2 NIMS National Incident Management System A standardized, all-hazard incident and resource management concept.A comprehensive, national approach to incident management that is applicable to all jurisdictional levels and across functional disciplines.( )The intent is to be applicable across a full spectrum of potential incidents and hazard scenarios, regardless of size or complexity ( )Designed to improve coordination and cooperation between public and private entities in domestic management activities.Response actions will be based on the ICS system.All First Responders comply with NIMS training requirements.
3 NIMS National Incident Management System Established to create uniformity:Organization Structure (ICS)PlansTraining/Exercises OrganizationResourcesCommunications/Technology
4 NIMS Implementation Activities for Hospitals Similar to expectations placed on government agenciesConsists of 14 objectives for FY 2009We will cover all requirements in detail in the next section: “Update on NIMS Requirements”.
5 NIMS Compliance HSPD-5 issued in 2004 For disaster response agencies and departments, NIMS made a condition for Federal assistanceConfusion over initial NIMS compliance for hospitals and healthcare facilitiesInitial compliance date Oct 1, 2006 pushed back to Oct 1, 2007.Annual FY requirements and 5-year plan( )
6 National Response Framework Went into effect in March 2008.Updated and revised the National Response Plan.The NRF establishes . . .Federal coordination structures/mechanismsDirection for incorporation of existing plansConsistent approach to managing incidentsCoordination( )
7 Relationship: NIMS vs. NRF Aligns command, control, organization structure, terminology, communication protocols, & resources/resource-typingUsed for all eventsResourcesKnowledgeFederalNRFIntegrates & applies Federal resources, knowledge, & abilities before, during, & after an incidentImplemented for incidents requiring Federal coordinationAbilitiesResponse or SupportStateResponseor SupportLocalResponseIncident( )
8 NRF ApplicabilityThe NRF applies to all Federal departments and agencies that have primary jurisdiction for or participate in operations requiring a Federal response, including:Major disasters, emergencies, and terrorist incidents including threatsOther events of lesser severity requiring a coordinated Federal response
9 Incidents of National Significance The NRF distinguishes between:Incidents that require the Secretary of Homeland Security to manage the Federal response, termed Incidents of National Significance, and,The majority of incidents occurring each year that are handled by responsible jurisdictions or agenciesDHS Secretary must declare an event as an Incident of National Significance
10 NRF StructureBase FrameworkDescribes the domestic incident management structures and processesAppendixesInclude acronyms, definitions, authorities, and a compendium of national interagency plansEmergency Support Function AnnexesDescribe the structures and responsibilities for coordinating incident resource supportSupport AnnexesProvide guidance for the functional processes and administrative requirementsIncident AnnexesAddress contingency or hazard situations requiring specialized application of the NRF
11 Scope of Emergency Support Functions ESF #1 – TransportationDepartment of TransportationAviation/airspace management and controlTransportation safetyRestoration/recovery of transportation infrastructureMovement restrictionsDamage and impact assessmentESF #2 – CommunicationsHomeland Security/NCSCoordination with telecommunications and information technology industriesRestoration and repair of telecommunications infrastructureProtection, restoration, and sustainment of national cyber and information technology resourcesOversight of communications within the Federal incident management and response structuresESF #3 – Public Works and EngineeringDepartment of DefenseUS Army Corps of EngineersInfrastructure protection and emergency repairInfrastructure restorationEngineering services and construction managementEmergency contracting support for life-saving and life-sustaining servicesESF #4 – FirefightingDepartment of AgricultureCoordination of Federal firefighting activitiesSupport to wildland, rural, and urban firefighting operations
12 Scope of Emergency Support Functions ESF #5 – Emergency ManagementHomeland Security/FEMACoordination of incident management and response effortsIssuance of mission assignmentsResource and human capitalIncident action planningFinancial managementESF #6 – Mass Care, Emergency Assistance, Housing, and Human ServicesHomeland Security/FEMAMass careEmergency assistanceDisaster housingHuman servicesESF #7 – Logistics Management and Resource SupportHomeland Security/FEMAComprehensive, national incident logistics planning, management, and sustainment capabilityResource support (facility space, office equipment and supplies, contracting services, etc.)ESF #8 – Public Health and Medical ServicesDept Health & Human Srvcs.Public healthMedicalMental health servicesMass fatality management
