2017 ADHS Annual PHEP/HPP All Partners Meeting 2/16/2017
Executive Summary Draft Date: 4/10/17 Final/Approved Date: 5/12/2017
This exercise document was supported in part by the CDC Cooperative Agreement, Catalog of Federal Domestic Assistance (CFDA) 93.069 and the Hospital Preparedness Program (HPP) Grant CFDA 93.889. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of CDC or the Department of Health and Human Services.
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2016 ADHS PHEP/HPP Executive Summary All Partners Meeting
TABLE OF CONTENTS
Workshop Overview ...... i
Workshop Summary ...... ii
Summary of Capabilities ...... 1 HPP Capability 1: Healthcare System Preparedness ...... 2 PHEP Capability 1: Community Preparedness ...... 2
Capabilities – Region Reports/Presentations ...... 3 Objective 1: Discuss how the PHEP and HPP programs in Arizona have progressed over the years ...... 3 Objective 2-4: Discuss- the Funding Opportunity Announcement (FOA) for Budget Period One, grant planning, and grant resources ...... 8
Appendix A: Exercise Participants ...... A-1 Exercise Participants ...... 1
Appendix B: Acronyms ...... B-1
Table of Contents BPHEP ARIZONA DEPARTMENT OF HEALTH SERVICES Homeland Security Exercise and Evaluation Program (HSEEP)
2017 ADHS PHEP/HPP Executive Summary All Partners Meeting
WORKSHOP OVERVIEW
Exercise Name 2017 ADHS PHEP/HPP All Partners Meeting
Exercise Dates 2/16/2017
This annual meeting is a workshop providing updates/information, Scope collaboration, and key priorities and initiatives for the new grant year.
Mission Area Prevention
PHEP Community Preparedness Capabilities HPP Healthcare System Preparedness
• Discuss how the PHEP and HPP programs in Arizona have progressed • Discuss the Funding Opportunity Announcement for Budget Period One Objectives • Discuss grant planning • Discuss grant resources
Sponsor Arizona Department of Health Services
Participating PHEP and HPP federal, state, tribal, local and non-profit partners. Please see Organizations Appendix A: Exercise Participants for the complete list of organizations.
Antonio Hernandez Section Chief, Partner Integration Arizona Department of Health Services Bureau of Public Health Emergency Preparedness 150 North 18th Avenue, Suite 150 Phoenix, Arizona 85007-3237 (602) 763-1774 [email protected] Points of
Contact Alyssa Van Story Exercise Coordinator Arizona Department of Health Services Bureau of Public Health Emergency Preparedness 150 North 18th Avenue, Suite 150 Phoenix, AZ 85007-3237 (602) 361-1229 [email protected]
Workshop Overview i BPHEP ARIZONA DEPARTMENT OF HEALTH SERVICES Homeland Security Exercise and Evaluation Program (HSEEP)
2017 ADHS PHEP/HPP Executive Summary All Partners Meeting
WORKSHOP SUMMARY The 2017 ADHS PHEP/HPP All Partners Meeting had 128 participants from each region, representing healthcare facilities, counties and tribes. This workshop and meeting functions to assist PHEP and HPP partners in identifying gaps from previous years, determining strategies to fill those gaps, collaborating with internal and external coalition partners, and beginning their overall planning process for the upcoming budget period. Attendees received an overview of the strategic framework with information from the Arizona Public Health and Healthcare System Preparedness Strategic Map for 2017 – 2021 describing the following goals: • Align Resources • Promote and Support Public Health and Safety • Make Focused Improvements in Public Health Infrastructure • Maximize Synchronization, Collaboration, and Coordination • Implement Best, Promising, and Evidence-Based Practices The workshop included program updates from regional, tribal, and pediatric coalitions. Sessions were then broken into particular categories to discuss: • BP1 FOA (Funding Opportunity Announcement) Review, Work plan, & Deliverable Document • BP1 Financial Considerations, Budget Tools, & Reporting Structure • BP1 Sub-Recipient Monitoring • Capabilities Planning Guide (CPG) • Training & Exercise Priorities (Regional & State) • Contract Overview • Meeting Schedule 2017-2018 • BP5 Closeout Procedures
Workshop Summary ii BPHEP ARIZONA DEPARTMENT OF HEALTH SERVICES Homeland Security Exercise and Evaluation Program (HSEEP)
2017 ADHS PHEP/HPP Executive Summary All Partners Meeting
SUMMARY OF CAPABILITIES Aligning exercise objectives and capabilities provides a consistent taxonomy for evaluation that transcends individual exercises to support preparedness reporting and trend analysis. Table 1 includes the exercise objectives, aligned capabilities, and functions for each capability as observed during the exercise and determined by the evaluation team. Table 1. Summary of Capability Performance
Capability Objective 1. Discuss how the PHEP and HPP programs in Arizona have progressed over the years 2. Discuss the Funding Opportunity HPP Capability 1: Healthcare System Announcement for Budget Period One Preparedness 3. Discuss grant planning – Capabilities Planning PHEP Capability 1: Community Guide (CPG), Training and Exercise Priorities, Preparedness Contract Overview, and the Meeting Schedule
4. Discuss grant resources
The following sections provide an overview of the performance related to each exercise objective and associated capability.
