slide1 l.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
National Disaster Medical System Regional Planning for NDMS Patient Movement and Medical Care PowerPoint Presentation
Download Presentation
National Disaster Medical System Regional Planning for NDMS Patient Movement and Medical Care

Loading in 2 Seconds...

play fullscreen
1 / 48

National Disaster Medical System Regional Planning for NDMS Patient Movement and Medical Care - PowerPoint PPT Presentation


  • 433 Views
  • Uploaded on

National Disaster Medical System Regional Planning for NDMS Patient Movement and Medical Care. HHS ASPHEP / OPHEP. Created by legislation (Bioterrorism Act) in Fall 2002

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'National Disaster Medical System Regional Planning for NDMS Patient Movement and Medical Care' - JasminFlorian


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
slide1

National Disaster Medical System

Regional Planning for NDMS Patient Movement and Medical Care

slide2

HHS ASPHEP / OPHEP

  • Created by legislation (Bioterrorism Act) in Fall 2002
  • Directs and coordinates HHS’s efforts to prevent, prepare for, respond to, and recover from, the public health and medical consequences of a disaster or emergency.
  • Coordinates implementation of the National Response Plan (NRP) and Emergency Support Function (ESF) #8.
  • Coordinates Federal-level response planning for public health and medical consequences of terrorism events or natural events and disasters.
slide3

HHS in NDMS

  • HHS is the lead for Emergency Support Function #8. Specifically, HHS will provide:
    • Technical assistance and coordination through the Secretary’s Operations Center (SOC);
    • Identify health and medical personnel (e.g. USPHS officers) available to augment DMAT staffing and to respond to requests for assistance from states, and coordinate their deployment
    • Track bed availability in non-NDMS hospitals.
slide4

HHS Secretary’s Operation Center

  • 24 hour state-of-the- art information and operations center with specialized technologies
  • Provides a single focal point for information sharing, command and control, communications, technical assistance and data collection supporting the federal health and medical response to large scale emergencies
  • Facilitates coordination of HHS

components and resources

under emergency and

non-emergency conditions.

hhs regional emergency coordinators in place as of 4 2005
HHS Regional Emergency Coordinatorsin place as of 4/2005
  • HHS Regions same as FEMA Regions
  • REC’s responsible for planning and coordination of federal medical response to large-scale emergencies in Regions
slide6

Secretary’s Emergency Response Team (SERT)

  • Activated for incidents of national significance requiring federal health & medical resources, or implementation of ESF #8.
  • Provides situational awareness to HHS SOC, ASPHEP
  • Typically led by a HHS Regional Emergency Coordinator (REC) who will work closely with other Federal assets
  • Integrates with the local incident managers and facilitates support as requested by State and Tribal authorities.
  • Provide coordinated Federal management of HHS and ESF #8 assets during a major public health and medical emergency.
slide7

DHS in NDMS

  • Major Components of DHS/NDMS
    • Medical Response
    • Patient Evacuation
    • Definitive Medical Care
slide8

DHS in NDMS (cont’d)

  • Considerations:
    • Local medical assets
    • Local infrastructure
    • Local transportation assets
      • Airports/Airstrips
      • Mass Transit
      • Local Trucking Resources
slide9

DHS in NDMS (cont’d)

  • Assumptions:
    • Local health & medical assets are inadequate
    • Patients will originate from multiple locations
    • Patients MAY be decontaminated
    • DOD resources are not committed
slide10

DHS in NDMS (cont’d)

  • What can NDMS bring to bear?
    • DMAT/Specialty Teams – More than 8,000
    • personnel
    • Equipment and Supplies
slide11

DHS in NDMS (cont’d)

NDMS Operational Disaster Medical Assistance Teams

AK

Seattle

WA

ME

MT

ND

VT

MI

OR

MN

Worcester

NH

MA

WI

Westland

Boston

SD

ID

Valhalla

RI

Eugene

WY

Providence

CA

Toledo

PA

IA

CT

RI

NV

UT

NE

San Francisco Bay Area

Dayton

NJ

Lyons

IL

IN

OH

DE

CO

MO

WV

MD

KS

St. Louis

VA

Los Angeles Area

San Bernardino

KY

NC

NM

OK

TN

Winston-Salem

AZ

Tulsa

AR

GA

SC

Albuquerque

MS

AL

HI

Maui

San Diego

SantaAna

Jacksonville

TX

LA

Mobile

USVI

Pensacola

FL

Tampa/St. Petersburg

Guam

Ft. Myers

Miami

PR

Fully Operational Teams

Operational Teams

slide12

DHS in NDMS (cont’d)

