About the Tri-Cities Medical Response System
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1 About the Tri-Cities Medical Response System What is a Medical Response System? TRIMRS is one of seven Medical Response Systems, or Health Care Coalitions, across the state of Nebraska. We exist to bring health care organizations and their response partners together to jointly prepare for disasters and public health emergencies that threaten to overwhelm the capability and the capacity of the medical community to respond. Who are Members? Our voting members include hospitals, health departments, emergency managers, EMS, and behavioral health. Our subcommittees also include subject matter experts such as ham radio operators, funeral directors, volunteer organizations and the American Red Cross. In addition, we work individually with counties to reach out to local partners, such as clinics, Long-Term Care, law enforcement and others. We cover 23 counties in the center of Nebraska. What does TRIMRS do? TRIMRS focuses on helping our members, their communities and the region meet health care preparedness capabilities in the areas of: medical surge (patient surge, evacuation, shelter-in-place, etc ), emergency operations coordination (coordinating with partners and fitting into the Incident Command Structure), healthcare recovery (continuity of operations during and post-disaster), communications (technology) and information sharing, responder safety and health, fatality management, and volunteer management. This is done through: Joint development of local and regional emergency operations plans (including creation and distribution of organization-level template plans, policies and procedures that meet regulatory requirements) Definition of various sector roles and responsibilities in an event (who to call for what) Development of memoranda of agreement between our partners to fulfill local staffing, equipment, supply and pharmaceutical needs in a patient surge or disaster Development and facilitation of local and regional multi-agency exercises Provision of education and training In an actual event, our members can contact TRIMRS to request assistance in securing resources and to provide situational awareness to other agencies. Is there a cost to be part of TRIMRS? No; not at this time. TRIMRS is funded through the State of Nebraska using federal grant funds. Why should a Long-Term Care facility consider being part of TRIMRS? Long-Term Care has many of the same needs for emergency preparedness and response as the hospitals do. It is important that Long-Term Care is at the table, so that both their needs and their capabilities can be recognized and considered during the planning process before a disaster or public health emergency affects them. In addition, many of the resources already developed for hospitals, such as template plans, agreements and exercises, can be altered to fit Long- Term Care, as well. Finally, Long-Term Care will benefit from participating in multi-agency exercises. How would Long-Term Care be involved in TRIMRS? At this time, TRIMRS is considering having Long-Term Care choose regional representatives, based on public health district geographical boundaries, to serve on the TRIMRS Steering Committee. Other Long-Term Care representatives can join capabilities-based subcommittees, per their own interest or expertise. I look forward to meeting you and discussing emergency preparedness further! Laura Meyers Tri-Cities Medical Response System ; lmeyers@kearneyfpa.com
2 TRIMRS Geographic Coverage County Hospital(s) within the County Health Dept. Emergency Mgmt. Adams Mary Lanning Memorial Healthcare South Heartland District Health Adams County Emergency Blaine Blaine County Emergency Buffalo CHI Health Good Samaritan/Richard H Young Hospital Two Rivers Public Health Buffalo County Emergency Kearney Regional Medical Center Clay South Heartland District Health Custer Callaway District Hospital Jennie M Melham Memorial Medical Center Dawson Cozad Community Hospital Two Rivers Public Health Gothenburg Memorial Hospital Lexington Regional Health Center Franklin Franklin County Memorial Hospital Two Rivers Public Health Garfield Gosper Two Rivers Public Health Greeley Hall CHI Health Saint Francis Central District Health Hamilton Memorial Community Health Central District Health Harlan Harlan County Health System Two Rivers Public Health Howard Howard County Medical Center Kearney Kearney County Health Services Two Rivers Public Health Loup Dept. Merrick Litzenberg Memorial County Central District Health Hospital Nuckolls Brodstone Memorial Hospital South Heartland District Health Phelps Phelps Memorial Health Center Two Rivers Public Health Dept. Sherman Valley Valley County Health System Dept. Webster Webster County Community South Heartland District Hospital Health Dept. Wheeler Clay County Emergency Custer County Emergency Dawson County Emergency Mgmt. Franklin County Emergency Garfield County Emergency Region 15 Emergency Greeley County Emergency GI/Hall County Emergency Hamilton County Emergency Mgmt. Harlan County Emergency Howard County Emergency Kearney County Emergency Loup County Emergency Region 44 Emergency Nuckolls County Emergency Region 15 Emergency Sherman County Emergency Valley County Emergency Webster County Emergency Wheeler County Emergency
3 TRIMRS ORGANIZATIONAL STRUCTURE The TRIMRS Steering Committee serves as the governing entity, responsible for development and execution of an annual work plan and preparation of a corresponding budget; it serves as the final decision making body for all activities and resource allocation. The TRIMRS Steering Committee is composed of hospitals, health departments, emergency managers, regional EMS representatives, Region 3 Behavioral Health and the Chairs of all subcommittees with each organization, regardless of size or function, having one vote. Meetings are held on a monthly basis, typically via telehealth technology, with periodic in-person meeting to for relationship development. TRIMRS considers relationship development to be a cornerstone of preparedness. The TRIMRS Steering Committee elects an Executive Committee that consists of a Chair, Vice-Chair, Secretary and Treasurer. In addition to the TRIMRS Steering Committee, the following subcommittees and advisory boards will meet on an as needed basis: Primary Focus Primary Focus Secondary Focus Primary Focus Medical Surge/EOC Combined Development of a Medical Surge Plan for the TRIMRS Health Care Coalition Pre-hospital and hospital surge coordination and management Continuous monitoring, offloading and on-loading of patients Risk assessment of potential surge Ability to provide no less than 20% immediate bed availability of staff members beds within 4 hours of an incident Rapid bed turnover/rapid discharge/transferring of lower acuity patients/deferral of electives and procedures Onloading through redeployment of resources for higher acuity admissions Tracking and documenting patient movement Healthcare Recovery Plan Development of a Healthcare Recovery Plan for the TRIMRS Health Care Coalition, which includes identification of critical services and key resources. Critical medical services (e.g. trauma, radiology, critical care, surgery, negative pressure, pediatrics, mental/behavioral health, EMS, decon, isolation) Critical medical support services (e.g. patient transport services, pharmacy, blood banks, laboratory, medical gas suppliers, mobile medical assets) Critical facility management services (e.g. power, water, sanitation, generators, heating, ventilation, HVAC) Critical healthcare information systems for information management/communication (e.g. failover and back-up, remote site hosting) Key health care resources (e.g. alternate care sites, staffing, equipment, beds, medical supply, PPE, pharmaceuticals) Post-disaster mental and behavioral health needs (risk-based estimates of potential mental healthcare needs, assessment of resources, process to obtain resources) Provide assistance to hospitals in developing COOP/BCP plan Communications/Information Sharing & Responder Safety and Health Combined Development (update) of an Information/Communication Plan for the TRIMRS Health Care Coalition Process to provide the status of resources (situational awareness TO membership) Process to provide the status of need (situation awareness FROM membership) Method to provide status (information management system, interoperable communications)
4 Primary Focus Identification of essential elements of information Development of a Resource Plan for the TRIMRS Health Care Coalition Protocols for resource management Protocols to receive and request resources that will provide pharmaceutical prophylaxis, and/or treatment and PPE to health care workforce (we have a lot of this) Protocol for assessing need and resource request process to fulfill need. Mass Fatalities Primary Focus Development or adoption of a Fatality Plan for the TRIMRS Health Care Coalition Develop plan for coalition OR Adopt the Nebraska DHHS Emergency Support Function Eight Mass Fatality Plan and Matrix Health Care System Preparedness Primary Focus Structure of the TRIMRS Health Care Coalition Discuss strategic planning process Review and amend policies and/or consider bylaws Set direction for future growth and sustainability Central Nebraska Medical Reserve Corps Advisory Council Primary Focus Oversight and direction of the Medical Reserve Corps Develop a strategic plan Review and amend policies Set direction for activities, growth and sustainability Exercise Design Team Primary Focus Development of Annual Exercise Regional exercises (objectives based upon contract deliverables) Individual hospital exercises, design and facilitation as requested Funding TRIMRS receives funding from the of Health & Human Services through the Hospital Preparedness Program grant (CFDA ), administered by the State of Nebraska of Health and Human Services.
5 TRIMRS Resources for our Members Many of the resources below were created for hospitals; however, most could be altered to be made applicable to long-term care facilities. Plans/Policies/Procedures/MOUs/Other: Medical Volunteer Hospital Plan Template Hospital Pandemic Influenza Plan Template Hospital CBRNE Plan Template Hospital Mass Fatality Plan Templates County Mass Fatalities/Mass Casualties Family Assistance Center Nebraska Emergency/Disaster Health and Medical Volunteer Plan Inter-Hospital Agreement for Resources (MOA) EMS Mutual Aid Agreement (MOA) Alternate Care Site Use Agreement (MOA) Hospital Alternate Care Site Plan Template Hospital Evacuation Plan Template Hospital Disaster Medical Record Central Nebraska Medical Reserve Corps Policies EMS Mass Casualty Incident Response TRIMRS Regional Plan Buffalo County Medical Table Plan Active Shooter Plan Checklist Plans/Policies/Procedures Actively in Development: Mass Fatalities Disaster Site Mass Fatalities Morgue Site Mass Fatalities Headquarters Hospital Rapid Discharge Pre-Hospital Regional Surge Planning Supplies/Equipment/Staffing: Inter-Hospital MOU (Staff, equipment, supplies, patient transfer) Local caches at area hospitals (mainly PPE) Mobile Medical Assets (Alternate Care Site equipment and supplies) Central Nebraska Medical Reserve Corps (Staff and mobile trauma trailer) ESAR-VHP (Staff) Education/Training: Incident Command for Hospitals Strategic National Stockpile Plan development workshops Ebola information Roles and Responsibilities Exercises: Pandemic Influenza/PanFlu Scramble Strategic National Stockpile Active Shooter Tornado Evacuation Ice Storm Evacuation/Shelter-in-Place Botulism Anthrax Transportation Evacuation Communications: Med 4 Radios Satellite Radio/Phones (GS and BMH) Emergency radio caches and mobile communications centers Ham radio operators/equipment TRIMRS Mass Notification Systems (to request help or provide situational awareness) Website (under construction) Facebook Disaster/Public Health Emergency Role: Liaison/Logistics: Assist in locating and arranging for hospital resources; situational awareness
6 As needed/requested
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