Mental Health All-Hazards Disaster Planning Guidance

Appendix A:
Elements of an All-Hazards State Disaster Mental Health Plan

1. Introductory Material	Present	Absent	N/A
A. Signature page
B. Dated title page
C. Record of changes
D. Record of distribution
E. Table of contents

2. Executive Summary	Present	Absent	N/A
Summary describing basic plan

3. Purpose	Present	Absent	N/A
General statement of plan’s purpose

4. Situation and Assumptions-General	Present	Absent	N/A
A. Assumptions (limits of mental health authority, highest probability scenarios, etc.)
B. Situation (probable impact, vulnerable/special facilities and populations, include low probability/high impact events, etc.)
C. Include matrix of events if desired

5. Concept of Operations-General (sequence and scope of response)	Present	Absent	N/A
A. Overview of approach (what should happen, when, who directs?)
B. Division of responsibility (State, Local, Federal, etc.)
C. General sequence of actions before, during, after event
D. Who is authorized to request aid, and in which situations?

6. Authorities and References	Present	Absent	N/A
Citation of legal authorities and reference documents as appropriate

7. Organization and Assignment of Responsibilities	Present	Absent	N/A
A. Listing, by position and organization, of the types of tasks to be performed (matrix of primary/secondary/shared responsibilities?)
B. Documents tasks of SMHA in FEMA format: definition of objective, characterization of the situation, general plan of action, delegation of responsibilities, information on resources and administrative support necessary to accomplish tasks. Includes description of treatment responsibilities (internal/external)
C. Describes State tasks outside SMHA authority
D. Tasks related to other governmental levels and organizations (e.g., counties, cities, Red Cross, faith organizations, FEMA, SAMHSA/CMHS, Department of Justice, etc.)
E. Describes coordination with other components of State and local government health department, substance abuse agency, criminal justice, law enforcement, fire and rescue, agriculture (including extension service and veterinary services), parks and recreation, animal care and control, victims services, social services, education
F. Ensures connectivity to State emergency plan and federal response plan

8. Administration, Logistics, Legal	Present	Absent	N/A
A. Administration—Recording and reporting program activities
B. Administration—Recording and reporting expenditures and obligations
C. Administration—Recording and reporting human resources utilization
D. Administration-Expectations of situation reports (format and frequency)
E. Administration-Recording and reporting of services provided by volunteer agencies
F. Administration-Management of volunteer offers/services
G. Logistics-Arrangements for support needs (food, water, fuel, etc.)
H. Logistics-Provision for self-support for at least 72 hours
I. Logistics-replacement/repair of damaged/destroyed essential equipment
J. Logistics-Access of personnel to impacted area (criteria method, transportation)
K. Logistics-Availability, transport, administration, safeguarding, recording medications
L. Logistics-Existence and scope of mutual aid agreements
M. Legal-Issues including licensing, informed consent, confidentiality, providers licensed in other jurisdictions, personal, professional, and organization liability, patient records management, waiver of contracting or other procurement rules during emergencies

9. Plan Development and Maintenance	Present	Absent	N/A
Describes who is responsible for modifications and updating, ensuring coordination with other State emergency planning elements

10. Communications	Present	Absent	N/A
A. Situation assumptions (types of situations likely to occur—should relate to earlier assumptions, types of communications necessary such as telephone, data, etc.)
B. Methods of communication among SMHA, local mental health agencies, State psychiatric hospitals, other psychiatric facilities, community-based treatment facilities, State emergency management, regional or field offices, emergency medical services, hospitals and clinics, shelter facilities.Ensure SMHA is on notification list from Governor’s Office
C. Alternatives in the event of failed communication capacity
D. Availability of technical expertise

11. Public Information	Present	Absent	N/A
A. Communications strategy
B. Identification of responsibility
C. Policies for public information (designation and authority of media liaison[s])
D. Existence of public information material (fact sheets, guides, multiple languages, access to services, distribution of materials, etc.)
E. Relationship with State emergency office public information officer
F. Identified means of disseminating information
G. Identification of experts/resources outside SMHA
H. Pre-event relationships with media

12. Warning: Mobilization Related to Internal Mental Health Systems	Present	Absent	N/A
A. Internal—Links with State emergency warning activities
B. Internal—Describes methods and procedures for notifying staff, facilities, service providers, others as appropriate (link to agency risk management as appropriate)
C. Internal—Establishes policies and procedures (e.g., sending staff home, holding staff in place, recall of essential staff, facilities evacuation, etc.) for SMHA offices and facilities
D. External—Identifies groups with special warning needs (e.g., persons who are deaf and have mental illness)
E. External—Notify mental health system (counties, providers, etc.)
F. External—Notification of private sector mental health resources

13. Evacuation	Present	Absent	N/A
A. Plan for evacuation of SMHA offices and facilities
B. Plan for alternate sites ("hot,” "warm,” and "cold" sites as appropriate)
C. Clear linkage with State emergency management evacuation plans and operations
D. Availability of technical expertise

14. Mass Care	Present	Absent	N/A
A. Documentation of coordination with State emergency management mass care plan
B. Links with Red Cross special populations facilities and other National Voluntary Organizations Active in Disasters

