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Emergency Preparedness: Essentials for Business Continuity Planning For Community Health Centers


Emergency Preparedness: Essentials for Business Continuity Planning For Community Health Centers Presented by: Bernadette Johnson and H. Duane Taylor – PowerPoint PPT presentation

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Title: Emergency Preparedness: Essentials for Business Continuity Planning For Community Health Centers

Emergency Preparedness Essentials for Business
Continuity Planning For Community Health Centers
  • Presented by Bernadette Johnson and H. Duane

  • Learning Objectives
  • Overview of Continuity of Operations Planning
    (COOP)/Business Continuity Plan
  • Special Considerations for Health Centers
  • Developing Your COOP -Elements of a Viable COOP
  • Implementing Your COOP
  • Test Your COOP
  • Self-Assessment Tool
  • Resources

Learning Objectives
  1. To introduce participants to business continuity
    planning and the process by which organizations
    ensure maintenance of critical operations when
    confronted with adverse events.
  2. To provide strategies to organizations regarding
    risk management as it relates to business
    continuity planning in order to minimize recovery
  3. To provide essential elements in the design of an
    effective business continuity plan for health

Overview of COOP
  • Continuity of Operations (COOP) is a Federal
    Initiative, required by Presidential Directive,
    to ensure the Executive Branch departments and
    agencies are able to continue to perform their
    essential functions under a broad range of
    possible hazardous circumstances.
  • For Health Centers and other business entities,
    COOPs are called Business Continuity Planning and
    ensures that a business can maintain operations
    beyond an EP event.
  • FEMA is the lead agency that is mandated to
    provide training and technical assistance to
    agencies in developing and testing their COOP

Overview of COOP -2
  • Federal Preparedness Circular (FP)-65 requires
    that all Federal Executive Branch agencies must
    have a COOP plan which includes some of the
    following elements
  • Be operational no later than 12 hours after
  • Be able to maintain sustained operations for up
    to 30 days
  • Include regular testing, training and exercising
    of personnel, equipment, systems, processes, and
    procedures used to support the agency during an
    EP event
  • Locate alternative site facilities in areas where
    the ability to initiate, maintain and terminate
    COOP is optimal

Benefits of COOP
  • Business Continuity Planning is a good business
    practice for health centers.
  • It is part of the fundamental mission of health
    centers to be a central, responsible and reliable
    public institution that provide essential health
    services to communities. Moreover, HRSA has
    strongly encouraged that business plans for
    health centers include EP plans. It is critical
    that the EP plan include Business Continuity
  • In todays changing environment, where EP
    disasters are not uncommon, the need for health
    centers to have a viable plan to determine how
    they will maintain and sustain their business is

Special Considerations for Health Centers
  • As health centers, there are various precautions
    we must explore in Business Continuity Planning,
  • Pharmacy/Medications
  • Security of patients/staff
  • Medical Supplies
  • Interoperable Communications with Hospitals,
    Health Departments, PCAs, and the State
  • Family Support Planning for our staff
  • EP Insurance

Developing Your COOP
  • There are Nine (9) Essential elements for
    creating a viable COOP/Business Continuity Plan,
    which include
  • Essential Functions
  • Delegations of Authority
  • Alternative Facilities
  • Interoperable Communications
  • Vital Records and Databases
  • Human Capital Management
  • Test, Training and Exercises
  • Devolution
  • Reconstitution

1. Essential Functions
  • A central component of developing your COOP is to
    determine and prioritize the essential functions
    at your agency. Essential functions are the
    agencys business functions that must continue
    with no or minimal disruption.
  • Essential functions are based on the agencys
    customers and needs. It is important to remember
    that a broad brush approach should not be used
    when determining essential functions at your
    health center.
  • The continuity of essential functions will be
    driven by the availability of Training
    personnel, Vital records/databases, Supplies and

Suggestions when determining essential functions
  • For health centers some suggestions in
    prioritizing essential functions are to examine
    the functions that enable an organization to
  • Provide vital services
  • Maintain the safety of the general public and
    staff within your health center
  • Sustain your agency financially during a crisis
    and beyond.

2. Delegation of Authority
  • Delegation of Authority is used for a specific
    purposes during an EP event for Business
    Continuity Planning. Delegations should be
    pre-determined and documented in writing. The
    document should specify any limitations on the
    delegated authority and should be as specific as
  • Delegation of Authority specifies who is
    authorized to make decision are act on behalf of
  • The Department or Agency Head
  • Other Key Individuals

2. Delegation of Authority-Order of Succession
  • Orders of succession are provisions for the
    assumption of senior agency leadership positions
    during an emergency when the incumbents are
    unable or unavailable to execute their duties.
    Succession is the order of who is in charge where
    in delegation of authority is the responsible
    from one person to another.

