Application Development Tools
HRSA Year 4 Coalition
Introduction
Nor-Cal EMS has developed and refined tools to help HRSA project coalition partners and others collect, organize and communicate the information required for timely application completion and successful project administration. In some cases this is very straightforward, such as specifying supply and equipment choices and quantities. In others the tools are provided to help with less tangible efforts such as developing consensus on strategic needs and priorities.
You are welcome to use those tools that will assist you, and to distribute them to other stakeholders and project decision-makers. We hope you find these tools useful in your efforts and look forward to working with you in the project.
Please let us know if there are other ways we can help you and your colleagues in this important project.
Instructions
The Key Questions for Benchmarks are provided to help guide more specific planning and decision-making efforts, both for individuals and groups. Nor-Cal will use coalition partners’ responses to these questions to formulate application narratives.
Attachments C and E are new for this grant cycle. They must be to be filled out and submitted with the application. For the letter of support that must accompany the completed application Nor-Cal EMS is providing a model letter for your convenience.
Calculations for HRSA Year 4are provided to serve as a starting point for project planning. Some of the figures provided there can help provide understanding about the program's expectations for each county.
The HRSA 4 County Spreadsheet is a calculating spreadsheet. It provides figures for Nor-Cal's allocation for implementation, coalition training and fiscal agent services. Individual counties may enter the amounts they wish to allocate to local goods and services in local training, state equipment and non-state equipment. The totals will calculate automatically, as will the difference between total figures entered and the allocation. (Being developed).
Key questions for Benchmarks:
Questions and information based on or quoted from grant.
Global strategy for grant: how do the pieces of equipment you purchased for HRSA years 1 through 3, and those you will be requesting this year mesh together? How does this all tie together by the end of the grant cycle? Think about the training pieces for preparedness and how to utilize the equipment that the region will be receiving.
Critical Benchmark #2-1, Surge Capacity Beds
1)What are the numbers of beds that your jurisdiction is capable of surging beyond the currently staffed bed capacity within a 3 hour time (broken down by categories as defined at the end of this document)?
2)Does your county have enough cots, soft-sided annexes (tents or temporary structures), and the auxiliary equipment such as heaters, lighting fixtures, tables, chairs, extension cords, and portable generators capable of providing the requirements of delivering care in an austere climate?
3)Has your jurisdiction begun to plan for special needs populations including the medically fragile?
4)How would you describe your current level of preparedness?
You can obtain the average daily census of the facility and then extrapolate the difference between the daily census and what they can handle during “peaks” of patient census. You can include all off-site options and “austere environments” when trying to determine if your county meets the minimal readiness for the HRSA Year 4 grant. When you normally transfer patients for isolation or trauma to tertiary referral centers in a large scale event, your facility may be called upon to hold these patients for up to 72 hours. Another point to remember is that alternative facilities can free inpatient beds (lower acuity patients) to accommodate a surge incident.
Each Acute Care facility needs to begin plans on how to rapidly evaluate and potentially move patients from labor intense units (e.g. ICU) to medical floors. The jurisdictions need to contact board and care facilities and skilled nursing facilities that may be called upon to accept patients rapidly from the hospitals to accommodate surge patients and develop MOU’s for those services.
Critical benchmark #2-2, Isolation Capacity
1)The minimum level of readiness for this benchmark is that each Acute Healthcare facility (hospital) has the ability to maintain one highly infectious disease case. Please list the number of negative isolation rooms that each hospital in your jurisdiction currently has at the end of this document.
2)What activities do anticipate for the benchmark?
It is not reasonable for the hospitals to undertake major retrofit for this purpose. There is portable isolation room equipment available to establish either single rooms or potentially “wards” that can handle multiple patients. Please remember that many of these patients may rapidly require mechanical ventilation (e.g. SARS and Pandemic Influenza). There may not be enough ventilators available and trained people to operate them. An option is “disposable” ventilators that Nor-Cal EMS is exploring. They are easily operated and without a steep learning curve per the manufacturer.
Critical Benchmark #2-5, Pharmaceutical Caches
Establish a regional system that ensures a sufficient supply of pharmaceuticals to provide for 3 days to hospital personnel (medical and ancillary staff), hospital based first responders and their families. Realize that the total number of medication caches may change and that each HRSA cache will serve 50 people for 3 days while waiting for the SNS stockpile pharmaceuticals to be deployed.
1)How many pharmaceutical caches does your county currently have?
2)What healthcare facility/or alternative site (local pharmacy) are currently storing them?
