Learning from the CMS Emergency Preparedness Rule and Looking Forward

MelissaHarvey,RN,MSPH,DirectorHHSASPRNHPPCaeciliaBlondiaux,CMSQuality,Safety&OversightGroup

PatrickAshley,MS,MBA,StateHospitalCoordinator,OfficeofEmergencyPreparedness,VirginiaDepartmentofHealth

ShayneBrannman,MS,ASPRTRACIEProgramDirector

NationalHealthcareCoalitionPreparednessConferenceNovember29,2018

Disclaimer

Thispresentationwaspreparedasatooltoassistandisnotintendedtograntrightsorimposeobligations.Althougheveryreasonableefforthasbeenmadetoassuretheaccuracyoftheinformationwithinthesepages,theultimateresponsibilityforthecorrectsubmissionofclaimsandresponsetoanyremittanceadvicelieswiththeproviderofservices.ThispublicationisageneralsummarythatexplainscertainaspectsoftheMedicareProgram,HHSOfficeoftheAssistantSecretaryforPreparednessandResponse(ASPR),andVirginiaDepartmentofHealth(VDH),butisnotalegaldocument.TheofficialMedicareProgramprovisionsarecontainedintherelevantlaws,regulations,andrulings.Medicarepolicychangesfrequently,andlinkstothesourcedocumentshavebeenprovidedwithinthedocumentforyourreferenceTheCentersforMedicare&MedicaidServices(CMS),VDH,andHHSASPRemployees,agents,andstaffmakenorepresentation,warranty,orguaranteethatthiscompilationofinformationiserror-freeandwillbearnoresponsibilityorliabilityfortheresultsorconsequencesoftheuseofthisguide.

3 Saving Lives. Protecting Americans.

Welcome and Introductions

Melissa Harvey, RN, MSPH Director, Division of National Healthcare Preparedness

Programs (NHPP), HHS ASPR

CMSEmergencyPreparednessRuleMedicareandMedicaidPrograms;EmergencyPreparednessRequirementsforMedicareandMedicaidParticipatingProvidersandSuppliers

UnderstandingtheEmergencyPreparednessFinalRuleWhereAreWeNow?

CaeciliaBlondiauxQuality,Safety&OversightGroupCenterforClinicalStandardsandQualityCentersforMedicare&MedicaidServices

FinalRule

•  PublishedSeptember16,2016withanimplementationdateofNovember15,2017

•  Appliestoall17providerandsuppliertypes•  CompliancerequiredforparticipationinMedicare(andMedicaid,asapplicable)•  EmergencyPreparednessisonenewCoP/CfCofmanyalreadyrequired

– Forexample,manyprovidersandsuppliersarerequiredtomeetlifesafetycodesthatprotectresidentsagainstfiresandhealthsafetycodesthatkeepareasonabletemperatureforresidents.

•  FacilitiesbeganbeingsurveyedforthenewrequirementsafterNovember2017inconjunctionwiththeirexistingsurveycycles

•  Intheeventfacilitiesarenon-compliant,thesamegeneralenforcementprocedureswilloccurasiscurrentlyinplaceforanyotherconditionsorrequirementscitedfornon-compliance.

5

Four Provisions for All Provider Types

Risk Assessment and Planning Policies and Procedures

Communication Plan Training and Testing

Emergency Preparedness

Program

8

Emergency Preparedness: An All-Hazards Approach

•  Anall-hazardsapproachisanintegratedapproachtoemergencypreparednessplanningthatfocusesoncapacitiesandcapabilitiesthatarecriticaltopreparednessforafullspectrumofemergenciesordisasters

•  Includesinternalemergencies;man-madeemergencies;naturaldisaster;and/oremerginginfectiousdiseases.

•  Specifictogeographiclocationoftheproviderorsupplierincludingstateandlocalrequirements

•  Thesemayinclude,butarenotlimitedto,care-relatedemergencies,equipmentandpowerfailures,interruptionsincommunications,includingcyber-attacks,lossofaportionorallofafacility,andinterruptionsinthenormalsupplyofessentialssuchaswaterandfood.

