Innovations in Primary Care Emergency Management: Planning, GIS Mapping, and Public Health Response Emergency Management Higher Education Conference June 4, 2009 - PowerPoint PPT Presentation

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Innovations in Primary Care Emergency Management: Planning, GIS Mapping, and Public Health Response Emergency Management Higher Education Conference June 4, 2009


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Title: Innovations in Primary Care Emergency Management: Planning, GIS Mapping, and Public Health Response Emergency Management Higher Education Conference June 4, 2009

Innovations in Primary Care Emergency Management
Planning, GIS Mapping, and Public Health
ResponseEmergency Management Higher Education
ConferenceJune 4, 2009
  • Nora OBrien, MPA California Primary Care

Presentation Overview
  • Review of California Community Clinics and Health
    Centers (CCHC) and emergency response roles
  • Current H1N1 Influenza Outbreak and CPCA response
  • CPCA Clinic Emergency Preparedness Resources
  • Application of Emergency Management Education to
    current work
  • Questions

CPCA Community Clinic and Health Centers
  • 822 community clinics and health centers (CCHCs)
  • CPCAs more than 740 members include
  • Federally Qualified Health Centers (FQHCs and
    FQHC Look-a-likes)
  • Rural Health Clinics
  • Community Clinics
  • Free Clinics
  • Planned Parenthood Clinics
  • 17 Regional Clinic Consortia

Who CA CCHCs Serve
  • Patients
  • 4 million patients
  • 49 of whom are limited English proficient
  • Visits
  • 12.5 million patient visits provided
  • 1 mil uninsured and 1.4 mil Medi-Cal
  • 3.6 million patients under 200 of the FPL
  • All information compiled by Jeanita Harris, CPCA
    Data Analyst. Numbers are based on 2007 OSHPD

CA CCHC Characteristics
  • CCHCs serve the most vulnerable
    patients-regardless of their ability to pay,
    insurance, or immigration status.
  • Health care safety net for many communities,
    counties and regions.
  • Provide multitude of services to
    uninsured/underinsured where hospitals and other
    medical providers may not exist.

Potential CCHC Emergency Response Roles
  • Medical surge capacity for hospitals and public
    health departments
  • Triage
  • Disease surveillance
  • Mental health services
  • Alternate Care Sites
  • Medical response staging
  • Deploy mobile units and CCHC staff
  • Ethnic community outreach
  • Serve as Points of Distribution (POD) sites
  • Translation services
  • Shelter residents
  • Social Services access

CCHCs can respond effectively to emergencies when
given resources, training, and equipment
H1N1 Influenza Outbreak
  • Why public health officials are alarmed
  • Novel virus- no one has immunity to it
  • Likely to kill more healthy adults than young and
  • Cases identified in outpatient settings like
  • One of earliest 107 confirmed cases was a member
  • 1918 pandemic followed similar pattern of mild
    cases then deadly outbreaks during fall and
  • Today we have greater syndromic surveillance
    capability, anti-viral meds, and instant

CPCA H1N1Influenza Outbreak Response
  • Situational awareness of local clinic and
    regional consortia response needs
  • Coordinate medical response with local, state,
    and national partners
  • Promote credible medical guidance from state and
    federal sources via CPCA website and snapblast
  • Advocate CCHC interests on state and federal
  • CCG testified H1N1 Influenza legislative hearing
  • Respond to media requests- LA Times, SF Chronicle

CCHC Emergency Response Efforts
  • Hurricane Katrina (2005)
  • Deployed mobile medical assets
  • Triaged to hospitals
  • Provided Rx primary care
  • Wildfires (2003, 07, 08)
  • Used Clinic practice management systems to ID
    patients at risk
  • Provided mental health services
  • Treated First responders and community
  • Provided translation services
  • Evacuation and shelter assistance
  • Deployed mobile medical assets

Challenges to CCHC Emergency Response
  • No consistent patient tracking system
  • Limited reimbursement for services rendered
  • Not all CCHCs integrated into local response
  • CCHCs at varying levels of preparedness
  • CCHC leadership buy-in for preparedness efforts

Clinic Emergency Preparedness EffortsMeeting the
  • No consistent patient tracking system!
  • Few CCHCs have Electronic Health Record systems
  • Limited reimbursement for services rendered
  • CPCA Policy Team involved in tracking,
    monitoring, and influencing legislation that can
    positively impact reimbursement to clinics.
  • Not all CCHCs integrated into local response
  • CPCA EOP Template

