Purpose:
To affirm the importance of student placement practices and to safely admit students and prevent unecessary exposure of current population.

Applicability:
Admitting, nursing, physician and staff working with that student.

General Statement:
A Free From Communicable Disease Form signed by an M.D., is requested for EVERY student prior to admission.
A. Since there are NO Isolation Rooms at HEC, any student found to have a communicable disease requiring isolation would be referred IMMEDIATELY to an appropriate facility by the School Physician.
B. Nursing assessments are done within 24 hours of Admission by an R.N.
C. Physicals are done within 30 days of an admission.

Controlling Infection

A. Admitting personnel will cooperate with nursing and the medical staff, when placing students who are immunosuppressed, at increased risk for infection, or suspected of/diagnosed with a communicable disease.
B. The physician will assess each student upon admission according to guidelines, and alert staff as to signs and symptoms, initial diagnosis, and type of precautions needed.
C. The ICC is to be notified AS SOON AS POSSIBLE of ANY student admitted who has a suspected or confirmed communicable disease.
D. Personnel potentially exposed to a student with tuberculosis, who was diagnosed after the admission process, will be .referred to Occupational Health.
E. If a student is admitted with a communicable disease such as: chicken pox, measles, etc., ALL personnel should be aware of their status. Staff members who have NO RECORD of having had the disease, report to the Charge Nurse. Other staff assignment may have to be made. ALL Pregnant staff, should be aware of communicable diseases they have had. This includes: Housekeeping, Dietary, etc. The ICC (or Designee) should be notified for evaluation.
F. If student currently in placement, develops a communicable disease that is deemed by the Medical Director not to require hospitalization or isolation, levels of bedrest will be initiated. See standing orders in Policies and Procedures for specifics on levels of bedrest. These levels provide for limited activity and decreased exposure to other students and staff as much as is possible in a residential setting.

Responsibilities

A. Training Coordinator

1. Document and maintain records of adequate education of ALL personnel, in infection control practice.
2. Assure compliance with Infection Control Polices and Procedures.
3. Assure compliance with Employee Health Program Policies.
4. Review and revise, as necessary, the Infection Control Policies and Procedures.
5. Submit ALL Policies and Procedures that may relate to infection control to the ICC for review, prior to adoption.
6. Report potential infection control hazards to the ICC and EOC Committee.
7. Make available to ALL Department personnel, ICC Policies, Procedures, and if applicable, Surveillance.

B. Infection Control Coordinator:

1. Available as a resource
2. Prepare, review and revise, Infection Control Policies and Procedures
3. Assist in preparing and presenting relevant educational infection control programs.
4. Periodically observe Departmental adherence to infection control practices.
5. Conduct additional investigations, as necessary.
6. Provide any surveillance or investigation data to Departments as indicated, by the EOC Committee.
 
C. EOC / IOP Committees

1. Review ALL Infection Control Policies.
2. Available as a Consultant.
3. Review ANY data and make recommendations concerning Departmental infection control practices.

Personnel:

A. UNIVERSAL PRECAUTIONS will be used by ALL personnel.
B. ALL staff will be screened for communicable diseases as stated in: Hillcrest Employee Health Policy.
C. ALL staff will participate in education programs at the time of hire, (BEFORE beginning job duties), and at least annually thereafter to review practices related to the prevention of infection.

MRSA:
Management of Community-Associated Staphylococcus Aureus (CA-MRSA) Infections

Purpose: To prevent the spread of MRSA infection from person to person ensuring the health and well-being of all students and staff.
Background: MRSA infections are skin infections that appear as pustules or boils which often are red, swollen, painful or have pus or other drainage. MRSA is typically transmitted by DIRECT skin to skin contact OR contact with shared items or surfaces (e.g. used towels, bandages, shared sports equipment, etc.). It is estimated that 30-50% of the population are carriers of the staphylococcus bacteria on his/her skin or in the nose passages and it can be easily transmitted from one person to another. According to the Centers for Disease Control and Prevention, almost all MRSA infections can be successfully treated with or without antibiotics.
Prevention is the best defense and students and staff should be reminded about the importance of simple hand washing and practicing good personal hygiene overall. All cuts and open draining wounds MUST be covered with a secure bandage.
Actions when a student is infected with MRSA:
1) Staff should notify nursing if a student has any signs of infected skin. (Pustule, redness, swelling, drainage)
2) Nursing staff will assess and treat the area. Cultures of any drainage will be obtained and sent to the lab. Other treatment may include obtaining vital signs, warm packs, application of antibiotic ointment and coverage of any draining area.
3) The nursing department will observe for worsening symptoms and call the physician’s office as necessary. If the culture report is positive for MRSA, physician should be notified. Antibiotic treatment may be instituted.
4) The student should come to the nursing department for dressing changes at least 2-3 times per day or as instructed. Any contaminated dressings should be disposed of properly and the area of examination cleaned with antibacterial wipes.
5) All staff should use universal precautions and barriers when exposed to any drainage. Towels, sheets and clothing coming in contact with the drainage should be washed and dried in the dryer. Students may need assistance with this task.
6) No sharing of personal items
7) Student should be reminded to leave the dressing intact and wash their hands frequently.

