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Disaster Planning for Behavioral Health Service Programs

1. Which of the following statements best defines the term disaster?

A. Any incident, whether natural or human-caused, that requires responsive action to protect life or property.

B. An occurrence of a natural catastrophe, technological accident, or human-caused incident that has resulted in severe property damage, deaths, and/or multiple injuries.

C. An occurrence involving a health care facility that results in death.

D. A natural, technological, or human-caused source or cause of harm or difficulty.


2. Which of the following statements best defines the term emergency?

A. Any incident, whether natural or human-caused, that requires responsive action to protect life or property.

B. Any state-wide incident that involves a natural disaster, and requires state intervention.

C. An occurrence involving a health care facility that results in property damage.

D. An occurrence involving a health care facility that results in death.


3. Which of the following best represents a "trigger" that may contribute to a higher demand for behavioral health services in a disaster?

A. Limited information

B. Disaster planning

C. Cognitive-behavioral therapy

D. Medication adherence


4. A health care professional has questions regarding continuity planning. Which of the following informational points of interest should be communicated to the health care professional?

A. Continuity planning requires programs to limit disaster planning to cover only senior health care personnel.

B. Continuity planning requires programs to limit disaster planning to gathering resources for inpatient care.

C. Continuity planning only requires programs to consider threats that could last for 24 - 48 hours.

D. Continuity planning requires programs to consider threats that could adversely affect essential functions.


5. Which of the following statements is most accurate?

A. Continuity planning focuses on helping programs prepare to avoid possible surges in demand for services related to SUDs.

B. Continuity planning focuses on helping programs prepare to avoid possible surges in demand for services related to methadone therapy.

C. Continuity planning can help programs prepare to meet a possible surge in demand from government agencies.

D. Continuity planning can help programs prepare to meet apossible surge in demand for services from existing, new, and temporary guest clients in the immediate aftermath of a disaster or in the months that follow.


6. The Centers for Medicare and Medicaid Services’ Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers Final Rule states that providers’ emergency plans must include which of the following?

A. A method to document risk assessment using an all hazards approach.

B. A method to document medication adherence among patients under the age of 18.

C. A method to account for patient mortality rates among individuals over the age of 65.

D. A method to account for medical errors among patients suffering from SUD.


7. Which of the following points of interest should be included in the introductory section of a basic disaster plan?

A. The populations a program serves

B. Staff training

C. Medication adherence

D. Medication waste


8. A health care professional is tasked with developing the Implementing Instructions section of a disaster plan. Which of the following points of interest should be included in the Implementing Instructions section of a disaster plan?

A. The program's essential functions

B. The objectives of the disaster plan

C. The scope of the disaster plan

D. Scripts for staff to use when providing disaster-related information to consumers and the public


9. Which of the following statements is most accurate?

A. The team leader of a disaster planning team should have final decision making authority over all team members with less than five years of experience.

B. The team leader of a disaster planning team should ensure team members receive the training they need to contribute effectively to disaster planning.

C. The individual who leads the disaster planning team should always be the individual assigned to lead the organization during its response to a disaster.

D. The individual who leads the disaster planning team should always be the individual assigned to lead the organization during its response to a disaster for the first 24 - 72 hours after a disaster.


10. A health care professional has questions regarding the process for selecting team members of a disaster planning team. Which of the following informational points of interest should be communicated to the health care professional?

A. Members should not include clinical staff.

B. Members should not include nonclinical staff.

C. All departments of the facility or organization, especially those providing essential functions, should be represented on the disaster planning team.

D. It is not necessary for all departments of the facility or organization to be represented on the disaster planning team.


11. A health care professional, serving on a disaster planning team, is asked to develop a document outlining information relevant to disaster-related funds. Which of the following informational points of interest should be included in the document?

A. Following a disaster, the state disaster behavioral health coordinator cannot help a program apply for disaster-related funds.

B. Following a disaster, the state disaster behavioral health coordinator can only help a program apply for disaster-related funds for a period of 24 hours after a disaster.

