EMERGENCY PREPAREDNESS AND	RESPONSE: MODEL POLICIES AND

PROCEDURES FOR STATE	LONG-TERM CARE	OMBUDSMAN PROGRAMS

Developed	by:

Office of Long-Term	Care Ombudsman Programs

Administration on	Aging

Administration for Community Living

U.S. Department	of Health & Human Services

November 23,	2015

CONTENTS

I. Purpose, Principles, and Responsibilities ....................................................................................3

A. Purpose of Model Policies and Procedures............................................................................3

B.	Principles................................................................................................................................4

C. Responsibilities in Developing and Implementing Policies and Procedures...........................5

II. Model Policies and Procedures ..................................................................................................6

100. Definitions ..........................................................................................................................6

200. Functions and Responsibilities ...........................................................................................7

200.1 State Unit	on Aging Functions and Responsibilities......................................................7

200.2 Ombudsman: Functions and Responsibilities...............................................................8

200.3 Agencies Hosting Local Ombudsman Entities: Functions and Responsibilities ............8

200.4 Representatives of the Office: Functions and Responsibilities.....................................8

300. Training...............................................................................................................................9

300.1 Training for Office Representatives..............................................................................9

300.2 Training Requirements .................................................................................................9

300.3 Training Tools .............................................................................................................10

400. Continuity of Operations..................................................................................................10

400.1 State Unit	on Aging (and Host	Agency, where applicable) .........................................10

400.2	Determining Capacity and Supports...........................................................................10

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400.3 Planning and Preparation ...........................................................................................10

400.4 Implementing the Continuity of Operations Plan.......................................................11

400.5	Individualized Emergency “Go Kits” ...........................................................................11

400.6 Ombudsman Program Information ............................................................................13

400.7 External Contacts Information....................................................................................13

400.8 Reminder System for Representatives of the Office ..................................................14

400.9 Communication Resources.........................................................................................14

400.10 Communication Priority Services..............................................................................14

401. Procedure Before an Anticipated Emergency ..................................................................15

402. Procedure During and After an Emergency (anticipated or not)......................................15

500. Coordination with Other Entities......................................................................................15

500.1 Ombudsman Ongoing Coordination...........................................................................16

500.2 Local Ombudsman Entity Ongoing Coordination .......................................................17

500.3 Coordination During and After an Emergency............................................................18

600. Ombudsman Program Services Related to Emergencies..................................................18

600.1 Adjustments in Response to Emergencies..................................................................18

600.2 Complaint	Processing .................................................................................................19

600.3 Providing Access to the Ombudsman Program ..........................................................20

600.4 Education and Outreach to Residents, Families, Other Resident	Representatives....20

600.5 Information and Consultation to Facility Providers....................................................21

Appendix: Resources....................................................................................................................23

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I. PURPOSE, PRINCIPLES, AND	RESPONSIBILITIES

Preparing for and responding to emergencies that	affect individuals living	in	long-term care

facilities requires coordinating the work	of many.	While	Long-Term Care Ombudsman	programs

(which will be referred to in this document	as Ombudsman programs, or the Office)	are not	first	

responders, they can play an important	role in emergency planning and response. Ombudsman

programs can resolve complaints, protect	rights, and promote access to services for residents

before,	during, and after emergencies and disasters.

Significant	weather events such as hurricanes and tornadoes, at	times, have devastated longterm care facilities and their residents across the country. Individual incidents—fires,

explosions,	floods, power outages and other disruptions—have forced residents to relocate.

Both state and local Ombudsman programs have been called on to assist	with preparation and

response, often without the benefit	of clear guidance or policies. The fact	that	Ombudsman

programs have risen to the challenges of emergency preparedness and response without	clear

guidance,	is evidence that	the Office staff are concerned, committed, and willing to assist	

residents.

A. PURPOSE OF MODEL POLICIES AND PROCEDURES

The Administration on Aging (AoA),	housed within the U.S. Department	of Health & Human

Services’ (HHS) Administration for Community Living (ACL), is responsible for administering

grants under the Older Americans Act (OAA).	The grants are for aging programs and services,

and include the Ombudsman program.1 AoA	is responsible	for developing policies and setting

priorities for the operation of programs authorized by the OAA. The OAA specifically requires

that programs authorized under the OAA develop plans for, and coordinate with, entities

responsible for emergency preparedness and disaster relief 2 through state and area	plans on

aging.	AoA has developed model policies and procedures for consideration by State Units on

Aging (SUA) and Ombudsman programs in order to support	the health, safety, welfare, and

rights of long-term care facility residents before, during, and after emergencies.

