PEPIN COUNTY EMERGENCY SUPPORT FUNCTION (ESF) 8 PUBLIC HEALTH AND MEDICAL

Transcription

1 PEPIN COUNTY EMERGENCY SUPPORT FUNCTION (ESF) 8 PUBLIC HEALTH AND MEDICAL LEAD AGENCY: SUPPORT AGENCIES: STATE PARTNERS: Pepin County Health Department Pepin County Emergency Management Pepin County Human Services Pepin County UW-Extension Emergency Medical Services/First Responders Pepin County Coroner American Red Cross Chippewa Valley Hospital/Clinics Wisconsin Department of Health Services Wisconsin Hospital Emergency Preparedness Program NW WI Healthcare Coalition I. INTRODUCTION A. Purpose B. Scope The purpose of ESF 8 is to describe how the county will provide health, medical, and mortuary services in the event of an emergency or disaster situation. To coordinate assistance to county and local governments, as well as private health and medical services providers in identifying and meeting the public health and medical needs of victims of an emergency or disaster. II. POLICIES ESF 8 policy and concepts of operations apply to state departments, county and local agencies, private health and medical service providers and volunteer organizations for activities relating to potential or actual emergencies and disasters. A. If the Governor declares a state of emergency related to public health and designates the Wisconsin Department of Health Services (DHS) as the lead state agency to respond to that emergency, WI-DHS shall act as the public health authority during the period of the state of emergency. During the state of emergency, the secretary may designate a local health department as an agent of the department and confer upon the local health department, acting under that agency, the powers and duties of the public health authority. Additional authorization is contained in the Federal Disaster Relief and Emergency Assistance Act (Stafford Act-PL ), Health Insurance Portability and Accountability Act of 1996 (HIPAA-PL ), and Wisconsin State Statutes Chapters and 250. B. The Pepin County Public Health Department is the lead coordinating agency for Page 1 E S F 8 P u b l i c H e a l t h a n d M e d i c a l

2 ESF 8 of the Pepin County Emergency Response Plan. Pepin County Public Health Department has the authority to plan for and respond to disasters involving health and medical services under the powers and authorities granted them in Wisconsin State Statutes Additional authorization is contained in the Federal Disaster Relief and Emergency Assistance Act (Stafford Act-PL ), Health Insurance Portability and Accountability Act of 1996 (HIPAA-PL ), and Wisconsin State Statutes Chapters C. State, county and local governments are responsible for providing health and medical services for citizens in the event of an emergency. The Pepin County Public Health Department, as the lead coordinating agency, and identified support agencies will assist the local effort as necessary. The lead and support agencies, at various levels of government shall conduct their functions in a manner that: 1. Support ESF 8 activities and services will be provided in accordance with local, county, state, and federal statutes, rules and regulations. 2. Health and medical services will be provided without regard to economic status or racial, religious, political, ethnic, or other affiliation. III. CONCEPT OF OPERATIONS Pepin County ESF 8 is coordinated by the Director of the Pepin County Public Health Department. State ESF #8 (Health and Medical Services) can be activated through either the DHS Duty Officer System, the WEM Duty Officer System, or through the State Emergency Operations Center (if activated) or through the declaration of a local public emergency according to Wisconsin Statutes or by the declaration of a Public Health Emergency as defined in Wisconsin Statutes Chapter 323. A. General 1. The county shall support municipal government with providing and coordinating health care needs of victims of emergencies or disasters by committing human, financial and material resources to the impacted area, as appropriate. a. ESF 8 support may vary depending on an assessment of incident impact, the magnitude and type of event, and the stage of the response and recovery efforts. b. ESF 8 is designed to reduce duplication of effort to the extent possible. Recovery efforts are initiated concurrently with response activities. This includes a clearly defined process for requesting resources from state and federal agencies. Close coordination is required among federal, state, county, local, and volunteer agencies responsible for response and recovery operations. c. ESF 8 encourages the use of trained volunteers to assist in public health and medical emergencies, through the Wisconsin Emergency Assistance Volunteer Registry (WEAVR), managed by DHS. Page 2 E S F 8 P u b l i c H e a l t h a n d M e d i c a l

