Nursing Care Plans Templates

***some technical difficulties****okay, having a problem getting the slides to move, if you want we can start over again.not sure where the problem is with the settings. oh, okay, now i think we’re there. ok, howabout i go back and we’ll start over again. what i want to do now is jump into the programthat we’ve been offering for a few years here. first thing i would like to do is goover the discussion of what we think an emergency management program (emp) should be for a communityhealth center. we always want to remind folks what it is that is important to them and whycommunity health centers play a role. the community health centers (chcs), the vulnerablepopulations and you all know this but the populations that you serve are the ones yousee most at risk during disasters. we’ve

had quite a few down here, and i think katrinawas the number one event where we had a lot of high-risk, uninsured, low-income patientsget moved from mississippi and louisiana, and a lot of them ended up in alabama. wesaw first hand the type of patients that need a lot of care, and community health centersdo that, and with our help, with the disaster plan and some training to help them work throughthe issues prior to these events happening. and it’s a huge, huge population.these are those groups that we talked about and there are a lot of those in alabama, andif you looked at the vulnerable populations of the uninsured, poor and rural, the communityhealth centers as a whole have said that with the right kind of planning, organization,resource management they could conceivably

manage up to 20 or 25% of the population inalabama, which is in the neighborhood of a million people. so there is a huge role forcommunity health centers, and we want to capitalize on what you all do. now the future role, nobodyis quite sure, but i do know there’s been talk of expanding the role of chcs, increasingthe numbers, and if that happens and those numbers go up, i think it’s logically, thatthe number of people who will be helped during the event, that will, that will increase aswell. we always like to start by defining wherechcs need to begin to process; we start with this center line across meeting the disaster,and meeting the challenge, the hazard throughout assessment, we think that htva is importantbecause it sets the rules for those things

you need to plan for: tornadoes, obviouslyin alabama, the terrorism events, although they are not likely or possible, we have problemswith hurricanes. center part of the us, the memphis-st. louis area is definitely proneto the earthquakes, as california, and then all the other disasters, including infectiousdisease outbreaks. those things are all important for chcs to plan for and as they define therisks. then we begin this process up at the top, of looking at the risks and threats,go back and look at lessons learned, what have other people learned from past experiences,and help write plans and do some training based on real events. those things reallytend to stick with people. the commitment to leadership has never beena problem in chcs. we want to stress incident

command, we want to stress disaster planningand the commitment and leadership in chcs is always, always really, really good in alabama,and hopefully that’s everywhere. that’s never been a problem, the building of foundationcapabilities: tools, templates, that’s where we kind of step in and help. we see disasterplans that are in place, some are good, some are not so good. we offer templates, guides,documentation that can be embedded into the plans, we help them with resources and supplies,and we most definitely what we do is training on everything from biological, chemical, radiologicalsurge, all the way to incident command. i would say we got 14-15 topics that are availablethat build on these capabilities, tools, templates and training. and that’s where we can bea lot of help.

the mandates and the legislation are thosethings that, you know there are two reasons why you do planning: one is, it’s the rightthing to do, and the other is someone says you have to do it. and that’s where themandates and legislation comes in. nims, joint commission, sometimes state, and local requirementswill look at those and see what requirements you have and make sure that you cover theminimum of what you should be doing. and really these mandates and legislation are all intendedto, to build on because it’s the right thing to do. so we don’t discourage it, we justwant to make sure that you know everything that we believe you’re required to do. andthe last part of this circle is the collaboration and partnerships, that’s probably the mostimportant. we really believe that about 80-90%

of disaster response is knowing the rightpeople to call for help, and knowing that if you call them, they will answer and theywill help you. community planning, working with public health emergency management, otherhealth care facilities, ems, public health, ema; all of those folks build this collaborationand partnership. so all of this is really the foundation of everything we go into withchcs and offer them. things that we ask them to consider, and alot of places will say, “well, we don’t, we wouldn’t do all of these things duringa disaster”, but, unfortunately, there’s evidence that you will do all of these, maybenot all at one time. of course you do manage your internal issues, potentially mass here,that’s not something that you would do on