7

AvailableTrainingResources

•  InSeptember,2017,CMSlaunchedthesurveyortrainingforemergencypreparednessrequirements.Availableathttps://surveyortraining.cms.hhs.gov/

•  TrainingthroughtheIntegratedSurveyorTrainingWebsiteisalsoavailableforproviders/suppliers.

•  Thewebsitealsoprovidesimportantlinkstoadditionalresourcesandorganizationswhocanassist.https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertEmergPrep/index.html

Wherearewenow?

•  SurveysbeganinlateNovemberandarebeingconductedbyeitherhealthsurveyorsorLifeSafetyCode(LSC)surveyors

•  Surveysareinconjunctionwithregularlyscheduledsurveycycles

•  Limitedinquiriesinrecentmonthsfromprovidersandsuppliersonwhattodoinordertobecompliant

•  CMSandASPRcontinuetomonitorcomplianceandworkwithhealthcareentities.

AnalysisofEPRuleCitations

•  CMSandASPRTRACIEreviewedrecentemergencypreparednessdeficienciesamongprovidertypesfromCMSsurveys

•  Updatingandmonitoringperformanceofhealthcareprovidersandsuppliers:‒  AnalyzingcitationsbasedonsurveysconductedbyCMSbetweenNovember15,2017though

September30,2018‒  Developusefuldisplaytemplates‒  Updatedataevery6months

•  Thepurposeofthiseffortisto:‒  Identifywaystostrengthenemergencypreparednesseffortsofhealthcareprovidersandsuppliersatalllevels(National;State;Regional;andLocalHealthcareEntity)

‒  Enhanceandhonefuturetechnicalassistanceefforts‒  Highlightgeographicvariances‒  Reducesurveyorvariances‒  Createareportingtemplate‒  Createabaselineofinformationthatcanbeupdatedandmonitored

OverviewofCurrentCMSEPRuleSurveys

•  CollatedpreliminarycitationsbasedonCMSstatesurveysconductedbetweenNovember15,2017thoughSeptember30,2018

•  Duringthatsametimeperiod:– 74,747healthcareentitieswereeligibleforEPSurveys(includingentitiesthatwereterminatedduringthistime)

– 28,171healthcareentitiesweresurveyedoneormoretimes– Onefacilitycanbesubjecttoupto39Tags(44Tagstotalbutnotallapplytoeachprovider)

– 6,251healthcareentitieswerecitedforatleastonetag• 19,620EPcitationstotalwereissuedtothese6,251healthcareentities

Note:SurveysconductedbyStateSurveyAgenciesinAugustandSeptember2018maynotbereflectedintheanalysisastheyaregiven70daystoreportsurveyoutcomesperreportingrequirements.

WhatdotheDataShow?

•  AsofSeptember30,2018,wehavesurveyedover90%ofthenursinghomesand29%ofhospitalsforcompliancewiththeserequirements.Nursinghomesreceiveanannualrecertificationsurvey,whilehospitalsaresurveyedeverythreetofiveyears.

•  Themajorityofproviderssurveyed(78%)metthenewemergencypreparednessrequirements.

•  78%ofnursinghomesand96%ofhospitalsofthosesurveyedbySeptember30,2018fullyincompliancewithrequirements.– 22%ofnursinghomesand4%ofthehospitalssurveyedreceivedatleastonedeficiencycitationunderEmergencyPreparedness.

•  Alldeficienciescitedrequireswiftcorrectionactiontoavoidtermination.Todate,allfacilitiescitedcorrecteddeficienciesandnofacilitieshavebeenterminatedfornotmeetingemergencypreparednessrequirements.

CMSAction/NextSteps

•  Withthedataasthecoredriver,CMSwillreviewthetrendsandcontinuetoanalyzecitationsonemergencypreparedness.

•  CMSplanstoworkcloselywithASPRonpotentialareasofimprovement,suchastemplates,additionalresources,andmoreinformationtoassistprovidersincompliance.

•  CMSwillalsoanalyzethespecificcitationstodeterminetheneedforincreasedsurveyortrainingopportunitiesandclarifications.

