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Introduction to Emergency Management Planning

According to Policy Information Notice (PIN) 2007-15, U.S. Department of Health and Human
Services, Health Resources and Services Administration (HRSA), “Health Centers must have
risk management policies and procedures in place that proactively and continually identify and
plan for potential and actual risks to the health center in terms of its facilities, staff,
clients/patients, financial, clinical, and organizational well-being. Plans and procedures for
emergency management must be integrated into a health center’s risk management approach
to assure that suitable guidelines are established and followed so that it can respond effectively
and appropriately to an emergency.”

Click here to view the full PIN, entitled Health Center Emergency Management Program
Expectations.

Benefits of an Emergency Management Plan

An emergency management plan (EMP; also known as an Emergency Response Plan), is
more than just an organizational tool. Having a plan assures that your center will be able to
function both during and after emergencies and be able to continue to serve patients who rely
on your center for care. An EMP will allow your organization to respond more efficiently to an
emergency and recover more quickly. An EMP will identify the role your health center will play
in many types of emergencies, both internal and external.

Having a plan:

Minimizes confusion among staff

Ensures the safety and wellbeing of staff and patients
Improves coordination and communication between staff and community partners
Defines chain of command
Defines roles, responsibilities, policies and procedures
Reduces fear and anxiety
Limits loss of life and property that occur because of disasters
Allows for continuity of operations
Helps steer training and exercise planning

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The Purpose of an Emergency Management Team
An emergency management team (also known as Emergency Management Committee) should
be established, which will be responsible for the development and implementation of the health
center’s emergency response plan. The size of the team will depend on the practice site’s
operations, requirements, and resources.

The makeup of the team will also vary depending on your circumstances. It is wise to include a
broad range of employees that possess a wide range of skills and expertise. Some suggested
members of the team are:

Facility Administrator / CEO

Emergency Response Coordinator
Medical Director
Director of Nursing
Infection Control Nurse
Staff Development Coordinator
Human Resources Manager
Technology Officer
Finance Director
Communications/Public Relations Director
Facilities Manager
Head of security

The roles and responsibilities that are assigned to each member of the team will be determined
by the resources and capacity of your organization. Module 3, National Incident Management
System (NIMS) and Incident Command System (ICS), will provide some guidance concerning
different types of roles and the corresponding responsibilities.

Emergency Management Coordinator

It is essential to appoint an Emergency Management Coordinator (EMC) and two backup
coordinators. The EMC, often the CEO or director of the facility, will be responsible for
managing all emergency preparedness activities for your center, as well as activating the
emergency management plan. A backup is necessary in the event the EMC or first designated
backup is unavailable at the time of an emergency.

Emergency Response Team

A community health center may also want to establish an emergency response team. The
members of this team may vary from that of the emergency management team and its
members will serve as the leaders during an actual emergency, directing specific components
of the response, such as operations, planning, logistics, and finance/administration. These

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components are specific to an actual emergency response (please see module III: NIMS and
ICS for more information).

Your Health Center’s Resources and Capacity

No one knows your organization better than you. It is essential to understand your current
resources and capacity as you move through the planning process. Your EMP should consider
the Center’s size, location, resources, as well as current state, local and/or community and
regional plans. Location and size of the facility, the number of staff, and the type of operations
are key factors to consider in developing an appropriate emergency management strategy.
Thus, when creating your EMP, consider your existing plans and policies, personnel,
equipment, and backup systems for critical functions.

Plans, policies, and procedures may include the following:

Communication Plan
Evacuation plan
Fire protection plan
Security procedures
Infection Control Procedures
Insurance programs
Finance and purchasing procedures
Organizational closing policy
Employee manuals
Hazardous materials plan
Risk management plan
Mutual aid agreements
Continuity of Operations

Some of these plans are covered in more detail in Module 2, “Developing Your Plan” and
Module 4, “Potential Roles for Community Health Centers in an Emergency.”

Equipment may include the following:

Fire protection and suppression equipment

Communications equipment
First aid/triage supplies
Warning systems
Emergency power equipment
Decontamination equipment
Personal protective equipment

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Equipment—Additional considerations:
It is prudent to properly maintain equipment and repair any equipment in a timely manner.
Poorly- or non-functioning equipment can worsen an emergency situation. Also, consider
updating any equipment that is out-of-date or regularly malfunctioning. Finally, don't forget to
properly insure all assets.

Backup systems for critical functions:

Payroll
Communications
Patient services
Patient records
Information/technology systems
Emergency power
Alternative work location

Additional considerations for Backup Systems for Critical Functions:

Backup electronic data should be stored off-site, preferably in a different region that will not be
impacted by the same disaster. Agreements should be in place with vendors or other
organizations to obtain temporary or replacement equipment, staff, and IT services in a timely
manner in the event of a loss. Finally, in the event that your facility must evacuate and/or close
down, alternative facilities should be preselected where people can obtain the services and
care they would have received at your center.

Personnel
Be knowledgeable of the number of staff you have and the skill set they bring to the table. This
will assist you in assigning roles and responsibilities during an emergency.

When writing your EMP, keep in mind the following:

Total number of staff types, including skills

Number of volunteers, if any
Volunteer organizations from which you can obtain assistance
Local medical resources and facilities that may be able to supply staff

Personnel—Additional considerations:
Keep in mind that not all staff will be available during an emergency, particularly if the
emergency affects many in the community and surrounding region. Access to roads and
transportation may be limited. Staff may need to attend to their own family and personal
matters. Additionally, fear may prevent some staff from reporting during an emergency.

To ensure your staff is as prepared as possible to report for work during an emergency, they

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should receive training on personal preparedness. Staff who are personally prepared are more
likely to report for work and be more effective during an emergency response. Personal
preparedness means having plans in place before an emergency happens to ensure the
protection and care of family members and pets during an emergency.

