EMERGENCY PREPAREDNESS COALITION DOCUMENTSPopulation: 42,000 people, part of NSC EP Coalition
7 member volunteer board
MRC Coordinator and EP Coordinator
Weaving EP into everyday work
Website: www.nscalert.org
DPH Action Steps:
• Update working loading dock in EDS Database for Salem HS
• Send re -supply protocol and tactical communication pathways
• Discuss with legal MDPH personnel the notion of picking up meds for anyone,
not just family
• Confirm 2-1-1 process and what information they would give if questions are
specific to BOH; create a database for the towns and what information to have if
people need info (intern?)
• Obtain PIO JAS — either from Boston or elsewhere
• Create inventory management form
• Consider emailing manifests of inventory to local board of health before
distributing medications
• Re -visit the "triggers" or thresholds that will stop forms collection and alter
standards of care
• Salem is delivering to Group homes — utilize North Shore Arc
Action Steps:
General Action Steps:
• Provide a copy of "finalized" plan that was reviewed to CDC and MDPH
Baseline Data and Section 1
• Plan to meet with major employers — power plant, keyspan, housing authority,
police, fire, using a push method to distribute to populations
• Make plan more anthrax oriented
• Organize people by voting precinct to stagger people (in process)
o Think about staffing, parking, messaging, contacting elected officials,
security at polling places
o Conduct an exercise to test this plan out
• Continue to exercise pieces of the plan (i.e. communications, dispensing)
• Use paragraph from National Response Plan as sign -off page so that each agency
agrees to their roles in the EDS plan
• Think about volunteers other than MRC
• Fill ICS management teams .
• Design a map for signs (where they should go); conduct an exercise
• Conduct Planning/Advisory Meetings monthly/quarterly/annually — continue
expanding the planning group
• Incorporate Legal Issues from State —
o Initial push of medications, so process for requesting re -supply
o Re -supply protocol/flowchart
o Unaccompanied minor
o # of regimens for pick-up
o Identification requirements
o Use of force guidelines
o Badging
o Section 1.6 legal issues —
• Standing orders/Medical practitioners will be waived
■ Liability — significant protection for non -licensed volunteers; gray
area for licensed professionals; legislation is pending
Workers Comp/Staff Comp — legislation
Section 2
• Exercise call -down of leads in core management team; duties of planning chief
have already been outlined to include this
Section 3
• Determine who is the person and back-up who will request SNS re -supply to the
local EOC; let emergency manager know that and document in plan
Section 4
• Document Tactical Communication/IT lead
• Identify hardware that you have — radios, land -line, etc. and discuss the exercises
• Test tactical communication/redundant communication between EDS/BOH/Local
EOC
• Document staff trainings about radios/redundant communication equipment
o Develop JIT for tactical communications
Section 5
• Document PIC personnel
• Include PIO Job Action Sheets
• 5.5 and 5.6 — Fact sheets for the sites/maps of banners/category A agent fact
sheets
• Focus on pre -event preparedness and message mapping
Section 6
• Obtain a sign -off sheet of security and what they agree to/ or obtain
Section 8
• Document in plan how you want to maintain IMS
• Develop internal thresholds of when you order re -supply
Section 10
• Develop thresholds for forms collection and altered standards of care
o The form can fit 5 people on it
o Think about filling out forms on the bus, controlling flow
• Document plan for first responders/critical infrastructure
• Give group home information to DPH — number of beds and staff X3
• Reference and document where fact sheets (i.e. on category A agents) are and
which ones you are using
• Continue to develop Job Action Sheets and JIT for EDS positions
• Continue to work on care/feed plan for staff
Section 12
• Define training plan and maintain HSEEP guidance at regional level/coalition
level
o Have the basics — objectives, AAR, CAP, IP
Fill out chart at end of this section
MDMH Guide to Providing a Behavioral Health (BH) Response to an Emergency
Dispensing Site (EDS)
Overview: In the event of a biological event requiring the mass dispensing of medication there
might be a high level of unease and even the possibility of panic. Affected community members
will be directed to an Emergency Dispensing Site to receive medications. Crisis counselors can
be highly effective in defusing panic, freeing the medical pers
providing emotional support. The Massachusetts Department
encourages local public health agencies to address behavioral,
their local behavioral health partners. These partners includ'`6
services and members of the Medical Reserve Corps who iq,
and other elements of disaster behavioral health. However, if
during an event, DMH acts as a second tier respons&:group to
and emergency management. If called to respond to'a dispen
closely with the local and state public health authority.
