COOP Planning Becomes Major Concern for Healthcare Facilities

For the uninitiated, a continuity of operations or “COOP” plan can be intimidating to understand, develop, and operationalize. The process may seem daunting, but a solid understanding of what is entailed and who should be involved can simplify the process significantly. 

COOP allows for the continuation of the essential functions of government departments or agencies during any incident or emergency that may disrupt normal operations. COOP addresses the recovery of critical and essential government operations in the event of an emergency. The disruption could be short-term – caused by a power failure, for example – where possessing a backup capability (e.g., systems, personnel, processes, and files) might quickly resolve the situation. It also could be longer-term, though – perhaps in the wake of a natural disaster when services are affected for several days or, in some cases, weeks. In either case, the rapid availability of an effective COOP plan facilitates the performance of a health department’s functions both during and after an unforeseen emergency or other situation that may interrupt normal services.

A health department’s COOP plan can be activated during any type of emergency or disaster that affects staffing levels with the understanding that, depending on the outside entities and organizations likely to be involved, help may not be available for some period of time (usually ranging from a minimum of 48 hours to perhaps several weeks). The overarching goal remains the same, though: to determine how to keep critical functions going when the staff and/or usual healthcare facilities available are “out of commission” for any of several reasons.

The development and retention of adequate COOP capabilities requires substantial effort. For that reason alone, COOP plans should be developed and maintained using a multi-year attitude and process – which should, among other things: (a) outline the progression the agency will follow to designate essential functions and resources; (b) define both short- and long-term COOP goals and objectives; (c) forecast budgetary requirements; (d) anticipate and address possible problem areas and potential obstacles; and (e) establish planning milestones.

“Doability” Trumps Theoretical Every Time It is important that COOP not simply be a paper plan. Arrangements must be made to guarantee the availability of the space and equipment needed – for alternate-site operations, for example. Without actual buildings and equipment – not to mention staff – COOP plans might be perfect in theory, but would be operationally worthless in a real time of crisis.

In the field of public health entities, a COOP plan offers guidance for health departments on practices that will make the continuation of critical services possible even with a limited number of staff as well as, if and when necessary, the shifting of some staff from non-critical services to other higher-priority functions. There are many elements involved with the effective development and implementation of an effective public health COOP plan, including but not limited to the following:

Creating a plan and procedures that address all-hazards assumptions – This primarily entails assembling the optimum members of a planning team: decision makers who fully understand the department and its capabilities as well as its truly critical functions;

Identifying critical functions and services – This element consists of: (a)entification of the services each public health program provides, on a regular basis, in a specific branch or division within the health department; (b) categorization of each public health program’s service, usually under one of the so-called “4Rs” – Reinforce, Run, Reduce, and Remove – in order to reduce or remove as many non-essential services as possible; and (c) ranking and prioritizing the order of importance of the health services needed in each program during times of emergency.

Identifying key personnel and orders of succession – This requires clearly outlining who will be responding during one of the aforementioned emergencies and what role that person (or persons) will play. A critical element here is to select the minimum number of local health department staff needed to carry out the services needed to continue in an emergency. (Additional points to consider include informing employees of the plan, ensuring that those employees have been properly trained, and planning for high employee absenteeism – as well as determining the feasibility of at least some staff working from home.)

Providing data support systems/vital records as well asentifying alternate facilities – This means locating specific public health entities that have significant physical plants available to house multiple functional units.

Identifying communication systems and emergency lists – This may be one of the last steps of the COOP planning process, but it is also one of the more crucial. Communication systems that will remain functional even when a large-scale emergency strikes must beentified and tested well in advance. In addition, emergency contact lists must be comprehensive – e.g., information about accounts, banks of record, landlords, insurance agents/companies, public works entities, media outlets, telephone companies – and constantly updated.

The COOP plan also should include an overall inventory list – e.g., all assets including their dates of purchase, initial cost, andentification/serial number – and a current list of employee contact information (including home phones, cell phones, and local addresses).

These are some but by no means all of the factors that must be taken into consideration when establishing an effective, and workable, COOP plan. The most important factor, though, is to ensure that the departmental leadership fully understands the need for and purpose of a COOP plan, and makes development and implementation of the plan a high priority. One final point: COOP must be a “living” plan, which means that its procedures and processes must be not only updated but also practiced on a regular basis.

Raphael Barishansky

Raphael M. Barishansky, DrPH, is a public health and emergency medical services (EMS) leader with more than 30 years of experience in a variety of systems and agencies in positions of increasing responsibility. Currently, he is a consultant providing his unique perspective and multi-faceted public health and EMS expertise to various organizations. His most recent position prior to this was as the Deputy Secretary for Health Preparedness and Community Protection at the Pennsylvania Department of Health, a role he recently left after several years. Mr. Barishansky recently completed a Doctorate in Public Health (DrPH) at the Fairbanks School of Public Health at Indiana University. He holds a Bachelor of Arts degree from Touro College, a Master of Public Health degree from New York Medical College, and a Master of Science in Homeland Security Studies from Long Island University. His publications have appeared in various trade and academic journals, and he is a frequent presenter at various state, national, and international conferences.

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