Issue 1: VMS Integration into the Overall Incident Response

STANDARDIZEDVOLUNTEER MANAGEMENT SYSTEM

For Public Health & Medical Emergency Response & Recovery

System Description & Concept of Operations

October 1, 2006

A product of: The George Washington University

Institute for Crisis, Disaster and Risk Management

For use by:Emergency Management Professionals

Funding provided by:The de Beaumont Foundation

Authors:Joseph A. Barbera, MD (Principle Investigator)

Anthony G. Macintyre, MDGreg L. Shaw, DSc

Lissa Westerman, RNValerie Seefried, MPH (Project Coordinator)

Frank Fiedrich, PhDSergio de Cosmo, MA

'Copyright with reproduction permitted for non-commercial purposes only. All use of this material should be referenced with the following: Barbera JA, Macintyre AG, Shaw GL, Westerman LT, Seefried V, Fiedrich F, de Cosmo S. Standardized Volunteer Management System for Public Health & Medical Emergency Response & Recovery (2006); The Institute for Crisis, Disaster, and Risk Management, The George Washington University.'

Standardized Volunteer Management System October 1, 2006 Public Health & Medical Emergency Response & Recovery VERSION 1.0



Table of Contents

Preface………………………………………………………………….. 3

System Description……………………………………………………... 5

Concept of Operations…………………………………………………..20

Appendix A – Position Descriptions & Job Action Sheets……………..55

Appendix B – Acronyms………………………………………………..93

Appendix C – VMS Implementation Issues & Recommendations…….97

Appendix D – The VMS Incident Planning Process………………….121

Appendix E – The VMS Tools: Forms & Checklists..……….………125 (Tools should be downloaded as separate files)

© Institute for Crisis, Disaster, and Risk ManagementThe George Washington University

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Preface

Volunteerism has a long and storied tradition in the United States. Of particular note has been the healthcare profession, where volunteers have stepped forward to provide selfless assistance in times of great need during war and disasters.

Professionalism in emergency management and incident response in the United States has progressed markedly over the past half century. In fact, “emergency management” is now a recognized professional discipline and the importance of using well established templates for managing response is increasingly recognized. The Incident Command System (ICS) is now the overarching response management template in the U.S., and provides ICS principles that should be incorporated into any and all response plans. As preparedness for emergencies and disasters has increased in importance, attention has been increasingly focused on the management and use of volunteers during response. To date, there has been little published effort to outline a detailed, effective system to manage the many “just-in-time” volunteers that are inevitable after disasters, and to process all volunteers, match their qualifications and interests with incident personnel needs, and effectively integrate them into the response.

At the same time, an increasing number of healthcare and other professionals are committing themselves to voluntarily assist in times of great need. It is therefore mandatory that the professionals in charge of preparedness examine the requirements inherent in processing volunteers and effectively integrating them into response efforts. This necessarily includes establishing an effective system that can collect, screen, process, credential, brief, and effectively deploy volunteers in a safe manner. In addition, the system must be capable of providing seamless integration of the volunteers into the existing response capabilities.

The standardized Volunteer Management System (VMS) presented in this document recognizes the complexities involved in managing volunteers. Rather than over-simplifying the process, the model system organizes the many volunteer-related responsibilities, tasks, and actions into a single coordinated system1 with an effective management component. Based upon the Incident Command System architecture and processes, it is designed to be fully consistent with the National Incident Management System (NIMS) and be easily integrated into current programs addressing volunteers at the national, state, local and individual agency or organization levels.

A large number of tools are provided to simplify the task of implementing the system. A companion electronic Volunteer Management System (e-VMS) is under development to

1 A “system” is defined by the authors as “A clearly defined functional structure, with defined processes, that coordinates disparate parts to accomplish a common goal.”


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enhance efficiency in operating the VMS. The VMS model is standardized to work for use with any type of volunteer population. The tools in this project were adapted specifically for health and medical volunteers, but can be easily revised to address other disciplines.

The Institute for Crisis, Disaster, and Risk Management (ICDRM) at The George Washington University is a multi-disciplinary institute founded in 1994. It conducts educational programs at the Master’s, Graduate Certificate, and Doctoral degree levels, and has produced research, academic products, and professional guidance across a very wide range of emergency, crisis, and risk areas. More information on the Institute and its work is available at http://www.gwu.edu/~icdrm/.

The ICDRM project team is grateful to the public health professionals in the Arlington County (Virginia) Division of Public Health, who initially interested the Institute in research and development in this area (see Arlington County Public Health Volunteer Management System, available at http://www.gwu.edu/~icdrm/) and to Lauren Fernandez, a doctoral student whose doctoral research formed the initial basis for the project that produced the standardized VMS. The Institute is also grateful to The de Beaumont Foundation and its principals, for their funding and for their enthusiasm and encouragement to develop a comprehensive model system.

It is the hope of the VMS project team that this product will promote optimal professionalism and effectiveness in the management of volunteers in future emergencies and disasters.


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http://www.gwu.edu/~icdrm/

http://www.gwu.edu/~icdrm/




System Description & Concept of Operations

INTRODUCTION

This project was performed under a grant from the de Beaumont Foundation. It presents a detailed, research-based system for managing public health & medical volunteers who are willing to assist in formal assignment during emergency response and recovery. While the model is presented for managing medical and public health volunteers, it has been constructed as a standardized Volunteer Management System (VMS) that can be adapted for use in managing any type of volunteer during emergency response and recovery, and interface with current volunteer data base and recruitment initiatives such as ESAR-VHP2 and Citizen Corps (including the Medical Reserve Corps).3

Managing large numbers of volunteers, especially spontaneous volunteers who may be placed in trust positions4 requiring advanced credentials, is very complex. The products of this project are designed to organize this complex task and promote both effective and efficient integration of public health and medical volunteers into incident response. The Volunteer Management System (VMS) model consists of a detailed System Description (describing the structure and primary functions required for the system) and Concept of Operations (how the system components function during each stage of response and recovery). It includes an appendix with Position Descriptions and Qualifications for the key positions within the VMS and an appendix outlining select system implementation issues and recommended solutions. The model is ‘operationalized’ through a tool kit containing mobilization/demobilization guidance, key position job actions sheets (operational checklists), forms, and procedure guidance. The ‘tools’ serve to drive both the management of the system and the processing and oversight of the volunteers.

This model VMS is specifically designed to address the processing and support of volunteers5 who may be assigned to response and recovery positions across the range of

2 Emergency System for Advance Registration of Volunteer Health Professionals, available at http://www.hrsa.gov/esarvhp/, accessed August 24, 2006.3 Medical Reserve Corp information available at: http://www.medicalreservecorps.gov/HomePage, accessed August 24, 2006.4 A “trust position” is defined as one in which the assigned personnel are performing high-consequence activities, especially if they are performed in a relatively independent fashion. Examples include a surgeon who is operating without direct supervision, or a public health advisor who shapes response policies or procedures.5 A “volunteer,” as used in this model, is defined as a person agreeing to provide service outside the scope of his/her employer and/or employed position, without additional or specific compensation for this voluntary commitment. This differentiates the “volunteer” from personnel who provide service as part of their job position in an assigned resource. An individual offering or providing this service is a “volunteer”


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http://www.medicalreservecorps.gov/HomePage

http://www.hrsa.gov/esarvhp/


public health and medical tasks required during an incident. The VMS may be expanded and configured as needed to meet the public health and medical personnel requirements of a specific incident. It may also be adapted and used as a tool for the management of jurisdictional employees assigned to non-traditional public health and medical tasks. Finally, it may be adapted to a generic VMS for all volunteers, but adapting the system for circumstances beyond those described in this project may require additional analysis and modification to the system model presented in this document.

Goal

The overall goal of this model is an effective, efficient Public Health and Medical Volunteer Management System (VMS) to process, assign, and ‘just-in-time’ train volunteers, both pre-registered and spontaneous, who arrive to assist during emergencies, disasters, or other challenging events.

ObjectivesThe objectives for this model that will accomplish the goal are defined as:1) Organize individual public health and medical volunteers and volunteer groups

for maximal order and effectiveness in supporting medical and public health incident response.

2) Provide for the safety of volunteers. 3) Process and catalogue volunteers to efficiently match the available volunteer

skills with the identified incident response personnel needs.4) Provide effective orientation and ‘just-in-time’ training for volunteers to

understand their roles, responsibilities, and supervision issues.5) Integrate the VMS and its processed volunteers into the Incident Command

System (ICS) that is managing the incident.6 6) Maximize the volunteer experience to promote increased volunteer participation

in future events.

Assumptions

The assumptions upon which this guidance is based are presented here, to provide the reader with an understanding of the rationale for this model system and for understanding the basis for the development of the VMS structure and function.

even if the volunteer's time is compensated through his/her usual employer and employment rate.6 The National Incident Management System (NIMS), promulgated in March 2003, requires that NIMS/ICS be used to directly manage all incident response. The VMS is therefore consistent with ICS and designed to effectively integrate into any ICS structure that is managing the incident. NIMS is available at www.dhs.gov


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http://www.dhs.gov/


Traditional emergency responders have incident response and recovery responsibilities that make it unlikely that focused volunteer management will be a high priority for them. In order to leverage volunteer opportunity and minimize risks inherent to volunteer participation, a functional entity with direct responsibility for volunteer management is required.

An effective incident command system (ICS) will be established to manage the overall incident at the jurisdictional level, and the VMS must integrate into this system or be capable of coordinating closely with appropriate ICS positions.

The command element of the incident command system (ICS) that is managing incident response owns the ultimate, overall responsibility for the safe and effective use of volunteers. The ICS may delegate authority for volunteer management to another resource. This extends the responsibility to the delegated authority, but does not absolve the ICS of final responsibility and accountability.

Within an incident, there may be resources, such as hospitals, with their own independent responsibility and accompanying authority for volunteers accepted by them for positions within their area of responsibility. All must be addressed in a comprehensive volunteer management system.

The VMS should be structured to conform to the ICS concepts provided in the National Incident Management System (NIMS). All public and private response organizations that respond to emergencies are required to comply with NIMS and the ICS it presents. The VMS should therefore be compatible with an effective Incident Management Team (IMT) that is managing the incident response.

Properly screened and trained volunteers, processed through the VMS and then appropriately assigned to the incident, can fill incident roles and be supervised by ICS personnel.

Volunteers who aren’t needed when they apply early in the response may provide manpower or valuable expertise later in the response, or in the recovery phase of the incident as needs evolve.

If volunteer assistance is not indicated for an incident, a resource is still needed to engage volunteers, convey the lack of need for volunteer services at that time, roster qualified personnel in case of future need, and assist in preventing trespassing and other ‘out-of-bounds’ behavior by delineating the consequences of these actions. The resource therefore must possess the capability to roster volunteers and establish a call back mechanism for future volunteer assignments that may arise.

The VMS must be capable of addressing the range of volunteers that could potentially present during adverse events. Categories of volunteers must therefore be defined so that they are addressed effectively by the management system.

The VMS must possess the ability to identify unusual volunteer skills that could potentially be valuable during incident response. This is necessary since not all disaster contingencies can be anticipated, and emergent groups have the ability to apply new strategies, tools, and technologies.7

7 Bolin, R.C. and L. Stanford, The Northridge Earthquake: Vulnerability and Disaster. 1998, London; New York: Routledge, pages xiii, 272.


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The majority of volunteers are not assumed to possess an operational understanding of ICS and how volunteers are integrated, supervised, and directed. Instead, this information must be explicitly provided in a just-in-time training format to volunteers.

The VMS will require further study and possibly field testing to define its capacity for processing and managing volunteers.


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VMS SYSTEMS DESCRIPTION 8

OVERVIEW

The Volunteer Management System is a resource that supports the incident response by providing selected, processed, trained, and tracked volunteers to fill needed incident response positions. As such, the VMS is a logistics resource that commonly may be placed as a direct report to the ICS Logistics Section, Supply Unit Leader. Alternatively, it may report to a staffing function within the Emergency Operations Center, but with close coordination with the ICS Logistics personnel (see Issue 1: VMS Integration into the Overall Incident Response - see Appendix C). The appropriate authority must be delegated to the VMS to allow effective performance (see textbox).

VMS’ delegated authorities and assigned responsibilities

As the VMS is established and its relationship to the ICS or EOC authorities is being defined, it is important to clearly delineate specific authorities delegated to the VMS as an extension from the jurisdictional authority, in addition to any assigned VMS responsibilities. For example, the authority to screen out unqualified volunteer applicants is delegated to the VMS by the local authorities (ICS or EOC) or any other entity that the VMS may be serving. It is also important to recognize that responsibility for the safety and well-being of volunteers deployed into the incident transitions from the VMS to organizations within the response that accept the assigned volunteers. Even though out-processing and follow-up of assigned volunteers may be accomplished by the VMS through proper direction and funding, the ultimate responsibility for this rests with the organizations that accepted the volunteers for their incident assignments. Many of the issues presented in this document relate to this concept. It is best that the delegated authorities and assigned responsibilities be established as early as possible during VMS development, and reaffirmed at the outset of any VMS response.

The physical location where the VMS is based during response, and where most of its services are provided, is designated in this model as the Volunteer Management Center (VMC). Because of the intent to minimize VMS staffing needs, the VMC combines the management of the VMS (this site is commonly called a Volunteer Command Post or Center) and the processing of volunteers (this site is commonly called a Volunteer Reception Center in other published materials) at the same site. A Volunteer Point of Assembly (VPOA) is delineated for the VMS model, in order to establish a defined location if the initial contact with potential volunteers needs to be separate from the physical location of the VMC.

8 System Description: A presentation of an overall system architecture and it components, including how they are organized, how they relate to each other, and what they do. The system description complements the Concept of Operations, which explains how the system and its components function through the successive stages of emergency response and recovery.


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The functional organization of the VMS is based upon ICS principles (see Figure 1.). Responsibilities and tasks necessary for the efficient management and integration of volunteers into the response are listed and grouped according to similarity of purpose. As ICS explains, not all functions or positions are staffed individually in all incidents. Staffing decisions are based upon the size, nature and complexity of the incident. In events where no individual is assigned to a functional position, the responsibility for accomplishing the function or task is assumed by the supervisory position for that function or task. This is further illustrated in Appendix A.

Figure 1. VMS functional organizational structure when the system is fully staffed.

To effectively process and monitor volunteers during incident response and recovery, the key tasks and responsibilities of the management system must be defined and addressed. They are presented in detail throughout the system description and concept of operations, but are summarized in Figure 2.


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Figure 2. VMS primary tasks related to volunteer management.

To effectively present the complex topic of volunteer management, specific terminology is used. Nomenclature related to volunteers is presented in the following textbox. Terminology that describes management tasks in a manner consistent with NIMS, and to delineate the processing and management activities of the VMS, is presented throughout this text, with key terms defined through footnote references.

Volunteer nomenclature

To effectively manage volunteers across the spectrum of voluntary service and through the stages of volunteer processing and incident activity, categories of volunteers have been defined. The term “volunteer” is defined earlier in footnote #4.

