become a master of disaster getting organized for a community disaster response october 30, 2014...
TRANSCRIPT
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BECOME A MASTER OF DISASTERGetting Getting
Organized for a Organized for a Community Community
Disaster Disaster ResponseResponse
October 30, 2014Weaving Connections:
Disaster Behavioral Health Planning
Summit
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• Forest Fires
• Flooding
• Illness outbreak
• Highway collisions
• Train derailment
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Know What Could Happen:Possible Disasters
Anticipated in Northern Arizona
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• Everyone in the community should be treated as a person we serve.
• Caring for people takes priority over funding, billing and documentation concerns.
• Self-care is critical. Use the airplane oxygen mask metaphor of putting on your own mask first and then helping others.
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Philosophy
When disaster strikes our communities. . .
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• T/RBHAs support and defer to the local providers unless more direct assistance is requested.
• National agencies (e.g. Red Cross) may assume authority, but T/RBHAs and providers are there for long-term needs.
• Member outreach, support and ongoing communication are the keys to minimizing trauma. 4
PhilosophyCONTINUED
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Activate Internal Manual policy and proceduresImmediate Jeopardy Contact
Notify Executive Team & PIOImmediate Jeopardy Contact
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Know What To Do:Immediate Response
Activate Phone TreesDirector of Facilities & SafetyImmediate Jeopardy Contact
Activate Crisis CommunicationsPIO
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Hour 1 - Executive Team meets Coordinates resources and determine
action steps based on ADHS requests, provider needs, media concerns, community response needs.
Includes PIO to collaborate and inform on messaging.
Hour 2 – Team distributes all-users email covering:
Situation details Response team contacts Self-care Responding to Media
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The Next Day
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• Executive Team• Crisis Services• Medical Team &
Utilization Mgmt• Pharmacy Help
Desk• Member Services• Data/MIS
• Clinical Services• Recovery Services• Cultural
Competency• Human Resources• Finance• Administrative
Support
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Know In Advance: Everyone’s Role for Response
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• Keeping staff apprised of events and response efforts is critical.
• Use recommended official resources for updates instead of using media reports.
• Requests for community support response often come in during this time.
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The First Week
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The Importance of Media Use for Community Communication .
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• Reporters and camera-staff can focus too much on the story and not see distress in people they approach for interviews.
• If you are there to assist victims, observe interviewee for signs of stress, trauma.
• Do not be afraid to step in and ask the victim if he/she is okay. Ask if they would like to step away from the interview. If yes. . .
• Look at the media representative and politely say, “This person appears to need some assistance. We are going to move to a care center. You are welcome to work in another location. Thank you.”
• Turn away and gently guide the person in stress to a sheltered area. 10
If Media Approaches Someone in Distress
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• Model of responding to individuals, groups or agencies in the community after an individual or mass trauma event.
• Detailed structure of a debriefing, not intended as a therapeutic process.
• Requires certification in CISM or substantial clinical experience to facilitate model.
• Sometimes used more as a guideline for compassionate response than a formal debriefing response to meet community needs
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Critical Incident Stress Management (CISM)
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• Inciweb
• Arizona Emergency Information Network
• Arizona Dept. of Health Services and local T/RBHA websites
• Official responder agency Facebook pages and Twitter feeds.
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Recommended Situation Resources
http://inciweb.nwcg.gov/
http://www.azein.gov
http://www.azdhs.gov
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LEARNING FROMPAST DISASTERS
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• Largest fire in Arizona history
• White Mountains, Apache, Greenlee, Graham & Navajo counties (and small part of NM)
• 6,000 evacuees, including Springerville & Eagar
• 16 injuries; 0 fatalities
• 72 structures destroyed across 732 square miles
• Affected RA: Little Colorado Behavioral Health Centers
• Affected CSA: NAZCARE
• Dates: May 29 to July 8 (41 days)
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2011 Wallow Fire
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• Initial response was minimal aside from coordination with LCBHC for community needs.
• Clinic Evacuation: As the fire approached Eagar and both it and Springerville evacuated, the LCBHC site at Springerville required assistance in medical records transfer to St. Johns.
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2011 Wallow Fire
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At the beginning of a disaster, coordinate how many and which employees will be available for emergent community response for all varieties of volunteer work and/or support.
