1. Contributing to the Volunteer Solution for Preparedness The Texas Medical Rangers A Proud Unit of the Texas State Guard

2. If a terrorist attack, disaster or other large scale public health emergency happens in Texas… A few critically important questions:  Who will be there to help?  Who will treat those affected?  Will there be enough people to respond adequately?

3. PREPARATION PROCESS Understanding Scenarios Plans – planning process, organizing coordination People – gap analysis, training Products – equipment, supplies, facilities Practice – individual, system of systems interfaces

4. Types of Agents/Casualties WeaponPotential Casualties Duration Chemical (Nerve)100’shours/days Biological100’s to 10,000’sweeks/months Radiation100’sHours/delayed Nuclear 100,000’sImmediate/months Explosive10’s to 100’sImmediate/days

5. Mass vaccination begins on Day 17: Effects on epidemic as function of % of population vaccinated Modeling a Smallpox Outbreak in San Antonio

6. WHO Model Biologic Attack: City of 1,000,000 AgentNumber of People at Risk DeathsIncapacitated Anthrax180,00095,00030,000 Plague100,00044,00036,000 Tularemia180,00030,00095,000

7. Pandemic Flu Outbreak 6-12 months 15% Attack Rate 35% Attack Rate Fatalities87,000207,000 Hospitalizations314,000733,000 Self-Care ill21 million50 million

8. 15 Kiloton “Hiroshima” Homemade Terrorist Bomb New York City Population: 8 million (1.5 million Manhattan) Dead: 1,000,000 Injured: 1,000,000

9. Many Volunteer Organizations Are Available for Disasters Volunteers are the Key Cog in the Preparedness Machine American Red Cross (non-medical) PROTECT TEXAS Volunteers Ready Texas Nurses Voluntary Organizations Active in Disaster (VOAD) Medical Reserve Corps [civilian style] Texas Medical Rangers – a military Medical Reserve Corps that is part of the Texas State Guard

10. PROTECT TEXAS Volunteers Emergency Public Health Response in Texas

11. TDH Volunteer Program Coordinators organize recruitment, orientation and training activities –In each of the 8 regional health departments, and –Within many local health departments Program Coordinators work routinely with concerned –Health education, emergency management and other experts –Disaster response and other community organizations –City and county officials Overall coordination of the PROTECT TEXAS Volunteer Program is at the state level of TDH PROTECT TEXAS Volunteer Program

12. www.tdh.state.tx.us/cphpr/protect/

13. www.texasnurses.org

14. www.nvoad.org

15. www.medicalreservecorps.gov

16. Are found all around the country

17. Mission To serve To serve the people of Texas by providing volunteer medical expertise of the highest reputation, and health service in support of public health emergencies, disasters, and other situations, at the call of the Governor. The Texas Medical Rangers

18. Vision To be the most valuable, health-related, statewide, volunteer organization in Texas and The best Medical Reserve Corps in the Nation Values Responsive, Professional, Adaptable The Texas Medical Rangers

19. Teams of organized, specially-trained volunteers from all health-related fields, including support skills, with verified licensure The Medical Reserve Corps of the Texas State Guard The Texas Medical Rangers

20. A nationally recognized unit of the U.S. Surgeon General’s network of Medical Reserve Corps local volunteer citizen organizations. Not subject to authority of U.S. President. Available for missions only within Texas, not other states or foreign countries. Available for missions expected to last a few days to a few weeks. The Texas Medical Rangers

21. No weapons, equipment, or supplies. Just good people willing to be ready to give a little of their time. We support the plans of those authorities with equipment, supplies and a short-term need for more people. Always at option of individual volunteer. Most volunteer organizations are local, we can support locally, regionally or statewide. The Texas Medical Rangers (Characteristics Cont’d)

22. Identifiable by military rank and uniform. When on state active duty official mission. –Texas HB 9 signed into law, effective 22 June 2003, provides immunity from civil liability. –State Guard worker’s compensation. –Leave of absence (with or without pay). –Health Science Centers (state employees maintain benefits and coverage). (Characteristics Cont’d) The Texas Medical Rangers

23. GOVERNOR ADJUTANT GENERAL TEXAS ARMY NATIONAL GUARD TEXAS AIR NATIONAL GUARD TEXAS STATE GUARD COMMANDER ------------------------------------------Texas Military Forces----------------------------------- TEXAS MEDICAL RANGERS REGIONAL GROUPS The Texas Medical Rangers

24. LEGEND Company Group Headquarters Groups and Companies El Paso Odessa/Midland Amarillo Lubbock Laredo Lower Rio Grande Valley Corpus Christi Victoria Wichita Falls Fort Worth Dallas Tyler College Station Galveston Houston San Antonio Fredericksburg Austin Waco Temple Killeen The Texas Medical Rangers

25. 450 Volunteers Currently [Jan 2008] 1500 Volunteers desired eventually Written into response plans by state, local authorities and Texas Military Forces Participating in exercises Active program to train others Participate in appropriate community events The Texas Medical Rangers Operational Capabilities Target

26. Examples of Augmentation Service Missions We are NOT First Responders Staff / Manage Acute Care Centers Augment TDH, Metro Health Dept. Staff Assist in Emer. Ops Centers / Staff Call Centers Staff Mass Vaccination / Antibiotic Sites Assist with Breakdown / Delivery of SNSP Assist in Mass Triage / Mental Health Counseling Veterinary and Dental Teams The Texas Medical Rangers

27. Missions  Supported the 6th Civil Support Team (CST) in contingency status for potential incidents during Super Bowl XXXVIII in Houston.  Supported a multi-state U.S. Northern Command sponsored UD04 exercise.  Participated in Operation Lone Star in the Lower Rio Grande Valley to provide medical care to thousands of indigent patients.  Provided medical expertise at the TXSG Health Risk Assessment Day at Camp Swift.  Participated in a multi-agency SNS exercise in Houston. The Texas Medical Rangers

28. “Come Ride with the Texas Medical Rangers ” Serving Texans with pride, competence and character Houston:swc2.hccs.edu/texasmedicalrangers Galveston:galvestontexasmedicalrangers.com Statewide: www.texasmedicalrangers.com Contact Info. The Texas Medical Rangers

29. Presenting of Texas Medical Rangers Colors March 20, 2004 The Texas Medical Rangers