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Continuity of Operations Planning C.O.O.P.

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1 Continuity of Operations Planning C.O.O.P.

2 COOP Overview Prepared by the faculty and staff at the Institute for Disaster and Emergency Preparedness (2011)

3 Course Overview What is a COOP? The “Plan”
Case example The “Plan” Testing, Training, and Exercises Implementation, Recovery Strategy, and Reconstitution

4 “Let our advanced worrying become our advanced planning”
- Winston Churchill Prevention is key. An ounce of prevention is worth a pound of cure.

5 COOP Competencies 1. Mobilization: Pre-stage Planning and Team Development 2. Clinical Disaster Operations and Communications 3. Protection and Preservation of Human Life and Continuity of Health Care Facility During a Disaster 4. Demobilization 5. Demonstration of Clinical Disaster and Emergency Preparedness Awareness Prevention is key. An ounce of prevention is worth a pound of cure.

6 Target Capabilities for National Preparedness Guidelines
Through the efforts of the last 50 years FEMA has dealt with national disasters and continuous planning for public emergencies Hurricane Hugo CPG18 Sept. 11 (CPG 101) Presidential Directive Target Capabilities for National Preparedness Guidelines Hurricane Katrina and Rita (NIMS National Response Network) West Mid floods (SLG 101)

7 Continuity of Operations and Continuity of Government
COOP and COG terms conceived during the Cold War as a way to ensure that the U.S. government would be able to continue in case of nuclear war Continuity planning was a requirement for state and local governments under the Civil Defense program mandates Today, COOP planning remains an important planning requirement. COOP and COG planning will help ensure government services in the face of any hazard. The basic function of COOP is to ensure that operations continue as close to maximum capacity as possible. If operations are not able to be performed, COOP provides a protocol to return to a state of normality as soon as possible.

8 The value of planning rests in its influence events before they occur
proven ability to influence events before they occur Planning involves elements of preparedness, self-sufficiency and thinking ahead

9 THERE IS NO CUT AND PASTE APPROACH
Purpose To give practical training on the concepts and development of a Continuity of Operations (COOP) plan for a community health center or public health department. THERE IS NO CUT AND PASTE APPROACH

10 Why a COOP Plan? Good business Planning requires agency
personnel to review functions critical to the agency Planning process allows consideration of threats that could impact the agency and planning for them Allows determination of vital resources such as personnel and others to support agency essential functions Plans for safety of all personnel

11 Your individualized plan must reflect what your facility will do to protect itself from its UNIQUE hazards with the UNIQUE resources it has or can obtain

12 There is a difference…. “Putting out the fire”
Immediate response and damage control “After the fire is out” Emphasis on recovery and resumption of services EMERGENCY OPERATIONS CONTINGENCY PLANNING

13 COOP CONTINUITY OF OPERATIONS PLAN
Keep in mind: Emergency response from local, state and national government can be delayed up to 96 hours

14 Keep in mind: Emergency response from local, state and national government can be delayed up to 96 hours (4 days). Reliance on outside sources may not be an option! Example: 2003 NE US blackout. Emergency services were overwhelmed with phone calls and over 11,000 traffic lights were non-operational.

15 Part of a Complete Community Emergency Management Program
Utilize “all hazards” approach Addresses four phases of emergency management Mitigation Preparedness Response Recovery

16 Ensures continuity of a Department’s or Agency’s essential functions and services
Across wide range of events and emergencies COOP planning is a fundamental mission Ensures continued performance of essential functions

17 Helps maintain the CHC’s reliability Shows the capability to
A COOP can help public health care providers and clinics fulfill their responsibilities in the event of a crisis Helps maintain the CHC’s reliability Shows the capability to continue essential program functions and to preserve facilities, equipment and records across a range of POTENTIAL public emergencies. CHCs are in a position to become first responders to a disaster e.g. Joplin, MO hospital was obliterated and CHCs helped mitigate the majority of patient care. Municipal services (Police, Fire, EMS, etc) will look to you. CHCs can also form MOA/MOU with local municipalities and services to restore normality. CHCs can be the nexus of fostering community cooperation. “ A good business practice”

18 COOP is NOT: Agency Occupant Emergency Plan (OEP)
OEP addresses occupant safety not COOP, but may be activated at the same time COOP is different than Continuity of Government (COG) COG is at Federal level departments and agencies activities at specific designated offices COOP support continuity mission of all offices At local and state levels COOP and COG planning and operational activities are generally the same