Common Volunteer categories:o Affiliated Volunteers : Volunteers who have established a pre-disaster association,

including registration, with an agency or organization that is participating in the disaster response. The pre-event training, registration information, and skills verification for these volunteers may vary. Rostering of affiliated volunteers by the VMS during an incident may be expedited by transfer of acceptable information for each qualified volunteer from their volunteer organization.

o Pre-registered Volunteers : Volunteers who have been pre-screened, with confirmed, up-to-date personal and credential information, and who demonstrate a current understanding of the orientation briefing material to the satisfaction of the appropriate VMS personnel. They therefore satisfy the criteria to be immediately rostered for an incident. This may occur through baseline (pre-incident) VMS operations or through approved volunteer organizations with their affiliated volunteers, using mechanisms acceptable to the VMS.

o Recruited volunteers : Volunteers with skills that could address unique or short-supply needs of the disaster response, and are individually requested by the response system (by name or by technical ability) to assist in the effort. They may be affiliated or unaffiliated volunteers.

o Spontaneous volunteers : Volunteers presenting to help at the disaster scene that were neither recruited nor affiliated with an organization that has been


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incorporated into the incident response. Also referred to as “unsolicited volunteers.”

o Support volunteers : Volunteers without identified or verified skills of traditional Public Health and Medicine, but that may still be quite valuable for support and other activities where professional medical and public health skills are not indicated.

o Unaffiliated volunteers : Volunteers with no prior association with the VMS or association with a recognized volunteer organization or traditional disaster response agency.

o Volunteer Groups : Volunteers presenting in a pre-established group that has internal organization and a management element for participating in the incident response. The management component of this group can provide the registration interface with the VMS during response, thereby expediting the affiliated volunteers’ entry integration into the incident response.

VMS-specific volunteer categories:o Rostered volunteers : Volunteers who are fully registered and credentialed by the

VMS but have not yet been assigned to an incident task. They have been placed on a roster list/s according to their professional qualifications, level of credential verification completed, and functional capacity within an assigned position.

o Assigned Volunteers : Volunteers who have been fully registered and credentialed, rostered into the VMS and assigned to an incident task that they have accepted.

o Deployed volunteers : Volunteers who have been processed, assigned to an incident position, and moved to the site for their individual incident operations.

VMS MANAGEMENT

The VMS manager provides the overall supervision of the VMS system and therefore has accepted responsibility for the overall effectiveness of the VMS response (see Position Description and Job Action Sheet - Appendix A). This responsibility involves:

Overseeing the functional mobilization and demobilization of the VMS. Designating the site for both the Volunteer Point of Assembly (VPOA) and the

Volunteer Management Center (VMC). Establishing the overall (control) objectives, along with the VMS operational

period objectives for each operational period. Assuring adequate function of the VMS. This is achieved in part by monitoring

VMS response operations in relation to incident and VMS objectives. Setting the timing and length for operational periods and the planning cycle for

the VMS. The timing should be coordinated with the planning cycles of the overall ICS.

Assuring that safety issues are adequately addressed for VMS personnel and the volunteers.


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Assuring the performance of the public information (media) function as indicated.

Performing the senior liaison function, as indicated, to appropriate organizations external to the VMS.

Problem solving and decision making as required, for issues that can’t be resolved at a lower level of the VMS.

Ensuring that the appropriate forms are being employed, including the VMS General Message Form (VMS 213) for transmittal of important information not documented in some other manner.

VMS OPERATIONS SECTION

The VMS Operations Section achieves the objectives set by VMS Management. It is the responsibility of the VMS Operations Section Chief (see Position Description and Job Action Sheets in Appendix A) to determine the tactics that will achieve the VMS objectives for the operational period. For the VMS, response objectives focus on organizing and processing volunteers, and integrating the accepted volunteers into the incident. Two Operations Branches, one for each of these focus areas, are described here: The Volunteer Processing Branch and the Incident Integration Branch. The Volunteer Processing Branch is focused primarily on recruiting, organizing, and processing the volunteer. The Incident Integration Branch, in contrast, is focused upon the incident parameters and requested volunteer positions for the incident, and the activities of the volunteers deployed into the incident.

VMS OPERATIONS SECTION - VOLUNTEER PROCESSING BRANCH

The Volunteer Processing Branch Director (see Position Description and Job Action Sheet - Appendix A) is responsible for the overall reception, cataloging, briefing, assigning, and scheduling of volunteers. All volunteer-related information must be conveyed to the VMS Plans Section for incident archiving and maintaining accountability of volunteer records. The Volunteer Processing Branch responsibilities include:

Staffing the Volunteer Point of Assembly (VPOA) : The VPOA is a physical location where volunteers should report to begin in-processing for the Volunteer Management Center (VMC) – the VPOA and VMC are commonly co-located for medical and public health events, but may be separated. A separate location for initially collecting potential volunteers could be due to: 1) perimeter security, 2) the recruitment of volunteers from a general volunteer reception center, or 3) space constraints at the established VMC. Volunteers are not allowed to participate in response unless they have been processed through the VPOA/VMC.


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VPOA initial reception and organization of incoming volunteers : This is accomplished by the VPOA Leader (see Position Description and Job Action Sheet - Appendix A), who provides the potential volunteers with a written VMS orientation packet, and directs those who remain interested to the VMC.

VMS orientation (i.e., introductory) briefing : This occurs at the VPOA if separate from the VMC or in the VMC registration line if the VPOA is contiguous to the VMC. The briefing may be most efficiently accomplished using the written brief, Volunteer Orientation and Acknowledgement of Responsibilities Form (VMS O7). This document presents an overview of the VMS and its role, plus the volunteer roles, responsibilities and accountability requirements. It provides for a signed acknowledgement by the prospective volunteer. The Public Health Risk Statement (VMS O7a) and any volunteer liability information are included with this orientation packet, for the prospect’s consideration before making the decision to volunteer.

Registration of volunteers : Registration obtains personal data, including contact information, and professional data, including health profession qualifications, relevant experience, and active healthcare organization privileges (see Volunteer Registration and Credentials Form - VMS O8).

Verification of Credentials (confirming identification/certification/qualification) and Rostering: The Credentials Verification Supervisor (see Position Description and Job Action Sheet - Appendix A) is responsible for the process of ensuring that offered identification and credentialing claims are genuine. Subsequent categorization of volunteers is based upon these verified credentials, and accomplished using a defined rostering strategy (see Concept of Operations).

Volunteer Assignment : This process is the responsibility of the Volunteer Assignment Supervisor (see Position Description and Job Action Sheet - Appendix A). The process includes:

o Receiving available assignments from Incident Integration Branch (see below).

o Matching assignments to appropriate volunteers using the roster categories developed/employed by the Credentials Verification Supervisor.

o Providing a position description to the volunteer and obtaining acceptance of the assignment.

o Providing an assignment briefing to accepted and assigned volunteers (see next section).

Assignment Briefing : The assignment briefing, which is a more detailed volunteer orientation to the incident and the volunteers’ assigned roles, is provided by the VMS Assignment Briefing Leader (see Position Description and Job Action Sheet - Appendix A) to volunteers who have been offered and accepted specific incident assignments (i.e., “assigned volunteers”). In-depth


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information about the incident (more detailed than contained in the written orientation briefing) is provided, based upon information collected by Incident Integration Branch and documented by them or by the VMS Plans Section. The brief may include the issue of personal protective equipment and/or other equipment and supplies for use in the volunteer positions. Operational level just-in-time training is provided for issued equipment or supplies. An opportunity is provided to volunteers to have their questions answered.

Access Privileging and Deployment : The Deployment & Out-processing Leader assures that the volunteers have been fully processed and received all indicated pre-deployment equipment, supplies and training. Each volunteer is then directed through the VMS badging process (if one is established). The VMS badge indicates that the bearer is a fully processed volunteer. Established access privileging procedures are then followed to ensure that an access badge or other incident site privilege indicator is provided to each assigned volunteer (in conjunction with appropriate ICS positions as indicated).

Transport to work assignments : Once equipped, supplied, trained and badged as indicated, the volunteers are transported to the site of their work assignment and “handed-off” to their supervisor for accountability throughout their incident work periods. Transport, if indicated, may be arranged through VMS Logistics in conjunction with ICS. This function also may transport volunteers back to the VMC at the completion of their assigned tasking.

Volunteer Reassignment, Rehabilitation, and Out-processing : Volunteers who have completed their assignment or series of assigned shifts are returned to the VMC from incident deployment. They are received by the VMS Deployment & Out-processing Leader (see Position Description and Job Action Sheet - Appendix A). They are evaluated and provided with rehabilitation (if indicated) and reassignment (if available) or out-processing and release from the incident. A summary of activities at this station (with more detail in the Concept of Operations) include:

o Assess the volunteer’s performance evaluation.o Refer for reassignment, if available positions, for qualified, willing

volunteers. o Out-processing: demobilization of volunteers who wish to leave or for

whom there are no more current or projected incident assignments. Out-processing activities include:

Incident review: a brief review of the volunteer-related activity. Medical or counseling referral as indicated. Recovery of issued equipment, unused supplies, and access

privilege badge. Obtain volunteer feedback on VMS functions.

Volunteer Recruitment : These activities are grouped under the Operations section and can be accomplished by the Volunteer Processing Branch Director or a


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designated Volunteer Recruitment Supervisor (see Position Description and Job Action Sheet – Appendix A). Activities include:

o Notifying and activating (as directed by VMS Operations Section Chief) pre-registered volunteers and volunteer organizations:

Provide initial incident parameters (as known) and any indicated health and safety message.

Request confirmation of the notification and obtain a response as to availability and response time of solicited volunteers.

o Conveying appropriate “no-need” messages (cleared with the VMS PIO function, which is usually the VMS manager) to pre-registered/pre-enrolled groups and individuals.

o Assisting the Public Information Officer (PIO) (usually the ICS PIO) with developing volunteer assistance appeals for the general public, and/or messages delineating that no more assistance is needed. This would be distributed to media and other recipients upon direction by VMS management.

o Assessing indications for developing a needs-based volunteer recruitment strategy specific to the incident; provide recommendations to VMS Operations Section Chief.

VMS OPERATIONS SECTION - INCIDENT INTEGRATION BRANCH

The Incident Integration Branch Director (see Position Description and Job Action Sheet - Appendix A) is responsible for working with ICS to identify incident volunteer needs and to monitor volunteers assigned to the incident. The responsibilities of the VMS Incident Integration Branch include:

Delineate the Incident Volunteer Needs : Information important to matching volunteers with available positions must be collected, processed, and transmitted:

o Identify current and projected incident volunteer needs through the ICS Logistics Section or the appropriate EOC as indicated.

o Describe and categorize the volunteer positions (position descriptions, required credentials and qualifications) for use by the VMS Assignment Supervisor.

Collect other volunteer-related incident information : Other information that is important for the processing and integrating of volunteers into the ICS response must be collected and acted upon. This includes:

o Identify site privilege badge procedures and convey to Volunteer Processing Branch.

o If volunteers have become involved in incident activities prior to VMS activation and volunteer processing, the Incident Integration Branch Director works with ICS personnel to determine the course of action to address the unprocessed volunteers (see Concept of Operations).


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o Obtain incident updates from ICS contacts (as well as other ICS reports and tools) for use in the Assignment Briefing Template, for anticipating future volunteer needs, and for demobilization and other planning purposes (provide to the VMS Plans Section and VMS Volunteer Processing Branch).

Provide VMS information to ICS personnel : This very important task assures that the appropriate ICS personnel understand the role of the VMS, and the ICS role in effective volunteer management:

o Orient ICS response staff, as indicated, to the availability of volunteers and their capabilities as indicated.

o Assure that ICS personnel understand the role/requirements for volunteers, and orient ICS response staff on their supervision of volunteers as indicated.

Assure Volunteer Tracking : This is accomplished by the Volunteer Tracking Supervisor (see Position Description and Job Action Sheet - Appendix A) if one is designated:

o Track volunteer resources as they deploy from the VMC, through transport, reporting to ICS, executing tasks, change in shifts for volunteer, completion of assignment and return to the VMC.

On-site volunteer coordination : This can be accomplished by the On-site Volunteer Coordinator if one is designated by either the VMS or ICS (see Position Description and Job Action Sheet - Appendix A). This function facilitates the on-site management of volunteer-related issues and can be used to address:

o Information exchange between the incident site and Incident Integration Branch.

o Site-specific volunteer processing activities.

‘Trouble desk’ function : This function provides a single point of contact for ICS staff or deployed volunteers to access when difficulties with, or questions concerning, deployed volunteers occur (e.g., questions about qualifications of a specific volunteer, volunteer missing from assigned location, liability concern, etc.). This is accomplished by a Trouble Desk Supervisor (see Position Description and Job Action Sheet - Appendix A).

VMS LOGISTICS SECTION

The VMS Logistics Section Chief (see Position Description and Job Action Sheet - Appendix A) is responsible for supporting VMS Operations in the areas of personnel, facilities, meals, transportation, and communications. Depending on the nature of the event, the ICS system in place, and the ICS-VMS relationship in the ICS structure, the VMS Logistics Section may be able to access many of the indicated services and


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materiel through ICS resources. Once volunteers are processed, assigned, and report to the ICS, assistance and support for the individual volunteers is provided directly by ICS staff at the assignment site. This extends to include any medical assistance for volunteers during assignments, but requires close coordination with the VMS. The direct VMS Logistics responsibilities include:

Establish and support the VPOA and the VMC : VMS Logistics is responsible for providing facilities, personnel, refreshment, hydration, communication, and transportation support to VMS either independently or in conjunction with ICS. The VMS Logistics section is also responsible for the systems administration of the electronic platform (e-VMS) if used for data management. This includes installation and ongoing maintenance of the electronic platform during system operations.

Support VMS operations through all stages of response and recovery: This covers mobilization, VMS operations, and demobilization of the VPOA and VMC. It includes all aspects of logistical support. This includes arranging and/or providing medical support for volunteers and for VMS staff (possibly through the ICS medical unit providing support for other incident personnel); and arrange any indicated post-incident medical surveillance and follow-up for VMS staff per jurisdictional determinations. See Concept of Operations for further details.

VMS PLANS SECTION

The Plans Section Chief (see Position Description and Job Action Sheet - Appendix A) provides planning support and maintains both volunteer and incident documentation for the VMS system. Direct VMS Plans Section responsibilities include:

VMS Situation Status : Maintain information/documentation (using the forms and other tools provided in the VMS package) on incident specific parameters and progress by the VMS in meeting its incident objectives.

VMS Resource Status : Tracks assigned VMS staff, available VMS personnel, and out-of-service personnel and captures the information in documentation. It may provide a similar service for critical equipment and supplies.

VMS Planning Support : Provide planning support to the Management and Operations Sections of VMS through setting and conducting of meetings, preparing planning documents, and providing specialized planning as indicated.

Information archiving : Archiving (for later use during the incident and after-action process) all relevant volunteer, incident, and VMC information as it is developed by other VMS components.


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For most small and/or standard incidents, the Plans Section services may be accomplished by a single person serving as Plans Section Chief, or even accomplished by the VMS manager.

VMS ADMININSTRATION and FINANCE SECTION

The Administration and Finance (Admin/Finance) Section Chief (see Position Description and Job Action Sheet - Appendix A) provides support to Management by maintaining expense records and documentation related to workmen’s compensation, other claims, and events that may serve as potential liability for the VMS. These responsibilities include:

VMS Procurement : Contracting and finance services related to purchasing (working closely with VMS Logistics Section personnel).

