SMALL REMINDERS

Determine upfront what facility type your management will support. Medical experts may want to pursue facilities that best meet CDC guidance which tend to be privately owned, inhabited, modern facilities. Others may favor the use of publicly owned facilities, even if they were less optimal. Midway, we changed our approach and thoroughly explored all potential public facilities before approaching private partners, such as hospitals, hospices, motels, etc.

Facilities siting should be closely linked to work conducted by your surveillance and communicable diseases epidemiologist teams. They will be the entry point for individuals whose homes won't work for I & Q.

CONSIDER MULTIPLE TYPES OF FACILITIES

To meet a variety of needs such as isolation, quarantine, mass patient care, and/or mass acute care, we chose to develop a range of facility options across the continuum:

  1. A single motel-type facility with 75 rooms for a small outbreak requiring isolation and/or quarantine alone.
  2. A secure facility for isolation of noncompliant persons.
  3. A processing facility (no one would spend the night there) at our international airport to meet "sick planes."
  4. We are also exploring the feasibility of using alternate care facilities, in partnership with our hospitals and neighboring counties, to address massive isolation and quarantine and/or massive patient care needs.

Facility Search

We used the following steps in our facility site search process. A Facilities Needs Assessment was conducted and produced helpful results for planning. Although the following steps may not follow a succinct order, the Needs Assessment and these steps outlined below provide a starting point for your planning considerations.

  1. Determine what needs you want your facility to meet: isolation, quarantine, mass patient care, and/or mass acute care.
  2. Identify the array of facility options available.
  3. Work with leadership in your organization to identify what potential options they support.
  4. Identify any specific public facilities (city, county, state) that are available.
    HINT: As public support for the developmentally disabled and mentally ill populations diminishes, states are likely to have facilities originally built for these populations sitting empty.
  5. Identify any specific private facilities that may be available.
  6. Develop strategic partnerships.
    HINT: Hospitals providers may be enthusiastic about collaborating on an alternate care facility model because it could meet their need to protect hospital resources for in-patient care, in addition to potential use as an isolation/quarantine facility.
  7. Recognize the potential for stigma associated with site selection.
    1. Determine the potential long-term impact of your choices.
    2. Determine your liability.
    3. Determine how you can mitigate that liability.
    4. Accept that there may not be a one-size-fits-all approach to site selection. Nor is there necessarily a right or best answer. Plan for scalability and flexibility.
    5. Assess the suitability of potential sites.
      1. Conduct security assessment with law enforcement partners
      2. Conduct ventilation assessment with a mechanical engineer, environmental health staff, and your CD-Epi staff
    1. Develop specific objectives for your Facility Partner Agreement with a specific site.
      1. Identify roles and responsibilities for Public Health and site management.
      2. Identify the type of expenses you will and will not compensate.
      3. Identify how you will restore the site after use.