Regional Planning and Assistance

1. Regional Planning and Assistance OSHA Training Institute – Region IX University of California, San Diego (UCSD) - Extension OSHA Training Institute

2. Objectives • To describe mutual aid compacts that enable disaster assistance between hospitals, and between states, and which could be accessed if local resources are overwhelmed • To describe advantages of Regional Planning OSHA Training Institute

3. Federal Emergency Management Agency (FEMA), through the Robert T. Stafford Disaster Relief and Emergency Assistance Act • Reimburses mutual aid agreement costs associated with emergency assistance provided all of the following conditions are met: • The assistance requested by the applicant is directly related to the disaster and is eligible for FEMA assistance • The mutual aid agreement is in written form and signed by authorized officials of the agreeing parties prior to the disaster OSHA Training Institute

4. Stafford Act (continued) • The mutual aid agreement applies uniformly in emergency situations. The agreement must not be contingent upon a declaration of a major disaster or emergency by the Federal government or on receiving Federal funds • The providing entity may not request or receive grant funds directly. Only the eligible applicant receiving the aid may request grant assistance • Upon request, the applicant must be able to provide FEMA with documentation that the services were requested OSHA Training Institute

5. Evacuation and Surge Capacity: The Link • Evacuation of hospital patients is directly linked to surge capacity • Surge capacity for an evacuation allows room for relocation of evacuated patients and staff • Resources commonly referred to in surge planning are also potential resources as destinations for hospital evacuees • Regional planning is one of the processes to achieve success when forced to evacuate hospitals OSHA Training Institute

6. Advantages of Regional Planning • Training, purchasing, and planning should occur on regional basis, for hospital administrators, nurses and physicians • Standardization of PPE, respiratory equipment, and surge supplies to maximize ability to use per diem and agency RNs and volunteers at multiple sites • Group purchases lead to reduced costs per item. • Contributions of expertise by each hospital in a region lead to stronger plans and better responses OSHA Training Institute

7. Example of Uses • The “Metropolitan Area Hospital Compact” of the Twin Cities in Minnesota • Off-Site Care Facility Operations Planning • The plan is regionally based, by hospitals • Minnesota Dept of Health Website (http://www.health.state.mn.us/divs/idepc/diseases/flu/pandemic/plan/pccoscf.pdf.) OSHA Training Institute

8. Emergency Management Mutual Aid Compact • 1996 - Ratified by Congress (P.L.104-321) as the first national disaster compact since 1950 (Civil Defense Compact) • Allows quick response from state to state for disaster resources for mutual aid for a governor-declared disaster • Once conditions of response have been set, there is a legal contract which makes affected state responsible for reimbursement OSHA Training Institute

9. EMAC: What it provides • Responding state knows there will no financial burden incurred for assisting • Personnel liability and Worker’s comp is assured • Allows credential approval across state line • Avoids bureaucratic wrangling • Achieves rapid response for any type of assistance OSHA Training Institute

10. What do individual states do once they sign on to the compact…? • Need to pass their own legislation to be consistent with the compact • Ex: professional licenses • “Model Act,” for states to use to model their own state legislation on, to standardize state laws, can be seen and is available on the EMAC Web site at www.emacweb.org OSHA Training Institute

11. WHY is having state laws consistent with a compact important? • Most states do not have legislation that allows medical professionals to practice with an out of state license, even when EMAC is utilized. • “Some states do not have legislation facilitating out of state licensing during emergencies, and the issue of hospital privileging is still a challenge in most states. States should address those potential limitations now – at the state level.” • http://www.astho.org/templates/display_pub.php?pub_id=1595 OSHA Training Institute

12. EMAC Responses - 2004 • EMAC responses to Hurricanes Charley, Frances, Ivan & Jeanne • Deployed over 800 state and local personnel from 38 states (including one then non-member state, California) • Cost was $15 million in personnel, equipment, and National Guard expenditures OSHA Training Institute

13. EMAC Responses - 2005 • EMAC scaled operations more than 20x as all member states combined deployed 65,929 personnel in response to Hurricanes Katrina and Rita to Louisiana, Mississippi, Texas, Alabama, and Florida. • More than 1,300 search and rescue personnel from 16 states; searched more than 22,300 structures and rescued 6,582 people • Nearly 3,000 Fire/Hazmat personnel from 28 states   OSHA Training Institute

14. EMAC Responses - 2005 • More than 6,880 sheriff's deputies and police officers from 35 states and countless local jurisdictions deployed across Louisiana and Mississippi -  a total of 35% of all of the resources deployed   • More than 2,000 healthcare professionals from 28 states; treated more than 160,000 patients in the days and weeks after the storms OSHA Training Institute

15. Website: http://www.emacweb.org/ OSHA Training Institute

16. Other Compacts • EMAC-like agreement exists among northeast states and Canadian provinces from Quebec eastward • International agreement, involving states in the northwest U.S. and neighboring Canadian provinces. OSHA Training Institute

17. Summary • Regionalization of planning reduces costs, reduces amount of training required in a region • Commonality of resources in a region is an advantage • EMAC and other compacts were reviewed OSHA Training Institute