Continuity of Operations (COOP) Planning

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					Continuity of Operations
   (COOP) Planning
An Introduction for Tribal Health Programs
            June 23-24, 2010
             Sacramento, CA
    Calvin Freeman        Brian Tisdale
           Presentation Objectives
• Define COOP
• Provide the rationale for COOP planning
• Describe how COOP fits into your overall
  emergency management program
• Describe the elements of a COOP and the
  plan development process
• List special considerations for Pandemic
  Influenza events
October 21, 2009   Continuity of Operations   2
                   Scenarios
What if your health center:
• Is severely damaged by a winter storm?
• Becomes inaccessible by staff and
  patients due to wildfire?
• Loses its lab capability and half of its exam
  rooms for 30 days from a fire?
• Faces 30% staff absenteeism over a two-
  week period from influenza?
October 21, 2009    Continuity of Operations   3
 Responding to a COOP Event
How do you:
• Continue to provide services for your
  patients?
• Respond to community disaster needs, if
  required?
• Return to full functionality?
• Recover expenditures and losses?


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      Continuity of Operations Plan
                 Defined
Plans, policies and procedures to ensure
  essential functions are performed during
  emergencies.




October 21, 2009   Continuity of Operations   5
           Clinic Emergency Plans
• Emergency Operations Plan (EOP)
• Community Disaster Response and
  Recovery Plan
• Facility emergency plans (fire, building
  evacuation, hazardous spills, etc.)
• Safety and illness and injury prevention
• Continuity of Operations and other
  business continuity plans
October 21, 2009   Continuity of Operations   6
    COOP vs. Other Emergency Plans

• Emergency operating procedures
      – Address only immediate aftermath of incident
• COOP
      – Addresses immediate aftermath, short-term, &
        long-term (up to 30 days), with focus on
        continuing essential functions




October 21, 2009       Continuity of Operations
             COOP Builds on Existing
                  Capabilities
• Safety policies and procedures
• Emergency response plans and procedures
• Information technology operational recovery
  plans
• Backup resources for personnel, supplies
  and equipment
• Insurance
      – Fire and other casualty
      – Business interruption?

October 21, 2009        Continuity of Operations   8
   Building Your COOP Capability

Focus on prevention and mitigation
• Update hazard vulnerability analysis
• Update/review/reinforce safety and
  illness/injury prevention procedures,
  including vaccinations
• Encourage employee and community
  home and work preparedness


October 21, 2009   Continuity of Operations   9
                   Goals of a COOP Plan
• Ensure timely & orderly continuous
  performance of essential functions during
  & after emergency
• Protect facilities, equipment, records, &
  other assets that support essential
  functions
• Reduce or mitigate disruptions to
  operations


October 21, 2009          Continuity of Operations
   Goals of a COOP Plan (continued)
• Reconstitution (resumption of normal
  operations) & devolution (continue as
  many essential functions as possible when
  reconstitution at primary facility is not
  possible) after emergency
• Minimize loss of life & injury to agency
  personnel
• Family support planning for agency
  personnel during emergency

October 21, 2009   Continuity of Operations
                   COOP Elements
1. Plans and procedures
2. Essential functions
3. Delegations of authority
4. Lines of succession
5. Alternate operating facilities
6. Interoperable communications
7. Vital records and databases
8. Protection of human capital and other resources
9. Tests, training and exercises
10. Devolution of direction and control
11. Reconstitution

October 21, 2009       Continuity of Operations      12
          1. Plans and Procedures
Defines how clinic will respond to event:
• Response triggers
• Alert and notifications
• Communications to patients, staff and other
  stakeholders
• Response management organization –
  commitment to ICS
• Initial response actions (e.g., shut down,
  relocation, steps to ensure safety of people
  and preservation of equipment, supplies, and
  records, etc.)

October 21, 2009   Continuity of Operations   13
 2. Define Essential Functions
• Identify functions and services critical to
  your mission
• Assign priorities and timeframe for operation
  (continuous, restore within 72 hours, etc.)
• For each essential function, determine:
      – Staff skills, numbers, experience, security
        clearances and licenses (and backups)
      – Other required inputs (facilities, IT, supplies,
        vendors, equipment, etc.)
      – Legal, regulatory and reporting requirements
      – Alternatives, if clinic cannot continue function

October 21, 2009         Continuity of Operations          14
      3. Delegations of Authority
Who has the authority to make critical
  decisions if the usual decision-maker is
  incapacitated or not available?
• Best if delegations are three-deep.




October 21, 2009   Continuity of Operations   15
             4. Lines of Succession
Who will take the place of a manager or
  executive who is unavailable or unable to
  perform duties?
• Best if delegations are three-deep.
• Especially critical for CEOs, Executive
  Directors or other executive staff



October 21, 2009     Continuity of Operations   16
                   Key Resources
5. Alternate operating facilities, if relocation is
   required.
6. Interoperable communications, to ensure
   essential functions maintain contact with
   other response elements, government
   agencies, vendors, patients, etc.
7. Maintain access to/protect vital records and
   databases (or backups), e.g. patient
   records, legal documents, contact lists.