a daily basis, mass casualty care is possible.this sorting and triage, we have some examples of that: helping hospitals with overflow,chcs taking primary care, hospitals taking emergent cases, but that’s that collaborationin the relationship building. all of these things, i could read them all to you but youcan see that there’s a possibility that every one of these things would play a rolein a community health center response. in alabama, and i suspect everywhere, thereare all types of facilities that would provide care during a disaster. we saw in mississippi,louisiana, not very far from here, probably as close as 40-50 miles, we were seeing, alot of the temporary facilities set up. and the reason the temporary facilities take onsuch a role, is that these permanent sites

are either overflowing or damaged or not functioning.and in that permanent site of the chcs, you have anywhere from one clinic to, some agencieshave 8 or 10 or 12. so where as a couple of clinics might not be usable, the other 6 or7 or 8 are. sometimes the chc’s staff will help over in these temporary sites, for massshelters, medical needs shelters. so again this gets back to the collaboration; whatcan you do in your community? what sorts of assets, capabilities do you have? can youmanage your own, can you help any others? i think this whole picture needs to be understoodfor everybody to, you know, relate best to each other.when we look at a program, there are three basic elements to any emp and each facilityneeds to consider these core elements of,

you know, protecting human rights, resourcesand protecting your physical plant. and business continuity means, how do i stay open and continueto function. those are universal for everybody if you convert that over to a community healthcenter i think those three elements are protecting your staff and make sure they can come inand function and feel comfortable about being there. protect you chc patients that’s probablynumber one, however, protecting your staff very well may be number one because if youdon’t have the staff you can’t take care of the patient. but keeping your patient safe,providing the good continuous care that really is the operations of the agency, and thencontinue to deliver that health care which is your continuity of operation. we take thesethree components and build off of them, to

build this program. also in that, we ask thechcs to consider the four phases that everybody has to consider: the mitigation is do youdo pre-event planning, do you put things in place to protect you when bad things do happen,this is the thinking ahead and pre-planning. the preparedness would be something like adisaster plan, having training and exercises, those things prepare you to respond. and that’sa big piece of it. the response activity, to me i think winds up being the easiest part,because that is the health care piece, that’s where you take care of the patients, you takecare of patients like you do everyday. the response piece might be difficult but, tome, i think it’s probably the easier. and i the fourth stage that we have to factorin is the recovery. how you put things back,

how do you return to that pre-disaster level,how do you get staff back on a regular schedules, how do you get resources replaced, how doyou put your buildings back. so these four phases are key to any emp plan and i thinkthat it all applies to chcs. now the good thing is that all, all emergencies,no matter how big they are, nationally, or state-wide or regionally, most of the timeyour involvement is very local. it’s your little world, it’s where we say it’s limitedin scope and range, everybody always used to say that every emergency is local, wellthat’s because you see what you see, you do what you do. and the good thing is you’rejust one piece of this huge event. that then sort of limits how big and how bad it canbe, if you are in the wrong place at the wrong

time, and those things do happen and it couldoverwhelm you. the good of all of this is that most of the time, your level of involvementis somewhat limited based on population, where you live and who can come and help. so it’snot nearly as dire as sometimes we make it out to be.so at this point we always ask: “where’s your emp?” we ask about their plan: do theyhave one, have they started talking about incident command, do they meet regularly,do you have this in place, something that’s reviewed once or twice a year and just whereare you. so at this point we’ll take a break and then we move into the next piece, todaywe’re not going to take a break, but i’m just explaining how we do our training ateach site.

