Innovations in Primary Care Emergency Management: Planning, GIS Mapping, and Public Health Response Emergency Management Higher Education Conference June 4, 2009 - PowerPoint PPT Presentation

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Innovations in Primary Care Emergency Management: Planning, GIS Mapping, and Public Health Response Emergency Management Higher Education Conference June 4, 2009

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Identification of Clinic Alternate Care Sites ACS Survey Tool ACS Outreach ... CPCA will host a General Staff WebEx training- June 2009 CPCA will offer the ... – PowerPoint PPT presentation

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Title: Innovations in Primary Care Emergency Management: Planning, GIS Mapping, and Public Health Response Emergency Management Higher Education Conference June 4, 2009


1
Innovations in Primary Care Emergency Management
Planning, GIS Mapping, and Public Health
ResponseEmergency Management Higher Education
ConferenceJune 4, 2009
  • Nora OBrien, MPA California Primary Care
    Association

2
Presentation Overview
  • Review of California Community Clinics and Health
    Centers (CCHC) and emergency response roles
  • Current H1N1 Influenza Outbreak and CPCA response
  • CPCA Clinic Emergency Preparedness Resources
  • Application of Emergency Management Education to
    current work
  • Questions

3
CPCA Community Clinic and Health Centers
  • 822 community clinics and health centers (CCHCs)
  • CPCAs more than 740 members include
  • Federally Qualified Health Centers (FQHCs and
    FQHC Look-a-likes)
  • Rural Health Clinics
  • Community Clinics
  • Free Clinics
  • Planned Parenthood Clinics
  • 17 Regional Clinic Consortia

4
Who CA CCHCs Serve
  • Patients
  • 4 million patients
  • 49 of whom are limited English proficient
  • Visits
  • 12.5 million patient visits provided
  • 1 mil uninsured and 1.4 mil Medi-Cal
  • 3.6 million patients under 200 of the FPL
  • All information compiled by Jeanita Harris, CPCA
    Data Analyst. Numbers are based on 2007 OSHPD
    data.

5
CA CCHC Characteristics
  • CCHCs serve the most vulnerable
    patients-regardless of their ability to pay,
    insurance, or immigration status.
  • Health care safety net for many communities,
    counties and regions.
  • Provide multitude of services to
    uninsured/underinsured where hospitals and other
    medical providers may not exist.

6
Potential CCHC Emergency Response Roles
  • Medical surge capacity for hospitals and public
    health departments
  • Triage
  • Disease surveillance
  • Mental health services
  • Alternate Care Sites
  • Medical response staging
  • Deploy mobile units and CCHC staff
  • Ethnic community outreach
  • Serve as Points of Distribution (POD) sites
  • Translation services
  • Shelter residents
  • Social Services access

CCHCs can respond effectively to emergencies when
given resources, training, and equipment
7
H1N1 Influenza Outbreak
  • Why public health officials are alarmed
  • Novel virus- no one has immunity to it
  • Likely to kill more healthy adults than young and
    old
  • Cases identified in outpatient settings like
    CCHCs
  • One of earliest 107 confirmed cases was a member
  • 1918 pandemic followed similar pattern of mild
    cases then deadly outbreaks during fall and
    winter
  • Today we have greater syndromic surveillance
    capability, anti-viral meds, and instant
    communication

8
CPCA H1N1Influenza Outbreak Response
  • Situational awareness of local clinic and
    regional consortia response needs
  • Coordinate medical response with local, state,
    and national partners
  • Promote credible medical guidance from state and
    federal sources via CPCA website and snapblast
  • Advocate CCHC interests on state and federal
    calls
  • CCG testified H1N1 Influenza legislative hearing
  • Respond to media requests- LA Times, SF Chronicle

9
CCHC Emergency Response Efforts
  • Hurricane Katrina (2005)
  • Deployed mobile medical assets
  • Triaged to hospitals
  • Provided Rx primary care
  • Wildfires (2003, 07, 08)
  • Used Clinic practice management systems to ID
    patients at risk
  • Provided mental health services
  • Treated First responders and community
  • Provided translation services
  • Evacuation and shelter assistance
  • Deployed mobile medical assets

10
Challenges to CCHC Emergency Response
  • No consistent patient tracking system
  • Limited reimbursement for services rendered
  • Not all CCHCs integrated into local response
    plans
  • CCHCs at varying levels of preparedness
  • CCHC leadership buy-in for preparedness efforts

11
Clinic Emergency Preparedness EffortsMeeting the
Challenges
  • No consistent patient tracking system!
  • Few CCHCs have Electronic Health Record systems
  • Limited reimbursement for services rendered
  • CPCA Policy Team involved in tracking,
    monitoring, and influencing legislation that can
    positively impact reimbursement to clinics.
  • Not all CCHCs integrated into local response
    plans
  • CAHAN
  • CPCA EOP Template

