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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: