California Emergency Mutual Aid System Gets Overhaul

The California Association of Health Facilities (CAHF) sees the state’s new Long-Term Care Mutual Aid Programs (LTC-MAPs) currently focused on Southern California as a proven way to assist nursing facilities to help each other and collaborate with local, county, and state emergency planners and responders to manage the frail and elderly during disasters.

After the failures in emergency evacuations of these populations during the tragic Eaton Fire of 2025 that engulfed wide swaths of the Los Angeles area, it was more than necessary to make a major overhaul happen, said Jason Belden, the CAHF director of emergency preparedness and physical plant services.

At its core, the LTC-MAP's power comes from the “like-care facilities” that are committed to helping each other in their time of need, according to a primer on the system by Jensen Hughes. They said benefits of the LTC-MAP include:

- Participation benefits all facilities directly by being better prepared and indirectly assists CMS providers (nursing homes) because the LTC-MAP fully or partially meets 32 of the 57 CMS Emergency Preparedness elements (56 percent) for members that fully comply and participate with all LTC-MAP programming.

- Participation benefits members as well as state, county and local stakeholders, and emergency planners because it provides a common framework for assisting member facilities to help each other as well as pre-establish a payor process for Medicare and Medi-Cal associated with evacuations and surge events.

Belden said the system is focused on skilled nursing facilities in Los Angeles County and will expand to surrounding counties as well. Assisted living is not part of LTC-MAP, yet.

“This is based on a system that is operational in Massachusetts, Connecticut, Virginia, and King County for Seattle in Washington. It is not a unique thing, but we are probably one of the first for a county the size of Los Angeles,” he said.

A total of 383 SNFs are now in the LTC-MAP.

Transfers the Focus

The problems that led to so many problems during the Eaton Fire centered on the trauma caused to residents during transfers from their facility, resulting in cardiac arrests and distress for those on respirators, as examples. The lack of a comprehensive plan hindered evacuations, Belden said.

“They did not die in the fire but during the evacuation because it was so poorly managed. There was a lack of information from the county. There was no official warning,” he said. Facility staff in many cases were calling for help as the grounds burned.

There was also no clearly identified place to take those residents being removed from fire-threatened locations, and the system was not set up for continuity of care.

Now, that has changed with LTC-MAP and the small startup funds ($200,000) provided by the state to have electronic health records updated on a consistent basis, so the state knows the status of residents if there is an emergency.

“I can’t tell you how excited providers are, especially line staff who actually do the work, as well as charge nurses and CNAs. The whole goal is you are going to minimize the folks you have to reach out to and be able to automatically match the level of care people need as they are evacuated during an emergency,” Belden said.

Under LTC-MAP, appropriate facility staff will receive quarterly training and there will be two annual exercises to test responses, he added.

Comments or questions? Contact Patrick Connole at pconnole@parkplacelive.com.