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Long Term Care Emergency Management Programs

State: NY Type: Model Practice Year: 2019

Brief description of LHD location, demographics of population served in your community The NYC Department of Health and Mental Hygiene (DOHMH) is one of the world's oldest and largest public health agencies. The Health Department has over 5500 employees and serves over 8 million ethnically and socio-economically diverse people living in the five boroughs of New York City. With an ambitious mission to protect and promote the health of all New Yorkers, DOHMH is frequently a leader in innovative policy and system and environmental approaches to public health. In addition, the agency is committed to developing bold strategies and programs that promote health, prevent disease, and improve access to quality healthcare. The agency is strategically organized into divisions, bureaus, offices and work units, all of which work together cohesively to provide essential public health services. The agency is led by Commissioner of Health, Dr. Mary Bassett. She is supported by Deputy, Associate and Assistant Commissioners who oversee 13 divisions and over 50 bureaus and offices. Public health programs and activities managed by the agency are diverse and many. Programs and activities include: disease surveillance; outbreak investigation; registration and analysis of all vital (birth and death) events; clinics (STD, TB and Immunization); veterinary and pest control services; early intervention services; tobacco cessation; school health; HIV prevention and control; collection, analysis and dissemination of public health data; restaurant and daycare inspections; chronic disease prevention and management; health education; laboratory testing services; coordination of medical, dental, and mental healthcare in NYC jails; supporting the adoption and use of prevention-oriented electronic health records among primary care providers in NYC's under-served communities; policy development; and internships and residencies for future public health professionals. The DOHMH serves all of NYC, which has 8.3 million residents; this is more than twice that of the nation's next most populous city. NYC is racially and ethnically diverse: 24% black, 27% Hispanic, 35% white and 12% Asian. Thirty seven percent of the population is foreign born and 20% of foreign born residents have immigrated in the last ten years. Over 1.2 million New Yorkers (more than 15%) live in the City's highest need areas (areas with the lowest health indicators, and highest mortality); these include East and Central Harlem, a large area of the South Bronx, and neighborhoods in North and Central Brooklyn. In these areas, poverty rates are 70% to 100% higher than the citywide poverty rate of 21%, and over 95% of residents are nonwhite. Blacks account for 25% of the city's population overall, but 49% in high need areas. Hispanics are 42% of residents in high need communities, compared with 27% citywide. With some areas of great wealth, NYC also has some areas of widespread poverty: 21% of New Yorkers live in poverty, compared to 12% nationwide. While the median annual household income is $38,293, the income range is wide, making NYC home to considerable economic disparity. About one third of the population receives some form of public assistance and just over one quarter of the population is college educated. Notable for the Associate's work is the size and complexity of NYC's healthcare system. In the five boroughs of NYC, there are 55 acute care hospitals, 450 ambulatory and primary care centers, 178 nursing homes and 74 adult care facilities. Describe public health issue In October 2012, New York City evacuated 4,506 vulnerable residents living in 17 nursing homes and 14 adult care facilities located within Hurricane Sandy's path[i] New York City's after-action report identified challenges that occurred during the response and pinpointed healthcare facility evacuations as a key area for improvement. The report also included recommendations calling for comprehensive evacuation plans, a patient tracking system for evacuees, and alternate power-independent communications equipment. Similarly, the Health and Human Services (HHS) Office of Inspector General published a report in 2012 titled, Gaps Continue to Exist in Nursing Home Emergency Preparedness and Response During Disasters: 2007-2010,”[ii] and concluded that nursing homes nationwide lack vetted emergency plans, adequate staff trainings, and relationships with state and local emergency entities. To address, these gaps, a pilot project was initiated to assist nursing homes to develop and implement an intensive emergency preparedness educational training program. The pilot program included 20 New York City nursing home facilities. After a successful first year, the NYC DOHMH created a three year progression program, staged