KatrinaWebinar - American Health Care Association

Transcription

www.watereddowntruth.com
Copyright © 2008 Robert Abrams All Rights Reserved
Watered-Down Truth
Presentation by: Robert Abrams
Watered-Down Truth
Pre-Katrina Warnings
. . . Devastating damage expected . . .
Hurricane Katrina . . . a most powerful
hurricane with unprecedented strength
. . . rivaling the intensity of Hurricane
Camille of 1969.
© 2008 Robert Abrams All Rights Reserved
Watered-Down Truth
Pre-Katrina Warnings
Most of the area will be uninhabitable
for weeks . . . perhaps longer. At least
one half of well constructed homes will
have roof and wall failure. All gabled
roofs will fail . . . leaving those homes
severely damaged or destroyed.
Persons . . . pets . . . and livestock
exposed to the winds will face certain
death if struck.
Watered-Down Truth
On Monday, August 29, 2005, 35
people drowned in a one-story
nursing home...
Watered-Down Truth
“As days passed, we would all learn more about
the death and destruction caused by, or as a
result of, Hurricane Katrina. We would reach
agreement as a nation that Katrina was one of
the worst disasters we ever faced.”
Excerpt from “Watered-Down Truth”
Watered-Down Truth
Trapped in their wheelchairs or on their beds,
these 35 nursing home residents were
helpless, stationary targets for this powerful
surge…
Nursing home owners Salvador and Mabel
Mangano, their staff and their ambulatory
residents survived.
Excerpt from Introduction to: Watered-Down Truth
Watered-Down Truth
Where are the Manganos?
According to Whom?
“The last I heard, they were spotted in
Natchez, Mississippi. And then recently I
was told . . . that the owners are actually
trying to leave the country.”
Joe Gallardo, Family Member,
Nancy Grace Cable TV Show
Watered-Down Truth
Rumors on the web and in print alleged
that the Manganos abandoned their
residents prior to the arrival of Hurricane
Katrina – but before they left, they tied
their non-ambulatory residents to their
beds and wheelchairs and left them to die.
Watered-Down Truth
Manganos Arrested
“My investigation found enough reason to place
these individuals under arrest. I think in times of
tragedy we have to act immediately to correct a
wrong and we did that in this case…”
Attorney General Foti announcing the
arrest of Salvador and Mabel Mangano
Watered-Down Truth
Manganos’ Counsel Reacts
“Foti has the legal acumen of an unlit
charcoal briquette – and that’s being too
hard on charcoal briquettes.”
James A. Cobb, Jr.
Esquire Magazine
Watered-Down Truth
Nationwide Support for Foti
In Louisiana and throughout the
country, there was wide public
support for Attorney General Foti
to CRIMINALLY PROSECUTE the
despised nursing home owners.
Watered-Down Truth
Familial Anger
“I want them to know there are a lot of people
devastated by their decision to leave our loved
ones in harm’s way.”
“They are guilty, guilty as hell.”
Yolanda Hubert
Daughter of Deceased Resident
Zerelda Delotte
Watered-Down Truth
24/7 Television Coverage and Commentary
NANCY GRACE . . .
“You know, it’s interesting, Susan.
I was
reading an AP wire, and it talked about two
fishermen. They were making a trip to rescue
some of their brothers. They lived off the Gulf
of Mexico. They go by St. Rita’s. Susan, they
see the oldsters on mattresses, floating up
near the ceiling inside the nursing home. So
they go back to try to rescue people.”
Watered-Down Truth
NANCY GRACE . . . (continued)
“Was that the evacuation plan St. Rita’s had
in mind, that maybe a fisherman from the
Gulf of Mexico might row by and save the
oldsters?”
Watered-Down Truth
AARP . . .
“St. Rita’s, the flooded Louisiana nursing
home where 34 bodies were discovered –
some still slumped in their wheelchairs has
become a disturbing symbol of the way older
Americans were abandoned, left on their own
during the swirling chaos of the Hurricane
Katrina disaster.”
Watered-Down Truth
Senator Charles E. Grassley . . .
