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Louisiana Department of Health Emergency Response Overview
Mardrah Starks-Robinson, MPA, Esq.
Bureau of Community Preparedness
Presentation Objectives
• Describe the structure of emergency response in Louisiana.
• Describe the structure of LDH emergency response.
• Describe the purpose and functions of the LDH EOC.
• Describe specific LDH emergency response activities.
• Provide strategies as Rural Health Clinics move forward implementing the CMS Requirements.
LDH Emergency Response Overview
Why is it important to have these discussions?
LDH EOC Concept of Operations
*Taken from the RAND Corporation.*
STATE RESPONSE OVERVIEWLDH Emergency Response Overview
LDH Emergency Response Overview
Louisiana Emergency Response Organization
• Statewide emergency response is coordinated by the Governor’s Office of Homeland Security and Emergency Preparedness (GOHSEP) through the State Emergency Operations Center (SEOC).
• The SEOC includes 16 emergency support functions (ESFs), each represented by a lead state agency.
• Response operations (evacuation, sheltering, etc.) usually involve multiple agencies, each coordinating with an agency EOC, which in turn coordinates with the state EOC through an ESF.
• Each of the 64 parishes has an Office of Homeland Security and Emergency Preparedness (OHSEP) which manages local emergency response and coordinates directly with the state EOC.
LDH Emergency Response Overview
Emergency Support Functions
ESF-1 Transportation
ESF-2 Communications
ESF-3 Public Works
ESF-4 Firefighting
ESF-5 Emergency Mgmt.
ESF-6 Mass Care & Housing
ESF-7 Resource Support
ESF-8 Public Health & Medical
ESF-9 Search & Rescue
ESF-10 Oil Spill & HazMat
ESF-11 Agriculture
ESF-12 Energy & Utilities
ESF-13 Public Safety & Security
ESF-14 Community Recovery
ESF-15 Public Information
ESF-16 Military Support
LDH Emergency Response Overview
ESF-8 Response Organization• LDH is the lead agency for ESF-8 (Public Health and Medical)
• The Secretary has appointed the State Health Officer (SHO) as the lead for LDH emergency response. The SHO is assisted by the LDH Executive Director of Emergency Preparedness.
• The State Health Officer coordinates LDH response operations through the ESF-8 Network and the LDH Emergency Operations Center (LDH EOC).
• The ESF-8 Network is composed of Designated Regional Coordinators (DRCs) in each LDH Region who represent community response partners such as hospitals, nursing homes, EMS providers, and other medical disciplines. Also, LDH staff within the regions Public Health Emergency Response Coordinators and Hospital Nurse Coordinators are a part of this network.
• The LDH EOC coordinates response activities carried out by LDH staff in the nine regions.
Louisiana Response Organization
State EOC
ESF Lead
Agency EOC
Response Operations
ESF Lead
Agency EOC
Response Operations
Parish OHSEP
Local Response Operations
LDH Emergency Response Overview
Rural Health Clinics
ESF-8 Response OrganizationESF-8 Command
LDH EOC
R1 Regional Command
R2 Regional Command
R3 Regional Command
R4 Regional Command
R5 Regional Command
R6 Regional Command
R8 Regional Command
R9 Regional Command
R7 Regional Command
Response Operations
Response Operations
Response Operations
Response Operations
Response Operations
Response Operations
Response Operations
Response Operations
Response Operations
DRC Network
State EOC
• 9 Regional Commands• NIM-ICS
ESF-8 Organization | State EOC
ESF-8
LDH
EMS LSU HospitalsLA Nursing
Home AssocLA Hospital
AssocLDH Health Standards
LDH EOC
SEOC Operations Section
Human Services Branch
ESF-6
DCFS
LouisianaState Emergency
Operations Center
Regional ESF-8 Network – Planning• Public Health Emergency Response Coordinator
(PHERC)
• Hospital Nurse Coordinator (HNC)
• Hospital Designated Regional Coordinator (DRC)
• Emergency Medical Services Designated Regional Coordinators (DRC)
• Home Health Designated Regional Coordinator (DRC)
• Nursing Home Regional Designated Coordinator (DRC)
• Other Health Partners
LDH EOC Concept of Operations
Why are these networks needed?
LDH EOC Concept of Operations
POP QUIZ!!
What is ESF-8?
Who is the lead agency?
