Business Continuity ESG Blog

Healthcare Business Continuity Planning in Los Angeles County

Written by William Tygart | 1/11/25 7:39 AM

Healthcare organizations in Los Angeles County face a unique set of challenges in ensuring the continuity of their operations during emergencies. From earthquakes and wildfires to pandemics and cyberattacks, the potential for disruption is significant. To address these challenges, the Los Angeles County Emergency Medical Services (EMS) Agency plays a crucial role in promoting healthcare business continuity planning (BCP). This report examines the efforts of the EMS Agency and its partners in fostering resilience within the healthcare system of Los Angeles County.

The Role of the Los Angeles County EMS Agency

The Los Angeles County EMS Agency takes a proactive approach to healthcare BCP, recognizing the importance of preparedness in mitigating the impact of disasters and other emergencies. The agency promotes BCP through the Hospital Preparedness Program (HPP) for participating hospitals and other members of the Los Angeles County Healthcare Coalition (HCC)1. This program is targeted towards Healthcare Emergency Managers, Hospital Preparedness Program (HPP) grant managers, and Clinical Directors of Long-Term Care Centers, Clinics, Surgery Centers, Dialysis Centers, Home Health/Hospice entities, and others directly responsible for healthcare continuity planning2. The EMS Agency emphasizes the following key aspects of BCP: 2

  • Identifying Essential Functions: Determining the critical services that must be maintained during an emergency to ensure continued healthcare delivery.
  • Continuity of Operations: Developing strategies and procedures to maintain essential functions during disruptions.
  • Protecting Health Information Systems: Safeguarding critical data and ensuring access to electronic health records during emergencies.
  • Supporting Recovery: Planning for the efficient restoration of normal operations following an incident.

The EMS Agency provides resources and support to healthcare organizations in their BCP efforts. This includes a BCP template and instruction manual, webinars, and workshops4. These resources are available on the EMS Agency website4.

The Hospital Preparedness Program (HPP)

The HPP is a federally funded program administered by the US Department of Health and Human Services (HHS). It is the primary source of federal funding for healthcare preparedness and response in the US5. In Los Angeles County, the EMS Agency oversees the HPP, which provides funding and guidance to hospitals to enhance their preparedness for emergencies6. Hospital recipients of HPP funds are required to attend the in-person Seminar Session and will have registration priority2. The HPP requires participating hospitals to meet specific requirements, including: 7

  • Maintaining an all-hazards emergency preparedness and response plan.
  • Establishing and maintaining advisory committees with representatives from various organizations involved in emergency response.
  • Testing expedited procedures for receiving emergency funds and procuring resources during incidents.
  • Implementing internal controls for sub-recipient monitoring.
  • Testing emergency authorities and mechanisms for workforce surge.

Collaboration with Public Health

The Los Angeles County EMS Agency collaborates with the California Department of Public Health to coordinate medical and public health responses during emergencies. This collaboration ensures a comprehensive and coordinated approach to addressing the health needs of the community during and after incidents8. This inter-agency coordination is crucial for effective emergency response, enabling efficient resource allocation, information sharing, and coordinated decision-making.

The HPP plays a vital role in ensuring that hospitals have the necessary resources and capabilities to respond effectively to a wide range of emergencies, from natural disasters to public health threats.

The Los Angeles County Healthcare Coalition (HCC)

The HCC is a collaborative network of healthcare organizations, emergency management agencies, and public health agencies in Los Angeles County6. The HCC facilitates communication, coordination, and resource sharing among its members to enhance preparedness and response capabilities9. The California Association of Health Facilities (CAHF) plays a unique role within this network, serving as a disaster preparedness liaison for long-term care facilities in LA County. This highlights the comprehensive nature of the county's preparedness network, extending beyond hospitals to encompass various healthcare providers10.

The HCC provides a platform for healthcare organizations to share best practices, participate in training exercises, and collaborate on emergency planning.

