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MICHIGAN Healthcare Coalitions
Dr. Yeskey Site Visit
MICHIGAN EM STRUCTURE
• Regional MCC
MICHIGAN EM STRUCTURE
EM Chart
STATEWIDE PROJECTS
• MITESA
• MIMORT
REGION 1
District 1 Regional Medical Response Coalition (D1RMRC)
• Population: Over 1 Million
• Comprised of 9 Counties: Gratiot, Clinton, Eaton, Ingham, Shiawassee, Livingston, Jason , Lenawee and Hillsdale.
• Geographic Details:
o 14 Hospitals Partners including;1 Level I Trauma center and 2 Level II Trauma centers.
o 45 Long Term Care Facilities.
o 7 Medical Control Authorities with 85 EMS Agencies and 62 MFR Fire Departments.
o 9 Emergency Management Jurisdictions.
REGION 1
REGION 8
The Region 8 Healthcare Coalition
• Population: Approximately 311, 361 (2010)
• Comprised of 15 Counties: Alger, Baraga, Chippewa, Delta, Dickinson, Gogebic, Houghton, Iron, Keweenaw, Luce, Mackinac, Marquette, Menominee, Ontonagon and Schoolcraft.
• Geographic Details:
o 16 Hospitals Partners including; 1 Level II Trauma center, 1 Level III Trauma canter and 14 critical access hospitals.
o 27 Long Term Care Facilities.
o 12 Medical Control Authorities with 67 EMS agencies and 147 fire departments.
o Michigan’s upper peninsula surrounded on all 3 sides by Lake Superior, Lake Michigan and Lake Huron. Area is considered very rural.
Natural Gas Line Explosion Outside Of L’Anse
REGION 1 & 8
• Leveraging 9-11
• Livingston County pictures of MEDDRUN & CHEMPACK
• MCI
• Ice Storm
• Incident Response
• MCI
• Ice Storm
• Father’s Day Flooding 2018
REGION 2 NORTH
The Region 2 North Healthcare Coalition
• Population: Over 2.2 Million
• Comprised of 3 Counties: Oakland, Macomb and St. Clair
• Geographic Details:
o 27 Hospitals Partners including; 1 Level I Trauma center, 7 Level II Trauma centers (2 more in process), 2 burn surge facilities and 1 Special Pathogen Tier 2 hospital.
o 81 Long Term Care Facilities.
o Regional Trauma Network and part of cities readiness initiative/Bio Watch.
o International bridge crossing with Canada.
REGION 2 NORTH
• Multiple “Meet and Greet” sessions for new and current CMS facility types (with Public Health, Emergency Management, EMS)
• Hosted FEMA Health Sector Preparedness Course
• Active Long Term Care Workgroup (Includes Public Health Partners)
• Meets every other month –between 50-90 people attend
• Now including Home Health and Hospice – forming their own workgroup in October
• Chair of Workgroup is a voting member of the Planning Board and attends Hospital Committee meetings.
• Community Tabletop Exercise in November (2017 and 2018)
• 150 people expected this year
• Surge scenario – facilities can continue exercise at their facility
• Website used for posting training, education, meetings, public documents, presentations, Executive Summary listing partners, etc. (including State, County, other Regions, etc.)
Nov. 2017 TTX
Sept. 2018 LTC MTG
REGION 2 SOUTH
The Region 2 South Healthcare Coalition
• Population: Over 2.3 Million
• Comprised of 3 Counties: Monroe, Washtenaw and Wayne.
• Geographic Details:
o 33 Hospitals Partners including; 4 Level I Trauma center, 2 Level I Children’s Hospitals, 5 Level II Trauma centers, 4 Level III Trauma Centers (2 more in progress) and 2 Veteran’s Affairs hospitals.
o 91 Long Term Care Facilities.
o 3 of the 6 Michigan burn centers, including the only 2 sites in Michigan verified by the American Burn Association.
o 29 Federally Qualified Health Centers, more than 85 Life Support agencies including Essex-Windsor EMS, Windsor-Essex County Health Unit and the Centers for Disease Control and Prevention (CDC) Quarantine Station.
o Shares an international border with Canada and a state border with Ohio.
