Health and Human Services Preparedness Program FY 2012-2013 Grant - - PowerPoint PPT Presentation

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Health and Human Services Preparedness Program

FY 2012-2013 Grant Round I Mandatory Workshop August 2012 Hospital Session

STEP TWO (2)

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Step Two (2)

2012-13 HPP Grant Awarded July 1 *Allocation Model Developed & Approved by Advisory Board August-Sept 2012 Participation Agreement Developed September - Nov 2012 Participation Agreements Mailed Oct 2012 - Jan 2013 Signed Participation Agreements & Budget Proposal Due Nov - Feb 2012 *Facility submits required documentation for reimbursement as required by Participation Agreement on one

• f the three deadlines

March, April or May 2013 *HPP grant staff review documentation for acceptable purchases and required documentation. Mar – June 2013 *HPP grant staff submits request to accounting department ; Accounting submits request invoice to DHH Mar – June 2013 Unspent Funds Reallocated (Reallocation 2) June 2013 Once funds received from DHH, LHA distributes grant dollars Sept 2013 Unobligated Funds Reallocated (Reallocation 1) Apr- Mar 2013 Regional Rounds meetings to discuss 2012-13 grant requirements are held August 2012 *Site Visits for 2010-11 Begin Nov 2012 *Site Visits for 2010-11 End March 2013

*Green = Documentation in binder **Blue = Monitoring Activities Spending & Documentation Review Process

Step 2

Step Two (2):

 Identify gaps and develop plan of action on how

grant goals will be met & how funds will be spent. (Budget Proposal)

 Submit signed Participation Agreement, Budget Proposal and

• ther requested documents.

 Spend funds and submit the Acceptable Documentation of Proof

• f Payment as indicated in Participation Agreement.

 Continue participation in HHS Emergency Preparedness activities

 Radio Roll Call  Regional and State Drills  Regional Meetings  ESF 8 Portal Activities

Identifying Gaps Five (5) Year Hospital Goals

FIVE YEAR PLAN – Goals Should Be Met By 2012 REGION SURGE BEDS CRITICAL CARE BEDS VENTILATORS PPE MASS FATALITY 1 1370 794 662 6 to 8 week supply 333 deaths 2 1181 684 570 6 to 8 week supply 270 deaths 3 939 544 453 6 to 8 week supply 215 deaths 4 727 421 351 6 to 8 week supply 174 deaths 5 545 316 263 6 to 8 week supply 130 deaths 6 722 418 349 6 to 8 week supply 172 deaths 7 1030 597 497 6 to 8 week supply 250 deaths 8 671 389 324 6 to 8 week supply 163 deaths 9 963 558 465 6 to 8 week supply 223 deaths Total 8,147 4,721 3,934

• 1,928 deaths

For planning purposes, the numbers presented in the table below were derived by averaging the mortality of the 1968 pandemic and the 1918 pandemic.

Identifying Gaps Current Grant Goals (Hospitals)

Surge Capacity

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Identify number of surge bed using the following the formula:

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Formula: Licensed Beds - Average Daily Census

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Note: Must have physical bed when using this formula

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If Surge Goal cannot be met with the above formula, hospitals should:

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Purchase cots, stretchers, air mattresses

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Purchase supporting equipment such as IV poles, monitors, carts, etc.



Identify in response plan location of surge beds and where the cots and stretchers will be placed in facility. If you cannot meet surge goal, facilities should document steps taken to achieve goal and reasons why goal could not be met.

Identifying Gaps Current Grant Goals (Hospitals)

Critical Care Capabilities

 Based on the altered Critical Care Bed definition, each

bed should include the following:

 1 electrical outlet,  1 50 PSI oxygen outlet,  1 50 PSI air outlet,  1 suction outlet or portable suction outlet, and  1 portable pulse oximetry

 Hint: Use existing surge beds as critical care surge beds.

Replace surge beds with cots or stretchers. May also want to double up in patient care rooms with the outlets

Identifying Gaps Current Grant Goals (Hospitals)

Ventilator Cache

 Formula = Number of Ventilators in Possession – Number in Use  To meet goal, facilities should count all ventilators capable of

providing full ventilatory support of a patient. (i.e. fixed, portable

• r disposable ventilators)

 Other Spending Suggestions:

 Additional circuits and filters.  Associated accessories including sufficient oxygen

 Develop contingency plans to include redundancy options.

Identifying Gaps Current Grant Goals (Hospitals)

Personal Protection Equipment (PPE)

 Facilities should determine and document formula used to determine

amounts in cache. (See handout for sample formula).

 Cache should include, but is not limited to, gloves and masks.  As storage becomes a problem, hospitals need to document

steps taken to achieve goal and reasons why goal could not be met. Facilities should consider other alternatives, such as outside storage areas.

 The located of cache, the amount and what equipment is in cache

should be documented and mentioned in plans.

Identifying Gaps Current Grant Goals (Hospitals)

Mass Fatality

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Facilities should have Mass Fatality Plan.

