As the Healthcare Coalition demobilizes, important HCRT objectives may remain, such as supporting remaining recovery objectives for member organizations and returning the HCRT to a state of readiness for the next emergency.
3.7.1 Managing the Healthcare Coalition through Recovery
There are additional management considerations for the Healthcare Coalition as its response to an incident draws to a close, including:
- The HCRT Leader and the Planning Section Chief (if this position is staffed) should be the last positions to demobilize.
- If the HCRT needs to support the recovery of member organizations or the jurisdiction, the staffed positions may vary from the HCRT response configuration. It may be more limited or staffed by different personnel than those who worked during HCRT emergency operations.
- In addition to incident recovery objectives, the Coalition may find it useful to address mitigation or improvement in its response capabilities during recovery. Funding opportunities often arise after an emergency. The Coalition should be ready with targeted initiatives that will increase HCRT resiliency and/or improve its response capabilities.
- The HCRT may assign personnel to assist with the Coalition’s AAR process or other organizational learning activities. When the HCRT demobilizes, the supervision of the AAR process transitions to the Coalition’s Emergency Management Committee (see Chapter 5).
3.7.2 Resource and Personnel Rehabilitation for the Healthcare Coalition
All resources used during emergency response should be rehabilitated to their pre-response state. Rapid return to readiness of key resources, such as the Coalition Notification Center, should be a primary focus. Any facilities used by the Healthcare Coalition should be returned to their normal configuration. Durable equipment must be rehabilitated and non-durable supplies should be re-stocked. Information collected and processed by the HCRT should be appropriately archived.
Rehabilitation for personnel who conducted incident operations for the HCRT may entail the following:
- Establishing a formal process for “out-processing” personnel and returning any issued equipment (e.g., radios)
- Debriefing personnel as they are out-processed and use their feedback to inform the AAR process
- Recognizing the efforts of personnel who staffed the HCRT and consider giving them personal time to recover before returning to their regular duties
- Conducting performance evaluations for personnel who staffed HCRT positions during emergency operations.
3.7.3 Reimbursement for Healthcare Coalition Response
Chapter 5 addresses funding of the Coalition’s preparedness activities. The funding of response activities is approached differently. The primary cost for operating the HCRT and Senior Policy Group is usually personnel time, which is often donated by the Coalition member organizations. However, it is still important to keep records of personnel time (or other Coalition expenses), since reimbursement mechanisms may be available. In some situations, established mechanisms may exist for reimbursing Coalition expenses (Exhibit 3-11).
Exhibit 3-11: Regional Hospital Preparedness Council and the Catastrophic Medical Operations Center*
A variety of medical organizations within 18 counties of Southeast Texas have organized to develop a Coalition that addresses common emergency preparedness and response issues. The Regional Hospital Preparedness Council is a 501c3 independently chartered organization that functions as a preparedness platform for these organizations. During emergency response, the associated Catastrophic Medical Operations Center (CMOC) is staffed to address many of the response objectives listed for Coalitions in section 2.2 of this handbook. For example, as Hurricane Ike approached Texas in 2008, the CMOC facilitated patient tracking for the evacuation of 56 hospitals and 220 nursing homes over a 60-hour period.
The CMOC is organized using a NIMS-consistent Incident Management Team structure with subject matter experts covering traditional ICS functions. Additional liaisons have included representatives of agencies such as HHS, Department of Aging and Disability, EMS, and Medical Societies.
The council currently receives no direct State or Federal preparedness funding. However, when the CMOC is activated by the State or a local jurisdiction during a declared emergency or disaster, it is financially supported through contract. Funds reimburse the costs of personnel staffing the CMOC as well as specified other expenses.
*Personal communication between the author (AGM) and Lori A. Upton, RN, BSN, MS; January 28, 2009.
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