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National Disaster Medical System Partnership Overview. NDMS Structural Changes. NDMS Structural Changes. NDMS Section. NDMS Section Chief Jack Beall. Program Analyst (2) Chief Medical Officer Chief Nurse Chief Veterinary Officer Program Manager, USPHS Chief Toxicologist.

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slide4

NDMS Section

NDMS Section Chief

Jack Beall

Program Analyst (2)

Chief Medical Officer

Chief Nurse

Chief Veterinary Officer

Program Manager, USPHS

Chief Toxicologist

Executive Officer

System Development

Systems Operations

Medical Field Operations

Operations Support Center

slide5

DHS in NDMS

  • Major Components of DHS/NDMS
    • Medical Response
    • Patient Evacuation
    • Definitive Medical Care
slide6

Roles of DHS

  • Lead Agency for NDMS
    • Chair Senior Policy Group & Directorate Staff
    • Medical Response Assets in DHS
      • Broad range of expertise
      • International response capability
slide7

NDMS Section

NDMS Provides the People!

Our People are the Heart of the System

107 Teams, over 9,000 personnel nation-wide dedicated to the service of victims caught in the chaos of a natural disaster or terrorist event or other threat to national security.

slide8

DHS in NDMS (cont’d)

  • What can NDMS bring to bear?
    • DMAT/Specialty Teams – More than 8,000
    • personnel
    • Equipment and Supplies
slide9

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

slide10

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
slide11

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
slide12

NDMS Surge Capacity

  • Joint Effort between DHS and HHS
  • 250 bed medical facility for deployment and staffing from NDMS teams
  • Includes coordination with CDC to manage disease outbreak of know or unknown origins
  • Coordination with other Federal Partners
    • New Patient Movement Concepts
    • Responsibility in Definitive Care
slide13

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
slide14

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
slide15

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
slide16

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
slide17

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.
slide18

Role of the ASPHEP

  • 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.
slide19

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.

slide20

Ongoing Initiatives

  • Surge Capacity Planning
      • Hospital Tracking
      • Strategic Planning
      • Computer Based Modeling
      • Federal Medical Contingency Stations
  • National Security Special Events & Emergency Responses
      • Summer Olympics (Athens, Greece)
      • Reagan Funeral (Washington, DC)
      • RNC & DNC (New York City & Boston)
      • Bush inauguration (Washington, DC)
      • 2004 Florida Hurricanes x 4
  • Exercises
      • Top Officials (TOPOFF 3)
slide21

DoD in NDMS

  • Support agency to ESF 8, Public Health and Medical Services
  • 1. Coordinate Patient Movement - DoD is lead for patient movement in collaboration with other federal agencies. Responsible for movement of patients on DoD resources.
  • Provides transportation assets, medical crews, patient regulating teams
  • Transportation medical assets include:
    • Aero-medical Evacuation Kits
    • Patient Movement Equipment
    • Civilian Reserve Air Fleet in Homeland Incident
slide22

DoD in NDMS

  • Coordinate Patient Movement (Cont)
  • Global Patient Movement Requirements Center (GPMRC) located at Scott AFB (O’Fallon, Illinois – St. Louis area)
    • Performs Medical Regulating
    • Coordinates the Transportation - Bed plan
  • Transportation Command Regulating and Command and Control Evacuation System (TRAC ES)
    • Combines transportation, logistics, and clinical decision elements into seamless patient movement; capable of assessing/prioritizing medical requirements, assigning proper resources; distributing relevant data

2

slide23

DoD in NDMS

  • TRANSCOM Regulating and Command & Control Evacuation System (TRAC ES) Benefits:
  • Seamless transition from peacetime to natural
  • disaster, contingencies and wartime
  • In-transit visibility of patient location and status
  • Integrates different modes of transportation (air/ground/sea) for patient movement
  • Advanced planning capabilities to develop precise plans and projections in resource constrained environments
  • Effective use of existing transportation resources
  • Projects limitations and patient movement “bottlenecks”
  • Situational awareness for patient recipient hospitals

