Presentation on theme: "ESF8: Medical Surge Planning and Coordination"— Presentation transcript:
1 ESF8: Medical Surge Planning and Coordination Emergency medical surge planning in your County and the value of integrating medical and non-medical volunteers into your planAGENCY LOGO
2 Emergency Support Function #8- Health and Medical (ESF8) ESF8 is a system of health and medical agencies that are coordinated in an emergency based on a common set of established plans, tools and resources in order to meet specific outcomes that affect the health and medical care of those involved in the incident (casualties and responders.)
3 ESF8 as a SystemNIMS/ICS principles apply to incident response but not always to EOC managementExisting system of relationships become extended beyond agency/jurisdictional boundariesExamples: Infection Control, Patient triage and tracking, Surge staffing for Alternate Care FacilityESF8 System ModelsBasic: agency-agencyIntermediate: multi-agency, limited number of ESFsComplex: multi-agency, multi-jurisdictional, full EOC response
4 ESF8 as Outcomes Effective Patient Tracking Effective coordination in response (resolves differences among agencies)Efficient utilization of resourcesEfficient and rapid response and request for supportCommon operational model (local, state, federal)Ensures agency response is competent based on agency/discipline standardsStrategic guidance and directionDo these fit your county?Are there others?Can you quickly determine what your priorities would be if you were requested by the EOC? Or requested by other ESF8 agencies?
5 Emergency Response Time Level of Response Complexity Analysis ICS Level ChangeAuthority ChangeEmergencyOperations CenterDepartmentalOperations CenterDepartmentalOperations CenterLevel of ResponseDailyOrganizational ObjectivesDailyOrganizational ObjectivesTime
6 Where did ESF originate? National Response Framework- assigned federal agencies to “Emergency Support Functions”:Guidance: “Governments at all levels should use the NIMS resource management principles described below to enhance response capabilities.”State Emergency Operations Plan (SEOP)County Emergency Operations Plan (Contains ESF annexes)Post 9-11 mandate to remove the “silos” that limit communication between organizations.“Seat” in the EOC/MACG?Ops vs. non-ops. Where will you fit in?Define all Acronyms“Seat” in EOC is a incident specific= Mass Casualty, ESF8 seat might be EMS…coordinating patient transfers.THE ESF SEAT is really a liaison role at the county level to engage in coordination and resource support for that particular Emergency Support Function. Sometimes the role will be more operational (i.e. coordinating the delivery of medical resources) and sometimes it will be more non-operational (informing other ESFs and the emergency manager of a particular area of concern or resource capability.)
7 National Response Framework (NRF) Framework Document (Base Plan)Support AnnexesIncident AnnexesEmergency Support Function (ESF) AnnexesOutline agency responsibilities for coordination, planning, support, resources, program implementation, and services during emergenciesESF #11 - Agriculture and Natural ResourcesESF #12 - EnergyESF #13 - Public Safety and SecurityESF #14 - Long-Term Recovery/MitigationESF #15 - External AffairsESF #1 - TransportationESF #2 - CommunicationsESF #3 - Public Works, EngineeringESF #4 - FirefightingESF #5 - Emergency ManagementESF #6 - Mass Care, HousingESF #7 - Resource SupportESF #8 - Public Health, Medical, MortuaryESF #9 - Urban Search and RescueESF #10 - Oil and Hazardous MaterialsNOT JUST Physicians… everybody has a role!
8 Colorado Emergency Support Functions 1. Transportation6. Mass Care, Housing &Human Services11. Agriculture & NaturalResources2. Communications7. Resource Support12. Energy3. Public Works & Engineering8. Public Health & Medical8a . Mental Health13. Public Safety & Security4. Fire Fighting4a. Wildfire Suppressions9. Search & Rescue14. Long Term Community Recovery & Mitigation5. Emergency Management10. Oil & Haz Mat Response15. External Affairs
9 ESF #8: Public Health, Medical, Mortuary CDPHE can provide local jurisdictions the following types of support:Health SurveillanceBiological Hazards ConsultationPharmaceutical Supplies and DistributionAssessment of Health/Medical NeedsHealth/Medical Equipment and SuppliesMedical Care PersonnelMortuary ServicesFood and Drug SafetyPotable Water/WastewaterSolid Waste DisposalRadiological and Chemical Hazards ConsultationVector ControlEnvironmental Impact AssistancePublic Health InformationESF #8 is responsible for providing public and environmental health, medical and mortuary assistance to local governments in the care and treatment for the ill and injured by mobilizing trained health and medical personnel, medical transport, emergency medical supplies, materials and facilities to the area(s) in need. Other activities include disease and vector control, and the collection, identification and protection of human remains when local resources are depleted. In addition, there is a component of ESF#8 that addresses the provision of mental health care during a disaster.This slide lists the various services that CDPHE can provide to local jurisdictions during an emergency if needed. Although we are identified as a lead ESF 8 agency, it is important to point out that we are responsible, but we are not necessarily the ones doing the work. For example, for mortuary services we’re a lead in planning for mass fatality, but the coroner or physician in the hospital has the authority for death declaration. Also, Mental Health is part of ESF8 response, but the department of health and human services are the ones responsible for addressing mental health response in Colorado.As every public health agency is unique, as is every county, your local health department or nursing service may not provide all of the services listed here. For example, Alamosa County Nursing Service doesn’t provide environmental health services in their county. Instead, these services are contracted and provided by CDPHE. As a county, emergency management and public health must work together to determine who the lead agency for ESF#8 is at the local level and what agencies and organizations can provide the various public health, medical and mortuary functions needed during local emergencies and disasters.ESF 8: Public Health and Medical
10 Organization Participant Functional RoleOrganization ParticipantPublic Health AuthorityLocal Public Health DepartmentHospitalsTrauma CentersCritical Access HospitalsVeteran’s HospitalsPrivate PhysiciansMedical SocietyIndependent Physicians AssociationPrimary Care OfficesEmergency Medical Services (EMS)Fire Department, EMS ServicesEMS CoordinatorMental HealthDepartment of Human ServicesMass Fatalities ManagementCoronerCan you think of other ways physicians might collaborate/coordinate?
