HEALTHCARELAW ENFORCEMENT INTERFACE Improving communication improving efficiency 2

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HEALTHCARE-LAW ENFORCEMENT INTERFACE Improving communication, improving efficiency

HEALTHCARE-LAW ENFORCEMENT INTERFACE Improving communication, improving efficiency

2 Objectives Define the Hospital-Law Enforcement interface Outline common structural elements Key operational elements

2 Objectives Define the Hospital-Law Enforcement interface Outline common structural elements Key operational elements of a successful interface Understand the benefits of a collaborative strategy

3 Session rules Be Collaborative This is an interactive session. Share your success stories,

3 Session rules Be Collaborative This is an interactive session. Share your success stories, share the gaps and questions that you have. Be Courteous “A tree is known by its fruit; a man by his deeds. A good deed is never lost; he who sows courtesy reaps friendship, and he who plants kindness gathers love. ” – Saint Basil Don’t break rules 1 and 2

4 Flow of the session GNYHA NYPD NYC H+H/Bellevue • Who we are •

4 Flow of the session GNYHA NYPD NYC H+H/Bellevue • Who we are • Identification of the problem & process used to resolve

5 GNYHA: who we are Founded in 1904, Greater New York Hospital Association (GNYHA)

5 GNYHA: who we are Founded in 1904, Greater New York Hospital Association (GNYHA) is a trade association comprising 140 hospitals and healthcare systems, both voluntary and public, in the New York metropolitan area and throughout the State, as well as New Jersey, Connecticut, and Rhode Island. Key areas of work: □ Advocacy □ Quality & Patient Safety □ Finance, Insurance, and Graduate Medical Education □ Emergency Preparedness □ Diversity & Community Health □ Provider Operations & Compliance

6 GNYHA: who we are Along with NYC Health + Hospitals we represent the

6 GNYHA: who we are Along with NYC Health + Hospitals we represent the Hospital Sector in citywide planning efforts Host monthly meeting, Emergency Preparedness Coordinating Council, that brings together emergency managers from across the region + key response agencies Citywide Planning Citywide Health & Medical Planning Emergency Preparedness Coordinating Council Dedicated Workgroups & Special Programming Participate in ESF-8 and Health and Medical Executive Advisory Group Host or co-host groups to work on more complex issues Special programming as needed; past events include mass casualty briefings and Ebolafocused meetings

7 GNYHA: who we are PREPAREDNESS RESPONSE Founding member of NYC Staffs desk at

7 GNYHA: who we are PREPAREDNESS RESPONSE Founding member of NYC Staffs desk at NYCEM Health & Medical EOC to coordinate 61 Executive Advisory Group hospitals via 1 liaison Staffs and supports NYS DOH Healthcare Facility Evacuation Center Founder and host of Emergency Preparedness Coordinating Council Active ESF-8 partner in New York City GNYHA is an integral part of the NYCEM infrastructure Supports NYCEM Logistics Center

8 Hospital coordination with law enforcement Concern Hospitals often have uniformed and nonuniformed members

8 Hospital coordination with law enforcement Concern Hospitals often have uniformed and nonuniformed members of service in their facility for various reasons. □ Medical personnel may not understand law enforcement actions, requests or reasoning □ Law enforcement personnel may not understand medical personnel actions, requests or reasoning Goal □ Build stronger relationships so that hospitals and law enforcement agencies can begin to better understand one another. □ Identify gaps and begin to address them.

9 Hospital coordination with law enforcement: forum □ Attended by: □ Nearly 30 agents

9 Hospital coordination with law enforcement: forum □ Attended by: □ Nearly 30 agents representing 14 different Federal, State and Local law enforcement agencies □ Various partnering agencies, including NYCEM, United Nations, US HHS, US DHS, NYC DOHMH, NYS DOH and more □ Over 125 representatives from GNYHA member hospitals

10 Hospital coordination with law enforcement: gaps & needs Hospital Law Enforcement □ Better

10 Hospital coordination with law enforcement: gaps & needs Hospital Law Enforcement □ Better communication from the field if □ Swift provision of a conference room(s) agents are bringing in violent/agitated persons □ Ways to verify identity of non-uniformed agents/officers □ Clearer understanding of “who is in charge? ” when multiple agencies are present. where agencies can gather and begin a coordinated investigation □ Access to contact information for key personnel in hospitals □ Better understanding of what information can be shared by hospitals relating to investigations.

11 Hospital coordination with law enforcement: follow-up projects □ Directory of duty desk numbers

11 Hospital coordination with law enforcement: follow-up projects □ Directory of duty desk numbers for hospitals □ Directory of hospital contact info for law enforcement partners □ Future programming and resource development related to sharing of PHI

LAW ENFORCEMENT INTERACTION WITH THE HEALTHCARE COMMUNITY AND ACTIVE SHOOTER RISK MITIGATION FOR THE

LAW ENFORCEMENT INTERACTION WITH THE HEALTHCARE COMMUNITY AND ACTIVE SHOOTER RISK MITIGATION FOR THE HOSPITAL Sgt Thomas Boyle NYPD SHIELD NYPD Counterterrorism Bureau 12

 • Comprised of 22 Sectors - BIDS - Chemical/Petroleum - Cultural - Education

• Comprised of 22 Sectors - BIDS - Chemical/Petroleum - Cultural - Education - Energy/Utilities - Entertainment - Finance & Banking - Governmental Agencies - Health & Hospitals - Hospitality & Tourism - Law Enforcement - Maritime - Media - Postal/Parcel - Professional Services - Real Estate & Property Mgt. - Religious - Retail/Merchant - Security - Telecommunications/IT - Transportation - Other NYPD Counterterrorism Bureau

