Weathering the Storm - NJHA · 2012-12-19 · Recovery Toolkit is designed to assist hospitals in preparing for, responding to and recovering from the potential consequences of a

Weathering the Storm:A Hurricane Planning, Response and Recovery Toolkit

Updated September 2010

TABLE OF CONTENTS

ACKNOWLEDGEMENTS ......................................................................................................................1INTRODUCTION ................................................................................................................................3

PART I: TYPES OF HURRICANESSTORM DEFINITIONS ..................................................................................................................5

PART II: WHAT TO EXPECTWHAT HOSPITALS CAN EXPECT ..................................................................................................7

A. PRE-STORM ......................................................................................................................7B. POST-STORM ......................................................................................................................7

PART III: ASSESSMENT TOOLPLANNING, RESPONSE AND RECOVERY ASSESSMENT TOOL ............................................................9

A. LEADERSHIP......................................................................................................................11B. INTERNAL (HOSPITAL) DEPARTMENT PLANS ..........................................................................19C. EMPLOYEE EXPECTATIONS ..................................................................................................25D. EMPLOYEE SUPPORT ........................................................................................................31E. SUPPLIES — SPECIAL CONSIDERATIONS FOR HURRICANES......................................................39F. UTILITIES ..........................................................................................................................43G. PATIENT ISSUES ................................................................................................................49H. COMMUNICATIONS ISSUES..................................................................................................53I. FACILITY MANAGEMENT AND SECURITY ..................................................................................59J. EXTERNAL RESOURCES AND MUTUAL AID ............................................................................65K. RECOVERY — DEMOBILIZATION ..........................................................................................69L. RECOVERY — PATIENT TRANSFER AND DISCHARGE ................................................................75M. RECOVERY — FINANCIAL RESOURCES ................................................................................79

PART IV: APPENDICES & RESOURCE LINKSPLANNING & RESPONSE RESOURCES ........................................................................................83

1. HOSPITAL DEPARTMENTS

A. DEPARTMENT PLAN TEMPLATE ........................................................................................89B. SAMPLE EMERGENCY CONTACT FORM ..............................................................................93

2. HOSPITAL EMPLOYEES

A. PREPARING YOUR WORK AREA ........................................................................................96B. SHELTERING NECESSITIES ..............................................................................................103C. HURRICANE PREPAREDNESS CHECKLIST ..........................................................................107D. PRE-SEASON EMPLOYEE ACKNOWLEDGEMENT FORM ........................................................111E. WORK EXEMPTION FORM..............................................................................................115F. CHILDCARE ENROLLMENT FORM ....................................................................................119

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Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit

3. KAISER PERMANENTE HAZARD VULNERABILITY ANALYSIS ......................................................1224. NJHA KEY RESOURCES FOR INCLEMENT WEATHER PREPAREDNESS ......................................1315. EVACUATE OR SHELTER-IN-PLACE DECISION GUIDE ..............................................................1356. SHELTER-IN-PLACE CHECKLISTS..........................................................................................139

A. 96—72 HOURS PRIOR TO ONSET..................................................................................143B. 72—48 HOURS PRIOR TO ONSET..................................................................................149C. 48—24 HOURS PRIOR TO ONSET..................................................................................155D. LESS THAN 24 HOURS PRIOR TO ONSET ........................................................................159

7. UTILITY FAILURE OPERATIONAL IMPACT CHART ....................................................................1638. CONSUMABLE SUPPLY OPERATIONAL IMPACT CHART ............................................................1679. DIALYSIS CONCERNS ........................................................................................................171

10. SAMPLE MUTUAL ASSISTANCE AGREEMENT ........................................................................175RECOVERY RESOURCES ............................................................................................................8411. SAMPLE INFORMATION FORM FOR DEPARTMENTS ................................................................18312. HOSPITAL STATUS REPORT FORM ......................................................................................19313. SAMPLE DEMOBILIZATION PLAN ........................................................................................197

ADDITIONAL RECOVERY RESOURCES ..........................................................................................84

Online links are provided for the following resources on page 84.Hospital Impact Assessments:

AHRQ Hospital Assessment Recovery ToolDemobilization:

ICS Form 214 Personnel RosterICS Form 211 Check-in ListICS Form 221 Demobilization CheckoutDemobilization Responsibilities Checklist

Disaster Mental Health:Guidance for Managing Worker Fatigue During Disaster OperationsCoping with a Disaster or Traumatic EventManaging Anxiety in Times of CrisisSafety, Function, Action ChecklistDisaster & Extreme Event Preparedness (DEEP) Center

Financial Resources:FEMA Grants and Assistance ProgramsFEMA Public Assistance Grant ProgramFEMA Forms Grants – Catalog of Federal Domestic Assistance

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ALBERT GUTIERREZ, FACHE, MBA, RT(R)President and CEOShore Memorial HospitalCOMMITTEE CHAIRMAN

JEFFREY ANDREWS

Cape Regional Medical Center

DENISE ARZOOMANIAN

Englewood Hospital and Medical Center

JIM BACA

Underwood-Memorial Hospital

DAVID BROOKS

Jersey Shore University Medical Center

NEIL BRYANT

Saint Barnabas Health Care System

SHIELA BUCHTA

HEALTHSOUTH Rehabilitation Hospital of Toms River

JACK BURNS

Hudson County OEM

ANTHONY CAPRIO, M.D.Hoboken University Medical Center

C. LYNN CENTONZE

New Jersey Office of Homeland Security

JAMES CHEBRA

Capital Health

STEVEN CICALA

LibertyHealth

CHARLES CRUGNOLA

Palisades Medical Center

JONATHAN CUVIELLO

Shore Memorial Hospital

MARY DANISH

Saint Michael’s Medical Center

GARY DEL MORO

Hackensack University Medical Center

MICHELE DENOIA

Southern Ocean County Hospital

BRIAN DOLAN

University of Medicine and Dentistry of New Jersey

ROBERT DONEGAN

Trinitas Regional Medical Center

MARIE DUFFY

Hoboken University Medical Center

KELLY ESPOSITO

Community Medical Center

RICHARD FERRANTE

Monmouth Medical Center

MARLENE FISCHER

South Jersey Healthcare

RON FRANCESCHINI

Bacharach Institute for Rehabilitation

STEPHEN GAUNT

Hoboken University Medical Center

EDWARD GERITY

Holy Name Medical Center

PATRICK GILDNER

Southern Ocean County Hospital

JOHN GILSON

Bayonne Medical Center

DAVID GRUBER

NJ Dept of Health & Senior Services

Ronald HammanBayonne Medical Center

RON HOFER

Jersey Shore University Medical Center

JAMES KELLY

AtlantiCare Regional Medical Center

BRIAN KUBIEL

HEALTHSOUTH Rehabilitation Hospital of Toms River

PAUL LAMBRECHT

Underwood-Memorial Hospital

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ACKNOWLEDGEMENTS

NJHA extends its sincere appreciation to the following individuals who participated in the HurricanePreparedness and Recovery Committees as well as the Winter Hazards Tabletop Exercises. Theirassistance and feedback was instrumental in the evolution of this toolkit. Development of this

resource was made possible through funding from the New Jersey Office of Homeland Security.

Continued on next page

JAMES LANGENBACH


MORENA LASSO

LibertyHealth-Jersey City Medical Center

ROSAMOND LOCKWOOD

Newton Memorial Hospital

BRADFORD MASON


BEN MAZZA


GERARD MCALEER


WILLIAM MCDOUGALL

VA New Jersey Health Care System

REBECCA MCMILLEN


RYAN MILLER

The Cooper Health System

CAROLE PAGE

Ocean Medical Center

ANTHONY PERDONI

Monmouth Medical Center

JOSEPH PICCIANO


ANTHONY PLINIO

Community Medical Center

DENNIS QUINN


LORI REES


THERESA REISS

The Valley Hospital

THOMAS ROSE


KEVIN SULLIVAN

Children’s Specialized Hospital

LARRY SWEENEY

AtlantiCare Regional Medical Center

RENE TARBY


CORINNE TREMBLER

Warren Hospital

TOM VINCENT

Kimball Medical Center

CHRISTOPHER WIENBERG

Englewood Hospital and Medical Center

DOUGLASS WILLIAMSON

The Valley Hospital

PHYLLIS WORRELL

Virtua

CONSULTANT

ANNE-CAROL BURKE, M.A.

President, A.C. Consulting, Inc.

NJHA STAFF

DIANE ANDERSON

Director, Emergency Preparedness

ALINE HOLMES

Senior Vice President, Clinical Affairs

PATRICIA RONDAN-MANN

Policy Analyst, Post-acute Policy and Special Initiatives

JESSICA WISNIEWSKI

Coordinator, Emergency Preparedness

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INTRODUCTION

PURPOSE AND SCOPE

The New Jersey Hospital Association’s Hurricane Planning, Response andRecovery Toolkit is designed to assist hospitals in preparing for, responding toand recovering from the potential consequences of a hurricane impacting theGarden State. More specifically, this toolkit focuses on sheltering-in-placeplanning and planning for recovery. It enhances current hospital all-hazardsdisaster plans and is not to be used in lieu of existing plans, but rather as aprimer for a facility preparing for the specific challenges presented by a hurri-cane. It is intended for use by those already familiar with their hospital’s all-hazards disaster plan and the fundamental concepts of disaster planning. Inaddition, hospitals are encouraged to consider their emergency managementinfrastructure, availability of community resources and site-specific hazard vulnerabilities when developing a facility-specific hurricane plan. Hurricaneseason begins June 1 and ends Nov 30 each year.

Once you begin the disaster planning process, it is important to have a comprehensive planning team with clear-ly defined roles and responsibilities. Planning teams should have representatives from all levels of managementand most departments within the hospital. All-hazards planning and hurricane planning needs to address all fourphases of emergency management: mitigation, preparedness, response and recovery. For example, a hospitalnot only plans for response actions but also for recovery actions. Plans are living documents and need to be main-tained through an ongoing planning, training and exercise cycle. The Homeland Security Exercise and EvaluationProgram (HSEEP) provides guidance and tools that can assist with exercises and improvement planning.

In addition to planning for the hospital’s response and recovery to a hurricane, it is important also to plan forhow the hospital will support its staff through all phases of an event such as a hurricane. The toolkit includesa focus on employee support and provides guidance on what hospitals can do to better prepare and miti-gate the impact a hurricane will have on staff. Many of us have experienced how challenging it can be tofocus on our work if we are worried about our home and family. Therefore, hospitals should consider pro-viding staff with tools and resources to prepare for, respond to and recover from a hurricane so that theymay be more productive when on duty. The latter sections of this toolkit focus on recovery. Facilities willneed to conduct an impact assessment first to help guide recovery decisions and actions.

Hurricanes can be unpredictable as to intensity and path. You will need to develop and be prepared to imple-ment plans for worst-case scenarios. The more intense the storm, the more damage to infrastructure you canexpect, resulting in longer recovery time and greater delays for re-supply and access to supportive resources.Due to the unpredictability and the geography (size and location) of New Jersey, all hospitals in the state mayneed to take preparedness actions if any portion of New Jersey is in the path of a storm. When watchingweather forecasts, it is important to note the entire “cone” or width of a storm, not just the line path for theeye of the storm. Hurricanes that threaten New Jersey have the potential to have a statewide impact.

Hospitals sheltering-in-place for a hurricane will take similar steps for each threat level, again bearing inmind the more intense the storm, the longer the facility will need to be self-sustaining. Though the focusof this toolkit is to assist hospitals with developing plans to shelter-in-place for a storm, it is imperativethese hospitals also have an evacuation plan. Hurricanes categorized as 4 or 5 on the Saffir-Simpson Scaleare catastrophic in nature. Hospitals projected to be impacted by a Category 4 or 5 storm will need to con-sider evacuation. In some cases, hospitals may need to evacuate for a Category 1 storm. This dependsupon your facility’s location and specific vulnerabilities.

Decisions regarding what category storm you should plan to evacuate for can be made in advance of anevent. The results of your hazard vulnerability analysis, the emergency management system, communityinfrastructure and resources where your facility is located and the information in this toolkit1 can assist youwith the decision-making process.

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1 See Evacuate or Shelter-In-Place Decision Guide, Appendix #5

PART I. TYPES OF HURRICANES

STORM DEFINITIONS

Information from the National Hurricane Center at http://www.nhc.noaa.gov/

Nor’easter - A strong low pressure system that affects the Mid Atlantic and New England states. It canform over land or over the coastal waters. These winter weather events are notorious for producingheavy snow, rain and tremendous waves that crash onto Atlantic beaches, often causing beach erosionand structural damage. Wind gusts associated with these storms can exceed hurricane force in intensity.A nor’easter gets its name from the continuously strong northeasterly winds blowing in from the oceanahead of the storm and over the coastal areas.

Please note: Tornadoes frequently are associated with hurricanes, so there is always the potential forwind-blown debris and downed trees with any storm category.

Tropical Storm – Winds 39-73 mph. There is potential for flooding and loss of utilities, with minor wind-blown debris and a few downed trees.

WATCHES AND WARNINGS

Hurricane Watch – A watch is announced when hurricane conditions are possible within 36 hours for aparticular area.

Hurricane Warning – A warning that sustained winds 64kt (74mph or 119km/h) or higher associatedwith a hurricane are expected in a specified coastal area in 24 hours or less. A hurricane warning canremain in effect when dangerously high water or a combination of dangerously high water and exceptionally high waves continue, even though winds may be less than hurricane force.

The Saffir-Simpson Hurricane Scale is a 1-5 rating system used to define a hurricane’s intensity. Itgives an estimate of the potential property damage and flooding expected along the coast from a hurricane landfall. Wind speed is the determining factor in the scale, as storm surge values are highlydependent on the slope of the continental shelf and the shape of the coastline in the landfall region.Note that all winds are defined using the US National Weather Service’s definition of sustained windswhich is the average winds over a period of one minute.

Category 1 Hurricane – Winds 74-95 mph (64-82 kt). Storm surge is generally 4-5 feet above normal.No real damage to building structures. Expect damage primarily to unanchored mobile homes, shrubberyand trees and some damage to poorly constructed signs. Also, expect some coastal road flooding andminor pier damage.

Examples: Gaston 2004, Lili 2002, Irene 1999 and Allison 1995

Category 2 Hurricane – Winds 96-110 mph (83-95 kt). Storm surge is generally 6-8 feet above normal.Expect some roofing material, door and window damage of buildings and considerable damage to shrubbery and trees with some trees blown down. Considerable damage to mobile homes, poorly constructed signs and piers. Coastal and low-lying escape routes flood 2-4 hours before arrival of thehurricane center. Small craft in unprotected anchorages break moorings.

Examples: Frances 2004, Isabel 2003, Bonnie 1998, Georges 1998 and Gloria 1985

Category 3 Hurricane – Winds 111-130 mph (96-113 kt). Storm surge is generally 9-12 feet above normal. Expect some structural damage to small residences and utility buildings with a minor amount ofpower failures, and damage to shrubbery and trees with foliage blown off trees and large trees blowndown. Mobile homes and poorly constructed signs are destroyed. Low-lying escape routes are cut by rising water 3-5 hours before arrival of the center of the hurricane. Flooding near the coast destroys

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smaller structures with larger structures damaged by battering from floating debris. Terrain continuouslylower than 5 feet above mean sea level may flood inland up to 8 miles (13 km) or more. Evacuation oflow-lying residences within several blocks of the shoreline may be required.

Examples: Katrina 2005, Jeanne 2004 and Ivan 2004

Category 4 Hurricane – Winds 131 – 155 mph (114-135kt). Storm surge is generally 13-18 feet abovenormal. Expect more extensive power failures, damage to doors and windows with some complete roofstructure failures on small residences. Shrubs, trees and all signs are blown down. Complete destructionof mobile homes. Low-lying escape routes may be cut by rising water 3-5 hours before arrival of thecenter of the hurricane. Expect major damage to lower floors of structures near the shore. Terrain that islower than 10 feet above sea level may be flooded, requiring massive evacuation of residential areas asfar inland as 6 miles (10 km).

Examples: Dennis 2005 (Cuba) and Charley 2004

Category 5 Hurricane – Winds 156 mph and up (135+kt).Storm surge is generally greater than 18 feetabove normal. Expect complete roof failure on many residences and industrial buildings and other complete building failures with small utility buildings blown over or away. All shrubs, trees and signs maybe blown down. Complete destruction of mobile homes. Expect severe and extensive window and doordamage. Low-lying escape routes are cut by rising water 3-5 hours before arrival of the center of thehurricane. Major damage to lower floors of all structures located less than 15 feet above sea level andwithin 500 yards of the shoreline. Massive evacuation of residential areas on low ground within 5-10miles (8-16 km) of the shoreline may be required.

Examples: The Labor Day Hurricane of 1935, Hurricane Camille (1969) and Hurricane Andrew (1992).The 1935 Labor Day Hurricane struck the Florida Keys with a minimum pressure of 892 mb—the lowest pressure ever observed in the United States. Hurricane Camille struck the Mississippi GulfCoast causing a 25-foot storm surge, which inundated Pass Christian.

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PART II. WHAT TO EXPECT2

WHAT HOSPITALS CAN EXPECT: PRE-STORM3

96 - 72 HOURS IN ADVANCE. During this time, there is much uncertainty regarding the path and intensity of a storm. This is a good time to review plans, implement just-in-time training and finalizestaffing plans. Notifications and communication plans and systems should be tested and implementedand emergency operation centers may be partially activating. Since hurricanes may expand over largeareas and their paths are uncertain, it is likely that all hospitals in the state will need to prepare to implement their hurricane plans. For those hospitals that may need to evacuate, this is the time toassess the potential situations and begin making evacuation decisions.

72 - 48 HOURS IN ADVANCE. During this time, there may still be some uncertainty, but you will have abetter sense of what you may be facing. Hurricane response plans should be activated and final preparations made. Supplies need to be secured and staff assignments need to be confirmed. Staff andthe community should be implementing their personal and family preparedness plans. Buildings andhomes will be boarded up and sandbags may be filled and appropriately placed. You can expect crowdedroadways and stores due to people gathering supplies. Evacuations may begin during this time. TheEmergency Operations Center may be fully operational and holding briefings on a frequent basis.

36 HOURS IN ADVANCE. Final preparations are being made, evacuations have begun and supplies andresources are being staged. Response plans should be activated, including Incident Command. Briefingswith multiple stakeholders will be occurring. For example, you may have regularly scheduled briefingswith the Emergency Operation Center (EOC), the State and other hospitals/hospital association.Planning meetings may become more frequent. Additional communication devices may be distributed atthis time. Unmet just-in-time training needs should be addressed.

24 HOURS IN ADVANCE. At this time, all of your preparedness plans should be activated and implemented. Any unmet needs should be addressed. Staff (and family) that will be staying at the hospital during the storm will be arriving. Keep in mind storm conditions set in before the actual landfallof the eye of the hurricane. You need to make sure that staff is at the hospital prior to the onset of storm conditions. Community shelters should be open, and residents will be traveling to check into the shelters. Storms may stall, change course or increase/decrease in intensity prior to landfall. Once youhave activated your response plan and everything is in place, there may be a period of time where youare simply waiting for the storm to hit. Incidents of panic may exist as stress builds from the waiting.

WHAT HOSPITALS CAN EXPECT: POST-STORM

FIRST 24 HOURS POST EVENT. Once severe weather has subsided, and it is daylight, you can beginassessing the damage to your facility and the status of staff and resources. Search and rescue operations may be conducted in your surrounding communities, and community damage/impact assessments may also be underway. Facility and partner incident management teams should already bein full operation. Staff will be anxious to connect with loved ones and to know the status of their homes.During this time consider the following:

� Conduct impact assessment and prioritize needs. It is during this time that evacuation decisions maybe made contingent on operational capacity. If you are not evacuating and operating at a severelydiminished capacity, you also may need to consider requesting additional resources such as aDisaster Medical Assistance Team (DMAT) and/or Medical Reserve Corps support.

� Identify additional resources needed and make requests accordingly.

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2 See NJHA’s Key Resources for Inclement Weather Preparedness, Appendix #43 See Shelter-In-Place Checklists, Appendix #6, for specific actions that may be taken during specified time intervals prior to storm onset.

� Assess status and need to activate continuity of operations plan (COOP). Has it been activated? Areany areas of your facility experiencing or are going to experience diminished capacity due to theeffects of the severe weather event? Hospitals may need to activate COOP in appropriate units ofhospital during recovery operations.

� Remove debris. When planning for recovery, consider pre-staging resources such as front loaders,salt and sand. Ensure vendor contracts are in place to promptly remove debris and/or snow promptlyfollowing an event.

24 – 48 HOURS POST EVENT. Depending on the severity of the event and the amount of time it takesto clear roads for safe travels, staff should be able to be rotated during this time. Hospitals need to beprepared to assist staff with the hardship they may face from damaged homes and the closures ofschools and childcare centers. Community resources and activities are most likely still discontinued,placing additional burden on hospitals to meet the needs of the community and staff.

During this time period, you may see an influx of acute injury patients from people trying to tend todamaged homes and remove debris from their properties (i.e. broken bones from falling off of a roof). Inaddition, if there is significant damage to the community, security may need to be increased to addressthe influx of persons seeking shelter, food, air conditioning/heat and other basic human needs.

The hurricane planning, response and recovery toolkit provides information on examples of staff support.For example, if banks are closed and it is pay day, can you pay staff in cash? Will you provide administra-tive leave to staff who need to take time off from work to meet with insurance claims processors? Willyou loan funds to employees to help them pay upfront high deductible costs? If possible, consider set-ting up in-house banks and providing space for FEMA and insurance processors to service staff.

48 – 72 HOURS POST EVENT. Hospitals should plan for the worst and still be able to be self-sufficientduring this time. What to expect during this time can vary significantly, depending on the severity of theevent and the state of community resources. If there is significant damage to community infrastructureincluding widespread power outages and damage to homes making them not habitable, you will contin-ue to have delays with patient discharges, most likely be operating on generator power, begin runninglow on supplies, and the media may be present with continued inquiries on the status of your facility’soperations. In addition, if dialysis centers are not operational, dialysis patients will begin seeking treat-ment at hospitals.

For less severe events, you may be able to begin demobilizing and standing down your incident com-mand team.

72 HOURS PLUS POST EVENT. If the event is severe enough and you have not yet demobilized, youwill continue to be handling the above mentioned issues but perhaps at a higher level of intensity. Fuelwill be in high demand by all, not just for facility generators but also for transportation for staff.Generator use in the community also leads to concerns of carbon monoxide poisoning. Generators mayhave been running long enough now that maintenance tasks will need to be performed (i.e. change fil-ters, change/add oil). Staff may be growing weary, and if schools are still closed, childcare/elder care forfamily members of staff will continue to be a concern. Emotional and mental health support will need tobe provided to healthcare workers and family members in the coming days and months. Hospitals needto plan to be self-sufficient for 96 hours or implement evacuation plans.

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PART III. ASSESSMENT TOOL: Planning, Response and Recovery

In the sections that follow, hurricane planning tasks and policy considerationsare broken down into the following areas:

A. Leadership

B. Internal (Hospital) Department Plans

C. Employee Expectations

D. Employee Support

E. Supplies — Special Considerations for Hurricanes

F. Utilities

G. Patient Issues

H. Communications Issues

I. Facility Management and Security

J. External Resources and Mutual Aid

K. Recovery — Demobilization

L. Recovery — Patient Transfer & Discharge

M. Recovery — Financial Resources

The following sections may refer you to other NJHA disaster planning modulesand appendices that contain additional information and supporting documents.


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prop

riate

sta

ff t

o id

entif

y an

d kn

ow p

roce

ss a

nd

proc

edur

es f

or r

eque

stin

g ad

ditio

nal r

esou

rces

.

15. E

nsur

e po

licy

deci

sion

s re

gard

ing

haza

rdpa

y an

d ac

com

mod

atio

ns

for

fam

ily, p

ets,

etc

. dur

ing

a st

orm

are

incl

uded

in t

he p

lan.

