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EMERGENCY MANAGEMENT

 

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Please read the following information regarding Emergency Management. To go to the following page click Next Page. Once finished, please complete the information requested and submit to get credit for the class.

 

INTRODUCTION

Our community is vulnerable to a wide range of emergencies, including natural, technological, and man-made disasters, all of which threaten the life, health and safety of its people, damage and destroy property, disrupt services and everyday business and recreational activities, and impede economic growth and development.

The purpose of our Plan is to support local emergency response efforts and reduce the vulnerability of our patients to injury and loss of life and property, loss of continuing needed home health care, and to be prepared to maintain our services to our patients who need our services under emergency situations, and prompt and efficient reinstatement of our services to patients when normal conditions are reestablished.  A Comprehensive Emergency Plan is prepared, reviewed annually, and revised as necessary, and fully implemented from November, 2000.

Florida Home Bound Emergency and Disaster Preparedness Plan ensures the health care needs of the patient are met in emergencies which may interfere with the delivery of health service.  Florida Home Bound utilizes a three-category classification system to prioritize patient activity and patient care needs during an emergency.  Please ask your Florida Home Bound representative if you have any questions regarding your classification.

 

EMERGENCY AND DISASTER PLAN

 

  1. 1. For critical emergencies such as severe chest pain, severe breathing problems, diabetic coma, fall with loss of movement or severe pain, sudden excessive or unexpected bleeding, or sudden unconsciousness, call 911, an ambulance, or go to the hospital immediately.  Do not waste valuable time calling the Agency.
  1. 2. For emergencies such as changes in consciousness, major changes in behavior, fever, difficulty urinating, sudden changes in bowel habits, vomiting and inability to retain food for a full day, please call your Case Manager at Florida Home Bound at 305 – 892-7272 or Physician.  Call your Physician if there is a sudden change in your physical or mental condition, or if you need prescription refills.
  1. 3. If a natural disaster occurs, go to the nearest designated shelter or, if medical conditions warrant, to the nearest hospital before, during and after natural disasters.  Keep in touch with local authorities such as the Sheriff’s Department or local Red Cross.
  1. 4. Caretakers of patients on mechanical ventilators should notify the nearest fire department, ambulance service, electric and telephone company of patient’s status so that appropriate interventions may be taken in the event of power failure or a natural disaster.
  1. 5. Patients using a stationary infusion pump should be taught to turn off the pump clamp tubing and disconnect the pump for evacuation.  Patients receiving continuous infusion medications which cannot be interrupted without risking patient safety should be maintained on an ambulatory pump and patient should take extra supplies and medication doses with them for the evacuation

 

AUTHORITIES AND REFERENCES

During an Emergency, our Agency has appointed the following personnel in charge of all of our emergency operations. Please call (305) 892-7272 to acquire more information regarding these emergency contacts:

›› Carol Joy Biggs-Owens, RN, Alternate Administrator/ Director of Continuous Quality Improvement

›› Davil  E. Biggs, PCC, Emergency Management Coordinator Assistant

›› Kay Herbert, Director of Nursing
›› Serge Darnal, Alternate Director of Nursing
›› Tameka Clayton, PCC
›› Yolanda Eguaras, PCC
›› Maria Maqueira, PCC
›› Roselyn Millan, PCC
›› Pakita Souverain, PCC
›› Damian Suarez, PCC
›› Jamilet Lawson

 

 

CONCEPT OF OPERATIONS

Direction and Control

To ensure continuous leadership and authority during emergency situations, the Administrator and the Director of Nursing are fully responsible for implementation and check-up of the Agency Emergency Management Plan.

Emergency:  An occurrence or threat thereof which results or may result in substantial injury or harm to the population, or substantial damage to or loss of property.

In the event of an emergency that disrupts the Agency’s ability to provide care, needs will be prioritized to determine whose needs are the greatest.  Patients will continue to receive care, if possible, with minimal disruption of schedule.  On all initial admissions and during home health care provisions, patients will be instructed on what to do in the event of an emergency situation if nursing availability is limited.

If an emergency occurs, either within the Agency causing staffing limitation (such as labor disputes, staff illnesses) or within the environment (such as floods, hurricanes, fires or other natural disasters), the Director of Nursing, or her designee, will be responsible for reviewing patients and prioritizing them according to the following classifications:

D1……….Category 1:
Patients who cannot safely forgo care: highly unstable patients with high probability of inpatient admission if home care is not provided; IV therapy, highly skilled wound care, with no family/caregiver, life sustaining medication or equipment.
D2……….Category II:
Patients whose condition recently worsened: moderate level of skilled care that should be provided that day, but could postpone visit until emergency situation improves.  Patients with untrained families or caregiver who could provide basis care in an emergency.
D3……….Category III:
Patients who can safely forego care or a scheduled visit including Home Health Aide visits; patients receiving routine supervisory visit, evaluation visits; patients with 1 or 2 visits/wk.; patients who have a competent family/caregiver.
D4……….Category IV:
Patients who refused information, or signed the registration release form releasing the Agency from evacuation responsibilities.
In the event evacuation of the patient is required, the local authority responsible for coordinating disaster preparedness and emergency response will be contacted by the Administrator, Director of Nursing, or their designee, to give authorities a list of patients requiring continued care during the emergency.  This list is updated daily and kept at the office and by the Administrator and DON.