SurveyDataVariability

•  ThedatarepresentedinthisanalysishassomevariabilitybecauseofsurveycyclesanddoesnotincluderesultsofsurveysconductedbyAccreditingOrganizations.TheemergencypreparednessrequirementsaresurveyedbasedonthefacilitytypesregularscheduledsurveycycleinconjunctionwiththeirhealthorLifeSafetyCodeSurveys.

•  Forexample:‒ NursingHomes&ICF/IIDs:Annual-NottoExceed15months‒ HomeHealthAgencies:Generallyevery2to3years‒ Hospitals:Generallyevery3to5years‒ ESRD:Generallyevery3years‒ Hospices:Generallyevery3years‒ RHCs&ASCs:Generallyevery6years‒ CMHCs:Generallyevery5years

Formoreinformationonsurveycycles,pleasevisit:https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/QSOG-Mission-and-Priority-Information.html

58

144

184

359

2,084

4,458

4,945

5,867

6,050

6,569

7,345

8,715

12,257

15,712

OrganProcurementOrganization

CommunityMentalHealthCenter

ComprehensiveOutpatientRehabFacility

PsychiatricResidentialTreatmentFacility

OutpatientPhysicalTherapy/SpeechPathology

RuralHealthClinic

Hospice

AmbulatorySurgicalCenter

IntermediateCareFacility/IndividualswithIntellectualDisabilities

Hospital

EndStageRenalDiseaseFacility

FederallyQualifiedHealthCenter

HomeHealthAgency

NursingFacility

NumberofHealthcareEntitiesImpactedbytheCMSEPRuleByProviderType(Nov15,2017–Sept30,2018)

TotalN=74,747 Note:NursingFacilityincludesNursingFacility,SkilledNursingFacility,andSkilledNursingFacility/NursingFacility(DistinctPartandDuallyCertified)

[VALUE](10%)

[VALUE](16%)

[VALUE](53%)

[VALUE](17%)

[VALUE](10%)

[VALUE](11%)

[VALUE](15%)

[VALUE](22%)

[VALUE](29%)

[VALUE](31%)

[VALUE](20%)

[VALUE](77%)

[VALUE](90%)

CommunityMentalHealthCenter

ComprehensiveOutpatientRehabFacility

OrganProcurementOrganization

PsychiatricResidentialTreatmentFacility

OutpatientPhysicalTherapy/SpeechPathology

RuralHealthClinic

AmbulatorySurgicalCenter

Hospice

Hospital

EndStageRenalDiseaseFacility

HomeHealthAgency

IntermediateCareFacility/IndividualswithIntellectualDisabilities

NursingFacility

NumberofHealthcareEntitiesSurveyedontheCMSEPRuleByProviderType(Nov15,2017–Sept30,2018)

TotalN=28,171 Note:FederallyQualifiedHealthCenterswerenotsurveyedduringthistimeperiod.

NumberofHealthcareEntitiesSurveyedthatReceivedCitationbyProviderType(Nov15,2017–Sept30,2018)

[VALUE](6%)

[VALUE](21%)

[VALUE](21%)

[VALUE](59%)

[VALUE](4%)

[VALUE](37%)

[VALUE](9%)

[VALUE](27%)

[VALUE](27%)

[VALUE](14%)

[VALUE](17%)

[VALUE](37%)

[VALUE](22%)

OrganProcurementOrganization

CommunityMentalHealthCenter

PsychiatricResidentialTreatmentFacility

ComprehensiveOutpatientRehabFacility

Hospital

OutpatientPhysicalTherapy/SpeechPathology

Hospice

RuralHealthClinic

AmbulatorySurgicalCenter

HomeHealthAgency

EndStageRenalDiseaseFacility

IntermediateCareFacility/IndividualswithIntellectualDisabilities

NursingFacility

TotalN=6,251(22%)

Top5NationalEPCitations(Nov15,2017–Sept30,2018)

1769

1250 11421004 996

EPTestingRequirements EPTrainingandTesting DevelopandMaintainEPProgram

DevelopmentofEPPoliciesandProcedures

Subsistenceneedsforstaffandpatients

EPTestingRequirements

•  “Failedtoconductexercisestotesttheemergencyplanatleastannually,includingunannouncedstaffdrillsusingtheemergencyprocedure”

