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Oakland County

State: MI Type: Promising Practice Year: 2019

Oakland County Health Division (OCHD) serves 1.2 million of 9.9 million Michigan residents. Oakland County is located northwest of the Detroit metropolitan area and is the second largest county in Michigan. As of 2015, the median age in Oakland County is 40.8 years old with roughly 15% (179,188) of the population age 65 years or older. The median income is $67,465 with 10.1% of individuals living below the poverty level. Oakland County's populations consists of 76.3% white, 13.9% black or African American, 6.3% Asian, and 3.7% is Hispanic or Latino individuals.

In January of 2017, Oakland County Health Division (OCHD) targeted long term care facilities and implemented Oakland County's Emergency Preparedness Best Practices Program for Healthcare Partners. This program recognized national emergency preparedness (EP) requirements as best practices and provided support through educational and training opportunities for healthcare partners to meet the requirements. Throughout 2017, both OCHD and Oakland County Homeland Security Division (OCHSD) received numerous phone calls from other types of healthcare providers seeking assistance in EP planning. OCHD recognized that overall community preparedness begins with healthcare provider readiness. OCHD took the initiative originally designed for long term care facilities a step further and expanded it to include all healthcare providers.

OCHD quickly recognized that EP planning and training were new concepts to many local healthcare organizations. Large healthcare organizations such as hospitals, have had significant experience with creating plans and conducting drills, while smaller organizations such as home health care, hospice, and long-term care facilities did not have the resources or staff to implement quality emergency plans and staff trainings. Oakland County Health Division took a proactive approach to implement a program to provide education, trainings and collaboration opportunities to improve planning and preparedness among local healthcare providers. This program was planned in direct correlation with national emergency preparedness standards thus supporting providers in meeting their emergency preparedness requirements.

At the time of program expansion, the goals, objectives, and title of the program were updated. The overarching goal for this new program was to build resilient communities by providing support to healthcare providers impacted by national regulations. The program name was changed to Oakland County's Emergency Preparedness Resilience in Healthcare Program. The objectives for this program included the development of sustainable resources and trainings, to assist healthcare providers in meeting their emergency preparedness requirements, and to build and establish emergency preparedness relationships among healthcare providers in Oakland County and beyond.

Beginning in 2018, OCHD provided six trainings to healthcare facilities at no cost to attendees.  The trainings offered were provided by Michigan Department of Health and Human Services, National Center for Biomedical Research and Training (NCBRT), Trainings & Treatment Innovations, and the Federal Bureau of Investigations.  These trainings provided information about Mental Health First Aid, Biological Incidents Awareness, Chemical Response, Community Healthcare Planning and Response to Disasters, the Incident Command System, and Cyber Security. 

Throughout 2018, OCHD facilitated 14 meetings, one tabletop exercise workshop, one webinar, and two full day emergency preparedness symposiums. The tabletop exercise workshop provided education and materials for facilities to exercise their emergency plans independently. The exercise materials were also made available electronically on the OCHD website. The full day symposiums brought together local emergency management, emergency preparedness, environmental health, representatives from the State of Michigan, and the Region 2 North Healthcare Coalition (R2N) to discuss EP planning.  An Emergency Preparedness Toolkit was developed and provided to all participants at the symposiums. Toolkit materials were also made available electronically on the OCHD website. In all, this program was considered successful as 350 healthcare workers representing over 150 facilities and organizations in Oakland County attended the 24 events held in 2018. OCHD received feedback from two health care facilities that directly attributed the success of meeting their emergency preparedness requirements to the trainings and partnerships provided through this program.


https://www.oakgov.com/health/services/Pages/Emergency-Preparedness.aspx


To improve community resilience and readiness utilizing healthcare providers as the cornerstone, OCHD piloted an engagement program for long term care facilities in the Oakland County Health Division Long Term Care Partnership Committee in 2017.  Due to the large influx of phone calls requesting assistance from various types of healthcare providers, OCHD identified a gap among healthcare organizations within the community regarding EP planning and training. OCHD recognized the importance of tailoring program content to include all provider types impacted by national requirements; thus, ensuring these facilities remain operational during large scale emergencies and to provide medical attention to community members. By 2018, this newly adapted program of providing support and EP resources to local healthcare partners, was operational. The new program model fit the needs of all healthcare providers in Oakland County and was designed to remain sustainable throughout the years. 

By partnering with the State of Michigan and conducting online research of local providers, Oakland County Health Division identified 368 health care organizations and invited them to participate in two symposiums. These events were held in April and July of 2018. Based on attendance at these two events alone, OCHD assisted 132 different organizations from various provider types including dialysis centers, federally qualified healthcare centers, home health care, hospitals, hospice, long term care facilities, surgery centers, and physical therapy centers. Approximately 36% of healthcare organizations invited to symposiums attended the events.

OCHD recognized the importance of collaboration with multiple local and regional partners to ensure the success of Oakland County's Emergency Preparedness Resilience in Healthcare Program.  OCHD collaborated with OCHSD, Region 2 North Healthcare Coalition, and local cities, townships, and villages to provide a broader view of EP planning and training to healthcare providers. 

As part of the Regional Healthcare Coalition, OCHD was involved in numerous regional trainings, exercises, and meetings that directly impacted healthcare partners.  A regional workgroup was established through the Region 2 North Healthcare Coalition for Home Health Care and Hospice agencies in which OCHD contributed to and attended on a regular basis. All home health care and hospice agencies were encouraged to work on a regional and local level. OCHD also partnered with local police and fire departments to provide additional trainings, including three Active Assailant (ALICE) Trainings and discussions on the importance of relationships between healthcare workers and first responders.

The Oakland County Emergency Preparedness Resilience in Healthcare Program was designed to allow for continuous adaptability and innovation to support all local healthcare organizations with emergency preparedness planning. While this program was not a requirement of OCHD's emergency preparedness work plan, OCHD recognized the importance of healthcare provider preparedness as essential in overall community preparedness. The various methods of education and training provided allowed for healthcare organizations to collaborate with peers and receive resources from OCHD and other subject matter experts. In totality, this program offered 24 different engagement opportunities for healthcare workers. There were 350 individuals representing over 150 healthcare providers at planned trainings and events.

The primary goal of the Oakland County Emergency Preparedness Resilience in Healthcare Program was to build resilient communities by providing support to healthcare providers that were impacted by national regulations. The objectives for this program included the development of sustainable resources and trainings, to assist healthcare providers in meeting their national emergency preparedness requirements, and to build and establish emergency preparedness relationships among healthcare providers in Oakland County and beyond.

These objectives allowed for OCHD to assist healthcare providers improve recovery planning in the event of a public health incident or emergency.  The resources and trainings provided by this program increased healthcare worker knowledge of emergency preparedness concepts as well as foster relationships with key stakeholders. This program took place from January 2018 to December 2018. Throughout the length of the program, healthcare providers were given numerous opportunities to meet with local emergency management and acquire emergency preparedness information.

To reach the primary goal, OCHD collaborated with local, regional, and state partners as well as all provider types impacted by national requirements. To maintain relationships and build collaboration, OCHD sent follow up emails, provided certificates of participation, sent thank you cards, and made phone calls to individual facilities and stakeholders. The alliance between all partners has remained on-going.  The relationship between OCHD and emergency preparedness stakeholders has strengthened through the year and has allowed for seamless support to be provided to all healthcare providers.

With the assistance of OCHSD, a webinar was created to educate healthcare providers about the Incident Command System; a key concept in emergency operations. This webinar was offered at various times throughout the year.  In addition, OCHSD presented at meetings and symposiums to give insight and assistance to healthcare providers on topics such as hazard vulnerability assessments and the Oakland County after-hours emergency line. The relationship with OCHSD allowed for timely responses to healthcare partners that needed assistance beyond the capacity of OCHD.

The Region 2 North (R2N) Healthcare Coalition participated in all meetings and trainings.  The R2N Healthcare Coalition gave presentations at Oakland County meetings, symposiums, and hosted a break out session for Oakland County Home Health and Hospice specific providers. OCHD also attended the R2N meetings, trainings, and events relevant to providers.  OCHD attended and participated in the 2018 R2N Annual Conference, Tabletop Exercise, and the FEMA training courses.  As integral members and partners, OCHD supported the efforts of the R2N Healthcare Coalition to create a regional Home Health & Hospice Workgroup. OCHD attended this meeting and encouraged all Oakland County healthcare partners to attend.  The relationship with the R2N Healthcare Coalition allowed for healthcare partners to receive additional resources and support.

The OCHD EP Unit also collaborated with Oakland County Medical Control Authority, Oakland County Medical Examiner's Office, and multiple internal partners. These relationships were imperative for the success of the program's main goal to build a resilient community as these partners provided ongoing support, assistance, and education to healthcare providers. The OCHD EP Unit staff attended various meetings, trainings, and conferences locally and nationally to remain knowledgeable about information and trends in emergency preparedness.

The costs associated with this program have been minimal as OCHD can secure meeting and event locations for free. In kind costs have been associated with material procurement (such as printing and mailing) and staffing. The OCHD Emergency Preparedness Unit is fully funded through Public Health Emergency Preparedness (PHEP) and Cities Readiness Initiative (CRI). The OCHD EP staff adopted this program as an additional project without need to hire more staff for implementation.

The Oakland County Emergency Preparedness Resilience in Healthcare Program was established to help healthcare providers meet their national emergency preparedness requirements and improve emergency planning.  The objectives for this program included the development of sustainable resources and trainings, to assist healthcare providers in meeting their national requirements, and to build and establish emergency preparedness relationships among healthcare providers in Oakland County and beyond. By accomplishing these objectives, the Oakland County community became better prepared and more resilient against public health emergencies.

The Oakland County Emergency Preparedness Resilience in Healthcare Program was successful in providing specific trainings and information related to emergency preparedness planning and community resilience. The success of these events was determined by attendance and surveys given after events. Program data was collected by OCHD EP staff at meetings, trainings, and events. The events and trainings provided to healthcare partners increased emergency preparedness knowledge.  In 2018, this program brought together over 150 different local healthcare organizations, as compared to the previous year that impacted 44 long term care facilities.

Local healthcare organizations were invited to participate in 24 emergency preparedness related training opportunities supporting over 350 healthcare workers in emergency preparedness planning.


The Oakland County Emergency Preparedness Resilience in Healthcare Program was designed to be sustainable.  All trainings were minimal or no cost to OCHD and were provided for free to participants.  Community stakeholders were involved and offered valuable information to assist in emergency planning.

Through 2018, OCHD learned that individual healthcare workers and organizations exist at varying degrees of emergency preparedness knowledge. One task of the program was to provide support to these individuals and organizations to help them grow in their preparedness; ultimately building resilience at various levels. OCHD EP Staff were trained to assist healthcare partners and direct them to appropriate information.  OCHD created an email distribution list for healthcare partners to distribute information and contact healthcare organizations when necessary. 

In addition, through conversations with healthcare workers, a need for continued involvement between the various types of providers and key stakeholders was identified. OCHD EP took this as a planning opportunity and is currently developing a three-year workplan for this program. The workplan will consist of specific meetings and trainings to support the goal of building resilience in Oakland County by aiding those impacted by national regulations. By supporting healthcare providers in emergency preparedness and recognizing their role as primary caregivers to our residents, Oakland County increases overall community resilience.



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