response and each emergency can have different characteristics, so the response may need to be adjusted based on current circumstances.
Once again, participating in the health and medical coalition in your area can be a key step toward building a workable CEMP. The relationships and interactions afforded through the contacts in these coalitions can provide invaluable resources for agencies who want to create a plan that works.