Post on 10-Jul-2020
Weathering the Storm:A Hurricane Planning, Response and Recovery Toolkit
Updated September 2010
TABLE OF CONTENTS
ACKNOWLEDGEMENTS ......................................................................................................................1INTRODUCTION ................................................................................................................................3
PART I: TYPES OF HURRICANESSTORM DEFINITIONS ..................................................................................................................5
PART II: WHAT TO EXPECTWHAT HOSPITALS CAN EXPECT ..................................................................................................7
A. PRE-STORM ......................................................................................................................7B. POST-STORM ......................................................................................................................7
PART III: ASSESSMENT TOOLPLANNING, RESPONSE AND RECOVERY ASSESSMENT TOOL ............................................................9
A. LEADERSHIP......................................................................................................................11B. INTERNAL (HOSPITAL) DEPARTMENT PLANS ..........................................................................19C. EMPLOYEE EXPECTATIONS ..................................................................................................25D. EMPLOYEE SUPPORT ........................................................................................................31E. SUPPLIES — SPECIAL CONSIDERATIONS FOR HURRICANES......................................................39F. UTILITIES ..........................................................................................................................43G. PATIENT ISSUES ................................................................................................................49H. COMMUNICATIONS ISSUES..................................................................................................53I. FACILITY MANAGEMENT AND SECURITY ..................................................................................59J. EXTERNAL RESOURCES AND MUTUAL AID ............................................................................65K. RECOVERY — DEMOBILIZATION ..........................................................................................69L. RECOVERY — PATIENT TRANSFER AND DISCHARGE ................................................................75M. RECOVERY — FINANCIAL RESOURCES ................................................................................79
PART IV: APPENDICES & RESOURCE LINKSPLANNING & RESPONSE RESOURCES ........................................................................................83
1. HOSPITAL DEPARTMENTS
A. DEPARTMENT PLAN TEMPLATE ........................................................................................89B. SAMPLE EMERGENCY CONTACT FORM ..............................................................................93
2. HOSPITAL EMPLOYEES
A. PREPARING YOUR WORK AREA ........................................................................................96B. SHELTERING NECESSITIES ..............................................................................................103C. HURRICANE PREPAREDNESS CHECKLIST ..........................................................................107D. PRE-SEASON EMPLOYEE ACKNOWLEDGEMENT FORM ........................................................111E. WORK EXEMPTION FORM..............................................................................................115F. CHILDCARE ENROLLMENT FORM ....................................................................................119
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Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
3. KAISER PERMANENTE HAZARD VULNERABILITY ANALYSIS ......................................................1224. NJHA KEY RESOURCES FOR INCLEMENT WEATHER PREPAREDNESS ......................................1315. EVACUATE OR SHELTER-IN-PLACE DECISION GUIDE ..............................................................1356. SHELTER-IN-PLACE CHECKLISTS..........................................................................................139
A. 96—72 HOURS PRIOR TO ONSET..................................................................................143B. 72—48 HOURS PRIOR TO ONSET..................................................................................149C. 48—24 HOURS PRIOR TO ONSET..................................................................................155D. LESS THAN 24 HOURS PRIOR TO ONSET ........................................................................159
7. UTILITY FAILURE OPERATIONAL IMPACT CHART ....................................................................1638. CONSUMABLE SUPPLY OPERATIONAL IMPACT CHART ............................................................1679. DIALYSIS CONCERNS ........................................................................................................171
10. SAMPLE MUTUAL ASSISTANCE AGREEMENT ........................................................................175RECOVERY RESOURCES ............................................................................................................8411. SAMPLE INFORMATION FORM FOR DEPARTMENTS ................................................................18312. HOSPITAL STATUS REPORT FORM ......................................................................................19313. SAMPLE DEMOBILIZATION PLAN ........................................................................................197
ADDITIONAL RECOVERY RESOURCES ..........................................................................................84
Online links are provided for the following resources on page 84.Hospital Impact Assessments:
AHRQ Hospital Assessment Recovery ToolDemobilization:
ICS Form 214 Personnel RosterICS Form 211 Check-in ListICS Form 221 Demobilization CheckoutDemobilization Responsibilities Checklist
Disaster Mental Health:Guidance for Managing Worker Fatigue During Disaster OperationsCoping with a Disaster or Traumatic EventManaging Anxiety in Times of CrisisSafety, Function, Action ChecklistDisaster & Extreme Event Preparedness (DEEP) Center
Financial Resources:FEMA Grants and Assistance ProgramsFEMA Public Assistance Grant ProgramFEMA Forms Grants – Catalog of Federal Domestic Assistance
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Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
ALBERT GUTIERREZ, FACHE, MBA, RT(R)President and CEOShore Memorial HospitalCOMMITTEE CHAIRMAN
JEFFREY ANDREWS
Cape Regional Medical Center
DENISE ARZOOMANIAN
Englewood Hospital and Medical Center
JIM BACA
Underwood-Memorial Hospital
DAVID BROOKS
Jersey Shore University Medical Center
NEIL BRYANT
Saint Barnabas Health Care System
SHIELA BUCHTA
HEALTHSOUTH Rehabilitation Hospital of Toms River
JACK BURNS
Hudson County OEM
ANTHONY CAPRIO, M.D.Hoboken University Medical Center
C. LYNN CENTONZE
New Jersey Office of Homeland Security
JAMES CHEBRA
Capital Health
STEVEN CICALA
LibertyHealth
CHARLES CRUGNOLA
Palisades Medical Center
JONATHAN CUVIELLO
Shore Memorial Hospital
MARY DANISH
Saint Michael’s Medical Center
GARY DEL MORO
Hackensack University Medical Center
MICHELE DENOIA
Southern Ocean County Hospital
BRIAN DOLAN
University of Medicine and Dentistry of New Jersey
ROBERT DONEGAN
Trinitas Regional Medical Center
MARIE DUFFY
Hoboken University Medical Center
KELLY ESPOSITO
Community Medical Center
RICHARD FERRANTE
Monmouth Medical Center
MARLENE FISCHER
South Jersey Healthcare
RON FRANCESCHINI
Bacharach Institute for Rehabilitation
STEPHEN GAUNT
Hoboken University Medical Center
EDWARD GERITY
Holy Name Medical Center
PATRICK GILDNER
Southern Ocean County Hospital
JOHN GILSON
Bayonne Medical Center
DAVID GRUBER
NJ Dept of Health & Senior Services
Ronald HammanBayonne Medical Center
RON HOFER
Jersey Shore University Medical Center
JAMES KELLY
AtlantiCare Regional Medical Center
BRIAN KUBIEL
HEALTHSOUTH Rehabilitation Hospital of Toms River
PAUL LAMBRECHT
Underwood-Memorial Hospital
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Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
ACKNOWLEDGEMENTS
NJHA extends its sincere appreciation to the following individuals who participated in the HurricanePreparedness and Recovery Committees as well as the Winter Hazards Tabletop Exercises. Theirassistance and feedback was instrumental in the evolution of this toolkit. Development of this
resource was made possible through funding from the New Jersey Office of Homeland Security.
Continued on next page
JAMES LANGENBACH
NJ Dept of Health & Senior Services
MORENA LASSO
LibertyHealth-Jersey City Medical Center
ROSAMOND LOCKWOOD
Newton Memorial Hospital
BRADFORD MASON
New Jersey Office of Homeland Security
BEN MAZZA
Holy Name Medical Center
GERARD MCALEER
New Jersey Office of Homeland Security
WILLIAM MCDOUGALL
VA New Jersey Health Care System
REBECCA MCMILLEN
NJ Dept of Health & Senior Services
RYAN MILLER
The Cooper Health System
CAROLE PAGE
Ocean Medical Center
ANTHONY PERDONI
Monmouth Medical Center
JOSEPH PICCIANO
New Jersey Office of Homeland Security
ANTHONY PLINIO
Community Medical Center
DENNIS QUINN
New Jersey Office of Homeland Security
LORI REES
Bacharach Institute for Rehabilitation
THERESA REISS
The Valley Hospital
THOMAS ROSE
Holy Name Medical Center
KEVIN SULLIVAN
Children’s Specialized Hospital
LARRY SWEENEY
AtlantiCare Regional Medical Center
RENE TARBY
Bacharach Institute for Rehabilitation
CORINNE TREMBLER
Warren Hospital
TOM VINCENT
Kimball Medical Center
CHRISTOPHER WIENBERG
Englewood Hospital and Medical Center
DOUGLASS WILLIAMSON
The Valley Hospital
PHYLLIS WORRELL
Virtua
CONSULTANT
ANNE-CAROL BURKE, M.A.
President, A.C. Consulting, Inc.
NJHA STAFF
DIANE ANDERSON
Director, Emergency Preparedness
ALINE HOLMES
Senior Vice President, Clinical Affairs
PATRICIA RONDAN-MANN
Policy Analyst, Post-acute Policy and Special Initiatives
JESSICA WISNIEWSKI
Coordinator, Emergency Preparedness
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Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
INTRODUCTION
PURPOSE AND SCOPE
The New Jersey Hospital Association’s Hurricane Planning, Response andRecovery Toolkit is designed to assist hospitals in preparing for, responding toand recovering from the potential consequences of a hurricane impacting theGarden State. More specifically, this toolkit focuses on sheltering-in-placeplanning and planning for recovery. It enhances current hospital all-hazardsdisaster plans and is not to be used in lieu of existing plans, but rather as aprimer for a facility preparing for the specific challenges presented by a hurri-cane. It is intended for use by those already familiar with their hospital’s all-hazards disaster plan and the fundamental concepts of disaster planning. Inaddition, hospitals are encouraged to consider their emergency managementinfrastructure, availability of community resources and site-specific hazard vulnerabilities when developing a facility-specific hurricane plan. Hurricaneseason begins June 1 and ends Nov 30 each year.
Once you begin the disaster planning process, it is important to have a comprehensive planning team with clear-ly defined roles and responsibilities. Planning teams should have representatives from all levels of managementand most departments within the hospital. All-hazards planning and hurricane planning needs to address all fourphases of emergency management: mitigation, preparedness, response and recovery. For example, a hospitalnot only plans for response actions but also for recovery actions. Plans are living documents and need to be main-tained through an ongoing planning, training and exercise cycle. The Homeland Security Exercise and EvaluationProgram (HSEEP) provides guidance and tools that can assist with exercises and improvement planning.
In addition to planning for the hospital’s response and recovery to a hurricane, it is important also to plan forhow the hospital will support its staff through all phases of an event such as a hurricane. The toolkit includesa focus on employee support and provides guidance on what hospitals can do to better prepare and miti-gate the impact a hurricane will have on staff. Many of us have experienced how challenging it can be tofocus on our work if we are worried about our home and family. Therefore, hospitals should consider pro-viding staff with tools and resources to prepare for, respond to and recover from a hurricane so that theymay be more productive when on duty. The latter sections of this toolkit focus on recovery. Facilities willneed to conduct an impact assessment first to help guide recovery decisions and actions.
Hurricanes can be unpredictable as to intensity and path. You will need to develop and be prepared to imple-ment plans for worst-case scenarios. The more intense the storm, the more damage to infrastructure you canexpect, resulting in longer recovery time and greater delays for re-supply and access to supportive resources.Due to the unpredictability and the geography (size and location) of New Jersey, all hospitals in the state mayneed to take preparedness actions if any portion of New Jersey is in the path of a storm. When watchingweather forecasts, it is important to note the entire “cone” or width of a storm, not just the line path for theeye of the storm. Hurricanes that threaten New Jersey have the potential to have a statewide impact.
Hospitals sheltering-in-place for a hurricane will take similar steps for each threat level, again bearing inmind the more intense the storm, the longer the facility will need to be self-sustaining. Though the focusof this toolkit is to assist hospitals with developing plans to shelter-in-place for a storm, it is imperativethese hospitals also have an evacuation plan. Hurricanes categorized as 4 or 5 on the Saffir-Simpson Scaleare catastrophic in nature. Hospitals projected to be impacted by a Category 4 or 5 storm will need to con-sider evacuation. In some cases, hospitals may need to evacuate for a Category 1 storm. This dependsupon your facility’s location and specific vulnerabilities.
Decisions regarding what category storm you should plan to evacuate for can be made in advance of anevent. The results of your hazard vulnerability analysis, the emergency management system, communityinfrastructure and resources where your facility is located and the information in this toolkit1 can assist youwith the decision-making process.
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Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
1 See Evacuate or Shelter-In-Place Decision Guide, Appendix #5
PART I. TYPES OF HURRICANES
STORM DEFINITIONS
Information from the National Hurricane Center at http://www.nhc.noaa.gov/
Nor’easter - A strong low pressure system that affects the Mid Atlantic and New England states. It canform over land or over the coastal waters. These winter weather events are notorious for producingheavy snow, rain and tremendous waves that crash onto Atlantic beaches, often causing beach erosionand structural damage. Wind gusts associated with these storms can exceed hurricane force in intensity.A nor’easter gets its name from the continuously strong northeasterly winds blowing in from the oceanahead of the storm and over the coastal areas.
Please note: Tornadoes frequently are associated with hurricanes, so there is always the potential forwind-blown debris and downed trees with any storm category.
Tropical Storm – Winds 39-73 mph. There is potential for flooding and loss of utilities, with minor wind-blown debris and a few downed trees.
WATCHES AND WARNINGS
Hurricane Watch – A watch is announced when hurricane conditions are possible within 36 hours for aparticular area.
Hurricane Warning – A warning that sustained winds 64kt (74mph or 119km/h) or higher associatedwith a hurricane are expected in a specified coastal area in 24 hours or less. A hurricane warning canremain in effect when dangerously high water or a combination of dangerously high water and exceptionally high waves continue, even though winds may be less than hurricane force.
The Saffir-Simpson Hurricane Scale is a 1-5 rating system used to define a hurricane’s intensity. Itgives an estimate of the potential property damage and flooding expected along the coast from a hurricane landfall. Wind speed is the determining factor in the scale, as storm surge values are highlydependent on the slope of the continental shelf and the shape of the coastline in the landfall region.Note that all winds are defined using the US National Weather Service’s definition of sustained windswhich is the average winds over a period of one minute.
Category 1 Hurricane – Winds 74-95 mph (64-82 kt). Storm surge is generally 4-5 feet above normal.No real damage to building structures. Expect damage primarily to unanchored mobile homes, shrubberyand trees and some damage to poorly constructed signs. Also, expect some coastal road flooding andminor pier damage.
Examples: Gaston 2004, Lili 2002, Irene 1999 and Allison 1995
Category 2 Hurricane – Winds 96-110 mph (83-95 kt). Storm surge is generally 6-8 feet above normal.Expect some roofing material, door and window damage of buildings and considerable damage to shrubbery and trees with some trees blown down. Considerable damage to mobile homes, poorly constructed signs and piers. Coastal and low-lying escape routes flood 2-4 hours before arrival of thehurricane center. Small craft in unprotected anchorages break moorings.
Examples: Frances 2004, Isabel 2003, Bonnie 1998, Georges 1998 and Gloria 1985
Category 3 Hurricane – Winds 111-130 mph (96-113 kt). Storm surge is generally 9-12 feet above normal. Expect some structural damage to small residences and utility buildings with a minor amount ofpower failures, and damage to shrubbery and trees with foliage blown off trees and large trees blowndown. Mobile homes and poorly constructed signs are destroyed. Low-lying escape routes are cut by rising water 3-5 hours before arrival of the center of the hurricane. Flooding near the coast destroys
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Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
smaller structures with larger structures damaged by battering from floating debris. Terrain continuouslylower than 5 feet above mean sea level may flood inland up to 8 miles (13 km) or more. Evacuation oflow-lying residences within several blocks of the shoreline may be required.
Examples: Katrina 2005, Jeanne 2004 and Ivan 2004
Category 4 Hurricane – Winds 131 – 155 mph (114-135kt). Storm surge is generally 13-18 feet abovenormal. Expect more extensive power failures, damage to doors and windows with some complete roofstructure failures on small residences. Shrubs, trees and all signs are blown down. Complete destructionof mobile homes. Low-lying escape routes may be cut by rising water 3-5 hours before arrival of thecenter of the hurricane. Expect major damage to lower floors of structures near the shore. Terrain that islower than 10 feet above sea level may be flooded, requiring massive evacuation of residential areas asfar inland as 6 miles (10 km).
Examples: Dennis 2005 (Cuba) and Charley 2004
Category 5 Hurricane – Winds 156 mph and up (135+kt).Storm surge is generally greater than 18 feetabove normal. Expect complete roof failure on many residences and industrial buildings and other complete building failures with small utility buildings blown over or away. All shrubs, trees and signs maybe blown down. Complete destruction of mobile homes. Expect severe and extensive window and doordamage. Low-lying escape routes are cut by rising water 3-5 hours before arrival of the center of thehurricane. Major damage to lower floors of all structures located less than 15 feet above sea level andwithin 500 yards of the shoreline. Massive evacuation of residential areas on low ground within 5-10miles (8-16 km) of the shoreline may be required.
Examples: The Labor Day Hurricane of 1935, Hurricane Camille (1969) and Hurricane Andrew (1992).The 1935 Labor Day Hurricane struck the Florida Keys with a minimum pressure of 892 mb—the lowest pressure ever observed in the United States. Hurricane Camille struck the Mississippi GulfCoast causing a 25-foot storm surge, which inundated Pass Christian.
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Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
PART II. WHAT TO EXPECT2
WHAT HOSPITALS CAN EXPECT: PRE-STORM3
96 - 72 HOURS IN ADVANCE. During this time, there is much uncertainty regarding the path and intensity of a storm. This is a good time to review plans, implement just-in-time training and finalizestaffing plans. Notifications and communication plans and systems should be tested and implementedand emergency operation centers may be partially activating. Since hurricanes may expand over largeareas and their paths are uncertain, it is likely that all hospitals in the state will need to prepare to implement their hurricane plans. For those hospitals that may need to evacuate, this is the time toassess the potential situations and begin making evacuation decisions.
72 - 48 HOURS IN ADVANCE. During this time, there may still be some uncertainty, but you will have abetter sense of what you may be facing. Hurricane response plans should be activated and final preparations made. Supplies need to be secured and staff assignments need to be confirmed. Staff andthe community should be implementing their personal and family preparedness plans. Buildings andhomes will be boarded up and sandbags may be filled and appropriately placed. You can expect crowdedroadways and stores due to people gathering supplies. Evacuations may begin during this time. TheEmergency Operations Center may be fully operational and holding briefings on a frequent basis.
36 HOURS IN ADVANCE. Final preparations are being made, evacuations have begun and supplies andresources are being staged. Response plans should be activated, including Incident Command. Briefingswith multiple stakeholders will be occurring. For example, you may have regularly scheduled briefingswith the Emergency Operation Center (EOC), the State and other hospitals/hospital association.Planning meetings may become more frequent. Additional communication devices may be distributed atthis time. Unmet just-in-time training needs should be addressed.
24 HOURS IN ADVANCE. At this time, all of your preparedness plans should be activated and implemented. Any unmet needs should be addressed. Staff (and family) that will be staying at the hospital during the storm will be arriving. Keep in mind storm conditions set in before the actual landfallof the eye of the hurricane. You need to make sure that staff is at the hospital prior to the onset of storm conditions. Community shelters should be open, and residents will be traveling to check into the shelters. Storms may stall, change course or increase/decrease in intensity prior to landfall. Once youhave activated your response plan and everything is in place, there may be a period of time where youare simply waiting for the storm to hit. Incidents of panic may exist as stress builds from the waiting.
WHAT HOSPITALS CAN EXPECT: POST-STORM
FIRST 24 HOURS POST EVENT. Once severe weather has subsided, and it is daylight, you can beginassessing the damage to your facility and the status of staff and resources. Search and rescue operations may be conducted in your surrounding communities, and community damage/impact assessments may also be underway. Facility and partner incident management teams should already bein full operation. Staff will be anxious to connect with loved ones and to know the status of their homes.During this time consider the following:
� Conduct impact assessment and prioritize needs. It is during this time that evacuation decisions maybe made contingent on operational capacity. If you are not evacuating and operating at a severelydiminished capacity, you also may need to consider requesting additional resources such as aDisaster Medical Assistance Team (DMAT) and/or Medical Reserve Corps support.
� Identify additional resources needed and make requests accordingly.
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Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
2 See NJHA’s Key Resources for Inclement Weather Preparedness, Appendix #43 See Shelter-In-Place Checklists, Appendix #6, for specific actions that may be taken during specified time intervals prior to storm onset.
� Assess status and need to activate continuity of operations plan (COOP). Has it been activated? Areany areas of your facility experiencing or are going to experience diminished capacity due to theeffects of the severe weather event? Hospitals may need to activate COOP in appropriate units ofhospital during recovery operations.
� Remove debris. When planning for recovery, consider pre-staging resources such as front loaders,salt and sand. Ensure vendor contracts are in place to promptly remove debris and/or snow promptlyfollowing an event.
24 – 48 HOURS POST EVENT. Depending on the severity of the event and the amount of time it takesto clear roads for safe travels, staff should be able to be rotated during this time. Hospitals need to beprepared to assist staff with the hardship they may face from damaged homes and the closures ofschools and childcare centers. Community resources and activities are most likely still discontinued,placing additional burden on hospitals to meet the needs of the community and staff.
During this time period, you may see an influx of acute injury patients from people trying to tend todamaged homes and remove debris from their properties (i.e. broken bones from falling off of a roof). Inaddition, if there is significant damage to the community, security may need to be increased to addressthe influx of persons seeking shelter, food, air conditioning/heat and other basic human needs.
The hurricane planning, response and recovery toolkit provides information on examples of staff support.For example, if banks are closed and it is pay day, can you pay staff in cash? Will you provide administra-tive leave to staff who need to take time off from work to meet with insurance claims processors? Willyou loan funds to employees to help them pay upfront high deductible costs? If possible, consider set-ting up in-house banks and providing space for FEMA and insurance processors to service staff.
48 – 72 HOURS POST EVENT. Hospitals should plan for the worst and still be able to be self-sufficientduring this time. What to expect during this time can vary significantly, depending on the severity of theevent and the state of community resources. If there is significant damage to community infrastructureincluding widespread power outages and damage to homes making them not habitable, you will contin-ue to have delays with patient discharges, most likely be operating on generator power, begin runninglow on supplies, and the media may be present with continued inquiries on the status of your facility’soperations. In addition, if dialysis centers are not operational, dialysis patients will begin seeking treat-ment at hospitals.
For less severe events, you may be able to begin demobilizing and standing down your incident com-mand team.
72 HOURS PLUS POST EVENT. If the event is severe enough and you have not yet demobilized, youwill continue to be handling the above mentioned issues but perhaps at a higher level of intensity. Fuelwill be in high demand by all, not just for facility generators but also for transportation for staff.Generator use in the community also leads to concerns of carbon monoxide poisoning. Generators mayhave been running long enough now that maintenance tasks will need to be performed (i.e. change fil-ters, change/add oil). Staff may be growing weary, and if schools are still closed, childcare/elder care forfamily members of staff will continue to be a concern. Emotional and mental health support will need tobe provided to healthcare workers and family members in the coming days and months. Hospitals needto plan to be self-sufficient for 96 hours or implement evacuation plans.
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Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
PART III. ASSESSMENT TOOL: Planning, Response and Recovery
In the sections that follow, hurricane planning tasks and policy considerationsare broken down into the following areas:
A. Leadership
B. Internal (Hospital) Department Plans
C. Employee Expectations
D. Employee Support
E. Supplies — Special Considerations for Hurricanes
F. Utilities
G. Patient Issues
H. Communications Issues
I. Facility Management and Security
J. External Resources and Mutual Aid
K. Recovery — Demobilization
L. Recovery — Patient Transfer & Discharge
M. Recovery — Financial Resources
The following sections may refer you to other NJHA disaster planning modulesand appendices that contain additional information and supporting documents.
Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
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A. L
EA
DE
RS
HIP
(C
ON
TIN
UE
D)
INN
OT
DA
TE
TOB
ELE
AD
STA
FF
AS
SIG
NM
EN
TC
OM
PLE
TE
DP
RO
GR
ES
SS
TAR
TE
DC
OM
PLE
TE
DM
EM
BE
R
13. D
eter
min
e in
adv
ance
crit
eria
/trig
gers
for
fac
ility
eva
cuat
ion.
4
14. A
ssig
n ap
prop
riate
sta
ff t
o id
entif
y an
d kn
ow p
roce
ss a
nd
proc
edur
es f
or r
eque
stin
g ad
ditio
nal r
esou
rces
.
15. E
nsur
e po
licy
deci
sion
s re
gard
ing
haza
rdpa
y an
d ac
com
mod
atio
ns
for
fam
ily, p
ets,
etc
. dur
ing
a st
orm
are
incl
uded
in t
he p
lan.
5
16. E
nsur
e pr
oces
ses
rega
rdin
g co
mm
unic
atio
n ne
eds
are
addr
esse
d in
the
pla
n.6
�D
urin
g re
spon
se a
nd re
cove
ry, c
omm
unic
ate
at re
gula
rly s
ched
uled
in
terv
als
with
par
tner
s su
ch a
s O
EM, M
CC
, DH
HS
and
sch
edul
e m
edia
brie
fings
.
