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Pediatric Special Needs Shelter Registry

State: FL Type: Model Practice Year: 2018

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Florida Department of Health in Broward County
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Pediatric Special Needs Shelter Registry
Broward County's 2016 population estimate of 1,809,604, represents 10% of Florida's population (US Census). Its residents represent over 200 different countries speaking more than 130 languages with 31.5% of residents are foreign-born. Broward County is a minority/majority county. Broward County has received federal designations of both a Health Professional Shortage Area and Medically Underserved Area and Population in multiple geographic areas and populations within the county. The Florida Department of Health in Broward County (DOH-Broward) is the official lead Public Health Agency in Broward County and is part of the Integrated Florida Department of Health (DOH) which provides core public health functions and essential services as part of a complex public health system that includes hospitals, clinics, planning agencies, and community-based organizations. There are four goals of the practice which were all achieved. They are: 1) increase the number of adult and pediatric residents pre-registered for Special Needs Sheltering (SpNS); 2) Develop and maintain a pediatric special needs registry; 3) assist the Emergency Operations Center call-center by fielding an off-site DOH-Broward special needs sheltering triage team call-center; and, 4) utilize staff with medical and/or hardship exemptions to work in a SpNS in pre- and post-storm activities. In March, 2017, DOH-Broward developed a pediatric special needs registry and conducted community and provider outreach to encourage year-round adult and pediatric special needs registration to increase the number of adult and pediatric residents pre-registered for SpNS. An electronic email list of more than 1,500 durable medical equipment providers, home health agencies, and physicians was developed to transmit information about the need to pre-register patients for emergency sheltering. Community presentations were conducted for emergency medical services providers, the Broward County Healthcare Coalition, Emergency Coordinating Council, Outreach Planning Group and the Broward Regional Health Planning Council's Health Care Access Committee. In August/September 2017, DOH-Broward activated a 30- person triage team to screen phone calls from worried SpNS residents during activation for Hurricane Irma. In order to utilize staff with medical and/or hardship exemptions to work in a SpNS in pre- and post-storm activities, exempted staff were reassigned to assist with operation of the call center, making copies of documents, and conducting well-check calls after impact. In order to assist the Emergency Operations Center call-center by fielding an off-site DOH-Broward special needs sheltering triage team call-center, all residents that called into the Emergency Operations Center (EOC) call center were transferred to the DOH-Broward headquarters call center. By pro-actively activating this team 5 days in advance of the Hurricane Irma impacts, more than 1,000 callers were provided telephone assistance without tying up the Emergency Operations Center (EOC) phone lines for other storm related needs. The exempted staff were also tasked with conducting multiple well-check calls, post-storm, to more than 700 facilities until electric power was restored. DOH-Broward generated a list of licensed facilities including boarding homes, sober homes, and assisted living facilities. The exempted staff were also tasked with conducting multiple well-check calls, post-storm, to more than 700 facilities until electric power was restored. DOH-Broward and ESF 8 personnel also enlisted the assistance of Florida Power and Light (FPL) representatives to ping” address to verify power restoration. Mission requests with information about the facility, its location, and the concern were submitted to the municipal coordinator through WebEOC for facilities requiring an in-person follow-up because of unverified power restoration or inability to reach a facility through well-check calls. The municipal coordinator would assign the appropriate municipal field representative the task of conducting the well-check and of reporting the results of the in-person visit back through mission tracking. WebEOC is the Crisis Information Management Software (CIMS) used by Broward County to manage and coordinate information and resources during a disaster. As of 12/5/17, the pediatric SpNS registry increased from 44 to 277 (629%) pediatric clients. The adult SpNS has increased from 208 to 1,212 (582%) SpNS adults. Ongoing outreach to include in-person presentations to home health agencies and durable medical equipment providers continues to be conducted to educate the community about the need to pre-register SpNS clients. Coordination activities and communications were improved between many organizations including Broward County Emergency Management Division, Children's Medical Services, emergency medical services providers, durable medical equipment providers, home health agencies, transportation providers, adult congregate living facilities, group and sober homes, physicians the Broward County Healthcare Coalition, Emergency Coordinating Council, Outreach Planning Group, Broward Regional Health Planning Council's Health Care Access Committee, Florida Power and Light and Broward County's 31 municipalities. Web Address (if applicable) www.broward.floridahealth.gov