Resources and Guides for Healthcare BCP

The Los Angeles County EMS Agency offers a variety of resources and guides to assist healthcare organizations in their BCP efforts. These resources include: 4

  • BCP Template and Instruction Manual: A comprehensive guide to developing and documenting a BCP.
  • Webinars and Workshops: Educational sessions on various aspects of BCP, including business impact analysis, essential functions identification, and recovery planning.
  • Online Resources: Tools and information available on the EMS Agency website, such as interviewing tips and best practices.

In addition to the resources provided by the EMS Agency, healthcare organizations can also access continuity planning guidance and resources from the California Governor's Office of Emergency Services (CalOES)11.

Case Studies and Examples

The EMS Agency highlighted the response of Ridgecrest Regional Hospital to the 2019 Ridgecrest Earthquake during its 2023 Healthcare Business Continuity Plan Seminar2. This example demonstrates the importance of BCP in enabling healthcare facilities to maintain operations and provide essential care during and after emergencies.

Risks Faced by Hospitals in Los Angeles County

Hospitals in Los Angeles County face a range of risks that can disrupt their operations. These risks include: 12

  • Financial Strain: Soaring costs for contract labor, prescription drugs, and other expenses, coupled with inadequate reimbursement rates, are putting significant financial pressure on hospitals.
  • Wildfires: The increasing frequency and intensity of wildfires in California pose a direct threat to hospital facilities and can disrupt operations due to evacuations, power outages, and road closures. Hospitals across the county have reported treating patients with burns, smoke inhalation, and eye irritation in their emergency rooms13. In some cases, over 700 people have been evacuated from nursing homes and other care facilities due to the impact of wildfires13.
  • Staffing Shortages: Burnout and other factors have contributed to staffing shortages in hospitals, making it challenging to maintain adequate staffing levels, especially during emergencies.

To mitigate these risks, the HPP employs a multi-pronged approach that includes providing funding and guidance to hospitals to enhance their preparedness and response capabilities6. This includes support for: 5

  • Developing and testing emergency plans.
  • Conducting training exercises.
  • Acquiring essential equipment and supplies.
  • Establishing partnerships with other healthcare organizations and emergency response agencies.

By strengthening the resilience of hospitals, the HPP helps to mitigate the impact of these risks and ensure the continuity of healthcare services during emergencies.

How the HPP Addresses Specific Risks

The HPP provides a framework for hospitals to address specific risks through a variety of mechanisms:

  • Financial Risk: The HPP provides funding to hospitals to support preparedness activities, including the acquisition of essential equipment and supplies, which can help to mitigate the financial impact of emergencies. For example, HPP funding was instrumental in equipping the Los Angeles County EMS Agency with the resources needed to support hospitals during the winter 2020 COVID-19 surge. This funding enabled hospitals to increase surge bed capacity through space conversion and the use of surge tents14.
  • Wildfire Risk: The HPP supports the development of evacuation plans, alternative care sites, and communication strategies to ensure continuity of care during wildfires. This includes funding for backup generators, alternative communication systems, and training for staff on wildfire response procedures15.
  • Staffing Shortages: The HPP promotes workforce surge planning and training to ensure that hospitals have adequate staffing levels during emergencies. This includes developing strategies for rapid recruitment, cross-training staff, and utilizing volunteer resources7.

By addressing these specific risks, the HPP helps to ensure that hospitals in Los Angeles County are prepared to maintain essential healthcare services during a wide range of emergencies.

Conclusion

The Los Angeles County EMS Agency plays a critical role in promoting healthcare BCP. Through the HPP, the HCC, and various resources and guides, the agency supports healthcare organizations in their efforts to prepare for and respond to emergencies. The HPP stands out as a crucial program, being the primary source of federal funding for healthcare preparedness and response in the US. This funding enables hospitals to acquire essential equipment, develop robust emergency plans, and conduct training exercises to enhance their resilience.

The HCC further strengthens the preparedness network by fostering collaboration and communication among healthcare organizations, emergency management agencies, and public health agencies. The inclusion of CAHF as a liaison for long-term care facilities demonstrates the comprehensive approach to preparedness in Los Angeles County.

