Hazard Vulnerability Assessment for Long Term Care Facilities

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Hazard Vulnerability Assessment for Long Term Care Facilities Dave Seebart WHEPP Reg. 3, Project Manager April 23, 25, & 26, 2013 1

Hazard Vulnerability Assessment (HVA) for Long Term Care Facilities (LTCF) Learning Objectives: Understand the purpose of an HVA. Become familiar with the HVA tool sections and headers. Become familiar with key term definitions. Understand how to apply the resulting HVA relative risk values. Become familiar with the recommended list of natural and man-made hazard scenarios. As a group, complete an analysis of one natural and one man-made hazard scenario. 2

PURPOSE The purpose of the HVA tool is to assist Long Term Care Facilities (LTCFs) of all sizes in identifying the greatest threats and vulnerabilities within your facility or local community, as well as using the tool to plan for emergencies and address resource gaps. 3

Information about the spreadsheet tool: Use the most current data available. Use examples of community-specific issues from staff or partners. An educated guess can yield a reasonable risk calculation. You can always update your data as it becomes available. 4

Who are your partners? All LTCF staff Health Department Fire and HazMat Law Enforcement Emergency Management Human Services Department Managed Care Organizations 5

Is there a good HVA source of information from which to start? Partner Communications and Alerting (PCA) Portal http://www.dhs.wisconsin.gov/pca/index.htm 6

The tool is generally defined by five color-coded areas: Blue Hazard Scenarios. Pink Probability. Orange Impact. Green Emergency Preparedness Yellow Relative Risk Value. 7

The tool is used from left to right on a horizontal line for each hazard scenario. For each assessment area column, a rank number value is assigned. The Probability and all Impact columns have a range of 0-3, with 3 being the highest value. The Emergency Preparedness columns have a range of 1-3, with 3 being the lowest value. 8

Hazard Scenarios. Presented in major categories: Natural. Man-Made. These are standard and recommended lists. You may disregard some or add others. 9

See page 10 of the Instruction Document. General definition for each hazard scenario provided. These definitions will be used when we perform our training activity today. 10

Each assessment area column has three sections: Title. Definition. Ranking scale with definition. 11

Probability likelihood of future occurrence. Ranking Scale (events/year): 0 = Implausible 1 = Low 2 = Moderate 3 = High 12

Probability consider: Known risk. Historical Data Manufacturer/Vendor Statistics. 13

Human Impact population likely to be injured or killed under an average occurrence. Ranking Scale (% affected): 0 = N/A (no impact expected) 1 = Low 2 = Moderate 3 = High 14

Human Impact consider potential for: Death. Injury requiring medical intervention. 15

LTCF Service Impact services likely to be affected under an average occurrence Ranking Scale (% affected) 0 = N/A (no impact expected) 1 = Low 2 = Moderate 3 = High 16

LTCF Service Impact consider potential for: Direct care. Facility infrastructure. Resident family support. Professional support. Ancillary services. 17

Community Impact community likely to be affected under an average occurrence. Ranking Scale (% affected) 0 = N/A (no impact expected) 1 = Low 2 = Moderate 3 = High 18

Community Impact consider potential for: Contamination. Air. Water. Food. Supply disruption. Facility evacuation. Disruption. Utilities. Transportation. 19

LTCF Property Impact properties likely to be affected under an average occurrence. Ranking Scale (% affected): 0 = N/A (no impact expected) 1 = Low 2 = Moderate 3 = High 20

Information about the spreadsheet tool LTCF Property Impact consider cost for: Replacement Temporary replacement Repair Time to recover 21

LTCF Business Impact businesses likely to be affected under an average occurrence. Ranking Scale (% affected) 0 = N/A (no impact expected) 1 = Low 2 = Moderate 3 = High 22

LTCF Business Impact consider : Business disruption. Employees unable to report. Contract violations. Fines, penalties or legal fees. Interrupted critical supplies. Reputation or image loss. Financial burden. 23

We need to understand the four cornerstones of emergency preparedness: Mitigation. Preparedness. Response. Recovery. 24

Mitigation includes but is not limited to: Emergency power. Stockpiles. Warning (NOAA weather radio). Fire suppression. Building air handling isolation. Partner MOUs. Insurance. 25

Preparedness includes but is not limited to: NIMS-type emergency organization. Plans and procedures. Communication systems. Scope of alternate sources of supply. Frequency of training and drills. Ability to self assess. 26

Response includes but is not limited to: Quick access to procedures and checklists. Efficient use of communication systems. Access to response equipment. Time needed to marshal an on-scene response. Scope of response capabilities. 27

Recovery includes but is not limited to: Business continuity plan. Process to end a response. Process to assess damages. Insurance coverage. Availability of temporary facilities. Access to services: Safety Inspection. Cleaning. 28

This format is common to all four cornerstones: Mitigation. Preparedness Response. Recovery 29

Internal Mitigation (Your LTCF): Emergency power. Stockpiles. Warning (NOAA radio). Fire suppression. Air handling isolation. Partner MOUs. Insurance. 30

External Mitigation (Local): Fire/HazMat. Law Enforcement. Vender & Supply. Community Sirens. Emergency Management. Hospital/Clinic Resources. EMS. 31

Internal Preparedness (Your LTCF): Supplies, type, and volume. Staff availability. Condition of procedures. Incident management skills. 32

External Preparedness (local): HVA for LTCFs Notification method to responders. Responder: Resources. Knowledge of your facility. Agreements & MOUs. 33

Ranking Scale 1 = Substantial 2 = Moderate 3 = Limited or none 34

Relative Risk In the form of a percent value. High percent indicates high urgency. Calculated using all entered ranking data. 35

Improve Your Emergency Planning Address the Results: Sort the hazard scenarios in order of highest to lowest percent value. Focus on the top three to five scenarios. Take actions, where possible, to: Reduce probability and impact. Increase effectiveness of emergency preparedness. Reassess and address other scenarios with a high percent value. 36

Frequently asked Questions What is the reason for doing this? 37

Frequently asked Questions Can multiple LTCFs coordinate to complete their HVA? 38

Frequently asked Questions How much time should I allow? 39

Frequently asked Questions Are there certain partners that are required to participate in the HVA? 40

Frequently asked Questions Is the HVA an annual requirement for LTCFs? 41

Hazard Scenario Definitions page 10 Natural Hazard Scenarios Blizzard Cold extreme and prolonged Earthquake Flood flash due to rain and local terrain Heat extreme and prolonged Ice Storm Landslide Tornado Wild Fire Other 42

Hazard Scenario Definitions page 10 Man-Made Hazard Scenarios Airplane Crash Biological/Infectious Outbreak Civil Disturbance adjacent to facility Communication Disruption major and prolonged Computer Failure system Explosion adjacent to facility Flood dam or reservoir failure Fuel Shortage for facility operation HazMat Release from fixed facility HazMat Release from transportation Nuclear Facility Incident with 10 or 50 miles Power Outage major and prolonged Supply Disruption Water Supply Contamination municipal Water System Failure facility or municipal Other 43

Break for 15 minutes After the break, we will complete 2 scenario HVAs. 44

Before we continue, are there any questions? 45

HVA activity #1 Tornado Remember: An HVA is for your one facility in one location. All data entered should be from the prospective of that one individual facility. If you don t know for sure, give an educated guess and find a more accurate value to include later. 46

HVA activity #2 Biological / Infectious Outbreak 47

Follow-up Questions? To obtain an electronic copy of the HVA spreadsheet and supporting handbook send an email to Dave Seebart Seebart_dr@co.brown.wi.us 48