19 Objectives of your CHC Plan
Ensure continuous performance of essential functions during “non normal” conditions Ensure the safety and reduce stress among employees Minimize harm (physical, financial, and psychological) to clients who depend on your services Protect essential facilities, equipment, records, and assets Minimize damages and losses Reduce disruption of operations Achieve a timely and orderly recovery from a public crisis

20 Plan Elements Vital Alternate Essential Records Orders Facilities
Functions Orders Of Succession Testing Training Delegations Of Authority Human Capital Management Recovery Communications Devolution

21 Consider all Departments
not just IT

22 “Not Business As Usual”
MUST: Be able to implement plan with out warning Operational within 12 hours; SOP may be “stood down” via delegation of authority Maintained for up to 30 days; may include alternate sites, systems, databases and vendors Have personnel tested on your COOP Update testing on a regular basis

23 Family Support Planning
Agency leaders must encourage all personnel to plan for family safety and security during COOP operations During a response employees need to focus on maintenance of functions not concerned with potential family safety issues Remember those with special needs, both employees and those with family members who may need assistance Activate an information call in number for employees

24 Go-Kits Personnel and their families should develop and maintain a Go-Kit to use during emergency Suggestions include: Personal items Water and food, needed medications, clothing … Financial and legal documents (water proof container) that cannot be easily replaced Name and phone numbers of contacts out of area Personal Preparedness Plan floridadisaster.org

25 Agency Role in Family Planning
Your Community Health Employee will remain more confident and encouraged knowing that the agency is concerned for family’s safety. COOP should include: Process for activation of emergency call-in number (operations, pay/benefits …) Employee accounting and tracking for both safety and resource issues Provisions for guidance and assistance for employees and family

26 Factors for Success Senior management buy in to the process
Consistent guidance policies and objectives Planning Team: Hands on from owners of essential functions Adequate resources: office, departments, etc. Training support with help desk and templates

27 Aside from preparedness COOP planning benefits agency’s:
Anticipation of events and necessary response Adapt to sudden changes in operational equipment Improve performance through I.D of essential Functions Work processes Communication methods Improve management controls by establishing performance measures Improve communication to support essential functions throughout the agency

28 Assumptions for CHC Planning
Crisis can negatively impact the Centers ability to continue support essential functions and provide support to the operations of clients and outside agencies. Each emergency is unique and will differ in priority and impact. Vulnerability = probability of an occurrence and the impact that it could have on the organization.

29 Pandemic Hazard Special considerations for pandemic hazards: requires lab equipment to collect and test specimens and also safely transport specimens to lab. Also, need vaccines, antibiotics and prophylactics to deter further spread of disease.

30 Essential Planning Telecommunications network
Social network to inform employees on current facts, advice for spread intervention, support. Continue as a resource for education and service CHC may want to consider telecommuting and off site work for non-essential personnel to deter spread of hazardous biological agents.

31 Diagnostic Lab Services
Recognizing and disseminating knowledge, surveillance data provide ongoing clinical services to the community

32 Staffing Management needs to identify, train and establish a chain of command of core personnel. Assignments must be clear. Cross training will add flexibility and coverage should you experience staff shortages.

33 Vendors and Supplies Purchasing and shipping, delivery and receipt of specimens, and waste disposal may require social distancing or quarantine.

34 Develop internal and external communications
Develop internal and external communications. Continuous contact lists should be maintained and a phone tree created for each unit. Post current pandemic information to everyone, including patients and outside agencies.

35 Regular updates will establish reliability, credibility and show compassion.
In general prepare for short and long term impact of staff, patients, and the community at large.

36 REVIEW Capable to implement without warning
Operational 12 hours after activation Operation sustained for 30 days Regular scheduled testing, training and exercise of staff and equipment Alternate facility location Maintenance and review of COOP capabilities Advantage of telecommuting, shared facilities and work-at-home

37 State Guidance HOMEWORK Continuity of Operation Implementation Guidance Division of Emergency Management Department of Community Affairs

38 References Producing Emergency Plans, A guide for All-hazard Emergency Operations Planning for State, Territorial, Local , Tribal Governments, INTERIM Version 1.0, July 11, 2008.FEMA State of California Governor’s Office of Emergency Services, Continuity of Operations (COOP) and Continuity of Governments (COG) Program Hartford County Health Department, Developing a Continuity of Operations (COOP) Plan, Public Health Emergency preparedness and Response COOP; Planning Course, John C. Pellosie, Jr., DO, MPH, FAOCOPM, Vice Chair Department of Preventive Medicine, NSU College of Osteopathic Medicine

