TSAV Rio Grande Valley Hospital Preparedness Coalition Meeting Minutes Wednesday February 17, 2016 @ 1:30 p.m.

Knapp Medical Center Weslaco, TX

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1. Call to Order The meeting was called to order by Rene Perez, Committee Chair, at 1:43 PM

2. Roll Call

Membership roll call was conducted by Jessy Hernandez. Coalition Members Present HPP: Marco Lozano, Jessy Hernandez, Luisana Lopez, c Cristina Madrid STEC: Rene Perez MedCare EMS: Ben Martinez Mission Regional: Ernie Ortiz Knapp: Jesse Colin Solara Hospital BRO/HARL: Danny Posada, Jennifer Steenland STHS: Marco Castor Solara Hospital MCA/EDIN: David Galvan Cameron Co EMC: Juan Martinez, Nicole Parker

CCDHHS: Dwayne Gutierrez, Raquel Castillo, Ileana Valdez DSHS Region 11: Sean Arviso BCHC: Emily Alpert, Terry Frizzell RGV HIE: Andrew Lombardo Elite EMS: Ester Salinas Valley Regional Medical Center: Michael LaCoste Weslaco Fire Dept.: Rick Stubbs Hidalgo Co. OEM: Ricardo Saldaña Hidalgo Co. Health Dept.: Eva Rubio, Rodney Elizondo

Introductions were made for coalition members & guests. A quorum was present.

3. Presentations

a. 2016 LRGV Aeromedical Evacuation Full Scale Exercise Marco Lozano presented on behalf of John O’Valle utilizing TDEM’s presentation. The HPP component of the full-scale exercise is scheduled for June 8, 2016, however the exercise commences on June 2, 2016. The goal of the exercise is to determine the state’s ability to assist local communities of the evacuation of its citizens through air-evacuation and shelter capabilities with local, state, and federal partners. This exercise will comprise of evacuating 500 general population through civilian aircraft and 80 medical patient volunteer evacuees via military aircraft (C-130s). Of the 80 medical patient volunteers, two Cameron County hospitals will have to identify 64 patients that meet the criteria to be flown via C-130s and test their evacuation plans. San Benito high school will serve as a reception hub for screening before being transferred over to an APOE. The air point of embarkation (APOE) will be Valley International Airport in Harlingen. Evacuees will be transported to shelter locations to remain overnight; San Antonio, Austin, DFW, and Dallas-Love. Evacuees will be returned to the Hub for reintegration the following day. All 24 healthcare facilities will have to test components of several HPP capabilities/objectives;

• Capability #2 Recovery/Continuity of Operations: possible activation of Continuity of Operations Plan (COOP) amongst hospital facilities and Hospitals will be required to provide HPP staff with a plan within 1.5 hours of notification

• Capability #3 Emergency Operations Coordination: exercise the ability to transport patients via the patient movement request and track medical patients at medical evacuation hubs and/or APOEs using EMTrack or WebEOC

• Capability #6 Information Sharing: A regional radio communication channel will be utilized during the incident. TSA-V healthcare providers will be required to respond via radio within 1 hour of notification of said channel.

• Capability #10 Medical Surge: Participating facilities will coordinate the pre identification and eligibility of patients needing transport out of TSA-V hospitals.

Dates to keep track of: Feb 22, 2016 Medical evaluation team meeting Feb 23, 2016 Initial planning meeting

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Apr 6, 2016 Mid-planning meeting, TDEM Conference in San Antonio May 11, 2016 Final planning meeting Jun 2-9, 2016 Full-Scale Exercise (Jun 8 Actual Exercise Date)

b. Zika Virus Information for Healthcare Clinicians Ms. Castillo, Leap Epidemiologist for Cameron County, provided an informational Zika presentation for Healthcare clinicians. Presentation consisted of a summary of the virus, differences to dengue and chikungunya, diagnostic testing procedures, criteria for CDC testing, and contact information of local health departments. The CDC website includes useful resources such as up-to-date guidance.

4. HPP Director’s Report Live Exercise – House Explosion

The AAR/IP was submitted to DSHS for the live event that occurred on December 25, 2015 on February 3, 2016. Capabilities measured for the event include: Capability #1: Healthcare System Preparedness, Capability #3: Emergency Operations Coordination, and Capability #6: Information Sharing. HPP improvement plan consisted of updating the contact call-down list of which HPP commenced to update immediately. The new updated HPP contact list was distributed to the coalition for an additional revision.

New Notification of Exercise Procedures HPP is available to help coordinate an exercise. Please contact Luisana Lopez, HPP TSA-V Exercise and Training Specialist for more information.