2

slide24

DoD in NDMS

  • Coordinate Definitive Patient Care
  • Twenty Six (26) Federal Coordinating Center Areas of Responsibility in CONUS
    • 8 Air Force FCCs w/ 10 AORs 7 Army FCCs 9 Navy FCCs
    • US Northern Command coordinates NDMS Bed Reporting
  • DoD participating in NDMS hospital training needs assessment survey
  • Participate in Medical Inter-Agency Coordination Group (MIACG)

Evans Army Medical Center

slide25

DoD Process When

NDMS Is Activated

DHS Activates NDMS

Emergency

Ops Center

SECDEF

ASD HD

Exec Sec

Activation

Coordination -------

(OASD HA)

Personnel

& Readiness

Joint Staff

NMCC

NORTHCOM

DWC

JFCOM

Ops Ctr

TRANSCOM

JMOC

Services

Ops Ctrs

SG

SG

SG

SG

GPMRC

SGs access data from GPMRC

FCCs

Bed reporting

slide26

DoD in NDMS

  • National and Regional Exercises
    • TOPOFF 3
    • Ardent Sentry – US NORTHCOM
    • Positive Response – Joint Staff
    • Lifesaver 2004 – Keesler AFB
    • Ultimate Caduceus 2005 – Seattle/Tacoma/Spokane
slide27

DoD in NDMS

  • 4. DoD Initiatives
  • Development of a National Patient Movement, Regulating and Medical Tracking System
    • One of DHS’ Interagency Security Plan initiatives
  • Description of DoD Aero-medical Evacuation Teams, Equipment and Supplies
    • For use by FEMA/ NDMS – create patient movement and definitive care teams
    • Will supplement DoD (and VA) in a mass casualty event
  • Development of medical readiness evaluation and metrics for DoD and VA Federal Coordinating Centers
slide28

VA in NDMS

  • VA Manages 43 of the 66 Federal Coordinating Centers that are responsible for coordinating the reception, care, and return of patients evacuated under the NDMS.
  • NDMS is one of the missions assigned to the Veterans Health Administration’s Emergency Management Strategic Healthcare Group (EMSHG)
slide29

EMSHG

Organization Chart

Chief Consultant

Executive Assistant

Director CEM

Program Specialist

Planning Specialist

Administrative Officer

Computer/Telecom Spec.

Budget Analyst

Operations Specialist

Western District

Manager

Program Specialist

Central District

Manager

Program Specialist

Eastern District

Manager

Program Specialist

Exercise/Training Specialist

Western District (6 VISNs)

9 Area Emergency

Managers

6 Management

Assistants

Central District (8 VISNs)

14 Area Emergency

Managers

8 Management

Assistants

Eastern District (8 VISNs)

14 Area Emergency

Managers

8 Management

Assistants

slide30

VA in NDMS

  • VA Readiness Operations Center
  • VHA/EMSHG Operations
  • Veterans Integrated Service Networks (VISNs)
  • VA Federal Coordinating Centers (FCCs)
slide31

VA in NDMS

  • Exercise Nifty Nugget (1978)
slide32

VA in NDMS

  • Exercise Nifty Nugget (1978)
  • Civilian-Military Contingency Hospital System (CMCHS) (1980)
slide33

VA in NDMS

  • Exercise Nifty Nugget (1978)
  • Civilian-Military Contingency Hospital System (CMCHS) (1980)
  • Emergency Mobilization Preparedness Board (EMPB) (1981)
slide34

VA in NDMS

  • Exercise Nifty Nugget (1978)
  • Civilian-Military Contingency Hospital System (CMCHS) (1980)
  • Emergency Mobilization Preparedness Board (EMPB) (1981)
  • Public Law 97-174 (1982)
slide35

VA in NDMS

  • Exercise Nifty Nugget (1978)
  • Civilian-Military Contingency Hospital System (CMCHS) (1980)
  • Emergency Mobilization Preparedness Board (EMPB) (1981)
  • Public Law 97-174 (1982)
  • NDMS (1984)
slide36

VA in NDMS

  • Exercise Nifty Nugget (1978)
  • Civilian-Military Contingency Hospital System (CMCHS) (1980)
  • Emergency Mobilization Preparedness Board (EMPB) (1981)
  • Public Law 97-174 (1982)
  • NDMS (1984) -- VA Signed MOU in 1986
slide37

We know the past and the present —

What is the future of NDMS?