The procedures for ensuring timely activation of the agency’s emergency management plan and staffing of the home health agency during an emergency are as follows:
APPENDIX B: INFORMATION FOR HOME HEALTH AGENCY PATIENTS
The following information should be supplied by the home health agency to those patients registered with the special needs registry, so they will be prepared prior to an evacuation to a special needs shelter.
Please note: The special needs shelter should be used as a place of last refuge. The evacuee will not receive the same level of skilled care received from staff in the home, and the conditions in a shelter might be stressful.
(1) If the patient has a caregiver , the caregiver must accompany the patient and must remain with the patient at the special needs shelter.
(2) The following is a list of what special needs patients need to bring with them to the special needs shelter during an evacuation:
Bed sheets, blankets, pillow, folding lawn chair, air mattress
The patient’s medication, supplies and equipment list supplied by the home health agency, including the phone, beeper and emergency numbers for the patient’s physician, pharmacy and, if applicable, oxygen supplier; supplies and medical equipment for the patient’s care; Do Not Resuscitate (DNRO) form, if applicable;
Name and phone number of the patient’s home health agency
Prescription and non-prescription medication needed for at least 72 hours; oxygen for 72 hours, if needed.
A copy of the patient’s plan of care
Identification & current address
Special diet items, non-perishable food for 72 hours & 1 gallon of water per person per day
Glasses, hearing aides and batteries, prosthetics and any other assistive devices
Personal hygiene items for 72 hours
Extra clothing for 72 hours
Flashlight and batteries
Self-entertainment and recreational items, like books, magazines, quiet games.
(3) Shelterees need to know the following:
If the patient has a caregiver, the caregiver must accompany all special needs shelterees. A special needs shelter can accommodate one caregiver at a time, and other family members, friends, etc. should go to a regular shelter.
The shelteree caregiver will have floor space provided. The caregiver must provide his or her own bedding.
Service dogs are allowed in the shelter. However, check with your local Emergency Management office to see if other pets are permitted.
Bring personal snacks, drinks, and any special dietary foods for 72 hours. It is possible only sparse meals will be provided.
Caregivers who regularly assist the patient in the home are expected to continue to do the same care in the shelter.
APPENDIX C: SUPPORT MATERIAL
COMFORT KEEPERS Special Needs form
Appendix B
COMFORT KEEPERS constantly monitors, through available means, (radio, TV, county disaster reporting center) for possible emergency conditions in our area. In the event that an emergency or disaster occurs, or becomes imminent, the Administrator, or DON, notifies the appropriate staff, via pager, phone, cellular or voicemail, to activate emergency procedures, i.e. report to office, begin patient notification process, secure the office, determine if patients for evacuation are activated. Types of emergencies that warrant plan implementation include, but are not limited to:
The threat, or occurrence, of hurricanes, tornadoes, floods and earthquakes;
4. Management of patients in private homes, assisted living facilities (ALF) and adult family home care (AFHC) who will continue to receive services by the home health agency during an emergency is to be provided as follows:
All staff scheduled for work during a declared emergency is expected to report to work as specified herein. Provision of services as scheduled wherever the patient is located will be continued as long as government officials allow travel on the roads and the travel route is deemed safe.
The facility emergency plan for patients who reside in Assisted Living Facilities or Adult Foster Homes will be reviewed and specifics, i.e. evacuation sites, will be documented in the patient’s clinical record. The agency will contact the facility during and following the emergency period to confirm plans and or changes in plans and to verify the whereabouts of the agency’s patients. Services will be provided to the facility patients and in the case of injections, etc, good faith efforts will be made to arrange alternate means to provide services on site.
B. Education of Patients Prior to an Emergency
1. The procedures for educating patients or patients’ caregivers about the agency’s emergency management plan are as follows:
At the time of “sign up” to the agency all new patients will be provided with materials in writing and verbally informed that the Agency has an emergency management plan that will be activated in the event of emergencies. At that time the patient will be placed in a category utilizing the Triage system outlined in this plan. They are placed on the priority list in the category determined. The patient is asked to notify the Agency if their personal emergency plans change or if circumstances change that would alter their level of priority so that the list can be updated. Since this area is more susceptible to hurricane activity, prior to June 1, existing patients are again given information regarding the plan and personal evacuation plans are reviewed and updated if changes have been made. Local sheltering locations and routes are provided in writing in the patient’s language.
