Moderator: Hello and
welcome everyone! This is Marcela Aguilar
from the Substance Abuse and Mental Health Services
Administration’s Disaster Technical Assistance
Center (or SAMHSA DTAC). I will be your host
for this webinar. Let’s begin with Promising
Practices in Disaster Behavioral Health, Legal
and Regulatory Authority. The webinar will feature Ms.
Terri Spear, Emergency Coordinator of the SAMHSA
Office of Policy, Planning and Innovation. Dr. Amy Mack, Project
Director of SAMHSA DTAC and Mr. Andrew Klatte,
Assistant Deputy Director of the Office of Addiction Services
and Disaster Management in the Indiana Family and Social
Services Administration. We will start with
Ms. Terri Spear. Ms. Spear serves as Emergency
Coordinator in the Substance Abuse and Mental Health Services
Administration, Division of Policy Coordination where she coordinates the SAMHSA response in emergency situations,
including ensuring cross SAMHSA coordination regarding terrorism
and mass trauma events. She serves as the primary SAMHSA
liaison with counterparts in other federal, state, local
and voluntary agencies, organizations and governments participating in crisis response operations. Ms. Spear earned a masters
of education in counseling psychology from the
State University of New York at Buffalo. Please welcome Ms. Terri Spear. Ms. Spear: Thank you. SAMHSA wishes to welcome all of
those accessing this webinar. The development of this series
is directly linked to the efforts SAMHSA included in its
March 2011 document, Leading Change, A
Plan for SAMHSA’s Roles and Actions 2011-2014. SAMHSA introduces eight new
strategic initiatives that will guide SAMHSA’s work to help
build strong communities, prevent behavioral
health problems and promote better health. This initiative falls
under trauma and justice. Just today, which is August
2011, a report was released indicating with four months
remaining in the year 2011, the United States has already
tied its yearly record for the number of weather disasters with
greater than $1 billion dollars or more of economic loss. This probably is not coming
as a surprise to anyone in the disaster field. However, research has shown that
18.9 percent of men and 15.2 percent of women in the U.S.
reported a lifetime experience of natural disasters. We also know that over the
past ten years the number of disasters occurring across the
country ranges between 65 and 100 federally declared
disasters and that many more occur that are not declared. The role of planning is
more clear now than it has been in previous years. Planning is of utmost importance
and this series is focused on disseminating the best of
what is known, equip the best response possible with
the resources at hand. Today’s program is roughly 60
minutes in length and is the seventh in a series
of nine webinars that are being produced. Moderator: Thank you
so much Ms. Spear. I would now like to
introduce Dr. Amy Mack. Dr. Mack is trained as a
clinical psychologist and has been the SAMHSA DTAC project
director since September 2009. She has worked in the public
and private sectors, often addressing issues of
violence and trauma. She’s managed evaluation
studies and program development projects to build capacity of
professionals in the fields of mental health and public
health and emergency management. Please welcome Dr. Amy Mack. Dr. Mack: Thank you
and hello everyone. For those of you who are joining
us for this series, if you have joined us before, welcome back
and for those of you who are with us for the
first time, welcome. I would like to follow up as to
what Terri just shared in terms of thinking about planning
materials that do exist, part of what I wanted to take a few
minutes to do is to let you know about materials that we
have at SAMHSA DTAC. Basically SAMHSA DTAC’s mission
primarily is to provide training and technical
assistance to states, territories and tribes so that
they are prepared for and able to respond to disaster
behavioral health needs. For a point of clarification,
when I use the term disaster behavioral health, or DBH please
note that this term is referring to both mental health and substance abuse issues. As you can see on the screen, we
have a brochure and you can download it for free
from our website. I will provide the link
to that website shortly. On the next slide you will see
an overview of these three different areas of free
services that we offer. They include consultation and
training and that relates to things focused on disaster
preparedness and response, such as, compassion fatigue training
and also working with special populations such as children and youth, older adults, tribes and people with disabilities or
access and functional needs. We also have dedicated training
and technical assistance for presidentially declared disaster grants, such as the FEMA crisis counseling assistance
and training program, also known as CCP. We also have identification
and promotion of promising practices. A great example of this
is this webinar series that we have been producing. We also wanted to make sure that
everyone is aware of the free resources we have on our website
that are available to you. As you see on the slide, this
webpage is of the disaster behavioral health information
series, also known as DBHIS. Here you can find tip sheets,