 Tier 1 hospitals should:

 Purchase body bags to meet goal listed in Attachment A.  Collaborate with local coroner for storage and pick up of remains.  Increase surge capacity (number of remains morgue can temporarily hold),

by lowering temperature and placing remains on stretcher in morgue or in another area of facility, and/or

 Contract with refrigerated truck companies.

 Tier 2 hospitals should:

 Document, in plans, protocol for expiration of patient.

Identifying Gaps Current Grant Goals (Hospitals)

Pharmaceutical Cache

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Facilities must have a biological cache to take care of inpatients, staff members and their family members for 72 hours.

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Cache should include at least one of the following drugs:

 Doxycycline  Ciprofloxacin  Levaquin  Gentamicin

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Formula = (3.5 x # of staff members) + inpatient beds) x 3 days

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Tier 2 hospitals with no pharmacy should obtain letter from local pharmacy saying they will stockpile cache and deliver it upon notice.

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Facilities should have a Mass Prophylaxis Plan.

Identifying Gaps Current Grant Goals (Hospitals)

Communication

 Hospitals should have a 700 MHz radio or HEAR, depending on

your region.

 Hospital plans should include language about their redundant

communication systems, including the ESF 8 portal.

Identifying Gaps Current Grant Goals (Hospitals)

Decontamination

 Tier 1 hospitals should have:

 5 member decontamination team  2 disposable suits per member  1 PAPR for use per team member

 Tier 1 facilities should have plan on how decontamination team is

activated and listing of members and contact information.

Identifying Gaps Grant Goals (Summary)

Tier 1 hospitals

 Surge Capacity  Ventilator Cache  Mass Fatality  Pharmaceutical Cache  Decontamination Team  PPE Cache  700 mhz radio

Tier 2 hospitals

 700 Mhz radio  Pharmaceutical Cache  PPE Cache

Step Two (2): Budget Proposal

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Include both spending category & description.

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Cash expenditures should be equal to or greater than “reimbursement limit”.

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Non-cash in kind should

• nly include

expenditures in which you do not have actual

• receipts. If you have

proof of payment, you may claim it under cash

• expenditures. Staff time

can only be claimed under in kind contributions.

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Budget should also include “assurance statement”.

STEP THREE (3)

Step Three (3): Site Visits

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Site visits increased from 5% to 20% of facilities. The following facilities will receive visits sometime between Nov. 2011 – February 2012.

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55 hospitals

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11EMS providers

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Every hospital and EMS provider will be visited over the next 5 years regardless of whether they participated in the last grant cycle.

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Site visits are more comprehensive than in the past. In addition to grant purchases, HHS grant staff will be reviewing and confirming:

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NIMS compliance

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Survey responses

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Compliance with Participation Agreement (Attachment A for hospitals)

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Surge planning – i.e. beds, pharmaceuticals, PPE, etc

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If a “red flag” is found in site visit, corrective action measures will be

• taken. Corrective action measures includes:

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No longer eligible to receive grant funds until measures have been met

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Return a portion grant funds received

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Provide justification as to why measure cannot been met

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Surge Equipment

Site Visits (Continued)

Performance Monitoring Activity

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Pharmacy Caches

Site Visits (Continued)

Performance Monitoring Activity

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Ventilator Caches

Newport ventilators Disposable ventilators

Site Visits (Continued)

Performance Monitoring Activity

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PPE Caches

N95 masks Gloves N95 masks, gloves, gowns, etc

Site Visits (Continued)

Performance Monitoring Activity

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Decontamination Equipment

Decon suits & boots Decon boots PAPR Hospital Decon Trailer Blow up manikins for training

Site Visits (Continued)

Performance Monitoring Activity

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Communication Equipment

700 MHz radios Repeater HEAR System Satellite Phone

Site Visits (Continued)

Performance Monitoring Activity

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Mass Fatality

Region 4 and 5 MERC System Refrigerated truck at hospital in Region 3 Body Bags Region 7 Hospital Mass Fatality Trailer

Performance Monitoring Activity Site Visits (Continued)

Site Visit Findings

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Surge Capacity: Some hospitals are calculating surge beds from their licensed beds while

• thers have been using the daily average census.

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Mass Fatality: Hospitals struggle with calculating their morgue surge capacity. Hospitals should consider not only refrigerated trucks but explore other options such as lowering temperature in room and/or doubling up in existing morgue areas.

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Pharmacy: On pharmacy section of survey, hospitals have asked whether clinic staff should be included in the employee numbers. If so, they will need to provide a biological cache for those employees as well. Tier 2 hospitals do not have pharmacies onsite, only a small cache of drugs. To meet minimum HHS grant requirements, hospitals either have their parent company stock the drugs

• r they have agreements with their pharmacy supplier to deliver the drugs once needed.

Some Tier 2 hospitals pay for the cache upfront and the supplier stores it. Others pay for drugs once the drugs are delivered. In this scenario, the concern is that the drugs may not be available if there is disaster.

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NIMS Compliance - Because the administrators change quite often in Tier 2 facilities, some are not aware of the NIMS requirements as this was done under their old administrations.

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Decontamination - All Tier 1 hospitals have decontamination teams, but some teams are more robust than others. We are looking for more guidance/ideas from other states on how to keep team members engaged and trained.