Presentation on theme: "Emergency Coordinator"— Presentation transcript:
1 Emergency Coordinator National Ambulance ContractCDR Amy O. TaylorDHHS/ASPR R6Emergency CoordinatorCole BrickerDHS/FEMA Region 6Operations
2 Federal National Ambulance Service: PURPOSE The purpose of the Federal National Ambulance and Para-transit Support Services contract is to provide a full array of licensed ground and air ambulance services and para-transit services that may be ordered as needed to supplement the Federal and Military response to a disaster, act of terrorism or other public health emergency in any of the 48 contiguous states.
3 Background Why a National Ambulance Contract? Multi-Agency Effort Cost ComplexityCredentialsCoordinationMulti-Agency EffortGSAHHSFEMA
4 MissionThe Department of Health and Human Services provides technical assistance to FEMA in support of contracted ground + air ambulances, and para-transit vehicles to support State, tribal and local governments ability to prepare for and respond to the effects of a major disaster.
5 Centrally managed, regionally coordinated contract Provide a full array of licensed ground, air ambulance and para-transit services to assist states in accomplishing patient evacuationMay be ordered as needed to supplement response to a disaster, act of terrorism or other public health emergency.State public health authorities determine there are unmet requirements to rapidly and safely evacuate patients with complex and ongoing medical needs;Initiate request for Federal assistance.
6 Authorities FEMA contract executed through HHS operational support Can only be utilized within a Stafford Act Activation/Declaration
8 Performance Requirements Per Zone GROUND AMBULANCE300 ground ambulances (ALS & BLS)Typically a 70%/30% ALS/BLS splitAIR AMBULANCE25 air ambulances, helicopter and/or fixed wingPARA-TRANSITAbility to Transport 3,500 individualsNot 3,500 vehiclesBOTTOM LINE: LIMITED NUMBER OF RESOURCES
11 Types of Ground Ambulances Type II – Advanced Life Support, Non-HazMatType IV – Basic Life Support, Non-HazMatType V – Bariatric Ambulance, ALSType VI – Med-Evac Bus, ALS> 4 stretcher patients
12 EMS Roles Patient triage, treatment & transport Hazard recognition Symptom surveillance & reportingOn-scene medical standbyRedistribution of pts. to free up hosp. bedsDistributing immunizationsStaffing sheltersStaffing emergency departmentsSetting up mobile medical units
15 Para-transit Restrictions Sending facility responsible for determining host facilities/destinationsOne-way distance < 200 miles or 6 hrs.Multiple trips expectedNo medical staff on vehiclesCaregiver must accompany patient if medical care is requiredOrder by patient type, not by vehicle typeNon-ambulatory, wheelchair boundAmbulatory with assistanceAmbulatory & no assistance needed
17 Types of Fixed-Wing Aircraft Type I – critical care ALS 2+ pts.Type II – critical care ALS 1 pt.Type III – ALS 2+ pts.Type IV – BLS 1 pt.Type V - Neonatal
18 Types of Rotary-Wing Aircraft Type II – ALS 2+ pts., night ops.Type III – ALS 1 pt., non-night ops.Type IV – ALS 1 pt., night ops. VFRType V - Neonatal Specific
19 Performance Requirements Per Zone 2 Zones3 Zones4 Zones300 ground amb.600 ground amb.900 ground amb.1,200 ground amb.25 air ambulances50 air ambulances75 air ambulances100 air ambulances3,500 bus seats7,000 bus seats10,500 bus seats14,000 bus seats
20 State Considerations Medical Evacuation Planning (State ESF-8 lead) Activation Request to FEMA Region (Governor)Coordination with HHS /ESF-8 regional office
21 Medical Evacuation Planning Considerations Planning must be performed whether it be deliberate or crisis-action and is a state ESF-8 responsibility. It should include:Number of patients to evacuatePatient locations (Pick up Points)HospitalsNursing HomesResidencesWhere will patients go?Intrastate or Interstate evacuationShelter/Hospital Agreements
22 Medical Evacuation Planning Considerations (cont) Staging area (Check-In site) locationsSecurityRepatriationMedical AssetsCan this be handled through EMAC?Will this require Federal augmentation
23 Activation Request to Region If activating the Federal Ambulance Contract, the state must prepare an ARF identifying the following information (at the very least):No. of patients to evacuate & condition:Critical/Intensive CareAdvanced Life SupportBasic Life SupportCheck-in siteHow they will be usedLocal augmentation of 911 dispatchTransportation/Evacuation of Patients
24 Needs IdentificationState/local identify numbers needing specific type of support during planning.State incorporates EMAC assets in planning (follow GAP analysis concept).State works with HHS Region to identify Federal piece.NOTE: The national contract is NOT a panacea- it is intended to augment State and local resources.