To learn more about personal preparedness, please see our online course “Personal
Preparedness.”

Collaborating with External Partners

Coordination with community partners
The time to establish a working relationship with partners is before an emergency occurs. Know
with whom you can partner in the event of an emergency. Also, know who is relying on you in
an emergency.

You can coordinate with these partners on preparation and planning, exercises and drills, and
performance evaluation. Share emergency plans, particularly with partners you plan to use in
an emergency. Partners may also be able to provide additional resources, including their
knowledge of emergencies, handbooks, demographic data, and training tools.

Remember that your facility or community does not have to be directly involved with a disaster
for it to have an effect on you. Consider, for instance, a power outage that affects a local
hospital but does not affect your center. It may, however, cause a surge of patients at your
center that would normally be handled by the hospital.

Integral part of community

Your community practice site is an integral part of the community. You know your community as
well as anyone. People in your community rely on your services both during and after a crisis.

If community partners have not already reached out to you as part of their emergency planning
process, you may need to take the initiative. You have valuable information and resources they
can use in planning for and responding to emergencies. They, in turn, have valuable
information and resources you can use. In 2011, the CDC released the Public Health
Preparedness Capabilities – National Standards for State and Local Planning. This is a tool to
help State and Local Health Departments Plan for Public Health Emergencies. As a
Community Health Center, your collaboration in this process is invaluable.

Your potential planning partners:

Regional and state partners:

State department of health
State emergency management agency

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 Regional Resource Center (RRC)
Local partners (public health, healthcare)
Local health department
Hospitals
Other community healthcare centers
Other healthcare organizations
Local partners (emergency response)
Office of emergency management
Law Enforcement
Transportation
Fire
EMS
Volunteer Agencies (such as MRC and CERT)
Community partners
Non-governmental organizations
Faith-based groups
School districts
Business groups, e.g. Chamber of Commerce
Red Cross
Community volunteers
Essential infrastructure (power, telecom)
Media

Community Emergency Response Team (CERT)

The Community Emergency Response Team (CERT) program educates people about disaster
preparedness for hazards that may impact their area and trains them in basic disaster
response skills, such as fire safety, light search and rescue, team organization, and disaster
medical operations.

Written agreements
To avoid confusion and conflict in an emergency, written mutual aid agreements (MAA) or
memorandums of understanding (MOU) should be established with local government,
emergency response, and healthcare organizations, volunteer organizations, as well as
businesses and other community partners. These will address activities or resources that might
be needed, such as providing shelter space, emergency storage, emergency supplies and
equipment, and medical support.

These agreements should:

Define the type and scope of assistance

Responsibilities of each party
Identify the chain of command for activating the agreement

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 Describe financial responsibilities of each party
Define communications procedures
Determine procedures for dealing with the media (ie: identifying a trained spokesperson
and an alternate spokesperson; establishing procedures to ensure information released is
complete, accurate, and approved).

Contractual agreements with key vendors and suppliers will also be beneficial during times of
emergencies. Such agreements should describe the type of assistance that vendors may
provide during an emergency, such as providing emergency equipment or supplies. Having
such agreements in place could mean the difference between closing down or staying open.

Emergencies and Hazards

Emergencies can occur at any time and in any place. They can be of any size. They can occur
as a result of several kinds of hazards.

The Federal Emergency Management Agency (FEMA) classifies hazards as:

Natural (e.g., tornadoes, ice storms)

Intentional (e.g., terrorist attack, civil disobedience)
Technological (e.g., failure of the power grid, hazardous materials spill)

Other ways to categorize hazards include:

Accidental versus intentional (e.g., a burst pipe versus an active shooter)

Internal versus external (e.g., a fire versus a flood)
Controllable versus beyond organization’s control (e.g., sick employee you can send
home/prevent from coming to work based on policies and procedures versus flu
pandemic)
Events with prior warning versus those without (e.g., hurricanes versus most
earthquakes)

Risk versus hazard

There is a difference between a risk and a hazard. A hazard is anything that has potential to do
harm to property, the environment, and/or people. A risk is the probability of that hazard
potential actually occurring. You need to be aware of and consider both as you develop your
plan.

Current emergency planning takes an “all-hazards” approach, which means plans are
developed to address a wide range of emergencies.

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All-Hazards Model
The “all-hazards model” is used to plan for the common elements in all disasters. It does not
mean that the emergency plan must cover everything that might be required in a disaster. It
does mean that you can identify common elements that occur in many kinds of disasters.

Common emergency actions

There are common actions that would be required by your center in most emergency situations.
These include:

Clear chain of command and responsibility

Working communications system, internal and external
Consideration of special needs of your patients
Communication of emergency plan to staff
Continuity plan so your facility can remain open or open again as soon as possible
Mutual agreements to get external resources to provide safety and continuity of services

Advantages of all-hazards model

By focusing on what all disasters have in common, the all-hazards model makes your planning
more efficient and avoids redundant use of personnel and materials. It makes your response
more effective because it simplifies decision making and streamlines action.

The all-hazards model:

Is cost effective. The all-hazards model encourages you to:

Define what common supplies are needed in all types of disasters.
Plan for efficient use of personnel.
Deals with the most probable events. The all-hazards model encourages you to:
Describe what common initial and ongoing actions will be taken in all types of
disasters.
Coordinate with agencies that will be involved in most disasters.
Promotes broader thinking:
The all-hazards model encourages managers and staff to think with a broader
perspective about real and potential emergencies. They must think not only about
localized incidents but also about emergencies that affect the facility and the local
community outside the facility.

© 2019 Center for Public Health Preparedness, University at Albany School of Public Health
Instructional Development by the Professional Development Program , University at Albany, New York

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