VMS personnel time and other incident costs : Track these parameters and maintain awareness of the financial costs for the VMS manager and ultimately, for the ICS or whoever is paying for the VMS services.

VMS liability claims : Processing workers’ compensation claims for VMS staff and adverse incidents involving VMS staff or volunteers. It assists in looking for trends and liability costs, which improves the abilities of the Plans Section Chief and the VMS Operations Section Chief in discerning corrective actions as the incident evolves. This section also assists volunteers in filing any worker’s compensation, expense, or other claims with the ICS Administration/Finance Section.

For most small and/or standard incidents, the Admin/Finance Section services may be accomplished by a single person serving as Section Chief, or even accomplished by the position (VMS manager or another section chief) covering the VMS Administration/Finance Section Chief position.


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VMS CONCEPT OF OPERATIONS

OVERVIEW

The concept of operations explains how the described system operates through each progressive stage of incident response and recovery. To clearly and comprehensively portray the VMS Concept of Operations, it is therefore presented according to the incident response and recovery stages noted in Figure 3. While the stages overlap as an incident progresses, each stage occurs in sequence and requires specific actions to be accomplished in an effective manner. This established methodology9,10,11 for describing the Concept of Operations promotes the delineation of a comprehensive, coordinated response by the VMS.

Any volunteers managed and integrated into the incident by the VMS may be ‘in-processed’ (registered, credentials verified, rostered, assigned, and briefed), tracked during their incident deployment, or ‘out-processed’ throughout the indicated stages.

Figure 3. Stages of Emergency response & Recovery presented in this VMS Concept of Operations.

9 Medical and Health Incident Management (MaHIM) System available under the “2002” heading at http://www.gwu.edu/~icdrm/publications/index.html, accessed 23 July, 2006.10 Medical Surge Capacity and Capability (MSCC): A Management Handbook for Integrating Medical and Health Resources During Large-Scale Emergencies available at http://www.hhs.gov/ophep/mscc_sept2004.pdf, accessed July 23, 2006.11 Emergency Management Principles and Practices for Healthcare Systems, available at: http://www1.va.gov/emshg/page.cfm?pg=122, accessed July 23, 2006.


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http://www1.va.gov/emshg/page.cfm?pg=122

http://www.hhs.gov/ophep/mscc_sept2004.pdf

http://www.gwu.edu/~icdrm/publications/index.html


The relationship between the VMS Concept of Operations and the ICS Concept of Operations (or EOC Concept of Operations if the VMS is assigned to integrate at the EOC level) is important to recognize (Figure 4), since the two by definition must be inter-related. Optimal coordination may be promoted through:

Time sequence relationship : The time relationship between the two systems is such that generally, the ICS will have been activated and mobilized prior to the VMS, though both may mobilize concurrently. As the incident is resolved, the ICS will typically demobilize after the VMS has demobilized.

Management relationship : The primary management interaction/coordination between the VMS and the larger ICS usually occurs at the level of the ICS Logistics Section (Figure 4.). Alternatively, the primary interface may be established at the level of the jurisdictional Emergency Operations Center (EOC), via the Public Health (PH) and Medical Emergency Support Function (ESF), another PH or medical unit, or through a Volunteer ESF, rather than directly with the primary ICS for the incident (see Issue 1: VMS Integration into the Overall Incident Response - Appendix C). The specific arrangement should be designated by the jurisdiction at the time of VMS activation.

Figure 4. The usual incident ICS and VMS relationship

Responsibility relationship : The ICS responsible for managing the incident has the responsibility to assure that the VMS is functioning properly and


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has the personnel, equipment and supplies necessary to accomplish its mission, which is within the Logistics Section of the overall ICS (see Figure 4). It extends some of this responsibility to the VMS, but remains ultimately responsible for volunteers, as well as directly responsible for incident activities that it primarily manages. The ICS, for example, is responsible for maintaining order for any large number of volunteers at the incident site or at a logical volunteer point of assembly (VPOA) prior to VMS activation.

VMS INCIDENT RECOGNITION

Incident recognition is the first stage of the Response Phase in emergency management. Incident recognition is the process that identifies an “anomaly” (independently or through communication from others), develops a situational assessment of the anomaly and related details, and determines whether an “incident response” by the organization may be indicated. The VMS Incident Recognition, therefore, is the process of determining whether the evolving event parameters indicate the need for activation of the VMS (either partial or full). Responsible parties for recognizing indications for VMS activation may include:

ICS management, operations, or logistics personnel : Designated positions that are responsible for adequate incident personnel, or responsible for maintaining scene control (which could include managing unsolicited volunteers).

VMS personnel responsible for the VMS : They may be alerted to the circumstances through the news media, other alert notification mechanisms within the public safety, medical or public health network, or by volunteer organizations that have personnel responding to an evolving event.

Indications for VMS activation (i.e., the event being recognized as a VMS incident) include:

Managing spontaneous volunteer issues : The need to manage spontaneous/unsolicited medical and/or public health volunteers presenting to the ICS managing an incident.

Volunteers needed for response : Potential or actual need for volunteer personnel to fill public health response and medical needs for the incident.

ICS indication of need : ICS request to activate the VMS.


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The ultimate decision as to whether this is an “incident” for the VMS, and therefore whether to activate the VMS, rests with ICS or EOC manager , since volunteers for public health and medical positions may be indicated through either ICS or EOC management area, according to incident circumstances. VMS personnel may also make the activation recommendation to ICS, and this may be prompted by requests or inquiries from Volunteer organizations.12

Information captured during this time period should be recorded in the VMS Initial Event Log (VMS 201) by the initial VMS manager. Once the formal incident planning process has begun, the responsibility for capturing incident information transitions to the VMS Plans Section Chief (see Appendix D).

VMS ACTIVATION/INITIAL NOTIFICATION

The activation decision is the process of determining the level of activity the VMS will undertake at the outset of its incident response. Initial activation determinations can range from (1) no actual activation at that time, but conveys relevant information to VMS personnel, (2) minimal to intermediate activation (based upon the projected incident needs), up to (3) a full-scale VMS response.

Determining the level of activation of the VMS will generally fall within the purview of the VMS manager unless another arrangement is developed during the VMS implementation. For example, the Volunteer Emergency Support Function within the EOC may accomplish this according to a pre-developed decision support tool (see Activation Procedure – VMS M1). The level of activation options are tied to the notification categories (below).

Site selection for the VPOA and VMC should be determined at the time of activation. The VPOA and VMC Site Selection tool (VMS M3) provides guidance, but sites should ideally have been determined during preparedness planning.

Initial notification is the process of communicating incident information and the level of activation (as appropriate) to VMS personnel, to ICS Logistics Section personnel that interface with the VMS, and to any pre-registered volunteers who are assisting with mobilizing and operating the VMS.13 Notification information (see VMS Notification & Activation Message - VMS M2) is provided in a standardized format using one of the following notification categories:

12 This demonstrates the need for a senior-level 24-hour VMS duty officer that is available and accessible to ICS leaders. If a potential or actual incident is identified where volunteers may be involved, the ICS can notify this on-call position and request a VMS response.13 The initial notification to volunteer organizations or volunteers who are fully registered and regularly respond for incident operations would be considered an “incident operations action” (similar to other standard personnel call-outs) rather than a VMS activation action, even if it occurs simultaneously with this VMS initial activation notification.


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Update : Conveys non-urgent incident or program information that is unlikely to require any type of immediate action. This is the standard category used for providing information to system members during baseline operations (i.e., non-response).

Advisory : Conveys brief description of an incident that is anticipated or has occurred. Usually indicates a ‘stand-by’ posture or heightened awareness (i.e., no immediate action) or indicates it is unlikely that VMS will be needed (i.e., no response anticipated).

Alert : Conveys brief description of the incident that is anticipated or has occurred. Commonly indicates that it is likely that VMS will be needed, and may authorize or request appropriate pre-activation actions.

Partial Activation : Conveys brief description of the incident that is anticipated or has occurred. Indicates that a specified level of activation (according to a pre-plan) is authorized.

Full Activation : Conveys brief description of the incident that is anticipated or has occurred. Full activation is authorized.

The notification message to VMS personnel should include the following (see VMS Notification & Activation Message template –VMS M2 for further detail):

Brief situation description : Incident parameters known at that time.

Activation level : The level of activation & requested action.

Reporting location : The designated address where the VMS personnel will meet to begin their assignments. This is commonly called a point of assembly (which is likely to be distinct from the VPOA).

Important safety information : Pertinent safety issues for personnel responding to their point of assembly, as known at that time.

Confirm notification receipt and provide status : Request for confirmation of message receipt, response status of the notified party, and response time to their point of assembly for the notified individual or group. This provides VMS management with an early indication of adequacy and timing for VMS staffing.

VMS MOBILIZATION

Mobilization is the stage in which the components of the activated VMS transition from baseline operations to the response level designated in the notification. This includes transport of VMS personnel, supplies, and equipment as indicated, set-up of the


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operational space for the VPOA and VMC (location/s should be determined by the VMS Manager in conjunction with ICS), and any initial assignment of personnel (see VMS Mobilization Checklist - VMS L1; and VMS Demobilization and Recovery Checklists - (VMS M4). Mobilization of the VMS is accomplished under the supervision of the VMS Logistics Section Chief. Work areas and communications equipment adequate for communicating with appropriate personnel in ICS are established (see VMS VPOA & VMC Site Selection - VMS M3, and VMC Site Set-up - VMS L2, plus the VPOA & VMC Signage - VMS L3 for the VMC). A schematic of the VMC is provided in Figure 5.

Figure 5. A suggested physical layout for the Volunteer Management Center to conduct the VMS operational processes presented in this guide.

ICS should provide the following assistance to VMS:

Security : Security and perimeter management for the VPOA/VMC. This should be established at the outset of VPOA/VMC mobilization

Logistics : Logistical support in establishing the VPOA and the VMC.


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Initial Operational Capability

Once the VMS has been activated and the mobilization stage is underway, the VMS Manager must ensure that a basic operational capability is rapidly established to process early arriving volunteers even as mobilization is evolving. This operational capability may be elementary, temporary, and sustained by only a minimal level of staffing.

VMS INCIDENT OPERATIONS

Incident Operations is defined as the period during which the VMS actively supports the incident by conducting all the described activities required for effective volunteer processing and management. These essential activities are presented according to the VMS functional sections and the key positions within those functions. Response actions could commence immediately upon activation of the VMS for sudden onset events, at the same time that mobilization is initiated. For example, assistance requests to volunteer organizations (Red Cross or Medical Reserve Corps, and others) could be made immediately, and before VMS mobilization is fully accomplished (see Notification Messages for Pre-registered Volunteers - VMS O6).

VMS may also be coordinating, at the direction of the ICS, with a larger, more generic effort that is attempting to coordinate all types of volunteers and/or with State volunteer offices.

VMS Management

The responsibilities and tasks of the VMS manager (see Position Description and Job Action Sheet – Appendix A) and any appointed VMS command staff positions include:

Implement customized pre-plans 14 : Management reviews the initial pre-plan VMS structure (using the VMS Organizational Chart - VMS 207) and revises as necessary, then makes key personnel assignments. This is disseminated to the VMS personnel and ICS. As VMS personnel arrive, they document their time on incident and their position assignment (using the VMS Personnel Check-in List - VMS 211) for each operational period.

14 “Pre-plans” are guidelines that describe processes and procedures to be followed, plus other response considerations, for the VMS. These build upon the more generic guidance in the System Description and Concept of Operations and tools, and are for specific types of incidents (i.e., hazard-specific) or specific locations. Many organizations refer to these detailed pre-plans as “Standard Operating Procedures” (“SOPs”).


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Complete staffing assignments : Staffing assignments to the VMS positions is accomplished by the VMS Manager and the appropriate section chiefs. Expert judgment needed for volunteer processing must be addressed during these position assignments, according to a pre-determined strategy developed during VMS implementation (see textbox).

Public Health & Medical Expertise in the VMS

Key positions within the VMS organizational structure should be staffed by individuals possessing the ability to apply ‘expert’ proficiency or knowledge to make critical decisions during the processing and management of volunteers. For example, the decision to assign a volunteer to a complex high-trust role requires expert judgment beyond confirming the volunteer’s required certifications. ‘Expertise’ in this area for a public health and/or medical response requires a high level of health and medical knowledge and skills, equivalent to an experienced RN, NP, or MD, based on incident parameters. Several implementation options are possible when selecting the VMS positions to be staffed by public health or medical experts (see Issue 2: Technical Expertise in VMS Management Positions - Appendix C).

Define Operational periods and planning cycle : Establishes the operational periods for the VMS, which then sets the planning cycle for the VMS. All of this is coordinated with the ICS planning cycle if feasible.

Set VMS objectives : Establishes overall (control) objectives for the VMS and the objectives for each operational period. From these, the VMS Manager assesses the overall effectiveness of VMS as the incident evolves, and institutes changes as indicated.

Address health and safety : This may be accomplished with a staffed VMS Safety Officer position (see VMS Safety Officer Job Action Sheet – Appendix A). Otherwise, it is the responsibility of the VMS Manager. The safety function assures the development of the VMS Health and Safety Plan (see VMS Health and Safety Plan – VMS 208) by a designated VMS Safety Officer, and assures the Safety Officer obtains the Public Health Risk Statement from ICS or develops one (see VMS Public Health Risk Statement for Volunteers - VMS O7a) for distribution to volunteers. This document outlines any specific health and medical risks to the volunteer while on assignment and describes precautions and interventions to address those risks. Oversees all aspects of VMS operations to assure safe practices, and intervenes as indicated.

Assure VMS action planning : Oversees the VMS Action Planning process, including reporting and planning requirements, and reviews/approves the VMS Action Plan for each operational period (see the VMS Plans Section


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Chief and VMS Planning Process textbox p. 46 below and The VMS Incident Planning Process – Appendix D).

Establish liaison & coordination : Maintains liaison functions as described in the VMS Systems Description.

Approve VMS public information : Accomplishes any indicated public information tasks for the VMS: The location of the VPOA and VMC should be disseminated to ICS, to VMS personnel, and to volunteer organizations. Much of this may be developed by the Volunteer recruitment Supervisor, but must be approved by the VMS Manager. When appropriate, this information should then be announced publicly through the ICS PIO function.

Maintain financial accountability for VMS costs : Monitor expenditures, liability concerns and contracting to assure adequate funding sources for the VMS (directly supervised by the Admin/Finance Section Chief if the position is staffed).

Monitor VMS effectiveness : Assures adequate functioning of the VMS (see system performance textbox)

System Performance

Monitoring system performance and applying organizational learning/improvement is an important element of the VMS and helps assure adequate function of the system. Measures of effectiveness for system performance, which are commonly tied to the system’s objectives, should therefore be identified early in the system mobilization and be tracked by VMS Management throughout the duration of VMS operations. Possible quantitative and qualitative measures to monitor include: The number of ICS volunteer requests filled compared to the total number of

requests made Average time elapsed from registration to an assignment or to completion of

volunteer processing Feedback from volunteers and from ICS volunteer supervisors Trouble desk issues

General oversight for system performance resides with the VMS Manager, but each section chief should monitor performance of their individual section. Changes, except for life-safety and extreme corrections, should be incorporated during the planning for the upcoming operational period.


