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Pediatric Care Requirements and Hospital Preparedness Progr Pediatric Care Requirements and Hospital Preparedness Progr

Pediatric Care Requirements and Hospital Preparedness Progr - PowerPoint Presentation

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Pediatric Care Requirements and Hospital Preparedness Progr - PPT Presentation

Cooperative Agreement AND CMS Emergency Preparedness Rules Related to Pediatric Care May 23 rd 2017 Teresa Ehnert ChiefBureau of Public Health Emergency Preparedness AGENDA Review of Pediatric Care Requirements for the Hospital ID: 591591

care emergency requirements pediatric emergency care pediatric requirements hpp preparedness children hcc 2017 health cms cooperative plan agreement rule

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Slide1

Pediatric Care Requirements and Hospital Preparedness Program: New 2017

Cooperative Agreement

AND

CMS Emergency Preparedness Rules Related to

Pediatric Care

May 23

rd

, 2017

Teresa Ehnert

|

Chief-Bureau of Public Health Emergency PreparednessSlide2

AGENDA

Review of Pediatric Care Requirements for the Hospital

Preparedness

Program (HPP) in New 2017 Cooperative Agreement

Review of CMS Rules Related to Children/Pediatric Care

Discussion on collaboration between HPP and Emergency Medical Services for Children (EMSC)

OPEN

DISCUSSIONSlide3

Pediatric

Care Requirements

HPP-2017

Cooperative

Agreement and CMS Requirements

GoalThe goal is to understand 2017 Cooperative Agreement and HPP Requirements related to Health Care Coalition (HCC), Pediatric Care and Emergency Medical Services for Children (EMSC)Slide4

Pediatric

Care Requirements for HCC

HIGHLIGHTS

-2017

Cooperative Agreement

Domain 1 Strategy:

Strengthen Community

Resilience

Activity 1:

Partner with Stakeholders by Developing and Maturing Health Care Coalitions

HPP Requirements:

Identify

HCC Members

Awardees and HCCs

should

expand HCC membership to include additional types of members

……..

HCCs

also should

include specialty patient referral centers such as

pediatric

, burn, trauma, and psychiatric centers, as HCC members within its geographic boundaries. They may also serve as referral centers to other HCCs where that specialty care does not exist

.Slide5

Pediatric

Care Requirements for HCC

HIGHLIGHTS

-2017

Cooperative Agreement

Domain 1 Strategy:

Strengthen Community

Resilience

Activity 2:

Characterize the Probable Risks to the Jurisdiction and the HCC Joint

Requirements-Jurisdictional

Risk Assessments

HPP Requirements:

Assess

Hazard Vulnerabilities and Risks

Each awardee-funded HCC

must

complete an annual hazard vulnerability analysis (HVA) to identify and plan for risks, in collaboration with the

awardee.

The

assessment components

should

address population characteristics, including demographics, and consider those

individuals who might require additional help

in an emergency including

children

, pregnant women, seniors, and individuals with access and functional needs, including people with disabilities and others with unique needs.Slide6

Pediatric

Care Requirements for HCC

HIGHLIGHTS

-2017

Cooperative Agreement

Domain 1 Strategy: Strengthen Community

Resilience

Activity

3:

Characterize Populations at Risk

HPP

Requirements :

HPP

awardees and HCCs

must

obtain de-identified data from the U.S. Department of Health and Human Services emPOWER map

every six months

to identify populations with unique health care needs …

As

part of inclusive planning for populations at risk conducted by HPP awardees, HPP-funded HCCs

must

:

Support

public health agencies with situational awareness and information technology (IT) tools already in use that can help identify

children

, seniors, pregnant women, people with disabilities, and others with unique

needs

PHEP

Requirements :

To address the needs of infants and children, awardees

should

collaborate with child-serving institutions such as schools and daycare centers to assure crisis preparedness plans are in place

.Slide7

Pediatric

Care Requirements for HCC

HIGHLIGHTS

-2017

Cooperative Agreement

Domain 2 Strategy:

Strengthen

Incident

Management

Activity 4:

Ensure HCC Integration and Collaboration with Emergency Support Function-8 (ESF-8

)-

HCC

Response

Plan

Each HCC funded by the awardee

must

develop a

response plan

that is informed by its members’ individual emergency operations plans and

submit

the plan to ASPR by the

end of Budget Period 2

with annual progress reports.

