The Gulf Coast Center · Web viewProcedure: 3.5 Hurricane Emergency Procedures. Policy Reference:...

The Gulf Coast Center

Procedure: 3.5 Hurricane Emergency ProceduresPolicy Reference: 3.0 Safety/Risk ManagementOrigin: AdministrationOversight: Center Safety/Risk Management Officer(s)Implementation Date: July 15th, 1996Last Revision Date: Annually – Most Recent: 5/1/14

Table of Contents3.5.1 Purpose…………………………………………………………………… 1 3.5.2 Definitions……………………………………………………………….. 1 3.5.3 Responsibility……………………………………………………………. 4 3.5.4 General Center Procedures for Hurricanes………………………………. 5 3.5.5 Center Operated Residential Programs Relocation………………………. 8 3.5.6 Other Center Consumer Evacuation Assistance…………………………. 10 3.5.7 Staff Evacuation and Hurricane Response Assistance…………………… 12 3.5.8 Facility Preparation………………………………………………………. 13 3.5.9 Vehicle Preparation………………………………………………………. 17 3.5.10 MIS Preparation………………………………………………………….. 17 3.5.11 Service Operations……………………………………………………….. 23 3.5.12 Mental Health Medication Services Preparation…………………………. 23 3.5.13 Consumer Support Services Preparation…………………………………. 27 3.5.14 Mental Health Children’s Hurricane Procedures…………………………. 283.5.15 Attachments………………………………………………………………. 31

3.5.1 Purpose

The Hurricane Emergency Procedures will outline the Center's general response in the event of a hurricane emergency threat. As hurricanes are unpredictable and subject to sudden changes, the procedures are to be used only as a guideline and may be subject to change as the situation presents itself. The procedures are to be reviewed at least annually, and updated and revised as required.

3.5.2 Definitions

Bedding Materials – May reference fold out cot; sleeping bag; and/or one to two blankets, and a pillow.

Center - The Gulf Coast Center; the community mental health, and intellectual and developmental disabilities authority, as designated by the State of Texas, for Galveston and Brazoria counties.

Center’s Catchment Area – Galveston and Brazoria Counties

Critical Services – Refers to services necessary to primary care of individuals and/or crisis response. Does not include Center operated residential programs/consumers.

of 34

CSC – Community Service Center (Mental Health)

CSS – Community Support Services

Consumers - Individuals served in and through Center services. May also be referred to as “client”.

DADS – Texas Department of Aging and Disability

DSHS – Texas Department of State Health Services

EBA (Expense Bank Account) – Program bank accounts established at local community banks for specific or emergency purchases by Center programs and services.

Emergency Supplies – For all Center programs; emergency supplies refers to first aid kits, flashlight(s), batteries, fire extinguisher, etc. For residential programs only; emergency supplies must also include food and water, one battery operated radio, batteries, and other basic food and security necessities needed for the number of persons involved for a minimum of five days.

Emergency Telephone Pyramid – Staff and telephone contact numbers for Center programs and services; which shows the order by which staff and other necessary personnel will be contacted in the event of an emergency. Also included is the designation of responsibility for securing key program and service materials; such as consumer listings. The centerwide Emergency Telephone Pyramid identifies the key personnel and telephone contact numbers for use in the event of a centerwide emergency or public relation issue.

Essential Staff – Refers primarily to Center executive management staff. May also refer to staff scheduled to accompany or coordinate consumers during the storm.

ETBHN – East Texas Behavioral Health Network; East Texas regional cooperative of community centers of which the Center is a member.

Executive Management Staff (EMT) - Refers to members of the Center’s Executive Management Team which may include the Executive Director, Chief Operating Officer, Director Legal Services, Director Human Resources, Director MH Adult Outpatient Services, Director Substance Use Recovery/Homeless Services, Director of Intellectual and Developmental Disabilities Services, Chief Financial Officer, and Director Information Technology.

FEMA – Federal Emergency Management Agency

HHSC – Texas Health and Human Services Commission

High Risk Area – Refers to areas in the direct path of a storm, areas ordered to be evacuated, and/or flooding or high water is possible.

Hurricane – Severe tropical weather system as defined by the National Weather Service. For these

of 34

procedures, this may include any identified tropical weather activity such as tropical wave, tropical depression, tropical storm, and/or named hurricane.

Hurricane Readiness Teams – Center staff(s) designated to assist in boarding and/or securing Center facilities, equipment, and vehicles. Each facility and primary service areas must be represented on teams.

Hurricane Readiness Materials – Materials located at each facility or other near-by identified location, used in securing and boarding Center facilities in the event of a hurricane emergency.

Key Personnel – Refers to Center Board of Trustee members, appropriate medical staff and hospital personnel, as well as local public officials.

MIS – Management Information Services

Petty Cash – Small cash amount in programs primarily for use for consumer emergencies or activities.

Priority Staff – Those staff previously identified and approved as having a need to be dismissed first due to their personal or living situation. Staff who believe, that due to their personal or living situation, they would qualify as a "priority staff", must notify their primary supervisor, their area supervisor, and Human Resources in writing as to their situation and request designation approval. Any staff whose primary living residence is in a category 1 risk area (as designated by the appropriate emergency agency) will be given first consideration for designation as a priority staff. However, the staff must notify their primary supervisor, their area supervisor, and Human Resources in writing of that situation as noted above. All requests must be made in writing and presented prior to the start of hurricane season and received no later than June 15 th of each fiscal year. Designation of "priority staff" does not eliminate a staff person's responsibility or job duties; and as needed, “priority staff” may be asked to return after securing their personal situation to assist in the Center’s response.

Phase Down – Refers to the period and activities that will occur prior to the Center's operations being closed completely in response to a hurricane emergency. May include non-medical care activities being discontinued, consumers being sent home or assisted with emergency information, or staff being reassigned to critical service areas to assist and/or provide additional support. Does not include Center operated residential programs/consumers.

Residential Programs/Consumers – Refers to Center operated residential programs and consumers previously identified as needing the Center's assistance to be relocated in the event of a storm.

State – State of Texas

Storm Period – Covers the period beginning at the point in time that all or part of the Center’s catchment area becomes at risk of a hurricane strike and continues through to the time the Center returns to operations.

of 34

Vehicles – When referenced, includes both Center revenue and non-revenue vehicles.

3.5.3 Responsibility

It is the responsibility of the Center's Executive Director or his/her posted designee to issue the final decisions with regards to the closure and/or re-opening of the Center and its services. It is the responsibility of the Center’s Executive Director or his/her posted designee to assure that all appropriate staff and personnel are kept informed through-out the hurricane emergency.

It is the responsibility of the Director Legal Services to develop procedures that provide a guideline for all Center programs and staff to follow in the event of a hurricane emergency. Annually at the beginning of hurricane season, the Director Legal Services will assure that all Center staff are informed and knowledgeable of the Center's Hurricane Emergency Procedures. Additionally, the Director Legal Services will assure that a Centerwide Emergency Telephone Pyramid (Attachment #1) is maintained and appropriately distributed. In accordance with Center Personnel Policies, Center staff are responsible for assuring that their correct street address and phone number(s) are on file with Human Resources and their appropriate program. This may be different than staff’s mailing address; but both the staff’s mailing address and actual street address where they live must be on file with the Center. To change or update their personal contact information, staff must complete and submit required paperwork as instructed by the Center’s Human Resource Department.

The Center will also develop alternate means of communication for use in the event of a major disaster. The Director Legal Services will distribute this alternate communication information to all staff and other appropriate personnel. This will include utilization of the Center’s website and Facebook page, alternate Center email address, local newspaper and news radios, as well as transfer of the Center’s crisis phone number to another community center. The Director Legal Services, or other designated personnel from the Center’s MIS Department will utilize the Center’s website (www.gulfcoastcenter.org), as well as the Center's Facebook page (https://www.facebook.com/GulfCoastCenter), to post status information on the Center and its services. All Center staff should assure that they know where and how to access these two sites outside of the Center's network system. Additional information specific to the operations of Connect Transit, will be posted on Connect Transit's Facebook page. The alternate Center email address ([email protected]) will be utilized in critical emergency situations only, and only when the Center’s primary network system is not available or operational. Utilization of the alternate Center email address will cease immediately upon the Center’s primary network system becoming operational. The alternate Center email address will be for Center staff and key State contract personnel (DSHS, DADS, HHSC) to contact the Center for information, emergency instructions, or status reporting. Access to the site to retrieve and respond to correspondence received will be restricted to the Executive Director and Director Legal Services.

