EXAMPLE Community-Based Workshop Caring for Elders During Disasters

EXAMPLE Community-Based Workshop Caring for Elders During Disasters

EXAMPLE Community-Based Workshop Caring for Elders During Disasters Photo courtesy of The Baton Rouge Advocate / 2005. Welcome & Introductions Lead Team: Theresa Isaac, Director Office of Emergency Preparedness Duval County Health Department Captain J. Stephen Grant Health & Medical Coordinator Jacksonville Fire & Rescue Department Linda Levin, Executive Director ElderSource / Aging & Disability Resource Center 2 Project Team: Ray Runo, MPA, Project Director Disaster, Strategies, & Ideas Group

Shirley Hunziker, RN, LHRM Clinical Risk Specialist, RB Health Partners April Henkel, Project Manager Florida Health Care Association Virginia Walker, Project Assistant RB Health Partners 3 Elder Care Stakeholders Introductions Around the Table Your Name & Organization In a couple of sentences, what does your organization do to support/serve seniors in Duval County? 4 Workshop Purpose Identify

elder care stakeholder roles & responsibilities in providing healthcare for elders during disasters Describe stakeholder dependencies & interdependencies Provide planning resources and tools to community stakeholders Support the integration of elder healthcare and support stakeholders into local emergency management communities Provide a tool for developing a local continuum of elder care (examples, directions)

Project Purpose & Overview Healthcare Systems Needs Analysis for Elders During Disasters A project funded by the Fla. Dept. of Health 6 Project Origin and Purpose Our History and Experience Project Rationale & Need for the Project Vision During disasters, the complex health and medical needs of Floridas elder population will be met. Mission To develop and implement a comprehensive methodology for identifying and

codifying disaster roles and responsibilities for the many stakeholders comprising the continuum of healthcare for Floridas elder population during disasters. 7 Three Year Project Identification of Elder Care Stakeholders Established a Core Planning Team Conducted regional stakeholder workshops Analyzed stakeholder roles & responsibilities Developed Continuum of Healthcare for Elders During Disasters & Planning Considerations (and tested the model) Preparing Communities to Care for Elders During Disasters the Community-Based Process

8 Elder Care Continuum Stakeholders County Emergency Management (EM) & Health Department (ESF8) Area Agency on Aging (AAA) 2-1-1 agencies (information and referral network) Alzheimers caregiver support organizations Behavioral Health Providers COAD / VOAD (when active in a community), including Red Cross Councils on Aging / Senior Centers / Other aging network provider organizations Emergency Response Agencies (e.g., EMS, fire, law enforcement) Energy providers Home health agencies & geriatric care managers Hospitals & other healthcare providers (e.g., clinics, medical equipment, VA) HUD housing (for seniors) Nursing homes, assisted living facilities & continuing care retirement communities Pharmacies Renal dialysis centers Selected Govt. partners (Dept. of Elder Affairs; Co. Health Dept.; Agency for Health Care Admin.; Adult Protective Serv./Dept. of Children & Families; Veterans Affairs) Transportation providers

OTHER groups important in the healthcare continuum for elders in the local community 9 The Community-Based Planning Process & Continuum Framework 10 The Community-Based Planning Process Identifies, engages and integrates all key stakeholders involved in elder care during disasters Results in specific solutions to improve the communitys capability to care for elders during disasters

11 Why is this approach needed? Emergency planners often lack awareness of the vulnerability and complex care requirements of many elders The scope of healthcare stakeholders for elders is broad and complex with many dependent and interdependent roles and responsibilities to coordinate and integrate Communities (& stakeholders) have varied levels of preparedness, planning & response capabilities/capacities Elder care stakeholders may not be actively

integrated into the communitys emergency management planning 12 Planning for the care of elders during disasters begins with an understanding of the communitys Healthcare and Support Continuum for Elders 13 Continuum of Care - Assumptions Individuals are unique - common care & support services. Condition and needs will change over the term of the disaster (decompensation).

In a disaster environment, healthcare, services and support will be limited, temporarily unavailable, or absent. Expect negative outcomes when the continuum is disrupted or broken. A communitys resiliency depends largely upon its augmentation and/or replacement strategies. 14 Continuum of Healthcare & Support for Elders ~~ A Complex System ~~ Social Networks Hobbies & Interests

Faith Based Support Community Support Services Medical Equip. & Supplies Electricity (e.g., Food Bank) Senior Centers & Activities Transportation Water Family support Home- &

Community Based Services Home Health Care Food Caregiver Support Vulnerable Elders Medicine Personal Disaster Plan Healthcare Facility Heathcare

Retirement Communities Federal Disaster Resources Air / Oxygen Personal Residence (Medical Services) Assisted Living Community Disaster Plan Shelter

State Disaster Resources Resources 15 On a Sunny Day in a Typical Community: Proportional Use of Healthcare Systems & Supports by Elders 16 On a Rainy Day in a Typical Community: Shifts in Proportional Use of Healthcare Systems & Supports by Elders 17

Proportional Shifts in Care & Support Event Duration, Scope, and Severity 18 Elder-Focused Planning Considerations Elders require a comprehensive approach to disaster-based planning considerations: #1 Elder community profile what are the characteristics of your elder population and who are the community stakeholders that serve them? #2 Risk identification and management how vulnerable are your elders? #3 Continuum of healthcare and support systems for elders who are your stakeholders and what are their dependencies, and interdependencies? #4 Community preparedness & response planning for elder populations how integrated and comprehensive are your stakeholders emergency plans 19 (your continuums stakeholders)? Planning Consideration #1 Characterizing the Elder Population

