“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-