•  “Failedtoprovidedocumentationofparticipationinacommunity-basedandtabletopdrill”

EPTrainingandTesting

•  “FailedtoensureEPtrainingandtestingforallstaffwasdocumented,reviewedandupdatedonanannualbasis”

DevelopandMaintainEPProgram

•  “FailedtodevelopandmaintainanEPplanthatwasreviewedandupdatedatleastannually”•  “FailedtoprovidetheannualreviewandupdateoftheirEPProgram”

DevelopmentofEPPoliciesandProcedures

•  “Failuretodevelopandimplementpoliciesandproceduresthatalignswiththehazardsidentifiedwithinthefacility'sriskassessment”

•  “ProvidedincompleteEPpoliciesandprocedures.Thiswasevidencedbyincompletepoliciesandproceduresfordisasteremergenciesrelatingtosewageandwastedisposalandtheuseofvolunteersduringadisasterscenario”

Subsistenceneedsforstaffandpatients

•  TheEPPdidnotincludeprovisionsforemergencyfoodpreparation,foodserviceandwatersupply.”•  “Failedtoprovidedocumentationthattheemergencypreparednessplanaddressvendorcontract

agreementstoprovideprovisionofsubsistenceincludingfoodandwater.”

TopfivenationalEPcitationsrepresent31%(n=6,161)ofthetotalnumberofcitations(n=19,620).

NursingFacility IntermediateCareFacility/Ind.withIntellectualDisabilities

HomeHealthAgency EndStageRenalDiseaseFacility

AmbulatorySurgicalCenter

EPTrainingProgram DevelopandMaintainEPProgram

EPTestingRequirements DialysisEmergencyEquipment

EPTestingRequirements

DevelopandMaintainEPProgram

EPTestingRequirements EPTrainingProgram ESRDEPTrainingProgram EmergencyPrepTrainingandTesting

EstablishmentoftheEmergencyProgram

EmergencyPrepTrainingandTesting

PoliciesandProceduresforVolunteers

EPTestingRequirements RolesunderaWaiverDeclaredbySecretary

EmergencyPrepTrainingandTesting

DevelopmentofEPPoliciesandProcedures

ProcessforEPCollaboration

ProcessforEPCollaboration

DevelopandMaintainEPProgram

EPTestingRequirements

DevelopmentofCommunicationPlan

MaintainandAnnualEPUpdates

EmergencyPrepTrainingandTesting

DevelopmentofCommunicationPlan

RuralHealthClinic Hospice Hospital OutpatientPhysicalTherapy/SpeechPathology

ComprehensiveOutpatientRehabFacility

DevelopmentofEPPoliciesandProcedures

EPTrainingProgram EPTrainingProgram PoliciesandProceduresincludingEvacuation

MaintainandAnnualEPUpdates

PoliciesandProceduresforVolunteers

EPTestingRequirements Subsistenceneedsforstaffandpatients

ProcessforEPCollaboration

ProcessforEPCollaboration

EmergencyPrepTrainingandTesting

MaintainandAnnualEPUpdates

DevelopandMaintainEPProgram

EPTrainingProgram EPTrainingProgram

ProcessforEPCollaboration

NamesandContactInformation

RolesunderaWaiverDeclaredbySecretary

EmergencyOfficialsContactInformation

EPTestingRequirements

EPTrainingProgram ArrangementwithotherFacilities

ProceduresforTrackingofStaffandPatients

PoliciesandProceduresforVolunteers

DevelopmentofCommunicationPlan

Top5CitationsbyProviders(Nov15,2017–Sept30,2018)

Highlightedcitationsindicatecitationsseenin5ormoreoftheproviders’top5citationslist.PsychiatricResidentialTreatmentFacilities,CommunityMentalHealthCenters,andOrganProcurementOrganizationswerenotincludedinthetableduetotheirlownumberofcitations.

