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U.S. Department of Homeland Security Emergency Preparedness and Response Federal Emergency Management Agency NDMS Secti

U.S. Department of Homeland Security Emergency Preparedness and Response Federal Emergency Management Agency NDMS Section – Response Division. Current NDMS Overview. Briefing Overview. National Disaster Medical System Alignment within Department of Homeland Security Background and Origins

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U.S. Department of Homeland Security Emergency Preparedness and Response Federal Emergency Management Agency NDMS Secti

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  1. U.S. Department of Homeland SecurityEmergency Preparedness and ResponseFederal Emergency Management Agency NDMS Section– Response Division Current NDMS Overview NDMS Section 2 May 2005

  2. Briefing Overview • National Disaster Medical System • Alignment within Department of Homeland Security • Background and Origins • Structure and Components of NDMS • ESF #8 in the National Response Plan • NDMS Role in ESF #8 • NDMS Capabilities and Enhancements NDMS Section 2 May 2005

  3. U.S. Department of Homeland Security Executive Secretary Commandant of Coast Guard Legislative Affairs Secretary ---------------------------------- Deputy Secretary Inspector General Public Affairs General Counsel State and Local Coordination Civil Rights and Civil Liberties Citizenship & Immigration Service Ombudsman Director, Bureau of Citizenship & Immigration Services Special Assistant to the Secretary (private sector) Director of the Secret Service Small & Disadvantaged Business Privacy Officer National Capital Region Coordination Chief of Staff International Affairs Shared Services Counter Narcotics Under Secretary Management Under Secretary Science and Technology Under Secretary Information Analysis and Infrastructure Protection Under Secretary Border & Transportation Security Under Secretary Emergency Preparedness and Response NDMS Section 2 May 2005

  4. Department of Homeland Security Federal Emergency Management Agency Major Organizational Elements • Office of National Security Coordination • Mitigation Division • Preparedness Division • Response Division • Recovery Division NDMS Section 2 May 2005

  5. Detailees Response Division Executive Secretary Advisory Services Executive Operational Services Response Services Branch OperationsBranch Logistics Branch NDMS Section 2 May 2005

  6. Operations Branch Military Support Team NDMS Section Jack Beall – Section Chief(S) Field Operations Section Urban Search & Rescue Section Incident Response Section NDMS Section 2 May 2005

  7. NDMS Section Jack Beall Chief NDMS Section Medical Systems System Development Unit Medical Field Operations Unit Operations Unit NDMS Section 2 May 2005

  8. Medical Systems Operations Unit • Mission: • Ensure that operationally-ready resources of NDMS can respond to emergency incidents, special events, and exercises in a timely and efficient manner, and that the operations of these resources are sustained for the duration of the incident. NDMS Section 2 May 2005 8

  9. Medical Systems Development Unit • Mission: • Provide for the ongoing development of the National Disaster medical System and its medical response, patient evacuation, and definitive care components, ensuring the capability of rapid, effective, and efficient response. NDMS Section 2 May 2005 9

  10. Medical Field Operations Unit • Mission: • Coordinate, and develop regional NDMS assets, including Regional Emergency Coordinators, for field medical response operations. • Perform critical analysis, provide advice, and integrate medical emergency management, preparedness, hospital, and health care activities in emergency medical response to all hazards in DHS regions. NDMS Section 2 May 2005 10

  11. NDMS Regional Emergency Coordinators NDMS Section 2 May 2005

  12. Roles for NDMS Emergency Coordinators • Develop regional Federal medical response assets • Liaison between States and FEMA on medical response issues • Review plans and consult with officials on ways to integrate NDMS • into State and local response • Principal representative for NDMS integration NDMS Section 2 May 2005

  13. NDMS is a public/private sector partnership Federal partners - DHS, HHS, DOD, VA NDMS Section 2 May 2005

  14. Background on the Origins of NDMS Presidential Initiative • 1981 - Established Emergency • Mobilization Preparedness Board • (EMPB)/Principle Working Groups • Directed to Develop National Policies and • Programs for Domestic Disasters and • National Security Emergencies NDMS Section 2 May 2005