“As Chairman of the Committee, I request that the
Department of Justice and the Office of Inspector
General, Department of Health and Human
Services, conduct a thorough investigation of the
deaths of nursing home residents in the Gulf Coast
states, including but not limited to the 34 deaths of
residents at St. Rita’s Nursing Home.”
Watered-Down Truth
Do-Over
“Unlike Governor Blanco, President Bush and Mayor
Nagin, Sal and Mabel no longer had jobs . . .”
“While these politicians apologized and
granted themselves and each other a
political do-over, Foti was not prepared
to forgive the Manganos and excuse
their failure to protect their nursing
home residents.”
Excerpts from “Watered-Down Truth”
Watered-Down Truth
Prosecution Trial Tactics
•
Demonize the Manganos
Guilty by Profession
•
Call 40 witnesses, including
one resident who was there
and several family members.
–
Watered-Down Truth
Prosecution Trial Tactics
•
Present the Manganos as greedy,
reckless killers who valued money
more than their residents.
•
Compare the Manganos’ behavior
with other nursing home owners in
their parish (county).
Watered-Down Truth
Defense Strategy
•
The risk of evacuation
•
The state of mind of Sal and
Mabel Mangano
•
The government must issue
a
mandatory evacuation order
Watered-Down Truth
Defense Strategy
•
Government incompetence resulted in
breached levees and the deadly
flooding that killed 1,600 people,
including 35 residents of St. Rita’s
nursing home
•
The Manganos acted in a reasonable
and professional manner
Watered-Down Truth
What chance do criminal defendants have
to compel a sitting governor to testify at
their trial?
Watered-Down Truth
Contrasting Styles of Prosecution and Defense
PROSECUTION
• 40 Witnesses
• 5 Witnesses
• Theatrics
Videos and Local
Celebrities
• Straight-forward
• Educate Jurors
• Emotion
• Demonize the Manganos
DEFENSE
• Demonize the
Government
Watered-Down Truth
Closing Arguments of the Prosecution
Paul Knight . . .
“. . . they stuck their heads in the sand, their
tails in the air and hoped Mother Nature didn’t
kick them in the butt. They gambled as they
were want [sic] to do with the lives of 59
people, and 35 of them died because they
gambled with their lives .”
Watered-Down Truth
Closing Arguments of the Defense
John Reed . . .
“We come to you in the hope that with your
verdict you will say to the State of Louisiana
that what happened and the way the
government handled its responsibility to the
homes, to the land, to the security of our
people, was not right. And blame cannot be
shifted to two ordinary human beings like
everybody else doing the best that they could in
that time .”
Watered-Down Truth
John Reed . . . (continued)
“If I had a hope, it would be that by your
verdict you would bring the people, who at
various times have sat on different sides of this
courtroom, together to put this behind us, to
say that the time for pointing fingers, the time
for laying blame, the time for putting people up
and hanging them is passed .”
Watered-Down Truth
Mr. Cobb’s closing arguments were strong
and unforgiving against the Prosecution,
especially Attorney General Foti.
He told the jury that he was going to be
positive – his version of positive . . .
Watered-Down Truth
P
:
Pathetic
O
:
Outrageous
S
:
Sinful
I
:
Insulting
T
:
Tyrannical
I
:
Illogical
V
:
Vindictive
E
:
Evil
Watered-Down Truth
Defense Attorneys Go Religious
Jim Cobb
“And I’m reminded from the Bible that the
elders came unto Jesus with a woman
accused of adultery and of being unclean.
And they approached Jesus saying, ‘Rabbi,
she’s accused of adultery and it is the law of
Moses saying she should be stoned unto
death. What say you, Rabbi?’”[sic]
Watered-Down Truth
Defense Attorneys Go Religious
Jim Cobb . . . (continued)
“For the elders meant to trick and deceive
Jesus and embarrass him. For his message
of hope was a threat to them. And Jesus,
who was sitting on the ground, said without
looking up, ‘You say it is the law. It is the
law. Let he among you who is without sin
pick up and cast the first stone.’”
