140 -Disaster Planning for Mental Health and Recovery Residences
Counselor Toolbox

 
 
00:00 / 57:32
 
1X

Disaster Planning:
An Ethical Obligation
Instructor: Dr. Dawn-Elise Snipes
Executive Director: AllCEUs Counselor Education
Podcast Host: Counselor Toolbox & Happiness Isn’t Brain Surgery

This course is available on-demand here: https://www.allceus.com/member/cart/index/search?q=Risk+and+Disaster+Management or as part of our Recovery Residence Administrator Training Program https://www.allceus.com/member/cart/index/product/id/619/c/
Objectives
~    Rationale and Process for Disaster Planning
~    Preparing for Disaster
~    Continuity Planning
~    Management of Prescription Medications
~    Testing the Plan
Rationale
~    Disaster planning can save lives, minimize injury and emotional trauma, protect property and operational capability, and prevent or reduce interruptions in treatment.
~    The behavioral health treatment program has a special obligation to prepare for disasters because it provides essential services.
~    By their nature, disasters have an impact on behavioral health:
~    Most people who experience a disaster, whether  as a victim or responder, will have some type of psychological, physical, cognitive, and/or emotional response to the event. Most reactions are normal responses to severely abnormal circumstances. (American Medical Association, 2005, p. 2)

Rationale
~    Disaster planning can prepare the program for continuing to provide the services to its existing clientele in order to prevent:
~    Relapse
~    Medical and psychological consequences for prematurely discontinuing medically managed detox or crisis stabilization
~    Homelessness if clients are in a residential facility
~    Client destabilization due to lack of access to medications prescribed and/or administered by the agency (antipsychotic injections, prescription refills, methadone)
~    Exacerbation of problems in at-risk populations as a result of lack of access to support
Rationale
~    Disaster Planning can help mitigate psychological issues in the community by providing services to new clients (Katrina)
~    Aid to other programs
~    Rapid response to influx of clients from other agencies or areas

Types of Disasters
~    Your facility is incapacitated or destroyed (fire, building flood, sink hole) but other facilities remain open and clients are in their homes
~    Your facility and others are incapacitated and clients are in shelters (Hurricane, blizzard, fires).
~    Your facility is functional in the aftermath of a natural disaster in which your patients are in shelters. (City-wide flood).
~    When the program must cease provision of nonessential services due to a sudden reduction in resources, infrastructure, or available personnel due to illness or diversion of resources.

Health department can provide a copy of the local Hazard Identification and Risk Assessment (HIRA)

Continuity Planning
~    Requires a program’s personnel to consider the threats that could adversely affect essential functions;
~    Determine the personnel, vital information (e.g., patient medical records including prescription records), and other resources required to continue those essential functions;
~    Develop plans for providing essential functions onsite or at alternate locations if needed
~    Make advance arrangements for obtaining the resources necessary to support essential functions throughout the disaster and recovery phases
~    Plan for the safety of all personnel during these periods.

Planning cont…
~    In its initial work, the disaster planning team conducts or gathers, from partner agencies in the community, a hazard identification and risk assessment
~    A hazard-specific appendix should not repeat information that is in either the basic plan

Types of Clients
~    Current clients
~    Current clients who are destabilizing
~    Guest clients
~    Prior clients whose recoveries are threatened
~    Individuals with an untreated mental health issue which must be addressed to prevent further deterioration
~    Family members of clients who need assistance to support their loved ones (Hotline, online support groups)
~    Patients who need prescription refills written
~    Patients on an opioid pain medication who cannot access their physician
The Plan
~    Introduction: Purpose of the plan and objectives
~    Concept of operations
~    Procedures for activating and deactivating (Who, What, When, How)
~    Staff responsibilities in the disaster
~    List of the personnel positions authorized to make requests for outside aid or assistance
~    the conditions under which to request aid
~    the procedures for managing requests to give aid
~    a list of resources that can be used in those efforts.

The Plan
~    Functional Annex (Response to a specific hazard type)
~    Hazardous weather/tornado warning
~    Facility Fire
~    Wildfire / Flood
~    Facility Flood
~    Hurricane / Blizzard
~    Earthquake
~    Viral Pandemic
~    Chemical Spill
~    Train or major vehicle wreck or explosion

The Plan
~    Implementation Instructions
~    Checklists and materials necessary to perform disaster related tasks
~    Scripts to respond to the media, public or consumers
~    Floorplans
~    Community Maps
~    Safety Related policies and procedures
~    Memoranda of Agreement including address of each facility, phone number and contact person

Keep It Simple
~    Basic plan should address
~    General procedures
~    Contain a general decision and notification tree
~    Plans for monitoring where clients go
~    Avoid having staff need to refer to multiple sections in the plan
~    If your agency has multiple locations or types of programs, each program type needs its own addendum to each functional annex (Detox, CSU, Residential, IOP, Adolescent)
~    Supervisory staff should maintain a paper copy and each building unit should maintain a paper copy in an accessible location
~    Administrative and Clinical staff must ALL be adequately trained including scenario training.
Coordination with Others / MOU
~    Memorandum of Understanding with:
~    Hospitals/Health Departments (Detox, crisis stabilization, medication maintenance)
~    Behavioral Health Disaster Response Team (Health Departments)
~    Emergency Management for evacuation of patients
~    Other clinics for mutual referral or staff borrowing
~    Sober homes for patients in addiction recovery
~    SAMHSA’s Disaster Technical Assistance  Center (DTAC) specialists  can help a program link with the disaster behavioral health coordinator for its State and answer questions about accessing state and federal funding
~    Health departments must coordinate disaster planning with the community’s behavioral health treatment systems