It is the responsibility of the Chief Financial Officer to assure that all Center facilities, properties, and equipment are properly and adequately insured. Insurance coverage will include general property, general and professional liability, flood, and windstorm and hail. Coverage will be reviewed annually to assure adequate and complete; and adjusted as necessary.

of 34

mailto:[email protected]

https://www.facebook.com/GulfCoastCenter

http://www.gulfcoastcenter.org/

http://www.facebook.com/profile.php?id=100000043718884%00%E5%A1%B9%EF%92%81%E1%B4%BB%E4%A1%BF%E2%B2%AF%E5%B6%82%E8%97%84%E6%8C%A7%00%00%EA%AE%A5#!/pages/Gulf-Coast-Center/212103858848856%00

It is the responsibility of the Director Legal Services and the Asset Management Director to assure that Hurricane Readiness Teams are staffed for each facility and primary service areas. These teams will provide assistance in assuring that Center facilities are properly secured and boarded as required. These teams will also provide assistance with securing Center equipment and vehicles as instructed. As assigned, primary coordination of the Hurricane Readiness Teams will be under the direction of the Center’s Asset Management Director.

Annually, designated members of the Center’s Executive Management Team will be responsible for assuring memorandums of agreements with local city and county offices for evacuation assistance are completed; staff identified to assist in the event of an evacuation; and emergency evacuation agreement(s) are in place.

Under the direction of the Center’s Chief Operating Office, staff from the Center’s Intellectual and Developmental Disabilities division will be responsible for assuring an agreement with Richmond State Supported Living Center for the availability of space and operational assistance for the provision of day respite. The agreement will be renewed annually.

Annually, the Center will designate contacts – at least one primary and one secondary staff person - who will work with the State Disaster Assistance Program in providing crisis coverage and assistance as needed in the event of a designated emergency, and coordinate the Center’s participation in State and/or FEMA emergency response as requested. As a part of the Center’s participation in any State and/or FEMA emergency response, Center staff will be requested to provide the needed crisis coverage, and will continue until such time that our services are no longer needed or other staffing arranged. The Center may be requested to provide crisis assistance to areas outside its catchment area in the event of a major State emergency. The Center’s designated contacts will act as the primary contacts to the State and/or FEMA in the event of an emergency response.

It is the responsibility of all Center staff to assure that they are personally prepared and have a response plan as recommended by State and Local government officials.

3.5.4 General Center Procedures for Hurricanes

The following outlines the primary steps that would be taken in the event of a hurricane emergency. As hurricanes are unpredictable and subject to sudden changes, the following are to be used only as a guideline and may be subject to change as the situation presents itself. The Center’s response will be primarily dictated by and responsive to the category level of threat, the communities’ call for evacuation, and the percentage risk of landfall in or reasonably near the Center’s catchment area.

Prior to the Start of Hurricane Season Identification of consumers and/or families needing evacuation assistance Assist with consumer and/or family enrollment in available community evacuation

assistance Identification of staff to assist with the Center’s evacuation activities Identification of evacuation equipment and supply needs

of 34

Review of facility securing materials and supplies Completion of memorandum of agreements Location(s) for vehicle storage identified Crisis response training support and assistance to Center staff and community agencies Mental Health First Aid training to Center staff, community agencies, and residents and

business within Galveston and Brazoria counties Participate in community hurricane preparedness meetings and activities Provide staff and consumer hurricane preparedness educational information

Hurricane Threat Develops Essential staff placed on alert Program and Service Area Directors contacted EBA's and Petty Cash funds replenished Programs review emergency supplies and re-stock as needed Vehicles reviewed, fueled, and readied

As hurricanes can develop quickly, Center vehicles should be readily available at all times during the Hurricane Season. Throughout the Hurricane Season, vehicles are to be fueled and readied for immediate use at the close of each business day. Center vehicles should not be allowed to be left at or below 1/3 tank at the close of a business day.

Center’s emergency response vehicle stocked, and relocated for immediate access Begin notifying consumers and families to prepare for emergency Area agencies contacted for available assistance for consumers and families Begin initial work on facilities and properties Key personnel notified of preparations Final listing of relocated consumers and accompanying staff provided to essential staff Center operated Residential programs prepare for relocation Identified Center evacuation consumers placed on alert All outside items, furniture, and equipment cleared or secured at each facility Communication initiated with appropriate local emergency and/or county personnel Regular updates / status reports provided to all Center personnel

Hurricane Watch Declared Facilities secured Essential staff placed on notice Center operated Residential programs relocated If mandatory evacuation called, identified Center evacuation consumers relocated Emergency telephone pyramid initiated Programs and transportation begin phase down Consumer work crews dismissed Post storm contact numbers/locations distributed Listing of alternate service sites finalized and distributed Computer data systems backed up as required and secured appropriately off-site Priority staff excused Re-assignment of vehicles and equipment per approved MOU’s

of 34

Hurricane Warning Declared Final check on facilities Transfer of the Center’s Crisis and other Emergency Phone Number(s) Programs and transportation discontinued Remaining vehicles secured and distributed Remaining staff dismissed Essential staff come on duty Red Cross or appropriate local emergency agency contacted for shelter information Key personnel informed of status

Post Hurricane Facilities inspected and damage assessed As safely appropriate, conduct staff and consumer welfare checks and follow-up Insurance company notified Storm equipment removed Center programs and transportation resume As safely appropriate, evacuated Center operated residential consumers returned As safely appropriate, evacuated Center consumers returned Work with State Disaster Assistance Program in area crisis coverage response As requested, provide crisis coverage assistance at designated FEMA locations Alternate service site locations accessed and posted as necessary Center consumers and families contacted Key personnel notified of damage Evaluate procedures and prepare report for Executive Director Recognize volunteers and/or emergency crews Participate in local emergency response and support

As the Center's services are continual, every effort will be made to maintain critical services in operation as long as safely possible. Again, the Center’s response will be primarily dictated by and responsive to the category level of threat, the communities’ call for evacuation, and the percentage risk of landfall in or reasonably near the Center’s catchment area. As the hurricane develops and approaches the Galveston and Brazoria county areas, programs and operations will begin phasing down when a watch is declared. All non-critical services will be phased down first. Phasing down will include non-medical care activities being discontinued, consumers being sent home or assisted with emergency information, or staff being reassigned to critical service areas to assist and/or provide additional support. Priority will be given to those programs and operations in high-risk areas or in the path of the storm. Program directors or his/her designee will notify one of the essential staff when their facility is finally completely secured and phased down to closure.

Every effort will be taken to assure that information is distributed and communicated in as quick a manner as possible and will be done primarily using the Center's Centerwide Emergency Telephone Pyramid as a guideline. Following the storm, the Center will use all means of communication available including the Center’s website, Center's Facebook page, alternate Center email address, newspapers, radio stations, and TV to distribute information to staff, consumers, and families. The Center’s catchment area’s primary news radio station for use in posting Center information will be KTRH 740 News Radio. In the event that communication fails prior to the completion of

of 34

instructions, staff should prioritize the safety of themselves and their consumers first and act accordingly, using these procedures as a guide. The Center will utilize developed alternate means of communication for use in the event of a major disaster. The Center’s Crisis Hotline Phone Number will be transferred as instructed to the Center’s Crisis Hotline contractor. All other emergency numbers will be transferred to a designated center member of the ETBHN; who will continue to answer through the storm period. The Director Legal Services or other designated personnel from the Center’s MIS Department will utilize the Center’s website (www.gulfcoastcenter.org) and Center's Facebook page (https://www.facebook.com/GulfCoastCenter) to post status information on the Center and its services. Information on start up, closures, staff contact instructions, and consumer contact instructions will be posted on the Center’s website and Facebook page as appropriate. The alternate Center email address ([email protected]) will be utilized in critical emergency situations only and only when the Center’s primary network system is not available or operational. Utilization of the alternate Center email address will cease immediately upon the Center’s primary network system becoming operational. The alternate Center email address will be for Center staff and key State contract personnel (DSHS, DADS, HHSC) to contact the Center for information, emergency instructions, or status reporting. Access to the site to retrieve and respond to correspondence received will be restricted to the Executive Director and Director Legal Services.

To further assist in distributing and receiving communication, the Center’s Director Legal Services will post and receive Center and Center program related messages on a designated phone number. At the time of these procedure’s most recent update, (409) 763-2373 will be the primary number. Staff may call the phone number for updates, and leave messages of their program’s status. Staff may not leave personal messages or use this phone number to inform the Center of their situation or return to work.

Center services will resume immediately following a storm as safely possible. Each staff is required to contact their primary supervisor within twenty-four hours following the storm’s passing to advise of their situation and obtain return to work information. Staff failing to notify or contact their primary supervisor or the Center's Human Resource division within seventy-two hours of the storm's passing could be subject to personnel action, up to and including termination.

