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Disaster Planning:
An Ethical ObligationInstructor: Dr. Dawn-Elise Snipes
Executive Director: AllCEUs Counselor Education
Podcast Host: Counselor Toolbox & Happiness Isn’t Brain Surgery
Disaster planning can save lives, minimize injury and emotional trauma, protect property and operational capability, and prevent or reduce interruptions in treatment.
The behavioral health treatment program has a special obligation to prepare for disasters because it provides essential services.
By their nature, disasters have an impact on behavioral health:
Most people who experience a disaster, whether as a victim or responder, will have some type of psychological, physical, cognitive, and/or emotional response to the event. Most reactions are normal responses to severely abnormal circumstances. (American Medical Association, 2005, p. 2)
Disaster planning can prepare the program for continuing to provide the services to its existing clientele in order to prevent:
Relapse
Medical and psychological consequences for prematurely discontinuing medically managed detox or crisis stabilization
Homelessness if clients are in a residential facility
Client destabilization due to lack of access to medications prescribed and/or administered by the agency (antipsychotic injections, prescription refills, methadone)
Exacerbation of problems in at-risk populations as a result of lack of access to support
Requires a program’s personnel to consider the threats that could adversely affect essential functions;
Determine the personnel, vital information (e.g., patient medical records including prescription records), and other resources required to continue those essential functions;
Develop plans for providing essential functions onsite or at alternate locations if needed
Make advance arrangements for obtaining the resources necessary to support essential functions throughout the disaster and recovery phases
Plan for the safety of all personnel during these periods.
Avoid having staff need to refer to multiple sections in the plan
If your agency has multiple locations or types of programs, each program type needs its own addendum to each functional annex (Detox, CSU, Residential, IOP, Adolescent)
Supervisory staff should maintain a paper copy and each building unit should maintain a paper copy in an accessible location
Administrative and Clinical staff must ALL be adequately trained including scenario training.
Behavioral Health Disaster Response Team (Health Departments)
Emergency Management for evacuation of patients
Other clinics for mutual referral or staff borrowing
Sober homes for patients in addiction recovery
SAMHSA’s Disaster Technical Assistance Center (DTAC) specialists can help a program link with the disaster behavioral health coordinator for its State and answer questions about accessing state and federal funding
Health departments must coordinate disaster planning with the community’s behavioral health treatment systems
Role of the Health department Engaging and coordinating with emergency management,
healthcare organizations (private and community-based), behavioral health providers, community and faith-based partners
Support the development of public health, medical, and mental/behavioral health systems that support recovery
Participate in awareness training with community and faith-based partners on how to prevent, respond to, and recover from public health incidents.
Promote awareness of and access to medical and mental/behavioral health resources that help protect the community’s health and address the functional needs of at-risk individuals
Receive and/or integrate the health needs of populations who have been displaced due to incidents that have occurred in their own or distant communities
Behavioral health emergency services including crisis and relapse prevention.
Track clients affected by dispersal and evacuation to ensure they continue to receive needed behavioral health services.
Assist clients in accessing needed medications.
Conduct drug testing for mandated clients.
Adhere to applicable State licensing standards.
Maintain treatment and billing records in accordance with regulatory requirements.
Protect client rights and privacy, including the integrity of PHI
As resources are available and based on mandates, provide disaster mental health services to the community including prevention specific guidance and crisis intervention
Prepare personal go-kits (1 per client) with water bottle,
flashlight, batteries, toiletries, and consider… t-shirt and
shorts, towel, high energy food bar (Can have clients bring
at admission)
Inventory and replace supplies at least quarterlyAllCEUs Counselor Education Unlimited CEUs $59 & Specialty Certificates $89 22
Mitigate Risk
Real-time data back-up of electronic health record at a remote location which can be accessed in emergency
Keep coolers on site for transportation of refrigerated medications
Ensure electric water pump (if any) are connected to back-up generator
Train all staff in emergency psychological first aid
Have a psychiatric advanced directive in the file for any patient who may destabilize in an emergency which includes helpful interventions and info about legal representative should they become incapacitated.