 

In the event some patient visits cannot be made and it is not a life-threatening situation, contact will be maintained by phone if possible.  If office phone service is disrupted, phones will be turned over to the 24-hour on-call person.

**All office and field staff members of Florida Home Bound MHA, Inc. are to remain on duty when a disaster is announced and continue on duty until specifically released.  A comprehensive list of all employees reporting for duty during a disaster shall be maintained.**

 

ON CALL AND EMERGENCY SERVICES

Policy:

All patients will be provided with the correct information regarding service hours of the Agency and access to staff for emergencies.  Our Agency will provide adequate qualified staff for emergency response and troubleshooting related to any services provided to patient/caregiver.  Patients/caregivers will be informed when home health visits originally scheduled during regular business hours need to occur after 5:30 p.m.

Procedure:

Emergency Response:
1.  On initial visit, patient/caregiver will be provided with an Agency Client Handbook and telephone number, and will be educated on Agency’s twenty-four (24) hours, seven (7) days per week, availability of home care staff.

2.  Staff will discuss Client Handbook with the patient/caregiver:
     a.  Telephone calls may be made to the Agency during the office hours of 9:00 a.m. to 5:00 p.m., Monday through Friday
     b.  After office hours and on weekends/holidays, on-call supervisor may be reached by dialing office number or 24-hour on-call number 305-301-0826.

3.  If a true emergency exists, caller will inform the 24-hour on-call person of the type of emergency, and staff member will return call immediately

4.  If caller chooses only to leave a message, he/she may do so, and Agency staff will follow up on the call on the next business day.

5.  Only emergency/scheduled visits are made on weekends and holidays.

6.  All patients/caregivers are instructed verbally on admission to contact 911 in the event a life-threatening emergency occurs.

7.  On-call representatives will handle all problems, or will contact the home care licensed staff as appropriate.

8.  The home health care staff is responsible for determining the necessity for a home visit, notifying the physician and/or taking other appropriate action.

**The on-call representative will keep a log of all calls and actions taken.**

 

POLICY ON EMERGENCY PROCEDURES

Purpose:

It is the policy of Florida Home Bound that all employees will be responsible for and be required to take the following actions in the event of an emergency involving a patient and/or employee or both.

Procedure:

1.  Exercise of prudence and good judgment in assessing the nature of the emergency and taking an action that he/she deems necessary and appropriate under the given circumstances.

2.  Establishing immediate phone contact with the office to alert the Emergency Management Director and/or Administrator or Director of Professional Services, or his/her designate.

3.   Establishing immediate phone contact with the skilled nurse in charge of the particular case, if applicable.

4.   Establishing immediate phone contact with the patient’s physician, if applicable.

5.   Establishing immediate phone contact with the emergency medical system phone number 911, if applicable.

6.   Establishing immediate phone contact with the local police, if applicable.

7.   All incidents shall be reported in writing on the following forms: Incident Report form and on the Communication Log in the patient’s files.

Notification:

During off-hours, weekends and holidays, each employee will address any Emergency Alert through our on-call services, dialing our phone number 305-892-7272 or our emergency number at 305-301-0826.  There is a 24 hour On-Call RN available at all times to answer questions or to respond to all emergencies.

Clinical Record Protection:
  1. 1.   The On-Call RN(s) will be responsible for taking and storing clinical records in safe areas.
  2. 2.   Back up client and billing computer records regularly and ensure patient data and required office client data forms are saved to a CD ROM or a Zip Drive and stored in a secure off-site location.  Larger corporate home health agencies may have a local area network server that utilizes a backup server.  This information should also be saved to a CD ROM or Zip Drive.
  3. 3.   Store back-up CDs on site in insulated containers.
  4. 4.   Make hard copies of pertinent client file contents including the Physician Orders, Assessment, Plan of Care or service provision plan and Advance Directives in a secure off-site location.
  5. 5.   Provide a copy of the record items listed above to the client and/or the client’s caregiver to store in their home(s).
  6. 6.   Transfer Special Needs Registry Lists and required information to a disc that is stored in a secure off-site location.
  7. 7.   Send updated discs and hard copy Special Needs Registry Lists to the county Special Needs Department on a regular basis.  Keep a copy on site in an insulated container.
  8. 8.   Scan record contents on a regular basis.  Small scanners can be purchased relatively inexpensively.  There are also corporate scanners available at reasonable prices.  Check Consumer Reports for the scanner that meets your agency’s needs.
  9. 9.   Store copies of the scanned records in a secure off-site location.
  10. 10.  Arrange for the evacuation of records to a designated backup facility if there is sufficient warning prior to the disaster.

