Louisiana Department of Health & Hospitals

1. Louisiana Department of Health & Hospitals RELIEF WORKERS (WAEs) ROLES & RESPONSIBILITES

2. Objectives • To define “Department of Health and Hospitals (DHH) Relief Worker”. • To review the roles and responsibilities of Emergency Support Function(ESF)8 and DHH during emergencies and disasters. • To review the supporting ESFs and the corresponding roles. • To review the functions of the various types of ESF 8 operations to which relief workers may be deployed. • To review the roles and responsibilities of Relief Workers for medical operations.

3. Pre-test • 1.What are some examples of disasters? • A. tornadoes • B. anthrax • C. oil spills • D. all of the above • 2. The Department of Health and Hospitals is the primary lead agency for Emergency Support Function 8 responsible for providing public health and medical services. True or False • 3. Emergency Support Function 8 deployment sites for Relief Workers are: • A. Medical Special Needs Shelter • B. Transportation Triage • C. Temporary Medical Operations Staging Areas • D. Receiving, Staging and Storage Warehouse • E. All of the above • F. None of the Above • G. a, b and c only

4. Pre-test • 4.What can transportation triage be used for? • A. Transport vehicles across the state to be utilized by citizens • B. A medical screening operation to determine the level of care needed by evacuees to determine if the individual will be placed in a Critical Transportation Needs Shelter, Medical Special Needs Shelter or healthcare facility. • C. oil spills • D. None of the above • 5. The Incident Command System (ICS) provides a standardized, on-scene, all hazards incident management approach for any size, scope or complex incident. All Emergency Support Function 8 medical operations are National Incident Management System (NIMS) compliant using the ICS structure. True or False

5. What are DHH Relief Workers? Relief Workers = WAEs (Workers as Employed) • Only work when they are activated for employment. • Comprise a labor pool that is readily activated, trained, and deployable. • Stand ready to respond when a federal declaration is established in the event of any emergency/disaster.

6. Who are DHH Relief Workers? • Physicians • Nurse Practitioners • Registered Nurses • Licensed Practical Nurses • Nursing Assistants • Respiratory Therapists • Social Workers • Administrators • Administrative Assistants

7. Types of Disasters • Natural and Human-Caused Tornados Hurricanes Flooding Winter storms, Freezes

8. Types of Disasters Chemical, Biological, Radiation, Nuclear, and Explosives Chemical Spills

9. Types of Disasters Transportation Accidents

10. ALL HAZARDS APPROACH:Preparations for All Types of Disasters • Severe Weather (thunderstorms, tornadoes, hurricanes, floods) • Toxic spills/chemicals (accidental toxic releases by railways, waterways, pipelines, and highways) • Naturally occurring disease outbreaks (West Nile virus, influenza)

11. ALL HAZARDS APPROACH:Preparations for All Types of Disasters (continued) • Biological Threats (anthrax, botulism, plague, smallpox, tularemia, viral hemorrhagic fever) • Radiation (accidental releases of radioactive material, a nuclear reactor meltdown, terrorist act)

12. INCIDENT COMMAND SYSTEM (ICS)

13. INCIDENT COMMAND SYSTEM (ICS) The Incident Command System (ICS) provides a standardized, on-scene, all hazards incident management approach for any size, scope or complex incident. All Emergency Support Function 8 medical operations are National Incident Management System (NIMS) compliant using the ICS structure.

14. EMERGENCY SUPPORT FUNCTIONS (ESFs)

15. Emergency Support Functions The Emergency Support Functions (ESFs) provide the structure for coordination of responses to an incident.

16. Emergency Support Functions (ESF) ESF-1 • Transportation ESF-2 • Communications ESF-3 • Public Works and Engineering ESF- 4 • Firefighting ESF-5 • Emergency Management ESF-6 • Mass Care, Housing and Human Services ESF-7 • Resource Support ESF-8 • Public Health and Medical Services ESF-9 • Search and Rescue ESF-10 • Oil Spill, Hazardous Materials and Radiological

17. Emergency Support Functions (ESF) ESF-11 • Agriculture ESF-12 • Energy ESF-13 • Public Safety and Security ESF-14 • Community Recovery, Mitigation, and Economic Stabilization ESF-15 • Emergency Public Information ESF-16 • Military Support to Civil Affairs

18. Emergency Support Functions (ESF) Roles/Responsibilities • ESF 1- Transportation– led byDepartment of Transportation and Development(DOTD)-assists with evacuation of nursing homes, Transportation Triage, and with Medical Special Needs Shelters (MSNS) transportation needs. • ESF 2- Communications-led by the Governor’s Office of Homeland Security and Emergency Preparedness(GOHSEP) • ESF 3- Public Works and Engineering- led by DOTD

19. Emergency Support Functions(ESF) Roles/Responsibilities • ESF 4- Firefighting- led by Department of Public Safety/Office of State Fire Marshall • ESF5- Emergency Management- led by GOHSEP • ESF 6- Mass Care, Housing, and Human Services - led byDepartment of Children and Family Services- responsible for Critical Transportation Needs Shelters(CTNS); Shelter management • ESF 7- Resources Support – led by GOHSEP

20. Emergency Support Functions(ESF) Roles/Responsibilities • ESF 8- Public Health & Medical Services – led by Department of Health & Hospitals • ESF 9- Search and Rescue -led by Department of Wild Life and Fishery • ESF 10 - Oil Spills, Hazardous Materials, Radiological - led by Departmentof Environmental Quality (DEQ) • ESF 11- Agriculture – led by Department of Agriculture • ESF 12- Energy - led by Department of National Resources .