NDMS Response Teams

25 Disaster Medical Assistance Teams – Fully Operational/Operational

30 Disaster Medical Assistance Teams – Augmentation/Developmental

4 National Medical Response Teams/WMD

5 Burn Teams

2 Pediatric Teams

1 Crush Medicine Team

3 International Medical/Surgical Teams (includes 2 under development)

3 Mental Health Teams

3 Veterinary Medical Assistance Teams

11 Disaster Mortuary Operational Response Teams (1 WMD)

1 Joint Management Team

20 Nurse/Pharmacist National Response Teams (10 each)

slide13

DHS in NDMS (cont’d)

  • Medical Care
    • NDMS Teams and personnel available to fill
    • gaps and augment local resources
    • Regional Team personnel engaged locally
      • Requirements for Non-Regional Team engagement
    • Movement of caches to region
slide14

DHS in NDMS (cont’d)

  • NDMS Medical Response
    • At Disaster Site or PRA
      • Triage
      • Austere Medical Care
      • Casualty Clearing/Staging
    • At Local NDMS Reception Area
      • Patient Reception
slide15

DHS in NDMS (cont’d)

  • Patient Movement
    • Coordinated inter-agency process
    • Identification of a need to move a patient
    • Admission of a patient at a destination
    • medical facility
slide16

DHS in NDMS (cont’d)

  • Medical Movement Functions
    • Patient Stabilization & Preparation
    • Patient Movement Request
    • Patient Reporting & Regulating
    • Patient Staging
    • Patient Movement Management
      • Embarkation
      • Debarkation
    • Coordination with Various System Elements
slide17

DHS in NDMS (cont’d)

  • NDMS Roles:
    • Patient Stabilization
    • Staffing of Regional EVAC Points (REP)
    • Staffing of Patient Reception Areas (PRA)
    • Patient Preparation
    • Patient Regulation
slide18

DHS in NDMS (cont’d)

  • Additional Transport Providers
    • ESF-8 Partners:
      • Department of Transportation
      • General Services Administration
      • U.S. Postal Service
      • American Red Cross
    • Private Contractors
slide19

DHS in NDMS (cont’d)

  • Possible NDMS Actions:
    • NDMS-Contracted Transport
      • Air and/or Ground
    • NDMS Training – patient regulation
      • Coordinated with Global Patient Movement

Requirements Center (GPMRC)

    • Increased interface/planning between NDMS
    • Regional Emergency Coordinators and partners
    • at regional level
slide20

This Briefing is Classified

UNCLASSIFIED

Department of Defense

Regional Planning for NDMS Patient Movement and Medical Care

DoD Perspective/Emerging Concepts

Lt Col Jim Baxter

NORAD/USNORTHCOM

Medical Coordinator

UNCLASSIFIED

overview

UNCLASSIFIED

Overview
  • Emerging Concepts-Regional Approach
  • NDMS National Security Special Event Plan (Example)
  • Joint Task Forces-Civil Support/Other
  • Patient Movement/Medical Support Challenges
  • Questions

UNCLASSIFIED

emerging concepts potential missions

UNCLASSIFIED

Emerging Concepts/Potential Missions

… for a Land Forces Component Command

  • Medical C2 on a regional basis
    • Versus a deployable function
  • Medical Response Forces
    • Foundation created by installation assets
    • Augmented by deployable forces in “region”
  • Medical Sustaining Forces
    • Larger, more robust than Medical Response Forces
      • Deployable Hospitals
      • Casualty Receiving Ships
      • Designated consequence management response forces
      • NDMS assets for patient movement and hospitalization
    • Augment Medical Response Forces in affected region

