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Wisconsin Hospital Emergency Preparedness Program(1)

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					     Wisconsin Hospital Emergency Preparedness Program




Supplemental Funding Opportunity Announcement

                                     For

    Participation in Operation Vigilant Guard
                 (ASPR FY 2010)



                            REVISED
                         January 26, 2011
     Minor changes have been made to the wording of the Checklist




           Applications must be submitted by 4:30 PM on
                    Monday, February 28, 2011

         Late applications will not be considered for award.




             For further information regarding this grant opportunity,
                contact your WHEPP Region Project Coordinator
Supplemental Funding Opportunity Announcement for Participation in Operation Vigilant Guard FY2010




                       Supplemental Funding for Operation Vigilant Guard
                                                              (FY 2010)

INTRODUCTION

The Wisconsin Hospital Emergency Preparedness Program provides financial and technical
assistance to hospitals and other healthcare facilities throughout the state to enhance healthcare
preparedness for public health emergencies.

In 2002, Section 319C-2 of the Public Health Service (PHS) Act, as amended by the Pandemic and
All-Hazards Preparedness Act (PAHPA) (P.L. 109-417) established the Federal Hospital
Preparedness Program to assist states in improving surge capacity and enhancing community and
hospital preparedness for public health emergencies. The Omnibus Appropriations Act, 2009,
provides funding for the FY 2010 grant awards (P.L. 111-8). The Wisconsin Hospital Emergency
Preparedness Program receives funding in the form of a Cooperative Agreement grant from the US
Department of Health and Human Services (DHHS), Office of the Assistant Secretary of
Preparedness and Response, Hospital Preparedness Program (CFDA 93.889, Federal Award
Number U3REP090269-02-01).

BACKGROUND

Vigilant Guard is an exercise program sponsored by the National Guard Bureau in conjunction with
NORAD and US Northern Command. The program provides an opportunity for State National
Guard Headquarters, State Joint Task Forces and Field Units to improve command and control and
operational relationships with internal, regional civilian, federal and military partners.

Operation Vigilant Guard 2011 is multi-state exercise linked to the National Level Exercise Tier 11,
Ardent Sentry 2011. The scenario for Ardent Sentry is an earthquake in Arkansas. The focus of
Operation Vigilant Guard will be support of affected states outside of Wisconsin.

PROJECT OVERVIEW

The purpose of this document is for Evacuee and other Participating Hospitals that have been
awarded Operation Vigilant Guard funding from the Wisconsin Hospital Emergency Preparedness
Program (WHEPP), to apply for a supplemental award to cover the costs of preparation time.

AVAILABLE FUNDS

Participating hospitals will receive $2,000 in funding from the Wisconsin Hospital Preparedness
Program to assist the hospital in developing Preparation Checklist necessary to organize and arrange
the details of your facility’s participation in the exercise. Funds awarded under this announcement
will be for the date of the award letter through April 29, 2011. Reimbursements to approved
Applicants will be issued within 45-60 days of submission of the required documentation.


1
    A National Level Exercise Tier 1 means that the President and/or Cabinet Members take part in this exercise.
ISSUING AGENCY

This funding announcement is issued by the WHEPP and Shared Health Services of LaCrosse LLC,
which acts as WHEPP fiscal agent for this project.

WHEPP provides financial and technical assistance to hospitals and other healthcare facilities
throughout the state to enhance healthcare preparedness for public health emergencies. Funding is
provided by the State of Wisconsin, Division of Public Health, Wisconsin Hospital Emergency
Preparedness Program via a cooperative agreement with the US Department of Health and Human
Services, Office of the Assistant Secretary of Preparedness and Response, Hospital Preparedness
Program (CFDA 93.889, Federal Award Number U3REP090269-02-00).

WHO MAY SUBMIT AN APPLICATION

Any hospital which has already been awarded funds from the Wisconsin Hospital Emergency
Preparedness Program (WHEPP) to participate in Operation Vigilant Guard

ALLOWABLE COSTS

All costs being reimbursed by this grant funding must have been incurred between the date of the
award letter and April 29, 2011. Funds may be used to help subsidize staff time involved in
planning for these exercises. All expenditures must comply with the Wisconsin Department of
Health Services Allowable Cost Manual, as well as federal guidelines including 45 CFR Parts 74
and 92 and OMB Circular A-110 and OMB Circular A-133.

