DOC

National Bioterrorism Hospital Preparedness Program (NBHPP

By Deborah Hamilton,2014-06-16 18:12
14 views 0
National Bioterrorism Hospital Preparedness Program (NBHPP ...

    Maine Center for Disease Control and Prevention (Maine CDC)

     Report to the Legislature on Regional Resource Centers and other Health Systems Resources

    January 2008

This annual report was developed in response to Chapter 634, S.P. 789, L.D. 2044, “An Act to

    Enhance the Protection of Maine’s Families from Terrorism and Natural Disasters” Section 19.

    Specific requirements stated that the Maine Center for Disease Control and Prevention shall report

    annually, beginning January 15, 2007, to the joint standing committee of the Legislature having

    jurisdiction over health and human services matters and the joint standing committee of the

    Legislature having jurisdiction over criminal justice and public safety matters, on the progress of the

    Regional Resource Center grantees on meeting the stated contractual deliverables related to the

    federal U.S. Department of Health and Services grant for Maine’s implementation of the Assistant

    Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program. In compliance

    with such requirements, Maine CDC first reported to the Task Force to Study Maine’s Homeland Security Needs by September 18, 2006 and to the Legislative committees by January 15, 2007.

Overview

    The U. S. Department of Health and Human Services, Assistant Secretary for Preparedness and

    Response (ASPR) Hospital Preparedness Program provides Cooperative Agreement funding

    authorized by section 2802 (b) of the Public Health Service (PHS) Act, as amended by the Pandemic

    and All-Hazards Preparedness Act (PAHPA) (P.L. 109-417). Eligible applicants are jurisdictional

    public health departments in all 50 states; the District of Columbia; Commonwealths of Puerto Rico

    and the Northern Marianas Islands; the Territories of Guam, American Samoa and the U. S. Virgin

    Islands; New York City; Chicago; and Los Angeles.

The mission of the Federally-funded National Bioterrorism Hospital Preparedness Program is to

    ready hospitals and supporting healthcare systems to deliver care to patients of public health

    emergencies. The primary focus is on the development and implementation of plans to improve the

    capacity of hospitals, hospital emergency departments and outpatient centers, Emergency Medical

    Services (EMS,) and other collaborative healthcare entities to respond to bio-terrorist attacks. Funds

    from the September 1, 2007 August 8, 2008 budget period are being used to build medical surge capability through associated planning, personnel, equipment, training and exercise capabilities at the

    State and local levels.

The Maine Center for Disease Control and Prevention (Maine CDC), Office of Public Health

    Emergency Preparedness (OPHEP)has facilitated such work in Maine by establishing and

    maintaining Regional Resource Centers for Public Health Emergency Preparedness at Maine’s three

    largest tertiary care centers Maine Medical Center (MMC), Central Maine Medical Center (CMMC),

    and Eastern Maine Medical Center (EMMC) with the intent of leveraging the existing Emergency

    Medical Services Trauma System. Their primary focus has been on assessment and reporting of

    regional healthcare system infrastructure and capacity for public health emergency response,

    healthcare systems planning, improving regional capacity for communication infrastructure, and

    training of health professionals.

The Regional Resource Centers are key partners in Maine’s implementation of the ASPR Hospital

    Preparedness Program. RRC’s are contracted partners who serve as Maine CDC healthcare system

     1/11/08 1

staff within their regions. Over the past four years, Maine CDC and the RRC’s have utilized Hospital

    Preparedness Program (HPP) funding from the U. S. Department of Health and Human Services to

    assist in building Maine’s healthcare system and public health capacity. Approximately $4 million of

    the funding has been used by the Regional Resource Centers to address high priority healthcare

    systems needs for emergency preparedness - including such items as communications equipment,

    personal protective equipment for health workers, and capital improvements or purchases to assure

    medical isolation capacity for EMS and hospitals. Maine CDC is charged with the management of

    HPP funding and has developed a collaborative strategic approach to ready hospitals and supporting

    healthcare systems to deliver care to patients of public health emergencies. The Maine CDC Division

    of Public Health Systems director and Office of Public Health Emergency Preparedness director

    meet monthly with key administrators at each RRC. These sessions have developed collaborative

    partnerships that assure coordination of HPP activities locally, among regions and with the central

    office at Maine CDC assuring Maine’s organizational capacity to provide the rapid and effective use

    of resources needed to conduct the project.