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VMS Operations Section Chief

The Operations Section Chief (see Position Description and Job Action Sheet – Appendix A) oversees the activities within the “Operations Section.” This position develops the tactics for each operational period, makes assignments for resources within the VMS Operations Section, evaluates progress towards the tactical objectives and makes changes as indicated (these may include additional staffing or expertise, adjustment of tactics, and others). The Operations Section Chief must also address the development of tactics and assignments for the next period (see textbox), accomplished in conjunction with other members of the Command and General Staff during the planning cycle.

Strategy and Tactics to be Determined for Each Specific VMS Incident

These are VMS issues that must be addressed to achieve the established control objectives: Volunteer collection methods and site for the VPOA Registration tactics, such as data collection methods and the configuration of

registration streams Identity & credentials verification strategy & tactics Volunteer roster categories Available position categories Badging methods Transportation of volunteers, or assuring that they have self-transported and arrived Volunteer tracking methods On-site coordinator assignment (VMS or ICS position) Volunteer recruitment strategy & tactics

Most of these tactical alternatives should be worked out in pre-plans. The appropriate pre-plan can then be rapidly selected and implemented.

VMS Operations Section - Volunteer Processing Branch

The processing steps for volunteers are conceptually presented in Figure 5.

1. Volunteer assembly : The collection and initial organization of volunteers occurs at the Volunteer Point of Assembly (VPOA), the reception area where volunteers initially congregate to be processed. This is accomplished by the VPOA Leader (see Position Description and Job Action Sheet – Appendix A).

2. VMS orientation (i.e., introductory) briefing : This briefing is provided through a written orientation instrument. Distribution may occur at the VPOA or, if the VPOA is contiguous with the VMC, in the line awaiting registration.


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Volunteers are presented with information related to the general role of the VMS, and the role and responsibility of the volunteer during response (See Volunteer Orientation and Acknowledgement of Responsibilities Form - VMS O7). This information includes:

o Appreciation for their willingness to volunteer, and delineate the inherent responsibilities inherent

o Volunteer participation rules, with signed acknowledgement by the volunteers that:

All volunteers accept supervision and operate within assigned parameters.

VMS manages volunteers until assigned to the incident. Designated ICS supervisors manage the volunteers once assigned

and deployed. When volunteers accept assignment, they commit to

professionally performing until their assignment is completed; unforeseen assignment issues are immediately reported to the Assignment Desk if not yet deployed, or to the Trouble-Desk function once on assignment.

The volunteer agrees to abide by the rules and understands the defined consequences of violating the rules (e.g., dismissal, trespassing charges, and other possible sanctions).

o Liability and workers’ compensation coverage information should be clearly outlined, indicating both the type and level of coverage, or should specifically state when coverage is not provided (see Issue 12: Liability Issues for VMS Staff and for Volunteers – Appendix C).

o A Public Health risk statement is provided, which should be available from the ICS Safety Officer. Otherwise, it is prepared by the VMS Safety Officer using the ICS safety plan (see Public Health Risk Statement For Volunteers- VMS O7a) It should outline any specific health and medical risks to the volunteer while on assignment and describe precautions and interventions to address those risks.

The VMS orientation briefing is designed to provide a clear understanding regarding volunteerism before the prospective volunteers commit to the registration process. The Volunteer Orientation and Acknowledgement of Responsibilities (VMS O7) includes an instrument to obtain a signed acknowledgement by the volunteer that he/she understands and accepts the volunteer role and responsibilities during incident response. This acknowledgement is archived through the Plans Section.


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Medical and Other Support to Volunteers

Volunteers who have been processed, credentialed, and assigned to professional positions within the response have formally accepted significant responsibility to perform tasks. During the preparedness phase, consideration should be paid to whether the agency or jurisdiction benefiting from this professional volunteerism will provide the same level of medical support and workers compensation coverage provided to paid professionals responding to emergencies and disasters. This includes, but is not limited to, access to medical care for problems developed due to their response activity, post-incident health monitoring and surveillance, and possibly some form of workers compensation coverage for injury or illness incurred while deployed on an assignment through the VMS.15 Benefits may be limited to those volunteers that have been fully processed and formally assigned through the VMS, thus limiting the financial exposure to the organization responsible for this medical or worker’s compensation coverage. Whatever benefits will be provided should be determined during the preparedness phase, and the orientation briefing should provide this information to the prospective volunteer. Qualified legal assistance in developing procedures for this issue is recommended.

3. VMS Registration : This is the initial station in the VMC itself. The registration process is accomplished under the direction of the Registration Supervisor (see Position Description and Job Action Sheet – Appendix A). Registration obtains self-reported personal data and professional qualifications from the prospective volunteers. The registration information includes:

o Personal information.o Emergency contact information.o Contact information for on-call and for on-assignment (cellular phone

and/or pagers are preferred).o Professional information: profession, capability (i.e., categorized skill

sets), certifications, qualifications (licensure, experience, and others), and an acceptable verification-of-credentials source if available (i.e., an accredited healthcare organization where the volunteer has professional privileges). Skill sets for volunteers are also sought if indicated. These could include foreign and sign language skills, computer or security expertise, or other capability.

This information is collected (see Volunteer Registration and Credentials Form - VMS O8) and provided to VMS Plans and to the Credentials Verification station. A Volunteer Process Checklist (VMS O10) is the final form in the registration packet; it allows both the VMS and the individual volunteer to assure that all the

15 Workers' compensation is a state-mandated insurance program that provides compensation to employees who suffer job-related injuries and illnesses. Workers Compensation laws vary by State.


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necessary processing steps are accomplished as the volunteer progresses through the system. A volunteer who has completed this step is then considered “registered.”

Depending on the kinds of volunteers presenting, registration can be configured for efficient processing so that urgently needed volunteers can be rapidly assigned. The configuration of the registration area (an operational tactic) is implemented by the Registration Supervisor and Volunteer Processing Branch Director after approval by the Operations Section Chief. For example, the number of registration stations and flow of volunteers can vary between events and even over the course of a single event. One implementation strategy to consider is the use of multiple registration/processing streams based upon categories of volunteers (individual volunteers, volunteers groups, pre-registered volunteers, individually requested volunteers), with “fast-track” for priority or easy-to-register categories. The processing of spontaneous, unaffiliated volunteers (individuals or groups) may be the most time intensive. Creating a distinct processing stream for these volunteers would allow other volunteer categories to be registered and assigned more quickly, permitting the VMS to meet ICS personnel requests more efficiently (see Issue 3: Volunteer Registration Strategies - Appendix C).

4. Identity & Credentials Verification : Registered volunteers then have their identity and their presented professional qualifications, experience and privileges confirmed as true and accurate (see Volunteer Registration and Credentials Form - VMS O8). These activities are performed under the direction of the VMS Registration Supervisor (see Position Description and Job Action Sheet – Appendix A). Privacy concerns should be addressed during the credentials verification process. This includes securing of forms, obtaining a Release of Information Form (VMS O9), signed by the volunteer during registration, to facilitate obtaining information on the volunteer, and using private areas for screening. Due to time urgencies and limited human resources to process volunteers, the methods used for credential verification must be carefully considered. Several specific strategies have been defined as options for accomplishing credentials verification: primary source verification, secondary source verification, and expedited emergency credentialing (see Issue 4: Credential Verification Strategies - Appendix C). The verification process includes:

o Confirmation of identity. o Confirmation of professional credentials (certification and other

qualifications including licenses, experience, and professional abilities) according to the jurisdiction’s established credentialing guidelines.

o Rostering volunteers with verified credentials according to a delineated rostering strategy.

o Providing the roster to the Volunteer Assignment station.


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Once identification is confirmed and satisfactory credential verification is attained, the volunteers are “rostered” according to verification level and the Credentials Verification Supervisor’s judgment of their qualifications for potential incident positions (see Creating Rostering Categories textbox and Issue 5: Rostering Strategy for Credentialed Volunteers - Appendix C).

Creating ‘Roster’ Categories for Volunteers

When being processed and accepted into the VMS, a volunteer can be ‘rostered’ to facilitate assignment matching. This can involve the use of a pre-defined tiered rostering strategy, which includes addressing professional classification, job category and the functional characteristics of the volunteer within that job category based upon the level of credential verification.

5. Volunteer Assignment : This “matching” function reviews the rostered volunteers and assigns them to available positions identified by the Incident Integration Branch (using the Volunteer Position Requests Form – VMS O1).16

It is accomplished by the VMS Assignment Supervisor ((see Position Description and Job Action Sheet – Appendix A). The process includes:

o Receiving available assignments from Incident Integration Branch (see below).

o Matching assignments to appropriate volunteers using the roster categories developed and used by the Credentials Verification Supervisor.

o Providing a position description to the volunteer and obtaining acceptance of the assignment. The position descriptions are best developed by the organizations requesting volunteers (ideally as attachments to VMS pre-plans). These position descriptions will facilitate the volunteer assignment process, as well as assist the volunteer with understanding what their roles and responsibilities will be during their assignment.

o Completing the Volunteer Assignment Slip (VMS O11) for that particular assignment.

o Referring accepted and assigned volunteers for an assignment briefing to (see next section).

The assignment supervisor should assure that priority positions, as identified by ICS, are filled first if possible (see textbox).

16 For complex and high-trust positions, this goes beyond merely matching credentials with task description. It may include the use of expert judgment to match individual attributes of the credentialed volunteer with the specific assignment requirements.


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Prioritization of Volunteer Requests and Assignments

As previously discussed, the system description and concept of operations for a community’s response to emergencies and disasters must define the point of integration for the Volunteer Management System within their response structure. The VMS should be assigned to a single function in the management construct, most often integrating through and reporting to the ICS Logistics Section or EOC resource tracking and dispatching function. In either case, it must establish a single channel of authority and communication process that the VMS will receive volunteer requests and the priority, if any, in which the requests should be filled. The lack of a clear, coordinated management construct that delineates direct lines of authority may cause the VMS to be receiving requests from multiple sources without a mechanism in place to prioritize all requests based on the overall incident needs, or to avoid processing redundant requests. As a result, it is important that the incident requests and the prioritization of volunteer requests be accomplished by ICS and clearly communicated through a single channel to the VMS.

Assignment is facilitated by the categorization of rostered volunteers into groupings as described above, and by grouping incident requests so that the assignment personnel can easily match personnel to available incident positions.

All ‘credentialed and rostered’ volunteers are processed through the Volunteer Assignment Supervisor (or designee) and placed into to one of three categories:

a) “Rostered and Assigned” - these are: o Volunteer(s) assigned to an incident position and scheduled for

immediate dispatch (after assignment briefing and training on duties) to perform ICS designated task (see Volunteer Assignment Slip - VMS 011).

o Volunteer(s) assigned to an incident position but scheduled for future shifts. They are staged for assignment briefing, then released to return prior to start of assigned shift to complete the required deployment activities.

b) “Rostered and Staged” - these are volunteers with assignments pending: the volunteer(s) is/are staged at the VMC or another staging area because of pending assignments.

c) “Rostered and Released On-call” – these are volunteers who are fully rostered but have no assignment available or immediately anticipated. The volunteers are released with instructions (see Volunteers Awaiting Assignments - VMS O14) regarding potential future assistance, call-back procedure, importance of respecting the incident perimeter, and caution about unauthorized entrance.

The issue of the unacceptable volunteer must also be addressed (see textbox).


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Addressing the Issue of the Unacceptable Volunteer

Some individuals are not competent to act as volunteers, and others may present with motivations that are troublesome to the VMS personnel. To address the issue of “unacceptable” volunteers while avoiding direct confrontation, it may be helpful to include a statement in the Volunteer Orientation & Acknowledgement of Responsibilities stating that the Credentialing Supervisor reserves the right to determine whether a registering volunteer is qualified for volunteer positions within the VMS. If the Credentialing Supervisor deems the volunteer unqualified to work within the VMS, the volunteer must duly accept the decision. How this is documented so that the volunteer is not assigned later must be addressed during VMS implementation.

6. Assignment Briefing : Volunteers who are “rostered and assigned” to a specific incident position are provided a briefing and “just-in-time” training (see textbox). This covers the general information necessary for the volunteer to effectively integrate into the incident and perform in a professional manner. The Assignment Briefing Leader (see Position Description and Job Action Sheet – Appendix A) is responsible for developing and conducting the briefing. This is facilitated by a VMS Assignment Briefing Template (VMS O13). It includes:o A situation update, including incident parameters and engaged resources.o Review of risks/safety issues specific to the incident.o Standard Personal Protective Equipment (PPE) orientation and any other

standard required safety measures for all volunteers.o Standard operating procedures for all volunteers, including on-call,

staging and/or mobilization procedures.o General information related to volunteer assignments (alternatively, this

may be accomplished by the ICS supervisor for the volunteer at the work site):

Specific expectations related to VMS processing and support. Expected shift-length and duration of assignment. Expected supervisory relationship within ICS. Location and personnel to whom the volunteers report. General responsibilities and duties. Trouble Desk contact information and procedures. Review liability/workman’s compensation coverage, if any.

o Time allotted for the volunteer to have questions answered. o The provision of any other equipment that is to be supplied (in addition to

PPE) and “just-in-time” training on that equipment.o The Assignment Briefing does NOT include job specific training – that is

the role of ICS supervisory personnel.


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Just-in-time Training

VMS “just-in-time training” is a way to deliver information and skills important for the volunteers to perform in their assigned positions. Just-in-time training designed for the volunteers imparts an understanding of how the VMS functions to support and integrate volunteers effectively into the response. The goal is to provide key information to all volunteers about their role and general rules of conduct prior to initiating their assignment, in order to minimize the number volunteers that opt out because of misconceptions or misunderstandings. It is important that volunteers have an understanding of their overall responsibilities and incident-associated risks prior to being deployed to a specific site. Basic incident information, including general risks, updated incident details, and rules of conduct are important components of the VMS just-in-time instruction.

Each individual volunteer assignment will also require some specific training based on the tasks to be accomplished by that position. This assignment-specific training is the responsibility of the ICS or agency accepting volunteers for work within their organization. The more general instruction and training components (for PPE or job-specific tasks) need to be clearly defined and pre-assigned to either the VMS or ICS so that no information gaps occur. These issues need to be coordinated between the VMS Incident Integration Branch and the ICS Logistics Branch with a special emphasis on documenting the types of instruction and training each volunteer receives.

Both the orientation information provided to volunteers and the information communicated to ICS personnel regarding the use of volunteers and functions of the VMS must be clear and consistent.


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Equipment Management

Volunteer public health and medical workers may require personal protective equipment (PPE) or other medical equipment/supplies for the effective and safe performance of their incident tasks.17 ICS and the VMS must jointly determine who will be providing the assigned volunteers with PPE (ultimately, this is the responsibility of the ICS and/or the resources accepting the volunteers) and specify the types of PPE required. The VMS may accept the ICS’s responsibility for promoting volunteer safety related to distributing PPE and assuring that volunteers are operationally competent to use the distributed PPE (for more detail, see Issue 6: Equipment and Training Strategies – Appendix C).