Actions when a staff is infected with MRSA:
1) If staff have any type of skin infection which is warm, red, swollen, painful or draining they should seek medical attention from their primary care physician.
2) The draining wound should be covered with a clean, dry bandage that contains the drainage.
3) If the drainage cannot be contained or you have fever greater than 101, you should not be at work.
4) The dressing should remain intact; skin to skin contact should be avoided.
5) Staff should engage in frequent hand washing or sanitizing
6) Report any infection and treatment to HR representative.

Precautions:
• Frequent hand washing is the single most important preventive measure to avoid infection with MRSA. Keep your hands clean by washing thoroughly with soap and water or using an alcohol-based hand sanitizer.
• Keep cuts and scrapes clean and covered with a bandage until healed.
• Avoid contact with other people’s wounds or bandages.
• Avoid sharing personal items such as towels or razors.
• Avoid unnecessary use of antibiotics.
• Additional material on MRSA can be found at the CDC web site: http://www.cdc.gov/Features/MRSAinSchools/

PURPOSE & GOAL: The program is designed, implemented, and evaluated to prevent or reduce the incidence of infection among students and staff at HEC.

1. Responsibility
A. The Infection Control Coordinator is responsible for the activities associated with surveillance, prevention, and control of infections among students and staff. The Coordinator is also available for consultation to the EOC Committee regarding any infection related discussions.

B. The EOC Committee will be comprised of the following members, as appropriate:
Chairperson
Workers Compensation Coordinator/EOC Coordinator
Nursing Department Representatives
Maintenance Representatives
Housekeeping Representatives
Direct Care Representatives

In addition, Representatives from other areas are invited to meetings for discussion of issues specific to each of these departments. The EOC Committee meets bi-monthly at each site with the exception of the Intensive Treatment Unit where the EOC Committee meets bi-monthly.

C. The Infection Control Coordinator is responsible for the annual review of the Plan for Surveillance including:
1) Data collection method(s), quality control measures, reporting mechanisms.
2) Effectiveness of program and actions taken for the previous year(s), including data and trends
3) Effectiveness of control measures and actions taken by the EOC Committee
4) New or revised Local, State, and Federal Regulations
5) CDC Guidelines for infection control issues/programs
6) Information regarding Infection control in professional publications or as distributed by Local, State, and/or Federal Departments of Health
7) Review available HEC data presented annually, identify trends, recognize opportunities for improvement, propose actions, assign responsibility, implement and evaluate the effectiveness of actions taken.
8) Annual review and approval of infection control policies and procedures

D. Statement of Authority: Infection Control Coordinator
In the event of a threat to the public health of HEC students and personnel the ICC has the authority to take any steps deemed necessary to control the identified threat. The Medical Director will be contacted and informed of the potential health risk, prior to action being taken in such a situation. However, if the Medical Director can not be reached to make a timely decision the ICC may take definitive action. These actions may include, but are not limited to:
ordering lab work
restricting visitors
requiring the use of personal protective equipment
restricting entry into specific areas
ordering surveillance
further precautions as deemed appropriate by the ICC.

E. Infection Prevention: The Infection Control Coordinator (ICC) has the authority to institute any surveillance activities, control measures, or procedures to prevent infection or its spread among students, visitors, and staff. The ICC will consult appropriately with the EOC Committee and its Chairperson(s).
The Infection Control Coordinator is consulted by Department Heads on issues regarding Infection control, including the following:
1). The purchase of equipment associated with Sterilization, Disinfection, and/or Cleaning
2). Revision of Policies or Procedures relevant to infection control practices
3). The purchase of personal protection equipment and barriers
4). Infectious disease(s) in Staff or Students.

