Function 1

Development and Maintenance of Medical and Health Disaster Plans, Policies, and Procedures

LEMSA Roles: Preparedness - Response - Recovery

Function Objective

Establish an infrastructure for the Operational Area disaster medical system that includes: (1) plans, policies, and procedures that incorporate the provisions of SEMS and are consistent with the planning guidance of local and state Offices of Emergency Services; (2) plans and procedures for the activation, operation and de-activation of the medical function in emergency operations centers; (3) training and exercises to ensure the response capability of EMS system personnel and organizations; and, (4) plans and procedures to conduct afteraction reviews of the disaster medical response.

Function Elements

Element 1.1 Disaster Medical System Planning

Element 1.2 Emergency/Departmental Operations Center Procedures

Element 1.3 Training and Exercises

Element 1.4 After Action Reviews

Element 1.1 Disaster medical system planning

Standard:

LEMSAs shall ensure the development of plans, policies and procedures that ensure the ability of the Operational Area disaster medical services system to respond effectively to the medical needs created by disasters.

Guideline 1.1.1

Medical/Health Operational Area Coordinator Responsibilities

LEMSAs should promote the development of duty statements that incorporate the following responsibilities for Medical Health Operational Area Coordinators:

1. Ensure establishment and operation of a 24-hour point of contact capable of communication with local, regional, and state government agencies and officials with emergency management responsibilities; hospitals and other healthcare entities; and individuals who are to be notified/mobilized in the event of activation of disaster medical response system.

2. Ensure that key disaster response personnel receive periodic training.

3. Develop and test plans, policies, procedures, and structures for the activation and implementation of the disaster response system.

4. Ensure that information management plans are developed and tested.

5. Provide authorization and direction for activation of the medical/health branch of the operational area EOC and ensuring systems are in place for management the Medical/Health Branch of the Operational Area EOC.

6. Coordinate the procurement and allocation of public and private medical, health and other resources required to support disaster medical and health operations in affected areas.

7. Communicate requests for out-of-county assistance.

8. Respond to requests from the Regional Disaster Medical Health Coordinator.

9. Develop a capability for identifying medical and health resources, medical transportation, and communication resources within the Operational Area.

10. Maintain liaison with the Operational Area Coordinators of other relevant emergency functions, e.g., communications, fire and rescue, law, transportation, care and shelter, etc.

11. Ensure that the existing Operational Area medical and health system for day-to-day emergencies is augmented in the event of a disaster requiring utilization of out-of-area medical and health resources.

12. Maintain records and filing required reports.

Guideline 1.12.12

Disaster Medical/Health Plan - Table of Contents

LEMSAs should support the development of Operational Area Disaster Medical/Health response plans that incorporate the following sections:

PLAN INTRODUCTION

· Acknowledgements and Disclaimer

· Record of Revisions

· Distribution List

· Plan Approval Process

· Plan Maintenance

· Training and Exercises

· Authorities and References

· Supporting Plans

BASIC PLAN

Forward to the Basic Plan

· Background

· Emergency Management Goals

· Activation of SEMS Emergency Plan

· Assumptions and Limitations

· How to Use This Plan

Introduction to the Basic Plan

· Purpose

· Authorities and References

· Goals and Objectives

· Concept of Operations

· Emergency Management Phases

• Preparedness Phase
• Response Phase
• Recovery Phase
• Mitigation Phase

· Peacetime Emergencies

· National Security Emergencies

· Hazard Identification and Analysis

· Standardized Emergency Management System

• General Description
• Incident Command System Principles

· SEMS Requirements for Local Government

· SEMS Organization Levels and Functions

· SEMS Organization Chart

· Operational Area Emergency Response Organization and Management

§ Definition

§ OES

§ Medical/Health Branch of EOC

§ Medical/Health OAC

· Regional Emergency Response Organization and Management

• OES
• RDMHC

· State Emergency Response Organization and Management

• Governor’s Office of Emergency Services
• California EMS Authority
• California Department of Health Services

· Federal Emergency Response Organization and Management

• Federal Emergency Management Agency
• National Disaster Medical System

· Mutual Aid

§ Mutual Aid System

• Mutual Aid Regions
• Mutual Aid Coordination
• Operational Area Plans and Agreements

Organization and Agency Roles

Operational Area Public Agencies

• Fire and Rescue
• Law Enforcement
• Health Agency / Department
• Environmental Health
• Mental Health
• Coroner
• Other Human Services Agencies

· Private and Voluntary Agencies and Organizations

• Private Ambulance Companies
• Hospitals
• American Red Cross
• Community Clinics
• Skilled Nursing and Residential Care Facilities

· Other Resources

• DMAT
• Critical Incident Stress Debriefing Team
• FEMA US&R Response System
• Metropolitan Medical Strike Teams (MMST)