7. Badging and Deployment : The Deployment & Out-processing Leader (see Position Description and Job Action Sheet – Appendix A) assures (using the Volunteer Processing Checklist) that the assigned volunteers have been fully processed and received all indicated pre-deployment equipment, supplies and training. A final step for the assigned volunteer includes the provision of a VMS identification badge. More importantly, an ICS site-privileging badge or some form of credential is given to the deployed volunteer that allows entry beyond the secure perimeters established by ICS. A log of volunteers granted ICS site privileges is maintained by the Deployment & Out-processing Leader. There are several options for site privileging, and one should be established in conjunction with the appropriate ICS personnel (for greater detail, see Issue 7: Site Privileging and Volunteer Badging – Appendix C):o The common site-privileging option is that the VMS provides

volunteers with a VMS badge, but all other site-privileging responsibilities are relegated to ICS. ICS will need to define the strategy for indicating site access privileges for assigned volunteers (another badge, armbands, stickers etc.) and appoint the responsibility of site privileging to either the ICS Volunteer Supervisor or to a designated function located outside the incident perimeter (if applicable). In these cases, ICS personnel will be required to meet the incoming assigned volunteers and walk them through the site privileging process. This maintains any ICS security measures and minimizes confusion that may arise between ICS and VMS about the privileging details.

o A second, simpler approach is for the ICS to provide site access badges to the VMS Deployment & Out-processing Leader. The Leader then issues them to assigned and fully processed volunteers, and provides a log to ICS of the personnel given the site access badges. Tight accountability,

17 Currently, standards for specific PPE for healthcare workers are regulated by the Food and Drug Administration (FDA) (FDA's Role in Regulating PPE is available at: http://www.fda.gov/cdrh/ppe/fdarole.html). Workplace health and safety regulations defined by OSHA state that PPE must be provided to employees and specifies the circumstances in which PPE is required. The CDC provides guidelines for the appropriate PPE selection and its use in the healthcare setting.


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http://www.fda.gov/cdrh/ppe/fdarole.html


including recovery of the badges at the conclusion of a volunteer’s service, should be assured.

Once the volunteer has been appropriately badged, the Volunteer Process Checklist is collected and, if all steps have been completed, the volunteer is deployed by the Deployment & Out-Processing Leader to his/her assignment location. This may include developing a volunteer transportation method in coordination with VMS Logistics. Volunteers that complete the deployment step are referred to as “deployed volunteers.”

8. Transportation : If needed, transport to and from the incident position for deployed volunteers is provided through ICS via arrangement made by VMS Logistics (see VMS Transportation Request Log - VMS L4).

9. Volunteer incident operations : The deployed volunteers receive a specific job briefing from their supervisors or designees and work the designated shift in their assigned positions. While volunteers are on location, any problems or concerns are addressed by their supervisor or the ICS on-site volunteer coordinator (if one is designated). If not resolved through these contacts, the volunteer (and/or their supervisor) can access the VMS Trouble Desk (see VMS Trouble Desk Information Form -VMS O3 and trouble desk function below) through contact information provided to them during their assignment briefing.

10. Volunteer out-processing or reassignment : As deployed volunteers complete assignments (or their series of assigned shifts) and are released from the assigned ICS area, they return to the VMC and are re-assessed at the Volunteer Deployment and Out-processing station (see Volunteer Out-processing/Rehabilitation Checklist - VMS 015). If a volunteer performed adequately (assessed through the Volunteer Performance Evaluation Form - VMS 226), and is sufficiently rested, (or “rehabbed”), possibly using the Waiting/Staging area of the VMC, and interested in further participation, the volunteer may be referred to the Assignment Supervisor and offered additional assignments; if not (or no further assignment is available), the volunteer is thanked and formally out-processed.

Activities to accomplish at this station include: o Assess the volunteer’s performance evaluation done by his/her ICS

supervisor, and review with volunteer (if not done by their ICS supervisor).

o Reassignment: new assignments for qualified, willing volunteers are provided through the Volunteer Assignment Supervisor.

o Rehabilitation: rest, hydration, meals, and restroom facilities between incident assignments as indicated.18

18 “Rehabilitation” is response terminology for rest, rehydration, feeding and other activities so that responders may resume safe and effective operations.


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o Out-processing: demobilization of volunteers who wish to leave or for whom there are no more current or projected incident assignments. Out-processing activities include:

Retrieval of issued equipment and unused supplies (VMS Equipment Issue and Return Form - VMS O12) and access badge.

Incident review: a brief review of activities focused on volunteer’s assigned role.

Address any incident-related medical or psychological issues for the volunteer (for example, completing the Exposure Form - VMS O16), with follow-up established as indicated.

Return of volunteer issued equipment and unused supplies. Recovery of access privilege badge. Request to volunteer to evaluate VMS and his/her participation

experience (Volunteer Feedback Form - VMS O17). Informing the volunteer of the time and location of the VMS after-

action meeting (as indicated). Provide documentation to volunteer certifying that the volunteer

contributed a specific number of hours of participation, the site, the task, and the immediate supervisor if known (Receipt for Volunteering -VMS O18).19

Volunteers who complete this step are considered “out-processed.” They may be “released” or “rostered and released on-call” (see assignment categories above) depending upon potential future incident needs and volunteer interest.

Apart from being fully “out-processed” as detailed above, it may be advantageous to develop a “daily monitoring” process for volunteers who are working multiple shifts at the same assignment. This may entail their return to the VMC for check-in and selected rehab activities, or may be accomplished remotely from the worksite or home setting for the volunteer.

The conceptual route of this volunteer processing is summarized below in Figure 6.

19 This may be important for volunteer recognition and for the volunteer’s IRS purposes. In addition, some jurisdictions have used documented volunteer hours as part of the jurisdiction’s matching contribution for FEMA, and for other disaster funds.


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Figure 6. Conceptual routing of volunteers from the VPOA through the VMC.

VMS Volunteer Recruitment

The Volunteer Processing Branch may be tasked with advertising and other recruitment activities to ensure a closely coordinated, needs-based recruitment strategy. If this becomes a significant activity, volunteer recruitment may be established as a separate branch under the VMS Operations Section (see Issue 8: Volunteer Recruitment Strategies - Appendix C for further details). Volunteer recruitment activities may be assisted by the Incident Integration Branch facilitating the link with the ICS PIO, who would ultimately be responsible for crafting or approving the actual message. Tasks for this function include:

Directed requests: These are directed appeals to pre-identified volunteer and professional organizations that have pre-registered volunteers qualified for medical and/or public health tasks. The requests may be for specific


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individuals (the recruited volunteer) with narrow skills necessary for an unusual incident position.

Public appeal for volunteers : VMS personnel will develop and refine messages publicizing volunteer needs. This may include messages stating that no volunteer needs are anticipated. This activity is coordinated with the ICS PIO. The follow-on messages are revised as volunteer needs evolve, or as needs are resolved and volunteers are no longer needed. The messages include the types of needed volunteers, the location of the VPOA and VMC, required documents, personal equipment and supplies, and expected length of deployment (see Volunteer Recruitment Request Process/Template – VMS O5). Establishing a telephone screening to identify needed volunteers may be another strategy that could streamline volunteer recruitment.

VMS Operations Section - Volunteer Incident Integration Branch

This branch of the VMS Operations Section has four primary objectives: 1) Assuring ICS understanding of the VMS and its role, 2) Obtaining incident details and the specific incident personnel needs (i.e., defining the positions to which the volunteers can be matched), 3) promoting optimal integration of the volunteers into the incident response, and 4) maintaining accountability of volunteers. Important tasks for this branch to address include:

Promoting an informed ICS : Assuring that appropriate ICS personnel understand the role of the VMS and how the VMS is integrated as a response resource. ICS positions must also understand their responsibilities and process/procedure related to requesting, receiving, and supervising volunteers deployed through the VMS (see textbox).

Orientation for ICS Staff and Receiving Agencies

ICS staff and any agency that may be receiving volunteers must be educated about the role of volunteers, the VMS, its function and key operating principles. This can be accomplished during the preparedness phase or carried out in the form of a just-in-time orientation or briefing delivered as needed. It is important to provide an explicit description of the process required to request volunteers based on the qualifications necessary to perform certain tasks and clear prioritization of requests. Issues of volunteer supervision such as the process for handling problems with volunteers (from unsuitability to a task, misbehavior and/or an incident or exposure), deployment, out-processing, and providing feedback must also be explained. An instrument such as a “VMS Fact Sheet” may be useful in providing the just-in-time orientation briefing for ICS staff. A Fact Sheet is a simple one-page document explaining the resource’s capabilities and capacity, contact information, and support needs.


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Obtaining incident information : From the onset of VMS operations, the Incident Integration Branch Director conducts a continuous evaluation of incident volunteer needs and other incident parameters. These may initially be captured in the Initial Event Log (VMS 201) by the VMS Manager. Changes to incident parameters and updates must be regularly obtained – it is important for Incident Integration Branch personnel to actively seek out the incident information and establish a relationship with ICS so that changes in incident parameters are likely to be reported. In fact, an ideal strategy would be to have the Integration Branch personnel sit as observers during the ICS planning meetings. Incident information acquisition is a continuous process throughout the incident. It may be obtained informally and/or obtained through access to the planning meetings and ICS Incident Action Plan for each operational period. Specific information tasks include:

o Determining the site privilege badge procedures and conveying the methods for obtaining badges for volunteers being deployed into the incident.

o Determine the support benefits and services available to volunteers who are formally processed and deployed into the incident through the VMS (see Medical and Other Support to Volunteers –Textbox page 31 for further detail). This information should be conveyed to the Assignment Briefing Leader for incorporation into the Assignment Briefing.

o Determine if unprocessed volunteers are already active in the incident prior to VMS activation, or if they have evaded VMS processing. See below if it is determined that unprocessed volunteers are working incident assignments.

o Obtain incident updates from ICS contacts (as well as other ICS reports and tools) for use in the Assignment Briefing Template, for anticipating future volunteer needs, and for demobilization and other planning purposes (provide to the VMS Plans Section and VMS Volunteer Processing Branch).

Obtaining and defining incident personnel needs : Starting with an incident type-specific pre-plan (written during VMS development) for anticipated volunteer requests, Incident Integration Branch personnel seek to determine from ICS what personnel needs could be addressed by VMS-processed volunteers. Immediate incident needs that could be filled by volunteers are defined and reported back to the Volunteer Processing Branch of the VMS (see VMS Operations Work Sheet – OPS II4). Tasks include:

o Develop and log volunteer position descriptions, benefits (if any), credential requirements (see textbox below), reporting and work locations, receiving personnel, and supervisors for volunteer task assignments, along with contact information.

o Translate requested position descriptions to align with the categories of current and anticipated “rostered” volunteers (see Issue 5: Rostering Strategy for Credentialed Volunteers – Appendix C).


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o Provide this list of available volunteer positions to the VMS Volunteer Processing Branch (and the VMS Plans Section for documentation).

o Continuously monitor incident needs that have been established by ICS and designated to be potentially filled by volunteers. Characterize the tasks, shifts that need to be covered, locations, and unique or unusual characteristics needed for the job.

o Inform ICS Logistics when it is anticipated that the VMS may be unable to fill volunteer requests. This information is developed with the assistance of the Volunteer Processing Branch, often from data used for a current Situation Report (VMS 209).

Incident Position Requests and Credential Requirements

Given the complexity of the credentialing issues, it is advantageous to establish in pre-plans the specific credentials required of volunteers that would fill incident positions during response. ICS staff holds the responsibility for delineating the minimum level of qualifications for personnel acceptable for these positions. These positions should be developed for each type of likely incident (as determined in the appropriate Hazard Vulnerability Analyses) and incorporated into pre-plans. Beyond identity confirmation, most positions will have only a few credential requirements such as confirming that they are employed in the healthcare field. Conversely, rigorous credentialing and privileging mechanisms may be required for volunteers being assigned to very “high-trust” positions within ICS, particularly those who may be working as independent medical practitioners or providing important incident response advice as technical experts.

Addressing volunteers already active prior to VMS mobilization : If volunteers are already present or operating in the ICS system at

the time the VMS becomes operational, establish methods (with ICS personnel) for processing these volunteers through the VMC. The ICS determines if and how volunteers will be relieved and directed to the VMC for processing (see Issue 9: Managing Volunteers Already Active in the Incident - Appendix C).

Maximizing coordination between the VMS and ICS : Successful VMS operations are dependent on close coordination and ongoing communications with ICS via their Logistics section. It is important that any gaps or overlap between the two systems be effectively addressed, particularly in areas such as site access, transportation of volunteers and other considerations (see textbox below).


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VMS/ICS Coordination Considerations

Successful VMS operations are dependent on close coordination and ongoing communications with ICS via their Logistics section (or EOC if applicable). In order to ensure that integration between the two systems has been effectively addressed it can be useful to review a list of responsibilities that could fall to either the VMS or ICS. Clearly establishing responsibilities for the following can facilitate response for both systems. The following should generally be established during VMS development and described in a pre-plan: VPOA and VMC site locations and any additional infrastructure related equipment Communications plans and protocols Process for orienting ICS personnel to the VMS Credentialing guidelines and minimum qualification requirements Transportation of volunteers to and from assigned worksites Ongoing provision of equipment and supplies for the VMS Provision of equipment and supplies (PPE) for volunteer use in the field Prophylaxis and coordination of health and medical plans Site privileges and badging procedures for access to the incident site On-site Volunteer Coordinator (whether this is a designated ICS or VMS position) Volunteer job-specific training (location and documentation mechanism) Relay of information on volunteer arrival and departure from worksite Deployment and out-processing procedures Provision of medical care to volunteers while onsite Long term follow-up of exposure or other physical/psychological health issues.

Tracking deployed volunteers : The Volunteer Tracking Supervisor maintains accountability for all assigned volunteers (see Assigned Volunteer Scheduling and Tracking Form - VMS T1) through continuous tracking of assigned volunteers, including while they are deployed. In some incidents where volunteers are deployed to multiple locations, such as several clinics or dispensing sites or when large numbers of volunteers are operating in any one site, the Incident Integration Branch may deploy an On-site Volunteer Coordinator (see Issue 10: On-site Volunteer Coordinator - Appendix C) to each site to accomplish these responsibilities. An On-site Volunteer Coordinator can also act as a mobile position, traveling between worksites to facilitate information exchange and to assist where and when needed. The On-site Volunteer Coordinator reports to the VMS Incident Integration Branch Director, but also provides the Volunteer Tracking Supervisor with tracking information.

“Trouble Desk” : This problem-solving resource is a single function for addressing question or issues related to deployed volunteers. It is available to ICS personnel and to deployed volunteers themselves. The ‘desk’ may be a


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virtual location with availability maintained through portable communications. The role of the trouble desk is to:

o Answer questions/issues by deployed volunteers, ICS supervisors or other ICS personnel. These may include issues surrounding a volunteer’s qualifications or motivations, a change in the volunteer’s willingness or ability to staff the assigned position, or any other concern that can’t be easily addressed by the IC supervisor or VMS on-site coordinator.

o Document any adverse incidents involving deployed volunteers, both to address liability and as an indication of possible VMS deficiency; investigate and intervene with involved volunteers or ICS as indicated; provide documentation to VMS Finance/Admin Section.

o Provide a summary of major VMS trouble desk issues to the Incident Integration Branch Director during each operational period. This information should be available for consideration during VMS action planning activities.