The Emergency planners responsible for clinical records will meet at least annually with our local emergency management personnel in our county.  Keeping abreast of new and better ways to protect our clinical records and equipment will help us get up and running quickly after a disaster.

 

POLICY AND PROCEDURE ON HURRICANE/TORNADO WARNINGS

 

When a patient is under the care of Florida Home Bound, and if there are other responsible relatives in the household, the same general protection and precautions taken by members of that household shall apply to the patient.  Our staff shall advise the members of the household to stockpile a “hurricane cupboard” with food and supplies in readiness for a hurricane.

  Hurricane

In a situation where a patient is alone in a house, a “hurricane cupboard” shall likewise be kept (with food and supplies).  In addition, our staff members shall make prearrangements to have the patient registered with the nearest Red Cross Center or other similar center which caters for the elderly, and in the event of a hurricane, the patient shall be transported by Dade County Transportation Services to the designated shelter previously arranged by our staff member and/or patient, and/or patient’s family member, and/or patient’s physician.

If due to emergency situation the Agency has to be ceasing operation, the patient or patient’s caregiver will be notified within 24 hours of ceasing time, and our Agency will assure that all patients needing continuing care will receive it, either from another home health agency, Special Needs shelter, or arrangements made by patient or patient’s caregiver.  The Emergency Management Director and/or Administrator/Director of Nursing or their respective designees, are responsible for implementation of the Emergency Plan.

Evacuation:

All medication, supplies and equipment used by our patients will be listed and will be updated as often as possible, and kept in the home to accompany the patient during evacuation to a Special Needs shelter if needed.  Our staff will educate the patient and/or caregiver concerning the list and other items accompanying the patient during the evacuation.

The Patient’s Return Home:

Immediately after a Disaster is over our staff will maintain continuous contact with Special Needs Shelters and/or patient’s Emergency Contact or caregivers to ensure to re-start the home care services as soon as possible. If patients are unable to return home, our Case Managers will become active in assisting in placing patients in temporary homes or ALFs, and visits will be scheduled immediately.

In each Emergency Plan left at patient’s home, the Agency’s phone number and skilled employee number will be clearly defined, and instruct patient/caregiver to keep that information with them, in order to establish contact after normal situation returns.  According to our previous emergency patients classification, we will reestablish care according to employee availability following the disaster/emergency.

Information, Training and Exercise:

The Emergency Preparedness Director and Assistants will warranty the training of all of our staff by internal in-service, which covers their roles before, during and after an emergency.  Each admission nurse is instructed in emergency definition, the Emergency Management Plan, all emergency forms used by our Agency, the importance to fill them out with accurate information, and to reinforce the need of patient education, for use and conservation in a safe/easy access place.  In addition, our office staff are trained with the full Emergency Plan, with our on-call system, and how they can work with the local state or county agency who will be managing and staffing the Special Needs Shelter during an emergency.  New employees are instructed on the full Emergency Plan in their initial training, and their roles explained.

For more information CLICK HERE.

 

EMERGENCY MANAGEMENT PLANNING CRITERIA

 

The following criteria will be used when developing Comprehensive Emergency Management Plans (CEMP).  This criteria will also serve as the Plan format for the CEMP, since they satisfy the basic Emergency Management Plan requirements of s.400.492, Florida Statutes, and 59A-8.027, Florida Administrative Code.

These criteria are not intended to limit or exclude additional information that we as a home health agency may decide to include to satisfy other requirements, or to address other arrangements that have been made for emergency preparedness.

This completed form will be attached to our agency’s Comprehensive Emergency Management Plan.  It will be used as a cross reference to our written Plan.

Purpose:

The purpose of our Plan is to support local emergency response efforts, and reduce the vulnerability of our patients to injury and loss of life and property, loss of continuing needed home health care, and to be prepared for maintaining our services to our patients who need our services under emergency situations, and prompt and efficient reinstallment of our services to patients whose services can be safely postponed until normal conditions are re-established.

Time Of Implementation:

In the event of any emergencies that are declared by local authorities, this Plan will be implemented.

Desired Outcome:

The desired outcome to be achieved is to protect and preserve our patients during an emergency.

 

FORM

Please fill out the following form, print, and keep in a place where it can easily be found.