Clinic Emergency Preparedness EffortsMeeting the
  • CCHCs at varying levels of preparedness
  • Exercise participation
  • GIS mapping
  • CCHC leadership buy-in for preparedness efforts
  • Ongoing meetings/discussions with leadership by
    key CPCA team members

CPCA CCHC Emergency Management Tools and
  • A robust CCHC-specific Emergency Operations Plan
  • Clinic Emergency Preparedness Help Desk
  • Emergency Flipchart
  • Clinic Emergency Preparedness Task Force
  • ACS, POD and Mobile Medical Asset GIS Mapping
  • CPCA Emergency Preparedness Training Modules
  • Clinic ICS/NIMS Training
  • Pandemic Influenza Planning Toolkit
  • Redundant Communication Training Module

ACS, POD Mobile Medical Asset GIS
  • Why GIS is Important to Emergency Preparedness
  • 9/11 Story
  • Integral to any comprehensive disaster management
  • Bottom line This stuff saves lives.
  • Identification of Clinic Alternate Care Sites
  • ACS Survey Tool
  • ACS Outreach
  • ACS Data Collection
  • GIS Mapping
  • Knowing what is in your community so that you can
    protect it
  • A spatial display and analysis tool that can
    answer key questions

CPCA Regional Outreach
  • Increased visits to CPCA Clinics/Increased
    interaction with CPCA field operations
  • Statewide Tabletops and expanded emergency
    preparedness exercises
  • Provision of expanded information, training and
    additional resources to CPCA members
  • Expanded CPCA Help Desk information and FAQs
  • Establishment of a CPCA Emergency Preparedness
    Quarterly Newsletter
  • Expanded opportunities for webinars, new training
    content, additional live seminars as needed

CCHC NIMS Expectations
  • Bureau of Primary Health Care (BPHC) Emergency
    Management Expectations expect FQHCs and
    Look-Alikes to move toward NIMS compliance and
    implement ICS in their EMPs- not required
  • ASPRs Hospital Preparedness Program (HPP)
    requires only hospital staff to meet the 14 NIMS
  • CCHCs likely required to implement some of the
    NIMS elements in future HPP guidance

Clinic Incident Command System NIMS Training
  • Modeled after the Hospital Incident Command
    System training and tailored to the CCHC setting
  • Developed with input from 40 CCHC medical and
    operational staff
  • Designed for three CCHC audiences
  • Command Module (4 hour)
  • ICS H 100, ICS H 200, and 700A CalEMA certified
  • Executive Module (1.5 hour)
  • General Staff Module (1 hour)

Clinic ICS/NIMS Training Next Steps
  • Final versions of the Command, Executive, and
    General staff module will be available on demand
    via CPCAs web-based Learning Management System-
    June 2009
  • CPCA will host a General Staff WebEx training-
    June 2009
  • CPCA will offer the Executive Module via
    videoconference- August 2009

Emergency Management Education
  • Masters of Public Affairs, Disaster and Emergency
    Management Program- Park University, KC, MO
  • Rationality, responsibility, and responsiveness
    in their organizations within a framework of the
    highest ethical values
  • Both Online and in-person classes
  • Experienced emergency management faculty- IAEM
    and IACP past presidents
  • Undergraduate and certificate DEM programs also

Application of Emergency Management Education to
Current Work
  • Provided an academic framework to emergency
    management work largely focused on preparedness
    rather than response
  • Firmer knowledge of in-depth emergency management
    concepts such as mitigation, business continuity,
    disaster resiliency, and vulnerable population
  • Modified work to reflect larger emergency
    management context, i.e., public safety, private
    sector, government, EMS

Emergency Management Academic Research Challenges
  • Paucity of emergency management research
    regarding vulnerable population preparedness and
  • LEP populations, resource poor individuals,
    disabled, seniors, children, etc.
  • Service providers of vulnerable populations need
    EM tools and resources to plan but lack
    infrastructure to implement
  • Disconnect between response to public health
    emergencies and other disasters/emergencies
  • Public health departments are often not
    integrated into local emergency management

  • Nora OBrien, MPA
  • Associate Director of Program Planning
  • and Development
  • California Primary Care Association
  • 1215 K Street, Suite 700, Sacramento, CA 95814
  • 916 440-8170 (F) 916 440-8172
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