1. Setting the Stage Coalitions and ESF 8: What?

2. Evolution of Hospital Preparedness  HRSA National Bioterrorism Hospital Preparedness Program  Regional response planning to strategic planning to now coordination/support planning  Facility planning, lab, EMS, poison control, decon…  Hospital Planning Matrix  2006-2007: Target Capabilities List and Capabilities-based planning  Critical Benchmarks to Metrics to Performance Measures  ESF 8 and “coalition”  Utilization of “coalition” mutual aid and ESF 8 partners jointly  Why counties are doing ESF 8 planning now?

3. Medical Surge Capacity and Capability Handbook  Released in September 2007  Discussion of integration of medical and health resources for large-scale emergencies  Serve as a basis for the Healthcare Preparedness Capabilities, refining TCLs  Guidance for healthcare organization, healthcare systems and healthcare coalitions preparedness efforts  Whole of community planning in accordance with PPD-8: National Preparedness  Look at continued development of the system within the context of emergency management programs

5. Organizational Management  Organizations need to optimally manage their own resources and to integrate with larger response community through its own Emergency Management Program  ED, Lab, decon, Medical/Surgical, Admin, etc  Emergency Operations Plan defines methodology and structure for this management  This serves as the basis for patient continuum of care and incident management actions

6. Healthcare “coalitions”  Emphasis on coordination and cooperative planning  Organizations maintain autonomy during incident response  Medical Mutual Aid, use of System partners, contracted suppliers  Leveraging of limited assets  Mobile Medical Facilities  CHEMPACK  CESSL  Distribution of supplies under the group’s responsibility to organizations in times of crisis

7. Jurisdictional Incident Management  Basis is the jurisdiction’s Emergency Management Plan  Brings together many agencies with defined roles in emergency or disaster response  Group activities include mitigation of, preparedness for, response to and recovery from incidents  Health and medical assets should be viewed as key components and should have direct input into preparedness and response planning  This is where ESF 8 comes in  Jurisdictional information processing is critical in timely application of community resources to organizations

8. State Response & Coordination  State Emergency Management Programs should incorporate health and medical with traditional disciplines  State ESF 8  Comprehensive Resource Management and Credentialing System (CRMCS) Health & Medical Guidelines  State-level incident management strengthens and supports jurisdictional/multi-jurisdictional response by coordinating resources and support  In incidents where state health and medical is primary attempts should be made to utilize Unified Management (Command) rather than ESF structure  Biological Incident Annex

9. Interstate Regional Coordination  Interstate information sharing  Situation assessments and resource updates  Overall management strategies  Use of HHS Regional Emergency Coordinators  Interstate management coordination  Interstate mutual aid  Emergency Management Assistance Compact (EMAC)  Emergency System for the Advance Registration of Volunteer Health Professionals (K-SERV)

10. Federal Response  Federal health and medical assistance under ESF 8 of the National Response Plan  NDMS, SNS, FMS, MRC, DOD and VA assets  Can temporarily waive or modify requirements such as Medicare, Medicaid, State Children’s Health Insurance Program during national emergency  National emergency is a public health emergency  Healthcare providers operate in good faith are given sufficient flexibilities to continue providing services to beneficiaries and receive reimbursement for services

11. Kansas Emergency Management System  The Kansas Emergency Management System is structured in a manner to promote the coordination of preparedness, mitigation, response and recovery activities utilizing Capabilities-based Planning  The utilization of Emergency Support Functions (ESF) to delegate emergency management responsibilities promotes effective and efficient activities and also fosters these community/coalition partnerships identified by CDC/HHS  “Each county within this state shall establish and maintain a disaster agency responsible for emergency management and coordination of response to disasters”

12. Coordination Strategery MSCC Strategy  Federal Response  Interstate Regional Coordination  State Response and Coordination  Jurisdictional Incident Management  Healthcare “coalitions”  Organizational Management KRP/ESF Strategy  Federal Response  Emergency Management Assistance Compact  State Response and Coordination  County Incident Management & ESF 8  Mutual Aid/Suppliers  Organizational Management

13. Review  Continued evolution of the programs/continued integration with emergency management  Regional operations to strategy to planning coordination  Continued/refined organizational and local efforts using Capabilities Continue to build the ability of our communities to mitigate against, prepare for, respond to and recovery from emergency incidents and promote the best quality of care for our citizens.