VMS Plans Section

While much of the actual VMS operations are pre-planned, the Plans Section maintains documentation and provides additional planning and meeting support as indicated. These activities include:

VMS Situation Status : A situation status delineates the incident-specific parameters, including characteristics of the hazard, impact on the ICS, and the structure and function of the ICS itself, equivalent to the standard ICS Situation Unit. This includes tracking and recording the chronology of VMS events and the categories of volunteers who have been registered, processed, assigned, and out-processed. The situation update is captured in the VMS Situation Report (VMS 209) and is developed for appropriate distribution as indicated by the incident (i.e., as determined by the VMS Manager).

VMS Resource Status : A resource status is a documented summary of the status of all assigned VMS staff (aggregate of completed VMS 203s), available personnel, and out-of-service personnel, plus any other resources assigned to assist the VMS in its mission. It includes a similar accounting of critical equipment and supplies. How detailed this is for the VMS may be situation dependent as determined by the VMS Manager,

VMS Incident Planning Support : Provides planning support to the Management and Operations Sections of VMS for VMS incident planning (see VMS Incident Planning Process textbox). This support is accomplished by conducting the VMS meetings during each operations period, assuring that planning documents are completed and processed into a VMS action plan, and providing long-range, contingency, alternate, and demobilization planning as indicated (See the textbox


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below and The VMS Incident Planning Process – Appendix D for more information on incident planning). These planning activities should be relatively simple (see Concept of Operations), since the menu of likely actions is pre-established, and relates primarily to anticipating the number of VMS staff that will be needed, the volunteer processing strategies, and other areas where the processes may be adapted according to incident circumstance. The VMS incident action plan usually will include completed forms for the upcoming operational period, including:

o VMS Assignment List (VMS 203)o VMS Communications Plan (VMS 205)o VMS Medical Plan (VMS 206)o VMS Organizational Chart (VMS 207)

The VMS action plan must be approved by VMS manager.

VMS Incident Planning Process

The overarching (control) objectives for the VMS are providing qualified volunteers to meet ICS personnel requests, and addressing safety and accountability of volunteers as an extension of the ICS authority. While these control objectives will remain relatively constant, the volunteer personnel requests and other incident parameters are likely to change during the evolution of an incident, as will the number and type of available volunteers, the just-in-time training requirements, and many other incident factors. To effectively respond to those changing parameters, VMS action planning20

will be required. Generally, when an incident is complex, involves multiple agencies, or is expected to be of extended duration, then formal action planning should occur through the use of specific VMS forms and the conduct of certain meetings in a cyclical fashion (see VMS Incident Planning Process – Appendix D for more information).

Measures of effectiveness : Evaluating the effectiveness of assigned volunteers in conjunction with Incident Integration Branch – the assessment information is conveyed to VMS Management for their consideration.

Information Archiving : Archive the volunteer registration information, the completed VMS management forms, action plans and other VMS-related incident documents. The VMS Plans section maintains accountability and

20 “Action planning,” more formally known as “incident action planning, is the collective term for activities that support the incident management process. It includes development of the incident action plan and support plans and accomplishing incident information processing. This is in contrast to preparedness planning, which is designed to ready a system for response.


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availability of volunteer records and provides other duties equivalent to the standard ICS Plans Documentation Unit.


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Long-term document storage

Maintenance of all incident documents is usually the responsibility of the ICS. As the incident draws to a close, VMS documents (or at least copies) should be offered for consolidation with other ICS incident archives. Other options for document storage include the VMS having a permanently designated document storage area that can be accessed over the long-term if required.

VMS Logistics Section

The VMS Logistics Section Chief (see Position Description and Job Action Sheet - Appendix A) is responsible for supporting VMS Operations in the areas of personnel, facilities, meals, transportation, and communications. Depending on the nature of the event, the ICS system in place, and the ICS-VMS relationship in the ICS structure, the VMS Logistics Section may be able to access many of the indicated services and materiel through ICS resources. Once volunteers are processed, assigned, and report to the ICS, assistance and support for the individual volunteers is provided directly by ICS. This extends to include any medical assistance for volunteers during assignments, but requires close coordination with the VMS. The direct VMS Logistics responsibilities include:

Establishing and supporting the VPOA and the VMC : VMS Logistics is responsible for mobilizing the VMS equipment and supplies, establishing the physical plant for the VMC, and maintaining/adjusting the physical configuration in response to VMS operational needs throughout the incident.

Volunteer transport : Transporting volunteers to their assigned locations, and returning volunteers to VMC as indicated, is coordinated and accomplished through VMS Logistics. If this is a complex task, the ICS logistics section should assist with this task.

Support VMS operations : Activities related to this task include:o VMC site maintenance.o Communications (see VMS Communication Plan - VMS 205).o Information technology, including information processing equipment and

connections, and maintenance of e-VMS systems administration if applicable.

o Food, fluids, refreshments as indicated for VMS staff and for volunteers awaiting assignment or undergoing rehab or out-processing.

o Maintain an adequate personnel pool of potential VMS staff for follow-on shifts and for longer-range (shift assignments are done by the appropriate


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Section Chief) and contingency plans (developed by Plans and approved by the VMS Manager).

o Sleeping quarters for staff as indicated.o The logistical needs of the volunteer staging and rehabilitation areas.o Acquire and manage cache of PPE and other general safety equipment for

dispensing by VMS Volunteer Processing Branch as indicated.o Establish a Medical Plan (see VMS Medical Plan - VMS 206) for VMC

staff and for volunteers who could need medical assistance while in the VMC. This should be a straightforward task and primarily for personnel in the VMC and volunteers who haven’t been deployed into the incident. Deployed volunteers and those returned and out-processed should be covered by the overall incident medical plan. The VMS Medical Plan should therefore be very consistent if not identical with the ICS Medical Plan. This action is accomplished by coordinating with the ICS Logistics Section Medical Unit. They also assure the arrangement of any indicated post-incident medical surveillance and follow-up for VMS staff per jurisdictional determinations.

o Supervise VPOA and VMC physical demobilization.

VMS Administration/Finance Section

Activities include:

VMS procurement : Provides contracting and other financial services related to acquiring the equipments, supplies and services necessary for augmenting the base VMS logistics cache for operation of the VMS.

VMS claims : Processes any injury, worker’s compensation claims, and expense reimbursements by VMS staff. Tracks injury and other claims by assigned volunteers in the system, and assists the volunteers with filing the claims with ICS. If indicated by the VMS-ICS arrangement, processes volunteer claims for the ICS Claims Unit.

VMS liability : Collects reports on incidents of concern regarding assigned volunteers in the system (Volunteer Incident Report - VMSO4) and manages the legal and financial liability issues for the VMS. It also maintains the records of any significant incidents involving volunteers to evaluate as indicators for improving VMS process and/or procedures. This function may coordinate closely with Risk Management from ICS.

VMS costs : Tracks expenses and assures payment of approved VMS charges (see VMS Incident Expense Log - VMS A1).

VMS personnel time : Track VMS personnel hours and assignments. Even though volunteers are not paid, tracking of aggregate


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volunteer times may be important for the jurisdiction to use in accounting for the jurisdiction’s matching funds with FEMA.

ICS Support to the VMS

The ICS that is responsible for the overall incident response will provide support to the VMS during the incident response. This may include the following:

Security : Maintaining perimeter security for the VMC and incident sites, assuring order within the VMC, and intercepting unprocessed volunteer before they gain access to the incident site and instead channel them to the location of VPOA/VMC.

Information : Providing a conduit (through ICS Logistics) with VMS Incident Integration Branch of Operations for:

o Furnishing VMS with evolving incident information through incident updates.

o Defining and redefining ICS needs that may be filled by volunteers.

Processing volunteers deployed prior to VMS activation : Volunteers may present to ICS before VMS activation, and indeed may be the trigger for VMS activation. Once the VMS has been mobilized, it can process any volunteers already working in the incident, and ICS personnel should assist in assuring that this occurs. The volunteers already operating on-site can be temporarily relieved by ICS for processing by the VMS (this would be an opportunity to provide badging for the volunteers as well). This can be a useful strategy that allows for re-evaluation of the volunteer’s appropriateness for their assigned tasks and re-assignment as necessary. Other options are also available to address these volunteers (see Issue 9: Managing Volunteers Already Active in the Incident ).

Managing deployed volunteers : These tasks may include:o Providing job or task-specific training for volunteers beyond that

accomplished by the VMS, including specific safety issues, orientation to ICS structure in the area of the assignment, and public health education and training for the specific job.

o Maintaining supervision and accountability of volunteers from the time they arrive on-site until they are returned to the VMC for out-processing.

o Assisting VMS with the site privileging process (badging and admission to the work sites).

o Providing input to VMS as to effectiveness of individuals or groups of volunteers, and assisting VMS with removal/dismissal of uncooperative or ineffective volunteers.


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o Addressing health and medical issues for volunteers. These include methods for evacuation, on-site treatment, and post-deployment health screening.

o Assuring that volunteers who have completed their assigned duties (or series of shifts) are escorted or otherwise returned to the Volunteer Out-processing area if the VMS is unable to ‘retrieve’ its volunteers for out-processing. Assist with demobilization of volunteers (including collection of issued equipment and badges). Alternatively, if VMS Incident Integration Branch personnel are on-site, they may accomplish the out-processing at that location. A volunteer would be given the opportunity to request reassignment per regular out-processing procedures.

Many of these issues can be addressed during preparedness planning. A memorandum of understanding (MOU) between the VMS and agencies/organizations that may use volunteers may be helpful in providing guidance for these addressing these issues (see VMS Memorandum of Understanding textbox below).

VMS Memorandum of Understanding

The development of a Memorandum of Understanding (MOU) should be accomplished during preparedness activities. It provides a written description of the relationship between the VMS and ICS recipient agencies who may be requesting volunteers. The guiding principles will help to ensure efficient coordination between these two groups during response.

Issues to address in the MOU include: Define the circumstances in which the MOU is applicable Describe the relationship of this MOU with existing emergency operations plans for the

involved jurisdiction, agencies, and/or non-governmental (healthcare) organization Describe how signing this MOU commits each agency to abide by the terms set forth in the

event of a health or medical disaster Define financial and legal liability Define the process for requesting volunteers (include reference to: the minimum qualifications

expected for volunteers by position, the level of credentialing required for specific positions) Include responsibilities of each party to the agreement

Examples of ICS responsibilities to the volunteer include:Providing adequate onsite supervisionProviding job specific briefingEvaluation by supervisor after assignment completionOn-site support services consistent with those provided to regular staff and responders such as access to medical care and rehabilitation services, nutrition, provision of PPE, prophylaxis, vaccine or other protective actionsProvision of necessary equipment for job assignment

VMS responsibilities include:Providing all VMS functions as outlined in the VMS Concept of OperationsProviding available volunteers based on ICS prioritization and position requirements Providing volunteer brief for operating within VMS guidelines


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Participation in ICS After-Action Report process

VMS DEMOBILIZATION

System demobilization is the process that accomplishes disengagement of the VMS system itself from the specific incident response. Individual volunteers or volunteer groups may be demobilized (i.e., “out-processed”) at any point during VMS Incident Operations and is a very distinct process).

Demobilization of the VMS

Demobilization of the VMS should be conducted according to incident response needs. It is an organized process that allows the system to contract down to a minimum number of required personnel within the organizational structure without creating gaps during the transition of responsibilities (i.e., VMS procedures follow the ICS tenet that when a specific position is no longer required [or is never activated], the remaining functional responsibilities of the position revert to the staffed position immediately above the position in the organizational chart). Therefore, as individuals assigned to VMS positions are demobilized, VMS procedures stipulate that the remaining functional responsibilities of any subordinate function are assumed by the staffed position above. For example, most of the Volunteer Processing Branch personnel (with the exception of the deployment & out-processing function) may be demobilized at a relatively early time, when it is determined that all possible ICS volunteer requests have been met. Any remaining processing functions may be assumed by the Volunteer Processing Branch Director.

While most VMS functional positions will be demobilized based on workload, certain functions (volunteer tracking, out-processing, planning, admin/finance, and logistics) may require longer attention. The functional responsibilities may be accomplished by the branch directors as lower positions are demobilized, until the tasks are administered by the VMS manager alone. Demobilization of the VMS may ultimately result in the transitioning of certain VMS functions/responsibilities back to the ICS. This is more apt to occur when only a few volunteers remain in the response system (see Issue 11: Management of Volunteers Post VMS Demobilization - Appendix C for further details).

Demobilization tasks for the VMS (see Demobilization and Recovery Checklist- VMS M4) include:

Notification of demobilization : Prior to VMS demobilization, the Volunteer Recruitment function coordinates with the ICS PIO to establish the


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message that volunteer objectives have been met and volunteers are no longer needed. Similar messages are provided at the VPOA.

Transition of persisting VMS functions : Accomplish an organized, formal transfer of remaining VMS responsibilities, such as tracking and out-processing the residual cadre of deployed volunteers still working in the response, to functional units of the ICS (see textbox above).

Site break-down and clean-up : Demobilization of VMC and VPOA, including breakdown, clean-up, and rehabilitation of the areas.

Conduct a VMS Incident Review : The incident review provides an opportunity for all VMS personnel to understand what occurred throughout the VMS deployment.21

Conduct a hot wash : Provide the opportunity for VMS personnel to evaluate system performance through a ‘hot wash’ (i.e., immediate, relatively informal After-Action meeting that follows the incident review).22

Medical follow-up : Address medical issues (if any) for VMS personnel, with follow up established as indicated. This would include any indicated psychological aftercare for VMS personnel.

Establish timing of After-Action Report process and meetings : Announce the expected date/time of the formal VMS After-Action Report (AAR) meeting. In some instances, it may be beneficial to coincide with ICS AAR meeting.

ICS responsibilities to the VMS related to demobilization include: Timing of VMS demobilization : Provide clear direction on when

ICS volunteer objectives have been met and VMS demobilization may be initiated.

21 In an “incident review,” personnel are brought together to review the timeline of the event for the purpose of clarifying the event for participants and presenting the details as they occurred. This should resolve any confusion that can result over what occurred and why certain decisions were made during Incident Operations. For more detail, see Emergency Management Principles and Practices for Healthcare Systems, Unit 3: Healthcare System Emergency Response and Recovery, page 3-164; available at: http://www1.va.gov/emshg/page.cfm?pg=122, accessed September 1, 2006. 22 A “hot wash” is a systems performance review that is generally less formal and detailed than the After-Action Report (AAR) meeting and occurs in close proximity to the end of the incident or exercise. For more detail, see Emergency Management Principles and Practices for Healthcare Systems, Unit 4: Emergency Management Instruction, System Evaluation, and Organizational Learning for Healthcare Systems, page 4-146; available at: http://www1.va.gov/emshg/page.cfm?pg=122, accessed September 1, 2006.


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Volunteer stand-down messages : Assure that the public message is effectively delivered that no more volunteers are needed.

Provide VMS performance assessment : This could include a composite performance assessment of all volunteers (as a reflection of the VMS performance in processing, assigning and training), and an overall performance assessment of VMS.

Incident information : Provide information for the VMS Incident Review, particularly related to controversial actions and to incident parameters that evolved in an unexpected or novel way.

Technical and manpower assistance : Assist as indicated with demobilization of VMS, including breakdown, clean-up and rehabilitation of used areas.

Residual VMS responsibilities : Some volunteers may continue working for ongoing response and recovery operations even after the full demobilization of the VMC and the formal VMS. Residual responsibilities should be transitioned to staffed ICS positions, so that continuing VMS-processed volunteers can be supervised and receive the same supervisory and out-processing benefits as other volunteers managed by the VMS (see Issue 11: Management of Volunteers Post-VMS Demobilization - Appendix C).

VMS RECOVERY

Recovery is defined as the time phase encompassing the processes that return the VMS to baseline state of readiness. Actions address:

Return to readiness of personnel : Rehabilitation of VMS personnel.

Return to readiness of equipment & supplies: Rehabilitating VMS equipment and re-supplying cache.

Return to readiness of administrative cache : Reassembling forms and paperwork.

Acknowledgment of effort : Publicly recognizing VMS personnel and volunteer assistance (coordinated with ICS), including support personnel who worked in return-to-readiness activities.

Medical follow-up : Continuing medical follow-up for injuries, illness or exposures of VMS personnel – this is a responsibility of ICS, and so oversight by ICS or its designee should be maintained after VMS demobilization.


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Organizational learning : This is the process of capturing “lessons” and incorporating improvements through organizational learning (i.e., changes in structure, functions, training, equipment and other organizational areas) rather than short-lasting “lessons learned.” 23 Tasks related to this include:o Conduct VMS after-action report (AAR) meeting/s and select appropriate

members of the VMS to participate in any ICS after-action evaluation.o Collect input from VMS personnel and volunteers for the AAR

evaluation using the format: Issue Background to the issue Proposed solution Suggested responsible party

o Track suggested changes through analysis and acceptance/incorporation or rejection/explanation.

SUMMARY

The VMS has been developed to enable the effective and efficient integration of volunteers during medical and public health emergency response. The model was developed to be consistent with ICS and the National Incident Management System (NIMS), and to provide practical guidance for conducting the complex activities necessary for effective volunteer management (see Figure 6). Volunteers themselves are provided a structured system that enables them to safely engage and provide effective, supervised, and professional assistance. As with any new systems development, implementation requires customization of the model for the individual organization’s needs, personnel designation, equipment purchase and storage/staging arrangements, and the follow-on steps of education, training, exercise/evaluation and system improvement.

23 “Organizational learning” is a systems-based process for assessing proposed changes to the system and incorporating the accepted proposals to effect lasting change in system performance. This is accomplished through alteration to system structure, process, competencies, facilities, equipment, supplies, and other parameters. This process is accessible to the whole organization and relevant to the organization’s core mission and objectives (Emergency Management Principles and Practices for Healthcare Systems, Unit 4: Emergency Management Instruction, System Evaluation, and Organizational Learning for Healthcare Systems, page 4-163; available at: http://www1.va.gov/emshg/page.cfm?pg=122, accessed September 1, 2006).


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APPENDIX A

POSITION DESCRIPTIONS, QUALIFICATIONS & JOB ACTION SHEETS

Standardized Volunteer Management System for Public Health and Medical Emergency Response & Recovery

Introduction

Per common ICS principles, not all functions or positions are staffed individually in all incidents. Staffing decisions are based upon the size, nature and complexity of the incident. In events where no individual is assigned to a functional position, the responsibility for accomplishing the function or task is assumed by the supervisory position for that function or task. For example, the VMS manager also is responsible for ICS functions in Plans, Logistics, and Admin/Finance if Section Chiefs for those sections are not appointed. Alternatively, in a small incident with a relatively few number of public health volunteers, or where the majority of public health volunteers are already pre-registered and affiliated with a known organization, the Manager may also be the Operations Section Chief and the Volunteer Processing Branch Director (see Figure 7).

Figure 7. Demonstration of multiple functional positions (shaded in the diagram) that can be filled by a single qualified person in an appropriately-sized incident.

The qualifications section of the Position Descriptions is designed to provide key considerations for use in assigning appropriate personnel to the various VMS organizational positions. Considerations include knowledge and/or experience within specific subject areas as well as proficiency levels for working competently within the VMS and the IMS systems.


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Proficiency levels are described as:

Awareness: Represents an understanding of the knowledge/skills/abilities encompassed by the competency, but not to a level of capability to adequately perform the competency actions within the organization’s system.

Operations: Represents the capability to safely and effectively perform the assigned tasks and activities, including equipment use as necessary.

Expert: Represents operations-level proficiency plus the additional knowledge/skills/abilities to apply expert judgment to solve problems and make complex decisions.

The job action sheets for VMS include: 1) a list of the key actions and responsibilities for each assigned position and 2) a listing of tools to be used by those assigned to each position.


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VMS Manager

Position Description Rev.8/30/06

Responsible for & provides overall direction for the VMS Address all command functions unless another functional command

position (public information, safety, senior liaison to outside entities) is staffed by a different individual

Assume responsibility (Job Action Sheets) for all unassigned positions within the VMS between Management and the next lower staffed position in the VMS organization chart (For example: in a small incident, the Manager may also be the Plans Section Chief and the Admin/Finance Section Chief)

Ensure the operational effectiveness of the VMS

Qualifications

Competencies: Operational level of proficiency in ICS Expert level of proficiency with the VMS Operational level of proficiency with health and medical emergency

operations plans and procedures Operational level of proficiency for managing health and medical

personnel (public health & medical expertise is beneficial)


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VMS ManagerJob Action Sheet

Job Actions Rev.9/7/06

Obtain initial incident information and volunteer staffing needs requested by ICS Coordinate VMS activation and VMC/VPOA site location with ICS (VMS M3); Monitor VMS

mobilization (under the direction of the VMS Logistics Section Chief) Assure data is entered into the Initial Event Log (VMS 201) Review VMS pre-plan organizational structure, determine the incident-specific VMS activation

level and organizational structure, and assign VMS staff positions based on incident parameters; continue until a Planning Section is established (VMS M1 and VMS 207)

Participate in all planning cycle meetings Assure notification to VMS personnel according to notification procedures (VMS M2) Create VMS staffing schedule using the VMS Assignment List (VMS 203) until a Planning

Section is established Set operational periods and planning cycle for VMS Establish the overall (control) objectives for each operational period Brief VMS Command & General Staff upon arrival and assignment (Operations, Planning,

Logistics, Administration and Finance Section Chiefs) – assure distribution of job action sheets and associated VMS tools

Approve the VMS Action Plan for each operational period, and its supporting plans: Health & Safety Plan (VMS 208), Medical Plan (VMS 206), Communications Plan (VMS 205), (all coordinated with ICS)

Perform Public Information (media) function as required by coordinating with the ICS PIO Perform senior liaison function as indicated to organizations external to the VMS Monitor expenditures, personnel costs, and liability issues; assure adequate funding sources Assure adequate function of the VMS (monitor VMS response operations in relation to the VMS

incident objectives) in coordination with the VMS Operations Section Chief Problem-solve as indicated, for problems/issues not addressed through lower VMS processes

Tools: o VMS Activation Procedure (VMS M1) o VMS Notification and Activation Messages

(VMS M2) o VMS Mobilization Checklist (VMS L1)o VMS Initial Event Log (VMS 201)o VMS Job Action Sheets o VMS Demobilization & Recovery Checklist

(VMS M4)o VMS General Message (VMS 213)o VPOA/VMS Site Selection Tool (VMS M3)

1st operational period: VMS Organizational Chart (VMS 207) VMS Staff Assignment List (VMS 203) VMS Personnel Check-in List (VMS 211)

Approval/Signature required:VMS Health and Safety Plan (VMS 208)VMS Medical Plan (VMS 208)VMS Communication Plan (VMS 205)VMS Situation Update (VMS 209)Volunteer Incident Report (VMS O4)


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VMS Safety Officer


Command Staff position that reports to the VMS Manager Responsible for assessing and maintaining a safe and healthy work

environment within VMS activities Coordinates with ICS to ensure the health and safety of volunteers

deployed to incident sites

Qualifications

Competencies: Operational level proficiency in ICS Operational level proficiency with the VMS Health & medical expert level proficiency related to the incident-

specific hazards (or access to expert information & ability to apply the information)


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VMS Safety Officer Job Action Sheet


Reports to: VMS Manager

Receive the initial brief from the VMS Manager Prepare the VMS Health and Safety Plan (VMS 208), coordinated with

and using information acquired from the ICS Safety Officer or by VMS Incident Integration Branch personnel; obtain approval from VMS Manager

Prepare the VMS Risk Statement for Volunteers (VMS O7a), obtain approval from VMS Manager, and distribute to the Registration Supervisor and to the Recruitment Supervisor if active recruitment is needed.

Review the VMS 208 and VMS O7a for each operational period; Update as required

Ensure all VMS Section Chiefs receive copies of the Health & Safety Plan (VMS 208) and incorporate the plan’s details in their section activities

Monitor VMS operations for continued health and safety compliance Suspend immediately dangerous activities so that intervention can be

accomplished Notify VMS Manager if unsafe practices are occurring and advise

regarding suspension of activities until safety is addressed Participate in all planning cycle meetings

Tools: VMS Health and Safety Plan (VMS 208) VMS Risk Statement for Volunteers (VMS O7a) VMS General Message (VMS 213)


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VMS Operations Section Chief


Reports to the VMS Manager Determines the operations tactics for achieving the VMS objectives Oversees all Operations Section activities in the VMS: both the Volunteer

Processing Branch & the Incident Integration Branch

Qualifications

Competencies: Operational level proficiency in ICS Operational level of proficiency with the VMS Expert level of proficiency in the VMS Operations Section responsibilities Operational level of proficiency with health and medical emergency

operations plans and procedures


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VMS Operations Section ChiefJob Action Sheet



Receive brief from VMS Manager Determine Operations section structure (using the VMS pre-plan) and assign positions based

on incident parameters – may involve the merging of positions based on assessed needs Assign/supervise additional Operations Section personnel as indicated; schedule follow-on

shifts Provide input to VMS Logistics with input on VPOA and VMC physical set up and supply and

equipment needs, if alterations from the pre-plan layout are indicated Brief operations staff and ensure all operations staff understand their roles and

responsibilities Ensure that an initial volunteer processing capability is in place to process early-arriving

volunteers and expedite volunteer registration Ensure coordination between the Volunteer Processing Branch and the Incident Integration

Branch to assure that incident volunteer needs are adequately met Address the following tactical considerations:

o Volunteer collection methods and site for the VPOAo Registration tactics, such as data collection methods and the configuration of registration

streamso Identity confirmation & credentials verification strategy & tacticso Volunteer roster categorieso Available position categorieso Badging methodso Transportation of volunteers, or assuring that they have self-transported and arrivedo Volunteer tracking methods to maintain accountability for deployed volunteers o On-site coordinator - assignment for VMS or ICSo Volunteer recruitment strategy & tactics

Monitor the operations of Volunteer Processing Branch and Incident Integration Branch. Key issues to assess:

o Review the VMS Situation Report (VMS 209) to determine whether ICS requests are being adequately met

o Review VMS Trouble Desk Information Form (VMS O3), Volunteer Performance Evaluation Form (VMS 226), and Volunteer Feedback Form (VMS O17) to identify any problem areas with VMS processes

Monitor VMC and VMS logistical needs for ongoing VMS operations and relay issues to VMS Logistics as necessary

Participate in all planning cycle meetings

Tools: VMS General Message (VMS 213)*


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VMS Volunteer Processing Branch Director


Reports to the VMS Operations Section Chief Coordinates and oversees the management of the Volunteer Processing

Branch of the VMS Operations Section

Qualifications

Competencies: Operational level proficiency in ICS Operational level proficiency with the VMS Expert level of proficiency in the VMS Volunteer Processing Branch

responsibilities Awareness level proficiency with health and medical emergency



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VMS Volunteer Processing Branch DirectorJob Action Sheet


Reports to: VMS Operations Section Chief

Receive brief from VMS Operations Section Chief Assign and oversee personnel for VMS volunteer processing positions –

Registration Supervisor, VPOA Leader, Credential Verification Supervisor, Assignment Supervisor, Assignment Briefing Leader, Deployment & Out-processing Leader, and Volunteer Recruitment Supervisor as indicated by incident parameters

Coordinate with VMS Operations Section Chief for incident specific tactical changes to the pre-plan volunteer processing layout and procedures (different processing streams, specific qualifications to meet incident needs etc. – see Job Action Sheet for VMS Operations Section Chief)

Maintain communication with Incident Integration Branch to obtain incident volunteer needs

Monitor VMS volunteer processing functions and adjust staffing, layout, and procedures to attain optimal effectiveness

Tools: VMS General Message (VMS 213) VMS Health and Safety Plan (VMS 208) VMS Communication Plan (VMS 205)


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VMS Registration Supervisor


Reports to the VMS Volunteer Processing Branch Director Oversees the Volunteer Point of Assembly (VPOA) Leader Oversees all volunteer registration activities

Qualifications

Competencies: Awareness level proficiency in ICS Operational level proficiency with the Volunteer Processing Branch

procedures of the VMS Awareness level proficiency for the overall VMS


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VMS Registration SupervisorJob Action Sheet


Reports to: VMS Volunteer Processing Branch Director

Ensure that the Volunteer Point of Assembly (VPOA) is functioning; Supervise the VPOA Leader Supervise any assigned registration workers Ensure that potential volunteers receive the volunteer Orientation & Acknowledgement of

Responsibilities Form (VMS O7); ensure that a signed Acknowledgement Form is returned Review Volunteer Registration & Credentials Form (VMS O8) and ensure that professional

classifications, job categories, and medical skills reflect the categorization of volunteers indicated for the type of incident; revise as indicated prior to distribution

Ensure that all the forms required for volunteer registration (VMS O7, VMS O7a, VMS O8, VMS O9, and VMS O10) are provided to the volunteer (see list of forms below)

Ensure that all the forms required for volunteer registration have been completed by the volunteer

Assign a volunteer identification number to each volunteer Sign each Volunteer Process Checklist (VMS O10) where appropriate when registration for the

volunteer is complete Direct volunteers to credentialing station after they complete their registration

Tools: Orientation & Acknowledgement of Responsibilities (VMS O7) Volunteer Registration & Credentials Form (VMS O8) VMS Public Health and Medical Risk Statement (VMS O7A) Release of Information Form (VMS O9) Volunteer Process Checklist (VMS O10)


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VMS VPOA Leader


Reports to the VMS Registration Supervisor Collects the potential volunteers and organizes them for registration Provides potential volunteers with a Volunteer orientation via written

instrument

Qualifications

Competencies: Awareness level proficiency of the VMS Awareness level proficiency of the VMS registration process Operational level of proficiency in answering potential volunteers’

questions about the VMS


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VMS VPOA LeaderJob Action Sheet


Reports to: VMS Registration Supervisor

Greet, direct and organize volunteers as they arrive, and conduct other actions to facilitate the registration process

Provide volunteers with the Orientation and Acknowledgement of Responsibilities Form (VMS P1) and the Public Health Risk Statement

Explain registration process as needed Respond to questions about the VMS Send volunteers bringing donations to appropriate location and direct the media and others to

appropriate VMS personnel

Tools: Orientation and Acknowledgement of Responsibilities (VMS O7) VMS Public Health and Medical Risk Statement (VMS O7a) or the ICS Public Health and

Medical Risk Statement (preferred)


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VMS Credentials Verification Supervisor


Reports to the VMS Volunteer Processing Branch Director Verifies identification and confirms credentials by professional

classification as listed on the registration form (VMS 08) Rosters volunteers according to functional capability categories indicated

for the incident (i.e. a volunteer is placed into a category indicating the professional category, job qualifications, level of supervision indicated, and specific job competencies based on credential verification)

Qualifications

Competencies: Operational level proficiency in the identification and credential

verification procedures for the VMS Experience in public health or medical staff credentialing or access to a

position within the VMS with credentialing expertise, and the ability to apply this expertise


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VMS Credentials Verification SupervisorJob Action Sheet



Supervise workers assigned to credentials verification activities Examine each volunteer’s government issued photo ID and confirm the volunteer’s identity Obtain copy of the prospective volunteer’s credentials and certifications from VMS

registration Verify credentials/certifications/licenses using the established credentialing verification

procedures Roster volunteer, using the roster categories for the incident type (from a pre-plan),

according to the confirmed credentials/qualifications and level verified. The roster categories reflect both qualifications and the level of supervision indicated during assignment; the roster categories are delineated as “Professional Classification,” the “Job Category,” then “Functional Characteristics” and, finally, specific and general “job competencies.”