C. Disaster-related funds may be available through the Robert T Stafford Disaster Relief and Emergency Assistance Act.

D. The Robert T Stafford Disaster Relief and Emergency Assistance Act only provides disaster-related funds to programs servicing individuals over the age of 65.


12. A 24-year-old male patient has questions regarding disaster-related anger and grief. Which of the following educational points should be expressed to the patient?

A. Disaster-related anger and grief do not typically affect individuals under the age of 40.

B. Anger and grief may show up as social withdrawal.

C. Disaster-related anger and grief should not be acknowledged in any way.

D. Individuals experiencing disaster-related anger and grief should not attend memorials.


13.   Which of the following best represents a sign that an adult might need crisis counseling or stress management assistance?

A. Excessive weight gain

B. Reluctance to leave home

C. Nocturnal enuresis

D. Polydipsia


14. Which of the following statements best defines a THIRA?

A. THIRA is an assessment that identifies the types and scopes of hazards that are most likely to occur across the U.S.

B. THIRA is an assessment that identifies the types and scopes of hazards that are most likely to occur across the U.S. over a period of six months.

C. THIRA is an assessment that identifies the types and scopes of hazards that are most likely to occur in a program's jurisdiction.

D. THIRA is an assessment that identifies the types and scopes of hazards most likely to occur in a program's jurisdiction over a period of four to five years.


15. A health care professional has questions regarding a QSOA. Which of the following informational points of interest should be communicated to the health care professional?

A. QSOAs are required under HIPAA.

B. QSOAs are required under 42 CFR Part 2.

C. QSOAs are not required.

D. QSOAs are not required for voluntary organizations.


16. Which of the following best represents one of an Incident Commander's responsibilities during a disaster and in its immediate aftermath?

A. Assessing damage

B. Ensuring medication adherence

C. Staff training

D. Staff scheduling


17. A disaster planning team is evaluating alternate facilities for continuing essential operations in the event of a disaster. What should the disaster planning team consider when evaluating alternate facilities?

A. Can the facility become operational in 12 hours or less?

B. Can the facility become operational in a period of 48 hours after a disaster?

C. Does the facility have enough space for at least one-third of all patients?

D. Does the facility have enough space for at least half of all patients?


18. Which of the following statements best defines a PAD?

A. A PAD is a legal document, accepted in most states, through which an individual can indicate preferences and instructions for treatment of mental disorders at times when he or she is not competent to express his or her own wishes.

B. A PAD is a legal document, accepted in most states, through which a health care professional can indicate preferences and instructions for the treatment of a patient with mental disorders during a disaster.

C. A PAD is a legal document, accepted in most states, through which a health care professional can indicate preferences and instructions for the treatment of a patient with mental disorders during a disaster for a period of 48 hours.

D. A PAD is not a legal document - however, it allows an individual to indicate preferences and instructions for treatment of mental disorders at times when he or she is not competent to express his or her own wishes.


19. Which of the following best represents an essential function of an outpatient treatment program during/after a disaster?

A. Provide residential care for patients who do not meet discharge criteria.

B. Coordinate or address transportation needs for accessing medical services.

C. Transfer clients to area residential providers if the program’s facility is unusable or destroyed.

D. Secure support from other providers to meet the needs of clients whose medications were destroyed.


20. Which of the following best represents an essential function of a residential treatment program during/after a disaster?

A. Discontinue medications after a period of 24 hours.

B. Discontinue medications after a period of 48 hours.

C. Discontinue medications after a period of 72 hours.

D. Continue medications and supportive counseling to patients to prevent decompensation or escalation of symptoms of mental or substance use disorders, or both.


21. Which of the following best represents an essential function of a medically supervised withdrawal program during/after a disaster?