UNCLASSIFIED

slide23

UNCLASSIFIED

Emerging Medical Concepts

  • A regionally based theater concept for HSS responses
  • Flexible enough to respond to all hazards, to include natural disasters and terrorist threats/events
  • Full spectrum operations … prevent-deter-mitigate-respond
  • Fosters total force integration … Active-Reserve-Guard
  • Generates an evolving concept for medical C2 in this theater (i.e. regional medical task forces)
  • Response options build incrementally thereby creating Force Package Options (FPO) …
    • Local Installation
    • State Regional Operational
    • National Strategic-Theater

UNCLASSIFIED

slide24

CONPLAN 2002

Base Plan

FOCUS

NRP

Base Plan

HLD

Annexes

NIMS

HLS

Appendices

CS

Base Plan

ESF Annexes

ALL

HAZARDS

Includes

Natural Disasters

Annexes

Spt Annexes

Appendices

Related Plans

CONPLAN

0500

Incident

Annexes

(DSCA)

CBRNE CM

Response

Annexes

Appendices

Appendices

MACDIS

+

Military Assistance

for Civil Disturbances

NRP CIS

Annexes

Appendices

UNCLASSIFIED

NRP Influence on NC Planning (U)

UNCLASSIFIED

joint strategic capabilities plan jscp

UNCLASSIFIED

Joint Strategic Capabilities Plan (JSCP)
  • (U) Joint Strategic Capabilities Plan
    • (U) CJCSI 3110.01 signed 22 Feb 2005
  • (U) Logistics Supplement to JSCP
    • (U) CJCSI 3110.03C
    • (U) March 2005 - Final Draft for GO/FO level review

UNCLASSIFIED

logistics supplement to jscp

UNCLASSIFIED

Logistics Supplement to JSCP
  • (U) Provides logistics planning guidance to the combatant commanders, Chiefs of the Services, and heads of DoD agencies in support of the tasks assigned in the JSCP
  • (U) Enclosures:

(U) A—Responsibilities

(U) B--Logistics Planning and Tasks

(U) C--Materiel Planning Guidance

(U) D--Support Force Planning Guidance

(U)E--Health Service Support Planning Guidance

(U) F--Operational Engineering Support Planning Guidance

(U) G--Contract Administration Services Planning Guidance

(U) H--Special Operations Support Planning Guidance

(U) I--Logistics Sustainability Analysis

UNCLASSIFIED

health service support planning guidance

UNCLASSIFIED

Health Service Support Planning Guidance

(U) Appendix C to Enclosure E

  • (U) Purpose. This appendix provides joint HSS planning guidance in support of JSCP-assigned tasks. It specifically highlights planning considerations for HLD and CS operations.
  • (U) Objectives. Homeland Defense (HLD) and Civil Support (CS) operations require a shift from current planning methods to support MCO.
  • (U) Enclosure E was significantly modified to delineate Health Service Support (HSS) by Major Combat Operations, Stability Operations and Homeland Defense.

UNCLASSIFIED

appendix c to enclosure e 1 of 3

UNCLASSIFIED

Appendix C to Enclosure E (1 of 3)

(U) Medical Response Forces

  • (U) The development of Medical Response Forces at the installation level creates the foundation all joint operations build upon. JFCs will augment Medical Response Forces in affected areas with Medical Response Forces in unaffected areas. If augmentation of installation assets is not enough to manage the HLD or CS situation, then JFCs employ Medical Sustaining Forces.
  • (U) Services will develop UTCs at the installation level to counter current asymmetric threats. At a minimum, Services will develop UTCs for disease investigation, vaccination, preventive medicine, veterinary, medical logistics distribution, mental health, patient decontamination, and medical treatment at all existing Medical Treatment Facilities to support the installation commander, the joint force commander, and, when directed, the lead federal agency.

UNCLASSIFIED

appendix c to enclosure e 2 of 3

UNCLASSIFIED

Appendix C to Enclosure E (2 of 3)

(U) Medical Sustaining Forces.

  • (U) USNORTHCOM will develop medical sustaining force modules that will enhance capabilities found in the Initial Entry Force (IEF) and Medical Response Forces found on installations. Resources will be drawn from multi-component units and placed on a rotational schedule to respond to catastrophic events involving mass casualties and fatalities. Force modules will include deployable hospitals, available casualty receiving ships, a hospital ship, and mortuary affairs teams, at a minimum.