  15. Principle Working Group on Health (PWGH) • PWGH Addressed Health • and Medical Issues NDMS Section 2 May 2005

  16. National Security Decision Directive 47 (NSDD-47) • Approved by the President • (July, 1982) • Set forth Emergency Mobilization • Preparedness Principles for: • National Security Emergencies • Domestic Emergencies NDMS Section 2 May 2005

  17. NSDD-47 Health It is the policy of the United States to develop systems and plans to ensure that sufficient medical personnel, supplies, equipment, and facilities will be available and deployed to meet essential civilian and military health care needs in an emergency. NDMS Section 2 May 2005

  18. PWGH Developed Plans to Implement NSDD-47 • Identified Key Steps in Establishing a • Nationwide Mutual Aid Network – NDMS • EMPB Approved Key Steps • President Approved National Plan of • Action (March, 1983) • Established the National Disaster • Medical System NDMS Section 2 May 2005

  19. National Disaster Medical System A public / private sector partnership DHS HHS DOD VA A Nationwide Medical Response System to: • Supplement state and local medical resources during disasters or major emergencies • Provide backup medical support to the military/ VA medical care systems during an overseas conventional conflict NDMS Section 2 May 2005

  20. NDMS Directorate Staff • Members: • DHS – Chief, NDMS Sec. (Chair) • HHS • DOD • OASD (HA) • ARMY • NAVY • AIR FORCE • VA • Responsibility: Implement Policy NDMS Participating Organizations NDMS Organizational Structure Senior Policy Group (SPG) • Members: • Director, Response Division, Emergency • Preparedness and Response, DHS • (Chair) • Assistant Secretary for Public Health • Emergency Preparedness, HHS • Assistant Secretary of Defense, • Health Affairs • Undersecretary for Health, VA • Responsibilities: • Set policy and Goals for National • Medical Preparedness • Oversee Directorate Staff NDMS Section 2 May 2005

  21. Major Components of NDMS • Medical Response • Patient Evacuation • Definitive Medical Care NDMS Section 2 May 2005

  22. NDMS Medical Response Lead Responsibility - DHS • Assist in Assessment of Health/Medical Needs • Provision of On-Scene Medical Services • Victim Identification/Mortuary Services • Veterinary Medical Services NDMS Section 2 May 2005

  23. NDMS Medical Response (DHS Lead) • DMAT/Specialty Teams - More • than 9,000 personnel • Equipment and Supplies NDMS Section 2 May 2005

  24. NDMS Medical Response Disaster Medical Assistance Teams(DMATs) • Volunteer Groups Affiliated with NDMS • Approximately 35 Persons per Team (> 9,000 personnel) • Variety of Health/Medical Skills • Locally Sponsored • Community Based • Local/ State Asset NDMS Section 2 May 2005

  25. NDMS Medical Response DMAT FUNCTIONS At Disaster Site • Triage • Primary Medical Care • Casualty Clearing/Staging At Local NDMS Reception Area • Patient Reception NDMS Section 2 May 2005

  26. NDMS Medical Response SPECIALTY TEAMS • Pediatric • Burn • Disaster Mortuary Operational Response Teams (DMORTs) • Urban Search and Rescue Medical Team • Mental Health • Veterinary Medical Assistance Teams (VMATs) • National Medical Response Teams (NMRTs) • International Medical Surgical Response Teams (IMSuRTs) NDMS Section 2 May 2005

  27. DMATs and Specialty Teams • Members are Intermittent Federal Employees • (Public Law 107-188) • Importance of Federalization • Licensure / Certification • Liability • Compensation NDMS Section 2 May 2005

  28. Management Support Team (MST) • Responds to Disaster Area • Provides Management Support to Deployable Teams • Uses Incident Command System (ICS) for C2 • Logistics • Communications • Operations • Finance / Procurement • Plans • Interface with Local Disaster Management System NDMS Section 2 May 2005