A. Closely monitor patients’ withdrawal symptoms.

B. Avoid transforming any and all patients.

C. Discharge patients after a period of 24 hours.

D. Discontinue medications after a period of 24 hours.


22. Which of the following best represents an essential function of an OTP during/after a disaster?

A. Confirm identities and dose information for patients receiving medication.

B. Provide or facilitate access to prescribed or dispensed medications, with the exception of methadone.

C. Deny "X waivers."

D. Deny "X waivers" for patients under the age of 65.


23. Which of the following best represents a benefit of cloud-computing platforms?

A. Reduces run-time failures

B. Prevents small IT allocations

C. Prevents increases in IT allocations as needed

D. Makes data security a shared responsibility between the program and the cloud clinician


24. A health care professional has questions regarding the HIPAA Privacy Rule. Which of the following informational points of interest should be communicated to the health care professional?

A. Under the Privacy Rule, covered entities may not disclose patient information for any reason.

B. Under the Privacy Rule, covered entities may disclose, with a patient’s authorization, protected health information about the patient as necessary to treat the patient or to treat a different patient.

C. A covered entity may not share protected health information with a patient’s family member for any reason.

D. A covered entity may share protected health information with a patient’s family member, relative, friend, or other persons identified by the patient as involved in the patient’s care.


25. A health care professional has questions regarding 42 CFR Part 2. Which of the following informational points of interest should be communicated to the health care professional?

A. Patient-identifying information may not be disclosed by a Part 2 program to medical personnel during an emergency.

B. Patient-identifying information may not be disclosed by a Part 2 program to medical personnel for any reason.

C. Patient-identifying information may not be disclosed by a Part 2 program for any reason.

D. Patient-identifying information may be disclosed by a Part 2 program or other lawful holders to medical personnel, without patient consent, to the extent necessary to meet a bona fide medical emergency in which the patient’s prior informed consent cannot be obtained.


26. Which of the following statements is most accurate?

A. PPAEMA allows emergency medical services personnel to administer Schedule II, III, IV, or V controlled substances if an authorizing medical professional is present at all times.

B. PPAEMA allows emergency medical services personnel to administer Schedule II, III, IV, or V controlled substances if an authorizing medical professional is present for a period of 24 hours.

C. PPAEMA allows emergency medical services personnel to administer Schedule II, III, IV, or V controlled substances without having an authorizing medical professional present, as long as state law allows it and there is a standing or verbal order from an authorizing medical professional.

D. PPAEMA allows emergency medical services personnel to only administer Schedule II and III controlled substances without having an authorizing medical professional present, as long as state law allows it and there is a standing or verbal order from an authorizing medical professional.


27. A health care professional has questions regarding methadone. Which of the following informational points of interest should be communicated to the health care professional?

A. Methadone is a Schedule II substance.

B. Methadone is a Schedule III substance.

C. During a disaster, "guest dosing" of methadone is prohibited.

D. During a disaster, "guest dosing" of methadone is prohibited if the methadone dose exceeds 50 mg daily.


28. A health care professional has questions regarding psychiatric medications and disasters. Which of the following informational points of interest should be communicated to the health care professional?

A. The abrupt discontinuation of psychiatric medications does not often lead to withdrawal symptoms.

B. The abrupt discontinuation of psychiatric medications does not often lead to psychosis.

C. Benzodiazepine should be discontinued following a disaster.

D. Clinicians should develop action plans for any patients who are receiving scheduled benzodiazepine dosing to prevent abrupt withdrawal if a disaster occurs.


29. A 40-year-old male patient asks a health care professional the following question: can a practitioner admit anew patient with OUD toanOTP using telehealth?What should be the health care professional's response to the previous question?

A. Yes, in the case of methadone.

B. No, in the case of methadone.

C. No, in the case of buprenorphine.

D. No, if the patient is under the age of 65 and is taking buprenorphine.


30. A 28-year-old female patient asks a health care professional the following question: can patients who are already being treated with methadone or buprenorphine continue to be treated via telehealth? What should be the health care professional's response to the previous question?

