1. Emergency Preparedness for Dialysis Kelly Brooks, MPA Mid-Atlantic Renal Coalition May 1, 2013 2013 Virginia Healthcare Emergency Management State Forum & Public Health Preparedness Summit

2. Mid-Atlantic Renal Coalition (MARC)  One of 18 Medicare-funded organizations in the U.S. responsible for improving the quality of care delivered to patients with End-Stage Renal Disease (ESRD).  Nonprofit corporation serving the District of Columbia, Maryland, Virginia, and West Virginia. 2013 Virginia Healthcare Emergency Management State Forum & Public Health Preparedness Summit

3. ESRD Network Program  ESRD Program established 1972  Extended Medicare coverage to virtually all individuals with ESRD who require kidney dialysis or transplantation to sustain life.  Subsequent legislation established health and safety standards applicable to ESRD service providers.  1978: ESRD Networks established to oversee quality of care provided to patients with ESRD and serve as liaison between federal government and ESRD service providers.  MARC is ESRD Network 5 2013 Virginia Healthcare Emergency Management State Forum & Public Health Preparedness Summit

4. Mid-Atlantic Renal Coalition (MARC) United States ~300,000 patients receiving treatment at ~5,000 freestanding facilities Network 5 ~23,000 patients receiving treatment at 319 facilities  DC: 1,850 patients/21 facilities  West Virginia: 1,950 patients/35 facilities  Maryland: 8,900 patients/122 facilities  Virginia: 10,350 patients/141 facilities 2013 Virginia Healthcare Emergency Management State Forum & Public Health Preparedness Summit Source: MARC 2011 Annual Report

5. Mid-Atlantic Renal Coalition (MARC)  MARC has staff of 11—quality improvement, data, patient services, support staff  Director of Operations  Serve as resource for facilities and patients in emergency preparedness, response, and recovery activities  Track patient/provider status and assist in locating displaced patients and alternative treatment if necessary  Coordinate with providers, partner agencies, and CMS to provide assistance as needed 2013 Virginia Healthcare Emergency Management State Forum & Public Health Preparedness Summit

6. Mid-Atlantic Renal Coalition (MARC) 2013 Virginia Healthcare Emergency Management State Forum & Public Health Preparedness Summit MARC CMS and Partner Agencies Dialysis Providers and Patients

7. Partners MARC must partner with organizations that understand the unique needs of dialysis facilities and patients…  CMS  Kidney Community Emergency Response (KCER) Coalition  Local, state, and federal emergency management and health agencies (e.g., state OEM/health depts, HHS ASPR, FEMA, CDC)  Large, small, and independent dialysis providers  Renal and patient organizations (e.g., ANNA, NKF)  Power, water, and transportation vendors 2013 Virginia Healthcare Emergency Management State Forum & Public Health Preparedness Summit

8. Partners  Dialysis Facilities MARC facilitates access to partner resources (e.g., ASPR, ACE generator registry, etc.)  Government Agencies MARC serves to educate response agencies about the needs of this small but vulnerable population while helping to coordinate response efforts across a 4-state region  CMS, KCER Coalition, and other ESRD Networks MARC provides critical data on facility and patient status in the aftermath of emergencies and collaborates with key stakeholders to assure access to dialysis 2013 Virginia Healthcare Emergency Management State Forum & Public Health Preparedness Summit

9. Mid-Atlantic Renal Coalition www.esrdnet5.org Kidney Community Emergency Response (KCER) Coalition www.kcercoalition.com www.esrdnet5.org www.kcercoalition.com 2013 Virginia Healthcare Emergency Management State Forum & Public Health Preparedness Summit

10. Questions?