REQUESTING SUPPORTLDH Emergency Response Overview
LDH Emergency Response Overview
Requesting Support | Parish to State
State EOC
Emergency Support Function
Agency EOC
Parish OHSEP
1. Parish OHSEP requests support from the state.
2. State EOC assigns request to appropriate ESF.
3. ESF sends request to agency EOC
4. Agency EOC provides requested support through regional or parish staff.
LDH Emergency Response Overview
Applicable to Rural Health Clinics
LDH EMERGENCY OPERATIONS CENTER
LDH Emergency Response Overview
LDH Emergency Response Overview
Purpose of the LDH EOC
• Coordinate the emergency response activities of LDH agencies.
• Provide access to needed resources for LDH response activities.
• Coordinate with overall state emergency response activities through the state emergency operations center as a part of Emergency Support Function 8 (ESF-8): Public Health and Medical.
LDH Emergency Response Overview
LDH Emergency Operations Center
Organization
• Divided into five sections according to NIMS - ICS.
– Command
– Operations
– Logistics
– Admin-Finance
– Planning
• Each section is responsible for specific response activities, as well as fulfilling requests for resources from various entities.
LDH Emergency Response Overview
LDH Emergency Operations Center
Incident Commander
Operations Logistics PlanningAdmin
Finance
EOC Manager
Public Information
Safety Officer
Deputy ICICS Structure
LDH Emergency Response Overview
LDH EOC Concept of Operations
WHO AM I?
I direct the emergency activities at the Emergency Operations Center.
LDH EOC Concept of Operations
RESPONSE OPERATIONSLDH Emergency Response Overview
LDH Emergency Response Overview
ESF-8 Response Operations• Medical Special Needs Shelters (MSNS)
– A shelter for persons with medical monitoring needs that cannot be adequately supported in a general shelter. A minimal level of care available; an MSNS is not appropriate for shelterees requiring hospital-level care.
– LDH staff serve in both medical and non-medical roles in an MSNS.
– MSNS are generally activated in LDH Regions 2, 6, 7, and 8. MSNS sites have been identified in all nine regions, however, and can be activated as needed.
– This is a joint operation with ESF-6 (Mass Care) for which the Department of Child and Family Services is the lead agency. ESF-1 (Transportation) and ESF-13 (Security) also provide support.
Federal Medical Stations (FMS)– An FMS is a federally staffed and equipped medical special needs shelter. FMS are
associated with a specific MSNS and are integrated into that command structure.
– FMS personnel are drawn from the U.S. Public Health Service (USPHS) and Federal Disaster Medical Assistance Teams (DMAT). Generally, the only LDH staff in an FMS is a liaison.
– FMS are supported by ESF-8 through the associated regional MSNS.
– FMS sites have been identified in LDH Regions 2, 6 (two sites), and 8.
LDH Emergency Response Overview
ESF-8 Response OperationsTransportation Triage
– Buses carrying medical special needs evacuees departing from the southeastern part of the state are routed through Transportation Triage, which is located at LSU in Baton Rouge.
– This operation evaluates medical special needs evacuees for fitness to travel to more distant shelters. Triage teams board the buses and briefly assess each evacuee.
– Those deemed unable to make a longer journey are sheltered at the Region 2 MSNS at LSU, or transported to a hospital, as appropriate.
– LDH staff serve on medical triage teams or in support roles such as coordinating transport for evacuees removed from the buses.
– This is a joint operation with ESF-6 (Mass Care) and ESF-1 (Transportation).
LDH Emergency Response Overview
ESF-8 Response OperationsPoint of Dispensing (POD)
– A POD is a location where the public can receive antibiotics or vaccines to prevent illness during a widespread disease outbreak or after exposure to a biological agent.
– An Open POD is where the general public can receive medication. These PODs are usually operated by the parish.
– A Closed POD serves a particular population (such as the staff of a hospital, or the employees and families of a private business).
– A First Responder POD provides medication to personnel responding to the incident.
– LDH staff assist in the operation of Open and First Responder PODS.
– A Receiving, Staging and Storage (RSS) site is a medical warehouse often activated in conjunction with POD operations. This is a joint operation with ESF-13 (Security) and, in some cases, with ESF-16 (Military Support).
LDH Emergency Response Overview
ESF-8 Response OperationsMedical Institution Evacuation Plan (MIEP)
– The MIEP concerns the evacuation of hospitals or other medical facilities.
