REGISTRY NAME

Powell Supportive Services, Inc.

COMPREHENSIVE EMERGENCY MANAGEMENT

PLAN FOR NURSE REGISTRIES

(CEMP)

Section 381.0303(7), F.S., states, “The submission of emergency management plans to county health departments by …nurse registry providers is conditional upon receipt of an appropriation by the department to establish disaster coordinator positions in county health departments unless the secretary of the department and a local county commission jointly determine to require that such plans be submitted based on a determination that there is a special need to protect public health in the local area during an emergency.” It is the nurse registry provider’s responsibility to contact the county health department of each of the counties listed on the provider’s license to determine and document whether the Comprehensive Emergency Management Plan (CEMP) should be submitted to that county and, if submission is required, whether the county health department will be reviewing the plan for compliance with Florida Statutes and rules. If the plan is to be submitted, e-mail with ‘read receipt requested’ or certified mail with return-receipt requested is recommended in order to document proof of submission.

In Compliance with: s. 400.506(15), (16), Florida Statutes

59A-18.018, Florida Administrative Code

Date: 03-2012


Table of Contents

Page

I. INFORMATION DISSEMINATION TO STAFF AND INDEPENDENT CONTRACTORS 3

II. IDENTIFYING INFORMATION ON NURSE REGISTRY 6

III. CONCEPT OF OPERATIONS

A. Responsibilities in Emergency Situations 7

B. Informing Patients Prior to an Emergency 7

C. Notification 9

D. During an Emergency 11

E. Evacuation 12

F. The Patients Return Home 13

IV. APPENDICES

A. Agreements and Understandings 14 B. Information for Nurse Registry Patients 14

C. Support Material 16

Instructions: Answer each of the items directly on the form. Once it is completed please e-mail it to the comprehensive emergency management plan (CEMP) reviewer for your county or multi-county area. If any changes are needed, the reviewer will send comments to your nurse registry via e-mail or regular mail with a due date for corrections to be forwarded back to the reviewer. The CEMP reviewer for your area is listed at our website at http://ahca.myflorida.com/licensing_cert.shtml. Click on “Nurse Registry” Look under Emergency Management Plan for the Emergency Management Plan Review Contacts... The CEMP reviewer will let you know when your plan is approved. Remember to update the plan on an annual basis or as needed.


I. INTRODUCTION

Insert any appropriate introductory or overview remarks.

General Statements:

Powell Supportive Services is registered with the local emergency management agency for Pasco County.

Powell Supportive Services has an Emergency Plan Policy describing the procedures to follow prior to, during, and after an emergency.

Powell Supportive Services has a Training Policy describing the required training for contractors.

The Safety Liaison will register for available CERT training classes.

Powell Supportive Services has Emergency Plan Training for each contractor.

contractors will be oriented and trained on emergency preparedness within 30 days of hire.

Topics covered in the emergency preparedness training:

Types of Emergencies

- Recognition of Emergencies

- Planning for Emergencies

- Creating a Personal Emergency Plan

- Responsibilities for:

- creating the patient’s Personal Emergency Plan

-ensuring each patient has an individualized Personal Emergency Plan

- ensuring each patient is educated and informed about emergencies

- ensuring continuous care is provided to each patient

- ensuring the same type and quantity of continuous care is provided in the special needs shelter that was provided prior to the emergency unless circumstances beyond the control of the contractor make it impossible to continue services

- Communications during an Emergency (main and contingency communication)

- Documentation Requirements

- Special Needs Registry – contractors will ensure:

- Special Needs Registration is completed on Intake for each patient who needs assistance when evacuating or when in a shelter

- Registration will be updated annually for each patient or when there are changes

- The patient is educated and informed about the Special Needs Registry

- The patient has a completed Personal Emergency Plan with all of its components, including a Prioritized List, a Plan of Action, Special Needs Registration information, and Emergency Kit information

- Each patient has a completed Prioritized List, which will be provided to the county health department and county emergency management office on request

Please provide responses for each item describing how the nurse registry will provide the following:

  1. The procedures on how key workers/independent contractors will be oriented and informed prior to an emergency, as to their roles and responsibilities during an emergency:

Each contractor will go through Emergency Preparedness Orientation with the Safety Liaison, complete the Emergency Training, answer questions about emergency preparedness, assist each patient with training on emergency preparedness, and assist each patient with creating an individualized Personal Emergency Plan.