Notification of Exercise(s) i. 2016 LRGV Aeromedical Evaluation FSE

A NOE has been submitted on time to credit HPP and healthcare facilities’ efforts with DSHS. ii. Operation Lone Star FSE – July 2016

iii. TTX – Radio Communication Review Tom Hushen, Cameron County EMC, will lead the second session of the training series, radio communication review, scheduled to take place at the Cameron County Annex Building in San Benito, TX on March 16, 2016.This session provides a good opportunity to test HPP radios and go over the radio communication plan for the region. The third session of the training series will meet the HPP state requirement to establish a regional High Consequence Infectious Disease Continuity of Operations plan. HPP has scheduled the workshop at the Pearl at South Padre Island for April 27-28, 2016. HPP is asking for 3-5 representatives of each facility to attend. Dee Grimm with BCFS will be leading the workshop and will draft the plan based on our needs as presented in the workshop. The resulting plan will be put into place for the region and all participating facilities will receive a template for their HCID COOP. Hotel information and flyers to the event will be distributed by the end of the week.

iv. 2016 South Texas Hurricane Conference 1. HPP Presentation: “Mass Fatality Exercise: Triage Tagging”

2016 Functional Exercise Requirements for Healthcare Facilities All TSA-V participating facilities must participate in at least one functional or full-scale exercise in FY2016 to test and evaluate the eight HPP capabilities. HPP staff must submit a NOE to DSHS at least 90 days prior to the exercise. AAR/IPs must be completed within 30 days after the exercise. Please advise HPP staff of any planned exercise at your healthcare facilities so you can credit your efforts and exercises with DSHS.

Update on Ebola Preparedness Supplies Spill Source, the vendor who was to provide our coalition with two customized bariatric isolation chambers, has notified us that they will not be able to create the chambers, so HPP is currently looking at different vendors and reached out to Grainger, however the Grainger bariatric chamber dimensions do not differ significantly to the current bariatric chambers we have in place. Therefore, HPP is open to suggestions.

Distribution of Evacuation Tool Kits Jessy Hernandez provided an overview of the Evacuation Tool Kits. Evacuation tool kits are expected to be delivered by the end of February or early March. Healthcare facilities must coordinate a date and

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time with Jessy Hernandez for the distribution of this item. Toolkits include Evacuation go-pouches, patient-tracking info forms, HICS vests, yellow caution tape, duct tape, clipboards, sharpies, and a quick-reference guide.

Update on EMResource/VOLO User Information Both EMResource and VOLO information have been updated and a regional notification alert will be sent to test the new distribution list this month. A national bed drill is scheduled to occur this month.

Distribution of new RGVHPC Contact List The email distribution list for HPP has been modified and updated in the past few weeks given facility turnover. Any updates or changes to the HPP contact list should be referred to Luisana Lopez.

5. Consent Agenda Items:

a. Approval of previous RGVHPC Coalition Meeting Minute(s) A motion to approve minutes for regular board meeting held on January 13, 2016 was made by Eva Rubio, seconded by Raquel Castillo.

Discussion and Possible Action Items 6. Discussion and possible action to approve the addition of Hidalgo County Emergency Management

Department as an appointed member of the RGVHPC. 7. Discussion and possible action to approve the addition of Health Information Exchange (HIE) as an

appointed voting member of the RGVHPC. 8. Discussion and possible action to approve the addition of Brownsville Community Health Center (BCHC)

as an appointed voting member of the RGVHPC. • Items 6, 7, & 8 were combined as one action item. • A motion to approve the addition of Hidalgo County Emergency Management Department,

Health Information Exchange (HIE), and Brownsville Community Health Center (BCHC) as appointed members of the RGVHPC was made by Eva Rubio, seconded by Juan Martinez.

• The item passed unanimously.

9. Discussion and possible action to select a new appointed member to the RGVHPC as designated by the revision of bylaws on Wednesday January 13, 2016.

• Item tabled.

10. Discussion and possible action to approve the Healthcare Preparedness Program Performance Measures for Capability #2: Healthcare System Recovery as prepared by the TSA-V Healthcare Preparedness Program.

• A motion to approve the Healthcare Preparedness Program Performance Measures for Capability #2: Healthcare System Recovery as prepared by the TSA-V Healthcare Preparedness Program was made by Juan Martinez, seconded by Dwayne Martinez.

• The item passed unanimously.

11. Discussion and possible action to approve the Healthcare Preparedness Program Performance Measures for Capability #3: Emergency Operations Coordination as prepared by the TSA-V Healthcare Preparedness Program.

• A motion to approve the Healthcare Preparedness Program Performance Measures for Capability #3: Emergency Operations Coordination as prepared by the TSA-V Healthcare Preparedness Program was made by Juan Martinez, seconded by Dwayne Martinez.

• The item passed unanimously.

12. Discussion and possible action to approve funding the Tactical Combat Casualty Care- Regional Training for first responders and local law enforcement from TSAV.