In the event that any part of the Galveston or Brazoria county areas are declared a disaster area or suffer major damage, the Center will participate as requested with local, state, and federal emergency response teams in providing needed assistance for the term required to affected community residents. The Center's Director Legal Services will act as the primary point of contact in receiving and distributing information in this effort.

3.5.5 Center Operated Residential Programs Relocation

Relocation of Center operated residential program(s) and consumers will begin immediately upon a hurricane watch being declared for the Galveston and/or Brazoria area; or as instructed by the Executive Director or his/her designee. Residential program supervisor(s) will prepare and maintain a listing of those consumers who would participate in the emergency relocation process. The listing of consumers should be update regularly during the hurricane season, to assure it is current and representative of the residential program(s) caseload. Additionally, supervisors will

of 34

mailto:[email protected]

https://www.facebook.com/GulfCoastCenter

http://www.gulfcoastcenter.org/

prepare and maintain a listing of Center staff that will assist in the relocation process (provide transportation), and those that will be available to respond to consumer related issues as may be needed. Copies of these listings are to be provided to essential staff upon completion, and updated as necessary. Center vehicles may be re-assigned to accommodate the relocation process. The residential program supervisors or his/her designees are responsible for assuring adequate vehicles are available for transportation. At a minimum, all individuals relocated should bring all required medications, clothing, and personal hygiene items. The length of time that residential programs and consumers will be relocated will be dependent on the storm and damages.

Relocation for Center operated residential program(s) may be completed in one of two phases – Phase One or Phase Two. The Center will maintain two phases of possible residential consumer relocation; and which phase will be utilized will be dependent on multiple factors - primarily the potential impact of the hurricane on the Center’s catchment area and the call for mandatory evacuation. Implementation of Phase One will be determined by the Center’s Executive Director or his/her designee; and generally implemented when there is minimal risk or projected impact expected on the Center’s catchment area. During Phase One, relocation is more of a precautionary move, and expected to be less than five days. In the event of a community mandatory evacuation order, Phase One is not an option; and the Center will move immediately to Phase Two. Beginning with the 2011 Hurricane Season, the Center entered into an agreement with the Wood Group to provide Phase Two emergency evacuation in the event of a disaster in Brazoria and/or Galveston County. By written agreement, the Wood Group will provide adequate staffing to manage and monitor those evacuated to the evacuation site by the Center; provide food, shelter, supervision, and if needed transportation to medical services; and provide those services until the Center determines that it is safe and appropriate for the individuals relocated to return. Phase Two relocation could last upwards of ten days or more.

PHASE ONE of the relocation process will consist of the coordination of Center operated residential program(s) and consumers to an identified Center owned relocation facility. At the time of this posting, the Center’s only Center operated residential program is the 10-bed HUD funded Transitional House in Galveston. During Phase One relocation, in the event the Center’s catchment area is at risk for a Category 3 or lower hurricane; the Transitional House program, consumers, and accompanying staff will be relocated to Lone Oak Ranch in Santa Fe to ride out the storm. Due to the Transitional House’s location on Galveston Island and the risk of flooding; the program, consumers, and staff must relocate during this time. Relocated program, staff, and consumers will be responsible for assuring all needed food and supplies, bedding, necessary client information, and adequate staffing. During Phase One relocation, staff and consumers should prepare for an estimated three to five day relocation. During this relocation, program operations will continue as normal; limited of course by the community emergency impact. The residential program director will assure adequate staffing, activities, and that both staff and consumers have sufficient materials and supplies to sufficiently operate the program. At no time will Phase One be an option if there is a mandatory evacuation order.

PHASE TWO of the relocation process will go into effect immediately upon the Center’s catchment area being at risk for a Category 4 or higher hurricane; or the local or State officials have called for a mandatory evacuation. During Phase Two relocation, the Transitional House program and consumers will relocate to a pre-determined site identified by the Wood Group outside the

of 34

Center’s catchment area and not in the direct path of the storm. Preliminary sites identified include Wood Group facilities in Waco, San Antonio, or Austin; with final determination approved by the Center and the Wood Group. Center staff will provide transportation for the residential consumers to the identified location; assuring that sufficient consumer information is provided to the Wood Group personnel to safely and adequately provide for those relocated. Additionally, Center staff will provide the names and contact information for those Center staff that will be available to provide crisis assistance, or answer care questions. At a minimum, two (2) Center staff will be identified and their contact information provided; and those identified Center staff must be available and responsive to the Wood Group throughout the emergency evacuation period as provided. The Wood Group will notify the identified contact staff if medical problems arise; and will provide transportation for a consumer to access appropriate medical treatment (physical health and/or behavioral health). If a consumer requires additional medication beyond the supply brought with them during the evacuation, the Center will be responsible for the cost of medications not covered by the consumer’s Medicaid, Medicare, or other third party coverage. Upon returning, PHASE ONE may be implemented (or re-implemented) until all relocated residential programs and consumers can return safely to their regular living arrangements. During Phase Two relocation, consumers should prepare for an estimated five to ten day relocation.

3.5.6 Other Center Consumer Evacuation Assistance

Annually, the Center will make available educational materials on hurricane preparedness to consumers and families. Consumers and families will be encouraged to evaluate their needs and prepare accordingly. The Center will provide assistance to consumers and families with accessing available community evacuation opportunities. Prior to the start of the annual Hurricane Season, consumers and families will be provided educational information on the State’s 2-1-1 community resource database system; as well as other similar system’s specific to cities and areas within the Center’s catchment area. Consumers and families will be encouraged to register with these systems. The 2-1-1 system is a statewide system, focused on persons with special needs who will need assistance in the event of an order to evacuate due to a hurricane threat. Doing so registers the need and assist cities and counties to adequately plan and prepare. To register, dial 2-1-1, and after a few seconds the caller will be asked a few questions. All individuals who may need assistance are strongly encouraged to register early, so that adequate preparations can be made in the event an evacuation becomes necessary.

Within this pre-hurricane consumer educational process, Center staff will complete a Consumer Evacuation Recommendation Form (Attachment #2) on each consumer identified as possibly needing special needs assistance in the event of a hurricane evacuation order. Through the completion of this form, Center staff will identify special needs, and make recommendations for the consumer’s evacuation. After the completion of the Consumer Evacuation Recommendation Form, for those consumers meeting the State’s definition of Special Needs, having no means of evacuation, and evaluated as being able to safely and clinically evacuate with available community resources; Center staff will provide additional referral assistance to available community evacuation opportunities. Additional referral assistance may be made for the consumer to access Flexible Spending Funds to further assist the consumer in the event of an evacuation.

of 34

After the completion of the Consumer Evacuation Recommendation Form, for those consumers identified as meeting the State’s definition of Special Needs, having no means of evacuation, but not clinically recommended for evacuation with available community evacuation opportunities, a referral will be made for the consumer’s evacuation with the Center’s evacuation process. Evacuation special requests from identified consumers with must be presented at this time to the Wood Group for approval. To evacuate with the Center’s evacuation process, the consumer must be an adult (over the age of 18), meet the State’s definition for Special Needs, have no means of evacuation assistance (i.e. family, friends, or personal vehicle), not be on oxygen or medical life support, and be clinically evaluated by the Center as best evacuating with the Center and not public community evacuation options. All elements of the evaluation must be met to be included with those to be evacuated with the Center’s evacuation process. For these identified consumers, the Center will provide evacuation assistance in the event of a mandatory evacuation order. Evacuation will occur immediately upon notification of the mandatory evacuation order. Beginning with the 2011 Hurricane Season, the Center entered into an agreement with the Wood Group to provide emergency evacuation in the event of a disaster in Brazoria and/or Galveston County for those consumers identified as meeting the State’s definition of Special Needs, having no means of evacuation, but not clinically recommended for evacuation with available community evacuation opportunities, a referral will be made for the consumer’s evacuation with the Center’s evacuation process. By written agreement, the Wood Group will provide adequate staffing to manage and monitor those evacuated to the evacuation site by the Center; provide food, shelter, supervision, and if needed transportation to medical services; and provide those services until the Center determines that it is safe and appropriate for the individuals relocated to return. Consumers will relocate to a pre-determined site identified by the Wood Group outside the Center’s catchment area and not in the direct path of the storm. Preliminary sites identified include Wood Group facilities in Waco, San Antonio, or Austin; with final determination approved by the Center and the Wood Group. Center staff will provide transportation for the residential consumers to the identified location; assuring that sufficient consumer information is provided to the Wood Group personnel to safely and adequately provide for those relocated. Additionally, Center staff will provide the names and contact information for those Center staff that will be available to provide crisis assistance, or answer care questions. At a minimum, two (2) Center staff must be identified and their contact information provided; and those identified Center staff must be available and responsive to the Wood Group throughout the emergency evacuation period as provided. The Wood Group will notify the identified contact staff if medical problems arise; and will provide transportation for a consumer to access appropriate medical treatment (physical health and/or behavioral health). If a consumer requires additional medication beyond the supply brought with them during the evacuation, the Center will be responsible for the cost of medications not covered by the consumer’s Medicaid, Medicare, or other third party coverage. This evacuation relocation will continued until it is determined that the consumers can return safely to their regular living arrangements. Consumers should prepare for an estimated five to ten day relocation at a minimum.