UNCLASSIFIED

appendix c to enclosure e 3 of 3

UNCLASSIFIED

Appendix C to Enclosure E (3 of 3)

(U) Medical Response Forces

  • (U) HSS concepts of operation require the integration of active, reserve, and guard assets and the employment of fixed and deployable assets from their home base in order to create habitual joint response relationships within DoD and with local-state-national organizations. HSS concepts must include the following components:
    • (U) Regionalization. HSS concepts for response to HLD or CS missions will focus on the augmentation and expansion of steady-state and Medical Response Forces found on installations, vice the projection of forces. Command and control of fixed and deployed HSS assets will focus on the designation of regional medical commands to support JFCs. These concepts minimize the burden on limited transportation assets, reduce the deployed footprint, and advocate steady-state relationships between HSS organizations and community counterparts.

UNCLASSIFIED

slide31

UNCLASSIFIED

Example: NDMS/CONOPS

Potential Strategic Patient Movement:

National Special Security Event

UNCLASSIFIED

proposed activation of fccs and ae hubs iso nsse presidential inauguration planning only

Supported Command

USNORTHCOM

N-NCSG, Medical Opns Cell

Colorado Springs, Colorado

Supporting Command

USTRANSCOM / Air Mobility Command

Global Patient Movement Req Center

Scott Air Force Base, Illinois

Supporting Command

USJFCOM

Norfolk, VA

V

UNCLASSIFIED

Proposed activation of FCCs and AE HubsISO NSSE Presidential Inauguration (Planning Only)

VA FCC Philadelphia PA:

Inbound Hub: McGuire AFB

VA FCC Bedford MA

Inbound Hub: Westover ARB

I

Navy FCC Newport RI:

Inbound Hub: Green International

II

AF FCC Dayton-Wright Patterson OH:

Inbound Hub: Wright-Patterson AFB

VA FCC Castle Point NY:

Inbound Hub: Stewart International

VA FCCs NY, and Brooklyn NY:

Inbound Hub: Newark International

VA FCC Pittsburgh PA:

Inbound Hub: Pittsburgh International

III

VA FCC Lyons NJ

Inbound Hub: Newark International

AF FCC Wilmington–Dover DE

Inbound Hub: Dover AFB

Presidential Inauguration/NCR

Outbound Hubs: Andrews AFB, Dulles, BWI

9

VA FCC Richmond

Inbound Hub: Richmond International

UNCLASSIFIED

joint task forces med dco jrmps

UNCLASSIFIED

Joint Task Forces - Med/DCO/JRMPs
  • Joint Task Force-Civil Support (JTF-CS) is an active unit
    • CBRNE Consequence Management Response Force (CCMRF)
    • Enabling Force, with various initial response capabilities
  • Other Joint Task Forces for consequence management can stand up as required
    • Example: National Special Security Events in National Capital Region (NCR) result in stand-up of JTF-NCR-Med
  • Joint Regional Medical Planners play increasingly vital role as liaisons between Disaster Control Officers, JTF-Meds, and USNC

UNCLASSIFIED

patient movement medical support challenges

UNCLASSIFIED

Patient Movement/Medical Support Challenges
  • Collaborative planning, and ongoing communication is critical
    • Integration with local response (FCCs are key)
  • Level of support is “requirements,” and “scenario,” driven
    • Competing demands for limited DoD resources…manpower, supplies/equipment, transport (no dedicated medical lift)
    • Potential transport support missions include:
      • Manpower/emergency response supplies, to bolster on scene support
      • Deployable hospitals/equipment to expand capabilities on scene
      • Mass casualty moves out of disaster area to Federal Coordinating Centers/NDMS beds

UNCLASSIFIED

patient movement medical support challenges35

UNCLASSIFIED

Patient Movement/Medical Support Challenges

Strategic Patient Movement/NDMS activation

  • Must consider all transport resources, not just DoD air assets
  • Patients decontaminated? Outbound hubs in safe zone?
  • Staging area locations; transport to staging areas (who?)
  • Coordination between local, regional, and DoD regulators/clinicians
    • DoD deployable regulating support limited (FCCs/local VA/DoD?)
    • Clinical validation of patients for air movement (coordination)
  • Numbers and types of patients; special equipment/care needs
  • Tracking, and throughput/reception issues