39 BREAK

40 COOP Plan

41 Objectives Continuous performance of essential functions during “non-normal conditions” Ensure safety and reduce stress among employees Protect facilities, equipment, records Minimize losses and damage Reduce disruptions to the system

42 Objectives Plan for all departments; not just IT
Orderly recovery to resume service to clientele Minimize harm (physical, financial, psychological) to clients whom your services benefit Source: Federal Preparedness Circular 65 (FPC 65)

43 Your Plan Plan Development is a team effort to specify how the operational components of the plan will be implemented Team effort: Includes everyone from the bottom up - doctors, nurses, clerical, custodial staff and all the way to CEO

44 COOP Planning Capable of implementation with little or no warning
Operational within 12 hours Maintain sustained operations up to 30 days Provide regular risk analysis of current alternate operating facilities Plan for existing field infrastructures and other options Municipal services (Police, Fire, EMS, etc) will look to you to help mitigate patient surge. May use you as a base of operations to help local populations.

45 COOP Planning Cross training, telecommuting, working at home, shared facilities Consider distance of the alternate facilities from primary Include regular testing, training and exercise of personnel, equipment and systems Include maintenance, review and revision of COOP capabilities

46 Plan Components Project Initiation ID of Essential Functions
Design and Development Implementation Training, Testing and Exercises Execution Revision and Maintenance Part of design and development: Service area mapping – assessing local population and service needs Plan needs to go beyond table top exercises – actual drilling and testing of critical systems is necessary.

47 Staff Often the same people who will be implementing COOP plans are responding to the emergency that resulted in a COOP activation Create a management structure, which includes staff that will be divorced from the emergency response Purpose of separate management and emergency response structure is to reduce stress and ensure continuity of tasks and objectives. Emergency response should focus on mitigating the disaster and management should focus on logistics and ensuring operations run smoothly

48 Staff Notification and communication requirements for these employees must be addressed as part of the plan Required “Go kits” at the ready with necessary equipment and personal items Family preparedness issues must also be addressed Family preparedness is also a major priority – if families of CHC employees aren’t cared for, there will be no motivation to maintain CHC functionality.

49 Involvement A team effort to specify how the operational components of the plan will be implemented. Senior management COOP coordinator COOP planning team

50 COOP Planning Team Team effort representing all organizational levels
Agency Leaders COOP Program Manager (Emergency Coordinating Officer) Emergency Relocation Group (ERG) Non-ERG personnel All levels of planning team must assess assets, liabilities and suggestions of COOP. Assets: materials, funding, people Liabilities: MOA, MOU, legal ramifications Suggestions: Troubleshooting, after action reports

51 Agency Leaders Senior agency leaders set tone of COOP planning
Establish COOP planning as priority Formulate agency policy to support COOP planning Appoint COOP Program Manager Identify agency’s essential functions Provide budgetary and other support for planning process Ensure systems are tested, staff trained, exercises conducted and lessons learned fed back into plan

52 Agency Leaders Plan and ensure agency is capable of carrying out each function related to the COOP Complete oversight of: Planning Activation Reconstitution Senior Managers may delegate many responsibilities; however overall accountability remains with them

53 Develop Coordinate Manage
COOP Program Manager Serves as coordinator for COOP activities Responsible for developing, coordinating, managing all activities required for agency to perform essential functions during an emergency or situation disruptive to agency normal operations Responsible for a ensuring a viable agency COOP capability Program manager Develop Coordinate Manage Program Manager

54 COOP Program Manager Responsible for day to day planning
Recommends personnel for planning team Develops program goals, objectives, and milestones Develops and monitors budget Coordinates plan for development Familiar with each department and their functions Comfortable in a leadership capacity with a willingness to assist Knowledge of COOP

55 Emergency Response Group (ERG) Personnel
Share expertise as active members or advisers to the planning team Familiarize themselves with plan and their roles Participate in COOP tests, trainings, exercises and after action sessions Prepare personal “go-kits” for COOP activation Ensure their family safety and security in the event of activation Report to the alternate facility upon activation