fact sheets, booklets and other materials about DBH preparedness
and/or response, information about specific kinds of
disasters such as floods, tornadoes, hurricanes and so
forth and also information on the specific populations, some of which I mentioned earlier. On the next screen is the list
of our various e-communications. We have The Bulletin, which is
our monthly newsletter and it contains relevant resources
to particular topics that are current. For example, with the hurricane
season coming soon you will see The Bulletin will focus
on resources related to the hurricane season. We also have The Dialogue, which
is our quarterly publication which is written by
disaster behavioral health professionals in the field. Lastly, our discussion board,
this is a great mechanism for DBH professionals to ask
questions of each other, share comments and information and really discuss DBH related topics with each other. Ways to subscribe
are on your screen. Last, as promised here is
our contact information. If you would like to request
training or technical assistance for you or for your staff
please either call the toll free number or email us. Of course, be sure to visit our
website too and as always, if you would like to
contact me directly please feel free to do so. My contact information
is on the screen. Moderator: Thank you Dr. Mack. I would now like to
introduce Mr. Andrew Klatte. Mr. Klatte has worked in the
field of mental health and developmental disabilities for
28 years, the past 21 years of which were with the
state of Indiana. He is a nationally known
speaker and has presented on the topics of psychological
aspects of terrorism, disaster preparedness and mental
health planning and response. Mr. Klatte was the point person
for the mental health teams that were deployed to Mississippi
following hurricane Katrina and to Haiti following the
earthquake in 2010. He is also the Director of
Project Aftermath, which is supported by the crisis
counseling assistance and training program and has
responded to 11 major, federally declared disasters in
Indiana since 1997. Please welcome Mr. Klatte. Mr. Klatte: Thank you very much
and thank you to SAMHSA DTAC for hosting this most
important webinar. As we begin to put our disaster
behavioral health plans together, one of the areas that
is most important is to make sure that we have the
appropriate authority to act. This authority can take
many shapes and sizes. The reason why we need this
authority is because it really helps us to begin to
understand the whole disaster response system. What DTAC did with their
emerging practices the last few months is that they have looked
at a number of state plans. They found some indicators of
what a plan should have as far as types of legal authority. This would include citations
of that legal authority, the process for developing and
how quickly you can obtain a memorandum of understanding
or a mutual aid agreement. An issue that we all have to
deal with, whether you are in fire or emergency medical
services or in disaster behavioral health is how is
liability addressed in our plans and how does
insurance work, how does workman’s compensation work. Since we are not doing the
traditional type of therapies, mental health therapies or
substance abuse therapy, what about confidentiality and
informed consent; how is this maintained and
how is informed consent obtained following a disaster. Why is it important that we
look at the issues of legal and regulatory authority? All responders who respond to a
situation or an event are doing so under some type
of legal authority. As I said before, these legal
authorities may take on different shapes of the law or
statute or code or policy or maybe an MOU between agencies
or a mutual aid agreement. The city or county and local
jurisdictions may take the form of an ordinance or on the state
level, an executive order or directive of some type. By having this type of legal
authority it really helps to minimize the confusion of who
will respond, what jurisdiction is in command, and when
and where is the help or assistance coming from. Those of us providing disaster
behavioral health response, what we really need to do is mirror
what is being done in all fields of disaster response. Let’s begin by looking at what
statutes are out there that address disaster response. The first slide that we are
going to look at will address the federal response. We have the legal authority
through the comprehensive emergency management plan. We have the Stafford Act
which also has listed under that the crisis counseling program,
disaster mental health. We have other access support,
the federal government on what they can and will do following
any type of disaster. We have the National Response
Framework and that is similar to what each state and local
jurisdiction has, part of the comprehensive emergency
management plan. This plan, like their
counterparts at the state and local level, include all 18
emergency support functions. Please be reminded that
behavioral health is under the emergency support
function eight. When we look at what is
available at the state level all states have a statute, and I am
sure this is true for your state, that addresses who and what type of responder will respond after any type
of disaster event. Each state, all 50 states and