These model policies and procedures allow AoA to:

§ clarify appropriate functions and limitations of Ombudsman programs in preparing for

and responding to emergencies affecting long-term care facility residents;

1 Sections 201, 712	of the	Older Americans Act (OAA); codified as 42	U.S.C. 3011, 3058g. 2 OAA Sections 307(a)(29), 306(a)(17); 42 USC 3027(a)(29), 3026(a)(17).

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§ assist	Ombudsman programs in developing program policies and procedures related to

emergency preparedness,	response, and recovery activities; and

§ assist	SUAs and area	agencies on aging to incorporate the functions of Ombudsman

programs related to emergency preparedness for long-term care facility residents into

their emergency preparedness planning.

AoA	recognizes that the OAA does	not	authorize Ombudsman programs to serve as first	

responders in emergencies or disasters. In fact, the OAA does not	contain any specific	

provisions regarding (nor does	Congress	provide specific appropriations to AoA	for) activities

related to Ombudsman program emergency preparedness or response. However, the OAA and

federal regulations3 do require the Ombudsman program to provide services to assist	residents

in protecting their health, safety, welfare, and rights, as well as to represent	the interests of	

residents before governmental agencies.4 In order to fulfill these functions during and after

disasters and other emergencies, AoA advises Ombudsman programs to take measures to

prepare for such	emergencies. In support of emergency preparedness by states and their

Ombudsman programs,	AoA	recommends adoption of the	following model policies and

procedures (adapted as needed for state-specific applicability) for use by states’ Ombudsman

programs.

B. PRINCIPLES

Through these model policies and procedures,	AoA	intends to support	the following principles:

Resident-centered	focus: The Ombudsman program works with and on behalf of

residents, and represents the interests of residents, including when preparing for or

responding to an emergency.

System-level	representation	of	residents’ interests: The Ombudsman program

advocates visibly and effectively with and on behalf of residents, representing the interests of	

residents, both within the aging network and to other agencies involved in emergency

preparedness and management.

Coordination and	communication:	The Ombudsman program coordinates and

communicates with the aging network and other agencies involved in emergency

preparedness and management. The Ombudsman and representatives of the office are not	

first	responders,	but	coordinate with and follow directions of	first	responders.

3 45	CFR 1327 4 OAA Section 712(a)(3)(B),(E), 712(a)(5)(B)(iii), (iv); 42	USC 3058g(a)(3)(B), (E), 3058g(a)(5)(B)(iii), (iv);	45	CFR

1327.13(a)(1),(5), .19(a)(1), (4)

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Emergency	preparedness: At	every level, the Ombudsman program– the Ombudsman,

the Office, local Ombudsman entities [if applicable], and representatives of the Office – is	

organizationally and personally prepared for emergencies. Preparation includes an all-hazards

emergency preparedness plan encompassing continuity of operations and an individual

preparedness plan that	addresses unique needs and functions during an emergency. The

Ombudsman program engages and collaborates with the State Department	of Health (or

public health emergency preparedness and response equivalent) to improve situational

awareness, communication, and coordination where appropriate prior to, during, and after

an emergency or disaster.

C. RESPONSIBILITIES IN DEVELOPING AND IMPLEMENTING POLICIES AND

PROCEDURES

State	Unit	on	Aging–In establishing and operating the Office, the SUA shall ensure that	the

Ombudsman program has adequate policies and procedures in place.5 AoA encourages states

to include provisions	related to emergency preparedness,	response, and recovery activities

into Ombudsman program policies and procedures.

State	Long-Term	Care	Ombudsman–The Ombudsman shall establish or	recommend	

Ombudsman program policies and procedures.6 AoA encourages Ombudsmen to include

provisions	related to emergency preparedness,	response, and recovery activities into

Ombudsman program policies and procedures.7

Local	Ombudsman	entities – Ombudsman program policies and procedures must	be

developed	in consultation with the agencies hosting local Ombudsman entities,	where	

applicable, and with representatives of the Office.8

5 45	CFR 1327.11(e), .15(b) 6 45	CFR 1327.11(e), 13(b)(1) 7 45	CFR 1327.11(e) provides: “Where the Ombudsman has the legal authority to	do	so, he or she shall establish or

recommend Ombudsman program policies and	procedures,	in	consultation	with	the	SUA,	to	carry	out	the

Ombudsman program in accordance with the Act. Where State law does not provide the Ombudsman with legal

authority to establish policies and procedures, the	Ombudsman shall recommend policies and procedures to the	

SUA or other agency in	which	the Office is organizationally located, and	such	agency shall establish	Ombudsman	

program policies and	procedures.” 8 45	CFR 1327.11(e).