TrainingandTestingProgram

•  CMShasandwillcontinuetoreachouttolocalandstateemergencyofficialstorelayinformationontheEPFinalRule

•  Challengesatstateandlocallevelsare:

‒ Assistingmultiplefacilitiesinexerciseswithlimitedresources‒ Coordinatingexercisesrelevanttofacilities

•  RiskAssessments&CompliantTrainingExercises

TheEPFinalRule&1135Waivers

•  TobecompliantwiththerequirementundertheEmergencyPreparednessFinalRule,facilitiesneedtohaveapolicyandprocedureforaddressingyourfacility’sawarenessofthe1135waiverprocess.

•  Thereisnospecificformordocumenttemplateforthepolicyorproceduretomeet

thisrequirement.Someelementsthatcouldbeconsideredandreflected(butnotlimitedto):‒  Facilityroleinprovidingcareandtreatmentatalternatesite–forexample:equipmentand

supplies,commandandcontrol,staffing‒  Collaborationwithlocalofficials–proactiveplanning,pre-designatedsite?Predestinatedroles,

emergencycredentialingproceduresforproviderstopracticeatalternatesite(ifwaiverdoesnotcoverproviderlicensure)

‒  Theprocedureforapplyingforan1135waiverandcontactinformationforRegionalOfficeandStateSurveyAgency.

YourRegionalOffices

• WhatistheroleofCMSRegionalOfficeduringanemergency?•  Respondingpromptlytorequestsfor1135(b)waiver

•  Referringquestionsandwaiver/suspensionofregulationrequeststoCMSCentralOffice,asneeded.

•  RequestingstatusreportsfromtheStateAgencyregardingaffectedhealthcareproviders

•  AssistingaffectedStateAgenciestoprovideessentialmonitoringandenforcementactivitiesiftheStateAgencyisoverwhelmed/unabletomeettheirsurveyandcertificationobligations.

KeyPoints

•  StateandLocalLaws(muststillcomply)•  EPFinalRuledoesnottakeawayanyexistingrequirements

•  LessonsLearnedfromEvacuations&Adherencetolocal/statemandates

•  StrongandEffectivePartnershipsareCriticaltoEmergencyPreparednessandResponse•  Continuetoanalyzethedatatoensurethatwearelearningfromthoseareasthathealthcareentitiesmaycontinuetostrugglewith–toprovidetechnicalassistanceandresourcesimprovingthepreparednessofourhealthcaresystem.

NewAppendixZAnticipatedChanges

• AddingEmergingInfectiousDiseases(guidance/recommendationonly)

•  IncludingNewCitationReferencesforHomeHealthAgencies

•  Clarificationsonuseofportablegenerators:

•  Portableandmobilegeneratorsmust:‒  Beconnectedtothefacilityelectricalsystemthroughacompatibleconnectingdeviceandtransferswitch.‒  Belocatedwhereprotectedfromdamageduringthecourseofanemergency.‒  Notbeoperatedinsidethefacility,inanenclosedareasuch(e.g.,garage,basement),orotherlocationthatwouldnotallowforproperventilationoftheexhaust.

‒  Notbelocatedwhereexhaustfromtheenginewouldbebroughtintothefacilitythroughwindowsorotherventilationsystemintakes.

‒  Notbelocatedinproximitytothebuildingwhereageneratorfirecouldspreadtothefacility.‒  Beoperated,testedandmaintainedinaccordancewithmanufacturer,localand/orStaterequirements.‒  Forrequirementsregardingpermanentlyinstalledgenerators,pleaserefertoexistingLifeSafetyCodeandNFPAguidance.

BurdenReductionProposedRule

•  CMSrecentlyreleasedtheproposedBurdenReductionRuleforNonLong-TermCare

•  Theproposalaskedforpublicfeedbackregardingchangestomultipleareas,onebeingtherequirementsforEP(commentperiodclosed11/19)‒ ProposedChangetoDocumentationofcollaborationwithStateandLocalpartners‒ Changestofrequencyofupdatingfromannualtobi-annual&asneeded‒ ChangestotrainingandTestingRequirements

•  Proposedisnotfinal.Facilitiesmustcontinuetocomplywiththecurrentrequirements.

