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Current Status: Active PolicyStat ID: 3929935

Disaster Preparedness, Response, and Disaster Recovery Requirements for Community Providers, 04-102

FULL IMPLEMENTATION DATE - October 16, 2017

REVISION TO BH RESPONSE REQUIREMENTS - JANUARY 24, 2018

APPLICABILITY

All Community Behavioral Health Providers: Tiers 1, 2, 2+ and Specialty

All Community Developmental Disability Providers

POLICY

In this policy, DBHDD addresses the minimum basic requirements for Disaster Preparedness, Response and Disaster Recovery for DBHDD Providers. In the event that a disaster occurs, this policy outlines the basic requirements for DD Providers, as well as the specific protocol requirements for Behavioral Health Providers, as applicable. All community providers under contract or Letter of Agreement with DBHDD must be in substantial compliance with all policies, regulations, federal and state requirements, contractual requirements, standards of care and practice, and provisions of the applicable DBHDD Provider Manual, and associated accrediting bodies.

This policy also addresses the necessary requirements regarding Continuity of Operations Plans (COOP) that each provider is responsible for developing, in the event of a disaster to assist with the preparedness of a disaster.

DEFINITIONS

Tier 1: Comprehensive Community Providers (CCP): Function as the safety net for the target population and serve the most vulnerable population and responds to critical access needs. The standards and requirements for CCP providers are found in Comprehensive Community Provider (CCP) Standards for Georgia's Tier 1 Behavioral Health Safety Net, 01-200. 

Tier 2: Community Medicaid Providers (CMPs): Provide behavioral health services and supports identified in the Medicaid State Plan for Serious Emotional Disturbance (SED) youth, young adults, Serious and Persistent Mental Illness (SPMI) Adults, and individuals with Substance Use Disorders (SUDs).The standards for CMPs are found in Community Medicaid Provider (CMP) Standards for Georgia's Tier 2 Behavioral Health Services, 01-230

DD Providers: Provide services for individuals with Developmental Disabilities and have a contract or Letter of Agreement with DBHDD.

After Action Report: A summary of the disaster response that identifies successes and areas for improvement.

Continuity of Operations Plan (COOP): A plan that provides for continued critical and essential functions to be performed during a wide range of disasters; including localized acts of nature, accidents, technological security breaches, and/or attack-related disasters (i.e. active shooter or terrorist attacks).

Crisis Counseling: Involves short-term interventions focusing on counseling goals of assisting disaster survivors in understanding their current situation and reactions, mitigating stress, assisting survivors in reviewing their disaster recovery options, promoting the use or development of coping strategies, providing emotional support, and encouraging linkages with other individuals and agencies who help survivors in their recovery process.

Demobilization: The orderly, safe, and efficient return of an incident resource to its original location and status.

Disaster: An occurrence causing widespread destruction and distress. Hurricanes, tornadoes, floods, ice storms and infectious diseases are examples of natural disasters. Explosions, chemical spills, bombs, accidents, technological security breaches, and/or attack-related disasters (i.e. active shooter or terrorist attacks) are examples of man-made disasters.

Disaster Recovery: Involves activities that support the restoration of the public health, health care, and social service networks to promote the resilience, health and well‐being of affected individuals and communities.

Disaster Recovery Centers: Readily accessible facilities or mobile offices where applicants can go for information about the Federal Emergency Management Agency (FEMA) or other disaster assistance programs, or for questions related to their case.

Evacuation: Organized, phased, and supervised movement of people from dangerous or potentially dangerous areas.

Local resources: Involves Tier 1 and Tier 2+ providers' personnel and supplies.

Non-traditional settings: Places such as disaster shelters, homes, and community settings where contact is made with disaster survivors, not in a traditional setting such as a clinical or office setting.

Preparedness: Involves activities that occur prior to an emergency or disaster to support and enhance response. Planning, training, exercises, coordinating with other agencies, community awareness and education are among such activities.

Response: Involves activities that address the immediate and short-term effects of an emergency or disaster. These activities help reduce casualties, damage, and speed recovery. Response includes coordination and direction, communications and warning, evacuation and emergency support function responsibilities (crisis counseling).

Scaled Response: Delivery of the specific resources, capabilities, and increased level of coordination appropriate to each disaster.

Shelter in place: A precaution where individuals remain in a safer area indoors during an emergency or disaster.

Specialty Services Providers: Providers who deliver a set of services/programs that offer a specific treatment modality.