2. Scope of Care

The objective of the Infection Control program is to recognize the occurrence of preventable infections among students and staff along with understanding the prevention of these infectious diseases. The scope of care also includes those practices related to disinfection and cleaning of equipment as well as the necessary supplies. The areas/services which are included in the Scope of the program are:
Residential and Academic Buildings
Offices
Outpatient Services provided by Hillcrest Psychological Services
Food Services
Environmental Services:
Maintenance Services
Housekeeping Services

In addition, contract services are reviewed for appropriate infection control practices.

3. Important Aspects of Care:

A. Surveillance is focused on:
• Total agency surveillance including outpatient services for identification and investigation of preventable infections
• The incidence of blood/body fluid(s) exposure
• The identification of outbreaks of infectious diseases and the institution of appropriate precautions to prevent further spread
• Identification and reporting of those diseases, Reportable by Law to Local and/or State Departments of Health.

B. Review of the policies and procedures as they relate to infection control and/or environmental control issues, particularly those which address prevention and containment of infectious diseases.
4. Indicators

A. Criteria used to identify preventable infections:
• Signs, symptoms, and laboratory findings, that were present and/or incubating at the time of admission.
• For an unknown incubation period, an infection is considered from external sources if it develops 72 hours or more after admission or returning from LOA.
• Infection present at the time of admission, will be referred to the Physician and treated as indicated.
• Self report disclosed by outpatient clients

 
Flu recommendations and procedures

In view of the recent information regarding the swine influenza A (H1N1) the following procedures will be available for all HEC campuses. The best way to prevent the spread of flu illness should be noted and encouraged at every opportunity. These steps include:

• Cover your cough or sneezes into a tissue or inside of arm, not your hands, dispose of the tissue
• Avoid touching your eyes, nose and mouth
• Wash your hands frequently with soap and water or hand sanitizer
• Stay home if you are sick with fever over 100.4F
• Clean surfaces such as desks, tables, counters, and door knobs with antibacterial solutions

On the occasion that the flu reaches our students these procedures should be followed:

• All students will be observed for the following symptoms: fever above 100.4 F, cough, sore throat, body aches, headache, chills and fatigue
• When these symptoms occur, every effort will be made to isolate the student in their room or a designated infirmary area on campus (to be determined by PD and Head Nurse)
• Saff who are assigned to be with ill students will be provided with N95 masks, gloves and disinfectant wipes
• Observation of symptoms will continue. If the BMC diagnostic criteria for testing is fulfilled then a nasopharyngeal swab will be obtained and sent to BMC Lab
• BMC lab will test the swab for Influenza A virus (results available within 24 hours), if present, a repeat specimen will be obtained and submitted to the State lab for subtyping
• Dr. Dempsey will be notified at which time anti-viral treatment may be initiated according to his orders
• If the testing does not reveal type A flu, isolation is not necessary. However, bedrest may be indicated depending on current symptoms assessed by the nurse on duty.
• Symptomatic treatment by staff and nursing will continue throughout the illness. This may include: tylenol/ ibuprofen, fluids and rest.
• Documentation of information will be completed by nursing on the Student Isolation Log. This information will be used to follow isolation and testing processes. (see attached)
• Staff will use the Student Monitoring Sheet to record pertinent information for each student in the isolation room. (see attached)
• The Head Nurses at each campus will make daily decisions on the students entering and leaving the isolation infirmary area.
• Updates on available information will be relayed to staff in Community Meetings
• Decisions on limiting travel or visitation on and off campus will be made by the SMT

Supplies to have on hand:
Anti-bacterial wipes
N 95 Masks
Gloves
Tissues
Nasopharyngeal swabs
Ibuprofen/Tylenol
Ginger ale
Sports drink/ other clear fluids

Flu in outpatient areas:
Appointments may be cancelled if client reports active flu illlness
Appointments may be cancelled if the clinicain experiences active flu symptoms 
Indicators for outbreaks of infection are defined by the Infection Control Coordinator and/or EOC Committee

The ICC will monitor the occurrence of pathogens, drug resistance, and report concerns regarding these to the EOC Committee, and will authorize surveillance as appropriate.

Indicators for Employee Health:

a) Incidence of Measles, Rubella, or Chicken Pox and post-exposure follow-up
b) Blood/body fluid exposures and follow up per OSHA’s Bloodborne Pathogen Standard.