October 21, 2009      Continuity of Operations    17
      8. Protect Human Capital and
             other Resources
Ensure:
• Safe facilities and operations
• Critical equipment, pharmaceuticals,
  and data are protected
• Security for facilities, whether occupied
  or unoccupied



October 21, 2009   Continuity of Operations   18
  9. Tests, Training and Exercises

• As with all emergency response
  activities training is essential and
  exercises serve to build proficiency.
• Suggestion: Build a Continuity of
  Operations component into your next
  fire drill. What steps would you take to
  restore services if the fire had created
  significant damage?

October 21, 2009   Continuity of Operations   19
                   10. Devolution
Devolution is “passing the baton” to
 another site or organizational unit, e.g.,
 if leadership is lost, direction and
 control may be passed to a satellite
 unit or to a non-health unit of tribal
 government.




October 21, 2009       Continuity of Operations   20
                   11. Reconstitution
• Return to previous clinic facilities or
  move operations to new site
• Replace employees lost during
  emergency




October 21, 2009        Continuity of Operations   21
                   Pandemic Influenza
                     Considerations
• Threat is to workforce rather than facilities
      – Response based on social distancing rather than
        relocating operations
      – Consider HR policies that discourage infected
        employees from coming to work
• Threat is widespread, not localized
      – Limits availability of mutual aid
      – Affects suppliers, government agencies,
        transporters



October 21, 2009        Continuity of Operations          22
                Pandemic Influenza
               General Considerations
General
• Threat is to workforce rather than facilities
      – Response based on social distancing rather than
        relocating operations
      – Consider HR policies that discourage infected
        employees from coming to work
• Threat is widespread, not localized
      – Limits availability of mutual aid
      – Affects suppliers, government agencies,
        transporters

October 21, 2009        Continuity of Operations          23
                   Pandemic Influenza
                     Considerations
Plans and Procedures
• Include monitoring of pandemic
  activation phases and public health
  guidance from CDC, California
  Department of Public Health and Local
  Health Department
• Create an Influenza Team to monitor
  and address pandemic issues

October 21, 2009        Continuity of Operations   24
                   Pandemic Influenza
                     Considerations
Essential Functions
• Review effect of pandemic on contract
  and support services
• Develop mitigation strategies if external
  suppliers are unable to provide needed
  resources



October 21, 2009        Continuity of Operations   25
                   Pandemic Influenza
                     Considerations
Delegations of Authority
• For multi-site clinics, consider tele-
  management
Alternate Operating Facilities
• Modify patient flow to increase social
  distancing
• Consider combining facilities to improve
  logistics and support services
• Focus on sanitation

October 21, 2009        Continuity of Operations   26
                   Pandemic Influenza
                     Considerations
Interoperable Communications
• Maximize use of wireless
  communications, PDAs, tele-
  conferencing rather than meetings
Vital Records
• Ensure maintenance of IT systems



October 21, 2009        Continuity of Operations   27
                   Pandemic Influenza
                     Considerations
Protection of Human Resources
• Review/Modify HR Policies
      –   Sick leave
      –   Fitness for duty
      –   Family medical leave
      –   Family assistance program
• Enforce infection control & hygiene
  measures
• Keep staff and their families informed
• Promote cross training

October 21, 2009         Continuity of Operations   28
                   Pandemic Influenza
                     Considerations
Tests, Trainings and Exercises
• Include social distancing and alternative
  patient flow strategies
Devolution of Direction and Control
• Develop detailed guidance that addresses
  essential functions, points of contact, and
  resources and phone numbers
Reconstitution
• Include provisions to maintain pandemic
  surveillance

October 21, 2009        Continuity of Operations   29
     References and Resources
• California OES COOP/COG and Pandemic Influenza Planning -
  http://www.oes.ca.gov/Operational/OESHome.nsf/PDF/CO
  OPCOG%20Document%20Downloads/$file/DP%20Pan%2
  0Influenza%20.pdf
• Pandemic Preparedness Planning Matrix - www.Naaep.org
• Pandemic Flu and Continuity of Operations (Colorado) -
  www.cdhs.state.co.us/Pandemic/Documents/SafetyMeeting.ppt
• Pandemic Planning Kit for Ambulatory Care Facilities (Georgia)
  - http://www.pandemicpractices.org/files/16/16_planning_kit.pdf




October 21, 2009         Continuity of Operations              30
            IHP Technical Assistance
                    Program
• FREE!
• On-site technical assistance
• Promote community and family
  preparedness
• Work with Executives, Boards and safety
  staff
• Plan and policy and procedure development
• Pandemic influenza preparedness
• Workshops and other training
October 21, 2009    Continuity of Operations   31
              Resources and Contact
• Video: Preparing for Coming Seasons
• Plan templates
• Trainings and workshops
Contact Us
• Barbara Aragon, MSW
      BAragon428@gmail.com
      (916) 201-6866

• Calvin Freeman
      Calvin_Freeman@comcast.net
      T: (916) 714-1793
      F: (916) 714-1794



October 21, 2009              Continuity of Operations   32

				
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