approach program which consisted of three components, which are Long Term Care Emergency Management Program (LTCEMP), The Long Term Care Exercise Program (LTCExP) and the Long Term Care Continuity Planning Program. Goals and objectives of the proposed practice Starting in 2013, NYC DOHMH's Office of Emergency Preparedness and Response addressed these gaps by investing funds received from the Office of the Assistant Secretary for Preparedness and Response's Hospital Preparedness Program (ASPR HPP) cooperative agreement. These funds helped build the New York City Long Term Care Emergency Preparedness Programs, seven-month emergency management training programs dedicated to improve long-term care (LTC) facilities' abilities to mitigate, prepare for, respond to and recover from emergencies and disasters. These programs' goals and objectives are described below: Program One: The Long-Term Care Emergency Management Program (LTCEMP) to increases LTC facilities' knowledge of emergency management concepts and accessibility to emergency management tools and resources so they can better respond to all-hazard events. These goals are achieved via in-person educational learning sessions, onsite facilitated coaching sessions, and participation in a tabletop exercise. Program Two: The Long-Term Care Exercise Program (LTCExP) helps facility teams design, develop, conduct, and evaluate meaningful exercises that identify the facility's strengths and opportunities for improvement in emergency response under simulated conditions. Program Three: The Long-Term Care Continuity Planning Program (LTCCPP) is developed to build resiliency and sustainability for LTC facilities in the areas of continuity of care for residents during a disaster, continuity of operations for the facility, and continuity and sustainability of the emergency management program at both the facility level and across the city. These goals are achieved via in-person learning sessions, four monthly onsite mentoring sessions, conduct and shadowing of a functional exercise. The New York City Long Term Care Preparedness Programs were created to provide the tools and resources necessary for nursing homes to participate effectively in overall emergency preparedness planning and response and specifically to develop and enhance the NYC nursing home sector's emergency preparedness capabilities by: · Improving the nursing home's ability to partner with city and state public health entities in order to improve their mitigation, preparedness, response, and recovery in disasters, · Creating and/or enhancing their Emergency Management Program, · Increasing participants' knowledge of emergency response roles and how to create the infrastructure to support these roles, and · Training nursing home leadership and staff in emergency preparedness methods relative to their sector, including planning, executing, and evaluating emergency preparedness exercises How was the practice implemented/activities: New York City Long Term Care Emergency Preparedness Programs were implemented in three phases, for Program I: Long Term Care Emergency Management Program, the activities are as follows (these programs are a stage approach, sites are encourage to participate in Program I then sites are eligible to participate in Program II, and those who have participated in Program I and II, are eligible to participate in Program III): Phase I: Pre-planning · NYC DOHMH created an advisory board comprised of representatives from NYC DOHMH, the New York State Department of Health (NYS DOH), NYC Emergency Management, Local 1199 Service Employees International Union, three NYC-based Nursing Home Associations, and four state Adult Care Facility associations to provide input and recommendations on program development · NYC DOHMH recruited and established relationships with LTC facilities with support from several of the city's long-term care associations who are part of the NYC Healthcare Coalition · NYC DOHMH created a LTC emergency management curriculum (with input from the advisory board) that comprised of the following topics: o Emergency Management Fundamentals o Continuity of Operations o Command and Control o National Incident Management System(NIMS) o Incident Command System(ICS) o Emergency Operations Center (EOC) o Risk Communications o Logistics Management o Personal Preparedness o Infectious Disease Preparedness o Community Engagement o Training and Disaster Preparedness Exercise per Homeland Security o Exercise Evaluation Program (HSEEP) o Regulatory Requirements and Waivers · Conducted pre assessments and emergency management plans/document review (the assessment tool determines if a facility's emergency management plan covers 10 core concepts emergency management fundamentals, risk analysis, command and control, logistics management, communications, continuity of operations, community engagement, training and exercises, infectious