Watered-Down Truth
The Manganos are Scapegoats
Robert Habans
“The word ‘scapegoat’ has come to mean a
person often innocent who is blamed and
punished for the sins and crimes of others. And
in Christianity, that same concept has been
adopted but with a slightly different spin. It
has been used as symbolic of the self-sacrifice
of Jesus who takes the sins of humanity on his
own head. . . . Having been driven into the
wilderness outside the city by the order of the
high priests .”
Watered-Down Truth
Habans then compares Jesus to
the Manganos and the jury to the
high priests.
Watered-Down Truth
Should You Compare Your Criminal Defendant
Clients to Jesus?
Is it appropriate
such
analogies
courtroom?
to make
in
a
Watered-Down Truth
A Quick Verdict
NOT GUILTY!
NOT GUILTY!
NOT GUILTY!
Watered-Down Truth
Hugs and Kisses
“The jurors, Sal and Mabel Mangano
embraced each other in a way that only
survivors with a common enemy can.”
Robert Abrams, Author
Watered-Down Truth
Watered-Down Truth
Case Will Be Decided By A Higher Authority
“The jury may not have found them guilty,
but our savior says they are. When they
face our maker, they’ll have to answer to
Him…”
Family Members
CBS News
Watered-Down Truth
Cowardly Prosecutor
?
Where was Foti during and after the trial?
No more press conferences.
But lots of questions . . .
Watered-Down Truth
Questions
Why did he refuse to meet with the Manganos
before he had them arrested?
When did he charge the Manganos as fugitives
when he knew where they were and that they
wanted to cooperate with his investigation?
Why did he emphatically state that a mandatory
evacuation was issued by St. Bernard Parish,
when, in fact, no such order was ever issued?
Watered-Down Truth
Questions
How could he charge the Manganos with
having a reckless disregard for the lives
of their residents, when they also put
their own lives and the lives of their
loved ones at risk by remaining in St.
Rita’s Nursing Home during the Katrina
catastrophe?
Watered-Down Truth
Questions
How could he prosecute the Manganos
for negligent homicide and at the same
time bring a multi-billion dollar suit
against the Army Corps of Engineers
for being responsible for the flooding
that killed over 1,600 Gulf Coast
residents, including the 35 residents of
St. Rita’s Nursing Home?
Watered-Down Truth
Questions
Why is it that the Manganos were
the only healthcare professionals
he prosecuted, even though he
claimed that he was investigating
many
other
nursing
homes,
hospitals and other healthcare
providers whose patients died
during the hurricane?
Watered-Down Truth
Questions
Was Foti’s decision to charge the
Manganos, but not the Lafon Nursing
Home owners racially and/or religiously
motivated?
Was this one of many
examples of a Foti practice of selective
prosecution?
Watered-Down Truth
Questions to be Answered
What does the case of The People
vs. Mangano tell us about long
term care in America?
Is this case an aberration?
Does the truth matter?
Watered-Down Truth
Many lessons can be learned from
disasters like Hurricane Katrina . . .
Watered-Down Truth
Special considerations for healthcare
providers
regarding
emergency
preparedness . . .
Lessons Learned
The Non-Watered-Down Truth
• Don’t be a victim of disaster denial
• Disasters happen – just check out
the FEMA website – www.fema.gov
• The government is an important
partner
in
emergency
preparedness
Lessons Learned
• Government leaders must be
truthful, decisive and available in
times of crisis
• There is no place for politics
during a serious emergency
Lessons Learned
The media has an important role in
emergency preparedness.
However . . .
The media must not view emergencies
as a sales opportunity.
Rather, they must view their role as a
public service.
Lessons Learned
Often, the best approach is for a
healthcare facility to shelter-inplace.
However . . .
Healthcare administrators must be
flexible and be prepared to evacuate
their facility when necessary!
Lessons Learned
If evacuation is necessary, the facility
should consider:
Modes of Transportation
• A contract with a transportation
provider does not mean that
transportation will be available.
Lessons Learned
Access
• Is it really possible to navigate
the roads?
