ESF8 Medical Surge Planning and Coordination

1. 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

2. 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.)

3. 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

4. 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

5. D aily O rganizational O bjectives Time D epartmental O perations C enter E mergency O perations C enter D aily O rganizational O bjectives D epartmental O perations C enter Complexity Analysis ICS Level Change Authority Change Emergency Response

6. 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?

7. 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 Resources ESF #12 - Energy ESF #13 - Public Safety and Security ESF #14 - Long-Term Recovery/Mitigation ESF #15 - External Affairs ESF #1 - Transportation ESF #2 - Communications ESF #3 - Public Works, Engineering ESF #4 - Firefighting ESF #5 - Emergency Management ESF #6 - Mass Care, Housing ESF #7 - Resource Support ESF #8 - Public Health, Medical, Mortuary ESF #9 - Urban Search and Rescue ESF #10 - Oil and Hazardous Materials

8. 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

9. 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

10. Functional Role Organization Participant Public Health Authority Local Public Health Department Hospitals Trauma Centers Critical Access Hospitals Veterans 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

11. Level 1 Local, 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 Transportation COVOAD volunteers Human Services Military Affairs Governors Office Governor Local Affairs Public Health & Environment Others Level 2 State, Local Response State Declaration Personnel and Admin Public Safety Higher Education Div of Emergency Mgmt Dept of Agriculture Natural Resources Local Affairs Regulatory County Commissioners City Council Response Teams Level 3 Regional Response Others Police Dept Fire Dept City Council Public Works Citizens Groups EMS Hospitals Level 4 Local Response Local HD Other Disaster Event Emergency Manager

12. Activation Must ESF8 be activated by emergency management?

13. 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

14. 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 .

15. 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 I TIER II TIER IV VA Hospital County Emergency Operations Center (EOC) EMS Agencies Primary Care & Medical Offices Human & Environmental Health

16. Basic Response Example: Agency to Agency Hospital-EMS Public Health- Hospital ICP

17. 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?

18. 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)