Summary of Capabilities 1 BPHEP ARIZONA DEPARTMENT OF HEALTH SERVICES Homeland Security Exercise and Evaluation Program (HSEEP)
2016 ADHS PHEP/HPP Executive Summary All Partners Meeting
CAPABILITIES – REGION REPORTS/PRESENTATIONS
Objective 1: Discuss how the PHEP and HPP programs in Arizona have progressed over the years HPP Capability 1: Healthcare System Preparedness
The regions provided attendees brief overviews about the coalitions’ history including their goals and objectives, membership, and geographic areas of responsibility through presentations and then opened up the floor for questions. The complete presentations can be found on the ADHS website. AzCHER Central The central coalition reports a mixture of significant improvements as well as additional challenges over the years. The current membership is as follows: • Hospitals (60+) • Community health clinics (30+) • Skilled nursing/LTC (120+) • Specialty care (25+) • Surgery Centers (20+) • Community Partners (80+) • In 2016 – 2017 they received funding for and were able to incorporate multiple different resources and additional personnel and programs such as; AzHHA: the coalition fiduciary agent, Chair and Co-Chair salaries, and a coalition Training Coordinator their website is http://www.azchercentral.org. The Central Coalition was the first coalition to do a hazard vulnerability assessment utilizing the Community HVA tool. The region completed their multi-year training and exercise plan that described among other things; two tabletop exercises, two functional exercises, three workshops and one full scale exercise over a three year period. Their emergency planning priorities would mainly be in the areas of medical surge and information sharing. And finally the central region, whose leadership includes that of county public health, described some opportunities for improvement that still need to be addressed such as: Capabilities 2 BPHEP ARIZONA DEPARTMENT OF HEALTH SERVICES Homeland Security Exercise and Evaluation Program (HSEEP)
2016 ADHS PHEP/HPP Executive Summary All Partners Meeting Infrastructure MOU Bylaws Funding Staffing Membership CMS rules Executive engagement Return on Investment (ROI)
AzCHER South The southern coalition reports a long history of healthcare response and preparedness dating back to 1998 with the activation of the metropolitan Medical Response System (MMRS). With nine local Tucson hospitals participating the goals included: • Build response to WMD events and capabilities both through Fire, EMS and Hospitals • To integrate mass casualty preparedness and response • Provides a structure for medical incident management • Achieves enhanced mutual aid and regional collaboration (including hospitals) • Enhances regional response capabilities • Complete and maintain requirements for funding from DHS, HRSA and CDC • Hospital collaborative mass casualty response planning This group would develop and grow to become the Arizona Coalition for Healthcare Emergency Response (AzCHER)-Southern Region with participants from healthcare organizations, public safety and public health. Organized as an executive board, planning committees and healthcare sectors the southern coalition developed into the Arizona Health Care Coalition – South Region (AzHCC-S) serving Cochise, Graham, Pima, Santa Cruz, and Yuma counties. Early preparedness goals focused on mitigation and overall regional development. Current goals are geared towards coordinating across agencies and jurisdictions and strengthening situational awareness.
