Emergency Preparedness: Essentials for Business Continuity Planning For Community Health Centers

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Emergency Preparedness Essentials for Business
Continuity Planning For Community Health Centers

• Presented by Bernadette Johnson and H. Duane
  Taylor

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Outline

• Learning Objectives
• Overview of Continuity of Operations Planning
  (COOP)/Business Continuity Plan
• Special Considerations for Health Centers
• Developing Your COOP -Elements of a Viable COOP
• Implementing Your COOP
• Test Your COOP
• Self-Assessment Tool
• Resources

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Learning Objectives

1. To introduce participants to business continuity
   planning and the process by which organizations
   ensure maintenance of critical operations when
   confronted with adverse events.
2. To provide strategies to organizations regarding
   risk management as it relates to business
   continuity planning in order to minimize recovery
   time.
3. To provide essential elements in the design of an
   effective business continuity plan for health
   centers

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Overview of COOP

• Continuity of Operations (COOP) is a Federal
  Initiative, required by Presidential Directive,
  to ensure the Executive Branch departments and
  agencies are able to continue to perform their
  essential functions under a broad range of
  possible hazardous circumstances.
• For Health Centers and other business entities,
  COOPs are called Business Continuity Planning and
  ensures that a business can maintain operations
  beyond an EP event.
• FEMA is the lead agency that is mandated to
  provide training and technical assistance to
  agencies in developing and testing their COOP

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Overview of COOP -2

• Federal Preparedness Circular (FP)-65 requires
  that all Federal Executive Branch agencies must
  have a COOP plan which includes some of the
  following elements
• Be operational no later than 12 hours after
  activation
• Be able to maintain sustained operations for up
  to 30 days
• Include regular testing, training and exercising
  of personnel, equipment, systems, processes, and
  procedures used to support the agency during an
  EP event
• Locate alternative site facilities in areas where
  the ability to initiate, maintain and terminate
  COOP is optimal

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Benefits of COOP

• Business Continuity Planning is a good business
  practice for health centers.
• It is part of the fundamental mission of health
  centers to be a central, responsible and reliable
  public institution that provide essential health
  services to communities. Moreover, HRSA has
  strongly encouraged that business plans for
  health centers include EP plans. It is critical
  that the EP plan include Business Continuity
  Planning.
• In todays changing environment, where EP
  disasters are not uncommon, the need for health
  centers to have a viable plan to determine how
  they will maintain and sustain their business is
  critical.

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Special Considerations for Health Centers

• As health centers, there are various precautions
  we must explore in Business Continuity Planning,
  including
• Pharmacy/Medications
• Security of patients/staff
• Medical Supplies
• Interoperable Communications with Hospitals,
  Health Departments, PCAs, and the State
• Family Support Planning for our staff
• EP Insurance

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Developing Your COOP

• There are Nine (9) Essential elements for
  creating a viable COOP/Business Continuity Plan,
  which include
• Essential Functions
• Delegations of Authority
• Alternative Facilities
• Interoperable Communications
• Vital Records and Databases
• Human Capital Management
• Test, Training and Exercises
• Devolution
• Reconstitution

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1. Essential Functions

• A central component of developing your COOP is to
  determine and prioritize the essential functions
  at your agency. Essential functions are the
  agencys business functions that must continue
  with no or minimal disruption.
• Essential functions are based on the agencys
  customers and needs. It is important to remember
  that a broad brush approach should not be used
  when determining essential functions at your
  health center.
• The continuity of essential functions will be
  driven by the availability of Training
  personnel, Vital records/databases, Supplies and
  Equipment/Systems

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Suggestions when determining essential functions

• For health centers some suggestions in
  prioritizing essential functions are to examine
  the functions that enable an organization to
• Provide vital services
• Maintain the safety of the general public and
  staff within your health center
• Sustain your agency financially during a crisis
  and beyond.

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2. Delegation of Authority

• Delegation of Authority is used for a specific
  purposes during an EP event for Business
  Continuity Planning. Delegations should be
  pre-determined and documented in writing. The
  document should specify any limitations on the
  delegated authority and should be as specific as
  possible.
• Delegation of Authority specifies who is
  authorized to make decision are act on behalf of
• The Department or Agency Head
• Other Key Individuals

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2. Delegation of Authority-Order of Succession

• Orders of succession are provisions for the
  assumption of senior agency leadership positions
  during an emergency when the incumbents are
  unable or unavailable to execute their duties.
  Succession is the order of who is in charge where
  in delegation of authority is the responsible
  from one person to another.