21. Emergency Support Functions(ESF) Roles/Responsibilities • ESF 13 - Public Safety and Security- led by Louisiana State Police with security tasked to Louisiana Army National Guard(LANG). • ESF 14 - Community Recovery, Mitigation and Economic Stabilization- led by GOHSEP • ESF 15- Emergency Public Information-led by GOHSEP and the Bureau of Media • ESF 16-Military Support to Civil Affairs – led byLouisianaArmy National Guard

22. What is ESF-8

23. Emergency Support Function 8: Public Health & Medical Services • DHH has the lead role for overall state efforts in providing leadership for planning, directing and coordinating public health and medical assistance. • The Secretary of Health and Human Services through the Office of Public Health Emergency Preparedness is responsible for the federal coordination.

24. ESF 8 Deployment Sites forRelief Workers • Medical Special Needs Shelter (MSNS) • Transportation Triage • Temporary Medical Operations Staging Areas (TMOSA) • RSS (Receiving, Staging, & Storage) Warehouses • Points of Dispensing Sites (PODS) • Emergency Operations Center (EOC)

25. MEDICAL SPECIAL NEEDS SHELTER (MSNS)

26. Functions of ESF 8 Deployment Sites forRelief Workers Medical Special Needs Shelter (MSNS) –provides sheltering for evacuees who • Require medical assistance with daily activities. • Cannot take care of themselves and are accompanied by a caregiver for assistance. • Do not have conditions severe enough to be admitted to a hospital.

27. Medical Special Needs Shelter (MSNS) ESF 8- Department of Health & Hospitals- Responsible for the coordination of medical care in the MSNS

28. Medical Special Needs Shelter • Medical (MDs, APRNs, Nurses, Social Services, Behavioral Health, Nurse Assistants etc.) • Non-Medical (Clerical, Environmental Health employees, IT etc.) • Volunteers

29. MSNS Services Provided • TRIAGE • MEDICAL ASSESSMENT AND TREATMENT • PHARMACY (MINIMAL OVER THE COUNTER MEDICATIONS) • DISCHARGE PLANNING • SECURITY • MEALS • BEHAVIORAL HEALTH COUNSELING • TRANSPORTATION(DIALYSIS)

31. Medical Special Needs Shelters are designed for Individuals who may require assistance with Activities of Daily Living or may require special equipment or medication in order to sustain life. Long journeys for these individuals may be harmful to their health.They may be individuals who have disabilities and who have no other recourse for care.Remember- A shelter is a "lifeboat, not a cruise ship" and like a lifeboat, should only be used as a last resort. Medical Special Needs Shelter

32. TRANSPORTATION TRIAGE

33. Functions of ESF 8 Deployment Sites forRelief Workers Transportation Triage- A medical screening operation to determine the level of care needed by evacuees in the CTNS (Critical Transportation Needs Shelter) evacuation operation. Personnel determine if an evacuee can continue on to a CTNS site or needs placement in an MSNS site or further definitive care.

34. TRANSPORTATION TRIAGE

35. TRANSPORTATION TRIAGE Objective: The emphasis is also on speed and efficiency to get vehiclesback enroute as soon as possible

36. CRITICAL TRANSPORTATION NEEDS SHELTER (CTNS) • A non-medical shelter operated for those persons evacuated by local governments from affected areas. • Evacuees who do not have their own means of transportation to evacuate. • Evacuees who are evacuated via bus or van according to city/state assisted plans.

37. TEMPORARY MEDICAL OPERATIONS STAGING AREA (TMOSA)

38. Temporary Medical Operations Staging Area (TMOSA) A mobile operation post event that has the capability to treat and stabilize patients suffering from emergent medical conditions including but not limited to all hazards. “MASH” type environment: Disposition may be to hospital, nursing home, MSNS or general shelter

39. RECEIVING, STAGING, AND STORING(RSS) SITE

40. RSS Warehouses Receive, stage, store and distribute relief supplies and equipment

41. Receiving, Staging and Storing (RSS) Sites • Assets arrive by ground or air • Large, secure temperature controlled warehouses

42. POINT OF DISPENSING SITE (POD)

43. Point Of Dispensing Site (PODS) A Point of Dispensing Site is facility where members of the community go during a public health emergency to receive medication.

44. Point of Dispensing (POD) sites • Location where medications/vaccines are provided to the public to prevent disease • Range from small clinics to very large facilities • Work within specific timelines to get the medicines to the public (national guidance for anthrax response recommends oral antibiotics within 48 hours)

45. EMERGENCY OPERATION CENTER (EOC)

46. Emergency Operation Center • A central control and command center that coordinates emergency response and recovery activities that provides needed resources and communication.

47. ACTIVATION/DEPLOYMENT

48. CALL TO DUTY (Activation/Deployment) The DHH Incident Commander approves “Stand-by” and “Activation/Deployment” orders for Relief Workers.

49. Activation & Deployment ofRelief Workers Goal: • Assist ESF 8 efforts and augment regional staffing in providing public health and medical services to Louisiana citizens and visitors. • When there is an impending emergency/disaster, DHH regions assess personnel resources and request additional staff. • Requests will be matched to the relief worker staffing pool.

50. DHH’s (9) Regions Region 7 Region 8 Region 6 Region 2 Region 9 Region 1 Region 5 Region 4 Region 3