17. E
nsur
e pl
an in
clud
es p
roce
sses
to
addr
ess
finan
cial
con
cern
s, i.
e.,
docu
men
tatio
n fo
r re
imbu
rsem
ent.
7
�D
ocum
ent
all e
xpen
ses
from
the
ons
et o
f th
e ev
ent.
Ens
ure
fede
ral a
nd s
tate
doc
umen
tatio
n st
anda
rds
are
met
. FE
MA
, HIC
S
and
othe
r IC
S f
orm
s m
ay b
e us
ed t
o as
sist
with
thi
s ta
sk.
18. E
nsur
e a
supp
ort
syst
em is
est
ablis
hed
to a
ddre
ss p
sych
osoc
ial
issu
es a
nd e
mot
iona
l dis
tres
s ex
perie
nced
by
staf
f, pa
tient
s an
d th
eir
fam
ilies
. �
Con
side
r co
nduc
ting
on-li
ne m
eetin
gs o
r fr
ee c
onfe
renc
e ca
lls.
�E
ncou
rage
an
unde
rsta
ndin
g of
the
effe
ctiv
enes
s of
alte
rnat
em
eans
of
supp
ort.
19. E
stab
lish
and
Impl
emen
t In
cide
nt C
omm
and
Syst
em (I
CS)
/Hos
pita
lIn
cide
nt C
omm
and
Syst
em (H
ICS
).�
Ens
ure
all s
taff
is t
rain
ed f
or r
oles
with
in t
he s
ytem
.�
Ens
ure
dele
gatio
n of
aut
horit
y an
d or
ders
of
succ
essi
on a
t le
ast
thre
e de
ep f
or k
ey p
ositi
ons.
�Fo
llow
doc
umen
tatio
n pr
oced
ures
out
lined
by
ICS
/HIC
S.
20. E
nsur
e ro
les
and
resp
onsi
bilit
ies
are
clea
rly d
efin
ed a
nd
com
mun
icat
ed t
o al
l sta
ff p
re-e
vent
and
dur
ing
resp
onse
and
re
cove
ry b
riefin
gs.
4S
ee E
vacu
ate
or S
helte
r-In-
Plac
e D
ecis
ion
Gui
de, A
ppen
dix
#55
See
Sec
tion
D, E
mpl
oyee
Sup
port
6S
ee S
ectio
n H
, Com
mun
icat
ions
Issu
es7
See
Sec
tion
J, E
xter
nal R
esou
rces
and
Mut
ual A
id
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it15
A. L
EA
DE
RS
HIP
(C
ON
TIN
UE
D)
INN
OT
DA
TE
TOB
ELE
AD
STA
FF
AS
SIG
NM
EN
TC
OM
PLE
TE
DP
RO
GR
ES
SS
TAR
TE
DC
OM
PLE
TE
DM
EM
BE
R
21. E
nsur
e th
e pl
an in
clud
es a
ppro
pria
te s
teps
to re
sum
e op
erat
ions
fo
llow
ing
a hu
rrica
ne. R
esto
re e
ssen
tial s
ervi
ces
and
phys
ical
pla
nt.
Ther
e m
ay b
e “n
ew n
orm
al”
post
sev
ere
even
ts.
The
build
ing
mus
t be
saf
e, d
ebris
rem
oved
from
cam
pus,
haz
ardo
us w
aste
pro
perly
di
spos
ed o
f and
ope
ratio
nalc
apac
ity re
stor
ed.
22. E
nsur
e th
e pl
an in
clud
es a
pro
cess
for d
rills
that
incl
udes
ver
ifica
tion/
test
ing
of a
ll m
emor
andu
ms
of u
nder
stan
ding
/mut
ual a
id a
gree
men
ts
and
ensu
re c
ontin
genc
y ag
reem
ents
/pla
ns a
re id
entif
ied
shou
ld
mut
uala
id n
ot b
e av
aila
ble.
23. I
n re
cove
ry, b
e pr
epar
ed t
o ac
tivat
e m
emor
andu
ms
of
unde
rsta
ndin
g an
d ot
her
resp
onse
pla
ns s
uch
as c
ontin
uity
of
oper
atio
ns.
24. B
e pr
epar
ed to
iden
tify
clea
r goa
ls fo
r rec
over
y. C
lear
goa
ls p
rovi
de
dire
ctio
n fo
r re
cove
ry o
bjec
tives
to
be in
clud
ed in
inci
dent
act
ion
plan
s (IA
Ps)
and
pro
vide
dire
ctio
n fo
r pr
iorit
izat
ion
of r
ecov
ery
activ
ities
and
res
ourc
e m
anag
emen
t.
25. E
nsur
e pl
ans
are
exer
cise
d an
d im
prov
emen
ts a
re m
ade
base
d on
afte
r-act
ion
repo
rts.
�C
onsi
der
exer
cisi
ng p
lans
in p
arts
to
redu
ce im
pact
on
daily
op
erat
ions
.
26. P
rovi
de B
oard
of T
rust
ees
with
fin
al h
urric
ane
plan
ning
, res
pons
e an
d re
cove
ry p
lan.
Pro
vide
deta
iled
info
rmat
ion/
educ
atio
n re
gard
ing
spec
ific
polic
ies/
proc
edur
es in
clud
ing
or a
ffect
ing
mem
bers
of
the
Boa
rd.
27. E
nsur
e th
e B
oard
is p
rope
rly e
duca
ted
abou
t hu
rric
anes
and
the
ir po
tent
ial i
mpa
ct o
n ho
spita
l ope
ratio
ns.
�E
duca
te t
he B
oard
abo
ut t
he n
eed
for
effe
ctiv
e pl
anni
ng.
�En
sure
Boa
rd’s
sup
port
prio
r to
activ
e pl
anni
ng.
28. E
nsur
e B
oard
has
an
unde
rsta
ndin
g of
loca
l, st
ate
and
fede
ral
auth
ority
dur
ing
hur
rican
e.
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it17
A. L
EA
DE
RS
HIP
(C
ON
TIN
UE
D)
INN
OT
DA
TE
TOB
ELE
AD
STA
FF
AS
SIG
NM
EN
TC
OM
PLE
TE
DP
RO
GR
ES
SS
TAR
TE
DC
OM
PLE
TE
DM
EM
BE
R
29. E
nsur
e a
proc
ess
is in
clud
ed t
o ed
ucat
e th
e B
oard
of T
rust
ees
on
thei
r ro
les
and
resp
onsi
bilit
ies
durin
g a
hurr
ican
e.
30.E
nsur
e pr
oced
ures
are
est
ablis
hed
to k
eep
Boa
rd o
f Tru
stee
s in
form
ed b
efor
e, d
urin
g an
d po
st e
vent
.�
Det
erm
ine
mul
tiple
mea
ns o
f co
mm
unic
atio
n w
ith B
oard
s of
Tru
stee
s.�
Hol
d br
iefin
gs, c
onfe
renc
e ca
lls a
nd s
hare
(via
em
ail,
post
ings
, et
c.) I
APs
and
Situ
atio
nR
epor
ts (S
itRep
s) w
ith B
oard
of T
rust
ees
at r
egul
ar in
terv
als.
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it19
B. I
NT
ER
NA
L (H
OS
PIT
AL)
DE
PAR
TM
EN
T P
LAN
S
INN
OT
DA
TE
TOB
ELE
AD
STA
FF
AS
SIG
NM
EN
TC
OM
PLE
TE
DP
RO
GR
ES
SS
TAR
TE
DC
OM
PLE
TE
DM
EM
BE
R
1. Id
entif
y w
ho w
ill b
e re
spon
sibl
e fo
r de
velo
ping
sta
ffin
g pl
ans.
8
�St
affin
g pl
ans
may
be
deve
lope
d by
dep
artm
ent w
ith re
view
by
the
plan
ning
team
to e
nsur
e vi
abilit
y of
pla
ns (i
.e. d
uplic
atio
n of
as
sign
men
ts, e
tc).
�En
sure
med
ical
sta
ff is
add
ress
ed o
r has
its
own
staf
fing
plan
that
is
inte
grat
ed in
to th
e fa
cilit
y pl
an.
�D
eter
min
e if
staf
fing
plan
requ
irem
ents
nee
d to
be
addr
esse
d in
po
licy.
If s
o, in
corp
orat
e in
to p
olic
y. F
or e
xam
ple,
the
faci
lity
may
re
defin
e a
wor
k da
y, w
ork
wee
k an
d/or
ove
rtim
e in
resp
onse
to a
di
sast
er/e
mer
genc
y in
acc
orda
nce
with
app
licab
le s
tate
and
fede
ral
wag
e la
ws.
Sta
ff m
ay b
e as
sign
ed to
per
form
dut
ies
they
do
not
norm
ally
per
form
with
resp
ect t
o sc
ope
of p
ract
ice.
2. Id
entif
y an
d pr
iorit
ize
serv
ice
requ
irem
ents
for
you
r de
part
men
t.�
Iden
tify
and
list
mis
sion
-crit
ical
(im
med
iate
) ser
vice
req
uire
men
ts.
�Id
entif
y an
d lis
t m
issi
on-e
ssen
tial (
dela
yed)
ser
vice
req
uire
men
ts.
3. Id
entif
y nu
mbe
r of s
taff
nece
ssar
y to
impl
emen
t ser
vice
requ
irem
ents
.�
Iden
tify
and
list
staf
f ne
eded
to
impl
emen
t m
issi
on-c
ritic
al
(imm
edia
te) s
ervi
ce r
equi
rem
ents
.�
Iden
tify
and
list
staf
f ne
eded
to
impl
emen
t m
issi
on-e
ssen
tial
(del
ayed
) ser
vice
req
uire
men
ts.
�Id
entif
y st
aff
that
may
be
dive
rted
, cro
ss t
rain
ed a
nd/o
r tr
aine
d ju
st-in
-tim
e to
sup
port
mis
sion
-crit
ical
and
mis
sion
-ess
entia
l ser
vice
s.
4. Id
entif
y st
aff
team
s by
shi
ft (i
.e. o
ne t
eam
per
shi
ft).
�E
xam
ple:
PR
E-s
torm
, DU
RIN
G s
torm
and
PO
ST s
torm
, or
sim
ply
Team
s A
, B, C
, D, o
r ha
ve t
eam
s cr
eate
nam
es f
or t
hem
selv
es.
�Pl
ease
not
e: Tw
o sh
ifts
are
requ
ired
for t
he “
DU
RIN
G”
stor
m te
am.
Bot
h sh
ifts
shou
ld a
rriv
e at
the
hos
pita
l prio
r to
ons
et o
f da
nger
ous
driv
ing
cond
ition
s. E
ach
shift
will
wor
k 12
on
and
12 o
ff. It
is
impo
rtan
t th
at s
taff
are
perm
itted
and
req
uire
d to
tak
e re
st p
erio
dsto
pro
mot
e op
timum
wel
l-bei
ng. N
o em
ploy
ee s
hall
wor
k m
ore
than
16
hour
s in
a 2
4-ho
ur p
erio
d.�
If st
aff i
s lim
ited,
you
may
use
the
sam
e te
am to
ser
ve P
RE
stor
m
and
POST
stor
m.
�P
RE
-sto
rm t
eam
(s) w
ill n
eed
to b
e al
lott
ed t
ime
to im
plem
ent
thei
r fa
mily
pre
pare
dnes
s pl
ans
prio
r to
the
sta
rt o
f th
eir
shift
s.
8S
ee D
epar
tmen
t Pl
an T
empl
ate,
App
endi
x #1
a
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it21
B. I
NT
ER
NA
L (H
OS
PIT
AL)
DE
PAR
TM
EN
T P
LAN
S (
CO
NT
INU
ED)
INN
OT
DA
TE
TOB
ELE
AD
STA
FF
AS
SIG
NM
EN
TC
OM
PLE
TE
DP
RO
GR
ES
SS
TAR
TE
DC
OM
PLE
TE
DM
EM
BE
R
5. Id
entif
y st
aff
resp
onsi
ble
for
deve
lopi
ng jo
b de
scrip
tions
and
re
spon
sibi
litie
s/jo
b ac
tion
shee
ts f
or r
espo
nse
role
s.
6. E
nsur
e al
l sta
ff k
now
s an
d ar
e tr
aine
d on
the
ir ro
les
and
resp
onsi
bilit
ies
befo
re, d
urin
g an
d af
ter
a st
orm
.�
Dev
elop
tra
inin
g pl
an t
o en
sure
sta
ff r
ecei
ve a
ppro
pria
te t
rain
ing
on t
heir
resp
onsi
bilit
ies,
ICS
/HIC
S a
nd m
eet
natio
nal t
rain
ing
guid
elin
es. F
or e
xam
ple,
lead
ersh
ip e
mpl
oyee
s w
ill c
ompl
ete
ICS
100
, 200
, IS
700
, IS
800
, and
all
empl
oyee
s w
ill c
ompl
ete
ICS
100
and
IS 7
00.
�C
onsi
der
inco
rpor
atin
g re
quire
d tr
aini
ng in
to n
ew e
mpl
oyee
or
ient
atio
n an
d an
nual
edu
catio
n re
view
s.�
Dev
elop
and
impl
emen
t a
trai
ning
pla
n th
at in
corp
orat
es d
rills
, ta
blet
op e
xerc
ises
and
aft
er-a
ctio
n re
view
s an
d im
prov
emen
t pl
anni
ng.
7. D
evel
op jo
b ac
tion
shee
ts a
s ne
eded
.�
HIC
S p
rovi
des
job
actio
n sh
eets
tha
t m
ay b
e us
ed a
s an
exa
mpl
e fo
r de
velo
ping
job
actio
n sh
eets
for
oth
er t
ypes
of
dutie
s/re
spon
se r
oles
.
8. D
evel
op ju
st-in
-tim
e tr
aini
ng a
s ne
eded
.�
Exam
ple:
Sho
rt, q
uick
, ref
resh
er t
rain
ing
mod
ules
for
how
to
use
the
radi
os a
nd o
ther
com
mun
icat
ions
equ
ipm
ent.
9. Id
entif
y pr
otec
tive
mea
sure
s fo
r al
l wor
k ar
eas.
9
�Id
entif
y w
ho is
res
pons
ible
for
impl
emen
ting
prot
ectiv
e m
easu
res
upon
pla
n ac
tivat
ion.
�Pr
otec
t vi
tal r
ecor
ds.
�B
ack-
up o
f da
ta s
yste
ms
and
stor
age
of r
ecor
ds o
ff-s
ite.
�Pr
int h
ardc
opie
s of
impo
rtan
t doc
umen
ts s
uch
as c
onta
ct li
sts.
�D
efin
e al
tern
ate
proc
edur
es fo
r ess
entia
l job
func
tions
sho
uld
equi
pmen
t fai
l (i.e
. use
of p
aper
and
pen
cil,
runn
ers,
etc
.).�
Mov
e eq
uipm
ent
away
fro
m v
ulne
rabl
e w
indo
ws.
9E
nsur
e th
at in
form
atio
n te
chno
logy
(IT)
sys
tem
s ar
e ad
dres
sed.
Dev
elop
rec
over
y tim
e ob
ject
ives
(RTO
s) a
nd R
ecov
ery
Poin
t O
bjec
tives
(RP
Os)
for
crit
ical
clin
ical
sys
tem
s, p
roce
sses
and
dat
a.
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it23
B. I
NT
ER
NA
L (H
OS
PIT
AL)
DE
PAR
TM
EN
T P
LAN
S (
CO
NT
INU
ED)
INN
OT
DA
TE
TOB
ELE
AD
STA
FF
AS
SIG
NM
EN
TC
OM
PLE
TE
DP
RO
GR
ES
SS
TAR
TE
DC
OM
PLE
TE
DM
EM
BE
R
10. T
rain
sta
ff t
o pr
ovid
e P
sych
olog
ical
Firs
t A
id t
o pa
tient
s, f
amily
m
embe
rs a
nd c
o-w
orke
rs.10
�Tr
ain
staf
f to
build
resi
lienc
e w
ithin
them
selv
es a
nd re
cogn
ize th
e ne
ed fo
r Ps
ycho
logi
cal F
irst A
id in
thei
r co-
wor
kers
.�
Trai
n or
gani
zatio
nal l
eade
rshi
p to
bui
ld r
esili
ence
with
in t
he
orga
niza
tion.
10S
ee N
JHA
Pan
dem
ic In
fluen
za T
oolk
it: P
sych
o-So
cial
Mod
ule,
http
://w
ww
.njh
a.co
m/p
anin
f/Pdf
/Psy
chos
ocia
l_Fi
nal.p
df
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it25
C. E
MP
LOY
EE
EX
PE
CTA
TIO
NS
INN
OT
DA
TE
TOB
ELE
AD
STA
FF
AS
SIG
NM
EN
TC
OM
PLE
TE
DP
RO
GR
ES
SS
TAR
TE
DC
OM
PLE
TE
DM
EM
BE
R
1. D
efin
e em
ploy
ee w
ork
expe
ctat
ions
for
hur
rican
es.11
�S
ampl
e Po
licie
s:
�E
mpl
oyee
s ar
e re
quire
d to
rep
ort
to w
ork
unle
ss a
n ex
empt
ion
has
been
gra
nted
in w
ritin
g w
ith s
uper
viso
ry s
igna
ture
. Fai
lure
to
do
so m
ay r
esul
t in
dis
cipl
ine
up t
o an
d in
clud
ing
term
inat
ion.
�
All
staf
f (c
linic
al a
nd n
on-c
linic
al) i
s co
nsid
ered
ess
entia
l and
m
ay b
e as
sign
ed t
o du
ties
that
are
not
per
form
ed r
egul
arly
. �
All
licen
sure
s w
ith r
egar
d to
sco
pe o
f pr
actic
e w
ill b
e ho
nore
d.
�A
ll st
aff
is r
espo
nsib
le fo
r m
aint
aini
ng c
orre
ct a
nd u
p-to
-dat
e co
ntac
t in
form
atio
n, m
aint
aini
ng a
nd im
plem
entin
g pe
rson
al/
fam
ily p
repa
redn
ess
plan
s an
d kn
owin
g th
eir
role
in a
dis
aste
r.12
2. D
eter
min
e w
hat
cons
ider
atio
ns m
ay o
r m
ay n
ot a
llow
for
em
ploy
ee e
xem
ptio
n, f
or in
stan
ce:
�If
sta
ff is
not
per
mitt
ed t
o br
ing
child
ren
to w
ork
durin
g a
stor
m,
then
con
side
r ha
ving
sin
gle
pare
nts
with
sm
all c
hild
ren
as a
n ex
empt
ion
crite
rion.
�If
sta
ff is
not
per
mitt
ed t
o br
ing
pets
dur
ing
a st
orm
, the
n m
ake
it cl
ear
that
ow
ning
a p
et is
not
an
acce
ptab
le r
easo
n fo
r an
ex
empt
ion.
The
pol
icy
shou
ld n
ote
that
it is
the
em
ploy
ee’s
re
spon
sibi
lity
to m
ake
arra
ngem
ents
for
pet
s.�
Con
side
r ho
w t
he f
acili
ty w
ill a
ddre
ss t
he n
eeds
of
staf
f th
at
may
live
in a
n ev
acua
tion
zone
. For
exa
mpl
e, e
mpl
oyee
s w
ho
live
in e
vacu
atio
n zo
nes
may
be
wel
l sui
ted
to s
erve
on
one
of
the
shift
s to
sta
y at
the
hos
pita
l dur
ing
the
stor
m.
�A
ddre
ss e
xpec
tatio
ns fo
r st
aff
who
wor
k fo
r m
ore
than
one
faci
lity.
�D
evel
op e
mpl
oyee
exe
mpt
ion
form
.13
11S
ee P
repa
ring
Your
Wor
k A
rea,
App
endi
x #2
a12
See
Pre
-sea
son
Empl
oyee
Ack
now
ledg
emen
t Fo
rm, A
ppen
dix
#2d
13S
ee W
ork
Exem
ptio
n Fo
rm, A
ppen
dix
#2e
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it27
C. E
MP
LOY
EE
EX
PE
CTA
TIO
NS
(CO
NT
INU
ED)
INN
OT
DA
TE
TOB
ELE
AD
STA
FF
AS
SIG
NM
EN
TC
OM
PLE
TE
DP
RO
GR
ES
SS
TAR
TE
DC
OM
PLE
TE
DM
EM
BE
R
3. D
evel
op e
mpl
oyee
exe
mpt
ion
from
wor
k po
licy
incl
udin
g th
e pr
oces
s fo
r gr
antin
g ex
empt
ions
.�
Sam
ple
Polic
y:
Exe
mpt
ions
will
be
hand
led
on a
cas
e-by
-cas
e ba
sis
with
req
uest
s m
ade
in a
dvan
ce a
nd s
uper
viso
r ap
prov
al.
Em
ploy
ees
may
be
exem
pt f
rom
wor
k if
thei
r sp
ouse
is r
equi
red
to w
ork
(i.e.
law
enf
orce
men
t, E
MS
) and
the
re a
re d
epen
dent
s at
hom
e su
ch a
s ch
ildre
n an
d/or
adu
lts w
ith s
peci
al n
eeds
. Prio
r to
the
sta
rt o
f hu
rric
ane
seas
on, e
mpl
oyee
s ar
e re
quire
d to
su
bmit
thei
r ex
empt
ion
requ
est
to t
heir
supe
rvis
or u
pon
annu
al
revi
ew. E
mpl
oyee
s re
ques
ting
an e
xem
ptio
n m
ust
subm
it a
form
ea
ch y
ear
for
revi
ew.
It is
und
erst
ood
that
unf
ores
een
circ
umst
ance
s m
ay a
rise
and
empl
oyee
s ar
e to
not
ify t
heir
supe
rvis
or a
s so
on a
s po
ssib
le s
houl
d th
ey r
equi
re a
last
-min
ute
exem
ptio
n.14
4. A
ddre
ss is
sues
sur
roun
ding
em
ploy
ee c
ompe
nsat
ion
incl
udin
g:�
Det
erm
ine
how
sta
ff w
ill b
e co
mpe
nsat
ed f
or h
ours
the
y ar
e re
quire
d to
be
at t
he h
ospi
tal b
ut a
re r
estin
g/of
f-du
ty. F
or
exam
ple,
sta
ff r
equi
red
to r
emai
n at
the
hos
pita
l for
24
hour
s or
m
ore
will
be
give
n “o
n ca
ll pa
y” f
or h
ours
not
wor
ked.
�
Det
erm
ine
how
sta
ff w
ill b
e co
mpe
nsat
ed f
or h
ours
wor
ked
over
40
hou
rs p
er w
eek,
i.e.
com
pens
ator
y le
ave
time.
�
Add
ress
man
dato
ry o
vert
ime.
For
exa
mpl
e, e
mpl
oyee
s w
ill n
ot
be e
xpec
ted
to w
ork
mor
e th
an 1
6 ho
urs
in a
24-
hour
per
iod
in
the
even
t th
e C
omm
issi
oner
of
Hea
lth w
aive
s lic
ensi
ng r
egul
atio
nssu
ch a
s st
ate
regu
latio
ns r
egar
ding
man
dato
ry o
vert
ime
durin
g a
stat
e of
em
erge
ncy.
�Ve
rify
requ
irem
ents
of
unio
n co
ntra
cts
and
ensu
re c
ompl
ianc
e.�
Ens
ure
com
plia
nce
with
labo
r la
ws
such
as
AD
A, F
MLA
and
N
J Fa
mily
Wor
k A
ct.
14S
ee C
hild
care
Enr
ollm
ent
Form
, App
endi
x #2
f
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it29
C. E
MP
LOY
EE
EX
PE
CTA
TIO
NS
(CO
NT
INU
ED)
INN
OT
DA
TE
TOB
ELE
AD
STA
FF
AS
SIG
NM
EN
TC
OM
PLE
TE
DP
RO
GR
ES
SS
TAR
TE
DC
OM
PLE
TE
DM
EM
BE
R
5. D
efin
e of
ficia
l for
ms
of c
omm
unic
atio
n an
d in
clud
e in
pol
icy.
�Ex
ampl
e: T
he f
ollo
win
g fo
rms
of c
omm
unic
atio
n w
ill b
e co
nsid
ered
off
icia
l reg
ardi
ng w
ork
assi
gnm
ents
: ver
bal o
rder
fr
om s
uper
viso
r, e-
mai
l, ra
dio
anno
unce
men
ts, T
V an
noun
cem
ents
and
text
mes
sage
s. S
houl
d te
leph
one
com
mun
icat
ions
fai
l (ce
ll an
d la
ndlin
e), o
r st
aff
are
unab
le t
o re
ach
supe
rvis
or f
or a
ny
reas
on, s
taff
are
to
liste
n to
rad
io s
tatio
n (X
YZ)
. Com
mun
icat
ions
fa
ilure
is n
ot a
n ac
cept
able
rea
son
not
to r
epor
t to
wor
k. S
taff
is
expe
cted
to
take
ste
ps t
o st
ay in
form
ed.15
6. E
stab
lish
empl
oyee
tra
inin
g re
quire
men
tsfo
r H
R p
olic
ies.
