Emergency Plan Manual

AHCA Form 3110-1022, Rev March 2013 Rule 59A-8.027, Florida Administrative Code http://ahca.myflorida.com/MCHQ/Health_Facility_Regulation/Home_Care/HHA/index.shtml#other . Page 31 of 54 EMERGENCY MANAGEMENT PLANNING CRITERIA FOR HOME HEALTH AGENCIES Agency for Health Care Administration Home Care Unit The following criteria are to be used when developing Comprehensive Emergency Management Plans (CEMP) for all home health agencies. The criteria also serve as the plan format for the CEMP, since they satisfy the basic emergency management plan requirements of s. 400.492, Florida Statutes, and 59A-8.027, Florida Administrative Code. These criteria are not intended to limit or exclude additional information that home health agencies may decide to include to satisfy other requirements, or to address other arrangements that have been made for emergency preparedness. This form must be attached to your agency’s Comprehensive Emergency Management Plan. Use it as a cross reference to your plan, by listing the page number and paragraph where the criteria are located in your plan on the line to the left of each item in this document. For your information, your local County Health Department and the local Emergency Management office may have Special Needs Shelter activity, work or planning groups. Please contact these state agencies in your area if you would like to participate in such committees or groups. Also, as you may be aware, health care workers can choose to volunteer at Special Needs Shelters during times of emergency. If your staff is interested in this please have them contact their licensing board to register. I. INTRODUCTION Provide basic information concerning the home health agency, to include: __pg 3__ 1. Name of the home health agency, address, phone number. __pg 3__ 2. Identify, by name and title, who is in charge during emergencies, including home and work phone numbers, pager or cell phone numbers, if available. Identify alternate(s), should that person be unavailable, with contact information for the alternate(s). __pg 4__ 3. Name of the owner(s) of the agency, addresses, work and home telephone numbers, pager or cell phone numbers, if available. __pg 4__ 4. Name, address, work and home telephone numbers of person(s) who developed this plan. II. CONCEPT OF OPERATIONS This section defines the policies, procedures, responsibilities and actions that the home health agency will take before, during and after any emergency situation. At a minimum, the home health agency plan needs to address: direction and control, notification, and evacuation.