Since their establishment in February of 2004, the Maine CDC Regional Resource Centers have

    worked collaboratively with public health, healthcare system, emergency management and

    community partners in their regions of the state as well as across regions. The RRC’s maintain key

    roles in:

    ? Developing surge capacity

    ? Providing local public health leadership

    ? Serving as policy advisors to Maine CDC

    ? Providing input and subject matter expertise on HPP medical / technical issues

    ? Developing coordinated systems with local hospital systems

    ? Partnering with Maine CDC in setting statewide priorities such as training, exercise and

    medical surge

    It is the intent of Maine CDC to maintain the original concept of the Regional Resource Centers,

    continuing support to Maine’s three primary healthcare organizations building Centers of Excellence

    in emergency preparedness and response. Funding to the Regional Resource Centers must be defined

    in the context of all public health preparedness and response activities. Understanding that all

    funding for healthcare system emergency preparedness and response that has been provided to date,

    and is anticipated in the near future are federal funds, the extent to which programs can be maintained

    and further developed depends on the availability of federal funding and annual program guidelines

    received from ASPR.

    The Regional Resource Centers primary activities will assure operations to the highest standards

    including:

    ? Surveillance and early detection of infectious diseases and bioterrorism agents.

    ? Command and Control protocol to define a collaborative tiered response for communication

    among key agencies during the time of a threat or response to an emergency.

    ? Integration of emergency preparedness and response activities between healthcare system and

    public health partners.

    ? Education, Training and Exercise regionally and statewide.

     1/11/08 2

    ? Community collaboration

    ? Data systems integration and development

Maine CDC maintains a strong commitment to assuring public health and healthcare system planning

    and response activities include considerations and the needs of at-risk individuals, including

    behavioral health. To accomplish this, OPHEP works in collaboration with a broad-based group of

    partners statewide including but not limited to:

Maine DHHS Disaster Behavioral Health

    Maine CDC Office of Minority Health

    Maine Office of Multicultural Health

    Maine CDC Regional Resource Centers and other hospitals

    Maine Primary Care Association

    Maine Center for Public Health

    Maine Emergency Management Agency

    Maine Council on Disabilities

    City of Portland, Public Health Division

    City of Bangor, Health and Welfare Department

Regional Resource Centers Outcomes

Since their establishment in February of 2004, the Maine CDC Regional Resource Centers have

    worked collaboratively with public health, healthcare system, emergency management and

    community partners in their regions of the state to:

    ? Conduct detailed assessments of current local regional health system response capacity utilizing a

    standard web-based survey tool provided by Maine CDC.

    ? Analyze assessment report data and develop regional assessment reports.

    ? Prioritize identified health system infrastructure needs (primarily capital expenditures such as

    healthcare and communication equipment and supplies.

? Develop purchase plans based on prioritized needs.

    ? Facilitate the purchase and distribution of identified capital expenditure equipment and supplies

    to healthcare systems partners regionally.

    ? Maintain web-based resource inventories for emergency related resources at the regional level.

    ? Develop and implement an equipment maintenance plan for all regional hospitals to ensure

    equipment is properly maintained and serviced.

    ? Identify gaps in regional healthcare systems emergency response capacity.

    ? Conduct regional planning activities to develop comprehensive regional healthcare system

    response plans for response to public health emergencies.

    ? Conduct individual hospital Hazard and Vulnerability Analysis (HVA) in each region.

     1/11/08 3

    ? Develop regional and statewide lists of Alternative Care Sites and site operational

    needs/requirements including models with mixed usage (e.g., behavioral health, pediatrics,

    med/surge etc.) to include engineering, telecommunications, clergy and others.

    ? Collaboratively create a Statewide Hospital Mutual Aid Memorandum of Understanding (MOU)

    among hospitals. The three RRC's and the Maine Hospital Association (MHA) developed this

    MOU to be universally used for all hospitals in the State of Maine.

    ? Collaborate with the Health and Environmental Testing Laboratory (HETL) to develop Mutual

    Aid Agreements among hospital sentinel laboratories for the sharing of equipment, reagents, and

    other resources as necessary during public health emergencies.

    ? Inventory and assess alternate care sites throughout each region to assist in the development of

    out of the hospital surge capacity to assist in response to public health emergencies.

    ? Collaborate with the Maine CDC, Maine Emergency Management Agency (MEMA), Maine

    Emergency Medical Services (EMS), Maine Primary Care Association (MPCA) and other

    partners to develop and implement a comprehensive public health emergency training and

    exercise program for public health and healthcare personnel statewide.

    ? Collaborate with the Maine CDC to implement a Maine based system for the Strategic National

    Stockpile.