Capabilities 3 BPHEP ARIZONA DEPARTMENT OF HEALTH SERVICES Homeland Security Exercise and Evaluation Program (HSEEP)
2016 ADHS PHEP/HPP Executive Summary All Partners Meeting
AzCHER Western: The western region is a robust group of hardworking members that serve: • Yuma Co – 204K pop. 5,500 sq. miles • La Paz Co – 20K pop. 4,500 sq. miles • Mohave Co – 204K pop. 13,400 sq. miles ∗ Yuma to Kingman 215 miles 4 hours
They had what they have termed, “The year of the child” completing an HVA, gap analysis and a disaster tabletop in pediatrics. And they have listed some of their challenges and barriers as geography and partner awareness.
Coming up in the future for the western region are new CMS COP’s for emergency preparedness and planning for terrorist events.
AzCHER Northern: The northern region is a widely diverse and hard working group that serves the following counties: • Apache • Coconino • Navajo and • Yavapai In partnership with these counties are several Native American sovereign nations such as: • Hopi • Kaibab Paiute • Navajo Nation and • White Mountain Apache Recently the northern region has offered training in the areas of Critical Incident Stress Management (CISM), SNS and health care leadership among others. They have had large scale infectious disease exercises and experienced the cedar and tenderfoot wild fires. Their challenges and barriers are mainly, funding, distance and participation. Coming up for the region; determining the training and exercise priorities for the next three years, emergency plans, hazard analysis and a regional tabletop exercise.
Tribal PHEP and AZTEC
Capabilities – Region Breakouts 4 BPHEP ARIZONA DEPARTMENT OF HEALTH SERVICES Homeland Security Exercise and Evaluation Program (HSEEP)
2016 ADHS PHEP/HPP Executive Summary All Partners Meeting
There are currently 12 tribal nations out of 22 participating in PHEP. AZTEC is interested in working with everyone. They view the new agreement as a supplement to the last one spanning 2012-2017. They are currently in the process of recapping the last five years with tribal members putting together a sub-recipient report, accounting for the work with PHEP partners to prepare for the new 2017-2022 project period. The Centers for Disease Control (CDC) will measure how well they work together.
Focus for tribes will be: • The size of the tribe, resources and personnel available • Whether or not a tribe has a health department or will require their county, state, or federal partners to make up for that • Regarding the 2017-2022 joint requirements and will emphasize working together with other tribes • The new domain structure and the best way to use it accordingly
Arizona Pediatric Disaster Coalition (APDC) The APDC has a rich history that is rooted in needs based assessments, critical response to medical surge events, and partner collaboration across multiple states. And as children represent 25% of the population, the costs and special circumstances surrounding pediatric events have inspired the members of this coalition to work particularly hard on overall partner development of pediatric preparedness and response plans and pediatric in-hospital emergency care.
As an advisory council to the health care coalitions across the state, the APDC works with Coyote Crisis Collaborative as a managing partner working towards guiding and assisting hospitals in pediatric issues. Following the successful execution of the National Pediatric Disaster Coalition Conference, the National Pediatric Disaster Coalition was launched.
The APDC partially consists of representatives from, pediatric hospitals, The Arizona Chapter of the American Academy of Pediatrics, ADHS Bureau of EMS and Trauma Services’ EMSC, Mountain States Pediatric Disaster Coalition (representing the states to the north of Arizona) and several more. Their mission includes identifying gaps in pediatric emergency management and their vision is to provide technical assistance in emergency preparedness.
Capabilities – Region Breakouts 6 BPHEP ARIZONA DEPARTMENT OF HEALTH SERVICES Homeland Security Exercise and Evaluation Program (HSEEP)
2016 ADHS PHEP/HPP Executive Summary All Partners Meeting
The APDC notes challenges in member participation as well as planning, training, and exercises focusing on pediatrics. Coming up in 2017 and 2018 are increasing partnerships with the Mountain States Pediatric Disaster Coalition, other regional partnerships, workshops focusing on pediatrics, and developing a new approach to pediatric evacuation.