25 Coordination Pre-Event During the Event Post-Execution HHS Regional Emergency Coordinators work with States to determine if medical evacuation assistance may be necessary and identify potential check-in sites for assets.Finalize State coordination of requirements.State ID’s potential types and numbers.During the EventMonitor usageState ID’s types and numbersPost-ExecutionForward draw-down and demobilization plan
26 Caveats Regions work through HQs No individual direct contact with contractor prior to activationESF #8 manages, FEMA paysJoint decision-coordination processUnder utilization= demobilizationState/ local exhaust available supportOwn contracts/assetsMutual aid and EMAC
29 Check In Ground Ambulance - verify quantity at Check-in ALS (usually 70%)BLS (usually (30%)Para-transit (seats)Verify quantity at check in25% of seats must have working wheelchair liftsAir – Verify quantity at check in. This may occur at a separate check in site from the ground assets.COTR must validate check-in times for each asset29
30 AMR/FEMA Vehicle Placard A=ALS ground ambulanceB=BLS ground ambulanceC=ALS bariatric grnd ambD=ALS Med-Evac busG=Type I sedan/minivanH=Type II minibusJ=Type III coach transit busK=Type IV wheelchair vanL=Type V ADA minibusM=Type VI ADA coach busX=Support vehicle
32 Inspection COTR Inspections (Random) “Contractor is responsible for maintaining all provisioning necessary to resupply all ambulances provided pursuant to any task order for extended periods” – SOO Section C-4COTR Inspections (Random)Medical Supply InspectionsExpiration DateType of supplies required are adequate for tasks assignedPersonnel CredentialsState DOT may perform vehicle inspections as well
33 Equipment IssuanceTransportation Management Services (TMS) contractor support staff will be at the check in site to tag each ground asset with a GPS transponderUsed for deployed evacuation assets across the evacuation transportation enterprisePlots and tracks assets in real time using Sprint i365 GPS enabled phoneProvides long-term historical tracking informationProvides online (web-based) real-time reporting through TelenavEnables quick setup and management – anytime from anywhere
34 Corrugated Container Box BESS Kit ContentsAdhesive Placard12V Y-Adapter120V AC ChargerLaminate PlacardCorrugated Container BoxPortable 12V DCPower PackSprint i36512V DC Charger
35 Reporting / Tracking The COTR must Provide regular status reports – frequency will be set by the National COTR. These reports will capture information on mobilization, missions being performed, asset utilization, inspections, demobilization, etcCoordinate with state representatives at staging areas and issue work orders to the contractor for missions (which will assign certain assets to a specific purpose for a duration of time)Adjust work orders as mission requirements demandMaintain a spreadsheet that tracks work order progress
36 Asset Utilization How many assets are redlined and why? Maintenance IssuesAssets should never be down due to driver rest requirementsCOTRs must identify how many assets are on missions out of total available (percent utilization)?Asset Utilization is the key metric used to lead demobilization coordination calls with the states.
44 Challenges Check in process Direct resource communication & tracking Resource utilizationInter-agency coordinationLogistics leveragingCosts
45 Summary Planning Activation Deployment Demobilization State and HHS region coordinateProject assets needed/ stagingActivationDeploy assets to staging areaFEMA placards for vehicle IDState/local briefing; credentialing (if necessary)DeploymentResources deploy from sating area to site(s)Once assets leave staging area, assigned to stateState/ local gov’t provide medical direction; patient distribution and trackingDemobilizationOnce task(s) or assignments complete, or asset no longer needed