Healthcare Coalitions
Paul L. Link, RN, MSHS
CDR USPHS
ASPR HPP Field Project Officer
ASPR: Resilient People. Healthy Communities. A Nation Prepared.
Objectives
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Healthcare Preparedness Guidance
Defining Healthcare Coalitions
Development of Healthcare Coalitions
HCC Preparedness
HCC Response
HCC Validation
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Healthcare Preparedness
Guidance
• The Healthcare Preparedness
Capabilities, National Guidance for
Healthcare System Preparedness,
was released in March, 2012
• This document provides direction for
Healthcare Coalition development
• Addressed in Capability 1 and
collaborative planning for the
healthcare system is the basis for
healthcare coalitions
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Definition
The Healthcare Coalition
• The Healthcare Coalition is a collaborative network of healthcare organizations and
their respective public and private sector response partners
• Serve as a multiagency coordinating group to assist with preparedness, response,
recovery, and mitigation activities related to healthcare organization disaster
operations
• Priority objective of the Healthcare Coalition includes sub-state regional, healthcare
system emergency preparedness activities involving the member organizations. This
includes planning, organizing and equipping, training, exercises and evaluation
• The response objective for Healthcare Coalitions includes representation of healthcare
organizations by providing multi-agency coordination to advise decisions made by
incident management regarding information and resource coordination for healthcare
organizations.
─ Includes a response role as part of a multi-agency coordination group to assist incident
management (area command/unified command) with decisions,
─ OR coordinated plans to guide decisions regarding healthcare organization support
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Role in Disaster
DISASTER CYCLE
Healthcare Coalitions:
Assist HCOs within their
region to return to normal
healthcare delivery
operations
Healthcare Coalitions:
Address areas in critical
infrastructure and key
resource allocation planning
that decreases the
vulnerability of the healthcare
delivery system
Recovery
Mitigation
Response
Healthcare Coalitions:
Integrate with ESF8 to
coordinate healthcare
organizations’ priorities and
needs to assist incident
management with resource
and information management
during response.
Preparedness
Disaster
Healthcare Coalitions:
Follow the steps of the
Preparedness Cycle to
effectively mitigate, respond
and recover from a disaster
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Development
Capability 1: Healthcare System Preparedness
•
Function 1: Develop, refine, or sustain Healthcare Coalitions
─ P1: Healthcare Coalition regional boundaries
─ P2: Healthcare Coalition primary members
─ P3: Healthcare Coalition essential partner memberships
─ P4: Additional Healthcare Coalition partnerships/memberships
─ P5: Healthcare Coalition organization and structure
─ P6: Multi-agency coordination during response
P1 = Planning Element 1
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Development
Regional Development
• Healthcare Coalitions can be developed
around or within a functional service
region/area such as
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Healthcare Coalition Regions =
DHEC Public Health Regions
healthcare service catchment areas,
trauma regions,
Emergency Medical Service (EMS) regions,
Regional Coordinating Hospital regions,
Public Health regions/districts,
county jurisdictions,
Emergency Management Agency (EMA)
regions,
or another type of functional service region.
• Participation in emergency management
preparedness and planning can be achieved
by
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The formation of Healthcare Coalitions as a
component of a larger planning region (e.g.,
EMS or EMA regions)
OR around healthcare delivery areas (e.g.,
Regional Coordinating Hospital Region, etc)
(this includes obtaining input for preparedness
from relevant response organizations and
stakeholders)
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Staged Development
Stage 1
Stage 2
• Determine regional approach
and boundaries
• Establish awardee support and
partnership
• Determine governance structure
• Establish the healthcare coalition
for purposes of preparedness
evidenced through appropriate
documentation
• Maintain the Stage 1
requirements through
sustainment and preparedness
activities
• Perform preparedness activities
as outlined in Capability 1:
Healthcare System
Preparedness
Stage 3
• Determine how healthcare
coalitions will address
multiagency coordination during
response and perform ongoing
regional exercises to test this
capability.