territories are now members of the EMAC, which is the emergency
management assistance compact. What this does is give states
the ability to request from other states assistance
following large scale disasters and those states that are coming
into provide that assistance are given liability protection,
given the fact that they can work under their
scope of practice by coming to that state. EMAC is a very important way of
having a response from another state and having that legal
authority to do that. Often the statutes that we have
at our state level, they also mirror the federal legislation. This would be an example of
the authority that the state would have in a
disaster response. The Governor’s executive orders
which would be very similar to a presidential directive, these
orders are often given soon after disasters, most of the
time in declaring a state a disaster the Governor will issue
an executive order mandating that all state agencies under the executive level will be able and working
in that disaster. States also have the
comprehensive emergency management plan that mirrors the
national response framework that they also include all 18
emergency support functions and in those, how the state
will provide that response. Again, disaster behavioral
health is listed under the ESF-8 at the local level as well. We really need to remind
ourselves that disaster events are local and they really do
require a bottom up response. That is the local response. The first response of these
events would rely on local ordinances for that local
responder to respond when the situation warrants it. Then there are mechanisms within
local jurisdictions that when triggered, when the event is
beyond that local government or tribal jurisdiction that would
then require the state to come in, just like there are triggers at the state response that when it is beyond the state control, to allow the federal government to come in and help. There are triggers in
these authorities. This would be the example on the
slide of local jurisdictions. Again, it would
mirror the state. Often in state statutes these
are the local ordinances or statutes or extensions of the
state statute, oftentimes creating local emergency management agencies and that sort of thing. All local jurisdictions just
like the federal and just like the state are required to have
a comprehensive emergency management plan that addresses all of those support functions. All 18 support functions are
listed and they also need to address the ESF-8, health and
medical which is where we will find the behavioral
health response under the ESF-8 support function. When we begin to develop our
disaster behavioral health plan, the legal authority, one of
the things I think is very important, it should
be clearly defined. We need to ask ourselves the
following questions: under what authority are you
developing your disaster behavioral health plan? Is it under a statute? Is it in code? Is it under an executive order? Is it a policy within
your agency? Memorandum of understanding, a
mutual aid agreement? As we work within the
comprehensive emergency plan it is very important for us to find
out who the lead agency is under emergency support function eight, health and medical. It may be your
health department. It may be your emergency
medical services. Are you currently working with
or have you identified who that ESF-8 agency is that you
are going to be working with? Is your plan being written as a
policy for your agency or is your plan a standalone
plan or is your plan-it could be all three. It could be a policy,
a standalone plan. It could also be an annex to
the state CEMP or the state ESF-8 plan as well. In Indiana in our disaster
behavioral health plan it is clearly stated in two places
where we are codified in state statutes. The disaster behavioral health
is mentioned in Indiana code as a responder so we are within
the state statute. We are a part of the overall
state emergency management plan disaster response. Disaster behavioral health is
mentioned and we have also developed within our own
department and through our own policy development committee and
has reviewed our state plan and all of our revisions with our
director signing off. In our plan, because it is
all one plan, it clearly defines who can respond. It clearly defines that we
will use and define the incident command system. It also includes procedures
imbedded into our plan that clearly state how and when
our disaster behavioral health teams will respond. Our plan is an annex
to our overall state emergency management plan. We also have an annex
to the ESF-8 plan. Both of these agencies, our
state Department of Homeland Security as well as the lead
agency for ESF-8 has reviewed our plan, their staff has
reviewed it and their leadership has signed off on our disaster behavioral health plan. That kind of gives us that level
of authority in order for us to make an appropriate response. The next few slides
are clearly listed. This is taken out of the Indiana
plan, what these legal citations would look like in a disaster
behavioral health plan. The executive order that is
listed on there, 0534059, those are executive orders that
were established declaring a state disaster and that
all state agencies would respond appropriately. For the next couple of slides it