As the Center will be contracting the emergency evacuation for those consumers identified as meeting the State’s definition of Special Needs, having no means of evacuation, but not clinically recommended for evacuation with available community evacuation opportunities with the Wood Group; all special requests from identified consumers must be approved by the Wood Group. Special requests may include the request that spouses or significant others accompany them; that children for which the consumer has legal responsibility for be approved for

of 34

accompaniment; and/or that identified evacuating consumers be able to take their pets with them. Any and all special requests must be known in advance (minimum 14 days) of a call for mandatory; so that the Center and Wood Group can completely review each request for approval consideration. Where the special request cannot be approved, referral for assistance will be made to available community resources as appropriate.

The Center’s Chief Operating Officer and the Director Adult Mental Health Services will coordinate with staff and programs to complete the Consumer Evacuation Recommendation Forms, develop the consumer listing, identify Center resource and equipment needs, coordinate with the Wood Group, and make appropriate referrals for consumers as identified. Where necessary, recommendations for access to available consumer emergency funds or Flexible Spending Funds to assist consumers and families in evacuation or hurricane response can be made as appropriate. For these referrals, funds will be restricted to assisting the consumer or family in evacuation or hurricane response only.

3.5.7 Staff Evacuation and Hurricane Response Assistance

The Center’s Executive Management Team will be responsible for assuring that adequate staff are available to provide evacuation assistance and response throughout the storm period, and subsequent to the storm’s passing as necessary. This would include staff to assist in the coordination process, evacuation of consumers, response to the Wood Group, and providing post storm relief or crisis coverage.

The Center’s Director Human Resources will act as the point of coordination and management of the recruitment of staff to assist in this process. The Director Human Resources will assure recommended staff are qualified to provided the identified assistance, and current in trainings and required certifications. The Chief Operating Officer will work with appropriate staff to assure the identification of staff to provide clinical and crisis coverage, and that adequate numbers of staff are identified so as to meet required obligations. The Center’s Chief Financial Officer and Director of Transportation will recruit and secure the required number of transit drivers (CDL certified) to fulfill contractual agreements with local cities and counties in the event of an emergency evacuation process.

For those staff positions and functions that will require identified staff to relocate to fulfill the contractual agreements; sufficient staff will need to be recruited to not only fulfill contractual requirements but assure that staff will work no more than seven (7) days straight; upon which they will need to be relieved from their assigned duty for at least the next seven (7) days before assisting again. The goal is to have sufficient staffing to provide assisting staff with non-work and sleep time during their seven (7) day work period. As a general rule, the Center will continue to pay these staff their regular pay for all hours worked. For non-exempt salaried and hourly staff, staff will be paid their appropriate overtime rate for hours worked and calculated as overtime – non-work and/or sleep time will not be included in the overtime calculation. For exempt salaried staff, staff will continue to receive their regular pay; plus an additional per day stipend for each day worked up to a possible $125 per day. The Center’s Director Human Resources will evaluate exempt salaried staff involvement and expected functions, and will determined the stipend amount prior to dispatching the staff person. The Center’s Executive

of 34

Management Team reserves the right to consider additional recognition as the situation may present.

Staff must document all hours worked during this time period in detail. As may be required by possible disaster response reimbursing funding sources, staff may be requested to do so by completing an additional time sheet attachment outlining their relief activities. This will be in addition to completing their regular on-line time sheet. Staff will be reimbursed for any personal mileage incurred in this process at the Center’s approved mileage reimbursement rate.

For those staff who evacuate and relocate under the Center’s memorandum of agreement with local cities and/or counties, they will also receive a daily per diem for food equal to the amount outlined in the Center’s Travel Policy and Procedures. Initially, these staff will receive three (3) days per diem in advance to assist in their preparation for the evacuation. Staff agreeing to participate in the Center’s evacuation requirements and required to relocate may bring family members; but it is requested that this be limited to direct family members only for which the staff person has responsibility for. As much as the Center encourages staff to provide assistance during this process; staff are reminded to consider the age and needs of their family members, and respond accordingly.

3.5.8 Facility Preparation

In the event of a hurricane emergency declaration for the Galveston and/or Brazoria area, where storm blinds are not installed, pre-cut and labeled plywood coverings shall be used at each facility the Center has responsibility for to secure the windows and glass door openings. The Center's Asset Management Director will maintain a facility listing with addresses, lessor information where applicable, and location of plywood window coverings. The Center’s Asset Management Director will coordinate and maintain a listing of hurricane readiness teams with designated leaders and alternate leaders to participate in this process. The Center may contract for such assistance, however; each facility must have designated staff to coordinate and monitor completion. As needed, sandbags may be prepared and available for use at those facilities where water entry is a possibility. The use of sandbags is considered to be assistance in minimizing water damage, and used only as recommended by the Center’s Asset Management Director.

The Center will post “closure” notices on all Center facilities. The Center’s Asset Management Director will coordinate the postings, which will be waterproof signs attached to the front door area, or as near to this entrance as possible. The notice will provide basic information as to the Center’s closure and recommended contact information. The Center’s Asset Management Director will coordinate their removal following the hurricane’s passing.

The following represents the general method for applying the plywood coverings for those facilities with plywood coverings; however, this may vary slightly at some facilities due to their construction. Each hurricane readiness team designated leader and alternate leader will review each site at the start of the hurricane season to assure familiarity with the materials location and installation. The Center’s Asset Management Director may hold hurricane response drills annually; alternating facilities. During these drills, materials and equipment will be evaluated and updated as needed.

of 34

For those facilities with alternative window and door coverings, specific instructions will be posted at the facility with installation guidelines. The Center’s Asset Management Director will have responsibility in coordinating those instructions, and providing training as needed.

Method of Installation The fastest method for installing the panels will be utilized. This may involve installing the panels in place with barrel bolts or hex-head screws that are self-tapping.

Instructions for Placement of Panels Each panel will be numbered or labeled for its' location. The numbering method is as follows: facing the front of the building, panel number one (1) begins at the first window at the left and proceeds in a counter-clockwise direction around the building. An arrow is placed on the panel to mark which way is the top. Panels, which are not numbered, will be labeled appropriately (i.e. front door, etc)

Storage of Materials A container with the screws and equipment is located in each facility with the Office Manager and is clearly labeled "Hurricane Use only". The wood panels are stored at each facility or at a nearby selected storage area. The panels and accessories must be well maintained and accessible at all times.

Facility Securing Each facility will be provided a transport dolly, six-foot step ladder, and multiple pairs of gloves for staff(s) to utilize in the transport and installation of the window panels. Most panels are secured to window frames by barrel bolts attached to the panels. Where necessary, metal self-tapping screws will be on hand at each facility by the panels, to be utilized as needed on glass doors and windows not compatible with barrel bolts. The Center’s Asset Management Director may reassign Lawn and Facility Services’ staff to assist in securing facilities as needed. Hurricane readiness materials will be removed from facilities as soon as safely possible; using the same process as they were installed.

Facilities At the time of this posting, Center facilities and location of securing materials are as follows:

Facilities Location of Hurricane Readiness Materials Bayou House – Angleton Window panels and sand bags are located in the shed on south side

of houseBoat House – Angleton Window panels and sand bags are located in the attached garage.

Lawn Service will bring an extension ladder for installation of high garage windows

GCC – League City Window panels are located in the shed in the back of the building.Northern Brazoria CSC – Alvin Window panels and sandbags are stored in the shed

Harbor House – Texas City Window panels are located in the shed in the back of the building.Island House(s) – Galveston Window panels and sandbags are located in the back of the houses.Jones Building – Pearland Window panels are located in the back storage area of the

of 34

workshop.Lone Oak (House) – Santa Fe Window panels and sandbags are located in the shed behind the

house by the playground. The extension ladder located in the barn will be utilized for the second story windows.

Lone Oak (Ranch) – Santa Fe Window panels are located inside the barn by the manager’s office. An extension ladder is located in the barn for installation.