disease management and evacuation) Phase II Intervention Phase · NYC DOHMH conducted learning sessions (collaborative model) to cover topics (as mentioned above in the LTC EM curriculum) each learning sessions lasted for approximately 7 hrs. and consisted of pre and post-test · NYC DOHMH conducted coaching sessions, to provide one-on-one technical assistance to facilities EM team, in building out or enhance their site-specific emergency management plans/procedures or plans. Two coaching sessions were schedule per month with the site emergency management team, for approximately 2 hrs. · NYC DOHMH conducts a Tabletop exercise to test policies and procedures created through the program with city partners (NYS Department of Health and NYC Emergency Management) · Receive emergency management equipment including MedSled evacuation equipment, 700 mhz radio, and Incident Command System vests Phase III Evaluation Phase · NYC DOHMH conducted post-assessment · NYC DOHMH conducted evaluation of the program For the Long Term Care Exercise Program (Program II,) the activities are as follows: Phase I Pre-planning · NYC DOHMH convened Advisory Board (same participants and duties as mentioned above) · Recruitment of NYC long term care facilities · Re-establishment of Emergency Management Team Phase II Intervention · Learning sessions - to review Homeland Security Exercise and Evaluation Program (HSEEP) doctrine on how to design, conduct and evaluate different exercises (from facilitated discussions to operations-based exercises) · Series of exercise planning meetings with LTC facilities (to coordinate a functional exercise with long term care facilities and city agencies (i.e. New York City Emergency Management, Long Term Care Associations, and New York State Department of Health) as well as Controller and Evaluator Briefing and Training sessions) - initial planning meeting (IPM), -midterm planning meeting (MPM) and -final planning meeting (FPM), · Functional exercise participating long term care facilities, activates their Emergency Operations Center on-site and work through the components of the exercise (scenarios have included coastal storm, respiratory virus based on LTC sector hazard vulnerability assessments), Phase III Evaluation Phase · Conducted After Action Conference / Reporting · Completed After Action Report and Improvement Plan · Conducted post-program assessment · Conducted evaluation of the program For the Long Term Care Continuity Planning Program (Program III), the activities are as follows Phase I - Pre-planning · NYC DOHMH convened Advisory Board (same participants and duties as mentioned above) · Re-establish Emergency Management Team (EMT) · NYC DOHMH conducted pre-survey to assess continuity baseline knowledge on continuity planning and facility level preparedness son continuity planning Phase III Intervention · Learning Sessions topics included: Continuity of Operations for the facility, Continuity of care for residents during a disaster and Continuity sustainability at the facility level · Advanced Practicum develop site specific Continuity of Operations Plan (COOP) · Mentoring Sessions to re-enforce knowledge provided on Continuity of Operations Plan (COOP) principles during the learning sessions and develop site specific COOP plans · Functional Exercise Shadowing Phase III Evaluation · Capstone project i.e. design a continuity exercise · Program evaluation Results/Outcomes (list process milestones and intended/actual outcomes and impacts. Program I: Long Term Care Emergency Management Program (LTCEMP) Expected Outcomes achieved are: · Created and enhanced a facility's emergency management program · Increased participants' knowledge of emergency response roles and how to create the infrastructure to support these roles · Improved the facility's capability to prepare for and respond to all-hazard events · Trained the facility in techniques to sustain appropriate readiness and response capabilities · Participation in a table top exercise with local health departments (State and City), New York City Emergency Management, LTC Associations, 1199 Union Program II: Long Term Care Exercise Program (LTCExP) Expected Outcomes achieved are: · Improve the effectiveness of the LTC facility's disaster readiness by having facility teams learn to design, develop, conduct and evaluate meaningful exercises · Identify the facility's strengths and opportunities for improvement in emergency response under simulated conditions · Participation in a citywide functional exercise (local health departments (State and City), New York City Emergency Management, LTC Associations, 1199 Union) Program III: Long Term Care Continuity Planning Program (LTCCPP) Expected Outcomes achieved are: · Build resilience and sustainability for long-term care facilities in four areas: o Continuity of operations (COOP) for the facility o Continuity of care for residents during a disaster o