REGION 2 SOUTH
• Early October 2012: CDC reports multi-state investigation of Fungal Meningitis secondary to epidural steroid injections
• 4 MI facilities identified as receiving contaminated products
• St. Joseph Mercy Hospital (SJMH) in Ann Arbor, MI reports large number of patients requiring admittance because of epidural abscesses
• November 2012: R2S contacted for additional staffing resources• 95 volunteers identified and credentialed within 24 hours
• MDHHS able to credential Ohio staff from sister facility within 24 hours
REGION 2 SOUTH
• November 2012:
• ≈ 400 additional patients identified requiring MRIs
• R2S identified additional facilities in S.E. Michigan with the expertise and capabilities needed
• R2S and R2N established schedule for routine bed availability reporting by hospitals
• R2S facilitated daily conference calls with all facilities in Southeast MI
• Assisted in additional pharmacy support staffing
REGION 2 SOUTH
In Summary R2 South
• Consult, dialogue with other hospitals, connection with State Poison Control Center
• Connection to State Dpt. Of Health
• Staffing assistance for general and specialized clinicians
• Situational awareness within the region’s healthcare community
• Facilitated collection of hospital census data
• Compiled list of hospital sites with capability and that were accepting patient transfers
• Planned and promoted weekly webinars to inform on standardized care
• Framework – provided Coalition assistance in daily operations in the absence of a non-declared disaster
REGION 2 SOUTH
• February 2013: MI patient summary
• 243 cases treated
• 154 patients requiring treatment for only abscesses were treated
• 41 patients requiring treatment for both Meningitis and abscesses treated
• 12 deaths from the outbreak in MI
• Resources stretched, causing them to expand capabilities
REGION 2 SOUTH
• Statewide Pediatric Drill – June 13, 2018
• Presentation conducted at morning Advisory Committee meeting
REGION 2 SOUTH
• R2S participates in all special event planning in Southeast MI, including:
• MLB All Star Game 2005
• NFL Super Bowl XL 2006
• MLB World Series 2006
• NCAA Final Four 2009
• Annual Detroit Belle Isle Grand Prix
• Annual Detroit Free Press Marathon
• Annual Detroit International Auto Show, Freedom Fireworks, Angel’s Night
REGION 3
The Region 3 Healthcare Coalition
• Population: Approximately 1.2 Million
• Comprised of 14 Counties: Alcona, Arenac, Bay, Genesee, Gladwin, Huron, Iosco, Lapeer, Midland, Ogemaw, Oscoda, Saginaw, Sanilac and Tuscola.
• Geographic Details:
o 24 Hospitals Partners including; 1 Level I Trauma center, 3 Level II Trauma centers, 1 Burn Unit and 1 Pediatric Level II Unit.
o 23 Acute Care Hospitals.
o 65 Long Term Care Facilities.
o 11 Medical Control Authorities with oversight of emergency medical services
o 14 Emergency Management Offices, 1 Michigan Regional Epidemiologist and 1 Public Health Regional Lab.
o 67 Life Support Agencies, ALS, BLS and MFR.
REGION 3
• Education – CMS Condition of Participation – Emergency Preparedness
• 85 partners attended our Health Sector Emergency Preparedness (AWR-336) Course that detailed the 4 core elements the CMS Rule. (BP-1)
• 100 partners, representing 11 agency types participated in regional TTX (ice storm) aimed specifically at meeting CMS requirement. (BP-1)
• 52 agencies, representing 9 agency types participated in regional full scale exercise aimed specifically at meeting CMS requirement within timeline. (BP-1)
• 40 partners participated in our 3 day ADLS/BDLS Training. (BP-1)
• Local Partners created 6 of their own FSE and TTX with regional help. (BP-1)
• Region 3 provided 19 long term care partner facilities with a unique LTC Incident Command course aimed specifically for long term care agency type. (BP-1)
• Continuity of Operations Planning training reaching 50+ agencies. (BP5, BP1)
Health Sector Emergency
Preparedness Course
Basic and Advanced Disaster Life Support Training
REGION 5
The 5th District Medical Response Coalition (5DMRC)
Population: Estimated to be 954, 568 (2015)
• Comprised of 9 Counties: Allegan, Barry, Berrien, Branch, Calhoun, Cass, Kalamazoo, St. Joseph and Van Buren.