Each

HCC’s response plan

must

clearly outline:

Activation

and notification processes for initiating and implementing medical surge response coordination among HCC members and other topics related to medical surge, including:

Strategies

to implement if the emergency overwhelms regional capacity or specialty care including trauma, burn, and

pediatric

capability

.Slide8

Pediatric

Care Requirements for HCC

HIGHLIGHTS

-2017

Cooperative Agreement

Domain 3 Strategy: Strengthen Information Management

Activity 2.

Share Emergency Information and Warnings across Disciplines, Jurisdictions, and HCCs and their

Members

Joint

Requirements:

Coordinate

Emergency Information Sharing between Public Health and Health

Care.

The

following are factors that HCCs, in coordination with HPP and PHEP awardees and other public health agency members,

should

consider when developing processes and procedures to rapidly acquire and share clinical knowledge.

Processes

and procedures should address a variety of emergencies such as chemical, biological, radiological, nuclear, or explosive (CBRNE), trauma, burn,

pediatrics

, or highly infectious disease

outbreaksSlide9

Pediatric

Care Requirements for HCC

HIGHLIGHTS

-2017

Cooperative Agreement

Domain 5 Strategy: Strengthen Surge

Management

Activity 2: Address Surge Needs

Joint

Requirements:

Family Reunification

During

a public health incident or crisis, families are at risk for becoming disconnected. HPP awardees and HCCs

must

serve as planning resources and

SMEs to

PHEP awardees and public health agencies as they develop or augment existing response plans for affected populations, including mechanisms for family reunification. These plans should give consideration to:

• Reunification considerations for

childrenSlide10

Pediatric

Care Requirements for HCC

HIGHLIGHTS

-2017

Cooperative Agreement

Domain 5 Strategy: Strengthen Surge

Management

Activity 4:

Address Specialty Surge

HPP

Requirements:

Pediatric Care

HPP awardees

must

collaborate

with the EMSC

program within its jurisdiction to better meet the needs of children receiving emergency medical care. Following are specific areas of collaboration:

The

HRSA

administer the EMSC program at the federal level, and

this

program works to ensure that

critically ill and injured children

receive optimal pediatric emergency care. Slide11

Pediatric

Care Requirements for HCC

HIGHLIGHTS

-2017

Cooperative Agreement

Domain 5 Strategy: Strengthen Surge

Management

Activity

4:

Address Specialty Surge

HPP

Requirements:

Pediatric Care

(Contd.)

Following are specific areas of collaboration.

HPP and

the EMSC program awardees within their jurisdictions

must

provide a

joint letter of support indicating

that EMSC and HPP are linked at the awardee level.

HPP

awardees

must

provide the initial letter of support with their funding applications

at the beginning of each budget period throughout the five-year project

period.

HPP

awardees

must

work with HCCs and EMSC to ensure that all hospitals are prepared to receive, stabilize, and manage

pediatric

patients.

At

the end of each budget period

, HRSA will provide HPP with data regarding each hospital’s capability to manage

pediatric medical emergencies

to assist with this work

.Slide12

Pediatric

Care Requirements for HCC

HIGHLIGHTS

-2017

Cooperative Agreement

HPP Evaluation and Performance Measurement StrategyTo measure and evaluate HPP performance, a variety of measures were developed at the input-, activity-, output-, or outcome-level. The 2017-2022 HPP performance measures target output and outcome measures to address the information needs of various stakeholders

.

One

of the 22 HPP performance measures and the six measures (23-28) for select U.S. territories and freely associated states is:

Percent

of hospitals with an Emergency Department (ED) recognized through a statewide, territorial, or regional standardized system that are able to stabilize and/or manage

pediatric medical emergencies

.Slide13

Pediatric

Care Requirements

CMS Emergency Preparedness Rule 2016

Comments on CMS EP Rules for Pediatric Care and

CMS Response:

Comment-1:

Joint

Guidelines for Care of

Children

in the Emergency Department, developed by the American Academy of Pediatrics, the American College of Emergency Physicians, and the Emergency Nurses Association,

as a resource

for the final rule.

Response to Comment 1:

We

also want to thank commenters for their recommendations for

additional resources

on emergency preparedness. We provided an extensive list of resources in the proposed and have included links to various resources in this final rule that facilities can use as resources during the development of their emergency preparedness plans. However, we note that these lists are not comprehensive

,…… since we intend to allow facilities flexibility as they implement the emergency preparedness requirements….

Omissions

from the list of resources set out in the proposed rule do not indicate any intention on our part to exclude other resources from use by facilities.Slide14

Pediatric

Care Requirements

CMS Emergency Preparedness Rule 2016

Comment-2

:

A commenter recommended that emergency preparedness plans should account for children's special needs during an emergency. The commenter stated that emergency preparedness plans should include

children's medication

and

medical device

needs, challenges regarding

patient transfer

for neonatal and pediatric intensive care patients, and issues involving behavioral health and family reunification

.