so at this point we move over to the nextsection, which kind of gets into the nims/incident command/ national response framework. thisis where we talk about the things that we have to do. the nims program is a nationalincident management program. it says that you have to do things a certain way, incidentcommand, is the command structure everybody must have and the national response framework,is sort of like the national plan. nims/ics/nrf and this statement at the bottom: “whileit is not a requirement for chcs at this time, compliance with nims is strongly encouraged.”what that means is that for the last few years, hospitals had to be compliant with nims, whereaschcs have not. however, you notice on the bottom, changes as of july 1st, the new guidelinesfor nims have come out and in the new guidelines

it says: all healthcare facilities will. soi think we’re going to see some changes as of july, where we might go from is stronglyencouraged to is required. but that will define itself over the next few months, and i thinkas we get closer to july, we’ll have a better idea of what chcs must do as far as optionalor mandatory compliance. nims is the standardized system that says we want all response agenciesto look, and act and feel the same. it’s a national approach. and really it’s madeof 5 basic pieces that everybody must comply with. i hate to use the word comply, but ifyou want to have a good program you have to kind of comply with, with the guidelines.those five things are organizational structure, plans, training, and exercises, sorry aboutthis, this word organization should be over

here, i think we just had a… the slidesare off a little bit. but organizational structure, plans, training, exercises, resources, communicationand technology. every agency must do these five things, and this word organization shouldbe in the circle because that’s what implies that if you do nims correctly, every agencyis organized and structured the same way. meaning structure, incident command, you havean incident commander, you use the system during disasters. everybody has a disasterplan and the plan is consistent. plans are sort of uniform from agency to agency. weall train and exercise on the same things, and we do this regularly, once or twice ayear. resources: everybody has to understand howto manage their assets. i think the resources

are probably the most vulnerable and theyare the most likely to put you out of business. you can work around staffing shortages, canwork around building, you can in some ways work around money, but if you run out of medicalsupplies and equipment, and you don’t have those things in your hand to provide care,that really limits what you can do. i think that’s vitally important; i think resources,even as much as command, plans and training, maybe even more. the stuff you have to treatpeople is critical. and then the fifth component is do you have communications and technologythat all other agencies use to maintain that link. our goal is to ensure that everybodydoes these 5 things to create organization. now the nims outline of the 11 elements, we’redon’t, we don’t have time to go through

those today, but i’ve included those ofjuly 1st. and basically it talks about adopting nims, being nims compliant, and money andawards that you get and revising your plans, do you have mutual-aid agreements, the trainingand exercises. these are fema courses 100, 200, 700, 800, that we encourage chc folksto get. do you apply nims and incident command to training and exercises? this is the playlike you practice and practice like you play theory. do you have the processes, equipment,data interoperability; all of these 11 things are consistent with the 5 things we talkedabout on the previous slide. these are the 11 principle elements of nims, that some pointi believe there will be a compliance of these 11 and can you verify to someone, that you’vemet all these requirements, maybe july, we’ll

see.incident command is the structure that says how we are going to run our agency duringan event. we talk about this at length because it’s a very military/police-like structure.it gives people this management system based on military and fire chain of command. youwill hear these terms: military, police and fire a lot, chief officer, commander, thosesorts of terms. and even though we’re not used to these terms in healthcare, it helpsus relate to all the other service agencies and response agencies in the community sothat when we do collaborate, we’re using the same terms, references, names, ideas.it creates that uniformity and everybody is using the same structure.its just like in the military, there are ranks

that are consistent across all branches ofthe service, so if you call someone a colonel you know what that colonel does. and you knowtheir position. and ics creates somewhat of that same environment, the terminology andstructure and you know who does what based on the fact that everybody’s doing it.incident command is critical. all of these characteristics we go over. we talk aboutthe terminology, the modular organization, meaning what does your chart, organizationalchart look like, how do you manage an event by the objectives and come up with a workingplan that’s a live plan during the disaster, we make sure everybody understands chain ofcommand, a unified command system where you actually go out and participate with otheragencies, the span of control comes back up

to your organization, how many people do youcontrol so that your more efficient with 2/3 people rather than 15/20. we talk about howyou organize that way. your emergency operations centers, might be something from me to you,might be called a command post, this is where a group of people sit down either within youragency, within the community, work together to solve problems, they call those emergencyop centers, we go into details there. the resource management piece how do we managemoney, buildings, people, supplies; how do we manage that and make it last. and whenwe start to run out, where do we get more; that’s all apart of incident command. andthe last piece is the information and intelligence that goes along with good communication.we could normally give our agencies a sample

