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National Incident Management System (NIMS) National Response Framework (NRF) Incident Command System (ICS) Independent Study – FEMA Courses The University.

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Presentation on theme: "National Incident Management System (NIMS) National Response Framework (NRF) Incident Command System (ICS) Independent Study – FEMA Courses The University."— Presentation transcript:

1 National Incident Management System (NIMS) National Response Framework (NRF) Incident Command System (ICS) Independent Study – FEMA Courses The University of South Alabama Center for Strategic Health Innovation © University of South Alabama Center For Strategic Health Innovation. All Rights Reserved. These slides are a part of the ARRTC program and cannot be reproduced for commercial purposes. August 7, 2012

2 NIMS - National Incident Management System A standardized, all-hazard incident and resource management concept A national approach to incident management that is applicable to all jurisdictional levels Applicable across a full spectrum of incidents and scenarios, regardless of size Improve coordination and cooperation between public and private entities Response actions will be based on the ICS system All Response Agencies must comply with NIMS

3 NIMS: NIMS Implementation Objectives: –Preparedness - Planning, Training and Exercises –Communication and Information Management –Command and Management –NIMS Adoption

4 Established to create uniformity: –Organization Structure (ICS) –Plans –Training/Exercises –Resources –Communications/Technology Organization NIMS - National Incident Management System

5 NIMS Implementation Requirements Activities for Health Care Agencies July 1, 2012 Consists of 11 Elements

6 NIMS Compliance HSPD-5 (Management of Domestic Incidents) issued in 2004 For disaster response agencies and departments, NIMS is a condition for Federal Preparedness assistance NIMS Implementation for Healthcare Organizations Guidance Revised activities from 14 to 11 DHHS requires that healthcare organizations implement NIMS in order to eligible for preparedness funding through ASPR/HPP program.

7 Adoption: Element 1 - Adoption of NIMS…throughout the healthcare organization including all appropriate departments and business units. NIMS objectives addressed in the facility’s Emergency Management Program (EMP/Emergency Operations Plan – EOP) documentation. Include a statement of adoption of NIMS in the EOP Refer to this tool and attach as an annex or sub-section of the EOP Obtain leadership support and have them review/sign plans Assign a NIMS Compliance Officer Organizational Implementation Requirements

8 Adoption: Element 2 – Federal Preparedness awards support NIMS Implementation…in accordance with the eligibility and allowable use of the awards. Utilize the Hospital Preparedness Program (HPP) funding for NIMS training courses. Document that HPP funds purchase standardized equipment in the county/state/ country. The EMP documentation includes the use of ICS and associated activities. Organizational Implementation Requirements

9 Preparedness: Planning Element 3 – Revise and Update EOPs, SOPs and SOGs to incorporate NIMS components. Revise plans as necessary to incorporate: Planning Training Response Exercises Equipment Evaluation Corrective Action Organizational Implementation Requirements

10 Preparedness: Planning Element 4 - Mutual-Aid and/or Assistant Agreements…to include public/private sector and non-governmental organizations. The EMP references Memorandums of Understanding (MOUs), agreements and/or mutual aid developed with hospitals, other healthcare providers, local public health, Emergency Medical Services (EMS), fire and safety, pharmacies, medical suppliers, water/food/fuel suppliers, etc. Organizational Implementation Requirements

11 Preparedness: Training and Exercises Element 5 – IS 100, 200 and 700. Security/Safety Laboratory Radiology Inter-facility Transport Maintain a record of completion and copies of completion certificates Physicians Nurses Ancillary Materials/Resource Managers Personnel to fill ICS Positions who must have documented training: Organizational Implementation Requirements

12 Preparedness: Training and Exercises Element 6 – IS 800 Those who take the lead in key ICS positions Key staff members – Liaison, Safety/Security, Legal… Incident Commander Emergency Management Planner Maintain a record of completion. Copies of completion certificates should also be maintained. Organizational Implementation Requirements

13 Preparedness: Training and Exercises Element 7 – Apply NIMS/ICS to training and exercises Utilize HICS for disaster exercises and actual events The EMP training and exercise documentation reflects the use of NIMS and HICS Utilize Homeland Security Exercise and Evaluation (HSEEP) Work in partnership with local/regional healthcare providers within the community to organize training and exercises that use NIMS and HICS Hospital should develop goals and objectives to follow during a drill that tests their ability to activate HICS, open their Command Post, develop and implement an Incident Action Plan (IAP), and communicate with partners Develop/use After Action Reports and Corrective Action Plans Organizational Implementation Requirements

