Long-Term Care Toolkit Appendix A.6.1: Supplemental Document for Group Homes, Home Care and Hospice

Introduction 

This document has been created to help illuminate the differences between larger facilities/agencies and smaller ones and/or ones without a brick-and-mortar building. Each section listed below follows the order of The Base Plan and gives additional resources for group homes, home care, and hospice facilities/agencies to facilitate better planning. The Base Plan, Appendixes, and Annexes are still great resources for smaller facilities/agencies and are customizable to each specific facility/agency. The information listed below is an additional resource, and other information to consider adding to your emergency preparedness plan when you are part of a smaller facility/agency. 

• See Appendix A.1 - CMS Emergency Preparedness Checklist
• See Appendix A.5 - MDH Crosswalk (a crosswalk between Appendix Z and facility/agency type)

Plain language 

• Same as the base plan. 

Continuity of operations plan (COOP) and succession planning

• Resident - who are your back up caregivers?

Hazard vulnerability analysis (HVA) 

• Resident - what are the specific hazards near where the resident lives? 
• General data on hazards can be obtained from the regional and county HVAs.

Communications

• Internal communication with staff and external communication with residents, their families, and the public.
• External communication with emergency preparedness officials of residents who need assistance with evacuation die to an emergency.
  • Have a method to communicate with on-duty staff during an emergency to ensure they are safe, and if unable to reach them, to inform emergency preparedness officials. 
• Resident - how are you communicating?
  • Text first, it takes less bandwidth.
  • Text family members ‘SAFE’ to let them know you are safe.
• See Appendix C.2 - External and Internal Contacts (Excel spreadsheet)
• Have an emergency preparedness document for the resident.
  • See Appendix A.6.2 - Resident Emergency Preparedness Plan

Incident command system (ISC)

• This may be your business organization structure, but who has the power to make decisions 24/7?
• See Appendix D – ICS Organization Chart – HICS Quick start.

Facility/agency information and contact information

• Resident - do not forget to have copies of insurance and vital records. These can be stored in the cloud for reference later.
• See Appendix E – Facility/Agency Contact list.

Building-specific information

• Resident - where is the power, gas (fuel oil, propane), and water shutoffs? Identify them by labeling each one and writing down where they are at.
  • CAUTION – if you turn off the gas for any reason, a qualified professional must turn it back on. NEVER attempt to turn the gas back on yourself.
  • Resident – are you on a private well and septic system or city water and sewer? If on a private well, when was the last time you tested your water? Protect your well from flood waters.
    • Water Quality/Well Testing/Well Disinfection
    • Flood Precautions For Private Water Wells 
• If you live in a flood-prone area, consider purchasing flood insurance to reduce your risk of flood loss.
• See Appendix F – Building specific information.

Decision-making

• Resident – who is your emergency contact?
  • Do you have a Durable Power of Attorney for Health Care?
  • Do you have a Living Will?
  • Do you have a Durable Power of Attorney for Finances?
  • Have copies of all official documents on site and in the cloud for reference later. 

HIPAA/1135 waiver in emergent situations

• Same as base plan.

Ethical guidelines

• Ethical guidelines include crisis standards of care. In the base plan there are links to several documents which have information of crisis standards of care.

Infection control

• Make sure you have an infection control plan and base on the resident or Federal/State guidelines follow them.
• Stay home when sick, cover your cough, and wash your hands.
• Cover Your Cough

Crisis staffing and volunteers

• Same as base plan.

Shelter in place

• Based on the disaster, sheltering in place is the best and safest location for you to be. However, this may not be in the basement. For example, if a flood is occurring, do not go to the basement. Think about the emergency occurring and which location would be the safest; here are questions to consider when planning locations for shelter-in-place.
  • Do you have a basement room with no windows, can the resident get there?
  • What about an interior bathroom with no windows?
  • Maintain a seven-day supply of nonperishable food and water.
  • Be prepared to close, lock and board/seal windows and doors.
  • Have an emergency supply kit.
  • Build A Kit
• A “bedside kit” has items you will need if you are trapped in or near your bed and unable to get to other parts of your home.
•  A “carry-on-you” kit for the essential items, such as medications, contact names and phone numbers, health information, your ID, etc. You need to keep this with you at all times.
• Keep important items in a consistent, convenient, and secured place, so you can quickly and easily get to them (items, such as teeth; hearing aids; prostheses; canes; crutches; walkers; wheelchairs; respirators; communication devices; artificial larynx; sanitary aids; batteries; eyeglasses; contact lens with cleaning solution, etc.).

Evacuation

• Are all the exits accessible at all times?
  • Does the resident winterize the house by enclosing it in plastic and/or having hay bales at the foundation? 
• Have a “grab bag” prepared. “Grab-and-go” kits are easy to carry kits you can grab if you must leave home (or school, workplace, etc.) in a hurry. They have the things you cannot do without, but that are not so big or heavy that you cannot manage them. 
  • Learn what can go into a kit: Build A Kit.
• Arrange for assistance if you are unable to evacuate by yourself.

Evacuation transportation

• Do you have an accessible vehicle the resident can get in?
• Does the resident have a vehicle that can be used?
• Keep a full tank of gas in your car.
• Have a kit for your vehicle. Learn more about Car Safety

Evacuation destination information

• Is there a family member that will take the resident?
• Work with the county emergency manager for an evacuation site location.
• Let others know where you are evacuating to and have a backup in case your original location is not available.

Evacuation staffing

• Who will care for the resident: staff/family?

Special considerations

Additional information on Ready.gov

• Individuals with Disabilities
• Older Adults

Pets

• Have a care plan for your pet. Extra food and/or medications, leashes, carriers, bowls, ID tags, etc. Check if your evacuation location will accept pets. 
• Prepare Your Pets for Disasters

Speech or communication issues

• If you use a laptop computer for communication, consider getting a power converter that plugs into the cigarette lighter and a battery backup.

Hearing issues

• Have a preprinted copy of key phrase messages handy, such as “I use American Sign Language (ASL),” “I do not write or read English well,” “If you make announcements, I will need to have them written simply, or signed.”
• Consider getting a weather radio with a visual/text display that warns of weather emergencies.
  • FEMA Mobile Products

Vision issues

• Mark your disaster supplies with fluorescent tape, large print, or Braille.
• Have high-powered flashlights with wide beams and extra batteries.
• Place security lights in each room to light paths of travel.

Assistive device users

• Label equipment with simple instruction cards on how to operate it (for example, how to "free wheel" or "disengage gears" of your power wheelchair). Attach the cards to your equipment.
• If you use a cane, keep extras in strategic, consistent, and secured locations to help you maneuver around obstacles and hazards.
• Keep a spare cane in your emergency kit.
• Know what your options are if you are unable to evacuate with your assistive device.

Memorandum of understanding

• Same as base plan.

Recovery plan

• Resident – if your dwelling has been damaged, take pictures and contact your insurance provider.

Staff care and behavioral health 

• Same as base plan.

Exercise, evaluation, and improvement planning

• Resident – test your communication and evacuation plans.
• Can you call important people on someone else’s phone or are all your important numbers in your phone contacts. See Communication section above.

Resources and support agencies 

• Same as base plan.