Emergency Form

 

CONCEPT OF OPERATIONS

Click here to view our Organizational Chart.

Procedures to ensure timely activation of the Agency’s Emergency Management Plan and staffing of the home health agency during an emergency and provisions for emergency workers’ families are the following:

If there is an emergency but the Agency remains operational, all staff, especially designated field staff, will come to or call the office.  Those not able to come to the office will maintain communications with the Agency for instructions.

In the event of an emergency that disrupts the Agency’s ability to provide care, needs will be prioritized to determine whose needs are the greatest.  Patients will continue to receive care, if possible, with minimal disruption of schedule.

During an emergency all office personnel will contact the Agency at 305-892-7272.  The Emergency Management Director or its designees will contact nursing personnel who were previously listed to participate in caring for our patients during an emergency, and assign them as previously started during Start of Care (SOC)  All Florida Home Bound patients are grouped according to and will be assigned to a field nurse according to their category.

 

Florida Home Bound will follow steps below to ensure Property Protection:
  1. 1.   Raise computers above the flood level and move them away from large windows.
  2. 2.   Move heavy and fragile objects to low shelves.
  3. 3.   Move file cabinets to the interior of the business location.
  4. 4.   Purchase materials (plastic sheeting) to cover computers and file cabinets.
  5. 5.   Install fire sprinkler systems.
  6. 6.   Install fire-resistant materials and furnishings:
  7. 7.   Install storm shutters for all exterior windows and doors.
  8. 8.   Secure light fixtures and other items that could fall.
  9. 9.   Place Velcro strips under tabletop computers.
  10. 10.   Install curtains or blinds that can be drawn over windows.

DIRECTION AND CONTROL

 

Category D1

These patients are assigned to a field nurse at SOC to be followed during an emergency.  Patients who fall under other categories will forego care until emergencies have passed. 

Patients who are currently under our care, living in Assisted Living Facilities (ALF) will fall under the ALF Emergency Plan.  If there are patients living in the ALF who are classified as D1 or D2, all efforts will be made to attempt to transfer these patients to a hospital setting.

There will be no special provisions by this Agency for staff families.

On initial admission and during home health care provisions, patients will be instructed on what to do in the event of an emergency situation if nursing availability is limited.  If an emergency occurs, either within the Agency causing staffing limitation (such as labor disputes, staff illnesses) or within the environment (such as floods, hurricanes, fires or other natural disasters), the Director of Nursing/Professional Services, or her designee, will be responsible for reviewing patients and prioritizing them according to the following classifications:

D1      Category 1:
Patients who cannot safely forgo care: highly unstable patients with high probability of inpatient admission if home care is not provided; IV therapy, skilled wound care, with no patient/caregiver life sustaining medication or equipment.

D2      Category II:
Patients whose condition recently worsened: moderate level of skilled care that should be provided that day but could postpone visit until emergency situation improves.  Patients with untrained families or caregiver who could provide basic care in an emergency.

D3      Category III:
Patients who can safely forgo care or a scheduled visit, including Home Health Aide visits: patients receiving routine supervisory visits, evaluation visits; patients with 1 or 2 visits/week; patients who have a competent family/caregiver.

D4      Category IV:
Patients who refused information, or signed the registration release form releasing the Agency from evacuation responsibilities.

In the event evacuation of the patient is required, the local authority responsible for coordinating disaster preparedness and emergency response will be contacted.  In the event some patient visits cannot be made and it is not a life-threatening situation, contact will be maintained by phone if possible.  If office phone service is disrupted, phones will be turned over to the on-call person.

 

All patients will, on admission to the Agency, be assigned a disaster code which describes their level of care.  Patients assigned to D1 code will be immediately on admission assigned to a Florida Home Bound MHA, Inc. skill nurse/therapist.

Nursing staff who are assigned to a case for emergency preparedness will immediately upon a warning of an emergency do the following:

  1. a. Skill staff will contact their assigned patients alerting them as to the actions (if any) they are to undertake.

  2. b. Contact the local authorities regarding patients who need to be transferred to a Special Needs Center (SNEC).

  3. c. Contact the physician for patients coded D1 for admission to hospital.

  4. d. Contact the office with documentation on steps followed above.

Provide information on the management of patients who will continue to receive treatment by the home health agency during an emergency.
  1. a. Patients who receive daily visits and are coded D1 on admission or during home care service will be assisted by contacting their physician for hospitalization for continued care.  The Agency will fax to hospital the patient thx. plan.

  2. b. The Administrator/DON or Intake personnel will be in contact with all assigned nursing personnel for scheduling and coverage of home visits.

  3. c. Home care visits will continue as previously scheduled, in the event the emergency is not a hurricane.  No staff will provide home care during a Hurricane Warning unless the location where patient is located is safe and visits are planned with pre-approval of the Emergency Management Plan Director.