14 Communication and Information Management: Element 8 – Processes, Equipment, Communication and Data interoperability Facilitate collection and distribution of consistent & accurate information Situational awareness of logistical resources Equipment purchased through the HPP is standardized The EMP documentation includes emphasis on the interoperability of response equipment and communications and data systems with external agencies Systems such as AIMS, ALERT, Web-EOC, etc. show compliance if utilized among healthcare facilities, county/area or state-wide. Organizational Implementation Requirements

15 Communication and Information Management: Element 9 – Common and consistent terminology The EMP includes emphasis on the use of plain English by staff during emergencies. Review and update EOP annually. Document a statement to this effect in the EMP documentation or EOP. Utilize a HICS acronym list. Organizational Implementation Requirements

16 Command and Management: Element 10 – Manage events with ICS The EOP explains the use of HICS, particularly incident action planning, a common communications plan and five specific activities: Initiation of Command, Transfer of Command, Termination of Command, Demobilization and Credentialing. Documentation utilization of HICS or other approved ICS structures as detailed in #7. Organizational Implementation Requirements

17 Command Issues & Terms Initiation of Command Transfer of Command Termination of Command Demobilization - Facilitates accountability Credentialing - Competence and proficiency

18 Specific Command Issues Initiation of Command: IC or Temporary IC need to know what they do Must be able to recognize the need to activate HICS Need a list of criteria to make the decision Have a group or select staff to ask for advice Update EOP with “Activation” section Understand how to transition into “Transfer of Command”

19 Specific Command Issues Transfer of Command: Follow EOP guidelines after “Initiation of Command” Upon arrival, the higher ranking individual will assume command, maintain command or reassign to a third party. Delegation of authority can occur if the scope of the response is complex or beyond capabilities or current/initial Incident Commander All with a need to know should be told the effective time and date of the transfer.

20 Specific Command Issues Termination of Command: IC needs to know what they do Must be able to recognize the time to de-activate HICS Need a list of criteria to make the decision Have a group or select staff to ask for advice Update EOP with “De-Activation” section Understand the transition into demobilization

21 Specific Command Issues Demobilization: The process of standing down Getting back to a normal schedule and routine Replacing equipment and supplies Adjusting personnel back to routine Planning begins at the same time as mobilization Facilitates accountability and efficiency Occurs in the Planning Section

22 Specific Command Issues Credentialing: Evaluation/documentation of an individual's: Current certification, license, or degree Training and experience Competence or proficiency Critical for health care agencies National, state, local AND agency requirements Legal implications

23 Command and Management: Element 11 – Adopt Public Information (PI) principles by using both JIS and JIC during events (Examples) The EOP explains the management and coordination of public information with external entities Indentify a PIO who is responsible for medial and public information as it pertains to an event. The PIO should establish working relationships, prior to an event with local media, EMA, law enforcement, public health, EMS, and other responding agencies PIO understands the relationship with the Joint Information System and Joint Information Center Documentation that the hospital participates in the JI process locally Organizational Implementation Requirements

24 Questions and/or a copy of the NIMS compliance manual:

25 National Response Framework Went into effect in March Updated and revised the National Response Plan. The NRF establishes... Federal coordination structures/mechanisms Direction for incorporation of existing plans Consistent approach to managing incidents Coordination

26 NIMS  Aligns command, control, organization structure, terminology, communication protocols, & resources/resource-typing  Used for all events State Response or Support Federal Response or Support Incident NRF  Integrates & applies Federal resources, knowledge, & abilities before, during, & after an incident  Implemented for incidents requiring Federal coordination Local Response Relationship: NIMS vs. NRF

27 NRF Structure Support Annexes Incident Annexes Appendixes Base Framework Describes the domestic incident management structures and processes Include acronyms, definitions, authorities, and a compendium of national interagency plans Provide guidance for the functional processes and administrative requirements Address contingency or hazard situations requiring specialized application of the NRF Describes the structures and responsibilities for coordinating incident resource support Emergency Support Function Annexes - 15