56 Non-ERG Personnel Provide input on execution of essential functions
Assist in identifying and backing-up vital records Become familiar with agency OEP and COOP plans Provide contact information Ensure family prepared for emergencies Prepare to deploy to support ERG if required

57 Communication Develop and maintain a communication plan for all employees: Regular, accurate and effective communications to all employees Updating information as necessary Procedures for securing worksite Provisions for safeguard of vital records Priority issue: All employees should contact family members to ensure that they are safe

58 Alternate Facilities Communications Telephone Email Fax
Face to face meetings Web sites Cell phones

59 External Backup and Mutual Aid
MOUs with other health centers and stand by contracts with private agencies Third party data backup operations People, computers, data banks etc. Mechanism to cooperate in sharing resources Work with other organizations or jurisdictions to forge mutual aid agreements Use nearby as well as distant organizations not likely impacted by a regional disaster

60 Disruption scenarios Loss of database Facility unavailable
Loss of communication systems (including computers) Loss of vendor services Loss of staff

61 Program Phases Phase 1: Planning Phase II: Development Phase III:
Operation Phase IV: Execution Needs Awareness Assessment Plan Construction Ongoing plan awareness Plan activation Advance Planning Plan testing Training of key participants Risk & Vulnerability Assessment Plan Implementation Plan Maintenance Plan Design Each phase of program should be reexamined at regular intervals.

62 Special Considerations
Incident Command Required for effective command, control, communication, and coordination Used by emergency management organizations Used in COOP activations Introductory ICS courses: IS-100.b – (ICS 100) Introduction to Incident Command System IS-700.a – National Incident Management System (NIMS), An Introduction IS-546.a –Continuity of Operations Awareness Course IS-547.a – Introduction to Continuity of Operations

63 References FEMA. Producing Emergency Plans, A guide for All-hazard Emergency Operations Planning for State, Territorial, Local , Tribal Governments, INTERIM Version 1.0, July 11, 2008 State of California Governor’s Office of Emergency Services, Continuity of Operations (COOP) and Continuity of Governments (COG) Program Hartford County Health Department, Developing a Continuity of Operations (COOP) Plan, Public Health Emergency Preparedness and Response Volunteer Florida, COOP for Smaller CBOs Toolkit

64 (Please see “Exercises & Activities” tab in the back of your manual)
Activity (Please see “Exercises & Activities” tab in the back of your manual)

65 Testing, Training, and Exercises

66 Objectives Assess and validate COOP plans, policies, and procedures
Ensure agency personnel familiarity with COOP procedures Ensure COOP personnel sufficiently trained to carry out essential functions Test and validate equipment assuring internal and external interoperability Foster resilience for CHC employees and practices

67 Purpose of Testing Testing is critical for
Alert, notification and activation procedures Communication systems Vital records and databases Information technology systems Reconstitution procedures Other aspects dependent on agency DISATER RECOVERY PLAN Important part of COOP readiness Personnel can assure policies and procedures work when needed and as needed All plans need to be tested and drilled. Table top exercises are part of this, but not the sole drill to conduct.

68 COOP Testing Requirements
Quarterly Semiannual Annual Alert, notification, and activation procedures Recovery plans of vital records and critical information systems, services, and data Primary and backup utilities and services at alternate operating facilities Communications capabilities Ongoing

69 COOP Training Requirements
Training familiarizes agency personnel with essential functions performed during COOP situations; Annual requirement: COOP awareness briefing for entire workforce Team training for COOP personnel Team training for agency personnel assigned to activate, support, and sustain COOP operations * When considering training, develop and conduct training based on actual needs

70 Training Types Prior to COOP Plan exercise
Health personnel must be trained so they know their responsibilities Have the skills and knowledge necessary to carry out responsibilities

71 Orientations Here the first training is conducted to :
Introduce general concepts of COOP Announce staff assignments, roles, and responsibilities Present general procedures Describe COOP testing and exercise as well as timeframes Local planning groups e.g. fire, police, civic departments) may help in development and deployment of plan.

72 Hands-On After familiarization, hands-on training can:
Provide practical practice in specialized skills Provide practice of newly acquired skills Maintain proficiency (especially of infrequently used skill sets)

73 Goal of Exercises Discovery of planning weaknesses
Communication network practice Clarification of roles and responsibilities Individual performance improvement Improve operational readiness

74 We are exercising a system, not individuals Exercises should achieve a change or modification in attitude…

75 Exercises Provide assessment, validation, and identification of problem areas for later correction Improve coordination Reveal resource gaps This is the time for a deep and critical look at your CHC’s COOP. Putting the plan “through its paces” is an important concept that will reveal weaknesses.