3. Alternative Facilities
  • During an EP event, if necessary, an alternative
    facility may need to be established. The
    alternative facility should be pre-determined.
    All health centers should examine if they had to
    have bare bones operations and could not utilize
    their primary site location could they create an
    alternative site location in the community.
    Moreover, how long would it take to be
    operational at that alternative site location.
    Any staff that requires relocation to the
    alternative facility are part of the Emergency
    Relocation Group (ERG).
  • Alternate facility sites may include
  • Other health centers
  • Community Locations (e.g. library)
  • Telecommuting for your staff

4. Interoperable Communications
  • Interoperable Communications are communications
    that provide the capacity to perform essential
    functions, in conjunction with other agencies,
    until normal operations can be resumed.
  • In order to have effective interoperable
    communications an agency must be able to
  • Externally with the organizations customers and
    business partners
  • Internally with the organizations leadership and
  • The KEY to interoperable communications is

4. Interoperable Communications-2
  • Interoperable communications must also be
  • Redundant
  • Available within 12 hours of activation, or less,
    depending on the mission and requirements of the
  • Sustainable for up to 30 days

5. Vital Records and Databases
  • In Business Continuity Planning or COOP, there
    are 2 main types of records
  • Emergency Operating Records-which includes plans,
    directives, delegations of authority, or staffing
    assignments and orders of succession in order to
    implement your Business Continuity Plan.
  • Legal and Financial Records-which includes,
    medical records, personnel records, payroll
    records, insurance records and contractor records
    (e.g. agreements).
  • Copies of medical records as well as offsite
    computer file storage is strongly recommending.

6. Human Capital Management
  • During COOP activation, health centers will have
    to perform their essential functions with reduced
    staffing. Human capital, then, is critical to
    ensuring the flexibilities required of ERG
    personnel. Agencies should ensure that all ERG
    personnel are adequately trained and
    cross-trained to enable the performance of all
    essential functions.
  • All employees, ERG and non ERG need to be kept
    informed during the course of an emergency
  • Family Emergency Planning is important for any
    emergency but is strongly to be encouraged for a
    COOP event

Family Emergency Planning
  • A COOP situation will affect you and your teams
  • There will be a period of uncertainty about what
    is happening, how bad the situation is, and what
    you should do to protect yourself and your loved
  • You may feel unsure of your job security,
    particularly if the threat is severe
  • You may also be concerned for your financial well
  • It is imperative that your agency develop a
    family emergency plan. At a minimum the plan
    should include
  • Contact and communication information
  • An immediate emergency checklist that includes
    medical, financial and legal information and
    other important documents.
  • Supplies, including medication, for at least 72

7. Test, Training and Exercises
  • Test, Training and Exercises (TTE) include
    measures to ensure that agencies COOP program is
    able to support the continued execution of its
    essential functions throughout an EP event.
  • Health Centers perform TTE to ensure that
  • All equipment and systems work as required
  • Employees are able to deploy to the alternative
    facility within the required time frame.
  • The alternate facility includes everything that
    is needed for the ERG to perform essential

8. Devolution
  • Devolution is the capability to transfer and
    delegate authority to other members of the team
    in order to carry out essential functions when
    primary team members are incapable of performing
    necessary functions. Remember that this is
    generally for a specified time period and limited
    authority that has been delegated.
  • Think of it is brining in the reserve players!

9. Reconstitution/Recovery
  • Reconstitution is the process by which agency
    personnel resume normal operations from the
    original or replacement primary operating
  • Agencies must identify and outline a plan to
    return to normal operations. This plan should
    have time lines, resources needed (including )
    and be as specific as possible.
  • It is encouraged that health centers appoint a
    Reconstitution Manager to oversee the
    reconstitution process.

Other Considerations for Developing Your Plan
  • Utilize Your Hazard Vulnerability Assessment in
    your planning.
  • Perform a Business Impact Analysis-which
    identifies the process of confirming what the
    critical functions are and prioritization of
    business services.
  • Examine Key Leadership-Roles and Responsibilities
    and create an outline and staffing chart.
  • Create an Activation Plan-describes the specific
    events or conditions that will trigger or invoke
    the plan.
  • Communications Planning- include
    internal/external communications as well as
    personnel notification and media.

Recap of Developing an Business Continuity Plan
  • Utilize the 9 Essential Elements for COOP
  • Use Elements of Your EP plan to drive the
    continuity plan
  • Remember Risk Management as a critical component
  • Time Specific
  • Test and Train on the COOP

Continuity of Operations Self Assessment Tool
  • This tool is designed to assist in the
    development of your COOP Plan and to assess the
    plan for all considerations.
  • The Self Assessment is promulgated on FPC 65
    guidance so we need to make it apply to health
  • Utilize it as a broad based template for planning
    and exercise purposes.

  • Your PCA
  • FEMA-great online course-http//www.training.fema.

Quiz-Question 1
  • For Agencies at the beginning stage of COOP
    planning, determining ________ must be completed
    before moving onto any other area of COOP
  • A. Essential Functions
  • B. Orders of Succession
  • C. Delegation of Authority
  • D. Communication Needs

Quiz-Question 2
  • 2. Essential functions include all functions that
    have been explicitly assigned by law or by order
    of the President in a COOP plan. (True or False)
  • A. True
  • B. False

Quiz-Question 3
  • 3. Interoperable communications include access to
    data, systems, and services. (True or False)
  • A. True
  • B. False

Quiz-Question 4
  • 4. Business Continuity Planning only considers
    Terrorist threats. (True or False)
  • A. True
  • B. False

Quiz-Question 5
  • 5. The term ERG stands for
  • A. Emergency Redesign Graphics
  • B. Emergency Redundancy Group
  • C. Emergency Regrouping Guidelines
  • D. Emergency Recovery Group

Quiz-Question 6
  • 6. Family Emergency Planning is not a
    consideration in COOP. (True or False)
  • A. True
  • B. False

Thank You!
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