UNCLASSIFIED

questions

UNCLASSIFIED

Questions

https://www.noradnorthcom.mil/SG/

UNCLASSIFIED

slide37

VA in Regional Response

At the present time the Veterans Health Administration (VHA) is organized into 21 Veterans Service Integrated Networks (VISNs) which include all 50 States, Puerto Rico, the Virgin Islands, and Guam.

slide38

Veterans Health Administration

21 Veterans Integrated Service Networks

slide39

VA in Regional Response

  • VA Office of Operations and Readiness
  • VHA/EMSHG Operations
  • VISN
  • VA Medical Facilities
slide40

VA in Regional Response

  • VA Office of Operations and Readiness
  • VHA/EMSHG Operations
  • VISN Federal Region
  • VA Medical Facilities
slide41

VA in Regional Response

(Possible) Associated VISNs & Regions

VISNRegionVISN Region

1 1 18 6

3 2 15 7

4 3 19 8

7 4 21 9

12 5 20 10

slide42

VA in Regional Response

Bottom Line

VA has the flexibility to plan and respond locally, regionally, or nationally, as may be required, to effect maximum resource utilization for and in response to any domestic disaster or emergency.

slide44

UNCLASSIFIED

BACK-UP SLIDES

UNCLASSIFIED

slide45

UNCLASSIFIED

Available NDMS Beds and Throughput for Selected FCCs

*Available bed and throughput figures represent data reported as part of the national bed reporting exercise that occurred on 19 January 2005. Available bed figures should be used as planning factors and not actual beds for medical regulating during an event. USNORTHCOM and USTRANSCOM will work with DoD Components and NDMS partners to obtain actual bed data in case of an event requiring medical regulation and patient movement. FCC SITES LISTED ABOVE ARE IDENTIFIED FOR PLANNING PURPOSES ONLY…THEY ARE NOT BEING ACTIVATED; HOWEVER, THEY WERE COORDINATED WITH NDMS PARTNERS DURING SEVERAL PLANNING SESSIONS.

10

UNCLASSIFIED

slide46

UNCLASSIFIED

Available NDMS Beds and Throughput for Selected FCCs

*Available bed and throughput figures represent data reported as part of the national bed reporting exercise that occurred on 19 January 2005. Available bed figures should be used as planning factors and not actual beds for medical regulating during an event. USNORTHCOM and USTRANSCOM will work with DoD Components and NDMS partners to obtain actual bed data in case of an event requiring medical regulation and patient movement. FCC SITES LISTED ABOVE ARE IDENTIFIED FOR PLANNING PURPOSES ONLY…THEY ARE NOT BEING ACTIVATED; HOWEVER, THEY WERE COORDINATED WITH NDMS PARTNERS DURING SEVERAL PLANNING SESSIONS.

11

UNCLASSIFIED

slide47

Surgeon/Clinician

1/0/0

Deputy Surgeon (GS Conversion)

0/0/1

Chief, Medical Operations Branch

1/0/0

Chief, Medical Plans Branch

1/0/0

Medical Operations Manager

0/1/0

Preventive Medicine Officer

1/0/0

Medical Intelligence Planner

1/0/0

Medical Planner Logistics

1/0/0

Patient Movement Operations Officer

1/0/0

Mission Assignments Officer

2/0/0

Veterinary Medicine Officer

1/0/0

Medical Operations NCO

0/1/0

Medical Planner Clinical Lab/Blood

0/0/1

Medical Readiness Manager

0/1/0

UNCLASSIFIED

JTF-CS Surgeon General

Officer/Enlisted/Civilian

C=3/1/2 (6)

P=7/2/0 (9)

UNCLASSIFIED

potential jtf cs initial response assets

UNCLASSIFIED

Potential JTF-CS Initial Response Assets

Medical C2 – Bde level

Medical C2 – Bn level

Area Support Medical Company X 3

PM Detachment (Sani)

SMART-HS

SMART-BURN

SMART-EMR

SMART-SM

SMART-MC3T

SMART-NBC

SMART-PC

Theater Epi Team

Air Ambulance Co

Med Log Distribution Co

EMEDS +25

AFRAT

CBIRF

UNCLASSIFIED