Flu Preparedness for Correctional Facilities in Albany, NY

1. Pandemic Flu Preparedness for Local Correctional Facilities NYS Commission of Correction 80 Wolf Road Albany, NY 12205 Daniel L. Stewart, Chairman

2. Assumptions • New Flu virus outbreak that will be widespread-Pandemic • Flu outbreak will last approximately 12 weeks in duration • Vaccines will not be available for 4-6 months and in limited amounts • 25%-40% of population will become ill, 1%-5% will die

3. Jail Medical Surge Considerations • At the peak weeks of the pandemic hospital/health care resources will be at or exceed capacity • Standards of care will change to provide the best care to the most amount of people • Hospitals will be examining admission standards and will have to discharge patients who are not fully recovered • Jails will have to prepare for hospital discharges who are not fully recovered

4. Jail Medical Surge Considerations • Jails should prepare to care for all but the most critical inmates • Defend in place for period up to 6 weeks • Isolate illness in inmate population when possible • Expect limited outside assistance and resources

5. Planning Considerations • Jail Administration should be familiar with the NYS DOH Pandemic Influenza Plan Sections • 1 Command and Control • 3 Healthcare Planning • 4 Infection Control • 8 Travel Related Disease Control & Community Prevention • Jail Administration should meet with Local Health Department and be familiar with the Local Pandemic Plan • Jails Administration should meet with the local hospital and have an understanding of their Emergency Preparedness Plan

6. Planning Considerations • Evaluate current medical support capacity in terms of staff, space, supplies, and develop plans to expand capacity • Estimate in advance the minimum number of caregivers and security staff needed for 40% of inmate population infected • Explore alternate medical staffing options • What basic care can be provided by CO’s

7. Planning Considerations • What supplies will you need to have stocked in the event of an outbreak? Assure adequate amounts are available including: • Regular or N-95 respirator masks for three days (1 mask per person per day) • Latex gloves • Plastic bags • Hydration supplies: cups, straws • Laundry supplies

8. Planning Considerations • Review medical screening process at intake to identify inmates with influenza like illnesses and those with known exposure • Exposed inmates may be asymptomatic (typical incubation period of 2 days) • Identify areas where inmates at intake with symptoms can be isolated • Move to isolation area if active flu case or general population if cleared • May require classification and general population areas for infected and non infected

9. Planning Considerations • Capacity Management • Identify number of inmates infirmary can hold • Can that number be expanded? • Identify specific units in jail where active influenza cases can be housed for up to 6 weeks • Identify common areas of those cell blocks or housing pods that can be used to cohort sick inmates

10. Planning Considerations • County and Local Courts • Review plans for declared Local or Statewide State of Emergency • Consider temporary use of video arraignments during pandemic period (Contingent on law waiver from OCA) • Consider suspension of weekend sentences during pandemic period

11. Planning Considerations • Inmate Discharge/Release • Provide info for protecting self and family against flu spread • Appropriate discharge plan for most seriously ill inmates • Custody Transfers • Proper notification made to receiving facility of inmate’s current medical condition (Minimum Standards 7300.7)

12. Trouble Shooting • Limited Health Care Providers • Limited access to hospitals and ER’s • Outside clinics and municipal health staff unavailable • Ill Employees or Employees absent due to family illness • Up to 50% of workforce absent • Policy and procedures to address staffing shortages

13. Trouble Shooting • Assess average weekly pharmacy supply needs for an average inmate population • Critical Chronic Care needs (i.e.: insulin) • How may this be affected if pharmacy supply is disrupted for 2 or more weeks? • Back up vendor • Advance supplies

14. Trouble Shooting • Food Service • How many days does your jail go between deliveries? • How many days would the jail be able to provide meals if normal suppliers are interrupted? • Are alternative suppliers available? • What alternative menus are available if food service staff are absent? • Are staff familiar and trained to use kitchen supplies in an emergency?

15. Trouble Shooting • Transfer to NYS DOCS • Plan on transfer delays during a Statewide State of Emergency • Expect transfers to resume only after peak of pandemic has passed

16. Trouble Shooting • Transfer to CNYPC • Expect no admissions allowed during Statewide State of Emergency • Plan for extended in-house management • Extended constant supervision • Onsite emergency psychiatric treatment

17. Commission Guidelines • Commission of Correction will provide guidance during a declared state of emergency regarding: • Capacity Management • Classification • Correction Law 500-b • Suspension of Essential Services • Visitation • Religious Services