1. Emergency Response Training and Incident Command
ACHA 2009 Annual Meeting
May 26-30, 2009
San Francisco, CA

2. Montclair State University Director, University Health Center
Presenters
Paul M. Cell
Chief of Police
Montclair State University
Donna M. Barry
Director, University Health Center

3. Workshop Objectives
Describe the National Incident Management System (NIMS), Incident Command System (ICS) and key emergency management principles as they apply to campus health care providers
Explain the importance of preparedness exercises and the impact on mitigation, response, and recovery

4. Workshop Objectives
List strategies for effective emergency response preparedness and communications for diverse audiences
Describe an example of the application of the Incident Command Structure on campus and the role of health care providers through a case presentation

5. “Imagine the Unimaginable”

6. Campus Incidents
Virginia Tech
Northern Illinois
H1N1 Novel Influenza

7. National Mandates Management of Domestic Incidents
HSPD-5
Management of Domestic Incidents
HSPD-8
National Preparedness
Mandates
National Mandate
Homeland Security Presidential Directive (HSPD) 5 called for a single, comprehensive system to enhance the ability of the United States to manage domestic incidents.
As presented earlier, the National Incident Management System (NIMS) provides a consistent nationwide template to enable all levels of government, the private sector, and nongovernmental organizations to work together during an incident.
In the remainder of this lesson, we will review the organizational structures outlined in the video presentation.
HSPD-5 identifies steps for improved coordination in response to incidents. It requires the Department of Homeland Security (DHS) to coordinate with other Federal departments and agencies and State, local, and tribal governments to establish a National Incident Management System (NIMS) and a National Response Framework (NRF).
HSPD-8 describes the way Federal departments and agencies will prepare. It requires DHS to coordinate with other Federal departments and agencies and State, local, and tribal governments to develop national preparedness guidelines.
Together, these related efforts align Federal, State, local, tribal, private sector, and nongovernmental preparedness, incident management, and emergency response plans into an effective and efficient national structure.

8. HSPD 5 Management of Domestic Incidents
IS-700.A: National Incident Management System, An Introduction
HSPD 5 Management of Domestic Incidents
Homeland Security Presidential Directive 5 (HSPD-5) directed the Secretary of Homeland Security to:
Develop and administer a National Incident Management System (NIMS).
Develop the National Response Framework (NRF).
Explain that Homeland Security Presidential Directive 5 (HSPD-5), "Management of Domestic Incidents," directed the Secretary of Homeland Security to:
Develop and administer a National Incident Management System (NIMS).
Develop the National Response Framework (NRF).
January 2009

9. Part of a Broader Strategy
The National Response Framework is required by, and integrates under, a larger National Strategy for Homeland Security.
Part of a Broader Strategy
The National Response Framework is required by, and integrates under, a larger National Strategy for Homeland Security that:
Serves to guide, organize, and unify our Nation's homeland security efforts.
Reflects our increased understanding of the threats confronting the United States.
Incorporates lessons learned from exercises and real-world catastrophes.
Articulates how we should ensure our long-term success by strengthening the homeland security foundation we have built.
[REFER TO THE NATIONAL STRATEGY FOR HOMELAND SECURITY]

10. National Strategy for Homeland Security Goals
Prevent and disrupt terrorist attacks.
Protect the American people and our critical infrastructure and key resources.
Respond to and recover from incidents that do occur.
Continue to strengthen the foundation to ensure our long-term success.

11. Framework Purpose
The purpose of the National Response Framework is to ensure that all response partners:
Understand domestic incident response roles, responsibilities, and relationships.
Respond effectively to any type of incident.
Purpose
The purpose of the National Response Framework is to ensure that all response partners across the Nation understand domestic incident response roles, responsibilities, and relationships in order to respond more effectively to any type of incident.
The Framework is written especially for government executives, private-sector and nongovernmental organization leaders, and emergency management practitioners.