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Sustainment
Healthcare Coalition
Governance
Finance
Legal/Policy
Technology
Business
Operations
Integration with
ESF#8
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Preparedness
Function 2: Coordinate healthcare planning to prepare the healthcare system for a
disaster
P1: Healthcare system situational assessments
P2: Healthcare System disaster planning
Function 3: Identify and prioritize essential healthcare assets and services
P1: Identify and prioritize critical healthcare assets and essential services
P2: Priority healthcare assets and essential services planning
Function 6: Improve healthcare response
capabilities through coordinated exercise
and evaluation
P3: Evaluation and improvement plans
P4: Best practice and lessons learned
sharing
S1: Exercise and evaluation training
Function 3: Identify and prioritize essential
healthcare assets and services
E1: Equipment to assist healthcare organizations
with the provision of critical services
Function 4: Determine gaps in the healthcare
preparedness and identify resources for
mitigation of these gaps
P1: Healthcare resource assessment
P2: Healthcare resource coordination
P3: Address healthcare information gaps
PLAN
EVALUATE/
IMPROVE
ORGANIZE/
EQUIP
EXERCISE
Function 6: Improve healthcare response
capabilities through coordinated exercise
and evaluation
P1: Exercise plans
P2: Exercise implementation and
coordination
S1: Exercise and evaluation training
TRAIN
Function 5: Coordinate training to assist
healthcare responders to develop the necessary
skills in order to respond
P1: Healthcare organization - (NIMS) training
S1: Training to address healthcare gaps and
corrective actions
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Response
Hospital C
Hospital
B
Hospital
A
LTC
MH/BH
Healthcare
Support
Healthcare
Support
MACC
HC
EM
ESF
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Healthcare
Coalition
PH
EMS
C
B
A
A
B
C
A
B
Jurisdiction Emergency Management and
Incident Management
Public Health
Agencies
C
Capabilities CONCEPT of HCC Response
EMS Agencies
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Healthcare Coalition Validation
• Occurs over the project period = 5 years (2012 – 2017)
• Includes:
─ Joint HPP-PHEP application requirements
─ Capability requirements
─ Performance measure requirements
• Validation is done using a combination of technical
assistance and monitoring
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Desk review of documents
Site visits (State level)
Coalition visits (regional level)
Exercise observation
• Will incorporate best practices from regions
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Healthcare Coalition Validation
• Application requirements (HPP specific – awardee level)
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Capability development
Coalition development
Training and exercise compliance
Interoperable communication compliance
HAvBED compliance
Integration of special populations
Application requirements: Found in the funding opportunity announcement at
Grants.gov under funding opportunity number CDC-RFA-TP12-1201 at:
http://www07.grants.gov/search/search.do;jsessionid=3h8KPRRSKTJ0Wvf6s
HKFdMgGK2tsGwJ4qstqykMJW77XfdnnjGGh!1869518295
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Healthcare Coalition Validation
• Capability development (regional level)
─ Review of plans (desk review)
─ Validation of CONOPs (site visit/exercise observation)
─ Validation of information management processes (site
visit/exercise observation)
─ Validation of resource management processes (site
visit/exercise observation)
•
ASPR’s Healthcare Preparedness Capabilities: National Guidance for
Healthcare System Preparedness available at:
http://www.phe.gov/Preparedness/planning/hpp/reports/Documents/capabiliti
es.pdf.
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Healthcare Coalition Validation
• Performance measurement
─ 8 HPP measures
─ 3 Joint HPP/PHEP measures
• HPP performance measurements are required to be met
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in the 5-year project period
There may be some adjustment to the measures this year
• HPP Performance Measures found here:
http://www.phe.gov/Preparedness/planning/evaluation/Documents/fY12-hppperf-measures.pdf
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HPP Performance Measures
(Provisional)
• HPP 1.1: % of HCCs that have established formalized agreements and demonstrate their ability to
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function and execute the capabilities for healthcare preparedness, response, and recovery as
defined in Healthcare Preparedness Capabilities
HPP 2.1: % of HCCs that have developed processes for short-term recovery of healthcare service
delivery and continuity of business operations
HPP 3.1: % of HCCs that use an integrated ICS to coordinate operations and sharing of critical
resources among HCC organizations during disasters
HPP 5.1: % of HCCs that have systems and processes in place to manage mass fatalities
consistent with their defined roles and responsibilities.
HPP 6.1: % of HCCs that can continuously monitor Essential Elements of Information (EEIs) and
demonstrate the ability to electronically send data to and receive data from coalition members to
inform a Common Operating Picture
HPP 10.1: % of HCCs that have a coordinated mechanism established that supports their
members’ ability both to deliver appropriate levels of care to all patients (including pre-existing
patients [both inpatient and outpatient], non-disaster-related patients, and disaster-specific
patients), as well as to provide no less than 20% bed availability of staffed members’ beds, within 4
hours of a disaster
HPP 14.1: % of HCCs of that have systems and processes in place to preserve healthcare system
functions and to protect all of the coalition member employees (including healthcare and nonhealthcare employees)
HPP 15.1: % of HCCs that have plans, processes and procedures in place to manage volunteers
supporting a public health or medical incident.
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Performance Measure HPP 10.1
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To ensure immediate bed availability in times of crisis, coalition partners must
continuously monitor acuity of patients and maintain full ability for patient movement.
Once a disaster happens, acute care facilities will need to prepare for an influx of new
disaster patients. Through agreements with coalition partners, movement of lower
acute patients begins from hospitals to other, appropriate facilities and care sites; thus
making room for higher acuity patients. These same agreements ensure that receiving
facilities are prepared to provide the appropriate level of care. See images below
Before
After
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Healthcare Coalition Validation
First Steps:
• Between July 1, 2012 and September 30, 2012
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Develop a draft 5 yr rotational schedule for HCC visits
May include regional meeting or regional exercise
Done with approval of HPP Coordinator and HCC
Request of initial assessment of regional level activity (i.e.,
tools developed by Region 5)
• For remainder of BP1 – BP5
─ Work with SC HPP as requested to provide HCC TA
─ Visit HCCs as available and requested to assist with
development
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QUESTIONS?
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Contact Information
Paul L. Link, RN, MSHS
Commander, USPHS
Field Project Officer, HHS Region IV
Hospital Preparedness Program
Office of the Assistant Secretary for Preparedness and Response
BlackBerry: 404-989-4922
Cell Phone: 850-499-8563
paul.link@hhs.gov
61 Forsyth St. S.W., Suite 5B-95
Atlanta, GA 30303
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