1. Emergency Preparedness Training for Social Workers New Jersey Preparedness Consortium (NJ-PTC) UMDNJ & US Department of HHS Grant No. T01HP01407

2. Goals & Objectives List 12 categories of items in an Emergency Preparation Kit Identify 3 ethical issues dealing with an emergency Name 2 laws dealing with legal issues in an emergency Identify the role of NIMS & ICS during a crisis

3. HSPD – 5 Executive Order #50 Executive Order #5 Homeland Security Presidential Directive – 5 Purpose: Develop & administer a National Incident Management System (NIMS) Executive Order #50 (Codey) Purpose: Mandates NIMS as state emergency response standard for NJ Executive Order #5 (Corzine) Purpose: Creates cabinet level Homeland Security Director to oversee state emergency response efforts

4. National Incident Management System (NIMS) Provides a national structure to prepare for, prevent, respond & recover from disasters Training at www.fema.gov/emiweb/iswww.fema.gov/emiweb/is

5. NIMS Components 1. Command & Management – Incident Command System (ICS) 2. Preparedness – Emergency Operations Plan (EOP), training 3. Resource Management – Personnel, facilities, equipment, supplies 4. Communications & Information Management – Public Information Officer (PIO) 5. Supporting Technologies – Computers 6. Ongoing Management & Maintenance – Changes, demobilization

6. Emergency Operations Planning – 4 Components 1. Preparedness – evaluate risks/probabilities 2. Response – how to deal with risks/probabilities 3. Mitigation – how to minimize the effects or prevent reoccurrence of disaster 4. Recovery – What would be needed to restore unmet needs/how to do this

7. Incident Command System (ICS) System for organizing a response (based on the Emergency Operations Plan) to an emergency after it occurs Common goal of stabilizing the incident - protecting life, property & the environment Directed by an Incident Commander (IC) Has 4 Basic Functions

8. 4 Basic Functions of ICS 1. Planning – Determine what specifically needs to be done to handle incident 2. Operations – Directs all resources to carry out the plan 3. Logistics – Provides the resources & all other services needed to support the plan 4. Finance/Administration – Monitors costs related to managing the incident

9. Laws Pertaining to Incidents Homeland Security Presidential Directive – 5 Established NIMS on national level Executive Order #50 Established NIMS on state level Executive Order #5 Established Cabinet Level Homeland Security Director NJ Emergency Health Powers Act - N.J.S.A. 26:13 Established powers of Commissioner of DHSS during incident Health Insurance Portability & Accountability Act - HIPAA Established permitted disclosures of identifiable health information

10. NJ Emergency Health Powers Act N.J.S.A. 26.13 Report Suspected Disease - DHSS Track Disease Process - Commissioner Emergency Health Care Providers Registry Transfer management of health care facility to DHSS Control of Health Care Supplies Vaccination – mandate Require Health Care Providers to Assist Immunity from Liability Reasonable Reimbursement for Services

11. HIPAA Personal Health Information (PHI) Persons exposed to reportable communicable diseases Persons who refuse treatment

12. Principles of Ethics Autonomy: Respect self-determination; choice of action Beneficence: Enhance welfare of others; avoid harm (nonmaleficence) Paternalism: Protect against self-harm or harming others (compromised autonomy) Justice: Equitable treatment

13. Biological Agents of Highest Concern Smallpox Anthrax Plague Tularemia Botulism Viral Hemorrhagic Fevers

14. Types of Illnesses These Agents Can Cause “Flu-like” illness (fever, sweats, nausea) Cough and/or pneumonia Headache, confusion Skin ulcers (anthrax, tularemia, plague) Rashes (smallpox, viral hemorrhagic fevers) Paralysis (botulism)

15. Contagious Agents Person-to-Person Transmission Smallpox Plague Pneumonia Some Viral Hemorrhagic Fevers (Ebola)

16. Antibiotics, Antitoxin, or Immunization Antibiotics – Anthrax, Plague, Tularemia Antitoxin – Botulism Immunization – Smallpox, Anthrax, Some Viral Hemorrhagic Fevers

17. Infection Control – Category A Critical Agents Standard precautions – all cases Airborne & contact precautions - smallpox, viral hemorrhagic fevers Droplet precautions – pneumonic plague

18. Infection Control Standard Precautions Disposable, non-sterile gloves Handwashing after glove removal Disposable gown/apron, face-shield if splashing anticipated Change protective gear between cases

19. Infection Control Contact Precautions Standard precautions plus Wear gloves & gown, change after contact with infectious material Dedicate non-critical patient care items to single patient or disinfect between patients

20. Infection Control Airborne Precautions Airborne Precautions Standard precautions plus Patient in negative air pressure room Wear respiratory protection (HEPA filter mask)

21. Infection Control Droplet Precautions Standard precautions plus Wear mask when within 6 feet of patient

22. Quarantine vs. Isolation Isolation: separation of a contagious person/group from other people to prevent spread of infection Quarantine: restrictions of activities or limitations of freedom of movement of those presumed exposed to communicable disease to prevent contact with those who have not been exposed

23. Severity of Response Dependent Upon Proximity to event (injured/bereaved) Intensely exposed (first responders) Displaced from home/work Loss of property Age (child/elderly) Special Needs (developmentally disabled/blind/cognitively impaired/etc) Culture

24. Severity of Response Dependent Upon Continued History of: Previous trauma Mental illness Substance Abuse Chronic Illness

25. Early Intervention Goal #1 Safety: Protect from further physical harm (remove from traumatic scene) See to basic needs (food, shelter, clothing, sanitation, sleep, medical care) Information dissemination

26. Early Intervention Goal #2 Function: Support to return to normal function (reduce stressors/reminders) Link to critical resources Reunite and keep families together Educate about responses to stressful or traumatic events

27. Early Intervention Goal #3 Action: Support to return to productive activity Redirect to constructive/helping tasks

28. Communication General Guidelines Tell the truth as it is known, when it is known Explain what is being done to deal with the situation Avoid withholding bad news or disturbing information Be forthright about what is not known Provide practical guidance Messages should be simple & straightforward

29. Self-Care Healthy lifestyle Self-regulation Positive coping skills (resilience) Stress management Education Emergency Preparedness Practice