INTRODUCTION

This policy addresses the essential business services and operations during and after any disaster while providing for the protection of life, health, and safety for all individuals served by behavioral health and developmental disabilities providers. Sections A through D of the policy applies to all DBHDD providers in terms of the standards and requirements for preparedness, as well as the response and recovery requirements in responding to disasters. Section E of the policy applies only to the Developmental Disabilities providers regarding their respective disaster requirements. Sections F, G, & H of the policy applies to Tier 1, Designated Tier 2+ Behavioral Health providers. Section I of the policy contains a list of frequently asked questions regarding the content of the policy. If there are any questions related to the policy, please send them to PolicyQuestions@DBHDD.ga.gov.

PROCEDURES

  1. MINIMUM PREPAREDNESS REQUIREMENTS FOR ALL DBHDD PROVIDERS
    1. All DBHDD providers are responsible for having and developing their own Continuity of Operations Plans (COOP) in the event of a disaster. COOP plans are vital in assuring that the capability exists to continue essential agency functions across a wide range of potential emergencies and/or disasters.
    2. Providers are responsible for designating personnel from their agency that drafts the plan.
      1. One staff member is designated to take DBHDD's Providers' Disaster Preparedness, Response and Disaster Recovery Training within 45 days after assuming the responsibility.
      2. If the designated staff member leaves the agency, another designee is selected from the agency and is required to complete the training. For more information and help with constructing your plan, please contact PolicyQuestions@DBHDD.ga.gov.
  2. BASIC STANDARDS FOR DISASTER PREPAREDNESS
    1. Providers are responsible for adhering to the basic standards for disaster preparedness as established by (as applicable to your agency), including but not limited to:
      1. National accreditation agencies such as the Joint Commission (TJC) and/or the Commission on Accreditation of Rehabilitation Facilities (CARF) and/or
      2. State certification, for example, DBHDD and/or Department of Community Health (DCH)
      3. Federal rules and regulations located at https://www.gpo.gov/fdsys/pkg/FR-2016-09-16/pdf/2016-21404.pdf. See Reference Materials (Attachment H).
      4. DBHDD policies and Community Provider Manuals
    2. Providers participate in local partnerships including, but not limited to:
      1. Georgia Hospital Association Regional Healthcare Coalitions, and the Healthcare Coalitions Map (Attachment A) which shows the boundaries of the healthcare coalitions.
      2. Georgia Department of Public Health (DPH) District Office of Emergency Preparedness (DOEP). DPH's DOEP contacts are located at http://dph.georgia.gov/public-health-districts. See Reference Materials (Attachment H); and
      3. County Emergency Management Agency. Information can be found at the Georgia Emergency Management Agency's (GEMA) website located at http://gema.ga.gov. See Reference Materials (Attachment H).
    3. The continuation of services to individuals during or immediately following disasters is important. This includes delivery of services to individuals in non-traditional settings. These settings include, but are not limited to:
      1. Disaster shelters
      2. Disaster recovery centers, and other places where disaster survivors gather.
    4. For more information on what is needed/required in a plan, all DBHDD providers, including DD providers, can refer to the Disaster Planning Handbook for Behavioral Health Treatment Providers. See Reference Materials (Attachment H).
  3. RESPONSE REQUIREMENTS FOR ALL DBHDD PROVIDERS
    1. In responding to disasters, all providers must implement their COOPs using a scaled response that matches the scope of the disaster.
    2. Providers are to maintain separate records of all expenses associated with disaster response.
  4. DISASTER RECOVERY REQUIREMENTS FOR ALL DBHDD PROVIDERS
    1. All providers are to demobilize resources (i.e. recalling staff and supplies)
    2. All Providers are to conduct an incident debriefing which includes the following:
      1. Develop an After Action Report (Attachment B) that contains an improvement plan for areas that need correction.
      2. Make changes to the COOP based on the improvement plan and to reflect any significant recommendations.
  5. DISASTER REQUIREMENTS FOR DD PROVIDERS
    1. DD Providers that have a contract or Letter of Agreement with DBHDD are required to deliver disaster services for their agency in the event a disaster occurs.
    2. DD Providers are required to have a Continuity of Operations Plan (COOP) in place that addresses disaster preparedness, response and recovery, per the DD Community Provider Manual located at http://dbhdd.org/files/Provider-Manual-DD.pdf.
    3. For more information or resources on how to create the plan, please contact PolicyQuestions@DBHDD.ga.gov.
    4. At the time of disaster plan implementation, DD providers are to contact:
      1. Regional Field Office
      2. Support Coordinators
      3. Family members/legal guardians
  6. DISASTER PREPAREDNESS REQUIREMENTS FOR BH PROVIDERS (TIER 1 AND DESIGNATED TIER 2+)
    1. Tier 1 and designated Tier 2+ providers are required to deliver disaster services for their agency in the event a disaster occurs.
    2. The Continuity of Operations Plan (COOP) for Behavioral Health providers must include the following procedures:
      1. Identifying a staff member and a backup person responsible for coordination of disaster preparedness, response and recovery.
      2. Name and contact information of those designees are forwarded to DBHDD's Disaster Mental Health Coordinator (DMHC);
      3. Collaborating/integrating with local emergency management systems and other community partners;
      4. Delivering disaster crisis counseling to the general population (outreach to anyone who has been impacted by the disaster):
        1. Services are carried out in non-traditional settings. These settings include disaster shelters, disaster recovery centers and other places where disaster survivors gather.
        2. Training of staff in American Red Cross Disaster Mental Health, or Disaster Mental Health Field Response Training, or Psychological First Aid.
        3. Description of how staff are deployed to non-traditional settings that includes methods of transportation, communication, and tracking of staff locations.