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II. MODEL POLICIES AND PROCEDURES

100. DEFINITIONS

Emergency – Any occasion or instance–such as a	hurricane, tornado, storm, flood, tidal wave,

tsunami, earthquake, volcanic eruption, landslide, mudslide, snowstorm, fire, explosion,

nuclear accident, or any other natural or man-made catastrophe–that	warrants action to

save lives and to protect	property, public health, and safety.9

NOTE: For purposes of these model policies and procedures, an emergency can also include

events that	affect residents locally, such as extreme temperatures, power outages, fires, etc.

NOTE: Under the Stafford Act, which provides authority for most	federal disaster response

activities, an emergency “means any occasion or instance for which, in the determination of

the President, Federal assistance is needed to supplement	state and local efforts and

capabilities to save lives and to protect	property and public	health and safety, or to lessen or

avert	the threat	of a catastrophe in any part	of the United States” (Stafford Act, Sec. 102(1),

42	U.S.C. 5122(1)).

First	Responder–Federal, state, and local emergency public safety, law enforcement,

emergency	response,	Emergency Medical System, hospital emergency facilities, and related

personnel, agencies, and authorities.

Long-Term	 Care	 Facility–Any skilled nursing facility, as defined in section 1819(a) of the

Social Security Act	(42 U.S.C. 1395i–3(a)); any nursing facility, as defined in section 1919(a)

of the Social Security Act	(42 U.S.C. 1396r(a)); a	board and care facility; and any other adult	

care home, including an assisted living facility, similar to a	 skilled nursing facility, nursing

facility or board and care facility.10

Memorandum	of	Understanding	or	Memorandum	of	Agreement–Document	

describing an agreement	between parties expressing an agreed upon course of action.

Office of	the	State	Long-Term	Care	Ombudsman–The organizational unit	in a	State or

territory headed by a	State Long-Term Care Ombudsman.11

Representatives	of	the	Office	of	the	State	Long-Term	Care	Ombudsman–The

employees or volunteers designated by the Ombudsman to fulfill the Ombudsman program

9 FEMA, Guide	For All-Hazard Emergency Operations Planning (SLG 101), 1996, p. GLO-2. 10 OAA Sec 102(a)(35); 42 USC 3022(a)(35). 11 45	CFR 1327.1

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duties, whether personnel supervision is provided by the Ombudsman or his or her

designees or by an agency hosting a	local Ombudsman entity designated by the

Ombudsman.12

Resident – An individual who resides in a	long-term care facility.13

State	Long-Term	Care	Ombudsman,	or	Ombudsman–The individual who heads the

Office and is responsible to personally, or through representatives of the Office, fulfill the

functions, responsibilities and duties set	forth in section 712 of the OAA.14

State	Long-Term	Care	Ombudsman	program,	Ombudsman	program,	or	program–

The program through which the functions and duties of the Office are carried out,

consisting of the Ombudsman, the Office headed by the Ombudsman, and the

representatives of the Office.15

200. FUNCTIONS AND	RESPONSIBILITIES

Policy: The Ombudsman program works to promote the health, safety, welfare, or rights of the

residents before, during, and after an emergency.

Procedure:

200.1	State	Unit	on	Aging Functions and	Responsibilities

a) Coordinate activities and develop emergency preparedness plans as required by section

307(a)(29) of the OAA.

b) Coordinate and communicate with the Ombudsman on relevant	emergency

preparedness issues.

c) Support	Ombudsman program emergency preparedness including, but	not	limited to:

information sharing, resource sharing, training, participating in	exercises, and facilitating

relationships with the State’s Healthcare Coalition,16 Department	of Health (or public

12 Id.

13 OAA Section 711(6); 42 USC 3058f 14 45	CFR 1327.1 15 Id.

16 A	healthcare coalition	is a group	of healthcare organizations, public safety and	public health	partners that join	

forces for	the common cause of	making their	communities safer, healthier	and more resilient. Coalitions are

forming all around the United States to support communities before, during	and after disasters and other crises.

http://healthcarecoalitions.org/

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health emergency preparedness and response equivalent), and other relevant	agencies

prior to, during, and after an emergency.

200.2 Ombudsman: Functions and	Responsibilities

a) Lead and manage the Office in coordination with the state agency and, where

applicable, any other agency carrying out	the Ombudsman program.

b) Assure that	the Ombudsman program is fulfilling the requirements of these policies and

procedures.	

Where applicable:

200.3 Agencies Hosting Local	Ombudsman	Entities:	Functions	and	

Responsibilities

a) Coordinate activities and develop emergency preparedness plans relevant	to its service

area	[and, for area	agencies on aging, as required by section 306(a)(17) of the OAA].

b) Coordinate and communicate with the Ombudsman and representatives of the Office

on	relevant	emergency preparedness issues.

c) Support the local Ombudsman entity with emergency preparedness including, but	not	

limited to: information sharing, resource sharing, training, participation in exercises, and

facilitation of relationships with local healthcare coalitions, public health agency, and

other relevant	agencies prior to, during, and after an emergency.

