Transcript Medical Needs Shelter Planning for Hudson County

Monique Davis, MPH, MCHES
Hudson Regional Health Commission
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Identify what type of shelter you will activate
◦ Co-located
◦ Stand-alone
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Identify and secure funding sources as early
in the process as possible
Secure Medical Director- needed in order to
issue standing orders for clinical staff to
provide services to evacuees & write Rx’s
Define the level of care your shelter will
provide
◦ General Population Shelter (Tier 1): Individuals who are
independent prior to the disaster or emergency. Some
of these individuals may have pre-existing health
problems that do not impede activities of daily living
(ADLs) and do not exceed basic first aid capabilities of
community shelters
◦ Medical Needs Shelter (Tier 2): Evacuees (patients) who
have no acute medical conditions but require some
medical surveillance and/or special assistance beyond
what is available in a traditional shelter
◦ Hospital Facility (Tier 3): Evacuees who need acute
medical care such as people experiencing significant
trauma, injury, or who have acute medical condition(s)
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Multidisciplinary Steering Committee
suggested
◦ Health & Human Services Representative (ESF #6)
 Include Mental Health Administrator
◦ Office of Emergency Management
◦ Public Health Representative
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 Include clinician
Hospital Representative
EMS Representative
Facilities/Engineering
Red Cross Liaison
Transportation Coordinator
AFN Representative
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Facility & Equipment/Supplies
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Staffing and Training
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Public Outreach and Education
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Public Health Advisory
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Plan and SOG Development
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Identified and assessed potential sites within the county
◦ Committee members present included OEM, Red Cross Liaison,
County Administration, Facilities representative, LINCS
representative
◦ Must be ADA compliant (General Population Shelters also)
Created equipment and supplies list based upon the suggested list in
the South Jersey Medical Needs Shelter Standard Operating Guidelines
(now the statewide adopted template)
◦ Identifying funding sources early in process is essential
◦ Become familiar with UASI projects relevant to sheltering
 FY 2012: Trailer, cots (including bariatric), “basic medical
equipment” - ?? For 25 patients + 25 staff
 FY 2013: Will build on MNS supplies; O2 Concentrator
◦ Work with clinical staff/MRC volunteer to select supplies; discuss
special needs menus (low sodium/diabetic, etc.)
◦ Don’t forget to identify storage location for all equipment/supplies
◦ Have plan in place for medication procurement
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Committee identifies potential staffing sources within county
(ie: Schools of Nursing, Medical Schools, Home Health
Agencies, county employees, hospital staff, etc.
Training needs and instructor resources for same are
identified
◦ Feedback statewide is that courses on caring for chronic
conditions such as diabetes, asthma, cardiac conditions,
etc. in elderly populations is needed. Many volunteers do
not regularly work with geriatric populations.
 Know your MRC! Are they school nurses, hospital
employees? Hudson used Survey Monkey to do “Skillset
Survey”. Tailor training to results of survey and gaps in
recent experience
 Consider asking local hospitals to teach one or two
courses; spread request around to all hospitals in county.
Remind them that shelters decrease surge for them –
WIN/WIN for everyone.
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Goal of this committee is to draft an outreach
and education campaign
◦ Targeted towards both public and professional
audiences
 Public: general education about who goes to a MNS,
what they should bring
 Professional: eligibility criteria, procedures for referral,
etc.
 EMS personnel
 Hospital ED/Discharge Planners
◦ Proposed awareness campaign to include press
releases, PSA’s, social media
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Purpose of this committee is to develop SOP’s
for the following:
◦ Environmental Assessment/Enforcement: Local
health responsible for assessment of site relative to
compliance with sanitary conditions, ie: availability
of handwashing facilities, toilet facilities, food
temperature and storage compliance, etc.
◦ Local Health strongly encouraged to have periodic
presence at shelter during activation period
◦ Communicable Disease Surveillance and Reporting:
 Shelter Management must be educated regarding
surveillance and reporting of communicable diseases.
 Especially important in congregate settings.
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South Jersey template is good starting point;
however, it does not include a clinical concept of
operations or SOG
◦ PHEP Public Health Nurse Group is currently developing
SOG’s for the clinical piece. Includes the following:
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Standing Orders
Medication Procurement
Forms/Triage/Registration/Discharge Planning
Special Needs Menu Planning
Patient Tracking
Training
Level of Care/Patient Ratio
Goal is to have Draft by June 2014
◦ Medical Reserve Corps (clinical and non-clinical)
◦ County Employees
 Department of Health and Human Services personnel (should
be ESF #6 Lead – Mass Care)
 County Hospital?
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Local Health Department Staff
FQHC Personnel
Board of Education Nurses
School of Nursing Faculty/Students?
Hospital Emergency Dept staff on off hours??
EMS Personnel
Community Organizations – ie. Doctors Without Borders
Clergy Representation
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Consider phone triage, as once evacuees arrive at
doorstep, it’s difficult to turn them away
Begin case management/discharge planning
upon admission to shelter – often takes that long
to plan adequately!
Consider having MOU’s with LTC’s. LTC’s often
have “respite” bed rates ~$200/day. Staff, O2,
meals, laundry – all in place
Include facilities management in planning.
Experts in HVAC issues. Need input regarding
temperature control and generator use.
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Plan for social services involvement and mental
health component as well
◦ Social services – Discharge Planning
◦ Mental Health – contact County Mental Health
Administrator to request Disaster Recovery Crisis
Counselors (DRCCs) and planning for clients with
substance abuse history
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Track personnel hours/other resources for
possible FEMA reimbursement!
◦ MRC volunteer hours can possibly be counted towards
“in-kind” match for FEMA reimbursement application if it
is a declared emergency. (NJMRC has Deployment Tool
for tracking volunteer hours)
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Contact Information:
Monique Davis, MPH, MCHES
Hudson Regional Health Commission
201-223-1133
[email protected]