        4. Cultural proficiency that takes into account the unique experiences, beliefs, norms, values, traditions, customs, and language of the individuals being served.
          • Examples of groups included are, but not limited to, non-English speaking individuals, refugees, and individuals with hearing loss.
        5. Implementing Federal Emergency Management Agency (FEMA) Crisis Counseling Assistance and Training Program (CCP) Immediate Services Program (ISP). The FEMA CCP ISP is a supplemental assistance program that funds crisis counseling assistance and training in presidentially declared disaster areas. In Georgia, this program is called the Georgia Recovery Project.
  7. RESPONSE REQUIREMENTS FOR BH PROVIDERS (TIER 1 AND DESIGNATED TIER 2+)
    1. Deploy resources upon the request of a local authority (e.g. county emergency management agency, Public Health District Office) and/or DBHDD.
      1. When responding to disaster shelters and other congregate situations, providers must set up a schedule that includes 24 hour staff coverage for disaster shelter residents until it is determined by the shelter manager, shelter nurse, and provider staff that 24 hour staff coverage is no longer needed. 
    2. Follow the response format in the DBHDD Tiered Response (Attachment C).
    3. When Georgia receives a presidential disaster declaration for Individual Assistance, DBHDD's Disaster Mental Health Coordinator contacts providers covering the counties within the declared area to inform them of the funding opportunity for FEMA CCP ISP.
      1. Information about the FEMA CCP ISP can be found at http://www.samhsa.gov/dtac/ccp and in the CCP Grant Funding Opportunity (Attachment D). See Reference Materials (Attachment H).
    4. Needs Assessments
      1. Providers are responsible for conducting needs assessments to determine if a FEMA CCP ISP is warranted. The table in the CCP Need Assessment Worksheet (Attachment E) or current census data is used for the needs assessment. The needs assessment is done cooperatively with the DBHDD DMHC.
    5. Applying for the CCP ISP
      1. DBHDD's DMHC completes the CCP ISP application
        1. The number of CCP staff for the providers is determined by using the results of the CCP Need Assessment Worksheet (Attachment E) and the staffing chart on page 2 of the ISP Application template found in the FEMA CCP Toolkit at http://media.samhsa.gov/DTAC-CCPToolkit/applying.htm. See Reference Materials (Attachment H).
      2. Providers work with DBHDD's DMHC to identify any special service delivery requirements for their catchment areas.
    6. Implement FEMA CCP ISP
      1. When grant funding is approved, FY2016 Crisis Counseling contracts are amended.
      2. Providers hire CCP staff based on the number of staff approved for the grant program
      3. DBHDD hires a Georgia Recovery Project Manager to oversee the program at the state-level. The Project Manager works closely with the providers to assist with and oversee start-up and all operations of the CCP on the provider-level. Contact information for the Project Manager is determined and shared with the providers at the time of implementation.
      4. Provider CCP staff attends required FEMA CCP ISP Core Content Training that is delivered by DBHDD after funding has been approved. The date, time and location of the training is determined by the size and scope of the program.
      5. Provider CCP staff delivers crisis counseling services following the outreach model presented in the required training.
      6. Monitoring and Reporting:
        1. Methods of monitoring and reporting are determined by the Georgia Recovery Project Manager at the State Office and is dependent on the size and scope of the disaster and program
        2. Requirements for data collection are described in the CCP program guidance and the FEMA CCP ISP Core Content Training contains a module dedicated to data collection. Providers receive instructions on specific methods for submission of data at the FEMA CCP ISP Core Content Training and through correspondence with the Georgia Recovery Project Manager.
        3. Monitoring of Tier 1 and 2+ providers includes program and fiscal site visits, conference calls and submission of Programmatic Reports. For an example of this report, see the Programmatic Report (Attachment F).
        4. Invoices are submitted at the end of each month for reimbursable expenses described in the CCP Grant Funding Opportunity (Attachment D).
  8. DISASTER RECOVERY PROCEDURES FOR BH PROVIDERS (TIER 1 AND DESIGNATED TIER 2+)
    1. When a FEMA CCP ISP is implemented, providers assess the need for a FEMA CCP Regular Services Program (RSP). The needs assessment is done cooperatively with the DBHDD Disaster Mental Health Coordinator and the Georgia Recovery Project Manager.
    2. Applying for the CCP RSP is the next step:
      1. DBHDD's DMHC completes the CCP RSP application
        1. The number of CCP staff for the providers is determined by using the needs assessment results and the staffing chart on page 3 of the RSP Application template found in the FEMA CCP Toolkit located at http://www.samhsa.gov/dtac/ccp-toolkit. See Reference Materials (Attachment H).
        2. Providers work with DBHDD's DMHC to identify any special service delivery requirements for their catchment areas.
    3. Providers implement FEMA CCP RSP, if approved. At the time of program establishment, FY2016 contracts are amended. Changes in staffing are possibly needed based on the number of staff approved for grant program.
    4. FEMA CCP RSP training is delivered by DBHDD at the beginning of program implementation.
    5. Monitoring and Reporting:
      1. Methods of monitoring and reporting are determined by the Georgia Recovery Project Manager at the State Office and is dependent on the size and scope of the disaster and program
      2. Requirements for data collection are described in the CCP RSP program guidance and training is provided on the use of the data collection tools. Specific methods for submission of data are established at the beginning of program implementation.
      3. Monitoring of Tier 1 and 2+ providers include program and fiscal site visits, conference calls and submission of Programmatic Reports. For an example of this report, see the Programmatic Report (Attachment F).
      4. Invoices are submitted at the end of each month for reimbursable expenses described in the CCP Grant Funding Opportunity (Attachment D).
  9. FREQUENTLY ASKED QUESTIONS
    1. Please see the Provider Disaster Policy FAQs (Attachment G).