Safety Concerns: Crisis Counselors and
in to provide assistance in a location that
would allow this. In a mass dispensing sc
contamination or infection to
Emergency Dispensing Site;(
Shift Staffing: At least ti
be assigned in four to six
counselors can prouide,st
At the site, at,least one;u<
responders. The other vc
the medibal Raff. At this
necessary.
volunteer,
should be
at injuries and
Health (DMH)
cerns by working with
ders of mental health
in
these resoura
rvthe needs of
tical first aid
overwhelmed
public health
'would work
health"pr' Uessionals should never be sent
highly un`lkely that first responders
)es not involve the danger of
iselors hould be deployed to the
V::
;Y
aged to each site, and ideally they should
tided for safety reasons and so that the
oniplbm Mary technical expertise, etc.) to each other
act as a floater to observe both the public and the
stationed either at the intake area, or complimentary to
eer can provide further assistance and triage if
Labeling and disaste „,behavioral health: It is believed that most people will not seek out
mental health assistancedn,Qhe wake of a major emergency or disaster event. Additionally, it has
been learned from previous responses that stigma surrounding asking for or accepting traditional
mental health services is�an impediment to providing disaster assistance. Due to this, DMH
discourages the listing of a resource or volunteers as "mental health." If there is a formal section
for disaster behavioral health provided at the site, the area should be labeled. "Emotional
Support" has been used as a preferred alternative term to "mental health." "Crisis Response" or
"Counseling Support" has also been used during events.
Quiet Space and Self-care: If possible, space should be provided so that crisis counselors may
provide emotional support and, if needed, perform mental health triage in (relative) private. This
space is often called the quiet room or quiet space. There should also be a separate private space
4/9/08
for all site volunteers to decompress and take breaks. Self-care should be encouraged at all times,
including getting appropriate rest, food and water.
Crisis Counseling - EDS: The goal of providing behavioral health support on-site is to assist
community members receiving medications at the Emergency Dispensing Site location in
making this process as trouble free and efficient as possible. As a member of the larger response
team, the job of crisis counseling is three -fold: 1) to assist in lessening the emotional impact the
incident, 2) to triage, with medical assistance, any individual(s) who are unable (mentally) to
participate in the dispensing process and may need a traditional mental health emergency
assessment for services and 3) to monitor the emotional health of the responders who are
working the site and may require on -the spot assistance th
may experience as part of their role. Having trained crisis
individuals are familiar with emergency management and
a disaster environment.
Behavioral Health Coordinator: The role of the co(
counseling volunteers. The coordinator also cornipin
with local emergency management, and any behavior
Throughout the response the coordinator should man
of the response. Back-up staff should be called in for
If providing a face -to face service is not P- 9'16
family assistance centers, EDS or providing in -pc
is a need for shelter in place or if response in per;
h"l
emotional support hotline and telephone counseli
w
again be high priority for monitoniigand crisis c(
24/7 in the Commonwealtlirto i)rovi& both crisis
mental health clinicians that
callers for emereencv=,needs
Exit Interview: All BH]
defusing session with a
to
to
would
Re`to, increased stress they
is recommended, as these
e,challenges of working in
is to manag&'Ih7 see crisis
ith the staff on tl'eseround, works
igencies,,,as necessary.
a=`
�heduling, and oversight
is also critical.
m dangers, setting up
not be feasible. If there
t the volunteer at risk, setting up an
critical. First responders will
;. Currently, MassSupport is available
ng via telephone and is staffed by
assessments over the phone to triage
should have the opportunity to take part in a
nal familiar with disaster response.
4/9/08 2
HUS-G
a
medical
reserve 9e c 1 os
corps
MA Region 4A MRC Mental Health Disaster Response Planning Committee Mission:
To Organize the MRC Mental Health in Disaster Response Team is the mechanism through which
volunteer psychologists and other Mental Health Professionals respond to local and national disasters
and other traumatic events and to volunteer their professional skills to individuals, families and
communities.