Role of the Health department
~    Engaging and coordinating with emergency  management, healthcare organizations (private and community-based), behavioral health providers, community and faith-based partners
~    Support the development of public health, medical, and mental/behavioral health systems that support recovery
~    Participate in awareness training with community and faith-based partners on how to prevent, respond to, and recover from public health incidents.
~    Promote awareness of and access to medical and mental/behavioral health resources that help protect the community’s health and address the functional needs of at-risk individuals
~    Receive and/or integrate the health needs of populations who have been displaced due to incidents that have occurred in their own or distant communities

Role of the DEA
~    Monitors and reviews actions the program takes in a disaster regarding controlled substances (e.g., relocating a methadone supply to an alternate facility)
~    Inform the local DEA agent about the use of controlled substances that are prescribed or dispensed to patients and stored at the facility (ADHD, Anxiety, Opiate)
~    The State Opioid Treatment Authority can assist in making contact with the local DEA official

Role of the Media
~    Assist in coordination of services
~    Request including in local TV and Radio emergency listings (operating status of the program, where to go if closed)
PreDisaster Preparedness
~¬†¬† ¬†Educate partners to destigmatize and ensure continuity of care at ‚Äúguest‚ÄĚ agencies or in shelters
~    Methadone / Suboxone
~    Schizophrenia
~    Educate the public about the importance and availability of behavioral health services in an emergency
~    Get Memoranda of Understanding

Pre-Disaster Preparedness
~    Educate local emergency response organizations about:
~    Characteristics of patients (especially residential)
~    Needs of patients during and after transport
~    Most appropriate settings most appropriate for relocation
~    Specific locations that have, through MOU, agreed to accept patients
~    Patients have a right to expect from general population emergency shelters support services that provides:
~    Access to medications to maintain health, mental health, and function
~    Refrigeration for medications
~    Assistance that may be required due to cognitive and intellectual disabilities.

Pre-Disaster Preparedness
~    Identify Essential Functions
~    Safety of clients and visitors
~    Behavioral health emergency services including crisis and relapse prevention.
~    Track clients affected by dispersal and evacuation to ensure they continue to receive needed behavioral health services.
~    Assist clients in accessing needed medications.
~    Conduct drug testing for mandated clients.
~    Adhere to applicable State licensing standards.
~    Maintain treatment and billing records in accordance with regulatory requirements.
~    Protect client rights and privacy, including the integrity of PHI
~    As resources are available and based on mandates, provide disaster mental health services to the community including prevention specific guidance and crisis intervention
PreDisaster Preparedness
~    Become aware of funding sources in an emergency and how to access them
~    State and Federal funds (e.g., Robert T. Stafford Disaster Relief and Emergency Assistance Act)
~    Crisis Counseling Assistance and Training Program (CCP) grants, which are funded by FEMA
~    SAMHSA Emergency Response Grants (SERGs)

Mitigate Risk
~    Improve facility’s ability to withstand a disaster
~    Hurricane window covering
~    Backup generators
~    Prepare for shelter-in-place for when evacuation is unsafe (Chemical spill)
~    Stockpile supplies: Cots, linens, soap, toothpaste, nonperishables for a 72-hour period
~    Prepare personal go-kits (1 per client) with water bottle, flashlight, batteries, toiletries, and consider… t-shirt and shorts, towel, high energy food bar (Can have clients bring at admission)
~    Inventory and replace supplies at least quarterly
Mitigate Risk
~    Real-time data back-up of electronic health record at a remote location which can be accessed in emergency
~    Keep coolers on site for transportation of refrigerated medications
~    Ensure electric water pump (if any) are connected to back-up generator
~    Train all staff in emergency psychological first aid
~    Have a psychiatric advanced directive in the file for any patient who may destabilize in an emergency which includes helpful interventions and info about legal representative should they become incapacitated.

Mitigate Risk
~    Prepare for financial resiliency
~    How to enroll clients in emergency Medicaid
~    Reimbursability of services
~    Educate payors about modified counseling services to facilitate reimbursement
~    Some agencies may have a reduction in cash flow due to relocation of community residents
~¬†¬† ¬†Staff members might be ‚Äúshared‚ÄĚ with programs experiencing an influx of clients to reduce payroll load
~    Consider how to support client retention through active outreach following a disaster

Summary
~    Disaster planning prepares for client safety and continuity of care and financial solvency for organizations in the event of a disaster
~    Getting MOUs with local agencies, the health department and emergency services is vital to preparation
~    A list of identified risks for your area can be accessed at your local health department
~    All staff needs to be trained in the disaster procedure and scenario training should occur periodically

By continuing to use the site, you agree to the use of cookies. more information

The cookie settings on this website are set to "allow cookies" to give you the best browsing experience possible. If you continue to use this website without changing your cookie settings or you click "Accept" below then you are consenting to this.

Close