of incident command chart, these are not cutin stone, but they are suggestions based on what the incident command systems should looklike, the ops, planning, logistics and finance pieces, the command section; who might takeon these roles. so we get in, look at theirs, if they don’t have one, offer this one forthem to use. and then we’ll go back and build it out, make sure they put the rightpeople in the right positions. all of this is great, you can have an incidentcommand system within your agency, but if you don’t use it to your advantage and buildthese collaborations and these relationships, i think you’re not going to do as well,you’re never able to do as well when you perform by yourself, and when you do withothers in your community. locally you get

the hospitals, health departments, emas, otherhealthcare facilities, and you all know who those people are and you work with them everyday.but its also helpful if you take it to that next level, and you go to the state associations,the state hospital groups, state health centers association, health departments, ema; thisallows you to get to that next layer of government that can bring in resources that you sometimescan’t get locally. but it really is focused all on state primary care associations; it’scritical that they have a presence in the state, they know where everybody is, theycan work with everyone, and they can work with public health and emas, and get you thesupport. they are sort of your state representatives during disasters.and if you look down in the lower corner,

this is a map of alabama; you can see whereall the chcs are. they are distributed out all over the state. you can see where if there’sa state association representative sitting in public health or ema, they have accessto every one of these dots on the map, and can help put resources in your hands and pushthem to you. so it’s a vital resource for us and they do a really good job with thisin alabama. boy that slide is all out of whack, but thenational response framework (nrf) is the sister document to the incident command system. andthe important word here is coordination. the incident command creates structure, and organization.the nrf creates coordination; the feds have a system now that says now that you all canlook and act the same, we’re going to put

our system in place that offers up coordination.we’re going to define who does what so everybody works better together. this is the slide thatcompares the two. nims creates an organizational structure and the nrf creates coordination.and really the nrf is that federal system that says if you run out of resources locally,you go up to the next level, maybe your county government, those folks help you, when yourun out of resources at that level, then you come up to part of your state, regional orhalf of your state, in alabama, we respond north and south, and then once resources aredepleted then the entire state comes to your aid, then you reach across borders to thenext, those adjoining states, to regions of the us and finally the peak of the pyramidis the federal government. that’s the coordination

piece that the nrf puts in place. the nicething is it translates from the feds all way down to the local, the same system, the sameguidelines, the same principles, and that’s what makes it efficient.in the nrf, they have broken this down into, actually there’s some places have 16 andsome have 15. in these slides i’ve put 16 because some states add an annex, but theemergency support functions, those are the responsibilities given to large departmentsor agencies. so for example, in the federal government they believe that 15/16 annexescan provide all the activities that are necessary during a disaster, during a response. andthis pattern flows from the peak of the pyramid from the feds all the way down to the countylevel. each governmental agency has this same

structure in place, and we’ll go over whatthose are right now. so in the national plan, emergency supportfunction 1, that is the transportation duties, so the department of transportation will dothese things during disasters; doesn’t mean they do it all, they do some, they coordinate,but as far as emergency support function 1 that falls to department of transportation.but what we want to get to is down here on the 2nd page, emergency support function 8that is the public health and medical service. that responsibility naturally falls to thedepartment of health and human services. and these are the things that they manage froma federal, state, and local level. not all public health departments do all of thesethings, they can do some, they coordinate.