Indicators for Environmental Controls

Housekeeping – Cleaning Procedures: Prior to any change in products used or in manner of use, the Dept. Manager will submit to the EOC Committee ALL available written literature substantiating the efficacy of the change relative to infection control. (See, Housekeeping Department, Policies for Infection Control).

Maintenance: The importance of effective infection control including the Maintenance of the Facility(ies) is recognized and reflected in Dept. policies (See, Maintenance Department, Policies for Infection Control).

The Manager of the Maintenance Department will consult with the ICC relative to appropriate infection control measures put in place prior to, and during all, construction, reconstruction, or major renovation (constituting entering into walls and/or ceilings) to the facility(ies).

Indicators for Policies and Procedures

Review and Revision:

1) ALL infection control policy and procedures are reviewed and revised to reflect current standards at least every 2 years.
2) New policy and procedures are added as required by Local, State, or Federal Laws or Regulations
3) Each Department Manager will consult with the ICC prior to effecting any revisions of Department Policy or Procedure relative to infection control.

REPORTABLE DISEASES

REPORT IMMEDIATELY BY PHONE
This includes both suspected and confirmed cases.
All cases should be reported to your local health department.
If unavailable, call the Massachusetts Department of Health
Telephone (617) 983-6800 Confidential Fax (617) 983-6813

Any Case of an unusual illness thought to have public health implications.

Any Cluster/Outbreak of Illness (Including, but not limited to foodborne Illness)

• Anthrax
• Botulism
• Brucellosis
• Diphtheria
• Encephalitis, any case
• Haemophilus influenzae, invasive
• Hemoêytic uremic syndrome (also report dWectty.to MDPH: 617-983-6800).
• Hepatitis A (lgM+ only)
• Meningitis, baterial community acquired
• Meningococcal disease, invasive
• (N. meningitidis)
• Plague
• Polio
• Q Fever
• Rabies in humans
• Rubella
• Smallpox
• Tetanus
• Tularemia
• Viral hemorrhagic fevers

***************************************************************

REPORT PROMPTLY (WITHIN 1-2 BUSINESS DAYS)
This includes both suspected and confirmed cases.
All cases should be reported to your local health department.
If unavailable, call the Massachusetts Department of Health
Telephone (617) 983-6800 Confidential Fax (617) 983-6813

• Ehrlichiosis
• Creutzfekit-Jakob disease
• Food poisoning and toxicity (includes poisoning by
ciguatera, scombrotoxln, mushroom toxin, tetrodotoxin,
paralytic shellfish and amnesic shellfish)
• Guillain Barré syndrome
• Hansen’s disease (leprosy)
• Hantavirus infection HBsAg+ pregnant women
• Leptospirosis
• Lyme disease
• Meningitis, viral (aseptic), and other infectious (non-bacterial)
• Pertussis (Whooping Cough)
• Psattacosis
• Reye syndrome
• Rheumatic fever
• Rlckettsialpox
• Rocky Mountain spotted fever
• Toxic shock syndrome
• Trichinosis
• Varicella (chickenpox)

105 CMR 300000 Reportable Diseases and Isolation and Quarantine Requirements February 2003, Page 1 of 2
 
REPORT DIRECTLY TO THE MASSACHUSETTS DPH
DEPARTMENT OF PUBLIC HEALTH

HIV infection and AIDS (617) 983-6560

Sexually Transmitted Diseases (617) 983-6940

Chanchrold Ophthalmia neonatorum:
Chalamydial infections (genital) a. Gonoccocal
Genital Warts b. Other agents
Gonorrhea Pelvic Inflammatory disease
Granuloma inguinale a. Gonococcal
Herpes, neonatal (onset within 30 days b. Other agents
after birth)
Lymphogranuloma venereum Syphilis

Tuberculosis suspect and confirmed cases: Report within 24 hours to (617) 983-6989 or
Toll Free (1-888) MASS-MTB (627-7682) or
Confidential Fax (617) 983-6990

Latent tuberculosis infection: Confidential Fax (617) 983-6990 or
Mall report to:
Massachusetts Department of Public Health
Division of Tuberculosis Prevention and Control
305 South Street, Jamaica Plain, MA 02130

***************************************************************
REPORTABLE DISEASES PRIMARILY ASCERTAINED THROUGH LABORATORY REPORTING OF EVIDENCE OF INFECTION

Please work with the laboratories you utilize for diagnostic testing to assure complete reporting.