3)Can the medications be adequately rotated to prevent expiration?
4)Have you begun to plan on how these caches will be delivered and dispensed to appropriate personnel? (Remember that HRSA wants this done within 12 hours of an incident being identified. In addition, you may not be able to count on local law enforcement for security during a disaster).
5)What resources do you have for obtaining and maintaining 50 person caches of nerve gas antidotes (used for organophosphate exposure), beside the Chempack program?
6)Please list the number of hospital personnel and first responder in the jurisdiction by facility.
7)What is the number of family member associated with the above mentioned? (Assume 4 individuals per family)
8)Does your jurisdiction feel that it is preferential to go with CDHS plan of having a State run Managed Inventory program similar to the SNS plans?
Critical Benchmark #2-6, Personal Protection
Each awardee must ensure adequate personal protective equipment (PPE) per awardee-defined region, to protect current and additional health care personnel, during an incident. This benchmark is tied directly to number of health care personnel the awardee must provide. The level of PPE will be established based on the Hazards Vulnerability analysis (HVA), and the level of decontamination being designated in CBM 2.7.
Minimal level of readiness is defined as: 1) Awardees will possess sufficient number of PPE to protect both the current and additional health care personnel deployed in support of an event and 2) Awardees will develop contingency plans to establish sufficient numbers of PPE to protect both current and additional health care personnel expected to be deployed in support of predictable high-risk scenarios.
1)Number of PPE available in each participating hospital or health care system?
2) Have you begun to establish mutual aid agreements with other hospitals, clinics or staffing agencies to supply additional personnel needed for a mass casualty event in your county?
3) Does your county have a Hazardous Materials Response Team?
4) What activities do you anticipate for this benchmark?
Critical Benchmark #2-7, Decontamination
1)How many decontamination units fixed or portable does your county have currently (please list by health care facility)?
2)Do you feel that your jurisdiction has sufficient decontamination units?
Remember that this is associated with total number of clinical providers currently (baseline) and those needed in a surge capacity. The HRSA Year 3 stated that you should be able “to decontaminate all patients and providers within 3 hours from the onset of the incident”. Units can be and should be for both hospitals and clinics. Patients will take themselves to places that they routinely receive care. In most decontamination scenarios, 80% of the exposed escape the scene without being decontaminated appropriately.
Critical Benchmark #2-10 Communication
Minimal level of Readiness: All participating hospital will have secure and redundant communications systems that allow connectivity to all other healthcare entities and emergency response agencies responding to a terrorist event or other public heath emergency.
This benchmark develops redundant communications capabilities. Please don’t include telephone or fax in your responses.
1)What agencies and disciplines in your county should be involved in a medical or health emergency, however can’t currently communicate with each other effectively in an event? Examples might include public health, hospitals, clinics, surge capacity sites, ambulance services, fire rescue, law enforcement, OES or others.
2)Please identify what was done pertinent to this benchmark in project years 1 through 3?
3)What other entities in the region would your county stakeholders need to communicate with in a large scale medical or health event?
4)Which communications methods are most valuable or important to develop for your county’s stakeholders?
- 2- way radio
- Internet
- Wireless voice and/or data
- Satellite telephone
- Others (please specify)
Critical Benchmark #5, Education and Preparedness Training
1)Please discuss and list all training whether “competency based” or not to date?
2)What are the training needs of your jurisdiction? These trainings need to include the triage, evaluation, and initial management and transport issues of adult, pediatric, and special needs populations. The definition of competency based training from HRSA Year 3 “acquire the knowledge, skills, and abilities required for a response and demonstrate the interaction of these elements in a given context, either in drills, exercises, or training evaluations”.
3)What training are planned for the upcoming year?
Critical Benchmark #6, Terrorism Preparedness Exercise
As part of the jurisdiction’s bioterrorism hospital preparedness plan, functional exercises will be conducted during FY2005 and should be based on the awardee HVA. These drills should involve State agencies and utilize the ICS system. The exercises should contain elements pertinent to special populations(young, elderly, handicapped, medically fragile), regional approach, and coordinated with State, Local Federal drills.
1)Please list all exercises that have been conducted by the entities in your jurisdiction.
2)Does your county plan on participating with the statewide disaster exercise for FY05?
3)What functional exercise(s) does your jurisdiction plan for the coming grant year? It should include the special needs populations, risk communications, psychological interventions, and be documented in an after-action report to include lessons learned and how will be applied to future exercises.