those are the folks who are your first lineof defense at the county level, those public health folks who are receiving guidance atthe peak of the pyramid, which would be the department of health and human services. soin your county, you will find a county plan that mimics the state plan that mimics thenational plan. and each one of these chapters is written by that agency whose been giventhe authority to write chapter 8 public health and medical.in your county, that’s going to be your county health department, and you’re goingto find chapter 8 in your county plan, written by the county health department; if you don’thave a copy of this chapter, you really should because that in all essence is your countyhealth care response plan. it’s important

to have that on hand, so that it’s accurateand you know who does what. we spend much more time on these than we can do today. andyou can see that they go on through, some have added support function 16, which is veterinaryservices, some do, some do not. this is that tiered response that we talkedabout, at the lowest level, county, parts of the state, the state, adjacent states andeventually the federal; that is the tiers of response. and as you work your way up youget more and more response from a higher and higher level of government. and it’s importantto understand how this works for you. the third section we talk about and we’lljust kind of go over these quickly, the joint commission emp requirements, not all chcsare joint commission accredited. we’ll go

over those, we’ll talk about what the requirementsare, what the standards are. this is good to know because it gives you a lot of goodguidance to what any emp should have in it. these requirements: emergency management,provision of care, human resources, these all follow right along with the nims’ requirements—alot of consistency between them. so for those who are joint commission accredited, it’sjust one more step in the process of making sure that you have a really detailed plan.in the next section that we cover, we go over examples of chc activities. and we do thisso that people can understand what exactly it is that they might have to do. we hearall of the time, “we would never have to do that, i can’t imagine what we’d haveto do during a disaster, do you think we would

really have to do that?”well, we give them examples. the first thing, so they understand what they might have todo, we suggest that they do a really good hazard vulnerability assessment, and we talkedabout that on the very first slide. what are those things that are in your area, what youare most at risk of? on the gulf coast, hurricanes, tornadoes, accidents, mass casualties, infectiousdisease outbreaks, those things that we sort of cheat the system and say we’re goingto plan for the things that are most likely. in california they have earthquake planning,in hawaii, i’m sure they have tsunami planning, so its regional, it depends on what you have.there’s no sense in planning and putting priority on things that you don’t have.so that’s the first thing we do, to kind

of get them to thinking what might we haveto do during disasters. here’s some local examples: katrina hit,within a few days, there was probably a million people displaced and the vast majority ofthem had chronic disease problems, and they ran out of their meds. so within the firstweek, along the coast, 15 health care sites were set up, seeing somewhere 1500-2000 peoplea day. and if you look at what they were seeing, some injuries mostly minor, but the illnessesstarted to take over: gi, respiratory, skin rash, 20% was med fills, med refills. post-katrina,this was, very quickly within the first week, shifting to almost a primary care outpatientevent, which then within the first month, looked like this, 78% of the patients, seeingalmost 80% were minor illnesses and chronic

disease, which were med refills, and reestablishingdisease management. who else does this, this well as well as chcs? so you see the roleand this happened from mississippi to louisiana, and into parts of texas and then it startedto present itself in other states where people had to evacuate to, and all of a sudden theywere taking these same problems from louisiana to iowa and montana and california. so thisis exactly why we think chcs play a role. these were just things they were seeing forthat first month, and it’s a lot of general illness not like the mass casualty traumaevent some people thought it was going to be. another problem was, in louisiana, thousandsand thousands of people were without any care, and there was one hospital over across theriver from down-town new orleans, west jefferson

stayed open, and prior to katrina they wereseeing 300-400 a day post-katrina at one time, jumped up to 3000 per day. so the hospitalwas on the verge of not being able to manage, in fact they were really struggling to manage.so they took control of an abandoned nursing home across the street from the hospital thatput a d-mat in the parking lot and then they worked with one of their chcs in the area.they said how bout we set you up in the nursing home, we’ll provide resources for you, we’lltriage out in the street, we’ll take the emergency patients the in-between categorypatients can go to the d-mat in the parking lot and the vast majority can go across thestreet to the chc. and if you notice, over just a short period of time they triaged 200,000patients by splitting up the load, working

with their chc. and t was a really, reallybig success, and it all gets back to community collaboration, and the primary care needswere all taken care of. that’s the way this is supposed to work. that’s what we pushfor and every time we do this talk in alabama, we use this example because it’s a perfectway to expand services, to manage surge, and put patients in the right places where peopleknow how to handle them the best. another place that chcs could take a roleon could be communicable disease or infectious disease outbreaks. h1 was a perfect example.primary care, outpatient, vaccination, pre-hospital, all of those things, expanding hours, increasingnumbers of staff to handle this and this was something that was discussed and planned inalabama as well. so those are the examples