13 Scope of Emergency Support Functions ESF #9 – Search and RescueHomeland Security/FEMALife-saving assistanceSearch and rescue operationsESF #10 – Oil and Hazardous Materials ResponseEPAOil and hazardous materials (chemical, biological, radiological, etc.) responseEnvironmental short- and long-term cleanupESF #11 – Agriculture and Natural ResourcesDepartment of AgricultureNutrition assistanceAnimal and plant disease and pest responseFood safety and securityNatural and cultural resources and historic properties protection and restorationSafety and well-being of household petsESF #12 – EnergyDepartment of EnergyEnergy infrastructure assessment, repair, and restorationEnergy industry utilities coordinationEnergy forecast
14 Scope of Emergency Support Functions ESF #13 – Public Safety and SecurityDepartment of JusticeFacility and resource securitySecurity planning and technical resource assistancePublic safety and security supportSupport to access, traffic, and crowd controlESF #14 – Long-Term Community RecoveryHomeland Security/FEMASocial and economic community impact assessmentLong-term community recovery assistance to States, local governments, and the private sectorAnalysis and review of mitigation program implementationESF #15 – External AffairsHomeland Security/FEMAEmergency public information and protective action guidanceMedia and community relationsCongressional and international affairsTribal and insular affairs
15 Incident Command System ICSIncident Command System
16 HICS is:A Proven Emergency Management System Based on Military and Fire Management Chains of CommandDesigned for all hazards and all sizes of response, as necessaryFlexible and adaptable – only activate what is needed.Manages routine or planned eventsProvides logistical & administrative support to operational personnelImproves Communication – Formal and InformalCost effective – avoids duplication of effortAllows for adaptation into a common response structure( ; ; /7)
17 Characteristics of ICS Common Terminology ( /9)Modular organizationReliance on an Incident Action Plan (IAP)Management by objectivesChain of command and Unity of command ( )Unified Command ( )Manageable Span of Control ( /21; )Emergency Operations CentersResource ManagementInformation, Intelligence and Communications
19 SectionsOrganizational levels with responsibility for a major functional area of the incidentOperationsPlanningLogisticsFinance/AdministrationThe person in charge is the Chief
20 Divisions and Groups Divisions Divide an incident geographically Is led by a SupervisorGroupsEstablished based on the needs of an incident.Labeled according to the job that they are assignedManaged by a SupervisorWork wherever their assigned task is needed and are not limited geographically
21 Branches and Units Branches Established if the number of Divisions or Groups exceeds the span of controlHave functional or geographical responsibility for major parts of incident operationsManaged by a Branch Director( )UnitsOrganizational elements that have functional responsibility for a specific activity
22 Task ForcesTask Forces are a combination of mixed resources with common communicationsOperate under the direct supervision of a Task Force Leader
23 Strike Teams Strike Teams are a set number of resources Of the same kind and typeWith common communicationsOperate under the direct supervision of a Strike Team Leader
24 ResourcesSingle: An individual(s) or piece of equipment with its personnel complement; or,A crew or team of individuals with an identified supervisorStaging Areas hold resources waiting for operational assignment ( ; )Typing: Identifies size, capability and staffing qualifications ( )Assigned, Available or Out-of-Service ( )
25 ICS Supervisory Titles OrganizationalLevelTitleSupport PositionIncident CommandCommanderDeputy(* Able to assume command!)Command StaffOfficerAssistantGeneral Staff (Section)ChiefBranchDirectorDivision/GroupSupervisorN/AUnitLeaderManagerStrike Team/Task ForceSingle Resource BossDistinct titles = most qualified 2. Standard titles = easy requests 3. Titles = common standard( ; ; )
26 Other Command Issues & Terms Initiation of CommandTransfer of CommandTermination of CommandDemobilization ( , pg 121) - Facilitates accountabilityCredentialing ( , pg 129) - Competence and proficiencyArea Command, On-Scene Command( , pg 155) - multiple incidents handled by separate IC orgs.