5

16. E

nsur

e pr

oces

ses

rega

rdin

g co

mm

unic

atio

n ne

eds

are

addr

esse

d in

the

pla

n.6

�D

urin

g re

spon

se a

nd re

cove

ry, c

omm

unic

ate

at re

gula

rly s

ched

uled

in

terv

als

with

par

tner

s su

ch a

s O

EM, M

CC

, DH

HS

and

sch

edul

e m

edia

brie

fings

.

17. E

nsur

e pl

an in

clud

es p

roce

sses

to

addr

ess

finan

cial

con

cern

s, i.

e.,

docu

men

tatio

n fo

r re

imbu

rsem

ent.

7

�D

ocum

ent

all e

xpen

ses

from

the

ons

et o

f th

e ev

ent.

Ens

ure

fede

ral a

nd s

tate

doc

umen

tatio

n st

anda

rds

are

met

. FE

MA

, HIC

S

and

othe

r IC

S f

orm

s m

ay b

e us

ed t

o as

sist

with

thi

s ta

sk.

18. E

nsur

e a

supp

ort

syst

em is

est

ablis

hed

to a

ddre

ss p

sych

osoc

ial

issu

es a

nd e

mot

iona

l dis

tres

s ex

perie

nced

by

staf

f, pa

tient

s an

d th

eir

fam

ilies

. �

Con

side

r co

nduc

ting

on-li

ne m

eetin

gs o

r fr

ee c

onfe

renc

e ca

lls.

�E

ncou

rage

an

unde

rsta

ndin

g of

the

effe

ctiv

enes

s of

alte

rnat

em

eans

of

supp

ort.

19. E

stab

lish

and

Impl

emen

t In

cide

nt C

omm

and

Syst

em (I

CS)

/Hos

pita

lIn

cide

nt C

omm

and

Syst

em (H

ICS

).�

Ens

ure

all s

taff

is t

rain

ed f

or r

oles

with

in t

he s

ytem

.�

Ens

ure

dele

gatio

n of

aut

horit

y an

d or

ders

of

succ

essi

on a

t le

ast

thre

e de

ep f

or k

ey p

ositi

ons.

�Fo

llow

doc

umen

tatio

n pr

oced

ures

out

lined

by

ICS

/HIC

S.

20. E

nsur

e ro

les

and

resp

onsi

bilit

ies

are

clea

rly d

efin

ed a

nd

com

mun

icat

ed t

o al

l sta

ff p

re-e

vent

and

dur

ing

resp

onse

and

re

cove

ry b

riefin

gs.

4S

ee E

vacu

ate

or S

helte

r-In-

Plac

e D

ecis

ion

Gui

de, A

ppen

dix

#55

See

Sec

tion

D, E

mpl

oyee

Sup

port

6S

ee S

ectio

n H

, Com

mun

icat

ions

Issu

es7

See

Sec

tion

J, E

xter

nal R

esou

rces

and

Mut

ual A

id

Wea

ther

ing th

e St

orm

�A

Hur

rica

ne P

lann

ing,

Res

pons

e an

d Re

cove

ry T

oolk

it15

A. L

EA

DE

RS

HIP

(C

ON

TIN

UE

D)

INN

OT

DA

TE

TOB

ELE

AD

STA

FF

AS

SIG

NM

EN

TC

OM

PLE

TE

DP

RO

GR

ES

SS

TAR

TE

DC

OM

PLE

TE

DM

EM

BE

R

21. E

nsur

e th

e pl

an in

clud

es a

ppro

pria

te s

teps

to re

sum

e op

erat

ions

fo

llow

ing

a hu

rrica

ne. R

esto

re e

ssen

tial s

ervi

ces

and

phys

ical

pla

nt.

Ther

e m

ay b

e “n

ew n

orm

al”

post

sev

ere

even

ts.

The

build

ing

mus

t be

saf

e, d

ebris

rem

oved

from

cam

pus,

haz

ardo

us w

aste

pro

perly

di

spos

ed o

f and

ope

ratio

nalc

apac

ity re

stor

ed.

22. E

nsur

e th

e pl

an in

clud

es a

pro

cess

for d

rills

that

incl

udes

ver

ifica

tion/

test

ing

of a

ll m

emor

andu

ms

of u

nder

stan

ding

/mut

ual a

id a

gree

men

ts

and

ensu

re c

ontin

genc

y ag

reem

ents

/pla

ns a

re id

entif

ied

shou

ld

mut

uala

id n

ot b

e av

aila

ble.

23. I

n re

cove

ry, b

e pr

epar

ed t

o ac

tivat

e m

emor

andu

ms

of

unde

rsta

ndin

g an

d ot

her

resp

onse

pla

ns s

uch

as c

ontin

uity

of

oper

atio

ns.

24. B

e pr

epar

ed to

iden

tify

clea

r goa

ls fo

r rec

over

y. C

lear

goa

ls p

rovi

de

dire

ctio

n fo

r re

cove

ry o

bjec

tives

to

be in

clud

ed in

inci

dent

act

ion

plan

s (IA

Ps)

and

pro

vide

dire

ctio

n fo

r pr

iorit

izat

ion

of r

ecov

ery

activ

ities

and

res

ourc

e m

anag

emen

t.

25. E

nsur

e pl

ans

are

exer

cise

d an

d im

prov

emen

ts a

re m

ade

base

d on

afte

r-act

ion

repo

rts.

�C

onsi

der

exer

cisi

ng p

lans

in p

arts

to

redu

ce im

pact

on

daily

op

erat

ions

.

26. P

rovi

de B

oard

of T

rust

ees

with

fin

al h

urric

ane

plan

ning

, res

pons

e an

d re

cove

ry p

lan.

Pro

vide

deta

iled

info

rmat

ion/

educ

atio

n re

gard

ing

spec

ific

polic

ies/

proc

edur

es in

clud

ing

or a

ffect

ing

mem

bers

of

the

Boa

rd.

27. E

nsur

e th

e B

oard

is p

rope

rly e

duca

ted

abou

t hu

rric

anes

and

the

ir po

tent

ial i

mpa

ct o

n ho

spita

l ope

ratio

ns.

�E

duca

te t

he B

oard

abo

ut t

he n

eed

for

effe

ctiv

e pl

anni

ng.

�En

sure

Boa

rd’s

sup

port

prio

r to

activ

e pl

anni

ng.

28. E

nsur

e B

oard

has

an

unde

rsta

ndin

g of

loca

l, st

ate

and

fede

ral

auth

ority

dur

ing

hur

rican

e.

Wea

ther

ing th

e St

orm

�A

Hur

rica

ne P

lann

ing,

Res

pons

e an

d Re

cove

ry T

oolk

it17

A. L

EA

DE

RS

HIP

(C

ON

TIN

UE

D)

INN

OT

DA

TE

TOB

ELE

AD

STA

FF

AS

SIG

NM

EN

TC

OM

PLE

TE

DP

RO

GR

ES

SS

TAR

TE

DC

OM

PLE

TE

DM

EM

BE

R

29. E

nsur

e a

proc

ess

is in

clud

ed t

o ed

ucat

e th

e B

oard

of T

rust

ees

on

thei

r ro

les

and

resp

onsi

bilit

ies

durin

g a

hurr

ican

e.

30.E

nsur

e pr

oced

ures

are

est

ablis

hed

to k

eep

Boa

rd o

f Tru

stee

s in

form

ed b

efor

e, d

urin

g an

d po

st e

vent

.�

Det

erm

ine

mul

tiple

mea

ns o

f co

mm

unic

atio

n w

ith B

oard

s of

Tru

stee

s.�

Hol

d br

iefin

gs, c

onfe

renc

e ca

lls a

nd s

hare

(via

em

ail,

post

ings

, et

c.) I

APs

and

Situ

atio

nR

epor

ts (S

itRep

s) w

ith B

oard

of T

rust

ees

at r

egul

ar in

terv

als.

Wea

ther

ing th

e St

orm

�A

Hur

rica

ne P

lann

ing,

Res

pons

e an

d Re

cove

ry T

oolk

it19

B. I

NT

ER

NA

L (H

OS

PIT

AL)

DE

PAR

TM

EN

T P

LAN

S

INN

OT

DA

TE

TOB

ELE

AD

STA

FF

AS

SIG

NM

EN

TC

OM

PLE

TE

DP

RO

GR

ES

SS

TAR

TE

DC

OM

PLE

TE

DM

EM

BE

R

1. Id

entif

y w

ho w

ill b

e re

spon

sibl

e fo

r de

velo

ping

sta

ffin

g pl

ans.

8

�St

affin

g pl

ans

may

be

deve

lope

d by

dep

artm

ent w

ith re

view

by

the

plan

ning

team

to e

nsur

e vi

abilit

y of

pla

ns (i

.e. d

uplic

atio

n of

as

sign

men

ts, e

tc).

�En

sure

med

ical

sta

ff is

add

ress

ed o

r has

its

own

staf

fing

plan

that

is

inte

grat

ed in

to th

e fa

cilit

y pl

an.

�D

eter

min

e if

staf

fing

plan

requ

irem

ents

nee

d to

be

addr

esse

d in

po

licy.

If s

o, in

corp

orat

e in

to p

olic

y. F

or e

xam

ple,

the

faci

lity

may

re

defin

e a

wor

k da

y, w

ork

wee

k an

d/or

ove

rtim

e in

resp

onse

to a

di

sast

er/e

mer

genc

y in

acc

orda

nce

with

app

licab

le s

tate

and

fede

ral

wag

e la

ws.

Sta

ff m

ay b

e as

sign

ed to

per

form

dut

ies

they

do

not

norm

ally

per

form

with

resp

ect t

o sc

ope

of p

ract

ice.

2. Id

entif

y an

d pr

iorit

ize

serv

ice

requ

irem

ents

for

you

r de

part

men

t.�

Iden

tify

and

list

mis

sion

-crit

ical

(im

med

iate

) ser

vice

req

uire

men

ts.

�Id

entif

y an

d lis

t m

issi

on-e

ssen

tial (

dela

yed)

ser

vice

req

uire

men

ts.

3. Id

entif

y nu

mbe

r of s

taff

nece

ssar

y to

impl

emen

t ser

vice

requ

irem

ents

.�

Iden

tify

and

list

staf

f ne

eded

to

impl

emen

t m

issi

on-c

ritic

al

(imm

edia

te) s

ervi

ce r

equi

rem

ents

.�

Iden

tify

and

list

staf

f ne

eded

to

impl

emen

t m

issi

on-e

ssen

tial

(del

ayed

) ser

vice

req

uire

men

ts.

�Id

entif

y st

aff

that

may

be

dive

rted

, cro

ss t

rain

ed a

nd/o

r tr

aine

d ju

st-in

-tim

e to

sup

port

mis

sion

-crit

ical

and

mis

sion

-ess

entia

l ser

vice

s.

4. Id

entif

y st

aff

team

s by

shi

ft (i

.e. o

ne t

eam

per

shi

ft).

�E

xam

ple:

PR

E-s

torm

, DU

RIN

G s

torm

and

PO

ST s

torm

, or

sim

ply

Team

s A

, B, C

, D, o

r ha

ve t

eam

s cr

eate

nam

es f

or t

hem

selv

es.

�Pl

ease

not

e: Tw

o sh

ifts

are

requ

ired

for t

he “

DU

RIN

G”

stor

m te

am.

Bot

h sh

ifts

shou

ld a

rriv

e at

the

hos

pita

l prio

r to

ons

et o

f da

nger

ous

driv

ing

cond

ition

s. E

ach

shift

will

wor

k 12

on

and

12 o

ff. It

is

impo

rtan

t th

at s

taff

are

perm

itted

and

req

uire

d to

tak

e re

st p

erio

dsto

pro

mot

e op

timum

wel

l-bei

ng. N

o em

ploy

ee s

hall

wor

k m

ore

than

16

hour

s in

a 2

4-ho

ur p

erio

d.�

If st

aff i

s lim

ited,

you

may

use

the

sam

e te

am to

ser

ve P

RE

stor

m

and

POST

stor

m.

�P

RE

-sto

rm t

eam

(s) w

ill n

eed

to b

e al

lott

ed t

ime

to im

plem

ent

thei

r fa

mily

pre

pare

dnes

s pl

ans

prio

r to

the

sta

rt o

f th

eir

shift

s.

8S

ee D

epar

tmen

t Pl

an T

empl

ate,

App

endi

x #1

a

Wea

ther

ing th

e St

orm

�A

Hur

rica

ne P

lann

ing,

Res

pons

e an

d Re

cove

ry T

oolk

it21

B. I

NT

ER

NA

L (H

OS

PIT

AL)

DE

PAR

TM

EN

T P

LAN

S (

CO

NT

INU

ED)

INN

OT

DA

TE

TOB

ELE

AD

STA

FF

AS

SIG

NM

EN

TC

OM

PLE

TE

DP

RO

GR

ES

SS

TAR

TE

DC

OM

PLE

TE

DM

EM

BE

R

5. Id

entif

y st

aff

resp

onsi

ble

for

deve

lopi

ng jo

b de

scrip

tions

and

re

spon

sibi

litie

s/jo

b ac

tion

shee

ts f

or r

espo

nse

role

s.

6. E

nsur

e al

l sta

ff k

now

s an

d ar

e tr

aine

d on

the

ir ro

les

and

resp

onsi

bilit

ies

befo

re, d

urin

g an

d af

ter

a st

orm

.�

Dev

elop

tra

inin

g pl

an t

o en

sure

sta

ff r

ecei

ve a

ppro

pria

te t

rain

ing

on t

heir

resp

onsi

bilit

ies,

ICS

/HIC

S a

nd m

eet

natio

nal t

rain

ing

guid

elin

es. F

or e

xam

ple,

lead

ersh

ip e

mpl

oyee

s w

ill c

ompl

ete

ICS

100

, 200

, IS

700

, IS

800

, and

all

empl

oyee

s w

ill c

ompl

ete

ICS

100

and

IS 7

00.

�C

onsi

der

inco

rpor

atin

g re

quire

d tr

aini

ng in

to n

ew e

mpl

oyee

or

ient

atio

n an

d an

nual

edu

catio

n re

view

s.�

Dev

elop

and

impl

emen

t a

trai

ning

pla

n th

at in

corp

orat

es d

rills

, ta

blet

op e

xerc

ises

and

aft

er-a

ctio

n re

view

s an

d im

prov

emen

t pl

anni

ng.

7. D

evel

op jo

b ac

tion

shee

ts a

s ne

eded

.�

HIC

S p

rovi

des

job

actio

n sh

eets

tha

t m

ay b

e us

ed a

s an

exa

mpl

e fo

r de

velo

ping

job

actio

n sh

eets

for

oth

er t

ypes

of

dutie

s/re

spon

se r

oles

.

8. D

evel

op ju

st-in

-tim

e tr

aini

ng a

s ne

eded

.�

Exam

ple:

Sho

rt, q

uick

, ref

resh

er t

rain

ing

mod

ules

for

how

to

use

the

radi

os a

nd o

ther

com

mun

icat

ions

equ

ipm

ent.

9. Id

entif

y pr

otec

tive

mea

sure

s fo

r al

l wor

k ar

eas.

9

�Id

entif

y w

ho is

res

pons

ible

for

impl

emen

ting

prot

ectiv

e m

easu

res

upon

pla

n ac

tivat

ion.

�Pr

otec

t vi

tal r

ecor

ds.

�B

ack-

up o

f da

ta s

yste

ms

and

stor

age

of r

ecor

ds o

ff-s

ite.

�Pr

int h

ardc

opie

s of

impo

rtan

t doc

umen

ts s

uch

as c

onta

ct li

sts.

�D

efin

e al

tern

ate

proc

edur

es fo

r ess

entia

l job

func

tions

sho

uld

equi

pmen

t fai

l (i.e

. use

of p

aper

and

pen

cil,

runn

ers,

etc

.).�

Mov

e eq

uipm

ent

away

fro

m v

ulne

rabl

e w

indo

ws.

9E

nsur

e th

at in

form

atio

n te

chno

logy

(IT)

sys

tem

s ar

e ad

dres

sed.

Dev

elop

rec

over

y tim

e ob

ject

ives

(RTO

s) a

nd R

ecov

ery

Poin

t O

bjec

tives

(RP

Os)

for

crit

ical

clin

ical

sys

tem

s, p

roce

sses

and

dat

a.

Wea

ther

ing th

e St

orm

�A

Hur

rica

ne P

lann

ing,

Res

pons

e an

d Re

cove

ry T

oolk

it23

B. I

NT

ER

NA

L (H

OS

PIT

AL)

DE

PAR

TM

EN

T P

LAN

S (

CO

NT

INU

ED)

INN

OT

DA

TE

TOB

ELE

AD

STA

FF

AS

SIG

NM

EN

TC

OM

PLE

TE

DP

RO

GR

ES

SS

TAR

TE

DC

OM

PLE

TE

DM

EM

BE

R

10. T

rain

sta

ff t

o pr

ovid

e P

sych

olog

ical

Firs

t A

id t

o pa

tient

s, f

amily

m

embe

rs a

nd c

o-w

orke

rs.10

�Tr

ain

staf

f to

build

resi

lienc

e w

ithin

them

selv

es a

nd re

cogn

ize th

e ne

ed fo

r Ps

ycho

logi

cal F

irst A

id in

thei

r co-

wor

kers

.�

Trai

n or

gani

zatio

nal l

eade

rshi

p to

bui

ld r

esili

ence

with

in t

he

orga

niza

tion.

10S

ee N

JHA

Pan

dem

ic In

fluen

za T

oolk

it: P

sych

o-So

cial

Mod

ule,

http

://w

ww

.njh

a.co

m/p

anin

f/Pdf

/Psy

chos

ocia

l_Fi

nal.p

df

Wea

ther

ing th

e St

orm

�A

Hur

rica

ne P

lann

ing,

Res

pons

e an

d Re

cove

ry T

oolk

it25

C. E

MP

LOY

EE

EX

PE

CTA

TIO

NS

INN

OT

DA

TE

TOB

ELE

AD

STA

FF

AS

SIG

NM

EN

TC

OM

PLE

TE

DP

RO

GR

ES

SS

TAR

TE

DC

OM

PLE

TE

DM

EM

BE

R

1. D

efin

e em

ploy

ee w

ork

expe

ctat

ions

for

hur

rican

es.11

�S

ampl

e Po

licie

s:

�E

mpl

oyee

s ar

e re

quire

d to

rep

ort

to w

ork

unle

ss a

n ex

empt

ion

has

been

gra

nted

in w

ritin

g w

ith s

uper

viso

ry s

igna

ture

. Fai

lure

to

do

so m

ay r

esul

t in

dis

cipl

ine

up t

o an

d in

clud

ing

term

inat

ion.

�

All

staf

f (c

linic

al a

nd n

on-c

linic

al) i

s co

nsid

ered

ess

entia

l and

m

ay b

e as

sign

ed t

o du

ties

that

are

not

per

form

ed r

egul

arly

. �

All

licen

sure

s w

ith r

egar

d to

sco

pe o

f pr

actic

e w

ill b

e ho

nore

d.

�A

ll st

aff

is r

espo

nsib

le fo

r m

aint

aini

ng c

orre

ct a

nd u

p-to

-dat

e co

ntac

t in

form

atio

n, m

aint

aini

ng a

nd im

plem

entin

g pe

rson

al/

fam

ily p

repa

redn

ess

plan

s an

d kn

owin

g th

eir

role

in a

dis

aste

r.12

2. D

eter

min

e w

hat

cons

ider

atio

ns m

ay o

r m

ay n

ot a

llow

for

em

ploy

ee e

xem

ptio

n, f

or in

stan

ce:

�If

sta

ff is

not

per

mitt

ed t

o br

ing

child

ren

to w

ork

durin

g a

stor

m,

then

con

side

r ha

ving

sin

gle

pare

nts

with

sm

all c

hild

ren

as a

n ex

empt

ion

crite

rion.

�If

sta

ff is

not

per

mitt

ed t

o br

ing

pets

dur

ing

a st

orm

, the

n m

ake

it cl

ear

that

ow

ning

a p

et is

not

an

acce

ptab

le r

easo

n fo

r an

ex

empt

ion.

The

pol

icy

shou

ld n

ote

that

it is

the

em

ploy

ee’s

re

spon

sibi

lity

to m

ake

arra

ngem

ents

for

pet

s.�

Con

side

r ho

w t

he f

acili

ty w

ill a

ddre

ss t

he n

eeds

of

staf

f th

at

may

live

in a

n ev

acua

tion

zone

. For

exa

mpl

e, e

mpl

oyee

s w

ho

live

in e

vacu

atio

n zo

nes

may

be

wel

l sui

ted

to s

erve

on

one

of

the

shift

s to

sta

y at

the

hos

pita

l dur

ing

the

stor

m.

�A

ddre

ss e

xpec

tatio

ns fo

r st

aff

who

wor

k fo

r m

ore

than

one

faci

lity.

�D

evel

op e

mpl

oyee

exe

mpt

ion

form

.13

11S

ee P

repa

ring

Your

Wor

k A

rea,

App

endi

x #2

a12

See

Pre

-sea

son

Empl

oyee

Ack

now

ledg

emen

t Fo

rm, A

ppen

dix

#2d

13S

ee W

ork

Exem

ptio

n Fo

rm, A

ppen

dix

#2e

Wea

ther

ing th

e St

orm

�A

Hur

rica

ne P

lann

ing,

Res

pons

e an

d Re

cove

ry T

oolk

it27

C. E

MP

LOY

EE

EX

PE

CTA

TIO

NS

(CO

NT

INU

ED)

INN

OT

DA

TE

TOB

ELE

AD

STA

FF

AS

SIG

NM

EN

TC

OM

PLE

TE

DP

RO

GR

ES

SS

TAR

TE

DC

OM

PLE

TE

DM

EM

BE

R

3. D

evel

op e

mpl

oyee

exe

mpt

ion

from

wor

k po

licy

incl

udin

g th

e pr

oces

s fo

r gr

antin

g ex

empt

ions

.�

Sam

ple

Polic

y:

Exe

mpt

ions

will

be

hand

led

on a

cas

e-by

-cas

e ba

sis

with

req

uest

s m

ade

in a

dvan

ce a

nd s

uper

viso

r ap

prov

al.

Em

ploy

ees

may

be

exem

pt f

rom

wor

k if

thei

r sp

ouse

is r

equi

red

to w

ork

(i.e.

law

enf

orce

men

t, E

MS

) and

the

re a

re d

epen

dent

s at

hom

e su

ch a

s ch

ildre

n an

d/or

adu

lts w

ith s

peci

al n

eeds

. Prio

r to

the

sta

rt o

f hu

rric

ane

seas

on, e

mpl

oyee

s ar

e re

quire

d to

su

bmit

thei

r ex

empt

ion

requ

est

to t

heir

supe

rvis

or u

pon

annu

al

revi

ew. E

mpl

oyee

s re

ques

ting

an e

xem

ptio

n m

ust

subm

it a

form

ea

ch y

ear

for

revi

ew.

It is

und

erst

ood

that

unf

ores

een

circ

umst

ance

s m

ay a

rise

and

empl

oyee

s ar

e to

not

ify t

heir

supe

rvis

or a

s so

on a

s po

ssib

le s

houl

d th

ey r

equi

re a

last

-min

ute

exem

ptio

n.14

4. A

ddre

ss is

sues

sur

roun

ding

em

ploy

ee c

ompe

nsat

ion

incl

udin

g:�

Det

erm

ine

how

sta

ff w

ill b

e co

mpe

nsat

ed f

or h

ours

the

y ar

e re

quire

d to

be

at t

he h

ospi

tal b

ut a

re r

estin

g/of

f-du

ty. F

or

exam

ple,

sta

ff r

equi

red

to r

emai

n at

the

hos

pita

l for

24

hour

s or

m

ore

will

be

give

n “o

n ca

ll pa

y” f

or h

ours

not

wor

ked.