that we go over with, over with all of thesecenters and it begins to make them think what can we do in our community, what resources,what assets, how do we collaborate. so we do that little piece that says here’s areminder of just that you might have to do. now let’s switch gears a little bit. communicationsand technology, if you remember, that was one of the nims’ requirements. in alabama,we have a system called the alabama incident management system (aims). it is a, it’san online information tool; it uses the term situational awareness. and this system isrun by our public health department. if you remember, emergency support function 8 ismanaged by public health. their job is to coordinate response and part of that is information.so they gather information from all the health

care facilities in the state, they do somethingwith that data, analyze it, send it back, make decisions. they do the resource managementsupport; help with supplies, equipment, and people. manage it from that highest levelof government back down, and this is the tool we use to do that.it requires that situational awareness, and it’s an information gathering tool. everychc has a secure login and public health will ask them to enter certain pieces of data periodicallyduring the day for a period time and its very simple: log on, enter the data, we will getthe information and then we will turn around and help you in any way that we can. that’sthe, that’s the best part of aims, is the help that it offers.right now with our system, we collect information

from hospitals, needs shelters, nursing homes,dialysis, all of these over here, everything from hospital down, are the data entry sites,these are healthcare facilities if you’d like. the emergency operation’s center modules,these are manned by state and area folks, by public health and ema. they absorb allthe information entered by these people, make the decisions and push the help back out.and you notice that chcs in alabama have their own login. the nice thing about aims is itsfree, its never turned off, its activated during disasters; they login, enter data,receive information back, and it’s really an efficient tool that you can use at yourdesk, at home, on your hand-held device, your smartphone, anything where you can accessthe internet, you have access to aims.

let me give you a quick look at what the dataentry module looks like. this is where you have your folks, gathering important informationand entering it in to aims you can put it into multiple points, you can put it in atone site, just depends on what you want. and the screen will…, let me get to that screen,sorry that screen’s not in here. it’s a login screen; when you go to aims.org, themain screen will pop up and say “you’re xyz community health center, please enterthe following information.” sorry about that, i thought that there was a slide inhere. but the, it’s their own private webpage where they can login and enter the data, andyou can see here that it’s monitored by public health and ema, very well received.and again, i apologize that i don’t have

the main page in there but, i’d be happyto show it to you, just let me know. you probably have something like this available in yourstate. as we get towards the end of the day, we askthem now to let us look at what’s within the components of their emp plan: what doesit look like, do they include all the right things, have they included the nims requirements,just what’s in there and is it a good plan, not so good plan? and we help them build thoseout. the first thing and again we come back to this analysis of hazard vulnerability assessment,if they’ve never done one, we’ll help them with one and give them the forms to dothe assessment. we can point them to the people in their community who have access to thecommunity hazard assessment. it’s really

important that they know what their threatsare, so they can begin to plan off of the 5, or 6, or 10 things they believe are themost likely to happen to them. when you do your hazard assessment, it rates what arethe probabilities that, how are we going to respond, what’s the human impact, propertyimpact, business impact. you can’t just check the boxes on these, you actually haveto have people sit down, talk about hurricanes, talk about tornadoes, what’s the probability,how bad might it be, what resources do we need, internal/external, all of those things.really a hazard vulnerability says these are the things that are most dangerous and here’show well we are prepared or not prepared. these are the documents we work off of, sofor a natural disasters, mass casualties,

technological events, human events, we gothrough all of these if they have them fine, if they don’t have them, we mark them offthe list. then we help them build their plans on all the other things based on all of thethings on this page that they’re likely to have happen. it becomes overwhelming attimes, because you really can’t take too many of these things out of your plan, butyou have to think of how we would do each one of these. and the example we give is,your response to a tornado is completely different than your response to the flu or some otherinfectious disease outbreak—different equipment, different supplies, different drugs, differentpeople. and so you have to be able to adjust, and then to be able to adjust, you have tobe able to identify your threats and from

