Crisis & Disaster Planning in Human Services Presented by Kathryn Dyjak, Deputy Commissioner

New York City Human Resources Administration San Diego, CA. October 8, 2013

HOW THE HUMAN SERVICE AGENCY’S ROLE IS EVOLVING

• How do you prepare in advance with limited resources and TIME?

• Present plans easy to implement?• Is it just about basic benefits?• Who really are your key players in an

emergency?

HRA and Super Storm Sandy• 2 centers that, with around the clock work, reopened in a week• Main administrative building -25 floor office building flooded • 7 facilities lost power• Find alternative work sites for over 3,000 staff displaced for over 3 months• Provided staff to an emergency shelter system prior to landfall and for weeks

afterwards• Staff out with FEMA within a day at 7 locations and prior to power and subway

restoration• Within 10 days, set up 6 facility-based centers across the city that operated

8am-8pm for several months• Emergency contract for 719,700 prepared meals served at a 8 sites • In addition to auto replacement in first month, processed more than 100,000

applications from households that applied for additional SNAP replacement benefits for second month.

• Operated a DSNAP program

Agency-Wide Goals During an Emergency

• Core functions/benefits are operational– TANF, MA, SNAP, Child Support

• Vulnerable population groups are safe– home care, APS, HASA, DV

• Support broader initiatives in the community– Food Distribution/Access– Disaster Assistance Centers/RC’s– Point of Distributions for Medication/Vaccines– Family Assistance Centers when fatalities involve 10 or more

potential deaths

PLANNING IN ADVANCE

1) Core functions/benefits are operational• Waiver Playbook• What functions need to be prioritized?- centers back up, checks to clients and

npo’s, turning off automated systems that negatively impact clients• Back up supplies in separate locations- ie extra Medicaid cards, manual checks,

special rubber stamps

2) Vulnerable population groups are safe• Service Contracts

– include emergency procedures and auditing on them– making sure CM systems that allow all users to input status daily

• Clients/Recipients- pre-identifying those in evacuation areas through data matches, those relying on machines needing power, medication that must be refrigerated, etc,

PLANNING IN ADVANCE (continued)3) Support broader initiatives in the community• Funding- understanding funding mechanisms of different agencies (federal

reimbursed line) • Colleagues – who does what and when• Emergency contracts that can be flipped on

– Electronics: dual headsets for language line, tablets versus laptops, cell phones, blackberries, copiers, etc.

– Hot food distribution: Out in the community, specialized shelters– Case management by non-profits?

• Language– Translation of key documents in advance- replacement of driver’s license,

passport, birth certificate, etc.– Mapped out languages of population over Evacuation Zone 1

PLANNING IN ADVANCE ACROSS ALL 3 MAJOR GOALSSandy reminded of the importance of …..

•Communication Plan for Staff•Staff phone trees •Geographic area of staff •Police radios and blackberries for those in field•Test putting notices up on system for staff (pass codes!)

•Buy-In from Across the Agency• Institutionalize “after action” process- bring together quarterly • Facilities, security, transportation, personnel, immigrant group, communications, previous crisis leads, finance, contracts, MIS

•Pre-Identified Staff •Language ability•Training•Personnel and Finance to set up system/ guidance for easier billing later

•Easy access to key documents•Ready To Go Book•Streamline Plans into Playbooks that can be easily followed•Shared drive (share point site) for an emergency

Playbook Format

• Quick review of its purpose• Activation triggers• Decision makers • Agencies/entities that implement• Guide checklist of likely actions to follow and who does what• Pre-identified likely initial resources and on-going • Needed forms (ie data collection, site selection specs, likely

equipment)• Pre-identified types of services and who can provide

Actions Checklist

ActionResponsible Agency Time

Pre- Activation of RC Plan

Inter-Agency Task Force call is convened to alert members of potential need for RC Plan activation; to solidify contact information and agency leads; and to determine any review RC Plan.

OEM and HRA D- 24 hrs

Activate RC Plan

Notify members of RC Policy Team of activation OEM and HRA

D+

12 hrs

Put the following entities on standby: Case Management/Intake providers DCAS Security Taskforce and Tenant Unit DoITT Language Access Steering Committee JIC (Communications)

Taskforce

Initiate daily conference calls, shared drive for document sharing, and any other needed tools for coordination.

Ready to Go Book• Key info about facilities

– Locations, capacities, flood zones, programs • Staff lists including home # and borough and languages• How to change emergency staff call information remotely and

any needed codes• Colleagues in other agencies and federal contact information• Key plans/playbooks• Agency emergency equipment, locations, and combinations

DURING AN EVENT Core functions/benefits are operational• Waivers and Easements- turn to playbook:

Medicaid (MA)•All closings in process stopped and were re-implemented 2 months later.•Cases due to expire in Nov. or Dec., 2012 received an automatic 2 month extension. •No case was closed for failure to respond to a renewal or other request for information.•New applicants were given an additional 7 days to respond to any request for additional information.•Suspension of negative budget actions (increases in surplus amounts consumers required to pay).•Medicaid Pay-In Program provided coverage for persons whose impacted medical provider attests in writing that services remain in place and meet the surplus. Home Care, Personal Care Services (PCS), etc•30 day extension of current authorization for PCS due to expire in November - January.•Extend of acceptance of physician orders to 60 days from the date of examination for PCS authorizations.•Relaxation of required timeframes for RN supervision for PCS.•Permission for HRA to grant case by case exceptions to Nursing Home applicants requesting additional time to produce documentation. •Payment of premiums without an invoice for those actively participating in the Third Party Premium Payment Program as of October, 2012. Cash Assistance and SNAP•During storm and initial recovery, no case closings or other adverse actions taken for missed appointments. • Re-certifications due at the end of month and next, each extended a month to allow time to complete.

DURING AN EVENT

Vulnerable Population Groups are Safe• Advanced Special Needs Warning System, • Call downs and visits prior to event and then daily check-ins with most

vulnerable • Heat emergency citywide calls (coordinating with health, con-ed, NWS)• Teams out to locate clients in the community- what support do they need

Support broader initiatives in the community• Working with FEMA • Utilized unlikely staff: attorneys, researchers, personnel, legislative• Newly-Vulnerables

THE FUTURE• What is human service agency role?