La. Admin. Code tit. 48 § I-8595

Current through Register Vol. 50, No. 11, November 20, 2024

Section I-8595 - Emergency Preparedness Plan

A. The ICF/DD shall incorporate an all hazards risk assessment into the facility's emergency preparedness plan which is designed to manage the consequences of medical emergencies, power failures, fire, natural disasters, declared disasters or other emergencies that disrupt the facility's ability to provide care and treatment or threatens the lives or safety of the residents. The facility shall follow and execute its emergency preparedness plan in the event or occurrence of a disaster or emergency. This plan shall be reviewed, updated and approved by the governing body at least annually. Upon the departments request, a facility shall present its emergency preparedness plan for review.

B. At a minimum the emergency preparedness plan shall include and address the following.

1. The emergency preparedness plan shall be individualized and site specific. All information contained in plan shall be current and correct. The plan shall be made available to representatives of the Office of the State Fire Marshal and the Office of Public Health upon request of either of these offices. The facility's plan shall follow all current applicable laws, standards, rules or regulations.

2. The facility's plan shall contain census information, including transportation requirements for the ICF/DD residents as to the need for:

a. wheelchair accessible or para-transit vehicle transport; or

b. the numbers of ICF/DD residents that do not have any special transport needs.

3. The plan shall contain a clearly labeled and legible master floor plan(s) that indicate the following:

a. the areas in the facility that is to be used by residents as shelter or safe zones during emergencies;

b. the location of emergency power outlets;

c. the locations of posted, accessible, emergency information; and

d. the detail of what will be powered by emergency generator(s), if applicable.

4. The facility's plan shall be viable and promote the health, safety and welfare of facility's residents.

5. The facility shall provide a plan for monitoring weather warnings and watches and evacuation orders from local and state emergency preparedness officials. This plan will include who will monitor, what equipment will be used, and procedures for notifying the administrator or responsible persons.

6. The plan shall provide for the delivery of essential care and services to residents during emergencies, who are housed in the facility or by the facility at another location, during an emergency.

7. The plan shall contain information about staffing for when the ICF/DD is sheltering in place or when there is an evacuation of the ICF/DD. Planning shall include documentation about staff that have agreed to work during an emergency and contact information for such staff. Plan shall include provisions for adequate, qualified staff as well as provisions for the assignment of responsibilities and duties to staff.

8. The facility shall have transportation or arrangements for transportation for evacuation, hospitalization, or any other services which are appropriate. Transportation or arrangements for transportation shall be adequate for the current census and meet the ambulatory needs of the residents.

9. The plan shall include procedures to notify the resident's family or responsible representative whether the facility is sheltering in place or evacuating to another site. The plan shall include which staff are responsible for providing this notification. If the facility evacuates, notification shall include:

a. the date and approximate time that the facility is evacuating; and

b. the place or location to which the facility is evacuating, including the:

i. name;

ii. address; and

iii. telephone number.

10. The plan shall include the procedure or method whereby each facility resident has a manner of identification attached to his person which remains with him at all times in the event of sheltering in place or evacuation, and whose duty and responsibility this will be; the following minimum information shall be included with him:

a. current and active diagnosis;

b. medications, including dosage and times administered;

c. allergies;

d. special dietary needs or restrictions; and

e. next of kin or responsible person and contact information.

11. The plan shall include an evaluation of the building and necessary systems to determine the ability to withstand wind, flood, and other local hazards that may affect the facility and should also include:

a. if applicable, an evaluation of each generator's fuel source(s), including refueling plans and fuel consumption; and

b. an evaluation of the facility's surroundings to determine lay-down hazards, objects that could fall on facility, and hazardous materials in or around the facility, such as:

i. trees;

ii. towers;

iii. storage tanks;

iv. other buildings;

v. pipe lines;

vi. chemicals;

vii. fuels; and

viii. biologics.

