Conceptos de Planificacion para Desastres Naturales 8-11-2018...y al trabajo Compromiso de la población local en la planificación y reconstrucción de las comunidades Entrenamiento,

Conceptos de Planificación para Desastres NaturalesMaría Fernanda Levis-Peralta, MPH, MPA, PCMH-CCE, CFRE

11 de agosto de 2018

IMPACTIVO

DISCLOSURE

• I, Maria Fernanda Levis-Peralta am CEO of Impactivo, LLC. which is a social impactfirm that works with all health system stakeholders with a mission to transformhealth care so that it is more patient centered.

• The materials for the SALUDame Saludable Campaign were developed under a sub-award from the U.S. Health Resources and Services Administration in Collaboration with Columbia University.

• The materials for the State Health Innovation Plan were developed under a sub-award from the Centers for Medicare and Medicaid Services.

• I have no other relevant financial relationships with comercial interests related tothe content of this presentation.

Learning Objectives

• Present population trends after the 2017 Hurricanes• Explain top issues facing the local health sector after the 2017

Hurricanes• Present a preparedness planning framework for clinics

Panorama del Sector de Salud Antes del Huracán María

Tendencias de la población Pre-María

Instituto de Estadísticas. U.S. Census Bureau Proyecta Población en Puerto Rico estará por debajo de tres millones de habitantes en tan solo 8 años. 17 de septiembre, 2017.https://estadisticas.pr/files/Comunicados/CP-Actualizacion_Proyeccione_Poblacionales_IDB-FINAL.pdf

https://estadisticas.pr/files/Comunicados/CP-Actualizacion_Proyeccione_Poblacionales_IDB-FINAL.pdf

Tendencias de la población Pre-María

Panorama después de la emergencia

Migración Post-María Un estudio del Centro de Estudios Puertorriqueños de CUNY estimó que sobre 135,000 personas migraron a un Estado después del huracán.

Estimado por estado:

ü Florida: 56,477 (42%)

ü Massachusetts: 15,208 (11%)

ü Connecticut: 13,292 (10%)

ü New York: 11,217 (8%)

ü Pennsylvania: 9,963 (7%)

ü New Jersey: 5,027 (4%)

Medicare y Medicaid

Source: https://medicaid.pr.gov/Statistics.aspx https://www.cms.gov/

Empleo en Puerto Rico Post-María (en miles)

Source: Bureau of Labor Statistics

Educación

Vivienda y Entornoconstruido

Contexto social y comunitario

Salud y cuidado de la salud

Ingresos y estabilidadeconómica

Factores ambientales

Pacientes presentando más necesidades sociales/básicas

Principales desafíos en el sector de salud después del Huracán María

1. Cambios en la demografía de la población2. Inestabilidad en las redes eléctricas, agua y telecomunicaciones 3. Pacientes presentando más necesidades sociales/básicas 4. Salud mental5. Migración de médicos6. Alineación de modelos de pago y políticas de contratación de

proveedores con un enfoque en la salud de los pacientes7. Maximización de fondos federales8. Inversión en el sector salud

Fases de alivio post-desastre

Fase 1: Alivio Fase 2: Recuperación Fase 3: RediseñarFase 4: Preparación para

desastresMarco de tiempo

Inmediato6 meses después de la fecha

ocurrida el desastre

Intermedio1 o 2 años después de la

fecha ocurrida el desastre

A largo plazo 5 a 15 años después de unas semanas o meses de la fecha

del desastre

Proceso continuo

MetaEstrategias a corto plazo

para establecer ordenEstabilización Reconstruir para un mejor

futuroReducción y prevención de los riesgos de emergencia

Servicios prestadosRescate, atención médica,

comida, agua, asilo temporalComida, agua, asilo a largo

plazo, sanidad, cuidado de la salud, retorno a las escuelas

y al trabajo

Compromiso de la población local en la planificación y

reconstrucción de las comunidades

Entrenamiento, creación de las políticas y

procedimientos, construcción de relaciones entre los proveedores de

servicios y las comunidades

MediosAmplia cobertura; mucha La cobertura disminuye a La cobertura disminuye Poca cobertura, sin atracción

Source: Strauss, 2017

Preparativos ante la próximaemergencia

Transformación del sistema de saludAlineación de entrega de servicios y modelos de pago

Five Planning BasicsPreparedness Tip #1: Know Your Local Team• Learn about the emergency plans that have been established in your

area by local government.

• Contact government agencies to see how you can become a participant in the planning or response efforts.

Preparedness Tip #2: Promote a Culture of Preparedness• Create a yearly plan for trainings and exercises.

• Schedule staff meetings to share emergency preparedness efforts at your facility.