3 d. The State of Wisconsin ESF 8 divides health functions into eight main areas. The principal activities for each functional area are described in the following sections. Page 3 E S F 8 P u b l i c H e a l t h a n d M e d i c a l 1. Triage and Hospital Pre-Treatment: This includes the capability to: appropriately dispatch emergency medical services (EMS) resources; adequately perform both patient (in-field) and hospital triage; to identify available beds and types of care within the disaster site and surrounding jurisdictions; to provide feasible, suitable, and medically acceptable pre-hospital triage and treatment of patients; to provide transport as well as medical care en-route to an appropriate receiving facility; and to track patients to a treatment facility. Patient triage and transportation are managed in accordance with each Emergency Medical System response plan and each hospital s Emergency Operations Plan. 2. Medical Surge: This includes the capability to rapidly expand the capacity of the existing healthcare system in order to provide triage and then to provide emergency medical care. 3. Mass Prophylaxis and Treatment: This includes the capability to protect the health of the population through administration of critical interventions (vaccinations, antibiotics, etc.) in response to a public health emergency in order to prevent the development of disease among those who are exposed or are potentially exposed to public health threats. 4. Medical Supplies Management and Distribution: This includes the capability to procure and maintain pharmaceuticals and medical materials prior to an incident and to transport, distribute, and track these materials during an incident. 5. Surveillance and Epidemiological Investigation: This includes the capacity to rapidly conduct epidemiological investigations; to detect and identify exposure and disease (both deliberate release and naturally occurring), to rapidly implement active surveillance, maintain ongoing surveillance activities, perform data analysis, communicate with the public, and providers about case definitions, disease risk and mitigation, and make recommendations for the implementation of control measures. 6. Public Health Laboratory Testing: This includes the capacity for ongoing surveillance, rapid detection, confirmatory testing, data reporting, investigative support, and laboratory networking to address potential exposure, or exposure, to all hazards which include chemical, radiochemical, and biological agents in all matrices including clinical specimens, food and environmental samples (e.g. water, soil, and air).

4 7. Containment Measures: This includes the capability to protect the health of the population through the use of isolation and/or quarantine measures in order to contain the spread of the disease. 8. Fatality Management: This includes the capability to effectively perform scene documentation; the complete collection and recovery of the dead, victim s personal effects, and items of evidence; decontamination of remains and personal effects (if required); transportation, storage, documentation, and recovery of forensic and physical evidence; determination of the nature and extent of injury; identification of the fatalities using scientific means; and certification of the cause and manner of death. It also includes development and maintenance of collaborative agreements state-wide to provide these services in mass casualty events. B. Organization 1. During an emergency or disaster situation, the primary and support agencies of ESF 8 will assign personnel to the County EOC. The Pepin County Health Department, as the responsible agency for implementing ESF 8 will respond directly to the Officer in Charge/Operations Officer in the EOC. Wisconsin Department of Health Services will work directly with Local Public Health staff regardless of whether or not an EOC is opened. 2. ESF 8 emergency response will coordinate the resources of Pepin County Public Health Department and other appropriate county agencies, support service providers, etc. with Operations/OIC. Pepin County Public Health Department may request additional resources from local, other county, state, or federal agencies as needed. 3. For health and medical related emergencies related specifically to animal health issues, DATCP coordinates with local government, state agencies, and federal responders and provides for implementation of State response plans, as appropriate and as described in ESF ESF 8 coordinates activities with ESF 1 (Transportation and Evacuation), ESF 5 (Emergency Management) and ESF 6 (Mass Care and Human Services), as well as other Emergency Response Plan support functions as necessary. 5. Pepin County Public Health Department will staff ESF 8 during the activation of the County EOC and will coordinate the resources of Pepin County Health Department and other appropriate county, local, state, and private organization resources with the EOC Officer in Charge. ESF 8 has been developed in conjunction with other supporting agencies to provide a framework for health and medical services response and Page 4 E S F 8 P u b l i c H e a l t h a n d M e d i c a l

5 C. Procedures (Activation) recovery actions for Pepin County. ESF 8 staff will coordinate with State ESF 8 counterparts. Refer to the Pepin County Public Health Emergency Plan (PHEP), as the primary county/local response plan. Secondary resources that describe various ESF 8 activities are listed in the reference section of ESF 8. Other supporting documents include the Wisconsin Emergency Response Plan, Wisconsin Hospital Emergency Preparedness Plan (WHEPP), and the Strategic National Stockpile Plan. D. Mitigation Activities The Pepin County Public Health Department promotes individual infection control measures, such as hand washing and cough etiquette as a means to prevent and reduce the number of public health outbreaks. Other community based actions that could be taken in the event of an epidemic include: isolation and treatment; voluntary home quarantine; dismissal of students from schools, school based activities, and childcare programs; and use of social distancing measures. E. Preparedness Activities 1. The Pepin County Emergency Response Plan, including ESF 8 enables participating institutions and agencies to meet local needs in a collaborative and organized manner in the event of infectious disease outbreaks, bioterrorism, other public health threats and emergencies and chemical, biological, radiological, nuclear, explosive (CBRNE) incidents that may involve large numbers of affected individuals by: a. Utilizing the National Incident Management System (NIMS) to insure that state and local agencies have a standardized approach to prepare, prevent, respond to, and recover from an incident. b. Identifying the necessary structure to allow the participants to call upon outside resources c. Describing the process for activating the EOP, operational parameters during the incident between participants and field operations, termination of the incident, recovery from the incident, and evaluation of performance. d. Providing for the protection of health care providers, emergency responders, and residents in the event of a natural or unnatural outbreak of an infectious disease. e. Providing authority and powers for local public health departments to request mutual aid through Wisconsin State Statutes Chapter Page 5 E S F 8 P u b l i c H e a l t h a n d M e d i c a l

6 2. The Wisconsin Emergency Response Plan (WERP) and the Wisconsin Hospital Emergency Preparedness Plan (WHEPP) are developed collaboratively and are intended to be mutually supportive and directly linked to activities in the local Public Health Emergency Plan. a. Establishes a structure and process to enable the participating health care institutions to meet community, county, and regional needs in a collaborative and organized manner during an incident. b. Describes the process for: Sharing resources between participant institutions; Activating the necessary resources; Operational parameters during the incident between participant institutions and field operations; Termination of and recovery from the incident; and the process for evaluating performance under the WHEPP. c. Enables the participant institution to: Meet community healthcare needs during an incident, in which an individual institution s capacity is exceeded. Provide a method for the participant institutions that is consistent. Integrate the community emergency operation plans developed by civil authorities with an emphasis on integrating pre-hospital, hospital, and home care. Provide a method for pre-determined initiating triggers, prehospital communication, resource mobilization and transportation to the appropriate hospital(s) and/or off-site treatment facilities. Provide mutual aid with other participant institutions and/or community, regional, state, or national resources as required. Provide a method for any participant institution to evacuate partially or fully should it become necessary as a result of either an internal or external disaster. Determine when the response to an incident may be terminated and hospital activities return to normal routines. 3. The Pepin County Public Health Emergency Plan a. Utilizing the National Incident Management System (NIMS) to ensure that state and local agencies have a standardized approach to prepare, prevent, respond to and recover from an event. b. Identifying the necessary structure to allow participants to call upon outside resources. c. Detailing the process for activating the PHEP, operational parameters during an event between public health and partner agencies, and the termination of an incident. Page 6 E S F 8 P u b l i c H e a l t h a n d M e d i c a l

7 d. Making provisions for the protection of health care providers, first responders and the public. e. Assuring memoranda of understanding are in place with partner health departments. f. Engaging partners such as hospitals, county emergency management, emergency medical system (EMS), fire, laboratories, HazMat teams, law enforcement agencies, human services, volunteer organizations, etc. to enhance preparedness through planning and coordination. g. Routinely reviewing and modifying the PHEP. h. Distributing copies of the PHEP to all relevant partners. i. Retaining all records related to public health emergency events according to state and administrative rule. F. Response Activities 1. Participate in the development of situation assessments along with appropriate Incident Command partners. 2. Activate available mutual aid requests to obtain needed resources in collaboration with other response partners. 3. Contribute to initiation of Pepin County Mass Casualty Plan as outlined in Health Department plans, with a focus on supporting the Family Assistance Center, if activated. 4. Collaborate with hospital partners to utilize WI-TRAC and other information needed to enhance bed availability when requested 5. Participate in phone bank/hotline functions as requested via Incident Command. Prepare public health and healthcare talking points as requested. 6. Assist in the activation and implementation of mutual aid requests for medical facilities and equipment as the incident warrants. 7. Implement plans to identify staff (including volunteers) and equipment resources to operate alternative care facilities in accordance with the Pepin County Public Health Emergency Plan. 8. Organize mass clinic treatments and manage medical orders of vaccines and supplies through the Department of Health Services, Division of Public Health. Page 7 E S F 8 P u b l i c H e a l t h a n d M e d i c a l

8 9. Maintain a system of receipt, inventory, control, and distribution for all medical materials, supplies, and services utilized in the public health emergency response; examples include WIR, RECIN, or other Inventory Management Systems. 10. Provide an early recognition based infectious/communicable disease surveillance system that incorporates reporting to participating state and public health departments, hospitals, laboratories, physician offices, and clinics. 11. Activate an enhanced surveillance network, which alerts hospitals, physicians, and clinicians of specified disease(s) or agent(s) for which to initiate surveillance, along with early signs and syndromes, treatment protocols, methods of rapid reporting of the detection, and risk communications for patients and the general public in regards to the particular disease(s) and agent(s). 12. Pepin County utilizes external laboratory services to provide public health lab testing; all collected specimens will be sent out to other agencies for evaluation. 13. Pepin County Public Health Department has the authority to activate quarantine measures to restrict movement of or to separate asymptomatic persons from the community who are determined to be at risk of becoming contagious or are in need of protection from exposure to a communicable disease. Quarantine measures will be used only for communicable diseases in which such measures are considered beneficial in controlling the disease. 14. Advise hospital or other healthcare facilities on proper infection control measures when requested. 15. Initiate the Pepin County Fatality Incident Response Plan if the incident exceeds the capacities of the local coroner and mortuary service providers. 16. Coordinate mortuary response team (D-FIRST and DMORT) assets/services as needed. G. Recovery Activities 1. Continue coordination/monitoring of the ESF 8 functions 2. Continue to maintain liaison with state, local, county, and tribal health care organizations. 3. Ensure Public Health and Medical facilities continue to be involved in the recovery process. Page 8 E S F 8 P u b l i c H e a l t h a n d M e d i c a l

9 IV. RESPONSIBILITIES A. Lead Coordinating Agency 1. Pepin County Health Department a. Analyze incoming case reports for possible outbreaks or epidemics, and provide timely reports back to clinicians (both human and animal) and Wisconsin Department of Health Services. b. Consult with the Wisconsin Department of Health Services as needed in order to coordinate disease investigations with local, regional, or federal investigations. c. Provide both human and animal medical staff with current epidemiological information on any disease outbreak, case definitions and supplemental documentation, consultation, and coordination of surveillance activities if other local health providers are involved. d. Report to or send a representative to the EOC, if activated. e. Support the activities of laboratory services, immunizations programs and quarantine procedures. f. Assist in the provision of functional needs support services within the Community Shelter. g. Request environmental agencies to monitor and evaluate the risks and hazards associated with the incident as needed. h. Coordinate the notification, investigation and response to public health emergencies with the WI DHS, U.S. Department of Health and Human Services, Center for Disease Control and Prevention, local hospitals and clinics and county responders. i. Request activation of the Area Medical Coordinating Center or the Regional Medical Coordinating Center as appropriate. j. Coordinate with WI-DHS to request and distribute medical supplies from the Strategic National Stockpile, if utilized. k. Utilize state and federal experts who can provide detailed information about specific agents, their short-and long-term effects and protective actions that can be taken to reduce the risk of injury or illness. l. Provide technical health-related information to responders. Distribute healthrelated information to the general public through Public Information Officers. m. Provide emergency information on health issues to victims through the Health Department Public Information Officer. Page 9 E S F 8 P u b l i c H e a l t h a n d M e d i c a l

10 n. Identify and implement appropriate protective actions and studies to address the long-term health effects. B. Support Agencies 1. Pepin County Emergency Management a. Coordinate with state and local agencies to identify and implement appropriate protective actions. b. Coordinate with state and private (e.g. forensic dentists, Wisconsin Funeral Directors Association, State Coroners Association) organizations to support local health, medical, and mortuary needs. c. Provide general emergency management support to all ESF 8 activities. d. Ensure the quality and safety of septic systems and well water (Zoning is a shared responsibility of the Pepin County Emergency Management Office and will be delegated to the assistant zoning administrator or private plumbers based on the scale of the emergency or disaster.) 2. Chippewa Valley Hospital/Clinics a. Advise the EOC of the facility s condition, available resources and number and type of beds available. b. Establish and maintain communications with the EOC, ICS and field EMS personnel. c. Provide advice and medical guidance to Emergency Medical Services. d. Coordinate with appropriate agencies and on-scene personnel to ensure that casualties are transported to the correct medical facility. e. Coordinate with emergency responders to isolate and decontaminate incoming patients if needed. f. Activate facility disaster plans to manage victims, concerned individuals and the media. g. Work with hospital bioterrorism planning region to utilize regional resources most effectively. h. Maintain contact with regional public health consortium to coordinate the management of casualties. i. Coordinate public information efforts with the EOC or Joint Public Information Center, if established. Page 10 E S F 8 P u b l i c H e a l t h a n d M e d i c a l

11 j. Support additional ESF 8 activities as described in the Pepin County Public Health Emergency Plan. 3. Emergency Medical Services/First Responders a. Report to or send a representative to the EOC. b. Assess the health, medical and mortuary needs of the situation; mobilize and coordinate resources as necessary. c. Maintain communications with the ICS, EOC, EMS, hospitals and other healthcare facilities to provide for and/or seek support and assistance. d. Provide pertinent information to the EOC or Joint Public Information Center, if established. e. Maintain a patient casualty tracking system. f. Coordinate the location, procurement, screening and allocation of health and medical supplies and resources. g. Perform triage and appropriate on-scene medical care to victims and responding personnel. h. Assist with evacuation efforts as directed by the ICS or EOC. i. Provide transportation of patients as designated by the ICS or the EOC. 4. Pepin County Human Services a. Provide services to people with special needs, disabilities, and the elderly. b. Ensure that appropriate mental health services are available to disaster victims, survivors, bystanders, responders and their families and other community caregivers. c. Provide support for shelters and reception centers as outlined in ESF 6 Mass Care and Human Services. d. Support additional ESF 8 activities as described in Pepin County Public Health Emergency Plan 5. Pepin County Coroner a. Provide for the collection, identification and care of human remains, including conducting autopsy s, collecting personal effects and locating and notifying the next of kin. Page 11 E S F 8 P u b l i c H e a l t h a n d M e d i c a l

12 b. Collect forensic evidence (including information relevant to determining the source of biological contamination in a bioterrorism, infectious disease outbreak, public health threat and other types of emergencies). c. Establish and maintain a comprehensive record keeping system. d. Maintain close liaison with on-site command post and county EOC. e. Establish temporary morgue as may be needed. f. Request security support from law enforcement for the protection of temporary morgue and personal effects of the deceased. g. If necessary, emergency disposition of bodies to prevent spread of disease. h. Release of bodies for final disposition. i. Sponsor critical incident debriefing for all mortuary workers. j. Completion of legal death related documents. k. Coordinate with funeral home directors for mortuary services as necessary. l. Communicate between federal, state, and local government agencies and with the family assistance center (if applicable). m. Provide information to activate D-FIRST and DMORT. 6. Pepin County UW-Extension a. Coordinate with veterinarians, animal hospitals, WI Department of Agriculture, Trade and Consumer Protection and WI Department of Natural Resources as necessary to provide for the needs of companion animals, livestock and wildlife. b. Coordinate with the WI Department of Natural Resources regarding location, collection and disposal of deceased animals. c. Investigate the outbreak of food borne illnesses, agricultural events, and animal disease epidemics d. Inspect food, water, drugs and other consumables that were exposed to the hazard for purity, usability and quality. e. Provide community education courses focused on the prevention and containment of food, agricultural or animal disease outbreaks. f. In the event of an animal based disease outbreak, perform the responsibilities outlined in ESF 11. Page 12 E S F 8 P u b l i c H e a l t h a n d M e d i c a l

