It is an ethical obligation to maintain continuity of care. Is your agency prepared in the event of an in-house disaster such as the entire facility flooding and having to close for a month? View the video here: https://www.youtube.com/watch?v=zepUrQlq2Vk Counseling CEUs for ethics can be earned here: https://www.allceus.com/member/cart/index/product/id/696/c/

1. Disaster Planning:
An Ethical Obligation
Instructor: Dr. Dawn-Elise Snipes
Executive Director: AllCEUs Counselor Education
Podcast Host: Counselor Toolbox & Happiness Isn’t Brain Surgery
AllCEUs Counselor Education Unlimited CEUs $59 & Specialty Certificates $89 1

2. Objectives
 Rationale and Process for Disaster Planning
 Preparing for Disaster
 Continuity Planning
 Management of Prescription Medications
 Testing the Plan
AllCEUs Counselor Education Unlimited CEUs $59 & Specialty Certificates $89 2

3. Rationale
 Disaster planning can save lives, minimize injury and
emotional trauma, protect property and operational
capability, and prevent or reduce interruptions in
treatment.
 The behavioral health treatment program has a
special obligation to prepare for disasters because it
provides essential services.
 By their nature, disasters have an impact on
behavioral health:
 Most people who experience a disaster, whether as a victim
or responder, will have some type of psychological, physical,
cognitive, and/or emotional response to the event. Most
reactions are normal responses to severely abnormal
circumstances. (American Medical Association, 2005, p. 2)
AllCEUs Counselor Education Unlimited CEUs $59 & Specialty Certificates $89 3

4. Rationale
 Disaster planning can prepare the program for
continuing to provide the services to its existing
clientele in order to prevent:
 Relapse
 Medical and psychological consequences for prematurely
discontinuing medically managed detox or crisis stabilization
 Homelessness if clients are in a residential facility
 Client destabilization due to lack of access to medications
prescribed and/or administered by the agency (antipsychotic
injections, prescription refills, methadone)
 Exacerbation of problems in at-risk populations as a result of
lack of access to support
AllCEUs Counselor Education Unlimited CEUs $59 & Specialty Certificates $89 4

5. Rationale
 Disaster Planning can help mitigate psychological
issues in the community by providing services to
new clients (Katrina)
 Aid to other programs
 Rapid response to influx of clients from other agencies
or areas
AllCEUs Counselor Education Unlimited CEUs $59 & Specialty Certificates $89 5

6. Types of Disasters
 Your facility is incapacitated or destroyed (fire, building flood,
sink hole) but other facilities remain open and clients are in
their homes
 Your facility and others are incapacitated and clients are in
shelters (Hurricane, blizzard, fires).
 Your facility is functional in the aftermath of a natural disaster
in which your patients are in shelters. (City-wide flood).
 When the program must cease provision of nonessential services
due to a sudden reduction in resources, infrastructure, or
available personnel due to illness or diversion of resources.
Health department can provide a copy of the local Hazard
Identification and Risk Assessment (HIRA)
AllCEUs Counselor Education Unlimited CEUs $59 & Specialty Certificates $89 6

7. Continuity Planning
 Requires a program’s personnel to consider the threats
that could adversely affect essential functions;
 Determine the personnel, vital information (e.g., patient
medical records including prescription records), and other
resources required to continue those essential functions;
 Develop plans for providing essential functions onsite or at
alternate locations if needed
 Make advance arrangements for obtaining the resources
necessary to support essential functions throughout the
disaster and recovery phases
 Plan for the safety of all personnel during these periods.
AllCEUs Counselor Education Unlimited CEUs $59 & Specialty Certificates $89 7

8. Planning cont…
 In its initial work, the disaster planning team
conducts or gathers, from partner agencies in the
community, a hazard identification and risk
assessment
 A hazard-specific appendix should not repeat
information that is in either the basic plan
AllCEUs Counselor Education Unlimited CEUs $59 & Specialty Certificates $89 8

9. Types of Clients
 Current clients
 Current clients who are destabilizing
 Guest clients
 Prior clients whose recoveries are threatened
 Individuals with an untreated mental health issue which
must be addressed to prevent further deterioration
 Family members of clients who need assistance to support
their loved ones (Hotline, online support groups)
 Patients who need prescription refills written
 Patients on an opioid pain medication who cannot access
their physician
AllCEUs Counselor Education Unlimited CEUs $59 & Specialty Certificates $89 9