12. Scope: Domestic Incident Response
Response includes:
Immediate actions to save lives, protect property and the environment, and meet basic human needs.
The execution of emergency plans and actions to support short-term recovery.
Scope: Domestic Incident Response
The Framework provides structures for implementing national-level policy and operational coordination for domestic incident response. The term “response” as used in this Framework includes:
Immediate actions to save lives, protect property and the environment, and meet basic human needs.
The execution of emergency plans and actions to support short-term recovery.

13. NRF Premises
The Framework is always in effect and can be implemented at any level at any time.
Incident management activities are initiated and conducted using the principles contained in the National Incident Management System (NIMS).
The Framework provides structures for implementing nationwide response policy and operational coordination for all types of domestic incidents. It can be partially or fully implemented in the context of a threat, in anticipation of a significant event, or in response to an incident. Selective implementation allows for a scaled response, delivery of the resources needed, and an appropriate level of coordination. The Framework is always in effect, and elements can be implemented as needed on a flexible, scalable basis that can help improve response.
The Framework retains the same core principles of the National Incident Management System (NIMS) in which first responders from different jurisdictions and disciplines can work together better to respond to natural disasters and emergencies, including acts of terrorism. Once response activities have begun, on-scene actions are based on NIMS principles.
A Federal department or agency acting on independent authority may be the initial and the primary Federal responder, but incidents that require more systematic Federal response efforts are now actively coordinated through the appropriate Framework mechanisms described in this document and in its supporting annexes.
Federal assistance can be provided to State, tribal, and local jurisdictions, and to other Federal departments and agencies, in a number of different ways through various mechanisms and authorities. Often, Federal assistance does not require coordination by DHS and can be provided without a Presidential major disaster or emergency declaration.
Why Is the Framework Always In Effect?
It is not always obvious at the outset whether a seemingly minor event might be the initial phase of a larger, rapidly growing threat.
The National Response Framework allows for the rapid acceleration of response efforts without the need for a formal trigger mechanism.
The Framework is always in effect, and elements can be implemented as needed on a scalable, flexible basis to improve resonse.

14. Response Doctrine
Response doctrine defines basic roles, responsibilities, and operational concepts for response across all levels of government and with the private sector and nongovernmental organizations.
Response Doctrine: Overview
Response doctrine defines basic roles, responsibilities, and operational concepts for response across all levels of government and with the private sector and nongovernmental organizations.
It is important to remember that the overarching objective of response activities is life safety, followed by protecting property and the environment.
Let’s review the five key principles of operations that support the Nation’s response mission.

15. Response Doctrine Engaged Partnership Tiered Response
Scalable, Flexible, and Adaptable Operational Capabilities
Unity of Effort Through Unified Command
Response Doctrine: Overview
Response doctrine defines basic roles, responsibilities, and operational concepts for response across all levels of government and with the private sector and nongovernmental organizations.
It is important to remember that the overarching objective of response activities is life safety, followed by protecting property and the environment.
Let’s review the five key principles of operations that support the Nation’s response mission.
The Framework establishes the following response doctrine:
Engaged partnership: Leaders at all levels must communicate and actively support engaged partnerships to develop shared goals and align capabilities so that none allows the other to be overwhelmed in times of crisis.
Tiered response: Incidents must be managed at the lowest possible jurisdictional level and supported by additional response capabilities when needed.
Scalable, flexible, and adaptable operational capabilities: As incidents change in size, scope, and complexity, the response must adapt to meet requirements.
Unity of effort through unified command: Response is a team effort. Effective unified command is indispensable to all response activities and requires clear understanding of the roles and responsibilities of each participating organization.
Readiness to act: Effective incident response requires readiness to act balanced with an understanding of risk. From individuals, families, and communities to local, State, and Federal agencies, national response depends on the instinct and ability to act.
Discussion Questions:
What does this doctrine mean to you personally?
What is an example of a preparedness or response action that would support this doctrine?
Readiness To Act

16. Key Principle: Engaged Partnership
Engaged partnership means that leaders at all levels develop shared response goals and align capabilities so that no one is overwhelmed in times of crisis. Engaged partnerships are essential to preparedness.
Engaged Partnership
Engaged partnership means that leaders at all levels develop shared response goals and align capabilities so that no one is overwhelmed in times of crisis.
Effective response activities begin with a host of preparedness activities conducted well in advance of an incident. Preparedness involves a combination of planning, resources, training, exercising, and organizing to build, sustain, and improve operational capabilities.
Next, we’ll review two examples that demonstrate the concept of engaged partnerships.