– Patients at facilities threatened by a disaster are transported to out-of-state hospitals in the National Disaster Management System (NDMS) (via military aircraft).
– Evacuating patients are transported by ambulance to Aero-medical Marshaling Points (AMPs) at designated regional airports for evacuation on military transport aircraft or federally-contracted air ambulances.
– This involves multiple ESFs, including ESF-16 (Military Support) and the U.S. Department of Defense.
LDH Emergency Response Overview
Temporary Medical Operations and Staging Area (TMOSA)
– A field hospital, able to care for a higher acuity level of patient than an MSNS, though not at the level of a full hospital.
– TMOSA are activated post-incident in areas where hospital services are limited or non-existent.
– TMOSA are usually opened in conjunction with search and rescue operations
Search and Rescue Base of Operations (SARBOO)
– A SARBOO is the command post and staging area for search and rescue in a disaster area. Rescued individuals are transported from the SARBOO to shelters.
– The LDH part of the operation provides medical evaluation and urgent medical care for rescued individuals.
– LDH fulfills primarily medical roles at a SARBOO.
– This is a joint operation with ESF- 9 (Search and Rescue), led by LDWF.
ESF-8 Response Operations
LDH Emergency Response Overview
WHAT AM I?
I can be open or closed. Persons can receive antibiotics or vaccines in me to stop illness during a widespread disease outbreak.
LDH EOC Concept of Operations
DO YOU SEE AN OPPORTUNITY FOR YOUR RURAL HEALTH CLINIC TO SUPPORT ESF-8 OPERATIONS?
LDH EOC Concept of Operations
MOVING FORWARD….Navigating CMS Preparedness Rules
LDH Emergency Response Overview
17 Effected Provider-Types Nationally Adult Day Health Care Immediate Care Facilities for Individuals with
Intellectual Disabilities (ICF)
Ambulatory Surgical Centers (ASC) Long Term Care Facilities (LTC) – Skilled Nursing Facilities (SNF)
Community Mental Health Centers (CMHC) Organ Procurement Organizations (OPO)
Comprehensive Outpatient Rehabilitation Centers (COR)
Outpatient Physical Therapy – Speech Pathology
Critical Access Hospitals Programs of All- Inclusive Care for the Elderly (PACE)
End Stage Renal Disease Centers (ERSD) Psychiatric Residential Treatment Facilities
Home Health Agencies (HHA) Rural Health and Federally Qualified Health Centers
Hospice Transplant Centers
Hospitals
Where is your organization on the preparedness cycle?
LDH EOC Concept of Operations
Moving Forward…
• Connect with partners to leverage resources and get input for:
– Community Risk Assessment / HVA
– All-hazards planning
– Exercise involvement
• Tap into the Regional ESF-8 Network for:
– Resources
– Insight
– Partner Meetings
Moving Forward….
• Assemble an Implementation Team within your organization to work through the requirements and develop a plan of action.
• Start Documentation Review. Your organization may have some of the planning documents. Review them to ensure they meet the standards.
• Conduct or participate in a risk assessment. Helpful in understanding what you are planning for and that threats that will have the biggest impact on your organization.
– OPH will conduct Jurisdictional Risk Assessments in late 2018.
Incorporate Emergency Preparedness into Regular Practice…
• Organization Incident Management Team
• Ongoing drills and exercises– Staff call-down drills.
• Emergency preparedness presentations at staff meetings
• Knowledge is Power! Emergency preparedness training for all staff.
• FEMA Courses for staff– FEMA Training IS-100
– FEMA Training IS-200
– FEMA Training IS-700
– FEMA Training IS-800
Use a phased in approach….
Risk Assessment Exercise
• In groups of 3-4, consider and list five potential hazards for rural health clinics. Be ready to explain your rationale.
LDH EOC Concept of Operations
Take Homes…
• Connect to your regional network.
• Emergency Preparedness is becoming even more critical and Rural Health Centers play a vital role in a community’s response and recovery
• Emergency Preparedness must become an integral component of the organization.
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7
6
5
42
9
3 1
8
Plaquemines
St. Bernard
Orleans
Lafourche
Jefferson
St.
Charles
St. John
the BaptistSt.