Continuity/sustainability of the long term care emergency management program at the facility level and across the City o Knowledge transfer · Development of continuity plans and activities for each facility · Shadowing of an experienced exercise team · Development of a facility-specific continuity of operations exercise · Application of COOP resources, tools, and templates Overall LTC Emergency Management Programming: o NYC is home to 170 nursing homes and 78 Adult Care Facilities (n=248) · 80% (136) of NYC's nursing home sector participated in the Long Term Care Emergency Management Program (P1) · 28% (22) of NYC's adult care facility sector participated in the Long Term Care Emergency Management Program (P1) · 55% (94) of NYC's nursing home sector participated in the Long Term Care Exercise Program (P2) · 12% (9) of NYC's adult care facility sector participated in the Long Term Care Exercise Program (P2) · 25% (43) of NYC's nursing home sector participated in the Long Term Continuity Planning Program (P3) · 4% (3) of NYC's adult care facility sector participated in the Long Term Continuity Planning Program (P3) Exercise Programs o Middle East Respiratory Syndrome pandemic outbreak TTX exercise · 23 nursing homes (14%) and 13 adult care facilities (17%) · The purpose of Operation MERSy 2017 was to test the participating facilities ability to establish incident command, assess infectious disease planning and response, Identify continuity priorities, assess ability to manage staff and material resources and evaluate worker protection strategies o Pandemic Influenza Functional Exercise · 39 nursing homes (23%) and 6 adult care facilities (8%) · The purpose of Operation NHExIS 2017 was to test the participating facilities ability to activate a NIMS compliant community supported incident command system, activate its newly created Emergency Operations Plans, Annexes and Hazard Specific Guides, conduct emergency operations in the context of a community impacted pandemic influenza outbreak and identified areas for improvement in emergency operations coordination, information sharing and fatality management protocols. o Since inception (2014), 94 nursing homes (55%) and 9 adult care facilities (12%) are now able to design, develop and execute their own functional exercises What specific factors led to the success of this practice? The success of the practice is due to the collaboration and partnership between the local health departments (City and State), New York City Emergency Management, Labor Union, LTC Associations. New York City Emergency Management provides support by providing LTC facilities with 700 Mhz radio for redundant communications, to date 96% of the 248 Long Term Care facilities in NYC, have a direct communication to New York City Emergency Management. Additionally, the LTC Associations, offers Continuing Education Credits to Administrators who attends the Learning Sessions; as well as they provide yearly, one (1) full day emergency preparedness conference and three (3), 1 hour webinars, offered to 170 facilities and their internal staff and Adult Care Facilities associations conduct one (1) full day emergency preparedness conference and four (4), 1 hour webinars to 78 facilities and their internal multidisciplinary staff. Topics covered during both webinars include those related to the Health Commerce System, hazard vulnerability analysis development and application, eFINDs, cyber incidents and security, compliance with CMS, costal storm table top exercises and being prepared for an emergency. As a result of these webinars, the LTC sector is better prepared to respond to specific hazards and threats to protect LTC residents and staff, protect health information and evacuate, and track patients in disasters requiring evacuation. Public Health impact of practice New York City Long Term Care Emergency Preparedness Programs model improves linkages and collaboration among public health, emergency management, and local long term care associations. The partnership between public health, long term care associations and labor union are LTC facilities are responsible for the care of some of the most vulnerable New Yorkers, and as such, emergency preparedness within these facilities is crucial to meeting the needs of these residents and assure their safety and that of staff and residents' families. Website for your program, or LHD: https://www1.nyc.gov/site/doh/health/emergency-preparedness/what-we-do.page [i] Assistant Secretary for Preparedness and Response. Hurricane Sandy in New York: October November 2012.” Available at: https://www.phe.gov/Preparedness/planning/hpp/sandy/Pages/default.aspx. Accessed 12-11-2018. [ii] Office of Inspector General. Gaps Continue to Exist in Nursing Home Emergency Preparedness and Respone During Disasters/: 2007-2010.” Available at: http://ltcombudsman.org/uploads/files/library/oig-report.pdf. Accessed 12-22-2017.