200.4 Representatives	of	the	Office: Functions	and	Responsibilities	

Prior to an emergency:

a) Develop preparedness plans as required by Policy 400 of this document.

b) Maintain knowledge of emergency preparedness through training as required by Policy

300.

During and/or after an emergency:

c) Follow emergency plans of Ombudsman program and of agency hosting local

Ombudsman entity, if applicable.

d) Follow instructions of public health officials and first	responders, including evacuation

orders, orders to shelter-in-place, and restrictions on accessing dangerous locations.

e) To extent	possible, continue providing residents with access to Ombudsman program

services.

f) Determine extent	of impact	on residents and long-term care facilities in service area,

while minimizing disruption to public health, first	responders and facility management	

and staff providing emergency response to residents.

g) Communicate observations and relevant	information to the Office.

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300. TRAINING

Policy:	The Ombudsman ensures that representatives of the Office are knowledgeable about	

their roles and responsibilities and possess appropriate skills related to emergency preparation

and response.	

Procedure:

300.1 Training	for	Office	Representatives

At	least	annually, the Office	offers	emergency preparedness and response training to

representatives of the Office statewide. Training may also be available in	an	on-demand,	webbased format.

300.2	Training	Requirements

Emergency preparedness and response training, at	a	minimum, includes the following topics.

a) Responsibilities of the Office and representatives of the Office before, during, and after

emergencies, as described in these policies, including:

i. communication and coordination with residents,	families, other resident	

representatives, and facility staff before,	during, and after an emergency;

ii. complaint	handling, including guidance regarding complaints frequently associated

with emergencies and, if applicable, changes to complaint	handling procedures

that	may be needed as a	result	of emergencies as set	forth in section 600.2; and,

iii. identification of issues for systems-level advocacy activities.

b) Responsibilities and local operations of	public health agencies, first	responders,

emergency management	agencies, and appropriate roles and responsibilities of	

representatives of the Office in coordinating with such entities prior to, during, and after

an emergency.

c) Responsibilities of	nursing	facilities, board and care, assisted living, and other similar

adult	care facilities before, during, and after emergencies,	including	review	of laws and

regulations governing facility preparedness and response.

d) Responsibilities of	state survey and certification and/or licensing agencies before,

during, and after emergencies.

e) Available federal, state, and local resources, including information clearinghouses and

registries, and how and when they can appropriately be accessed.

f) Overview of the Federal Emergency Management	Agency (FEMA), its resources and

tools.

g) Personal safety, individual preparedness plans, and preparation guidance.

h) Description of emergency types, including:

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i. all hazards emergency types of natural and human-caused disasters including

public health emergencies and natural disasters most	anticipated in the

geographic area;	and,

ii. facility-wide, all hazard emergencies affecting residents, including extreme

weather and temperatures, power outages, water-contamination,	and fires.

300.3	Training Tools

Training tools, at	a	minimum, comprise the following.

a) A tool kit including:

i. emergency preparedness checklists, including those prepared by the HHS’ Centers

for Medicare & Medicaid Services (CMS); and,

ii. resource lists and/or templates for local emergency preparedness and response,

and program emergency preparation and response policies and procedures.

b) A train-the-trainer module to replicate this training as needed to train representatives of	

the Office, when applicable.

400. CONTINUITY OF OPERATIONS

Policy:	The Ombudsman prepares the Ombudsman program to function as fully as possible

during an emergency and remain capable of fulfilling its resident-centered responsibilities.

Procedure:

400.1	State	Unit	on	Aging	(and	Host	Agency,	where	applicable)

The Ombudsman coordinates with SUA and, where applicable, with the host	agency of the

Office to plan and prepare for an emergency.

400.2	Determining	Capacity	and	Supports

The Ombudsman coordinates with representatives of the Office and,	where	applicable, with

local Ombudsman entities to determine capacity and the support	needed	to plan and prepare

for	emergencies.

400.3 Planning	and	Preparation

Representatives of the Office coordinate with their respective host	agency and, where	

applicable, with the Ombudsman to plan and prepare for an emergency.

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400.4	Implementing	the	Continuity	of	Operations	Plan

The Ombudsman program implements the continuity of operations plan described in 400–402	

to meet	operational needs at	the state, local and individual level.

400.5 Individualized	Emergency	“Go Kits”

The Ombudsman and each representative of the Office develop and maintain an individualized

emergency	Go	Kit that	includes,	at	a	minimum:17

17 See	www.ready.gov for	more information on Go Kits and resources for	both personal and business emergency

planning,	including interactive	tools	and	worksheets	that	may	be	relevant	to Ombudsman program work

environment.

