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“ Preparation for the Flu Pandemic, Mobilizing Human Resources”

Expect the Unexpected: Are We Clearly Prepared?. “ Preparation for the Flu Pandemic, Mobilizing Human Resources”. CAPT Lynn A. Slepski, RN, MSN, CCRN Senior Public Health Advisor US Department of Homeland Security. Council on Licensure, Enforcement and Regulation. 2006 Annual Conference.

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“ Preparation for the Flu Pandemic, Mobilizing Human Resources”

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  1. Expect the Unexpected: Are We Clearly Prepared? “Preparation for the Flu Pandemic, Mobilizing Human Resources” CAPT Lynn A. Slepski, RN, MSN, CCRN Senior Public Health Advisor US Department of Homeland Security Council on Licensure, Enforcement and Regulation 2006 Annual Conference Alexandria, Virginia

  2. Standard Continuity of Operations (COOP) Planning • SCALE related • 1 Geography • Less than 30 days • Essential functions only • Essential personnel only • Resumption plan • Emergency plan that translates to specific situations Presented at the 2006 CLEAR Annual Conference September 14-16 Alexandria, Virginia

  3. COOP Example—Y2K • Major businesses developed a plan • Upstream and downstream • Wrote Y2K plans into contracts • Actually verified/critiqued the plans • Result—No issue Presented at the 2006 CLEAR Annual Conference September 14-16 Alexandria, Virginia

  4. 1.5 million people 90,000 square miles Louisiana, Mississippi, and Alabama 770,000 persons displaced 89,000 persons evacuated to make-shift shelters Medical infrastructure sustained extraordinary damage Triggered the largest natural disaster relief and recovery operations in United States history Created an unprecedented demand for relief healthcare services Hurricane Katrina Presented at the 2006 CLEAR Annual Conference September 14-16 Alexandria, Virginia

  5. Original plan Ring the impact area and prepare to flow support in LA alone 10 – 12 shelters Major chains would “adopt” a shelter Based on census either support from off site OR establish a mobile pharmacy Reality >200 shelters Very poor information Lost time drafting legal language for emergency powers Katrina Example-Pharmacy Support Presented at the 2006 CLEAR Annual Conference September 14-16 Alexandria, Virginia

  6. Pharmacy Response • Exercised previous relationships • Businesses worked directly w/ the LA Board-practice modifications • Pharmacists could dispense w/o Rx • Any mobile pharmacies could operate without an inspection to operate • Accept any pharmacist license-Immediate reciprocity • Disposal of compromised drugs—hazardous wastes • Remote processing…Pharmacists could enter into a database and begin filling process • Developed a database took all available records Presented at the 2006 CLEAR Annual Conference September 14-16 Alexandria, Virginia

  7. Pandemic Planning Assumptions • 40 percent or more of workforce out (Sick, taking care of family or afraid to work) • School closures (day care – universities) • Supply and delivery chains disrupted • Travel delayed or halted; large public gatherings canceled • Healthcare system overwhelmed • Essential services interrupted • Some believe that all rules/regulations will be suspended Presented at the 2006 CLEAR Annual Conference September 14-16 Alexandria, Virginia

  8. Pandemic Challenges • Pandemics are different from other types of emergencies • There will be no clear beginning and end • Almost all locations will be affected simultaneously • There will be multiple waves • Resources cannot be shifted geographically as in other emergencies • Every country will be affected, but countries with better plans will be less vulnerable to terrorism and other threats during a pandemic Presented at the 2006 CLEAR Annual Conference September 14-16 Alexandria, Virginia

  9. DHS Federal Responsibilities • Above and beyond our own continuity planning…. • Federal incident management • Border control • **Maintaining critical infrastructure and key resources (CI/KR) (85% owned privately) • N=17. Examples are food, water, public health, emergency services, energy, transportation • Continuity of operations – essential (COP-E) • Catastrophic planning for essential services • Identify in advance where regulatory relief may be helpful Presented at the 2006 CLEAR Annual Conference September 14-16 Alexandria, Virginia

  10. Regulatory Waivers • Certain waivers should be considered to ensure that public and private sector responders can react and recover effectively • Pre-identify areas where rules/regulations can be modified or waived temporarily • Weigh risks vs. benefits as entities struggle to maintain response • Quality • Safety • Don’t want to further compromise vulnerable populations when possible • GOAL: Policies in anticipation • What is expected • How laws will be applied and enforced Presented at the 2006 CLEAR Annual Conference September 14-16 Alexandria, Virginia

  11. Public/Private Partnerships • US Chamber • Trade and Professional Organizations • Businesses • CI/KR Sectors • Advisory Councils • Governments and Governmental Agencies Presented at the 2006 CLEAR Annual Conference September 14-16 Alexandria, Virginia

  12. Transportation Issues GOAL: Maintain supply chains • Change authorities • Commercial Drivers License (CDL) drive interstate when providing emergency services • Decrease restrictions • Drive times, weight restrictions, etc. • Licenses, Credentials or Certifications • Federal pre-emption of state and locally decided closures to allow movement of critical supplies Presented at the 2006 CLEAR Annual Conference September 14-16 Alexandria, Virginia

  13. Liability Issues GOAL: Liability protection for businesses • Medical care, anti-virals and vaccines for side effects and consequences • Protective equipment Presented at the 2006 CLEAR Annual Conference September 14-16 Alexandria, Virginia

  14. Sharing of Information GOAL: Continuity of Care • Databases • Electronic medical records Presented at the 2006 CLEAR Annual Conference September 14-16 Alexandria, Virginia

  15. Personnel Issues GOAL: Protect workers/ maintain operations • Fair Labor Standards Act • Time recording, exempt/non-exempt duties, overtime, etc. • Confidentiality Requirements • HIPPA, ADA, FMLA • Discussions regarding employees or family members • Tracking of illness • Employer Responses • Benefit documentation (ERISA) response time • Requirements to pay employees w/i a certain period Presented at the 2006 CLEAR Annual Conference September 14-16 Alexandria, Virginia

  16. Scopes of Practice GOAL: Accomplishing the greatest good • Healthcare scopes of practice • EMT vs. ACLS • Prescription authorities • Drug dispensation • Identify “able” providers • Who can perform tasks—How to find Presented at the 2006 CLEAR Annual Conference September 14-16 Alexandria, Virginia

  17. Regulatory Requirements GOAL: Protecting the workforce • OSHA fit-testing for masks • Expedited SAFETY Act application review Presented at the 2006 CLEAR Annual Conference September 14-16 Alexandria, Virginia

  18. Your Role in Pandemic Planning • Does your group have a plan? Family? • Consider where there may be room for discussion • Don’t wait for an invitation to “come to the party” • Encourage cross-walking of plans • Help identify possible options—be part of a solution Presented at the 2006 CLEAR Annual Conference September 14-16 Alexandria, Virginia

  19. Conclusion • Regulatory bodies are key stakeholders • Role in both the development and implementation of emergency preparedness plans. • Regulatory relief will be necessary • maintain CI/KR • facilitate effective mobilization of resources at a local level • Challenge--Consider non-traditional ways of meeting the health and safety needs of the public in a time of crisis. Presented at the 2006 CLEAR Annual Conference September 14-16 Alexandria, Virginia

  20. Speaker Contact Information CAPT Lynn A. Slepski, RN, MSN, CCRN U.S. Department of Homeland Security/Prep Washington, DC 20528 Desk (202) 282-9697 FAX: (202) 282-8191 Lynn.Slepski@dhs.gov Presented at the 2006 CLEAR Annual Conference September 14-16 Alexandria, Virginia

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