PREPAREDNESS Life in the County Emergency Management Plan T. R. Belcuore April 2007

RULES OF THE ROAD Presently, we operate under a crisis and consequence scenario The National Incident Management System (NIMS or ICS) is for crisis The Emergency Support Function System (ESF) is for consequences of the crisis And now for the BIG ONE……

COUNTY PREPAREDNESS RESPONSE PLANS ARE LIKE LONG UNDERWEAR, ONE SIZE DEFINITELY DOES NOT FIT ALL.

CORE ELEMENTS Emergency Support Function (ESF 8 or 18) Special Needs Shelters HazMat Response Lab and Sampling Laboratory/Chain of Custody Rumor Control

CORE ELEMENTS- HURRICANE Special Needs Shelters Epidemiology Environmental Health Long Term Care-Discharge Planning Hospitals Rumor Control

NEW ELEMENTS Incident/Unified Command Points Of Dispensing/Distribution (PODs) Alternate Care Sites RDSTF Quarantine/Isolation

EMERGENCY SUPPORT FUNCTIONS Designed post –Andrew 16 core functions that distribute the activities CHD’s normally operate in ESF-8; however, a few counties use ESF 18 ESF-17 is animal control- while not yours you might want to consider it

ESF ORGANIZATION 1-Transportation 2-Communications 3Public Works 4-Fire/Rescue 5-Planning 6-Mass Care 7-Resource support 8-Health/Medical 9-Search/Rescue 10-HazMat 11-Food and Water 12-Energy 13-Military Support 14-Public Info 15-Volunteers 16-Law Enforcement 17-Animal Care

SHELTER MANAGEMENT CHD’S have responsibility by statute for persons with Special Needs Done usually in conjunction with ESF-6 (mass care). Red Cross has lead, but… All orders placed through Emergency Manager

SOME SHELTER BASICS Rotate your shifts on 12 hour segments- this synchs up with regular planning cycles However, change your supervisors two hours prior to staff shift- therefore, better flow Give each shelter a FIXED time YOU will call them (sitrep). Give them a fixed set of questions you want answered: so, what are the questions?

MORE SHELTER BASICS Consult with EM to determine level of acuity shelter will take, but…. Remember, hospitals won’t take most of them Role of CMS? SpNS require alternative power to run concentrators and suctioning machines. Arrange this though EM now. When things go bad…fires, N. Homes

SHLETER BASICS-2007 State statute now defines Special Needs clients There is no standard form to enroll a Special Needs client Attempt to have County EM accept a different form Advocate for a standard form

HazMat Coordination between you, DEP, local EDP (sometimes) Anthrax Sampling Protocol- might be the time to change yours Key point is chain of custody Get to know the HazMat chief(s)

LAB AND SAMPLING Keep copy of what gets sent where from your county Arbovirus work to Lillian Starke (Tampa) plus things like cryptosporidium The path for results goes through Tally Make use of the molecular capability we have in outbreaks

RUMOR CONTROL Do not confuse this with risk communication Identify who does it in your county Any rumor allowed 8 hours without response becomes validated

NEW ELEMENTS Added primarily after Sept. 11 However, response planning commenced in July of 1999 with the creation of the State Working Group (SWG) Then, current system created the RDSTF (Regional Domestic Security Task Force)

INCIDENT COMMAND SYSTEM Developed by Fire Service Adopted as the statewide response mechanism Starts with 4-6 basic elements and grows as needed

BASIC STRUCTURE INCIDENT COMMANDER or UNIFIED COMMAND OPERATIONS CHIEF PLANNING CHIEF LOGISTICS CHIEF FINANCE CHIEF SAFETY OFFICER LIAISON OFFICER

THE STRUCTURE EXPANDS INCIDENT COMMAND PLANNING CHIEF RESOURCE OFFICER TECHNICAL SPEC. OPERATIONS CHIEF MEDICAL BRANCH LOGISTICS CHIEF MEDICAL SUPPORT FINANCE TIME UNIT SAFETY OFFICER PIO LIAISON

THE STRUCTURE EXPANDS AGAIN INCIDENT COMMAND PLANNING CHIEF RESOURCE OFFICER TECHNICAL SPEC. SIT. STAT UNIT OPERATIONS CHIEF MEDICAL BRANCH HOSPITAL POD/VAX BEHAVIORAL ALT. Tx CENTER LOGISTICS CHIEF MEDICAL SUPPORT VAX/PROPHY CISD FINANCE/ADMIN SAFETY OFFICERPIO/JIC