�

Det

erm

ine

how

sta

ff w

ill b

e co

mpe

nsat

ed f

or h

ours

wor

ked

over

40

hou

rs p

er w

eek,

i.e.

com

pens

ator

y le

ave

time.

�

Add

ress

man

dato

ry o

vert

ime.

For

exa

mpl

e, e

mpl

oyee

s w

ill n

ot

be e

xpec

ted

to w

ork

mor

e th

an 1

6 ho

urs

in a

24-

hour

per

iod

in

the

even

t th

e C

omm

issi

oner

of

Hea

lth w

aive

s lic

ensi

ng r

egul

atio

nssu

ch a

s st

ate

regu

latio

ns r

egar

ding

man

dato

ry o

vert

ime

durin

g a

stat

e of

em

erge

ncy.

�Ve

rify

requ

irem

ents

of

unio

n co

ntra

cts

and

ensu

re c

ompl

ianc

e.�

Ens

ure

com

plia

nce

with

labo

r la

ws

such

as

AD

A, F

MLA

and

N

J Fa

mily

Wor

k A

ct.

14S

ee C

hild

care

Enr

ollm

ent

Form

, App

endi

x #2

f

Wea

ther

ing th

e St

orm

�A

Hur

rica

ne P

lann

ing,

Res

pons

e an

d Re

cove

ry T

oolk

it29

C. E

MP

LOY

EE

EX

PE

CTA

TIO

NS

(CO

NT

INU

ED)

INN

OT

DA

TE

TOB

ELE

AD

STA

FF

AS

SIG

NM

EN

TC

OM

PLE

TE

DP

RO

GR

ES

SS

TAR

TE

DC

OM

PLE

TE

DM

EM

BE

R

5. D

efin

e of

ficia

l for

ms

of c

omm

unic

atio

n an

d in

clud

e in

pol

icy.

�Ex

ampl

e: T

he f

ollo

win

g fo

rms

of c

omm

unic

atio

n w

ill b

e co

nsid

ered

off

icia

l reg

ardi

ng w

ork

assi

gnm

ents

: ver

bal o

rder

fr

om s

uper

viso

r, e-

mai

l, ra

dio

anno

unce

men

ts, T

V an

noun

cem

ents

and

text

mes

sage

s. S

houl

d te

leph

one

com

mun

icat

ions

fai

l (ce

ll an

d la

ndlin

e), o

r st

aff

are

unab

le t

o re

ach

supe

rvis

or f

or a

ny

reas

on, s

taff

are

to

liste

n to

rad

io s

tatio

n (X

YZ)

. Com

mun

icat

ions

fa

ilure

is n

ot a

n ac

cept

able

rea

son

not

to r

epor

t to

wor

k. S

taff

is

expe

cted

to

take

ste

ps t

o st

ay in

form

ed.15

6. E

stab

lish

empl

oyee

tra

inin

g re

quire

men

tsfo

r H

R p

olic

ies.

�Ex

ampl

e:Su

perv

isor

s sh

ould

revi

ew w

ith a

ll st

aff t

he h

ospi

tal

hurr

ican

e po

licy

and

empl

oyee

role

s an

d re

spon

sibi

litie

s ea

ch y

ear

prio

r to

the

star

t of H

urric

ane

Seas

on, w

hich

is J

une

1 –

Nov

30.

�A

ll pe

rson

nel a

re t

o si

gn a

n ac

know

ledg

emen

t for

m. E

xem

ptio

n an

d ch

ildca

re e

nrol

lmen

t fo

rms

are

to b

e up

date

d an

nual

ly.

Sup

ervi

sors

sho

uld

revi

ew e

mpl

oyee

s’ e

xpec

tatio

ns t

o w

ork

and

thei

r ro

le a

nd r

espo

nsib

ilitie

s as

def

ined

in t

he d

epar

tmen

t pl

an.

15S

ee H

urric

ane

Prep

ared

ness

Che

cklis

t, A

ppen

dix

#2c

Wea

ther

ing th

e St

orm

�A

Hur

rica

ne P

lann

ing,

Res

pons

e an

d Re

cove

ry T

oolk

it31

D. E

MP

LOY

EE

SU

PP

OR

T

INN

OT

DA

TE

TOB

ELE

AD

STA

FF

AS

SIG

NM

EN

TC

OM

PLE

TE

DP

RO

GR

ES

SS

TAR

TE

DC

OM

PLE

TE

DM

EM

BE

R

1. E

stab

lish

and

iden

tify

area

s fo

r st

aff

to s

leep

and

sho

wer

.�

Ens

ure

staf

f ha

s re

alis

tic e

xpec

tatio

ns r

egar

ding

sha

red

show

ers

and

slee

ping

are

a.�

Det

erm

ine

if st

aff

is r

espo

nsib

le f

or b

ringi

ng t

heir

own

linen

s,

tow

els,

toi

letr

ies

and

othe

r su

pplie

s. T

his

shou

ldbe

ref

lect

ed o

n ch

eckl

ists

dev

elop

ed f

or s

taff.

16

2. E

stab

lish

proc

edur

es t

o pr

ovid

e a

fuel

sou

rce

for

empl

oyee

s to

be

able

to

com

mut

e to

wor

k in

the

eve

nt p

ower

out

ages

are

ext

ensi

vem

akin

g op

erab

le g

as s

tatio

ns d

iffic

ult

to a

cces

s. (S

peci

al N

ote:

If a

fu

el d

epot

is e

stab

lishe

d by

em

erge

ncy

man

agem

ent

in y

our

area

fo

r firs

t res

pond

ers,

hos

pita

ls, e

tc. e

nsur

ela

w e

nfor

cem

ent i

s aw

are

that

non

-clin

ical

sta

ff is

ess

entia

l at

a ho

spita

l, no

t ju

st d

octo

rs a

nd

nurs

es, a

nd t

here

fore

will

req

uire

acc

ess

to f

uel.)

�Ex

ampl

es: I

f ho

spita

ls e

lect

to

prov

ide

fuel

ons

ite, e

stab

lish

an

agre

emen

t with

a n

earb

y ve

ndor

or w

ork

with

em

erge

ncy

man

agem

ent

for

esta

blis

hing

fue

l dep

ots.

If w

orki

ng w

ith a

loca

l ve

ndor

, ver

ify t

he v

endo

r’s h

urric

ane

plan

and

ens

ure

the

term

s of

agr

eem

ent

can

be m

et.

�If

the

hosp

ital p

rovi

des

fuel

to e

mpl

oyee

s, d

efin

e th

e ex

pect

atio

n fo

r pa

ymen

t.

3. E

stab

lish

proc

edur

es fo

r pro

vidi

ng tr

ansp

orta

tion

for s

taff

pre-

and

po

st-s

torm

.�

Iden

tify

tran

spor

tatio

n re

sour

ces

to a

ssis

t st

aff

with

com

mut

ing

to a

nd f

rom

wor

k if

need

ed. E

stab

lish

cont

ract

s as

nee

ded

for

serv

ices

(e.g

. ren

tal c

ar a

genc

ies)

.�

Dev

elop

tran

spor

tatio

n lo

gs w

ith c

heck

lists

.�

Iden

tify

tran

spor

tatio

n re

sour

ces

suita

ble

for

adve

rse

road

co

nditi

ons.

�E

nsur

e co

ordi

natio

n w

ith e

mer

genc

y m

anag

emen

t.�

Ensu

re c

oord

inat

ion

with

law

enf

orce

men

tfor

acc

ess

to ro

ads

that

m

ay b

e re

stric

ted.

�D

eter

min

e, in

con

cert

with

law

enf

orce

men

t, ac

cept

able

form

s of

id

entif

icat

ion

(i.e.

hos

pita

l ID

) tha

t w

ill a

llow

em

ploy

ees

to a

cces

sro

ads

for

com

mut

ing

to a

nd f

rom

wor

k.

16S

ee S

helte

ring

Nec

essi

ties,

App

endi

x #2

b

Wea

ther

ing th

e St

orm

�A

Hur

rica

ne P

lann

ing,

Res

pons

e an

d Re

cove

ry T

oolk

it33

D. E

MP

LOY

EE

SU

PP

OR

T(C

ON

TIN

UE

D)

INN

OT

DA

TE

TOB

ELE

AD

STA

FF

AS

SIG

NM

EN

TC

OM

PLE

TE

DP

RO

GR

ES

SS

TAR

TE

DC

OM

PLE

TE

DM

EM

BE

R

4. E

stab

lish

proc

edur

es to

pay

em

ploy

ees

in c

ash,

if n

eces

sary

. (Ex

tens

ive

pow

er o

utag

esm

ake

it di

fficu

lt to

pur

chas

e go

ods

and

serv

ices

unl

ess

you

have

cas

h si

nce

cred

it ca

rd m

achi

nes,

ATM

s, e

tc. d

o no

t wor

k.)

�Id

entif

y de

lega

tion

of a

utho

rity

and

orde

rs o

f su

cces

sion

at

leas

t th

ree

deep

for

per

sonn

el a

utho

rized

to

carr

y ou

t th

is d

uty.

�E

nsur

e ad

equa

te c

ash

rese

rves

prio

r to

the

ons

et o

f a

stor

m.

�E

stab

lish

mem

oran

dum

s of

agr

eem

ent

as n

eces

sary

with

ban

ks.

5. E

nsur

e pl

ans

are

coor

dina

ted

with

loca

l em

erge

ncy

man

agem

ent.

�E

mer

genc

y m

anag

emen

t m

ay b

e ab

le t

o as

sist

with

logi

stic

s an

dre

sour

ces

such

as

tran

spor

tatio

n an

d fu

el.

6. D

eter

min

e if

empl

oyee

s re

quire

d to

wor

k du

ring

the

stor

m m

ay

have

fam

ilym

embe

rs s

tay

at th

e ho

spita

l. If

so, c

onsi

der t

he fo

llow

ing

in y

our p

olic

y:�

Iden

tify

who

qua

lifie

s as

a fa

mily

mem

ber o

r de

pend

ents

, e.g

. sp

ouse

, dep

ende

nt c

hild

ren

and

depe

nden

t (o

n em

ploy

ee) p

aren

t/el

derly

fam

ily m

embe

rs a

re p

erm

itted

to

stay

with

wor

king

sta

ff

mem

bers

at

the

hosp

ital.

�D

evel

op a

che

cklis

t of

item

s fa

mily

mem

bers

, inc

ludi

ng c

hild

ren,

ar

e to

brin

g w

ith t

hem

to

the

hosp

ital.1

7

�C

larif

y ex

pect

atio

ns r

egar

ding

car

e fo

r fa

mily

mem

bers

or

depe

nden

ts w

ith s

peci

al n

eeds

, e.g

. the

hos

pita

l will

not

pro

vide

ca

re fo

r fa

mily

mem

bers

and

dep

ende

nts.

Dev

elop

wai

ver

for

thos

e th

at e

lect

to b

ring

fam

ily m

embe

rs/d

epen

dent

s to

the

faci

lity.

18

�Id

entif

y ar

eas

in t

he h

ospi

tal w

here

fam

ily m

embe

rs w

ill s

tay,

in

clud

ing

slee

ping

and

sho

wer

ing

area

s.�

Iden

tify

area

s fo

r su

perv

ised

car

e of

chi

ldre

n an

d ad

ults

with

sp

ecia

l nee

ds.

�Id

entif

y po

tent

ial s

taff

tha

t m

ay s

uper

vise

chi

ldre

n an

d ad

ults

w

ith s

peci

al n

eeds

. Con

side

r ha

ving

fam

ily m

embe

rs o

f st

aff

volu

ntee

r. C

onsi

der

part

nerin

g w

ith lo

cal c

hild

care

age

ncy.

�

Dev

elop

enr

ollm

ent/

wai

ver

form

tha

t ad

dres

ses

liabi

lity

prot

ectio

ns f

or d

epen

dent

s.19

�R

equi

re e

mpl

oyee

s to

com

plet

e th

e en

rollm

ent/w

aive

r fo

rm a

nd

subm

it it

to t

heir

supe

rvis

or e

ach

year

, prio

r to

the

sta

rt o

f hu

rric

ane

seas

on, w

hich

is f

rom

Jun

e 1

– N

ov 3

0.�

Add

ress

par

king

nee

ds.

17S

ee S

helte

ring

Nec

essi

ties,

App

endi

x #2

b18

See

Chi

ldca

re E

nrol

lmen

t Fo

rm, A

ppen

dix

#2f

19S

ee C

hild

care

Enr

ollm

ent

Form

, App

endi

x #2

f

Wea

ther

ing th

e St

orm

�A

Hur

rica

ne P

lann

ing,

Res

pons

e an

d Re

cove

ry T

oolk

it35

D. E

MP

LOY

EE

SU

PP

OR

T(C

ON

TIN

UE

D)

INN

OT

DA

TE

TOB

ELE

AD

STA

FF

AS

SIG

NM

EN

TC

OM

PLE

TE

DP

RO

GR

ES

SS

TAR

TE

DC

OM

PLE

TE

DM

EM

BE

R

7. I

f sp

ace

is u

nava

ilabl

e at

fac

ility

, con

side

r w

orki

ng w

ith lo

cal

emer

genc

y m

anag

emen

t to

iden

tify

a sh

elte

r fo

r em

ploy

ee f

amily

m

embe

rs, i

nclu

ding

dep

ende

nts.

�

Det

erm

ine

who

will

be

in c

harg

e of

pre

para

tions

and

sh

elte

r op

erat

ions

. �

Est

ablis

h m

emor

andu

m o

f un

ders

tand

ing

as n

eede

d.

8. If

fam

ily m

embe

rs a

re n

ot p

erm

itted

to

stay

at

the

hosp

ital,

dete

rmin

e if

child

or

depe

nden

t ca

re w

ill b

e av

aila

ble

to c

areg

iver

s.

If s

o, c

onsi

der

the

follo

win

g in

you

r po

licy:

�Id

entif

y ar

ea o

f th

e ho

spita

l for

sup

ervi

sed

child

care

and

an

area

fo

r ad

ult

depe

nden

ts w

ith s

peci

al n

eeds

.�

Iden

tify

pote

ntia

l sta

ff t

hat

may

sup

ervi

se c

hild

ren

and

assi

st

spec

ial n

eeds

adu

lts. C

onsi

der

usin

g su

ppor

t st

aff

from

no

n-cr

itica

l fun

ctio

ns.

�C

onsi

der

part

nerin

g w

ith a

loca

l chi

ldca

re a

genc

y an

d an

eld

er

day

care

age

ncy

to a

ssis

t yo

u.�

Dev

elop

an

enro

llmen

t/w

aive

r fo

rm t

hat

addr

esse

s lia

bilit

y pr

otec

tions

.20�

Req

uire

em

ploy

ees

to c

ompl

ete

the

enro

llmen

t/w

aive

r fo

rm a

nd

subm

it it

to t

heir

supe

rvis

or p

rior

to t

he s

tart

of

hurr

ican

e se

ason

, w

hich

is J

une

1 –

Nov

30

each

yea

r.�

If f

amily

mem

bers

are

not

per

mitt

ed t

o st

ay a

t the

hos

pita

l, co

nsid

er d

evel

opin

g a

budd

y sy

stem

for c

hild

/dep

ende

nt c

are.

For

ex

ampl

e, t

wo

sing

le p

aren

ts c

ould

wor

k op

posi

te s

hift

s an

d ca

re

for

each

oth

er’s

chi

ldre

n w

hile

the

oth

er is

wor

king

. The

hos

pita

l co

uld

assi

st w

ith m

akin

g th

ese

arra

ngem

ents

.

9. If

no

fam

ily m

embe

rs a

re p

erm

itted

at

faci

lity,

con

side

r ne

gotia

ting

cont

ract

ser

vice

s fo

r ch

ild c

are

and

elde

r ca

re f

or s

taff.

20S

ee C

hild

care

Enr

ollm

ent

Form

, App

endi

x #2

f

Wea

ther

ing th

e St

orm

�A

Hur

rica

ne P

lann

ing,

Res

pons

e an

d Re

cove

ry T

oolk

it37

D. E

MP

LOY

EE

SU

PP

OR

T(C

ON

TIN

UE

D)

INN

OT

DA

TE

TOB

ELE

AD

STA

FF

AS

SIG

NM

EN

TC

OM

PLE

TE

DP

RO

GR

ES

SS

TAR

TE

DC

OM

PLE

TE

DM

EM

BE

R

10. D

eter

min

e if

empl

oyee

s re

quire

d to

wor

k du

ring

the

stor

m m

ay

brin

g pe

ts.

�Ex

ampl

e: A

ll an

imal

s m

ust

be c

rate

d an

d up

-to-

date

on

all

vacc

inat

ions

(i.e

. rab

ies)

. Pro

per

docu

men

tatio

n of

vac

cina

tions

isre

quire

d at

the

tim

e of

che

ck in

. Ow

ners

/em

ploy

ees

mus

t pr

ovid

eal

l nec

essa

ry it

ems

to c

are

for

thei

r pe

t (i.

e. fo

od, w

ater

, litt

er,

com

fort

item

s). P

et o

wne

rs a

re r

espo

nsib

le f

or c

lean

ing

up a

fter

an

d ca

ring

for

thei

r pe

t(s)

.�

Iden

tify

area

s of

the

hos

pita

ls w

here

pet

s m

ay s

tay.

�

Dev

elop

a c

heck

list

of it

ems

that

mus

t be

bro

ught

to

the

hosp

ital

with

the

pet

.�

Ensu

re s

taff

is a

war

e of

pet

em

erge

ncy

prep

ared

ness

info

rmat

ion.

21

11. E

nsur

e st

aff

is t

rain

ed o

n fa

mily

pre

pare

dnes

s.

�Pr

ovid

e st

aff

with

too

ls a

nd r

esou

rces

to

help

the

m d

evel

op t

heir

pers

onal

pre

pare

dnes

s pl

an.22

21S

ee h

ttp:

//ww

w.a

spca

.org

/pet

-car

e/di

sast

er-p

repa

redn

ess/

and

http

://w

ww

.rea

dy.g

ov/a

mer

ica/

geta

kit/

pets

.htm

l22

See

ht t

p://w

ww

.rea

dy.g

ov/

Wea

ther

ing th

e St

orm

�A

Hur

rica

ne P

lann

ing,

Res

pons

e an

d Re

cove

ry T

oolk

it39

E. S

UP

PLI

ES

- S

PE

CIA

L C

ON

SID

ER

AT

ION

S F

OR

HU

RR

ICA

NE

S

INN

OT

DA

TE

TOB

ELE

AD

STA

FF

AS

SIG

NM

EN

TC

OM

PLE

TE

DP

RO

GR

ES

SS

TAR

TE

DC

OM

PLE

TE

DM

EM

BE

R

1. E

stab

lish

proc

edur

es t

o as

sess

cur

rent

sup

ply

inve

ntor

y le

vels

23an

dde

term

ine

incr

ease

d su

pply

nee

ds t

o sh

elte

r-in-

plac

efo

r on

e w

eek.

2. D

eter

min

e ho

w fa

r in

adv

ance

of

a st

orm

add

ition

al s

uppl

ies

need

to

be o

rder

ed t

o en

sure

del

iver

y pr

ior

to s

torm

impa

cts/

evac

uatio

ns.

Hos

pita

ls w

ill ne

ed to

mak

e su

re a

dditi

onal

sup

plie

s ar

e se

cure

d pr

ior

to in

terru

ptio

ns o

f del

iver

y se

rvic

es.

2. In

clud

e th

is in

form

atio

n on

faci

lity

chec

klis

t.

3. C

heck

with

ven

dors

to

dete

rmin

e th

eir

limita

tions

of

deliv

ery

in t

heev

ent

of s

torm

thr

eats

and

/or

evac

uatio

ns. I

n in

stan

ces

of in

tens

e st

orm

s, t

ruck

s m

ay n

ot m

ake

deliv

erie

s as

sch

edul

ed fo

r fea

r of

bein

g ca

ught

in e

vacu

atio

n tr

affic

.

4. Id

entif

y al

tern

ate/

addi

tiona

l ven

dors

and

dev

elop

pur

chas

ing

proc

edur

es.24

�D

evel

op s

et o

f em

erge

ncy

purc

hase

ord

ers

that

may

be

quic

kly

impl

emen

ted

(or

activ

ated

with

the

ven

dor

dire

ctly

via

pho

ne) a

ndfil

e w

ith v

endo

rs.

�D

evel

op e

mer

genc

y ba

ckup

pro

cedu

res

to e

xped

ite p

urch

asin

g of

cr

itica

l sup

plie

s sh

ould

nor

mal

pur

chas

ing

proc

edur

es b

e in

terr

upte

d or

del

ayed

.�

Exp

lore

alte

rnat

e gr

oup

purc

hasi

ng a

gree

men

ts.

�D

eter

min

e w

ho h

as a

utho

rity

to im

plem

ent

emer

genc

y pu

rcha

sing

orde

rs a

nd t

rigge

r po

ints

to

activ

ate,

e.g

., 72

hou

rs p

rior

to la

ndfa

ll.En

sure

del

egat

ions

of

auth

ority

and

ord

ers

of s

ucce

ssio

n at

leas

t th

ree

deep

.

5. R

evie

w lo

gist

ical

nee

ds a

nd o

ptio

ns f

or p

re-p

ositi

onin

g an

d di

strib

utin

g su

pplie

s w

ithin

the

hos

pita

l. C

onsi

der

desi

gnat

ing

supp

ly s

tagi

ng a

reas

on

each

flo

or.

23S

ee C

onsu

mab

le S

uppl

y O

pera

tiona

l Im

pact

Cha

rt, A

ppen

dix

#824

See

Sam

ple

Emer

genc

y C

onta

ct F

orm

, App

endi

x #1

b

Wea

ther

ing th

e St

orm

�A

Hur

rica

ne P

lann

ing,

Res

pons

e an

d Re

cove

ry T

oolk

it41

E. S

UP

PLI

ES

- S

PE

CIA

L C

ON

SID

ER

AT

ION

S F

OR

HU

RR

ICA

NE

S (

CO

NT

INU

ED)

INN

OT

DA

TE

TOB

ELE

AD

STA

FF

AS

SIG

NM

EN

TC

OM

PLE

TE

DP

RO

GR

ES

SS

TAR

TE

DC

OM

PLE

TE

DM

EM

BE

R

6. E

nsur

e us

e of

Inve

ntor

y M

anag

emen

t Sy

stem

or

iden

tify

alte

rnat

e pr

oced

ures

for i

nven

tory

man

agem

ent i

n th

e ev

ent o

f a p

ower

out

age.

�Ve

rify

capa

city

of I

nven

tory

Man

agem

ent

Syst

em. B

e aw

are

of

syst

em li

mita

tions

and

the

impa

ct t

his

may

hav

e on

man

agin

g in

vent

ory

durin

g an

eve

nt. P

lan

acco

rdin

gly.

�Ex

ampl

e: A

bac

k-up

sys

tem

may

be

the

use

of E

xcel

file

s on

a

batt

ery

back

-up

com

pute

r th

at c

an b

e pl

ugge

d in

to a

n ou

tlet

pow

ered

by

a ge

nera

tor.

Als

o, p

aper

and

pen

cil w

ork

too.

Con

side

rpr

e-po

pula

ting

inve

ntor

y fo

rms

and

prin

ting

them

pre

-eve

nt t

o ea

se p

aper

and

pen

cil m

etho

ds.