· Continuation of Essential Functions

· Preservation of Vital Records

Medical and Health Response Functions

· Alert and Notification

· Assessment, Reporting and other Information Management

· Response Management

· Communications

· Pre-hospital Services

· Patient Dispersal and Evacuation

· Hospital Support

· Sheltering for Medically Fragile

· Resource Acquisition

· Resource Management

· Recovery

· Health Surveillance and Epidemiologic Analyses

· Food Safety

· Exposure to Hazardous Agents

· Mental Health Services

· Medical and Health Public Information

· Vector Control

· Potable Water Suppy

· Management of Waste Material

· Control of Communicable Disease

· Animal Control

STANDARD OPERATING PROCEDURES

EOC Procedures and Checklists

· Management Section Position Descriptions and Checklists

· Operations Section Position Descriptions and Checklists

· Planning Section Position Descriptions and Checklists

· Logistics Section Position Descriptions and Checklists

· Finance Section Position Descriptions and Checklists

DOC Procedures and Checklists

· Management Section Position Descriptions and Checklists

· Operations Section Position Descriptions and Checklists

· Planning Section Position Descriptions and Checklists

· Logistics Section Position Descriptions and Checklists

· Finance Section Position Descriptions and Checklists

DOC Documentation and Forms

· DOC Action Plans

· After Action Plan

· Significant Event Log

· Logistics Request Form

· DOC Reports and Charts

· DOC Message Forms

· Response Information Management System (RIMS) Forms

· Situation Status Report Forms

Damage Assessment Procedures and Forms

Recovery Operations

· Phases of Recovery

· Management of Recovery Activities

· Disaster Application Centers (DAC)

APPENDICES

References

· List of Acronyms and Abbreviations

· List of Definitions

Utilization of Volunteers

· Recruitment of Volunteers

· Specific Responsibilities

· Insurance Coverage

· Volunteer Disaster Service Workers

· Organized Volunteers

· Utilization of Individual Volunteers

· Filing a Worker’s Compensation Claim

· Disaster Service Workers Rules and Regulations

· Volunteer Call Format

· Loyalty Oath Form

· Volunteer Registration Form

Legislation and Legal Documents

· Excepts from California Emergency Plan

· Good Samaritan Liability

· California Disaster and Civil Defense Master Mutual Aid Agreement

· Robert T. Stafford Disaster Relief & Emergency Assistance Act

· Natural Disaster Assistance Act

Element 1.2 Emergency/Departmental Operationsg Center Procedures

Standard:

LEMSAs shall ensure the development and exercising of written plans and procedures for the activation, operation and de-activation of the operating center responsible for coordinating the medical response to disasters.

Guideline 1.2.1

Response Activation

LEMSAs should support development of criteria for establishing a Department Operations CenterDepartmental Operations Center and determining the positions that will be activated for:

Actual events that require response.

Planned events that may experience emergencies that require response.

Unanticipated events that may generate emergencies that require response.

following disasters.

These criteria should include:

·

• Nature and severity of the disaster event.
• The degree of escalation or potential for escalation.
• The need for incident coordination beyond the scene. degree to which coordination of the incident is not efficiently accomplished at the scene.
• The existence of multiple disaster scenes.
• The need for acquisition of additional resources

Guideline 1.2.2

Response Start-up and Operation

LEMSAs should ensure procedures are established for the activation and operation of the Medical/Health Branch of the EOC and the Departmental Operations Center. Procedures should include the following:

• A list of supplies, equipment and schematic layout for operation center or Medical/Health Branch.
• Start-up checklists for the M/H OAC and key SEMS positions.
• Copies of status sign in sheets, report forms, message forms, logs, etc.

Guideline 1.2.3

Department Operations CenterDepartmental Operations Center (DOC) Activation Criteria - When to Activate

Local LEMSAs should promote the development of criteria for the opening of Department Operations CenterDepartmental Operations Centers. The decision to activate should be made by the Medical/Health Operational Area Coordinator. This decision should be based on the intelligence related to the actual or anticipated individual situation or event or uncertainty due to a lack of reliable information. Potential criteria appropriate for each level action are:

NO ACTIVATION REQUIREDSURVEILLANCE

· Incident occurs without warning and is able to be handled by one division or with assistance of mutual aid agencies. The coordination necessary to control the event can be effectively accomplished at the field level.

ACTIVATION ADVISEDPARTIAL ACTIVATION

· Incident escalates or is about to escalate to the point, either due to the Incident management complexity is increased due to the number of agencies and divisions involved, the amount personnel and other response resources required, or where the coordination of the incident is can not efficiently be accomplished at the field level. at an

· Any of the persons authorized to activate the DOC determines that coordination of the response/recovery would be enhanced by multi-division coordination in the DOC.

· When the level of The level and variety of resources requesteds for varied resources from within the LEMSA OA are received and coordination of these requests requires coordination are better facilitated at one central point.

ACTIVATION ESSENTIALFULL ACTIVATION

· Incidents are of such magnitude that coordination of the response(s) at the scene or another location is not possible, i.e. major earthquake, HAZMAT incident requiring large evacuation and sheltering, major fire, commercial passenger aircraft, rail, or other mass casualty incident, etc.

· When the resources of the LEMSA necessary to respond to or recover from a disaster or other emergency are overwhelmed or are expected to be overwhelmed.

Guideline 1.2.4

Deactivation/De-escalation/Demobilization of Department Operations CenterDepartmental Operations Center

Procedures for deactivation/de-escalation/demobilzation of the Department Operations CenterDepartmental Operations Center should include the following actions:

	ACTION	ASSIGNED RESPONSIBILITY
1.	Determine when to deactivate/de-escalate the DOC and which sections will be closed down first.	DOC Director Section Chiefs
2.	Ensure required reports and forms are completed.	DOC Director Section Chiefs
3.	Ensure that any open actions are completed or transferred to other appropriate response organization.	DOC Director Section Chiefs
4.	Return phones, microwave sets, radios, and other equipment to place of storage. Send any malfunctioning equipment for repairs.	Using Units
5.	Inform M/H OAC, neighboring jurisdictions, and cooperating agencies that DOC is shutting down.	Liaison Officer
6.	Inform appropriate support services when space will be clear.	Logistics Chief
7.	Inventory supplies and reorder.