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B e y ond P a tie n t M o v eme n t: Alas k a ’ s Cur r e n t R esponse Planning

B e y ond P a tie n t M o v eme n t: Alas k a ’ s Cur r e n t R esponse Planning. S ondra LeClai r , Health E mergen c y Re s ponse Ope r ations Unit Manag e r , S t ate of Alas k a CAPT J o hn Smart, Depa r t m ent of Health and Human Service s , Regional Emergen c y Coordinato r , Region X.

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B e y ond P a tie n t M o v eme n t: Alas k a ’ s Cur r e n t R esponse Planning

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  1. BeyondPatientMovement:Alaska’s CurrentResponsePlanning SondraLeClair,HealthEmergencyResponseOperations UnitManager,StateofAlaska CAPTJohnSmart,DepartmentofHealthandHuman Services,RegionalEmergencyCoordinator,RegionX

  2. DisclosureStatement-CE/CME • Thereisnoconflictofinterest for anyoneinvolved inplanningorpresentingthislearningactivity. • ToreceiveCME/CEhours forqualified • sessions: attendthe sessionor participateinthe skillslabandcompletea CE(ContinuingEducation) verificationform. • –Formsareinyourpacket. • QuestionsaboutCME/CE—Stop bytheregistration • deskfor assistance

  3. SessionObjectives • Objective#1:Definethestate-levelplanfor patientcareandmovementinresponsetoa catastrophicincident. • Objective#2:Assessthestateandfederal assetstosupporttheplan,andengageinadiscussionregardingthealignmentofthestate’seffortswithlocalplanning.

  4. HealthEmergencyResponse Operations • Healthandmedicaldisaster preparedness, response, recovery • Planning • Training • Exercise • ESF8 Lead • EmergencySupportFunction8 = PublicHealth and MedicalServices • Departmentof Health and SocialServices EmergencyOperationsCenter (DHSSEOC)

  5. DHSSEOC/ResponseTeam KarieHawk,MCMCoord. CharlesPelton,Training/Exer. SondraLeClair,Unit Manager JessicaGould, Grants Coord. Todd Lecours,AKRespond/ Trauma BonnieBailey,Healthcare PreparednessCoord. AllisonNatcher,Planner KarlEdwards,Warehouse& EOC

  6. DHHS ASPR RegionalStaff David Csernak Healthcare Preparedness Program Moji Obiako Medical Reserve Corps CAPT John Smart REC Rick Buell Regional Administrator LCDR Jennifer Cockrill REC Regional Emergency Coordinators (RECs) serve as ASPR’s primary representatives throughout the country at the regional level. RECs build relationships with federal, state, local, tribal and territorial officials and healthcare partners and stakeholders in order to conduct planning for effective federal emergency response, and to facilitate coordinated preparedness and response activities for public health and medical emergencies. MRC is a national network of local groups of volunteers committed to improving the health, safety, and resiliency of their communities. HPP provides federal funding to support regional health care system preparedness, promotes a sustained national focus to improve patient outcomes, minimize the need for supplemental state and federal resources during emergencies, and enable rapid recovery

  7. A BriefHistoryofPatient MovementPlanningin Alaska

  8. FEMACatastrophic AlaskaAnnex • Collaborative plancreated withinputfrom State ofAKandFEMA • Catastrophicearthquakein • SouthcentralAlaska • Primary areas impacted: Anchorage,KPB, Kodiak, Valdez, Cordova,Mat-Su • Masscasualties,mass fatalities, widespread infrastructure damage

  9. Patient MovementExercises • AlaskaShield2014 • Seaquarium2014 • Rock&A Hard Place2015 • AlaskaShield2016 • Arctic Chinook 2016 • FrozenContagion2017

  10. PatientMovementLessons • Importance of coordinationbetween: • DHSS EOC • SendingHospitals • ReceivingHospitals • Private air medical • Federalairmedical • Airport • LocalEMS • LocalEmergencyManagement • Need to be flexibleand scalableto the community • Availableresources

  11. MassCasualtyPlanning Patient Movement State Aeromedical StagingFacility AlaskaMedical Station FamilyAssistance Centers CrisisStandardsof Care DHSSEOP MassCasualty Annex

  12. PatientMovement PlanElements PatientMovement Plan Eventto96 Hours IntegrationofFederalAssets 96+ Hours Recoveryof HealthCare Capability Repatriationof Patients

  13. RegionalPatientMovement Model • Patientmovementhassome general planning elementscommon to all areas • Other elementsdependenton theregion • Approached the stateplan with a regionalperspective: • Anchorage • Mat-SuBorough • KenaiPeninsula • IncludesCordova,Valdez,Kodiak forpatientmovement purposes • Fairbanks • Other areaswill be added in the future

  14. RegionalPatientMovementPlan Structure • Purpose • Scenario • EstimatedImpacts • HealthcareFacilities OperationalStatus

  15. RegionalPatientMovementPlan Structure

  16. CommunityPlanningVisits • Validateplanswithcommunities • Validation/Planningmeetingsoccurredin: • Fairbanks • Mat-SuBorough • Soldotna/Kenai • JBER/Anchoragetore-validateDisaster AeromedicalStagingFacility 17