Wea

ther

ing th

e St

orm

�A

Hur

rica

ne P

lann

ing,

Res

pons

e an

d Re

cove

ry T

oolk

it43

F. U

TIL

ITIE

S

INN

OT

DA

TE

TOB

ELE

AD

STA

FF

AS

SIG

NM

EN

TC

OM

PLE

TE

DP

RO

GR

ES

SS

TAR

TE

DC

OM

PLE

TE

DM

EM

BE

R

1. D

eter

min

e R

ecov

ery

Tim

e O

bjec

tives

(RTO

) for

crit

ical

and

sup

port

fu

nctio

ns.25

�A

n R

TO la

ys o

ut t

he m

axim

um a

ccep

tabl

e do

wnt

ime

for

a pr

oces

s. F

or e

xam

ple,

if t

he c

linic

al r

egis

trat

ion

syst

em g

oes

dow

n,yo

u m

ay h

ave

an R

TO o

f on

e ho

ur t

o ge

t it

back

up.

A r

ecov

ery

poin

t ob

ject

ive

(RP

O) i

s th

e m

axim

um a

mou

nt o

f allo

wab

le d

ata

loss

follo

win

g an

unp

lann

ed IT

eve

nt s

uch

as a

crit

ical

dis

k fa

ilure

or

a fl

ood

in y

ourd

ata

cent

er. T

he R

PO h

elps

you

dec

ide

how

ofte

n yo

u w

ill ba

ckup

you

r dat

a. If

you

r RPO

is o

ne w

eek,

then

you

cou

ld

back

up y

our

data

onc

e a

wee

k so

the

max

imum

am

ount

of

data

yo

u w

ould

lose

is o

nly

data

sin

ce t

he la

st b

acku

p.If

it is

un

acce

ptab

le t

o lo

se a

ny d

ata,

and

you

r R

PO

is o

ne m

illis

econ

d,

then

you

wou

ld re

quire

a m

irror

ed s

ite s

o th

at d

ata

is s

imul

tane

ousl

ypr

esen

t on

you

r pr

imar

y sy

stem

and

you

r ba

ckup

sys

tem

.

2. E

stab

lish

alte

rnat

e so

urce

s of

pow

er t

hat

are

sust

aina

ble

for

at

leas

t 96

hou

rs a

s re

quire

d by

the

Joi

nt C

omm

issi

on a

nd u

p to

one

w

eek.

�Id

entif

y lo

ad r

equi

rem

ents

.�

Iden

tify

and

acqu

ire a

ppro

pria

te e

quip

men

t.�

Iden

tify

imm

edia

te a

nd d

elay

ed p

ower

nee

ds fo

r eac

h de

part

men

t. N

ote:

Sho

rt te

rm p

ower

nee

ds (<

12 h

ours

) diff

er fr

om lo

ng te

rm

pow

er n

eeds

. Pre

pare

for a

n ex

tens

ive

pow

er o

utag

e. F

or e

xam

ple,

co

nsid

er t

he n

eed

to p

ower

air

cond

ition

ers/

vent

ilatio

n sy

stem

s,

wat

er c

hille

rs, a

ncill

ary

area

s, a

cces

s co

ntro

l/sec

urity

sys

tem

s,

tele

phon

es a

nd c

ompu

ter

syst

ems,

in a

dditi

on t

o cl

inic

alca

re

oper

atio

ns.

�E

stab

lish

back

up s

ourc

es o

f po

wer

to

mai

n al

tern

ate

sour

ce (i

.e.

port

able

gen

erat

ors

to b

ack

up m

ain

gene

rato

r, la

rge

batt

erie

s on

w

heel

s).

25S

ee U

tility

Fai

lure

Ope

ratio

nal I

mpa

ct C

hart

, App

endi

x #7

Wea

ther

ing th

e St

orm

�A

Hur

rica

ne P

lann

ing,

Res

pons

e an

d Re

cove

ry T

oolk

it45

F. U

TIL

ITIE

S(C

ON

TIN

UE

D)

INN

OT

DA

TE

TOB

ELE

AD

STA

FF

AS

SIG

NM

EN

TC

OM

PLE

TE

DP

RO

GR

ES

SS

TAR

TE

DC

OM

PLE

TE

DM

EM

BE

R

3. E

stab

lish

proc

edur

es f

or m

aint

aini

ng a

ltern

ate

sour

ces

of p

ower

pr

e- a

nd p

ost-

even

t.�

Ens

ure

alte

rnat

e po

wer

sou

rces

are

pro

tect

ed f

rom

flo

odin

g an

d w

ind.

�

Ens

ure

mai

nten

ance

sup

plie

s ar

e av

aila

ble

for

gene

rato

rs (i

.e.

filte

rs, s

park

plu

gs, o

il, e

tc.).

�M

aint

ain

capa

city

to

mak

e re

pairs

and

ope

rate

pow

er s

ourc

es (i

.e.

Eng

inee

r is

con

side

red

criti

cal p

erso

nnel

).�

Ens

ure

suff

icie

nt a

mou

nts

of f

uel f

or g

ener

ator

s ar

e av

aila

ble

and

secu

red

pre-

stor

m f

rom

win

d an

d flo

odin

g.

4. E

stab

lish

proc

edur

es t

o se

cure

add

ition

al s

uppl

ies.

�Fo

od: I

ncre

ase

food

ord

erin

g fo

rmul

as t

o ac

coun

t fo

r ad

ditio

nal

staf

f an

d fa

mily

mem

bers

; ide

ntify

foo

ds t

hat

do n

ot r

equi

re

refr

iger

atio

n; c

onsi

der

disp

osab

le p

rodu

cts

for

serv

ing

food

and

ea

ting.

�O

xyge

n: O

xyge

n-de

pend

ent

patie

nts

may

hav

e in

terr

uptio

ns t

o th

eir

oxyg

en s

uppl

y or

ele

ctric

ity a

nd m

ay s

eek

assi

stan

ce a

t th

e ho

spita

l.�

Line

ns: P

lan

for

addi

tiona

l sta

ff a

nd p

oten

tial i

nter

rupt

ions

to la

undr

yse

rvic

es.

�P

harm

aceu

tical

s: C

omm

unity

pow

er o

utag

es m

ay li

mit

avai

labi

lity

of p

resc

riptio

n m

edic

atio

n. Id

entif

y co

mm

only

use

d m

edic

atio

ns

and

incr

ease

inve

ntor

y.�

Blo

od s

uppl

y: R

each

out

to

bloo

d ce

nter

s/su

pplie

rs a

nd v

erify

th

eir

cont

inge

ncy

plan

s fo

r hu

rric

anes

to

bett

er d

eter

min

e bl

ood

inve

ntor

ies

need

ed p

re-s

torm

to

ensu

re a

n ad

equa

te b

lood

sup

ply

thro

ugh

post

-sto

rm a

nd r

ecov

ery

perio

ds.

Wea

ther

ing th

e St

orm

�A

Hur

rica

ne P

lann

ing,

Res

pons

e an

d Re

cove

ry T

oolk

it47

F. U

TIL

ITIE

S(C

ON

TIN

UE

D)

INN

OT

DA

TE

TOB

ELE

AD

STA

FF

AS

SIG

NM

EN

TC

OM

PLE

TE

DP

RO

GR

ES

SS

TAR

TE

DC

OM

PLE

TE

DM

EM

BE

R

5. E

stab

lish

proc

edur

es t

o en

sure

an

adeq

uate

sup

ply

of p

otab

le a

nd

non-

pota

ble

wat

er.

�Id

entif

y us

es o

f no

n-po

tabl

e w

ater

(i.e

. flu

shin

g to

ilets

, coo

ling

vent

ilatio

n to

wer

s, f

ire s

uppr

essi

on s

yste

m).

�Id

entif

y so

urce

s of

non

-pot

able

wat

er (i

.e. P

orta

-Pot

ty o

r w

ell).

�E

stab

lish

cont

ract

with

ven

dor2

6(i.

e. w

ater

buf

falo

)�

Iden

tify

sour

ces

of p

otab

le w

ater

(i.e

. bot

tled

wat

er).

�E

stab

lish

cont

ract

with

ven

dors

as

need

ed.

6. E

stab

lish

proc

edur

es t

o en

sure

ade

quat

e su

pplie

s to

m

aint

ain

vent

ilatio

n sy

stem

.�

Mai

ntai

n ca

paci

ty t

o m

ake

repa

irs t

o sy

stem

(i.e

. Eng

inee

r is

co

nsid

ered

crit

ical

per

sonn

el).

�E

nsur

e (n

on-p

otab

le) w

ater

sup

ply

for

cool

ing

tow

ers.

7.

Est

ablis

h pr

oced

ures

to

man

age

was

te.

�W

aste

col

lect

ion

serv

ices

may

be

inte

rrup

ted.

�Id

entif

y ad

ditio

nal s

tora

ge c

apac

ity f

or w

aste

.�

Ens

ure

prop

er h

andl

ing

of w

aste

to

prev

ent i

njur

y an

d th

e sp

read

of

dis

ease

.

26S

ee S

ampl

e Em

erge

ncy

Con

tact

For

m, A

ppen

dix

#1b

Wea

ther

ing th

e St

orm

�A

Hur

rica

ne P

lann

ing,

Res

pons

e an

d Re

cove

ry T

oolk

it49

G. P

AT

IEN

T IS

SU

ES

INN

OT

DA

TE

TOB

ELE

AD

STA

FF

AS

SIG

NM

EN

TC

OM

PLE

TE

DP

RO

GR

ES

SS

TAR

TE

DC

OM

PLE

TE

DM

EM

BE

R

1. E

stab

lish

proc

edur

es t

o ex

pedi

te p

atie

nt t

rans

fers

and

pat

ient

tr

acki

ng in

a d

isas

ter.

�N

ote:

Kno

w c

riter

ia a

nd e

stab

lish

prot

ocol

s fo

r w

hen

patie

nt

tran

sfer

s ar

e no

long

er a

llow

ed d

ue t

o un

safe

roa

d co

nditi

ons

(Exa

mpl

e: In

sus

tain

ed w

inds

of

> 4

5 m

ph, a

mbu

lanc

es c

an n

o lo

nger

tra

nspo

rt p

atie

nts)

.�

Dev

elop

abb

revi

ated

for

ms

and

chec

klis

ts f

or p

atie

nt t

rans

fers

an

d di

scha

rge,

if n

eede

d.�

Ens

ure

patie

nt t

rack

ing

proc

edur

es a

re e

stab

lishe

d an

d fo

llow

ed.

2. E

stab

lish

Mem

oran

da o

f U

nder

stan

ding

/Mem

oran

da o

f A

gree

men

t (M

OU

/MO

A) w

ith f

acili

ties

in a

nd o

ut o

f st

ate

for

patie

nt t

rans

fers

an

d ev

acua

tions

.

3. E

stab

lish

proc

edur

es to

dis

char

ge p

atie

nts.

�E

nsur

e al

l reg

ulat

ory

requ

irem

ents

are

met

whe

n di

scha

rgin

g pa

tient

s.�

Ens

ure

patie

nts

are

prov

ided

pro

per

hom

e ca

re in

stru

ctio

ns a

nd

acce

ss t

o su

ppor

ting

med

ical

equ

ipm

ent.

�E

nsur

e pa

tient

s ha

ve s

uffic

ient

sup

ply

of m

edic

atio

ns.

�E

nsur

e av

aila

bilit

y of

tra

nspo

rtat

ion.

If e

vacu

atio

ns h

ave

star

ted

in

your

are

a, o

r a

near

by a

rea,

roa

ds m

ay b

e ja

mm

edan

d us

ual

tran

spor

tatio

n as

sets

may

not

be

avai

labl

e.4.

Est

ablis

h pr

oced

ures

for

assi

stin

g ox

ygen

-dep

ende

nt p

atie

nts

that

m

ay p

rese

nt b

efor

e or

aft

er a

sto

rm.

�C

oord

inat

e w

ith E

mer

genc

y M

anag

emen

t/H

ealth

Dep

artm

ent

to

dete

rmin

e if

any

reso

urce

s ar

e av

aila

ble

in t

he c

omm

unity

to

assi

st w

ith o

xyge

n-de

pend

ent

patie

nts.

Are

the

re s

peci

al n

eeds

sh

elte

rs a

vaila

ble

with

est

ablis

hed

alte

rnat

e so

urce

s of

pow

er?

�

Be

prep

ared

to

assi

st o

xyge

n-de

pend

ent

patie

nts.

�C

onsi

der e

stab

lishi

ng p

artn

ersh

ips

with

hom

e he

alth

age

ncie

s an

d as

sist

ed li

ving

faci

litie

s to

add

ress

thi

s ne

ed.

�E

nsur

e ad

equa

te a

mou

nts

of o

xyge

n, t

anks

and

sup

plie

s.

Wea

ther

ing th

e St

orm

�A

Hur

rica

ne P

lann

ing,

Res

pons

e an

d Re

cove

ry T

oolk

it51

G. P

AT

IEN

T IS

SU

ES

(CO

NT

INU

ED)

INN

OT

DA

TE

TOB

ELE

AD

STA

FF

AS

SIG

NM

EN

TC

OM

PLE

TE

DP

RO

GR

ES

SS

TAR

TE

DC

OM

PLE

TE

DM

EM

BE

R

5. R

evie

w e

xist

ing

reso

urce

s to

ass

ist

with

pla

nnin

g fo

r the

nee

ds o

f di

alys

is p

atie

nts.

27

�C

heck

with

are

a di

alys

is c

ente

rs r

egar

ding

the

ir hu

rric

ane

plan

an

d re

sour

ces.

�B

e pr

epar

ed t

o ad

dres

s di

alys

is p

atie

nt n

eeds

pos

t-st

orm

.�

Est

ablis

h pa

rtne

rshi

ps a

s ne

eded

.�

Edu

cate

pat

ient

s on

pla

ns a

nd p

roce

dure

s.�

Be

prep

ared

to

incr

ease

wat

er s

uppl

y an

d pr

essu

re a

s ne

eded

.

6. E

stab

lish

proc

edur

es f

or m

anag

ing

preg

nant

wom

en.

�C

oord

inat

e w

ith m

edic

al s

taff

to

dete

rmin

e cr

iteria

for

adm

ittin

g pr

egna

nt w

omen

prio

r to

sto

rm.

�E

nsur

e pr

oced

ures

are

com

mun

icat

ed c

lear

ly w

ith p

atie

nts.

7. E

stab

lish

proc

edur

es f

or li

miti

ng a

dmis

sion

s w

hen

a st

orm

is

appr

oach

ing.

�Ex

ampl

e: E

stab

lish

proc

edur

es t

o ca

ncel

ele

ctiv

e su

rger

ies

to

redu

ce in

patie

nt s

tays

.�

Be

prep

ared

for

per

sons

see

king

adm

issi

on t

hat

wou

ld n

ot

typi

cally

do

so u

nder

nor

mal

circ

umst

ance

s.

�Id

entif

y co

mm

unity

res

ourc

es t

o re

fer

pers

ons

seek

ing

shel

ter

at y

our

faci

lity.

Som

e pe

ople

may

wan

t to

use

you

r fa

cilit

y as

a

safe

hav

en.

�Ed

ucat

e co

mm

unity

on

thes

e re

sour

ces

and

enco

urag

e pe

rson

s w

ith s

peci

al n

eeds

to

have

pre

pare

dnes

s pl

ans.

The

hos

pita

l is

NO

T a

shel

ter.

8. E

stab

lish

proc

edur

es f

or m

ovin

g pa

tient

s w

ithin

fac

ility

whe

n el

evat

ors

are

not

wor

king

at

full

capa

city

, if

at a

ll.�

Iden

tify

equi

pmen

t ne

eds

and

acqu

ire a

ppro

pria

te e

quip

men

t su

ch a

s st

retc

hers

/litt

ers.

�E

nsur

e st

aff

is t

rain

ed o

n pr

oced

ures

and

equ

ipm

ent

use.

27S

ee D

ialy

sis

Con

cern

s, A

ppen

dix

#9

Wea

ther

ing th

e St

orm

�A

Hur

rica

ne P

lann

ing,

Res

pons

e an

d Re

cove

ry T

oolk

it53

H. C

OM

MU

NIC

AT

ION

ISS

UE

S

INN

OT

DA

TE

TOB

ELE

AD

STA

FF

AS

SIG

NM

EN

TC

OM

PLE

TE

DP

RO

GR

ES

SS

TAR

TE

DC

OM

PLE

TE

DM

EM

BE

R

1. E

nsur

e ca

pabi

lity

and

capa

city

of r

edun

dant

form

s of

com

mun

icat

ions

.�

Iden

tify

all f

orm

s of

com

mun

icat

ions

. (R

emem

ber,

pape

r, pe

ncil

and

runn

ers

also

are

opt

ions

.)�

Verif

y in

tero

pera

bilit

y of

com

mun

icat

ions

equ

ipm

ent

with

par

tner

ag

enci

es, r

espo

nse

agen

cies

and

loca

l and

sta

te a

genc

ies.

�Te

st c

omm

unic

atio

n sy

stem

s re

gula

rly.

�E

nsur

e ad

equa

te n

umbe

r of

per

sonn

el is

tra

ined

on

how

to

oper

ate

equi

pmen

t.�

Iden

tify

com

mun

ity r

esou

rces

to

assi

st w

ith r

esto

ratio

n of

co

mm

unic

atio

n sy

stem

s. F

or e

xam

ple,

doe

s yo

ur lo

cal e

mer

genc

y m

anag

emen

t ag

ency

hav

e ag

reem

ents

with

cel

l pho

ne c

ompa

nies

to b

ring

in p

orta

ble

com

mun

icat

ion

tow

ers

post

-eve

nt?

2. E

nsur

e st

aff

notif

icat

ion

and

activ

atio

n pr

oces

ses

are

esta

blis

hed

and

clea

rly d

efin

ed.

�S

taff

is t

o m

aint

ain

curr

ent

cont

act

info

rmat

ion.

�E

stab

lish

call

dow

n pr

oced

ures

and

tes

t re

gula

rly (i

.e. c

all t

ree)

.�

Shou

ld p

hone

sys

tem

s fa

il, id

entif

y al

tern

ate

sour

ces

for

empl

oyee

info

rmat

ion

rega

rdin

g w

hen

to r

epor

t to

wor

k. F

or e

xam

ple,

es

tabl

ish

an a

gree

men

t w

ith a

loca

l rad

io s

tatio

n th

at w

ill m

ake

anno

unce

men

ts f

or y

our

hosp

ital.

3. E

stab

lish

proc

edur

es t

o ke

ep s

taff

and

Boa

rd o

f Tru

stee

s in

form

ed

pre-

, dur

ing

and

post

-eve

nt.

�Ex

ampl

e:B

riefin

gs f

or a

ll st

aff

will

be

held

at

regu

lar

inte

rval

s an

dIn

cide

nt A

ctio

n P

lans

(IA

P) a

nd S

ituat

ion

Rep

orts

(SitR

eps)

will

be

dist

ribut

ed t

o al

l per

sonn

el v

ia e

-mai

l and

pos

ted

on c

afet

eria

bu

lletin

boa

rd.

�E

stab

lish

proc

edur

es f

or a

n em

ploy

ee h

otlin

e.�

Ens

ure

staf

f br

iefin

gs a

re h

eld

regu

larly

dur

ing

shift

s an

d at

sh

ift c

hang

e.

Wea

ther

ing th

e St

orm

�A

Hur

rica

ne P

lann

ing,

Res

pons

e an

d Re

cove

ry T

oolk

it55

H. C

OM

MU

NIC

AT

ION

ISS

UE

S(C

ON

TIN

UE

D)

INN

OT

DA

TE

TOB

ELE

AD

STA

FF

AS

SIG

NM

EN

TC

OM

PLE

TE

DP

RO

GR

ES

SS

TAR

TE

DC

OM

PLE

TE

DM

EM

BE

R

4. E

stab

lish

proc

edur

es t

o ke

ep c

omm

unity

par

tner

s an

d co

mm

unity

le

ader

s in

form

ed.

�En

sure

coo

rdin

atio

n of

info

rmat

ion

flow

bet

wee

n ho

spita

l, co

mm

unity

par

tner

s an

d ot

her

stak

ehol

ders

.�

Ens

ure

cont

act

lists

for

com

mun

ity p

artn

ers

are

curr

ent.

�E

stab

lish

com

mun

icat

ion

chan

nels

and

pro

toco

ls w

ith p

artn

ers

and

lead

ersh

ip.

�E

stab

lish

bed

trac

king

/rep

ortin

g pr

oced

ures

.�

Con

side

r ha

ving

hos

pita

l rep

rese

ntat

ive

at E

mer

genc

y O

pera

tions

C

ente

r.�

Sen

d IA

P a

nd S

itRep

s to

com

mun

ity le

ader

s an

d pa

rtne

rs.

5. E

stab

lish

proc

edur

es t

o en

sure

hos

pita

l rec

eive

s in

form

atio

n fr

om

com

mun

ity p

artn

ers.

�Ex

ampl

e: H

ospi

tal r

epre

sent

ativ

e at

tend

s EO

C b

riefin

gs, h

ospi

tal o

n EO

C e

-mai

l dis

trib

utio

n lis

t to

rece

ive

SitR

eps

and

IAPs

and

oth

er

impo

rtan

t ale

rts

from

com

mun

ity p

artn

ers/

EOC

.

6. E

stab

lish

proc

edur

es t

o en

sure

com

mun

icat

ion

and

coor

dina

tion

of p

atie

nt c

are

with

med

ical

sta

ff.�

Est

ablis

h pr

oced

ures

to

ensu

re c

omm

unic

atio

ns a

mon

g m

edic

al s

taff.

�Es

tabl

ish

proc

edur

es to

ass

ist m

edic

al s

taff

with

com

mun

icat

ing

need

ed in

form

atio

n to

pat

ient

s. F

or e

xam

ple,

a p

hysi

cian

’s o

ffice

is

seve

rely

dam

aged

and

est

ablis

hes

oper

atio

ns a

t an

alte

rnat

e lo

catio

n; h

ospi

tals

may

wan

t to

assi

st w

ith p

rovi

ding

this

info

rmat

ion

to p

atie

nts

and

the

com

mun

ity.28

7. C

olla

bora

te w

ith lo

cal a

nd s

tate

pub

lic h

ealth

and

em

erge

ncy

man

agem

ent

to c

omm

unic

ate

with

the

com

mun

ity a

bout

res

ourc

esav

aila

ble

to s

uppo

rt p

erso

ns w

ith s

peci

al n

eeds

.�

Enco

urag

e pe

rson

s w

ith s

peci

al n

eeds

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stab

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�E

nsur

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l sta

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Ens

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gatio

ns o

f au

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ity a

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rder

s of

suc

cess

ion

at le

ast

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ader

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s.�

Follo

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utlin

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y IC

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9. E

stab

lish

proc

edur

es t

o co

mm

unic

ate

with

the

med

ia.29

�E

nsur

e al

l sta

ff k

now

pro

toco

l for

res

pond

ing

to m

edia

req

uest

s.

For

exam

ple,

all

staf

f ar

e to

ref

er m

edia

req

uest

s to

the

Pub

lic

Info

rmat

ion

Off

icer

(PIO

).�

Iden

tify

med

ia s

tagi

ng a

reas

to

assi

st t

he m

edia

with

set

ting

up

equi

pmen

t an

d to

hav

e an

est

ablis

hed

area

for

brie

fings

.�

Con

side

r es

tabl

ishi

ng r

egul

ar b

riefin

g tim

es w

ith m

edia

.

10. E

stab

lish

proc

edur

es fo

r com

mun

icat

ions

bet

wee

n in

tern

al

com

man

d ce

nter

and

sta

ff.�

Exam

ple:

Con

side

r us

ing

wal

kie-

talk

ies

for

inte

rnal

hos

pita

l us

e am

ong

staf

f.

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1. E

stab

lish

proc

edur

es t

o en

sure

acc

ess

cont

rol t

o fa

cilit

y.�

Est

ablis

h pr

oced

ures

to

rest

rict

acce

ss p

oint

s in

to t

he f

acili

ty.

�C

oord

inat

e w

ith lo

cal l

aw e

nfor

cem

ent

agen

cies

on

secu

rity

plan

s.�

Cla

rify

role

and

res

pons

ibili

ties

with

loca

l law

enf

orce

men

t re

gard

ing

faci

lity

secu

rity.