roblem Statement - Lack of integration of the long term care sector in citywide planning for disasters and public health emergencies; as well as a comprehensive emergency management program dedicated to the long term care sector. So they can provide continuity of care for the medically vulnerable populations and residents they serve. The tool used the is the Mobilizing for Action through plannings and partnerships (MAPP) - this is not a new to the field of public health, but is a creative use of existing tool and practice. This program is a partnership with the local health departments (City and State,Local 1199 Service Employees International Union (SEIU) Labor Management Project, New York City Emergency Management, and Long Term Care Associations dedicated to building a comprehensive emergency management and technical assistant program to long term care facilities personnel. Since it's inception of this program in 2013, these partners established an advisory board comprised of stakeholders that can vet materials developed. What target population is affected by problem (please include relevant demographics) - What is the target population size? § In New York City's long term care sector, there are 170 nursing homes and 78 Long Term Care facilities, located throughout the five boroughs of New York City. · What percentage did you reach? (see below) What has been done in the past to address the problem? Prior to Super storm Sandy, NYC Department of Health and Mental Hygiene did not directly engage long term care facilities in public health emergency preparedness and training, In directly, hospitals received funding to include their ambulatory and long term care facilities in emergency planning. However, if a long term care facility was not linked to hospital, they were often not integrated in citywide planning and preparedness. Now in its sixth year, these three programs have been instrumental in providing emergency preparedness education to the LTC sector allowing sustainment of emergency preparedness within their facilities, the chart below indicates that we are able to reach at 82% of all LTC facilities in program one, 49% in program two and 21% in program three. Number of LTC facilities that completed each program, by year Program 2014 2015 2016 2017 2018 (enrolled) Total % of total LTC LTCEMP 21 36 38 23 21 139 82% LTCExP 0 14 20 33 16 83 49% LTCCPP 0 9 10 17 36 21%
The objectives of the 3 emergency preparedness programs are outlined below: Long Term Care Emergency Management Program (LTCEMP) Create and/or enhance a facility's emergency management program by: o Increasing participants' knowledge of emergency response roles and how to create the infrastructure to support these roles o Improving the facility's capability to prepare for and respond to all-hazard events o Training the facility in techniques to sustain appropriate readiness and response capabilities o Participation in a table top exercise Long Term Care Exercise Program (LTCExP) - Improve the effectiveness of the LTC facility's disaster readiness by having facility teams learn to design, develop, conduct and evaluate meaningful exercises - Identify the facility's strengths and opportunities for improvement in emergency response under simulated conditions - Participation in a citywide functional exercise Long Term Care Continuity Planning Program (LTCCPP) - Build resilience and sustainability for long-term care facilities in four areas: o Continuity of operations (COOP) for the facility o Continuity of care for residents during a disaster o Continuity/sustainability of the long term care emergency management program at the facility level and across the City o Knowledge transfer - Development of continuity plans and activities for each facility - Shadowing of an experienced exercise team - Development of a facility-specific continuity of operations exercise - Application of COOP resources, tools, and templates What did you do to achieve the goals and objectives? To achieve the program goals it was comprised of three phases - 1) pre-planning, intervention and evaluation, as described below: Steps taken to implement the program are Long Term Care Emergency Management Program (LTCEMP) Pre-Planning Phase o Recruit NYC nursing home and adult care facilities o Establish an Emergency Management Team (EMT) o Conduct a document review o Conduct a pre-assessment Intervention Phase o Conduct (2) learning sessions and (240) coaching sessions/techincal assistance sessions o Participate in a tabletop exercise o Receive emergency management equipment including MedSled evacuation equipment, 700 mhz radio, and Incident Command System vests Evaluation Phase o Post-Assessment o Evaluation of the Program Long Term Care Exercise Program (LTCExP Pre-Planning Phase o Recruit NYC LTC facilities o Re-establish Emergency Management Team (EMT) Intervention Phase o Conduct Learning Session o Hold 3 Planning Meetings o Functional Exercise Evaluation Phase o Site Specific and Overall After Action Report and Improvement Plan o Evaluation of the Program Long Term Care Continuity lanning rrogram (LTCCPP Pre-Planning Phase o Recruit NYC LTC Facilities o Re-establish Emergency Management Team (EMT) o 2 Surveys Intervention Phase o Advanced Learning Session o 240 Mentoring Sessions with an experienced emergency preparedness professional o Shadowing how to conduct an exercise (LTCExP) Evaluation Phase o Capstone Project o Program Evaluation