27 Specific Command Issues Initiation of Command:IC or Temporary IC need to know what they doMust be able to recognize the need to activate HICSNeed a list of criteria to make the decisionHave a group or select staff to ask for adviceUpdate EOP with “Activation” sectionNeed to understand “Transfer of Command”
28 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 authority. ( )All with a need to know should be told the effective time and date of the transfer ( )
29 Specific Command Issues Termination of Command:IC needs to know what they doMust be able to recognize the time to de-activate HICSNeed a list of criteria to make the decisionHave a group or select staff to ask for adviceUpdate EOP with “Activation” sectionNeed to understand demobilization and what is involved
30 Specific Command Issues Demobilization: The process of standing downGetting back to a normal schedule and routineReplacing equipment and suppliesAdjusting personnel back to routinePlanning begins at the same time as mobilizationFacilitates accountability and efficiencyOccurs in the Planning Section( )
31 Specific Command Issues Credentialing: Evaluation and documentation of an individual's:Current certification, license, or degreeTraining and experienceCompetence or proficiencyCritical for health care agenciesNational, state, local AND agency requirementsLegal implications( )
32 Specific Command Issues Area Command: Creates to oversee the management of:Multiple incidents that are each being handled by an Incident Command System organizationA very large incident that has multiple Incident Management Teams assigned to itDesigned to ensure the effective management of assigned incidents( )
33 Management by Objectives Tactical Results, Needs, IncidentOccursIncidentReported& IdentifiedTacticalResponseICS LaunchedChiefs Meeting:Develop Strategy& Tactics to MeetObjectivesIC SetsObjectivesIncidentAction Plan( )( /18)( )Chiefs & OfficersSet Meeting withIC to Re-evaluateTactical ResponseInitiatedOperation ReportsTactical Results, Needs,Engage Liaison,Logistics, Planning,Finance for supportPlanning EvaluatesProgress Reports
34 ICS Form 201 – Incident Briefing Form An eight-part form that provides an Incident Command/Unified Command with basic information that can be used to brief incoming resources, an incoming Incident Commander or team, or an immediate supervisor.The basic information includes the:Incident situation (map and significant events).Incident objectives.Summary of current actions.Status of resources assigned to or ordered for the incident or event.Can serve as the initial Incident Action Plan (IAP) for the first shift change and will remain in force and continue to develop until the response ends, or until a Planning Section has been established and generates, at the direction of the Incident Commander, an IAP.Suitable for briefing assigned and newly arriving Command and General Staff members.( )
36 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, an HICS chart that matches (or comes close to matching) your day-to-day organizational chart is much more effective and understood during an event.
37 Incident Command System (ICS) Model Incident CommanderPublic InformationOfficerLiaisonOfficerCommandStaffSafety & SecurityOfficer( )Logistics SectionChiefPlanning SectionChiefFinance/AdminSection ChiefOperations SectionChiefGeneralStaff( ; ; )
40 The Five Sections Command = the buck stops here Planning = creates & develops incident planOperations = implement the plan.Logistics = supports the plan.Finance = pays for the plan.
41 ICS – Command Section Incident Commander Public Information Officer LiaisonOfficerCommandStaffSafety & SecurityOfficerLogistics SectionChiefPlanning SectionChiefFinance/AdminSection ChiefOperations SectionChiefGeneralStaff
42 Incident CommanderManages all emergency activities, including development, implementation, and review of strategic decisions from the Command Post, as well as post event assessment during recovery. Top priority = Safety! ( ; ; ; )Serves as the authority for all emergency response efforts and supervisor to the Public Information Officer (PIO), Liaison Officer, Safety Officer, Operations Section Chief, Planning Section Chief, Logistics Section Chief, and Finance & Administration Section Chief.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. ( )
43 Public Information Officer 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.Be the organizer of correct information.Manage the facility’s Public Information Plan.
44 Safety & Security Officer 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.( )
45 Liaison OfficerIs responsible for coordinating with external partners, such as the city, 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( ; /12)
46 Legal OfficerProvides legal and ethical advice to the IC, Command Staff, General Staff and the agency.Brought about by recent issues in hospitals in New Orleans post Katrina.
