Quality Health Care You Can Trust Recovering After an Emergency Chandra Smiley Executive Director Escambia Community Clinics, Inc.

Escambia Community Clinics, Inc Escambia Community Clinics, Inc. (ECC) is located in the Northwest Florida Panhandle

Our Mission Provision of comprehensive primary and preventive health care services to medically needy, under insured and uninsured residents of Escambia County and surrounding area.

Our Core Values Each patient is treated with: Respect Dignity Compassion Loyalty To empower the patient to become a better health care consumer

ECC History 1992 – Present Opened in November 1992 as a result of the closure of the county owned University Hospital Designated an FQHC by HRSA on September 1, 2007. Progressive and orderly growth of patients and encounters each year since 2007. To date have provided over 78,000 outpatient encounters. Have positive collaborative relationships with area hospitals and county government. Grown to nine sites in a two county area. Have over 140 dedicated staff members. Have endured six major floods since 1998 with the April 2014 flood being catastrophic.

Plans are nothing; planning is everything. ~ Dwight D. Eisenhower Failing to plan is planning to fail. ~ Alan Lakein

Continuity of Operations Plan – COOP Getting Your Plan…. Continuity of Operations Plan – COOP Major Plan objectives Ability to implement without warning Ability to be operational within 12 hours Ability to maintain operations for 30 days

Team and Process Identify your Leadership Team * Who will Respond * Identify Tasks and Who will be Responsible Identify your Personnel * Development of a structure which includes staff that will not be a part of the emergency response Identify your Communication Process * How will information be disseminated * Ensure that message is consistent * Phone trees and accuracy of information Identify your Location * Where will your operations be? * What readiness preparation can be done ahead of time? * Identify and maintain a Line of Credit Identify your process for securement of data * How will data be secured? * How will systems be transferred to an alternate location?

April 29, 2014 – Flooding Devastates Northwest Florida and 3 ECC Sites (Main, Waterfront, Dental) Presidential Disaster Declaration FEMA-4177-DR Mr. Turner

April 29, 2014 Over the course of 24 hours 26 inches of rain fell in the Pensacola area. Entire neighborhoods were destroyed… For ECC Three Sites Devastated Main Service Delivery Site – Representing over 35,000 visits/year Homeless Clinic – Opened in February 2014 daily census 18/day Dental Clinic – Opened in November 2013 represented 450 visits/month

The Team and Process In Action Leadership Team Tasks and Responsibilities CEO – Communication with Board of Directors and HRSA Project Officer COO – Oversight of inventory for insurance CFO – Communication with insurance/securing policies CMO – Oversight of re-establishment of clinical operations CIO – Oversight of IT set-up and securement of data Facilities Manager – Oversight of debris removal Personnel Re-location of staff to other satellite locations Identification of essential and non-essential Developed Alternate time keeping procedures Communications Development of Message Staff contacted via phone tree Patients contacted Developed method for assisting patients that were unable to be contacted Press Releases – Contact made to collaborative partners

The Team and Process – Cont. Identification of Alternate Location 14 West Jordan – currently had leased space Identified suites and items needed Identify your process for securement of data IT set-up – data secured Staff assessed information at site and appropriately destroyed (through shredding company when necessary)

Post Flood Activities: Relocated all operations to 14 West Jordan Street. Initiated FEMA and SBA Request for Support. ECC Board determined that we will not return to 2200 N. Palafox site. Engaged Consultants to assist with long-term mitigation process. Submitted Emergency CIS effective May 5, 2014 for address change of main site to 14 West Jordan Street and Dental Vans. Submitted formal CIS for permanent address change to 14 W. Jordan St. on August 5th and Dental Vans Captured 80% of projected visits Mr. Turner

FEMA - Process Event Presidential declaration – will list counties eligible Submission of request (RPA) state has their own systems PW submitted and approved Grant period identified - typically 18 months to completion Note – if not a “critical non-profit” will have to apply to SBA prior to FEMA

FEMA Categories of Work Category A – Debris Removal Category B – Emergency Protective Measures Category C – Roads and Bridges Category D – Water Control Facilities Category E – Buildings and Equipment Category F – Utilities Category G – Parks and Recreation

Other FEMA Funds Improved Projects Alternate Projects Mitigation Projects Sandy Recovery Improvement Act of 2013 – Alternate procedures for permanent work

www.nachc.org – “Emergencies Happen” www.fachc.org – Emergency Management Tab www.fema.gov – Prepare, Plan and Mitigate Tab www.hrsa.gov – Search Emergency Preparedness

References “Continuity of Operations (COOP): Training for FQHC’s and other Community-Based Health Care Providers”. Developed by: Florida Association of Community Health Centers Institute for Disaster and Emergency Preparedness College of Osteopathic Medicine/Nova Southeastern University “Emergencies Happen: An In-Depth Guide to Emergency Management for Health Center” National Association of Community Health Centers “Get a Plan!” The Florida Division of Emergency Management

Chandra Smiley, Executive Director THE END THANK YOU! Chandra Smiley, Executive Director csmiley@ecc-clinic.org