17. Key Principle: Tiered Response
A basic premise of the Framework is that incidents are generally handled at the lowest jurisdictional level possible.
Tiered Response
Incidents begin and end locally, and most are managed at the local level. Many incidents require unified response from local agencies, the private sector, and nongovernmental organizations. Other incidents may require additional support from neighboring jurisdictions or the State.
A small number require Federal support. National response protocols recognize this and are structured to provide additional, tiered levels of support.

18. Key Principle: Scalable, Flexible, Adaptable
As incidents change in size, scope, and complexity, the response must adapt to meet requirements.
Scalable, Flexible, and Adaptable Operational Capabilities
The number, type, and sources of resources must be able to expand rapidly to meet needs associated with a given incident. The Framework builds on the National Incident Management System (NIMS). Together, the Framework and NIMS help to ensure that all response partners use standard command and management structures that allow for scalable, flexible, and adaptable operational capabilities.

19. Key Principle: Unified Command
Unity of effort through Unified Command:
Is a collective, strategic approach.
Enables different agencies and jurisdictions to coordinate, plan, and interact effectively.
Uses joint priorities and resource allocation.
Relies on a single plan and set of objectives.
Unity of Effort Through Unified Command
Success requires unity of effort, which respects the chain of command of each participating organization while harnessing seamless coordination across jurisdictions in support of common objectives.
As a team effort, unified command allows all agencies with jurisdictional authority and/or functional responsibility for the incident to provide joint support through mutually developed incident objectives and strategies. Each participating agency maintains its own authority, responsibility, and accountability.
Unified command is an Incident Command System (ICS) application used when more than one agency has jurisdiction or when incidents cross political jurisdictions. Agencies work together through the designated members of the unified command to establish a common set of objectives and strategies and a single Incident Action Plan.
As a team effort, unified command allows all agencies with jurisdictional authority and/or functional responsibility for the incident to provide joint support through mutually developed incident objectives and strategies established at the command level. Each participating agency maintains its own authority, responsibility, and accountability.
[PULL FROM 402 COURSE]

20. Key Principle: Readiness to Act
Readiness is a collective responsibility. Effective national response depends on our readiness to act.
Readiness To Act
A forward-leaning posture is imperative for incidents that have the potential to expand rapidly in size, scope, or complexity, and for no-notice incidents.
Once response activities have begun, on-scene actions are based on NIMS principles. An effective national response relies on disciplined processes, procedures, and systems.

21. IS-700.A: National Incident Management System, An Introduction
NIMS Mandate
HSPD-5 requires all Federal departments and agencies to:
Adopt and use NIMS in incident management programs and activities.
Make adoption of NIMS a condition for Federal preparedness assistance (through grants, contracts, and other activities).
Explain that HSPD-5 requires all Federal departments and agencies to:
Adopt NIMS and use it in their individual incident management programs and activities.
Make adoption of NIMS by State, tribal, and local organizations a condition for Federal preparedness assistance (through grants, contracts, and other activities).
January 2009

22. IS-700.A: National Incident Management System, An Introduction
NIMS Overview
What ? NIMS provides a consistent nationwide template . . .
Who? to enable Federal, State, tribal, and local governments, the private sector, and nongovernmental organizations to work together . . .
How? to prepare for, prevent, respond to, recover from, and mitigate the effects of incidents regardless of cause, size, location, or complexity . . .
Why? in order to reduce the loss of life and property, and harm to the environment.
Explain to the participants that the National Incident Management System (NIMS) provides a consistent framework for incident management at all jurisdictional levels regardless of the cause, size, or complexity of the incident. NIMS is not an operational incident management or resource allocation plan.
Tell the participants that the NIMS document was developed through a collaborative intergovernmental partnership with significant input from the incident management functional disciplines, nongovernmental organizations (NGOs), and the private sector.
Originally published on March 1, 2004, the NIMS document was revised in 2008 to reflect contributions from stakeholders and lessons learned during recent incidents.
January 2009