  29. NDMS RESPONSE TEAMS • 25 Disaster Medical Assistance Teams - (Fully Operational/Operational) • 30 Disaster Medical Assistance Teams - (Augmentation/Developmental) • 4 National Medical Response Teams / WMD • 4 Burn Teams • 2 Pediatric Teams • 1 Crush Medicine Team • 3 International Medical / Surgical Teams * • 2 Mental Health Teams • 4 Veterinary Medical Assistance Teams • Disaster Mortuary Operational Response Teams (1 WMD) • National Pharmacist Response Teams • 10 National Nurse Response Teams • 1+ Management Support Team(s) • * Includes 2 under development NDMS Section 2 May 2005

  30. NDMS Operational Disaster Medical Assistance Teams AK Seattle ME WA MT ND VT MN Eugene NH Worcester Boston MA WI OR Valhalla SD MI CT ID Westland Providence WY PA NJ Toledo IA San Francisco Bay Area RI Dayton MD DE NE OH IN WV MO IL UT CO NV CA St. Louis VA KS KY Winston-Salem San Bernadino TN NC Tulsa SC Los Angeles Area Albuquerque OK San Diego NM AR AL GA Maui AZ MS LA Santa Ana Jacksonville HI TX USVI Tampa/St. Petersburg FL Miami USVI GUAM PR Fully Operational Teams NDMS Section 2 May 2005 Operational Teams

  31. Outpatient Facility - 250 pts. Per day Treatment with Limited Holding Capacity (Alternative Care Facility) - 160 patients per day CapabilitiesSingle Team 35 person - D + 1Care Provided • Augment Standard Med-Surgical Ward • - 50 Patients • Casualty Collection Center • - 150 Patients • (Similar to NDMS Reception Center) NDMS Section 2 May 2005

  32. Outpatient Facilities 5000 pts. Per day Treatment with Limited Holding Capacity (Alternative Care Facilities) - 224 In patients - 4500 Out patients per day CapabilitiesEntire NDMS System - Day + 3: (1100 Personnel)Care Provided • Augment Standard Med-Surgical Wards • - 1400 Patients • Casualty Collection Centers • - 4200 Patients NDMS Section 2 May 2005

  33. NDMS Patient Evacuation Lead Responsibility - DOD • Provide Patient Movement from the Disaster Area • Utilize All Types of Transportation • Primarily Relies on Aeromedical NDMS Section 2 May 2005

  34. Medical Evacuation Functions • Patient Reporting • Patient Regulating • Patient Movement Request • Patient Staging • Patient Lift • Embarkation • Debarkation • Coordination with Various System Elements NDMS Section 2 May 2005

  35. NDMS Definitive Medical Care Lead Responsibility - DOD/VA • Federal Coordinating Centers (FCCs) • Concentrated in Major Metropolitan Areas • Air Access • Available Hospital Support • Patient Reception and Distribution Capabilities NDMS Section 2 May 2005

  36. NDMS Definitive Medical Care • Network of approximately 1,800 • non-Federal hospitals • 62 FCCs, which coordinate in • excess of 82 receiving areas NDMS Section 2 May 2005

  37. NDMS Definitive Medical Care Federal Coordinating Centers (FCCs) WA AK MT ND ME MN VT OR NH WI MA SD NY RI CT ID WY MI PA CA IA NV NJ NE OH MD DE IL UT CO WV IN KS VA MO KY NC AZ OK NM TN SC TX AR AL MS LA GA FL USVI HI GUAM PR • Army FCC Navy FCC Air Force FCC VA FCC NDMS Section 2 May 2005

  38. NDMS Federal Coordinating Centers Responsibilities: • Coordinate NDMS Definitive Medical Care in • Assigned 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 NDMS Section 2 May 2005

  39. Role of Participating Hospital • Voluntary Commit Hospital Support to NDMS • Provide Bed Availability Information to Local • NDMS Federal Coordinating Center • Treat NDMS Patients • Participate in NDMS Exercises NDMS Section 2 May 2005

  40. Circumstances for Which NDMS May be Activated • Presidential Declaration of Disaster or Emergency • State Request for Major Medical Assistance • NTSB Request to Support Transportation Accident • Military Contingency - Overseas Conventional • Armed Conflict Involving U.S. Forces NDMS Section 2 May 2005

