UASI Health and Medical Committee – August Notes

Posted By: Ian Feldman August 17, 2020

The following items were covered during the August meeting of the UASI Health and Medical Committee:

  • The UASI Executive Committee released Informational Bulletin #4, which supersedes IB #1 and covers the appropriate tasks for UASI grant-funded personnel. In short, normal job duties must tie to a terrorism nexus, the UASI project under which the staff member is funded, and to the overall UASI Strategic Plan. For emergency incidents, UASI-funded personnel can be used to support jurisdictional operations, but that work should be able to be tied back to an implementation step in the UASI Strategic Plan (even if it is not from a goal related to the staff member’s project) and those staff members must be rotated back to their grant-funded duties as soon as is practical. All grant-funded personnel and their supervisors received a copy of the document, and questions can be addressed to alison.belcher@houstontx.gov.
  • The second quarter grant-funded personnel reports were reviewed by the Committee Chairs and no issues were identified. The reports have been forwarded to the Executive Committee as per the normal process.
  • Jurisdictions on the call provided updates on their COVID-19 response.
    • Most are continuing as they have been throughout the response. Brazoria County is seeing turnover among its epidemiology staff. The City of Houston continues to promote distancing, testing, and mask-wearing. METRO is continuing its use of barriers on vehicles, requiring masks for its staff, and performing frequent disinfection services.
    • Lori Upton said that across the 25-county region, hospital numbers are starting to trend better. There are fewer patients being held in emergency rooms waiting beds (in ICUs or other parts of hospitals) and SETRAC is doing follow-up with facilities that are holding patients to see if alternate destinations are available. Overall, numbers are close to where the region was in mid-June, prior to the most recent peak; the goal is to continue to improve those numbers and get on the same footing we were in April or May (or March).
    • SETRAC is also looking forward to ensure that when state support ends for surge staffing and PPE distributions that there are mechanisms in place for facilities to transition smoothly.
      • Regarding surge staffing, SETRAC is concerned that if the state abruptly ends funding for additional nurses, those nurses will find work in other states and our region will be left with a staffing gap. SETRAC wants Texas facilities to have the proper time to negotiate directly with these providers so they can sign contracts here in Texas and the region’s capacity is not reduced.
      • Similarly with the PPE supply chain, if the state ends its allocation process, SETRAC is advocating that the state transition to a model where all facilities and providers, regardless of size, can leverage the state and federal contracts at the same price. Though the cost burden would shift to the facility rather than being provided PPE through regular allocations as is currently occurring, this model would ensure all entities can continue to have stable access to PPE at fair prices.
  • Alison Belcher briefed on the project to update the THIRA’s pandemic scenario (previously based on the 1918 Pandemic Influenza).
    • The THIRA has specific requirements, and the scenario used for that will likely be COVID-19 and flu concurrently. Modeling work for this will be done by Johns Hopkins University, with delivery of results in October.
    • However, as this process continues, there may be opportunities to leverage the work for our region’s needs and to that end, Alison will be collecting potential other model outputs that public health and medical staff will find useful. Please see the Pandemic THIRA Scenario Updates document for additional details and the submission link. Submissions are due by Friday 28 August 2020.
  • Updates were provided on grant projects. Projects from FY18 should be closed out. Most FY19 projects are continuing as normal, though some have experienced delays related to COVID. Any projects with cost savings should identify alternate uses for that money prior to November; the state limits the times at which change requests can occur, and the UASI puts additional restrictions on movement of money between projects.
  • Tina Rose briefed on the Clinical Advisory Committee’s ongoing work to meet new planning standards from ASPR. Last year, the group developed a pediatric mass surge plan, and this year, the group is working on surge for burn care. Future plans will include pandemic response, chemical incidents, and nuclear incidents. The committee meets monthly in a virtual format, and anyone who is interested in participating should contact tina.rose@houstontx.gov.
  • Tina Rose also informed the group that while in-person Continuity of Operations classes have been cancelled due to COVID-19, FEMA has started offering virtual delivery of these courses (now called K-548 and K-550 instead of their in-person G equivalents); registration is online at https://training.fema.gov/netc_online_admissions/. The K courses can be used interchangeably with the G courses for Continuity Practitioner certifications. For those who only want an introduction to COOP, FEMA has a new IS-1300 course, available at https://training.fema.gov/is/courseoverview.aspx?code=IS-1300.
  • Lori Upton briefed on recent SETRAC corridor exercises and with the nursing homes and long-term care facilities. These exercises considered hurricane response while also dealing with COVID-19. Take-aways included the need to evacuate non-COVID patients first to avoid contaminating ambulances early in an evacuation, the need for facilities to determine if their generators can support negative pressure rooms, and the need to send additional PPE with staff supporting evacuated patients in addition to the normal compliment of supplies.
  • Ian Feldman briefed on the City of Houston’s Evacuation Hub exercise. Normally, this exercise focuses on the mechanics of registering evacuees at the George R Brown who then board state buses. Due to COVID, the format changed; OEM staff acted as role-players in video-taped scenarios, which were then used as part of a virtual table-top exercise. This format allowed participants at all levels to see some of the interactions that would otherwise just be limited to specific role-players and evacuation hub staff during a non-COVID exercise.
  • No formal updates were provided on STEAR, but Lori Upton mentioned that she heard that there was a very sharp rise in registrations in Brazoria and Chambers Counties, and if this was a valid change then it would indicate a greater need for resources in coastal counties than in the past. Lanny Brown will check with Steve Rosa on this.
  • Alison Belcher provided an update on the grants process for FY21 and the upcoming THIRA/SPR and Strategy updates. All will be as virtual as possible.
    • The normal FY21 UASI timeline is expected to follow past years.
    • Regarding the THIRA/SPR process, the region may use some past capability assumptions and apply them forward to get to new numbers in order to reduce the burden on staff in the region. While the region petitioned for a reduction in requirements for all core capabilities due to the stress that COVID-19 has placed on regional emergency management and public health staff, FEMA was not willing to relax requirements on the public health core capabilities, as they are very interested in the impacts COVID has had.
    • Jonathan Wiggins also noted that the UASI Strategy will be revised this year on a timeline to be determined. It is possible that the goals that are assigned to the Health and Medical Committee will be revised at the group’s October meeting, but that is pending approval of the overall timeline.
  • Alison Belcher also informed the group that Houston applied for RCPGP under FY20.
    • That program, while similar to the existing Food, Water, and Sheltering program, will instead focus on the Health and Medical community lifeline. Alison’s goal is to ensure that the work under that grant aligns well with other work being done in that area by the Health and Medical Committee and other groups, including possibly supporting efforts to revise the region’s mass fatality plans.
    • Lori Upton reminded the group of a past effort to crosswalk grant requirements on the public health side; revisiting that work now would help ensure that no duplication of effort takes place across multiple grants. To that end, Alison Belcher added that the CCTA grant program is looking at Family Assistance Center planning, which is also under this committee’s purview. The group agreed that soliciting UASI planner support to assist with this effort would be beneficial.
  • Ian Feldman briefed the group on the DHS Special Events Data Call, an annual effort by DHS to gather data on special events and mass gatherings. Data is collected for the upcoming year (1 December 2020 through 30 November 2021). The EMCs are the primary points-of-contact, and those on the call interested in assisting should reach out to their EMCs or to Ian Feldman for more information. The data collection is important to the region as it factors into a formula used by FEMA to allocate homeland security funding between different states and urban areas.