Conceptos de Planificación para Desastres Naturales María Fernanda Levis-Peralta, MPH, MPA, PCMH-CCE, CFRE 11 de agosto de 2018
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
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
Source: Emergency Preparedness Toolkit for Primary Care Providers
Source: Emergency Preparedness Toolkit for Primary Care Providers
Source: Emergency Preparedness Toolkit for Primary Care Providers
Source: Emergency Preparedness Toolkit for Primary Care Providers
Source: Emergency Preparedness Toolkit for Primary Care Providers
¿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.
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 A Practival Guide to Emergency Preparedness forOffice-Based Family Physicians
AAFP A Practival Guide to Emergency Preparedness forOffice-Based Family Physicians
AAFP Medical Emergency Preparedness in Office Practice
Source: Emergency Preparedness Toolkit for Primary Care Providers
Source: Emergency Preparedness Toolkit for Primary Care Providers