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TA KE WITH	YOU KEEP IN A	 GO KIT O R IN A	 VEHICLE 	

Identification	and	charge cards	

ü Organization identification card

ü Driver’s	license

ü Organization travel card, if applicable

ü Personal charge card

Personal	contact	numbers	

ü Emergency phone numbers and

addresses (e.g., relatives, medical

doctor, pharmacist)

ü Cash, small amount

ü Sufficient	water and food for two weeks

(i.e. bottled water, non-perishable food

such as tuna, granola, dried fruit, etc.)

ü First	Aid Kit

ü Flashlight

ü Maps of surrounding area	

ü Clothing

ü Gloves

Medical/functional needs	 ü Toiletries, hand sanitizer

ü Insurance information ü Pet	food

ü List	of allergies/medical conditions and Vehicle	specific	items

blood type ü Traction gripper such as kitty litter

ü Hearing aids and extra	batteries ü Small shovel

ü Glasses/contact	lenses ü Blanket, gloves,

ü Extra	pair of eyeglasses/contact	lenses ü Charger

ü Copy of prescriptions ü Booster cables

ü Prescription drugs ü Emergency flares

ü Over-the-counter medications and ü Fluorescent	distress flag

dietary supplements ü Attempt	to maintain a	half a	tank of gas

ü Any assistive technology needed for at	all times

functional limitations

Communication	equipment

ü Organization cell phone /pager/

BlackBerry

ü Laptop

ü Personal cell phone

ü Chargers/extra	batteries for phones,

laptop, etc.

ü Pen and paper

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400.6 Ombudsman Program	Information

The Ombudsman program maintains, and regularly updates, an electronic and hard copy of	

Ombudsman program-related information, which includes, at	minimum:

a) contact	information for the Ombudsman, representatives of the Office (both staff and

volunteer), State	Ombudsmen from other states;

b) copy of	Ombudsman laws, regulations, program policies and procedures, including

emergency preparation and response policies and procedures;

c) copy of Ombudsman training manual;

d) business	cards;

e) Ombudsman program brochures	and/or other outreach materials;	and,

f) Ombudsman program forms, such as consent	to access and disclosure forms.

400.7 External Contacts	Information

The Ombudsman program maintains and regularly updates both an electronic and hard copy of

relevant	agencies contact	information, including the following.

State

Relevant	state entities or agencies may include:

a) State Unit	on Aging

b) State survey and certification and/or licensing agencies

c) State Public Health Agencies

d) State Emergency Management	Agency

e) Governor’s	Office

f) State National Guard

g) State Healthcare Coalition

Federal

Relevant	federal agencies may include:

a) Department	of Health and Human Services (HHS) including but	not	limited to:

o Administration for Community Living (ACL)

o Assistant	Secretary for Preparedness and Response (ASPR)

o Centers for Medicare and Medicaid Services (CMS)

o Centers for Disease Control and Prevention (CDC)

o Substance Abuse and Mental Health Services Administration (SAMHSA)

b) Department	of Homeland Security (DHS) Federal Emergency Management	Agency	

(FEMA)

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Local

a) Local public health agencies

b) Legal services, adult	protective services, and other relevant	agencies available for

resident	referrals

c) Local healthcare coalitions

d) Utility companies

e) American Red Cross (local chapters)

400.8 Reminder	System	for	Representatives	of	the	Office

The Office implements a	system to remind all representatives of the Office to review and restock their individualized Go Kits and to send any updated contact	information semi-annually.

400.9	Communication Resources

The Ombudsman annually assesses the need for Ombudsman program communication

resources and develops guidelines for their use by the representatives of the Office in order to

maintain communication before, during (if possible) and after a	disaster. Relevant	

communication resources may include:

a) Landline phones (not	cordless),

b) Mobile phones,

c) Smart	phone apps (e.g. Facebook Safety Check, Twitter, etc.),

d) Websites, other social media	tools,

e) Satellite phones,

f) Ham radio through amateur radio associations,	

g) Other as available or identified by the Ombudsman.

400.10 Communication Priority	Services

The Ombudsman annually assesses the need for priority service enrollment of	Ombudsman

program communication resources. The Ombudsman also facilitates resource	procurement	and

guidelines	for	use,	including	evaluating the need for these services at	the state and local level.

Priority services for communication include the following resources:	

a) Telecommunications Service Priority for telecommunications circuits restoration,

b) Government	Emergency Telecommunications Service for landline telephones,

c) Wireless Priority Service, and

d) Other state and local alerts and services, as available.