10. The Plan
 Introduction: Purpose of the plan and objectives
 Concept of operations
 Procedures for activating and deactivating (Who, What,
When, How)
 Staff responsibilities in the disaster
 List of the personnel positions authorized to make
requests for outside aid or assistance
 the conditions under which to request aid
 the procedures for managing requests to give aid
 a list of resources that can be used in those efforts.
AllCEUs Counselor Education Unlimited CEUs $59 & Specialty Certificates $89 10

11. The Plan
 Functional Annex (Response to a specific hazard type)
 Hazardous weather/tornado warning
 Facility Fire
 Wildfire / Flood
 Facility Flood
 Hurricane / Blizzard
 Earthquake
 Viral Pandemic
 Chemical Spill
 Train or major vehicle wreck or explosion
AllCEUs Counselor Education Unlimited CEUs $59 & Specialty Certificates $89 11

12. The Plan
 Implementation Instructions
 Checklists and materials necessary to perform disaster
related tasks
Scripts to respond to the media, public or consumers
Floorplans
Community Maps
 Safety Related policies and procedures
 Memoranda of Agreement including address of each
facility, phone number and contact person
AllCEUs Counselor Education Unlimited CEUs $59 & Specialty Certificates $89 12

13. Keep It Simple
 Basic plan should address
 General procedures
 Contain a general decision and notification tree
 Plans for monitoring where clients go
 Avoid having staff need to refer to multiple sections in the plan
 If your agency has multiple locations or types of programs, each
program type needs its own addendum to each functional annex
(Detox, CSU, Residential, IOP, Adolescent)
 Supervisory staff should maintain a paper copy and each
building unit should maintain a paper copy in an accessible
location
 Administrative and Clinical staff must ALL be adequately
trained including scenario training.
AllCEUs Counselor Education Unlimited CEUs $59 & Specialty Certificates $89 13

14. Coordination with Others / MOU
 Memorandum of Understanding with:
 Hospitals/Health Departments (Detox, crisis stabilization,
medication maintenance)
 Behavioral Health Disaster Response Team (Health Departments)
 Emergency Management for evacuation of patients
 Other clinics for mutual referral or staff borrowing
 Sober homes for patients in addiction recovery
 SAMHSA’s Disaster Technical Assistance Center (DTAC)
specialists can help a program link with the disaster
behavioral health coordinator for its State and answer
questions about accessing state and federal funding
 Health departments must coordinate disaster planning with
the community’s behavioral health treatment systems
AllCEUs Counselor Education Unlimited CEUs $59 & Specialty Certificates $89 14

15. Role of the Health department
 Engaging and coordinating with emergency management,
healthcare organizations (private and community-based),
behavioral health providers, community and faith-based partners
 Support the development of public health, medical, and
mental/behavioral health systems that support recovery
 Participate in awareness training with community and faith-based
partners on how to prevent, respond to, and recover from public
health incidents.
 Promote awareness of and access to medical and
mental/behavioral health resources that help protect the
community’s health and address the functional needs of at-risk
individuals
 Receive and/or integrate the health needs of populations who
have been displaced due to incidents that have occurred in their
own or distant communities
AllCEUs Counselor Education Unlimited CEUs $59 & Specialty Certificates $89 15

16. Role of the DEA
 Monitors and reviews actions the program takes in
a disaster regarding controlled substances (e.g.,
relocating a methadone supply to an alternate
facility)
 Inform the local DEA agent about the use of
controlled substances that are prescribed or
dispensed to patients and stored at the facility
(ADHD, Anxiety, Opiate)
 The State Opioid Treatment Authority can assist in
making contact with the local DEA official
AllCEUs Counselor Education Unlimited CEUs $59 & Specialty Certificates $89 16

17. Role of the Media
 Assist in coordination of services
 Request including in local TV and Radio
emergency listings (operating status of the
program, where to go if closed)
AllCEUs Counselor Education Unlimited CEUs $59 & Specialty Certificates $89 17