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2011 Wallow FireLesson Learned
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• Valley of multiple tiny towns south of Prescott, Yavapai County into Maricopa County
• 600 evacuees, including Peeples Valley & Yarnell
• 23 injuries; 19 fatalities
• 129 structures destroyed across 8,400 acres
• Affected RAs: WYGC, SBHS & CFSS
• Affected CSA: NAZCARE
• Dates: June 28 to July 10 (13 days)
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2013 Yarnell Hill Fire2013 Yarnell Hill Fire
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• Regional Providers WYGC, SBHS & CFSS completed their own outreach to affected members and families within the first 2 days.
• NARBHA reached out to and collaborated with Magellan to offer crisis services at the Wickenburg evacuation shelter.
• June 30: 19 Granite Mountain Hotshots (based in Prescott) firefighters were killed
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2013 Yarnell Hill Fire
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• Prescott entered the national spotlight after the firefighter deaths.
• Media coverage was unprecedented.
• Community and media briefings occurred twice daily.
• NARBHA remained in contact with Crisis Prevention & Recovery of Phoenix, who offered support for firefighters and families of the victims.
• One CISM session was facilitated in Prescott19
2013 Yarnell Hill Fire
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• Over 35 Staff from NARBHA, WYGC, SBHS and CFSS, members and family members volunteered to bring support, care needs and health monitoring during the service.
• Attended by more than 3,000 people.
• NARBHA support at more than half the stations around the perimeter as well as in the Command Center.
• Special recognition certificate from the Red Cross.
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2013 Yarnell Hill FireThe Prescott 19 Memorial
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• Red Cross assumed behavioral health and medical responsibility for the evacuation shelters and local community; neither T/RBHA nor provider staff were allowed in to assist until preparation for the July 9 memorial service.
• Press releases in local newspapers reminding residents of T/RBHA & providers’ local, long-term support as well as immediate coping skills were effective.
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2013 Yarnell Hill FireLessons Learned
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• An internal (temporary) Command Center would have allowed NARBHA to gather resource material, supplies, maps and provided a common place for team updates and response needs from the start of the event.
• Communications among internal staff and the executive team must be coordinated & controlled to reduce stress on team, staff, and provider staff as well as to improve efficiency and effectiveness of response activities.
• Contact information for various involved agencies (Red Cross, CISM response sites) must be centralized and updated constantly. 22
2013 Yarnell Hill FireLessons Learned
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• Oak Creek Canyon burned, smoke affected Flagstaff, Sedona
• Hundreds of evacuees from OCC and Kachina Village
• 0 fatalities
• 0 structures destroyed across 21,227 acres
• Affected RAs: Spectrum, TGC, SBHS, CFSS
• Affected CSAs: NAZCARE, Hope Lives
• Dates: May 20 to June 4 (15 days)
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2013 Yarnell Hill Fire2014 Slide Fire
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• The importance of outreach to those with cardiac and respiratory conditions was exemplified in saving the life of someone hours from death due to smoke inhalation.
• Community meetings may not always provide updated information, but are critical to networking with other responder agencies.
• Provide Orientation to new employees on Disaster Response
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2014 Slide FireLessons Learned
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SELF-CARE ISCRITICAL
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• Educate yourself about the situation as much as possible before going in.
• Prepare yourself emotionally, mentally, physically.
• Be mindful and attentive of your own needs.
• Be aware that symptoms and reactions may not arise for days.
• Have a trusted friend, colleague that you can debrief with about YOUR experience. 26
Responders – Prepare with Self Care
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• Recognize that caretakers may have dualistic needs related to being a caretaker and a disaster survivor.
• Respect their boundaries.
• Provide support, honor their expertise.
• Display empathy and concern.
• Encourage self-care. 27
Taking Care of Caretakers
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• Shock, disbelief
• Tension and irritability
• Fear, anxiety, guilt
• Difficulty making decisions
• Emotionally numb
• Loss of appetite
• Anger
• Sadness
• Sleep disturbances, nightmares
• Feeling powerless and/or hopeless
• Headaches, back pain, stomach issues
• Fatigue, low energy
• Trouble concentrating
• Desire to be alone
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Common Symptoms
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• Be mindful of your needs and honor them.
• Talk with others.
• Connect socially.
• Eat well.
• Exercise .
• Get plenty of sleep.
• Be kind and gentle with yourself.
• Maintain a routine.
• Take frequent breaks.
• Avoid drugs and alcohol.
• Remember – it will not always be/feel this way.
• Engage in your spiritual practice.
• Express your feelings in healthy outlets.
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Self Care Tips