Amebiasis
Babesiosis
Calicvirus infection
Campylobacteriosis
Cholera
Cryptococcosis
Cryptosporidiosis
Cyclosporlasis
Dengue fever virus
Eastern equine encephahtis virus
E. coil 0157:H7
Enteroviruses (from CSF)
Giardiasis
Group A streptococcus, invasive infection
Group B streptococcus, invasive infection
Hepatitis B
Hepatitis C
Hepatitis – infectious, not otherwise specified
Evidence of human prion disease
Influenza
Legionellosis
Listeriosis
Malaria
Salmonellosis
Shiga toxin-producing organisms
Shigellosis
Streptococcus pneumoniae, invasive
infection /
Toxoplasmosis
West Nile virus
Yellow fever virus
Yersiniosis

105 CMR 300000 Reportable Diseases and Isolation and Quarantine Requirements February 2003, Page 2 of 2

COLLECTING AND ORGANIZING DATA

Data is collected, organized, and presented annually by the ICC and includes:

Incidence of all specific types of infections as well as anaylsis of campus location.

Indicators of environmental controls affecting this data are collected by the EOC Committee, who then notify the ICC of variances.

Communicable diseases are reported to the appropriate Department of Health, by the Medical Director, and reviewed by the ICC when appropriate, such as when further surveillance or action is necessary.

EVALUATION OF CARE

Data is trended and reviewed by the ICC and presented to the EOC Committee annually.

Analysis of data is done for the following reasons:
a) To identify problems
b) To determine the necessity for further data collection or further investigation
c) To quantify the problem and determine causes
d) To compare data to current issues in the professional infection control literature, with national or local data, or other appropriate benchmarks in order to evaluate efficacy of the infection control program
e) To review new CDC Guidelines, OSHA Regulations, state and local Laws to assure compliance
f) To coordinate efforts with Occupational Health to protect employees
g) To provide data to health care providers when appropriate, so that action can be taken to reduce known risks
h) To identify cases of significant epidemiological variation, in order to institute further investigation
 
ACTION TAKEN TO IMPROVE PROGRAM

The ICC and EOC Committee will take action to solve problems or reduce risk of infection, including the following:

1. Use of Knowledge:
a) Present annual infection control programs to all staff, to reinforce and broaden their knowledge base.
b) Orient new employees to accepted infection control procedures.
c) Integrate new procedures or practice recommendations into ongoing programs.
d) Present special programs to staff, relative to new practices, as this information becomes available.
e) Distribute information or current infection control issues at meetings and/or in writing.

2. Assessment of Behaviors
a) The ICC or EOC Committee may institute appropriate measures to modify staff practices necessary to assure compliance with current standards.
b) New policy and procedures as developed, and/or revised, should incorporate the following strategies:
i) Scientifically valid and pertinent information including CDC Guidelines and OSHA Regulations.
ii) Employee Health policies as they relate to infectious disease, prevention, and treatment.
iii) Methods used to reduce the risk of cross-infection between staff/staff, staff/student, and student/student. This may include review of universal precautions, as well as policies on disinfection and handwashing.

Assess Actions

Data Collection and Evaluation
A. The ICC will assess the effectiveness of actions taken by collecting and comparing data and noting any further trends.
B. If improvement is acceptable to ICC, no further action is taken unless specifically requested by the Medical Director.
C. In the event that further action is needed, as determined by Assessment or Request, there will be further data collection and evaluation by the ICC, who will then report this, as appropriate to the Medical Director.

Communicate Relevant Actions Taken

Surveillance Reports
A. The ICC will present pertinent infection control information at IOP Meetings.
B. The ICC will present pertinent infection control information to the EOC Committee quarterly.
C. The Annual Report will include a summary of surveillance data, trends, and actions taken.

 

Hillcrest Educational Centers, (HEC) is committed to providing a safe environment for students and staff. All preventative health care measures are consistently monitored to decrease the risk of exposure to communicable disease.
Upon review of the types of reasonably anticipated exposures occurring in residential settings, this manual was developed to describe the procedures currently employed by our agency to address potential risk(s).

BROOKSIDE ALARM
Main Bldg.: V5-0629
School: V5-0658
Dorm 1: A1-0831
Dorm 2: A1-0832
Gym: A1-0854

HILLCREST CENTER
Tetro Academic Center: A1-0870
Dellea Left: A1-0446
Dellea Right: A1-0445
Miller Hall: A1-0554
Gym: A1-0648

HIGHPOINT
Fernbrook: V5-1585

Main Bldg. A1-0621
Chyla Hall: A1-0505
School: V2-0069
Gym: A1-0855
West pump station: V2-0261
East pump station: V2-0260

HILLCREST ACADEMY
Fire: V5-1503
Security: A2-10000
AO 788 South St.: V5-0689

• If an alarm sounds while you are working in the maintenance shop, stay calm, turn off any running equipment and evacuate the building.