�Id

entif

y ad

ditio

nal s

ecur

ity p

erso

nnel

to

rem

ain

at f

acili

ty d

urin

g th

e st

orm

. �

Esta

blis

h co

ntra

cts

with

priv

ate

secu

rity

com

pani

es a

s ne

eded

.�

Test

pla

ns w

ith p

rivat

e an

d pu

blic

sec

urity

age

ncie

s.

2. E

stab

lish

proc

edur

es t

o m

aint

ain

acce

ss c

ontr

ol w

hen

elec

tron

ic

secu

rity

syst

ems

fail

or a

re n

ot p

ower

ed.

�E

stab

lish

proc

edur

es t

o re

stric

t ac

cess

poi

nts.

�Id

entif

y an

d dr

ill lo

w t

ech

secu

rity

mea

sure

s su

ch a

s us

e of

a

key

log.

�En

sure

ligh

ting

at d

esig

nate

d en

tran

ces.

�

Bui

ld s

ecur

ity p

lan

arou

nd p

re-d

esig

nate

d, r

estr

icte

d en

tran

ces

for

use

durin

g an

eve

nt.

�Id

entif

y R

TO s

ecur

ity s

yste

ms

(i.e

., de

term

ine

num

ber

of h

ours

se

curit

y sy

stem

may

be

with

out

pow

er u

ntil

the

func

tion

mus

t be

res

umed

).�

Coo

rdin

ate

need

s fo

r al

tern

ate

sour

ces

of p

ower

with

app

ropr

iate

pers

onne

l.

3. E

stab

lish

proc

edur

es t

o en

sure

acc

ess

cont

rol a

nd p

rote

ctio

n of

hi

gh-r

isk

area

s w

ithin

the

fac

ility

.�

For

exam

ple,

ens

ure

the

phar

mac

y is

sec

ure

and

can

rem

ain

secu

re w

hen

elec

tron

ic s

yste

ms

fail.

�Id

entif

y lo

catio

ns th

at n

eed

alte

rnat

ive

low

-tech

sec

urity

mea

sure

s.�

Ide

nti

fy a

nd

dri

ll lo

w-t

ech

se

curi

ty m

easu

res

such

as

use

of

lock

s an

d ch

ains

.

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proc

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ting

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curit

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�Id

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ecur

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h as

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icer

s w

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nfor

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Esta

blis

h co

ntra

cts

with

priv

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secu

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pani

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or a

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onal

se

curit

y pe

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nel.

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uest

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cess

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cal,

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onal

and

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te la

wen

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s th

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h O

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. �

Iden

tify

and

drill

the

loca

l EO

C P

oint

of

Con

tact

for

the

law

en

forc

emen

t em

erge

ncy

supp

ort

func

tion.

�U

se o

f im

prop

er re

ques

t pro

cedu

res

may

impa

ct r

eim

burs

emen

t,

whe

n av

aila

ble.

5. E

stab

lish

proc

edur

es t

o en

sure

ade

quat

e lig

htin

g of

hos

pita

l ca

mpu

s in

the

eve

nt o

f ex

tend

ed p

ower

out

ages

.�

Iden

tify

reso

urce

s fo

r lig

htin

g pa

rkin

g ar

eas

and

othe

r ho

spita

l gr

ound

s to

ens

ure

safe

ty.

�E

stab

lish

agre

emen

ts w

ith v

endo

rs a

s ne

eded

. Con

side

r co

ntin

gent

con

trac

ts f

or s

elf-

pow

ered

por

tabl

e lig

hts.

�E

nsur

e su

ffic

ient

ligh

ting

with

in f

acili

ty w

hen

usin

g al

tern

ate

sour

ces

of p

ower

. �

Ens

ure

loca

l pow

er p

rovi

der

has

faci

lity

prop

erly

prio

ritiz

ed

for

reco

very

.

6. E

stab

lish

proc

edur

es to

faci

litat

e em

ploy

eeac

cess

to

rest

ricte

d ro

ads

for

com

mut

ing

to a

nd f

rom

wor

k.�

Det

erm

ine,

in c

once

rt w

ith la

w e

nfor

cem

ent,

acc

epta

ble

form

s of

iden

tific

atio

n (i.

e. h

ospi

tal I

D) t

hat

will

allo

w e

mpl

oyee

s to

ac

cess

roa

ds f

or c

omm

utin

g to

and

fro

m w

ork.

Roa

d ac

cess

m

ay b

e re

stric

ted

to r

espo

nse

pers

onne

l and

may

be

rest

ricte

d du

e to

cur

few

s.�

Est

ablis

h pr

oced

ures

for

tra

ffic

con

trol

nea

r fa

cilit

y.�

Be

prep

ared

to

adju

st s

taff

ing

sche

dule

s in

con

cert

with

cur

few

s.�

Be

prep

ared

to

adju

st p

atie

nt v

isiti

ng h

ours

in c

once

rt

with

cur

few

s.D

eter

min

e in

adv

ance

if s

erio

usly

ill p

atie

nts

may

ha

ve a

n ov

erni

ght

visi

tor

and

if th

e pa

rent

s of

chi

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n m

ay s

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nigh

t.

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evel

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nd im

plem

ent

an a

ctio

n pl

an t

o m

itiga

te f

lood

ing

haza

rds

and

risks

.�

Kno

w y

our

flood

haz

ards

and

ris

ks.31

Are

you

in a

flo

od p

lane

?

Wha

t le

vel o

fst

orm

sur

ge w

ould

cau

se f

lood

ing

in y

our

area

?�

Che

ck o

n st

atus

of

stor

m d

rain

s (e

.g. c

lear

of

debr

is, d

rain

ef

fect

ivel

y).

�C

heck

sta

tus

of li

ft s

tatio

ns. D

oes

the

tow

nshi

p ha

ve g

ener

ator

s fo

r lif

t st

atio

ns?

Wha

t is

the

impa

ct o

n yo

ur f

acili

ty if

cer

tain

lift

st

atio

ns a

re n

ot o

pera

tiona

l?�

Che

ck s

tatu

s of

pro

tect

ive

mea

sure

s to

pre

vent

sew

age

back

up

(e.g

.,ins

talla

tion

of b

ack-

flow

pre

vent

ers)

.

8. Id

entif

y an

d ac

quire

nec

essa

ry s

uppl

ies

to p

rote

ct f

acili

ty.

�B

e pr

epar

ed t

o pr

otec

t fa

cilit

y fr

om s

tron

g w

inds

and

win

d-bo

rne

debr

is. F

orex

ampl

e, w

indo

w c

over

ings

/shu

tter

s m

ay p

rote

ct

win

dow

s an

d su

mp

pum

psm

ay a

ssis

t w

ith f

lood

ing

in s

ome

area

s.�

Coo

rdin

ate

with

ven

dors

to

addr

ess

supp

ly q

ualit

y, e

.g.,

fuel

di

strib

utor

s sh

ould

pro

vide

ass

uran

ce t

hat

the

fuel

isno

t co

mpr

omis

ed d

ue t

o ag

e or

slu

dge.

9. E

stab

lish

proc

edur

es f

or d

ebris

rem

oval

pos

t-ev

ent.

�M

aint

ain

trim

min

g of

tre

es a

nd s

hrub

s th

roug

hout

the

hur

rican

e se

ason

to

min

imize

deb

ris p

ost-e

vent

. For

exa

mpl

e,tr

im t

rees

and

sh

rubb

ery

at e

ntra

nces

for

vis

itors

, med

ical

sta

ff a

nd p

atie

nts.

�Id

entif

y ve

ndor

and

est

ablis

h co

ntra

ct in

adv

ance

of

an e

vent

for

de

bris

rem

oval

pos

t-ev

ent.

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entif

y pr

oces

s an

d pr

oced

ures

for

requ

estin

g ad

ditio

nal r

esou

rces

.

2. E

nsur

e ap

prop

riate

req

uest

pro

cedu

res

are

follo

wed

to

assi

st w

ith

the

reco

very

of

cost

s fr

om F

EM

A a

nd o

ther

sou

rces

of

fund

ing.

�E

nsur

e ap

prop

riate

doc

umen

tatio

n is

mai

ntai

ned

durin

g th

e ev

ent

to b

ette

r su

ppor

t po

tent

ial r

eque

sts

for

reim

burs

emen

t.

3. E

stab

lish

proc

edur

es t

o ac

quire

add

ition

alst

aff

as n

eede

d.�

Dev

elop

mut

ual a

id a

gree

men

ts w

ith o

ther

fac

ilitie

s to

pro

vide

st

affin

g.32

�A

ddre

ss c

ompe

nsat

ion,

liab

ility

and

cre

dent

ialin

g as

par

t of

m

utua

l aid

agr

eem

ents

. �

Iden

tify

and

know

pro

cess

to

acce

ss s

taff

thr

ough

Em

erge

ncy

Syst

em f

or A

dvan

ce R

egis

trat

ion

of V

olun

teer

Hea

lthPr

ofes

sion

als

(ESA

R-V

HP

), M

edic

al R

eser

ve C

orps

(MR

C) a

nd E

mer

genc

y M

anag

emen

t A

ssis

tanc

e C

ompa

cts

(EM

AC

).

4. E

stab

lish

MO

U/M

OA

with

fac

ilitie

s in

and

out

of

stat

e fo

r pa

tient

tr

ansf

ers

and

evac

uatio

ns.

5. V

erify

/tes

t al

l MO

U/M

OA

and

hav

e co

ntin

genc

y ag

reem

ents

/pla

ns

shou

ld m

utua

l aid

not

be

avai

labl

e.

6. H

ave

an u

nder

stan

ding

of

the

impa

cts

of t

he S

tate

Em

erge

ncy

Hea

lth P

ower

s A

ct a

nd t

he p

oten

tial i

mpl

icat

ions

for

a fa

cilit

y.�

Com

mun

icat

e th

is u

nder

stan

ding

with

sta

ff a

s ap

prop

riate

.

7. H

ave

an u

nder

stan

ding

of

disa

ster

dec

lara

tions

at

the

loca

l and

st

ate

leve

l and

the

pot

entia

l im

plic

atio

ns fo

r a

faci

lity.

�C

omm

unic

ate

this

und

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andi

ng w

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taff.

�Id

entif

y ru

les

and

regu

latio

ns t

hat

need

to

be a

ddre

ssed

in

dec

lara

tion

for

hosp

itals

to

be a

ble

to im

plem

ent

thei

r hu

rric

ane

resp

onse

pla

n.

8. E

nsur

e ad

equa

te h

ospi

tal i

nsur

ance

cov

erag

e an

d es

tabl

ish

proc

edur

es t

o m

aint

ain

prop

er d

ocum

enta

tion

for

reim

burs

emen

t.�

Verif

y an

d un

ders

tand

insu

ranc

e co

vera

ge.

�E

nsur

e ap

prop

riate

doc

umen

tatio

n is

mai

ntai

ned.

�Ta

ke p

ictu

res

and

vide

otap

e ho

spita

l ass

ets/

prop

erty

.

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e M

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ent,

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EN

TC

OM

PLE

TE

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ES

SS

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OM

PLE

TE

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EM

BE

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�Id

entif

y an

y po

tent

ial r

eim

burs

able

rep

air

cost

s an

d de

term

ine

requ

ired

docu

men

tatio

n an

d pr

oces

s to

acq

uire

rei

mbu

rsem

ent.

�E

nsur

e ap

prop

riate

per

sonn

el h

ave

copi

es a

nd k

now

whe

re t

o fin

d a

copy

of

polic

ies.

�Id

entif

y tim

efra

mes

for

lega

l rec

ours

e to

be

take

n sh

ould

tha

t de

cisi

on b

ecom

e re

quire

d.

9. E

nsur

e ca

paci

ty t

o ad

dres

s le

gal c

laim

s in

a t

imel

y m

anne

r th

at

may

aris

e ag

ains

t th

e or

gani

zatio

n or

its

pers

onne

l.�

Ens

ure

abili

ty t

o co

ntac

t in

sure

rs a

nd le

gal c

ouns

el d

urin

g ad

vers

e ev

ents

.

10. E

stab

lish

proc

esse

s to

ens

ure

the

docu

men

tatio

n of

all

expe

nses

as

soci

ated

with

eve

nt.

�W

hen

usin

g IC

S o

r H

ICS,

thi

s m

ay b

e ad

dres

sed

thro

ugh

the

Fina

nce

Sec

tion

lead

by

the

Fina

nce

Chi

ef.

Wea

ther

ing th

e St

orm

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rica

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lann

ing,

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K. R

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OV

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MO

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IZA

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TOB

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AD

STA

FF

AS

SIG

NM

EN

TC

OM

PLE

TE

DP

RO

GR

ES

SS

TAR

TE

DC

OM

PLE

TE

DM

EM

BE

R

1. E

nsur

e sa

fe a

nd e

ffic

ient

ret

urn

of r

esou

rces

to

orig

inal

loca

tion

or s

tatu

s.

2. In

dica

tors

for

dem

obili

zatio

n:�

No

new

res

ourc

e or

ders

and

end

of

inci

dent

is in

sig

ht.

�R

esou

rces

ava

ilabl

e an

d no

t as

sign

ed.

�H

ospi

tal h

as t

he a

bilit

y to

man

age

inco

min

g pa

tient

s an

d no

ad

ditio

nal s

urge

is a

ntic

ipat

ed.

�Pa

rtne

r ag

enci

es a

re d

emob

ilizi

ng.

�C

omm

unity

infr

astr

uctu

re is

ret

urni

ng t

o no

rmal

ope

ratio

ns.

3. D

emob

iliza

tion

unit

is w

ithin

the

pla

nnin

g se

ctio

n an

d co

ordi

nate

s w

ith p

rocu

rem

ent a

nd d

ocum

enta

tion

units

.

4. M

aint

ain

ICS

and

Inci

dent

Man

agem

ent T

eam

cha

in o

f co

mm

and.

5. Id

entif

y re

leas

e pr

iorit

ies.

Con

side

r th

e im

pact

a f

unct

ion

will

hav

e on

oth

er r

ecov

ery

oper

atio

ns o

r im

pact

on

retu

rn t

o no

rmal

op

erat

ions

. �

Kno

w r

ecov

ery

goal

s an

d pr

iorit

ies.

�Kn

ow c

ritic

al fu

nctio

ns a

nd c

ritic

al n

eeds

.�

Con

side

r ho

w lo

ng s

taff

has

bee

n at

hos

pita

l on

slee

p-w

ork

sche

dule

.

6. C

omm

unic

ate

dem

obili

zatio

n ac

tiviti

es.

Not

ify:

�H

ospi

tal s

taff,

pat

ient

s an

d fa

mili

es;

�Pa

rtne

rs s

uch

as O

EM, D

OH

and

MC

C;

�G

ener

al p

ublic

; and

�

Med

ia a

nd n

ote

final

brie

fing

sche

dule

.

Wea

ther

ing th

e St

orm

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rica

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OV

ER

Y –

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IZA

TIO

N(C

ON

TIN

UE

D)

INN

OT

DA

TE

TOB

ELE

AD

STA

FF

AS

SIG

NM

EN

TC

OM

PLE

TE

DP

RO

GR

ES

SS

TAR

TE

DC

OM

PLE

TE

DM

EM

BE

R

7. A

ccou

nt f

or a

ll de

ploy

ed r

esou

rces

and

ass

ocia

ted

expe

nses

.�

Ens

ure

all i

ncid

ent

docu

men

ts a

re s

ubm

itted

to

Doc

umen

tatio

n U

nit.

�S

ectio

n ch

iefs

sho

uld

be a

war

e of

exc

ess

reso

urce

s an

d no

tify

Dem

obili

zatio

n U

nit.

�Lo

gist

ics

is r

espo

nsib

le f

or t

rack

ing

supp

ly r

esou

rces

(i.e

. pr

oper

ty a

nd n

on-e

xpen

dabl

e eq

uipm

ent)

dep

loym

ent

and

retu

rn.

�O

pera

tions

is r

espo

nsib

le f

or d

eter

min

ing

pers

onne

l nee

ds.

�Fi

nanc

e is

res

pons

ible

for

per

sonn

el t

ime

reco

rds,

inju

ry r

epor

ts,

and

clai

ms

repo

rts.

8. N

otify

sta

ff o

f tim

e to

be

rele

ased

and

che

ck o

ut p

roce

dure

s.�

ICS

for

ms

may

be

help

ful f

or d

emob

iliza

tion

chec

kout

.33

9. C

oord

inat

e tr

ansp

orta

tion

need

s fo

r pe

rson

nel a

nd

equi

pmen

t (L

ogis

tics)

.

10. R

etur

n an

d re

-sto

ck u

nuse

d ite

ms.

11. E

nsur

e al

l com

mun

icat

ions

equ

ipm

ent

that

was

dis

trib

uted

is

retu

rned

and

che

cked

for

dam

age/

func

tiona

lity

(i.e.

Ens

ure

dam

aged

rad

ios

are

repa

ired

prio

r to

re-

stoc

king

.)

12. H

old

clos

eout

brie

fing.

A c

lose

out

brie

fing

incl

udes

the

fol

low

ing:

�In

cide

nt s

umm

ary;

�M

ajor

eve

nts

that

hav

e la

stin

g ra

mifi

catio

ns;

�D

ocum

enta

tion,

incl

udin

g w

hat

is n

ot y

et c

ompl

eted

;�

Opp

ortu

nity

to

shar

e co

ncer

ns; a

nd�

Eva

luat

ion

of a

ctio

ns.

33S

ee IC

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orm

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n C

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EC

OV

ER

Y –

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MO

BIL

IZA

TIO

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DA

TE

TOB

ELE

AD

STA

FF

AS

SIG

NM

EN

TC

OM

PLE

TE

DP

RO

GR

ES

SS

TAR

TE

DC

OM

PLE

TE

DM

EM

BE

R

13. C

ondu

ct A

fter

-Act

ion

Rev

iew

�D

iscu

ss w

hat

you

set

out

to d

o vs

. wha

t yo

u ac

tual

ly d

id.

�D

iscu

ss w

hat a

ctua

lly h

appe

ned

and

why

.�

Iden

tify

wha

t w

ill b

e do

ne d

iffer

ently

nex

t tim

e.�

Iden

tify

less

ons

lear

ned.

�D

eter

min

e w

hat

need

s fo

llow

-up,

by

who

m, a

nd b

y w

hen.

�C

onsi

der

givi

ng s

taff

the

opp

ortu

nity

to

shar

e fe

edba

ck

anon

ymou

sly.

Fo

r ex

ampl

e, c

onsi

der

havi

ng s

taff

dro

p ca

rds

in a

“d

ebrie

fing

box”

tha

t st

ate

wha

t w

ent

wel

l and

wha

t ne

eds

to

be im

prov

ed.

14. E

nsur

e em

otio

nal a

nd m

enta

l hea

lth s

uppo

rt f

or s

taff

and

th

eir

fam

ilies

.

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ther

ing th

e St

orm

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rica

ne P

lann

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pons

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ry T

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EC

OV

ER

Y -

PA

TIE

NT

TR

AN

SFE

R A

ND

DIS

CH

AR

GE

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DA

TE

TOB

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AD

STA

FF

AS

SIG

NM

EN

TC

OM

PLE

TE

DP

RO

GR

ES

SS

TAR

TE

DC

OM

PLE

TE

DM

EM

BE

R

1. P

repa

re t

o re

ceiv

e on

ly p

re-d

eter

min

ed (i

.e. v

ent-

depe

nden

t)

patie

nts

from

long

-term

and

long

-term

sub

-acu

te c

are

(LTC

) fac

ilitie

s.�

Coo

rdin

ate

plan

s in

adv

ance

of

even

t w

ith L

TC/s

ub-a

cute

, in

clud

ing

iden

tifyi

ngw

hich

pat

ient

s yo

u w

ill r

ecei

ve (i

.e.,

vent

-dep

ende

nt).

�Es

tabl

ish

tria

ge a

nd a

ccep

tanc

e pr

oces

sfo

r pa

tient

tra

nsfe

rs, t

o in

clud

e pa

tient

tra

ckin

g pr

oced

ures

.�

Coo

rdin

ate

with

med

ical

she

lters

.�

Iden

tify

in a

dvan

ce w

hat

mus

t co

me

with

pat

ient

tra

nsfe

rs.

�N

ame

& c

onta

ct in

form

atio

n�

Med

icat

ions

�M

edic

al r

ecor

d/ch

art

– at

a m

inim

um n

ote

alle

rgie

s

2. E

nsur

e EM

S is

aw

are

of p

atie

nt t

rans

fer

and

evac

uatio

n pr

oced

ures

.

3. E

stab

lish

proc

edur

es t

o cr

eden

tial a

nd a

ccep

t st

aff

from

LTC

and

ho

me

heal

th a

genc

ies

to c

ome

into

hos

pita

l to

care

for

thei

r pa

tient

s.

4. E

nsur

e th

e co

ordi

natio

n of

hom

e ch

ecks

for

pat

ient

dis

char

ge.

�Vo

lunt

eer

grou

ps/la

w e

nfor

cem

ent

may

ass

ist

with

hom

e ch

ecks

.

5. C

onsi

der

havi

ng c

ase

wor

ker

in e

mer

genc

y de

part

men

t to

ass

ist

with

pat

ient

dis

char

ge.

6. E

nsur

e tr

ansp

orta

tion

of p

atie

nts

back

to

hom

es o

r to

fam

ily.

7. C

oord

inat

e w

ith O

EM

clo

sure

s of

med

ical

she

lters

. Hos

pita

l may

ne

ed t

he m

edic

al s

helte

rs t

o st

ay o

pen

for

an e

xten

ded

perio

d of

tim

e to

ass

ist

with

car

e fo

r th

ose

who

do

not

need

acu

te c

are

but

cann

ot y

et r

etur

n to

the

ir ho

me

or f

amily

. With

OE

M, h

ospi

tals

will

ne

ed t

o pl

an f

or s

helte

r cl

osur

es s

o th

at b

oth

com

mun

ity a

nd

hosp

ital n

eeds

are

met

.

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FF

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ES

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EM

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8. P

repa

re t

o ha

ve d

ialy

sis

patie

nts

seek

ing

trea

tmen

t at

you

r fa

cilit

y.

�P

lan

in a

dvan

ce w

ith E

nd S

tage

Ren

al D

isea

se (E

SR

D) n

etw

ork

and

OE

M t

o es

tabl

ish

tran

spor

tatio

n pr

oced

ures

for

pat

ient

s ne

edin

g di

alys

is p

ost-

even

t sh

ould

dia

lysi

s ce

nter

s be

clo

sed

or

if pu

blic

tra

nspo

rtat

ion

is n

ot y

et r

unni

ng.

�Es

tabl

ish

poin

ts o

f con

tact

s w

ith d

ialy

sis

netw

orks

for

coo

rdin

atin

g ac

cess

to

dial

ysis

res

ourc

es p

ost-

even

t.

9. E

stab

lish

proc

edur

es fo

r phy

sici

an s

uppo

rtto

car

e fo

r pa

tient

s in

al

tern

ate

loca

tions

. �

Iden

tify

how

the

hosp

ital w

ill kn

ow w

hen

phys

icia

n pr

actic

es

re-o

pen

and

how

hos

pita

ls c

an h

elp

com

mun

icat

e th

is t

o pa

tient

s.�

For

exam

ple,

you

may

wan

t to

hav

e a

“car

e co

ordi

nato

r” f

or

patie

nts

seek

ing

med

ical

car

e at

you

r fa

cilit

y th

at t

hey

wou

ld

norm

ally

see

k at

a p

hysi

cian

off

ice.

Car

e co

ordi

nato

rs c

ould

be

posi

tione

d in

em

erge

ncy

depa

rtm

ents

and

fro

nt e

ntra

nce

area

s to

pro

vide

info

rmat

ion

on p

hysi

cian

acc

ess.

