The Division of Quality Assurance is responsible for assuring the safety, welfare and health of persons using regulated health and community care provider services in Wisconsin.
The State Expert Panel on Healthcare Facilities was established to help regulated health and community care provider services in their emergency preparedness efforts. The State Expert Panel consists of Division of Public Health and Division of Quality Assurance staff, health care providers, and other stakeholders, and provides resources and training for emergency preparedness.
Your facility is a vital asset and plays a critical role in the health of residents in your community. There are many potential hazards that may damage your facility and threaten the health and safety of your residents and staff. "Preparedness" will help protect your facility, your residents, and your staff.
The State Expert Panel has developed assessment tools and sample plans to assist providers in their emergency preparedness efforts.
Emergency Preparedness
The following documents are provided by the Wisconsin Department of Health Services, Wisconsin Hospital emergency Preparedness Program. They are intended for use by Long Term Care or Assisted Living facilities.
Emergency Preparedness Plan and Procedures for Long Term Care / Assisted Living Facilities (PDF, 141 KB) - presents information on how to apply the guidance portions of the plan template, application of the administrative procedure template and use of the eight Job Action Sheet (JAS) samples.
Emergency Preparedness and Response Plan (Word, 168 KB) - contains standard text and guidance information for any facility to develop this template into a site specific plan that is National Incident Management System (NIMS) compliant.
Procedure Template - Administrative Activity (Word, 53 KB) - may be used to operationalize any aspect of the emergency plan other than response procedures which will be addressed in the Job Action Sheet (JAS) format.
Hazard Vulnerability Assessment
The following documents are provided by the Wisconsin Department of Health Services, Wisconsin Hospital emergency Preparedness Program. They are intended for use by Long Term Care or Assisted Living facilities.
Hazard Vulnerability Assessment (HVA) Instructions (PDF, 86 KB) - handbook to be use with the HVA Tool that provides an explanation of the assessment process, definitions, and how the tool is to be used.
Hazard Vulnerability Assessment (HVA) Slides (PDF, 295 KB) - presents both the tool and the instruction handbook in PowerPoint format.
Hazard Vulnerability Assessment (HVA) Tool (Excel, 48 KB) - spreadsheet with embedded formulas to calculate the relative risk between hazard scenarios assessed using the spreadsheet.
Incident Management Team/Job Action Sheet (JAS) Samples
This is a set of the eight key Incident Management Team positions. These are samples written with Long Term Care and Assisted Living facilities in mind. They may be modified as needed by a given facility.
The following incident command team JASs are provided:
Financial Chief (Word, 105 KB)
Incident Commander (Word, 129 KB)
Liaison Officer (Word, 103 KB)
Logistics Chief (Word, 111 KB)
Operations Chief (Word, 109 KB)
Planning Chief (Word, 106 KB)
Public Information Officer (Word, 105 KB)
Safety/Security Officer (Word, 104 KB)
Publications
Emergency Preparedness Regulations – Assisted Living, P-01208 (PDF, 54 KB)
Emergency Preparedness Regulations – Long Term Care, P-01209 (PDF, 66 KB)
Evacuation Cot Policy for Hospitals, Nursing Homes, and Assisted Living Facilities (PDF, 59 KB)
Memorandum of Understanding Templates for Long-Term Care or Assisted Living Organizations Background and Guidance (PDF, 87 KB)
Additional Resources
Listed below are emergency preparedness related websites:
Centers for Disease Control (CDC) Preparedness Resources for Healthcare Facilities
Centers for Medicare and Medicaid Services (CMS) Emergency Preparedness
National Weather Service NOAA Weather Radio
Wisconsin Environment Health Resources
Wisconsin Emergency Management (WEM)