Resourcesfor1135Waivers

•  EmailAddressesforCMSRegionalOffices:•  ROATLHSQ@cms.hhs.gov(AtlantaRO):Alabama,Florida,Georgia,Kentucky,Mississippi,NorthCarolina,SouthCarolina,andTennessee;

•  RODALDSC@cms.hhs.gov(DallasRO):Arkansas,Louisiana,NewMexico,Oklahoma,andTexas•  ROPHIDSC@cms.hhs.gov(NortheastConsortium):Delaware,DistrictofColumbia,Maryland,Pennsylvania,Virginia,WestVirginia,NewYork,NewJersey,PuertoRico,VirginIslands,Connecticut,Maine,Massachusetts,NewHampshire,RhodeIsland,andVermont

•  ROCHISC@cms.hhs.gov(MidwestConsortium):Illinois,Indiana,Michigan,Minnesota,Ohio,Wisconsin,Iowa,Kansas,Missouri,andNebraska

•  ROSFOSO@cms.hhs.gov(WesternConsortium):Colorado,Montana,NorthDakota,SouthDakota,Utah,Wyoming,Alaska,Idaho,Oregon,Washington,Arizona,California,Hawaii,Nevada,andthePacificTerritories.

•  Quality,Safety&OversightGroup1135WaiverResourceWebsiteat:https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertEmergPrep/1135-Waivers.html

ResourcesAvailable

•  ASPR’s TRACIE Website ‒ Provider Checklists are available ‒ Risk Assessment Examples

•  CMS encourages facilities to use TRACIE to allow for some level of consistency in format & development of programs

•  Our CMS Website https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertEmergPrep/Emergency-Prep-Rule.html

Thankyou!

SCGEmergencyPrep@cms.hhs.gov

Learning from the CMS Emergency Preparedness

Rule and Looking Forward

•  PatrickAshley,MS,MBA

•  Patrick.Ashley@vdh.virginia.gov

•  StateHospitalCoordinator,OfficeofEmergencyPreparedness,VirginiaDepartmentofHealth

VirginiaHealthcareEmergencyManagementProgramVirginia’s System •  6HealthcareCoalitions

•  MirrorPublicHealthRegions

•  COALITIONStaff•  RegionalHealthcareCoordinator•  RHCCManager•  VulnerablePopulationsCoordinator

•  CoalitionMembership•  HPPCoreMembership•  AdditionalRequired:LongTermCare•  Dialysisstronglyencouraged

VirginiaHealthcareEmergencyManagementProgramVirginia’s System, Continued •  24/7RHCCActivation• CommonSituationalAwarenessProduct

Virginia Healthcare Emergency Management Program Virginia’s System, Continued

VDH CMS Survey Agency

•  VDH Office of Licensure and Certifications

HPP/PHEP Awardee •  VDH Office of Emergency

Preparedness

Shared Executive Oversight

Virginia Emergency Support Team

•  VDEM •  VSP / VDOT •  VDH •  National Guard

What does the CMS rule mean to me?

Facilities Emergency Managers Public Health Fire Department EMS Random People Off the Street!

Initial Questions

How many facilities are we talking about?

What do facilities need to know? What do partners need to know?

What do partners need to do?

What can we do to help?

Opportunity

Three Groups of Facilities

Hospitals*

In-Patient/Residential Providers Dialysis Providers

Outpatient Providers

Identify YOUR Priorities It’s OK To Say No.

Take the Show on the Road

Meet Them Where They’re Already At. Education Sessions

Local Emergency Managers Facility Groups Public Health Virginia Emergency Management Association Virginia Healthcare Association Leading Age Regional Groups Surveyors

Facility Education

What does Emergency Management actually mean? What does the regulation ACTUALLY say? How do I do this? Can you hold my hand?

Can you do it for me?

Consulting

For those facilities that just can’t or wont.

Exercises

The 3 PM Phone Call. Understanding what the rule says. Regional Exercises. Partnering with Existing Exercises.

Surveyor Education

Surveyor Training / Priorities. What’s the number to FEMA? Two Way Dialogue.