• Ben Martinez provided an overview of the proposed train-the-trainer Tactical Combat Casualty Care- Regional Training for first responders and local law enforcement; 2-Day course of 16.00

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hours, CEUs available. The training is recommended by the Stop the Bleed campaign set forth by the White House Hartford Consensus that aims at increasing capacity to responding to mass casualty and active shooter events. The train-the-trainer course is estimated to cost about $12,780 for a return of 18 instructors who will in turn be able to train others, including medical facilities, in the region.

• Motion to approve funding of the Tactical Combat Casualty Care-Regional Training for first responders and local law enforcement from TSA-V pending DSHS approval was made by Rick Saldaña, seconded by Juan Martinez.

• The item passed unanimously.

13. Discussion and possible action to authorize a change of vendor request from Spill Source to Grainger Inc. for the purchase (2) Bariatric Isolation Chambers.

• Spill Source, the vendor who was to provide our coalition with two customized bariatric isolation chambers, has notified us that they will not be able to create the chambers, so HPP is currently looking at different vendors and reached out to Grainger, however the Grainger bariatric chamber dimensions do not differ significantly to the current bariatric chambers we have in place. HPP is open to suggestions and recommendations.

• Item tabled.

Discussion Items 14. Discussion of Bed Drill Status Report for DSHS Bed Drill on Thursday January, 14, 2016.

15. Discussion of PICU Bed Drill Status Report for DSHS Bed Drill on Tuesday February 2, 2016.

Healthcare facilities in TSA-V have all responded accordingly to bed drills held on January 14 and February 2 yielding a 100% response rate.

16. Discussion of RGVHPC Attendance Survey.

Luisana Lopez provided a brief overview of coalition responses to the Attendance Survey conducted in January. HPP received responses from about 18 individuals who expressed time conflict and meetings running long as reasons to low interest in attendance. Recommendations included starting morning meetings as mid-day meetings may not be convenient for many.

17. Discussion of Regional Ebola Assessment as per Ebola Grant Requirements. Cristina Madrid provided a brief overview of Regional Ebola Assessment. The TSA-V Ebola Response Readiness Assessment which consisted of 40 questions was created by DSHS and distributed to all healthcare coalitions throughout the state to assess Ebola response readiness for frontline and assessment hospitals. This assessment was created to assist our region and the state to identify healthcare system and facility gaps in operational readiness for both Frontline and Assessment Hospitals. The top three gaps identified as per the responses collected from assessment and frontline facilities in TSA-V include: • More than 50% of facilities indicated they do NOT have a written plan for how to handle the remains

of someone who dies and is suspected or confirmed to have a HCID, such as Ebola. • 50% of facilities do NOT have a designated location where EMS crew can clean and decontaminate

their ambulance after transporting a patient suspected to have a HCID, such as Ebola. • 2/3 of facilities indicated they are NOT prepared to receive and isolate a patient under investigation

for a HCID, such as Ebola, via transfer from another healthcare facility.

18. Discussion and update on Full Scale Exercise (LRGV Aeromedical Evacuation) on June 2-10, 2016 as per grant requirements. a. Presentation of HPP objectives b. TSA-V Hospital Participation Requirements

i. Bed Count Update (every 4 hrs.) ii. Radio Communication

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c. Cameron County Hospital Participation – Medical Patient Evacuation

19. Discussion of upcoming trainings: a. HPP Training Series 2016, Session 1: WebEOC & EMSystems (February 17, 2016) b. HPP Training Series 2016, Session 2: Effective Radio Communication Tabletop Exercise (March 16,

2016) c. HPP Training Series 2016, Session 3: Establishing a Regional Highly Infectious Disease Continuity of

Operations Plan (April 27- 8, South Padre Island, TX) d. 2016 Preparedness, Emergency Response & Recovery Consortium & Expo (March 22-24, Orlando,

FL) – Jessy Hernandez and Marco Lozano will represent HPP at the conference and will bring back information to the coalition.

e. 2016 South Texas Hurricane Conference (March 23-24, McAllen Convention Center) – HPP will be presenting a Triage Tagging Workshop on Day 2 of the Hurricane Conference hosted by Hidalgo County.

f. Radiological Workshop in Hidalgo County (April 2016) – Eva Rubio expanded on the workshop stating it would be beneficial for hospitals to attend as it will cover the radiological response component. Tentatively scheduled for April 14, 2016.

g. NACCHO Preparedness Summit (April 19-22, Dallas Hilton Anatole) h. TDEM Conference San Antonio i. TRAC Symposium – April 8-9, 2016 at the Hilton Garden Inn at South Padre Island

20. Open Forum

No discussion.

21. Adjourn • Motion was made by Rick Saldaña, seconded by Juan Martinez