Broward County has a significant number of vulnerable residents with a variety of access and/or functional needs. According to 2016 FLHealthCharts data (flcharts.com), approximately 206,318 residents have 1 or more disabilities. Broward County's population includes 246,154 residents aged 65-84 and 45,749 aged 85 and over. 108,077 elders live alone. There are 37,272 probable Alzheimer's cases in residents aged 65 and over. Data further indicates that 32,661 residents aged 18-64 have difficulty with independent living, 15,432 have hearing difficulty and 17,821 have vision difficulty. There are also 10,572 Children's Medical Services clients. DOH-Broward is the lead agency for Emergency Support Function 8 (ESF 8) Health and Medical. Broward County Emergency Management Division (BEMD) is responsible for maintaining a special medical needs registry and Broward County Children's Medical Services is responsible for the children's registry. In 2016, Broward County activated its Emergency Operations Center in response to the approach of Hurricane Matthew. ESF 8 was inundated with phone calls from worried residents including last-minute requests from residents for special needs sheltering (SpNS). The adult special needs residents had 208 residents fully registered for SpNS with the children's registry having 44 children preregistered. Additional health department personnel were called in to field the large volume of phone calls from residents wanted to register during the activation for SpNS. As a part of after action and improvement planning, DOH-Broward decided to develop a pediatric special needs registry and conduct community and provider outreach to encourage year-round adult and pediatric special needs registration. Initial efforts included development of the pediatric registry and implementing a coordination mechanism with Children's Medical Services. BEMD is responsible for maintaining the adult SpNS registry. DOH-Broward requested and received permission from BEMD to conduct outreach and education to the community to increase the number of adults who pre-register for sheltering. An electronic email list of more than 1,500 durable medical equipment providers, home health agencies, transportation providers and physicians was developed to transmit information about the need to pre-register patients for emergency sheltering. Community presentations were made to emergency medical services providers, the Broward County Healthcare Coalition, Emergency Coordinating Council, Outreach Planning Group and the Broward Regional Health Planning Council's Health Care Access Committee. In past activations, DOH-Broward staff who requested medical and/or hardship exemptions for SpNS assignments were excused from all activation responsibilities. During activation for Hurricane Irma in August/September 2017, DOH-Broward activated a 30- person triage team to screen phone calls from worried SpNS residents. Exempted staff were reassigned to assist with operation of the call center, making copies of documents, and conducting well-check calls after impact. All residents that called into the Emergency Operations Center (EOC) call center were transferred to the DOH-Broward headquarters call center. By pro-actively activating this team 5 days in advance of the Hurricane Irma impacts more than 1,000 callers were provided telephone assistance without tying up the EOC phone lines. The exempted staff were also tasked with conducting multiple well-check calls, post-storm, to more than 700 facilities until electric power was restored. DOH-Broward and ESF 8 personnel also enlisted the assistance of Florida Power and Light (FPL) representatives to ping” address to verify power restoration. Facilities requiring in-person follow-up as a result of unverified power restoration, or inability to reach a facility through well-check calls, information about the facility, its location, and the concern were submitted to the municipal representative for The pediatric SpNS registry increased from 44 to 277 (629%) pediatric clients. The adult SpNS has increased from 208 to 1,212 (582%) SpNS adults. Ongoing outreach to include in-person presentations to home health agencies and durable medical equipment providers continues to be conducted to educate the community about the need to pre-register SpNS clients.
