National Disaster Medical System (NDMS ) Hospital Bed Availability, Collecting and Reporting DHS HHS DOD VA FEMA

1. National Disaster Medical System (NDMS)Hospital Bed Availability, Collecting and ReportingDHS HHS DOD VA FEMADana Shropshire, FPEM, CHS-III

2. Briefing Overview NDMS Purpose Components of NDMS Roles and Responsibilities Alert and Activation Civilian and Military Bed Reporting, Availability, Type Throughput NDMS Hospital Report, MTF Report and FCC Report Benefits/Importance

3. NDMS Purpose A Nationwide Medical Response System to: 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.

4. Health and Medical Response Natural Disasters Transportation Disasters Terrorism Technological Disasters

5. Major Componentsof NDMS Response Medical Response Patient Evacuation Definitive Medical Care

6. NDMS Federal Coordinating Centers Role and Responsibilities of FCC • Coordinate National Disaster Medical Systems (NDMS) Definitive Medical Care inAssigned Local Areas • Solicit and Organize Community Support Services • Enroll Non-Federal Local Hospitals in NDMS • Coordinate Bed Availability • Coordinate with Local / State Authorities on: • Preparing of Local NDMS Patient Reception Plans • Plan and Conduct Annual NDMS Exercises • NDMS Operations During Activation

7. Roles of NDMS Participating Hospitals • Voluntary Commit Hospital Support to NDMS • Provide Bed Availability Information to Local NDMS Federal Coordinating Center • Treat NDMS Patients • Participate in NDMS Exercises

8. FCC Alerted • Should patient requirements dictate the need for NDMS beds, a PRA under management of this FCC could be among the next to receive patients. However patients are not currently being regulated to this PRA. This status does not necessarily authorize reimbursement of FCC and/or PRA expenses incurred preparing for possible reception of patients • FCC could expect at least 24 hour notice of patient arrival.

9. FCC Activated • This status implies that FCC reimbursement of all patients reception activities is authorized. It signifies that patients are to be regulated, or have regulated to a PRA under management of this FCC. • FCC can expect to receive patients within 24 hours.

10. NDMS Alert & Activation: Civilian • Presidential declaration after the Governors request. • National Response Plan (NRP) activated. • State Coordinating Officer directs request to Federal Coordinating Officer (FCO). • Approved request is forwarded to DHS FEMA National Response Coordination Center (NRCC). • Under Secretary for Emergency Preparedness and Response will activate NDMS. • Notifications to Assistant Secretary of Defense, Health Affairs (ASD(HA) who will activate DoD/VA Federal Coordinating Centers (FCCs) • DHS will notify Joint Director of Military Support (JDOMS)

11. NDMS Alert & Activation: State • State Health Officer may request NDMS activation from the Under Secretary of Emergency Preparedness and Response in situations without Presidential disaster declaration. • State may be liable for cost incurred in this type of activation

12. NDMS Alert & Activation: Military • When the number of military patients exceed or is expected to exceed the capability of DoD Military Healthcare Systems (MHS) and VA medical systems, NDMS may be activated. • ASD(HA) notifies DHS NDMS and authorizes NDMS alert. • ASD(HA) notifies Services to activate select DoD/VA FCC’s. • National Military Command Center and the Joint Chiefs of Staff will request patient evacuation support from USTRANSCOM through USNORTHCOM. • Maintain Communications between ASD(HA) and (JDOMS) on action taken.

13. Bed Reporting FCC Operations • Upon system activation, FCC’s will receive specific patient movement and reception instructions from Global Patient Movement Requirements Center (GPMRC) • FCC’s will collect bed data from all participating hospitals, consolidate and coordinate NDMS Patient Reception Area’s and report this information to GPMRC. • Bed Availability will be reported via TRAC2ES to Transcom.

14. Bed Reporting FCC Operations Cont’ • When you have multiple PRA’s your bed reports need to be submitted separately for each PRA. • Coordination with airfields are a must!! “First in First out” privileges for the evacuation aircraft.

15. Hospital Bed Availability • Ensure accurate bed availability reporting that NDMS can use via GPRMC in a specific area • Available Beds- Beds that are vacant the day previous to the day reported. • Bed Reports – A hospitals real-time capacity to receive, admit, and treat patients from a disaster or war. The FCCs capability, including all available beds for hospitalization.

16. Hospital Bed Availability cont’ • Bed Reports evaluate the following: • Capability – The maximum number of patients a facility can accommodate. • Capacity – The number of patients that a facility can accommodate at a given point in time. • Category – Specific area of medical care used to identify the nature of a patients illness or injury.

17. Bed Report by Type CC= Critical Care –Adult or pediatric patients requiring sophisticated intervention to restore or maintain life processes. Those beds in licensed intensive care units. MM/SS= Medical/Surgery – Patients having or suspected of having, medical illness or injuries that may require surgical intervention, not coming within the purview of a more specific medical specialty. MP=Psychiatry – Patients who require specialized psychiatric care in a medical treatment facility.

18. Bed Report by Type cont’ SBN= Burns – Patients having second degree burns of 25% or more over the body surface. All patients with third degree burns of 10% or more of the body surface. MC = Pediatric – Patients having or suspected of having diseases or injuries requiring the services of pediatric health care providers.

19. Staffed Bed Beds in a facility that are currently set up and ready to accept and care for patients with appropriate staff, equipment, space, medical material, ancillary and support services to operate under normal circumstances.

20. Throughput The maximum number of patients that can be received at the NDMS patient reception area (off-load), staged, triaged, transported and admitted to the destination hospital or NDMS hospital within a 24 hour period. This is an estimate……relevant factors will affect this number. Throughput is vital to GPMRC

21. NDMS Hospital Report As of 2400 hours: Facility Name: Shands Categories: Avail: Reporter: K. Disaster MM/SS 35 Email: k.disaster@help.com MP 10 Comm Phone: 904-244-5035 SBN 1 Fax Phone: 904-244-5638 MC 15 CC 10 Total: 71 THROUGHPUT: 60

22. MTF Hospital Report As of 2400 hours: Facility Code: N0107 Categories: Avail: Reporter: Dana Shropshire MM/SS 20 Email: dlshropshire@sar.med.navy.mil MP 10 Comm Phone: 904-542-7921 SBN 0 Fax Phone: 904-542-7263 MC 10 CC 15 Total: 55 THROUGHPUT: 50

23. FCC Bed Report As of 2400 hours: Facility Code: D0107 Categories: Avail: Reporter: Dana Shropshire MM/SS 196 Email: dlshropshire@sar.med.navy.mil MP 26 Comm Phone: 904-542-7921 SBN 1 Fax Phone: 904-542-7263 MC 30 CC 36 Total: 289 THROUGHPUT: 200 This is 14 of 16 facilities reporting *Spinal/Brain rehabilitation facility in area = 36 additional beds

24. NDMS Benefits • Maximizes the Utilization of Existing Resources (Speciality hospitals for additional beds and Disaster Medical Assistance Teams (DMATs for PRAs ) • Provides Identified Levels of Care • Integrates Pre-hospital Phase with Medical Facilities • Helps Contain Health Care Costs • Designed to Reduce Mortality and Morbidity

25. 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

26. QUESTIONS