Regional Planning
and Assistance
OSHA Training Institute – Region IX
University of California, San Diego (UCSD) - Extension
OSHA Training Institute 1
Objectives
To describe mutual aid compacts that
enable disaster assistance between
hospitals, and between states, and which
could be accessed if local resources are
overwhelmed
To describe advantages of Regional
Planning
OSHA Training Institute 2
Federal Emergency Management Agency
(FEMA), through the Robert T. Stafford
Disaster Relief and Emergency Assistance Act
Reimburses mutual aid agreement costs
associated with emergency assistance provided
all of the following conditions are met:
The assistance requested by the applicant is
directly related to the disaster and is eligible
for FEMA assistance
The mutual aid agreement is in written form
and signed by authorized officials of the
agreeing parties prior to the disaster
OSHA Training Institute 3
Stafford Act (continued)
The mutual aid agreement applies uniformly in
emergency situations. The agreement must not
be contingent upon a declaration of a major
disaster or emergency by the Federal
government or on receiving Federal funds
The providing entity may not request or receive
grant funds directly. Only the eligible applicant
receiving the aid may request grant assistance
Upon request, the applicant must be able to
provide FEMA with documentation that the
services were requested
OSHA Training Institute 4
Evacuation and Surge Capacity:
The Link
Evacuation of hospital patients is directly linked
to surge capacity
Surge capacity for an evacuation allows room for
relocation of evacuated patients and staff
Resources commonly referred to in surge
planning are also potential resources as
destinations for hospital evacuees
Regional planning is one of the processes to
achieve success when forced to evacuate
hospitals
OSHA Training Institute 5
Advantages of Regional Planning
Training, purchasing, and planning should occur
on regional basis, for hospital administrators,
nurses and physicians
Standardization of PPE, respiratory equipment,
and surge supplies to maximize ability to use per
diem and agency RNs and volunteers at
multiple sites
Group purchases lead to reduced costs per item.
Contributions of expertise by each hospital in a
region lead to stronger plans and better
responses
OSHA Training Institute 6
Example of Uses
The “Metropolitan Area Hospital Compact”
of the Twin Cities in Minnesota
Off-Site Care Facility Operations Planning
The plan is regionally based, by hospitals
Minnesota Dept of Health Website
(http://www.health.state.mn.us/divs/idepc/diseases
/flu/pandemic/plan/pccoscf.pdf.)
OSHA Training Institute 7
Emergency Management
Mutual Aid Compact
1996 - Ratified by Congress (P.L.104-321) as the
first national disaster compact since 1950 (Civil
Defense Compact)
Allows quick response from state to state for
disaster resources for mutual aid for a governor-
declared disaster
Once conditions of response have been set,
there is a legal contract which makes affected
state responsible for reimbursement
OSHA Training Institute 8
EMAC: What it provides
Responding state knows there will no financial
burden incurred for assisting
Personnel liability and Worker’s comp is
assured
Allows credential approval across state line
Avoids bureaucratic wrangling
Achieves rapid response for any type of
assistance
OSHA Training Institute 9
What do individual states do once they
sign on to the compact…?
Need to pass their own legislation
to be consistent with the compact
Ex: professional licenses
“Model Act,” for states to use to
model their own state legislation
on, to standardize state laws, can
be seen and is available on the
EMAC Web site at
www.emacweb.org
OSHA Training Institute 10
WHY is having state laws consistent
with a compact important?
Most states do not have legislation that allows medical
professionals to practice with an out of state license,
even when EMAC is utilized.
“Some states do not have legislation facilitating out of
state licensing during emergencies, and the issue of
hospital privileging is still a challenge in most states.
States should address those potential limitations now –
at the state level.”
http://www.astho.org/templates/display_pub.php?pu
b_id=1595
OSHA Training Institute 11
EMAC Responses - 2004
EMAC responses to Hurricanes Charley,
Frances, Ivan & Jeanne
Deployed over 800 state and local personnel
from 38 states (including one then non-
member state, California)
Cost was $15 million in personnel, equipment,
and National Guard expenditures
OSHA Training Institute 12
EMAC Responses - 2005
EMAC scaled operations more than 20x as all
member states combined deployed 65,929
personnel in response to Hurricanes Katrina and
Rita to Louisiana, Mississippi, Texas, Alabama,
and Florida.
More than 1,300 search and rescue personnel
from 16 states; searched more than 22,300
structures and rescued 6,582 people
Nearly 3,000 Fire/Hazmat personnel from 28
states
OSHA Training Institute 13
EMAC Responses - 2005
More than 6,880 sheriff's deputies and police
officers from 35 states and countless local
jurisdictions deployed across Louisiana and
Mississippi - a total of 35% of all of the
resources deployed
More than 2,000 healthcare professionals from
28 states; treated more than 160,000 patients in
the days and weeks after the storms
OSHA Training Institute 14
Website: http://www.emacweb.org/
OSHA Training Institute 15
Other Compacts
EMAC-like agreement exists among
northeast states and Canadian provinces
from Quebec eastward
International agreement, involving states
in the northwest U.S. and neighboring
Canadian provinces.
OSHA Training Institute 16
Summary
Regionalization of planning reduces costs,
reduces amount of training required in a
region
Commonality of resources in a region is
an advantage
EMAC and other compacts were reviewed
OSHA Training Institute 17