Louisiana Department of Health Emergency Response...

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.

37

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: Tina.Stefanski@la.gov 337-581-5847

Orleans MD: VACANT (504) 658-4000

H-DRC: Denice.Eshleman@lcmchealth.org 504-235-7193

H-DRC: Brenda Bankston bbankston@ochsner.org; 504-228-3209

A-DRC: Cindy Davidson Region1adrc@gmail.com 225-939-1313

E-DRC: Fgraff@ejgh.org 504-234-7193

E-DRC: Wtsalmeron@nola.gov 504-250-2378

Region 9

MD: Gina.Lagarde@la.gov 225-329-5919

PHERC: Thomas.Jordan@la.gov 985-320-0753

H-DRC: Region9DRC@yahoo.com 985-290-2642

E-DRC: Dmeche@acadian.com 985-974-4000

Tjacobsen@acadian.com 985-320-3944

Region 2MD: Parham.Jaberi@la.gov 225-342-2655

PHERC: VACANT 225-354-5649

H-DRC: Richard.Boyer@ololrmc.com 401-338-7582

Connie.Deleo@brgeneral.org 225-572-9658

E-DRC: pbrocato@acadian.com 225-931-1903

E-DRC: rtaylor2@acadian.com 225-454-0039

Region 3

MD: chip.riggins@la.gov 512-887-0130

PHERC: Kayla.Guerrero@la.gov 985-855-2492

H-DRC: Percy.Mosely@tgmc.com 985-804-5275

H-DRC: Kim Beetz - Region3DRC@yahoo.com 985-413-2859

E-DRC: Cdavis@acadian.com 985-637-0695

E-DRC: gnaquin@acadian.com 985-791-7496

Region 4

MD: Tina.Stefanski@la.gov 337-581-5847

PHERC: Karen.Buroker@la.gov 337-380-1922

H-DRC: Donald.simon@lourdesrmc.com 337-319-7710

lharmon@lgh.org 337-570-4230;cstegeman@lgh.org

337-374-1253

E-DRC: eburleigh@acadian.com 337-278-1268

E-DRC: tyler.traweek@acadian.com 225-718-2286

Region 5

MD: Bertrand.Foch@la.gov 225-573-6275

PHERC: Mike.Parent@la.gov 225-614-5051

H-DRC: Jeron.Kyle@christushealth.org 337-274-2898

H-DRC: Rfavre@wcch.com 337-563-6403

H-DRC: lharmon@lgh.org 337-570-4230

E-DRC: Mconner@acadian.com 337-912-2668

lowers@acadian.com 337-316-2974

wvincent@acadian.com 337-302-9275

Region 6

MD: David.Holcombe@la.gov 318-542-9790

PHERC: Patricia.White@la.gov 318-613-2854

H-DRC: Mary.Tarver@christushealth.org 318-664-0843

E-DRC: Detheridge@acadian.com 318-541-6395

Jandries@acadian.com 318-290-0447

Region 7

MD: Martha.Whyte@la.gov 225-247-4988

PHERC: Frank.Robison@la.gov 225-252-3045

H-DRC: wandr1@lsuhsc.edu 318-465-9500

E-DRC: bpems505@bellsouth.net 318-464-7995

E-DRC: casey@balentineambulance.com 318-422-4226

Region 8

MD: Vacant

Assist. Admin: Jeff.Toms@la.gov 318-475-1789

PHERC: Sheila.Hutson@la.gov 318-366-5828

A-DRC: Bramem@stfran.com 318-348-7096

E-DRC: Justin.Nowlin@amr.net 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 EOCJguidry@la.gov 225-938-8049

Rosanne.Prats@la.gov

225-938-8059

DHH EOCDoris .Brown@la.gov 225-202-2336

Keith.Phillips@la.gov 225-329-6063

Mardrah.Starks-robinson@la.gov

318-518-2796

EMS TOCChris.hector@la.gov 225-610-2588

Ted.calligan@la.gov 337-298-3806

ESF8 Network – May 2018

Contact Information

Mardrah Starks-Robinson, MPA, Esq.Deputy Director

Bureau of Community PreparednessOffice of Public Health

Email: Mardrah.Starks-Robinson@la.govPhone: 225.354.3511

QUESTIONS?LDH Emergency Response Overview

LDH Emergency Response Overview