• Will traffic make an evacuation
possible?
Lessons Learned
Does the facility have adequate
supplies and equipment?
Lessons Learned
Practice should make for
response to all emergencies.
a
perfect
Applicable laws and regulations require
that healthcare facilities hold practice
drills.
Regulators must be sure facilities practice
in a meaningful and appropriate manner.
Lessons Learned
Facility staff, residents, family members
and all other interested parties must be
educated about and participate in the
facility’s
emergency
preparedness
program.
Lessons Learned
Emergency Communication
• Before
• During
• After
Lessons Learned
(continued)
The facility leadership maximize
communication.
How will you communicate?
• Primary
• Secondary
• Tertiary
Lessons Learned
(continued)
Communication Priority List
(may vary from one facility to another)
• Residents
• Staff/Consultants
• Government Representatives
• Emergency operations officials
• Department of Health
• Local, state and federal agencies
Lessons Learned
(continued)
• Family Members
• Vendors
• Emergency
• Food
• Medical
• Pharmacy
• Transportation
• Water
Lessons Learned
(continued)
• Other Facilities
(especially if evacuation is required)
• Ombudspersons
Lessons Learned
Will the facility be able to properly
care for residents with special
needs?
Lessons Learned
The facility staff must meet their
obligations to their residents, as
well as their personal family
members and loved ones!
Lessons Learned
Note:
• During Hurricane Katrina, nursing
facilities that evacuated made special
provisions for the family members of
their staff.
• Facilities that sheltered-in-place set
up temporary shelters for family
members of their staff.
Lessons Learned
The following information must be kept
current and made available to your
“emergency” team:
A. Location of Special Needs Residents
1.
Non-Ambulatory
2.
Communication Challenges
a. Non-Verbal
b. Non-English Speaking
3.
Dementia Residents
4.
Behavioral Residents
5.
Infectious Diseases
Lessons Learned
B.
Building Construction and
Emergency Plans and Documents
1.
Any Structural Issues
2.
Construction Activities
3.
Locations of Exits
Lessons Learned
C.
Current
list
with
contact
information for all staff and other
key members of your community.
The list should include:
1.
Home Phone #
2.
Cell Phone #
3.
Text
4.
E-mail
Lessons Learned
D.
If you need to pick up staff, a
prepared travel plan.
E.
List of “Emergency Supervisors,” by
location and/or any other organized
system.
F.
Location
of
where
emergency
supplies are prepared and stored.
Lessons Learned
G.
How will you protect and preserve
medical
records
and
documentation?
H.
What is the facility’s obligation to
its neighborhood?
Example:
shelter?
Will the facility be a safe
place
for
others
to
Lessons Learned
I.
List of residents who have capacity
and a list of those who lack capacity.
Note:
Residents with capacity may
refuse to cooperate with the
emergency plan.
Watered-Down Truth
For a comprehensive list of resources
please visit:
To purchase a copy please visit our website:
A MIGHTY WIND
Starring: Eugene Levy, Fred
Willard, Katrina, Rita, Gustav,
and Ike
Presenter:
Joseph Donchess
Executive Director Louisiana Nursing Home Association
AHCA Webinar
A
t 2009
Advance Planning
1. Review and update, if necessary, facility
emergency preparedness plan at least once a
year before hurricane season.
2. Meet with staff and make assignments of
responsibilities.
3. Review emergency preparedness plan with
vendors, pharmacist, medical director and
physicians
4. Make a list of supplies needed.
5. Categorizing residents as Category I
(medically complex) or Category II
Advance
Planning
6. Verify agreement with sheltering site (s).
7. Verify agreement with transportation service (s).
8. Plan for needs of evacuating staff and
accompanying families.
9. Attend meetings with local Office of Emergency
Preparedness. Develop a personal, professional
relationship with the local director, Police Chief
and Fire Chief.
10. Business Interruption Insurance.
Evacuation
1. Go or Stay ???
2. Wait for ‘mandatory’ evacuation or leave
early? Leaving early means less traffic,
shorter period of time to deal with incontinent
patients; more reliable cell phone usage.