11 Event Transportation Environmental Protection Agency Level 1Local, State, FederalResponseFederal DeclarationDepartment of JusticeHealth & Human ServicesEnvironmental Protection AgencyFederal Emergency Management AgencyDepartment of EnergyDepartment of DefenseInteriorTransportationGeneralServicesAmericanRed CrossOther FederalAgenciesTransportationCOVOADvolunteersHumanServicesMilitaryAffairsGovernors’OfficeGovernorLocalPublicHealth &EnvironmentOthersLevel 2State, Local ResponseState DeclarationPersonnel and AdminSafetyHigher EducationDiv of Emergency MgmtDept of AgricultureNatural ResourcesLocal AffairsRegulatoryCountyCommissionersCity CouncilResponseTeamsLevel 3Regional ResponseOthersPoliceDeptFire DeptCityCouncilPublicWorksCitizensGroupsEMSHospitalsLevel 4Local ResponseLocal HDOtherDisasterEventEmergencyManagerDisasters/incidents escalate and involve all aspects of incident command at the varying response levels. Each organization/agency has a designated role. ESFs form the backbone of organizing the response/support.
12 Must ESF8 be activated by emergency management? ActivationMust ESF8 be activated by emergency management?No. ESFs are able, through their own planning and collaboration processes to function and coordinate prior to formal activation through the Emergency manager and the EOC.
13 Medical Surge ESF8 Activation Thresholds Patient surge exceeds countyMedical Resources exceed availability in countyPatient surge exceeds hospitalMedical SurgeHospital needs additional resourcesConsider activating Mesa County Hospital Coordination CenterConsider activating Mesa County Multi-agency Coordination GroupConsider Declaration of Emergency
14 ESF8 Planning Committee Mission Statement: “The County Emergency Support Function 8 Planning Committee (ESF8 Committee) is a multi-disciplinary, coordinating group representing ESF8 agencies and organizations. The Committee addresses critical healthcare needs in our Community. The ESF8 Committee develops strategies and solutions which synchronize the use of diverse healthcare resources during emergencies or disasters affecting County.
15 ESF 8 On the Ground County Health Department Medical Supply Caches/WarehouseCommunications CenterHospital Coordination System or Hospital DesigneeEmergency Medical ServicesCounty Healthcare Coordination System (HCS)/ESF8Medical Reserve CorpsState PH LiaisonRegional LiaisonsCDEM/RETAC/Public HealthHospital #1Hospital #2Hospital #3TIER IIITIER ITIER IITIER IVVA HospitalCounty Emergency Operations Center (EOC)EMS AgenciesPrimary Care & Medical OfficesHuman & Environmental Health
16 Basic Response Example: Agency to Agency Hospital-EMSPublic Health- Hospital ICPSmall school bus starts on fire…smoke inhalation…no casualties- only worried well to transport.Nursing home/hospital/clinic norovirus outbreak.How would this evolve into a larger effort with more staff/agencies/facilitiesOther examples?
17 Intermediate Response Example: Multi-Agency, Multi-Jurisdiction, Limited Number of ESFs Alamosa, CO, Salmonella (ESFs 3, 5, 8, and 15)Limited geographic area flooding/natural disaster.Chemical hazmat spill response with casualties.H1N1? Intermediate or severe? Where were we at?Alamosa- let the participants decide what the org chart MIGHT HAVE LOOKED LIKE in their county.Pick the disaster of you choice and support it’s reasonableness.ESF8 partners should be planning around “LIKELY SCENARIOS” . The goal of this committee (ESF8) is to identify those initially in the planning.
18 Complex Response Example: Multi-Agency, Full EOC Response Catastrophic natural event (Snowstorm, outbreak, flooding)Pitkin County, CO- Dirty bomb/mass casualtyTrain derailment (i.e. Silverton-Durango, Amtrak)Dr. Tice/Cameron, help with support for Haiti.