Elder demographics and locations Residential Areas/Mapping Service Providers (stakeholder groups) Elders living independently Elder Behavior during Disasters Evacuation behavior (Dont move my cheese!) Use of healthcare services & supports Elder healthcare system demands versus community capabilities 20 Planning Consideration #2 Risk Identification and Management Community Specific Clinical

hazards and vulnerabilities hazard impacts on elders risk factors for elders Morbidity and mortality issues Decompensation Strategies for managing elder risk factors 21 Planning Consideration #3 Continuum of Healthcare Systems for Elders During Disasters Similar to the continuum of care concept in aging services there are many stakeholders in the continuum of healthcare & support services

Reflects functional roles and responsibilities, relationships, dependencies, and interdependencies that link stakeholders together on behalf of elders during disasters Supports the identification of gaps in the healthcare continuum for elders during disasters 22 Continuum of Healthcare ~~ Normal (Sunny) Day ~~ Medical Equipmen t& Supplies Family Support Home & Comm.based Services Medical

Support Services Medicatio ns Mrs. Brown Transp. Services Utilities Faith Based Support Social Supports (e.g. friends; neighbors; senior center) Food and

Water Green = OK Yellow = Reduced Red = Off-line 23 Continuum of Healthcare ~~ Disaster (Rainy Day) ~~ Family Support Utilities Home- & Comm.based Services Faith Based Support Time Progression Decompensation

Medical Support Services Mrs. Brown Medical Equip. & Supplies Social Support Services Transp. Services Food & Water Green = OK Yellow = Reduced Red = Off-line Medicatio ns 24

Continuum of Healthcare ~~ Disaster (Rainy Day) ~~ Shelter ? Hospita l? Family Suppor t Utilities Home & Comm.based Serv. Medical Suppor t Service s Faith Mrs. Brown

Transp. Based Service Suppor s t Food Medical & Equip. Social & Water Supplie Medica Support s Service tions s Time Progression Continuum disrupted Advanced decompensation

What next? Family/friends? Shelter? Hospital? What are the communitys planning contingencies? Green = OK Yellow = Reduced Red = Off-line 25 A Stakeholder Example Other Transp . Provider s Nutrition Providers

CCE Provide rs Contract Services / Vendors Admin (payroll) Volunteers Physical Plant / Maint. Area Agency on Aging Continuum Senior Center Info. &

Referr s al Service s Electricit yUtilities Phones Info. Tech. (IT) Off-Site Facilities (other AAA offices) Green = OK Yellow = Reduced Red = Off-line

Hurricane Impacts: Essential Systems Reduced or Off-Line Transp. Provider s Admin (e.g. payroll) Volunteers Nutrition Providers Area Agency on Aging Senior CCE Providers Center s Info. &

Referra l Service s Physical Plant / Maint. Electricity - Utilities Phones Off-Site Facilities (other AAA offices) Info. Tech. (IT) Green = OK

Yellow = Reduced Red = Off-line Another Stakeholder Example Admin Other . Trans p. Contract Services / Vendors (e.g. payroll) Funding (e.g. govt., UW) Volun- teer

Servic es Service s Phys. Plant & Maint. Health / Serv. Staff Senior Center Case Mgrs. Caregiver Suppor ts

OffSite Facilities (e.g. meal sites) Info. Tech. (IT) Activit y Staff Utiliti es Phone s Green = OK Yellow = Reduced Red = Off-line Another Stakeholder Example

Admin Other . Trans p. Contract Services / Vendors (e.g. payroll) Funding (e.g. govt., UW) Volun- teer Servic es Service

s Phys. Plant & Maint. Health / Serv. Staff Senior Center Case Mgrs. Caregiver Suppor ts OffSite Facilities

(e.g. meal sites) Info. Tech. (IT) Activit y Staff Utiliti es Phone s Green = OK Yellow = Reduced Red = Off-line Planning Consideration #4 Community Preparedness & Response Planning for Elder Populations

Planning requirements legislative & others Planning guidance tools and resources Response triggers and contingency plans Identification, involvement, and integration of community partners What service and support systems exist? Integration into local EM and ESF 8 planning, training, and exercise programs 30 Local Perspectives Characterizing the Elder Population in Duval County Disaster Risks & Vulnerabilities

Community Preparedness & Response Planning 31 Using the Healthcare & Support Systems Continuum 32 Individual Stakeholder Continuums 20 minutes Stakeholder Analysis Individually Write or in Stakeholder Groups your organizations name in the center Outer petals who/what does your

organization depend upon to deliver services? Discussion: Surprises? Whats Missing? Whos Missing? 33 LUNCH ON YOUR OWN SEE LIST OF NEARBY OPTIONS 34 Scenario-Based Discussion Module 1 Pre-Landfall Foreseeable Consequences and Impacts ~~~ Booklet ~~~ 35

Scenario-Based Discussion Module 2 Post-Landfall Known Consequences and Impacts ~~~ Booklet ~~~ 36 Summary What were the todays key findings (gaps issues stakeholders) How will Duval County sustain todays momentum? Planning Training Exercising Evaluating

37 Where do we go from here? 38 Duval County Work Group Facilitates the Planning Process by Providing ongoing guidance and direction for the community-based planning process Identifying additional key stakeholders involved in the Duval County healthcare and support continuum for elders Developing integrated after action plans to resolve gaps

Actively facilitating the integration of stakeholders into the Duval County emergency management system Workshop Evaluation What was the value of todays workshop? How can we improve on the workshop format/content? Other comments/questions? (please complete the feedback form) 40 ~ For More Information ~

Duval County Lead Team: Theresa Isaac ([email protected]) Stephen Grant ([email protected]) Linda Levin ([email protected]) Project Team: Ray Runo ([email protected]) April Henkel ([email protected]) Robin Bleier ([email protected]) 41

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