Captain Kevin Sheehan, U.S. Public Health Service

Regional Emergency Coordinator/Field SupervisorHHS Region IX

Regional Emergency Coordinator Program -

Preparedness, Response and Recovery

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Federal Medical Preparedness & Response for Disasters and Special Events

• Responses:─ Haiti Earthquake

─ American Samoa Tsunami

─ President Obama Inauguration

─ Republican and Democratic National Conventions

─ G-8 and G-20 Meetings

─ North Dakota Floods

─ Gulf Oil Spill

─ Hurricane Katrina

─ Hurricane Ike & Gustav

─ Many other hurricanes

─ http://www.phe.gov/Preparedness/news/Pages/anationprepared.aspx

• Preparedness─ Southern California Earthquake

Plan

─ New Madrid Earthquake Plan

─ Improvised Nuclear Plan for Nevada

─ Hurricane Plan for Hawaii

─ Typhoon Plan for Guam

─ Northern California Earthquake Plan

─ Cascadia Subduction Zone Plan – Northern California

ASPRAssistant Secretary for

Preparedness & Response

OPEOOffice of Preparedness &

Emergency Operations

RECRegional Emergency

Coordinators

RHARegional Health Administrators

HHSDept Health & Human Services

HPPHospital Preparedness

Program staff

RE

GIO

NS

HE

AD

QU

AR

TE

RSIGA

Intergovernmental AffairsASH

Assistant SecretaryFor Health

RDRegional Directors

MRCMedical Reserve

Corps

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Today’s Agenda

• Role of the Emergency Support Function 8

• Role of the Regional Emergency Coordinator Program─ National Disaster Medical System (NDMS) Patient

Movement

• Federal Medical Service Access Teams and how they will interact with NDMS hospitals after a disaster

• US Department of Health and Human Services role in Recovery

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• How the United States Government will respond

• Coordination missions that are Federal responsibility

• Selectively activated as needed

• Provide staffing for incident management organizations

National Response Framework National Response Framework Emergency Support Functions (ESF)Emergency Support Functions (ESF)

ESF #1 Transportation

ESF #2 Communications

ESF #3 Public Works & Engineering

ESF #4 Firefighting

ESF #5 Emergency Management

ESF #6 Mass care, housing, human services

ESF #7 Resource Support

ESF #8 Public Health & Medical Services

ESF #9 Urban Search & Rescue

ESF #10 Oil & HAZMAT Response

ESF #11 Agriculture & Natural Resources

ESF #12 Energy

ESF #13 Public Safety & Security

ESF #14 Long-term recovery

ESF #15 External Affairs

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Emergency Support Function (ESF) # 8 Department of Health & Human Services (HHS)

• Medical Care • Medical Equipment &

Supplies• Patient Evacuation• Behavioral Health Care• Vector Control/Potable

Water & Sanitation• Mortuary Services• Public Health Veterinary

Care

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About National Disaster Medical System (NDMS)

• The mission of the National Disaster Medical System to temporarily supplement Federal, Tribal, State and Local capabilities by funding, organizing, training, equipping, deploying and sustaining a specialized and focused range of public health and medical capabilities.

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Disaster Medical Assistance Teams (DMAT)

• locally sponsored and community based.

• ready to deploy within 12 hours of notification and then remain self-sufficient for 72 hours

• consists of approximately 35-50 individuals in each deployable unit

• ER docs, nurses, paramedics, coms, command & control

• deploy for 14 days

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Medical Response

• Surgical Teams─ Haiti

• Mortuary Teams─ Haiti

─ Buffalo Plane Crash

• US Public Health Service Officers

─ Public Health Teams

─ Mental Health Teams

─ Environmental Health

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Health and Human Service Partners for Medical Response

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Agenda continued,

• Role of the Emergency Support Function 8

• Role of the Regional Emergency Coordinator Program─ Health and Human Services in the Region

─ National Disaster Medical System (NDMS) Patient Movement

• Federal Medical Service Access Teams and how they will interact with NDMS hospitals after a disaster

• US Department of Health and Human Services role in Recovery

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Event Occurs

Goal: Community Resiliency Goal: Effective Field Operations

Risk ManagementMitigationPreventionIntegration

Preparedness and Readiness Planning (Ready to Act)

Response and Transition to Recovery

Training and ExercisesICSNRF/NIMS/Health Security

Intergovernmental/Agency Coordination and IntegrationManage Response TeamsImprove Response Times/EffectivenessLogisticsAfter Action Lessons Learned

Information Analysis and Performance Measurement

Regional Emergency Coordinators (RECs)HHS/ASPR REGIONAL OFFICE RESPONSIBILITIES

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RD REC

RHA

ASPR RegionalExecutive Leadership

Network

Faith Based Organizations

TribesState Health Officers

Public Health Preparedness Directors

Universities

Local Health Officials

Community Volunteer Based Organizations

FEMA

VADHS

State EMA

DoD

ESF #8 Response Assets

Local Elected Officials

Congress

Governor’s Offices

Public Affairs

Private Industry

Other Federal Agencies

HHS/ASPR Region Spheres of Influence

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Federal ESF#8

Federal ESF#8

Traditional EMR Encounter

Origination / Disaster

Area

DestinationSite

Origination / Disaster

Area

Patient Movement Schematic“The Continuum of Patient Movement”

Local

Patient Transport

Begins APOE APOD

DoD Air Transport

NGB – E

MAC /

Title

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FEMA A

mbula

nce C

ontract

(Am

bulance

s an

d Car

e Flig

ht)

DoD Mil

Air

NDMS

FCC

NDMS

DestinationSite

Hospital / FMS

Ground /

NGB – E

MAC /

Title

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FEMA A

mbula

nce C

ontract

(Am

bulance

s an

d Car

e Flig

ht)

