Medical Re-entry/Repopulation

1. Medical Re-entry/Repopulation Rick Bays – DSHS

2. Medical Evacuee Repopulation“How to get them home”

3. SITUATION The disaster event has ended and the Emergency Management directors in evacuated areas have authorized the return of citizens for part or all areas within their jurisdictions.

4. ASSUMPTIONS • Medical evacuees may check out of shelters at any time but shelter residents are requested to follow check out procedures of the shelter. • Ambulances and aircraft may not be immediately available for repopulation because of SAR support operations.

5. ASSUMPTIONS • Critical infrastructure (power, water, telecommunications) is available in evacuated areas. • Essential Care Services such as home health, hospitals, 911, DME providers, dialysis, Meals on Wheels, pharmacy need to be available prior to return of medical evacuees.

6. MEDICAL EVACUEE REPOPULATIONCONCEPT OF OPERATIONS • DDC in affected areas, through the DDC MOC, should work with local jurisdictions and essential care providers to assess availability of critical care services.

7. Medical evacuees will receive a medical assessment at the shelter and cleared to return to their evacuated area. • Medical assessment includes: • Medically stable for transportation • Type of transportation needed • Availability of infrastructure • Essential care services needed • Destination location

8. General evacuees accompanying Medical evacuees should repopulate together when possible. • Medical transportation assets should be requested from the DDC in sheltering areas. • May have transportation assets available • If no transportation, contact SOC/SMOC • Late day/night medical transports are strongly discouraged.

9. Repopulation of Medical evacuees in hospitals will be coordinated between sending and receiving hospitals. • Transportation may be available by hospital • Hospitals request transportation assets through local EMC to DDC to SOC/SMOC

10. MEDICAL EVACUEE REPOPULATIONRESPONSIBILITIES OF DSHS • Through SMOC coordinate and prioritize all medical repopulation efforts. • Deploy M-IST to DDC MOC to assist with transportation assets, staging and demobilization. • Assist with continuing medical shelters if medical evacuees cannot return to home.

11. Coordinate and manage medical transportation assets. • Perform individual medical discharge assessments of medical evacuees. • Through MOC, validate critical infrastructure and essential care services available .

12. MEDICAL EVACUEE REPOPULATIONRESPONSIBILITIES OF EVACUATING AREA DDC • Coordinate requests from evacuating jurisdictions for repopulation of residents. • Coordinate assessment of critical infrastructure and essential care services in evacuated areas and communicate information to sheltering DDC and SMOC. • Submit unmet medical transportation needs requests to SOC/SMOC.

13. MEDICAL EVACUEE REPOPULATIONRESPONSIBILITIES OF SHELTERING AREA DDC Coordinate the organized repopulation of multiple jurisdictions to maximize use of transportation resources. Coordinate and schedule medical transportation assets for repopulation.

14. Coordinate with evacuating area DDC for all repopulation efforts. • Communicate information to sheltering jurisdictions and SOC/SMOC.

15. MEDICAL EVACUEE REPOPULATIONRESPONSIBILITIES OF EVACUATING JURISDICTION • Authorize repopulation. • Determine availability of critical infrastructure. • Coordinate departure and arrival times with sheltering jurisdictions. • Provide transportation assets when possible.

16. MEDICAL EVACUEE REPOPULATIONRESPONSIBILITIES OF SHELTERING JURISDICTION • Coordinate medical transportation needs with DDC. • Ensure Medical evacuees are medically stable for transport and essential care services are available.

17. When possible, provide food and water for evacuees during transport. • Coordinate departure and arrival times with evacuating jurisdictions.

18. Questions?

19. Vector/mosquito control“Mosquitos can bite the pocketbook too!”

20. Vector/Mosquito ControlBackground • Mosquito Control always becomes an issue after a big storm along the coast or when there is significant flooding • Increased mosquito populations can pose a public health risk due to vector borne diseases and can significantly hamper recovery activities • Ground based mosquito control such as ground spraying and larvicide treatment is the most long term effective treatment

21. Background (Con’t) • Aerial Spraying is extremely effective for immediate treatment but is temporary and costly • FEMA has fairly strict guidelines for reimbursement for mosquito abatement costs • To receive reimbursement, DSHS must declare a public health risk

22. Background (Con’t) • DSHS cannot declare a public health risk without data to support the risk • History of Vector diseases • Species of mosquitoes in jurisdiction • Landing rate counts

23. Background (Con’t) • Even after declaring a public health risk, DSHS must coordinate with FEMA, CDC, EPA, and other federal agencies before aerial spraying can occur • DSHS and FEMA can only support mosquito abatement costs and activities in populated areas, not rural ranch or farm land

24. Vector ControlResponse Operating Guidewww.dshs.state.tx.us/commprep/response/rog.aspx

25. Response Operating Guide • Outlines responsibilities at each level of government • Provides data collection forms • Provides background information on vector diseases • Field surveillance techniques • FEMA policy on mosquito abatement

26. Mosquito AbatementLocal Jurisdiction Responsibilities • Develop a local response plan • Perform landing rate counts • Trap mosquitoes for submission to DSHS lab • Preform ground spraying and larvicide treatment • Use local resources first

27. Mosquito AbatementDSHS Responsibilities • Test mosquitoes trapped for species and aboviruses • Collect landing rate counts • Declare public health risk • Coordinate with FEMA, CDC, etc • Provide technical assistance to locals thru HSRs • Provide additional resources for chemicals, larvicide and aerial spraying, if warranted

28. Questions?