LEGAL REFERENCES

Official Code of Georgia Annotated Chapter 37-1-20

Rules of Georgia Department of Human Resources Public Health Chapter 290-5-45

Disaster Preparedness Plans, Georgia Emergency Operations Plan, Emergency Support Functions 6 & 8 (Official Code of Georgia, Title 38, Section 3, Articles 1 through 3)

RELATED POLICIES

Provider Manual for Community Behavioral Health Providers, 01-112

Community Behavioral Health Provider Network Structure, 01-199

Comprehensive Community Provider (CCP) Standards for Georgia's Tier 1 Behavioral Health Safety Net, 01-200

Community Medicaid Provider (CMP) Standards for Georgia's Tier 2 Behavioral Health Services, 01-230

Continuity of Operations Planning (COOP) at DBHDD State Office (Two Peachtree Street), 20-103

Psychiatric Residential Treatment Facility (PRTF) Manual, 01-301

Provider Manuals for Community Developmental Disability Providers, 02-1201

REFERENCE MATERIALS

See Attachment H

Attachments:

Approval Signatures

Approver Date
Anne Akili, Psy.D.: Director, Policy Management 8/14/2017
Monica Johnson, MA, LPC: Director, Division of Behavioral Health 8/14/2017
Ron Wakefield: Director, Division of Developmental Disabilities 8/11/2017
Jeannette David: Disaster Mental Health Services Coordinator 8/11/2017
Anne Akili, Psy.D.: Director, Policy Management 8/10/2017
Angela Jones, MHA: Policy Coordinator 8/10/2017
Older Version Approval Signatures
Approver Date
Anne Akili, Psy.D.: Director, Policy Management 8/14/2017
Monica Johnson, MA, LPC: Director, Division of Behavioral Health 8/14/2017
Ron Wakefield: Director, Division of Developmental Disabilities 8/11/2017
Jeannette David: Disaster Mental Health Services Coordinator 8/11/2017
Anne Akili, Psy.D.: Director, Policy Management 8/10/2017
Angela Jones, MHA: Policy Coordinator 8/10/2017
Older Version Approval Signatures
Joetta Prost, Ph.D.: DBHDD Policy Director 5/22/2012
Joetta Prost, Ph.D.: DBHDD Policy Director 12/8/2011