  1. The person(s) who will provide the orientation, as well as the orientation content (to include a definition of what constitutes an emergency, when the emergency management plan will go into effect, the roles and responsibilities of essential and non-essential staff, the procedures for educating patients about the emergency management plan and the special needs registry):

Person Providing Orientation -

Powell Supportive Services, Inc., Safety Liaison, Karl Powell will provide orientation to each independent contractor on hire, annually, and when there is a change. Each contractor will provide orientation to each patient served on intake, annually, and when there is a change.

Content of Orientation

Powell Supportive Services, Inc., Emergency Management Plan orientation consists of The Nurse Registry Emergency Preparedness Packet which includes:

- Powell Supportive Services Comprehensive Emergency Management Plan

- Powell Supportive Services Emergency Plan Policy

- Powell Supportive Services Emergency Training

- Types of Emergencies

- Preparing for an Emergency

- Getting Informed

- Caregiver Information & Responsibilities

- Creating a Personal Emergency Plan

- Creating a Prioritized List (Contact, Transportation Needs, Skilled Nursing Needs,Pre-Agreements (with physician, utility companies, emergency response teams, etc)

- Creating Equipment-Supply List, and Medication List

- Creating a Plan of Action

- Creating Emergency Kits

- Preparing Your Home

- Shelter vs Stay at Home

Local Emergency Contacts

Community Emergency Response Programs

Resources & Links

Handouts

- Tips for Evacuating Vulnerable Populations- Get A Plan

- SNAPP (Special Needs Assistance Population Program) Form (Pasco Emergency Management)

- The Special Needs Shelter Fact Sheet (Department of Health)

- Hurricane Guide

  1. The nurse registry administrative staff person responsible for orientating new independent contractors regarding their disaster related roles and responsibilities:

Person Providing Orientation

Powell Supportive Services, Inc., Safety Liaison, Karl Powell will provide orientation to each independent contractor on hire, annually, and when there is a change.

Each independent contractor will provide orientation to each patient served on intake, annually, and when there is a change.

  1. The procedures for informing independent contractors on how they can work (if they choose to do so) with the local, state or county agency which will be managing and staffing special needs shelters during an emergency (pursuant to s. 456.38, F.S., and

s. 381.0303, F.S.,) are as follows:

All independent contractors must be certified in CPR, First Aid, HIV/AIDS, and have training in conditions caused by bioterrorism. In addition, the Nurse Registry Emergency Policy, which each independent contractor signs on hire and annually, will identify any independent contractor who is interested in being available to provide health care services in special needs shelters or to help staff disaster medical assistance teams during times of emergency or major disaster. The Emergency Policy also states that certain termination of or discrimination against a practitioner providing disaster medical assistance is prohibited.


II. IDENTIFYING INFORMATION ON NURSE REGISTRY

1.  Basic Information

Nurse Registry Name: Powell Supportive Services, Inc.

Administrator Name: Natasha Powell, Owner, Communications Coordinator

Address: 3632 Land O’Lakes Blvd Ste. 106 Rm. 5 Land O’Lakes, FL 34639

Phone Number: 813-767-3808

2.  Person In Charge During Emergency (Key Staff)

Primary Name/Title: Karl Powell/*Safety Liaison, Emergency Plan Coordinator

Home Phone Number:

Work Phone Number: 813-446-4655

Cell Phone Number: 813-446-4655

*Per x. 408.821 (1) F.S., revised 7/1/09: A licensee required to have an emergency operations plan must designate a “Safety Liaison” to serve as the primary contact for emergency operations.

Alternate Name/Title: Nurse Administrator/TBD

Home Phone Number:

Work Phone Number: 813-767-3808

Pager Number:

Cell Phone Number:

Insert additional alternates as appropriate.

Alternate Name/Title: Heather Buchanan

Home Phone Number:

Work Phone Number: 727-326-4565

Pager Number:

Cell Phone Number:

3.  Registry Owner

Owner Name: Natasha Powell/Karl Powell

Address: 3632 Land O’Lakes Blvd Ste. 106 Rm. 5 Land O’Lakes, FL 34639

Work Phone Number: 813-767-3808

Pager Number:

Cell Phone Number: 813-767-3808

Insert additional owners as appropriate.


III. CONCEPT OF OPERATIONS

Insert any appropriate introductory or overview remarks.

Please provide responses for each item describing how the nurse registry will provide the following:

A. Responsibilities in Emergency Situations

1.  The chain of command to ensure continuous leadership and authority in key positions:

The chain of command to ensure continuous leadership and authority is for all Nurse Registry independent contractors, in the event of an emergency and for all emergency orientation and emergency training, to report to the Safety Liaison, Karl Powell.

