Policy Issues Facing the MAA

1
Policy Issues Facing the MAA

• Fran Santagata
• Special Assistant to the Governor
• Homeland Security All Hazards Coordinator

2
EMAC

• Lets not reinvent the wheel!
• Consider expanding the disaster definition
• Consider using EMAC Architecture for non-disaster
  MOU
• What about reimbursement for services?

3
EMAC shortfalls

• Does not cover volunteers
• Must hire volunteers temporarily under EMAC
• EMAC responding agencies use their own medical
  protocols SOPs (may not be same as host site)-
  but are under the operational control (ICS) of
  host state

4
Deployment Issues

• Retirees
• Can they safely operate in a disaster
  environment?
• Familiarity with current meds?
• Familiarity with current biomed equipment?
• Limitations
• Previous experience public health vs.ED vs. Peds
  vs. OR, etc.

5
Hosting out of State Evacuees

• What do you do when evacuees do not have
  insurance?
• How do you prescribe meds without knowing
  previous prescription?
• What meds do you need in your disaster cache?

6
When to transition Acute Phase gt Longterm
recovery?

• What about longterm care when patient has no
  insurance?
• What about special needs populations?
• Those that need assistive living/nursing home
  care?
• Providing wheelchairs other assistive devices?
• What biomed equipment do you provide
  (glucometers, insulin pumps, etc)
• Chronic mental health
• Schizophrenics on psychotropics
• Drug addicts

7
Surveillance Issues

• What should be anticipated?
• Who will it be shared with who will follow up
  on these patients when they return home?

8
Use of Temporary shelters

• Mothballed facilities
• Water quality
• Sewer
• Cleanliness
• ADA compliant?

9
Security

• Background checks?
• What actions do you take to separate bad
  actors?
• Credentialing of staff evacuees?
• Armed vs. unarmed?

10
Reimbursement Issues

• How will this be done?
• What do you tell healthcare facilities?

11
Mass Care/ Sheltering Defined

• What should be included in the definition?
• Who is responsible
• VOADs?
• State?
• Feds?

12
Confidentiality Issues

• What information can you share with whom?
• Other evacuees?
• Shelter managers/ICS?
• Pastoral care?

13
Death of an Evacuee

• Who do you notify?
• Who covers the burial costs?
• Where is the burial
• Host state?
• Home state?