Patient Reentry Transport Begins

ExitsTRAC2ES

State

APOD APOE

DoD Air Transport

DoD Mil

Air

NDMS

FCC

EntersTRAC2ES

JPATS / EMRNoTRAC2ESHand-Off to Final Destination Facility

* Initial JPATS Entry / EMR Encounter

* Notional / Desired Entry of Pt Info

Air Transport

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Agenda

• Role of the Emergency Support Function 8

• Role of the Regional Emergency Coordinator Program─ Health and Human Services in the Region

─ National Disaster Medical System (NDMS) Patient Movement

• Federal Medical Service Access Teams and how they will interact with NDMS hospitals after a disaster

• US Department of Health and Human Services role in Recovery

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Service Access Teams Overview

• Involves returning patients who were evacuated through Federal ESF#8─ Destination locations could include home,

originating facilities, intermediate care facilities• HHS Service Access Teams (SATs) shall ensure proper

services afforded medical evacuees• SAT will serve as patient advocates and provide

medical and human services case management• Patients will be tracked through the system using Joint

Patient Assessment Tracking System (JPATS)

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Service Access Team (SAT)

• SAT will coordinate all aspects of patient return to ensure smooth transition from host State to final destination. Scope of services will include:

─ Work with FCCs, sending and receiving facilities, as well as State EOCs and health departments to identify/track patients

─ Ensure transportation, human services (language translation, food, lodging, etc) and arrangements for discharged patients and attendants

─ Coordinate return of patients and attendants to home state

─ Facilitate communication between attending physician and accepting physician in home state for those requiring follow-on care

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SAT Primary Functions

# 1 - Coordination of Evacuee Return

• Desired end state is return to home or appropriate placement

• Medical evacuees are allowed to return when:─ They are well enough to travel

─ The evacuated state has declared it is safe to return

─ There is an appropriate receiving facility

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SAT Primary Functions

#2 – Medical Case Management• Coordinate services with facility discharge planners,

receiving facilities, others as required

• Communicates clearly to patients, families, providers, and staff of receiving facility

• Arranges for medical transportation/ equipment

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SAT Primary Functions

# 3 – Coordinate Evacuee Travel • SAT communicates with patient movement contractor or

the ASPR Response travel Section to arrange transportation

• Movement may be through a variety of modes: air, train, ground

• Arrange transportation services for non-medical attendants and/or family members who accompanied patient

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SAT Primary Functions

# 4 – Coordinate Human Services

• HHS through the SAT will coordinate lodging and human services needs for all discharged patients until transportation to their final destination can be facilitated

─ Note: Family members that accompany patients or non-medical attendants will likely re-enter with patient and will require transportation that matches the patient

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Service Access Teams (SAT)

#5 – Data Collection

• SAT works with medical facilities, nursing homes, rehabilitative services units who are providing care to evacuees

• SAT personnel will have access to the Joint Patient Tracking System (JPATS). Once operational, the SAT will be responsible for updating JPATS until patients are returned to their home state

• Coordination with appropriate local and state agencies

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In Case of Death

• If a patient dies during response operations- SAT will coordinate with local or State medical examiner’s office and patient’s family for disposition of remains

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JPATSConcept of Operations

Joint Patient Assessment Tracking System (JPATS) Team Basics:

• Deployed as 2-person strike teams

• Deployment locations: ─ Aerial Port of Embarkation (APOE)─ Aerial Port of Debarkation (APOD) / FCC

• Deployed within 24 hours of notification

• Will remain until host unit (i.e., FCC) able to use JPATS

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Agenda

• Role of the Emergency Support Function 8

• Role of the Regional Emergency Coordinator Program─ Health and Human Services in the Region

─ National Disaster Medical System (NDMS) Patient Movement

• Federal Medical Service Access Teams and how they will interact with NDMS hospitals after a disaster

• U.S. Department of Health and Human Services role in Recovery

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Health and Human Services during Recovery

• HHS Roles during Recovery

• Lead for Recovery in Region – Regional Health Administrator

• Disaster Response Framework (in progress)─ ~ National Response Framework

• Recovery Support Functions (in progress)─ ~ Emergency Support Functions

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Health and Human Services Recovery

• Recovery Issues─ Restoration of Clinical Care

Facilities (HHS/FEMA)─ Patient

Discharge/Placement (HHS/ASPR)

─ Patient Care for Uninsured (HHS/CMS)

─ Long term population surveillance (HHS/CDC)

─ Environmental Health (HHS/EPA)

─ Restoration of Essential Social Services (HHS/ACF/AOA)

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Health & Human Services Recovery

• Laboratory Capacity (HHS/ASPR/CDC)

• Coordination of Social Services / Disaster Case Management (FEMA/HHS/ACF)

• Behavioral Health (HHS/SAMHSA)

• Long term responder, occupational health issues (HHS/CDC/NIOSH & DOL/OSHA)

• Fatality Management (HHS/ASPR)

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Review

• Role of the Emergency Support Function 8

• Role of the Regional Emergency Coordinator Program─ Health and Human Services in the Region

─ National Disaster Medical System (NDMS) Patient Movement

• Federal Medical Service Access Teams and how they will interact with NDMS hospitals after a disaster

• U.S. Department of Health and Human Services role in Recovery

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Haiti Hospital Site

• Gheskio University in Port-Au-Prince Haiti

• Health and Human Services Surgical Team deployment

• http://www.youtube.com/watch?v=OM6qhVTRjRE&feature=player_embedded

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Contact Info

• Region IX Regional Emergency Coordinators─ Kevin Sheehan