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401. PROCEDURE BEFORE AN ANTICIPATED EMERGENCY

Before an anticipated emergency,	the Ombudsman shall:

a) implement	appropriate emergency plans; including coordination with other entities

described in Section 500;

b) monitor the situation for continued decision-making;

c) work to ensure situational awareness, coordination and collaboration with all relevant	

agencies i.e., public health and emergency management	agencies, healthcare coalitions,

etc.

d) communicate with representatives of the Office to determine their capacity to carry out	

Ombudsman program services; and,

e) facilitate coordination among local Ombudsman entities, where applicable.

402. PROCEDURE DURING	AND	AFTER AN EMERGENCY (ANTICIPATED	OR	NOT)

During and after an emergency, the Ombudsman shall:

a) obtain information regarding affected facilities and/or geographic areas and impact	of

the emergency on facility residents;

b) coordinate with the SUA, or the host	agency, if applicable, and other entities engaged in

the emergency response;

c) maintain communications with local Ombudsman entities, if applicable, and

representatives of the Office in the impacted geographic area; and

d) provide	technical assistance and support,	such as:

i. coordination to determine availability of representatives of the Office from other

service areas,	and

ii. provision of consultation and other services by telephone or other remote means

to residents, families, and other resident	representatives by the Office and/or local

Ombudsman entities from other service areas, if applicable.

500. COORDINATION	WITH OTHER	ENTITIES

Policy:	The Ombudsman program coordinates with relevant	entities before, during, and after

emergencies and represents the interests of residents.

Procedure:

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The Ombudsman analyzes the level of need for involvement	of the Ombudsman program in

multi-state, state, regional, and local emergency planning. The Office	becomes involved	in	such	

planning before,	during, and after an emergency as determined by the Ombudsman.

500.1 Ombudsman Ongoing Coordination

a) The Ombudsman communicates and coordinates with relevant	state officials and

regional representatives of federal agencies regarding ongoing emergency planning, to

prepare for anticipated emergencies and to coordinate response during an emergency.	

i. Relevant	state entities may include:

§ State Unit	on Aging

§ State survey and certification and/or licensing agencies

§ State Public Health Agencies

§ State Emergency Management	Agency

§ Governor’s	Office

§ State National Guard

§ State Healthcare Coalition

ii. Relevant	federal agencies may include:

§ Department	of Health and Human Services (HHS) including but	not	limited to:

- Administration for Community Living (ACL)

- Assistant	Secretary for Preparedness and Response (ASPR)

- Centers for Medicare and Medicaid Services (CMS)

- Centers for Disease Control and Prevention (CDC)

- Substance Abuse and Mental Health Services Administration (SAMHSA)

§ Department	of Homeland Security (DHS) Federal Emergency Management	

Agency (FEMA)

b) The Ombudsman participates with non-governmental organizations for emergency

planning and assistance.

i. Relevant	organizations may include:

§ National and state and local long-term care provider associations

§ Long-term care facility corporate leaders

§ American Red Cross

§ Association of State and Territorial Public Health Officials

§ National Association of County and City Health Officials (NACCHO)

§ Association of Area	Agencies on Aging

c) The Ombudsman communicates and coordinates by:

i. Informing agencies of	the role, responsibilities, and functions of the Ombudsman

program with respect	to emergency preparation and response, including, at	a	

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minimum, the complaint	process and information and consultations to residents,

their families, other resident	representatives, and facility staff.

ii. Attending or assisting with development	of	joint agency planning, trainings, and

emergency	exercises.

iii. Participating in the state emergency planning team as part	of the public health and

emergency	management	operations center,	when appropriate, and serving as a	

visible advocate of resident’s interests.

iv. Maintaining familiarity with residential facilities registries.

v. Maintaining familiarity with state’s Central Clearinghouse of Information—used	

during emergencies to keep track of bed availability through the National Hospital

Beds for Emergencies and Disasters (HavBED)--to address residents sheltering in

place, and resident	transfers to mass care shelters, hospitals, or other congregate

care facilities.

vi. Clarifying the responsibilities and limitations of the Ombudsman program in	

contributing to and updating information contained in the Central Clearinghouse

of Information.

vii. Developing educational preparedness materials for residents and families and

supporting coordinated messaging.

viii. Discussing systems issues with provider associations related to emergency plans

with attention to residents’ rights and preferences and collaborating on relevant	

legislation, regulations, policies, and training opportunities.

ix. Informing provider associations of available registries, such as a	“clearinghouse of

information,” and which agency manages them, and the procedures for their

utilization.

d) The Ombudsman is responsible for communicating and coordinating with other State

Ombudsman programs as necessary (i.e., nearby states or regions) regarding emergency

planning, information sharing, and resource sharing when it	is anticipated that	residents

will be relocated across state lines.

