Health and Human Services Preparedness Program FY 2012-2013 Grant - PowerPoint PPT Presentation

Health and Human Services Preparedness Program FY 2012-2013 Grant Round I Mandatory Workshop August 2012 Hospital Session 1

STEP TWO (2)

Step Two (2) Participation Agreements 2012-13 *Allocation Model Developed & Mailed HPP Grant Approved by Advisory Board Awarded Oct 2012 - Jan 2013 August-Sept 2012 July 1 Step 2 Regional Rounds Participation *Site Visits Signed meetings to Agreement for 2010-11 Participation discuss 2012-13 Developed Begin Agreements & grant requirements Budget Proposal September - Nov Nov 2012 are held Due 2012 August 2012 Nov - Feb 2012 *Site Visits for 2010-11 End March 2013 *HPP grant staff submits request to accounting *Facility submits required department ; documentation for Once funds received reimbursement as required by from DHH, LHA Accounting submits request Participation Agreement on one distributes grant dollars invoice to DHH of the three deadlines Sept 2013 Mar – June 2013 March, April or May 2013 Unspent Funds Reallocated *HPP grant staff review documentation Unobligated Funds (Reallocation 2) for acceptable purchases and required Reallocated *Green = Documentation in binder documentation. (Reallocation 1) June 2013 **Blue = Monitoring Activities Mar – June 2013 Apr- Mar 2013 3 Spending & Documentation Review Process

Step Two (2):  Identify gaps and develop plan of action on how grant goals will be met & how funds will be spent. (Budget Proposal)  Submit signed Participation Agreement, Budget Proposal and other requested documents.  Spend funds and submit the Acceptable Documentation of Proof of Payment as indicated in Participation Agreement.  Continue participation in HHS Emergency Preparedness activities  Radio Roll Call  Regional and State Drills  Regional Meetings  ESF 8 Portal Activities

Identifying Gaps Five (5) Year Hospital Goals FIVE YEAR PLAN – Goals Should Be Met By 2012 REGION SURGE CRITICAL VENTILATORS PPE MASS CARE FATALITY BEDS BEDS 1 1370 794 662 6 to 8 week supply 333 deaths 2 1181 684 570 6 to 8 week supply 270 deaths 3 939 544 453 6 to 8 week supply 215 deaths 4 727 421 351 6 to 8 week supply 174 deaths 5 545 316 263 6 to 8 week supply 130 deaths 6 722 418 349 6 to 8 week supply 172 deaths 7 1030 597 497 6 to 8 week supply 250 deaths 8 671 389 324 6 to 8 week supply 163 deaths 9 963 558 465 6 to 8 week supply 223 deaths Total 8,147 4,721 3,934 -- 1,928 deaths For planning purposes, the numbers presented in the table below were derived by averaging the mortality of the 1968 pandemic and the 1918 pandemic.

Identifying Gaps Current Grant Goals (Hospitals) Surge Capacity Identify number of surge bed using the following the formula:  Formula: Licensed Beds - Average Daily Census  Note: Must have physical bed when using this formula   If Surge Goal cannot be met with the above formula, hospitals should: Purchase cots, stretchers, air mattresses  Purchase supporting equipment such as IV poles, monitors, carts, etc.   Identify in response plan location of surge beds and where the cots and stretchers will be placed in facility. If you cannot meet surge goal, facilities should document steps taken to achieve goal and reasons why goal could not be met.

Identifying Gaps Current Grant Goals (Hospitals) Critical Care Capabilities  Based on the altered Critical Care Bed definition, each bed should include the following:  1 electrical outlet,  1 50 PSI oxygen outlet,  1 50 PSI air outlet,  1 suction outlet or portable suction outlet, and  1 portable pulse oximetry  Hint: Use existing surge beds as critical care surge beds. Replace surge beds with cots or stretchers. May also want to double up in patient care rooms with the outlets

Identifying Gaps Current Grant Goals (Hospitals) Ventilator Cache  Formula = Number of Ventilators in Possession – Number in Use  To meet goal, facilities should count all ventilators capable of providing full ventilatory support of a patient. (i.e. fixed, portable or disposable ventilators)  Other Spending Suggestions:  Additional circuits and filters.  Associated accessories including sufficient oxygen  Develop contingency plans to include redundancy options.

