UTMB

1. UTMB The Challenges of Recovering When the Patient is your Hospital Mike Mastrangelo: Program Director Institutional Preparedness

2. Emergency Program New Institutional Safety and Security Committee: Executive institutional oversight of emergency program (President and EVPs) • Annual Review • Executive Input • Approval of annual program • Preparedness, Prevention, Protection, Mitigation, Response, Recovery

3. Mitigation • General Approach: • New Construction – critical Infrastructure: 25 feet above Base Flood Elevation • Hot water rather than steam (more resilient) • Combined heat and power system (if possible) • Community Partners: Water and Power • Mitigation Plan Approved and Adopted • New Mitigation Projects Underway • Flood and Wind Retrofits

4. FEMA Approved Mitigation (so far) • Emergency Power Systems: Elevate generators • Normal Power Distribution: Elevate lines, switchgear, distribution panels • Chilled Water: Harden and elevate lines

5. Hospital Incident Command System • HICS workshop (TEEX) for senior executives on HICS positions (President, EVPs, Senior VPs, VPs) • How UTMB would implement HICS (Hospital/Research Center/National Lab/Academic Enterprise) • Filled positions (goal 5 deep) • Incident Commander for incidents with warning • Staffing of Command Center based on storm severity (Alternate Command Center on Mainland if needed)

6. HICS / Resource Management • Incident Action Plan: Incident Commander’s Objectives • Strategies and Tactics • Resources / Resource Request • Map Resources to each Objective • Documentation: Work done can be tracked back by date to specific Incident Command objectives

7. HICS / Resource Management and Documentation • HICS Documentation Training for Planning, Finance/Admin, Logistics sections • Knowledge of Public Assistance / Debris Removal rules and regulations • Contract in place to provide Planning Section with documentation support if needed • Contract in place to support Public Assistance claims process

8. Damage Assessment • Developed a Damage Assessment Process to include contract photographic recording • Damage Assessment Teams include Asset Management and Departmental Representatives • No work until Damage Assessment is complete • Use of Computer Aided Facilities Management software applications • Estimating total damage (can you afford to rebuild?)

9. Hurricane Response • Saffir - Simpson Scale and 120 hour clock • Triggered Response Evacuation Plan based on Hurricane Severity Index • 10 phase response plan • Coordination with response partners • Ambulance Staging Area • Communications / COML Team • Regional Coordination with CMOC, EMTF-6, and Regional Communications Center for asset mobilization

13. Hurricane Response • Coordination with Receiving Hospital(s) • (Primarily Seton Hospital in Austin) • MOUs in place • Joint Planning – including use of the Texas Emergency Tracking Network • Exercises • Access to electronic medical records • Standardization of forms • Improve information flow • Staff to accompany patients • Equipment that accompanies patients

14. (Not Just) Hurricane Response • Hazard Vulnerability Analysis • High priority risks • Industrial Incidents / Mass Casualty Incidents • New Focus on Healthcare Coalitions • Tabletops in February and March 2012 • Regional Partners • Early emphasis on communications planning

15. (Not Just) Hurricane Response • On Call system for facilities and health system • Response to after-hours no-notice incidents • Emergency plans for major scheduled outages and construction activity (especially regarding utilities) • Event – outage or construction • Objectives • Organizational Assignment List (on-call if needed) • Communications (notification) Plan • Safety Plan

16. (Not Just) Hurricane Response • Active Shooter (Violence on Campus) • New mass notification system • New voice capability – fire alarms • Active Shooter Exercises • Student / Student Government Participation in planning • Threat Assessment Team

17. (Not Just) Hurricane Response Galveston National Lab support for H1N1 outbreak

18. Processes • Rules for Force Account Labor • Policies on ‘disaster pay’ • HICS - Track and certify Time & Effort records (be ready to integrate paper and electronic T&E systems) • UT Mutual Aid – ‘a system can’t provide itself ‘mutual aid’’ • Use contractors • State emergency procurement laws – (use competitive procurement and have contracts in place ready to go) • Contract Monitoring Teams: Project Managers

19. Response Contractors • Expectation – knowledge of Public Assistance Rules and Regulations (meeting with major contractors) • Contractually - Integrate operations into HICS (at UTMB discretion) • Work only with signed 213RR with scope of work • Any work in excess is volunteer work and will not be compensated • Contract amendments • Separate ‘supplies’ to degree possible • Headcounts included in documentation • Debris Removal and Debris Removal Monitoring Plan submitted to TDEM and FEMA • Protective Measures: Policy – no assets on ground floors without approval of facilities committee. If approved, a continuity plan is required (Contracts to protect assets) • No Time and Materials Contracts

20. Questions