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onsi

der

a ph

ysic

ian

hotli

ne t

o ca

ll in

and

not

ify o

f pr

actic

e st

atus

.

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uild

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83


PART IV. APPENDICES & RESOURCE LINKS: PLANNING & RESPONSE

You also may refer to accompanying CD for easy access to online links.

PLANNING & RESPONSE

These documents are included in this toolkit beginning on page 89.

1. Hospital Departments: a. Department Plan Template http://www.njha.com/ep/content.aspx?id=2391

b. Sample Emergency Contact Form http://www.njha.com/ep/content.aspx?id=2392

2. Hospital Employees: a. Preparing Your Work Area http://www.njha.com/ep/content.aspx?id=2393b. Sheltering Necessities http://www.njha.com/ep/content.aspx?id=2394c. Hurricane Preparedness Checklist http://www.njha.com/ep/content.aspx?id=2395d. Pre-season Employee http://www.njha.com/ep/content.aspx?id=2396

Acknowledgement Forme. Work Exemption Form http://www.njha.com/ep/content.aspx?id=2397

f. Childcare Enrollment Form http://www.njha.com/ep/content.aspx?id=2405

3. Kaiser Permanente Hazard http://www.njha.com/ep/content.aspx?id=2411Vulnerability Analysis

4. Key Resources for Inclement http://www.njha.com/ep/content.aspx?id=2377Weather Preparedness

5. Evacuate or Shelter-in-Place http://www.njha.com/ep/content.aspx?id=2398Decision Guide

6. Shelter-in-Place Checklistsa. 96 – 72 Hours Prior to Onset http://www.njha.com/ep/content.aspx?id=2407b. 72– 48 Hours Prior to Onset http://www.njha.com/ep/content.aspx?id=2408c. 48 – 24 Hours Prior to Onset http://www.njha.com/ep/content.aspx?id=2409d. Less than 24 Hours Prior to Onset http://www.njha.com/ep/content.aspx?id=2410

7. Utility Failure Operational Impact Chart http://www.njha.com/ep/content.aspx?id=2399

8. Consumable Supply Operational http://www.njha.com/ep/content.aspx?id=2400Impact Chart

9. Dialysis Concerns http://www.njha.com/ep/content.aspx?id=2401

10. Sample Mutual Assistance Agreement http://www.njha.com/ep/content.aspx?id=2402

84


RECOVERYThese documents are included in this toolkit beginning on page 183.

11. Sample Information for Departments http://www.njha.com/ep/content.aspx?id=2403

12. Hospital Status Report Form http://www.njha.com/ep/content.aspx?id=2446

13. Sample Demobilization Plan http://www.njha.com/ep/content.aspx?id=2404

ADDITIONAL RECOVERY RESOURCES

These documents may be accessed via the links below.

AHRQ HOSPITAL ASSESSMENT RECOVERY TOOL http://www.ahrq.gov/prep/hosprecovery/hosprecovery.pdf

DEMOBILIZATION:

a. ICS Form 214 Personnel Roster http://www.fema.gov/pdf/emergency/nims/ics214.pdf

b. ICS Form 211 Check-In List http://www.fema.gov/pdf/emergency/nims/ics211.pdf

c. ICS Form 221 Demobilization http://www.fema.gov/pdf/emergency/nims/ics221.pdfCheckout

d. Demobilization Responsibilities http://www.osha.gov/SLTC/etools/ics/demo_lead.html#generalChecklist

DISASTER MENTAL HEALTH:

a. Guidance for Managing Worker Fatigue During Disaster Operationshttp://www.cdc.gov/niosh/topics/oilspillresponse/pdfs/NRT-Fatigue-for-Emergency-Workers.pdf

b. Coping with a Disaster or http://www.bt.cdc.gov/mentalhealth/Traumatic Event

c. SAMHSA Disaster Kit http://store.samhsa.gov/product/SMA10-DISASTER

d. Safety, Function, Action Checklist http://www.njha.com/ep/content.aspx?id=2447

e. Disaster & Extreme Event http://www.umdeepcenter.org/x32.xmlPreparedness (DEEP) Center

FINANCIAL RESOURCES:

a. FEMA Grants and http://www.fema.gov/government/grant/index.shtmAssistance Programs

b. FEMA Public Assistance http://www.fema.gov/government/grant/pa/index.shtmGrant Program

c. FEMA Forms http://www.fema.gov/help/forms.shtm

d. Grants – Catalog of Federal https://www.cfda.gov/Domestic Assistance

APPENDICESPlease note: Web sites presented here are for informational purposesand are presented without warranty, either express or implied. Theirinclusion should not be considered an endorsement of the informa-tion provided nor the providing entity. Author does not attest to thecontent or quality of the information provided by these Web sites.


PLANNING & RESPONSE

APPENDIX 1A

HOSPITAL DEPARTMENTS:Department Plan Template

89


DEPARTMENT PLAN TEMPLATE

Severe Weather/Hurricane Plan for [xxx] Department

DEPARTMENT MANAGER/SUPERVISOR: ________________________________ DATE ______________________

LAST UPDATE: ________________________________________________________________________________

SIGNATURE: __________________________________________________________________________________

I. PURPOSE AND SCOPE

II. POLICIES AND PROCEDURESA. Expectation to work B. ExemptionsC. Who may or may not stay at the hospital (family members)D. ChildcareE. Personal/family preparednessF. Training, drills, exercises, plan updates

III. CONCEPT OF OPERATIONSA. Direction and control (e.g. who is in charge, ICS assignments)B. Delegations of authority (by position title, 3 deep)C. Orders of succession (by position title, 3 deep)D. Notifications and activationE. Roles and responsibilities

Mission critical and essential functions

MISSION CRITICAL (IMMEDIATE) RESOURCES/EQUIPMENT STAFF TO PERFORM FUNCTION/FUNCTION REQUIRED STAFF ASSIGNMENT

F. Protective Measures

IV. STAFFINGA. Communications (e.g. official forms of communication, employee hotline, etc.)B. Staff assignments & shiftsC. SleepingD. ShoweringE. EatingF. Breaks

V. RECOVERY – Returning to normal operations.

Attachment 1 - Contact list & call-down proceduresAttachment 2 - Forms – exemption, childcare, etc.Attachment 3 - Checklists


PLANNING & RESPONSE

APPENDIX 1B

HOSPITAL DEPARTMENTS:Sample Emergency Contact Form

93


DATE REVIEWED: _____________________

DATE COMPLETED: _____________________(TO BE DONE ANNUALLY)

EMERGENCY CONTACT FORMHOUSEKEEPING SUPPLIES

PRIMARY VENDORS:

COMPANY NAME: ______________________________________________________________________________

CONTACT NAME: ____________________________________ PHONE:____________________________________

TITLE: ____________________________________________ CELL: ____________________________________

DATE PURCHASE ORDER SUBMITTED: ______________________________________________________________

CONTACT DURING AN EMERGENCY: WORK PHONE: ______________________________________CELL: ____________________________________

COMPANY NAME: ______________________________________________________________________________


TITLE: ____________________________________________ CELL: ____________________________________



SECONDARY VENDORS:

COMPANY NAME: ______________________________________________________________________________


TITLE: ____________________________________________ CELL: ____________________________________



TERTIARY VENDORS:

COMPANY NAME: ______________________________________________________________________________


TITLE: ____________________________________________ CELL: ____________________________________




PLANNING & RESPONSE

APPENDIX 2A

HOSPITAL EMPLOYEES: Preparing Your Work Area

96


PREPARING YOUR WORK AREA

Hurricanes can have a powerful impact on coastal and inland communities. To help you understand how(hospital name) responds in the event of a hurricane or severe weather situation, we’ve created the(handbook name) using information from New Jersey Office of Emergency Management Hurricane

Preparedness Plan. This resource will inform you about what to expect during a hurricane and how our organization responds to ensure that the health needs of our community are met. Areas addressed includeemployee responsibility, storm communication, safety, sheltering, staffing of special needs shelters and more.We also recommend that you review our Hurricane Preparedness Plan for a more complete understanding of thetopics in the handbook.

Please note: Because each department is responsible for developing its own response in support of ourHurricane Preparedness Plan, be sure to check with your department director or supervisor for your specific responsibilities during a hurricane.

(Hospital name) remains open and adequately staffed during a hurricane. The (hospital) Emergency OperationsCenter (EOC) is located here and directs the storm preparations of the entire organization. The team in the EOCwill be in constant communication with county and state emergency officials for storm updates and will updatethe (internal hospital communication line) regularly. Patients ready for discharge will go home so additionalbeds are available for patients transferred from other facilities, area dialysis patients and others who requiretreatment. Additional quantities of medications, food, water, linen, medical/surgical supplies, etc. will be delivered. The facility will be secured, with access granted only to those authorized to be here.

Local, county and state EOCs also remain open in the event of a hurricane to help meet the emergencyneeds of the citizens in our area.

All departments fill a variety of roles during a hurricane situation, which may include working in differentsettings or job functions as needs are identified. Some members of (hospital) administrative team willreport to the EOC during a storm, while others will provide post-storm relief. The Public Relations department representative will communicate our disaster preparations to local newspapers, radio and television media, update the (internal hospital communication line) and field the numerous calls about thestatus of our patients and medical center after a storm. Finance employees will work with our financialinstitutions to make sure funds are available to (the hospital) in the event of storm damage.

EDUCATION - June has been designated as “Hurricane Preparedness Month” at (the hospital) - a time todiscuss hurricane preparedness and communicate our Hurricane Preparedness Plan with all employees atthe start of hurricane season. Informing new employees and reminding a veteran about their roles duringa hurricane is very important. That’s why all new employees receive information on hurricane preparednessduring their department or unit orientation and before the start of hurricane season (June 1) each year.

EXEMPTION FORMS – (The hospital) understands some employees may have extenuating circumstances that make it impossible for them to work during a storm. Because of these situations, anemployee may be considered exempt and excused from working during a storm. To be eligible, theemployee must submit an Exemption Form annually to his or her manager, review “Staffing underEmergency Situations” of the Hurricane Preparedness Plan and meet at least one of the following criteria:

� You provide care for an elderly, immediate relative who cannot care for himself or herself on a routine basis. There are no other adult family members to provide this care. This person would nototherwise qualify for a special needs shelter.

� You provide care that cannot otherwise be delivered for an immediate relative who is handicapped,or otherwise has a chronic illness.

� You are the sole caregiver of a child less than two years of age and cannot make other arrangements.

� When both parents of a child less than two years old, one of whom works for another emergencyservices employer (i.e. nursing, other medical center, law enforcement and fire/rescue and city

97


employee) are required to work and have simultaneous roles during a storm, the employee is exempt.

� When both parents of a child less than two years old work at (the hospital) and normally would havesimultaneous roles during a storm, one is exempt.

Please note:

� While an approved Exemption Form excuses an employee from working during a storm, theemployee will be required to work in the pre- and/or post-storm phases.

� (The hospital) also understands that sudden life changes occur, so emergency exemptions may begranted by your department director.

� If your situation doesn’t fit into any of the categories above, you may be asked to work during a hurricane.

CHILDCARE ENROLLMENT FORMS - For employees who volunteer or are required to work during and/orafter a storm, (the hospital) provides child care for children who are age 18 or younger. A Childcare EnrollmentForm must be completed upon hire and annually in May each year. If you have children older than age 16,they may be allowed to volunteer in other areas of the medical center. If schools and daycare facilities aren’topen post-storm, working employees who have no other childcare options may bring their children to the designated childcare area. (Check with the internal hospital communication line for details post-storm.)

STORM COMMUNICATIONS - Communication is the key to emergency preparedness. In the event of animpending storm, (the hospital) Intranet and hotline are revised on a regular basis to give employees up-to-date information on facility preparations, conditions and some work schedule expectations. However,these systems are not intended to replace communicating with your supervisor, manager or director, sobe sure to check your home answering machine frequently and keep in touch with your department foryour responsibilities during and after a storm. Arrangements have been made with local radio and television stations to transmit information for our employees. For the latest updates in the event of a hurricane, turn to any of the following:

LIST TV AND RADIO STATIONS

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

ALL RADIO STATIONS LISTED HAVE AGREED TO CARRY (HOSPITAL) ANNOUNCEMENTS.

STORM STAFFING - All employees play key roles in meeting the needs of our community when faced witha hurricane. While many of our employees work within the hospital setting, others work in ancillary and support departments and are not covered specifically under a hospital hurricane plan. Their roles in supportof the organization plan may require them to work in other areas not specific to their regular jobs by staffingthe “Labor Pool.” Departments will usually request additional staffing support in May, before the start ofhurricane season. The needs of clinical and non-clinical departments to assign work and respite areas arecoordinated through the (insert responsible party). One challenge we face during a storm is facility security.Many don’t understand that hospitals are not general population shelters. To ensure those inside our facilities truly belong there, employees working before, during or after a storm will be required to show their(hospital) ID badges before entering and exiting a facility. In addition, the ID badges also are used foremployees to return to the hospital when roads are cleared for travel and a curfew is still in force.

98


(HOSPITAL)’S EMERGENCY OPERATIONS CENTER (EOC) – (The hospital) EOC ensures the adequacyof the hospital’s storm preparations and provides the communications link with state and county emergency management officials. Preparations coordinated through the EOC include facility staffing,patient census, bed availability, computer system status, sleeping area designations, childcare and attaining 100 percent readiness before the storm hits. The EOC is located in the (insert location). EOCstaffing is defined by the Hurricane Preparedness Plan with the facility being operational 12 to 24 hoursprior to the expected arrival of the storm.

SLEEPING ARRANGEMENTS - Maintaining mental alertness during a stressful situation, especially a hurricane, is very important. Proper rest is paramount to having a sharp team, ready for anything. Becauseof this, respite hours and areas are assigned to all employees and physicians who are at the facility duringthe storm. These areas will be identified and assigned by _______________. Personnel will receive theirspecific room assignments when they report for hurricane duty. Remember to bring your own pillows,linens, towels, soap, toilet articles, etc.

FACILITY SAFETY - A common question during a hurricane or severe storm is, “How safe is the facility?”While the nature of a disaster prevents a guarantee of total safety, as healthcare workers who stay duringa storm, we accept a level of risk to serve our patients. (The hospital) performs regular vulnerability assess-ments to all facilities to make them as safe as possible. Experienced structural engineers assess eachbuilding’s physical strengths and weaknesses.

VOLUNTEERS - To make sure we can accommodate a high demand for services should a hurricane directlyimpact our area, volunteers and auxiliaries are available after a storm. During the storm, they should seekother shelter or evacuate when directed to do so by the local and county Offices of EmergencyManagement.

SHELTERING - Caring for patients in the hospital, as well as those injured after hurricane arrival, requiresa well-staffed facility. In the event roads are impassable after a storm, the hospital must have enough staffto operate without interruption for a few days. Each department is responsible for its own staffing plans,so be sure to talk with your department director, manager or supervisor.

Three distinct groups will be in the facility during a hurricane, each with unique circumstances. Theseinclude patients, employees and physicians. A great deal of planning has been directed toward this subject, and each group is addressed below:

Patients and their families: Patients are our primary concern and the reason we’re here, so it’s importantto reassure them and their families during a hurricane. In the event of a storm, family members are alwaysencouraged to seek the safety of an approved shelter.

However, if requested, one family member will be allowed to stay with each patient. The family memberwill be required to bring the same supplies for personal use as are (hospital) employees.

Employees and their families: Our employees are critical to (hospital) success in any emergency, especiallya hurricane, and (hospital) understands the stress of preparing a home and family for a storm. We understandhow important it is to ensure your family’s safety, so the following services will be provided as needed:

� For employees who volunteer or are required to work during or post-storm, (hospital) provides childcare for children age 20 or younger. A Childcare Enrollment Form must be completed upon hire andannually in May each year. Children older than 16 may be permitted to volunteer in other areas of themedical center, as appropriate.

� If schools and daycare facilities aren’t open post-storm, working employees who have no other childcare options may bring their children to designated childcare facilities.

� Employees working during a storm will be given information before the storm to prepare theirhomes. If your family members must evacuate, they should bring enough supplies to their shelterlocation to be comfortable for at least 72 hours.

99


� A list of approved shelters in (County Name) is available at (list resource).

� Employees scheduled to work post-storm should only evacuate when required and only go as far asnecessary.

Physicians and their families: Volunteer physicians help maintain the readiness of our hospital during ahurricane. Without their assistance, we would not be prepared to care for our patients. In the event of astorm, physicians’ families are always encouraged to seek the safety of an approved shelter. However,these physicians are not hospital employees, so if requested, the hospital allows them to bring their families to the facility during the storm. As with patients’ family members, they must bring their own sleeping and food supplies.

Special Needs Shelters: Many individuals in our community require special assistance when they’re evacuated, but not the acute care that’s provided in hospitals. People with special needs may include thoserequiring 24-hour healthcare maintenance or medical equipment that requires 24-hour electrical power.Residents with special needs should register with the County Office of Emergency Management. When ahurricane is approaching, emergency officials will open the special needs shelters as designated for the particular season.

PREPARING YOUR WORK AREA - Even with the diverse types of departments within (the hospital), thereare a number of work preparedness tasks that should be completed by everyone to prevent damage andloss, especially to protect electronic equipment. Your department plan/checklist may have additional tasksfor you to complete. The following are general guidelines for all (hospital) departments. Please be sure tocheck with your department director, manager or supervisor to identify other items to be completed within your department before a storm:

PERSONAL COMPUTERS (PCS)� Disconnect your PC, monitor, keyboard and mouse from each other and the wall power outlets. Be

sure to also disconnect the network cable on the back of your PC (it looks like a telephone cable).Please note that the Information Services department recommends that you disconnect the networkcable from the PC, and not from the wall. This allows you or Information Services to more quicklyget the equipment operating after a storm.

� If not already mounted above the floor, move any PC equipment off the floor at least 10 feet from awindow, mark it with your name and wrap it in plastic. Do not use red biohazard bags for thisprocess.

TELEPHONES

� Please leave your phone connected. � Wrap it in plastic and mark it with your name. As with PCs, do not use red biohazard bags in this

process.

Fax machines, printers and copiers� Please be sure all department fax machines, printers and copier are disconnected from outlets. � Move them at least 10 feet away from windows and cover them in plastic. Once again, do not use

red biohazard bags.

Miscellaneous desktop items� Remove all papers, books, and loose materials from your desk. � Place these materials in a box marked with your name and store it off the floor in a safe place.

Finally, please be sure to check with your fellow employees to see if they need any assistance preparingtheir areas or the department. Teamwork is the cornerstone of hurricane preparation.


PLANNING & RESPONSE

APPENDIX 2B

HOSPITAL EMPLOYEES: Sheltering Necessities

103


FAMILY/STAFF CHECKLIST FOR STAYING AT HOSPITAL DURING A STORM

Family and staff are responsible for providing all of their own necessities.

� Medications

� Toiletries

� Clothing

� Towels

� Linens

� Sleeping bag

� Quiet games

Insert other appropriate items for your facility, with respect to facility/organization’s policies. Note in policy what is NOT permitted and limitations of items.

��

��


PLANNING & RESPONSE

APPENDIX 2C

HOSPITAL EMPLOYEES: Hurricane Preparedness Checklist

107


EMPLOYEE HURRICANE PREPAREDNESS CHECKLIST

Employees are to complete the following each year by May 30.

� Review Hurricane Human Resource Policy ##

� Complete Hurricane HR Policy ## acknowledgement form

� Complete other forms as needed: work exemption, childcare enrollment

� Review department hurricane plan

� Review hospital hurricane plan

� Check with supervisor regarding your role and responsibilities

� Know staffing (team) assignment

� Develop a family preparedness plan

� Have a disaster supply kit

Supervisors and above are to complete the following in addition to previous items:

� Update hurricane department plan as needed

� Update staffing plans

� Submit a copy of staffing plan to _____

� Identify and document any special equipment or supply needs you have for hurricanes and submitthis information to ____

� Review Hurricane HR Policy ##, acknowledgement form and childcare enrollment form with staff

� Ensure staff have signed all appropriate forms

� Sign forms and submit as directed on form

� Update protective measures for your department/work area

� Ensure protective measures are clearly communicated to staff

� Post checklist of protective measures for staff

INSERT ADDITIONAL CHECKLIST ITEMS AS APPROPRIATE FOR YOUR FACILITY.

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PLANNING & RESPONSE

APPENDIX 2D

HOSPITAL EMPLOYEES: Pre-season EmployeeAcknowledgement Form

111


HURRICANE PRE-SEASON EMPLOYEE ACKNOWLEDGEMENT FORM

Complete form annually by May 30 and update as needed during hurricane season.

PLEASE PRINT

EMPLOYEE NAME ______________________________________________________________________________

DEPARTMENT __________________________________________________________________________________

SUPERVISOR __________________________________________________________________________________

FACILITY (IF PART OF A SYSTEM) ____________________________________________________________________

I ____(insert name)_________________ have read and acknowledge understanding of the HurricanePolicy ##, my department’s hurricane plan and have checked with my supervisor and know my assignment per our department plan.

INITIAL ONE OF THE FOLLOWING:

_______ I understand that I am not exempt from working during a tropical storm or hurricane.

_______ I am exempt from working during a tropical storm or hurricane and have completed the exemption form.

In addition, I ____(insert name)_________________ understand it is my responsibility to have a familypreparedness plan (and INSERT APPROPRIATE LANGUAGE FOR YOUR FACILITY i.e. I am not permittedto have family members come to work with me during a storm OR I may have my spouse and dependentchildren/dependent elderly parent come to work with me during a tropical storm or hurricane.)

_______ I have completed the childcare enrollment form.

EMPLOYEE SIGNATURE ______________________________________________ DATE ______________________

SUPERVISOR SIGNATURE ____________________________________________ DATE ______________________

SUPERVISORS SUBMIT FORM TO ________________________________________________________________


PLANNING & RESPONSE

APPENDIX 2E

HOSPITAL EMPLOYEES: Work Exemption Form

115


HURRICANE WORK EXEMPTION FORM


PLEASE PRINT

EMPLOYEE NAME ______________________________________________________________________________

DEPARTMENT __________________________________________________________________________________

SUPERVISOR __________________________________________________________________________________


I __________________ am requesting an exemption from working at ________________________ during a

tropical storm or hurricane. I meet one or more of the following permissible exemptions:

_______ I provide care for an immediate family member who cannot care for him/herself, due to

physical limitations, handicap or chronic illness, on a routine basis and there are no other

family members who can provide this care.

_______ I have a child(ren) that is less than (_____) year(s) of age and no other family member is

available to care for the child(ren).

INSERT APPROPRIATE CRITERIA FOR YOUR FACILITY

I ___________________ certify that the above checked statement is true and understand that providing

false information may result in discipline up to and including termination.



SUPERVISORS SUBMIT FORM TO ________________________________________________________________

employee name facility name

employee name


PLANNING & RESPONSE

APPENDIX 2F

HOSPITAL EMPLOYEES: Childcare Enrollment Form

119


CHILDCARE ENROLLMENT FORM


PLEASE PRINT

EMPLOYEE NAME ______________________________________________________________________________

DEPARTMENT ____________________________________________________SUPERVISOR __________________


I am assigned to the � pre � during � post storm staff team. *Seek legal counsel for facility for statement regarding liability protections*

PLEASE COMPLETE THE FOLLOWING INFORMATION FOR EACH CHILD.

NAME ____________________________________________________________BIRTH DATE __________________

MEDICATIONS __________________________________________________________________________________

ALLERGIES ____________________________________________________________________________________

SPECIAL CONCERNS______________________________________________________________________________

PHYSICIAN CONTACT: NAME____________________________________________PHONE ______________________

NAME ____________________________________________________________BIRTH DATE __________________

MEDICATIONS ______________________________________________________ALLERGIES __________________



NAME ____________________________________________________________BIRTH DATE __________________

MEDICATIONS ______________________________________________________ALLERGIES __________________





SUPERVISORS: SUBMIT FORM TO ______________________________________________________________


PLANNING & RESPONSE

APPENDIX 3KAISER PERMANENTE HAZARDVULNERABILITY ANALYSIS

122


© 2001 Kaiser Foundation Health Plan, Inc. Kaiser Permanente HVAReprinted with Permission

123


© 2001 Kaiser Foundation Health Plan, Inc. Kaiser Permanente HVA

124


©20

01 K

aise

r Fo

unda

tion

Hea

lth P

lan,

Inc.