2.  The procedures to ensure timely activation of the nurse registry plan and staffing of the nurse registry during an emergency:

When an emergency is imminent and during an emergency, the Safety Liaison will notify the Nurse Administrator who will notify all Nurse Registry independent contractors of the emergency and the actions to initiate.

Contact will be maintained between the Safety Liaison and Nurse Administrator to ensure the Powell Supportive Services Emergency Plan is activated.

3.  The operational and support roles of all those nurse registry administrative staff who are designated to be involved in emergency measures during times of emergency:

Karl Powell, Safety Liaison

Natasha Powell, Communications Coordinator

Karl Powell, Emergency Plan Coordinator

Nurse Administrator, Emergency Plan Coordinator Alternate

Heather Buchanan, Communications CoordinatorAlternate

4.  Management of patients who will continue to receive services in the home, assisted living facilities (ALF) and in adult family care homes (AFCH) by the nurse registry’s independent contractors during an emergency:

Independent contractors will continue to provide care in the same manner, quantity, and quality to patients who were in their care prior to an emergency occurring. Should the independent contractor be unable to continue care provision due to circumstances beyond his control, he will notify the Emergency Plan Coordinator who will make every attempt to replace the contractor with another contractor.

B. Informing Patients Prior to an Emergency

1.  The procedures for notifying patients or patients’ caregivers about the nurse registry’s management plan:

Each patient will be provided with emergency training which will include the Nurse Registry’s Emergency Management Plan, on intake, annually, and when there is a change. The independent contractor will assist the patient with training, creating an emergency plan, and understanding what to do if there is an emergency.

2.  The nurse registry procedures for instructing nurse registry administrative staff of their responsibilities for discussing with those patients who need continued services either in the home, ALF or AFCH (and who are not registered with the special needs registry), the patients’ plan prior to and during, and immediately following, an emergency:

Each independent contractor will sign the Powell Supportive Services, Inc., Emergency Plan Policy, be familiar with the Emergency Management Plan, and will be trained about emergencies including the contractor’ responsibilities before, during, and after an emergency.

Each patient will be provided with emergency training on intake, annually, and when there is a change. The independent contractor will assist the patient with training, creating an emergency plan, and understanding what to do if there is an emergency. The contractor, the patient, and the patient’s Circle of Support (guardian, family, friends, Attending Caregiver) will be provided with the Nurse Registry Emergency Preparedness Packet in writing.

TBD: Training to be available on the internet is currently being developed to include all of the information in the Nurse Registry Emergency Preparedness Packet.

3.  The procedures for instructing nurse registry administrative staff as to their responsibility to discuss the special needs registry with those patients who will require to be evacuated to a special needs shelter (pursuant to s. 252.355, F.S.) during an emergency:

Each independent contractor will receive training on hire and annually on the Nurse Registry Emergency Preparedness Packet which includes all contractor responsibilities. The independent contractor will receive Emergency Orientation from the Nurse Registry Safety Liaison, review the training materials, answer questions about the materials, conduct training for each patient, and assist the patient in developing an individualized Personal Emergency Plan to include information about the special needs registry and the requirement for the contractor to assist the patient with Special Needs Registration.

4. The nurse registry’s procedures for collecting patient registration information for the special needs registry, (pursuant to 59A-18.018 (6), F.A.C.) which must be done prior to an emergency, not when an emergency is approaching or occurring:

Each contractor will follow the information and procedures in the Nurse Registry Emergency Preparedness Packet to complete the patient’s Personal Emergency Plan which will include registration information. This will be done on intake, annually and when there is a change. The contractor will submit the completed Packet to the Nurse Administrator for review, and the Nurse Administrator will submit the completed Packet to the Owner for review. A master Special Needs Registry will be maintained with all patients’ names and each patient’s individualized Personal Emergency Plan will be maintained in the patient’s file.

5.  The procedures on how independent contractors and nurse registry administrative staff will be informed of their responsibility to educate patients about maintaining their medication, supplies and equipment list (refer to Appendix B, Section 2):

Each contractor will follow the information and procedures in the Nurse Registry Emergency Training to ensure that the patient is educated about maintaining the Prioritized List, Medication List, and Equipment-Supply List as well as the Emergency Kit and to ensure that all medications, equipment, and supplies are accessible, maintained, and updated annually. The required Personal Emergency Plan for each patient will be completed/updated, submitted to the Safety Liaison and then to the Nurse Administrator and when approved will be submitted to the Pasco Emergency Management Office and Health Department, on request.