28 Scopes of ESFs ESF #1 – Transportation Department of Transportation ESF #1 – Transportation Department of Transportation Aviation/airspace management and control Transportation safety Restoration/recovery of transportation infrastructure Movement restrictions Damage and impact assessment Aviation/airspace management and control Transportation safety Restoration/recovery of transportation infrastructure Movement restrictions Damage and impact assessment ESF #2 – Communications Homeland Security/NCS ESF #2 – Communications Homeland Security/NCS ESF #3 – Public Works and Engineering Department of Defense US Army Corps of Engineers ESF #3 – Public Works and Engineering Department of Defense US Army Corps of Engineers ESF #4 – Firefighting Department of Agriculture ESF #4 – Firefighting Department of Agriculture Coordination with telecommunications and information technology industries Restoration and repair of telecommunications infrastructure Protection, restoration, and sustainment of national cyber and information technology resources Oversight of communications within the Federal incident management and response structures Coordination with telecommunications and information technology industries Restoration and repair of telecommunications infrastructure Protection, restoration, and sustainment of national cyber and information technology resources Oversight of communications within the Federal incident management and response structures Coordination of Federal firefighting activities Support to wild land, rural, and urban firefighting operations Coordination of Federal firefighting activities Support to wild land, rural, and urban firefighting operations Infrastructure protection and emergency repair Infrastructure restoration Engineering services and construction management Emergency contracting support for life-saving and life- sustaining services Infrastructure protection and emergency repair Infrastructure restoration Engineering services and construction management Emergency contracting support for life-saving and life- sustaining services

29 ESF #5 – Emergency Management Homeland Security/FEMA ESF #5 – Emergency Management Homeland Security/FEMA ESF #6 – Mass Care, Emergency Assistance, Housing, and Human Services Homeland Security/FEMA ESF #6 – Mass Care, Emergency Assistance, Housing, and Human Services Homeland Security/FEMA ESF #7 – Logistics Management and Resource Support Homeland Security/FEMA ESF #7 – Logistics Management and Resource Support Homeland Security/FEMA ESF #8 – Public Health and Medical Services Dept Health & Human Services ESF #8 – Public Health and Medical Services Dept Health & Human Services Coordination of incident management and response efforts Issuance of mission assignments Resource and human capital Incident action planning Financial management Coordination of incident management and response efforts Issuance of mission assignments Resource and human capital Incident action planning Financial management Mass care Emergency assistance Disaster housing Human services Mass care Emergency assistance Disaster housing Human services Comprehensive, national incident logistics planning, management, and sustainment capability Resource support (facility space, office equipment and supplies, contracting services, etc.) Comprehensive, national incident logistics planning, management, and sustainment capability Resource support (facility space, office equipment and supplies, contracting services, etc.) Public health Medical Mental health services Mass fatality management Public health Medical Mental health services Mass fatality management Scopes of ESFs

30 NRF – ESF 8 at the Federal Level

31 Alabama EOP – ESF 8 at the State Level

32 Tier Tier Tier Tier 3--- Tier Tier Federal Response Inter-state Coordination Intra-state Coordination Area Jurisdiction Response: Area Health Care Coalition County Jurisdiction Response: County Health Care Coalition Health Care Facility Response DHHS Region 4 DHHS ADPH/CEP Area PH County PH HCF

33 ESF #9 – Search and Rescue Homeland Security/FEMA ESF #9 – Search and Rescue Homeland Security/FEMA Life-saving assistance Search and rescue operations Life-saving assistance Search and rescue operations ESF #10 – Oil and Hazardous Materials Response EPA ESF #10 – Oil and Hazardous Materials Response EPA ESF #11 – Agriculture and Natural Resources Department of Agriculture ESF #11 – Agriculture and Natural Resources Department of Agriculture ESF #12 – Energy Department of Energy ESF #12 – Energy Department of Energy Oil and hazardous materials (chemical, biological, radiological, etc.) response Environmental short- and long-term cleanup Oil and hazardous materials (chemical, biological, radiological, etc.) response Environmental short- and long-term cleanup Nutrition assistance Animal and plant disease and pest response Food safety and security Natural and cultural resources and historic properties protection and restoration Safety and well-being of household pets Nutrition assistance Animal and plant disease and pest response Food safety and security Natural and cultural resources and historic properties protection and restoration Safety and well-being of household pets Energy infrastructure assessment, repair, and restoration Energy industry utilities coordination Energy forecast Energy infrastructure assessment, repair, and restoration Energy industry utilities coordination Energy forecast Scopes of ESFs

