Talking Paper - HAH EMERGENCY SERVICES COALITION

PATH FORWARD for 2015-16
Program Strategic Assessment and Plan
CONFIDENTIAL
Toby L. Clairmont, RN, CEM
(808) 599-2899
tclairmont@hah-emergency.net
FOR OFFICIAL USE ONLY
No public disclosure of this document, in whole or part is authorized.
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I. Planning Assumptions…
New leaders in state and federal government – Legislative and Executive
Coalition has experienced a 33%+ reduction in federal HPP funding (funding reduced
to ~ $915,000/year at 75% share)
HPP grant will continue another 2 years at level funding – reauthorization likely
No new significant changes to HPP requirements are anticipated
Coalition must cope with reduced funding by reducing services and generating
complementary revenue
No expectation of sustainable state or county replacement funding – Coalition
receives none now
Tier one organizations will continue to be fiscally constrained as ACA is further
implemented
Current public concerns regarding Ebola Virus Disease (EVD) will continue to diminish
Organizational consolidation and realignment among hospitals will continue
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II. Major Accomplishments in 2014…
RIMPAC 2014 HA/DR exercise involving hospitals statewide and 21 nations
Collaborative work with John A. Burns School of Medicine
Initiatives related to EVD preparedness launched & operational
Emergency aeromedical missions in Hawaii and into the Pacific
CDMA swap strategy for non-hospital organizations
Special support to Blue Angels Airshow, Honolulu Marathon
Learning Management System (LMS) fully operational
All hospital emergency department computer workstations upgraded
Area Coordinator (contract) positions fully staffed
Active Shooter program launched
Makani Pahili 2014 exercise included Kauai deployment
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II. Major Accomplishments in 2014…con’t
HAH Area Caches on Lanai and Molokai islands
3rd and final increment of Med-Sleds deployed
6 each 11 KW diesel generators procured
New Everbridge contract negotiated at 50% reduction in cost
Highly successful and favorable HPP federal Site Visit in October 2014
Kalawao Rescue membership tops 110 members
New Request for Assistance (RFA) process and technology
Clean (no findings) A-133 audit
Dialysis providers joined into Coalition membership
Additional on-site training provided to Kalaupapa Settlement together with enhanced
satellite communications
Responded to two hurricanes in Hawaii
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III. SWOT: Strengths…
Federal Site Visit revealed numerous ‘best practices’ – highly favorable
Major systems and technologies in place & operational
Mature, statewide HPP Emergency Services Coalition 125+ Coalition member
organizations
Member confidence in HAH Emergency Services remains very high based on recent
satisfaction surveys
Highly favorable reputation and strong support from county, state and federal
(particularly USCG and military) agencies
Multi-Mission emergency response teams – Hawaii DMAT and Kalawao Rescue
> 95% of required HPP 2012-2016 Capabilities already in place and operational
Recognized as ‘the’ disaster emergency medical provider in the State of Hawaii and
Pacific region
Competent, responsive staff and Coalition leadership
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IV. SWOT: Weaknesses…
Many qualified health care organizations are not members of the Coalition
General public and most state leaders (legislative and executive) are unaware of
Coalition, its mission or capabilities
Hospital-based HERT membership not fully trained, prepared
No funding support from HAH, counties or the State of Hawaii
Inadequate options for the administrative management of Kalawao Rescue injuries
and illnesses
No funding available for major events such as 2016 IUCN World Conservation
Congress
Collaboration and cooperation with SDOH Disease Outbreak Control Division needs
improvement
Most Hawaii residents are ill-prepared for major emergencies or disasters however
situation may improve with the emergence of community resiliency groups
Coalition operational capabilities have been reduced by at least 25% due to shrinkage
in cached medical supplies and pharmaceuticals – consequence of reduced funding
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V. SWOT: Opportunities…
Well-positioned to develop and implement complementary (alternative) sources of
revenue for direct program support
Potential to incorporate new Coalition members on a ‘pay to play’ basis
Proposed revisions to CMS life-safety rules likely to generate many opportunities for
Coalition support
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VI. SWOT: Threats…
Emergence of cyber-terrorism and active shooter as new, significant hazards
Staff time needed to pursue complementary revenue may ‘crowd-out’ core HPP-related
activities
Coalition has experienced a 33%+ reduction in federal HPP funding – Coalition unable to
replace or upgrade major systems as they age-out
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VII. 2015-16 Objectives…
GROW
1. Progressively incorporate healthcare recovery planning and Crises Standards of Care over
next 2 years
2. Identify and Implement strategies to develop complementary (alternative sources of revenue
3. Develop new HAH WebEOC applications including on-line ‘Response Clinical Record’
4. Orient new governmental leaders early in their tenures
5. Improve operational and administrative coordination with the Hawaii State Department of
Health
6. Align federal resource and bed reporting to align with HAVBED version 4.0
7. Enhance participation of non-hospital organizations in Coalition
8. Orient new governmental leaders early in their tenures
9. Enhance HERT program
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VII. 2015-16 Objectives…con’t
SUSTAIN
1. Maintain existing core systems and essential services as defined in HPP application and State
DOH contract
2. Maintain Kalawao Rescue membership above 100 members
3. Maintain recently-developed EVD preparedness and response capabilities with an eye on
emerging infectious diseases
SHRINK
1. Reduce program services and resources commensurate with available funding as defined in
‘Shrink to fit’ initiative initiated in early 2014
2. Phase-out dedicated mass fatality storage (HRH’s) capabilities by August 2016
3. Conduct only one (1) statewide, communications and coordination functional exercise each
year going forward
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