Capabilities – Region Breakouts 6 BPHEP ARIZONA DEPARTMENT OF HEALTH SERVICES Homeland Security Exercise and Evaluation Program (HSEEP)
2016 ADHS PHEP/HPP Executive Summary All Partners Meeting
Objective 2-4: Discuss- the Funding Opportunity Announcement (FOA) for Budget Period One, grant planning, and grant resources PHEP Capability 1: Community Preparedness During the general discussion with attendees on the new FOA, ADHS leadership presented the new and applicable information for Arizona as well as facilitated a question and answer activity. The first question was presented to the audience from ADHS – What does the funding look like for BP1? What does or should the structure look like?
Regarding “Activity 1” from the Requirement and Timelines document, it was mentioned that some of these requirements have already been accomplished and there just needs to be sustainment. There was also a question as to where it stated or talked about the “core membership” in the Cooperative Agreement.
Regarding activities 2 and 3, ADHS explained that there is a new requirement about obtaining de-identified data from emPOWER regarding access and functional needs and that training will be available.
The following feedback was requested by ADHS and obtained from those in attendance regarding BP1 deliverables and what is to be expected:
• We will be required to work with fusion centers, but will they be going to be required to work with coalitions? This situation has been difficult in the past.
• Maricopa County mentioned that they would focus on assisting with current capabilities and identified gaps.
• The question was posed, “Do you want to come up with priorities for the deliverable document”?
• Some attendees would like to focus on Responder Safety and Health and Access and Functional Needs.
• Environmental health tracking systems – What is this?
ADHS requested feedback on what coalitions feel they need or want to see more of in the areas of planning, training and exercises:
• More frequent active shooter training • Triage training • Mass casualty training • State hospital evacuation planning Capabilities 8 BPHEP ARIZONA DEPARTMENT OF HEALTH SERVICES Homeland Security Exercise and Evaluation Program (HSEEP)
2016 ADHS PHEP/HPP Executive Summary All Partners Meeting
• Evacuation equipment training • Communication equipment maintenance • Foster EMS relationships • Exercises – preference to include 25% victims as children (0-12) • Planning technical assistance • Developing flexible response plans with pediatric consideration • Surge – pediatric focus • Patient tracking • Suggest award process be competitive (explanation of challenges and restrictions with competitive awards • Growing memberships in smaller regions • May find 1-2 activities within each domain to focus on that address priority gaps • Need more time to review FOA • Building coalition has been a challenge • Possibility of using one coordinator between Western and Northern regions – would help bridge activity efforts • Like idea of a coordinator for each region (coalition) to help with planning and administrative responsibility
In closing, overall for the new standards to work and to assist Arizona in its preparedness goals, member engagement is essential. An HPP hospital is no longer a term that should or will be used. An active, participating member in a coalition can receive funds for release-time for training and exercise participation, travel and other requests. ADHS will put together a plan (draft deliverable) document that will be sent out to partners for feedback.