12. For ICF/DDs that are geographically located south of Interstate 10 or Interstate 12, the plan shall include the determinations of when the facility will shelter in place and when the facility will evacuate for a hurricane and the conditions that guide these determinations.

a. A facility is considered to be sheltering in place for a storm if the facility elects to stay in place rather than evacuate when located in the projected path of an approaching storm of tropical storm strength, or a tropical cyclone. The facility has elected to take this action after reviewing all available and required information on the storm, the facility, the facility's surroundings and consultation with the local or parish Office of Homeland Security and Emergency Preparedness (OHSEP). The facility shall accept all responsibility for the health and well being of all residents that shelter with the facility before during and after the storm. In making the decision to shelter in place or evacuate the facility shall consider the following:

i. what conditions will facility shelter for;

ii. what conditions will facility close or evacuate for; and

iii. when will these decisions be made.

b. If the facility shelters in place, the facility's plan shall include provisions for seven days of necessary supplies to be provided by the facility prior to emergency event, to include:

i. drinking water or fluids; and

ii. non-perishable food.

13. The facility's emergency plan shall include a posted communications plan for contacting emergency services and monitoring emergency broadcasts and whose duty and responsibility this will be.

14. The facilitys plan shall include how the ICF/DD will notify OHSEP and LDH when the decision is made to shelter in place and whose responsibility it is to provide this notification.

15. The facility shall have a plan for an ongoing safety program to include:

a. continuous inspection of the facility for possible hazards;

b. continuous monitoring of safety equipment and maintenance or repair when needed;

c. investigation and documentation of all accidents or emergencies;

d. fire control and evacuation planning with documentation of all emergency drills (residents can be informed of emergency drills);

e. all aspects of the facility's plan, planning, and drills shall meet the current requirements of the Office of the State Fire Marshal, and the Life Safety Code NFPA 101; and

f. the facility shall inform the resident and/or responsible party of the facility's emergency plan and the actions to be taken.

C. An ICF/DD shall electronically enter current facility information into the departments ESF-8 portal or into the current LDH emergency preparedness webpage or electronic database for reporting.

1. The following information shall be entered or updated before the fifteenth of each month:

a. operational status;

b. census;

c. emergency contact and destination location information; and

d. emergency evacuation transportation needs categorized by the following types:

i.red-high-risk residents who will need to be transported by advanced life support ambulance due to dependency on mechanical or electrical life sustaining devices or very critical medical condition;

ii.yellow-residents who are not dependent on mechanical or electrical life sustaining devices, but cannot be transported using normal means (buses, vans, cars), may need to be transported by an ambulance; however, in the event of inaccessibility of medical transport, buses, vans or cars may be used as a last resort; and

iii.green-residents who do not need specialized transportation may be transported by car, van, bus or wheelchair accessible transportation.

2. An ICF/DD shall also enter or update the facilitys information upon request, or as described per notification of an emergency declared by the secretary. Emergency events may include, but are not limited to:

a. hurricanes;

b. floods;

c. fires;

d. chemical or biological hazards;

e. power outages;

f. tornados;

g. tropical storms; and

h. severe weather.

3. Effective immediately, upon notification of an emergency declared by the secretary, all ICFs/DD shall file an electronic report with the ESF-8 portal or into the current LDH emergency preparedness webpage or electronic database for reporting.

a. The electronic report shall be filed, as prescribed by department, throughout the duration of the emergency declaration.

b. The electronic report shall include, but is not limited to, the following:

i. status of operation;

ii. availability of beds;

iii. generator status;

iv. evacuation status;

v. shelter in place status;

vi. mobility status of clients;

vii. range of ages of clients;

viii. intellectual levels/needs of clients; and

ix. any other client or facility related information that is requested by the department.

NOTE: The electronic report shall not be used to request resources or to report emergency events.

D. The facilitys plan shall include a process for tracking during and after the emergency/disaster for on-duty staff and sheltered clients.

E. The facilitys plan shall also include a process to share with the client, family, and representative appropriate information from the facilitys emergency plan.

La. Admin. Code tit. 48, § I-8595

Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 38:3207 (December 2012), Amended by the Department of Health, Bureau of Health Services Financing, LR 43524 (3/1/2017).

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and R.S. 40:2180-2180.5.