23. Builds on Best Practices
IS-700.A: National Incident Management System, An Introduction
Builds on Best Practices
NIMS integrates emergency management best practices that:
Lay the groundwork for the components of NIMS.
Provide for the further development and refinement of supporting national standards, guidelines, protocols, systems, and technologies.
Explain how, by building on the foundation provided by existing emergency management and incident response systems used by jurisdictions, organizations, and functional disciplines at all levels, NIMS integrates best practices into a comprehensive framework.
Tell the participants that these best practices lay the groundwork for the components of NIMS and provide the mechanisms for the further development and refinement of supporting national standards, guidelines, protocols, systems, and technologies.
January 2009

24. NIMS: What It Is/What It’s Not
IS-700.A: National Incident Management System, An Introduction
NIMS: What It Is/What It’s Not
NIMS is . . .
A flexible framework of:
Doctrine
Concepts
Principles
Terminology
Organizational processes
Applicable to all hazards and jurisdictions
NIMS is not . . .
An operational incident management plan
A resource allocation plan
A terrorism/WMD-specific plan
Designed to address international events
Refer the participant to items on the visual stating “What NIMS Is” and “What NIMS Is Not.” Read aloud the following situations (or other examples that would be relevant to the audience). Tell the participants to indicate if they are consistent or inconsistent with NIMS:
Local officials are using the Incident Command System (ICS) to plan for the upcoming Fourth of July celebration. Answer: Consistent With NIMS Explanation: NIMS encourages the use of ICS for both planned events and incidents.
A jurisdiction/agency follows NIMS only when incidents are complex enough to involve other jurisdictions. Answer: Not Consistent With NIMS Explanation: NIMS applies to all hazards independent of size or complexity.
An agency is replacing its operational plan for responding to incidents with the guidance provided in NIMS. Answer: Not Consistent With NIMS Explanation: NIMS provides overall response principles and structures but does not provide specific plans.
An organization is reorganizing and using NIMS/ICS titles for day-to-day routine activities. Answer: Not Consistent With NIMS Explanation: NIMS is designed to manage incidents rather than day-to-day business operations.
January 2009

25. Collaborative Incident Management
IS-700.A: National Incident Management System, An Introduction
Collaborative Incident Management
NIMS:
Is not an operational incident management or resource allocation plan.
Represents a core set of doctrines, concepts, principles, terminology, and organizational processes
Enables effective, efficient, and collaborative incident management.
Tell the participants that NIMS is not an operational incident management or resource allocation plan.
Explain that NIMS represents a core set of doctrines, concepts, principles, terminology, and organizational processes that enables effective, efficient, and collaborative incident management.
January 2009

26. IS-700.A: National Incident Management System, An Introduction
NIMS Is Dynamic
NIMS:
Is not a static system.
Fosters the development of specialized technologies that facilitate response.
Allows for the adoption of new approaches that will enable continuous refinement of the system.
Note that NIMS is not a static system.
Explain that NIMS fosters the development of specialized technologies that facilitate emergency management and incident response activities, and allows for the adoption of new approaches that will enable continuous refinement of the system over time.
January 2009

27. IS-700.A: National Incident Management System, An Introduction
Flexibility
Planned Events
Forecasted Events
Explain to the participants that the components of NIMS are adaptable and scalable to any situation, from routine, local incidents, to incidents requiring the activation of interstate mutual aid, to those requiring a coordinated Federal response. NIMS applies to all types of incidents.
No-Notice Events
January 2009