JamesAssumption
Terrebonne
St. Mary
St. Tammany
Washington
TangipahoaLivingston
St. Helena
East
Feliciana
East Baton Rouge
West
Feliciana
Pointe
Coupee
West
Baton
Rouge
Iberville Ascension
St.
Landry
St. Martin
Iberia St.
MartinVermillion
Lafayette
Acadia
EvangelineAllen
Jefferson
Davis
Cameron
Calcasieu
Beauregard
Avoyelles
Concordia
CatahoulaLaSalle
Rapides
Grant
Winn
Vernon
NatchitochesSabine
DeSoto
Jackson
Caldwell
Ouachita
Lincoln
FranklinTensas
Madison
West
Feliciana
MorehouseUnion West
CarrollEast
Carroll
Bienville
Claiborne
Webster
Bossier
Caddo
Red
River
Region 1
ADM: VACANT 225-458-3313
PHERC: VACANT 225-485-6322
OPH MD: [email protected] 337-581-5847
Orleans MD: VACANT (504) 658-4000
H-DRC: [email protected] 504-235-7193
H-DRC: Brenda Bankston [email protected]; 504-228-3209
A-DRC: Cindy Davidson [email protected] 225-939-1313
E-DRC: [email protected] 504-234-7193
E-DRC: [email protected] 504-250-2378
Region 9
MD: [email protected] 225-329-5919
PHERC: [email protected] 985-320-0753
H-DRC: [email protected] 985-290-2642
E-DRC: [email protected] 985-974-4000
[email protected] 985-320-3944
Region 2MD: [email protected] 225-342-2655
PHERC: VACANT 225-354-5649
H-DRC: [email protected] 401-338-7582
[email protected] 225-572-9658
E-DRC: [email protected] 225-931-1903
E-DRC: [email protected] 225-454-0039
Region 3
MD: [email protected] 512-887-0130
PHERC: [email protected] 985-855-2492
H-DRC: [email protected] 985-804-5275
H-DRC: Kim Beetz - [email protected] 985-413-2859
E-DRC: [email protected] 985-637-0695
E-DRC: [email protected] 985-791-7496
Region 4
MD: [email protected] 337-581-5847
PHERC: [email protected] 337-380-1922
H-DRC: [email protected] 337-319-7710
[email protected] 337-570-4230;[email protected]
337-374-1253
E-DRC: [email protected] 337-278-1268
E-DRC: [email protected] 225-718-2286
Region 5
MD: [email protected] 225-573-6275
PHERC: [email protected] 225-614-5051
H-DRC: [email protected] 337-274-2898
H-DRC: [email protected] 337-563-6403
H-DRC: [email protected] 337-570-4230
E-DRC: [email protected] 337-912-2668
[email protected] 337-316-2974
[email protected] 337-302-9275
Region 6
MD: [email protected] 318-542-9790
PHERC: [email protected] 318-613-2854
H-DRC: [email protected] 318-664-0843
E-DRC: [email protected] 318-541-6395
[email protected] 318-290-0447
Region 7
MD: [email protected] 225-247-4988
PHERC: [email protected] 225-252-3045
H-DRC: [email protected] 318-465-9500
E-DRC: [email protected] 318-464-7995
E-DRC: [email protected] 318-422-4226
Region 8
MD: Vacant
Assist. Admin: [email protected] 318-475-1789
PHERC: [email protected] 318-366-5828
A-DRC: [email protected] 318-348-7096
E-DRC: [email protected] 318-355-0498
1. Parish Directors can be found at this link:
http://gohsep.la.gov/parishoepnumbers.aspx
Code:ADM – Regional Administrator
MD – Regional Medical Director
PHERC – Public Health Emergency Response Coordinator
H-DRC – Hospital Designated Regional Coordinator
A-DRC – Administrative Hospital Designated Regional Coordinator
EMS-DRC – EMS Designated Regional Coordinator
GOHSEP [email protected] 225-938-8049
225-938-8059
DHH EOCDoris [email protected] 225-202-2336
[email protected] 225-329-6063
318-518-2796
EMS [email protected] 225-610-2588
[email protected] 337-298-3806
ESF8 Network – May 2018
Contact Information
Mardrah Starks-Robinson, MPA, Esq.Deputy Director
Bureau of Community PreparednessOffice of Public Health
Email: [email protected]: 225.354.3511
QUESTIONS?LDH Emergency Response Overview
LDH Emergency Response Overview