those threats you build these specific partsof your plan that handles each one of those types of events. that’s critical beforeyou ever start writing your plan. we look at things like mutual aid agreements,you have agreements with others, and you have an agreement with a hospital, with other chcs,with nursing homes, public health. you can even get into compacts and contracts: whatabout your vendors, food, water, fuel, all of these things are important for a coupleof reasons. one is agreements lay out the ground rules of who is going to do what, whois going to support whom, that’s important that you know what’s going to happen. theother is from a potential reimbursement financial side: mutual aid agreements, compacts, contracts,all of those things that need to be in place

before an event. so that if you’re eligiblefor reimbursement, the agreement spelled out specifically what you did and the agreementsthat were in place before hand so that it helps speed up that reimbursement processbut that’s a big “if”. you just don’t know what you’re going to be eligible for.mutual aid agreements are a key part to your disaster plan.other things we go through via page by page, do you talk about continuity of operations,how are you going to continue to run the business? if number one is not there, who is two, iftwo’s gone, who’s three. what happens if you lose part of your building, can youmove to an additional site? what if you have half your staff, how are you going to work?and what are you going to prioritize? so that’s

the continuity piece. the command and controlis incident command, we help build that out. how you going run your facilities and commandand control? we help with training and exercises, we lay out what we think they should be trainingon and exercising. now i can go on down the list, each one ofthese topics is probably a half-hour to an hour discussion. so you see this can becomesa lengthy process, when we go through their plan making sure that they address all thesethings. and i know not everything is on this list. this is a starting place for us to actuallysit down, look at their disaster plan and see if it meets the minimal, minimal list,of all these things. somewhere, all of these things have to be in their plan. we have puttogether a disaster plan template, we have

pushed that out to the chcs, they have it.some have said, “can we just change the name and use it?” others have said, “wealready have a plan, we’ll use it as a guide; we’ll measure your template against ours.”and i don’t have any of the attachments but that is available if you would like usto send you a copy of this plan, we know that it’s not perfect for everybody, but it’sat least a template that says here are all the things that should be in your emergencyplan. use it or use it as a guide, look at the plan, look at your plan, compare the two,did you forget something, did it make you want to add something. and again, we sit downwith the centers and we them help through the process; we think it’s the process,more than the plan, we take their documents,

look at our template and help match it upto the best tool that they have. and a lot of them have been working on this, the planninghas, has gotten significantly better over the last couple years.this is us, we are the national center for disaster medical response (ncdmr), some ofour folks remember us as the advanced regional response training center. we started out purelyas training but now we’ve actually gotten into planning and response with the universityof south alabama. that is my email address: dwallace@usouthal.edu, and you can find usat that phone number [(251) 461 1805]. we are plenty busy within the state of alabamaand it is a full-time job for us with hospitals, nursing homes, chcs, public health, ems, allof the traditional healthcare facilities but

we can always find time to help. if there’sanything we can do, as far as providing you documentation, doing some training, um, maybetrain the trainer, there’s no limit to people’s imaginations, so anything that you’ve seenin this presentation, feel free to get in touch with us. we are more than willing tohelp and we’ll make ourselves available one way or the other.and i believe the last is our training center, this is a brochure of the classes that weprovide and those are free. they are provided free to health care professionals in alabama,we’ll pay their mileage and put them up in a hotel; anyone from outside the stateof alabama is welcome to come, we just can’t provide travel costs for people other thanthose living in alabama. but you are welcome

to come and you can find that at our website.these are the courses that we offer. and these stay consistent through the year. and againif you go to our website you’ll see the calendar, the topics, we do post power pointsof each of these presentations. so they are available to you as well.so that’s where our information came from just to make sure we validate the informationthat we’re using: list of references. and i believe that…..end of powerpoint. �