28. IS-700.A: National Incident Management System, An Introduction
Standardization
Standardized organizational structures:
Improve integration and connectivity among jurisdictions and disciplines.
Allow those who adopt NIMS to work together.
Foster cohesion among various response organizations.
Describe how NIMS provides a set of standardized organizational structures that improve integration and connectivity among jurisdictions and disciplines, starting with a common foundation of preparedness and planning.
Personnel and organizations that have adopted the common NIMS framework are able to work together, thereby fostering cohesion among the various organizations involved in all aspects of an incident.
January 2009

29. IS-700.A: National Incident Management System, An Introduction
NIMS Components
Preparedness
Communications and Information Management
Incident Command System
Resource Management
Multiagency Coordination Systems
Command and Management
Ongoing Management and Maintenance
Public Information
Tell the participants that NIMS is much more than just using the Incident Command System or an organization chart.
Following is a synopsis of each major component of NIMS. 
Preparedness. Effective incident management and incident response activities begin with a host of preparedness activities conducted on an ongoing basis, in advance of any potential incident. Preparedness involves an integrated combination of planning, procedures and protocols, training and exercises, personnel qualification and certification, and equipment certification.
Communications and Information Management. Emergency management and incident response activities rely on communications and information systems that provide a common operating picture to all command and coordination sites. NIMS describes the requirements necessary for a standardized framework for communications and emphasizes the need for a common operating picture. NIMS is based on the concepts of interoperability, reliability, scalability, portability, and the resiliency and redundancy of communications and information systems.
Resource Management. Resources (such as personnel, equipment, and/or supplies) are needed to support critical incident objectives. The flow of resources must be fluid and adaptable to the requirements of the incident. NIMS defines standardized mechanisms and establishes the resource management process to: identify requirements for, order and acquire, mobilize, track and report, recover and demobilize, reimburse for, and inventory resources.
Command and Management. The Command and Management component within NIMS is designed to enable effective and efficient incident management and coordination by providing flexible, standardized incident management structures. The structure is based on three key organizational constructs: the Incident Command System, Multiagency Coordination Systems, and Public Information.
Ongoing Management and Maintenance. DHS/FEMA manages the development and maintenance of NIMS. This includes developing NIMS programs and processes as well as keeping the NIMS document current.
January 2009

30. ICS Incident Command Structure30

31. ICS Features Standardization of terminology
Definitive Chain of Command
Unity of Command
Planned, Organized Structure
Facilities/Resources Management
Communications and Information Management

32. Standardization: Common Terminology
Using common terminology helps to define:
Organizational functions.
Incident facilities.
Resource descriptions.
Position titles.

33. Chain of Command
Chain of command is an orderly line of authority within the ranks of the incident management system that may be different than your campus line of authority.
Authority

34. Unity of Command
Under unity of command, personnel:
Report to only one supervisor within the ICS structure.
Receive work assignments only from the ICS supervisors.

35. ICS Organization In the ICS organization:
There is no correlation with the administrative structure of the University.
Someone who serves as a Manager every day may not hold that title when deployed under an ICS structure.

36. ICS for Campuses

37. Management by Objectives
ICS is managed by objectives that are communicated throughout the entire ICS system.

38. Reliance on an Incident Action Plan
Every incident must have an Incident Action Plan (IAP) that:
Specifies the incident objectives.
States the activities to be completed.
Covers a specified timeframe, called an operational period.
Your campus Pandemic Response Plan is an example of an Incident Action Plan

39. Comprehensive Resource Management
Resource management includes processes for:
Categorizing resources.
Ordering resources.
Dispatching resources.
Tracking resources.
Recovering resources.
It also includes processes for reimbursement for resources, as appropriate.

40. Integrated Communications
Incident communications are facilitated through:
The development and use of a common communications plan.
The interoperability of communication equipment, procedures, and systems.
Before an incident, it is critical to develop an integrated voice and data communications system (equipment, systems, and protocols).