  17. Kenai& SoldotnaSite Visit • • February27-28,2018 • Beganwith3.5hourstakeholdermeeting • Attendees: • StateDHSS • FederalHHS • AlaskaState Troopers • USNorthernCommand • Kenai Police • KenaitzeTribe • Dena’inaWellnessCenter • Nikiski FireDepartment • City ofKenai Fire • Kenai BoroughEmergencyManagement • CentralPeninsulaHospital • CentralEmergencyServices • HeritagePlace • East WestProtectionsPlanner/MedicalLogisticsExpert

  18. CommunitySiteVisit Kenai/Soldotna

  19. CommunitySiteVisit Kenai/Soldotna

  20. LessonsLearnedfrom CommunityVisits • Underscoredthevalueof vettingtheplan with widearrayof stakeholders • Challengesof logistically providing resourcesneededfor response • Importanceofutilizingall lifelinesincommunitythatsupportpatienthealth • Patientmovementwas onlyoneofmanyplanningfactors

  21. Expanding PatientMovementPlanning To PatientResponsePlanning

  22. ContributingFactors • Community Planning Visits • FEMATransportationFeasibilityMeetings • LessonsLearnedfromRecentDisasters

  23. FEMATransportationFeasibility Study • Driven by previous state and national level exercises and after action observations • StateESFleads,stateemergencymanagement,FEMA • Focusonprioritization and coordination of response capabilities due to limitationsintransportationfollowingcatastrophic earthquake • Restrictionsonairports,roads,ports • Majorcapabilitiestobemovedintoarea • SAR, MedicalSupport, PowerRestoration • Forced to address restrictionsoncargospaceandpersonnel • Underscoredneedtoconsiderallcapabilities incommunity • Bridgethetime gapduetorestrictions

  24. LessonsLearnedfromRecent Disasters • Functional critical infrastructure is key • Decision-makingatthelocallevel is key • Chronicmedicalconditions • Smaller hasa bigger impact • NGO and private parties have capability to support • Injuries and healthneeds thatoccur aftertheevent • Ongoingpharmaceutical,durablemedical equipment, medical supplyneeds

  25. PatientResponsePlanning Elements Hospital Emergency Mgmt: Local,State DHSS Pharmacies /Medical Supplies Patient Response Healthcare Providers (non- hospital) FMS/AMS/ LowAcuity Transporta- tion/Airport EMS

  26. ContinuingPatient Care • Hospital • Maintainstaffing levels • Maintainsupplies • Abilitytodecompress • Redundantutilitiesorback-ups • Redundantcommunications • EMS • Maintainstaffing • Maintainsupplies • #ofambulancesavailable • National EMSContract • Communicationinfrastructuretosupportmoreambulances

  27. ContinuingPatient Care • Transportation • Non-EMSvehiclestomoveambulatory,non-criticalpatients • Airport infrastructure • Roads/bridgesthatimpactstaffinglevels • FMS/AMS/LowAcuityFacility • Outletforlowacuitypatients • Staffingneeds • Wraparoundsupportneeds

  28. ContinuingPatient Care • Pharmacies and MedicalSupplies • Dothesesuppliersexist locally? • Howmany days of supplymaintainedon site • Methods forre-supply • Healthcare Providers (non-hospital) • Dialysis • Long-termcare • Pediatricclinics • Primary care clinics • Urgentcare • Surgerycenters • Addictionclinics/facilities

  29. RolesandResponsibilities

  30. FederalRolesand Responsibilities • Ongoingplanningpartnershipwith state • Maintaining/enhancing methodsusedto maintain situational awareness • Readinessfor deployment • –PublicHealthandMedicalresources • Regional support(Region X)

  31. HHS Secretary • Disaster Medical Assistance Teams (DMATs) • Health & Medical Task Forces (HMTFs) • Trauma & Critical Care Teams (TCCTs) • Rapid Deployment Forces (RDFs) • Mental Health Teams (MHTs) • Applied Public Health Teams (APHTs) • Disaster Mortuary Response Teams (DMORTs) • Strategic National Stockpile (Managed Inventory, Push Pack, Chem Pack, etc) • National EMS contract ASPR/ Emergency Management and Medical Operations Strategic Secretary’s Ops Center/ Incident Support Operational Federal Health Coordinating Official Incident Management Team Tactical

  32. VA DHHS Definitive Care Patient Evacuation Medical Response DHS DoD Major Components of theNational Disaster Medical System USPHS and NDMS MHT National EMS Contract NDMS Hospitals HHS FMS USPHS APHT NDMS DMATs Medical Logistics Resources – durable equipment, pharmaceuticals and supplies Emergency Departments ICU/Trauma Critical Care / Acute Inpatient Care Food / Water Safety Drug /Blood Safety Quarantine Support Pre-hospital Care / facility transfers Med. Special NeedsSheltering Non-acute InpatientCare MentalHealth Health Surveillance

  33. StateRoleand Responsibilities • Planningwith federalpartners • Pre-identifyneeds • Quicklysubmitresource requests • Planningwith local partners • Understandneeds,challenges,priorities • Maintain DHSSEOC • Maintain deployable assets • Maintain communicationwith local community

  34. LocalRoleand Responsibilities • Engage inindividualfacility planningto prepareforsurge/infrastructuredamage • Engage incommunity-levelplanning • Bring togethercriticalstakeholdersandlifelines • Emphasizeimportanceof otherhealthcare providertypes • Maximizelocal resources

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