KY Public Health Association (KPHA) ConferenceCrowne Plaza Hotel, Louisville, KY

March 9, 20111:00-2:30 PM.

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Session PresentersEmergency Preparedness , Response and Recovery in Long Term

Care Facilities Arleen Johnson, PhD, Director, Ohio Valley Appalachia Regional Geriatric Education

Center, University of Kentucky College of Public Health, Lexington KY (859) 257-8314, arleen@uky.edu http://www.mc.uky.edu/aging/gec.html

Betty Shiels, ABD, Co-Director, Ohio Valley Appalachia Regional Geriatric Education Center, University of Louisville Kent School of Social Work, Louisville KY (502) 852-8003 emshie01@louisville.edu

Home Health Care Patients In Emergency Situations: Who are they? What do they look like? Mary J. “Missy” Pfaadt, RN-C, MSN, Administrator/Executive Director, Caretenders

Visiting Services of Louisville, Louisville, KY (502) 238-5150 missypfaadt@caretenders.com

In Case of Disaster: Be Prepared for Persons with Memory Disorders Renee Chase, BBA, Mdiv, Professional Training Coordinator, Alzheimer’s Association,

Greater KY and Southern Indiana Chapter, Lexington, KY (859) 266-5283 Renee.Chase@alz.org

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Session ObjectivesUpon completion of this session, learners should be able

to:

1. Explain why older people are disproportionately affected by disasters

2. Discuss issues related to disaster care in Long Term Care Facilities

3. Utilize resources for emergency planning and response for older persons living in the community and in long term care settings (Arleen Johnson and Betty Shiels)

4. Discuss issues related to disaster care for home health patients

(Missy Pfaadt)5. Identify challenges of providing disaster care for persons with

memory disorders (Renee Chase)

Funding through KCHFS/KDPH 2010- 2011 contract #PON2 7281000004025 2 UK /UL Emergency Preparedness for Aging Training Grant

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Older Kentuckians at RiskKY Hospitals : 7,544 daily occupied beds Nursing Facilities: 26,714 daily occupied

beds --69% have memory disorder (18,432)

Personal Care Homes: 4,447 licensed beds Assisted Living: 3,356 licensed beds Home Health: 41,626 daily bed censusHospice : 2,838 licensed beds

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Older Persons: High Risk in an Emergency

Altered immune functionHigher risk of infectious

illnessReduced response to

antibioticsAtypical presentation of

disease Chronic medical conditionsGreater risk of pneumoniaMemory

disorder/DementiaHyper/hypothermiaMultiple medicationsSensory Changes

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Need assistance with activities of daily living

Use of portable oxygen & other medical supplies

Use of wheelchairs, walkers, canes, assistive devices

Anxiety about leaving familiar surroundings

Decreased rebound after emergency

Delayed onset of Post-traumatic Stress Syndrome

Language/cultural influences

Personal Preparedness & Response

Emergency Plan in place and shared with others

Personal support network in placePlans for contacting needed othersRegular practice and Plan RevisionPre-approval as volunteer for

CERT, MRC, K-HELPS, Red CrossAwareness of community plansParticipation in community exercises

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Agency Preparedness & Response

Risk Assessment HVACommunity PlanningIncident Command

TrainingAgency PreparationPolicies/Procedures for

Caregivers on StaffMOAs with Multiple

VendorsStaff ResourcesSupplies Inventory

Shelter-in-Place PlanEvacuation PlanDirect Care PlanFiles/Contact

InformationContinuity of

OperationsStaff /SupervisionTimekeepingContinued PayrollInvoice PaymentCash on Hand

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Networking• Identify and Meet Community Partners

o Emergency Management, Emergency Medical, Fire, Police, Utilities

o Long Term Care & Aging Services Providerso Faith-Based Communities; Schoolso Hospital Preparedness Coalition Memberso Media, Transport Services, Water, Fuel, Laundry Supplierso Funeral Homeso Special Medical Services i.e. Dialysis Care

• Invite Partners to your Facility • Get Contact Information• Discuss Roles in an Emergency• Share Facility Plans with Community Partners• Negotiate Memorandums of Agreement

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Shelter-in-PlaceDecision to Shelter-in-Place

Type of DisasterSafety of Staying vs Going

Incident Command SystemNotificationsActivate call listsEnable communicationSupplies/equipment in place for 3-7 daysUtilities/Safety and SecurityMemorandums of Agreement (Supplies,

Equipment, Services, etc.)