34 ESF #13 – Public Safety and Security Department of Justice ESF #13 – Public Safety and Security Department of Justice ESF #14 – Long-Term Community Recovery Homeland Security/FEMA ESF #14 – Long-Term Community Recovery Homeland Security/FEMA ESF #15 – External Affairs Homeland Security/FEMA ESF #15 – External Affairs Homeland Security/FEMA Facility and resource security Security planning and technical resource assistance Public safety and security support Support to access, traffic, and crowd control Facility and resource security Security planning and technical resource assistance Public safety and security support Support to access, traffic, and crowd control Social and economic community impact assessment Long-term community recovery assistance to States, local governments, and the private sector Analysis and review of mitigation program implementation Social and economic community impact assessment Long-term community recovery assistance to States, local governments, and the private sector Analysis and review of mitigation program implementation Emergency public information and protective action guidance Media and community relations Congressional and international affairs Tribal and insular affairs Emergency public information and protective action guidance Media and community relations Congressional and international affairs Tribal and insular affairs Scopes of ESFs

35 ICS Incident Command System

36 Incident Commander Public Information Officer Logistics Section Chief Incident Command System (ICS) Model Liaison Officer Safety & Security Officer Planning Section Chief Finance/Admin Section Chief Operations Section Chief Command Staff General Staff

37 Incident Command System Organizational Charts Theoretically, your ICS chart should not correlate with any administrative organizational chart in you facility: Creates confusion over position titles and duties. In reality, for hospitals, a HICS chart that matches (or comes close to matching) your day-to-day organizational chart is much more effective and understood during an event.

38 HOSPITAL INCIDENT COMMAND SYSTEM HICS (2003)

39 HOSPITAL INCIDENT COMMAND SYSTEM HICS (2006)

40 Management by Objectives Incident Occurs Incident Reported & Identified Tactical Response ICS Launched IC Sets Objectives Chiefs Meeting: Develop Strategy & Tactics to Meet Objectives Incident Action Plan Tactical Response Initiated Operation Reports Tactical Results, Needs, Engage Liaison, Logistics, Planning, Finance for support Planning Evaluates Progress Reports Chiefs & Officers Set Meeting with IC to Re-evaluate

41 The Five Sections Command = the buck stops here Planning = creates & develops incident plan Operations = implement the plan Logistics = supports the plan. Finance = pays for the plan.

42 Incident Commander Public Information Officer Logistics Section Chief Liaison Officer Safety & Security Officer Planning Section Chief Finance/Admin Section Chief Operations Section Command Staff

43 Incident Commander Public Information Officer Logistics Section Chief ICS – Command Section Liaison Officer Safety & Security Officer Planning Section Chief Finance/Admin Section Chief Operations Section Chief Command Staff General Staff

44 Manages all emergency activities, usually from the Command Post. Top priority = Safety! Serves as the authority for the response efforts and is supervisor to the Command and General Staff. May serve as any or all of the positions in the Command and General Staff, depending on the complexity of the event. Is IC until authority is transferred to another person. The only position ALWAYS staffed in an ICS activation. Incident Commander

45 Responsible for relaying incident related information to the public, other organizations and the media. Participate in a Joint Information System (JIS) and work in the local Joint Information Center (JIC) when activated. Communicates with other agencies’ public information officers. The organizer of correct information. Manage the facility’s Public Information Plan. Public Information Officer

46 Monitors, evaluates and recommends procedures for all incident operations for hazards and unsafe conditions. Monitors, evaluates and recommends procedures for all incident operations, including the health and safety of emergency responder personnel. Organizes and reinforces scene/facility protection and traffic. Establish a security command post. Safety & Security Officer

47 Is responsible for coordinating with external partners, such as the county, state, federal agencies, and public and private resource groups, as well as other Health Care Facilities. Serves as the incident contact person for representatives from other agencies and may work from the local Emergency Operations Center. Communicates into and out of the hospital. Works closely with the IC and PIO Liaison Officer