76 Functional Exercises Simulate a function such as an alert or notification, inside a real incident. Test a single part of COOP activation independent of other responders.

77 Full Scale Exercise A solid, meaningful exercise requires time and careful planning (approx 18 months) Assure devoted time necessary for development and exercise of your COOP plan Test agency total response capability As close to reality as possible with personnel, equipment and systems deployed and exercised. Include setbacks and disruptions as well.

78 Tabletop A simulation activity with presentation of scenario to participants who respond and react Scenario presentation presented via Orally Written Audio/Visual means

79 When to Use Tabletop Exercise
Useful in: Low stress discussion of Plans Policies Procedures Assist in resolution of questions relative to coordination and responsibility *Particularly useful in assessing new or newly revised plans

80 Alerts to Poor Performance
Let data and measures stand for themselves Work as a team to identify weak areas, identify reasons and suggests methods of improvement Record performance accurately in after-action reports. Address weak areas in future training exercises.

81 Training After COOP plan development all personnel involved should be trained and equipped to perform their emergency duties Cross-Training team members should be strong consideration in case essential functions must continue with reduced staff

82 Training Activities each intended to provide information and refine skills Instruction in core competencies and skills means individuals achieve levels of proficiency Provides tools needed to accomplish goals, meet mandates, and acquire specified capability

83 COOP Training Plans Effective Plans will provide for:
Individual and teams with integration of skills to carry out essential functions Refresher training Courses and materials designed to improve knowledge and skills relative to COOP responsibilities

84 Testing is to evaluate capability not personnel
Functions such as: Communications connectivity Alert and notification procedures Deployment procedures

85 Exercises Health center plans should include periodic exercises to test and improve: Plans and procedures Systems Equipment Consideration must be given to new agency personnel, using an all hazards approach COOP should be just like fire and tornado drills: Tested periodically and taken seriously.

86 What to Exercise Full spectrum of COOP operations
Alert, notification, and activation Relocation to alternate facilities Operations Logistical support, services, and infrastructure to alternate facility Devolution Reconstitution Include interface between COOP plan and agency Occupant Emergency Plan (OEP)

87 Maintenance Issues Include: Designate a review team
Identification of issues impacting frequency of changes required of the COOP plan Establishing a review cycle, at least annually

88 Designation of a Review Team
Must have Knowledge of overall operations Expertise in advisory areas Expertise in essential functions Team should meet after each exercise and regularly throughout the year

89 Establish Review Cycle
Review Annually, COOP: Policies Procedures Additional Reviews Following each exercise and testing of major systems Issues arising from training If possible, involve community partners and those listed in MOU/MOAs during drills and reviews.

90 Issues Affecting the COOP Plan
Most arise from exercises, or; Presidential directives and State and local ordinances Direction from FACHC leadership Policy and/or mission changes Changes in technology Change in client needs

91 Develop a Multiyear Strategy and Program Management Plan (MYSPMP)
Ensure COOP plan reflects current conditions as they occur; Reviewed as part of training and exercise program Changes to agency structure, essential functions, or mission

92 Components of Plan - Review
Reference to general COOP planning requirements Description of essential elements Identify resources required for each element Discussion of specific management and policy issues Timelines for establishment of COOP capability and approval Endorsement by leadership Budget

93 Maintenance Budget Budget developed considers costs of:
Planning team time Plan/procedure development Alternate facility Interoperable communications Tests, training, and exercises Logistics and administration Security MOUs /MOAs

94 Distribution of Plan Remember this is a team activity.
Everyone gets a plan and knows the plan!

95 Fulfillment of FPC-65 requirements, all Executive agencies are to develop Multi-Year; Test, Training, and Exercise Plan addressing: COOP TT&E requirements Resources to support TT&E activities COOP TT&E planning calendar

96 Maintenance Tasks: Cross training key individuals and teams
Conducting regular/refresher COOP exercises to include a variety of hazards and types of training Institution of multi-year process ensuring regular update

97 Working Document Comprehensive debriefing and after-action reports should be completed with lessons learned incorporated into plan, training, and exercises.