�Ex
ampl
e:Su
perv
isor
s sh
ould
revi
ew w
ith a
ll st
aff t
he h
ospi
tal
hurr
ican
e po
licy
and
empl
oyee
role
s an
d re
spon
sibi
litie
s ea
ch y
ear
prio
r to
the
star
t of H
urric
ane
Seas
on, w
hich
is J
une
1 –
Nov
30.
�A
ll pe
rson
nel a
re t
o si
gn a
n ac
know
ledg
emen
t for
m. E
xem
ptio
n an
d ch
ildca
re e
nrol
lmen
t fo
rms
are
to b
e up
date
d an
nual
ly.
Sup
ervi
sors
sho
uld
revi
ew e
mpl
oyee
s’ e
xpec
tatio
ns t
o w
ork
and
thei
r ro
le a
nd r
espo
nsib
ilitie
s as
def
ined
in t
he d
epar
tmen
t pl
an.
15S
ee H
urric
ane
Prep
ared
ness
Che
cklis
t, A
ppen
dix
#2c
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it31
D. E
MP
LOY
EE
SU
PP
OR
T
INN
OT
DA
TE
TOB
ELE
AD
STA
FF
AS
SIG
NM
EN
TC
OM
PLE
TE
DP
RO
GR
ES
SS
TAR
TE
DC
OM
PLE
TE
DM
EM
BE
R
1. E
stab
lish
and
iden
tify
area
s fo
r st
aff
to s
leep
and
sho
wer
.�
Ens
ure
staf
f ha
s re
alis
tic e
xpec
tatio
ns r
egar
ding
sha
red
show
ers
and
slee
ping
are
a.�
Det
erm
ine
if st
aff
is r
espo
nsib
le f
or b
ringi
ng t
heir
own
linen
s,
tow
els,
toi
letr
ies
and
othe
r su
pplie
s. T
his
shou
ldbe
ref
lect
ed o
n ch
eckl
ists
dev
elop
ed f
or s
taff.
16
2. E
stab
lish
proc
edur
es t
o pr
ovid
e a
fuel
sou
rce
for
empl
oyee
s to
be
able
to
com
mut
e to
wor
k in
the
eve
nt p
ower
out
ages
are
ext
ensi
vem
akin
g op
erab
le g
as s
tatio
ns d
iffic
ult
to a
cces
s. (S
peci
al N
ote:
If a
fu
el d
epot
is e
stab
lishe
d by
em
erge
ncy
man
agem
ent
in y
our
area
fo
r firs
t res
pond
ers,
hos
pita
ls, e
tc. e
nsur
ela
w e
nfor
cem
ent i
s aw
are
that
non
-clin
ical
sta
ff is
ess
entia
l at
a ho
spita
l, no
t ju
st d
octo
rs a
nd
nurs
es, a
nd t
here
fore
will
req
uire
acc
ess
to f
uel.)
�Ex
ampl
es: I
f ho
spita
ls e
lect
to
prov
ide
fuel
ons
ite, e
stab
lish
an
agre
emen
t with
a n
earb
y ve
ndor
or w
ork
with
em
erge
ncy
man
agem
ent
for
esta
blis
hing
fue
l dep
ots.
If w
orki
ng w
ith a
loca
l ve
ndor
, ver
ify t
he v
endo
r’s h
urric
ane
plan
and
ens
ure
the
term
s of
agr
eem
ent
can
be m
et.
�If
the
hosp
ital p
rovi
des
fuel
to e
mpl
oyee
s, d
efin
e th
e ex
pect
atio
n fo
r pa
ymen
t.
3. E
stab
lish
proc
edur
es fo
r pro
vidi
ng tr
ansp
orta
tion
for s
taff
pre-
and
po
st-s
torm
.�
Iden
tify
tran
spor
tatio
n re
sour
ces
to a
ssis
t st
aff
with
com
mut
ing
to a
nd f
rom
wor
k if
need
ed. E
stab
lish
cont
ract
s as
nee
ded
for
serv
ices
(e.g
. ren
tal c
ar a
genc
ies)
.�
Dev
elop
tran
spor
tatio
n lo
gs w
ith c
heck
lists
.�
Iden
tify
tran
spor
tatio
n re
sour
ces
suita
ble
for
adve
rse
road
co
nditi
ons.
�E
nsur
e co
ordi
natio
n w
ith e
mer
genc
y m
anag
emen
t.�
Ensu
re c
oord
inat
ion
with
law
enf
orce
men
tfor
acc
ess
to ro
ads
that
m
ay b
e re
stric
ted.
�D
eter
min
e, in
con
cert
with
law
enf
orce
men
t, ac
cept
able
form
s of
id
entif
icat
ion
(i.e.
hos
pita
l ID
) tha
t w
ill a
llow
em
ploy
ees
to a
cces
sro
ads
for
com
mut
ing
to a
nd f
rom
wor
k.
16S
ee S
helte
ring
Nec
essi
ties,
App
endi
x #2
b
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it33
D. E
MP
LOY
EE
SU
PP
OR
T(C
ON
TIN
UE
D)
INN
OT
DA
TE
TOB
ELE
AD
STA
FF
AS
SIG
NM
EN
TC
OM
PLE
TE
DP
RO
GR
ES
SS
TAR
TE
DC
OM
PLE
TE
DM
EM
BE
R
4. E
stab
lish
proc
edur
es to
pay
em
ploy
ees
in c
ash,
if n
eces
sary
. (Ex
tens
ive
pow
er o
utag
esm
ake
it di
fficu
lt to
pur
chas
e go
ods
and
serv
ices
unl
ess
you
have
cas
h si
nce
cred
it ca
rd m
achi
nes,
ATM
s, e
tc. d
o no
t wor
k.)
�Id
entif
y de
lega
tion
of a
utho
rity
and
orde
rs o
f su
cces
sion
at
leas
t th
ree
deep
for
per
sonn
el a
utho
rized
to
carr
y ou
t th
is d
uty.
�E
nsur
e ad
equa
te c
ash
rese
rves
prio
r to
the
ons
et o
f a
stor
m.
�E
stab
lish
mem
oran
dum
s of
agr
eem
ent
as n
eces
sary
with
ban
ks.
5. E
nsur
e pl
ans
are
coor
dina
ted
with
loca
l em
erge
ncy
man
agem
ent.
�E
mer
genc
y m
anag
emen
t m
ay b
e ab
le t
o as
sist
with
logi
stic
s an
dre
sour
ces
such
as
tran
spor
tatio
n an
d fu
el.
6. D
eter
min
e if
empl
oyee
s re
quire
d to
wor
k du
ring
the
stor
m m
ay
have
fam
ilym
embe
rs s
tay
at th
e ho
spita
l. If
so, c
onsi
der t
he fo
llow
ing
in y
our p
olic
y:�
Iden
tify
who
qua
lifie
s as
a fa
mily
mem
ber o
r de
pend
ents
, e.g
. sp
ouse
, dep
ende
nt c
hild
ren
and
depe
nden
t (o
n em
ploy
ee) p
aren
t/el
derly
fam
ily m
embe
rs a
re p
erm
itted
to
stay
with
wor
king
sta
ff
mem
bers
at
the
hosp
ital.
�D
evel
op a
che
cklis
t of
item
s fa
mily
mem
bers
, inc
ludi
ng c
hild
ren,
ar
e to
brin
g w
ith t
hem
to
the
hosp
ital.1
7
�C
larif
y ex
pect
atio
ns r
egar
ding
car
e fo
r fa
mily
mem
bers
or
depe
nden
ts w
ith s
peci
al n
eeds
, e.g
. the
hos
pita
l will
not
pro
vide
ca
re fo
r fa
mily
mem
bers
and
dep
ende
nts.
Dev
elop
wai
ver
for
thos
e th
at e
lect
to b
ring
fam
ily m
embe
rs/d
epen
dent
s to
the
faci
lity.
18
�Id
entif
y ar
eas
in t
he h
ospi
tal w
here
fam
ily m
embe
rs w
ill s
tay,
in
clud
ing
slee
ping
and
sho
wer
ing
area
s.�
Iden
tify
area
s fo
r su
perv
ised
car
e of
chi
ldre
n an
d ad
ults
with
sp
ecia
l nee
ds.
�Id
entif
y po
tent
ial s
taff
tha
t m
ay s
uper
vise
chi
ldre
n an
d ad
ults
w
ith s
peci
al n
eeds
. Con
side
r ha
ving
fam
ily m
embe
rs o
f st
aff
volu
ntee
r. C
onsi
der
part
nerin
g w
ith lo
cal c
hild
care
age
ncy.
�
Dev
elop
enr
ollm
ent/
wai
ver
form
tha
t ad
dres
ses
liabi
lity
prot
ectio
ns f
or d
epen
dent
s.19
�R
equi
re e
mpl
oyee
s to
com
plet
e th
e en
rollm
ent/w
aive
r fo
rm a
nd
subm
it it
to t
heir
supe
rvis
or e
ach
year
, prio
r to
the
sta
rt o
f hu
rric
ane
seas
on, w
hich
is f
rom
Jun
e 1
– N
ov 3
0.�
Add
ress
par
king
nee
ds.
17S
ee S
helte
ring
Nec
essi
ties,
App
endi
x #2
b18
See
Chi
ldca
re E
nrol
lmen
t Fo
rm, A
ppen
dix
#2f
19S
ee C
hild
care
Enr
ollm
ent
Form
, App
endi
x #2
f
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it35
D. E
MP
LOY
EE
SU
PP
OR
T(C
ON
TIN
UE
D)
INN
OT
DA
TE
TOB
ELE
AD
STA
FF
AS
SIG
NM
EN
TC
OM
PLE
TE
DP
RO
GR
ES
SS
TAR
TE
DC
OM
PLE
TE
DM
EM
BE
R
7. I
f sp
ace
is u
nava
ilabl
e at
fac
ility
, con
side
r w
orki
ng w
ith lo
cal
emer
genc
y m
anag
emen
t to
iden
tify
a sh
elte
r fo
r em
ploy
ee f
amily
m
embe
rs, i
nclu
ding
dep
ende
nts.
�
Det
erm
ine
who
will
be
in c
harg
e of
pre
para
tions
and
sh
elte
r op
erat
ions
. �
Est
ablis
h m
emor
andu
m o
f un
ders
tand
ing
as n
eede
d.
8. If
fam
ily m
embe
rs a
re n
ot p
erm
itted
to
stay
at
the
hosp
ital,
dete
rmin
e if
child
or
depe
nden
t ca
re w
ill b
e av
aila
ble
to c
areg
iver
s.
If s
o, c
onsi
der
the
follo
win
g in
you
r po
licy:
�Id
entif
y ar
ea o
f th
e ho
spita
l for
sup
ervi
sed
child
care
and
an
area
fo
r ad
ult
depe
nden
ts w
ith s
peci
al n
eeds
.�
Iden
tify
pote
ntia
l sta
ff t
hat
may
sup
ervi
se c
hild
ren
and
assi
st
spec
ial n
eeds
adu
lts. C
onsi
der
usin
g su
ppor
t st
aff
from
no
n-cr
itica
l fun
ctio
ns.
�C
onsi
der
part
nerin
g w
ith a
loca
l chi
ldca
re a
genc
y an
d an
eld
er
day
care
age
ncy
to a
ssis
t yo
u.�
Dev
elop
an
enro
llmen
t/w
aive
r fo
rm t
hat
addr
esse
s lia
bilit
y pr
otec
tions
.20�
Req
uire
em
ploy
ees
to c
ompl
ete
the
enro
llmen
t/w
aive
r fo
rm a
nd
subm
it it
to t
heir
supe
rvis
or p
rior
to t
he s
tart
of
hurr
ican
e se
ason
, w
hich
is J
une
1 –
Nov
30
each
yea
r.�
If f
amily
mem
bers
are
not
per
mitt
ed t
o st
ay a
t the
hos
pita
l, co
nsid
er d
evel
opin
g a
budd
y sy
stem
for c
hild
/dep
ende
nt c
are.
For
ex
ampl
e, t
wo
sing
le p
aren
ts c
ould
wor
k op
posi
te s
hift
s an
d ca
re
for
each
oth
er’s
chi
ldre
n w
hile
the
oth
er is
wor
king
. The
hos
pita
l co
uld
assi
st w
ith m
akin
g th
ese
arra
ngem
ents
.
9. If
no
fam
ily m
embe
rs a
re p
erm
itted
at
faci
lity,
con
side
r ne
gotia
ting
cont
ract
ser
vice
s fo
r ch
ild c
are
and
elde
r ca
re f
or s
taff.
20S
ee C
hild
care
Enr
ollm
ent
Form
, App
endi
x #2
f
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it37
D. E
MP
LOY
EE
SU
PP
OR
T(C
ON
TIN
UE
D)
INN
OT
DA
TE
TOB
ELE
AD
STA
FF
AS
SIG
NM
EN
TC
OM
PLE
TE
DP
RO
GR
ES
SS
TAR
TE
DC
OM
PLE
TE
DM
EM
BE
R
10. D
eter
min
e if
empl
oyee
s re
quire
d to
wor
k du
ring
the
stor
m m
ay
brin
g pe
ts.
�Ex
ampl
e: A
ll an
imal
s m
ust
be c
rate
d an
d up
-to-
date
on
all
vacc
inat
ions
(i.e
. rab
ies)
. Pro
per
docu
men
tatio
n of
vac
cina
tions
isre
quire
d at
the
tim
e of
che
ck in
. Ow
ners
/em
ploy
ees
mus
t pr
ovid
eal
l nec
essa
ry it
ems
to c
are
for
thei
r pe
t (i.
e. fo
od, w
ater
, litt
er,
com
fort
item
s). P
et o
wne
rs a
re r
espo
nsib
le f
or c
lean
ing
up a
fter
an
d ca
ring
for
thei
r pe
t(s)
.�
Iden
tify
area
s of
the
hos
pita
ls w
here
pet
s m
ay s
tay.
�
Dev
elop
a c
heck
list
of it
ems
that
mus
t be
bro
ught
to
the
hosp
ital
with
the
pet
.�
Ensu
re s
taff
is a
war
e of
pet
em
erge
ncy
prep
ared
ness
info
rmat
ion.
21
11. E
nsur
e st
aff
is t
rain
ed o
n fa
mily
pre
pare
dnes
s.
�Pr
ovid
e st
aff
with
too
ls a
nd r
esou
rces
to
help
the
m d
evel
op t
heir
pers
onal
pre
pare
dnes
s pl
an.22
21S
ee h
ttp:
//ww
w.a
spca
.org
/pet
-car
e/di
sast
er-p
repa
redn
ess/
and
http
://w
ww
.rea
dy.g
ov/a
mer
ica/
geta
kit/
pets
.htm
l22
See
ht t
p://w
ww
.rea
dy.g
ov/
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it39
E. S
UP
PLI
ES
- S
PE
CIA
L C
ON
SID
ER
AT
ION
S F
OR
HU
RR
ICA
NE
S
INN
OT
DA
TE
TOB
ELE
AD
STA
FF
AS
SIG
NM
EN
TC
OM
PLE
TE
DP
RO
GR
ES
SS
TAR
TE
DC
OM
PLE
TE
DM
EM
BE
R
1. E
stab
lish
proc
edur
es t
o as
sess
cur
rent
sup
ply
inve
ntor
y le
vels
23an
dde
term
ine
incr
ease
d su
pply
nee
ds t
o sh
elte
r-in-
plac
efo
r on
e w
eek.
2. D
eter
min
e ho
w fa
r in
adv
ance
of
a st
orm
add
ition
al s
uppl
ies
need
to
be o
rder
ed t
o en
sure
del
iver
y pr
ior
to s
torm
impa
cts/
evac
uatio
ns.
Hos
pita
ls w
ill ne
ed to
mak
e su
re a
dditi
onal
sup
plie
s ar
e se
cure
d pr
ior
to in
terru
ptio
ns o
f del
iver
y se
rvic
es.
2. In
clud
e th
is in
form
atio
n on
faci
lity
chec
klis
t.
3. C
heck
with
ven
dors
to
dete
rmin
e th
eir
limita
tions
of
deliv
ery
in t
heev
ent
of s
torm
thr
eats
and
/or
evac
uatio
ns. I
n in
stan
ces
of in
tens
e st
orm
s, t
ruck
s m
ay n
ot m
ake
deliv
erie
s as
sch
edul
ed fo
r fea
r of
bein
g ca
ught
in e
vacu
atio
n tr
affic
.
4. Id
entif
y al
tern
ate/
addi
tiona
l ven
dors
and
dev
elop
pur
chas
ing
proc
edur
es.24
�D
evel
op s
et o
f em
erge
ncy
purc
hase
ord
ers
that
may
be
quic
kly
impl
emen
ted
(or
activ
ated
with
the
ven
dor
dire
ctly
via
pho
ne) a
ndfil
e w
ith v
endo
rs.
�D
evel
op e
mer
genc
y ba
ckup
pro
cedu
res
to e
xped
ite p
urch
asin
g of
cr
itica
l sup
plie
s sh
ould
nor
mal
pur
chas
ing
proc
edur
es b
e in
terr
upte
d or
del
ayed
.�
Exp
lore
alte
rnat
e gr
oup
purc
hasi
ng a
gree
men
ts.
�D
eter
min
e w
ho h
as a
utho
rity
to im
plem
ent
emer
genc
y pu
rcha
sing
orde
rs a
nd t
rigge
r po
ints
to
activ
ate,
e.g
., 72
hou
rs p
rior
to la
ndfa
ll.En
sure
del
egat
ions
of
auth
ority
and
ord
ers
of s
ucce
ssio
n at
leas
t th
ree
deep
.
5. R
evie
w lo
gist
ical
nee
ds a
nd o
ptio
ns f
or p
re-p
ositi
onin
g an
d di
strib
utin
g su
pplie
s w
ithin
the
hos
pita
l. C
onsi
der
desi
gnat
ing
supp
ly s
tagi
ng a
reas
on
each
flo
or.
23S
ee C
onsu
mab
le S
uppl
y O
pera
tiona
l Im
pact
Cha
rt, A
ppen
dix
#824
See
Sam
ple
Emer
genc
y C
onta
ct F
orm
, App
endi
x #1
b
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it41
E. S
UP
PLI
ES
- S
PE
CIA
L C
ON
SID
ER
AT
ION
S F
OR
HU
RR
ICA
NE
S (
CO
NT
INU
ED)
INN
OT
DA
TE
TOB
ELE
AD
STA
FF
AS
SIG
NM
EN
TC
OM
PLE
TE
DP
RO
GR
ES
SS
TAR
TE
DC
OM
PLE
TE
DM
EM
BE
R
6. E
nsur
e us
e of
Inve
ntor
y M
anag
emen
t Sy
stem
or
iden
tify
alte
rnat
e pr
oced
ures
for i
nven
tory
man
agem
ent i
n th
e ev
ent o
f a p
ower
out
age.
�Ve
rify
capa
city
of I
nven
tory
Man
agem
ent
Syst
em. B
e aw
are
of
syst
em li
mita
tions
and
the
impa
ct t
his
may
hav
e on
man
agin
g in
vent
ory
durin
g an
eve
nt. P
lan
acco
rdin
gly.
�Ex
ampl
e: A
bac
k-up
sys
tem
may
be
the
use
of E
xcel
file
s on
a
batt
ery
back
-up
com
pute
r th
at c
an b
e pl
ugge
d in
to a
n ou
tlet
pow
ered
by
a ge
nera
tor.
Als
o, p
aper
and
pen
cil w
ork
too.
Con
side
rpr
e-po
pula
ting
inve
ntor
y fo
rms
and
prin
ting
them
pre
-eve
nt t
o ea
se p
aper
and
pen
cil m
etho
ds.
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it43
F. U
TIL
ITIE
S
INN
OT
DA
TE
TOB
ELE
AD
STA
FF
AS
SIG
NM
EN
TC
OM
PLE
TE
DP
RO
GR
ES
SS
TAR
TE
DC
OM
PLE
TE
DM
EM
BE
R
1. D
eter
min
e R
ecov
ery
Tim
e O
bjec
tives
(RTO
) for
crit
ical
and
sup
port
fu
nctio
ns.25
�A
n R
TO la
ys o
ut t
he m
axim
um a
ccep
tabl
e do
wnt
ime
for
a pr
oces
s. F
or e
xam
ple,
if t
he c
linic
al r
egis
trat
ion
syst
em g
oes
dow
n,yo
u m
ay h
ave
an R
TO o
f on
e ho
ur t
o ge
t it
back
up.
A r
ecov
ery
poin
t ob
ject
ive
(RP
O) i
s th
e m
axim
um a
mou
nt o
f allo
wab
le d
ata
loss
follo
win
g an
unp
lann
ed IT
eve
nt s
uch
as a
crit
ical
dis
k fa
ilure
or
a fl
ood
in y
ourd
ata
cent
er. T
he R
PO h
elps
you
dec
ide
how
ofte
n yo
u w
ill ba
ckup
you
r dat
a. If
you
r RPO
is o
ne w
eek,
then
you
cou
ld
back
up y
our
data
onc
e a
wee
k so
the
max
imum
am
ount
of
data
yo
u w
ould
lose
is o
nly
data
sin
ce t
he la
st b
acku
p.If
it is
un
acce
ptab
le t
o lo
se a
ny d
ata,
and
you
r R
PO
is o
ne m
illis
econ
d,
then
you
wou
ld re
quire
a m
irror
ed s
ite s
o th
at d
ata
is s
imul
tane
ousl
ypr
esen
t on
you
r pr
imar
y sy
stem
and
you
r ba
ckup
sys
tem
.
2. E
stab
lish
alte
rnat
e so
urce
s of
pow
er t
hat
are
sust
aina
ble
for
at
leas
t 96
hou
rs a
s re
quire
d by
the
Joi
nt C
omm
issi
on a
nd u
p to
one
w
eek.
�Id
entif
y lo
ad r
equi
rem
ents
.�
Iden
tify
and
acqu
ire a
ppro
pria
te e
quip
men
t.�
Iden
tify
imm
edia
te a
nd d
elay
ed p
ower
nee
ds fo
r eac
h de
part
men
t. N
ote:
Sho
rt te
rm p
ower
nee
ds (<
12 h
ours
) diff
er fr
om lo
ng te
rm
pow
er n
eeds
. Pre
pare
for a
n ex
tens
ive
pow
er o
utag
e. F
or e
xam
ple,
co
nsid
er t
he n
eed
to p
ower
air
cond
ition
ers/
vent
ilatio
n sy
stem
s,
wat
er c
hille
rs, a
ncill
ary
area
s, a
cces
s co
ntro
l/sec
urity
sys
tem
s,
tele
phon
es a
nd c
ompu
ter
syst
ems,
in a
dditi
on t
o cl
inic
alca
re
oper
atio
ns.
�E
stab
lish
back
up s
ourc
es o
f po
wer
to
mai
n al
tern
ate
sour
ce (i
.e.
port
able
gen
erat
ors
to b
ack
up m
ain
gene
rato
r, la
rge
batt
erie
s on
w
heel
s).
25S
ee U
tility
Fai
lure
Ope
ratio
nal I
mpa
ct C
hart
, App
endi
x #7
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it45
F. U
TIL
ITIE
S(C
ON
TIN
UE
D)
INN
OT
DA
TE
TOB
ELE
AD
STA
FF
AS
SIG
NM
EN
TC
OM
PLE
TE
DP
RO
GR
ES
SS
TAR
TE
DC
OM
PLE
TE
DM
EM
BE
R
3. E
stab
lish
proc
edur
es f
or m
aint
aini
ng a
ltern
ate
sour
ces
of p
ower
pr
e- a
nd p
ost-
even
t.�
Ens
ure
alte
rnat
e po
wer
sou
rces
are
pro
tect
ed f
rom
flo
odin
g an
d w
ind.
�
Ens
ure
mai
nten
ance
sup
plie
s ar
e av
aila
ble
for
gene
rato
rs (i
.e.
filte
rs, s
park
plu
gs, o
il, e
tc.).
�M
aint
ain
capa
city
to
mak
e re
pairs
and
ope
rate
pow
er s
ourc
es (i
.e.
Eng
inee
r is
con
side
red
criti
cal p
erso
nnel
).�
Ens
ure
suff
icie
nt a
mou
nts
of f
uel f
or g
ener
ator
s ar
e av
aila
ble
and
secu
red
pre-
stor
m f
rom
win
d an
d flo
odin
g.
4. E
stab
lish
proc
edur
es t
o se
cure
add
ition
al s
uppl
ies.
�Fo
od: I
ncre
ase
food
ord
erin
g fo
rmul
as t
o ac
coun
t fo
r ad
ditio
nal
staf
f an
d fa
mily
mem
bers
; ide
ntify
foo
ds t
hat
do n
ot r
equi
re
refr
iger
atio
n; c
onsi
der
disp
osab
le p
rodu
cts
for
serv
ing
food
and
ea
ting.
�O
xyge
n: O
xyge
n-de
pend
ent
patie
nts
may
hav
e in
terr
uptio
ns t
o th
eir
oxyg
en s
uppl
y or
ele
ctric
ity a
nd m
ay s
eek
assi
stan
ce a
t th
e ho
spita
l.�
Line
ns: P
lan
for
addi
tiona
l sta
ff a
nd p
oten
tial i
nter
rupt
ions
to la
undr
yse
rvic
es.