• Find a supervisor to determine if it is a false alarm.

• Provide any necessary assistance to the supervisor with evacuation of students or determination of source of alarm.

• NEVER re-enter any building without a supervisor knowing your whereabouts.

• Be available at a central location to aid the Fire Dept. as needed.

• If it is determined that there was a false alarm, and if you are needed to re-set the alarm, follow up with the supervisor as to your actions. Make sure everyone knows when and if the alarm has been restored, including a call to Berkshire Communicators.

• Berkshire Communicators: 413-499-3650

When a fire alarm goes off at a program or work site the monitoring company, Berkshire Communicators, performs the following actions in the following order:

1) Dispatches the fire department to the program/work site.
2) Calls the program/work site for more information. (See NOTE 1 below)
3) Calls the HEC maintenance department cell phone, which is carried by the on-call maintenance manager.
4) If #3 is not successful, calls through the call list of designated Maintenance staff until 1 is reached.
5) If the monitoring company cannot reach a designated Maintenance staff, they will try to reach (in this order) the Program Director, the Executive Vice President or the President/CEO.

NOTE 1:
The monitoring company will try to reach the program or work site to acquire more information to be sure that no other help is needed, such as an ambulance, police, etc.

If a Supervisor has definitely ascertained and verified that there is a false alarm (i.e., a student was seen by a staff member pulling the fire alarm), the Supervisor may directly call the Fire Department — not Berkshire Communicators — to alert them that the alarm is a verified false alarm.

All other alarms should be treated as unknown, and normal building evacuation should take place.

The following procedure pertains to the gasoline powered generators, and the steps described are a general guideline. Each campus has a more detailed instruction manual specific for that site.

• Notify Supervisor of testing

• Check oil and fuel level; add if necessary.

• Start generator.

• Move Gen-Tran switches from “LINE” to “GEN”.

• Walk through building and observe that all circuits are operating, record findings. Allow generator to run for thirty minutes.

• Return switches from “GEN” to “LINE”.

• Turn off generator, wait 10 minutes to cool.

• Close generator housing.

• Notify Supervisor that testing is complete.

The Highpoint and Center campuses have a winter and summer schedule for the operation of the generators.

Due to extreme cold temperatures, the generators are kept in the heated garage at the Center campus during the winter months, generally from December through March. If they are needed, a supervisor will contact the Maintenance Dept. person on call who will come in to plug in the generators and supply back up power.

Hazard surveillance inspections are conducted on each campus at least quarterly. Hazard surveillance inspection reports, any security related reports and any investigation findings are reviewed by campus Environment of Care Committees.

At least three times each year, the Maintenance Dept. will conduct a Hazard Surveillance to check all doors equipped with magnetic auto closure mechanisms, to insure that the doors close and latch when the fire alarm goes off and the magnet disengages the door.

These fire door focused Hazard Surveillance activities will be scheduled in, and documented by the SchoolDude Preventative maintenance direct system

LOCAL AND AGENCY RESOURCE ANALYSIS
I Purpose
The Hazard Vulnerability and Local Resource Analysis is conducted as part of a larger, ongoing effort associated with Emergency Preparedness and Management, in order to:
• insure a safe and supportive environment of care for Hillcrest students and staff.
• to insure the efficient and effective provision of student care and treatment
• do so in a manner compliant with regulations promulgated by the Mass. Department of Early Education and Care (DEEC), Mass. Department of Education (DOE), standards established by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), and all other applicable laws, regulations and standards.

II Objective
The Hazard Vulnerability and Local Resource Analysis is conducted in order to:
• identify reasonably likely potential hazards and disasters.
• identify potential direct and indirect effects these may have on Hillcrest operations.
• identify internal and/or local resources that can be utilized to mitigate and/or respond to emergencies and/or disasters.

III Hazard Vulnerability Analysis
The Hazard Vulnerability Analysis should be viewed within the specific context provided by Hillcrest Educational Centers, including the following elements and dimensions:
• Hillcrest primarily provides residential treatment for children and adolescents. Hillcrest also provides day therapeutic education. Students in both types of programs are physically healthy and do not suffer from any major medical problems or physical disabilities. They are capable of self-preservation.
• Hillcrest provides very intensive staffing and supervisor ratios, including awake overnight staffing, at every residential campus.
• Staff are regularly trained in emergency procedures and fire/evacuation drills are regularly conducted.
• Hillcrest campuses are equipped with required fire and smoke detection systems, all Hillcrest buildings are equipped with fire extinguishers, and all HEC dormitories are equipped with sprinkler systems. Each Hillcrest residential campus is equipped with emergency power generators.
• Hillcrest’s Maintenance Department regularly conducts campus safety inspections and major systems maintenance.
• Hillcrest maintains and utilizes snow removal and sanding/salting vehicles/equipment for use on campuses.
Based upon the geographic location of Hillcrest Educational Centers, state and national agency data, experience and history, it has been determined that the potential hazards most likely to have impact on general agency operations and on the safety, care and treatment of Hillcrest students and on the safety of staff include the following.

A) Natural disasters

1) Meteorological, Topological and Underground disasters:
Hurricanes and tornadoes, hailstorms, ice storms and snowstorms, droughts, floods, earthquakes.
Analysis (low risk)
For the most part, the potential impact of meteorological, topological and underground disasters is assessed to be low.
Hurricanes, tornadoes, droughts, floods and earthquakes are historically and statistically relatively rare in western Massachusetts, and particularly in the local areas in which Hillcrest campuses are located. For example, the MA Emergency Management Agency states-that moderate to major earthquake activity occurs in Mass. only about every 50 – 70 years, with more serious earthquake activity occurring only every 200 – 300 years. Hurricanes in the region tend to affect western MA. through heavy rains, rather than destructive winds.
Of these types of natural disasters, then, those which have the highest potential for affecting Hillcrest are winter weather related events such as ice storms and snowstorms, and these tend to be most significant for Hillcrest when they affect the electric power supply and the ability of staff to travel to/from the work site.
Discussion
a) Loss of electric power is relatively rare (0 – 3 times/year) and, most commonly, for very short periods of time (less than one hour) when it does occur. These losses are managed using emergency power generators at each Hillcrest residential campus. The generators are positioned to insure safety, the maintenance of relative comfort for students, and adequacy of food storage.
In the event of loss of power at the day program, students can be transported back to their residences.
b) Staff travel — Thanks to the effectiveness of the local municipalities in performing snow removal and road maintenance activities during winter months, staff travel is rarely affected. When and if staff travel is affected for short periods (e.g., half a day), agency staff with four wheel drive vehicles can, have and will assist with staff transport to/from work sites, as possible.
Staff who are unable to travel home after work could be temporarily housed on campus, as necessary, separate and apart from students.
In the event of severely inclement weather, the day program would be cancelled, as it is when local public schools are cancelled due to weather.

2) Biological disasters:
Communicable disease epidemics.
Analysis (low risk)
Given the stringency of state regulations and Hillcrest policies and practices pertaining to student immunizations and routine health care, as well as to policies and practices pertaining to staff health status and care, and the infection control monitoring done at each Hillcrest program, the potential for this type of disaster to affect Hillcrest is seen as extremely low.
Discussion
NA
(Please also refer to the Hillcrest Infection Control Manual and Hillcrest Policies and
Procedures.
Please also refer to the HEC Plan For Managing Widespread Infection Or Contagion.)

B) Person-made disasters
1) Civil disasters:
Riots, demonstrations, strikes.
Analysis (low risk)
Given the location and nature of the communities and region within which Hillcrest operates, the potential for this type of disaster is seen as extremely low.
Discussion
NA
2) Criminal/terrorist action:
Bomb threat/incident, nuclear, chemical, or biological attack, hostage incident.
Analysis (low risk)
Given the location and nature of the communities and region within which Hillcrest operates, the potential for this type of disaster is seen as extremely low. Additionally, Hillcrest’s intensive direct care and supervisor staffing ratios and levels help to insure student and staff safety and security with regard to these types of potential risks.
Discussion
NA
3) Accidents:
Transportation (planes, trucks, automobiles, trains and ships), structural collapse (buildings, dams, bridges, mines, and other structures), explosions, fires, chemical (toxic waste and pollution) biological (sanitation).
Analysis (low risk)
Given the location and nature of the communities and region within which Hillcrest operates, the potential for this type of disaster is seen as extremely low.
Discussion
NA
(Please also refer to the HEC Emergency Preparedness and Management Plan regarding Emergency Evacuation Procedures.
Please also refer to HEC policy on Workplace Violence)
Summary and Conclusion
According to the Massachusetts Emergency Management Agency and the National Weather Service, the following types of emergency/disaster events are statically the most common for Massachusetts as a whole: flood, hurricane, snow, HAZMAT, tornado. However, based on the actual geographic location of Hillcrest Educational Centers, experience and history indicate that, of these, the “natural disasters” are the ones most likely to occur due to the agency’s location. Of these “natural disasters”, historically and statistically the ones most likely to be problematic to Hillcrest operations are winter ice and snowstorms which sometime result in loss of electric power for relatively brief periods of time and which Hillcrest is adequately prepared to manage.