Any criteria for who was selected to receive the practice (if applicable)? o Any New York City long term care facility is eligible until the program recruitment cap is reached, perference is given to those facilities located in evacuation zones 1-6, as identified by NYC Emergency Management. - What was the timeframe for the practice were other stakeholders involved? The programs runs from Fall (October/November) to Spring (April/May). Stakeholders participates in quarterly advisory board meetings to provide in put on programmatic development and implementation, as well as exercise design and execution. - What was their role in the planning and implementation process? Stakeholders are required to review and vet the comprehensive curriculum developed on core emergency management principles, participate in all planning meetings of the exercise; be active players during exercise play. Additionally, stakeholders, such as the Long Term Care Associations provides quarterly webinars on specific topics such as, antibiotic stewardship, pandemic influenza. NYC Emergency Management engages the sector throughout the program via the emergency radio communication program; each facility participate in roll call to test the use and connectivity of their 700 Mhz radio to NYC Emergency Management. Prior to this program, only hospitals, had radios with direct communication to NYC Emergency Management. - What does the LHD do to foster collaboration with community stakeholders? Describe the relationship(s) and how it furthers the practice goal(s) When developing the three emergency preparedness programs, NYC DOHMH collaborated with a diverse group of stakeholders. DOHMH created an advisory board comprised of representatives from NYC DOHMH, the New York State Department of Health (NYS DOH), NYC Emergency Management, Local 1199 Service Employees International Union, three NYC Nursing Home Associations, and four state adult care facility associations to provide input and recommendations on program development. For the implementation for the programs, NYC DOHMH contracted an external entity with emergency management experience to conduct assessments and provide LTC facilities with one-on-one coaching. NYC DOHMH recruited and established relationships with LTC facilities with support from several of the city's long-term care associations who are part of the NYC Healthcare Coalition. Tabletop and functional exercises are collaborative and supported with representation and involvement from nursing home associations, New York State Department of Health, New York City Emergency Management, and trade associations. The nursing home facilities are also encouraged to involve their local community stakeholders including their vendors and other healthcare facilities in the area in their exercise planning. - Any start up or in-kind costs and funding services associated with this practice? Please provide actual data, if possible. Otherwise, provide an estimate of start-up costs/ budget breakdown. The start up cost for the program was $450K Evaluation From 2013-16, 118 of New York City's 170 nursing homes completed the programs. Eighteen additional nursing homes and two adult care facilities participated in the programs in 2017-18. NYC DOHMH measures readiness levels in participating LTC facilities through pre-and post- implementation assessments of the LTCEMP program. The assessment tool determines if a facility's emergency management plan covers 10 core concepts – emergency management fundamentals, risk analysis, command and control, logistics management, communications, continuity of operations, community engagement, training and exercises, infectious disease management, and evacuation. - In 2017-18, 65 percent of participating LTC facilities had minimal components in their emergency management plans. After participating in the program, all participating facilities saw an increase in their preparedness levels and enhanced their all-hazards emergency management plans. o Due to the participation of individual facilities, the city's five boroughs are better equipped to handle an all-hazards event: o The Bronx's scores rose from 60 to 91 percent. Facilities without developed plans before enrollment achieved comprehensive all-hazards emergency management plans upon program completion. o Although no new sites in Staten Island participated in 2017-18, facilities that participated in 2016-17 increased their scores from 49 to 86 percent. Facilities that started with minimal emergency plans before enrollment achieved comprehensive all-hazards emergency management plans upon program completion. o Queens and Brooklyn's score rose from 44 to 79 percent, and 44 to 78 percent, respectively. Facilities that started with minimal emergency plans achieved developed and event-specific plans and procedures. o Manhattan's score rose from 36 to 50 percent. Participating facilities still have minimal emergency plans but are on their way to achieving the next step in incorporating most of the critical components in an emergency plan to eventually create comprehensive all-hazards emergency management plans. Overall, New York City's readiness rose from 46 to 80 percent, from having minimal emergency plans to developed and event-specific plans and procedures in 2017-18. - Did you evaluate your practice? o List any primary data sources, who collected the data, and how (if applicable) § Incident Management Systems (vendor) collected