WEBSITE • www. nypdshield. org NYPD Counterterrorism Bureau 14

WEBSITE • www. nypdshield. org NYPD Counterterrorism Bureau 14

POLICE DEPARTMENT DAILY INTERACTIONS WITH HOSPITAL PERSONNEL • Guarding Injured Prisoners • Motor Vehicle

POLICE DEPARTMENT DAILY INTERACTIONS WITH HOSPITAL PERSONNEL • Guarding Injured Prisoners • Motor Vehicle Accidents • Large Scale Accident/Disaster • Injured Police Officer • Domestic Violence Incidents • Missing Persons NYPD Counterterrorism Bureau 15

Coordination with Hospital Staff • Hurdles Law enforcement faces when conducting business in hospitals

Coordination with Hospital Staff • Hurdles Law enforcement faces when conducting business in hospitals - Miscommunication - Lack of information about prisoners - HIPAA Laws – Confusion on both sides - Hospital Layout - Emergency Plan NYPD Counterterrorism Bureau 16

NYPD Counterterrorism Bureau 17

NYPD Counterterrorism Bureau 17

NYPD Counterterrorism Bureau 18

NYPD Counterterrorism Bureau 18

NYPD Counterterrorism Bureau 19

NYPD Counterterrorism Bureau 19

New York City FOX 5 NYPD Counterterrorism Bureau 20

New York City FOX 5 NYPD Counterterrorism Bureau 20

NYPD Counterterrorism Bureau 21

NYPD Counterterrorism Bureau 21

NYPD Counterterrorism Bureau 22

NYPD Counterterrorism Bureau 22

WHAT’S NEXT? • HOSPITAL SHUTDOWN • PUBLIC RELATIONS OBSTACLES • POSSIBLE UNFAVORABLE PRESS •

WHAT’S NEXT? • HOSPITAL SHUTDOWN • PUBLIC RELATIONS OBSTACLES • POSSIBLE UNFAVORABLE PRESS • LOSS OF BUSINESS CONTINUITY NYPD Counterterrorism Bureau 23

NYPD Counterterrorism Bureau 24

NYPD Counterterrorism Bureau 24

25 NYC H+H/Bellevue • • • Flagship of NYC Health and Hospitals Corp. Comprise

25 NYC H+H/Bellevue • • • Flagship of NYC Health and Hospitals Corp. Comprise of 11 Acute Care facilities, 5 Rehab And Nursing facilities, and 21 NYC school based clinics. 828 bed Tertiary care center w/31 k discharges – • Level I Trauma Center – • • 524 k OP and 124 k ED visits 3 Forensic units: 68 psychiatry & 34 medical beds 279 Psychiatry beds: Adult, Child, Detox – • • Emergency Microsurgical re-implantation for NY City CPEP, MMTP, Diverse population – LEP, Hispanic & Asian TB Detention, Isolation and Quarantine Unit Designated hospital for POTUS and United Nations Dignitaries. Designated Ebola Treatment Center & National Ebola Training & Education Center.

26 Bellevue Hospital Police Training Academy

26 Bellevue Hospital Police Training Academy

27 Hospital Coordination with Law Enforcement □ Successes to an effective collaboration ( Hospital

27 Hospital Coordination with Law Enforcement □ Successes to an effective collaboration ( Hospital ) - NYPD Liaison Officer assigned to hospital - Establish a relationship with local Police Department - Involve hospital leadership in conversation - Understanding implementation of Unified Command - Establish plans for pre-determind designated areas for Law Enforcement to gather during an incident. - Establish system for identifying non-uniformed agents/officers.

28 Hospital coordination with Law Enforcement □ ( Hospitals ) cont. - Drills (

28 Hospital coordination with Law Enforcement □ ( Hospitals ) cont. - Drills ( ex. DHSSS drill ) - Share contact information - Conduct Panel discussion with Law Enforcement

29 Hospital Coordination with Law Enforcement

29 Hospital Coordination with Law Enforcement

30 Hospital Coordination with Law Enforcement □ Successes to an effective collaboration ( Law

30 Hospital Coordination with Law Enforcement □ Successes to an effective collaboration ( Law Enforcement) - Understanding Hospital Incident Command Structure ( HICS ) - Share contact information with Incident Command - Clearer understanding of what information can be by hospitals during an incident. HIPPA Rules.

31 Challenges to a Successful Collaboration □ Sharing of patient information during an investigation

31 Challenges to a Successful Collaboration □ Sharing of patient information during an investigation □ Collaboration when multiple agencies are involved.

32 Takeaways □ Needs of each side of a Hospital-law enforcement interface □ Hospital

32 Takeaways □ Needs of each side of a Hospital-law enforcement interface □ Hospital or Healthcare Entity □ Law Enforcement Agency □ A framework for a more efficient Hospital-Law Enforcement Interface

33 Thank You! Patrick S. Meyers Senior Project Manager, Emergency Management Greater New York

33 Thank You! Patrick S. Meyers Senior Project Manager, Emergency Management Greater New York Hospital Association Sgt. Thomas Boyle NYC Police Department Counterterrorism Division NYPD SHIELD Boyd Dixon Director, Emergency Management NYC H+H/Bellevue Hospital