47 Incident Command System (ICS) Model Incident CommanderPublic InformationOfficerLiaisonOfficerCommandStaffSafety & SecurityOfficerLogistics SectionChiefPlanning SectionChiefFinance/AdminSection ChiefOperations SectionChiefGeneralStaff
49 Logistics Chief Food Shelter Supplies Comms Equipment Transportation Organize and direct operations associated with the maintenance of the physical environment:FoodShelterSuppliesComms EquipmentTransportationMedical support( ; )
50 Logistics Chief Facility Unit Leader Communications Unit Leader Transport Unit LeaderMaterials Supply Unit LeaderNutritional Supply Unit Leader
51 Incident Command System (ICS) Model Incident CommanderPublic InformationOfficerLiaisonOfficerCommandStaffSafety & SecurityOfficerLogistics SectionChiefPlanning SectionChiefFinance/AdminSection ChiefOperations SectionChiefGeneralStaff
53 Planning ChiefOrganize and direct all aspects of the planning section - Incident Action PlanUsually runs the Operational Period briefing (Team Chief strategy meeting)Document and distribute the facility action plan.Ensure distribution of critical information/data.Compile scenario projections from all section chiefs and effect long range planning.Ensure adequate personnel for response.( /24; )
54 Planning Chief Situation Status Unit Leader Labor Pool Unit Leader Medical Staff Unit LeaderPatient Tracking OfficerPatient Information Officer
55 Incident Command System (ICS) Model Incident CommanderPublic InformationOfficerLiaisonOfficerCommandStaffSafety & SecurityOfficerLogistics SectionChiefPlanning SectionChiefFinance/AdminSection ChiefOperations SectionChiefGeneralStaff
57 Finance Section Monitor the utilization of financial assets. Oversee the acquisition of supplies and services to carry out the medical mission.Supervise the documentation of expenditures relevant to the emergency incident.Pre-planning for a rainy dayBusiness RECOVERY( /47; )
58 Finance Chief Time Unit Leader Procurement Unit Leader Claims Unit LeaderCost Unit Leader
59 Incident Command System (ICS) Model Incident CommanderPublic InformationOfficerLiaisonOfficerCommandStaffSafety & SecurityOfficerLogistics SectionChiefPlanning SectionChiefFinance/AdminSection ChiefOperations SectionChiefGeneralStaff
60 Operations Section Day to Day activities – On Steroids! Provision of Care – “Your Hospital’s Mission”Known as the Tactical Response: Operations, Objectives and Direction.( /5)( )( )
61 Operations Chief Medical Staff Director Medical Care Director Ancillary Services DirectorHuman Services Director
62 Operations Chief Medical Staff Director Medical Care Director In-Patient AreasSupervisorTreatment AreasSupervisorSurgical ServicesUnit LeaderTriageUnit LeaderDischargeUnit LeaderMaternal & ChildUnit LeaderImmediate TxUnit LeaderMorgueUnit LeaderCritical CareUnit LeaderDelayed TxUnit LeaderGeneral NursingUnit LeaderMinor TxUnit LeaderOut-PatientServices Leader
67 PHICS Incident Commander Public Information Officer Liaison Officer - ExternalLiaison Officer -InternalSafety and Security OfficerLegal OfficerLogistics ChiefPlanning ChiefFinance ChiefOperations Chief
68 ADPH Incident Command System Positions Chart Incident ManagementAdvisory Group/CEPIncident CommanderPublic Information OfficerSafety and Security OfficerLiaison Officer InternalLegal OfficerLiaison Officer ExternalLogistics ChiefPlanning ChiefFinance ChiefOperations ChiefCommunications Unit LeaderSituation Status Unit LeaderTime Unit LeaderOperations Section continued on next pageDamage Assessment Unit LeaderHuman Resources Unit LeaderProcurement Unit LeaderStrategic Epidemiology & Surveillance Unit LeaderTransportation Unit LeaderMaterials Supply & Nutrition Unit LeaderADPH Incident Command System Positions ChartJanuary 4, 2010
69 ADPH Incident Command System Positions Chart - Operations Incident CommanderIncident ManagementAdvisory Group/CEPPublic Information OfficerSafety and Security OfficerLiaison Officer InternalLegal OfficerLiaison Officer ExternalOperationsChiefLaboratoryBranchEnvironmentalGroupMedical CareBranchSubject Matter ExpertsBiologicalChemicalRadiationZoonoticInfection ControlField SurveillanceBranchFood Safety GroupMedical Needs ShelterPharmaceutical SupportPharmacySocial Service Coordination BranchLaboratoryBranchPharmaceutical SupportVaccinationADPH Incident Command System Positions Chart - OperationsJanuary 4, 2010EMS GroupPatient Management GroupPatient Placement Unit