Upload
terence-shannon-hunter
View
212
Download
0
Tags:
Embed Size (px)
Citation preview
EMS: EMS: On the Radar On the Radar
Screen at Screen at OPHEP?OPHEP?
Sandy Bogucki, MD, PhD Sandy Bogucki, MD, PhD
Senior Medical AdvisorSenior Medical AdvisorOffice of Public Health Emergency PreparednessOffice of Public Health Emergency Preparedness
Department of Health & Human ServicesDepartment of Health & Human Services
[email protected]@hhs.gov
ASPHEPASPHEPStewart SimonsonStewart Simonson
• Secretary’s principal advisor on matters related Secretary’s principal advisor on matters related to:to:– BioterrorismBioterrorism– Other public health emergenciesOther public health emergencies– Natural disasters generating medical emergenciesNatural disasters generating medical emergencies
• Coordinates interagency activities regarding EP Coordinates interagency activities regarding EP and PH emergency responses between HHS and PH emergency responses between HHS andand– Other federal departments, agencies, officesOther federal departments, agencies, offices– State, local officialsState, local officials
e.g. Project BioShield
BioShield was announced by President Bush in his State of the
Union address on January 28, 2003.
Secretaries Thompson (HHS) and Ridge (DHS) jointly transmitted the “Project BioShield Act of 2003 to Congress on February 26, 2003.
Purpose: To accelerate the process of research, development, purchase, and availability of effective countermeasures against agents of bioterror.
OPHEP:OPHEP:• Office of R&D CoordinationOffice of R&D Coordination
• Primarily NIHPrimarily NIH
OPHEP:OPHEP:• Office of R&D CoordinationOffice of R&D Coordination
• Office of State & Local PreparednessOffice of State & Local Preparedness• coordinating and integrating CDC's and HRSA's Cooperative coordinating and integrating CDC's and HRSA's Cooperative
Agreement Programs ($2.5 Billion FY ’02, ’03)Agreement Programs ($2.5 Billion FY ’02, ’03)• Public Health Cooperative Agreement (CDC)Public Health Cooperative Agreement (CDC)
• Regional public health preparedness planningRegional public health preparedness planning
• Increasing lab capacityIncreasing lab capacity
• Increasing surveillanceIncreasing surveillance
• Establishing rapid communication systemEstablishing rapid communication system
• Bioterrorism Hospital Preparedness Cooperative Agreement (HRSA)Bioterrorism Hospital Preparedness Cooperative Agreement (HRSA)• Regional surge planning (beds, personnel, and equipment)Regional surge planning (beds, personnel, and equipment)
• Lab capacityLab capacity
• Mental health consequences of terrorismMental health consequences of terrorism
• Training: ICS, PPE, SmallpoxTraining: ICS, PPE, Smallpox
OPHEP:OPHEP:• Office of R&D CoordinationOffice of R&D Coordination• Office of State & Local PreparednessOffice of State & Local Preparedness• Office of Planning & Emergency Response Office of Planning & Emergency Response
Coordination Coordination (OPERC)(OPERC)– Operates the SOC 24/7, with liaison in HSOCOperates the SOC 24/7, with liaison in HSOC
• Representatives of Op Div’sRepresentatives of Op Div’s– Some via video linkSome via video link
• Interagency LiaisonsInteragency Liaisons• USPHS (CC)USPHS (CC)• Local, regional officesLocal, regional offices
– Coordinates ESF #8Coordinates ESF #8• (federal response)(federal response)
• Preventive and Public Health Services
• Environmental Health Services
• Medical Services • Mental Health Services
Provided by DHS, VA, DoD, and HHS assets
Supplements state/local resources in response to public health and medical care needs following a major disaster or emergency.
```
ESF #8 Health & Medical Services
Let the conference calls begin…Let the conference calls begin…
S&R/Recovery, triage, field Rx, Prolonged Tx times? Evacuate hospitals? Augment medical, morgue staffing Hospital beds (hundreds? thousands?) Locate burn care capability? Isolation capability? FAX ARF’s to DHS
Receive mission assignmentsReceive mission assignments NDMSNDMS
TeamsTeams Mass Evac Transport, DestinationMass Evac Transport, Destination
SERT, SNSSERT, SNS USPHS, Op Div’sUSPHS, Op Div’s DoD, VADoD, VA ARCARC Local, mutual aid
State
FEMA HHSOp Div,VA, DoD HHS
Federal aid
```
• Speed of mobilizationSpeed of mobilization– To compromised ACF’s, e.g.To compromised ACF’s, e.g.
– For mass casualty careFor mass casualty care
• Difficulty preparing for impending threatDifficulty preparing for impending threat• Inadequate federal work force of Inadequate federal work force of
qualified HCWsqualified HCWs• DoD capabilities degraded when DoD capabilities degraded when
engaged elsewhereengaged elsewhere• Cost effectivenessCost effectiveness• Medical/Mass transportMedical/Mass transport
– DoD assignment as described in NDMSDoD assignment as described in NDMS
– EMS back-up??EMS back-up??
ESF #8 Concerns: Observations & Extrapolations
```
• RegionalRegional– All concentric tiers have to become All concentric tiers have to become
functional (not just conduits)functional (not just conduits)– All must have ongoing operational All must have ongoing operational
function (not just function (not just planning/preparation)planning/preparation)
EMS and Hospital Surge Capacity
NeighboringNeighboringStateState
Teams
RegionMutual AidMutual Aid
Federal response other than $Federal response other than $
Teams
Teams
State
RegionalResource Coordinating Center (RRCC) or Joint
Field Office (JFO)
HHSREC
(chair)
SOC
DHS MMRSCoordinator
MMRS programs in Region
EMAC Rep
OP Div Regional Reps e.g.
FDA, HRSA, IHS, BOP, AOA, CMS, SAMHSA,
CDC
Individual Agency Headquarters
CDC & HRSA Cooperative Agreement
Coordinators(State)
Regional ECs CDC & NDMS
Interagency Regional Reps
e.g. VA Regional Manager,
USDA, Forest Service, EPA,
OSHA
SERT
1 rep + 1 alt
Response Operations
Hospital Surge
Function (state)
Hospital Surge
Function across region
(state)
Health Dept.(metropolitan)
Metropolitan Health Depts.
across the region
Hospital Surge Function
(metropolitan)
Hospital Surge Function
across region(Metropolitan)
Ambulance/ EMS System
EMSConsortia
1 rep + 1 alt 1 rep + 1 alt1 rep + 1 alt
State Emergency
Management
State Emergency
Management across region
1 rep + 1 alt
Metropolitan Emergency
Management
Metropolitan Emergency
Management across the
region
1 rep + 1 alt
Medical Reserve Corps (MRC)
Other MRC
units in region
1 rep + 1 alt
State HealthDept.
State Health Depts. across region
1 rep + 1 alt1 rep + 1 alt
1 rep + 1 alt
CDC & HRSA
Program Managers(Federal)
ConclusionConclusion
• Opportunity to include EMS in Cooperative Opportunity to include EMS in Cooperative Agreement GuidanceAgreement Guidance
• EMS on Regional TF’sEMS on Regional TF’s– Representative (operational) consortiaRepresentative (operational) consortia– Inter-medical direction, Inter-state credentialing issuesInter-medical direction, Inter-state credentialing issues– Deployable EMSDeployable EMS– Multiple, mass transport EMS, including inter-facilityMultiple, mass transport EMS, including inter-facility