• Provide family and individual preparedness resources to your staff and patients.

Preparedness Tip #3: Create a Practice Response Team • Assemble a practice team for responding to emergencies/disasters.

Include key roles such as Incident Manager, Public Information Officer, Operations Chief, Planning Chief and Logistics Chief.

• Create a master emergency contact list with contact information for the practice team, local government resources and key partners. Update annually.

Preparedness Tip #4: Assess Your Facility Annually• Conduct planning with all members of the team.

• Contact your local emergency management agency to get local information.

• Use the Hazard Assessment worksheet to assess your facility for risk.

Preparedness Tip #5: Support the Needs of Your Staff • Provide counseling to support the mental health needs of your staff as

they respond.

• Identify areas where staff and their families can get food, shelter and other basic needs met. Consider providing resources onsite for staff and their families.

Source: Emergency Preparedness Toolkit for Primary Care Providers

CMS Emergency Preparedness Rule

http://www.arhealthcare.com/sites/default/files/2017-06/2Understanding_the_CMS_Emergency_Preparedness_Rule_Webinar_final.pptx

Providers and Suppliers that wish to participate in Medicare and Medicaid –i.e. the nation’s largest insurer – must demonstrate they meet new

emergency preparedness requirements in rule.

Inpatient Outpatient

• Hospitals

• Critical AccessHospitals

• Religious Nonmedical Health Care Institutions (RNHCIs)

• Psychiatric Residential Treatment Facilities (PRTFs)

• Long-Term Care (LTC) / Skilled Nursing Facilities

• Intermediate Care Facilities for Individualswith Intellectual Disabilities (ICF/IID)

• Ambulatory Surgical Centers

• Clinics, Rehabilitation Agencies, and Public Health Agencies as Providers of Outpatient Physical Therapy and Speech-Language Pathology Services

• Community Mental Health Centers (CMHCs)

• Comprehensive Outpatient Rehabilitation Facilities (CORFs)

• End-Stage Renal Disease (ESRD) Facilities

• Rural Health Clinics (RHCs) and Federally QualifiedHealth Centers (FQHCs)

• Home Health Agencies (HHAs)

• Hospice

• Organ Procurement Organizations (OPOs)

• Programs of All-Inclusive Care for the Elderly(PACE)

• Transplant Centers

Who does it apply to?

Core elements

Emergency Plan

• Based on a risk

assessment

• Using an all-

hazards approach

• Update plan

annually

Policies & Procedures

• Based on risk

assessment and

emergency plan

• Must address:

subsistence of staff

and patients,

evacuation,

sheltering in place,

tracking patients

and staff

Communications Plan

• Complies with

Federal and State

laws

• Coordinate patient

care within facility,

across providers,

and with state and

local public health

and emergency

management

Training & Exercise Program

• Develop training

program, including

initial training on

policies &

procedures

• Conduct drills and

exercises

Emergency and Standby Power

• Higher level of

requirements for

hospitals, critical

access hospitals,

and long-term care

facilities.

• Locate generators

in accordance with

National Fire

Protection

Association (NFPA)

guidelines.

• Conduct generator

testing, inspection,

and maintenance as

required by NFPA.

• Maintain sufficient

fuel to sustain

power during an

emergency.

Evacuations

• Home health

agencies and

hospices must

inform officials of

patients in need of

evacuation






¿Preguntas?

PMB 1401357 Ashford AvenueSan Juan, PR 00907(787) 993-1508 (t)Email: [email protected]: www.impactivo.comhttps://www.facebook.com/Impactivo/

Impactivo Información de Contacto:

¿Qué es Impactivo?Impactivo es una firma consultora de impacto social que trabaja con líderes para hacer que la salud y el bienestar sean accesibles para las comunidades.

mailto:[email protected]

http://www.impactivo.com/

https://www.facebook.com/Impactivo/

References

• AAFP A Practical Guide to Emergency Preparedness for Office-Based FamilyPhysicians• AAFP Emergency Preparedness• CDC Medical Office Preparedness Planner• Disaster Planning as a Practice• Emergency Care Preparation in Your Office Practice• Emergency Preparedness Toolkit Primary Care Providers• Ready.gov Business• FEMA Continuity of Operations (COOP) Division• Continuity of Operations (COOP) Planning Workbook Developed by Harford

County Health Department

Other resources

Emergency Preparedness Toolkit for Primary CareProviders

AAFP A Practival Guide to Emergency Preparedness forOffice-Based Family Physicians



AAFP Medical Emergency Preparedness in Office Practice



Documents

Conceptos de Planificacion para Desastres Naturales 8-11-2018...y al trabajo Compromiso de la población local en la planificación y reconstrucción de las comunidades Entrenamiento,