Post on 01-Apr-2015
ESF8: Medical Surge Planning and Coordination
Emergency medical surge planning in your County and the value of
integrating medical and non-medical volunteers into your plan
AGENCY LOGO
Emergency Support Function #8- Health and Medical (ESF8)
ESF8 is a system of health and medical agencies that are coordinated in an emergency based on a common set of established plans, tools and resources in order to meet specific outcomes that affect the health and medical care of those involved in the incident (casualties and responders.)
ESF8 as a System
• NIMS/ICS principles apply to incident response but not always to EOC management
• Existing system of relationships become extended beyond agency/jurisdictional boundaries– Examples: Infection Control, Patient triage and
tracking, Surge staffing for Alternate Care Facility• ESF8 System Models
– Basic: agency-agency– Intermediate: multi-agency, limited number of
ESFs– Complex: multi-agency, multi-jurisdictional, full
EOC response
ESF8 as Outcomes• Effective Patient Tracking• Effective coordination in response
(resolves differences among agencies)• Efficient utilization of resources• Efficient and rapid response and request
for support• Common operational model (local, state,
federal)• Ensures agency response is competent
based on agency/discipline standards• Strategic guidance and direction
Daily Organizational Objectives
Time
DepartmentalOperations Center
EmergencyOperations Center
Daily Organizational Objectives
DepartmentalOperations Center
Complexity Analysis
ICS Level Change
Authority Change
Emergency Response
Where did ESF originate?
• National Response Framework- assigned federal agencies to “Emergency Support Functions”:– Guidance: “Governments at all levels should use the
NIMS resource management principles described below to enhance response capabilities.”
– State Emergency Operations Plan (SEOP)– County Emergency Operations Plan (Contains ESF
annexes)– Post 9-11 mandate to remove the “silos” that limit
communication between organizations.
• “Seat” in the EOC/MACG?– Ops vs. non-ops. Where will you fit in?
National Response Framework (NRF)
• Framework Document (Base Plan)• Support Annexes• Incident Annexes • Emergency Support Function (ESF) Annexes
– Outline agency responsibilities for coordination, planning, support, resources, program implementation, and services during emergencies
ESF #11 - Agriculture and Natural ResourcesESF #12 - EnergyESF #13 - Public Safety and SecurityESF #14 - Long-Term Recovery/MitigationESF #15 - External Affairs
ESF #1 - TransportationESF #2 - CommunicationsESF #3 - Public Works, EngineeringESF #4 - FirefightingESF #5 - Emergency ManagementESF #6 - Mass Care, HousingESF #7 - Resource SupportESF #8 - Public Health, Medical, MortuaryESF #9 - Urban Search and Rescue ESF #10 - Oil and Hazardous Materials
Colorado Emergency Support Functions
1. Transportation 6. Mass Care, Housing &
Human Services
11. Agriculture & Natural
Resources
2. Communications 7. Resource Support 12. Energy
3. Public Works & Engineering
8. Public Health & Medical
8a . Mental Health
13. Public Safety & Security
4. Fire Fighting
4a. Wildfire Suppressions
9. Search & Rescue 14. Long Term Community Recovery & Mitigation
5. Emergency Management 10. Oil & Haz Mat Response
15. External Affairs
ESF #8: Public Health, Medical, Mortuary
• CDPHE can provide local jurisdictions the following types of support:– Health Surveillance – Biological Hazards Consultation – Pharmaceutical Supplies and Distribution – Assessment of Health/Medical Needs – Health/Medical Equipment and Supplies – Medical Care Personnel – Mortuary Services – Food and Drug Safety – Potable Water/Wastewater – Solid Waste Disposal – Radiological and Chemical Hazards Consultation – Vector Control – Environmental Impact Assistance – Public Health Information
ESF 8: Public Health and Medical
Functional Role Organization Participant
Public Health Authority Local Public Health Department
Hospitals Trauma Centers
Critical Access Hospitals
Veteran’s Hospitals
Private Physicians Medical Society
Independent Physicians Association
Primary Care Offices
Emergency Medical Services (EMS)
Fire Department, EMS Services
EMS Coordinator
Mental Health Department of Human Services
Mass Fatalities Management Coroner
Level 1Local, State, Federal
Response
Federal Declaration
Department of Justice
Health & Human
Services
Environmental Protection
Agency
Federal Emergency
Management Agency
Department of Energy
Department of Defense
Interior
Transportation
General Services American
Red Cross
Other Federal Agencies
TransportationCOVOAD
volunteers
Human Services
MilitaryAffairs
Governors’ Office
Governor
Local Affairs
Public Health &
Environment
Others
Level 2State, Local Response
State Declaration
Personnel and Admin
Public Safety
Higher Education
Div of Emergency
Mgmt
Dept of Agricultur
e
Natural Resources
Local Affairs
Regulatory
CountyCommissioners
City Council
ResponseTeams
Level 3Regional Response
Others
Police Dept
Fire Dept
City Council
PublicWorks
CitizensGroups
EMS Hospitals
Level 4Local Response
Local HD
Other
Disaster Event
Emergency Manager
ActivationMust ESF8 be activated by
emergency management?
Medical Surge ESF8 Activation Thresholds
Hospital needs additional resources
Patient surge exceeds hospital
Consider activating Mesa County Hospital
Coordination Center
Consider activating Mesa County Multi-
agency Coordination Group
Medical Resources exceed availability in county
Patient surge exceeds county
Consider Declaration of Emergency
ESF8 Planning Committee Mission Statement:
• “The County Emergency Support Function 8 Planning Committee (ESF8 Committee) is a multi-disciplinary, coordinating group representing ESF8 agencies and organizations. The Committee addresses critical healthcare needs in our Community. The ESF8 Committee develops strategies and solutions which synchronize the use of diverse healthcare resources during emergencies or disasters affecting County.
ESF 8 On the Ground
County Health Department
Medical Supply Caches/Warehouse
Communications Center
Hospital Coordination System or Hospital Designee
Emergency Medical Services
County Healthcare Coordination System
(HCS)/ESF8 Medical Reserve Corps
State PH Liaison
Regional Liaisons
CDEM/RETAC/Public Health
Hospital #1
Hospital #2
Hospital #3
TIER III
TIER ITIER IITIER IV
VA Hospital
County Emergency Operations Center (EOC)
EMS Agencies
Primary Care & Medical Offices
Human & Environmental Health
Basic Response Example: Agency to Agency
• Hospital-EMS
• Public Health- Hospital ICP
Intermediate Response Example: Multi-Agency, Multi-Jurisdiction,
Limited Number of ESFs
• Alamosa, CO, Salmonella (ESFs 3, 5, 8, and 15)
• Limited geographic area flooding/natural disaster.
• Chemical hazmat spill response with casualties.
• H1N1? Intermediate or severe? Where were we at?
Complex Response Example: Multi-Agency, Full EOC Response
• Catastrophic natural event (Snowstorm, outbreak, flooding)
• Pitkin County, CO- Dirty bomb/mass casualty
• Train derailment (i.e. Silverton-Durango, Amtrak)