  4. d. Assist in identifying home health agency staff who have an agreement with those local agencies which will be medically managing and staffing the Special Needs Shelters during an emergency.

In the event patients of Florida Home Bound are registered with a SNEC, the Administrator, Alternate Administrator and DON will have a written agreement with the local agencies to assist in medically managing and staffing the SNEC during an emergency.

 

Notification:

Procedures must be in place for the home health agency to receive timely information on impending threats and the alerting of home health agency decision makers, staff, and patients of potential emergency conditions.

All assigned staff are instructed to constantly monitor news broadcasting from emergency stations and news organizations.  The Agency Administrator during declared or possible approaching emergencies will ALERT all assigned nursing staff that implementation of the Plan is now in effect.

The 24 hour telephone number is 305-892-7272.
Emergency numbers are: 305-301-0826 and 305-298-4165.

 

The Agency Administrator during declared or possible approaching emergencies will ALERT all assigned nursing staff that implementation of the Plan is now in effect.

  1. a. The Administrator or personnel in Intake Department will contact by phone or beeper all assigned nursing staff and provide them with their schedules.
  2. b. Assigned nursing staff will immediately upon this warning of an emergency from the Administrator do the following:
  3. c. Contact their assigned patients, alerting them as to the actions (if any) they are to undertake
    1. i. Emergency Coordinators will contact the local authorities regarding patients who need to be transferred to a Special Needs Center (SNEC).
    2. ii. Schedule visits with D1 coded patients for the following 72 hours
    3. iii. Contact the office with documentation on steps followed above

On initial contact with patients and during home care services, all patients are provided with instructions regarding the Agency Preparedness Plan and the category under which they are assigned.  Only patients that are in Category D1 are assigned to a field nurse at SOC to be followed during an emergency.  Patients who fall under other categories will forego care until the emergency has passed.  Patients who are currently under our care living in an Assisted Living Facility (ALF) will fall under the ALF Emergency Plan.

On all initial admission and during home health care provision, all patients/caregivers are instructed on what to do in the event of an emergency situation if nursing availability is limited.  If an emergency occurs, either within the Agency causing staffing limitation (such as labor disputes, staff illnesses) or within the environment (such as floods, hurricanes, fires or other natural disasters), the Director of Nursing or her designee will be responsible for reviewing clients and prioritizing them according to their classifications.  The Administrator or assigned nursing staff will contact patients by telephone to alert them on the precautionary measures that will be taken.
Should the primary system of notification fail and the emergency conditions are not already in effect and the roads are safe, the assigned staff nurse will personally visit the patient’s home to alert them as to the emergency activities of the Agency.

In the event the Agency is ceasing operations, all patients will be contacted by phone and advised that the Agency is ceasing operation until further notice.  Patients requiring continuous care will be instructed to go to an evacuation shelter, hospital, or make alternate arrangements for their care.  Should the primary system of notification fail and the emergency conditions are not already in effect and the roads are safe, the assigned staff nurse will personally visit the patient’s home to alert them as to the emergency activities of the Agency.

 

Upon admission each patient is prioritized according to their clinical needs, and are assigned to the Disaster Plan Code of 1-4.  This list is updated periodically.  The list is kept in Medical Records.  The list will indicate how services shall be continued during an emergency for each patient; if the patient is to be transported to a Special Needs Shelter by the local Emergency Management office (or an entity working under their direction); if the patient is receiving skilled care and what care includes; the patient’s medication, supplies and equipment needs.  The Agency will note in the patient’s record if the patient is registered with the Special Needs Registry; if they will be evacuated to a Special Needs Shelter, or if the patient or the patient’s caregiver will be responsible for evacuation.

The overall goal of the Florida Home Bound MHA, Inc. Emergency Plan is the reduction of mortality and disability resulting from acute injury during an emergency.  There are three forms that are completed during Initial Assessment of the patients.  These forms are kept in the patient’s medical record and home chart:
a.   The Comprehensive Emergency Plan Form: which includes the patient’s name, address, home phone number, patient’s emergency contact name and phone number, Agency address, emergency phone numbers, and patient coded classification.

  1. Patient Care Plan: which included patient’s medical and treatment data, special needs of the patient, information on supplies and equipment needs of the patient
  2. Medication Profile: which lists all medications that the patient is presently on, and is updated as needed.

These 3 forms are kept in the patient’s home chart.  All patients are instructed that in case of an evacuation to take their home chart with them.

On admission, all patients are provided with the information on the Agency’s Emergency Preparedness Plan.  They are instructed that most importantly all medications should be placed in a plastic bag or container for safe-keeping; supplies and equipment needed should also be taken along.

