An intro to the… Toledo Area Disaster Medical Assistance Team OH-1 DMAT

1. An intro to the… Toledo Area Disaster Medical Assistance Team OH-1 DMAT

2. Briefing Overview • Part of the National Disaster Medical System • Role in Federal Response (ESF #8) • Details about the team • Review of past missions / deployments

3. Types of disasters the team may respond to Natural Disasters Transportation Disasters Terrorism Technological (Man Made) Disasters

4. NDMS is a public/private sector partnership Federal partners - HHS, DOD, VA, FEMA

5. National Disaster Medical System A Nationwide Medical Response System to: • NDMS is a public/private sector partnership • Federal partners - HHS, DOD, VA, FEMA • Supplement state and local medical resources during disasters or major emergencies • Provide backup medical support to the DOD/VA medical care systems during an overseas conventional conflict • Network of over 2000 hospitals nationwide

6. Major Components • Medical Response • Patient Evacuation • Definitive Medical Care

7. NDMS Medical Response Disaster Medical Assistance Teams(DMATs) • Volunteer Groups Affiliated with NDMS • Non-profit 501-(3)C organization • Approximately 35 deployed on a Response Team • Many teams have 3 – 4 times that number on their roster • > 8,000 active personnel nationwide • Variety of Health/Medical Skills • Locally Sponsored • Community Based • Local/ State Asset

8. NDMS RESPONSE TEAMS 29 Disaster Medical Assistance Teams - (Level 1) 24 Disaster Medical Assistance Teams - (Level 2 & 3) 5 Burn Teams 2 Pediatric Teams 1 Crush Medicine Team 1 International Medical / Surgical Team 3 Mental Health Teams 4 Veterinary Medical Assistance Teams 11 Disaster Mortuary Teams – including 1 WMD team 1 Management Support Team 4 National Medical Response Teams / WMD

9. Level 1 DMATs ME WA AK NH MT ND VT MA MN OR WI NY CT MI ID SD RI WY PA NJ IA NE OH DE IL IN WV MD NV UT VA CO MO KS KY CA NC TN SC OK AZ AR NM MS AL GA TX LA FL HI CA-6 San Francisco CA-9 Los Angeles CO-2 Denver FL-1 Pensacola FL-2 Port Charlotte FL-5 Miami GA-3 Atlanta OR-2 Eugene PHS-1 Rockville, MD RI-1 Providence TX-1 El Paso WA-1 Seattle AK-1 Anchorage AL-1 Birmingham AR-1 Little Rock CA-1 Santa Ana CA-2 San Bernardino CA-4 San Diego HI-1 Wailuku, Maui KY-1 Ft. Thomas MA-1 Boston MA-2 Worcester MI-1 Westland NC-1 Winston-Salem NJ-1 Orange NM-1 Albuquerque NY-2 Valhalla OH-1 Toledo OK-1 Tulsa

10. Level 2 & 3 DMATs ME WA NH ND AK VT MT MN NY MA OR WI CT MI ID SD RI WY PA NJ IA NE OH DE IL IN WV MD NV UT VA CO KS MO KY CA NC TN SC OK AR AZ NM MS AL GA TX LA FL HI PR AL-2 Huntsville AL-3 Mobile AZ-1 Tucson CA-11 Sacramento FL-3 Tampa Fl-4 Jacksonville FL-6 Orlando GA-4 Augusta IA-1 Dubuque ID-1 Boise MN-1 Minneapolis MO-1 St. Louis MS-1 Brandon NV-1 Las Vegas NY-4 Rockland County OH-5 Dayton OH-6 Youngstown PA-1 Pittsburgh PA-3 Erie PR-1 San Juan SC-1 Charleston TN-1 Chattanooga TX-3 Houston TX-4 Dallas

11. Ohio Assets DMAT MMRS (*Local Asset) DMORT

12. NDMS Medical Response DMAT FUNCTIONS At Disaster Site • Triage • Casualty Clearing / Staging • Sophisticated medical care in austere conditions • Self sufficient for 72 hours ($350,000 supply cache) • Carry our own food, water, shelter, medical supplies At Local NDMS Reception Area • Patient Reception and assist with definitive care

13. NDMS Medical Response DMAT Components DMAT Deployment Asset 35 member team working under the Incident Command System • Command • Finance • Communications • Logistics/security • Pharmacy • Medical care providers

14. OH-1 Toledo • Formed 1986 • Membersip - 120 • Command - 5 • EMT - 19 • Nursing - 30 • Physicians - 19 • Veterinarian - 1 • Logistics/Support - 12 • Cross trained Level I Team Full basic load Pharmacy cache