Kai

ser

Perm

anen

te H

VA

125


©20

01 K

aise

r Fo

unda

tion

Hea

lth P

lan,

Inc.

Kai

ser

Perm

anen

te H

VA

126


©20

01 K

aise

r Fo

unda

tion

Hea

lth P

lan,

Inc.

Kai

ser

Perm

anen

te H

VA


127

©20

01 K

aise

r Fo

unda

tion

Hea

lth P

lan,

Inc.

Kai

ser

Perm

anen

te H

VA

128


© 2001 Kaiser Foundation Health Plan, Inc. Kaiser Permanente HVA


PLANNING & RESPONSE

APPENDIX 4NJHA KEY RESOURCES FORINCLEMENT WEATHER PREPAREDNESS

131


KEY RESOURCES FOR INCLEMENT WEATHER PREPAREDNESS

NEW JERSEY

NJ Trafficwww.511nj.org or by calling 511

Description: Real-time traffic information, including weather-related incidents.

Atlantic City Electrichttp://www.atlanticcityelectric.com/home/emergency/

Description: Outages and emergency preparedness resources. Maps provide snapshots of Atlantic City Electric’selectrical outages and active work locations.

PSEGhttp://www.pseg.com/outagecenter/index.jsp

Description: Outage Center provides map and table view of customer outages throughout the state.

Jersey Central Power & Light (JCP&L) http://www.firstenergycorp.com/outages/outages.do?state_code=NJ

Description: Maps and other resources including power outage news and information are located in the Outage Help tab.

Orange & Rocklandhttp://www.oru.com/energyandsafety/storms/

Description: Storm Information Center including outage map for Orange & Rockland clients.

PENNSYLVANIA

PA Traffichttp://www.511pa.com/Traffic.aspx

Description: Map providing information regarding winter road conditions.

DELAWARE

Delaware Department of Transportation (DELDOT)http://www.deldot.gov/public.ejs?command=PublicLocatableMap

Description: Interactive traffic map providing weather-related information.


PLANNING & RESPONSE

APPENDIX 5EVACUATE OR SHELTER-IN-PLACEDECISION GUIDE

135


It is imperative that all hospitals have an evacuation plan. Category 4 or 5 hurricanes are catastrophic in nature. Hospitals in the projected path of a Category 4 or 5 storm will need to strongly considerevacuation. In some cases, hospitals may need to evacuate for a Category 1 storm. This is dependent

on your facility’s location and specific vulnerabilities.

Decisions regarding what category would necessitate evacuation can be made in advance of an event.The results of your hazard vulnerability analysis, the emergency management system, community infrastructure and resources where your facility is located, and the information below may assist youwith making this determination.

When making the decision to evacuate or shelter-in-place, consider the following (*this list is not all-inclusive):

� Nature of the event

� What is the expected duration of the event?

� What is the scope of the event? How broad of an area is expected to be impacted? (Note:Given the size of New Jersey, it is likely that a hurricane will impact the entire state. Also, dueto the uncertainty of the exact path and how far reaching the storm may be, it is likely that allfacilities in the state will need to take preparedness measures.)

� What threats does the event pose to your facility?

� What were the results of your facility’s hazard vulnerability analysis relative to the event/potential threats?

� Location of facility

� Is your facility in a flood plane?

� What is the expected storm surge associated with the storm? Is your facility in the stormsurge zone?

� Integrity of facility based on facility assessments in respect to the effects of hurricanes

� What is the structural integrity of the building? Has it been rated for safety relative to sustained wind speeds? If so, what is the safety rating and what are the expected windspeeds of the approaching storm?

� Are the windows of your facility protected from wind-borne debris either with storm shuttersor have storm windows with impact glass been installed?

� Availability of supplies pre- and post-event

� Will you be able to access supplies post-event?

� What is the length of time your facility can be self-sufficient without utilities and having sustained minor damage? Can your facility remain self-sufficient until outside resources willagain be accessible? (Note: the more intense the storm and the larger the area the stormimpacts, the longer you will need to remain self-sufficient)

� Impact on staff

� Will staff be able to rotate shifts?

� Will staff be able to stay at the hospital while they are not on duty?

� What is the potential for major roadways to be flooded to and from your facility?

� Will staff be able to travel on roads to and from the facility pre & post event?

136


� Impact on patients

� What is the potential impact on standards of care due to the event?

� Will you be able to sufficiently support the patient population in your facility with reduced operational capacity?

If it is appropriate for your facility to evacuate for a storm, evacuation plans need to consider the following (*this list is not all-inclusive):

� Plan in concert with local and state emergency management as appropriate

� Transportation of patients

� Consider including the use of air assets for transporting patients

� Consider transporting patients out- of-state

� Be prepared to transport staff to multiple hospitals

� Patient tracking

� Consider use of different color arm bands to designate triage level for transport

� Patient records transfer

� Consider developing a patient evacuation checklist that includes basic patient information,medications, current diagnosis and treatment, physician name and contact information, etc.

� Consider providing patient medications for transfer and establish procedures for doing so.

� Staff assignments and logistics

� Will staff travel with patients? Will staff stay and work at accepting facility?

� Staff transportation, lodging, etc

� Staff privileges and licensure reciprocity with other states

� Mutual aid agreements and contracts for needed services and resources

RESOURCES: National Criteria for Evacuation Decision-making in Nursing Homes http://www.fhca.org/news/evacsurvey.pdf

GAO-06-443R, Disaster Preparedness: Preliminary Observations on the Evacuation of Hospitals andNursing Homes Due to Hurricanes http://www.gao.gov/new.items/d06443r.pdf


PLANNING & RESPONSE

APPENDIX 6SHELTER-IN-PLACE CHECKLISTS

139


SHELTER-IN-PLACE: PRE-STORM HOURS CHECKLISTS

Hurricanes can be unpredictable as to intensity and path; therefore you will need to be prepared toimplement plans for worst case scenarios. The closer or more intense the storm, the more damageto infrastructure you can expect, resulting in longer recovery time and greater delays for re-supply

and access to supportive resources. Due to the unpredictability and the geography (size and location) ofNew Jersey, all hospitals in the state may need to take preparedness actions if any portion of NewJersey is in the path of a storm. Hurricanes that threaten New Jersey have the potential to have astatewide impact.

Hospitals sheltering-in-place for a hurricane will take very similar steps for each threat, again bearing inmind the more intense the storm, the longer the facility will need to be self-sustaining. Though the focusof this toolkit is for hospitals planning to shelter in place for a storm, it is imperative hospitals also havean evacuation plan. Hurricanes categorized as 4 or 5 on the Saffir-Simpson Scale are catastrophic innature. Hospitals projected to be impacted by a Category 4 or 5 storm will need to consider stronglyevacuation. In some cases, hospitals may need to evacuate for a Category 1 storm. This is dependentupon your facility’s location and specific vulnerabilities.

Decisions regarding what category storm will necessitate evacuation can be made in advance of anevent. The results of your hazard vulnerability analysis, the emergency management system, communityinfrastructure and resources where your facility is located can assist you with the decision-makingprocess.34

34 See also Evacuate or Shelter-in-Place Decision Guide, Appendix #5


PLANNING & RESPONSE

APPENDIX 6ASHELTER-IN-PLACE CHECKLIST: 96-72 Hours Prior to Onset

Wea

ther

ing th

e St

orm

�A

Hur

rica

ne P

lann

ing,

Res

pons

e an

d Re

cove

ry T

oolk

it14

3

96-7

2 H

OU

RS

PR

IOR

TO

ON

SE

T

BY

TAS

KC

OM

PLE

TE

DW

HO

MW

HE

N

All

adm

inis

trat

ive

and

supe

rvis

ory

staf

f re

view

fac

ility

hur

rican

e pl

an.

All

staf

f re

view

dep

artm

ent

hurr

ican

e pl

an.

Verif

y an

d up

date

con

tact

list

s an

d in

form

atio

n fo

r al

l sta

ff.

Clo

sely

mon

itor

wea

ther

rep

orts

and

info

rmat

ion

prov

ided

by

em

erge

ncy

oper

atio

ns o

ffic

ials

.

Fina

lize

staf

fing

plan

s.

Not

ify s

taff

of

staf

fing

plan

s.

Act

ivat

e hu

rric

ane

disa

ster

pla

n.

Not

ify s

taff

of

plan

act

ivat

ion.

Act

ivat

e al

l add

ition

al c

omm

unic

atio

n ve

nues

, i.e

. em

ploy

ee h

otlin

e, W

eb p

age,

etc

.

Act

ivat

e IC

S/H

ICS.

Sen

d br

iefs

(i.e

. Situ

atio

n R

epor

ts/In

cide

nt A

ctio

n P

lans

) reg

ular

ly t

o al

l sta

ff,

stak

ehol

ders

, par

tner

s, B

oard

of T

rust

ees,

etc

.

Che

ck in

vent

ory

and

orde

r ad

ditio

nal m

edic

al s

uppl

ies.

�O

xyge

n, o

xyge

n ta

nks

and

asso

ciat

ed s

uppl

y pa

rts

�Ph

arm

aceu

tical

s –

mak

e lis

t in

adva

nce

of c

omm

only

used

med

icat

ions

su

ch a

s m

aint

enan

ce t

ype

med

icat

ions

, med

icat

ion

for

pain

an

d an

tibio

tics.

�In

sert

item

s sp

ecifi

c to

you

r ho

spita

l’s p

lan.

Ord

er a

dditi

onal

foo

d in

vent

ory

and

supp

lies.

Che

ck in

vent

ory

of o

ther

faci

lity

supp

lies

and

orde

r ad

ditio

nal s

uppl

ies

as n

eede

d

�To

ilet

pape

r�

Fuel

No

te T

ime

Inte

rval

s fo

r b

rief

s

ON

GO

ING

Wea

ther

ing th

e St

orm

�A

Hur

rica

ne P

lann

ing,

Res

pons

e an

d Re

cove

ry T

oolk

it14

5

96-7

2 H

OU

RS

PR

IOR

TO

ON

SE

T(C

ON

TIN

UE

D)

BY

TAS

KC

OM

PLE

TE

DW

HO

MW

HE

N

�G

ener

ator

mai

nten

ance

sup

plie

s

�Li

nens

�W

ater

– p

otab

le a

nd n

on-p

otab

le

�In

sert

add

ition

al it

ems

spec

ific

to y

our h

ospi

tal’s

pla

n

Che

ck a

ltern

ate

sour

ces

for

pow

er a

nd a

ddre

ss a

ny u

nmet

nee

ds.

Con

tact

pow

er c

ompa

ny a

nd e

nsur

e pr

iorit

y st

atus

.

Che

ck a

ltern

ate

sour

ces

for

pota

ble

and

non-

pota

ble

wat

er,

and

addr

ess

any

unm

et n

eeds

.

Verif

y pa

tient

dis

char

ge a

nd t

rans

fer

proc

edur

es. A

ddre

ss u

nmet

nee

ds.

Verif

y pa

tient

tra

ckin

g pr

oced

ures

. Add

ress

unm

et n

eeds

.

Che

ck c

omm

unic

atio

ns e

quip

men

t; v

erify

fun

ctio

nalit

y of

re

dund

ant f

orm

s of

com

mun

icat

ion.

Add

ress

unm

et n

eeds

.

Impl

emen

t jus

t-in-

time

and

refr

eshe

r tra

inin

g as

nee

ded

(i.e.

sta

ff pe

rform

ing

dutie

s th

at th

ey d

o no

t per

form

regu

larly

).

�Pr

ovid

e tr

aini

ng o

n co

mm

unic

atio

ns e

quip

men

t.

�Pr

ovid

e in

stru

ctio

ns o

n ba

ckin

g up

com

pute

r fil

es.

�In

sert

just

-in-ti

me

trai

ning

app

licab

le t

o yo

ur h

ospi

tal’s

pla

n.

Rev

iew

saf

ety

and

secu

rity

proc

edur

es. A

ddre

ss u

nmet

nee

ds.

Verif

y M

emor

andu

ms

of U

nder

stan

ding

/Mut

ual A

id/C

ontr

act

agre

emen

ts.

Verif

y do

cum

enta

tion

proc

edur

es a

nd u

se o

f ap

prop

riate

for

ms

to t

rack

ex

pens

es a

ssoc

iate

d w

ith t

he e

vent

.

Verif

y w

aste

man

agem

ent

proc

edur

es.

Mak

e ev

acua

tion

deci

sion

s as

app

ropr

iate

.


PLANNING & RESPONSE

APPENDIX 6B

SHELTER-IN-PLACE CHECKLIST: 72-48 Hours Prior to Onset

Wea

ther

ing th

e St

orm

�A

Hur

rica

ne P

lann

ing,

Res

pons

e an

d Re

cove

ry T

oolk

it14

9

72-4

8 H

OU

RS

PR

IOR

TO

ON

SE

T

BY

TAS

KC

OM

PLE

TE

DW

HO

MW

HE

N

Impl

emen

t pr

otec

tive

mea

sure

s fo

r fa

cilit

y (e

.g. p

lace

shu

tter

s on

win

dow

s).

Impl

emen

t pr

otec

tive

mea

sure

s in

all

wor

k ar

eas.

Impl

emen

t pr

otec

tive

mea

sure

s fo

r co

mpu

ter

syst

ems

and

equi

pmen

t.

Sec

ure

addi

tiona

l med

ical

sup

plie

s.�

Oxy

gen,

oxy

gen

tank

s an

d as

soci

ated

sup

ply

part

s ne

eded

to

supp

ort

oxyg

en d

epen

dent

pat

ient

s.�

Pha

rmac

eutic

als.

�Li

st a

dditi

onal

hos

pita

l-spe

cific

item

s.

Sec

ure

addi

tiona

l foo

d in

vent

ory

and

supp

lies.

Sec

ure

othe

r fa

cilit

y su

pplie

s.�

Toile

t pa

per

�Fu

el�

Gen

erat

or m

aint

enan

ce s

uppl

ies.

Be

able

to

mai

ntai

n al

tern

ate

sour

ces

of p

ower

.�

Line

ns�

Wat

er –

pot

able

and

non

-pot

able

�S

ani b

ags

�Li

st a

dditi

onal

hos

pita

l-spe

cific

item

s.

Obt

ain

and

secu

re c

ash.

Secu

re a

ny lo

ose

item

s th

at m

ay b

e bl

own

by s

tron

g w

inds

(e.g

. un

secu

red

outd

oor

furn

iture

, sta

tuar

y, d

ebris

, etc

.)

Beg

in r

evie

w o

f pa

tient

dis

char

ge.

Dis

char

ge p

atie

nts

that

can

be

safe

ly d

isch

arge

d.*

Tran

sfer

pat

ient

s th

at n

eed

to b

e tr

ansf

erre

d.*

* Pa

tient

tra

nsfe

rs a

nd d

isch

arge

s w

ill n

eed

to b

e co

ordi

nate

d in

adv

ance

of

whe

n of

ficia

ls c

all f

or e

vacu

atio

ns.

Wea

ther

ing th

e St

orm

�A

Hur

rica

ne P

lann

ing,

Res

pons

e an

d Re

cove

ry T

oolk

it15

1

72-4

8 H

OU

RS

PR

IOR

TO

ON

SE

T(C

ON

TIN

UE

D)

BY

TAS

KC

OM

PLE

TE

DW

HO

MW

HE

N

Ens

ure

patie

nt t

rack

ing

proc

edur

es a

re f

ollo

wed

.

Impl

emen

t lim

ited

adm

issi

ons

proc

edur

es a

s ne

eded

.

Ens

ure

all s

taff

has

an

oppo

rtun

ity t

o im

plem

ent

pers

onal

pr

epar

edne

ss p

lans

.N

otify

med

ia o

f br

iefin

g tim

es.

No

te b

rief

ing

ti

mes

.

Est

ablis

h in

terv

als

to u

pdat

e em

ploy

ee h

otlin

e.N

ote

tim

e in

terv

als.

Upd

ate

empl

oyee

hot

line

regu

larly

.


PLANNING & RESPONSE

APPENDIX 6C

SHELTER-IN-PLACE CHECKLIST: 48-24 Hours Prior to Onset

Wea

ther

ing th

e St

orm

�A

Hur

rica

ne P

lann

ing,

Res

pons

e an

d Re

cove

ry T

oolk

it15

5

48-2

4 H

OU

RS

PR

IOR

TO

ON

SE

T

BY

TAS

KC

OM

PLE

TE

DW

HO

MW

HE

N

Beg

in li

miti

ng a

nd/o

r ca

ncel

ing

elec

tive

surg

erie

s to

avo

id

post

-ope

rativ

e st

ays.

Rev

iew

sec

urity

pro

cedu

res

with

sta

ff.

Impl

emen

t ad

ditio

nal s

ecur

ity m

easu

res.

Bac

k up

all

data

and

pat

ient

and

em

ploy

ee r

ecor

ds.

Prin

t ha

rd c

opie

s of

vita

l inf

orm

atio

n th

at m

ay b

e ne

eded

du

ring

the

stor

m.

�C

onta

ct li

sts

�In

sert

list

of

item

s sp

ecifi

c to

you

r ho

spita

l’s p

lan.

Pre-

posi

tion

supp

lies

thro

ugho

ut h

ospi

tals

.

Arr

ange

and

des

igna

te a

reas

of

hosp

itals

for

fam

ily, c

hild

car

e an

d pe

ts (a

s ap

prop

riate

bas

ed o

n yo

ur p

lan/

polic

ies)

.

Rep

ort

bed

stat

us r

egul

arly

to

emer

genc

y op

erat

ions

per

sonn

el.

Con

tinue

to

mon

itor

wea

ther

rep

orts

and

info

rmat

ion

from

em

erge

ncy

oper

atio

ns p

erso

nnel

.

Con

tinue

to

prov

ide

upda

tes

to a

ll st

aff,

stak

ehol

ders

, par

tner

s,

emer

genc

y of

ficia

ls, e

tc.

Ens

ure

all p

rote

ctiv

e m

easu

res

have

bee

n im

plem

ente

d in

all

wor

k ar

eas.

Ens

ure

staf

fing

sche

dule

s ar

e co

mpl

eted

and

com

mun

icat

ed

to a

ll st

aff.


PLANNING & RESPONSE

APPENDIX 6D

SHELTER-IN-PLACE CHECKLIST: Less than 24 Hours Prior to Onset

Wea

ther

ing th

e St

orm

�A

Hur

rica

ne P

lann

ing,

Res

pons

e an

d Re

cove

ry T

oolk

it15

9

LES

S T

HA

N 2

4 H

OU

RS

TO

ON

SE

T

BY

TAS

KC

OM

PLE

TE

DW

HO

MW

HE

N

Post

sig

nage

to

desi

gnat

e fa

mily

, chi

ldca

re a

nd p

et a

reas

of

hosp

ital.

Sta

ff r

epor

t as

ass

igne

d (t

wo

shift

s to

sta

y th

roug

h th

e st

orm

).

Sup

port

sta

ff r

epor

ting

to h

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PLANNING & RESPONSE

APPENDIX 7UTILITY FAILUREOPERATIONAL IMPACT CHART

163



PLANNING & RESPONSE

APPENDIX 8CONSUMABLE SUPPLYOPERATIONAL IMPACT CHART

167



PLANNING & RESPONSE

APPENDIX 9DIALYSIS CONCERNS

171


PATIENTS ON DIALYSIS

Several resources are available online to assist with planning for addressing the needs of dialysispatients. Hospitals should check with local dialysis centers to ensure coordination of emergency plans.

� Emergency Instructions for Dialysis Patientshttp://www.esrdnetwork.org/disaster-planning/patients/emergency-instructions.asp

� Preparing for Emergencies: A Guide for People on Dialysishttp://www.medicare.gov/Publications/Pubs/pdf/10150.pdf

� Trans-Atlantic Renal Council - Disaster preparedness information for patients and providershttp://www.tarcweb.org/quality_improvement/emergency_disaster.asp#informationforprovidershttp://www.tarcweb.org/treatmentlocations/newjersey.asp

� End Stage Renal Dialysis Network of Texas Web site has many links including:� • Triage checklist to assess need for acute dialysis� • Shelter triage checklist for Hemodialysis and Peritoneal Dialysis patients� • List of high potassium foods to avoid� • http://www.esrdnetwork.org/disaster-planning/hurricane/hospitals-shelters.asp

GUIDANCE FOR DIALYSIS CARE PROVIDERS

� What to do when your municipal water supplier issues a “boil water advisory”http://www.cdc.gov/ncidod/dhqp/dpac_dialysis_boilwater.html

� Safe Use of “Tanker” Water for Dialysishttp://www.bt.cdc.gov/disasters/pdf/watertanker.pdf

� Infection Control for Peritoneal Dialysis (PD) Patientshttp://www.bt.cdc.gov/disasters/pdf/icfordialysis.pdf

� DaVita Hurricane Hotline Number 800-400-8331


PLANNING & RESPONSE

APPENDIX 10SAMPLE MUTUAL

ASSISTANCE AGREEMENT

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MUTUAL ASSISTANCE AGREEMENT

This Mutual Assistance Agreement is entered into by and among those hospitals executing it, effec-tive as to each hospital on the date of its execution. The North Dakota Healthcare Association(NDHA) will advise each hospital executing this Agreement of the identity of other hospitals which

have executed the Agreement, and the names, addresses and telephone numbers of each executinghospital’s Designated Representative. Each executing hospital and the North Dakota Department ofHealth shall be a “party” to this Agreement.

RECITALS

� WHEREAS, hospital acknowledges that each party may from time to time find it necessary toevacuate and transfer patients due to the occurrence of an external or internal disaster; and

� WHEREAS, the parties further acknowledge that each party may from time to time lack the staff,equipment, supplies and other essential services to optimally meet the needs of patients due tothe occurrence of an external or internal disaster; and

� WHEREAS, the parties recognize that certain of the equipment and supplies which may be used inmeeting the needs of patients during an internal or external disaster were purchased through grantmoney provided by the Department; and

� WHEREAS, the parties have determined that a Mutual Assistance Agreement, developed prior to asudden and immediate disaster is needed to facilitate communication between and among theparties to coordinate the transfer of patients and the sharing of staff, equipment, supplies andother essential services in the event of an external or internal disaster;

� NOW, THEREFORE, in consideration of the above recitals and for other good and valuable consider-ations, the receipt and sufficiency of which are hereby acknowledged, the parties agree as follows:

1. DEFINITIONS.

a. “Affected Hospital” is a party which is impacted by an External or Internal Disaster and requeststo transfer patients to another party, or requests the assistance of another party.

b. “Assisting Hospital” is a party which is available upon request to receive the transfer of patientsfrom an Affected Hospital.

c. “Designated Representative” is the individual or position designated by each party to communi-cate with another party and to determine the distribution of information within their own health-care organization in the event of an External or Internal Disaster.

d. “External Disaster” means a disaster occurring or imminent in the community surrounding aparty. An External Disaster may affect the entire facility or only a portion of the facility.

e. “Internal Disaster” means a disaster occurring within a party’s facility that materially affects theparty’s ability to provide patient care. An Internal Disaster may affect the entire facility or only aportion of the facility.

f. “Lending Hospital” is a party which is available to provide staff, equipment, supplies and/or otheressential services to another party in the event of an External or Internal Disaster. Each executinghospital recognizes and agrees that, depending on circumstances, it may be an Affected Hospital,an Assisting Hospital, or a Lending Hospital.