  41. NDMS Readiness Activities • Maintenance of Plans • Training • Exercises • Special Events • Annual Conferences NDMS Section 2 May 2005

  42. Partial Listing of Endorsement for NDMS • American Burn Association • American Hospital Association • American Medical Association • American Nurses Association • American College of Emergency Physicians • American College of Surgeons Committee on Trauma • American College of Healthcare Executives • American Red Cross • Emergency Nurses Association • National Association of State EMS Directors • National Association of Emergency Medical Technicians • National Emergency Management Agency • National Fire Protection Association • National Funeral Directors Association • Society for Academic Emergency Medicine NDMS Section 2 May 2005

  43. NDMS Activations Somerset County Terrorist Hijacking IMF Meeting Papal Visit Transportation Accidents: TWA 800; Alaska Air; Egypt Air 990; Quincy, IL; Monroe, MI; Guam; Bourbonaise, IL train wreck; Wilkes-Barre, PA (Executive Air); American Airlines Flight 587 Indiana Storms New York Ice Storm New York City World Trade Center Terrorist Attack Oklahoma City Bombing; Tornados Grand Forks Floods Winter Ice Storms Kosovar/ Ft Dix Refugees 2002 Winter Olympic Games 2001 Presidential Inaugural NATO 50th Pentagon Terrorist Attack Walker County, Georgia 1996 Olympic Games Northridge Earthquake Wildfires Hantavirus Tropical Storm Allison Floods: Midwest, Southwest, Houston, Southeast Georgia, California, Northwest, Oregon, Minnesota, North Dakota, Kentucky, Idaho, Ohio, Nevada, Hawaii, Texas, West Virginia Hurricanes: Floyd, Dennis, Lenny, Eduardo, Bertha, Hortense, Marilyn, Opal, Andrew, Fran, Georges, Brett, Hugo, Emily, Isabel Hurricane Iniki NDMS Section 2 May 2005

  44. 2004 NDMS Hurricane ResponsesDemonstrated Capability (Augmentation personnel: 316 - Total personnel: 800+) • Storms Alerted Teams Deployed TeamsTotal Patients • Charley 3 12 3,782 • Frances 10 8 1,461 • Ivan 11 13 3,446 • Jeanne 5 2 961 • Totals 29 35 9,740 NDMS Section 2 May 2005

  45. National Response Plan NDMS Section 2 May 2005

  46. National Response PlanEmergency Support Functions (ESFs) 1. Transportation Department of Transportation 2. Communications Dept. of Homeland Security/NCS 3. Public Works and Engineering Army Corps of Engineers FEMA 4. Firefighting Department of Agriculture Forest Service 5. Emergency Management FEMA 6. Mass Care, Housing and Human Services FEMA and American Red Cross 7. Resource Support General Services Administration 8. Public Health and Medical Services Department of Health and Human Services 9. Urban Search and Rescue Federal Emergency Management Agency 10. Oil and Hazardous Materials Environmental Protection Agency & DHS, U.S. Coast Guard 11. Agriculture and Natural Resources Department of Agriculture Department of Interior 12. Energy Department of Energy NDMS Section 2 May 2005

  47. National Response PlanEmergency Support Functions (ESFs)(Continued 13. Public Safety & Security Departments of Homeland Security & Justice 14. Long-term Community Recovery and Mitigation Departments of Homeland Security/FEMA 15. External Affairs - Department of Homeland Security/FEMA NDMS Section 2 May 2005

  48. Support Annexes • Financial Management • International Coordination • Logistics Management • Private Sector Coordination • Public Affairs • Science and Technology • Tribal Relations • Volunteer and Donations Management • Worker Safety and Health NDMS Section 2 May 2005

  49. Incident Annexes • Biological Incident • Catastrophic Incident • Cyber Incident • Food and Agriculture Incident • Nuclear/Radiological Incident • Oil and Hazardous Materials Incident • Terrorism Incident Law Enforcement and Investigation NDMS Section 2 May 2005

  50. ESF #8 Role in theNational Response Plan NDMS Section 2 May 2005

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