Planning Assistance in Action
by Kristen E. Humphrey, MLA, Local Assistance and Training Planner
Those of you who follow Planning Practice Monthly regularly may have noticed my name on the some of the bylines, or spotted my profile in a Meet the Staff piece currently posted on Planning’s Facebook page. (I serve as the principal writer and editor for the newsletter as part of my broader Local Assistance and Training Planner role for the department).
You might have also noticed that the newsletter was on hiatus for several months and that this is our first issue following that break. The reason for the break was, starting mid-December to early-January, several Maryland Department of Planning (Planning) staff accepted temporary, but indefinite, assignments with various partner agencies to assist with the state’s response to the COVID-19 crisis. We have been asked to share some of our experiences beginning with this edition.
Most of us were assigned to roles with the Maryland Department of Health (MDH) and at least one staff member was assigned to assist the Maryland Emergency Management Agency (MEMA). I, together with my colleague, Cassandra Malloy, was assigned to work with MDH’s Community and Facility Initiative (CFI or “The Initiative”), which was created on an emergency basis in March 2020 as the body tasked with addressing the COVID-19 outbreaks in Maryland’s congregate care facilities.
The term congregate care is generally used to refer to skilled nursing facilities (aka nursing homes) and assisted living facilities, of which there are approximately 230 nursing homes and more than 1,200 assisted living facilities across the state. Other types of congregate living circumstances include facilities such as prisons, halfway houses, and rehab facilities, to name a few.
Nursing homes and assisted living facilities, just by virtue of the congregate care setting (e.g., close quarters along with shared spaces and services), are more subject to an outbreak of a highly infectious disease such as the COVID-19 virus. Furthermore, as they house some of the most medically fragile people among our population, residents are especially vulnerable to illness and/or death if an outbreak occurs.
Similarly, because of close proximity to residents, those who care for them are also at high risk. The combination of proximity and vulnerability is a recipe for potential disaster: facilities are at high risk of having the virus brought in from the outside via visitors and staff, and staff are at high risk for becoming infected at work and carrying the disease into the community and their homes. Therefore, congregate care facilities are particularly at risk of staff shortages resulting from high rates of infection and illness.
It is easy to see why outbreaks in nursing homes, assisted living, and other congregate facilities were both early and severe, and had some of the highest infection and death rates across the country and the globe. To try to slow and ultimately get ahead of the problem, the CFI team was formed at the direction of Governor Hogan and is made up of doctors, nurses, physician assistants, and nurse assistants to aid facilities that became overwhelmed by providing them with technical assistance.
Assistance was needed and provided in many areas: interpreting and disseminating the latest guidance and recommendations from the CDC, MDH, and Governor’s office; COVID-19 testing; fit testing – which involves using specialized equipment for properly fitting N95 masks; and, perhaps most importantly, providing temporary clinical staff to act as a bridge in the event that a facility was shorthanded. The CFI team also assisted with training for the administration of approved treatments and therapies as they emerged for the disease and, when the vaccination became available, the team immediately pivoted to get vaccines to the places and to the people needed.
As one might imagine, to mount a response to the challenges of the outbreaks in so many facilities throughout the state, and to ultimately get ahead of the disease, required a tremendous amount of coordination and communication in addition to having the necessary medical staff and providing them with on-the-go training. Hence, several of the top executives running the Initiative had military experience, most hailing from the Maryland National Guard, as well as medical backgrounds.
Having never worked in either field, I was deeply impressed with the efficiency, efficacy, organization, and endurance of the leadership and team members. I was further impressed to see that they were able to keep their calm and patience, remain kind, and even retain their senses of humor, all while working, quite literally, with people’s lives in the balance. I could not have been more in awe or had greater respect for these folks! Expressions such as “grace under pressure” hardly do them justice.
And what did I do while on the team? My role in assisting the team was genuinely very small, working behind the scenes on various administrative tasks together with Cassandra, ranging from data entry, identifying missing or conflicting information, communicating with those who could reconcile the data, and pulling together weekly reports from highly disparate sources of information and circulating them to team leadership.
Additionally, I assisted leadership with some small graphics projects, helped to draft and refine standard operating procedures, and wrote step-by-step manuals for specific tasks so that, as staff and the demands of the pandemic changed, new members would know how to “keep the train running.” These documents will also help to provide some institutional history that may be instructive for mounting a response to a similar public health crisis in the future.
Truly, in the grand scheme of things, this was really, really, small stuff – but it felt good knowing that it might free someone else up to focus on the bigger, much more urgent tasks at hand. I am so glad I had this opportunity, not only for the eye-opening experience of seeing how people can be mobilized in an emergency, but also for the chance to work with a group of truly wonderful people and witness their extraordinary passion, commitment, and humanity in action.
I would gladly help out again — in a proverbial heartbeat.