 

EMERGENCY EVACUATION ASSISTANCE PROGRAM

 

 

At SOC patients will be identified if they will need to be assisted by the Emergency Evacuation Assistance Program.  In the event that there is the need, the Social Worker at Florida Home Bound will be contacted to assist patient in completing the Special Needs Evacuation Center form.  The Emergency Management Plan Director will become involved in assisting with the completion of this form by contacting patient’s physician to complete the form and arranging for delivering or mailing form to the Dade County Emergency Management Office.

Patient’s name will be logged onto the Florida Home Bound Emergency Evacuation Assistance Program, beginning with date of Application sent to the Miami-Dade Office of Emergency Management.

In the event of an emergency requiring patient to be evacuated, the E.M.P. Director will contact the Miami Dade Office of Emergency Management 24 hours prior (in case of a hurricane) to ensure that patients are evacuated safely from their homes.  Patients must be reminded that in order to participate in this program they must have a companion to accompany them.  Florida Home Bound will not be able to provide this resource.

Florida Home Bound will attempt to arrange with local hospitals for those patients who are coded as D1 (patients who are not able to forego care).  The physician will be contacted 24-48 hours prior (in case of hurricane) for direct hospital admission.

All patients are instructed that in case of an evacuation to take their home chart with them.  In addition, all patients/caregivers are provided with written information on: HURRICANE EMERGENCY INSTRUCTIONS FOR PEOPLE WITH SPECIAL NEEDS.  Admission nurse will inform patients at admission that if they have special needs, they should register to go to a Special Needs Shelter.  A regular shelter is not set up for their needs.  Conditions in a regular shelter can be uncomfortable, stressful; and with no medical personnel for them.

 

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 caregiver1, 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, blanket, 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 and current address
  • Special diet items, non-perishable food for 72 hours, and 1 gallon of water per person per day
  • Glasses, hearing aids 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)  Shelters 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.  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.
  • 1 Caregivers can be relatives, household members, guardians, friends, neighbors and volunteers.

**Remember: Hurricane Shelters cannot provide advanced life support.  If you have special needs, make arrangements with your physician now.**

If you have questions at any time, please call us at 305-892-7272.

When a patient is under the care of this Agency in his/her own home, and if the home situation is such that there are other responsible relatives in the household, the same general protection and precautions taken by members of that household shall apply to the patient.  Our staff shall advise the members of the household to stockpile a “hurricane cupboard” with food and supplies in readiness for a hurricane.

In a situation where a patient is alone in a house, a “hurricane cupboard” shall likewise be kept (with food and supplies).  In addition, our staff members shall make prearrangements to have the patient registered with the nearest Red Cross Center or other similar center which caters to the elderly, and in the event of a hurricane the patient shall be transported by Dade County Transportation Services to the designated shelter, previously arranged by our staff member, and/or patient and/or patient’s family member and/or patient’s physician.

The Patient’s Return Home:

Once patients have been evacuated from their homes, procedures need to be in place for the return of patients and the re-start of home health care in the patient’s home. 

Florida Home Bound staff will provide home care services to patients in Special Needs Shelters and in other safe locations before and after a disaster.  Florida Home Bound will provide the same services patient was receiving prior to the disaster if at all possible until patient returns home.  In each Emergency Plan left at patient’s home, the Agency’s phone number and skilled employee number will be clearly defined, and instruct patient/caregiver to keep that information with them, in order to establish contact after normal situation returns.  According to our previous emergency patient’s classification, we will reestablish care according to employee availability following the disaster/emergency.

 

Information, Training And Exercise:

The Emergency Management Director will warranty the training of all of our staff, by internal In-Service, which cover their roles before, during and after an emergency.  Each admission nurse is instructed in emergency definition, the Emergency Management Plan, all emergency forms used by our Agency, the importance to fill them out with accurate information, and to reinforce the need of patient education, for use and conservation in safe/easy access place.  Also, all field and other staff are trained with the full Emergency Plan, with our on-call system, and how they can work with the local state or county agency who will be managing and staffing the Special Needs Shelter during an emergency.  New employees are instructed on the full Emergency Plan in their initial training and their roles explained.

When the emergency has passed, the Intake Department will establish phone contact with each field staff assigned to cases with an updated schedule to resume care to patients who could forego care during the immediate disaster.

In the event that there is a shortage of field staff, the Administrator will contact other certified home health agencies for help in filling patient’s needs.  The Administrator will refer to each patient’s priority code, and patients requiring daily skill care will be assigned to available staff nurses, aides and other ancillary personnel.  The Administrator/Alternate, the DON/designee will all be included in home care visit coverage until the Agency is back in full operation.