Current lists of medications, supplies and equipment are maintained in the patient’s home in the agency folder. The patient has been informed about the list at the time of admission and has been instructed to take the list to the shelter if sheltering is required during the emergency. In addition they will be provided with a written copy of Appendix B of this plan.
2. The procedures for discussing with those patients in private homes, ALFs and AHCHs who need continued services, who are not registered with the special needs registry, the patients’ plan during, and immediately following, an emergency and contacting the ALF and/or AFCH for patients served by the home health agency regarding the plan for the patient during, and immediately following, an emergency are as follows:
Patients will be informed that in the event of an emergency in which we do not close the office, visiting staff will continue to provide services to patients in their homes and provide assistance as scheduled. If the patient is not leaving the home, the name of the caregiver who will be assisting them will be listed in the medical record. Provision for emergencies will be discussed with the patient/family on admission and an ongoing basis during the course of care and documented in the clinical record. In the event that the plan of care needs to be altered to allow for patients of more immediate medical need to be seen, the physician will be contacted and the patient will be notified of any change in plans. However every effort will be made to provide normal service to the patients according to their set schedules. Patients located in ALFS and or AFCH facilities will be treated as if in personal homes as far as provision of services is concerned.
3. The procedures for discussing the special needs registry with those patients who will require to be evacuated to a special needs shelter during an emergency are as follows:
Patients will be informed of the availability of special needs shelters at the time that they are placed in the Triage category of needing one. Special Needs patients are defined as follows: “have no one to help them evacuate and are not able to do so by them selves, or have no other place to stay if they must evacuate.” A listing and location of “special needs shelters” will be provided to the patient and or caregiver at this time.
4.The agency’s procedures for collecting patient registration information for the special needs registry, (pursuant to 59A-8.027(12), F.A.C.), –Patients must be registered with the special needs registry prior to an emergency, not when an emergency is approaching or occurring.– are as follows:
At the time that the patient is categorized for “special needs” sheltering, the appropriate information required for completion of the registration forms will be collected by the nurse and submitted to the agency office. (See attached form). The county specific forms will be obtained from the Sarasota County Office of Emergency Management, accurately completed, and returned to that office after obtaining proper required (physician) documentation. The designated clerical assistant will ensure that the forms are submitted have been submitted to the County Office of Emergency Management’s registry system within 48 hours.
5. Patients will be educated in the role of their medication, supplies and equipment (in accordance with Appendix B, Section 2). In addition, the following information is to be provided:
The patients will be provided with a copy of Appendix B, along with verbal explanation of expectations and needs for the shelter.
6. Patients registered with the special needs registry will also be educated (in accordance with Appendix B, Sections 1 and 3). This will include the limitation of services and conditions in a shelter; that the level of services will not equal what they receive at home; that conditions in the shelter may be stressful and may even be inadequate for their needs; and that the special needs shelters are an option of last resort. Specific procedures for disseminating this information are as follows:
Patients who are on the current prioritized list of persons registered for special needs sheltering will be informed verbally of the following:
Limitations of services and conditions in a shelter;
the level of services will not equal what they receive in the home;
the conditions in the shelter may be stressful;
may even be inadequate for their individual needs; and
that the special needs shelters are an option of the last resort.
The patients will be provided with a copy of Appendix B.
C. Notification
1. The procedures on how the home health agency staff in charge of emergency plan implementation will receive warnings of emergency situations, including off hours, weekends and holidays are as follows:
Administrative staff of COMFORT KEEPERS constantly monitors emergency-prone situations, via all currently available means of information transmission – television, radio, telephone, cellular phone, pagers, and the Internet 24 hours a day. Staff will be notified 24 hours per day seven days per week by the Administrator or her designee. Information is disseminated to staff primarily through the telephone, voice mail and alpha paging. Information will be disseminated verbally, or in writing, at the office location should electronic means of transmission fail. Staff is to physically transport themselves to the agency if roads are passable and open at a minimum of 1 time during office hours during an emergency situation if electronic means of communication fails or requests are made by administration. This assures continuity of communication and planning activities. The facility will remain open for business; unless the authorities order it closed, without communication capability. All staff will report for duty in the event of an emergency even though it may be their regularly scheduled day off. The 24 hour contact number is (941) 921-4747
2. (If the home health agency provides skilled care) the agency’s 24-hour contact number, if different than the number listed in the introduction, is:
SKILLED SERVICES ARE NOT PROVIDED
3. The procedures for alerting key staff are as follows:
Staff will be notified 24 hours per day seven days per week by the Administrator or her designee utilizing telephone, voice mail and alpha paging.