18. PreDisaster Preparedness
 Educate partners to destigmatize and ensure
continuity of care at “guest” agencies or in
shelters
 Methadone / Suboxone
 Schizophrenia
 Educate the public about the importance and
availability of behavioral health services in an
emergency
 Get Memoranda of Understanding
AllCEUs Counselor Education Unlimited CEUs $59 & Specialty Certificates $89 18

19. Pre-Disaster Preparedness
 Educate local emergency response organizations about:
 Characteristics of patients (especially residential)
 Needs of patients during and after transport
 Most appropriate settings most appropriate for relocation
 Specific locations that have, through MOU, agreed to accept
patients
 Patients have a right to expect from general population
emergency shelters support services that provides:
 Access to medications to maintain health, mental health, and
function
 Refrigeration for medications
 Assistance that may be required due to cognitive and
intellectual disabilities.
AllCEUs Counselor Education Unlimited CEUs $59 & Specialty Certificates $89 19

20. Pre-Disaster Preparedness
 Identify Essential Functions
 Safety of clients and visitors
 Behavioral health emergency services including crisis and relapse
prevention.
 Track clients affected by dispersal and evacuation to ensure they
continue to receive needed behavioral health services.
 Assist clients in accessing needed medications.
 Conduct drug testing for mandated clients.
 Adhere to applicable State licensing standards.
 Maintain treatment and billing records in accordance with
regulatory requirements.
 Protect client rights and privacy, including the integrity of PHI
 As resources are available and based on mandates, provide
disaster mental health services to the community including
prevention specific guidance and crisis intervention
AllCEUs Counselor Education Unlimited CEUs $59 & Specialty Certificates $89 20

21. PreDisaster Preparedness
 Become aware of funding sources in an
emergency and how to access them
 State and Federal funds (e.g., Robert T. Stafford
Disaster Relief and Emergency Assistance Act)
 Crisis Counseling Assistance and Training Program (CCP)
grants, which are funded by FEMA
 SAMHSA Emergency Response Grants (SERGs)
AllCEUs Counselor Education Unlimited CEUs $59 & Specialty Certificates $89 21

22. Mitigate Risk
 Improve facility’s ability to withstand a disaster
 Hurricane window covering
 Backup generators
 Prepare for shelter-in-place for when evacuation is unsafe
(Chemical spill)
 Stockpile supplies: Cots, linens, soap, toothpaste,
nonperishables for a 72-hour period
 Prepare personal go-kits (1 per client) with water bottle,
flashlight, batteries, toiletries, and consider… t-shirt and
shorts, towel, high energy food bar (Can have clients bring
at admission)
 Inventory and replace supplies at least quarterlyAllCEUs Counselor Education Unlimited CEUs $59 & Specialty Certificates $89 22

23. Mitigate Risk
 Real-time data back-up of electronic health record at a
remote location which can be accessed in emergency
 Keep coolers on site for transportation of refrigerated
medications
 Ensure electric water pump (if any) are connected to
back-up generator
 Train all staff in emergency psychological first aid
 Have a psychiatric advanced directive in the file for any
patient who may destabilize in an emergency which
includes helpful interventions and info about legal
representative should they become incapacitated.
AllCEUs Counselor Education Unlimited CEUs $59 & Specialty Certificates $89 23

24. Mitigate Risk
 Prepare for financial resiliency
 How to enroll clients in emergency Medicaid
 Reimbursability of services
Educate payors about modified counseling services to
facilitate reimbursement
 Some agencies may have a reduction in cash flow due
to relocation of community residents
 Staff members might be “shared” with programs
experiencing an influx of clients to reduce payroll load
 Consider how to support client retention through
active outreach following a disaster
AllCEUs Counselor Education Unlimited CEUs $59 & Specialty Certificates $89 24

25. Summary
 Disaster planning prepares for client safety and
continuity of care and financial solvency for
organizations in the event of a disaster
 Getting MOUs with local agencies, the health
department and emergency services is vital to
preparation
 A list of identified risks for your area can be accessed
at your local health department
 All staff needs to be trained in the disaster procedure
and scenario training should occur periodically
AllCEUs Counselor Education Unlimited CEUs $59 & Specialty Certificates $89 25