THE STRUCTURE EXPANDS AGAIN INCIDENT COMMAND PLANNING CHIEF RESOURCE OFFICER TECHNICAL SPEC. SIT. STAT UNIT OPERATIONS CHIEF MEDICAL BRANCH HOSPITAL BEHAVIORAL ALT. TX CENTER SHELTER BRANCH PODS LTC SUPPORT COMMUNITY BRANCH EPI EVH LOGISTICS CHIEF MEDICAL SUPPORT VAX/PROPHY CISD SERVICES SUPPORT FINANCE/ ADMIN SAFETY OFFICER PIO/JIC LIAISON

OF LSA’s,PODS, JICS, JOCS, ( AND OTHER STUFF) Points of Dispensing Look a lot like vaccine clinics- so use your base operational plans Critical areas are security, traffic control, and behavioral health Need a POD manager and logistics unit- everyone else is providing care PODs deal with people, not county lines Use of school lunchrooms…..

ALTERNATE CARE SITES (s/k/a CASUALTY COLLECTION POINTS) Designed for when hospital ED is overrun However, SARS created them as well Use in conjunction with hospital diversion plan Potential need for full time epi staff Plan may use in conjunction with POD locale, but infection issues will occur

The “Q” and “I” WORDS Some statutory confusion (TB) Quarantine is for well persons, isolation is for ill persons Quarantine now in statute Quarantine/isolation plan in draft now X facilities and their role

RUMOR CONTROL ON STEROIDS Biologicals will create the greatest amount of fear “Internet Amplification” Restructure of Rumor Control Establish rumor controls with LE, Fire, Hospitals, and reporting path Use JIC to provide citizens with info dispelling rumor du jour (hour)

HURRICANE-A DRAMA IN THREE PARTS THE RUN-UP THE EVENT THE POST-EVENT

THE RUN-UP This encompasses the time from today until the wind starts blowing: SCHOOL/SHELTER SITES − Have they changed your area? − Drawings for placement of cots − Generator in place or brought in − Power cord needs

THE RUN-UP POPULATION PLANNING − Age distribution and where they live − Birth rate for last three years − Flood area county evacuation − Host vs. Strike shelters WATER − Calculate 3L/day for drinking

THE RUN-UP WATER SUPPLY − Public supply certification − # samples needed − # private wells (flood issues) SANITATION − # Porto-Lets available on demand HOSPITAL − Fuel type and burn rate (if known)

THE RUN-UP COMMUNICATION − Establish your ESF-8 call list − Establish a DL for partners − Radio capabilities identified − Test Test Test Test KNOW THE POPULATION − Homeless and others

THE EVENT BALANCE YOUR LEAD TEAM − Get them rest prior to the event − Make sure your lead team is safe − Make sure that EVH is resting Establish Call Times − Set a time for the Shelter Leads to be called by you − Have an established set of questions

THE EVENT COMMUNICATION − Stay in touch with the partners − Prepare situation reports and contingency plans for immediate response − Keep SEOC notified by objectives and SitStat GET SOME SLEEP!! It’s not going anywhere for a while……

THE POST EVENT Each event has a “signature” Each event is time sequenced There are phases- i.e. the “chain saw phase”, the “blame phase”

THE POST-EVENT ASSESSMENTS − If you’ve been tracking, part of it is already in objective form − If an area is not calling in, check them FIRST − Don’t reinvent the assessment wheel

THE POST EVENT ASSESSMENTS Air-Water-Medicine-Food Hospital and LTC capacity Flood issues-know your roads And Finally…. Coordinate with the SEOC on who is doing what

THE POST-EVENT Day 0-3 Establish medical capability and repair DMAT may not be the answer Establish epi system Establish future EVH needs Mass Fatality Plan Status of the LTC system

THE POST EVENT Day 4-7 Enter the chain saw phase Enter the blame phase Environmental Health Issues Contingency Planning in effect Staff exhaustion Discharge Planning Consolidation of shelters

AND IN CONCLUSION USING ICS WILL HELP YOU: Manage by Objective Keep It Simple Focused on O 2 -H 2 O-MEDS-FOOD

WE’RE ALL IN THIS TOGETHER! QUESTIONS??