IV. Local & Agency Resource Analysis
The areas in which all Hillcrest sites are located, including four campuses, the day program, and Central Administration office operations, are categorized as “suburban”. All have relatively easy access to the local resources detailed below.
The following local resources can be utilized to mitigate and/or respond to emergencies and/or disasters.

A) Local Fire Departments, local and State Police units – These well-coordinated agencies usually function as Emergency Management Agencies in the towns in which Hillcrest operates.

B) Local hospitals and medical facilities – Located in Pittsfield and Great Barrington. Additional medical facilities are located within manageable distances in various directions, for example, to the north (e.g., North Adams), east (e.g., Springfield, MA) and to the west (e.g., Troy and Albany, NY).
C) American Red Cross – Located in Pittsfield. ARC provides disaster relief coordination and services.
D) Lodging – Because it is a tourist and business area, there is a plethora of hotels and motels that can provide shelter as necessary.
E) Local private and public schools, houses of worship, and other large facilities which could temporarily house groups of people during emergency conditions.
F) Numerous gasoline service stations in close proximity to each campus at which gasoline for the emergency power generators can be obtained.
Each Hillcrest residential campus is equipped with between one and three emergency power generators that can be utilized almost indefinitely in the event that electric power is lost for any significant period. The generators are deployed so that, minimally, heat, light and some refrigeration can be maintained to insure student safety and relative comfort.
Each residential campus is equipped with one or more weather radios that are strategically located within ear shot of staff and which are left plugged in, with battery back up, at all times. Weather radios provide weather warning and emergency notifications transmitted by the national weather service.
Each residential campus has awake staff and supervisor coverage 24 hours per day, 365 days per year, and all campus have communication capability supported by walkie-talkies that can access local emergency assistance channels. Additionally, all Hillcrest buildings are equipped with fire extinguishers, all but two Hillcrest dormitories on the residential campuses are sprinkler equipped, each campus conducts at least two fire drills per shift per quarter, two evacuation drills per year, and emergency preparedness training on a quarterly basis. Therefore, response to fires, emergencies, disasters and/or other forms of hazards can be very rapid and efficient.
Finally, because the farthest Hillcrest campuses are only 45 minutes away from one another, with the Administrative Offices and day program approximately halfway between these, the three residential treatment centers can provide shelter if necessary. These three campuses each have full sized gymnasiums, fully equipped kitchens, nursing staff, etc. The agency also has a fleet of vans and an assortment of utility vehicles which can be used to transport people, supplies and equipment if and as necessary.

CompuWorks has taken the place of our internal IT Department for the receiving and resolving of all IT related issues here at Hillcrest Educational Centers.

Please submit any IT related issues to CompuWorks by eMail: healthyit@compuworks.biz or by telephone: (413) 499-0607 between the hours of 7:30 am – 5:30 pm, Monday – Friday and the issue will be resolved in a timely manner.   

In the event significant problems occur during non-business hours that prevent you from performing work related tasks, please follow the policy below:

For Loss of Network/Internet Connectivity:

If your device/laptop is not hard wired to the Hillcrest Network, please try to log into a device/workstation that is hard wired to the Network to continue working.

If the Internet/Network connectivity issue still persist 1.) after attempting to log in to another network hard wired device/workstation and 2.) the task you are working on is urgent (cannot wait to be completed on the next business day

OR

If successfully logged in but cannot access an application and/or server:

Please contact CompuWorks on their Emergency AFTER HOURS Support line at (413) 266-1124.

Leave a message that includes the issue you are experiencing, attempts you have made to remedy issue, your location and a call back number.

Upon receiving message, CompuWorks will return call and begin assessing issue via phone and/or visit location to continue troubleshooting.