A. Yes

B. Yes, but only for 24 hours.

C. Yes, but only for48 hours.

D. No


31. A 32-year-old male patient asks a health care professional the following question: can a practitioner with a Drug Addiction Treatment Act of 2000 (DATA) waiver treat new and existing buprenorphine patients outside of an OTP? What should be the health care professional's response to the previous question?

A. Yes.

B. Yes, but only for 24 hours.

C. Yes, but only for48 hours.

D. No.


32. A 40-year-old male patient asks a health care professional the following question: can an OTP dispense methadone or buprenorphine based on an evaluation conducted via telehealth? What should be the health care professional's response to the previous question?

A. Yes, up to 5 doses for clinically less stable patients and 10 doses for clinically stable patients.

B. Yes, up to 8 doses for clinically less stable patients and 12 doses for clinically stable patients.

C. Yes, up to 14 doses for clinically less stable patients and 28 doses for clinically stable patients.

D. No.


33. A 38-year-old female potential patient is receiving opioid medication for pain. The potential patient loses access to the opioid medication, due to a disaster, and experiences withdrawal. The potential patient asks a health care professional working in an OTP for assistance. According to SAMHSA  recommendations, how should the health care professional proceed?

A. Dispense two doses of methadone to the potential patient.

B. Dispense two doses of buprenorphine to the potential patient.

C. Dispense four doses of buprenorphine to the potential patient.

D. Refer a potential patient to a local physician, preferably a pain management specialist.


34. Which of the following statements is most accurate?

A. Pregnant women who contract influenza are at decreased risk for severe illness or death.

B. Pregnant women, over the age of 18, who contract influenza are at decreased risk for severe illness or death.

C. Pregnant women who contract influenza are at increased risk for severe illness or death, and babies born to them have increased risk of adverse outcomes.

D. Pregnant women who contract influenza are at increased risk for severe illness or death - however, babies born to them have a decreased risk of adverse outcomes.


35. Which of the following best represents a potential pandemic effect for an outpatient treatment program?

A. Clients may not heed instructions to stay home if experiencing disease symptoms and consequently transmit the illness to other clients and staff.

B. Emergencies for mental health issues may decrease by half.

C. Beds may be redirected for use by patients with a pandemic disease.

D. Health care professionals may have to report to work even if they are infected.


36. Which of the following best represents a potential pandemic effect for a residential treatment program?

A. Methadone will have to be discontinued.

B. All patients will have to receive antiviral medications, whether they are infected or not.

C. All health care professionals will have to receive antiviral medications, whether they are infected or not.

D. Visits may need to be suspended orhighly restricted.


37. Which of the following best represents a potential pandemic effect for an OTP?

A. An OTP may have to stop providing patients with take-home methadone doses due to disaster laws.

B. An OTP may have to stop providing patients, under the age of 65, with take-home methadone doses due to disaster laws.

C. An OTP may need to provide patients with take-home methadone doses for longer periods than usual.

D. Treatment with methadone will be discounted.


38. A health care professional has questions regarding when a health care professional with COVID-19 can return to work. Which of the following informational points of interest should be communicated to the health care professional?

A. Personnel who are not severely immunocompromised and were asymptomatic throughout their infection may return to work when at least 5 days have passed since the date of their first positive viral diagnostic test.

B. Personnel who are not severely immunocompromised and were asymptomatic throughout their infection may return to work when at least 10 days have passed since the date of their first positive viral diagnostic test.

C. Personnel who are severely immunocompromised but who were asymptomatic throughout their infection may return to work when at least 12 days and up to 30 days have passed since the date of their first positive viral diagnostic test.

D. Personnel who are severely immunocompromised but who were asymptomatic throughout their infection may return to work when at least 14 days and up to 40 days have passed since the date of their first positive viral diagnostic test.


39. A 52-year-old female patient has questions regarding COVID-19. Which of the following educational points should be expressed to the patient?