Where applicable:

500.2	Local	Ombudsman	Entity	Ongoing Coordination

a) Local Ombudsman entities communicate and coordinate by:

i. Informing local agencies of	the role, responsibilities, and functions of the

Ombudsman program with respect	to emergency preparation and response;

include, at	a	minimum, the complaint	process and consultations to residents, their

families, other resident	representatives, and facility staff.

ii. Attending or assisting with development	of joint	agency planning, trainings, and

emergency	exercises.

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iii. Participating in the local emergency planning team and serving as a	visible	

advocate of resident’s interests.

500.3	Coordination	During	and	After	an	Emergency

a) The Ombudsman program facilitates resident	access to response and recovery efforts

and resources when	needed, including through providing information and consultation

to facility staff.

b) The Ombudsman program advises the Health Care Coalition and similar organizations on

outreach and effective service provision to improve accessibility for residents.

c) The Ombudsman analyzes strengths, weaknesses, opportunities, and challenges faced in

response to the emergency in order to facilitate improvements and to plan for future

emergencies. The Ombudsman also shares the findings with appropriate agencies.

d) The Ombudsman conducts systems-level advocacy to address gaps in	resident-centered

emergency preparedness including development	and maintenance of information

clearinghouses and registries.

600. OMBUDSMAN PROGRAM SERVICES RELATED TO EMERGENCIES

Policy:	The Ombudsman program assists residents, their families other resident	

representatives, and facilities in preparing for and responding to emergencies. It continues to

provide resident-centered ombudsman services to the extent	possible despite, and in	response

to, an emergency.

Procedure:

600.1 Adjustments	in	Response to	Emergencies

a) The	Ombudsman assesses Ombudsman program procedures and standards applicable

to the delivery of services under normal operating conditions and determines if	there is

a	need to make adjustments in response to emergencies.

b)	 Procedures and standards are adjusted in collaboration with the SUA, and are

communicated, as relevant, to impacted area agencies on aging, local Ombudsman

entities and/or representatives of the Office.

c)	 Such adjustments may include temporary changes to procedures or standards,

including, but	not	limited to:

i. timely response to complaints;

ii. facility coverage through visits to residents;

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iii. access by representatives of the Office to residents, and ability to provide

ombudsman services, in	non-facility settings to which residents may have been

relocated, such as emergency shelters, FEMA’s Individual Assistance programs

and Disaster Recovery Centers;

iv. coordinating with the SUA and, where applicable, with agencies hosting local

Ombudsman entities to coordinate representatives of the Office in providing

services outside of the geographic boundaries of their service areas; and,

v. suspension	of	some Ombudsman program services, such as presentations to

resident	or family councils, or community education, except	as those activities

support	emergency response efforts.

600.2 Complaint Processing

a) The Ombudsman assesses complaint	intake, response, investigation, referral, and

resolution procedures and standards applicable under normal operating conditions and

then determines if adjustments are needed in order to respond to emergencies. The

complaint	process during emergencies shall continue to reflect	the primacy of the

resident’s goals, wishes and determination of satisfaction with the resolution, as

required by 45 CFR	1327.19(b).

b) The Ombudsman program maintains complaint processing practices regarding

disclosure of resident	or complainant identifying information, as required by 45 CFR	

1327.19(b). Informed	consent	is	obtained to the greatest	extent	possible with

consideration of the specific circumstances of each emergency.

c) The Ombudsman shall provide technical assistance and support	to representatives of

the Office on	working with entities not	familiar with complaint	processes and resident	

rights such as emergency shelters, and first	responders.

d) The Ombudsman shall provide training and technical assistance to assure the

competency of representatives of the Office to process complaints frequently

associated with emergency response and recovery, such as:

i. relocation and evacuation with accessible transportation;

ii. wishes related to returning to the facility or to move to other settings;

iii. quality of care;

iv. access to medications;

v. access to resident	medical and social records;

vi. security concerns;

vii. access to durable medical equipment;

viii. residents who cannot	be immediately located and reunification assistance

services;

ix. loss of residents’ personal belongings;

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x. access to FEMA’s Individual Assistance programs or other eligible	recovery	funds;

xi. utility response time to power outages;

xii. pets or service animals; and,

xiii. emergency management	response.

600.3 Providing	Access to the	Ombudsman Program	

The Office facilitates Ombudsman program visitation to residents for	services, both in

emergency shelters and in facilities, as soon as possible after the emergency continuing on a	

regular basis until residents and facilities recover. Procedures may include the following:

i. Coordinating among local Ombudsman entities,	where	applicable, and/or other

states’ Ombudsman programs, when residents must	evacuate out	of the state or

to a	different	part	of the state.

ii. Providing	alternative means of providing access (e.g.,	telephone, e-mail) when

visits are impractical or	impossible (such as due to impassable roads or other

safety hazards).

iii. Providing	instructions to representatives of the Office regarding reporting of

emergency-related information to the Office. Reports may include, for example:

§ describing the impact of the emergency,

§ needed areas of service or advocacy, and

§ whether the facility has reported to the agency coordinating the Clearinghouse

of Information.