Mackey Buildings – Texas City Window panels are stored in the utility room of Mackey Building A. Sandbags are stored in Mackey Building B.

Mainland CSC – Texas City Window panels and sandbags are stored in the shed by MCSC Building #1.

MIS Operations – Alvin Window panels and sandbags are stored in the shed behind the building.

Southern Brazoria CSC – Angleton

Window panels are stored in the shed on the east side of Southern Brazoria CSC Building 1 by the parking lot.

Generators To further support its operations and return to services, the Center will provide and maintain generators. The Center will provide and maintain several small, portable generators; one mobile diesel unit; one diesel gas generator (Lone Oak Ranch) and one 80kw natural gas generator (Northern Brazoria CSC - Alvin). The Center will assure that carbon monoxide testers or other appropriate safety monitoring devices are installed at all locations that could be affected by generator use; and that staff are sufficiently trained in the generator operations and safety procedures.

Portable GeneratorsThe small, portable generators will be made available for minor service continuance. The Center’s Asset Management Director will coordinate their distribution and monitor use. At least two (2) staff persons at the facilities where the generators are stored will be trained annually on the operation of the electrical generator. Training will be documented and at least quarterly, either the Center's Facility Safety Officer or the Asset Management Director will inspect the generator(s) and document accordingly. For safe operation, the electric generators are to be operated outdoors, under an overhead shelter to protect them from the rain. Generators must be well ventilated at all operating times and never used or operated in a closed area or by untrained staff. The operator's manual is to be located with each generator and should be referred to for other safety precautions. Only unleaded gasoline can be used. Two (2) five (5) gallon safety-approved gasoline cans and two (2) 25' or 50' heavy duty, weather proof extension cords must be available for each generator. At a minimum, one or more of these generators will be located at the Lone Oak Ranch facility in Santa Fe, and the Administrative Services warehouse. These generators will be relocated as necessary to maximize usage and maintain services.

Mobile Diesel Generator UnitInstalled in August 2007, this generator unit is mounted on a trailer to facilitate relocation as may be needed by the Center and its services. Depending on the hurricane threat location, the generator unit will be relocated and properly secured, to provide immediate access after the storm’s passing. Re-location priority will be given to maximizing the Center’s resources so as to provide services as soon as safely possible. Regular, scheduled training

of 34

and maintenance will be conducted on the generator to assure proper operation and use. The Center’s Asset Management Director will have primary management responsibility of this generator.

80kw Natural Gas GeneratorInstalled in August 2007, this generator unit is located at the Center’s Northern Brazoria CSC - Alvin facility. This site was selected as it is also the primary location of the Center’s computer network system and servers. The generator system is tied directly into the facility to minimize service interruptions and maximize return to service options. Depending on damage and access ability, the Alvin CSC facility may act as the Center’s primary management site due to the location of this generator. Regular, scheduled training and maintenance will be conducted on the generator to assure proper operation and use. In partnership with the Center’s MIS Department, the Center’s Asset Management Director will have primary management responsibility of this generator.

Diesel Gas GeneratorInstalled in the fall 2009, this generator unit is located at the Center’s Lone Oak Ranch – main house – facility in Santa Fe. This site was selected as it is also a Phase One re-location for the Center’s residential program. The generator system is tied directly into the facility to minimize service interruptions and maximize return to service options. Depending on damage and access ability, the Lone Oak Ranch facility may act as the Center’s residential alternate site until the primary location can be re-accessed. Regular, scheduled training and maintenance will be conducted on the generator to assure proper operation and use. The Center’s Asset Management Director will have primary management responsibility of this generator.

Emergency Response Vehicle Acquired in 2011, the Emergency Response Vehicle will be available during a hurricane emergency to provide post-storm community assistance, and/or an alternate service delivery option in the event of major facility damage. The Center’s Asset Management Director will have primary responsibility for assuring operating procedures are in place. These procedures will be considered an integral part of those procedures, and referenced as an attachment accordingly. The Center’s Asset Management Director will be primary responsible for providing annual training to all staff with potential to coordinate the use of the vehicle. The Director Adult Mental Health Services in coordination with the Center’s Asset Management Director, will assure needed supplies and materials are in the vehicle, to assure its availability for immediate use following the hurricane emergency.

In addition to the Emergency Response Vehicle, at least one (1) of the Center’s larger vehicles will be identified, and secured for use as a possible mobile clinic should Center facilities suffer damage such as preventing access and service deliver. Additionally, at least two (2) other Center vehicles will be identified, and secured for use as support to the possible mobile clinics set up. These vehicles will provide staff working the mobile clinic sites options to provide assistance to those served at the mobile clinic site locations. These identified vehicles will be co-located with the Emergency Response Vehicles. For clarification, the intent in using the Emergency Response Vehicle or the alternate larger vehicle is not to operate a full clinic site; but provide a temporary

of 34

means to provide direct basic assistance and contact opportunities to those served during an emergency period. As best as possible, the vehicles will be parked on or near one of the Center’s four mental health adult clinics or on or near one of the Center’s two mental health child clinics. Decision of their utilization will be determined based on need, damage situation, and accessibility; as well as community need. The vehicles will be stored during the storm at pre-determined sites identified for other Center vehicle storage (3.5.9 Vehicle Preparation). Determination of the site will be made by the Director Legal Services and Asset Management Director; and will be based on intensity and direction of the incoming storm, and potential need post-storm.

Post Hurricane Emergency Needs The Center’s Asset Management Director will assure that the Center has available materials and supplies so as to make emergency repairs, pending completion of repairs and maintenance. The Center’s Asset Management Director will maintain a listing of available vendors to assist in completing needed facility repairs and maintenance; and will coordinate with these vendors for completion of repairs. Within twenty-four hours (or as safely possible) all Center facilities will be reviewed and damage assessed. The Center’s Asset Management Director will work with the appropriate insurance carrier for all claims and coordination of repairs and maintenance.

3.5.9 Vehicle Preparation

At the start of a hurricane emergency, all Center vehicles will be reviewed, fueled, and readied and remain that way throughout the threat period. Vehicle Custodians should assure that vehicle emergency equipment will be located and re-stocked as necessary. The Executive Director or his/her designee may during this time, re-allocate vehicles to essential staff or priority programs as deemed necessary. Priority will be given to those vehicles equipped with mobile radios, phones, or GPS systems; so that staff may remain in contact with the Center. Vehicles not assigned during this time will be located to previously identified vehicle storage areas. The Center will enter into an agreement with Santa Fe ISD for vehicle storage area – the highest location within Galveston County; and reasonably located to all Center locations. The agreement will be reviewed annually for continuance. The Center may also utilize space available at the Victory Lakes Park-n-Ride in League City; a Center operated facility completed in May 2012.

As hurricanes can develop quickly, Center vehicles should be readily available at all times. Throughout the Hurricane Season, vehicles are to be fueled and readied for immediate use at the close of each business day. Center vehicles should not be allowed to be left at or below 1/3 tank at the close of any business day.

3.5.10 MIS Preparation

The Center’s MIS Department will be primary responsible for providing oversight and management of the Center enterprise network system. The Center’s MIS Department will coordinate the security and safe-keeping of data files and back-up materials; and provide recommendations for security and maintenance of the Center’s computer equipment and enterprise network system. In the event of a hurricane emergency and computer service or access interrupted; priority will be given to critical clinical services. All back-up materials and diskettes will be properly secured off-site.

of 34

It will be the responsibility of the Center’s Director Information Technology or his/her designee to assure that the Director Legal Services and Asset Management Director are kept informed through-out the shut down and re-start procedures. Should the situation present, determination of priority programs and services will be that of the Executive Director or his/her designee.

Backing up Data FilesIn accordance with standard MIS Department recommendations, all Center staff are to back-up all Center-related computer files and data information on a regular basis to their designated folder on the centerwide network. This ensures that Center work is backed up nightly by the Center’s automated backup systems; and readily available in the event of a hurricane emergence. Staff having questions regarding computer back-up procedures should contact the Center’s MIS Help Desk for assistance.

All CMHC and associated system data is regularly backed up nightly by an automated back-up system in the Center’s MIS Department. In the event of an impending hurricane emergency, an additional back-up will be run just prior to initiating centerwide network shut down procedures. When the backup is completed and verified, it will be immediately transported to the designated bank vault in Alvin for offsite storage and safekeeping from storm damage.