�P
harm
aceu
tical
s: C
omm
unity
pow
er o
utag
es m
ay li
mit
avai
labi
lity
of p
resc
riptio
n m
edic
atio
n. Id
entif
y co
mm
only
use
d m
edic
atio
ns
and
incr
ease
inve
ntor
y.�
Blo
od s
uppl
y: R
each
out
to
bloo
d ce
nter
s/su
pplie
rs a
nd v
erify
th
eir
cont
inge
ncy
plan
s fo
r hu
rric
anes
to
bett
er d
eter
min
e bl
ood
inve
ntor
ies
need
ed p
re-s
torm
to
ensu
re a
n ad
equa
te b
lood
sup
ply
thro
ugh
post
-sto
rm a
nd r
ecov
ery
perio
ds.
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it47
F. U
TIL
ITIE
S(C
ON
TIN
UE
D)
INN
OT
DA
TE
TOB
ELE
AD
STA
FF
AS
SIG
NM
EN
TC
OM
PLE
TE
DP
RO
GR
ES
SS
TAR
TE
DC
OM
PLE
TE
DM
EM
BE
R
5. E
stab
lish
proc
edur
es t
o en
sure
an
adeq
uate
sup
ply
of p
otab
le a
nd
non-
pota
ble
wat
er.
�Id
entif
y us
es o
f no
n-po
tabl
e w
ater
(i.e
. flu
shin
g to
ilets
, coo
ling
vent
ilatio
n to
wer
s, f
ire s
uppr
essi
on s
yste
m).
�Id
entif
y so
urce
s of
non
-pot
able
wat
er (i
.e. P
orta
-Pot
ty o
r w
ell).
�E
stab
lish
cont
ract
with
ven
dor2
6(i.
e. w
ater
buf
falo
)�
Iden
tify
sour
ces
of p
otab
le w
ater
(i.e
. bot
tled
wat
er).
�E
stab
lish
cont
ract
with
ven
dors
as
need
ed.
6. E
stab
lish
proc
edur
es t
o en
sure
ade
quat
e su
pplie
s to
m
aint
ain
vent
ilatio
n sy
stem
.�
Mai
ntai
n ca
paci
ty t
o m
ake
repa
irs t
o sy
stem
(i.e
. Eng
inee
r is
co
nsid
ered
crit
ical
per
sonn
el).
�E
nsur
e (n
on-p
otab
le) w
ater
sup
ply
for
cool
ing
tow
ers.
7.
Est
ablis
h pr
oced
ures
to
man
age
was
te.
�W
aste
col
lect
ion
serv
ices
may
be
inte
rrup
ted.
�Id
entif
y ad
ditio
nal s
tora
ge c
apac
ity f
or w
aste
.�
Ens
ure
prop
er h
andl
ing
of w
aste
to
prev
ent i
njur
y an
d th
e sp
read
of
dis
ease
.
26S
ee S
ampl
e Em
erge
ncy
Con
tact
For
m, A
ppen
dix
#1b
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it49
G. P
AT
IEN
T IS
SU
ES
INN
OT
DA
TE
TOB
ELE
AD
STA
FF
AS
SIG
NM
EN
TC
OM
PLE
TE
DP
RO
GR
ES
SS
TAR
TE
DC
OM
PLE
TE
DM
EM
BE
R
1. E
stab
lish
proc
edur
es t
o ex
pedi
te p
atie
nt t
rans
fers
and
pat
ient
tr
acki
ng in
a d
isas
ter.
�N
ote:
Kno
w c
riter
ia a
nd e
stab
lish
prot
ocol
s fo
r w
hen
patie
nt
tran
sfer
s ar
e no
long
er a
llow
ed d
ue t
o un
safe
roa
d co
nditi
ons
(Exa
mpl
e: In
sus
tain
ed w
inds
of
> 4
5 m
ph, a
mbu
lanc
es c
an n
o lo
nger
tra
nspo
rt p
atie
nts)
.�
Dev
elop
abb
revi
ated
for
ms
and
chec
klis
ts f
or p
atie
nt t
rans
fers
an
d di
scha
rge,
if n
eede
d.�
Ens
ure
patie
nt t
rack
ing
proc
edur
es a
re e
stab
lishe
d an
d fo
llow
ed.
2. E
stab
lish
Mem
oran
da o
f U
nder
stan
ding
/Mem
oran
da o
f A
gree
men
t (M
OU
/MO
A) w
ith f
acili
ties
in a
nd o
ut o
f st
ate
for
patie
nt t
rans
fers
an
d ev
acua
tions
.
3. E
stab
lish
proc
edur
es to
dis
char
ge p
atie
nts.
�E
nsur
e al
l reg
ulat
ory
requ
irem
ents
are
met
whe
n di
scha
rgin
g pa
tient
s.�
Ens
ure
patie
nts
are
prov
ided
pro
per
hom
e ca
re in
stru
ctio
ns a
nd
acce
ss t
o su
ppor
ting
med
ical
equ
ipm
ent.
�E
nsur
e pa
tient
s ha
ve s
uffic
ient
sup
ply
of m
edic
atio
ns.
�E
nsur
e av
aila
bilit
y of
tra
nspo
rtat
ion.
If e
vacu
atio
ns h
ave
star
ted
in
your
are
a, o
r a
near
by a
rea,
roa
ds m
ay b
e ja
mm
edan
d us
ual
tran
spor
tatio
n as
sets
may
not
be
avai
labl
e.4.
Est
ablis
h pr
oced
ures
for
assi
stin
g ox
ygen
-dep
ende
nt p
atie
nts
that
m
ay p
rese
nt b
efor
e or
aft
er a
sto
rm.
�C
oord
inat
e w
ith E
mer
genc
y M
anag
emen
t/H
ealth
Dep
artm
ent
to
dete
rmin
e if
any
reso
urce
s ar
e av
aila
ble
in t
he c
omm
unity
to
assi
st w
ith o
xyge
n-de
pend
ent
patie
nts.
Are
the
re s
peci
al n
eeds
sh
elte
rs a
vaila
ble
with
est
ablis
hed
alte
rnat
e so
urce
s of
pow
er?
�
Be
prep
ared
to
assi
st o
xyge
n-de
pend
ent
patie
nts.
�C
onsi
der e
stab
lishi
ng p
artn
ersh
ips
with
hom
e he
alth
age
ncie
s an
d as
sist
ed li
ving
faci
litie
s to
add
ress
thi
s ne
ed.
�E
nsur
e ad
equa
te a
mou
nts
of o
xyge
n, t
anks
and
sup
plie
s.
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it51
G. P
AT
IEN
T IS
SU
ES
(CO
NT
INU
ED)
INN
OT
DA
TE
TOB
ELE
AD
STA
FF
AS
SIG
NM
EN
TC
OM
PLE
TE
DP
RO
GR
ES
SS
TAR
TE
DC
OM
PLE
TE
DM
EM
BE
R
5. R
evie
w e
xist
ing
reso
urce
s to
ass
ist
with
pla
nnin
g fo
r the
nee
ds o
f di
alys
is p
atie
nts.
27
�C
heck
with
are
a di
alys
is c
ente
rs r
egar
ding
the
ir hu
rric
ane
plan
an
d re
sour
ces.
�B
e pr
epar
ed t
o ad
dres
s di
alys
is p
atie
nt n
eeds
pos
t-st
orm
.�
Est
ablis
h pa
rtne
rshi
ps a
s ne
eded
.�
Edu
cate
pat
ient
s on
pla
ns a
nd p
roce
dure
s.�
Be
prep
ared
to
incr
ease
wat
er s
uppl
y an
d pr
essu
re a
s ne
eded
.
6. E
stab
lish
proc
edur
es f
or m
anag
ing
preg
nant
wom
en.
�C
oord
inat
e w
ith m
edic
al s
taff
to
dete
rmin
e cr
iteria
for
adm
ittin
g pr
egna
nt w
omen
prio
r to
sto
rm.
�E
nsur
e pr
oced
ures
are
com
mun
icat
ed c
lear
ly w
ith p
atie
nts.
7. E
stab
lish
proc
edur
es f
or li
miti
ng a
dmis
sion
s w
hen
a st
orm
is
appr
oach
ing.
�Ex
ampl
e: E
stab
lish
proc
edur
es t
o ca
ncel
ele
ctiv
e su
rger
ies
to
redu
ce in
patie
nt s
tays
.�
Be
prep
ared
for
per
sons
see
king
adm
issi
on t
hat
wou
ld n
ot
typi
cally
do
so u
nder
nor
mal
circ
umst
ance
s.
�Id
entif
y co
mm
unity
res
ourc
es t
o re
fer
pers
ons
seek
ing
shel
ter
at y
our
faci
lity.
Som
e pe
ople
may
wan
t to
use
you
r fa
cilit
y as
a
safe
hav
en.
�Ed
ucat
e co
mm
unity
on
thes
e re
sour
ces
and
enco
urag
e pe
rson
s w
ith s
peci
al n
eeds
to
have
pre
pare
dnes
s pl
ans.
The
hos
pita
l is
NO
T a
shel
ter.
8. E
stab
lish
proc
edur
es f
or m
ovin
g pa
tient
s w
ithin
fac
ility
whe
n el
evat
ors
are
not
wor
king
at
full
capa
city
, if
at a
ll.�
Iden
tify
equi
pmen
t ne
eds
and
acqu
ire a
ppro
pria
te e
quip
men
t su
ch a
s st
retc
hers
/litt
ers.
�E
nsur
e st
aff
is t
rain
ed o
n pr
oced
ures
and
equ
ipm
ent
use.
27S
ee D
ialy
sis
Con
cern
s, A
ppen
dix
#9
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it53
H. C
OM
MU
NIC
AT
ION
ISS
UE
S
INN
OT
DA
TE
TOB
ELE
AD
STA
FF
AS
SIG
NM
EN
TC
OM
PLE
TE
DP
RO
GR
ES
SS
TAR
TE
DC
OM
PLE
TE
DM
EM
BE
R
1. E
nsur
e ca
pabi
lity
and
capa
city
of r
edun
dant
form
s of
com
mun
icat
ions
.�
Iden
tify
all f
orm
s of
com
mun
icat
ions
. (R
emem
ber,
pape
r, pe
ncil
and
runn
ers
also
are
opt
ions
.)�
Verif
y in
tero
pera
bilit
y of
com
mun
icat
ions
equ
ipm
ent
with
par
tner
ag
enci
es, r
espo
nse
agen
cies
and
loca
l and
sta
te a
genc
ies.
�Te
st c
omm
unic
atio
n sy
stem
s re
gula
rly.
�E
nsur
e ad
equa
te n
umbe
r of
per
sonn
el is
tra
ined
on
how
to
oper
ate
equi
pmen
t.�
Iden
tify
com
mun
ity r
esou
rces
to
assi
st w
ith r
esto
ratio
n of
co
mm
unic
atio
n sy
stem
s. F
or e
xam
ple,
doe
s yo
ur lo
cal e
mer
genc
y m
anag
emen
t ag
ency
hav
e ag
reem
ents
with
cel
l pho
ne c
ompa
nies
to b
ring
in p
orta
ble
com
mun
icat
ion
tow
ers
post
-eve
nt?
2. E
nsur
e st
aff
notif
icat
ion
and
activ
atio
n pr
oces
ses
are
esta
blis
hed
and
clea
rly d
efin
ed.
�S
taff
is t
o m
aint
ain
curr
ent
cont
act
info
rmat
ion.
�E
stab
lish
call
dow
n pr
oced
ures
and
tes
t re
gula
rly (i
.e. c
all t
ree)
.�
Shou
ld p
hone
sys
tem
s fa
il, id
entif
y al
tern
ate
sour
ces
for
empl
oyee
info
rmat
ion
rega
rdin
g w
hen
to r
epor
t to
wor
k. F
or e
xam
ple,
es
tabl
ish
an a
gree
men
t w
ith a
loca
l rad
io s
tatio
n th
at w
ill m
ake
anno
unce
men
ts f
or y
our
hosp
ital.
3. E
stab
lish
proc
edur
es t
o ke
ep s
taff
and
Boa
rd o
f Tru
stee
s in
form
ed
pre-
, dur
ing
and
post
-eve
nt.
�Ex
ampl
e:B
riefin
gs f
or a
ll st
aff
will
be
held
at
regu
lar
inte
rval
s an
dIn
cide
nt A
ctio
n P
lans
(IA
P) a
nd S
ituat
ion
Rep
orts
(SitR
eps)
will
be
dist
ribut
ed t
o al
l per
sonn
el v
ia e
-mai
l and
pos
ted
on c
afet
eria
bu
lletin
boa
rd.
�E
stab
lish
proc
edur
es f
or a
n em
ploy
ee h
otlin
e.�
Ens
ure
staf
f br
iefin
gs a
re h
eld
regu
larly
dur
ing
shift
s an
d at
sh
ift c
hang
e.
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it55
H. C
OM
MU
NIC
AT
ION
ISS
UE
S(C
ON
TIN
UE
D)
INN
OT
DA
TE
TOB
ELE
AD
STA
FF
AS
SIG
NM
EN
TC
OM
PLE
TE
DP
RO
GR
ES
SS
TAR
TE
DC
OM
PLE
TE
DM
EM
BE
R
4. E
stab
lish
proc
edur
es t
o ke
ep c
omm
unity
par
tner
s an
d co
mm
unity
le
ader
s in
form
ed.
�En
sure
coo
rdin
atio
n of
info
rmat
ion
flow
bet
wee
n ho
spita
l, co
mm
unity
par
tner
s an
d ot
her
stak
ehol
ders
.�
Ens
ure
cont
act
lists
for
com
mun
ity p
artn
ers
are
curr
ent.
�E
stab
lish
com
mun
icat
ion
chan
nels
and
pro
toco
ls w
ith p
artn
ers
and
lead
ersh
ip.
�E
stab
lish
bed
trac
king
/rep
ortin
g pr
oced
ures
.�
Con
side
r ha
ving
hos
pita
l rep
rese
ntat
ive
at E
mer
genc
y O
pera
tions
C
ente
r.�
Sen
d IA
P a
nd S
itRep
s to
com
mun
ity le
ader
s an
d pa
rtne
rs.
5. E
stab
lish
proc
edur
es t
o en
sure
hos
pita
l rec
eive
s in
form
atio
n fr
om
com
mun
ity p
artn
ers.
�Ex
ampl
e: H
ospi
tal r
epre
sent
ativ
e at
tend
s EO
C b
riefin
gs, h
ospi
tal o
n EO
C e
-mai
l dis
trib
utio
n lis
t to
rece
ive
SitR
eps
and
IAPs
and
oth
er
impo
rtan
t ale
rts
from
com
mun
ity p
artn
ers/
EOC
.
6. E
stab
lish
proc
edur
es t
o en
sure
com
mun
icat
ion
and
coor
dina
tion
of p
atie
nt c
are
with
med
ical
sta
ff.�
Est
ablis
h pr
oced
ures
to
ensu
re c
omm
unic
atio
ns a
mon
g m
edic
al s
taff.
�Es
tabl
ish
proc
edur
es to
ass
ist m
edic
al s
taff
with
com
mun
icat
ing
need
ed in
form
atio
n to
pat
ient
s. F
or e
xam
ple,
a p
hysi
cian
’s o
ffice
is
seve
rely
dam
aged
and
est
ablis
hes
oper
atio
ns a
t an
alte
rnat
e lo
catio
n; h
ospi
tals
may
wan
t to
assi
st w
ith p
rovi
ding
this
info
rmat
ion
to p
atie
nts
and
the
com
mun
ity.28
7. C
olla
bora
te w
ith lo
cal a
nd s
tate
pub
lic h
ealth
and
em
erge
ncy
man
agem
ent
to c
omm
unic
ate
with
the
com
mun
ity a
bout
res
ourc
esav
aila
ble
to s
uppo
rt p
erso
ns w
ith s
peci
al n
eeds
.�
Enco
urag
e pe
rson
s w
ith s
peci
al n
eeds
to
have
pre
pare
dnes
s pl
ans.
28S
ee N
JHA
Pan
dem
ic In
fluen
za T
oolk
it: C
omm
unic
atio
ns M
odul
e,ht
tp://
ww
w.n
jha.
com
/pan
inf/
/Com
mun
icat
ions
_Pla
nnin
g_an
d_A
sses
smen
t_To
ol.p
df
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it57
H. C
OM
MU
NIC
AT
ION
ISS
UE
S(C
ON
TIN
UE
D)
INN
OT
DA
TE
TOB
ELE
AD
STA
FF
AS
SIG
NM
EN
TC
OM
PLE
TE
DP
RO
GR
ES
SS
TAR
TE
DC
OM
PLE
TE
DM
EM
BE
R
8. E
stab
lish
and
Impl
emen
t IC
S/H
ICS.
�E
nsur
e al
l sta
ff is
tra
ined
for
the
ir ro
le w
ithin
the
sys
tem
.�
Ens
ure
dele
gatio
ns o
f au
thor
ity a
nd o
rder
s of
suc
cess
ion
at le
ast
thre
e de
ep f
or le
ader
ship
pos
ition
s.�
Follo
w d
ocum
enta
tion
proc
edur
es o
utlin
ed b
y IC
S/H
ICS.
9. E
stab
lish
proc
edur
es t
o co
mm
unic
ate
with
the
med
ia.29
�E
nsur
e al
l sta
ff k
now
pro
toco
l for
res
pond
ing
to m
edia
req
uest
s.
For
exam
ple,
all
staf
f ar
e to
ref
er m
edia
req
uest
s to
the
Pub
lic
Info
rmat
ion
Off
icer
(PIO
).�
Iden
tify
med
ia s
tagi
ng a
reas
to
assi
st t
he m
edia
with
set
ting
up
equi
pmen
t an
d to
hav
e an
est
ablis
hed
area
for
brie
fings
.�
Con
side
r es
tabl
ishi
ng r
egul
ar b
riefin
g tim
es w
ith m
edia
.
10. E
stab
lish
proc
edur
es fo
r com
mun
icat
ions
bet
wee
n in
tern
al
com
man
d ce
nter
and
sta
ff.�
Exam
ple:
Con
side
r us
ing
wal
kie-
talk
ies
for
inte
rnal
hos
pita
l us
e am
ong
staf
f.
29S
ee N
JHA
Pan
dem
ic In
fluen
za T
oolk
it: C
omm
unic
atio
ns M
odul
e,ht
tp://
ww
w.n
jha.
com
/pan
inf/
/Com
mun
icat
ions
_Pla
nnin
g_an
d_A
sses
smen
t_To
ol.p
df
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it59
I.FA
CIL
ITY
MA
NA
GE
ME
NT
AN
D S
EC
UR
ITY
30
INN
OT
DA
TE
TOB
ELE
AD
STA
FF
AS
SIG
NM
EN
TC
OM
PLE
TE
DP
RO
GR
ES
SS
TAR
TE
DC
OM
PLE
TE
DM
EM
BE
R
1. E
stab
lish
proc
edur
es t
o en
sure
acc
ess
cont
rol t
o fa
cilit
y.�
Est
ablis
h pr
oced
ures
to
rest
rict
acce
ss p
oint
s in
to t
he f
acili
ty.
�C
oord
inat
e w
ith lo
cal l
aw e
nfor
cem
ent
agen
cies
on
secu
rity
plan
s.�
Cla
rify
role
and
res
pons
ibili
ties
with
loca
l law
enf
orce
men
t re
gard
ing
faci
lity
secu
rity.
�Id
entif
y ad
ditio
nal s
ecur
ity p
erso
nnel
to
rem
ain
at f
acili
ty d
urin
g th
e st
orm
. �
Esta
blis
h co
ntra
cts
with
priv
ate
secu
rity
com
pani
es a
s ne
eded
.�
Test
pla
ns w
ith p
rivat
e an
d pu
blic
sec
urity
age
ncie
s.
2. E
stab
lish
proc
edur
es t
o m
aint
ain
acce
ss c
ontr
ol w
hen
elec
tron
ic
secu
rity
syst
ems
fail
or a
re n
ot p
ower
ed.
�E
stab
lish
proc
edur
es t
o re
stric
t ac
cess
poi
nts.
�Id
entif
y an
d dr
ill lo
w t
ech
secu
rity
mea
sure
s su
ch a
s us
e of
a
key
log.
�En
sure
ligh
ting
at d
esig
nate
d en
tran
ces.
�
Bui
ld s
ecur
ity p
lan
arou
nd p
re-d
esig
nate
d, r
estr
icte
d en
tran
ces
for
use
durin
g an
eve
nt.
�Id
entif
y R
TO s
ecur
ity s
yste
ms
(i.e
., de
term
ine
num
ber
of h
ours
se
curit
y sy
stem
may
be
with
out
pow
er u
ntil
the
func
tion
mus
t be
res
umed
).�
Coo
rdin
ate
need
s fo
r al
tern
ate
sour
ces
of p
ower
with
app
ropr
iate
pers
onne
l.
3. E
stab
lish
proc
edur
es t
o en
sure
acc
ess
cont
rol a
nd p
rote
ctio
n of
hi
gh-r
isk
area
s w
ithin
the
fac
ility
.�
For
exam
ple,
ens
ure
the
phar
mac
y is
sec
ure
and
can
rem
ain
secu
re w
hen
elec
tron
ic s
yste
ms
fail.
�Id
entif
y lo
catio
ns th
at n
eed
alte
rnat
ive
low
-tech
sec
urity
mea
sure
s.�
Ide
nti
fy a
nd
dri
ll lo
w-t
ech
se
curi
ty m
easu
res
such
as
use
of
lock
s an
d ch
ains
.
30S
ee N
JHA
Hea
lthca
re F
acili
ty M
anag
emen
t R
eadi
ness
Ass
essm
ent T
ool,
http
://w
ww
.njh
a.co
m/e
p/pd
f/61
2200
8913
16A
M.p
df
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it61
I.FA
CIL
ITY
MA
NA
GE
ME
NT
AN
D S
EC
UR
ITY
(CO
NT
INU
ED)
INN
OT
DA
TE
TOB
ELE
AD
STA
FF
AS
SIG
NM
EN
TC
OM
PLE
TE
DP
RO
GR
ES
SS
TAR
TE
DC
OM
PLE
TE
DM
EM
BE
R
4. Id
entif
y an
d do
cum
ent
the
proc
edur
es fo
rre
ques
ting
addi
tiona
l se
curit
y re
sour
ces.
�Id
entif
y ad
ditio
nal s
ecur
ity p
erso
nnel
suc
h as
res
erve
off
icer
s w
ith lo
cal l
aw e
nfor
cem
ent
agen
cies
.�
Esta
blis
h co
ntra
cts
with
priv
ate
secu
rity
com
pani
es f
or a
dditi
onal
se
curit
y pe
rson
nel.
�K
now
the
req
uest
pro
cess
to
acce
ss lo
cal,
regi
onal
and
sta
te la
wen
forc
emen
t of
ficer
s th
roug
h O
EM
. �
Iden
tify
and
drill
the
loca
l EO
C P
oint
of
Con
tact
for
the
law
en
forc
emen
t em
erge
ncy
supp
ort
func
tion.
�U
se o
f im
prop
er re
ques
t pro
cedu
res
may
impa
ct r
eim
burs
emen
t,
whe
n av
aila
ble.
5. E
stab
lish
proc
edur
es t
o en
sure
ade
quat
e lig
htin
g of
hos
pita
l ca
mpu
s in
the
eve
nt o
f ex
tend
ed p
ower
out
ages
.�
Iden
tify
reso
urce
s fo
r lig
htin
g pa
rkin
g ar
eas
and
othe
r ho
spita
l gr
ound
s to
ens
ure
safe
ty.
�E
stab
lish
agre
emen
ts w
ith v
endo
rs a
s ne
eded
. Con
side
r co
ntin
gent
con
trac
ts f
or s
elf-
pow
ered
por
tabl
e lig
hts.
�E
nsur
e su
ffic
ient
ligh
ting
with
in f
acili
ty w
hen
usin
g al
tern
ate
sour
ces
of p
ower
. �
Ens
ure
loca
l pow
er p
rovi
der
has
faci
lity
prop
erly
prio
ritiz
ed
for
reco
very
.
6. E
stab
lish
proc
edur
es to
faci
litat
e em
ploy
eeac
cess
to
rest
ricte
d ro
ads
for
com
mut
ing
to a
nd f
rom
wor
k.�
Det
erm
ine,
in c
once
rt w
ith la
w e
nfor
cem
ent,
acc
epta
ble
form
s of
iden
tific
atio
n (i.
e. h
ospi
tal I
D) t
hat
will
allo
w e
mpl
oyee
s to
ac
cess
roa
ds f
or c
omm
utin
g to
and
fro
m w
ork.
