“Preparation for the Flu Pandemic, Mobilizing Human Resources”

CAPT Lynn A. Slepski, RN, MSN, CCRNSenior Public Health Advisor

US Department of Homeland Security

2006 Annual Conference

Alexandria, Virginia

Council on Licensure, Enforcement and Regulation

Expect the Unexpected: Are We Clearly Prepared?

Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia

Standard Continuity of Operations (COOP) Planning

• SCALE related– 1 Geography– Less than 30 days– Essential functions only– Essential personnel only– Resumption plan

• Emergency plan that translates to specific situations

Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia

COOP Example—Y2K

• Major businesses developed a plan• Upstream and downstream• Wrote Y2K plans into contracts• Actually verified/critiqued the

plans• Result—No issue

Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia

Hurricane Katrina• 1.5 million people • 90,000 square miles • Louisiana, Mississippi, and

Alabama• 770,000 persons displaced• 89,000 persons evacuated to

make-shift shelters • Medical infrastructure

sustained extraordinary damage

• Triggered the largest natural disaster relief and recovery operations in United States history

• Created an unprecedented demand for relief healthcare services

Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia

Katrina Example-Pharmacy Support

• Original plan– Ring the impact area and

prepare to flow support in– LA alone 10 – 12 shelters– Major chains would “adopt”

a shelter– Based on census either

support from off site OR establish a mobile pharmacy

• Reality – >200 shelters– Very poor information– Lost time drafting legal

language for emergency powers

Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia

Pharmacy Response• Exercised previous relationships• Businesses worked directly w/ the LA

Board-practice modifications– Pharmacists could dispense w/o Rx– Any mobile pharmacies could operate

without an inspection to operate– Accept any pharmacist license-Immediate

reciprocity– Disposal of compromised drugs—hazardous

wastes– Remote processing…Pharmacists could

enter into a database and begin filling process

– Developed a database took all available records

Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia

Pandemic Planning Assumptions

• 40 percent or more of workforce out(Sick, taking care of family or afraid to work)

• School closures (day care – universities)• Supply and delivery chains disrupted• Travel delayed or halted; large public

gatherings canceled• Healthcare system overwhelmed • Essential services interrupted• Some believe that all rules/regulations

will be suspended

Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia

Pandemic Challenges• Pandemics are different from other types of

emergencies• There will be no clear beginning and end• Almost all locations will be affected

simultaneously• There will be multiple waves• Resources cannot be shifted geographically as

in other emergencies• Every country will be affected, but countries

with better plans will be less vulnerable to terrorism and other threats during a pandemic

Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia

DHS Federal Responsibilities

• Above and beyond our own continuity planning….

• Federal incident management• Border control• **Maintaining critical infrastructure and key

resources (CI/KR) (85% owned privately)– N=17. Examples are food, water, public health,

emergency services, energy, transportation– Continuity of operations – essential (COP-E)

• Catastrophic planning for essential services– Identify in advance where regulatory relief may

be helpful

Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia

Regulatory Waivers• Certain waivers should be considered to

ensure that public and private sector responders can react and recover effectively– Pre-identify areas where rules/regulations can be

modified or waived temporarily– Weigh risks vs. benefits as entities struggle to

maintain response• Quality• Safety

– Don’t want to further compromise vulnerable populations when possible

• GOAL: Policies in anticipation– What is expected– How laws will be applied and enforced

Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia

Public/Private Partnerships

• US Chamber• Trade and Professional Organizations• Businesses • CI/KR Sectors• Advisory Councils• Governments and Governmental

Agencies

Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia

Transportation IssuesGOAL: Maintain supply chains

• Change authorities– Commercial Drivers License (CDL) drive

interstate when providing emergency services

• Decrease restrictions– Drive times, weight restrictions, etc.

• Licenses, Credentials or Certifications• Federal pre-emption of state and locally

decided closures to allow movement of critical supplies

Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia

Liability Issues

GOAL: Liability protection for businesses

• Medical care, anti-virals and vaccines for side effects and consequences

• Protective equipment

Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia

Sharing of Information

GOAL: Continuity of Care

• Databases• Electronic medical records

Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia

Personnel Issues

GOAL: Protect workers/ maintain operations

• Fair Labor Standards Act– Time recording, exempt/non-exempt duties,

overtime, etc.• Confidentiality Requirements

– HIPPA, ADA, FMLA • Discussions regarding employees or family members• Tracking of illness

• Employer Responses– Benefit documentation (ERISA) response time– Requirements to pay employees w/i a certain period

Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia

Scopes of Practice

GOAL: Accomplishing the greatest good

• Healthcare scopes of practice– EMT vs. ACLS

• Prescription authorities • Drug dispensation• Identify “able” providers

– Who can perform tasks—How to find

Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia

Regulatory Requirements

GOAL: Protecting the workforce

• OSHA fit-testing for masks• Expedited SAFETY Act application

review

Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia

Your Role in Pandemic Planning

• Does your group have a plan? Family?• Consider where there may be room for

discussion• Don’t wait for an invitation to “come

to the party”• Encourage cross-walking of plans• Help identify possible options—be part

of a solution

Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia

Conclusion

• Regulatory bodies are key stakeholders• Role in both the development and

implementation of emergency preparedness plans.

• Regulatory relief will be necessary– maintain CI/KR– facilitate effective mobilization of resources

at a local level

• Challenge--Consider non-traditional ways of meeting the health and safety needs of the public in a time of crisis.

Presented at the 2006 CLEAR Annual ConferenceSeptember 14-16 Alexandria, Virginia

Speaker Contact Information

CAPT Lynn A. Slepski, RN, MSN, CCRNU.S. Department of Homeland Security/PrepWashington, DC 20528Desk (202) 282-9697 FAX: (202) 282-

8191Lynn.Slepski@dhs.gov