Hurricane Readiness Teams AssistanceThe Center’s MIS Department will work with the existing hurricane readiness teams at each facility and service site to review and train on MIS related hurricane preparedness procedures and requirements. The hurricane readiness teams will be instructed by the designated MIS staff member on PC, printer, and laptop preparations prior to hurricane season each year. In addition, one person and a designated back up person from each hurricane readiness team will be selected to receive additional training on server shut down and re-start procedures. A list of these individuals will be compiled just prior to hurricane season; and provided to the appropriate Center staff including the Center’s Director Information Technology, Asset Management Director, and the Director Legal Services. The Center’s Director Information Technology or his/her designee is responsible for coordinating with the hurricane readiness teams and providing the necessary training each year. These trained individuals will also be trained in the coordinated shut down and restart of the Center’s telephone VOIP systems. All shut down and restart will be in accordance with technical guidelines established by the system vendor. Additionally, the Center’s Director Information Technology or his/her designee will also be responsible for scheduling and conducting a “practice” of network shutdown and restart procedures each year in preparation for hurricane season. This “practice” and results will be documented and follow-up provided. A copy of all will be provided to the Center’s MIS Director Information Technology, Asset Management Director, and the Director Legal Services.

Desktop ComputersOnce the order to secure Center facilities is given, the hurricane readiness teams at each facility will do the following:

1) Properly shutdown all facility computers and turn off peripheral devices (printers, scanners, etc.)

of 34

2) Unplug all computers and peripherals from the power sources and network outlets.3) Cover and secure all computers, monitors, and peripherals with plastic and tape

securely. 4) Plastic or plastic bags (preferably 4mil thick) should be carefully placed over the

computer and secured. Do not pick up and place the equipment in the bag; just place the plastic securely over and around the equipment.

5) The process identified above should also be followed for any additional electronic equipment located in the facility such as fax machines or postage machines.

6) Movement of computer equipment should be minimized to protect against inadvertent damage due to jostling or bumping. However, any PC’s or printers or other electronic equipment near a window, or in an area prone to damage from a storm, should be elevated and/or moved to a secure height and/or area. In addition, any computer related equipment (such as a surge protector, speakers, etc.) on the floor needs to be removed and placed on the desktop safe from rising water.

7) As best as possible, related computer equipment (i.e. CPU, monitor, speaker, key board) should be stored and secured together as a system. At a minimum, equipment should be properly labeled or identified for easy re-assembly.

8) Unplug all telephone handsets from the wall 9) Do not gather all computers and other electronic equipment to one central location of

the facility; instead maintain the computer and other electronic equipment disbursed throughout the facility.

Laptop RelocationAll staff with laptops should pack the laptop and all its accessories in the appropriate case. The laptop and case should accompany the staff member when they leave the facility. As always, staff will be responsible for the care and maintenance of the equipment while in their care.

Network Shutdown Remote Servers

Once all desktop equipment is secured and the final backups completed and verified, the Center’s Director Information Technology or his/her designee will initiate network shut down procedures. One facility at a time will be shut down. This entire shutdown operation will occur under the specific direction and coordination of the Center’s Director Information Technology or his/her designee. The shutdown will timed and coordinated so as to assure and maintain data integrity.

The “network trained” hurricane readiness team members at each site will follow the following procedure:

1) Shut down server2) Turn off the power switch.3) Turn off the power strip and the UPS4) Unplug electrical power cords from the electrical wall outlets5) Move the server up off the floor and secure in safe area. 6) Allow the server to cool and cover with plastic and secure with tape.7) Call Network manager and report shutdown complete.

of 34

Alvin Server ShutdownAfter all remote facilities are shut down and properly secured, the final step is to shutdown all the Alvin (primary location at the time of this at the time of this posting) servers and equipment. This will include the shutdown of the Center’s VOIP Telephony equipment. The Center’s Director Information Technology or his/her designee will perform this process with the assistance of other available MIS Department staff.

1) Power down equipment in accordance with each unit’s technical guidelines.a) VOIP Telephony b) SCO boxc) 2 Bui Serversd) back up servere) SQL server

2) Unplug power cords.3) Unplug power strips and switch off UPS’s. 4) Allow equipment to cool, and as appropriate, drape and secure with plastic.

Equipment must cool adequately to avoid formation of condensation under the plastic. Take great care not to disturb or damage any fiber optics, switches, and racks.

5) Shut down dedicated A/C unit, shut, and lock door.

MIS Facility PreparationIn addition to normal shutdown procedures followed by other remote facilities, the Center’s MIS Department will:

1) Take all training laptops and accessories and secure in appropriate case. Place each laptop and case up on a training table and drape and secure with

plastic. 2) Remove the LCD projector from the ceiling and place it in its appropriate case. Cover with plastic and store with training laptops.3) The Center’s MIS Department will assure that all of the Center’s purchased original

licensed software is properly stored in its appropriate case or box. The software will then be placed in large plastic bags, tied, and secured; then placed back in the software cabinet and lock securely.

Electrical Power in Tact to Server RoomAfter a hurricane emergency, the Center’s immediate priority with regards to MIS services will be to verify status of equipment and restore functionality of the Center’s LAN’s and WAN to the extent necessary to get CMHC and associated systems operational to support the re-opening of both adult and child medication clinics. The following is the order of priority in which facility equipment is restored to operational status:

1. 101 Brennen, Alvin (all servers and phone system)2. League City-Amegy Bank (MIS help desk and system monitor)3. League City Administration4. Texas City Clinic

of 34

5. Angleton Clinic6. Galveston Clinic7. Children’s clinic Anchor Point8. All others

Once the hurricane emergency has passed, the Center’s Director Information Technology or his/her designee will proceed to the League City –Amegy Bank facility to determine the status of the building, electrical power, DS3, T1’s and all other mission critical network equipment. Once safe entrance is determined or possible, the first task is to determine if electrical power remains intact. An inspection of the building and server room will be conducted. If standing water or flooding is noted, no electrical or network equipment will be started until the water has receded and the area is dry. It is the responsibility of the Center’s Director Information Technology or his/her designee to determine when it is dry enough to start the equipment.

If the area is dry and electrical power remains, normal re-start procedures of all servers and phone systems will be initiated. Re-start will be in accordance with the technical guidelines established for each server (SCO box, Exchange server, Bui servers, etc.). Once the main location of the servers and equipment are back on line, the Center’s Director Information Technology or his/her designee will contact the designated hurricane readiness team member at each additional Center facility by cell phone. The call will result in a status report on each building, its server, and computer equipment. Those locations reporting no damage and no loss of power will be given the “ok” to begin restart of their server. Each facility will be brought up only at the designated time and under the specific direction of the Center’s Director Information Technology or his/her designee. All will be coordinated via each facility’s designated cell phone. Locations reporting a questionable server status will have a Center MIS Department staff person dispatched. This staff person will make a closer inspection and determine whether the server and associated equipment can be re-started.

Once the servers are back on line, each facility will be given the “ok” to begin reconnecting computers and all peripheral equipment. The designated staffs from the hurricane readiness teams will assure that equipment is brought back on line slowly since power surges are likely after such emergencies. This also includes the re-start of all network printers. Each facility will report to the Center’s Director Information Technology or his/her designee when all equipment is reconnected and back on line. The Center’s Director Information Technology or his/her designee will review each LAN and the WAN to assure connectivity of the T1’s and the DS3. Any T1’s appearing out shall be immediately reported to SBC for repair scheduling.

If any one of the priority clinic sites is unable to achieve connectivity with the WAN, the Center’s MIS Department will dispatch laptop computers equipped with aerial internet cards to be utilized until such time that normal connectivity can be established. It will be the responsibility of the Center’s Director Information Technology or his/her designee to detail, report, track, and follow-up on all network connectivity related repairs.

Each facility’s designated hurricane readiness team member will complete a form identifying the number and problems noted with any PC’s or peripheral equipment during the reconnect and

of 34

restart procedures. These forms can be faxed or emailed to the Center’s MIS Department help-desk for initiating the proper action. Priority will be given to computers designated as essential to clinic operations. It will be the responsibility of the Center’s MIS Department personnel to provide a replacement computer, for use, until the priority computer can be repaired or replaced.

No Electrical Power To Server’sIf it is determined electrical service is not intact at the MIS main facility, the Center’s Director Information Technology or his/her designee will attempt to determine the length of time before service is restored. The Center’s Asset Management Director will provide consultation with the Center’s Director Information Technology or his/her designee with regards to power related issues; and act as primary contact with the power company. If it appears that service cannot be restored within 1-2 hours, the Center’s Director Information Technology or his/her designee will give the call to begin start-up of the supplemental generator. It is the responsibility of the designated Center MIS Department generator team to get the generator started and provide oversight of its safe operation during the entire time it is needed. The Center’s MIS Department staff will take shifts as necessary along with other designated staff to keep it running.