600.4 Education and	Outreach	to	Residents, Families,	and	Other	Resident	

Representatives

Policy:	The Ombudsman program assists residents, families, and other resident	representatives

in preparation for emergencies.

Procedure:

a) The Office	provides technical assistance and resources to assist representatives of the

Office to educate to residents, families, and other resident	representatives in order to

raise awareness about	emergency planning.

b) Representatives of the Office shall provide resident	and/or family education during

resident visits, during resident	or family council meetings, or through other

mechanisms. The content	of such education shall include, but	not	be limited to:

i. responsibilities of facility staff (e.g. evacuation plan, family notification, and

reunification),	

ii. responsibilities of first	responders, health care and behavioral health providers,	

and other relevant	parties during an emergency; and,

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iii. distribution and promotion of the CMS emergency planning checklist	and/or

similar long-term care facility-focused checklists.

c) Representatives of the Office shall support	resident	and/or family councils in	emergency

preparedness by:

i. developing	goals to conduct	outreach to resident and family councils annually;

ii. providing a	ready-made presentation, recommended materials, other talking

points and a	mechanism to track which councils/facilities have received this

training;

iii. encouraging and facilitating councils’ involvement	in facility emergency	

preparations and exercises (e.g. evacuate, shelter-in-place, point	of distribution,

etc.); and,

iv. providing assistance or referrals when requested.

d) The Office shall assure that	representatives of the Office have access to resources to

assist	them in meeting the requirements of these procedures,	including:	

i. ready-made presentations for use in training or discussions;

ii. CMS Emergency Planning Checklist and/or similar long-term care facility-focused	

checklists; and,

iii. guidance on how to obtain facility-specific emergency plans and procedures.

e) During or immediately after an emergency, the	Office shall utilize a	variety of methods

and communication tools to disseminate regular updates on the status of an

emergency. Tool and methods will depend on the circumstances of the emergency.

These methods may include, but	are not	limited to:

i. Ombudsman program and/or related websites,

ii. Ombudsman program telephone helpline,

iii. media	announcements, and/or

iv. social media.

f) During or immediately after an emergency, the Office will give representatives of the

Office materials describing how the Ombudsman program can be a	resource to

residents, families, other resident	representatives, and facility to facilitate access to

recovery	services.

600.5	Information	and	Consultation to	Facility Providers

Policy:	The Ombudsman program provides information and consultations to long-term care

facility providers	to support	resident-centered emergency planning and response.

Procedure:

a) The Ombudsman provides information to provider associations, and representatives of

the Office consult	with facility leaders, on emergency planning as follows:

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i. Informing facility providers of the responsibilities of the Ombudsman program in

responding to emergencies,

ii. Informing facility	providers of emergency preparedness and recovery resources,

including, but	not	limited to:

§ CMS Emergency Planning Checklist and/or similar long-term care facilityfocused	resources, training resources,

§ Opportunities to participate in Health Care Coalitions and

§ resources to support resident	access to recovery funds.	

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APPENDIX: RESOURCES

THE NATIONAL LONG-TERM CARE OMBUDSMAN RESOURCE	CENTER

Emergency Preparedness Resources

Ombudsmen-Before, During & After

Emergency	Management	Dictionary

Ombudsmen Communications

Ombudsman Training

Smart	Phone Apps for Ombudsman

CENTERS FOR MEDICARE	AND MEDICAID SERVICES

Emergency Preparedness Checklist: Health Care Facility

Emergency Preparedness Checklist: Persons with Medical Needs Living at	Home

Emergency Preparedness Checklist: Residents, Families, and Ombudsmen

Medicare: Getting Medical Care and Prescription Drugs in a	Disaster or Emergency Area

DEPARTMENT OF	HOMELAND SECURITY COMMUNICATIONS TOOLS

Priority Telecommunications Services Brochure

Government	Emergency Telecommunications Service Fact	Sheet

Telecommunications Service Priority Fact	Sheet

Wireless Priority Service Fact	Sheet

Continuity Guidance Circular 1 (CGC 1)

FEDERAL	EMERGENCY MANAGEMENT	AGENCY FACT	SHEETS

Preparation:

Plan, Prepare, Mitigate

Response/Recovery:

Incident	Command Structure Resource Center

Disaster Assist	Website

Access to Disaster Help and Resources Fact	Sheet

Disaster Survivor Application Checklist	Fact	Sheet

Disaster Recovery

SUBSTANCE ABUSE AND	MENTAL	HEALTH SERVICES ADMINISTRATION

Disaster Technical Assistance Center Brochure

Disaster Distress Helpline Brochure

23