Roa
d ac
cess
m
ay b
e re
stric
ted
to r
espo
nse
pers
onne
l and
may
be
rest
ricte
d du
e to
cur
few
s.�
Est
ablis
h pr
oced
ures
for
tra
ffic
con
trol
nea
r fa
cilit
y.�
Be
prep
ared
to
adju
st s
taff
ing
sche
dule
s in
con
cert
with
cur
few
s.�
Be
prep
ared
to
adju
st p
atie
nt v
isiti
ng h
ours
in c
once
rt
with
cur
few
s.D
eter
min
e in
adv
ance
if s
erio
usly
ill p
atie
nts
may
ha
ve a
n ov
erni
ght
visi
tor
and
if th
e pa
rent
s of
chi
ldre
n m
ay s
tay
over
nigh
t.
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it63
I.FA
CIL
ITY
MA
NA
GE
ME
NT
AN
D S
EC
UR
ITY
(CO
NT
INU
ED)
INN
OT
DA
TE
TOB
ELE
AD
STA
FF
AS
SIG
NM
EN
TC
OM
PLE
TE
DP
RO
GR
ES
SS
TAR
TE
DC
OM
PLE
TE
DM
EM
BE
R
7. D
evel
op a
nd im
plem
ent
an a
ctio
n pl
an t
o m
itiga
te f
lood
ing
haza
rds
and
risks
.�
Kno
w y
our
flood
haz
ards
and
ris
ks.31
Are
you
in a
flo
od p
lane
?
Wha
t le
vel o
fst
orm
sur
ge w
ould
cau
se f
lood
ing
in y
our
area
?�
Che
ck o
n st
atus
of
stor
m d
rain
s (e
.g. c
lear
of
debr
is, d
rain
ef
fect
ivel
y).
�C
heck
sta
tus
of li
ft s
tatio
ns. D
oes
the
tow
nshi
p ha
ve g
ener
ator
s fo
r lif
t st
atio
ns?
Wha
t is
the
impa
ct o
n yo
ur f
acili
ty if
cer
tain
lift
st
atio
ns a
re n
ot o
pera
tiona
l?�
Che
ck s
tatu
s of
pro
tect
ive
mea
sure
s to
pre
vent
sew
age
back
up
(e.g
.,ins
talla
tion
of b
ack-
flow
pre
vent
ers)
.
8. Id
entif
y an
d ac
quire
nec
essa
ry s
uppl
ies
to p
rote
ct f
acili
ty.
�B
e pr
epar
ed t
o pr
otec
t fa
cilit
y fr
om s
tron
g w
inds
and
win
d-bo
rne
debr
is. F
orex
ampl
e, w
indo
w c
over
ings
/shu
tter
s m
ay p
rote
ct
win
dow
s an
d su
mp
pum
psm
ay a
ssis
t w
ith f
lood
ing
in s
ome
area
s.�
Coo
rdin
ate
with
ven
dors
to
addr
ess
supp
ly q
ualit
y, e
.g.,
fuel
di
strib
utor
s sh
ould
pro
vide
ass
uran
ce t
hat
the
fuel
isno
t co
mpr
omis
ed d
ue t
o ag
e or
slu
dge.
9. E
stab
lish
proc
edur
es f
or d
ebris
rem
oval
pos
t-ev
ent.
�M
aint
ain
trim
min
g of
tre
es a
nd s
hrub
s th
roug
hout
the
hur
rican
e se
ason
to
min
imize
deb
ris p
ost-e
vent
. For
exa
mpl
e,tr
im t
rees
and
sh
rubb
ery
at e
ntra
nces
for
vis
itors
, med
ical
sta
ff a
nd p
atie
nts.
�Id
entif
y ve
ndor
and
est
ablis
h co
ntra
ct in
adv
ance
of
an e
vent
for
de
bris
rem
oval
pos
t-ev
ent.
31S
ee K
aise
r Pe
rman
ente
Haz
ard
Vuln
erab
ility
Ana
lysi
s, A
ppen
dix
#3
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it65
J. E
XT
ER
NA
L R
ES
OU
RC
ES
AN
D M
UT
UA
L A
ID
INN
OT
DA
TE
TOB
ELE
AD
STA
FF
AS
SIG
NM
EN
TC
OM
PLE
TE
DP
RO
GR
ES
SS
TAR
TE
DC
OM
PLE
TE
DM
EM
BE
R
1. Id
entif
y pr
oces
s an
d pr
oced
ures
for
requ
estin
g ad
ditio
nal r
esou
rces
.
2. E
nsur
e ap
prop
riate
req
uest
pro
cedu
res
are
follo
wed
to
assi
st w
ith
the
reco
very
of
cost
s fr
om F
EM
A a
nd o
ther
sou
rces
of
fund
ing.
�E
nsur
e ap
prop
riate
doc
umen
tatio
n is
mai
ntai
ned
durin
g th
e ev
ent
to b
ette
r su
ppor
t po
tent
ial r
eque
sts
for
reim
burs
emen
t.
3. E
stab
lish
proc
edur
es t
o ac
quire
add
ition
alst
aff
as n
eede
d.�
Dev
elop
mut
ual a
id a
gree
men
ts w
ith o
ther
fac
ilitie
s to
pro
vide
st
affin
g.32
�A
ddre
ss c
ompe
nsat
ion,
liab
ility
and
cre
dent
ialin
g as
par
t of
m
utua
l aid
agr
eem
ents
. �
Iden
tify
and
know
pro
cess
to
acce
ss s
taff
thr
ough
Em
erge
ncy
Syst
em f
or A
dvan
ce R
egis
trat
ion
of V
olun
teer
Hea
lthPr
ofes
sion
als
(ESA
R-V
HP
), M
edic
al R
eser
ve C
orps
(MR
C) a
nd E
mer
genc
y M
anag
emen
t A
ssis
tanc
e C
ompa
cts
(EM
AC
).
4. E
stab
lish
MO
U/M
OA
with
fac
ilitie
s in
and
out
of
stat
e fo
r pa
tient
tr
ansf
ers
and
evac
uatio
ns.
5. V
erify
/tes
t al
l MO
U/M
OA
and
hav
e co
ntin
genc
y ag
reem
ents
/pla
ns
shou
ld m
utua
l aid
not
be
avai
labl
e.
6. H
ave
an u
nder
stan
ding
of
the
impa
cts
of t
he S
tate
Em
erge
ncy
Hea
lth P
ower
s A
ct a
nd t
he p
oten
tial i
mpl
icat
ions
for
a fa
cilit
y.�
Com
mun
icat
e th
is u
nder
stan
ding
with
sta
ff a
s ap
prop
riate
.
7. H
ave
an u
nder
stan
ding
of
disa
ster
dec
lara
tions
at
the
loca
l and
st
ate
leve
l and
the
pot
entia
l im
plic
atio
ns fo
r a
faci
lity.
�C
omm
unic
ate
this
und
erst
andi
ng w
ith s
taff.
�Id
entif
y ru
les
and
regu
latio
ns t
hat
need
to
be a
ddre
ssed
in
dec
lara
tion
for
hosp
itals
to
be a
ble
to im
plem
ent
thei
r hu
rric
ane
resp
onse
pla
n.
8. E
nsur
e ad
equa
te h
ospi
tal i
nsur
ance
cov
erag
e an
d es
tabl
ish
proc
edur
es t
o m
aint
ain
prop
er d
ocum
enta
tion
for
reim
burs
emen
t.�
Verif
y an
d un
ders
tand
insu
ranc
e co
vera
ge.
�E
nsur
e ap
prop
riate
doc
umen
tatio
n is
mai
ntai
ned.
�Ta
ke p
ictu
res
and
vide
otap
e ho
spita
l ass
ets/
prop
erty
.
32S
ee S
ampl
e M
utua
l Ass
ista
nce
Agr
eem
ent,
App
endi
x #1
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ther
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J. E
XT
ER
NA
L R
ES
OU
RC
ES
AN
D M
UT
UA
L A
ID(C
ON
TIN
UE
D)
INN
OT
DA
TE
TOB
ELE
AD
STA
FF
AS
SIG
NM
EN
TC
OM
PLE
TE
DP
RO
GR
ES
SS
TAR
TE
DC
OM
PLE
TE
DM
EM
BE
R
�Id
entif
y an
y po
tent
ial r
eim
burs
able
rep
air
cost
s an
d de
term
ine
requ
ired
docu
men
tatio
n an
d pr
oces
s to
acq
uire
rei
mbu
rsem
ent.
�E
nsur
e ap
prop
riate
per
sonn
el h
ave
copi
es a
nd k
now
whe
re t
o fin
d a
copy
of
polic
ies.
�Id
entif
y tim
efra
mes
for
lega
l rec
ours
e to
be
take
n sh
ould
tha
t de
cisi
on b
ecom
e re
quire
d.
9. E
nsur
e ca
paci
ty t
o ad
dres
s le
gal c
laim
s in
a t
imel
y m
anne
r th
at
may
aris
e ag
ains
t th
e or
gani
zatio
n or
its
pers
onne
l.�
Ens
ure
abili
ty t
o co
ntac
t in
sure
rs a
nd le
gal c
ouns
el d
urin
g ad
vers
e ev
ents
.
10. E
stab
lish
proc
esse
s to
ens
ure
the
docu
men
tatio
n of
all
expe
nses
as
soci
ated
with
eve
nt.
�W
hen
usin
g IC
S o
r H
ICS,
thi
s m
ay b
e ad
dres
sed
thro
ugh
the
Fina
nce
Sec
tion
lead
by
the
Fina
nce
Chi
ef.
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it69
K. R
EC
OV
ER
Y –
DE
MO
BIL
IZA
TIO
N
INN
OT
DA
TE
TOB
ELE
AD
STA
FF
AS
SIG
NM
EN
TC
OM
PLE
TE
DP
RO
GR
ES
SS
TAR
TE
DC
OM
PLE
TE
DM
EM
BE
R
1. E
nsur
e sa
fe a
nd e
ffic
ient
ret
urn
of r
esou
rces
to
orig
inal
loca
tion
or s
tatu
s.
2. In
dica
tors
for
dem
obili
zatio
n:�
No
new
res
ourc
e or
ders
and
end
of
inci
dent
is in
sig
ht.
�R
esou
rces
ava
ilabl
e an
d no
t as
sign
ed.
�H
ospi
tal h
as t
he a
bilit
y to
man
age
inco
min
g pa
tient
s an
d no
ad
ditio
nal s
urge
is a
ntic
ipat
ed.
�Pa
rtne
r ag
enci
es a
re d
emob
ilizi
ng.
�C
omm
unity
infr
astr
uctu
re is
ret
urni
ng t
o no
rmal
ope
ratio
ns.
3. D
emob
iliza
tion
unit
is w
ithin
the
pla
nnin
g se
ctio
n an
d co
ordi
nate
s w
ith p
rocu
rem
ent a
nd d
ocum
enta
tion
units
.
4. M
aint
ain
ICS
and
Inci
dent
Man
agem
ent T
eam
cha
in o
f co
mm
and.
5. Id
entif
y re
leas
e pr
iorit
ies.
Con
side
r th
e im
pact
a f
unct
ion
will
hav
e on
oth
er r
ecov
ery
oper
atio
ns o
r im
pact
on
retu
rn t
o no
rmal
op
erat
ions
. �
Kno
w r
ecov
ery
goal
s an
d pr
iorit
ies.
�Kn
ow c
ritic
al fu
nctio
ns a
nd c
ritic
al n
eeds
.�
Con
side
r ho
w lo
ng s
taff
has
bee
n at
hos
pita
l on
slee
p-w
ork
sche
dule
.
6. C
omm
unic
ate
dem
obili
zatio
n ac
tiviti
es.
Not
ify:
�H
ospi
tal s
taff,
pat
ient
s an
d fa
mili
es;
�Pa
rtne
rs s
uch
as O
EM, D
OH
and
MC
C;
�G
ener
al p
ublic
; and
�
Med
ia a
nd n
ote
final
brie
fing
sche
dule
.
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it71
K. R
EC
OV
ER
Y –
DE
MO
BIL
IZA
TIO
N(C
ON
TIN
UE
D)
INN
OT
DA
TE
TOB
ELE
AD
STA
FF
AS
SIG
NM
EN
TC
OM
PLE
TE
DP
RO
GR
ES
SS
TAR
TE
DC
OM
PLE
TE
DM
EM
BE
R
7. A
ccou
nt f
or a
ll de
ploy
ed r
esou
rces
and
ass
ocia
ted
expe
nses
.�
Ens
ure
all i
ncid
ent
docu
men
ts a
re s
ubm
itted
to
Doc
umen
tatio
n U
nit.
�S
ectio
n ch
iefs
sho
uld
be a
war
e of
exc
ess
reso
urce
s an
d no
tify
Dem
obili
zatio
n U
nit.
�Lo
gist
ics
is r
espo
nsib
le f
or t
rack
ing
supp
ly r
esou
rces
(i.e
. pr
oper
ty a
nd n
on-e
xpen
dabl
e eq
uipm
ent)
dep
loym
ent
and
retu
rn.
�O
pera
tions
is r
espo
nsib
le f
or d
eter
min
ing
pers
onne
l nee
ds.
�Fi
nanc
e is
res
pons
ible
for
per
sonn
el t
ime
reco
rds,
inju
ry r
epor
ts,
and
clai
ms
repo
rts.
8. N
otify
sta
ff o
f tim
e to
be
rele
ased
and
che
ck o
ut p
roce
dure
s.�
ICS
for
ms
may
be
help
ful f
or d
emob
iliza
tion
chec
kout
.33
9. C
oord
inat
e tr
ansp
orta
tion
need
s fo
r pe
rson
nel a
nd
equi
pmen
t (L
ogis
tics)
.
10. R
etur
n an
d re
-sto
ck u
nuse
d ite
ms.
11. E
nsur
e al
l com
mun
icat
ions
equ
ipm
ent
that
was
dis
trib
uted
is
retu
rned
and
che
cked
for
dam
age/
func
tiona
lity
(i.e.
Ens
ure
dam
aged
rad
ios
are
repa
ired
prio
r to
re-
stoc
king
.)
12. H
old
clos
eout
brie
fing.
A c
lose
out
brie
fing
incl
udes
the
fol
low
ing:
�In
cide
nt s
umm
ary;
�M
ajor
eve
nts
that
hav
e la
stin
g ra
mifi
catio
ns;
�D
ocum
enta
tion,
incl
udin
g w
hat
is n
ot y
et c
ompl
eted
;�
Opp
ortu
nity
to
shar
e co
ncer
ns; a
nd�
Eva
luat
ion
of a
ctio
ns.
33S
ee IC
S F
orm
221
, Dem
obili
zatio
n C
heck
out,
at h
ttp:
//ww
w.fe
ma.
gov/
pdf/
emer
genc
y/ni
ms/
ics2
21.p
df
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it73
K. R
EC
OV
ER
Y –
DE
MO
BIL
IZA
TIO
N(C
ON
TIN
UE
D)
INN
OT
DA
TE
TOB
ELE
AD
STA
FF
AS
SIG
NM
EN
TC
OM
PLE
TE
DP
RO
GR
ES
SS
TAR
TE
DC
OM
PLE
TE
DM
EM
BE
R
13. C
ondu
ct A
fter
-Act
ion
Rev
iew
�D
iscu
ss w
hat
you
set
out
to d
o vs
. wha
t yo
u ac
tual
ly d
id.
�D
iscu
ss w
hat a
ctua
lly h
appe
ned
and
why
.�
Iden
tify
wha
t w
ill b
e do
ne d
iffer
ently
nex
t tim
e.�
Iden
tify
less
ons
lear
ned.
�D
eter
min
e w
hat
need
s fo
llow
-up,
by
who
m, a
nd b
y w
hen.
�C
onsi
der
givi
ng s
taff
the
opp
ortu
nity
to
shar
e fe
edba
ck
anon
ymou
sly.
Fo
r ex
ampl
e, c
onsi
der
havi
ng s
taff
dro
p ca
rds
in a
“d
ebrie
fing
box”
tha
t st
ate
wha
t w
ent
wel
l and
wha
t ne
eds
to
be im
prov
ed.
14. E
nsur
e em
otio
nal a
nd m
enta
l hea
lth s
uppo
rt f
or s
taff
and
th
eir
fam
ilies
.
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it75
L. R
EC
OV
ER
Y -
PA
TIE
NT
TR
AN
SFE
R A
ND
DIS
CH
AR
GE
INN
OT
DA
TE
TOB
ELE
AD
STA
FF
AS
SIG
NM
EN
TC
OM
PLE
TE
DP
RO
GR
ES
SS
TAR
TE
DC
OM
PLE
TE
DM
EM
BE
R
1. P
repa
re t
o re
ceiv
e on
ly p
re-d
eter
min
ed (i
.e. v
ent-
depe
nden
t)
patie
nts
from
long
-term
and
long
-term
sub
-acu
te c
are
(LTC
) fac
ilitie
s.�
Coo
rdin
ate
plan
s in
adv
ance
of
even
t w
ith L
TC/s
ub-a
cute
, in
clud
ing
iden
tifyi
ngw
hich
pat
ient
s yo
u w
ill r
ecei
ve (i
.e.,
vent
-dep
ende
nt).
�Es
tabl
ish
tria
ge a
nd a
ccep
tanc
e pr
oces
sfo
r pa
tient
tra
nsfe
rs, t
o in
clud
e pa
tient
tra
ckin
g pr
oced
ures
.�
Coo
rdin
ate
with
med
ical
she
lters
.�
Iden
tify
in a
dvan
ce w
hat
mus
t co
me
with
pat
ient
tra
nsfe
rs.
�N
ame
& c
onta
ct in
form
atio
n�
Med
icat
ions
�M
edic
al r
ecor
d/ch
art
– at
a m
inim
um n
ote
alle
rgie
s
2. E
nsur
e EM
S is
aw
are
of p
atie
nt t
rans
fer
and
evac
uatio
n pr
oced
ures
.
3. E
stab
lish
proc
edur
es t
o cr
eden
tial a
nd a
ccep
t st
aff
from
LTC
and
ho
me
heal
th a
genc
ies
to c
ome
into
hos
pita
l to
care
for
thei
r pa
tient
s.
4. E
nsur
e th
e co
ordi
natio
n of
hom
e ch
ecks
for
pat
ient
dis
char
ge.
�Vo
lunt
eer
grou
ps/la
w e
nfor
cem
ent
may
ass
ist
with
hom
e ch
ecks
.
5. C
onsi
der
havi
ng c
ase
wor
ker
in e
mer
genc
y de
part
men
t to
ass
ist
with
pat
ient
dis
char
ge.
6. E
nsur
e tr
ansp
orta
tion
of p
atie
nts
back
to
hom
es o
r to
fam
ily.
7. C
oord
inat
e w
ith O
EM
clo
sure
s of
med
ical
she
lters
. Hos
pita
l may
ne
ed t
he m
edic
al s
helte
rs t
o st
ay o
pen
for
an e
xten
ded
perio
d of
tim
e to
ass
ist
with
car
e fo
r th
ose
who
do
not
need
acu
te c
are
but
cann
ot y
et r
etur
n to
the
ir ho
me
or f
amily
. With
OE
M, h
ospi
tals
will
ne
ed t
o pl
an f
or s
helte
r cl
osur
es s
o th
at b
oth
com
mun
ity a
nd
hosp
ital n
eeds
are
met
.
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it77
L. R
EC
OV
ER
Y -
PA
TIE
NT
TR
AN
SFE
R A
ND
DIS
CH
AR
GE
(CO
NT
INU
ED)
INN
OT
DA
TE
TOB
ELE
AD
STA
FF
AS
SIG
NM
EN
TC
OM
PLE
TE
DP
RO
GR
ES
SS
TAR
TE
DC
OM
PLE
TE
DM
EM
BE
R
8. P
repa
re t
o ha
ve d
ialy
sis
patie
nts
seek
ing
trea
tmen
t at
you
r fa
cilit
y.
�P
lan
in a
dvan
ce w
ith E
nd S
tage
Ren
al D
isea
se (E
SR
D) n
etw
ork
and
OE
M t
o es
tabl
ish
tran
spor
tatio
n pr
oced
ures
for
pat
ient
s ne
edin
g di
alys
is p
ost-
even
t sh
ould
dia
lysi
s ce
nter
s be
clo
sed
or
if pu
blic
tra
nspo
rtat
ion
is n
ot y
et r
unni
ng.
�Es
tabl
ish
poin
ts o
f con
tact
s w
ith d
ialy
sis
netw
orks
for
coo
rdin
atin
g ac
cess
to
dial
ysis
res
ourc
es p
ost-
even
t.
9. E
stab
lish
proc
edur
es fo
r phy
sici
an s
uppo
rtto
car
e fo
r pa
tient
s in
al
tern
ate
loca
tions
. �
Iden
tify
how
the
hosp
ital w
ill kn
ow w
hen
phys
icia
n pr
actic
es
re-o
pen
and
how
hos
pita
ls c
an h
elp
com
mun
icat
e th
is t
o pa
tient
s.�
For
exam
ple,
you
may
wan
t to
hav
e a
“car
e co
ordi
nato
r” f
or
patie
nts
seek
ing
med
ical
car
e at
you
r fa
cilit
y th
at t
hey
wou
ld
norm
ally
see
k at
a p
hysi
cian
off
ice.
Car
e co
ordi
nato
rs c
ould
be
posi
tione
d in
em
erge
ncy
depa
rtm
ents
and
fro
nt e
ntra
nce
area
s to
pro
vide
info
rmat
ion
on p
hysi
cian
acc
ess.
�C
onsi
der
a ph
ysic
ian
hotli
ne t
o ca
ll in
and
not
ify o
f pr
actic
e st
atus
.
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it79
(CO
NT
INU
ED)
INN
OT
DA
TE
TOB
ELE
AD
STA
FF
AS
SIG
NM
EN
TC
OM
PLE
TE
DP
RO
GR
ES
SS
TAR
TE
DC
OM
PLE
TE
DM
EM
BE
R
1.R
evie
w P
ublic
Ass
ista
nce
Gui
de.
http
://w
ww
.fem
a.go
v/go
vern
men
t/gra
nt/p
a/pa
g07_
t.sht
m
2. R
evie
w a
pplic
atio
n pr
oces
s.ht
tp://
ww
w.fe
ma.
gov/
gove
rnm
ent/g
rant
/pa/
proc
ess.
shtm
3. R
evie
w p
olic
ies
and
elig
ible
cos
ts.
�N
ote
elig
ibilit
y fo
r rei
mbu
rsem
ent i
n C
ateg
orie
s A
(Deb
ris R
emov
al),
B (P
rote
ctiv
e M
easu
res)
and
E (B
uild
ings
and
Equ
ipm
ent)
.
4. R
evie
w e
ligib
ility
for
sno
w a
ssis
tanc
e in
the
FEM
A P
ublic
Ass
ista
nce
Gui
de: h
ttp://
ww
w.fe
ma.
gov/
pdf/g
over
nmen
t/gra
nt/p
a/pa
guid
e07.
�S
ee S
no
w R
em
oval,
page
76
�S
ee §
206.2
27 S
no
w A
ssis
tan
ce, p
age
B-2
9A
lso,
see
FEM
A S
now
Ass
ista
nce
and
Seve
re W
inte
r Sto
rm P
olic
y at
ht
tp://
ww
w.fe
ma.
gov/
pdf/g
over
nmen
t/gra
nt/p
a/95
23_1
5. R
evie
w e
ligib
ility
for
debr
is r
emov
al in
the
FEM
A P
ublic
Ass
ista
nce
Gui
de: h
ttp://
ww
w.fe
ma.
gov/
pdf/g
over
nmen
t/gra
nt/p
a/pa
guid
e07.
�S
ee D
eb
ris R
em
oval,
page
67
Als
o, s
ee t
he f
ollo
win
g FE
MA
pol
icie
s:�
Deb
ris R
emov
al f
rom
Priv
ate
Prop
erty
, 952
3.13
ht
tp://
ww
w.fe
ma.
gov/
gove
rnm
ent/g
rant
/pa/
9523
_13.
shtm
�D
ebris
Ope
ratio
ns- H
and-
load
ed T
ruck
s an
d Tr
aile
rs, 9
523.
12
http
://w
ww
.fem
a.go
v/go
vern
men
t/gra
nt/p
a/95
23_1
2.sh
tm
6. R
evie
w e
ligib
ility
for
bui
ldin
g sa
fety
insp
ectio
ns.
http
://w
ww
.fem
a.go
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M. R
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AN
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ES
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fford
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ssis
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Ass
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nce
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ttp://
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ent/g
rant
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inde
x.sh
tmfo
r de
tails
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polic
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reg
ulat
ions
, and
how
to
appl
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r as
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ance
. App
licat
ions
mus
t be
coo
rdin
ated
with
the
loca
l and
stat
e of
fices
of
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genc
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anag
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t.
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ttp://
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ma.
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iew
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d=27
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ess
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form
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d to
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erm
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ate
nonp
rofit
(PN
P) e
li-gi
bilit
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ther
ing th
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orm
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rica
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oolk
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R
7. R
evie
w e
ligib
ility
for
dam
age
to a
pplic
ant-
owne
d eq
uipm
ent
perf
orm
ing
emer
genc
y w
ork
(e.g
., ge
nera
tors
).ht
tp://
ww
w.fe
ma.
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rnm
ent/g
rant
/pa/
9525
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8. R
evie
w e
ligib
ility
for
em
erge
ncy
med
ical
car
e/m
edic
al e
vacu
atio
ns.