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3. Alternative Facilities

• During an EP event, if necessary, an alternative
  facility may need to be established. The
  alternative facility should be pre-determined.
  All health centers should examine if they had to
  have bare bones operations and could not utilize
  their primary site location could they create an
  alternative site location in the community.
  Moreover, how long would it take to be
  operational at that alternative site location.
  Any staff that requires relocation to the
  alternative facility are part of the Emergency
  Relocation Group (ERG).
• Alternate facility sites may include
• Other health centers
• Community Locations (e.g. library)
• Telecommuting for your staff

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4. Interoperable Communications

• Interoperable Communications are communications
  that provide the capacity to perform essential
  functions, in conjunction with other agencies,
  until normal operations can be resumed.
• In order to have effective interoperable
  communications an agency must be able to
  communicate
• Externally with the organizations customers and
  business partners
• Internally with the organizations leadership and
  co-workers
• The KEY to interoperable communications is
  Connectivity

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4. Interoperable Communications-2

• Interoperable communications must also be
• Redundant
• Available within 12 hours of activation, or less,
  depending on the mission and requirements of the
  organization.
• Sustainable for up to 30 days

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5. Vital Records and Databases

• In Business Continuity Planning or COOP, there
  are 2 main types of records
• Emergency Operating Records-which includes plans,
  directives, delegations of authority, or staffing
  assignments and orders of succession in order to
  implement your Business Continuity Plan.
• Legal and Financial Records-which includes,
  medical records, personnel records, payroll
  records, insurance records and contractor records
  (e.g. agreements).
• Copies of medical records as well as offsite
  computer file storage is strongly recommending.

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6. Human Capital Management

• During COOP activation, health centers will have
  to perform their essential functions with reduced
  staffing. Human capital, then, is critical to
  ensuring the flexibilities required of ERG
  personnel. Agencies should ensure that all ERG
  personnel are adequately trained and
  cross-trained to enable the performance of all
  essential functions.
• All employees, ERG and non ERG need to be kept
  informed during the course of an emergency
• Family Emergency Planning is important for any
  emergency but is strongly to be encouraged for a
  COOP event

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Family Emergency Planning

• A COOP situation will affect you and your teams
  families
• There will be a period of uncertainty about what
  is happening, how bad the situation is, and what
  you should do to protect yourself and your loved
  ones.
• You may feel unsure of your job security,
  particularly if the threat is severe
• You may also be concerned for your financial well
  being.
• It is imperative that your agency develop a
  family emergency plan. At a minimum the plan
  should include
• Contact and communication information
• An immediate emergency checklist that includes
  medical, financial and legal information and
  other important documents.
• Supplies, including medication, for at least 72
  hours

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7. Test, Training and Exercises

• Test, Training and Exercises (TTE) include
  measures to ensure that agencies COOP program is
  able to support the continued execution of its
  essential functions throughout an EP event.
• Health Centers perform TTE to ensure that
• All equipment and systems work as required
• Employees are able to deploy to the alternative
  facility within the required time frame.
• The alternate facility includes everything that
  is needed for the ERG to perform essential
  functions.

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8. Devolution

• Devolution is the capability to transfer and
  delegate authority to other members of the team
  in order to carry out essential functions when
  primary team members are incapable of performing
  necessary functions. Remember that this is
  generally for a specified time period and limited
  authority that has been delegated.
• Think of it is brining in the reserve players!

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9. Reconstitution/Recovery

• Reconstitution is the process by which agency
  personnel resume normal operations from the
  original or replacement primary operating
  facility.
• Agencies must identify and outline a plan to
  return to normal operations. This plan should
  have time lines, resources needed (including )
  and be as specific as possible.
• It is encouraged that health centers appoint a
  Reconstitution Manager to oversee the
  reconstitution process.

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Other Considerations for Developing Your Plan

• Utilize Your Hazard Vulnerability Assessment in
  your planning.
• Perform a Business Impact Analysis-which
  identifies the process of confirming what the
  critical functions are and prioritization of
  business services.
• Examine Key Leadership-Roles and Responsibilities
  and create an outline and staffing chart.
• Create an Activation Plan-describes the specific
  events or conditions that will trigger or invoke
  the plan.
• Communications Planning- include
  internal/external communications as well as
  personnel notification and media.

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Recap of Developing an Business Continuity Plan

• Utilize the 9 Essential Elements for COOP
• Use Elements of Your EP plan to drive the
  continuity plan
• Remember Risk Management as a critical component
• Time Specific
• Test and Train on the COOP

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Continuity of Operations Self Assessment Tool

• This tool is designed to assist in the
  development of your COOP Plan and to assess the
  plan for all considerations.
• The Self Assessment is promulgated on FPC 65
  guidance so we need to make it apply to health
  centers.
• Utilize it as a broad based template for planning
  and exercise purposes.

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Resources

• Your PCA
• NACHC
• FEMA-great online course-http//www.training.fema.
  gov/EMIWeb/IS/is546.asp

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Quiz-Question 1

• For Agencies at the beginning stage of COOP
  planning, determining ________ must be completed
  before moving onto any other area of COOP
  planning.
• A. Essential Functions
• B. Orders of Succession
• C. Delegation of Authority
• D. Communication Needs

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Quiz-Question 2

• 2. Essential functions include all functions that
  have been explicitly assigned by law or by order
  of the President in a COOP plan. (True or False)
• A. True
• B. False

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Quiz-Question 3

• 3. Interoperable communications include access to
  data, systems, and services. (True or False)
• A. True
• B. False

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Quiz-Question 4

• 4. Business Continuity Planning only considers
  Terrorist threats. (True or False)
• A. True
• B. False

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Quiz-Question 5

• 5. The term ERG stands for
• A. Emergency Redesign Graphics
• B. Emergency Redundancy Group
• C. Emergency Regrouping Guidelines
• D. Emergency Recovery Group

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Quiz-Question 6

• 6. Family Emergency Planning is not a
  consideration in COOP. (True or False)
• A. True
• B. False

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Thank You!