15. OH-1 Toledo • Experience • Numerous disaster deployments and readiness activities • Assist with mass gatherings such as the Airshow etc. • Act as a community resource for education and preparedness – MCO Medical School, EMS seminars, etc. • Training • HAZMAT • DOD WMD in Alabama • 180th ONG • Lucas County EMS

16. DMATs and Specialty Teams • Under Memorandum of Understanding (MOU) • with U.S. Public Health Service • Federal Enrollment of Team Members • Federalization Upon Activation • Special Needs Authority • Accepted Volunteer Services Authority • Importance of Federalization • Licensure / Certification • Liability • Compensation

17. Importance of NDMS • Improves Federal Mission Readiness • Ability to Mobilize and Deploy Medical • Teams, Supplies, and Equipment • Ability to Provide Patient Evacuation • System • Ability to Provide Definitive Medical Care • Adds Value to America

18. OH-1 DMAT’s past Activations • 1992 - Hurricane Andrew • 1993 - Hurricane Emily (on advisory) • 1994 - Northridge Earthquake (on advisory) • 1995 - Hurricanes Marilyn • 1996 - Centennial Olympic Games • 1996 - Hurricane Fran (on advisory) • 1997 - North Dakota Floods (1 team member deployed) • 1999 - NATO Summit & 50th Anniv • 1999 - Hurricane Floyd • 1999 - Provide Refuge (Kosovo Refug.) (1 team member) • 1999 - Y2K (on alert) • 2001 – Presidential Inaugural (1 team member) • 2001 – Terrorist Attack on NY/DC • 2002 – Olympics – Salt Lake City • 2002 – VA Avian Influenza • 2002 – Independence Day (on alert)

19. Why have an MOU? Local First Responders County Executive Disaster Occurs Alert Governor Requests Aid From FEMA Regional Director Informs Field Operations THE FEDERAL RESPONSE PLAN Declares Disaster Advises FEMA Director Requests Assistance Contacts 12 Emergency Support Functions (ESFs) President Declares Disaster Provides Sets Up Emergency Response Team Federal Coordinating Officer Disaster Field Office Appoints Joins State Coordinating Officer

20. Federal Response PlanEmergency Support Functions DOE USDA AID DOJ ARC DVA EPA DOD FEMA DOT GSA DOE NCS USDA DOT Energy Food EPA Transportation NCS Hazardous Materials 12 11 1 Communication 10 2 Urban Search and Rescue ESF 9 Public Works (USACE) 3 FEMA DOD 8 8 4 7 Health and Medical 5 Health & Medical Services 6 Firefighting HHS USDA & FS Resource Support Information & Planning HHS Mass Care GSA FEMA ARC

21. Roles of Emergency Support Function #8 • 1. Assessment of Health and Medical Needs • 2. Health Surveillance • 3. Medical Care Personnel • 4. Health/Medical Equipment and Supplies • 5. Patient Evacuation • 6. In-Hospital Care • 7. Food/Drug/Medical Device Safety • 8. Worker Health/Safety • 9. Radiological, Chemical, and Biological Hazards • 10. Mental Health • 11. Public Health Information • 12. Vector Control • 13. Potable Water/Wastewater & Solid Waste Disposal • 14. Victim Identification/Mortuary Services • 15. Veterinary Services

22. Past Deployments

23. Hurricane Andrew South Florida (Dade County) Fall 1992

24. The track of Hurricane Andrew 1992

25. TADMAT - 65 members at Toledo Express Airport Deploying to Hurricane Andrew 1992

26. Equipment being loaded onto the C-141

27. Receiving briefing from NM-1 DMAT

28. The Cutler Ridge Justice Center treatment area

29. Cutler Ridge Justice Center

30. Community Health Clinic - Now a Field Hospital

31. Office building - Now a Field Hospital

32. Field Hospital set up at Cutler Ridge Elementary School

33. A group loads up to go on an outreach mission

34. Supplies being delivered to the CHI site

35. Communications Officer at work

36. Marilyn 1995 St. Thomas, US Virgin Islands

37. 9 hour flight from Toledo to USVI on a C-130

38. Significant impact on the local infrastructure

39. Damage to many “transient” homes

40. And almost 80% of the permanent ones

41. Where most of the island health care is delivered

42. DMAT Field Hospital on the back lawn of the hospital

43. Labor intensive setup

44. Typical living conditions

45. Assistance from many Government branches / agencies

46. Patient care and field hospital operations

47. Winter Olympcs 2002 Salt Lake City, Utah