A. Individuals who are severely immunocompromised could remain infectious for up to 5 days after symptom onset.

B. Individuals who are severely immunocompromised could remain infectious for up to 10 days after symptom onset.

C. Individuals who are severely immunocompromised could remain infectious for up to 15 days after symptom onset.

D. Individuals who are severely immunocompromised could remain infectious more than 20 days after symptom onset.


40. A health care professional is developing an educational lecture on the five essential elements of ongoing recovery. Which of the following education points should be included in the health care professional's educational lecture?

A. When attempting to calm individuals, health care professionals should not ask individuals the following question: how are you doing?

B. When attempting to encourage individuals to connect, health care professionals should not encourage individuals to "stay in touch" with coworkers.

C. When attempting to assess competence, health care professionals should not ask individuals the following question: do you have any concerns about being able to handle what’s going on in your life?

D. When attempting to instill or assess confidence in individuals, health care professionals should check in with individuals regularly and/or share optimistic news.


41. A health care professional is tasked with developing the pandemic appendix of a pandemic plan. The pandemic appendix should state/include which of the following?

A. What information to use to make the decision to activate the plan.

B. Who is in charge of medication distribution to patients.

C. What to do with medication waste.

D. How to define medication adherence in the aftermath of a disaster.


42. Which of the following best represents a pandemic planning assumption related to time factors?

A. The pandemic may last as long as five years, with mortality and morbidity increasing steadily over time.

B. The pandemic may last as long as eight years, with mortality and morbidity increasing steadily over time.

C. The pandemic may last as long as 10 months, with mortality and morbidity decreasing steadily over time.

D. The pandemic may last as long as 18 months and occur in several waves, with mortality and morbidity increasing and decreasing sporadically.


43. Which of the following best represents a pandemic planning assumption related to the prevention and treatment of influenza?

A. Antiviral medications will always be effective in treating influenza.

B. Antiviral medications will always be effective in treating influenza, and will be in supply.

C. Antiviral medications will always be effective in treating influenza - however, they will not be in supply.

D. Even if effective, antiviral medications may be in limited supply, and their distribution may occur in phases.


44. Which of the following best represents a pandemic planning assumption related to services?

A. Services will not be stressed.

B. Telecommuting practices may be implemented for support services.

C. Programs will be able to rely on mutual aid resources to support its response efforts.

D. Programs providing methadone treatment will be closed.


45. Which of the following organizations offers courses in all aspects of disaster response with an emphasis on different organizations collaborating in all-hazard emergencies?

A. CDC

B. WHO

C. FEMA

D. FDA


46. Which of the following organizations offers a tool for developing training exercises and establishing and evaluating the exercise goals?

A. CDC

B. WHO

C. HSEEP

D. Red Cross


47. Which of the following statements regarding discussion-based disaster exercises is most accurate?

A. Discussion-based exercises include seminars, workshops, and tabletop exercises.

B. Discussion-based exercises do not include seminars, workshops, and tabletop exercises.

C. Discussion-based exercises occur during a disaster.

D. Discussion-based exercises always occur immediately after a disaster.


48. A health care professional has questions regarding operations-based disaster exercises. Which of the following informational points of interest should be communicated to the health care professional?

A. Operations-based exercises include seminars.

B. Operations-based exercises include drills.

C. Operations-based exercises occur during a disaster.

D. Operations-based exercises always occur immediately after a disaster.


49. A health care professional is developing an educational lecture on full-scale disaster exercises. Which of the following education points should be included in the health care professional's educational lecture?

A. Full-scale disaster exercises should focus on one specific function.

B. Full-scale disaster exercises should have two specific functions.

C. A full-scale disaster exercise should be a comprehensive enactment of a disaster, with people acting out their roles in real-time, using actual equipment, and testing multiple emergency functions.

D. A full-scale disaster exercise should be a comprehensive enactment of a disaster, with people acting out their roles in real-time and testing actual equipment on patients.


50. Which of the following statements best defines the term deactivation?

A. The process of closing a methadone treatment center during a disaster.

B. The process of closing a methadone treatment center after a disaster.

C. The process by which a program ends its state of emergency and initiates limited operations.

D. The process by which a program ends its state of emergency and resumes normal operations.


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