Funds may not be used for:
    Supplanting of current salaries
    Salaries for staff to backfill for other staff attending or participating in grant-funded
      activities
    Direct hiring of staff
    Public Education and Outreach
    Political education or lobbying activities
    Fundraising activities

SUBMITTAL OF APPLICATION

   1. The applicant must submit one signed copy of the application to their respective WHEPP
      Region Project Coordinator no later than 4:30 PM on Monday, February 28, 2011. (See
      list of Project Coordinators contact information by WHEPP Region at the end of this
      funding announcement).

   2. All applications received after the closing date will not be accepted.
DELIVERABLES, REIMBURSEMENT PROCEDURE AND DEADLINE

Reimbursement requests should be sent to the Regional Project Coordinator and must include:

   1. Completed Checklist for the May 18th, 2011 Operation Vigilant Guard exercise.

Requests for reimbursement must be received by the Regional Project Coordinator by 4:30 PM on
Friday, April 29, 2011. Late requests will not be eligible for reimbursement.
Supplemental Funding Opportunity Announcement for Participation in Operation Vigilant Guard FY2010




 FY 2010 Supplemental Funding for Participation in Operation Vigilant Guard
Please complete the following information and return this page to your WHEPP Regional Project
Coordinator by no later than 4:30 PM on Monday, February 28, 2011.

Applicant Information:

Name of Hospital:

Address:

City, State, Zip Code:

Contact Person:

Title:

Phone:                                             Email:


If awarded, the hospital must be willing to submit the completed “Hospital Participation Checklist for
2011 Operation Vigilant Guard” along with participation in the May 18th, 2011 Operation Vigilant Guard
exercise.

By signing this application, you state that your facility will submit the “Hospital Participation Checklist
for 2011 Operation Vigilant Guard” to the Regional Project Coordinator by 4:30 PM on Friday, April 29,
2011.




________________________________________________________________________________
Authorized Signature and Title                                    Date




________________________________________________________________________________
Authorized Signature of Administrator                             Date
                                                                Supplemental Operation Vigilant Guard (FY 2010)
                                                                             Funding Application
                                                           Wisconsin Hospital Emergency Preparedness Program (WHEPP)
                                                                                       Regional Project Coordinators
                     Region 1
         Hilde Surbaugh Perala
         13975 W. Peninsula Road
                                                                                                          Region 2
         Hayward, WI 54843                                                         Jim Monarski
         Phone: 715-790-6429                                                       3400 Ministry Parkway
         Duluth
         Fax: 715-634-0719                                                         Weston, WI 54476
         HildePerala@centurytel.net                                                Phone: 715-393-2779
                                                                                   Fax: 715-393-2781
                                                                                   Cell: 715-574-8121
                                                                                   James.Monarski@ministryhealth.org
                      Douglas           Bayfield
                                                                     Iron
                                                                                                                                                                        Region 3
                          Washburn                         Ashland                        Vilas                                                                Dave Seebart
                                                                                                                                                               610 S Broadway Street
                                                                 Price
                                                                                                                                                               Green Bay, WI 54303
           Burnett                     Sawyer
                                                                                                                                  Florence                     Phone: 920-448-6476
                                                                                       Oneida
                                                                                                                        Forest                                 Fax: 920-448-6449
              Polk     Barron          Rusk                                                                                                                    Cell: 920-465-0361
                                                                                                                                         Marinette
                                                                                       Lincoln                                                                 seebart_dr@co.brown.wi.us
Twin
Cities
                                                                     Taylor                                  Langlade
         St. Croix                   Chippewa
                       Dunn
                                                                                 Marathon                               Menomonee
                                                                                                                                       Oconto
                                                                                                                                        Oconto
                                                           Clark                                                                                                 Door
     Pierce                                                                                                           Shawano
                        Pepin        Eau Claire
                                                                                                                Waupaca                                   Kewaunee
                         Buffalo                                                                   Portage
                                       Trempealeau                                                                               Outagamie
                                                                                                                                 Outagamie Brown
                                                                                                                                                                            Region 6
                                                              Jackson          Wood
                                                                                                                                                Tracey Froiland
                                                                                                                                          Manitowoc
                                                                                                                     Winnebago                  N9152 S. Kernan Avenue
                Region 4                                                                                                          Calumet
                                                                                                     Waushara                                   Appleton, WI 54915
    Bob Ritger                                             Monroe                      Adams
                                           La Crosse
                                                                                                                                                Phone: 920-738-9242
    306 9th Avenue South                                                                                       Green                            Fax: 920-720-7290
                                                                                                     Marquette Lake
    Onalaska, WI 54650                                                        Juneau                                                            Cell: 920-427-2229
                                                                                                                      Fond du Lac     Sheboygan
    Phone: 608-783-3735                           Vernon                                                                                        tracey.froiland@thedacare.org
    Fax: 608-781-0761                                                              Sauk
                                                                                                                         Dodge
    Cell: 608-780-6789                                             Richland                          Columbia                                        Ozaukee
    onaritger@charter.net                          Crawford                                                                             Washington
                                                                                                   Dane
                                                                                                                        Jefferson
                                                                                                                                     Waukesha
                                                                            Iowa
                                                                                                                                                     Milwaukee
                                                      Grant
                                                                                                                                             Racine    Region           7
                                                                         La Fayette               Green        Rock              Walworth
                                                                                                                                        Elizabeth Corneliuson
                                   Region 5
                                                                                                                                               Kenosha
                                                                                                                                        400 Woodland Prime
                     Lori Wallman
                     3922 Paunack Avenue                                                                                               N74 W12501 Leatherwood Ct.
                     Madison, WI 53711                                                                          Rockford               Menomonee Falls, WI 53051-4480
                     Phone: 608-467-7222                                                                                               Phone: 414-777-0146
                     Fax: 608-467-7221                                                                                                 Fax: 414-777-7055
                     Cell: 608-669-3510                                                                                                Cell: 262-853-3289
                     lwallman@grantregional.com                                                                                        ecorneli@fmlh.edu
       Hospital Participation Checklist for 2011 Operation Vigilant Guard
This list is to be completed and submitted for reimbursement to your WHEPP Coordinator no later than
April 29, 2011. (The verification date should be between the date of award letter and April 29, 2011.)