lists what a legal citation would look like if it was a
part of your disaster behavioral health plan. Part of the reason why we are
looking at the authority and regulatory issue when it becomes
part of a disaster response is one of the issues that is
constantly brought up at responder training and
in policy meetings, the issue of liability. People want to know if they
respond, if their agency responds, if the state asks for
folks to go out and respond following a disaster, what is the liability in the event that one of our responders is
hurt during that response. What is the risk? What is the liability
that people would have? That is a really good question
and that is a question that we all need to take
very seriously. It has to be spelled out very
clearly to everyone, whether it is our leadership or responders
or other responders, everyone needs to understand that risk
is involved in any type of response and has to be clearly
stated that if a person is going to respond following a disaster
that there inherently is some risk and it doesn’t matter if it is fire, EMS, hazmat, disaster behavioral health; there
are some risks involved. While we can’t do away with risk
there are certain things that we can do in our plans to help minimize some of this risk. Some of this can be written into
our plans that liabilities may be mitigated by clearly defining the role of our responders, what is it that we are
asking them to do. We need to have clear
information on understanding the workman’s compensation
laws for your state. We would have to get-in
our state it would be the Department of Labor involved. The staff at your emergency
management agency probably has already addressed some of these issues as they are learning and working with their
responders as well. Descriptions before the
disaster, the responsibilities of the responder, that we really
don’t want our responders getting outside of their lane, that they are there to provide a disaster behavioral
health response. They are not there to help cut
down a tree-they have to maintain work within the
scope of their practice. I am telling you, training,
training, training, is a really very important part of
talking about liability and talking about risk. Having open discussions
during your training about a risk as a response. Let me go back for a
second and talk about the Good Samaritan Law. One of the things that I would
do is look and contact your staff attorney or your emergency management attorney or attorney general to see if your state
does have a Good Samaritan Law and would that apply
within your agency. One of the things that is very
important to help mitigate some of the liability is that
requiring all responders, all disaster behavioral
health responders to complete the NIMS training. It is free online from FEMA. It really does help people
understand the whole issue of incident command and what that
looks like and how we fit under an incident
command system. It should be mandated
before anyone responds. Another way that liability can
be mitigated is by working with your emergency management
agency and having the disaster behavioral health response work under the state liability, as an asset of
the state response. As we are looking at our
disaster behavioral health plan, does your plan include the
following features, clear and concise supervision and team management plan, including an organization chart. One of the things that
responders want to know is who is in command, who is their team
lead and be able to work under that incident command system. It is very important that in our
plans we have very clear and concise supervision and
team management plan. It is also important in our
plans that we have some really concise language on policies and procedures for our responders, including a very vigorous application process. Folks who want to do a
behavioral health response go through; that includes training,
the completion of the required NIMS, a medical screening,
interviewed by the team leaders and other folks. An orientation to a code
of conduct or a code of ethics are also important. If you don’t have a code of
conduct or a code of ethics I would certainly recommend
that you develop them. Under no circumstances would
our disaster behavioral health team self-deploy. If you are working under an
incident command structure you would have mission assignments,
requests from Homeland Security or from your emergency
management agency requesting disaster behavioral
health teams be deployed. That also offers a sense of
authority and regulation that we are working under the
incident command system. Most of our state departments
also have the use of policy development committees. Most state statutes that
talk about creation of state departments it gives us the
authority to develop polices to carry out our official duties. One of the ways that we can have
some of this authority is to have our disaster behavioral
health plans reviewed by, looked at, vetted by our policy development committees. Some of the examples of a
disaster behavioral health policy would be a development of
a disaster behavioral health committee that helps oversee
training and exercises, that sort of thing. The actual establishment of our
disaster behavioral health teams could be a policy
by our department. Certainly the code of conduct