Comment-3:

A commenter recommended that

CMS collaborate

closely with the Emergency Medical Services for Children (EMSC) program administered by the Health Resources and Services Administration (HRSA). The commenter noted that this program focuses on improving the

pediatric

components of the EMS system

.Slide15

Pediatric

Care Requirements

CMS Emergency Preparedness Rule 2016

Response to Comment 2 & 3:

We appreciate the commenter's concerns. As required in § 482.15(a)(1), (2), and (3), when a provider or supplier develops an emergency preparedness plan, we will expect that the provider/supplier will use a facility-based and community-based risk assessment to develop a plan that addresses that facility's patient population, including at-risk populations.

If the provider serves children, or if the majority of its patient population is children, as is the case for children's hospitals,

we will expect the provider

to take into account children's access and functional needs during an emergency or disaster in its emergency preparedness plan.Slide16

Pediatric

Care Requirements

CMS Emergency Preparedness Rule 2016

Comment-4:

A commenter recommended that we include the

Joint Guidelines for Care of Children in the Emergency Department, developed by the American Academy of Pediatrics, the American College of Emergency Physicians, and the Emergency Nurses Association, as a resource for the final rule.

Response to Comment 4:

At § 482.15(a)(3), we proposed that a hospital's emergency plan address its patient population, including, but not limited to, persons at-risk. We also discussed in the preamble of the proposed rule that “at-risk populations” are individuals who may need additional response assistance, including those who have disabilities, live in institutionalized settings, are from diverse cultures, have limited English proficiency or are non-English speaking, lack transportation, have chronic medical disorders, or have Start Printed Page 63875pharmacological dependency

.

According

to the section 2802 of the PHS Act (42 U.S.C. 300hh-1) as added by Pandemic and All-Hazards Preparedness Act (PAHPA) in 2006, in “

at-risk individuals” means

children

, pregnant women, senior citizens and other individuals who have special needs in the event of a public health emergency as determined by the Secretary. Slide17

Pediatric

Care Requirements

CMS Emergency Preparedness Rule 2016

Comment-5:

A commenter stated that it could be difficult for

children's hospitals to maintain a comprehensive list of people and entities, as required for a hospital's communication plan. The commenter gave an example of a hospital that maintains a listing for most managers Start Printed Page 63884and above, but not for all general staff and volunteers.

Response to Comment 5:

…We

disagree

with the commenters who suggested that it would be overly burdensome for hospitals to maintain a current contact list.

As a best practice

, most hospitals maintain an up-to-date list of their current staff for staffing directories and human resource management. In addition, most hospitals have procedures or systems in place to handle their roster of volunteers.

We believe that a hospital would have a comprehensive list

of their staff, given that these lists are necessary to maintain operations and formulate a

payroll.....

Furthermore,

we clarify

that we are not requiring hospitals to include in their

communication plan

contact information for the families of staff, or the families of patients who are not directly involved in the patient's care, or contractors not currently providing services under arrangement. Slide18

Pediatric

Care Requirements

CMS Emergency Preparedness Rule 2016

Comment-6:

A commenter recommended that CMS consider including non-healthcare facilities in the communication plan, such as

child care programs and schools, where children with disabilities and other access and functional needs may be sheltering in place.

Response to Comment 6:

We do not believe

that it is appropriate to require hospitals to include other providers of services, such as child care programs and schools, in their communication plan in these conditions of participation. However, we have allowed facilities the flexibility and the discretion to include such providers in their communication plans if deemed appropriate for that facility and patient population.Slide19

CMS EMERGENCY PREPAREDNESS NEW

RULE:

RESOURCES AND ADHS-BPHEP TECHNICAL ASSISTANCE

IMPORTANT LINK

2017 Performance Measures:

2017-2022 HPP Performance Measures Implementation

Guidance

ASPR-TRACIE:

https://asprtracie.hhs.gov

/

Medicare

and Medicaid Programs; Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and

Suppliers

https

://

www.federalregister.gov/documents/2016/09/16/2016-21404/medicare-and-medicaid-programs-emergency-preparedness-requirements-for-medicare-and-medicaidSlide20

THANK YOU

Teresa Ehnert

| Chief-Bureau of Public Health Emergency Preparedness

teresa.ehnert@azdhs.gov

|

602-364-3571

azhealth.gov

@

azdhs

facebook.com

/

azdhs