3. You may want to evacuate your heavier care
patients early when resources are still
available, and in adequate numbers.
Evacuation
3. Activate Plan
• Notify staff, and local OEPs( yours and receiving
parish).
• Notify families of decision; order extra meds.
• Determine which residents can be discharged to the
care of their family…Notify families for pick up.
• Prepare emergency kits and resident baggies.
• Place ID bands on residents.
• Designate staff member as ‘ first to arrive’ at shelter
to direct set up and activities.
• Designate staffer (maintenance worker) to stay at or
near facility in order to assess damage after storm
passes and to determine when it can be re-occupied.
Evacuation
3. Activate Plan
–
Triage residents for bus trip. Load most ambulatory
patients first. They will be on bus for longest time.
–
Each bus should have at least two nursing staff, ice
chest or refrigerator, emergency medical supplies.
–
Do a ‘walk-through’ of facility before leaving.
–
Each bus must have enough supplies – wet wipes,
diapers, towels, water, Gatorade, sipper cups.
–
Patients needing oxygen should be transported by
ambulance.
Tips for lining up transportation in
advance of a disaster
• Know your residents. Identify their acuity levels. That will help
determine the type of transportation you will need.
• Be a partner with the local emergency preparedness department.
Once you establish contracts with transportation providers, run
those contracts by the department for review. Establish a
relationship with a local transportation association.
• Keep costs in mind. Decide what you are willing to spend for an
evacuation contract with a transportation company. Talk to state
transportation association about reasonable amounts.
• Consider talking to local churches or schools about using their
means of transportation if necessary.
Source: McKnight's interviews with transportation and long-term care experts, 2007
During The Onset (or Aftermath) of an
Emergency Event
Goals of Receiving
Facilities
1. Mobilize staff to care for incoming evacuees
•
Staff from evacuating facility will, likely, be few and exhausted.
•
Cross Train employees – Housekeepers, laundry, dietary
personnel.
2. Organize community volunteers to ‘welcome’
evacuee residents.
3. Provide a home away from home.
4. Elderly don’t do well.
Journal of American Geriatrics Society “Biobehavioral Correlates of Relocation in the Frail Elderly”
Goals of Receiving
Facilities
5.
Minimize disruption to residents of receiving facility
•
6.
Maintain their daily regimens and routines as much as possible
Notify local Office Of Emergency Preparedness that
nursing home evacuees will be arriving – may be a good
resource for finding volunteers or responders to help with
“offloading”.
7.
Local Fire and Emergency Departments will more than
likely help to offload residents, if they have the available
manpower.
Immediate Challenges
of Receiving Facilities
1. Communication
•
During evacuation trip, communication between
receiving facility and evacuating staff will be sporadic at
best (Blackberries are good for emailing).
2. Paperwork of Evacuee Residents
•
•
•
Medication Administration Record
Health and Physical
Admission documentation
•
If evacuated facility is damaged, receiving facility may have to
admit evacuee residents.
•
State Medicaid Agency should be helpful in this process.
Immediate Challenges of
Receiving Facilities
3. Physical Plant Preparations
•
Bedding, supplies, equipment
4. Staff Housing
•
Children usually accompany evacuating staff
members
5. Verify licenses of incoming staff.
Ongoing
Concerns
1. Communications with families, responsible
parties (who are likely displaced too).
2. Reconstructing medical records if they
were left behind or lost.
3. Cultural and religious differences (Catholic
communities moving to Baptist
communities)
4. Return transportation – false starts
Ongoing
Concerns
5. Publicity
6. Adequate Staffing
a. Agency staffing
b. Overtime
c. Burnout
d. Crisis counselors for staff and residents
e. Morale
Sheltering In Place
1.
2.
3.
4.
When all other forms of communication were
inoperable, Ham Radios worked. Contact local groups
or organizations of Ham Radio Operators to see if they
will help.
Have Security at facility. If law enforcement or National
Guard is not available, hire private security.