Note: This checklist applies to all participating hospitals except the four hospitals that will be
evacuating patients Region 4. These four hospitals will receive a special checklist.

Hospital Name:                                   City:

    1. WI Trac is loaded in the hospital on at least one computer in a staffed location and is monitored
       24/7 (monitoring can be by audible tone, text message or pager alert).
        Name and title of person who has verified this:
        Date on which this has been verified:

    2. There is one person assigned per shift to enter bed availability on WI Trac when a WI Trac alert
       requests this posting. (It is recommended that this person be the person/function who is
       responsible daily for knowing the number of available inpatient beds).
        Name and title of person who has verified this:
        Date on which this has been verified:

    3. The hospital has received, acknowledged and entered bed availability during the weekly,
       statewide bed polling exercise at least once in both the months of March and April 2011.
        Name and title of person who has verified this:
        Date on which this has been verified:

    4. The hospital has updated the Facility Status Report on WI Trac between July1, 2010 and April
       29, 2011.
        Name and title of person who has verified this:
        Date on which this has been verified:

    5. The hospital has participated in at least one regional WI Trac exercise between July 1, 2010 and
       April 29, 2011 in which the hospital has either initiated or updated an alert.
        Name and title of person who has verified this:
        Date on which this has been verified:

    6. The hospital has identified those persons or functions that will participate in the May18, 2011
       exercise and those who will activate and staff the Incident Command System during this exercise.
        Name and title of person who has verified this:
        Date on which this has been verified:

    7. At a minimum, those persons involved in the exercise, have reviewed the hospital surge capacity
       plan and are able to activate the hospital surge capacity plan on May 18, 2011 at least in table-top
       exercise fashion.
        Name and title of person who has verified this:
        Date on which this has been verified:
8. The hospital has identified the person(s) who will complete the Exercise Evaluation Guide (EEG)
   during the May 18, 2011 exercise.
    Name and title of person who has verified this:
    Date on which this has been verified:

9. The hospital has identified the person(s) who will complete the After Action Report (AAR) after
   the May 18, 2011 exercise.
    Name(s) and title(s) of person(s) that will complete the AAR:
    Date on which this has been verified:

10. The hospital has a plan to communicate with staff and, if appropriate, the community about its
    participation in this national exercise (a template will be provided).
     Name and title of person who has verified this:
       Date on which this has been verified:

				
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