It is the policy of Florida Home Bound MHA, Inc. that all employees of this Agency will be responsible for and be required to take the following actions in the event of an emergency involving a patient, an employee, or both:

Exercise of prudence and good judgment in assessing the nature of the emergency, and taking an action that he/she deems necessary and appropriate under the given circumstances.

  1. Establishing immediate phone contact with the emergency medical system (EMS phone number 911), if applicable.
  2. Establishing immediate phone contact with the patient’s physician, if applicable.
  3. Establishing immediate phone contact with the office to alert the Administrator or Director of Professional Services, or his/her designee.
  4. Establishing immediate phone contact with the Case Manager in charge of the particular case, if applicable.
  5. Establishing immediate phone contact with the local police, if applicable.

All incidents shall be reported in writing on Communication Sheets in the patient’s files.

All employees of Florida Home Bound MHA, Inc. shall participate in annual implementations of the disaster plan within in response to an actual emergency or in a planned drill.  Their performance during the implementation of the Plan shall be documented, evaluated and presented to the CQI Committee.

The evaluation of the disaster plan will involve review and evaluation of the effectiveness of their emergency preparedness training program and the initiation of the plan.  The Administrator and the CQI advisory board will review the plan.

The Emergency Management Director will warranty the training of all of our staff during their initial orientation and annual mandatory re-orientation, and by internal In-Service training, which covers their roles before, during, and after an emergency.  Each admission nurse is instructed in emergency definition, the Emergency Management Plan, all emergency forms used by our Agency, the importance to fill them out with accurate information, and to reinforce the need of patient education, for use and conservation in safe/easy access place.  Also, the rest of our staff are trained with the full Emergency Plan, with our on-call system, and how they can work with the local state or county agency who will be managing and staffing the Special Needs Shelter during an emergency.  New employees are instructed on the full Emergency Plan in their initial training, and their roles explained.

 

POLICY FOR PATIENT HURRICANE PROCEDURE

 

When a hurricane is approaching, procrastination and indecision can be hazardous.  It is essential that plans are made in advance.  If the Dade County Office of Emergency calls for the evacuation of any area, it must be done immediately

1. Hurricane Preparation List
  1. a.  Battery operated radio
    b.  Flashlight and bulbs
  2. c.   Emergency cooking utilities
  3. d.  Lantern, fuel, candles
  4. e.  Matches and can opener
  5. f.  Canned food
  6. g.   Extra medications, especially for diabetic patients using insulin.  Advise patient to purchase extra insulin and syringes.  Patients should purchase extra cardiac medication such as Nitroglycerine for emergency use.  The Registered Nurse will provide extra surgical supplies, such as material for changing dressings, N.G. tube, for Foley supplies, etc. if required.
    h.  First-aid kit
    i.   Boarding or tape for windows
  7. j.   Bleach
  8. k.  Fire extinguisher
  9. l.  Car should be full of gas prior to storm
  10. m.  Emergency evacuation plan
  11. n.  A flashlight with extra batteries
  12. o.  Transistor radio with extra batteries
  13. p.  Manually operated can opener
  14. q.  Sterno stove and fuel
  15. r.  Measuring cup and plastic spoons
  16. s.  2 gallons distilled water
  17. t.  Matches and candles
  18. u.  Paper plates and paper cups
  19. v.  Plastic containers with lids for mixing
2.  Medicines on Hand 
  1. a.  Check your prescriptions, and have a 7-day supply available
  2. b.  If you are diabetic, have insulin or oral medications, and you should consult your physician about how to adjust your insulin dosage during emergency situations
  3. c.   If you take Kayexalate and Sorbitol, have an ample supply
  4. d.   Vitamin pills, one bottle
    e.   Phosphate binders (antacids), one bottle
    f.    Blood pressure medications
  5. g.   The Red Cross suggests having a first aid kit available.
3. Plan a course of action to do one of the following:
  1. ›› Relocate outside the area
  2. ›› Stay with local friends or relatives
  3. ›› Stay home
  4. ›› Go to a Red Cross shelter (pets are not allowed in Red Cross shelters)
4. When a Hurricane Threatens:
  1. ›› Pay attention to official announcements on radio and/or television
  2. ›› If you are in a vulnerable area, be prepared to evacuate
  3. ›› Clear your property of all outdoor debris, such as lawn chairs, trash, garbage cans, and other potentially projectible item
5. During the storm:
  1. ›› Stay indoors
  2. ›› If the power goes, flashlights are safer than candles or kerosene lamps
  3. ›› Use your telephone for emergencies only
  4. ›› Continue to monitor your radio
  5. ›› Remain indoors until an official “All Clear” is give
6. After the hurricane:
  1. ›› Respond to instructions given by police and media announcements by County Emergency Management and the Red Cross
  2. ›› Avoid low-hanging wires
  3. ›› Beware of weakened roads, bridges, and tree limbs
  4. ›› Use the telephone for emergencies only
  5. ›› Avoid the temptation to sightsee, think “safety first”
Procedures For Notification of a Hurricane Watch

1.  Administration – Call all patients to activate the Comprehensive Preparedness Plan.

2.  Medical Records – Call all patients to ensure Emergency Contact is identified on the Comprehensive Emergency Preparedness Plan form.  Inform patients that our office may be closed because of the storm.  Let patients know that the 24-hour telephone number to call for any emergencies is 305 892-7272 or 305 301-0826.