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EvacuationWho decides –collaborative or mandatoryScale of evacuation – to other nursing facilities, community shelter, remote shelterPartial or total evacuationRoles of County Emergency Manager/EMS/FireTransportation arrangements – ambulance, bus,

vanEvacuation timing and routing– plan on 3-4 times

longer than normal and possible barriers/debrisEvacuation supplies, equipment, staffContinuity of operations Return to facility

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National Level Earthquake ExerciseKDPH training coordinators deeply involved in

training with long term care Additional partners with long term care includes

KDPH Preparedness Branch, KHA, 2 state LTC associations, KY Dept. of Veterans Affairs and the KY Long Term Care Ombudsman Program

Regional Tabletop Exercises planned for western KY regions impacted by an earthquake

--HPP Regions 1, 2 & 3 LTC March 31, 2011 -- HPP Regions 4, 5, 6 & 12 LTC May-June, 2011

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Networking and Funding

Prior to an emergency, health care provider agencies can network with other providers and may qualify for Hospital Preparedness Coalition (HPC) funding for equipment & supplies. Requirements may include:

1. Complete Incident Command System ICS 100 & 200, NIMS 700, and NIMS 800

2. Actively participate on regional Healthcare Planning Coalitions/Long Term Care Committees

3. Register with and/or provide agency data on WEB-EOC or other data base required by KY Department of Public Health

4. State-specific requirements

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Kentucky HPC Regions

Wayne

Mercer

Henry

Woo

dfor

d

Grant

OldhamHarrison

ShelbyScott

Bourbon

FayetteClark

Jefferson

Nelson

Spencer

Robertson

Mason

Fleming

Lewis

Carter

BathRowan

Greenup

Elliott

Menifee Morgan

Martin

Breathitt Pike

Powell

Floyd

Wolfe

Lee

Owsley

Leslie

PerryKnott

LetcherClay

Estill

Laurel

Madison

Harlan

Bell

Knox

Whitley

Pulaski

LincolnMarionLarue

Monroe

Casey

Boyle

Allen

HardinBreckinridge

Grayson

Todd

Hopkins

Meade Bullitt

Fulton Graves Calloway

Ballard

Carlisle

Hickman

ChristianTrigg

Ohio

DaviessUnion

Henderson

Webster

Hart

BarrenLogan

Butler

WarrenAdair

Taylor

Lawrence

Owen

Area 1

Area 2

Area 4

Area 3

Area 5

Area 6

Area 7

Area 8

Area 9

Area 10

Area 11

Area 12

Area 13

Area 14

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2

3

4

5

6

7 813 9

10

12

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Regional Healthcare Planning Coalitions (HPC)

Public Health First Responders What level of preparedness

involvement have you had with at-risk older persons in your community?

How familiar are you with the emergency preparedness /response challenges that they present?

What revisions might be required in your health department/county plans to respond to these at-risk elders?

What support does your agency need to assure their safety in an emergency?

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Resources for Preparedness and Response

KDPH TRAIN KY Training Modules https://ky.train.org/DesktopShell.aspx Helping Elders Prepare for Bioterrorism and

Emergencies (Course ID 1006475)Disaster Preparedness: Developing Agency

Emergency Plan (Course ID 1007090)CERT Community Emergency Response Team

(Course ID 1005655) The Aging Network (Course ID 1006470) Medical

Reserve Corps-An Introduction to Incident Command (Course ID 1014646)

Pandemic Influenza (future TRAIN Course ID 1009188) Interim Link: http://cwte.louisville.edu/ovar/avianflu/index.html

Medical Reserve Corps-An Introduction to Incident Command (Course ID 1014646)

Pandemic Influenza (future TRAIN Course ID 1009188) Interim Link: http://cwte.louisville.edu/ovar/avianflu/index.html

OVAR/GEChttp://www.mc.uky.edu/aging/

gec.htmlKY All Hazards LTC Planning & Resource

ManualEmergency Plans- Individual & AgencyBiomedical IssuesAging and Public Emergencies/DVDsPlanning and Mobilizing ResourcesPublic CommunicationMental and Behavioral IssuesEthical and Legal IssuesAdditional Resources

FEMA NIMS Resource Center

http://www.fema.gov/emergency/nims/ NIMS Training Courses – Fact Sheets

http://www.fema.gov/emergency/nims/NIMSTrainingCourses.shtm#item1

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Resources for Preparedness and Response OVAR/GEC E-News Emergency Preparedness for Aging Geriatric Education Resources

http://cwte.louisville.edu/ovar/emergency/fall2007.htm Preparedness for Long Term Care

http://cwte.louisville.edu/ovar/emergency/winter2008.htm Health Literacy for Emergency Preparedness/ Aging

http://cwte.louisville.edu/ovar/emergency/spring2008.htm Pandemic Flu and Aging

http://cwte.louisville.edu/ovar/emergency/summer2008.htm Long Term Care:

http://cwte.louisville.edu/ovar/emergency/winter2008.htm http://cwte.louisville.edu/ovar/emergency/winter2009.htm http://cwte.louisville.edu/ovar/emergency/summer2009.htm http://cwte.louisville.edu/ovar/emergency/winter2010.htm

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Questions? Arleen Johnson, PHDOVAR/GEC at UK859/257-8314arleen@uky.eduhttp://www.mc.uky.edu/aging/

gec.html

Betty Shiels, PHD-COVAR/GEC at U of L502/852-8003emshie01@louisville.edu

Funding through KCHFS/KDPH 2010-2011 grant #PON2-728-1000004025-2UK Emergency Preparedness for Aging Training Grant

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