•  Funnel Facilities to Coalition for TA •  Event Notification

Joint Surveyor / EP Training.

Stakeholder Education

Why are these facilities calling me? Can you make it stop?

Why do I want to engage with these facilities? What can the coalition do to help?

Training

Hazard Vulnerability Analysis. Brings people together. The topic doesn’t really matter as long as it’s interesting and starts a dialogue. Respect their time. Bring food. Interdisciplinary whenever possible.

Information Sharing

What did we learn?

•  Full time "Medically Vulnerable Populations Coordinator" responsible for engaging these groups and getting face time in front of facility decision-makers. Can’t be other duties as assigned.

•  Annual regional exercise opportunities (tabletop and full scale). •  CMS providers often reach out to us following a negative survey or in

preparation for a survey when they realize they are behind the ball. •  Quarterly MVP meetings/workshops on relevant emergency preparedness

topics •  MVP representation on coalition executive board. •  Disclaimers.

What did we learn?

•  These facilities are not hospitals and have different needs •  Many of these facilities are where hospitals were 20 years ago. •  Bringing emergency management and public health to the table as these

discussions occur is also a feather in the cap for everyone. It lends credibility to the HCC and ensures engagement from other critical partners in the community's emergency response system.

•  Make them sign an MOU with activities defined. •  Like to Like Collaboration and Mutual Aid. •  Engagement of Survey Agency is key.

ASPR’s Technical Resources, Assistance Center, & Information Exchange

Shayne Brannman, MS, ASPR TRACIE Program Director

49 Saving Lives. Protecting Americans.

ASPR TRACIE: Three Domains • Self-service collection of audience-tailored materials • Subject-specific, SME-reviewed “Topic Collections” • Unpublished and SME peer-reviewed materials highlighting

real-life tools and experiences

• Personalized support and responses to requests for information and technical assistance

• Accessible by toll-free number (1844-5-TRACIE), email (askasprtracie@hhs.gov), or web form (ASPRtracie.hhs.gov)

• Area for password-protected discussion among vetted users in near real-time

• Ability to support chats and the peer-to-peer exchange of user-developed templates, plans, and other materials

50 Saving Lives. Protecting Americans.

ASPRtracie.hhs.gov/tracie-resources

51 Saving Lives. Protecting Americans.

Healthcare Coalition Resource Examples

•  Coalition Administrative Issues TC •  Coalition Models and Functions TC •  Coalition Response Operations TC •  General Overview of Healthcare Coalitions •  HCC Fiscal Models •  HCC Preparedness Plan •  HCC Recovery Plan Template •  HCC Resource and Gap Analysis Aggregator •  HCC Resource and Gap Analysis Tool •  HCC Response Plan •  HCC Pandemic Checklist •  HCC Select Resources Page •  HCC Webinar Series

52 Saving Lives. Protecting Americans.

Technical Assistance Trends

53 Saving Lives. Protecting Americans.

ASPR TRACIE CMS EP Rule Resource Examples

•  CMS EP Rule Resource Page •  CMS and Disasters: Resources at Your

Fingertips •  CMS EP Rule General Briefing Slides •  Integrated Healthcare Systems Implications •  Provider and Supplier Types Covered by the EP

rule Facility-Specific Requirement Overviews •  EP Rule Citation Analysis Project

54 Saving Lives. Protecting Americans.

ASPR TRACIE and the CMS EP Rule Analysis Project

§  ASPR TRACIE created a baseline EP Rule reporting template that will be routinely updated and monitored

§  Continue identifying ways to strengthen emergency preparedness, response, and recovery efforts at all levels

§  Hone future technical assistance efforts, based on identified knowledge gaps §  Continue highlighting geographic variances §  Continue to be a force multiplier and thought leader §  Listen (and act upon) feedback

ü How can we enhance the reporting template? §  Keep pushing the envelope, with our partners, so we can all learn together

55 Saving Lives. Protecting Americans.

Contact Us

asprtracie.hhs.gov 1-844-5-TRACIE askasprtracie@hhs.gov

56 Saving Lives. Protecting Americans.

Audience Discussion and Q&A