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://w
ww
.fem
a.go
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vern
men
t/gra
nt/p
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.sht
m
9.
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iew
pro
visi
on fo
r te
mpo
rary
rel
ocat
ion
faci
litie
s.
http
://w
ww
.fem
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vern
men
t/gra
nt/p
a/95
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.sht
m
10. R
evie
w p
rovi
sion
s fo
r la
bor
cost
s.
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://w
ww
.fem
a.go
v/go
vern
men
t/gra
nt/p
a/95
25_7
.sht
m
11. R
evie
w e
ligib
ility
for
chi
ld c
are
serv
ices
(i.e
., fo
r fa
cilit
ies
plan
ning
to
offe
r ch
ild c
are
for
empl
oyee
s w
hen
scho
ols
are
clos
ed).
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://w
ww
.fem
a.go
v/go
vern
men
t/gra
nt/p
a/95
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htm
12. E
nsur
e co
mpr
ehen
sive
, det
aile
d an
d ac
cura
te d
ocum
enta
tion
of
even
ts a
nd c
osts
ass
o cia
ted
with
reco
very
act
iviti
es.
�D
ocum
ent
who
, wha
t, w
here
, whe
n, w
hy a
nd h
ow m
uch.
13. C
ompl
ete
a pr
ojec
t w
orks
heet
for
eac
h pr
ojec
t fo
r w
hich
you
se
ek r
eim
burs
emen
t:
http
://w
ww
.fem
a.go
v/lib
rary
/vie
wR
ecor
d.do
?id=
2620
14. A
ctiv
ate
pre-
esta
blis
hed
cost
cen
ter
for
your
tim
e ke
epin
g,
inve
ntor
y an
d ac
coun
ting
syst
ems
to t
rack
cos
ts a
ssoc
iate
d w
ith
reco
very
ope
ratio
ns.
�N
otify
sta
ff t
o co
de h
ours
wor
ked
on r
ecov
ery
oper
atio
ns t
o ap
prop
riate
cos
t ce
nter
(i.e
., no
t al
l wor
k, e
spec
ially
the
pr
ovis
ion
of m
edic
al c
are
by p
hysi
cian
s an
d nu
rses
is e
ligib
le).
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dent
ify a
nd u
se t
rans
port
atio
n lo
gs t
o do
cum
ent
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spor
tatio
n re
sour
ces.
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app
ropr
iate
, doc
umen
t:�
Mile
age
(i.e.
, tra
nspo
rt o
f st
aff)
�Ti
me
requ
ired
for
tran
spor
tatio
n (i.
e., d
river
tim
e)
16. D
ocum
ent
and
trac
k ge
nera
tor
run
times
and
load
per
hou
r.
17. U
se v
olun
teer
sig
n-in
and
sig
n-ou
t sh
eets
to
trac
k vo
lunt
eer
hour
s.
18. K
eep
reco
rds
for
a m
inim
um o
f th
ree
year
s.
83
Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
PART IV. APPENDICES & RESOURCE LINKS: PLANNING & RESPONSE
You also may refer to accompanying CD for easy access to online links.
PLANNING & RESPONSE
These documents are included in this toolkit beginning on page 89.
1. Hospital Departments: a. Department Plan Template http://www.njha.com/ep/content.aspx?id=2391
b. Sample Emergency Contact Form http://www.njha.com/ep/content.aspx?id=2392
2. Hospital Employees: a. Preparing Your Work Area http://www.njha.com/ep/content.aspx?id=2393b. Sheltering Necessities http://www.njha.com/ep/content.aspx?id=2394c. Hurricane Preparedness Checklist http://www.njha.com/ep/content.aspx?id=2395d. Pre-season Employee http://www.njha.com/ep/content.aspx?id=2396
Acknowledgement Forme. Work Exemption Form http://www.njha.com/ep/content.aspx?id=2397
f. Childcare Enrollment Form http://www.njha.com/ep/content.aspx?id=2405
3. Kaiser Permanente Hazard http://www.njha.com/ep/content.aspx?id=2411Vulnerability Analysis
4. Key Resources for Inclement http://www.njha.com/ep/content.aspx?id=2377Weather Preparedness
5. Evacuate or Shelter-in-Place http://www.njha.com/ep/content.aspx?id=2398Decision Guide
6. Shelter-in-Place Checklistsa. 96 – 72 Hours Prior to Onset http://www.njha.com/ep/content.aspx?id=2407b. 72– 48 Hours Prior to Onset http://www.njha.com/ep/content.aspx?id=2408c. 48 – 24 Hours Prior to Onset http://www.njha.com/ep/content.aspx?id=2409d. Less than 24 Hours Prior to Onset http://www.njha.com/ep/content.aspx?id=2410
7. Utility Failure Operational Impact Chart http://www.njha.com/ep/content.aspx?id=2399
8. Consumable Supply Operational http://www.njha.com/ep/content.aspx?id=2400Impact Chart
9. Dialysis Concerns http://www.njha.com/ep/content.aspx?id=2401
10. Sample Mutual Assistance Agreement http://www.njha.com/ep/content.aspx?id=2402
84
Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
RECOVERYThese documents are included in this toolkit beginning on page 183.
11. Sample Information for Departments http://www.njha.com/ep/content.aspx?id=2403
12. Hospital Status Report Form http://www.njha.com/ep/content.aspx?id=2446
13. Sample Demobilization Plan http://www.njha.com/ep/content.aspx?id=2404
ADDITIONAL RECOVERY RESOURCES
These documents may be accessed via the links below.
AHRQ HOSPITAL ASSESSMENT RECOVERY TOOL http://www.ahrq.gov/prep/hosprecovery/hosprecovery.pdf
DEMOBILIZATION:
a. ICS Form 214 Personnel Roster http://www.fema.gov/pdf/emergency/nims/ics214.pdf
b. ICS Form 211 Check-In List http://www.fema.gov/pdf/emergency/nims/ics211.pdf
c. ICS Form 221 Demobilization http://www.fema.gov/pdf/emergency/nims/ics221.pdfCheckout
d. Demobilization Responsibilities http://www.osha.gov/SLTC/etools/ics/demo_lead.html#generalChecklist
DISASTER MENTAL HEALTH:
a. Guidance for Managing Worker Fatigue During Disaster Operationshttp://www.cdc.gov/niosh/topics/oilspillresponse/pdfs/NRT-Fatigue-for-Emergency-Workers.pdf
b. Coping with a Disaster or http://www.bt.cdc.gov/mentalhealth/Traumatic Event
c. SAMHSA Disaster Kit http://store.samhsa.gov/product/SMA10-DISASTER
d. Safety, Function, Action Checklist http://www.njha.com/ep/content.aspx?id=2447
e. Disaster & Extreme Event http://www.umdeepcenter.org/x32.xmlPreparedness (DEEP) Center
FINANCIAL RESOURCES:
a. FEMA Grants and http://www.fema.gov/government/grant/index.shtmAssistance Programs
b. FEMA Public Assistance http://www.fema.gov/government/grant/pa/index.shtmGrant Program
c. FEMA Forms http://www.fema.gov/help/forms.shtm
d. Grants – Catalog of Federal https://www.cfda.gov/Domestic Assistance
APPENDICESPlease note: Web sites presented here are for informational purposesand are presented without warranty, either express or implied. Theirinclusion should not be considered an endorsement of the informa-tion provided nor the providing entity. Author does not attest to thecontent or quality of the information provided by these Web sites.
Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
PLANNING & RESPONSE
APPENDIX 1A
HOSPITAL DEPARTMENTS:Department Plan Template
89
Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
DEPARTMENT PLAN TEMPLATE
Severe Weather/Hurricane Plan for [xxx] Department
DEPARTMENT MANAGER/SUPERVISOR: ________________________________ DATE ______________________
LAST UPDATE: ________________________________________________________________________________
SIGNATURE: __________________________________________________________________________________
I. PURPOSE AND SCOPE
II. POLICIES AND PROCEDURESA. Expectation to work B. ExemptionsC. Who may or may not stay at the hospital (family members)D. ChildcareE. Personal/family preparednessF. Training, drills, exercises, plan updates
III. CONCEPT OF OPERATIONSA. Direction and control (e.g. who is in charge, ICS assignments)B. Delegations of authority (by position title, 3 deep)C. Orders of succession (by position title, 3 deep)D. Notifications and activationE. Roles and responsibilities
Mission critical and essential functions
MISSION CRITICAL (IMMEDIATE) RESOURCES/EQUIPMENT STAFF TO PERFORM FUNCTION/FUNCTION REQUIRED STAFF ASSIGNMENT
F. Protective Measures
IV. STAFFINGA. Communications (e.g. official forms of communication, employee hotline, etc.)B. Staff assignments & shiftsC. SleepingD. ShoweringE. EatingF. Breaks
V. RECOVERY – Returning to normal operations.
Attachment 1 - Contact list & call-down proceduresAttachment 2 - Forms – exemption, childcare, etc.Attachment 3 - Checklists
Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
PLANNING & RESPONSE
APPENDIX 1B
HOSPITAL DEPARTMENTS:Sample Emergency Contact Form
93
Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
DATE REVIEWED: _____________________
DATE COMPLETED: _____________________(TO BE DONE ANNUALLY)
EMERGENCY CONTACT FORMHOUSEKEEPING SUPPLIES
PRIMARY VENDORS:
COMPANY NAME: ______________________________________________________________________________
CONTACT NAME: ____________________________________ PHONE:____________________________________
TITLE: ____________________________________________ CELL: ____________________________________
DATE PURCHASE ORDER SUBMITTED: ______________________________________________________________
CONTACT DURING AN EMERGENCY: WORK PHONE: ______________________________________CELL: ____________________________________
COMPANY NAME: ______________________________________________________________________________
CONTACT NAME: ____________________________________ PHONE:____________________________________
TITLE: ____________________________________________ CELL: ____________________________________
DATE PURCHASE ORDER SUBMITTED: ______________________________________________________________
CONTACT DURING AN EMERGENCY: WORK PHONE: ______________________________________CELL: ____________________________________
SECONDARY VENDORS:
COMPANY NAME: ______________________________________________________________________________
CONTACT NAME: ____________________________________ PHONE:____________________________________
TITLE: ____________________________________________ CELL: ____________________________________
DATE PURCHASE ORDER SUBMITTED: ______________________________________________________________
CONTACT DURING AN EMERGENCY: WORK PHONE: ______________________________________CELL: ____________________________________
TERTIARY VENDORS:
COMPANY NAME: ______________________________________________________________________________
CONTACT NAME: ____________________________________ PHONE:____________________________________
TITLE: ____________________________________________ CELL: ____________________________________
DATE PURCHASE ORDER SUBMITTED: ______________________________________________________________
CONTACT DURING AN EMERGENCY: WORK PHONE: ______________________________________CELL: ____________________________________
Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
PLANNING & RESPONSE
APPENDIX 2A
HOSPITAL EMPLOYEES: Preparing Your Work Area
96
Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
PREPARING YOUR WORK AREA
Hurricanes can have a powerful impact on coastal and inland communities. To help you understand how(hospital name) responds in the event of a hurricane or severe weather situation, we’ve created the(handbook name) using information from New Jersey Office of Emergency Management Hurricane
Preparedness Plan. This resource will inform you about what to expect during a hurricane and how our organization responds to ensure that the health needs of our community are met. Areas addressed includeemployee responsibility, storm communication, safety, sheltering, staffing of special needs shelters and more.We also recommend that you review our Hurricane Preparedness Plan for a more complete understanding of thetopics in the handbook.
Please note: Because each department is responsible for developing its own response in support of ourHurricane Preparedness Plan, be sure to check with your department director or supervisor for your specific responsibilities during a hurricane.
(Hospital name) remains open and adequately staffed during a hurricane. The (hospital) Emergency OperationsCenter (EOC) is located here and directs the storm preparations of the entire organization. The team in the EOCwill be in constant communication with county and state emergency officials for storm updates and will updatethe (internal hospital communication line) regularly. Patients ready for discharge will go home so additionalbeds are available for patients transferred from other facilities, area dialysis patients and others who requiretreatment. Additional quantities of medications, food, water, linen, medical/surgical supplies, etc. will be delivered. The facility will be secured, with access granted only to those authorized to be here.
Local, county and state EOCs also remain open in the event of a hurricane to help meet the emergencyneeds of the citizens in our area.
All departments fill a variety of roles during a hurricane situation, which may include working in differentsettings or job functions as needs are identified. Some members of (hospital) administrative team willreport to the EOC during a storm, while others will provide post-storm relief. The Public Relations department representative will communicate our disaster preparations to local newspapers, radio and television media, update the (internal hospital communication line) and field the numerous calls about thestatus of our patients and medical center after a storm. Finance employees will work with our financialinstitutions to make sure funds are available to (the hospital) in the event of storm damage.
EDUCATION - June has been designated as “Hurricane Preparedness Month” at (the hospital) - a time todiscuss hurricane preparedness and communicate our Hurricane Preparedness Plan with all employees atthe start of hurricane season. Informing new employees and reminding a veteran about their roles duringa hurricane is very important. That’s why all new employees receive information on hurricane preparednessduring their department or unit orientation and before the start of hurricane season (June 1) each year.
EXEMPTION FORMS – (The hospital) understands some employees may have extenuating circumstances that make it impossible for them to work during a storm. Because of these situations, anemployee may be considered exempt and excused from working during a storm. To be eligible, theemployee must submit an Exemption Form annually to his or her manager, review “Staffing underEmergency Situations” of the Hurricane Preparedness Plan and meet at least one of the following criteria:
� You provide care for an elderly, immediate relative who cannot care for himself or herself on a routine basis. There are no other adult family members to provide this care. This person would nototherwise qualify for a special needs shelter.
� You provide care that cannot otherwise be delivered for an immediate relative who is handicapped,or otherwise has a chronic illness.
� You are the sole caregiver of a child less than two years of age and cannot make other arrangements.
� When both parents of a child less than two years old, one of whom works for another emergencyservices employer (i.e. nursing, other medical center, law enforcement and fire/rescue and city
97
Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
employee) are required to work and have simultaneous roles during a storm, the employee is exempt.
� When both parents of a child less than two years old work at (the hospital) and normally would havesimultaneous roles during a storm, one is exempt.
Please note:
� While an approved Exemption Form excuses an employee from working during a storm, theemployee will be required to work in the pre- and/or post-storm phases.
� (The hospital) also understands that sudden life changes occur, so emergency exemptions may begranted by your department director.
� If your situation doesn’t fit into any of the categories above, you may be asked to work during a hurricane.
CHILDCARE ENROLLMENT FORMS - For employees who volunteer or are required to work during and/orafter a storm, (the hospital) provides child care for children who are age 18 or younger. A Childcare EnrollmentForm must be completed upon hire and annually in May each year. If you have children older than age 16,they may be allowed to volunteer in other areas of the medical center. If schools and daycare facilities aren’topen post-storm, working employees who have no other childcare options may bring their children to the designated childcare area. (Check with the internal hospital communication line for details post-storm.)
STORM COMMUNICATIONS - Communication is the key to emergency preparedness. In the event of animpending storm, (the hospital) Intranet and hotline are revised on a regular basis to give employees up-to-date information on facility preparations, conditions and some work schedule expectations. However,these systems are not intended to replace communicating with your supervisor, manager or director, sobe sure to check your home answering machine frequently and keep in touch with your department foryour responsibilities during and after a storm. Arrangements have been made with local radio and television stations to transmit information for our employees. For the latest updates in the event of a hurricane, turn to any of the following:
LIST TV AND RADIO STATIONS
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
ALL RADIO STATIONS LISTED HAVE AGREED TO CARRY (HOSPITAL) ANNOUNCEMENTS.
STORM STAFFING - All employees play key roles in meeting the needs of our community when faced witha hurricane. While many of our employees work within the hospital setting, others work in ancillary and support departments and are not covered specifically under a hospital hurricane plan. Their roles in supportof the organization plan may require them to work in other areas not specific to their regular jobs by staffingthe “Labor Pool.” Departments will usually request additional staffing support in May, before the start ofhurricane season. The needs of clinical and non-clinical departments to assign work and respite areas arecoordinated through the (insert responsible party). One challenge we face during a storm is facility security.Many don’t understand that hospitals are not general population shelters. To ensure those inside our facilities truly belong there, employees working before, during or after a storm will be required to show their(hospital) ID badges before entering and exiting a facility. In addition, the ID badges also are used foremployees to return to the hospital when roads are cleared for travel and a curfew is still in force.
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Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
(HOSPITAL)’S EMERGENCY OPERATIONS CENTER (EOC) – (The hospital) EOC ensures the adequacyof the hospital’s storm preparations and provides the communications link with state and county emergency management officials. Preparations coordinated through the EOC include facility staffing,patient census, bed availability, computer system status, sleeping area designations, childcare and attaining 100 percent readiness before the storm hits. The EOC is located in the (insert location). EOCstaffing is defined by the Hurricane Preparedness Plan with the facility being operational 12 to 24 hoursprior to the expected arrival of the storm.
SLEEPING ARRANGEMENTS - Maintaining mental alertness during a stressful situation, especially a hurricane, is very important. Proper rest is paramount to having a sharp team, ready for anything. Becauseof this, respite hours and areas are assigned to all employees and physicians who are at the facility duringthe storm. These areas will be identified and assigned by _______________. Personnel will receive theirspecific room assignments when they report for hurricane duty. Remember to bring your own pillows,linens, towels, soap, toilet articles, etc.
FACILITY SAFETY - A common question during a hurricane or severe storm is, “How safe is the facility?”While the nature of a disaster prevents a guarantee of total safety, as healthcare workers who stay duringa storm, we accept a level of risk to serve our patients. (The hospital) performs regular vulnerability assess-ments to all facilities to make them as safe as possible. Experienced structural engineers assess eachbuilding’s physical strengths and weaknesses.
VOLUNTEERS - To make sure we can accommodate a high demand for services should a hurricane directlyimpact our area, volunteers and auxiliaries are available after a storm. During the storm, they should seekother shelter or evacuate when directed to do so by the local and county Offices of EmergencyManagement.
SHELTERING - Caring for patients in the hospital, as well as those injured after hurricane arrival, requiresa well-staffed facility. In the event roads are impassable after a storm, the hospital must have enough staffto operate without interruption for a few days. Each department is responsible for its own staffing plans,so be sure to talk with your department director, manager or supervisor.
Three distinct groups will be in the facility during a hurricane, each with unique circumstances. Theseinclude patients, employees and physicians. A great deal of planning has been directed toward this subject, and each group is addressed below:
Patients and their families: Patients are our primary concern and the reason we’re here, so it’s importantto reassure them and their families during a hurricane. In the event of a storm, family members are alwaysencouraged to seek the safety of an approved shelter.
However, if requested, one family member will be allowed to stay with each patient. The family memberwill be required to bring the same supplies for personal use as are (hospital) employees.
Employees and their families: Our employees are critical to (hospital) success in any emergency, especiallya hurricane, and (hospital) understands the stress of preparing a home and family for a storm. We understandhow important it is to ensure your family’s safety, so the following services will be provided as needed:
� For employees who volunteer or are required to work during or post-storm, (hospital) provides childcare for children age 20 or younger. A Childcare Enrollment Form must be completed upon hire andannually in May each year. Children older than 16 may be permitted to volunteer in other areas of themedical center, as appropriate.
� If schools and daycare facilities aren’t open post-storm, working employees who have no other childcare options may bring their children to designated childcare facilities.
� Employees working during a storm will be given information before the storm to prepare theirhomes. If your family members must evacuate, they should bring enough supplies to their shelterlocation to be comfortable for at least 72 hours.
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Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
� A list of approved shelters in (County Name) is available at (list resource).
� Employees scheduled to work post-storm should only evacuate when required and only go as far asnecessary.
Physicians and their families: Volunteer physicians help maintain the readiness of our hospital during ahurricane. Without their assistance, we would not be prepared to care for our patients. In the event of astorm, physicians’ families are always encouraged to seek the safety of an approved shelter. However,these physicians are not hospital employees, so if requested, the hospital allows them to bring their families to the facility during the storm. As with patients’ family members, they must bring their own sleeping and food supplies.
Special Needs Shelters: Many individuals in our community require special assistance when they’re evacuated, but not the acute care that’s provided in hospitals. People with special needs may include thoserequiring 24-hour healthcare maintenance or medical equipment that requires 24-hour electrical power.Residents with special needs should register with the County Office of Emergency Management. When ahurricane is approaching, emergency officials will open the special needs shelters as designated for the particular season.
PREPARING YOUR WORK AREA - Even with the diverse types of departments within (the hospital), thereare a number of work preparedness tasks that should be completed by everyone to prevent damage andloss, especially to protect electronic equipment. Your department plan/checklist may have additional tasksfor you to complete. The following are general guidelines for all (hospital) departments. Please be sure tocheck with your department director, manager or supervisor to identify other items to be completed within your department before a storm:
PERSONAL COMPUTERS (PCS)� Disconnect your PC, monitor, keyboard and mouse from each other and the wall power outlets. Be
sure to also disconnect the network cable on the back of your PC (it looks like a telephone cable).Please note that the Information Services department recommends that you disconnect the networkcable from the PC, and not from the wall. This allows you or Information Services to more quicklyget the equipment operating after a storm.
� If not already mounted above the floor, move any PC equipment off the floor at least 10 feet from awindow, mark it with your name and wrap it in plastic. Do not use red biohazard bags for thisprocess.
TELEPHONES
� Please leave your phone connected. � Wrap it in plastic and mark it with your name. As with PCs, do not use red biohazard bags in this
process.
Fax machines, printers and copiers� Please be sure all department fax machines, printers and copier are disconnected from outlets. � Move them at least 10 feet away from windows and cover them in plastic. Once again, do not use
red biohazard bags.
Miscellaneous desktop items� Remove all papers, books, and loose materials from your desk. � Place these materials in a box marked with your name and store it off the floor in a safe place.
Finally, please be sure to check with your fellow employees to see if they need any assistance preparingtheir areas or the department. Teamwork is the cornerstone of hurricane preparation.
Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
PLANNING & RESPONSE
APPENDIX 2B
HOSPITAL EMPLOYEES: Sheltering Necessities
103
Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
FAMILY/STAFF CHECKLIST FOR STAYING AT HOSPITAL DURING A STORM
Family and staff are responsible for providing all of their own necessities.
� Medications
� Toiletries
� Clothing
� Towels
� Linens
� Sleeping bag
� Quiet games
Insert other appropriate items for your facility, with respect to facility/organization’s policies. Note in policy what is NOT permitted and limitations of items.
����
���
Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
PLANNING & RESPONSE
APPENDIX 2C
HOSPITAL EMPLOYEES: Hurricane Preparedness Checklist
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Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
EMPLOYEE HURRICANE PREPAREDNESS CHECKLIST
Employees are to complete the following each year by May 30.
� Review Hurricane Human Resource Policy ##
� Complete Hurricane HR Policy ## acknowledgement form
� Complete other forms as needed: work exemption, childcare enrollment
� Review department hurricane plan
� Review hospital hurricane plan
� Check with supervisor regarding your role and responsibilities
� Know staffing (team) assignment
� Develop a family preparedness plan
� Have a disaster supply kit
Supervisors and above are to complete the following in addition to previous items:
� Update hurricane department plan as needed
� Update staffing plans
� Submit a copy of staffing plan to _____
� Identify and document any special equipment or supply needs you have for hurricanes and submitthis information to ____
� Review Hurricane HR Policy ##, acknowledgement form and childcare enrollment form with staff
� Ensure staff have signed all appropriate forms
� Sign forms and submit as directed on form
� Update protective measures for your department/work area
� Ensure protective measures are clearly communicated to staff
� Post checklist of protective measures for staff
INSERT ADDITIONAL CHECKLIST ITEMS AS APPROPRIATE FOR YOUR FACILITY.
������
���
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�
Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
PLANNING & RESPONSE
APPENDIX 2D
HOSPITAL EMPLOYEES: Pre-season EmployeeAcknowledgement Form
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HURRICANE PRE-SEASON EMPLOYEE ACKNOWLEDGEMENT FORM
Complete form annually by May 30 and update as needed during hurricane season.
PLEASE PRINT
EMPLOYEE NAME ______________________________________________________________________________
DEPARTMENT __________________________________________________________________________________
SUPERVISOR __________________________________________________________________________________
FACILITY (IF PART OF A SYSTEM) ____________________________________________________________________
I ____(insert name)_________________ have read and acknowledge understanding of the HurricanePolicy ##, my department’s hurricane plan and have checked with my supervisor and know my assignment per our department plan.
INITIAL ONE OF THE FOLLOWING:
_______ I understand that I am not exempt from working during a tropical storm or hurricane.
_______ I am exempt from working during a tropical storm or hurricane and have completed the exemption form.
In addition, I ____(insert name)_________________ understand it is my responsibility to have a familypreparedness plan (and INSERT APPROPRIATE LANGUAGE FOR YOUR FACILITY i.e. I am not permittedto have family members come to work with me during a storm OR I may have my spouse and dependentchildren/dependent elderly parent come to work with me during a tropical storm or hurricane.)