15. Health and Medical	Present	Absent	N/A
A. Documentation of coordination with State emergency management health and medical plan staffing, logistics, costs, availability of pharmaceuticals
B. Provision of mental health services/consultation as part of State’s emergency medical plan (Emergency Support Function #8, VA resources, etc.)
C. Roles identified in areas of services/consultation to primary victims, secondary victims, response and recovery workers, incident command, public information, body identification and recovery, mortuary services, other State agencies and departments (e.g., health epidemiology, education, social services, etc.)
D. Documentation of coordination with Red Cross mental health services
E. Documentation of coordination with Red Cross health services

16. Resource Management	Present	Absent	N/A
A. Purpose — Documents means, organization, and process by which SMHA will find, obtain, allocate, and distribute necessary resources
B. Personnel
C. Transportation for staff
D. Communications equipment
E. Emergency equipment as necessary
F. Mass care supplies for SMHA resources
G. Intrastate mutual aid
H. Management of offers of assistance and invited/uninvited volunteers
I. Availability of aid from other States and Federal government
J. Plan for maintaining financial and legal accountability
K. Resources for initial and ongoing needs assessment

17. All-Hazards Specific Planning Materials (Natural and Accidental)	Present	Absent	N/A
A. Plan allows for accommodation of unique aspects of hazards
B. Identifies nature of hazard
C. Identifies areas of high risk
D. Communications equipment
E. Emergency equipment as necessary
F. Mass care supplies for SMHA resources
G. Intrastate mutual aid
H. Management of offers of assistance and invited/uninvited volunteers
I. Availability of aid from other States and Federal government
J. Plan for maintaining financial and legal accountability
K. Resources for initial and ongoing needs assessment
J. Plan for maintaining financial and legal accountability
K. Resources for initial and ongoing needs assessment
J. Plan for maintaining financial and legal accountability
K. Resources for initial and ongoing needs assessment
J. Plan for maintaining financial and legal accountability
K. Resources for initial and ongoing needs assessment
J. Plan for maintaining financial and legal accountability
K. Resources for initial and ongoing needs assessment

18. Terrorism	Present	Absent	N/A
A. Describes nature of potential hazards (chemical, biological, nuclear/radiological, explosive, cyber, combined)
B. Potential targets are identified and/or reflective of State emergency plan
C. Describes incident management for SMHA
D. Describes and/or reflects State emergency plan's situational assumptions (environment, populations, urbanicity, infrastructure, transport patterns, airports, trains/subways, government facilities, recreation facilities, military installations, HazMat facilities, other high risk targets such as financial institutions, universities, hospitals, research institutes, schools, daycare centers)
E. Reflects coordination with state emergency plan's modeling of potential release areas
F. Incident management reflects roles of other State and Federal roles and resources
G. Consequence management reflects involvement of various federal components
H. SMHA plan reflects knowledge of and integration with State emergency plan with respect to warning, communication, emergency public information, protective actions, mass care, health and medical annex, resource management
I. Describes links to health and medical entities for purposes of assisting in screening potential victims for mental disorders and psychogenic symptomatology, functional impairment, substance abuse, etc.
J. Describes links with State public health structure for surveillance, screening, consultation, intervention planning, risk communication
K. Describes SMHA role in risk communication planning and response
L. Describes SMHA participation in exercises and drills

19. Continuity of Operations- SMHA	Present	Absent	N/A
A. Contains overview of goals of Continuity of Operations Plan (e.g., to maintain/reestablish vital functions of SMHA during the first 72 hours following an event that would seriously compromise or halt normal operations)
B. Documents coordination with overall State Continuity of Operations Plan
C. Identifies vital functions to be maintained within first 72 hours
D. Identifies vital records/data necessary to function within first 72 hours
E. Describes plans related to human resources (e.g., essential staff, staff notification, family support)
F. Describes alternate locations of essential operations
G. Describes transportation and staff support
H. Describes alternate vital record/document sites (e.g., assurance of access to disaster plan, staff rosters, patient vital medical records if existing sites are destroyed or inaccessible)

20. Other Special Planning Concerns	Present	Absent	N/A
A. Description of SMHA's presence and role in State emergency management structure
B. Documentation of regional or multi-State planning and coordination
C. Describes various issues around licensing within State, out-of-State providers, scope of practice, etc.
D. Documentation of plans to prepare and support SMHA staff during and following deployment under plan (physical, health, special medical needs, family support, psychological)
E. Documentation of plans to prepare and support emergency service responders (e.g., police, fire, hospital emergency department staff, mortuary workers) during and following deployment
F. Documentation of public sector links with private mental health resources
G. Documentation of coordination with business and corporations and other private sector interests in planning for behavioral health response and consequences
H. Documentation of appropriate planning links with institutions of higher learning (academic departments, student health services, etc.)
I. Provides assurance that all SMHA facilities meet JCAHO or other appropriate standards for disaster and emergency preparedness
J. Describes SMHA role in crisis and emergency risk communication
K. Ensures SMHA's role in disaster training and exercises
L. Describes SMHA's role in coordination of research
M. Describes SMHA's role in data collection/evaluation/and gatekeeping to balance information needs with victims' needs

21. Standard Operating Procedures and Checklists	Present	Absent	N/A
A. Contains applicable standard operating procedures
B. Contains applicable checklists (e.g., emergency contact numbers, lists of facilities, etc.)

22. Glossary of Terms	Present	Absent	N/A
A. State specific terms
B. Emergency management terms
C. Public health terms
D. Mental health terms

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Mental Health All-Hazards Disaster Planning Guidance

Appendix A: Elements of an All-Hazards State Disaster Mental Health Plan

Appendix A:
Elements of an All-Hazards State Disaster Mental Health Plan