48 Provides legal and ethical advice to the IC, Command Staff, General Staff and the agency. Legal Officer

49 Incident Commander Public Information Officer Logistics Section Chief Incident Command System (ICS) Model Liaison Officer Safety & Security Officer Planning Section Chief Finance/Admin Section Chief Operations Section Chief Command Staff General Staff

50 Logistics Section “Boy, do I need stuff”

51 Logistics Chief Facility Unit Leader Communications Unit Leader Transport Unit Leader Materials Supply Unit Leader Nutritional Supply Unit Leader 2003

52 Logistics Chief Service Branch Director Communications Unit ITAS Unit Staff Food and Water Unit Support Branch Director Employee Health and Well-Being Unit Family Care Unit Supply Unit Facilities Unit Transportation Unit Labor Pool and Credentialing Unit 2006

53 Incident Commander Public Information Officer Logistics Section Chief Incident Command System (ICS) Model Liaison Officer Safety & Security Officer Planning Section Chief Finance/Admin Section Chief Operations Section Chief Command Staff General Staff

54 Planning

55 Planning Chief Labor Pool Unit Leader Medical Staff Unit Leader Patient Tracking Officer Patient Information Officer Situation Status Unit Leader 2003

56 Planning Chief Documentation Unit Leader Demobilization Unit Leader Situation Unit Leader 2006 Resource Unit Leader Personnel Tracking Material Tracking Personnel Tracking Material Tracking

57 Incident Commander Public Information Officer Logistics Section Chief Incident Command System (ICS) Model Liaison Officer Safety & Security Officer Planning Section Chief Finance/Admin Section Chief Operations Section Chief Command Staff General Staff

58 Finance Section $$ MONEY

59 Finance Chief Time Unit Leader Procurement Unit Leader Claims Unit Leader Cost Unit Leader 2003

60 Finance Chief Time Unit Leader Procurement Unit Leader Compensation/Claims Unit Leader Cost Unit Leader 2006

61 Incident Commander Public Information Officer Logistics Section Chief Incident Command System (ICS) Model Liaison Officer Safety & Security Officer Planning Section Chief Finance/Admin Section Chief Operations Section Chief Command Staff General Staff

62 Operations Chief Medical Staff Director Medical Care Director Ancillary Services Director Human Services Director 2003

63 Operations Chief Medical Staff DirectorMedical Care Director In-Patient Areas Supervisor Treatment Areas Supervisor Surgical Services Unit Leader General Nursing Unit Leader Out-Patient Services Leader Maternal & Child Unit Leader Critical Care Unit Leader Delayed Tx Unit Leader Immediate Tx Unit Leader Triage Unit Leader Minor Tx Unit Leader Morgue Unit Leader Discharge Unit Leader 2003

64 Operations Chief Human Services Director Staff Support Unit Leader Psychological Support Unit Leader Dependent Care Unit Leader 2003

65 Operations Chief Ancillary Services Director Laboratory Unit Leader Radiology Unit Leader Pharmacy Unit Leader Cardiopulmonary Unit Leader 2003

66 Operations Chief Staging Manager Medical Care Branch Director 2006 Personnel Staging Team Vehicle Staging Team Equipment/Supply Staging Team Medication Staging Team Inpatient Unit Outpatient Unit Casualty Care Unit Mental Health Unit Clinical Support Services Unit Patient Registration Unit

67 Operations Chief Infrastructure Branch Director Haz-Mat Branch Director 2006 Power/Lighting Unit Water/Sewer Unit HVAC Unit Building/Grounds Damage Unit Medical Gases Unit Medical Devices Unit Environmental Services Unit Food Services Unit Detection/Monitoring Unit Spill Response Unit Victim Decontamination Unit Equipment Decontamination Unit

68 Operations Chief Security Branch Director B usiness Continuity Branch Director 2006 Personnel Staging Team Vehicle Staging Team Equipment/Supply Staging Team Medication Staging Team Access Control Unit Crowd Control Unit Traffic Control Unit Search Unit Law Enforcement / Interface Unit

69 FEMA TRAINING NIMS Elements 5 & 6 IS 100 IS 200 IS 700 IS 800

70 training.fema.gov/is/

71 Required Courses

72

73 Questions


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