Overview
Background
Rhode Island’s single, statewide healthcare emergency preparedness coalition, the Healthcare Coalition of Rhode Island (also referred to as HCRI, or the Coalition), has been in place since 1999 and has grown over time to meet changing needs and guidance. While the Coalition has undergone several name changes over the years, its mission has remained fundamentally the same: to serve as a forum for cooperation among organizations to develop a networked plan for interaction and collaboration in disaster-related planning, mitigation, response, and recovery efforts that address Rhode Island’s healthcare system. Since its inception, HCRI has been cited several times by the federal Hospital Preparedness Program as a best practice.
Coalition Boundaries
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Coalition Members
In general, all healthcare organizations in Rhode Island are considered stakeholders of HCRI. Because RIDOH co-chairs HCRI and has responsibilities, both statutory and issued by grant guidance, to a broad host of healthcare organizations, any healthcare organization in Rhode Island may be eligible, pending approval from the Coalition’s leadership, to participate in the Coalition. Each organization should consult regulations, licensing standards, funding agreements, professional groups, and other relevant sources to understand its respective disaster preparedness and response obligations.
Once approved by the Coalition’s leadership, new members are provided a brief document that outlines roles and responsibilities of Coalition members (see Attachment C). New members are asked to sign this document, which is then kept on file by the Coalition’s leadership. Membership information is maintained by the Coalition leadership. Members agree to share their respective organizations’ 24/7 emergency contact information with the Coalition and its members for disaster preparedness and response purposes.
In accordance with federal HPP guidance, certain healthcare providers and emergency services, specifically hospitals, emergency medical services (EMS), emergency management agencies, and public health, play especially active roles in the Coalition, and thus make up the Core Membership. Additional, non-Core Members include health centers, nursing homes, assisted living communities, blood centers, first response agencies (police and fire), tribal nations, federal partners, military, home health agencies, etc., which play important roles in supporting the healthcare system during emergencies.
Organizational Structure and Governance
HCRI is co-chaired by the Rhode Island Department of Health’s Center for Emergency Preparedness and Response’s Healthcare Emergency Management Director and the Hospital Association of Rhode Island’s Healthcare Emergency Management Director.
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Voting Process
Each Core Member sector (e.g., Hospitals) has one collective vote (i.e., one vote for Hospitals, one vote for EMS, one vote for Public Health, and one vote for Emergency Management). Inside each Core Member sector, represented entities will vote on the given issue. The outcome of the vote within each sector will determine the sector’s collective vote. (Example: Hospitals vote 10-2 in favor of Option A; therefore, the Hospital sector casts its one collective vote in favor of Option A.) HCRI’s Co-Chairs will collectively cast one vote. Rhode Island’s Principal Investigator for the federal Hospital Preparedness Program grant (who may not him or herself otherwise vote on issues) will retain veto power.
Risk
On an annual basis, the Coalition’s membership convenes to identify threats and hazards, members’ vulnerabilities, and best practices to mitigate risk during the annual HCRI Conference. The Conference includes speakers on relevant topics (e.g., facility evacuations, utilities, active shooters) determined by the HCRI Conference Workgroup. Selection of speakers and topics is typically influenced by real-world events and demand from the Coalition’s membership.
Risk posed to Coalition members will be evaluated through the analysis and aggregation of individual members’ HVAs.
A summary of the Coalition’s most recent HVA findings can be found in Attachment B.
Gaps
Gaps identified through risk assessments, for instance the State’s (Threat and) Hazard Identification and Risk Assessment (THIRA and HIRA) or the Coalition’s annual conference, will be addressed by HCRI leadership and its membership during regularly scheduled HCRI meetings. Depending on the gap, its mitigation or remediation may include planning, resource acquisition, training, and/or exercising.
HCRI currently conducts regular resource assessments of its healthcare organizations, including facility information (e.g., bed types, clinical capabilities, vendors, alternate care sites), equipment inventories (including all equipment previously purchased with preparedness funds, such as communications and IT equipment), and detailed electrical, generator, and other utility information. As circumstances dictate (e.g., the PPE required by the Ebola funding or specific medications when there are shortages), relevant healthcare partners are queried about resource availability and the collated information is shared among the Coalition’s membership. When resource gaps are identified, HCRI will typically work to leverage group purchases of the lacking resource in order to reduce cost.
Compliance Requirements
Recognizing that healthcare organizations are subject to a host of requirements from various entities (e.g., the Centers for Medicare and Medicaid, the Joint Commission, and the Occupational Safety and Health Administration), HCRI leadership facilitates cooperation between applicable healthcare organizations and municipal agencies (e.g., emergency management), especially with respect to meeting whole community planning and exercise requirements. To further aid members in meeting various compliance requirements, HCRI leadership may coordinate training and educational opportunities, when available.
RIDOH’s HCRI representative maintains strong working relationships with RIDOH’s Center for Health Facilities Regulation.