and our ethics for those who are responding have those codified
through the policy mechanism. In those policies it should
be clearly spelled out, the roles and responsibilities
of the responders. Those polices should also
clearly state who and what and under what authority
the responders will be deployed to a disaster. Also I think it would be very
important in our disaster behavioral health plans to begin
to identify and look at what other agencies we
are looking at. Who are those other agencies
we are working with? What are their roles? How will we coordinate
with those other agencies? Whether it be Red Cross, NOVA,
chaplains, how are we going to coordinate with them? Who is going to do what? Have these agreements
and information spelled out before the disaster. You certainly don’t want to try
to work out agreements and that sort of thing during
the disaster. It is quite difficult. Have these agreements worked out
prior to the disaster. Another way to address the issue
of authority may be that our plans would have some type of
agreements with these agencies that we are working with. As we begin to identify who else
we will be working with and identify how we work together it
might be a good idea that perhaps we want to go and
formalize these types of relationships before
that disaster occurred. It would cut down on confusion. It would cut down on who is
responding it cuts down on turf issues and that sort of thing. If you had this in some type of
agreement, are these folks that you are working with
also working under the incident command structure. I want to go over briefly two
ways that we can do this. We can do it either through a
memorandum of understanding, which is a document describing
bilateral or multilateral agreement between parties. This really is a way that folks
who have some common interest spell out who is doing
what and integrating some of those services. An example of an MOU might be
that your disaster behavioral health team and the Red Cross
mental health folks may have some mutual interests. A lot of the Red Cross folks
may be working in shelters. Our folks may be working in the
community and can we provide some cross training and work
together in order to have more comprehensive response. MOU’s are a way to do that. A lot of folks in the disaster
response field understand and know about mutual
aid agreements. These have been quite common for
many years, especially in fire departments where you would have a mutual aid agreement between counties where if one county is
being overwhelmed in an emergency response such as a
big fire, another county would provide assistance to that
county and these understandings usually take a form of
personnel, equipment, materials. They usually can be
done pretty rapidly. Sometimes they are done during
that disaster but a lot of times mutual aid agreements are done
before hand and these are quite common in disaster
response, especially with fire and that sort of thing. An example of a mutual aid
agreement might be there may be a district mental health team
that would go over and provide assistance to another district. They would have the mutual aid
agreements done beforehand where either side could
activate it and request assistance from the other. We are going to go through
very quickly the elements of the memorandum of understanding. You have these on your slides so
I won’t go over it too much. We have an
introductory section. We have the
purpose section. The introductory section is
probably the one that we really want to make sure that you have
some really clear concise language on why the MOU is
necessary, what are the agreements that are going to
be set forth in this MOU. Then we have the scope section,
what are the capabilities that this MOU is going to apply to,
what it is that you are wanting done in this MOU. What it is that you are going to
provide each other is spelled out in the scope section as
well as the definitions. We all have different
terminology for everything that we use. Crisis counseling may be one
entity and it may mean something different to someone else. Debriefing may mean one
thing to one group. It may mean something
to another group. In the MOU we want to make sure
we have common language and a good way to do that in our MOU
is to have a definition section. Then we have the policy section
that spells out when and where and who is going to
authorize the use of this MOU, who can activate it. Who is going to be the one
to actually implement this MOU? Then we have the user procedure
section which talks about what trainings are available and
are trainings going to be cross training. Will I accept the training
of your group if you accept the training of our group? All of that can be
spelled out in the MOU. Then we have the oversight
section where we are looking at who is going to provide that
oversight, the updates. One of the things that I really
like is that standard operating procedure, the compliance
section that if you sign this MOU you will agree to
use your procedures. I have the copy of
your procedures. You will have the copy of mine
that those SOP’s are going to be followed as well as
the updates later on if we need to update our MOU. The other thing I want to
talk about briefly are these mutual aid agreements. These are done to establish