4. The policies and procedures for reporting to work for key workers, when the home health agency remains operational are as follows:
Staff will be notified 24 hours per day seven days per week by the Administrator or her designee utilizing telephone, voice mail and alpha paging.
5. The procedures on how patients in private homes will be alerted, how every ALF and/or AFCH where patients are served is contacted to confirm the plan for the patients, and the precautionary measure that will be taken, including but not limited to voluntary cessation of the agency’s operations (Refer to s.400. 492(3), F.S., for a definition of voluntary cessation) are as follows:
Patients have been informed about the emergency management process on admission and again between June 1 and November 30 that as long as possible the agency will remain operational and services will continue.
Whenever possible, prior to the emergency, patients will be notified by telephone of ongoing services that can and will be provided, i.e. changes in schedules. If telephone service is not available cell phones, community based ham radio groups, public announcements through radio or television, driving directly to the patient’s home or contact with police or emergency rescue services may be utilized. Patients needing continued treatment during an emergency will be assisted through capable and able caregivers or emergency services shelters. COMFORT KEEPERS will assist, per policy, all agency patients who require on-going assistance before, during, and after an emergency.
Patients will be notified by telephone of impending closure of the agency whenever possible. In the event that a visiting staff member is in the patient’s home and has knowledge of impending closure, they will be informed verbally in person. Local emergency reporting sources will be notified of impending closure so that the information can be included in local media public service announcements. Patients needing continued treatment during an agency closure would be assisted through capable and able caregivers or emergency services shelters. Comfort Keepers staff will assist, per policy, all agency patients who require on-going assistance before, during, and after an emergency.
6. The procedures for alternative means of notification should the primary system fail (pursuant to s.400.492, F.S.) are as follows:
If regular telephone service is not available, cell phones, community based ham radio groups, public announcements through radio or television, driving directly to the patient’s home or contact with police or emergency rescue services may be utilized
7. The agency will maintain a current prioritized list of patients who need continued services during an emergency in the home, ALFs and AFCHs. The list shall indicate how services shall be continued in the event of an emergency or disaster for each patient and if the patient is to be transported to a special needs shelter, and shall indicate if the patient is receiving skilled nursing services and the patient’s medication and equipment needs. The list shall be furnished to county health departments and to local emergency management agencies, upon request (pursuant to s.400.492 (2), F.S.). The procedures for accomplishing this are as follows:
The Agency will maintain the Priority list in the front of the Emergency Management Plan binder in the office. It will be reviewed and updated monthly by the Administrator and PRN as patient conditions and circumstances change. Upon discharge or a change in status, the Emergency Management Office will be promptly notified by FAX and the staff caring for the patient will be notified by telephone. Status changes which evoke a variation in the emergency management plan for the patient will be discussed in case conference and documented in the patient record as well as noted on the priority list. The priority list will indicate the destination of the patient as well as the priority of evacuation or the patient’s choice to remain in the home. The facility emergency plan for patients who reside in Assisted Living Facilities or Adult Foster Homes will be reviewed and specifics, i.e. evacuation sites, will be documented in the patient’s clinical record. The agency will contact the facility during and following the emergency period to confirm plans and or changes in plans and to verify the whereabouts of the agency’s patients.
Services will be provided to the facility patients and in the case of injections, etc, alternate arrangements will be made.
A notation in the clinical record will be made concerning the patients’ registration with the special needs registry, and any evacuation plans that have been made. Patients will be asked to notify the agency of any alternate evacuation sites, excluding the special needs shelter. All patients who are registered will be given “Appendix B: Information for Home Health Agency Patients.”
Patients who are on the current prioritized list of persons registered for special needs will be assisted, within our staffs’ capabilities, in getting to the special needs shelters in order of medical priority. Those with the most severe medical needs will be assisted first. The priority list will be made available to the local emergency management agency or health department as requested and mandated by law. The list will contain at a minimum, the following information on each patient:
What services should be continued for this patient during an emergency;
Available transport to the shelter if applicable;
Nature of specific care required for this patient;
Current lists of the patient’s medications, supplies and equipment needs.
In the event you have any question regarding our policy, please contact the office, we will be happy to answer your questions.
941-921-4747