Only equipment necessary to bring up the servers and support the Alvin clinic will run with generator power. Non-essential equipment will not be powered up during the generator’s operation. The Center’s Director Information Technology or his/her designee will determine which equipment is priority following determination consultation with the Center’s Director Legal Services, Asset Management Director, and/or Chief Operating Officer.

Once power is provided to the building via the generator, normal system start-up procedures of the Alvin servers will commence. While generator power is in place, only priority sites will be brought back on line to limit the activity to this equipment. Priority sites will be contacted for status and each will be given the command to initiate start up procedures. In the event a remote site has an inoperable server, or is unable to achieve connectivity, the site will utilize laptops with aerial internet to connect with CMHC and other internet based applications necessary to clinic operations.

Disaster/Recovery PurposesThe Center’s MIS Department will maintain and post a Center MIS Disaster/Recovery Plan. The Center’s MIS Disaster/Recovery Plan will be separate and apart from hurricane emergency procedures; and cover catastrophic loss of Center equipment and/or damage to Center facilities preventing proper re-start or MIS operations. As related to hurricane emergencies and the Center’s post-hurricane emergency response as related to MIS services, if determined there is significant enough damage to the building and servers at the Alvin facility that the WAN cannot be properly and completely restored, MIS Disaster/Recovery procedures will be initiated. This will be at the direction of the Center’s Director Information Technology or his/her designee following determination consultation with the Center’s Director Legal Services, Asset Management Director, and/or Chief Operating Officer. The pre-storm back up will be taken to the designated Non-Center site per the Center’s MIS Disaster/Recovery Plan and loaded on alternate SCO box. Designated Center facilities and programs will achieve connectivity with CMHC via VPN connections to the designated disaster site.

of 34

Purchase, and/or repair of the affected equipment will then be initiated in accordance with the Center’s MIS Disaster/Recovery Plan. Once the equipment is repaired/replaced, normal network startup will be initiated.

3.5.11 Service Operations

All Center services will review and develop Individual Disaster Plans specifically for their service area; addressing pre-, during, and post hurricane operations. Consideration should be given to the following:

Adequate computer equipment to support needs, and provide access to forms. Alternative options should be considered; such as availability of hard copies of key forms, file folders, pens and pencils, paper, and storage containers.

Caseload listings; including basic consumer contact information MapQuest of consumer addresses (sorted by zip code)

Contract listings; including basic contact information Staff responsibilities and expectations Staff contact information Respite services for consumers and families Key program needs; including medications, lab services

3.5.12 Mental Health Medication Services Preparation

Mental Health Medication Services Hurricane Emergency Procedure Purpose:

- To secure and safeguard medications- To provide guidelines for assembling medications and other items necessary for medical

clinic operations - To identify options for medication provision in the event of an evacuation and/or

significant site damage- To identify those individuals most dependent on the Center for medication treatment and

promote a means to maintain that treatment in the event of an evacuation and/or site damage

- To identify a process to inform clients of Center procedures in the event of an evacuation and/or significant site damage

- To identify an out of area contact for each client

I. Pre-EvacuationA. Medication Inventories during Hurricane Season

1. Each county will maintain Crisis Medications in a container suitable for transport

2. An inventory binder will be placed in the transport container that provides for a perpetual inventory upon distribution of the medications

3. Crisis Medication Inventories will include at least the following:

ORAL Medications IM MedicationsAbilify Lorazepam IM or IV

of 34

Amitriptyline 25 mg (M-CSC, SB-CSC)Buspirone 15 mg Cogentin Ampule 1 mg 2cc Citalopram 20 mg (M-CSC, SB-CSC)Lexapro (samples) Diphenhydramine 50 mg IM Lithium carb 300 mg (M-CSC, SB-CSC)Prozac (fluoxetine) 20 mg Risperdal Consta 25 mg & 50 mgRisperdal (risperidone) 2 mg Haloperidol decanoateSeroquel XR 300 (samples) Fluphenazine decanoateTrazodone 100 mgZoloft (sertraline) 100mgBenztropine 1 mgClonazepam 1 mgDiphenhydramine 25 mg (M-CSC, SB-CSC)Hydroxyzine 25 mg

B. The following supplies necessary to support the operation of a mobile medication clinic will be placed in the Emergency Vehicle with a secondary supply at Southern Brazoria CSC:

1. Gulf Coast Center prescription forms, 1 package2. ETBHN prescription forms, #503. Medication Distribution sheets, #504. Disposable gloves, 1 box5. Return Appointment/clinic business cards, #1006. Alcohol preps, #507. Band aids, #508. AIMS forms, #209. Nursing progress notes (blank), #5010. Injection Records, #2511. Clozaril forms (1-2 week supply)12. Ink pens, black, #1013. Stapler, mini14. Tape dispenser, mini15. Paper clips, 1 box16. Legal pads, #217. Post It notes18. 10 manila folders19. 10 pocket folders20. Hand Sanitizer, waterless21. Paper towels, 1 package22. Spray disinfectant23. 2011 calendar24. Brown lunch bags, 1 package25. Zip-lock bags, 1 box26. Medication Consent Forms, #2527. Lab requisitions, #25

of 34

28. Syringes (two week supply)29. Vacu-tainers (#25)30. Tourniquet31. Stethoscope32. Sphygmomanometer 33. Thermometer with disposable covers34. Stock bottle Diphenhydramine, #40035. OTC analgesic (ex: Tylenol or Advil)36. Mini brown envelopes 37. Sharps container, small38. Bio-hazard bags39. Flashlight with extra batteries40. Physicians’ Desk Reference (PDR) in electronic format41. Medication Services Manual42. Scissors43. First Aid Kit44. Disposable masks45. Insect Repellant46. Sun Screen Lotion47. Local Community Resources (food/shelter/emergency assistance)

B. Risperdal Consta1. Each clinic shall keep in reserve an insulated container adequate to

transport the clinic inventory of Risperdal Consta 2. Four packets of gel ice-substitute will be kept frozen at each clinic for the

transport of Risperdal Consta 3. An inventory log shall be maintained for placement with the Risperdal

Consta if transport is necessary

D. Pharmacy Services1. East Texas Behavioral Health Network (ETBHN) Pharmacy

a. Phone: 800.564.6701b. Fax: 800.564.7591c. Address: 2704 Homer Alto Road

Lufkin, TX 75904d. Emergency contact: 936-240-5808, cell # Laura Steelmane. Commercial carriers (ex. FED EX) will likely refuse to enter Galveston and Brazoria Counties after the issuance of a Hurricane Warning or Evacuation Order (even a Voluntary Evacuation Order). At such time, Gulf Coast Center shipments may be directed to a Harris County address, as appropriate for delivery and distribution by Center personnel

2. Clients will be instructed to take Rx bottles with them in the event of an evacuation, regardless of the quantity remaining in bottle (if a significant hurricane impact occurs, pharmacies will likely honor the refill of prescription when presented with intact orders on a pharmacy bottle). In the event that clients, dependent on the Center for medication provision (have no pharmacy

of 34

benefits) needs refills during an emergency situation and the Center is not able to provide the medications, the Center will provide reimbursement for client purchased medications according to the following guidelines:

a. Only formulary medications prescribed by a Center physician’s current order b. Legible pharmacy receipt is presented to clinic staff, itemizing

medications (Center to keep original and return a copy to client)c. An initial 2 week supply will be reimbursed; if Center operations are

compromised for a longer period of time, additional quantities will be considered as warranted

d. Reimbursement amount not to exceed $500 per person e. Lost medications will not be reimbursedf. The guidelines in this section will be made available to clients as

appropriate (ex: attachment #1 provided at time of clinic visit & also posted in clinics)

E. Medication Evacuation Bags 1. To be distributed to all MH Adult clients at the beginning of Hurricane Season

2. Quart or gallon size zip-lock freezer bags, with the following attached on 3” x 4” mailing (waterproof) label:

NAME: ___________________________________ADDRESS: ___________________________________

___________________________________EMERGENCY CONTACT & #:____________________

___________________________________PHYSICIAN: ___________________________________THE GULF COAST CENTER (fill in clinic #)EMERGENCY MED LINE: 281.585.7300ALLERGIES: ___________________________________

Place all medications in original bottles in this bag. Also, consumers should be reminded to bring a picture ID.

3. Designated clinic personnel will fill in the appropriate information in the label blanks, explain the Medication Services Hurricane Procedures (per attachment #1) to each client and place a copy of attachment #1 in the client’s Medication Evacuation Bag, advising the client to keep the bag in an accessible location

G. Identification of an Out of Area Contact Each client will be asked to identify an Out of Area Contact by name and phone number. This information will be listed on a printed label and will be adhered to the inside front cover of the chart binder.

