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Emergency Preparedness: Mitigation, Preparedness, Response and Recovery

In Texas, we have very detailed regulations around emergency preparedness for Home Care agencies. We must have a plan (as most states do), but we must also activate that plan or do a drill every calendar year. If you've already activated your plan for this year, make sure it’s documented! If it's not documented, make sure that you finish that up ASAP. If you don't have a plan yet, then you need to get an Emergency Preparedness and Response Plan and then follow it.

In Texas, we have specific requirements about what goes into an emergency preparedness and response plan. If you're not in Texas, check your state regulations and see what may apply to you. Be sure that your plan includes the following:


This means determining ahead of time, what disasters could happen in your service area. What happens often? Is it flooding, ice storms, snow, excessive heat? Is it a pandemic and epidemic? Maybe you have a lot of industrial plants in the area, an there's potential for hazardous material spills. You may live on the coast where there is potential for hurricanes or typhoons. Mitigation means looking to see what we need to prepare for? Mitigation includes creating the plan itself, and having a "Hazard Vulnerability Assessment" for each service area. If your Emergency Preparedness and Response Plan doesn't come with one, you can reach out to your local Emergency Management Service for that information.


Then there's preparedness. That is a combination of staff training on what to do when a disaster happens, as well as emergency planning with clients. What is expected of your staff when there is an emergency? Not only will you want to give your staff tools about what they can do to prepare for an emergency in their own home and with their own family, you will also want them to know what is expected of them in regard to client care and working shifts when there is a natural disaster, or any kind of emergency that occurs. Another part of preparedness is helping clients understand that your agency is not their emergency backup because if there's an emergency, it's going to affect your agency and your employees may not be able to work with them. They need an alternate plan, which you can help them create when you do an admission. If they're unable or unwilling to make a plan when you admit, then the next time you go to do a supervisory visit, spend some time emergency planning with those clients and remind them of what they can expect when a local or state-wide disaster occurs.


The response phase needs to be outlined in the Emergency Preparedness and Response Plan. You need details about plan implementation; how you're going to handle agency business when you find out about an emergency. How are you going to contact your clients, staff, and clients' emergency contacts? What form of communication are you going to use if electricity or the internet is down? Where do you find out about all this information? If you can't operate from your regular office, what is the backup location?

The response itself is the ACTION you take during an actual disaster event or during a drill scenario. You'll follow your plan as closely as you can and document everything along the way. Documentation needs to cover what actually happened. What is happening? Where is it affecting people? How are we communicating? When did the disaster begin and end? Who (clients/staff) was negatively affected by the disaster (went without care, sick, injured, deceased)? Is there going to be an evacuation or not?

Depending on the type/severity of the disaster, you'll ask/tell your clients different things. Inquire about shelter and general safety first. You may need to make sure that your clients have potable water in case there is a problem with the water supply. and they have food that can be eaten and prepared without electricity. If the client has cognitive loss, make sure they're dressed appropriately for a weather related incident. Is there a nearby shelter the client should go to if they must evacuate? There are many factors to consider.


The last element that must be in your emergency preparedness is recovery. How are we going to resume normal business or new-normal business? Right after COVID-19, we were placed into a new normal. Look at how business operations are going to resume, how client care is going to resume, and then look back and say, how did it go? Look deeply at the good, the bad, and the ugly. What could we have done better? Document these things and use that information to audit or improve your Emergency Plan for next time there is an emergency or drill, and decide how you are going to operate differently. Document all of this. It can be in a narrative or a form. There really is not a wrong way to document this as long as it’s done!

An Emergency Drill is encouraged, especially if you're a new agency or under new leadership, or even if you get an updated/new Emergency Plan. A drill should use all of the elements in your plan, and should be run as much like a true emergency/disaster as possible. A good drill takes at least a couple of hours and you’ll need to include all of your clients and all of your staff. If you're able to document that each of your staff members were involved in the drill, this can be considered the employees' annual Emergency Preparedness training.

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