Make sure emergency generators are operable. Have
adequate supply of fuel. Air conditioning is a must in
the South. Heat killed most elderly after Hurricane
Katrina.
Will sheltering facility accept new admissions?
Families of elderly living at home will scurry to admit
them to a nursing home rather than take them on their
own evacuation journey.
78 Hours to Landfall
6 Hours to Landfall
Approximate time of Landfall
NURSING HOMES:
PART OF THE SOLUTION IN COMMUNITY PREPAREDNESS
AHCA Webinar, 2009
Jocelyn Montgomery, RN, PHN
California Association of Health Facilities ‐ Disaster Preparedness Program
LONG TERM CARE FACILITY
• Refers to any of a range of institutions that provide health care to people who are unable to manage independently in the community.
www.longtermcareliving.com/glossary
WIDE RANGE OF RECIPIENTS IN
LONG TERM CARE
• It can include people who are: o
o
o
o
o
o
o
pediatric, elderly, in between
ambulatory non ambulatory cognitively intact
cognitively impaired
minimal assistance
completely dependant for all activities of daily living
And have special medical and/or behavioral needs
SKILLED NURSING FACILITY DEFINED
“Skilled nursing facility" is defined as an institution
(or a distinct part of an institution) which is primarily engaged in providing skilled nursing care and related services for residents who require medical or nursing care, or rehabilitation services for the rehabilitation of injured, disabled, or sick persons, and is not primarily for the care and treatment of mental diseases; …
§§1819(a) and 1919(a) of the Social Security Act
SNAPSHOT OF NATION’S SNFS
•
•
•
•
•
•
•
Approximately 16,000 SNFs
1,730,000 licensed beds
917,000 nursing staff
122,400 RNs
192,100 LPNs
608,900 CNAs
12,500 NAs/Orderlies
CDC National Center for Health Statistics 2006/2007 data
SNAPSHOT OF SNF RESIDENTS
• 1,492,200 living in skilled nursing homes on any given day.
• The vast majority of these people are: • 75 or older
• Female
• Stay less than 3 months
• Disease prevalence high SNF DISASTER CAPABILITIES
• A critical component of the healthcare system
• Experts in caring for medically fragile populations
• Regulatory oversight
• Bed capacity
• Back up o
o
o
Power
Medications
Emergency Supplies
SNF DISASTER NEEDS
• More involvement with local planning efforts
• Stronger facility emergency operation plans from the “walls out”
• Assistance to prepare as a partner
in response
SOUTHERN CALIFORNIA 2007
LARGEST EVACUATION (CA HISTORY)
•
Approximately 515, 000 people evacuated
• Over 2,200 medical patients evacuated
• 14 Skilled Nursing Facilities
• 5 Intermediate Care Facilities (MR)
• 1 Acute Psychiatric Facility
• 3 General Acute Care Hospitals
HOW DID LTC DO?
`
No structures lost
`
No disaster – related deaths `
Displace residents received excellent care at other facilities and shelters
`
Staff reported to work many not knowing whether or not their houses were standing
FIRE STORM “LESSONS LEARNED”
• Coordination special needs response operations, patient and bed tracking. • Patient identification with critical medical information.
• Staff identification that enable them to cross barriers to return to facilities.
• Plans that adequately address transport and reception of patients to other facilities.
• Criteria for approval to repatriate facility.
PANDEMIC INFLUENZA PREPAREDNESS
• A general lack of preparedness in long term care for pandemic
• Have never been required to provide respirators to workers
• Infectious disease emergencies addressed in emergency operation plans:
o
o
o
o
Less than 40% had planned for quarantine
Less than 40% had planned for reconfiguring space
for wide scale isolation
Less than 30% had planned for storage of remains
TIPS TO AVOID SWINE FLU
TIP # 1
H1N1 PREPAREDNESS
• Robust Infection Control
• Workforce Protection
• Social Distancing Policies
• Excellent Communication and Collaboration with Local Community
CAHF DISASTER PREPAREDNESS PROGRAM
http://www.cahf.org/public/dpp
•
Pandemic Influenza Workbook for Long Term Care
•
CAHF’s Model Respiratory Protection Program
•
CAHF’s Nursing Home Incident Command System (NHICs)
•
READY SET GO Fact Sheets
•
Disaster Preparedness Conference for Long Term Care “REALLY READY TOO!”
