LeadingAge Magazine · September/October 2013 • Volume 03 • Number 05

Mutual Aid Plans: Helping Each Other When Disaster Strikes

August 30, 2013 | by Linda Barbarotta

Providers and state associations are joining or creating ever-more sophisticated mutual aid plans to protect and support vulnerable seniors and communities during and after emergencies and natural disasters.

Connecticut and Massachusetts are among several states and localities that have mutual aid plans for their aging-services providers. These plans are emergency planning systems that complement local, regional and state emergency response strategies. A key plan feature is that participants commit to helping each other in an emergency to support resident evacuation or provide resources and assets to avoid evacuation. LeadingAge Connecticut and LeadingAge Massachusetts were key players in the development of the programs in their states.

Connecticut (through Region 3 Council of Governments) and Massachusetts (through LeadingAge Massachusetts) hired Russell Phillips & Associates (RPA) to create their mutual aid plans and worked closely with Scott Aronson, principal at RPA. LeadingAge Massachusetts provided the grassroots funding to support the planning.

RPA provides a customized website tool, MutualAidPlan.org, extensive pre-planning, an emergency communication system, staff training and annual practice disaster exercises for participants. During an evacuation, the chief goals are to track and protect residents, get the provider what it needs to remain open, and shelter-in-place and facilitate rapid information on the beds and resources available from other providers. An electronic tracking system and redundant paper tracking processes for residents are key plan components.

When providers join, they gain access to MutualAidPlan.org, which manages emergency information for evacuation, resources and assets. All providers are assigned their own page where they input information in 25-30 categories that serves as a detailed inventory of their resources and residents. The information includes key contacts, which are uploaded into the plan’s communication system, resident acuity, generator type and capacity, suppliers/vendors, equipment and transportation support. Providers also provide a list of beds and resources they could offer other communities in the event of a crisis.

Participants pay yearly dues to maintain the program.

Once this information is loaded, the provider is linked into the network. If an emergency happens to a provider, the plan is activated and all members report their status and what they can offer the affected organizations. “Long-term care coordinating centers,” run by trained provider staff, are set up ahead of time and, along with local, regional and state governments, coordinate the resources, assets and evacuation assistance that may be needed.

In the 2011, 2012 and 2013 storms in the Northeast, the states using mutual aid plans were the only ones capable of giving rapid and concise information to CMS in one consolidated, automated format.

The Connecticut Long Term Care Mutual Aid Plan (LTC-MAP) began in central Connecticut (Region 3) in 2009 with funding from the Capitol Region Council of Governments. LTC-MAP is now active in four out of five of the state’s regions, with 178 of 231 nursing homes enrolled.

Mag Morelli, president of LeadingAge Connecticut, was involved in the initial planning. She says there was excellent cooperation among the members of the planning group, which consisted of various state associations and the department of public health, which came to hold LTC-MAP in the highest regard.

Morelli is a strong supporter of the plan and found unexpected benefits to her own organization. “With LTC-MAP in place, I have the reassurance and peace of mind that my nursing home members in those participating regions are well prepared for an emergency and in a position to help each other. I get real-time updates and assessments through e-mails and automatic phone calls in the event of an emergency, as well as have access to the website.” She adds, “I would highly recommend other LeadingAge state associations explore this option.”

Vinnie DeSanti, assistant operations officer of Hebrew Health Care in West Hartford was part of the central Connecticut team that first established LTC-MAP. He is a strong proponent of the plan and sees a significant difference between how emergencies were handled before and after the plan.

“One good example,” says DeSanti, “is what happened to a nursing home about 18 months ago. The home reported a generator failure and fire to LTC-MAP. While it was not clear if the [community] would need to evacuate, the administrator wanted to be ready. Within 45 minutes, 80-90 percent of the network reported in their bed and transportation availability and an evacuation plan was in place. Prior to having the LTC-MAP in place, the nursing home would have probably only called 911 to alert authorities and scrambled to secure beds for their residents in nearby [providers].”

DeSanti strongly recommends that nursing homes in other states set up a mutual aid plan. “I would ask them, ‘if you had to evacuate your home, where would your residents go? How would they get there? How will they be tracked? How would you get resources if your vendors were unable to support you? Wouldn’t it be nice to have this planned ahead of time and know that your neighbors across the region or the state had already committed to help?’” He adds, “Basically, we are all here to help each other.”

Kevin Burke, LeadingAge Massachusetts’ board chair, brought the idea of establishing a mutual aid plan to his state, having been active in a similar plan in Rochester, NY.

In 2006, various stakeholders around the state, including LeadingAge Massachusetts, Mass Senior Care Association, MassALFA, the Department of Public Health, the Executive Office of Elder Affairs, the Massachusetts Emergency Management Agency and others gathered to discuss the idea. Early on, the group decided to build a statewide plan and became the first state to do so. Eventually, the statewide group became MassMAP, a separate 501(c)(3) that now runs the program. Currently, 426 nursing homes and 75 assisted living communities and rest homes are enrolled.

Elissa Sherman, president of LeadingAge Massachusetts, says the idea had great support from the stakeholders from the beginning. The department of public health has been very pleased with providers' cooperation and with how well the plan functioned in real emergencies and annual practice drills. So pleased, in fact, it is using civil monetary penalties to pay the 2013 plan fees for all nursing homes.

Sherman is a strong supporter of MassMAP. “The plan works beautifully with already existing local, regional and state emergency plans. But it goes beyond those plans. State-required emergency response plan plans take providers to the sidewalk, but what happens then? MassMAP goes further and fills in the gaps.”

Valerie Gingras, administrator at Carleton-Willard Village in Bedford, was part of the initial planning group. She remembers that putting the necessary policies and procedures in place took some time but once they were established, aging-services providers began to enroll. She sees a significant improvement in communication between providers and between the state’s regions.

Gingras is so committed to MassMAP that she has taken full advantage of the opportunities that come with the annual disaster exercises. She has volunteered Carleton-Willard to be a mock disaster site and to receive evacuated residents. “Volunteering to be a disaster site meant doing a lot of preparation and work to get ready but the hands-on experience of actually going through an evacuation was invaluable for our staff.”

Between April and June of 2013, every MassMAP and Connecticut LTC-MAP member went through regional disaster exercises and 15 were evacuated or went through an evacuation simulation in preparation for the storm season.

Recently, Rhode Island has set up its own Long-Term Care Mutual Aid Plan. With state department of health funding and the support of Jim Nyberg, LeadingAge Rhode Island director, all 90 nursing homes in the state have joined the plan. In November, all 59 assisted living residences will be added with department of health funding.

RPA Principal Scott Aronson sees the addition of Rhode Island as an essential step to these states helping each other: “This is now becoming a Southern New England mutual aid plan. All three states will have the same resident tracking tools, the same web-based systems and emergency reporting process, and more importantly, a common approach for training and exercising to assist in continuity of care in a regional disaster.”