    ? Collaborate with Maine CDC, MEMA, and other key partners to development and implement a

    single solution for the registry of public health and healthcare professionals statewide, assuring

    compliance with U.S, Department of Health and Human Services, Emergency System for

    Advance Registration of Voluntary Health Professionals (ESAR VHP).

    ? Serve as members of county level key leadership teams facilitating the development of the

    medical response component of draft county Pandemic Influenza planning documents.

As a 2007 - 2008 project year priority, Maine will develop an operational healthcare system surge

    plan for the medical response to public health emergencies, including the coordination of various

    “strike teams” and response groups such as DMAT, Northern New England-MMRS, MRC, and

    others. Maine CDC will establish a coordinated system to bring their deployment and management

    into one structure, with the three RRC’s as key partners. This planning will assure that federally

    defined Level-One Capabilities are met and Level-Two Capabilities are prioritized. Maine has made

    significant progress in each of the capability areas yet also has significant work ahead.

Capabilities needing further work and those to be addressed in HPP project year 2007-2008 include:

    1. Interoperable Communications

    2. Bed tracking

    3. ESAR-VHP personnel

    4. Fatality Management (excess fatality)

    5. Hospital evacuation

    6. Alternate Care Sites

    7. Other assets (mobile assets, ventilators, negative pressure)

     1/11/08 4

8. Hospital Pharmaceutical Cache

    9. Personal Protective Equipment

    10. Decontamination

    Initiatives:

    Statewide healthcare system surge planning for the medical response to public health

    emergencies

    ? Assure daily reporting of bed availability using HAvBED definitions at hospitals, health

    centers and other designated sites is a component of Regional Resource Center county level

    Pandemic Influenza planning currently underway in Maine. The Healthcare system

    component of established leadership teams, lead by the Maine CDC RRC’s, have been

    working with hospitals in their regions to assure daily status reports will be made available to

    Maine CDC.

    ? Maine CDC will assure the development, management, and utilization of a health professional

    volunteer registry. The technical tool will be defined, implemented and tested to serve the

    statewide collaborative effort for registering, credentialing, managing, and utilizing a registry

    for volunteer public health and healthcare professionals. Systems will be developed and

    hosted off the Maine government network, but will meet all State Office of Information

    Technology (OIT) requirements determined by OIT .Maine’s ESAR VHP compliant system

    will provide much needed coordination between current volunteer agencies such as The

    Northern New England MMRS, Disaster and Medical Response Teams (MRC) and a Maine

    Nurse Volunteer Registry that was established by Maine CDC in 2004 in response to the flu

    vaccine shortage. Coordination among such teams will assure Maine a key pool of people

    who have expressed interest in serving their local communities as well as supporting public

    health emergency response regionally, statewide and beyond. The system will be available to

    the Regional Resource Centers and other hospitals, Maine Primary Care Association, Maine

    Emergency Management Agency, Maine Emergency Medical Services and others serving to

    identify and coordinate healthcare systems and public health planning and training. As

    alternate care sites are being developed to meet surge capacity requirements, a coordinated

    volunteer registry of health professionals will play a critical role in identifying healthcare

    workers to staff such facilities.

    ? Maine CDC is currently developing a program for collecting fatality surveillance data through

    the use of a web portal that will support entry of influenza deaths to the NEDSS base system.

    Other documentation and tracking of the final disposition of the dead will be addressed in the

    next round of planning, as will the issue of alternatives to funerals and other issues identified

    in the planning assumptions. Region 1 DMORT staff and Maine’s Office of the Chief

    Medical Examiner has worked directly with Maine CDC to define priorities from a policy

    perspective that will assure increased capacity for certification of death in the event of an

    extreme public health emergency such as an influenza pandemic. In the past legislative

    session a bill was introduced and put into law granting Physician Assistants the authority to

    declare deaths in such events. Maine CDC has defined as a 2007-2008 HPP level one priority

    the establishment of an operational Medical Mass Fatality Plan for Maine.

     1/11/08 5

    ? A primary roles for the RRC’s is to work collaboratively with public health to provide

    leadership and technical assistance to healthcare system, emergency management and

    community partners in their regions of the state as well as across regions. Key partners have

    been hospitals within each RRC region. Draft standardized hospital-based evacuation plans

    have been developed by the RRC’s; during the upcoming project period, RRC’s will facilitate

    evacuation planning by each hospital within their regions and participate in evacuation drills

    as well as their evaluation

Medical Alternate Care Sites

    Maine CDC Regional Resource Centers will continue to work with partners in each of their regions

    as well as across regions to define a system for standing up medical alternate care sites to facilitate

    the medical response to an extreme public health emergency.