98 Questions?

99 Implementation, Recovery Strategy and Reconstitution

100 Restoring Normalcy The community health center can serve an important role in the aftermath General support and specific services Psychological first aid and coping measures Restoration of normalcy begins as soon as the disaster is over and when recovery operations begin. A return of normalcy will help mitigate physical and psychological trauma.

101 COOP vs. OEP Hazardous Materials events may require facility evacuation with little notice and result in activation of Occupant Emergency Plan (OEP) but cause relatively short term disruptions Severe emergencies causing facility to be unusable for longer periods and adversely impacting operations may require COOP implementation

102 When to Execute COOP FOLLOWING THE PROCESS WILL NEGATE
Develop a decision making process Allowing for quick review of situation Providing best course of action for response and recovery FOLLOWING THE PROCESS WILL NEGATE IMPLEMENTATION TO SOON OR TOO LATE Like any protocol, follow the steps to ensure success. At the same time, we want to make sure that the COOP is flexible for ever changing conditions.

103 May be activated in part or in whole depending on the event
Based on Threat Level; procedures may permit partial deployment of essential functions to operations.

104 Keys to Successful Implementation
Publish the Plan Present to Entire Organization Educate on Employee Responsibilities

105 Capital Management: AKA People
Must be seen as REAL assets and resources. Don’t expect boxes to fit into round holes. Select jobs with the expert of essential function. TRAIN AND CROSS TRAIN with CLEAR expectations of what you expect in an emergency. Right tools for the job. Try to use each person effectively and don’t discount volunteers within your own organization.

106 Planning for Family Needs
Remember those with special needs, both employees and those with family members who may need assistance Activate an information call in number for employees Involve staff in the planning process at all levels. If you do not, they may not respond.

107 You cannot resume services unless your employees can get to work.
Alternative transportation Emergency housing Day care Short term financial aid Security/access to new location Payroll continuity

108 Implementation = Three Phases
Activation and relocation Alternate operating facility operations Reconstitution Activation and Relocation Reconstitution Alternate Operating Facility Operations

109 Initial 12 hours following activation of COOP
Phase I: Activation Initial 12 hours following activation of COOP Activate Plans, Procedures and Schedules; transferring essential functions, personnel, records and equipment to alternate operating facilities.

110 Agencies must be prepared to activate COOP for all emergencies regardless of warning period, time of day or within/outside duty hours (24/7) Activation requires notification of: Alternate facilities FEMA Operations Center (FOC) COOP essential and nonessential Personnel

111 Up Stream Losses Those you will experience when your suppliers are affected and cannot deliver. If his business is damaged he will not keep his pre-disaster schedule.

112 Down Stream Losses Lives of your clientele are affected by a disaster. No transportation, walk-ins no payment, refugees, limited resources for health care.

113 COOP Team Deployment Written procedures guiding the deployment process, reduces stress and ensures important concerns are not overlooked during transition.

114 Deployment Procedures
What should personnel do and what materials should be taken? Will you take computers, etc., or leave them? Administrative requirements associated with travel to and check-in at alternate facility

115 Relocation: Remember 3 to 5 deep!
Actual movement of essential functions, personnel, records, and equipment to the alternate operating facility. Remember 3 to 5 deep!

116 I II III IV V Level of Emergency Impact on Health Center
Up to 12 hours of disruption II hours Limited COOP activation III 1 or 2 essential functions up to 3 days ? Alternate site; >1 week IV 1 or 2 functions, days Possible order of succession Alternate site; < 1 week V Entire center disruption lasting 14 days Activation of succession Movement of operations to alternate site

117 Devolution = “We need to abandon ship”
Your health center’s capability of transferring authority and responsibility for essential function from primary staff and facility to other employees and facilities. Addresses catastrophic or other disasters rendering you incapable of performing essential functions from your building. Order to “abandon ship” may come not necessarily come from Incident commander, but may be initiated by government officials (mayor, governor, etc.)

118 Vital records, documents and databases must be available and up-to-date at the devolution site

119 Required planning as part of your COOP planning process
Who? What? Why? Where? When? How?

120 Patients How are their medical records kept? How are they accessed?
What are arrangements for continued care for those with chronic illness? How will the patients contact you? Can you handle walk-ins?

121 Supplies Ordering supplies and equipment not already in place at the alternate facility What emergency supplies are already available? How will they be transported? What assistance will you need to move furniture, equipment, medications, office supplies, etc?