terms and conditions by which either party may request aid and
assistance from the other. These are a little bit
less formal than an MOU. They can be done quickly. They can be done specific for
that particular response agency. The mutual aid agreements that
I am familiar with are usually long lasting mutual aid
agreements where primarily disaster response folks will provide mutual aid to each other following any type of big disaster where my agency is being overwhelmed and
I need additional assistance from your agency. What I like about these two is
that the agreement date usually is a day of the
actual signatures. Once that party has signed it
and signed off on it then that is the date of the execution of
the mutual aid agreement. A lot of times these mutual
aid agreements, what a lot of agencies like about them, there is usually no reimbursement because you are assuming that if you come and provide aid to me, I will be able to come in and provide aid to you and there won’t be any reimbursement
costs, or very little reimbursement costs. As we are looking at the
legal, regulatory, or policy authorities it should be very
clearly stated that the disaster behavioral health plans need to address some of these issues,: liability, confidentiality, how we are going to implement the memorandum of understanding, how
we are going to implement the mutual aid agreements,
confirmation that your plan is looking at HIPAA. You need to work with your
HIPAA compliance officer. Discuss with him or her the
role of disaster behavioral health following a disaster. Who are the people who
are going to respond? What are their licensing, their
credentialing and who are you working with,
survivors, responders. All of that needs to be spelled
out very clearly in your disaster behavioral health plan. How will you document
your interactions with those folks that you work with? That is very important as well. Other issues that we
need to look at is this whole issue of confidentiality. A lot of states — what a lot
of people have done is have responders sign confidentiality
statements that the work that they do, the people that
they see will have that measure of confidentiality. The plan should also
address clear and concise management plan. Who is going to be in
charge of your team? Who is going to be able to
activate your team, deploy your team and under what authority? Plans should also address
the mandatory reporting requirements, adult protective services, child services. How are you going to
deal with a survivor that is dealing with suicide? These are issues that need to be
addressed in your plan as well. Your plan should also include
the process for credentialing. I know there has been lots of
talk on credentialing, registering responders. How will we do that? Our plans probably should also
deal with reimbursement issues. Are we going to have some
reimbursement issues from our response and how are you
going to be able to reimburse responders, agencies and
that sort of thing? As we are looking at different
states’ plans and some of the cool things that a lot of states
were doing, listed here are just some of the best practices that
DTAC and others have found in our disaster behavioral
health plans. State liability coverage is in
state statutes and district team structures in state statutes. The disaster behavioral health
people have a seat at the state emergency operations
center, which also includes the legal desk. Disaster behavioral health is
listed as a state asset under the state Homeland Security
Department and this provides a level of authority when
deployed by the state. That the state mental health
authority provides a legal requirement for background
checks on all responders. These are some of the best
practices that came out of plans that were reviewed. We will quickly talk
about confidentiality and informed consent. We know that most of the time we
are not required to open up medical records on the people
that we serve so we have to make sure that we do document,
that we do somehow figure out how we are going to
record information, not necessarily names. I would have all of those in
place before the disaster because our policy directors and emergency management folks will want to know how many survivors you met with, what their issues were and that sort of thing. Be prepared to document. Informed consent is very
important, I think it is important that we
train our staff on how they approach survivors. That they need to be very clear
of who they are and why they are there and who sent them. This is very important to be
clear because most people, after disasters, have trouble
concentrating so they may need to be reminded who you are. It is very good to have training
as part of training curriculum on how to approach survivors. Disaster mental health programs
do not require that medical records be opened or maintained
but a lot of states and some states have a code of
conduct that addresses confidentiality and making sure
that the confidentiality is part of that person’s license or
profession certainly carries on over to the disaster
behavioral health. The next step for when we start
developing our own plans, I would contact our Homeland
Security folks, your emergency management folks and get copies
of all of the relevant laws. I would contact your legal