The EMS Agency's efforts in promoting a culture of preparedness and collaboration are essential for ensuring the resilience of the healthcare system in Los Angeles County. However, it is important to recognize that BCP is not a static process. The evolving nature of risks and emergencies requires continuous improvement and adaptation. Healthcare organizations must remain vigilant, regularly review and update their BCPs, and actively participate in training and exercises to ensure their ongoing readiness. By embracing a proactive and adaptive approach to BCP, healthcare organizations in Los Angeles County can effectively mitigate the impact of emergencies and ensure the continued delivery of essential healthcare services to the community.

Works cited

  1. dhs.lacounty.gov, accessed January 11, 2025, https://dhs.lacounty.gov/emergency-medical-services-agency/home/disaster-programs/business-continuity-planning-bcp/#:~:text=The%20Los%20Angeles%20County%20Emergency,Los%20Angeles%20County%20Healthcare%20Coalition.
  2. Business Continuity Planning (BCP) - Emergency Medical Services ..., accessed January 11, 2025, https://dhs.lacounty.gov/emergency-medical-services-agency/home/disaster-programs/business-continuity-planning-bcp/
  3. Business Continuity Planning (BCP) - LA County Healthcare Coalition, accessed January 11, 2025, https://www.lacountyhcc.org/business-continuity-planning-bcp
  4. Business Continuity Plan - Lacounty - COUNTY OF LOS ANGELES, accessed January 11, 2025, https://file.lacounty.gov/dhs/cms1_243592.pdf
  5. Hospital Preparedness Program (HPP) - ASPR, accessed January 11, 2025, https://aspr.hhs.gov/HealthCareReadiness/HPP/Pages/default.aspx
  6. Hospital Preparedness Program (HPP) - LA County Healthcare Coalition, accessed January 11, 2025, https://www.lacountyhcc.org/hospital-preparedness-program
  7. 2019-2024 HPP Requirements Application Requirements and Capabilities, Objectives and Activities See Appendix A on pages 42-82 of, accessed January 11, 2025, https://www.programinfosite.com/oepr/files/2019/09/2019-2024-HPP-Requirements.pdf
  8. HEALTHCARE SURGE PLANNING GUIDE - Lacounty, accessed January 11, 2025, https://file.lacounty.gov/SDSInter/dhs/1029478_HealthcareSurgePlanningGuide20170926-Final.pdf
  9. LOS ANGELES COUNTY HEALTHCARE COALITION GOVERNANCE DOCUMENT 2012, accessed January 11, 2025, http://file.lacounty.gov/SDSInter/dhs/217042_HealthcareCoalitionGovernanceDocument.pdf
  10. NOTE - Lacounty - COUNTY OF LOS ANGELES, accessed January 11, 2025, https://file.lacounty.gov/SDSInter/bos/supdocs/193020.pdf
  11. Continuity Planning | California Governor's Office of Emergency Services - CA.gov, accessed January 11, 2025, https://www.caloes.ca.gov/office-of-the-director/operations/planning-preparedness-prevention/planning-preparedness/continuity-planning/
  12. Hospitals Hurting - Los Angeles Business Journal, accessed January 11, 2025, https://labusinessjournal.com/featured/hospitals-hurting/
  13. Doctors, nurses press ahead as wildfires strain Los Angeles' health ..., accessed January 11, 2025, https://www.news-medical.net/news/20250110/Doctors-nurses-press-ahead-as-wildfires-strain-Los-Angelese28099-health-care.aspx
  14. Los Angeles County Expands Surge Capacity with HPP Funds During COVID-19 Surge, accessed January 11, 2025, https://aspr.hhs.gov/HealthCareReadiness/StoriesfromtheField/Pages/Stories/LA-County-HPP-Funds-Essential-Resources-CA.aspx
  15. Los Angeles County 2020 HPP Recipient Fact Sheet - ASPR, accessed January 11, 2025, https://aspr.hhs.gov/HealthCareReadiness/HealthCareReadinessNearYou/Documents/2020%20FactSheets%20Archive/LAC_2020%20HPP%20Recipient%20Fact%20Sheet_508krb.pdf