3.  QA Department – Call all skill staff to let them know that all visits are to be made immediately before a hurricane or until winds are 40 miles per hour.  Inform them that the 24-hour telephone number to call for any questions regarding their visit is 305 892-7272 or 305 301-0826.

4.  Intake – Call all patients with scheduled visits for the day of the Hurricane Watch and Hurricane Warning to inform on their home visits.  Give patients the 24-hour telephone number of 305 892-7272.  Inform patient that the Agency will continue to provide same home care services immediately before and after hurricane.

5.  Case Management – Call pharmacy at 9:00 a.m. for any medications that are due.  Inform patient and give them our 24-hour telephone number of 305 892-7272 or 305 301-0826.  Notify nurses to prepare medications for those patients being evacuated to Special Needs Shelters.

6.  Hospital Coordinator – will be responsible for contacting patients in the hospital and notifying nurse case manager whether or not patients will be discharged from hospital.  Hospital Coordinator will make every attempt to prevent discharge until after hurricane.  Patients scheduled for discharge will be provided home care immediately before or after hurricane.

7.  Personnel Department – will provide Agency Administration with all patient’s names and Emergency Contact list updated at Start Of Care.  Medical Records will be responsible for keeping this list updated at all times.

8.  The Emergency Preparedness Director or the On-Call R.N. will be responsible in keeping all active patients medical record safe.  He/She will place all medical records in an alternate safe location.

 

AGREEMENTS AND UNDERSTANDINGS

 

At this time Florida Home Bound has a verbal agreements or understandings between the Agency and patients’ Primary Care Physicians.  Florida Home Bound stays in contact with patients’ Primary Care  Physicians at all times.  Last year patients who needed to be admitted to hospitals were admitted through a direct admission by the physician.

Florida Home Bound will contact the Red Cross Unit at 305 – 644-1200 (Fax: 305 – 644-1038) immediately upon notification of an impending disaster.  Location: 335 S.W. 27 Avenue, Miami, Florida 33135.

All Florida Home Bound patients are instructed to store sufficient (for 3-5 days) non-perishable foods in an “Emergency Cupboard”.  Mr. Michael Salem, the Executive Director of Steps In The Right Direction, a non-profit agency, will be contacted immediately after notification of an impending disaster  We have a verbal agreement with Mr. Salem for the following:  he will arrange for “Box Food” in the event electricity is off for more than 3 days.

Steps In The Right Direction, Inc. is located at 1651 W. 37 Street, #406, Hialeah, Florida 33012.  Their telephone number is 305 – 231-9936.

Florida Home Bound will contact patient’s PCP to contact area hospital for patient’s classified as D-1 and D-2.

The number to contact for the Dade County Emergency Management Office is 305 – 513-7700 or 305 – 468-5400.

Their website is: www:co.Miami-dade.fl.us/oem

The Dade County Emergency Management Office (or OEM) does not have specific locations predetermined for shelters before disaster events.

Florida Home Bound will contact the Red Cross Unit at 305 – 644-1200 (Fax: 305 – 644-1038) immediately upon notification of an impending disaster.  Location: 335 S.W. 27 Avenue, Miami, Florida 33135.

All Florida Home Bound patients are instructed to store sufficient (for 3-5 days) non-perishable foods in an “Emergency Cupboard”.  Mr. Michael Salem, the Executive Director of Steps In The Right Direction, a non-profit agency, will be contacted immediately after notification of an impending disaster  We have a verbal agreement with Mr. Salem for the following:  he will arrange for “Box Food” in the event electricity is off for more than 3 days.

Steps In The Right Direction, Inc. is located at 1651 W. 37 Street, #406, Hialeah, Florida 33012.  Their telephone number is 305 – 231-9936.
Florida Home Bound will contact patient’s PCP to contact area hospital for patient’s classified as D-1 and D-2.

In the event the office of Florida Home Bound is damaged and we are not able to use this site, an alternate site will be 4515 N. Jefferson Avenue, Miami Beach, Florida 33140.  Our Emergency telephone number to call is 305 – 301-0826.

 

SUBMIT

 

You have finished the Emergency Management orientation.

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