staff and legal staff at emergency management to see how
you could get disaster behavioral health implemented
into state statute or work through existing
policy development. You need to find out who your
emergency support function eight lead and I would survey
community agencies that you are currently working with to
see if there is a need to formalize that relationship. With that, I am
finished and I will be happy to take any questions. Moderator: Thank you so much for
your presentation, Mr. Klatte. We have three questions for you. I will read you each one and
give you some time to answer. Can you further explain how you
think the incident command system liability
can be mitigated? Mr. Klatte: All responders are
required to work under the incident command structure. What that does is it really
prohibits a lot of responders from going out and
actually self-deploying. That you wait until there is a
request for your services. As disaster behavioral health
people we need to wait until some jurisdiction, local,
state would want a disaster behavioral health response. What that will also do is
by running this through the incident command system there is
documentation that certainly is part of that that we all
have to keep track of, mission assignments, who is assigned
that mission and what was the follow up that was done. I think it really does
help with cutting down on responders self-deploying. Moderator: You mentioned
the use of having a code of conduct for responders. What are some examples of this? Mr. Klatte: From what I could
put together some of the code of conduct that responders
have put together in our state and other states is such
as that responders will follow the National Incident
Management System. That you will maintain
confidentiality, that you will respect, honor everybody that
you are working with. That there is-most responders
wear uniforms so that part of that conduct is that you
are part of a team so you are there as part of a team. You are not there self-promoting
or anything like that. That would be part of
a code of conduct. A code of ethics would be
following the code of ethics for your own particular discipline
or license and that you perform as part of a team that provides services in accordance to the approved models that has been outlined by the state or by the overall authority for
disaster behavioral health. Moderator: Do our responders
need to have a consent form signed by a survivor before
they can talk with them? Mr. Klatte: Again, I would check
with your local legal folks. I would think not as long as you
identify who it is that you are, why you are there and under what
authority that you are there. Giving that person the option if
they don’t want to talk, they certainly don’t have
to engage you at all. They can say, “I
don’t want to talk.” I don’t think you need to have
an informed consent as long as you are telling that person
exactly who you are and they certainly have every
right to not want to talk to you if that is their choice. Moderator: Thank you Mr. Klatte. We have had one question
come in via chat. We wanted to check in and see if
you knew by any chance how many counties or states incorporate
and cover healthcare coverage for all responders
when deployed? Mr. Klatte: Healthcare coverage? From what I understand for
responders, fire, police and that sort of thing, they would
have their health coverage part of their occupation. As far as disaster behavioral
health, I don’t know if any of that would cover healthcare
while on deployment. They would probably have to
use their own insurance. Moderator: Thanks
so much Mr. Klatte. Ms. Terri Spear has some
closing remarks for us. Ms. Spear: Thank you very
much Mr. Klatte for your informative presentation. This section concludes the legal
and regulatory webinar as part of the Promising Practices
in Disaster Behavioral Health Planning Series. Subsequent sessions will explore
each of the standards in greater depth, providing examples,
lessons learned and good stories about how to enhance your
disaster behavioral health plan. Moderator: Thank you Ms. Spear. Dr. Mack will now tell us
about the upcoming webinars. Dr. Mack: Thank you. As you see on your screen the
next webinars are integrating your disaster behavioral health
plan and that takes place August 25th at 2 PM Eastern Time. That is featuring
Mr. Steve Moskowitz. The last one, plan scalability
that is August 30th at 2 PM Eastern Time, featuring
Dr. Anthony Spire. As promised to give you contact
information so that you have it if you want to follow up with us
you can feel free to contact me directly or any of our technical
assistance staff at the toll-free number on the
line or by emailing us. Lastly, I want to thank you Mr.
Klatte for your time today. We do recognize it has been a
very difficult time for you and for the staff who has needed to
respond to the recent tragedy in which there was a concert
stage that collapsed. Five people were killed
and 48 were injured. We know that it has
been a difficult time. We appreciate you taking the
time to share your expertise with us today and we
greatly appreciate that. Moderator: Thank you Dr. Mack
and thank you all for participating in the Promising
Practices in Disaster Behavioral Health, Legal and Regulatory
Authority webinar.

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