PREPAREDNESS

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

2. 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……

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

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

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

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

7. EMERGENCY SUPPORTFUNCTIONS • 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

8. 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 ESF ORGANIZATION

9. 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

10. 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?

11. 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

12. 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

13. 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)

14. 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

15. 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

16. 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)

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

18. BASIC STRUCTURE

19. THE STRUCTURE EXPANDS

20. THE STRUCTURE EXPANDSAGAIN

21. THE STRUCTURE EXPANDS AGAIN

22. 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…..

23. 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

24. 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

25. RUMOR CONTROL ONSTEROIDS • 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)

26. HURRICANE-A DRAMAIN THREE PARTS • THE RUN-UP • THE EVENT • THE POST-EVENT

27. 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

28. 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

29. 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)

30. 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

31. 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

32. 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……

33. 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”

34. 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

35. 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

36. 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

37. 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

38. AND IN CONCLUSION USING ICS WILL HELP YOU: • Manage by Objective • Keep It Simple • Focused on O2-H2O-MEDS-FOOD

39. WE’RE ALL IN THIS TOGETHER!QUESTIONS??