Draft for discussion only.

1
Draft for discussion only.  This document is not
for general distribution and has not been
approved by any agency or entity.No further /
external distribution is authorized
2
Health and Medical Surge Capacity
Draft

• Part I Concept of Operations

3
Surge Capacity

• Patient care (includes EMS private healthcare)
• Epidemiologic investigation
• Risk communication (coordination with PIOs)
• Mass prophylaxis or vaccination (coordination of
  local health department plans )
• Mass fatality management (medical examiners)
• Other activities (hospice, facilities)
• (To completed later) behavioral health

4
The Process

• Based on previous work, including the COG
  Planning Guidance for Health System Response to
  a Bioevent (9/6/01) and other plans (State
  Health Plans, Federal Plans)
• This team was appointed by the SPG to create a
  surge plan
• Led by State Health Departments with active Local
  and Federal participation. Invited participation
  from all sectors of health and medical arena

5
So far

• Focused on tri-State and multi-jurdistionals
  system linkages with medical partners
• At each level of event description of how
  medical information is evaluated, and by whom
• Description of how medical hypothesis generated,
  and what officials are involved
• Analysis of information gathered and disseminated
  methods

6
Now

• The states have developed detailed systems and
  solicit, evaluate and support input from local
  responders and partners
• Limited distribution for comments until April 29
• To read the full document, visit
  www.MWCOG.org/committee/committee/default.asp?COMM
  ITTEE_ID182 and select Documents
• Submit comments to health_at_mwcog.org

7
The Players

• 3 states
• 5 Virginia Counties
• 3 Maryland Counties
• 40 hospitals
• Assorted Cities
• Seat of Federal Government
• Independent Healthcare Providers
• NCR Health Information Group
• Representatives of Hospice, Private Practice
  Medicine, and Other Medical Partners
• Representatives of the State and local EMS

8
Purpose

• Coordinate the emergency response activities of
  the health care systems which make up the
  National Capitol Region during a natural or
  man-made catastrophic event
• The next edition will incorporate progress on the
  interoperability grant

9
The Health Information Group Does NOT

• Replace, supersede or dictate the response of
  sovereign jurisdictions
• Drill down to implementation level standards and
  benchmarks

10
The Health Information Group Does

• Pull decision makers together
• Facilitate communication, and
• Facilitate coordination of decision making

11
Health Information Group
Info shared
Coordination by State/District Health Directors
Info shared
Info shared
12
Response System

• Tiered system
• Based on US HHS handbook (Medical Surge Capacity
  and capability august 2004)
• Adapted to fit the NCR conditions

13
6 Tiers

• Management of Individual Healthcare Assets
  focus on local events
• Management of Healthcare Coalition when an
  event affects more than one jurisdiction
• Jurisdictional Incident Management
• Management of State Response
• Interstate Regional Management Coordination
  when the entire region is affected
• Federal support to state and jurisdiction
  management national emergency

14
Public Health

• A government function
• Provide and where appropriate, coordinate
• Planning
• Assessment
• Direct medical care where none other exists
• Assurance that appropriate health care services
  are being provided
• State/District Health Directors coordinate the
  response to public health emergencies
• Public health is woefully understaffed (about
  2,000 in NCR)

15
State Systems

• Each state system is unique, but in all cases a
  large part of the legal public health
  responsibility is primarily at the state level
  rather than at the local jurisdictional level
• Many decisions are made at the state level
• The federal government communicates and
  coordinates through state health departments

16
Private Health Care

• Where most medical care occurs
• Willing partners with public health
• Operate independently under standards of care.
• Often first to report emerging disease or
  problem
• Major concern is surge capacity and capability
  beds, equipment, supplies, medications, space and
  staff, and ability to meet specialized needs
  (burns, pediatrics, etc.)

17
Emergency Medical Services detained descriptions
covered in EMS-ESF

• Scene triage
• Scene treatment
• Transportation
• Inter-facility transport (when possible)
• Scene management
• Certain patient care supplies
• Coordination of definitive care resources
• Support to health care system
• Documentation of patient care records

18
Behavioral Health

• This section to be developed by behavioral health
  surge committee
• Normal reaction to an abnormal situation--provide
  information and assistance
• Serious reactions --provide treatment

19
Medical Examiners

• Identify deceased
• Examine deceased
• Provide services for the dead and their families
• Each state will follow own plan
• Memoranda of understanding being developed

20
Coordinated With

• US DHHS Medical Surge Capacity and Capability
• NIMS
• NRP
• 15 scenarios
• Additional tools, standards and guides as they
  become available

21
Next

• Final sign off from state health departments
• Present to SPG
• Provide hard copies and/or CD versions to EOCs
  and partners
• Post partial version on open website?
• Part 2 benchmarking and gap analysis
• Develop plans to fill the gaps