13 7. American Red Cross a. Provide food for emergency medical workers, volunteers and patients in coordination with other volunteer agencies when requested and as appropriate. b. Provide follow-up services for the injured or relatives of the deceased after proper authorities make initial notification. c. Provide emergency first aid and health services to supplement local emergency medical and health services through coordination with local health authorities. d. Provide a 24-hour telephone number for disaster welfare inquiries. e. Provide emergency and preventive health services to disaster victims at emergency aid stations and mass care sites (e.g., reception center, shelter.) f. Provide support to people with disaster related needs or disaster-related health needs and assist people with finding resources to meet health-related financial obligations. g. Obtain and distribute blood and blood products. h. Create a list of health resources when time and situation allows. i. Coordinate with local mental health agencies to provide community services. V. REFERENCES The following are included by reference and can be viewed in the Pepin County Emergency Management Office: Pepin County Emergency Response Plan Pepin County Public Health Emergency Plan Pepin County Pandemic Influenza Plan Wisconsin Public Health Emergency Plan (Western Region Consortium) WRPPHP Mass Clinic Plan Page 13 E S F 8 P u b l i c H e a l t h a n d M e d i c a l

14 ESF 8 Health and Medical Attachment 1: Agency Approval Signature Sheet The undersigned have hereby reviewed and approved ESF 8 of the County Emergency Response Plan. County Board Chair Date Director of Public Health Date Emergency Management Director Date ESF 8 Documentation of Changes Converted from Annex (EOP) format to ESF format February 2016; finalized edits March 2016 Page 14 E S F 8 P u b l i c H e a l t h a n d M e d i c a l

15 ESF 8 Health and Medical Attachment 2: Mobilization of Local Resources In responding to a need for EMS response, the County EMS Coordinator may mobilize or seek assistance from any or all of the following entities within and outside the county: 1. Durand Ambulance Service ( ) (911): a. 2 ambulances; 13 EMT s on staff ; rescue vehicle with extrication equipment, and field defibrillator equipment. b. Trained in hazardous materials response and equipped with personal protective gear Class C. 2. Pepin Ambulance Service ( ) (911): a. 1 ambulance; 8 EMT s on staff. 3. Chippewa Valley Hospital ( ): a. 30 bed acute care facility; emergency department; cardiac care unit. b. Medical personnel potentially available for transport to site of emergency. 4. Medical Helicopter Services: a. Eau Claire or Twin Cities 5. First Responders: a. 25 volunteers trained as First Responders. b. Transport vehicle useful for non-emergency victim transfer. 6. Department of Health Services (DHS): a. Guidance for field EMS providers on protective actions and patient care in toxic exposures b. Guidance for hospitals and physicians in definitive care and follow-up of toxic exposure patients. c. Access to databases on the health effects of toxic exposures. d. Promulgation of public health advisories related to toxic releases and exposures. e. Nurses and Emergency Medical Technicians to provide staffing assistance to hospitals, care centers and ambulance services. f. Patient beds and patient care resources at various WI-DHS care facilities. 7. Department of Military Affairs: a. Personnel and equipment from medical evacuation and hospital units. b. Helicopters and crews for use in evacuation of casualties or transport of supplemental personnel and supplies. 8. American Red Cross: a. Disaster nursing personnel to supplement local resources. b. Pool of first-aid trained individuals to supplement local resources. c. Access to emergency blood supplies. Page 15 E S F 8 P u b l i c H e a l t h a n d M e d i c a l