WE ARE SAFER IF WE WORK TOGETHER!
JOCELYN MONTGOMERY RN
DIRECTOR OF CLINICAL AFFAIRS
CALIFORNIA HEALTH CARE ASSOCIATION
[email protected]
Novel H1N1 Influenza A
Update
Janice Zalen
Sr. Director of Special Programs
American Health Care Association
[email protected]
115
Novel HINI Influenza A
y
As of August 21, 2009
◦ 7,963 hospitalizations from lab confirmed
H1N1
◦ 522 deaths from lab confirmed H1N1
◦ More than one million cases (unconfirmed)
y
What will happen this Fall? Get Ready!!
◦ H1N1 will co-circulate with seasonal influenza
◦ Will 65+ population continue to be at less
risk than younger age groups?
116
Influenza Vaccines
y
Initial limited supply of H1N1vaccines
targeted to 5 key populations
◦ Does NOT include 65+ population
◦ Does include healthcare personnel, including
LTC direct care staff
x Check in with your public health department
NOW
y
Seasonal influenza vaccines is in good
supply and very strongly recommended
117
CDC Interim Anti-Viral Medication
Recommendations
y
Those individuals at high risk of serious seasonal flurelated complications are considered high risk of
H1N1-related complications
◦ Residents of “nursing homes and other chronic-care facilities”
are high-risk for complications of H1N1
y
y
Prophylaxis use of antivirals is recommended for people
at high risk of serious seasonal flu-related complications
who have been in close contact with someone who is ill
with H1N1.
Health care workers who were in close unprotected
contact with persons sick with H1N1 also should be
considered for chemoprophylaxis.
118
Massive Federal Campaign
CDC churning out interim guidance
y Federal grants to states to plan and
prepare
y Involvement also of Departments of
Homeland Security, Education,
Commerce, and Labor
y Within Department of Health and Human
Services: FDA, CDC, ASPR, CMS
y Goal: Minimize impact of H1N1
y
119
H1N1 CDC Resources
y
y
y
y
CDC H1N1 Home Page:
http://www.cdc.gov/h1n1flu/
CDC Guidance for Businesses and Employers
http://www.cdc.gov/h1n1flu/business/guidance/
Communication Toolkit for Businesses and
Employers
http://www.cdc.gov/h1n1flu/business/toolkit/
Clinical and Public Health Guidance
http://www.cdc.gov/h1n1flu/guidance/
120
Infection Control and N95
Respirators
y
y
y
Interim guidance on infection control for patients in
health care setting
http://www.cdc.gov/h1n1flu/guidelines_infection_contro
l.htm
◦ All healthcare personnel who enter the rooms of patients
in isolation for swine influenza should wear a fit-tested
disposable N95 respirator or equivalent (e.g., powered air
purifying respirator)
IOM to make final decision in early September
Planning for N95 use—AHCA memo:
http://www.ahcancal.org/facility_operations/clinical_prac
tice/Pages/SwineFluUpdate14.aspx
121
N95 Respirators (con’d)
Will N95s be available in the Fall?
y Will your employees feel more safe?
y Is a small supply a possibility and will your
local public health department help?
y CMS’ H1N1 Flu -State Survey Agency
Guidance
y
http://www.cms.hhs.gov/SurveyCertificationGen
Info/downloads/SCLetter09_36.pdf
122
More Resources
y
y
y
y
y
AHCA/NCAL H1N1 site:
http://www.ahcancal.org/facility_operations/clini
cal_practice/Pages/SwineFlu.aspx
Includes CDC twitter and other tweet updates
AHCA summarized updates
Links to useful resources (including CAHF’s
resources)
One stop access to U.S. government pandemic
information: http://www.flu.gov/
123

KatrinaWebinar - American Health Care Association

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