_______ I have completed the childcare enrollment form.
EMPLOYEE SIGNATURE ______________________________________________ DATE ______________________
SUPERVISOR SIGNATURE ____________________________________________ DATE ______________________
SUPERVISORS SUBMIT FORM TO ________________________________________________________________
Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
PLANNING & RESPONSE
APPENDIX 2E
HOSPITAL EMPLOYEES: Work Exemption Form
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HURRICANE WORK EXEMPTION FORM
Complete form annually by May 30 and update as needed during hurricane season.
PLEASE PRINT
EMPLOYEE NAME ______________________________________________________________________________
DEPARTMENT __________________________________________________________________________________
SUPERVISOR __________________________________________________________________________________
FACILITY (IF PART OF A SYSTEM) ____________________________________________________________________
I __________________ am requesting an exemption from working at ________________________ during a
tropical storm or hurricane. I meet one or more of the following permissible exemptions:
_______ I provide care for an immediate family member who cannot care for him/herself, due to
physical limitations, handicap or chronic illness, on a routine basis and there are no other
family members who can provide this care.
_______ I have a child(ren) that is less than (_____) year(s) of age and no other family member is
available to care for the child(ren).
INSERT APPROPRIATE CRITERIA FOR YOUR FACILITY
I ___________________ certify that the above checked statement is true and understand that providing
false information may result in discipline up to and including termination.
EMPLOYEE SIGNATURE ______________________________________________ DATE ______________________
SUPERVISOR SIGNATURE ____________________________________________ DATE ______________________
SUPERVISORS SUBMIT FORM TO ________________________________________________________________
employee name facility name
employee name
Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
PLANNING & RESPONSE
APPENDIX 2F
HOSPITAL EMPLOYEES: Childcare Enrollment Form
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Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
CHILDCARE ENROLLMENT FORM
Complete form annually by May 30 and update as needed during hurricane season.
PLEASE PRINT
EMPLOYEE NAME ______________________________________________________________________________
DEPARTMENT ____________________________________________________SUPERVISOR __________________
FACILITY (IF PART OF A SYSTEM) ____________________________________________________________________
I am assigned to the � pre � during � post storm staff team. *Seek legal counsel for facility for statement regarding liability protections*
PLEASE COMPLETE THE FOLLOWING INFORMATION FOR EACH CHILD.
NAME ____________________________________________________________BIRTH DATE __________________
MEDICATIONS __________________________________________________________________________________
ALLERGIES ____________________________________________________________________________________
SPECIAL CONCERNS______________________________________________________________________________
PHYSICIAN CONTACT: NAME____________________________________________PHONE ______________________
NAME ____________________________________________________________BIRTH DATE __________________
MEDICATIONS ______________________________________________________ALLERGIES __________________
SPECIAL CONCERNS______________________________________________________________________________
PHYSICIAN CONTACT: NAME____________________________________________PHONE ______________________
NAME ____________________________________________________________BIRTH DATE __________________
MEDICATIONS ______________________________________________________ALLERGIES __________________
SPECIAL CONCERNS______________________________________________________________________________
PHYSICIAN CONTACT: NAME____________________________________________PHONE ______________________
EMPLOYEE SIGNATURE ______________________________________________ DATE ______________________
SUPERVISOR SIGNATURE ____________________________________________ DATE ______________________
SUPERVISORS: SUBMIT FORM TO ______________________________________________________________
Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
PLANNING & RESPONSE
APPENDIX 3KAISER PERMANENTE HAZARDVULNERABILITY ANALYSIS
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© 2001 Kaiser Foundation Health Plan, Inc. Kaiser Permanente HVAReprinted with Permission
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© 2001 Kaiser Foundation Health Plan, Inc. Kaiser Permanente HVA
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©20
01 K
aise
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unda
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lth P
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ser
Perm
anen
te H
VA
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© 2001 Kaiser Foundation Health Plan, Inc. Kaiser Permanente HVA
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PLANNING & RESPONSE
APPENDIX 4NJHA KEY RESOURCES FORINCLEMENT WEATHER PREPAREDNESS
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KEY RESOURCES FOR INCLEMENT WEATHER PREPAREDNESS
NEW JERSEY
NJ Trafficwww.511nj.org or by calling 511
Description: Real-time traffic information, including weather-related incidents.
Atlantic City Electrichttp://www.atlanticcityelectric.com/home/emergency/
Description: Outages and emergency preparedness resources. Maps provide snapshots of Atlantic City Electric’selectrical outages and active work locations.
PSEGhttp://www.pseg.com/outagecenter/index.jsp
Description: Outage Center provides map and table view of customer outages throughout the state.
Jersey Central Power & Light (JCP&L) http://www.firstenergycorp.com/outages/outages.do?state_code=NJ
Description: Maps and other resources including power outage news and information are located in the Outage Help tab.
Orange & Rocklandhttp://www.oru.com/energyandsafety/storms/
Description: Storm Information Center including outage map for Orange & Rockland clients.
PENNSYLVANIA
PA Traffichttp://www.511pa.com/Traffic.aspx
Description: Map providing information regarding winter road conditions.
DELAWARE
Delaware Department of Transportation (DELDOT)http://www.deldot.gov/public.ejs?command=PublicLocatableMap
Description: Interactive traffic map providing weather-related information.
Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
PLANNING & RESPONSE
APPENDIX 5EVACUATE OR SHELTER-IN-PLACEDECISION GUIDE
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Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
It is imperative that all hospitals have an evacuation plan. Category 4 or 5 hurricanes are catastrophic in nature. Hospitals in the projected path of a Category 4 or 5 storm will need to strongly considerevacuation. In some cases, hospitals may need to evacuate for a Category 1 storm. This is dependent
on your facility’s location and specific vulnerabilities.
Decisions regarding what category would necessitate evacuation can be made in advance of an event.The results of your hazard vulnerability analysis, the emergency management system, community infrastructure and resources where your facility is located, and the information below may assist youwith making this determination.
When making the decision to evacuate or shelter-in-place, consider the following (*this list is not all-inclusive):
� Nature of the event
� What is the expected duration of the event?
� What is the scope of the event? How broad of an area is expected to be impacted? (Note:Given the size of New Jersey, it is likely that a hurricane will impact the entire state. Also, dueto the uncertainty of the exact path and how far reaching the storm may be, it is likely that allfacilities in the state will need to take preparedness measures.)
� What threats does the event pose to your facility?
� What were the results of your facility’s hazard vulnerability analysis relative to the event/potential threats?
� Location of facility
� Is your facility in a flood plane?
� What is the expected storm surge associated with the storm? Is your facility in the stormsurge zone?
� Integrity of facility based on facility assessments in respect to the effects of hurricanes
� What is the structural integrity of the building? Has it been rated for safety relative to sustained wind speeds? If so, what is the safety rating and what are the expected windspeeds of the approaching storm?
� Are the windows of your facility protected from wind-borne debris either with storm shuttersor have storm windows with impact glass been installed?
� Availability of supplies pre- and post-event
� Will you be able to access supplies post-event?
� What is the length of time your facility can be self-sufficient without utilities and having sustained minor damage? Can your facility remain self-sufficient until outside resources willagain be accessible? (Note: the more intense the storm and the larger the area the stormimpacts, the longer you will need to remain self-sufficient)
� Impact on staff
� Will staff be able to rotate shifts?
� Will staff be able to stay at the hospital while they are not on duty?
� What is the potential for major roadways to be flooded to and from your facility?
� Will staff be able to travel on roads to and from the facility pre & post event?
136
Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
� Impact on patients
� What is the potential impact on standards of care due to the event?
� Will you be able to sufficiently support the patient population in your facility with reduced operational capacity?
If it is appropriate for your facility to evacuate for a storm, evacuation plans need to consider the following (*this list is not all-inclusive):
� Plan in concert with local and state emergency management as appropriate
� Transportation of patients
� Consider including the use of air assets for transporting patients
� Consider transporting patients out- of-state
� Be prepared to transport staff to multiple hospitals
� Patient tracking
� Consider use of different color arm bands to designate triage level for transport
� Patient records transfer
� Consider developing a patient evacuation checklist that includes basic patient information,medications, current diagnosis and treatment, physician name and contact information, etc.
� Consider providing patient medications for transfer and establish procedures for doing so.
� Staff assignments and logistics
� Will staff travel with patients? Will staff stay and work at accepting facility?
� Staff transportation, lodging, etc
� Staff privileges and licensure reciprocity with other states
� Mutual aid agreements and contracts for needed services and resources
RESOURCES: National Criteria for Evacuation Decision-making in Nursing Homes http://www.fhca.org/news/evacsurvey.pdf
GAO-06-443R, Disaster Preparedness: Preliminary Observations on the Evacuation of Hospitals andNursing Homes Due to Hurricanes http://www.gao.gov/new.items/d06443r.pdf
Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
PLANNING & RESPONSE
APPENDIX 6SHELTER-IN-PLACE CHECKLISTS
139
Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
SHELTER-IN-PLACE: PRE-STORM HOURS CHECKLISTS
Hurricanes can be unpredictable as to intensity and path; therefore you will need to be prepared toimplement plans for worst case scenarios. The closer or more intense the storm, the more damageto infrastructure you can expect, resulting in longer recovery time and greater delays for re-supply
and access to supportive resources. Due to the unpredictability and the geography (size and location) ofNew Jersey, all hospitals in the state may need to take preparedness actions if any portion of NewJersey is in the path of a storm. Hurricanes that threaten New Jersey have the potential to have astatewide impact.
Hospitals sheltering-in-place for a hurricane will take very similar steps for each threat, again bearing inmind the more intense the storm, the longer the facility will need to be self-sustaining. Though the focusof this toolkit is for hospitals planning to shelter in place for a storm, it is imperative hospitals also havean evacuation plan. Hurricanes categorized as 4 or 5 on the Saffir-Simpson Scale are catastrophic innature. Hospitals projected to be impacted by a Category 4 or 5 storm will need to consider stronglyevacuation. In some cases, hospitals may need to evacuate for a Category 1 storm. This is dependentupon your facility’s location and specific vulnerabilities.
Decisions regarding what category storm will necessitate evacuation can be made in advance of anevent. The results of your hazard vulnerability analysis, the emergency management system, communityinfrastructure and resources where your facility is located can assist you with the decision-makingprocess.34
34 See also Evacuate or Shelter-in-Place Decision Guide, Appendix #5
Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
PLANNING & RESPONSE
APPENDIX 6ASHELTER-IN-PLACE CHECKLIST: 96-72 Hours Prior to Onset
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it14
3
96-7
2 H
OU
RS
PR
IOR
TO
ON
SE
T
BY
TAS
KC
OM
PLE
TE
DW
HO
MW
HE
N
All
adm
inis
trat
ive
and
supe
rvis
ory
staf
f re
view
fac
ility
hur
rican
e pl
an.
All
staf
f re
view
dep
artm
ent
hurr
ican
e pl
an.
Verif
y an
d up
date
con
tact
list
s an
d in
form
atio
n fo
r al
l sta
ff.
Clo
sely
mon
itor
wea
ther
rep
orts
and
info
rmat
ion
prov
ided
by
em
erge
ncy
oper
atio
ns o
ffic
ials
.
Fina
lize
staf
fing
plan
s.
Not
ify s
taff
of
staf
fing
plan
s.
Act
ivat
e hu
rric
ane
disa
ster
pla
n.
Not
ify s
taff
of
plan
act
ivat
ion.
Act
ivat
e al
l add
ition
al c
omm
unic
atio
n ve
nues
, i.e
. em
ploy
ee h
otlin
e, W
eb p
age,
etc
.
Act
ivat
e IC
S/H
ICS.
Sen
d br
iefs
(i.e
. Situ
atio
n R
epor
ts/In
cide
nt A
ctio
n P
lans
) reg
ular
ly t
o al
l sta
ff,
stak
ehol
ders
, par
tner
s, B
oard
of T
rust
ees,
etc
.
Che
ck in
vent
ory
and
orde
r ad
ditio
nal m
edic
al s
uppl
ies.
�O
xyge
n, o
xyge
n ta
nks
and
asso
ciat
ed s
uppl
y pa
rts
�Ph
arm
aceu
tical
s –
mak
e lis
t in
adva
nce
of c
omm
only
used
med
icat
ions
su
ch a
s m
aint
enan
ce t
ype
med
icat
ions
, med
icat
ion
for
pain
an
d an
tibio
tics.
�In
sert
item
s sp
ecifi
c to
you
r ho
spita
l’s p
lan.
Ord
er a
dditi
onal
foo
d in
vent
ory
and
supp
lies.
Che
ck in
vent
ory
of o
ther
faci
lity
supp
lies
and
orde
r ad
ditio
nal s
uppl
ies
as n
eede
d
�To
ilet
pape
r�
Fuel
No
te T
ime
Inte
rval
s fo
r b
rief
s
ON
GO
ING
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it14
5
96-7
2 H
OU
RS
PR
IOR
TO
ON
SE
T(C
ON
TIN
UE
D)
BY
TAS
KC
OM
PLE
TE
DW
HO
MW
HE
N
�G
ener
ator
mai
nten
ance
sup
plie
s
�Li
nens
�W
ater
– p
otab
le a
nd n
on-p
otab
le
�In
sert
add
ition
al it
ems
spec
ific
to y
our h
ospi
tal’s
pla
n
Che
ck a
ltern
ate
sour
ces
for
pow
er a
nd a
ddre
ss a
ny u
nmet
nee
ds.
Con
tact
pow
er c
ompa
ny a
nd e
nsur
e pr
iorit
y st
atus
.
Che
ck a
ltern
ate
sour
ces
for
pota
ble
and
non-
pota
ble
wat
er,
and
addr
ess
any
unm
et n
eeds
.
Verif
y pa
tient
dis
char
ge a
nd t
rans
fer
proc
edur
es. A
ddre
ss u
nmet
nee
ds.
Verif
y pa
tient
tra
ckin
g pr
oced
ures
. Add
ress
unm
et n
eeds
.
Che
ck c
omm
unic
atio
ns e
quip
men
t; v
erify
fun
ctio
nalit
y of
re
dund
ant f
orm
s of
com
mun
icat
ion.
Add
ress
unm
et n
eeds
.
Impl
emen
t jus
t-in-
time
and
refr
eshe
r tra
inin
g as
nee
ded
(i.e.
sta
ff pe
rform
ing
dutie
s th
at th
ey d
o no
t per
form
regu
larly
).
�Pr
ovid
e tr
aini
ng o
n co
mm
unic
atio
ns e
quip
men
t.
�Pr
ovid
e in
stru
ctio
ns o
n ba
ckin
g up
com
pute
r fil
es.
�In
sert
just
-in-ti
me
trai
ning
app
licab
le t
o yo
ur h
ospi
tal’s
pla
n.
Rev
iew
saf
ety
and
secu
rity
proc
edur
es. A
ddre
ss u
nmet
nee
ds.
Verif
y M
emor
andu
ms
of U
nder
stan
ding
/Mut
ual A
id/C
ontr
act
agre
emen
ts.
Verif
y do
cum
enta
tion
proc
edur
es a
nd u
se o
f ap
prop
riate
for
ms
to t
rack
ex
pens
es a
ssoc
iate
d w
ith t
he e
vent
.
Verif
y w
aste
man
agem
ent
proc
edur
es.
Mak
e ev
acua
tion
deci
sion
s as
app
ropr
iate
.
Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
PLANNING & RESPONSE
APPENDIX 6B
SHELTER-IN-PLACE CHECKLIST: 72-48 Hours Prior to Onset
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it14
9
72-4
8 H
OU
RS
PR
IOR
TO
ON
SE
T
BY
TAS
KC
OM
PLE
TE
DW
HO
MW
HE
N
Impl
emen
t pr
otec
tive
mea
sure
s fo
r fa
cilit
y (e
.g. p
lace
shu
tter
s on
win
dow
s).
Impl
emen
t pr
otec
tive
mea
sure
s in
all
wor
k ar
eas.
Impl
emen
t pr
otec
tive
mea
sure
s fo
r co
mpu
ter
syst
ems
and
equi
pmen
t.
Sec
ure
addi
tiona
l med
ical
sup
plie
s.�
Oxy
gen,
oxy
gen
tank
s an
d as
soci
ated
sup
ply
part
s ne
eded
to
supp
ort
oxyg
en d
epen
dent
pat
ient
s.�
Pha
rmac
eutic
als.
�Li
st a
dditi
onal
hos
pita
l-spe
cific
item
s.
Sec
ure
addi
tiona
l foo
d in
vent
ory
and
supp
lies.
Sec
ure
othe
r fa
cilit
y su
pplie
s.�
Toile
t pa
per
�Fu
el�
Gen
erat
or m
aint
enan
ce s
uppl
ies.
Be
able
to
mai
ntai
n al
tern
ate
sour
ces
of p
ower
.�
Line
ns�
Wat
er –
pot
able
and
non
-pot
able
�S
ani b
ags
�Li
st a
dditi
onal
hos
pita
l-spe
cific
item
s.
Obt
ain
and
secu
re c
ash.
Secu
re a
ny lo
ose
item
s th
at m
ay b
e bl
own
by s
tron
g w
inds
(e.g
. un
secu
red
outd
oor
furn
iture
, sta
tuar
y, d
ebris
, etc
.)
Beg
in r
evie
w o
f pa
tient
dis
char
ge.
Dis
char
ge p
atie
nts
that
can
be
safe
ly d
isch
arge
d.*
Tran
sfer
pat
ient
s th
at n
eed
to b
e tr
ansf
erre
d.*
* Pa
tient
tra
nsfe
rs a
nd d
isch
arge
s w
ill n
eed
to b
e co
ordi
nate
d in
adv
ance
of
whe
n of
ficia
ls c
all f
or e
vacu
atio
ns.
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it15
1
72-4
8 H
OU
RS
PR
IOR
TO
ON
SE
T(C
ON
TIN
UE
D)
BY
TAS
KC
OM
PLE
TE
DW
HO
MW
HE
N
Ens
ure
patie
nt t
rack
ing
proc
edur
es a
re f
ollo
wed
.
Impl
emen
t lim
ited
adm
issi
ons
proc
edur
es a
s ne
eded
.
Ens
ure
all s
taff
has
an
oppo
rtun
ity t
o im
plem
ent
pers
onal
pr
epar
edne
ss p
lans
.N
otify
med
ia o
f br
iefin
g tim
es.
No
te b
rief
ing
ti
mes
.
Est
ablis
h in
terv
als
to u
pdat
e em
ploy
ee h
otlin
e.N
ote
tim
e in
terv
als.
Upd
ate
empl
oyee
hot
line
regu
larly
.
Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
PLANNING & RESPONSE
APPENDIX 6C
SHELTER-IN-PLACE CHECKLIST: 48-24 Hours Prior to Onset
Wea
ther
ing th
e St
orm
�A
Hur
rica
ne P
lann
ing,
Res
pons
e an
d Re
cove
ry T
oolk
it15
5
48-2
4 H
OU
RS
PR
IOR
TO
ON
SE
T
BY
TAS
KC
OM
PLE
TE
DW
HO
MW
HE
N
Beg
in li
miti
ng a
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erie
s to
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id
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pro
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res
with
sta
ff.
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nal s
ecur
ity m
easu
res.
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k up
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and
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and
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ee r
ecor
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l inf
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at m
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thro
ugho
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ospi
tals
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and
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te a
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hosp
itals
for
fam
ily, c
hild
car
e an
d pe
ts (a
s ap
prop
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lan/
polic
ies)
.
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ort
bed
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egul
arly
to
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genc
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erat
ions
per
sonn
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tinue
to
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itor
wea
ther
rep
orts
and
info
rmat
ion
from
em
erge
ncy
oper
atio
ns p
erso
nnel
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, par
tner
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emer
genc
y of
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ls, e
tc.
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ure
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have
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n im
plem
ente
d in
all
wor
k ar
eas.
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ure
staf
fing
sche
dule
s ar
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and
com
mun
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ed
to a
ll st
aff.
Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
PLANNING & RESPONSE
APPENDIX 6D
SHELTER-IN-PLACE CHECKLIST: Less than 24 Hours Prior to Onset
Wea
ther
ing th
e St
orm
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rica
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pons
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nage
to
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gnat
e fa
mily
, chi
ldca
re a
nd p
et a
reas
of
hosp
ital.
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ff r
epor
t as
ass
igne
d (t
wo
shift
s to
sta
y th
roug
h th
e st
orm
).
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port
sta
ff r
epor
ting
to h
ospi
tal f
or s
torm
dut
y.
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ure
prop
er f
orm
s, w
aive
rs, e
tc a
re c
ompl
ete.
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trib
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radi
os f
or in
tern
al h
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tal u
se.
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med
ia in
des
igna
ted
med
ia s
tagi
ng a
reas
.
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plet
e fin
al p
atie
nt t
rans
fers
.
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tinue
to
mon
itor
patie
nt c
ensu
s.
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ure
patie
nt t
rack
ing
proc
edur
es a
re b
eing
fol
low
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y pr
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fin
anci
al d
ocum
enta
tion
proc
edur
es
wer
e im
plem
ente
d.
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chec
k pr
e-po
sitio
ned
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lies.
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y ba
ck u
p in
vent
ory
trac
king
pro
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res.
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y ba
ck u
p of
all
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and
dat
a sy
stem
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plet
e an
y ac
tions
list
ed a
bove
not
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com
plet
ed.
Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
PLANNING & RESPONSE
APPENDIX 7UTILITY FAILUREOPERATIONAL IMPACT CHART
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Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
PLANNING & RESPONSE
APPENDIX 8CONSUMABLE SUPPLYOPERATIONAL IMPACT CHART
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Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
PLANNING & RESPONSE
APPENDIX 9DIALYSIS CONCERNS
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PATIENTS ON DIALYSIS
Several resources are available online to assist with planning for addressing the needs of dialysispatients. Hospitals should check with local dialysis centers to ensure coordination of emergency plans.
� Emergency Instructions for Dialysis Patientshttp://www.esrdnetwork.org/disaster-planning/patients/emergency-instructions.asp
� Preparing for Emergencies: A Guide for People on Dialysishttp://www.medicare.gov/Publications/Pubs/pdf/10150.pdf
� Trans-Atlantic Renal Council - Disaster preparedness information for patients and providershttp://www.tarcweb.org/quality_improvement/emergency_disaster.asp#informationforprovidershttp://www.tarcweb.org/treatmentlocations/newjersey.asp
� End Stage Renal Dialysis Network of Texas Web site has many links including:� • Triage checklist to assess need for acute dialysis� • Shelter triage checklist for Hemodialysis and Peritoneal Dialysis patients� • List of high potassium foods to avoid� • http://www.esrdnetwork.org/disaster-planning/hurricane/hospitals-shelters.asp
GUIDANCE FOR DIALYSIS CARE PROVIDERS
� What to do when your municipal water supplier issues a “boil water advisory”http://www.cdc.gov/ncidod/dhqp/dpac_dialysis_boilwater.html
� Safe Use of “Tanker” Water for Dialysishttp://www.bt.cdc.gov/disasters/pdf/watertanker.pdf
� Infection Control for Peritoneal Dialysis (PD) Patientshttp://www.bt.cdc.gov/disasters/pdf/icfordialysis.pdf
� DaVita Hurricane Hotline Number 800-400-8331
Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
PLANNING & RESPONSE
APPENDIX 10SAMPLE MUTUAL
ASSISTANCE AGREEMENT
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MUTUAL ASSISTANCE AGREEMENT
This Mutual Assistance Agreement is entered into by and among those hospitals executing it, effec-tive as to each hospital on the date of its execution. The North Dakota Healthcare Association(NDHA) will advise each hospital executing this Agreement of the identity of other hospitals which
have executed the Agreement, and the names, addresses and telephone numbers of each executinghospital’s Designated Representative. Each executing hospital and the North Dakota Department ofHealth shall be a “party” to this Agreement.
RECITALS
� WHEREAS, hospital acknowledges that each party may from time to time find it necessary toevacuate and transfer patients due to the occurrence of an external or internal disaster; and
� WHEREAS, the parties further acknowledge that each party may from time to time lack the staff,equipment, supplies and other essential services to optimally meet the needs of patients due tothe occurrence of an external or internal disaster; and
� WHEREAS, the parties recognize that certain of the equipment and supplies which may be used inmeeting the needs of patients during an internal or external disaster were purchased through grantmoney provided by the Department; and
� WHEREAS, the parties have determined that a Mutual Assistance Agreement, developed prior to asudden and immediate disaster is needed to facilitate communication between and among theparties to coordinate the transfer of patients and the sharing of staff, equipment, supplies andother essential services in the event of an external or internal disaster;
� NOW, THEREFORE, in consideration of the above recitals and for other good and valuable consider-ations, the receipt and sufficiency of which are hereby acknowledged, the parties agree as follows:
1. DEFINITIONS.
a. “Affected Hospital” is a party which is impacted by an External or Internal Disaster and requeststo transfer patients to another party, or requests the assistance of another party.
b. “Assisting Hospital” is a party which is available upon request to receive the transfer of patientsfrom an Affected Hospital.
c. “Designated Representative” is the individual or position designated by each party to communi-cate with another party and to determine the distribution of information within their own health-care organization in the event of an External or Internal Disaster.
d. “External Disaster” means a disaster occurring or imminent in the community surrounding aparty. An External Disaster may affect the entire facility or only a portion of the facility.
e. “Internal Disaster” means a disaster occurring within a party’s facility that materially affects theparty’s ability to provide patient care. An Internal Disaster may affect the entire facility or only aportion of the facility.
f. “Lending Hospital” is a party which is available to provide staff, equipment, supplies and/or otheressential services to another party in the event of an External or Internal Disaster. Each executinghospital recognizes and agrees that, depending on circumstances, it may be an Affected Hospital,an Assisting Hospital, or a Lending Hospital.