122 Special Issues Communications and information management systems must be transferred to the new site. Delegations of authority must include senior personnel at the new site

123 Special Issues cont’d How will on call responsibilities be affected?
If electronic data is secured in a back up, is this off- site access available for your data retrieval? How will pharmaceuticals requiring refrigeration be stored? What alternatives do you have for x-ray and laboratory services? Will you need a courier service for results?

124 Written procedures in the “Go Kit” will guide your staff through transition and result in quicker COOP implementation Include: Minimum standards for communication, direction and control to be maintained until new site is operational Activation of plans, procedures and schedules to transfer activities Securing your primary health center and non-movable equipment and records

125 Administrators “Go Box”
Fireproof / waterproof container in an alternate location Documentation of insurance policies, agent numbers Vendors numbers (plumbers, electricians, contractors, mold remediation) What type of payment will they take in a emergency? Camera (disposable) for pictures of damage Copy of any licensure Voice mail box # remote password and update info to provide instructions to employees, clients, etc. Arrange for programmable call forwarding to a serviceable number Copy of back up files or servers Copy of COOP Plan Emergency payroll procedures Listing of inventory

126 Transition to Alternate Facility
Execution will be quicker if equipment and administrative supplies are located at facility prior to an emergency

127 Phase II: Alternate Operating Facility Operations
12 hours after activation up to 30 days Highest priority functions are activated first Lower priority essential functions are then brought online Operations at alternate facilities will vary widely dependant on the community health care center and their essential functions

128 Reception and In-Processing
How does the deployed personnel know where to go? Check-in Receive assignment to their work spaces and needed information about hotel, restaurant, laundry, medical facilities…

129 In-Processing Packets
Provide in each employee “Go Kit”: Hours of operation Anticipated duration of relocation, if known Safety and security measures Information line telephone number

130 Personnel Accountability
An accountability procedure is critical to ensure: All personnel are safe Members have arrived at your relocation site Replacement and augmentation personnel can be indentified quickly Assignments to key staff Additional providers if staffing is inadequate (MRC) Personnel at relocation must perform as proficiently as agency’s primary personnel

131 Phase III: Reconstruction
Process to resume normal operations from the original / replaced primary health center once the disruption is over. Basic planning for this takes place with COOP planning Specific planning begins as COOP implemented

132 Reconstruction Agencies must identify a plan to return to normal operation after leaders determine reconstitution operation can begin Suggest designation of Reconstitution Manager due to its complexity

133 Reconstitution Manager
TEAM TASKS STAFF RESTRUCTURING CRISIS MANAGEMENT SPACE & FACILITY REQUIREMENTS NEGOTIATES FOR STRUCTURALLY SAFE SPACE IF HEALTH CENTER IS DAMAGED PHASED PLAN FUNCTIONS LISTS PROJECT PRIORITY

134 First Step: In the first 24 hours of relocation, the team will need to initiate the process of evaluating your health center and attempt to salvage and restore the building Begin with a safety check by the local authorities.

135 Second Step: Regardless of the disruption that activated the COOP plan, the reconstitution pre-planning must be coordinated. You will need to outline your plan if it is necessary to re-locate and make a smooth transition

136 Reconstitution Tasks Primary tasks:
Determine extent of repair to make primary facility usable Schedule orderly TRANSFER of personnel, vital records, documents and databases Transfer of communication capabilities, supplies and equipment Notification of employees Assessment and reassessment are critical functions of any COOP plan. Assessment allows everyone involved in the COOP to have constant feedback of the situation. Constant feedback will allow adjustment of protocol to allow for a safe return to normality.

137 Reconstitution Resources General Services Administration
Identification of new space if primary site is destroyed or requires prolonged time to repair GSA or State or local government facilities coordinator can also assist in procurement of furnishing, equipment, and services required to return agency to normal ops

138 Reconstitution Resources Office of Personnel Management
Questions arise during reconstitution concerning personnel issues such as: Pay for non-deployed staff Overtime pay for ERG members Collective bargaining issues Something to consider during an emergency: If your employees and their families aren’t cared for and safe, the motivation to continue work during a disaster is greatly diminished.

139 Recovery operations may take longer than the emergency itself
Clinics may be the only source of primary care so they must remain operational to the community If you intend to survive the aftermath plan ahead for rapid recovery

140 Preparing for the“ Big What If ”of someday, helps us manage the everyday.
Build partnerships and network with other organizations Use of social media should not be neglected Very useful way to reach many people at once

141 Questions?


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