The functions MRC Mental Health in Disaster Response Team include:
1. Providing volunteer Mental Health support to communities within MA Region 4A effected by
trauma, crisis and disaster;
2. Providing access to disaster mental health training for its members;
3. Supporting members in their provision of trauma-related services;
4. Upholding professional standards of disaster mental health care; and
5. Coordinating collaboration with other organizations providing trauma and disaster relief
services
6. Bring this training to all Region 4A MRC volunteers at the local level
The primary function of the MHDRPC is to facilitate joint activities with the Medical Reserve Corps,
American Red Cross and other local disaster response services. A variety of relationships will be
developed at the state level between the Red Cross and State, local and Commonwealth Psychological
Associations. The relationships are determined and developed by MA Region 4A.
Activities on the local level include local disaster relief operations and to work with a variety of
community and partner with national organizations in providing disaster mental health services.
These Guidelines have been prepared at the direction of The MA Region 4A Disaster Response
Planning Committee.
The Role of Mental Health in Disaster Response:
• Regional Mental Health contact list
• Periodic regional summits
• Disaster mental health specific training events for Region 4A
• Collaboration among Region 4A Communities in the development of coherent, robust, and
ultimately useful nominal mental health disaster plans.
Collaboration and communication with the Emergency Response and Emergency Management
communities
wu w.rne ficalreservecorps.Aov • ww u.region4a-mrc.org • wu w.region4a.org
a
medicol
reserve 94 Q' a?
corps
Training for MRC Metal Health Professionals:
• Tabletop scenario exercises for Region 4A that involve mental health.
• Role play disaster drills for scenarios that include bioterrorism decontamination units and
victim debriefing.
• Research and collaboration for best -practices mental health preparedness & response
programs that can be adapted for a variety of emergency/disaster scenarios.
• Initiation of a disaster mental health volunteer database spanning MA Region 4A.
• Certification and training for non-traditional mental health responders, such as faith -based
community leaders.
Resources:
http://www.dmh.missouri.Eov/diroffice/disaster/disaster.htm
http://www.bt.edc.gov/disasters/volunteers.asp
http://www.empowermentzone.com/disaster.txt
http://www.apa.org/practice/drnguide.htmi
http://www2a.cdc.gov/phtn/webcast/stress-05/TrainingW orkbookstress-edity l.pdf
http://www.apsu.edu/oconnort/3430/3430lect07a.htm
http://www.searo.who.int/LinkFiles/List of Guidelines for Health Emereency community level-
workers.pdf
http://neptsd.va.aov/ncmain/nedoes/fact shts/fs self care disaster.html?printable-template=factsheet
Video Clips:
http://www.istss.ore/video/video2.cfm
http://youtube.com/watch?v=AOSa7vycGsk (this is a political movie but the picture are very moving, interesting song
hftj):Hvoutube.com/watch?v=inqCZybaVeY
http://youtube.com/watch?v=KVNitafk5Os
http://youtube.com/watch?v=-RFSKsbXYEc
www.med'cafreserveco!ls.goy• unvw.region4a-mrc.org. wwm.region4a.org
Letter of Agreement
The Emergency Dispensing Site Management and Operations Plan (EDS Plan) is an all -discipline plan
that establishes a single, comprehensive
framework for the management of dispensing medication within 48 hours of notification by the
Massachusetts Strategic National Stockpile (following a 24 hour ramp -up period) of the requirement to
dispense medication to Salem residents.. It provides the structure and mechanisms for the
coordination of State support to local incident managers and for exercising local public health and
municipal authorities.
By signing this letter of agreement, Salem government departments and agencies and other
organizations commit to:
■ Supporting the EDS concepts, processes, and structures and carrying out their assigned functional
responsibilities to ensure effective and efficient incident management;
■ Designating staff to fill Incident Command positions;
■ Providing cooperation, resources, and support to the Site Coordinator in the implementation of
the EDS Plan, as appropriate and consistent with their own authorities and responsibilities;
■ Utilizing department- and agency -specific authorities, resources, and programs to facilitate incident
management activities in accordance with the EDS Plan; and
■ Participating in exercises, and refining department/agency capabilities to ensure sustained operational
capabilities.
Signatory departments and agencies follow: