Speaker 1: Hello, everyone. This is the employee emergency preparedness training for Rural Health Clinics video. This is recorded in September 2021. First off, we would like to thank you for being a member of our team. Welcome aboard. We're going to be doing some training. All new employees and healthcare entities are required to get HIPAA training, OSHA training and emergency training, among other types of trainings that are required to protect the patients, to protect yourself, and to protect our organization from things like COVID-19 or flooding or Hurricane Ida. Those types of things we are required to have a plan to address and respond as best we can. Here are the OSHA COVID-19 emergency temporary standard that came into play in June 21, 2021. We won't be going over those, but those will be another session that you guys will be having on how to address those COVID-19 standards. Also, HIPAA as a healthcare entity, we are required to abide by HIPAA, and there will be training that you have to have for that as well. What we're going to concentrate on this video is on emergency preparedness training. This is something that we've seen more and more. As I'm recording this, Hurricane Ida has just come through New York, 40-something people died there. This is what the mayor said about that extreme weather has now become the norm, and that is true. We're having extreme weather. Tornadoes are worse than they were before. All sorts of flash flooding out of nowhere is happening. Climate change is really here, and you never think it's going to happen to you until it does. This is straight from Lake Tahoe. There's a huge fire going on there right now. These types of emergencies are happening more and more, and we have to be more and more prepared for them. That is the goal. Ever since Katrina came in 2005, we've learned that we really weren't ready for these mass casualties, mass incident types of things that are going on. It's still hard to respond to something as massive as what Ida has done, but there is a shared burden. There is a plan to address it ahead of time that makes the death, makes the destruction less severe. We are mitigating the effects of these huge events. By working together, we can help the outcomes from these disasters. These emergencies are going to happen. The goal is to mitigate what happens so that these emergencies don't turn into disasters. The goal, again, is to prevent them from happening in the first place as much as we can. The goal, again, is to prevent them from happening in the first place as much as we can, to prepare for them, and when they're happening, respond accordingly. We should be able to recover quickly once we've had the emergency, and if we can get through it quickly, and we can respond accordingly during the event. We're trying to build up what we call muscle memory, so when something happens, we know exactly what to do when it does happen. Things are going to happen. Our clinic participates in the Rural Health Clinic Program. It first came about in 1977 under Public Law 95-10, and we are required to participate in emergency preparedness under these rules. Here are some of the things that we have to do under Public Law 95-10. Number one, what we're doing right now, we are training, and you'll have to go through training every two years. You'll have to take a test and pass that test. Lucky, it's an easy test that we're going to give you. If we can get seven out of ten, then we've passed the test. We also have to do what's called an all-hazard risk assessment, where we look at the types of things geographically, based upon our physical location, the types of things that might happen to us. We have to evaluate that, determine the things that are most likely and that would have the biggest impact, and then put together an emergency plan to lay out what we would do in case that does happen, and put together emergency policies and procedures on how would we do that and what's in our emergency plan. We'd also need to put together a communication plan. That's why you're going to be asked to provide emergency contact information so we can get a hold of you in case of emergency or get a hold of your loved ones so that we can tell you what we need you to do if this emergency occurs when you're not at work. And then, we have to test the plan. Once a year, we'll have to do some type of drill that has what's called an after-action report with it, and that's one drill per year. It used to be two. Now, it's one for a rural health plan. We used to be required to outreach to the community. That's no longer required, but it is a best practice, and it's something that we recommend is that you reach out to your local EMA director and get on their listserv and work with them to be prepared for emergencies in your community. And then, every two years, we have to go through this process of reviewing and signing off and changing whatever needs to be changed. So, here is what's called the emergency plan and risk assessment. Here's just the wording that we use for that. You see here we're talking about HIPAA. You are required to protect the privacy of your patients in an emergency. However, if the Red Cross calls up and is looking for a certain person, you can tell them that they are there. So, there's a little bit of relaxing of the HIPAA regulations in that case. And here is your communication plan. Remember, this has to be updated at least biannually every two years, and anytime you have a change of information, anytime we hire somebody, we terminate somebody, if you change your phone numbers or your addresses, please let the clinic know so that they can update their contact information in their emergency plan. Testing of the system. Again, you have to do one drill per year. If you reach out to your local EMA director, they can help you do these fun things, these full-scale exercises where they blow up stuff and do all sorts of neat stuff. On your own, you can do what's called a facility-based drill, and a lot of people do something called the shakeout drill, which is an earthquake drill, and it's pretty simple to do. So, you may want to look up shakeout drill and get the instructions on that. And then we have to do training. And again, this is what we're doing today. We have a test for you. It has 10 questions on it, and it's very, very simple. We're trying to give you true information. So, let's go through what the test is right now. Number one, true or false, RAC is supposed to develop and maintain an emergency preparedness plan that is reviewed and updated by EMA. That means every two years, and of course, the answer to that is true. That's what we're talking about today. Second one is a true question. The clinic has specific instructions to evacuate the clinic in case of emergencies, and that is true as well. You do want to practice your evacuation plan. Make sure you know where your assembly point is. Make sure you know who is responsible for getting patients out of the clinic. In a fire situation, you want to shut the doors behind you and make sure that you evacuate safely, but know where that assembly point is. Question number three, is HIPAA required during an emergency? The answer is yes, but it can be relaxed, so you can tell people that if there's people that have been injured or whatever, you can let your local Red Cross or your local EMA person know. Number four, when assessing compliance with emergency training, the surveyor should review personnel or training records and verify that staff completed this training. Absolutely, your surveyors will be looking that you have done this, so we are required to do this. If the surveyor asks you a question you don't know the answer to, it's perfectly acceptable for you to say, I don't know the answer, but let me check with policy, and I'll get right back to you, so that's important that you would do that. Question number five, true or false, RHCs are required to participate in two drills every year and test the emergency preparedness system, and of course, we know that it's one drill, so that one is going to be false, so we're being a little bit tricky there. It used to be two, now it is one, so that one's going to be false. True or false, emergency preparedness is a condition of participation that RHCs must comply, and if you do not comply, failure to comply will result of removal from the RHC program, and that is absolutely true. We, if we do not do this, we have not met the condition of participation to be in the RHC program, and we will be terminated from the program, and that would not be beneficial to the clinic if that happens. We need to stay in this program. True or false, RHCs are required, number, question number seven, true or false, RHCs are required to develop and maintain emergency preparedness training and testing based upon standards set by the Fourth and local EMA agencies, HC, and that one is actually false. We do not have to follow the thousand pages of HC regulations, but we do have to have training and testing, but we just don't have to follow those horribly long, very complex rules, thank goodness, so the answer to that one is false. Number eight, true or false, RHCs are required to develop a communication plan to support coordination of care within the facility across healthcare providers, state and local public health departments, EMAs, all sorts of people. The answer to that one is absolutely true. We do have to have that communication plan where we're working with local agencies and working with them. That communication plan has to be updated. How often must the RHC review and update their communication plan contact information? The answer to this one is D, when any information changes or at least once every two years is how often we have to review this information. And final question, true or false, RHCs are required to develop policy procedures for patients and staff to shelter in place during an emergency. However, we're not required to maintain four days of supplies. We're not required to have a generator. We're not required to have all this stuff. If we were an inpatient hospital or a nursing home, we would have to have all that. The answer to this one is true. We do have to have shelter in place. Basically, you would be sheltering in place maybe during a tornado is a good example or if you have a chemical spill somewhere close by, you may be required to shelter in place in that case. Here's the answer key to this for you guys. There's your answers for it. And if you have questions about emergency preparedness in our clinic, please ask your office manager. Thank you for what you're doing. I know this is an incredibly difficult time to be in health care, incredibly scary. So please stay safe. Thank you for what you're doing for your patients and for us. Have a great day.