12
Clinic Emergency Preparedness EffortsMeeting the
Challenges
  • CCHCs at varying levels of preparedness
  • Exercise participation
  • GIS mapping
  • CCHC leadership buy-in for preparedness efforts
  • Ongoing meetings/discussions with leadership by
    key CPCA team members

13
CPCA CCHC Emergency Management Tools and
Resources
  • A robust CCHC-specific Emergency Operations Plan
  • Clinic Emergency Preparedness Help Desk
  • Emergency Flipchart
  • Clinic Emergency Preparedness Task Force
  • ACS, POD and Mobile Medical Asset GIS Mapping
  • CPCA Emergency Preparedness Training Modules
  • Clinic ICS/NIMS Training
  • Pandemic Influenza Planning Toolkit
  • Redundant Communication Training Module

14
ACS, POD Mobile Medical Asset GIS
Tracking
  • Why GIS is Important to Emergency Preparedness
  • 9/11 Story
  • Integral to any comprehensive disaster management
    plan
  • Bottom line This stuff saves lives.
  • Identification of Clinic Alternate Care Sites
  • ACS Survey Tool
  • ACS Outreach
  • ACS Data Collection
  • GIS Mapping
  • Knowing what is in your community so that you can
    protect it
  • A spatial display and analysis tool that can
    answer key questions

15
CPCA Regional Outreach
  • Increased visits to CPCA Clinics/Increased
    interaction with CPCA field operations
  • Statewide Tabletops and expanded emergency
    preparedness exercises
  • Provision of expanded information, training and
    additional resources to CPCA members
  • Expanded CPCA Help Desk information and FAQs
  • Establishment of a CPCA Emergency Preparedness
    Quarterly Newsletter
  • Expanded opportunities for webinars, new training
    content, additional live seminars as needed

16
CCHC NIMS Expectations
  • Bureau of Primary Health Care (BPHC) Emergency
    Management Expectations expect FQHCs and
    Look-Alikes to move toward NIMS compliance and
    implement ICS in their EMPs- not required
  • ASPRs Hospital Preparedness Program (HPP)
    requires only hospital staff to meet the 14 NIMS
    elements
  • CCHCs likely required to implement some of the
    NIMS elements in future HPP guidance

17
Clinic Incident Command System NIMS Training
  • Modeled after the Hospital Incident Command
    System training and tailored to the CCHC setting
  • Developed with input from 40 CCHC medical and
    operational staff
  • Designed for three CCHC audiences
  • Command Module (4 hour)
  • ICS H 100, ICS H 200, and 700A CalEMA certified
  • Executive Module (1.5 hour)
  • General Staff Module (1 hour)

18
Clinic ICS/NIMS Training Next Steps
  • Final versions of the Command, Executive, and
    General staff module will be available on demand
    via CPCAs web-based Learning Management System-
    June 2009
  • CPCA will host a General Staff WebEx training-
    June 2009
  • CPCA will offer the Executive Module via
    videoconference- August 2009

19
Emergency Management Education
  • Masters of Public Affairs, Disaster and Emergency
    Management Program- Park University, KC, MO
  • Rationality, responsibility, and responsiveness
    in their organizations within a framework of the
    highest ethical values
  • Both Online and in-person classes
  • Experienced emergency management faculty- IAEM
    and IACP past presidents
  • Undergraduate and certificate DEM programs also
    available

20
Application of Emergency Management Education to
Current Work
  • Provided an academic framework to emergency
    management work largely focused on preparedness
    rather than response
  • Firmer knowledge of in-depth emergency management
    concepts such as mitigation, business continuity,
    disaster resiliency, and vulnerable population
    response
  • Modified work to reflect larger emergency
    management context, i.e., public safety, private
    sector, government, EMS

21
Emergency Management Academic Research Challenges
  • Paucity of emergency management research
    regarding vulnerable population preparedness and
    response
  • LEP populations, resource poor individuals,
    disabled, seniors, children, etc.
  • Service providers of vulnerable populations need
    EM tools and resources to plan but lack
    infrastructure to implement
  • Disconnect between response to public health
    emergencies and other disasters/emergencies
  • Public health departments are often not
    integrated into local emergency management
    agencies

22
Questions?
  • Nora OBrien, MPA
  • Associate Director of Program Planning
  • and Development
  • California Primary Care Association
  • 1215 K Street, Suite 700, Sacramento, CA 95814
  • 916 440-8170 (F) 916 440-8172
  • nobrien_at_cpca.org
  • www.cpca.org/resources/cepp
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