in-person and online survey data to evaluate the impacts of the program. o List any secondary data sources used (if applicable) (N/A?) o List performance measures used. Include process and outcome measures as appropriate. Process measures: LTCEMP § ~80 % of recruited and participating NHs and ACFs for LTCEMP § Identification of EPC at each NH and ACF § 2 full day LSs completed § 135 of NHs and ACFs (and types of staff) that participate in LS § Identified Emergency Preparedness levels for NHs and ACFs (increase in EM preparedness – beginning to end of program) § 240 of coaching sessions § 30 of NHs and ACFs that participate in 2 TTXs § 30 Completion of pre-and post-assessment; Completion of evaluation report outlining next steps LTCEXP/LTCCPP § 30% of recruited and participating NHs and ACFs for LTCEMP § Identification of EPC at each NH and ACF § 2 full day LSs completed § 135 of NHs and ACFs staff (and types of staff - administrative and clinical staff) that participate in LS § Identified Emergency Preparedness levels for NHs and ACFs (increase in EM preparedness – beginning to end of program) § 240 of coaching sessions § 30 of NHs and ACFs that participate in 2 TTXs § 30 Completion of pre-and post-assessment; Completion of evaluation report outlining next steps o Describe how results were analyzed - data was analyze with basic frequencies and averages, captured from excel spreadsheet o Were any modifications made to the practice as a result of the data findings? Modifications made to the program, to have site in the Long Term Care Continuity Planning Program conduct a Continuity of Operations exercise either Tabletop or functional exercise, instead of just shadowing the simulated cell of a functional exercise. Additionally, DOHMH is exploring making program one - with the intensive onsite coaching, a train-the-trainer model hosted on an online platform to teach LTC facilties the content on emergency management and how to teach their staff these emergency management prinicples. Key evaluation stats: Long Term Care Emergency Management Program (LTCEMP) - Respondents gave high marks to their overall experience in Program Year One, 91% (29) said the program was high quality or very high quality. - Most respondents (84%, 27) said that the program experience had impacted their organization's ability to respond to an emergency at least a lot.” - All respondents (31, 100%) indicated that the program's introduction of the new Comprehensive Emergency Management Plan (CEMP) was at least somewhat helpful to their emergency management program, with 25 (81%) saying that was very helpful. - Twenty-five respondents (81%) said that they had adopted the CEMP as their plan and customized it to be specific to their LTC facility. Long Term Care Exercise Program (LTCExP) - Respondents gave good marks to their overall experience in Program Year Two, with 97% (24) saying the program was high quality or very high quality. - The vast majority of respondents (91%, 58) said that the program experience had impacted their organization's ability to respond to an emergency at least a lot.” - Most respondents (94%, 60) indicated that the May 3, 2017 exercise was of high or very high quality. - When asked to describe the three things of most value from the exercise experience nearly all respondents described that the experience strengthened or brought their team together. Other responses included: identified resources in the area,” ability to interact with OEM, DOH, other hospitals and SNFs,” opportunity to challenge our existing plans.” Long Term Care Continuity Planning Program (LTCCCP) - Respondents gave good marks to their overall experience in Program Year Three; 63 percent (10) said the program was high quality and 13 percent (2) said it was very high quality. - Nearly all respondents (86%, 13) said that the program experience had impacted their organization's ability to continue providing its services after an emergency at least a lot.” - When asked how the Year Three experience impacted their ability to do COOP-related work, 60 percent (9) of respondent said a great deal Lessons learned in relation to practice. o Although getting facilities to volunteer and commit seven to nine months for each program can be challenging, the programs were successful due to support from the LTC facilities' administration and the program's advisory board, and the staff's dedication to complete the programs. o LTC facilities found the individualized trainings and designated coaching sessions most valuable. o Recognizing funding reductions for preparedness programs, NYC DOHMH will be exploring the development of a train-the-trainer option to make the LTCEMP, LTCExP, and LTCCPP programs sustainable. o Since NYC DOHMH developed the LTCEMP, LTCExP, and LTCCPP as scalable and multifaceted programs, other healthcare sectors, such as dialysis and pediatric centers, are also able to implement these programs. - Lessons learned in relation to partner collaboration (if applicable) - No. - Did you do a cost/benefit analysis? If so, describe. No - Is there sufficient stakeholder commitment to sustain the practice? Exertnal partners are committed to the sustainment of the program. The long term care associations, provides Administrators' CEU to encourage and sustain participation. Additional Information How did you hear about the Model Practices Program: - I am a previous Model Practices applicant