• Geographic Details:
o 16 Acute Hospitals Partners including; 1 Level I Trauma center, 1 Level II Trauma center which are also stroke and PCI centers, 1 burn unit, 1 pediatric unit, 3 designated Critical Access Hospitals and 1 Veterans Administration Medical Center.
o 50 Long Term Care Facilities.
o 11 Medical Control Authorities with oversight of emergency medical services
o 10 Homeland Security( Michigan State Police) Emergency Management Units.
o The region is home to 2 nuclear power plants: 1/3 of the region’s counties comprise a significant portion of the region’s nuclear emergency preparedness zones.
REGION 5
• First HCC in state / Created Feb/2002 (before HPP)
• Strong interdisciplinary collaborationo Leveraging DHS and ASPR funding on joint projects
• Partnership with WMU School of Medicine
• Coordinates statewide NDLS Program
• One of 2 TESA units
• Active Regional Medical Coordination Center
• Multiple real world responseso 197- vehicle crash/MCI
o Hurricane Katrina reception center
o Many smaller MCIs/Large events
REGION 6
The Region 6 Healthcare Coalition
• Population: Approximately1.6 Million
• Comprised of 13 Counties: Clare, Ionia, Isabella, Kent, Lake, Mason, Mecosta, Montcalm, Muskegon, Newaygo, Oceana Osceola and Ottawa.
• Geographic Details:
o 24 Acute Care Hospitals Partners including; 2 Level I Trauma center and 3 Level II Trauma centers, 2 Level III Trauma centers, 1 Tier I Special Pathogen Treatment Facility, 1 tertiary Care Center, 1 Rehabilitation Hospital and 1 Children’s Specialty Hospital.
o 66 Long Term Care Facilities.
o 11 Medical Control Authorities with 11 EMS Agencies.
o 9 Emergency Management Jurisdictions.
REGION 6
• 501c3
• WMRMC is the fiduciary for the Region 6 and Region 7 HPP grants
• WMRMC is a 501c3 and has worked to develop services that will generate income for the regional HPP programs
• Fiscal year 18 – generated $41,000 in gross income in 6 months
• Current pause to design marketing program
REGION 6
• 40,000 tickets plus over 5,000 workers each day for
a 5 night weekend
▪ Now two consecutive weekends in June/July
• Electronic music festival
Electric Forest
REGION 7
The Region 7 Healthcare Coalition
• Population: Approximately 500,000
• Comprised of 17 Counties: Alpena, Antrim, Benzie, Charlevoix, Cheboygan, Crawford, Emmet, Grand Traverse, Kalkaska, Leelanau, Manistee, Misaukee, Montmorency, Otsego, Presque Isle, Roscommon and Wexford.
• Geographic Details:
o 11 Acute Care Hospitals Partners including;1 Level II Trauma center and 2 Burn Surge Facilities.
o 29 Long Term Care Facilities.
o 7 Medical Control Authorities.
o 2 major National Guard training facilities.
o Mackinac Bridge with rural areas.
REGION 7
Rural HICS & HCC Support
Bridge Walk
SBCC / BURN SURGE MEETING
STATEWIDE NATIONAL DISASTER LIFE SUPPORT COURSES
• Michigan leads the nation in NDLS training• Started in 2008• Diverse participants from healthcare (MD/DO, RN, EMS)
• Basic Disaster Life Support (BDLS)• Essential knowledge of disaster medicine / CBRNE• ~8 hour course
• Advanced Disaster Life Support (ADLS)• ~16 hours involving application of knowledge and skills in
realistic settings• “Stress inoculation”• Decon., PPE, MCI response, triage, CBRNE
• 5,090 BDLS Trained
• 1,141 ADLS Trained
• Michigan has been successfully piloting “flipped classroom” approach to NDLS courses, moving lectures to online education