    Maine CDC Regional Resource Centers will:

    ? Establish an alternate care site assessment form and staffing models with mixed usage (e.g.,

    behavioral health, pediatrics, med/surge etc.) to include engineering, telecommunications,

    clergy and others. This form will be utilized statewide.

    ? Continue to work with the American Red Cross to define their support to Alternate Care Sites

    (set-up, cots, mass feeding etc.)

    ? Hospitals within each RRC region will include ACS planning in their emergency

    preparedness efforts, this effort throughout the 2007-2008 project period.

    ? Operationalize the Statewide Hospital Mutual Aid Memorandum of Understanding (MOU)

    developed by the three RRC's and the Maine Hospital Association (MHA).

Interoperable Communications

    Maine CDC Regional Resource Centers will be key partners in the implementation of the new Maine

    Health Alert Network transitioning from the one-direction alerting system in current use ( and which

    will be continued as redundant support) to a more robust system capable of two-way communication

    and information sharing among partners with the following features:

    ? A document library for storing policies, press releases, etc.

    ? The capacity for shared on-line document development

    ? The capacity for two-way communication - the systems singularly most important feature

    ? The capacity for self-administered information sharing groups (veterinarians, dentists, first

    responders, etc.) that can communicate securely among the members. This feature supports

    more informal communication without engaging the entire group. All group members will be

    able to share all communication within the group. There are no practical limits of the size of

    groups, to the number of groups or to the number of groups in which a member can

    participate.

    ? The ability to link to other software systems enabling rapid surveys, specialized surveillance

    programs, and others.

    ? Multi-device alerting. The system can provide alerts, advisories and notices to any individual

    by landline telephone, cellular telephone, fax, email, and/or pager. Alerting can be

    accomplished in near-real time.

     1/11/08 6

    Brief Summary of Maine’s Use of Funds for Maine CDC Regional Resource Centers

    Project Period 7/1/06-8/31/07

The mission of this Federally-funded (U.S. Department of Health and Human Services) Hospital Preparedness

    Program is to ready hospitals and supporting healthcare systems to deliver care to patients of public health

    emergencies.

Regional Resource Centers for Public Health Emergency Preparedness were established at Maine’s three

    largest tertiary care centers (MMC, CMMC, EMMC), with the intent of leveraging the existing Emergency

    Medical Services Trauma System. Their primary focus has been on assessment and reporting of regional

    healthcare system infrastructure and capacity for public health emergency response, healthcare systems

    planning, improving regional capacity for communication infrastructure, and training of health professionals.

Approximately $4 million of the funding has been used by the Regional Resource Centers to address high

    priority healthcare systems needs for emergency preparedness - including such items as communications

    equipment, personal protective equipment for health workers, and capital improvements or purchases to assure

    medical isolation capacity for EMS and hospitals.

    Eastern Maine Regional Resource Center Project Period

    7/1/06-8/31/07 Eastern Maine Medical Center

     Amount

    $661,110.96

     Personnel

    Salary 4,359.54 Personnel Benefits (fringe) 1,441.94 Total 5,801.48

    Consultants - EMMC Project Support Specialists 335,804.43 Total 335,804.43

    Training / Exercise 86,072.74

    Equipment 53,028.55

    Operating Costs Telephone, pagers, radios, remote access, supplies, office furniture and rental, travel, $107,971.48 education

    Indirect Cost 72,432.28 GRAND TOTAL $ 661,110.96

     1/11/08 7

    Southern Maine Regional Resource Center Project Period

    7/1/06-8/31/07 Maine Medical Center

     Amount

    $ 478,701.11

     Personnel

    Salary 310,069.66 Personnel Benefits (fringe) 83,999.20 Total 394,068.86

     Consultants

    39,235.87 Operating Costs

    Telephone, pagers, radios, remote access, supplies, office furniture and rental, travel, education

    Indirect Cost 45,396.38 GRAND TOTALS $ 478,701.11

    Central Maine Regional Resource Center Project Period

    7/1/06-8/31/07 Central Maine Medical Center

     Amount

    $ 419,049.05

     Personnel

    Salary 171,031.29 Personnel Benefits 34,206.67 Total 205,237.96

    Consultants 191.40

    Operating Costs Supplies, telephone, postage, travel, references, educational 66,172.06

    Focused Project Expenses 18,032.00

    GRAND TOTAL 289,633.42 Unspent Funds (129,415.63)

     1/11/08 8

1/11/08 9

Report this document

For any questions or suggestions please email
cust-service@docsford.com