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Regional Planning and Assistance

OSHA Training Institute – Region IXUniversity of California, San Diego (UCSD) - Extension

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Objectives

To describe mutual aid compacts that enable disaster assistance between hospitals, and between states, and which could be accessed if local resources are overwhelmed

To describe advantages of Regional Planning

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Federal Emergency Management Agency (FEMA), through the Robert T. Stafford Disaster Relief and Emergency Assistance Act

Reimburses mutual aid agreement costs associated with emergency assistance provided all of the following conditions are met:The assistance requested by the applicant is

directly related to the disaster and is eligible for FEMA assistance

The mutual aid agreement is in written form and signed by authorized officials of the agreeing parties prior to the disaster

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Stafford Act (continued)

The mutual aid agreement applies uniformly in emergency situations. The agreement must not be contingent upon a declaration of a major disaster or emergency by the Federal government or on receiving Federal funds

The providing entity may not request or receive grant funds directly. Only the eligible applicant receiving the aid may request grant assistance

Upon request, the applicant must be able to provide FEMA with documentation that the services were requested

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Evacuation and Surge Capacity: The Link

Evacuation of hospital patients is directly linked to surge capacity

Surge capacity for an evacuation allows room for relocation of evacuated patients and staff

Resources commonly referred to in surge planning are also potential resources as destinations for hospital evacuees

Regional planning is one of the processes to achieve success when forced to evacuate hospitals

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Advantages of Regional Planning Training, purchasing, and planning should occur

on regional basis, for hospital administrators, nurses and physicians

Standardization of PPE, respiratory equipment, and surge supplies to maximize ability to use per diem and agency RNs and volunteers at multiple sites

Group purchases lead to reduced costs per item. Contributions of expertise by each hospital in a

region lead to stronger plans and better responses

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Example of Uses

The “Metropolitan Area Hospital Compact” of the Twin Cities in Minnesota

Off-Site Care Facility Operations PlanningThe plan is regionally based, by hospitals

Minnesota Dept of Health Website(

http://www.health.state.mn.us/divs/idepc/diseases/flu/pandemic/plan/pccoscf.pdf.)

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Emergency Management Mutual Aid Compact

1996 - Ratified by Congress (P.L.104-321) as the first national disaster compact since 1950 (Civil Defense Compact)

Allows quick response from state to state for disaster resources for mutual aid for a governor-declared disaster

Once conditions of response have been set, there is a legal contract which makes affected state responsible for reimbursement

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EMAC: What it provides

Responding state knows there will no financial burden incurred for assisting

Personnel liability and Worker’s comp is assured

Allows credential approval across state line Avoids bureaucratic wrangling Achieves rapid response for any type of

assistance

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What do individual states do once they sign on to the compact…?

Need to pass their own legislation to be consistent with the compact Ex: professional licenses

“Model Act,” for states to use to model their own state legislation on, to standardize state laws, can be seen and is available on the EMAC Web site at www.emacweb.org

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WHY is having state laws consistent with a compact important?

Most states do not have legislation that allows medical professionals to practice with an out of state license, even when EMAC is utilized.

“Some states do not have legislation facilitating out of state licensing during emergencies, and the issue of hospital privileging is still a challenge in most states. States should address those potential limitations now – at the state level.”

http://www.astho.org/templates/display_pub.php?pub_id=1595

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EMAC Responses - 2004

EMAC responses to Hurricanes Charley, Frances, Ivan & JeanneDeployed over 800 state and local personnel

from 38 states (including one then non-member state, California)

Cost was $15 million in personnel, equipment, and National Guard expenditures

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EMAC Responses - 2005

EMAC scaled operations more than 20x as all member states combined deployed 65,929 personnel in response to Hurricanes Katrina and Rita to Louisiana, Mississippi, Texas, Alabama, and Florida.

More than 1,300 search and rescue personnel from 16 states; searched more than 22,300 structures and rescued 6,582 people

Nearly 3,000 Fire/Hazmat personnel from 28 states  

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EMAC Responses - 2005

More than 6,880 sheriff's deputies and police officers from 35 states and countless local jurisdictions deployed across Louisiana and Mississippi -  a total of 35% of all of the resources deployed  

More than 2,000 healthcare professionals from 28 states; treated more than 160,000 patients in the days and weeks after the storms

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Website: http://www.emacweb.org/

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Other Compacts

EMAC-like agreement exists among northeast states and Canadian provinces from Quebec eastward

International agreement, involving states in the northwest U.S. and neighboring Canadian provinces.

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Summary

Regionalization of planning reduces costs, reduces amount of training required in a region

Commonality of resources in a region is an advantage

EMAC and other compacts were reviewed