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There are four goals of the practice which are: 1) increase the number of adult and pediatric residents pre-registered for Special Needs Sheltering; 2) Develop and maintain a pediatric special needs registry; 3) assist the Emergency Operations Center call-center by fielding an off-site DOH-Broward special needs sheltering triage team call-center; and, 4) utilize staff with medical and/or hardship exemptions to work in a SpNS in pre- and post-storm activities. In order to increase the number of adult and pediatric residents pre-registered for SpNS, in March, 2017, DOH-Broward decided to develop a pediatric special needs registry and conduct community and provider outreach to encourage year-round adult and pediatric special needs registration. Initial efforts included development of the pediatric registry and implementing a coordination mechanism with Children's Medical Services. Broward County Emergency Management Division (BEMD) is responsible for maintaining the adult SpNS registry. DOH-Broward requested and received permission from BEMD to conduct outreach and education to the community to increase the number of adults who pre-register for sheltering. An electronic email list of more than 1,500 durable medical equipment providers, home health agencies, and physicians was developed to transmit information about the need to pre-register patients for emergency sheltering. Community presentations were made to emergency medical services providers, the Broward County Healthcare Coalition, Emergency Coordinating Council, Outreach Planning Group and the Broward Regional Health Planning Council's Health Care Access Committee. In past activations, DOH-Broward staff who requested medical and/or hardship exemptions for SpNS assignments were excused from all activation responsibilities. During activation for Hurricane Irma in August/September 2017, DOH-Broward activated a 30- person triage team to screen phone calls from worried SpNS residents. In order to utilize staff with medical and/or hardship exemptions to work in a SpNS in pre- and post-storm activities, exempted staff were reassigned to assist with operation of the call center, making copies of documents, and conducting well-check calls after impact. In order to assist the Emergency Operations Center call-center by fielding an off-site DOH-Broward special needs sheltering triage team call-center, all Broward residents that called into the Emergency Operations Center (EOC) call center were transferred to the DOH-Broward headquarters call center. By pro-actively activating this team 5 days in advance of the Hurricane Irma impacts more than 1,000 callers were provided telephone assistance without tying up the EOC phone lines. The exempted staff were also tasked with conducting multiple well-check calls, post-storm, to more than 700 facilities until electric power was restored. DOH-Broward generated a list of licensed facilities including boarding homes, sober homes, assisted living facilities. The exempted staff were also tasked with conducting multiple well-check calls, post-storm, to more than 700 facilities until electric power was restored. DOH-Broward and ESF 8 personnel also enlisted the assistance of Florida Power and Light (FPL) representatives to ping” address to verify power restoration. Facilities requiring in-person follow-up as a result of unverified power restoration, or inability to reach a facility through well-check calls, information about the facility, its location, and the concern were submitted to the municipal coordinator through WebEOC as mission requests. The municipal coordinator would assign the appropriate municipal field representative the task of conducting the well-check and of reporting the results of the in-person visit back through mission tracking. As of 12/5/17, the pediatric SpNS registry increased from 44 to 277 pediatric clients. The adult SpNS has increased from 208 to 1,212 SpNS adults. Ongoing outreach to include in-person presentations to home health agencies and durable medical equipment providers continues to be conducted to educate the community about the need to pre-register SpNS clients. The practice did not result in any additional costs and also identified unused personnel resources (exempt staff) to assist in better fulfilling the DOH-Broward and ESF 8 mission.
All four of the practice goals were met. A pediatric special needs registry was developed and implemented in March, 2017. The number of adult and pediatric residents pre-registered for SpNS. As of December 5, 2017, the pediatric SpNS registry increased from 44 to 277 pediatric clients. The adult SpNS has increased from 208 to 1,212 SpNS adults. Ongoing outreach to include in-person presentations to home health agencies and durable medical equipment providers continues to be conducted to educate the community about the need to pre-register SpNS clients. Coordination activities and communications were improved between many organizations including Broward County Emergency Management Division, Children's Medical Services, emergency medical services providers, durable medical equipment providers, home health agencies, transportation providers, adult congregate living facilities, group and sober homes, physicians the Broward County Healthcare Coalition, Emergency Coordinating Council, Outreach Planning Group, Broward Regional Health Planning Council's Health Care Access Committee, Florida Power and Light and Broward County's 31 municipalities. The Emergency Operations Center call-center operation was augmented by fielding an off-site DOH-Broward special needs sheltering triage team call-center, all residents that called into the Emergency Operations Center (EOC) call center were transferred to the DOH-Broward headquarters call center. By pro-actively activating this team 5 days in advance of the Hurricane Irma impacts more than 1,000 callers were provided telephone assistance without tying up the EOC phone lines. DOH-Broward staff who requested medical and/or hardship exemptions for SpNS assignments were utilized to support the call center, make copies of documents, and conducting well-check calls after impact. By pro-actively activating this team as well as the triage team 5 days in advance of the Hurricane Irma impacts more than 1,000 callers were provided telephone assistance without tying up the EOC phone lines. The exempted staff were also tasked with conducting multiple well-check calls, post-storm, to more than 700 facilities until electric power was restored.
Seven hotwash sessions were held, one with each of the five SpNS teams, one with all of the SpNS managers and one with the DOH-Broward incident management team and ESF 8 members. In addition, a hotwash was held with the Broward Healthcare Coalition and one with Broward County Emergency Response teams. Positive feedback was provided for this new practice. Coordination activities and communications continue between many organizations including Broward County Emergency Management Division, Children's Medical Services, emergency medical services providers, durable medical equipment providers, home health agencies, transportation providers, adult congregate living facilities, group and sober homes, physicians the Broward County Healthcare Coalition, Emergency Coordinating Council, Outreach Planning Group, Broward Regional Health Planning Council's Health Care Access Committee, Florida Power and Light and Broward County's 31 municipalities.
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