2. IDENTIFICATION OF DESIGNATED REPRESENTATIVE. Each party agrees to provide to the NDHAand the Department the name and contact information of its Designated Representative who will beavailable to perform the functions stated in the definition above, and at least one back-up individual toserve as the Designated Representative in the primary Designated Representative’s absence. Thenames and contact information for the executing hospital’s Designated Representative and back-upindividual will be provided to each executing hospital by the NDHA.

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3. TRANSFER OF PATIENTS. Each party is willing to accept patients transferred by another party underthe terms and conditions set forth in this Agreement.

4. TRANSFER RESPONSIBILITIES OF AFFECTED HOSPITAL. The parties agree that in the event itbecomes necessary to transfer patients from an Affected Hospital to an Assisting Hospital, theAffected Hospital shall

a. Contact the Designated Representative at the Assisting Hospital as soon as the Affected Hospitalbecomes aware of the need to transfer patients;

b. Comply with any limitations communicated to the Affected Hospital regarding the numbers andtypes/acuity of patients that the Assisting Hospital is able to accept;

c. Triage all patients prior to transfer to verify that the types and acuity of services required are with-in any limitations communicated to the Affected Hospital regarding the numbers and types/acuityof patients that the Assisting Hospital is able to accept;

d. Arrange for the transport of each patient to the Assisting Hospital, with support of such medicalpersonnel and equipment as is required by the patient’s condition;

e. Deliver to the Assisting Hospital, with each patient transferred, to the extent available, thepatient’s medical records, or copies thereof, sufficient to indicate the patient’s diagnoses, condi-tion, and treatment provided and planned;

f. Make available one or more physicians of the Affected Hospital to address questions from themedical staff at the Assisting Hospital; and

g. If feasible, inventory the patient’s personal effects and valuables transported to the AssistingHospital with the patient. The Affected Hospital shall deliver the inventory and the patient’s valuablesto the personnel transporting the patient, and receive a receipt for such items. The AssistingHospital shall, in turn, acknowledge and sign a receipt for the valuables delivered to it.

5. TRANSFER RESPONSIBILITIES OF ASSISTING HOSPITAL. The parties agree that in accepting thetransfer of patients from an Affected Hospital, an Assisting Hospital shall:

a. Ensure that the Designated Representative is available twenty-four (24) hours a day, seven (7)days a week to implement this Agreement and to communicate with the Affected Hospital regard-ing the numbers and types/acuity of patients who may be transferred.

b. Accept all transfers from the Affected Hospital that are within the limitations communicated bythe Designated Representative of the Assisting Hospital. An Assisting Hospital shall not be obli-gated to accept any patients which exceed its capacity or staffing, which shall be determined inthe Assisting Hospital’s sole discretion.

c. Record in the clinical records of each transferred patient notations of the condition of the patientupon arrival at the Assisting Hospital.

d. If personal effects and valuables of the patient are transported with the patient, check those itemsagainst the inventory prepared by the Affected Hospital, and issue a receipt for such items as arereceived by the Assisting Hospital to the personnel transporting the patient.

6. RETURN OF PATIENTS TO AFFECTED HOSPITAL. Once the internal or external disaster conditionsthat required the transfer have sufficiently resolved, and if medically appropriate for each individualpatient, an Assisting Hospital shall make arrangements to transfer the patients back to the AffectedHospital as soon as practicable. Upon re-transfer to the Affected Hospital, the Assisting Hospital willreturn any original medical records, including x-ray films, transferred with the patient. The AssistingHospital shall also provide copies of medical records regarding all care provided to the patient by theAssisting Hospital.

7. DISCHARGE BY ASSISTING HOSPITAL. If a transferred patient is discharged by an AssistingHospital, the Assisting Hospital will return to the Affected Hospital any original medical records,including x-ray films, transferred with the patient. If the Affected Hospital is not then able to receive

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the returned medical records, the Assisting Hospital will retain the records in its records departmentuntil requested by the Affected Hospital.

8. CHARGES FOR SERVICES. All charges for services provided at an Affected Hospital or at anAssisting Hospital for patients transferred pursuant to this Agreement shall be collected by the partyproviding such services directly from the patient, third party payor or other source normally billed bythe party. The parties agree to cooperate with each other in billing and collecting for services fur-nished to patients pursuant to this Agreement. The billing and collection of charges for transportationof the patient from an Affected Hospital to an Assisting Hospital (and to return the patient to theAffected Hospital) shall be the responsibility of the Affected Hospital.

9. LOANS OF PERSONNEL. The parties agree that an Affected Hospital may, due to an external or inter-nal disaster, require the need for additional personnel from a Lending Hospital. The Lending Hospital,in its sole discretion and consistent with paragraph 24 below, will identify personnel that it can makeavailable to the Affected Hospital, the time periods during which the personnel are available, and theduration of time the Lending Hospital anticipates it can continue to make such personnel available tothe Affected Hospital. If at any time the Lending Hospital determines the return of all or some of itsloaned personnel is necessary for the proper staffing of the Lending Hospital, then upon notice to theAffected Hospital, the Lending Hospital may direct its personnel to return to work at the LendingHospital and such action shall not be a breach of this Agreement.

10. COMMUNICATION OF REQUEST FOR PERSONNEL. A request for the loan of personnel can bemade verbally. The request, however, must be followed up in writing. The Affected Hospital will iden-tify to the Lending Hospital the following:a. The type (including required competencies) and number of requested personnel;b. An estimate of how quickly the response is needed;c. The location where such loaned personnel are to report; andd. A brief description of how the loaned personnel will be used.

11. IDENTIFICATION OF LOANED PERSONNEL. Arriving loaned personnel will present their identification atthe site designated by the Affected Hospital. The Affected Hospital will be responsible for the following:a. Meeting the arriving loaned personnel; andb. Confirming the loaned personnel’s identification with the list of personnel provided by the Lending

Hospital.

12. SUPERVISION OF LOANED PERSONNEL. The Affected Hospital’s Designated Representative willidentify where and to whom the loaned personnel are to report. Professional staff of the AffectedHospital will supervise the loaned personnel.

13. CREDENTIALS OF LOANED PERSONNEL. The Affected Hospital agrees to accept the professionalcredentialing determination made by the Lending Hospital for those services for which such person-nel are credentialed or certified by the Lending Hospital.

14. RETURN OF LOANED PERSONNEL. The Affected Hospital is responsible for providing the loanedpersonnel transportation necessary for their return to the Lending Hospital.

15. CHARGES. The Affected Hospital will reimburse to Lending Hospital all costs associated with theloaned personnel, including, without limitation, the wages and benefits of such personnel for theperiod loaned. The Lending Hospital will furnish to the Affected Hospital an invoice reflecting thecosts, and upon request by the Affected Party will provide information as necessary to reasonablyverify the claimed costs. All charges for patient care provided by loaned personnel will be billed byand shall be the property of the Affected Hospital.

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16. LOANING SUPPLIES AND/OR EQUIPMENT. The parties agree that an Affected Hospital may, due toan external or internal disaster, need the use of additional supplies and equipment.

17. COMMUNICATION OF REQUEST FOR SUPPLIES AND EQUIPMENT. A request for supplies or theloan of equipment can be made verbally. The request, however, must be followed up in writing. TheAffected Hospital will identify the following:a. The quantity and exact type of requested items;b. An estimate of how quickly a response is needed;c. Time period for which the supplies or equipment will be needed; andd. Location to which the supplies or equipment should be delivered.

17. The Lending Hospital, in its sole discretion and consistent with paragraph 24 and subject to para-graph 25 below, will identify which requests it can meet, how long it will take to fulfill the request,and, in the case of loaned equipment, how long the equipment can be made available to the AffectedHospital. If at any time the Lending Hospital determines the return of all or some of the loan equip-ment is necessary for the proper operation of the Lending Hospital, then upon request by notice tothe Affected Hospital, the Affected Hospital will return such equipment, and such request shall notbe a breach of this Agreement.

18. DOCUMENTATION OF SUPPLIES AND EQUIPMENT. The Affected Hospital will use the LendingHospital’s standard order requisition form as documentation of the request and receipt of the materi-als. The Affected Hospital’s Designated Representative will confirm the receipt of the materialresources. The documentation will detail at least the following:a. The supplies and/or equipment involved; andb. The condition of the equipment prior to the loan (if applicable).

19. TRANSPORTATION OF SUPPLIES AND EQUIPMENT. When feasible, the Affected Hospital will beresponsible for transporting the requested supplies and equipment. If the Affected Hospital is unableto transport such supplies or equipment, the Lending Hospital will arrange for shipping/transportationto and from the Affected Hospital. All expenses of shipping/transport shall be the responsibility ofthe Affected Hospital.

20. RESPONSIBILITY FOR SUPPLIES AND EQUIPMENT. The Affected Hospital is responsible forappropriate use and maintenance of all loaned supplies and equipment.

21. CHARGES FOR LOANED SUPPLIES AND EQUIPMENT. The Affected Hospital shall be responsiblefor all costs arising from the use, damage, or loss of requested supplies and loaned equipment.Charges for equipment shall be at actual lease rate prorated by the number of days of use, or by thefair market rental value of comparable equipment, as chosen by the Lending Hospital. Charges forsupplies will be at the Lending Hospital’s costs.

22. RESPONSIBILITY; INSURANCE. Each party shall be responsible for any and all property damage or per-sonal injury caused by the acts or omissions of its employees acting within the scope of employment.Each party shall throughout the term of this Agreement maintain comprehensive general liability insur-ance, workers compensation insurance, property insurance and professional liability (malpractice) insur-ance to cover their activities hereunder and upon request of another party shall provide to the otherparty certificates evidencing the existence of such insurance coverage. Each party may at its option sat-isfy its obligations under this section through self-insurance programs and protections deemed by it tobe comparable to the insurance coverage described herein, and upon request, provide to the other partyinformation showing that the self-insurance programs offer such comparable protection.

23. INDEPENDENT RELATIONSHIP. None of the provisions of this Agreement are intended to createnor shall be deemed or construed to create a partnership, joint venture or any relationship betweenthe parties other than that of independent entities contracting with each other solely for the purposeof effecting the provisions of this Agreement.

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24. AFFILIATION WITH OTHER FACILITIES. Nothing in this Agreement shall be construed as limitingthe right of the parties to affiliate or contract with any other entity operating a hospital or any otherhealth care facility on either a limited or general basis while this Agreement is in effect. Each partyacknowledges that, in the event of a large scale External Disaster, the ability of an Assisting Hospitalto accept patients from the Affected Hospital may be affected by its receipt of patients from othersources, including direct admissions from the community and transfers of patients from other facili-ties, or other factors. This Mutual Assistance Agreement is not intended to establish a preferred sta-tus for patients of Affected Hospitals. All decisions regarding allocation of available personnel, equip-ment and supplies will be made by the Assisting Hospital and/or the Lending Hospital using its bestjudgment about its capabilities at the time and the needs of its community.

25. AUTHORITY OF DEPARTMENT. All parties to this agreement recognize that certain of the suppliesand equipment available for use in any internal and external disaster have been purchased through agrant administered by the Department. In the event of an internal or external disaster requiring coor-dination at statewide level, as determined by an appropriate representative designated by theGovernor, the Department may direct the distribution, utilization and location of use of any and allsupplies and equipment owned by any party to this Agreement, which supplies and equipment wereinitially purchased with grant funds from the Department.

26. EFFECT OF AGREEMENT. The execution of this Agreement shall not give rise to any liability orresponsibility for failure to respond to any request for assistance, lack of speed in answering such arequest, inadequacy of equipment, or abilities of the responding personnel.

27. COPY OF AGREEMENT. A conformed copy of this Agreement, with all amendments, if any, togetherwith a copy of any policies and procedures, referral forms or other documents adopted by the partiesto implement this Agreement shall be kept in an administrative file of each of the parties for readyreference.

28. MODIFICATION OF AGREEMENT. This Agreement contains the entire understanding of the partiesand shall not be modified except by an instrument in writing signed by the parties.

29. NO WAIVER. No waiver of a breach of any provision of this Agreement shall be construed to be awaiver of any breach of any other provision of this Agreement or of any succeeding breach of thesame provision.

30. GOVERNING LAW. This Agreement, and the rights, obligations and remedies of the parties hereto,shall be governed by and construed in accordance with the laws of the State of North Dakota.

31. ACCESS TO RECORDS. If this Agreement is subject to Section 952 of the Omnibus ReconciliationAct of 1980, 42 U.S.C. § 1395-x (v)(1)(I) (the “Statute”) and the regulations promulgated thereunder,42 C.F.R. Part 420, Subpart D (the “Regulations”), the parties shall, until the expiration of four (4)years after furnishing of services pursuant to this Agreement, make available, upon proper request,to the Secretary of Health and Human Services and to the Comptroller General of the United States,or any of their duly authorized representatives, the Agreement and the books, documents andrecords of the parties that are necessary to certify the nature and extent of the cost of services fur-nished pursuant to the Agreement for which payment may be made under the Medicare program. Ifthe Agreement is subject to the Statute and Regulations and any party carries out any of the dutiesof the Agreement through a subcontract, with a value or cost of $10,000 or more over a twelve (12)month period, with a related organization, that subcontract shall contain a clause to the effect thatuntil the expiration of four (4) years after the furnishing of services pursuant to such subcontract, therelated organization shall make available, upon proper request, to the Secretary and the ComptrollerGeneral, or any of their duly authorized representatives, the subcontract and the books, documentsand records of such related organization that are necessary to verify the nature and extent of suchcosts.

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32. TERMINATION OF AGREEMENT BY PARTY. Any party may terminate its participation in thisAgreement by providing sixty (60) days written notice to the President of NDHA. The NDHA will noti-fy all other parties of said termination.

DATE: ________________________________________________

BY:__________________________________________________

ITS:__________________________________________________

IDENTIFICATION OF DESIGNATED REPRESENTATIVES: ____________________________________________________

Reprinted with permission. North Dakota Healthcare Association


RECOVERY

APPENDIX 11SAMPLE INFORMATION FORM

FOR DEPARTMENTS

183


RECOVERY

SUPPORT SERVICES AND ASSISTANCE

After a major emergency or disaster, many people in our community will be distressed by personaland professional difficulties. It is likely that affected staff and physicians may need some schedulingflexibility or other temporary help in order to return to their customary activities. The following are

only some of the resources available on campus and in our community:

HOSPITAL RESOURCES

Counseling for employees

Transportation information

Child care referrals

Pet care resources

Special needs resources

Medication resources

ATM machines & other money sources

DOCUMENTING EMERGENCY OUTCOMES

Once the safety and status of your staff has been assured and emergency conditions have subsided,assemble a Department Emergency Recovery Team to support the hospital Incident Command Systemand the Facilities Department in restoring your department’s operations. Your team’s earlier work ondefining mission-critical operations and staffing will be a starting point for the recovery process.

It will be important to begin a timely and comprehensive assessment of the emergency’s physical andoperational effects. Plan ahead for how you will collect this important impact information. Be aware that

� Your department director will need ongoing status reports from your unit during the emergency toestimate when your program can be fully operational and to identify special facility, equipment andpersonnel issues or resources that will speed business resumption.

� The hospital may need detailed facilities data for the area to estimate temporary space reallocationneeds and strategies.

� Most insurance and FEMA assistance claims will require extensive documentation of damagedfacilities, lost equipment and resources and special personnel expenses. Workers’ compensationclaims may arise if there are injuries in your department.

The following forms provide formats for summarizing this crucial information.

� Take note that you also should plan to photograph or videotape facility or equipment damage inyour department to provide a visual supplement for the written impact data.

� It is very important that you record the emergency’s physical effects before you clean your area ormake repairs.

COMMUNITY RESOURCES

Disaster relief & referrals

Transportation information

Counseling/mental health

Claims information

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(HOSPITAL NAME)SUMMARY: DEPARTMENT EMERGENCY STATUS

DATE/TIME ____________________________________________ # OF PAGES IN THIS REPORT ________________

TO: ADMINISTRATOR: ____________________________________ FAX:__________________________________

EOC: ________________________________________________ FAX:__________________________________

FROM: ________________________________________________ FAX:__________________________________

DEPT/BLDG ____________________________________________

CURRENT OPERATIONAL SITUATION

IMMEDIATE FACILITY AND SPACE NEEDS: ____________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

URGENT EQUIPMENT REQUIREMENTS TO BECOME OPERATIONAL: __________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

CRITICAL PERSONNEL ISSUES: ____________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

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RECOVERY: DETAILED SPACE ASSESSMENT

Use this form to describe damage to utilities, fixtures, ceilings, walls, floors, windows, etc. in your department. Send the informa-tion to the Emergency Operation Center. The EOC will send a prioritized list to the Facilities Department and other designated depart-ments with a signed cover memo.

DEPT/BLDG ____________________________________________________ROOM______________________

DAMAGE ____________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

DEPT/BLDG ____________________________________________________ROOM______________________

DAMAGE ____________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

DEPT/BLDG ____________________________________________________ROOM______________________

DAMAGE ____________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

DEPT/BLDG ____________________________________________________ROOM______________________

DAMAGE ____________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

DEPT/BLDG ____________________________________________________ROOM______________________

DAMAGE ____________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

186


RECOVERY: DETAILED EQUIPMENT ASSESSMENT

Use this form to describe all damaged furnishings, office-laboratory equipment, and materials expended dur-ing the emergency. Send the information to the EOC.

DEPT/BLDG ____________________________ ROOM ____________________________

ITEM________________________________ MANUFACTURER __________________________

____________________________________ HOSPITAL ______________ ORIGINAL

MODEL# ____________________________ INVENTORY# ____________ COST ____________

DAMAGE DESCRIPTION __________________________________________________________

____________________________________________________________________________

EST. REPAIR $ ________________________ EST. REPLACEMENT $ ______________________

DEPT/BLDG ____________________________ ROOM ____________________________





____________________________________________________________________________


DEPT/BLDG ____________________________ ROOM ____________________________





____________________________________________________________________________


page _____of _____

187


RECOVERY: DETAILED PERSONNEL IMPACTS(This should be coordinated through the HR Department)

Use this form to describe the emergency’s impact on staffing. Describe personnel issues related to programresumption. Document employee overtime related to your emergency response and recovery. Send this infor-mation to the EOCSummary: EMERGENCY IMPACTS TO DEPARTMENT STAFFING

SUMMARY: EMERGENCY IMPACTS TO DEPARTMENT STAFFING

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________L: STAFF OVERTIME HOURS RELATED TOHE EMERGENCY. Include data for temps hired for emergency recovery

LIST STAFF OVERTIME HOURS RELATED TO THE EMERGENCY AND EMERGENCY DUTIES PERFORMED.Include data for temps hired for emergency recovery.

NAME________________________________________________________ EMPLOYEE#______________________

JOB TITLE ____________________________________________________ HOURLY RATE ____________________

OT RATE __________________________________ BENEFITS % ______________________________________

DATE(S) WORKED ______________________ HOURS____________ DUTIES PERFORMED ______________

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

NAME________________________________________________________ EMPLOYEE#______________________

JOB TITLE ____________________________________________________ HOURLY RATE ____________________

OT RATE __________________________________ BENEFITS % ______________________________________

DATE(S) WORKED ______________________ HOURS____________ DUTIES PERFORMED ______________

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Page ______ of _______

188


SUMMARY

ROLES AND RESPONSIBILITIES

List all staff names, addresses and phone numbers (regular and emergency) as well as position in thedepartment.

For each person, list to whom that person reports, in order of responsibility. Be able to show at a glancewho is in charge if someone above is unable to respond.

List roles and responsibilities in an emergency. Consider overlaps in case someone is not able to fulfill a role.

Be able to answer these questions:� Who will provide first aid?� Who will take any medications?� Who will take the first aid kit?� Who will take emergency information on each person?� Who will call for help?� Who will carry the cellular phone?� Who will carry the emergency kits?� Who makes sure everyone is out of the building?� Who is responsible for backing up vital records/information?� Where are copies of information stored?� Who is responsible for equipment?

Share the list with the staff and discuss it so there is no surprise during an emergency. Everyone shouldknow their primary and back-up responsibilities.

Maintain an attendance list at all times:� Who is in the building?� When did they arrive?� When did they leave?

Have emergency information with the attendance list. Make sure you know health information and have per-mission for emergency medical treatment and know of any special requirements or medications for staff.

Below is a sample listing of common areas of interest to be covered when compiling your departmental plan:

� Who � Names/phone numbers of everyone in your department� Who is considered essential in times of emergency� Who will be responsible for contacting employees in times of emergency� Who will have access to vital information/records� Who will have access to equipment/supplies

189


� What

� What equipment is in the department

� What supplies are in the department� What equipment and supplies are needed in times of emergency� What role does your staff have on a day-to-day basis� What role will your staff have in an emergency situation� What vendors are available 24/7 in times of emergency

� When � When do you activate your departmental plan� When is your department considered unable to function due to lack of

personnel/equipment/supplies

� Where � Where do people go when they evacuate� Where are emergency supplies and first aid kits

� How � How do employees find out about the status of the department� How do you disseminate information to your staff/students/departments� How will you backup your information � How you will contact employees in times of emergency

� How Many� How many personnel are needed to keep the department functioning� How many generators are needed for your area� How many flashlights are needed� How many employees will need shelter� How many employees will need daycare services� How many employees will need medication� How many animals are to be fed/when/how/by whom� How many people have cell phones/text messaging capability/numbers available


RECOVERY

APPENDIX 12HOSPITAL STATUS REPORT FORM

193



RECOVERY

APPENDIX 13SAMPLE DEMOBILIZATION PLAN

197


DEMOBILIZATION

SAMPLE DEMOBILIZATION PLANFacilities also may choose to capture their demobilization

priorities and actions in an Incident Action Plan (IAP).

I. General Information – This section is to summarize the situation and demobilization priorities. This section also should include any unique considerations for the current event. General guidelines shouldbe noted here:

A. General guideline example – personnel that has been on duty the longest should be releasedfirst.

B. General guideline example – operations will be restored according to COOP/DRP plan prioritization of critical functions.

II. Responsibilities

A. Planning Section

i. Ensure demobilization information is disseminated in sufficient time for an orderly downsizingof incident resources.

ii. Ensure command has approved demobilization plan.

iii. Ensure compliance with demobilization checkout form (ICS – 221).

iv. Ensure coordination with procurement and documentation units and coordination with othersections.

B. Operations Section

i. Identify and notify planning of excess personnel and equipment available for demobilization.

ii. Identify operational capacity status of various units in hospital. Notify which units can returnto normal operations and which ones cannot. Determine impact of unit inter-dependenciesrelative to operational status.

C. Logistics Section

i. Coordinate all personnel and equipment transportation needs.

ii. Ensure communications equipment has been returned, checked for damage and ensurerepairs as needed.

iii. Ensure resources have been tracked and accounted for, both consumables and non-consumables. Ensure completion of equipment tracking forms (ICS-211).

D. Finance Section

i. Ensure completion of personnel time reports and coding to appropriate cost centers.

ii. Ensure completion of equipment time reports and coding to appropriate cost centers.

iii. Ensure documentation requirements are met for application of relief under FEMA or privateinsurance policies.

III. Release Priorities – list release priorities.

IV. Release Procedures – procedures may be listed by section or by topic (i.e. personnel). For example,note how personnel are to check out and what the expectations are for returning to work. For exam-ple, staff are to schedule their next work shift with their supervisor or their supervisor’s designeeprior to going home.

V. Approvals

PREPARED BY:______________________________________________________ DATE ________________________________________________Demobilization Unit Leader

CONCUR: ________________________________________________________ DATE ________________________________________________Planning Section Chief

CONCUR: ________________________________________________________ DATE ________________________________________________Logistics Section Chief

APPROVED:________________________________________________________ DATE __________________________________________________Incident Commander


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Documents

Weathering the Storm - NJHA · 2012-12-19 · Recovery Toolkit is designed to assist hospitals in preparing for, responding to and recovering from the potential consequences of a