H. Individuals most dependent on Center for Medication Treatment--

of 34

During Hurricane Season, the clinics will maintain a folder with copies of the most current physician orders and an inclusive listing/spreadsheet for:

1. Risperdal Consta2. Invega Sustenna3. Haldol (haloperidol) Decanoate 4. Prolixin (fluphenazine) Decanoate 5. Clozaril/Fazaclo/clozapine

II. EvacuationThe Medication Assistance Director and Staff (as identified by the Director Adult Mental Health Services) will be responsible for the evacuation of medications and medical supplies in the 4 clinics, as appropriate, depending on the particular circumstances. Two individuals of this group will have access to each clinic so as to provide back up if an after hours / weekend evacuation is necessary. Additional staff may be asked to assist as appropriate, depending on the particular circumstances.

III. Post-EvacuationThe Medication Assistance Director and Staff (as identified by the Director Adult Mental Health Services) will assist in coordination of the delivery of medications and supplies to a determined rendezvous site if clinics are not operational.

3.5.13 Consumer Support Services Preparations

The following outlines the primary steps that would be taken in the event of a hurricane emergency by the Center’s Consumer Support Services. Consumer Support Services (CSS) has primary responsibility for the maintenance, coordination, and oversight of consumer related funding and emergency support opportunities; including consumer payee bank accounts, and available flexible funds. All confidential records within and related to CSS will be properly secured in metal locked cabinets.

Hurricane Threat DevelopsConsumer Accounts

Per CSS Consumer Accounts procedures, payee consumers will have emergency funds budgeted during the hurricane season, June through October each year.

Consumers will be provided their budgeted emergency funds at the initial phase of the emergency alert

CSS Consumer Accounts staff will distribute consumer emergency funds to each clinic and identified case management staff will distribute to consumers.

Computers and Printers will be covered and all equipment removed from the floor and covered as instructed by the Center’s MIS Department.

Checks will be secured in a locked box and removed from the facility by the CSS Specialist; as approved by the Center’s Executive Director or his/her designee.

As instructed by the Center’s MIS Department, the Cfm and Cfm2 program files (CSS software system) will be backed up as required and downloaded on to an approved portable data storage device for transport and maintenance by the CSS Program Director.

of 34

Post HurricaneConsumer Accounts

The CSS Specialist will be available at the identified location, or GCC mobile clinic units for consumer account assistance if Center network is inaccessible.

Using the portable data storage device back-up for maintaining the Cfm and Cfm2 programs, accounts are verified and consumer checks are manually issued as needed.

All disbursements will be posted manually to a spreadsheet for future transfer to program system.

3.5.14 Mental Health Children’s Hurricane Procedures

PurposeThe intent of this hurricane procedure is to describe the process Child & Adolescent Mental Health Services will follow in the event a local disaster of any kind leads to the inability to operate the respective clinics as usual. Disaster impacting the local community yet not resulting in significant structural damage to the operation’s assigned facilities may result in a response from Child & Adolescent Mental Health Services as requested and directed. An organized response to a disaster is subject to change in legislation and redefinition by state committee and therefore may be revised in the event of a disaster as required or necessary. Child & Adolescent Mental Health Services will follow Procedure: 3.00.04 Hurricane Emergency Procedures as the overall governing policy for step by step procedures set below.

DefinitionsEssential Staff – Refers primarily to Children Leadership Staff.

Emergency Supplies – One plastic tub per clinic location consisting of the following: Prescription tablets including triplicates #1 package; Disposable gloves #2 boxes; Return appointment/clinic business cards #100; Hand gel #4 bottles; AIMS Form #10; Black ink pens #1 box; Mini stapler #1 and staples #1 box; Tape dispenser and tape #1; Paper clips #1 box; Regular note paper #4 tablets; Post-it notes #1 package; Manila folders #1 box; Paper towels #1 package; Spray disinfectant #1 bottle; Current calendar #1; First aid kit #1; Stethoscope #1; Pediatric and adult blood pressure cuffs #1 each; Flash light with extra batteries #1;

of 34

Current PDR #1; Current DSM #1; Consent for Treatment #1 package; Mutual Exchange Verbal Consent #2 package; Written Information Consent #2 package; HIPAA Privacy Practice #1 package; Printed Microsoft Word Template for manual documentation if needed #20; Physician Team Medication Evaluation Form #20; Printed Microsoft Word LPHA Admission Evaluation Template for manual

documentation if needed #20; Printed Microsoft Word Financial Template for manual documentation if needed #20; Coloring Books, Crayons, Reading Books, Story Books and puzzles as available and

appropriate.

Emergency Roster – Pyramid listing of all staff currently assigned to Child & Adolescent Services.

Priority Staff – As defined by Center Hurricane Emergency Procedure 3.00.04.

Disaster Preparation Education Service – Assure the following key elements are reviewed with families:

Child’s medication function, dosage, side effects, and medical dangers associated with abruptly stopping medication;

Completion of a provided template allowing client’s medication name and dosage to be listed including physician name, Center staff assigned, Center Crisis Hotline number and Center address;

Provide families with self adhesive name tags allowing guardians to write their child’s name, address, parent name and cell phone to be attached to their child during actual evacuation;

Coping strategies and development of a plan of action for families specific to preparation for hurricane evacuation.

Psychological First Aide – Evidence-informed modular approach for assisting children, adolescents, adults, and families in the immediate aftermath of disaster and terrorism.

Center – The Gulf Coast Center

Hurricane – Severe tropical weather system as defined by the National Weather Service. For these procedures, this may include any identified tropical weather activity such as tropical wave, tropical depression, tropical storm, and/or hurricane.

Phase Down – Refers to the period and activities that will occur prior to the Center’s operations being closed completely in response to a hurricane emergency. May include non-medical care activities being discontinued, consumers being sent home or assisted with emergency information, or staff being reassigned to critical service areas to assist and/or provide additional support.

of 34

ResponsibilityIt is the responsibility of the Director of Child & Adolescent Services to make certain that procedures are practiced as indicated. Director of Child & Adolescent Services will identify key staff to assist with implementation of procedures set forth.

Hurricane Threat Develops Essential Staff are put on alert; Review emergency supplies and re-stock as necessary; Review Service Area Emergency Roster; Vehicles reviewed, fueled and readied; Begin notifying consumers and families to prepare for emergency; Implement education service specific to disaster preparation for families; Attempt to coordinate and assist admitted families in the process of refilling or filling

prescribed medication to assure medication supply of 30 days for client; Identify any families without evacuation transportation or location to evacuate to in order

to provide referrals of resources as available – accessing emergency funds as available; Secure or clear all outside items, furniture, and equipment at each Child & Adolescent

Service Clinic location; Regular updates / status reports provided to all Child & Adolescent Staff.

Watch Declared Child & Adolescent Emergency telephone pyramid initiated; Assure all staff has the current Child & Adolescent Emergency Roster, Center Website

Address, Center and Service Area Disaster/Emergency Procedures; Alternate service sites finalized and discussed with all Child & Adolescent Staff; Assure staff have their assigned lap tops with note templates in Word; Instruct staff to evacuate with their assigned lap top; Three (3) Child & Adolescent Facilities secured; Desktop computers secured as required by Center policy; Essential staff identify staff to phase down as necessary within current situation; Phase down staff as possible and priority staff excused; Assure all families reached have access to 30 day supply of all prescribed medication for

client.

Warning Declared Vehicles secured at location required by Center policy; Services discontinued; Remaining staff dismissed; Essential staff to take emergency supplies off site in evacuation.

Post Storm Facilities assessed to determine availability of regular operation; Re-set facility to pre-storm operation; Participate in local emergency response and support;

of 34

Coordinate services resuming under regular operation if no structural damage impeding that operation is evident or under use of alternate service site;

Assure all staff have their assigned lap tops; Disaster resulting in working off line staff will utilize Word templates to document their

services provided until brought back on-line; Initiate provision of Psychological First Aid to clients and families served as appropriate.

3.5.15 Attachments

1. Centerwide Emergency Telephone Listing (1) and Attachment (1A)2. Consumer Evacuation Recommendation Form3. Emergency Response Vehicle Operating Guidelines (Separate Attachment)

of 34

ATTACHMENT #1 (3.5.15)

Centerwide Emergency Telephone Listing (1) and Attachment (1A)

of 34


Consumer Evacuation Recommendation Form

of 34


Emergency Response Vehicle Operating Guidelines (Separate Attachment)

of 34

The Gulf Coast Center · Web viewProcedure: 3.5 Hurricane Emergency Procedures. Policy Reference:...

Documents

Transcript of The Gulf Coast Center · Web viewProcedure: 3.5 Hurricane Emergency Procedures. Policy Reference:...