Capabilities 8 BPHEP ARIZONA DEPARTMENT OF HEALTH SERVICES Homeland Security Exercise and Evaluation Program (HSEEP)
2016 ADHS PHEP/HPP Executive Summary All Partners Meeting
APPENDIX A: EXERCISE PARTICIPANTS
Exercise Participants Federal CDC DSLR Phoenix Veterans Affairs Health Care System Indian Health Services State Arizona Department of Health Services Arizona Department of Economic Security Tribal Colorado River Indian Tribe Quechan Indian Tribe Pascua Yaqui tribe Winslow Indian Health Care Center Gila River Indian Community Cocopah Indian tribe White Mt. Apache Tribe Fort Mojave Indian Tribe The Hopi Tribe San Carlos Apache Tribe Tohono Oodham Nation Counties Maricopa County Department of Emergency Management Maricopa County Department of Public Health Pima County Health Department Pima County Office of Emergency Management
Exercise Participants A BPHEP ARIZONA DEPARTMENT OF HEALTH SERVICES Homeland Security Exercise and Evaluation Program (HSEEP)
2016 ADHS PHEP/HPP Executive Summary All Partners Meeting
Exercise Participants Cochise County Office of Emergency Services Yavapai County Community Health Services Mohave County Department of Public Health Yuma County PHEP Graham County Health Department Greenlee County Health Department Coconino County Public Health Services District Santa Cruz County Health Services Pinal County Public Health Services District Navajo County Public Health Cities Phoenix Fire Department-Homeland Defense Bureau Glendale Emergency Management Hospital and Health Care Facilities Mt Graham Regional Medical Center Phoenix Indian Medical Center Dignity Health Banner University Medical Center - Tucson Adelante Healhtcare Canyonlands Health Care Tsaile Health Center La Paz Regional Hospital Maricopa Integrated Health System CopperQueen Community Hospital Carondelet Health Network Abrazo Maryvale Campus
Exercise Participants A BPHEP ARIZONA DEPARTMENT OF HEALTH SERVICES Homeland Security Exercise and Evaluation Program (HSEEP)
2016 ADHS PHEP/HPP Executive Summary All Partners Meeting
Exercise Participants Arizona Spine & Joint Hospital Abrazo Arizona Heart Hospital Mayo Clinic MWPERLC, University of Arizona Tuba City Regional Health Care Corporation Mayo Clinic Hospital Copper Queen Community Hospital Carondelet Health Network, St Joseph's Hospital Yuma Regional Medical Center Abrazo Arrowhead Campus Phoenix & Tempe St. Luke's Hospital Banner Payson Medical Center Abrazo Scottsdale Campus Sun Life Family Health Centers Yavapai regional medical center Flagstaff MedicalCenter Carondelet S. Mary's Hospital Health Care Coalitions AzCHER Central AzHCC South AzCHER Northern AzCHER Western Arizona Health Care Association Arizona Tribal Executive Committee Arizona Pediatric Disaster Coalition Coyote Crisis Collaborative
Exercise Participants A BPHEP ARIZONA DEPARTMENT OF HEALTH SERVICES Homeland Security Exercise and Evaluation Program (HSEEP)
2016 ADHS PHEP/HPP Executive Summary All Partners Meeting
Exercise Participants Other Laurence LLC Independent Health Care Consulting
Exercise Participants A BPHEP ARIZONA DEPARTMENT OF HEALTH SERVICES Homeland Security Exercise and Evaluation Program (HSEEP)
2016 ADHS PHEP/HPP Executive Summary All Partners Meeting
APPENDIX B: ACRONYMS
Acronym Term ADHS Arizona Department of Health Services AFN Access and Functional Need AHCA Arizona Health Care Association AZTEC Arizona Tribal Executive Committee BP4 Budget Period 4 CDC Centers for Disease Control and Prevention CPG Capability Planning Guide DEMA Division of Emergency and Military Affairs DOD Department of Defense DPS Department of Public Safety EM Emergency Management EMS Emergency Medical Services EOC Emergency Operations Center ESF Emergency Support Function FEMA Federal Emergency Management Agency HPP Hospital Preparedness Program HHS Health and Human Services ICS Incident Command System JIC Joint Information Center LTC Long Term Care MCM Medical Countermeasures NDMS National Disaster Medical System PAHPA Pandemic and All Hazards Preparedness Act PHEP Public Health Emergency Preparedness PIO Public Information Officer RBHA Regional Behavioral Health Authority
Appendix B: Acronyms B BPHEP ARIZONA DEPARTMENT OF HEALTH SERVICES Homeland Security Exercise and Evaluation Program (HSEEP)
2016 ADHS PHEP/HPP Executive Summary All Partners Meeting
SAC Senior Advisory Council SERRP State Emergency Response and Recovery Plan SNS Strategic National Stockpile VA Department of Veterans’ Affairs
Appendix B: Acronyms B BPHEP ARIZONA DEPARTMENT OF HEALTH SERVICES Homeland Security Exercise and Evaluation Program (HSEEP)