Identifying Gaps Current Grant Goals (Hospitals) Personal Protection Equipment (PPE)  Facilities should determine and document formula used to determine amounts in cache. (See handout for sample formula).  Cache should include, but is not limited to, gloves and masks.  As storage becomes a problem, hospitals need to document steps taken to achieve goal and reasons why goal could not be met. Facilities should consider other alternatives, such as outside storage areas.  The located of cache, the amount and what equipment is in cache should be documented and mentioned in plans .

Identifying Gaps Current Grant Goals (Hospitals) Mass Fatality  Facilities should have Mass Fatality Plan.  Tier 1 hospitals should:  Purchase body bags to meet goal listed in Attachment A.  Collaborate with local coroner for storage and pick up of remains.  Increase surge capacity (number of remains morgue can temporarily hold), by lowering temperature and placing remains on stretcher in morgue or in another area of facility, and/or  Contract with refrigerated truck companies.  Tier 2 hospitals should:  Document, in plans, protocol for expiration of patient.

Identifying Gaps Current Grant Goals (Hospitals) Pharmaceutical Cache Facilities must have a biological cache to take care of inpatients, staff  members and their family members for 72 hours.  Cache should include at least one of the following drugs:  Doxycycline  Ciprofloxacin  Levaquin  Gentamicin Formula = (3.5 x # of staff members) + inpatient beds) x 3 days   Tier 2 hospitals with no pharmacy should obtain letter from local pharmacy saying they will stockpile cache and deliver it upon notice. Facilities should have a Mass Prophylaxis Plan. 

Identifying Gaps Current Grant Goals (Hospitals) Communication  Hospitals should have a 700 MHz radio or HEAR, depending on your region.  Hospital plans should include language about their redundant communication systems, including the ESF 8 portal.

Identifying Gaps Current Grant Goals (Hospitals) Decontamination  Tier 1 hospitals should have:  5 member decontamination team  2 disposable suits per member  1 PAPR for use per team member  Tier 1 facilities should have plan on how decontamination team is activated and listing of members and contact information.

Identifying Gaps Grant Goals (Summary) Tier 1 hospitals  Surge Capacity  Ventilator Cache  Mass Fatality  Pharmaceutical Cache  Decontamination Team  PPE Cache  700 mhz radio Tier 2 hospitals  700 Mhz radio  Pharmaceutical Cache  PPE Cache

Step Two (2): Budget Proposal  Include both spending category & description.  Cash expenditures should be equal to or greater than “reimbursement limit”.  Non-cash in kind should only include expenditures in which you do not have actual receipts. If you have proof of payment, you may claim it under cash expenditures. Staff time can only be claimed under in kind contributions.  Budget should also include “assurance statement”.

STEP THREE (3)

Step Three (3): Site Visits Site visits increased from 5% to 20% of facilities. The following facilities  will receive visits sometime between Nov. 2011 – February 2012. 55 hospitals  11EMS providers  Every hospital and EMS provider will be visited over the next 5 years  regardless of whether they participated in the last grant cycle . Site visits are more comprehensive than in the past. In addition to grant  purchases, HHS grant staff will be reviewing and confirming: NIMS compliance  Survey responses  Compliance with Participation Agreement (Attachment A for hospitals)  Surge planning – i.e. beds, pharmaceuticals, PPE, etc  If a “red flag” is found in site visit, corrective action measures will be  taken. Corrective action measures includes: No longer eligible to receive grant funds until measures have been met  Return a portion grant funds received  Provide justification as to why measure cannot been met 

18 Performance Monitoring Activity Site Visits (Continued) Surge Equipment

19 Performance Monitoring Activity Pharmacy Caches Site Visits (Continued)

Site Visits (Continued) Performance Monitoring Activity Ventilator Caches Disposable ventilators Newport ventilators 20

Site Visits (Continued) Performance Monitoring Activity Gloves PPE Caches N95 masks, gloves, gowns, etc N95 masks 21

Site Visits (Continued) Performance Monitoring Activity Decontamination Equipment PAPR Decon boots Decon suits & boots Blow up manikins for training 22 Hospital Decon Trailer

Site Visits (Continued) Performance Monitoring Activity Communication Equipment Satellite Phone HEAR System 700 MHz radios 23 Repeater

Performance Monitoring Activity Site Visits (Continued) Mass Fatality Refrigerated truck at hospital in Region 3 Body Bags 24 Region 7 Hospital Mass Fatality Trailer Region 4 and 5 MERC System