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U.S. Department of Homeland Security How Healthcare Providers and Plans Can Work With FEMA To Make Emergency Response Successful National Emergency Management Summit New Orleans, Louisiana March 5, 2007 Glenn M. Cannon Director, Response Division Federal Emergency Management Agency

Lead the Federal Government s response to emergencies and major disasters, natural and man made, including acts of terrorism All-Hazards FEMA Mission Save lives Protect property Ensure basic human needs are met 2

NIMS and NRP National Incident Management System (NIMS) Standardized process and procedures for incident management Incident NIMS aligns command & control, organization structure, terminology, communication protocols, resources and resource typing to enable synchronization of efforts in response to an incident at all echelons of government Healthcare Community Local Support or Response State Support or Response Federal Support or Response DHS integrates and applies Federal resources both pre- and post-incident Resources, knowledge, and abilities come from independent Federal Departments and Agencies National Response Plan (NRP) Activation and proactive application of integrated Federal resources-activated for Incidents of National Significance 3

Disaster Response Emergency/Disaster FEMA Regional Operations Local State Federal Emergency Support Functions Joint Preliminary Damage and Needs Assessment Local Mayor/County First Executive Alert Requests Governor Responders Aid from Activate Local EOC Activate local EOC and coordinate with local public health, medical, volunteer, and other organizations Activate State EOC Provides Emergency Supports Sets Up Response Team Joint Field Office Joins Informs Governor Declares State Emergency/ Disaster Gov. Requests Emergency/Major Disaster Declaration PFO, FCO, SFLEO State Coordinating Officer DHS/FEMA Regional Director Appoints Reports To DHS Secretary/ FEMA Director Disaster Declaration IIMG, NRCC, OFA s Contacts President of the United States 4 9

Disaster Response Support 5

Hurricane Katrina Deadliest U.S. Hurricane since 1928 with more than 1,300 fatalities. Winds reach 175 mph Over 1 million evacuated from Florida, Alabama, Mississippi, Georgia and Louisiana 1,470 personnel and teams pre-positioned or enroute prior to landfall 1,232 Truck Trailers of commodities staged throughout the Gulf Coast prior to landfall Only 3 of 16 hospitals in New Orleans were open after the storm Lost Big Charity (largest New Orleans medical center and only Level 1 Trauma Center) with its capability to treat 144,000 emergency room patients/407,000 out patients annually In Mississippi 40 % of the 775 medical clinics and individual medical practices were closed or only offered limited services 5,944 patient-care physicians in the 10 counties and parishes affected by the flooding were displaced 6

Hurricanes Katrina and Rita Overview FIRST time the US government evacuated US citizens on US soil: 220,000 to 230,000 citizens were evacuated by boat, air, bus, and train in 5 days The largest air evacuation operation on US soil in US History The largest disaster response deployment of US Military forces on US soil The largest bus fleet assembled in US in a 4 day period of time FIRST use of the National Defense Reserve Fleet. FIRST use of all NDMS components in response to a Catastrophic Event: 163,000 + Patients treated (72,420 for Immunizations); 15,658 Animals Treated 9,740 patients were treated during the 2004 hurricanes FIRST use of NDMS patient evacuation system for a mass casualty event in US: 5,059 patients and 700 litter patients evacuated by NDMS and DOD FIRST time all 28 Urban Search and Rescue Task Forces deployed: 6,538 rescues--katrina response was 5.75 times greater than 2004 hurricane responses FIRST time mandatory evacuation ordered in New Orleans. FIRST time Foreign nations (130 nations) offered aide to US disaster victims. Logistics -- 4,245 truckloads of supplies delivered in first 6 days to Katrina -- 3,703 truckloads over 7 weeks to multiple hurricanes in 2004 7 28

Hurricane Katrina Lessons Learned Federal-level review led by President s Homeland Security Advisor Assessed the Federal response Issued report in February 2006 with lessons learned and recommendations: 17 Executive Branch Challenges 125 Specific Recommendations for Federal departments and agencies 14 Critical Actions for immediate correction Other After Action Reports and Analyses DHS Inspector General General Accountability Office Congressional Internal 8

Functional Areas Identified for Improvement Operational Response Doctrine, Policies and Procedures Operational Response and Team Capabilities Interagency and Intra-agency Coordination Common Operating Picture, Situational Awareness, and Deployable/Interoperable Communications Logistics Enterprise and Resource Tracking Improved Business Practices/Private Sector Involvement Disaster Surge Workforce Catastrophic Planning Victim Assistance, Registration, Housing, and Care Debris Removal 9

Future Vision for FEMA FEMA-The Nation s Preeminent Emergency Management Agency Leader and model agency in developing emergency management competencies at all levels of government Actively reducing the impact of all-hazard events on the Nation Ready and capable of supporting all-hazards incident management, recovery, mitigation and continuity programs Strengthened disaster response operational competencies Leveraging capabilities of DHS components Credible and respected at the inter-agency level, by State and Local governments, industry and non-governmental organizations 10

Successful Emergency Response Building successful emergency response capabilities requires: Detailed planning in advance of events Focused training and exercises Development and continual refinement of disaster response procedures, and capabilities with adequate staffing and equipment 11

Planning Should Be Contingency Based Flood Earthquake Tornado Hurricane Typhoon Landslide Tsunami Ice Storm Drought Wildfire Disease Epidemic Chemical Spill Utility Outage Transportation Accident Industrial Accident Radiological Incident Nuclear Incident Explosion Accidental Natural Strike Protest Domestic Effects of War Public Demonstration Nation-State Attack Civil Disturbance Mass Migration Civil / Political Terrorist / Criminal CBRNE Attack Cyber Attack Other Terrorism Inaugural State of the Union Olympics Major Sporting Event Summit Conference Special Event / Special Security Event 12

Pandemic Influenza Planning Initiative Supports National Strategy for Pandemic Influenza and the HSC Interagency Implementation Plan Each Federal department is required to develop supplemental contingency/operational plans to address its operational approach to: Protect the health of employees Maintain essential functions and services Support Federal response and that of States/communities Communicate to stakeholders 13

Successful Emergency Response Plan ahead--coordinate closely with your local emergency management and public health authorities Participate in local hazard and risk assessments Conduct realistic capacity assessments Establish close working relationships and mutual aid agreements in the community Participate in the development and implementation of comprehensive EMS plans and implementation of regional protocols for the triage, treatment, transport and transfer of patients. Know what equipment and supplies you have, what you need, and where it is coming from 14

Successful Emergency Response Acquire resources and develop your own surge capacity Share your plans with EVERYONE! Participate in the planning, design, and conduct of exercises Conduct after action briefings---listen to what others tell you---institute corrective actions Exercise your plans after changes are made Develop risk communications/public affairs strategies Remember, if it doesn t work during an exercise it won t work in the real event Consequences of Complacency It can t happen here! 15

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