Calculations for HRSA Year 4 (FY 05-06)
ButteCounty- population=214,119
Benchmark #2-1 Surge Capacity-Hospital Bed Capacity
Minimal Level of Readiness based on grant
- Acute Infectious Diseases (1:2000 population)= 107
- Acute Botulism Intoxication (1:20,000 population)=11
- Acute Burns/Trauma (1:20,000 population)=11
- Acute Radiation Sickness (1:20,000 population)=11
Benchmark #2-2 Surge Capacity-Isolation Bed Capacity (please fill in)
EnloeMedicalCenter=
OrovilleMedicalCenter=
Biggs-GridleyMemorialHospital=
Feather RiverHospital=
Colusa County-population = 20,880
Benchmark #2-1 Surge Capacity-Hospital Bed Capacity
Minimal Level of Readiness
1)Acute Infectious Diseases (1:2000 population)= 10
2)Acute Botulism Intoxication (1:20,000 population)=1
3)Acute Burns/Trauma (1:20,000 population)=1
4)Acute Radiation Sickness (1:20,000 population)=1
Benchmark #2-2 Surge Capacity-Isolation Bed Capacity (please fill in)
ColusaRegionalMedicalCenter=
Glenn County-population = 28,197
Benchmark #2-1 Surge Capacity-Hospital Bed Capacity
Minimal Level of Readiness
1)Acute Infectious Diseases (1:2000 population)= 14
2)Acute Botulism Intoxication (1:20,000 population)=1
3)Acute Burns/Trauma (1:20,000 population)=1
4) Acute Radiation Sickness (1:20,000 population)=1
Benchmark #2-2 Surge Capacity-Isolation Bed Capacity (please fill in)
GlennMedicalCenter=
Lassen County-population = 35,455
Benchmark #2-1 Surge Capacity-Hospital Bed Capacity
Minimal Level of Readiness
1)Acute Infectious Diseases (1:2000 population)= 18
2)Acute Botulism Intoxication (1:20,000 population)=2
3)Acute Burns/Trauma (1:20,000 population)=2
4)Acute Radiation Sickness (1:20,000 population)=2
Benchmark #2-2 Surge Capacity-Isolation Bed Capacity (please fill in)
BannerLassenMedicalCenter=
Modoc County-population= 9,700
Benchmark #2-1 Surge Capacity-Hospital Bed Capacity
Minimal Level of Readiness
1)Acute Infectious Diseases (1:2000 population)= 5
2)Acute Botulism Intoxication (1:20,000 population)=1
3)Acute Burns/Trauma (1:20,000 population)=1
4)Acute Radiation Sickness (1:20,000 population)=1
Benchmark #2-2 Surge Capacity-Isolation Bed Capacity (please fill in)
ModocMedicalCenter=
PlumasCounty – population= 21,231
Benchmark #2-1 Surge Capacity-Hospital Bed Capacity
Minimal Level of Readiness
1)Acute Infectious Diseases (1:2000 population)=11
2)Acute Botulism Intoxication (1:20,000 population)=1
3)Acute Burns/Trauma (1:20,000 population)=1
4)Acute Radiation Sickness (1:20,000 population)=1
Benchmark #2-2 Surge Capacity-Isolation Bed Capacity (please fill in)
PlumasDistrictHospital=
SenecaDistrictHospital=
Eastern PlumasDistrictHospital=
IndianValleyHospital=
SierraCounty- population= 3,538
Benchmark #2-1 SurgeCapacity-Hospital Bed Capacity
Minimal Level of Readiness
1)Acute Infectious Diseases (1:2000 population)= 2
2)Acute Botulism Intoxication (1:20,000 population)=1
3)Acute Burns/Trauma (1:20,000 population)=1
4)Acute Radiation Sickness (1:20,000 population)=1
Benchmark #2-2 Surge Capacity-Isolation Bed Capacity (please fill in)
Western Sierra Medical Clinic=
Clinic in Loyalton=
Tehama County-population = 60,019
Benchmark #2-1 Surge Capacity-Hospital Bed Capacity
Minimal Level of Readiness
1)Acute Infectious Diseases (1:2000 population)= 30
2)Acute Botulism Intoxication (1:20,000 population)=3
3)Acute Burns/Trauma (1:20,000 population)=3
4)Acute Radiation Sickness (1:20,000 population)=3
Benchmark #2-2 Surge Capacity-Isolation Bed Capacity (please fill in)
St. Elizabeth Community Hospital=
1