1. The Role of DADS Regulatory During Disaster Events

2. OBJECTIVES Ability to recognize DADS role in disaster events Share challenges and lessons learned during disaster events

3. Regional Expectations DADS staff are on call during all disaster events Staff are expected to maintain communications with their regional offices to ensure the continuity of services

4. PRE-DISASTER

5. Pre-Disaster State Office / Regional Director will initiate disaster plan for the region.

6. Pre-Disaster These individuals will assure that regional staff is informed of the disaster and what actions need to be taken. Initiate Internal Disaster Procedures Implementing Staff Rotation Call List (both Support Staff and Survey Staff) – Volunteers will be deployed first Sharing Contact Information/List of Facilities Initiating phone/fax/e-mail Contact with Facilities Managers will assign facilities to their staff for the responsibility of maintaining contact Information to include primary and secondary phone numbers.

7. Regional Communications Prepare staff–explain expectations/timelines Provide needed supplies Persist with regional plan Facility communications and tracking Faxes/ Special communications Tracking information and documentation

8. Regional Communications Communications with Director of operations Staffing with your Local EOC/ DDC/ RMOC Provider concerns-resistance to evacuation and transportation Dividing responsibilities/ consistency Establish central point for information with backup as needed

9. LTSS Staff Providing Disaster Support (Pre-Disaster) LTSS Staff and Local Ombudsman Staff in the region will assist Regulatory Services as needed with disaster and shelter activities.

10. DISASTER EVENT

11. Shelter In Place (Disaster)  No mandatory disaster evacuation by local government  Local offices responsible for all nursing facility, adult day care center, assisted living facility, home health agency, in-patient hospice, and ICFMR facility contacts  Staff in effected areas are “on call” for the duration of event unless needing assistance themselves.  Some regional staff will provide support to DDC/ EOC/ RMOC  Surveys or non-priority complaints will not be conducted in the geographical area affected  The ONLY investigations completed will be PRIORITY ONE status

12. Evacuation (Disaster) 1.Selected volunteer staff from regional offices will be relocated outside the disaster area. 2. Regional Director and volunteer staff will assist with facility evacuation according to regional disaster plans. These plans will vary from region to region. The affected region is expected to assist with evacuation until all regulated facilities have begun relocation.

13. Evacuation (Disaster) Regional Director will initiate alerts to all facilities/agency providers regarding the need for evacuation. Alerts include: a.Nursing Facility evacuating and receiving b.Home Health/Hospice and In-Patient Hospice c.ICFMR evacuating and receiving facilities

14. Evacuation (Disaster) Regulatory Services will track essential information during and after the disaster event for both evacuating and receiving facilities. Evacuation status/destination Staffing issues Food/Water Medications Available beds

15. Evacuation (Disaster) Shelter leads and volunteers will track evacuees transitioning from a shelter to a nursing facility by DADS staff. Managers will instruct staff regarding frequency of communication with evacuating facilities and receiving facilities. (Managers will avoid duplication of calls and coordinate with RD and State Office). The only investigations to be completed in the region during disaster at facilities that have been evacuated, facilities accepting evacuees, and facilities heavily impacted by the storm are PRIORITY ONE status.

16. Shelter Activities (Disaster) Regional staff will assist with the coordination of support activities in shelters Staff from Community Care Access & Intake will assist with volunteers from their program areas The following forms will be used for assessment and tracking of vital information: a.Time Sheet b.Evacuee Assessment c.Shelter Procedures for Transfer to Nursing Facility d.Special Needs Assessment and Instructions e.Disaster Placements and Billing Information

17. Shelter Activities (Disaster) Nursing facilities that accept evacuees from shelters (non-Medicaid Long Term Care residents) directed from State and Federal Officials will be paid for services provided The following resident identifying information must be collected for timely admission to nursing facilities: a.Name b.Address c.Social Security Number, if available d.Date of Birth, Sex, Age, County of Residence e.Dates services were provided

18. Transportation Challenges (Shelters To Nursing Facilities) Type of transportation needed (if going by ambulance do they need a bariatric size gurney) Items needing to be transported (i.e. electric wheelchairs) Is anyone traveling with them and do they need a place to stay. Most nursing homes do not have access for family members to stay.

19. POST-DISASTER

20. Shelter In Place (Post-Disaster)  Continue facility/provider communications and tracking as needed  Continue ROC/ DDC/ RMOC activities as needed  Resume Regulatory functions per State Office and Regional Director instructions. Functions will be resumed based on the degree of impact to individual facilities

21. Evacuation (Post-Disaster) 1.Continue shelter activities as needed 2.Continue ROC / DDC/ RMOC activities as needed 3. Continue facility/provider communications and tracking as needed

22. RE-POPULATION Regional staff will be responsible for tracking evacuees who have been transferred from shelters to nursing facilities Information will be communicated to DSHS for purpose of determining where evacuees are located that require transportation back to their homes Regional staff will continue communication with the evacuating and receiving facilities until re-population complete

23. Transportation Challenges (Nursing Facilities To Home) Assess the resident to make sure he/she is physically able to make the trip home Call facility to make sure that they are expecting the resident to return Contact the family and let them know the resident is being sent back to the facility in which he/she came Make transportation arrangements, make sure you document the type of transportation needed, pick up point, any special items such as pets to be picked up, electric wheel chairs, lots of clothing, etc.

24. General Information 1. Remind Nursing/ICFMR facilities to register with FIVES 2. Requests by Provider to exceed 20% licensed capacity can be done by: a. Phone contact with Carol Ahmed b. E-mail to Carol Ahmed c. E-mail contact with Regional Director  Facility that is evacuating can continue to get paid daily rate.  Facility makes agreement with receiving facility for payment.  Provider can contact Claims Management with any questions.  Claims Management staff cannot guarantee payments for Providers who admit evacuees, but will try to answer questions.

25. General Information 3. Toll free number for FEMA – 1-800-621-FEMA (3362) or online at www.fema.govwww.fema.gov 4. Regional Management contact numbers will be shared with all staff 5. Emergency Prescription Assistance Program (EPAP) information found at 1-866-935-4135. (THIS NUMBER MAY CHANGE)

26. CONTACT NUMBERS  Dorothea Raiford, Regional Director, Region 4/5 Beaumont: 409-951-3236  Mark Kendall, Regional Director, Region 6 Houston: 713-767-2291  Janice Brister, Regional Director, Region 8 San Antonio: 210-438-6300  Jim Anderson, Regional Director, Region 11 San Benito: 956-361-4268  Carol Ahmed, Director of Survey Operations Austin: 512-438-5695