ESF-8: Resource Roundup

1. ESF-8:Resource Roundup Texas Disaster Medical System Texas Emergency Management Conference April 2012

2. Objectives • Define Emergency Support Function (ESF)-8 • Describe ESF-8 Resources • Local • State • Federal • Illustrate Resource Request Process

4. ESF-8 Functional Areas Health and Medical Supplies/Equipment Assessment of Health and Medical Needs To support: general / medical shelters, existing medical facilities & EMS assets PH infrastructure Mental health care Hospital, dialysis, and LTC facilities and capacity EMS Home-bound population

5. ESF-8 Functional Areas Evacuation In-Hospital Care Medical ground and air assets Staging Facility evacuations and destinations Embarkation/reception triage/shelter placement Surge Resources

6. ESF-8 Functional Areas Medical/PH Care Personnel Health Surveillance (see handouts) Deployment teams and staff General and medical shelters Hospitals, dialysis, and LTC facilities Illness, injuries, and death

7. ESF-8 Functional Areas Food/Drug/Medical Devices Mental Health Services Food safety Pharmacy services Supplies and equipment O2 Disaster behavioral health Substance abuse services

8. ESF-8 Functional Areas Mortuary Services PH/Medical Information Victim Identification Mortuary services Risk messaging Worker health and safety EMS PH policy and guidance

9. ESF-8 Functional Areas Environmental Health Recovery Potable water/ wastewater Solid waste disposal Re-entry of evacuees Infrastructure Vector control

10. Emergency Management Emergency Management EMS Fire Police Law Enforcement ESF-8 Requires Multi-agency Coordination ESF-8 Coordination RACs LMHA Dialysis Centers Healthcare Providers Academic Health Centers Clinics Nurses Hospitals Doctors Local PH Depts Regional PH Depts Non-Profit Orgs Community Based Orgs Faith Based Orgs Acute Medical Care Public Health

11. Local ESF-8 Resources • EMS Providers • Local Public Health Departments • Healthcare institutions • Local Mental Health Agencies • Trauma Regional Advisory Councils (RACs). • Regional DSHS Offices (Health Service Region) • Disaster District Committees

12. Regional Advisory Councils • 22 Regional Advisory Councils in Texas (A-V) • Coordinating body for a trauma service area (TSA) • Advancement of healthcare services (trauma, stroke, pediatric, cardiac care) and disaster preparedness • Multi-disciplinary approach of regional coordination • Hospitals, LTAC, EMS, public safety, public health

13. Trauma Service Areas Correlate with Regional Advisory Councils (RAC) regions

14. What can Regional Advisory Councils do for you?

15. Regional DSHS Offices • 11 Health Service Regions • 8 Regional DSHS Headquarters • Coordination of local, regional, and state public health partners • Ensures the provision of public health services to the community • Including during disasters and disease outbreaks

16. Health Service Regions Anchored with Regional DSHS Offices

17. Disaster District Committees • Offices (DDCs) that serve as the initial source of state emergency assistance to local jurisdictions • Committee Chairman is the local Texas Highway Patrol (Captain or Lieutenant) • District Coordinators (formerly RLOs) coordinate disaster preparedness and response in the region • Multi-disciplinary response • Law enforcement, fire, EMS, emergency management, transportation, public health and medical

18. DPS Regions 7 Correlate with Disaster District Committee (DDC) Regions 1. Dallas Region 2. Houston Region 3. McAllen Region 4. El Paso Region 5. Lubbock Region 6. San Antonio Region • 6. Capital Region 7

19. WebEOC & TWIRP • Web-based Crisis Information Management System for decision-making before, during, and after disasters • Texas WebEOC Interoperability Project (TWIRP) • Provision of interoperable communications • Consistency throughout the state • Improvement of application from Lessons Learned

20. Texas ETN • Texas ETN = Emergency Tracking Network • Activated by TDEM/DSHS during statewide emergencies • Connects 4 disparate standalone systems into an integrated statewide tracking system • EMTrack + EvacCenter + SNCA + WebEOC

21. State ESF-8 Resources • Department of State Health Services (DSHS) • Lead agency for ESF-8 coordination in Texas per Texas Emergency Management Plan, Annex H • Texas Disaster Medical System (TDMS) • DSHS Public Health Deployable Teams • Emergency Medical Task Force (EMTF)

22. Texas Disaster Medical System The Texas Disaster Medical System is the collaboration of all public health and acute medical care preparedness initiatives within the State of Texas relating to the mitigation of, response to, and recovery from natural and manmade disasters and other significant events within any region in Texas, with respect to Emergency Service Function (ESF)-8 functions. “Alphabet soup” of Texas ESF-8 Resources drove the need for a coordinated system Formed and funded in 2010

23. Steering Committee Objectives

24. ESF-8 Coordination

25. Acute Care Public Health ESF-8 Coordination TDMS Steering Committee

26. TDMS Today… • Gaining knowledge of current planning and operational groups around the state • Identifying gaps and overlaps in ESF-8 response • Educating local jurisdictions about TDMS • Forming 4 subcommittees • Resource Typing, Education, Staffing, Document • Constructing Overview Document and Strategic Plan

27. DSHS PH Deployable Teams

28. DSHS PH Deployable Teams

29. DSHS PH Deployable Teams

30. Emergency Medical Task Force

31. Need for EMTF?

32. EMTF Response Strategy • Rapidly deployable for statewide incidents • Builds upon regional capability • Integrated command & control elements • Self-sufficient for 72 hours • NIMS-compliant • Modular deployment options • ASPR-funded strategy for FY11 & FY12

33. EMTF Structure • Regional & Statewide Strategic Oversight Group • Budget, Strategy, Legal, Policy Issues • Final Decision-Making Authorities • Regional & Statewide EMTF TFL/Managers • Operations, Protocols, Mission Profile, Equipment, Position Descriptions, Personnel Management

36. Ambulance Strike Teams Currently 32 ASTs engaged, 150+ units 5 Ambulances/AST (25 total) Pre-identified teams No-notice regional deployment Statewide tasked missions Common communications

37. Mobile Medical Units • 16-32 bed capacity • Provide emergency stabilizing care and transfer • Staffed with physicians, nurses, techs, logistics, clerical, etc • 6-12 hr launch time for 72-96 hr deployment • Standardized cache of supplies, pharmaceuticals, and capabilities

38. EMTF Deployable Zumro Capability

40. AMBUS Project • MPV = Multi-Patient Vehicle • Transport >12 litter patient at a time • Pre-plumbed for O2 and medical gases • No-notice regional and statewide taskings • 4-6 paramedics/AMBUS

41. MPV: Current Response Within 30 Minutes Statewide Response

42. MPV: Current Response Within 1 hour Statewide Response

43. MPV: Current Response Within 1.5 hrs Statewide Response

44. MPV: Current Response Within 2 hrs Statewide Response

45. MPV: Current Response Within 2.5 hrs Statewide Response

46. What’s in store for 2012?

47. MPV: 2012 Response Within 30 min Statewide Response

48. MPV: 2012Response Within 1 hr Statewide Response

49. MPV: 2012 Response Within 1.5 hrs Statewide Response

50. MPV:2012Response Within 2 hrs Statewide Response