2. IDENTIFICATION OF DESIGNATED REPRESENTATIVE. Each party agrees to provide to the NDHAand the Department the name and contact information of its Designated Representative who will beavailable to perform the functions stated in the definition above, and at least one back-up individual toserve as the Designated Representative in the primary Designated Representative’s absence. Thenames and contact information for the executing hospital’s Designated Representative and back-upindividual will be provided to each executing hospital by the NDHA.
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3. TRANSFER OF PATIENTS. Each party is willing to accept patients transferred by another party underthe terms and conditions set forth in this Agreement.
4. TRANSFER RESPONSIBILITIES OF AFFECTED HOSPITAL. The parties agree that in the event itbecomes necessary to transfer patients from an Affected Hospital to an Assisting Hospital, theAffected Hospital shall
a. Contact the Designated Representative at the Assisting Hospital as soon as the Affected Hospitalbecomes aware of the need to transfer patients;
b. Comply with any limitations communicated to the Affected Hospital regarding the numbers andtypes/acuity of patients that the Assisting Hospital is able to accept;
c. Triage all patients prior to transfer to verify that the types and acuity of services required are with-in any limitations communicated to the Affected Hospital regarding the numbers and types/acuityof patients that the Assisting Hospital is able to accept;
d. Arrange for the transport of each patient to the Assisting Hospital, with support of such medicalpersonnel and equipment as is required by the patient’s condition;
e. Deliver to the Assisting Hospital, with each patient transferred, to the extent available, thepatient’s medical records, or copies thereof, sufficient to indicate the patient’s diagnoses, condi-tion, and treatment provided and planned;
f. Make available one or more physicians of the Affected Hospital to address questions from themedical staff at the Assisting Hospital; and
g. If feasible, inventory the patient’s personal effects and valuables transported to the AssistingHospital with the patient. The Affected Hospital shall deliver the inventory and the patient’s valuablesto the personnel transporting the patient, and receive a receipt for such items. The AssistingHospital shall, in turn, acknowledge and sign a receipt for the valuables delivered to it.
5. TRANSFER RESPONSIBILITIES OF ASSISTING HOSPITAL. The parties agree that in accepting thetransfer of patients from an Affected Hospital, an Assisting Hospital shall:
a. Ensure that the Designated Representative is available twenty-four (24) hours a day, seven (7)days a week to implement this Agreement and to communicate with the Affected Hospital regard-ing the numbers and types/acuity of patients who may be transferred.
b. Accept all transfers from the Affected Hospital that are within the limitations communicated bythe Designated Representative of the Assisting Hospital. An Assisting Hospital shall not be obli-gated to accept any patients which exceed its capacity or staffing, which shall be determined inthe Assisting Hospital’s sole discretion.
c. Record in the clinical records of each transferred patient notations of the condition of the patientupon arrival at the Assisting Hospital.
d. If personal effects and valuables of the patient are transported with the patient, check those itemsagainst the inventory prepared by the Affected Hospital, and issue a receipt for such items as arereceived by the Assisting Hospital to the personnel transporting the patient.
6. RETURN OF PATIENTS TO AFFECTED HOSPITAL. Once the internal or external disaster conditionsthat required the transfer have sufficiently resolved, and if medically appropriate for each individualpatient, an Assisting Hospital shall make arrangements to transfer the patients back to the AffectedHospital as soon as practicable. Upon re-transfer to the Affected Hospital, the Assisting Hospital willreturn any original medical records, including x-ray films, transferred with the patient. The AssistingHospital shall also provide copies of medical records regarding all care provided to the patient by theAssisting Hospital.
7. DISCHARGE BY ASSISTING HOSPITAL. If a transferred patient is discharged by an AssistingHospital, the Assisting Hospital will return to the Affected Hospital any original medical records,including x-ray films, transferred with the patient. If the Affected Hospital is not then able to receive
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the returned medical records, the Assisting Hospital will retain the records in its records departmentuntil requested by the Affected Hospital.
8. CHARGES FOR SERVICES. All charges for services provided at an Affected Hospital or at anAssisting Hospital for patients transferred pursuant to this Agreement shall be collected by the partyproviding such services directly from the patient, third party payor or other source normally billed bythe party. The parties agree to cooperate with each other in billing and collecting for services fur-nished to patients pursuant to this Agreement. The billing and collection of charges for transportationof the patient from an Affected Hospital to an Assisting Hospital (and to return the patient to theAffected Hospital) shall be the responsibility of the Affected Hospital.
9. LOANS OF PERSONNEL. The parties agree that an Affected Hospital may, due to an external or inter-nal disaster, require the need for additional personnel from a Lending Hospital. The Lending Hospital,in its sole discretion and consistent with paragraph 24 below, will identify personnel that it can makeavailable to the Affected Hospital, the time periods during which the personnel are available, and theduration of time the Lending Hospital anticipates it can continue to make such personnel available tothe Affected Hospital. If at any time the Lending Hospital determines the return of all or some of itsloaned personnel is necessary for the proper staffing of the Lending Hospital, then upon notice to theAffected Hospital, the Lending Hospital may direct its personnel to return to work at the LendingHospital and such action shall not be a breach of this Agreement.
10. COMMUNICATION OF REQUEST FOR PERSONNEL. A request for the loan of personnel can bemade verbally. The request, however, must be followed up in writing. The Affected Hospital will iden-tify to the Lending Hospital the following:a. The type (including required competencies) and number of requested personnel;b. An estimate of how quickly the response is needed;c. The location where such loaned personnel are to report; andd. A brief description of how the loaned personnel will be used.
11. IDENTIFICATION OF LOANED PERSONNEL. Arriving loaned personnel will present their identification atthe site designated by the Affected Hospital. The Affected Hospital will be responsible for the following:a. Meeting the arriving loaned personnel; andb. Confirming the loaned personnel’s identification with the list of personnel provided by the Lending
Hospital.
12. SUPERVISION OF LOANED PERSONNEL. The Affected Hospital’s Designated Representative willidentify where and to whom the loaned personnel are to report. Professional staff of the AffectedHospital will supervise the loaned personnel.
13. CREDENTIALS OF LOANED PERSONNEL. The Affected Hospital agrees to accept the professionalcredentialing determination made by the Lending Hospital for those services for which such person-nel are credentialed or certified by the Lending Hospital.
14. RETURN OF LOANED PERSONNEL. The Affected Hospital is responsible for providing the loanedpersonnel transportation necessary for their return to the Lending Hospital.
15. CHARGES. The Affected Hospital will reimburse to Lending Hospital all costs associated with theloaned personnel, including, without limitation, the wages and benefits of such personnel for theperiod loaned. The Lending Hospital will furnish to the Affected Hospital an invoice reflecting thecosts, and upon request by the Affected Party will provide information as necessary to reasonablyverify the claimed costs. All charges for patient care provided by loaned personnel will be billed byand shall be the property of the Affected Hospital.
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16. LOANING SUPPLIES AND/OR EQUIPMENT. The parties agree that an Affected Hospital may, due toan external or internal disaster, need the use of additional supplies and equipment.
17. COMMUNICATION OF REQUEST FOR SUPPLIES AND EQUIPMENT. A request for supplies or theloan of equipment can be made verbally. The request, however, must be followed up in writing. TheAffected Hospital will identify the following:a. The quantity and exact type of requested items;b. An estimate of how quickly a response is needed;c. Time period for which the supplies or equipment will be needed; andd. Location to which the supplies or equipment should be delivered.
17. The Lending Hospital, in its sole discretion and consistent with paragraph 24 and subject to para-graph 25 below, will identify which requests it can meet, how long it will take to fulfill the request,and, in the case of loaned equipment, how long the equipment can be made available to the AffectedHospital. If at any time the Lending Hospital determines the return of all or some of the loan equip-ment is necessary for the proper operation of the Lending Hospital, then upon request by notice tothe Affected Hospital, the Affected Hospital will return such equipment, and such request shall notbe a breach of this Agreement.
18. DOCUMENTATION OF SUPPLIES AND EQUIPMENT. The Affected Hospital will use the LendingHospital’s standard order requisition form as documentation of the request and receipt of the materi-als. The Affected Hospital’s Designated Representative will confirm the receipt of the materialresources. The documentation will detail at least the following:a. The supplies and/or equipment involved; andb. The condition of the equipment prior to the loan (if applicable).
19. TRANSPORTATION OF SUPPLIES AND EQUIPMENT. When feasible, the Affected Hospital will beresponsible for transporting the requested supplies and equipment. If the Affected Hospital is unableto transport such supplies or equipment, the Lending Hospital will arrange for shipping/transportationto and from the Affected Hospital. All expenses of shipping/transport shall be the responsibility ofthe Affected Hospital.
20. RESPONSIBILITY FOR SUPPLIES AND EQUIPMENT. The Affected Hospital is responsible forappropriate use and maintenance of all loaned supplies and equipment.
21. CHARGES FOR LOANED SUPPLIES AND EQUIPMENT. The Affected Hospital shall be responsiblefor all costs arising from the use, damage, or loss of requested supplies and loaned equipment.Charges for equipment shall be at actual lease rate prorated by the number of days of use, or by thefair market rental value of comparable equipment, as chosen by the Lending Hospital. Charges forsupplies will be at the Lending Hospital’s costs.
22. RESPONSIBILITY; INSURANCE. Each party shall be responsible for any and all property damage or per-sonal injury caused by the acts or omissions of its employees acting within the scope of employment.Each party shall throughout the term of this Agreement maintain comprehensive general liability insur-ance, workers compensation insurance, property insurance and professional liability (malpractice) insur-ance to cover their activities hereunder and upon request of another party shall provide to the otherparty certificates evidencing the existence of such insurance coverage. Each party may at its option sat-isfy its obligations under this section through self-insurance programs and protections deemed by it tobe comparable to the insurance coverage described herein, and upon request, provide to the other partyinformation showing that the self-insurance programs offer such comparable protection.
23. INDEPENDENT RELATIONSHIP. None of the provisions of this Agreement are intended to createnor shall be deemed or construed to create a partnership, joint venture or any relationship betweenthe parties other than that of independent entities contracting with each other solely for the purposeof effecting the provisions of this Agreement.
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24. AFFILIATION WITH OTHER FACILITIES. Nothing in this Agreement shall be construed as limitingthe right of the parties to affiliate or contract with any other entity operating a hospital or any otherhealth care facility on either a limited or general basis while this Agreement is in effect. Each partyacknowledges that, in the event of a large scale External Disaster, the ability of an Assisting Hospitalto accept patients from the Affected Hospital may be affected by its receipt of patients from othersources, including direct admissions from the community and transfers of patients from other facili-ties, or other factors. This Mutual Assistance Agreement is not intended to establish a preferred sta-tus for patients of Affected Hospitals. All decisions regarding allocation of available personnel, equip-ment and supplies will be made by the Assisting Hospital and/or the Lending Hospital using its bestjudgment about its capabilities at the time and the needs of its community.
25. AUTHORITY OF DEPARTMENT. All parties to this agreement recognize that certain of the suppliesand equipment available for use in any internal and external disaster have been purchased through agrant administered by the Department. In the event of an internal or external disaster requiring coor-dination at statewide level, as determined by an appropriate representative designated by theGovernor, the Department may direct the distribution, utilization and location of use of any and allsupplies and equipment owned by any party to this Agreement, which supplies and equipment wereinitially purchased with grant funds from the Department.
26. EFFECT OF AGREEMENT. The execution of this Agreement shall not give rise to any liability orresponsibility for failure to respond to any request for assistance, lack of speed in answering such arequest, inadequacy of equipment, or abilities of the responding personnel.
27. COPY OF AGREEMENT. A conformed copy of this Agreement, with all amendments, if any, togetherwith a copy of any policies and procedures, referral forms or other documents adopted by the partiesto implement this Agreement shall be kept in an administrative file of each of the parties for readyreference.
28. MODIFICATION OF AGREEMENT. This Agreement contains the entire understanding of the partiesand shall not be modified except by an instrument in writing signed by the parties.
29. NO WAIVER. No waiver of a breach of any provision of this Agreement shall be construed to be awaiver of any breach of any other provision of this Agreement or of any succeeding breach of thesame provision.
30. GOVERNING LAW. This Agreement, and the rights, obligations and remedies of the parties hereto,shall be governed by and construed in accordance with the laws of the State of North Dakota.
31. ACCESS TO RECORDS. If this Agreement is subject to Section 952 of the Omnibus ReconciliationAct of 1980, 42 U.S.C. § 1395-x (v)(1)(I) (the “Statute”) and the regulations promulgated thereunder,42 C.F.R. Part 420, Subpart D (the “Regulations”), the parties shall, until the expiration of four (4)years after furnishing of services pursuant to this Agreement, make available, upon proper request,to the Secretary of Health and Human Services and to the Comptroller General of the United States,or any of their duly authorized representatives, the Agreement and the books, documents andrecords of the parties that are necessary to certify the nature and extent of the cost of services fur-nished pursuant to the Agreement for which payment may be made under the Medicare program. Ifthe Agreement is subject to the Statute and Regulations and any party carries out any of the dutiesof the Agreement through a subcontract, with a value or cost of $10,000 or more over a twelve (12)month period, with a related organization, that subcontract shall contain a clause to the effect thatuntil the expiration of four (4) years after the furnishing of services pursuant to such subcontract, therelated organization shall make available, upon proper request, to the Secretary and the ComptrollerGeneral, or any of their duly authorized representatives, the subcontract and the books, documentsand records of such related organization that are necessary to verify the nature and extent of suchcosts.
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32. TERMINATION OF AGREEMENT BY PARTY. Any party may terminate its participation in thisAgreement by providing sixty (60) days written notice to the President of NDHA. The NDHA will noti-fy all other parties of said termination.
DATE: ________________________________________________
BY:__________________________________________________
ITS:__________________________________________________
IDENTIFICATION OF DESIGNATED REPRESENTATIVES: ____________________________________________________
Reprinted with permission. North Dakota Healthcare Association
Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
RECOVERY
APPENDIX 11SAMPLE INFORMATION FORM
FOR DEPARTMENTS
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RECOVERY
SUPPORT SERVICES AND ASSISTANCE
After a major emergency or disaster, many people in our community will be distressed by personaland professional difficulties. It is likely that affected staff and physicians may need some schedulingflexibility or other temporary help in order to return to their customary activities. The following are
only some of the resources available on campus and in our community:
HOSPITAL RESOURCES
Counseling for employees
Transportation information
Child care referrals
Pet care resources
Special needs resources
Medication resources
ATM machines & other money sources
DOCUMENTING EMERGENCY OUTCOMES
Once the safety and status of your staff has been assured and emergency conditions have subsided,assemble a Department Emergency Recovery Team to support the hospital Incident Command Systemand the Facilities Department in restoring your department’s operations. Your team’s earlier work ondefining mission-critical operations and staffing will be a starting point for the recovery process.
It will be important to begin a timely and comprehensive assessment of the emergency’s physical andoperational effects. Plan ahead for how you will collect this important impact information. Be aware that
� Your department director will need ongoing status reports from your unit during the emergency toestimate when your program can be fully operational and to identify special facility, equipment andpersonnel issues or resources that will speed business resumption.
� The hospital may need detailed facilities data for the area to estimate temporary space reallocationneeds and strategies.
� Most insurance and FEMA assistance claims will require extensive documentation of damagedfacilities, lost equipment and resources and special personnel expenses. Workers’ compensationclaims may arise if there are injuries in your department.
The following forms provide formats for summarizing this crucial information.
� Take note that you also should plan to photograph or videotape facility or equipment damage inyour department to provide a visual supplement for the written impact data.
� It is very important that you record the emergency’s physical effects before you clean your area ormake repairs.
COMMUNITY RESOURCES
Disaster relief & referrals
Transportation information
Counseling/mental health
Claims information
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Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
(HOSPITAL NAME)SUMMARY: DEPARTMENT EMERGENCY STATUS
DATE/TIME ____________________________________________ # OF PAGES IN THIS REPORT ________________
TO: ADMINISTRATOR: ____________________________________ FAX:__________________________________
EOC: ________________________________________________ FAX:__________________________________
FROM: ________________________________________________ FAX:__________________________________
DEPT/BLDG ____________________________________________
CURRENT OPERATIONAL SITUATION
IMMEDIATE FACILITY AND SPACE NEEDS: ____________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
URGENT EQUIPMENT REQUIREMENTS TO BECOME OPERATIONAL: __________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
CRITICAL PERSONNEL ISSUES: ____________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
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RECOVERY: DETAILED SPACE ASSESSMENT
Use this form to describe damage to utilities, fixtures, ceilings, walls, floors, windows, etc. in your department. Send the informa-tion to the Emergency Operation Center. The EOC will send a prioritized list to the Facilities Department and other designated depart-ments with a signed cover memo.
DEPT/BLDG ____________________________________________________ROOM______________________
DAMAGE ____________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
DEPT/BLDG ____________________________________________________ROOM______________________
DAMAGE ____________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
DEPT/BLDG ____________________________________________________ROOM______________________
DAMAGE ____________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
DEPT/BLDG ____________________________________________________ROOM______________________
DAMAGE ____________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
DEPT/BLDG ____________________________________________________ROOM______________________
DAMAGE ____________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
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RECOVERY: DETAILED EQUIPMENT ASSESSMENT
Use this form to describe all damaged furnishings, office-laboratory equipment, and materials expended dur-ing the emergency. Send the information to the EOC.
DEPT/BLDG ____________________________ ROOM ____________________________
ITEM________________________________ MANUFACTURER __________________________
____________________________________ HOSPITAL ______________ ORIGINAL
MODEL# ____________________________ INVENTORY# ____________ COST ____________
DAMAGE DESCRIPTION __________________________________________________________
____________________________________________________________________________
EST. REPAIR $ ________________________ EST. REPLACEMENT $ ______________________
DEPT/BLDG ____________________________ ROOM ____________________________
ITEM________________________________ MANUFACTURER __________________________
____________________________________ HOSPITAL ______________ ORIGINAL
MODEL# ____________________________ INVENTORY# ____________ COST ____________
DAMAGE DESCRIPTION __________________________________________________________
____________________________________________________________________________
EST. REPAIR $ ________________________ EST. REPLACEMENT $ ______________________
DEPT/BLDG ____________________________ ROOM ____________________________
ITEM________________________________ MANUFACTURER __________________________
____________________________________ HOSPITAL ______________ ORIGINAL
MODEL# ____________________________ INVENTORY# ____________ COST ____________
DAMAGE DESCRIPTION __________________________________________________________
____________________________________________________________________________
EST. REPAIR $ ________________________ EST. REPLACEMENT $ ______________________
page _____of _____
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RECOVERY: DETAILED PERSONNEL IMPACTS(This should be coordinated through the HR Department)
Use this form to describe the emergency’s impact on staffing. Describe personnel issues related to programresumption. Document employee overtime related to your emergency response and recovery. Send this infor-mation to the EOCSummary: EMERGENCY IMPACTS TO DEPARTMENT STAFFING
SUMMARY: EMERGENCY IMPACTS TO DEPARTMENT STAFFING
____________________________________________________________________________
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____________________________________________________________________________L: STAFF OVERTIME HOURS RELATED TOHE EMERGENCY. Include data for temps hired for emergency recovery
LIST STAFF OVERTIME HOURS RELATED TO THE EMERGENCY AND EMERGENCY DUTIES PERFORMED.Include data for temps hired for emergency recovery.
NAME________________________________________________________ EMPLOYEE#______________________
JOB TITLE ____________________________________________________ HOURLY RATE ____________________
OT RATE __________________________________ BENEFITS % ______________________________________
DATE(S) WORKED ______________________ HOURS____________ DUTIES PERFORMED ______________
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NAME________________________________________________________ EMPLOYEE#______________________
JOB TITLE ____________________________________________________ HOURLY RATE ____________________
OT RATE __________________________________ BENEFITS % ______________________________________
DATE(S) WORKED ______________________ HOURS____________ DUTIES PERFORMED ______________
____________________________________________________________________________________________
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SUMMARY
ROLES AND RESPONSIBILITIES
List all staff names, addresses and phone numbers (regular and emergency) as well as position in thedepartment.
For each person, list to whom that person reports, in order of responsibility. Be able to show at a glancewho is in charge if someone above is unable to respond.
List roles and responsibilities in an emergency. Consider overlaps in case someone is not able to fulfill a role.
Be able to answer these questions:� Who will provide first aid?� Who will take any medications?� Who will take the first aid kit?� Who will take emergency information on each person?� Who will call for help?� Who will carry the cellular phone?� Who will carry the emergency kits?� Who makes sure everyone is out of the building?� Who is responsible for backing up vital records/information?� Where are copies of information stored?� Who is responsible for equipment?
Share the list with the staff and discuss it so there is no surprise during an emergency. Everyone shouldknow their primary and back-up responsibilities.
Maintain an attendance list at all times:� Who is in the building?� When did they arrive?� When did they leave?
Have emergency information with the attendance list. Make sure you know health information and have per-mission for emergency medical treatment and know of any special requirements or medications for staff.
Below is a sample listing of common areas of interest to be covered when compiling your departmental plan:
� Who � Names/phone numbers of everyone in your department� Who is considered essential in times of emergency� Who will be responsible for contacting employees in times of emergency� Who will have access to vital information/records� Who will have access to equipment/supplies
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Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
� What
� What equipment is in the department
� What supplies are in the department� What equipment and supplies are needed in times of emergency� What role does your staff have on a day-to-day basis� What role will your staff have in an emergency situation� What vendors are available 24/7 in times of emergency
� When � When do you activate your departmental plan� When is your department considered unable to function due to lack of
personnel/equipment/supplies
� Where � Where do people go when they evacuate� Where are emergency supplies and first aid kits
� How � How do employees find out about the status of the department� How do you disseminate information to your staff/students/departments� How will you backup your information � How you will contact employees in times of emergency
� How Many� How many personnel are needed to keep the department functioning� How many generators are needed for your area� How many flashlights are needed� How many employees will need shelter� How many employees will need daycare services� How many employees will need medication� How many animals are to be fed/when/how/by whom� How many people have cell phones/text messaging capability/numbers available
Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
RECOVERY
APPENDIX 12HOSPITAL STATUS REPORT FORM
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Weathering the Storm � A Hurricane Planning, Response and Recovery Toolkit
RECOVERY
APPENDIX 13SAMPLE DEMOBILIZATION PLAN
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DEMOBILIZATION
SAMPLE DEMOBILIZATION PLANFacilities also may choose to capture their demobilization
priorities and actions in an Incident Action Plan (IAP).
I. General Information – This section is to summarize the situation and demobilization priorities. This section also should include any unique considerations for the current event. General guidelines shouldbe noted here:
A. General guideline example – personnel that has been on duty the longest should be releasedfirst.
B. General guideline example – operations will be restored according to COOP/DRP plan prioritization of critical functions.
II. Responsibilities
A. Planning Section
i. Ensure demobilization information is disseminated in sufficient time for an orderly downsizingof incident resources.
ii. Ensure command has approved demobilization plan.
iii. Ensure compliance with demobilization checkout form (ICS – 221).
iv. Ensure coordination with procurement and documentation units and coordination with othersections.
B. Operations Section
i. Identify and notify planning of excess personnel and equipment available for demobilization.
ii. Identify operational capacity status of various units in hospital. Notify which units can returnto normal operations and which ones cannot. Determine impact of unit inter-dependenciesrelative to operational status.
C. Logistics Section
i. Coordinate all personnel and equipment transportation needs.
ii. Ensure communications equipment has been returned, checked for damage and ensurerepairs as needed.
iii. Ensure resources have been tracked and accounted for, both consumables and non-consumables. Ensure completion of equipment tracking forms (ICS-211).
D. Finance Section
i. Ensure completion of personnel time reports and coding to appropriate cost centers.
ii. Ensure completion of equipment time reports and coding to appropriate cost centers.
iii. Ensure documentation requirements are met for application of relief under FEMA or privateinsurance policies.
III. Release Priorities – list release priorities.
IV. Release Procedures – procedures may be listed by section or by topic (i.e. personnel). For example,note how personnel are to check out and what the expectations are for returning to work. For exam-ple, staff are to schedule their next work shift with their supervisor or their supervisor’s designeeprior to going home.
V. Approvals
PREPARED BY:______________________________________________________ DATE ________________________________________________Demobilization Unit Leader
CONCUR: ________________________________________________________ DATE ________________________________________________Planning Section Chief
CONCUR: ________________________________________________________ DATE ________________________________________________Logistics Section Chief
APPROVED:________________________________________________________ DATE __________________________________________________Incident Commander
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