Process measures: LTCEMP § # / % of recruited and participating NHs and ACFs for LTCEMP § Identification of EPC at each NH and ACF § # of (2) full day LSs completed § # of NHs and ACFs (and types of staff) that participate in LS § Identified Emergency Preparedness levels for NHs and ACFs (increase in EM preparedness beginning to end of program) § # of coaching sessions § # of NHs and ACFs that participate in 2 TTXs § # Completion of pre-and post-assessment; Completion of evaluation report outlining next steps LTCEXP/LTCCPP § # / % of recruited and participating NHs and ACFs for LTCEMP § Identification of EPC at each NH and ACF § # of (2) full day LSs completed § # of NHs and ACFs (and types of staff) that participate in LS § Identified Emergency Preparedness levels for NHs and ACFs (increase in EM preparedness beginning to end of program) § # of coaching sessions § # of NHs and ACFs that participate in 2 TTXs § # Completion of pre-and post-assessment; Completion of evaluation report outlining next steps Key evaluation stats: LTCEMP - Respondents gave high marks to their overall experience in Program Year One, 91% (29) said the program was high quality or very high quality. - Most respondents (84%, 27) said that the program experience had impacted their organization's ability to respond to an emergency at least a lot.” - All respondents (31, 100%) indicated that the program's introduction of the new Comprehensive Emergency Management Plan (CEMP) was at least somewhat helpful to their emergency management program, with 25 (81%) saying that was very helpful. - Twenty-five respondents (81%) said that they had adopted the CEMP as their plan and customized it to be specific to their LTC facility. LTCExP - Respondents gave good marks to their overall experience in Program Year Two, with 97% (24) saying the program was high quality or very high quality. - The vast majority of respondents (91%, 58) said that the program experience had impacted their organization's ability to respond to an emergency at least a lot.” - Most respondents (94%, 60) indicated that the May 3, 2017 exercise was of high or very high quality. - When asked to describe the three things of most value from the exercise experience nearly all respondents described that the experience strengthened or brought their team together. Other responses included: identified resources in the area,” ability to interact with OEM, DOH, other hospitals and SNFs,” opportunity to challenge our existing plans.” LTCCCP - Respondents gave good marks to their overall experience in Program Year Three; 63 percent (10) said the program was high quality and 13 percent (2) said it was very high quality. - Nearly all respondents (86%, 13) said that the program experience had impacted their organization's ability to continue providing its services after an emergency at least a lot.” - When asked how the Year Three experience impacted their ability to do COOP-related work, 60 percent (9) of respondent said a great deal. Please enter the evaluation results of your practice (2000 Words Maximum) Sustainability Sustainability is determined by the availability of adequate resources. In addition, the practice should be designed so that the stakeholders are invested in its maintenance and to ensure it is sustained after initial development (NACCHO acknowledges that fiscal challenges may limit the feasibility of a practice's continuation.) - Lessons learned in relation to practice. o Although getting facilities to volunteer and commit seven to nine months for each program can be challenging, the programs were successful due to support from the LTC facilities' administration and the program's advisory board, and the staff's dedication to complete the programs. o LTC facilities found the individualized trainings and designated coaching sessions most valuable. o Recognizing funding reductions for preparedness programs, NYC DOHMH will be exploring the development of a train-the-trainer option to make the LTCEMP, LTCExP, and LTCCPP programs sustainable. o Since NYC DOHMH developed the LTCEMP, LTCExP, and LTCCPP as scalable and multifaceted programs, other healthcare sectors, such as dialysis and pediatric centers, are also able to implement these programs.
Lessons learned in relation to practice. o Although getting facilities to volunteer and commit seven to nine months for each program can be challenging, the programs were successful due to support from the LTC facilities' administration and the program's advisory board, and the staff's dedication to complete the programs. o LTC facilities found the individualized trainings and designated coaching sessions most valuable. o Recognizing funding reductions for preparedness programs, NYC DOHMH will be exploring the development of a train-the-trainer option to make the LTCEMP, LTCExP, and LTCCPP programs sustainable. o Since NYC DOHMH developed the LTCEMP, LTCExP, and LTCCPP as scalable and multifaceted programs, other healthcare sectors, such as dialysis and pediatric centers, are also able to implement these programs. - Lessons learned in relation to partner collaboration (if applicable) - Did you do a cost/benefit analysis? If so, describe. No - Is there sufficient stakeholder commitment to sustain the practice? Long Term Care Associations committed to the program by providing CEUs. o Describe sustainability plans is to develop the program in a train-the-trainer model via online platform.
I am a previous Model Practices applicant