41. Incident Commander and Command Staff Functions41

42. Incident Commander Role
The Incident Commander:
Provides overall leadership for incident response.
Delegates authority to others.
Takes general direction from agency administrator/official.
Incident Commander

43. Command Staff
Incident
Commander
Provide information, liaison, and safety services for the entire organization
Report directly to the Incident Commander
Public Information
Officer
Health Officer
Liaison Officer
Safety Officer

44. Public Information Officer (PIO)
Advises Incident Commander on information dissemination and media relations. Incident
Commander approves information that the PIO releases.
Obtains information from and provides information to Planning Section.
Obtains information from and provides information to community and media.
Reports directly to Incident Commander

45. Health Officer
Advises Incident Commander on issues regarding medical and public health response
Obtains information from and provides information to Liaison and Public Information Officers, Section Chiefs
Reports directly to Incident Commander 45

46. Liaison Officer
Assists Incident Commander by serving as point of contact for agency representatives who are helping to support the operation.
Provides briefings to and answers questions from supporting agencies.
Reports directly to Incident Commander

47. Safety Officer
Advises Incident Commander on issues regarding incident safety.
Works with Operations to ensure safety of field personnel.
Ensures safety of all incident personnel.
Reports directly to Incident Commander

48. General Staff Functions48

49. General Staff Command Staff General Staff Incident Commander
Public Information
Officer
Command Staff
Liaison
Officer
Safety
Officer
General Staff
Operations
Section
“Doers”
Planning
Section
“Thinkers”
Logistics
Section
“Getters”
Finance/Admin
Section
“Payers”

50. Operations Section “The Doers”
Incident
Commander
The Operations Section:
Directs and coordinates all incident tactical operations.
Is typically one of the first organizations to be assigned to the incident.
Expands from the bottom up.
Has the most incident resources.
May have Staging Areas and special organizations.
Operations
Section
Staging Area
Rescue
Group
Investigation
Group

51. Operations Section Chief
The Operations Section Chief:
Develops and implements strategy and tactics to carry out the incident objectives.
Organizes, assigns, and supervises the tactical field resources.
Supervises air operations and those resources in a Staging Area.
Operations Section Chief

52. Planning Section “ The Thinkers”
Maintains resource status.
Maintains and displays situation status.
Prepares the Incident Action Plan.
Develops alternative strategies.
Provides documentation services.
Prepares the Demobilization Plan.
Provides a primary location for Technical Specialists assigned to an incident.

53. Planning Section Chief
The Planning Section Chief:
Gathers, analyzes, and disseminates information and intelligence.
Manages the planning process.
Compiles the Incident Action Plan.
Manages Technical Specialists.
Planning Section Chief

54. Logistics Section “The Getters”
Responsible for:
Communications.
Medical support to incident personnel.
Food for incident personnel.
Supplies.
Facilities.
Ground support.
Ground
Unit
Food
Facilities
Medical
Supply
Commun.
Support
Branch
Service
Logistics Section

55. Logistics Section Chief
The Logistics Section Chief:
Provides resources and services required to support incident activities.
Develops portions of Incident Action Plan and forwards them to Planning Section.
Contracts for and purchases goods and services needed at the incident.
Logistics Section Chief

56. Finance/Administration Section “The Payers”
Finance/Admin Section
Contract negotiation and monitoring
Timekeeping
Cost analysis
Compensation for injury or damage to property
Time
Unit
Compensation/
Claims Unit
Procurement
Unit
Cost
Unit

57. Finance/Administration Section Chief
The Finance/Admin Section Chief:
Is responsible for financial and cost analysis.
Oversees contract negotiations.
Tracks personnel and equipment time.
Processes claims for accidents and injuries.
Works with Logistics to ensure resources are procured.
Finance/Administration Section Chief

58. Training and Exercises
Training (NIMS Compliance)
Tabletops
Full Scale Exercises

59. Having a plan is not good enough!
Incident Action Plans
Having a plan is not good enough!
Remember the three “R”s:
Review
Rehearse
Revise

60. ICS Simulation Planning – blue Logistics – pink Operations – green
Finance/Administration – yellow
Assign Section Chief and Scribe