Complete “credential verification” portion of the Volunteer Registration & Credentials Form (VMS O8)

Complete “functional characteristics” portion of the Volunteer Registration & Credentials Form (VMS O8), and add additional “medical skills” to this section if indicated by the type of incident.

Transfer completed and confirmed data to Assignment Supervisor and direct volunteer to Assignment Desk for evaluation and potential matching to an incident assignment

Complete credential verification portion of Volunteer Process Checklist (VMS O10)

Tools: Volunteer Registration and Credentials Form (VMS O8) Volunteer Release of Information Form (VMS O9) Volunteer Process Checklist (VMS O10) VMS General Message (VMS 213)


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VMS Assignment Supervisor

Report to the VMS Volunteer Processing Branch Director Match rostered volunteers with ICS requests and make assignments Supervise the Assignment Briefing Leader Supervise Deployment & Out-Processing Leader

Qualifications

Competencies: Operational level of proficiency in ICS Operational level of proficiency in the VMS Operations Section Expert level of proficiency in interpreting position requirements for

requested positions and matching them with rostered volunteers (or the ability to access this proficiency and apply the recommendations

Experience in public health or medical staffing is beneficial Awareness level of proficiency in public health and medical operations

and an awareness level of proficiency of position qualification necessary within public health and medical operational areas



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VMS Assignment SupervisorJob Action Sheet



Supervise personnel working in the Volunteer Assignment area Coordinate with Incident Integration Branch personnel to understand the professional

classification, job categories, functional characteristics and job/language competencies required for requested positions

Identify qualified and credentialed volunteer applicants that match requested positions Conduct rapid volunteer interview, if indicated, to evaluate candidates for specialized

assignments Match the volunteers with appropriate assignments Schedule matched volunteers according to current and future incident needs (using the

Volunteer Position Requests Form - VMS O1); document volunteers scheduled for future shifts for notification purposes; fill in Volunteer Assignment Slip (VMS O11) for each assignment

Review the match with each volunteer and obtain acceptance of assignment by the volunteer; provide assigned volunteers with completed Volunteer Assignment Slip (VMS P6) - these are now “rostered and assigned volunteers”

Complete the portion of the VMS Equipment Issue & Return Form (VMS O12) indicating the equipment and supplies to be issued for the assigned volunteer; forward VMS O11 to Assignment Briefing Leader

Provide rostered yet unassigned and or unscheduled volunteers with Volunteers Awaiting Assignments (VMS O14) sheet; designate them as “rostered and staged” if assignments are anticipated, or otherwise as “rostered and released” for call-back if needed

Forward copy of assignment information to the Volunteer Tracking Supervisor Complete assignment portion of Volunteer Process Checklist (VMS O10) Supervise Assignment Briefing Leader and ensure that current information is available to them

to conduct the volunteer assignment briefing Supervise Deployment & Out-Processing Leader Assure that reminder notifications are sent to volunteers scheduled for future shifts Review past Volunteer Performance Evaluations (VMS 226) prior to reassigning any volunteer Direct “assigned” volunteers to the Assignment Briefing area, “rostered and staged” to a waiting

area, and “rostered and released” to the VMC exitsTools:

Volunteer Assignment Slip (VMS O11) Volunteers Awaiting Assignments (VMS O14) VMS Equipment Issue & Return Form (VMS O12) Volunteer Process Checklist (VMS O10) Volunteer Registration & Credentials Form (VMS O8) VMS General Message (VMS 213)


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VMS Assignment Briefing Leader


Reports to VMS Assignment Supervisor Provides assignment briefing, provides indicated equipment/supplies, and

assures adequate just-in-time training to assigned volunteers

Qualifications

Competencies: Operational level of proficiency in ICS Operational level of proficiency in the VMS Operations Section Operational level of proficiency in any personal protection or other

equipment/skills that may be taught or confirmed during the Assignment Briefing sessions

Operational level of expertise in developing and conducting the Assignment Briefings from pre-plans and incident-specific information

Medical and health expertise adequate for briefing about the medical and public health assignments


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VMS Assignment Briefing LeaderJob Action Sheet


Reports to: VMS Assignment Supervisor

Create and provide an assignment briefing using VMS Assignment Briefing Template (VMS O13), coordinating with the Incident Integration Branch personnel to obtain incident and assignment-specific information

Continuously assure that the information used for volunteer orientation and assignment briefings is current and consistent with ICS staff briefings (see ICS Situation Report, VMS Health and Safety Plan, VMS Communications Plan)

Coordinate with VMS Logistics to dispense equipment and supplies that have been listed in the VMS Equipment Issue & Return Form (VMS O12) for each volunteer (filled in by the Assignment Supervisor when assignment is made); instruct on the use of issued equipment/supplies and indicated procedures and assure operational level of proficiency by the trainees; forward to Deployment & Out-processing Leader.

Ensure completion of Assignment Briefing Template (VMS O13) Complete Assignment Brief and Equipment Issue portion of Volunteer Process

Checklist (VMS O10) File Assignment Briefing Template (VMS O13) with Plans Section Transmit the VMS Equipment Issue & Return Form (VMS O12) to the Deployment

& Out-processing Leader Direct briefed volunteer to the Deployment & Out-processing area

Tools: VMS Assignment Briefing Template (VMS O13) VMS Equipment Issue & Return Form (VMS O12) Volunteer Process Checklist (VMS O10) VMS General Message (VMS 213) Volunteer Assignment Slip (VMS O11)


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VMS Deployment & Out-processing Leader


Reports to VMS Assignment Supervisor Assures the volunteer is fully processed before being deployed to an

incident assignment, then directs the volunteer to transportation resources if indicated

Provides for the deployment, out-processing and rehabilitation services needed for assigned and deployed volunteers

Qualifications

Competencies: Operational level of proficiency in ICS Operational level of proficiency in VMS Volunteer Processing Branch Awareness level of proficiency understanding the ICS positions to which

the volunteers are assigned


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Deployment & Out-processing Leader


Reports to: VMS Assignment Supervisor

DEPLOYMENT Ensure that a volunteer transport method is available, if indicated, coordinating with VMS

Logistics Section Obtain names of volunteers being deployed Provide appropriate site access privilege badge to fully processed volunteers if directed by

ICS Logistics; instruct volunteers on the need to wear the badge at all times Review each Volunteer’s Process Checklist (VMS O10); ensure all required process steps

are complete Direct “deployed” volunteers to the transportation staging area for deploying volunteers

OUT-PROCESSING Obtain names of volunteers being out-processed from Assigned Volunteer Scheduling &

Tracking Form (VMS O2) for volunteer files Follow actions outlined in the Out-processing/Rehabilitation Checklist (VMS O15) Review the Volunteer Performance Evaluation Form (VMS 226); review with volunteer (if not

done by ICS supervisor); file in the volunteer file Collect issued equipment; complete VMS Equipment Issue & Return Form (VMS O12) Collect site badge if not already accomplished at the work site Provide and collect Volunteer Feedback Form (VMS O17), transmit to VMS Plans Section Provide Exposure Form (VMS O16) if indicated Provide volunteer with information on counseling and medical follow-up if needed Provide directions for volunteer to attend After Action Review as indicated Forward volunteer out-processing information to Volunteer Tracking Supervisor Provide volunteer with Receipt of Volunteerism (VMS O18) noting assignment and hours Refer available, willing and appropriate volunteers for re-assignment Complete Volunteer Process Checklist (VMS O10) and refer or release volunteer Send volunteer’s file to Plans Section for archiving when complete and volunteer is released

Tools: Out-processing/Rehabilitation Guide (VMS O15) Equipment Issue & Return Form (VMS O12) Exposure Form (VMS O16) Volunteer Feedback Form (VMS O17) Receipt of Volunteerism (VMS O18) Volunteer Process Checklist (VMS O10) VMS General Message (VMS 213)

Job Action Sheet


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VMS Volunteer Recruitment Supervisor


Reports to the VMS Volunteer Processing Branch Director (or directly to the VMS Operations Section Chief if Volunteer Recruitment is elevated to a separate Operations Section branch)

Responsible for the recruitment of additional volunteers to ensure an adequate supply of qualified volunteers are available to the labor pool

Develops draft messages for volunteer recruitment, including notice when no further volunteers are needed

Coordinates message development and release with the ICS Public Information Officer

Qualifications

Competencies: Awareness level of proficiency in ICS Operational level of proficiency in VMS Operational level of proficiency in public information messages

(Communications/media experience or training is beneficial)


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VMS Volunteer Recruitment SupervisorJob Action Sheet



Obtain briefing from the VMS Volunteer Processing Branch Director or the VMS Operations Section Chief, depending upon the VMS configuration

Establish communication/relationship with the ICS Public Information Officer (PIO), keeping the VMS manager involved in all message development

Review the Situation Report (VMS 209) and Volunteer Position Requests Form (VMS O1) to assist in the development of a needs-based volunteer recruitment strategy specific to the incident

Develop public announcement of the activation of the VMS, location of the VPOA, and details for potential volunteers (what to bring, what to expect, etc.) to be included in the Volunteer Recruitment Request Process (VMS O5)

Review risk, liability and compensation statements and include appropriate information in recruitment messages

Notify pre-registered volunteers and volunteer organizations when indicated, using the template of Notification Messages for Pre-registered Volunteer (VMS O6)

If volunteers are not needed, or the volunteer assistance needs have changed, provide appropriate “no need” or “new need” messages in coordination with the ICS PIO

Coordinate and disseminate recruitment messages through the ICS PIO, after they have been approved by the VMS Manager

Tools: Volunteer Recruitment Request Process/Template (VMS O5) Notification Messages for Pre-registered Volunteer (VMS O6) VMS General Message (VMS 213)


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VMS Incident Integration Branch Director


Reports to the VMS Operations Section Chief Coordinates and oversees the Integration of the VMS operations with the

Incident Command System Works with ICS to identify incident volunteer needs Coordinates with VMS Assignment Supervisor to provide descriptions of

positions that may be filled by volunteers Monitors and tracks the performance of volunteers on assignment, and

oversees the ‘trouble desk’ function that addresses any volunteer-related issues within the incident

Qualifications

Competencies: Operational level proficiency in ICS Operational level proficiency with the VMS Expert level of proficiency in the VMS Incident Integration Branch

responsibilities Operational level proficiency in health and medical emergency

operations plans and procedures Operational level of proficiency in describing public health & medical

jobs, or access to this expertise and the ability to apply the expertise


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VMS Incident Integration Branch DirectorJob Action Sheet


Reports to: VMS Operations Section Chief

Receive briefing from VMS Operations Section Chief Contact ICS Logistics for volunteer position requests and associated information

(characterize incident positions available to volunteers by: o Professional job classification (1st order)o Job category within the professional classification (2nd order)o Functional characteristics within each job category (3rd order)o Specific job competencies critical to the position (4th order)o Language and additional competencies (included in 4th order)Also obtain tasks description, assignment & reporting locations, receiving and supervisor contact information, support benefits, and any other pertinent data

Complete Volunteer Position Requests Form (VMS O1) with information obtained each operational period or as frequently as required; forward to VMS Assignment Supervisor

Obtain updated ICS situation reports, incident action plans, and other pertinent information to be used for the development VMS plans, statements and briefing templates

Coordinate with ICS to define requirements and responsibilities related to:o Transportation of volunteers to and from assigned worksites (in coordination with VMS

Deployment & Out-processing Leader and VMS Logistics Section)o Provision of equipment and supplies (such as PPE) and associated training for deployed

volunteers o Decisions on the administration of prophylaxis and coordination of health and medical plan

between ICS and VMSo Site privileges and badging procedures for access to the incident siteo Volunteer job-specific training (location and documentation mechanism)o Process for orienting ICS personnel to the VMS

Provide ICS Logistics with assigned volunteer scheduling information Oversee Trouble Desk Supervisor and VMS On-Site Coordinator to assure maximal

coordination between VMS and ICS Oversee the Volunteer Tracking Supervisor to assure location of deployed volunteers is

known at all times Determine if unprocessed volunteers are active in the incident and coordinate with ICS to

have these volunteers processed through VMS

Tools: Volunteer Position Requests Form (VMS O1) General Message (VMS 213)


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VMS Volunteer Tracking Supervisor


Reports to VMS Incident Integration Branch director Responsible for tracking processed and assigned volunteers from

deployment through completion of assignments and return to the VMC Coordinates with Volunteer On-site Coordinator or ICS supervisors for

volunteer tracking information

Qualifications

Competencies: Awareness level proficiency in ICS Operations level proficiency in VMS Incident Integration Branch Operational level of proficiency in the indicated communications methods


82


VMS Volunteer Tracking SupervisorJob Action Sheet


Reports to: VMS Incident Integration Branch Director

Maintain Assigned Volunteer Scheduling & Tracking Form (VMS O2) by posting data received from all sections

Obtain information required from ICS On-site Volunteer Coordinator(s) or ICS supervisors Notify Volunteer On-site Coordinator, Trouble Desk Supervisor, and/or Incident Integration

Branch Director if volunteer location is compromised or concerns arise

Tools: Assigned Volunteer Scheduling & Tracking Form (VMS O2)


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VMS Trouble Desk Supervisor


Reports to the VMS Incident Integration Branch Director Responds to reported volunteer issues or questions that arise during

deployment, from deployed volunteers, volunteer ICS supervisors, and other ICS personnel

Qualifications

Competencies: Operational level proficiency in ICS Operational level proficiency with the VMS Operational level of proficiency in health and medical emergency

operations plans and procedures Operational level of proficiency in problem solving and human interaction

(human resources experience may be beneficial)


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VMS Trouble Desk SupervisorJob Action Sheet


Reports to: PH&M-VMS Incident Integration Branch Director

Answer Trouble Desk hotline and use the Trouble Desk Information Form (VMS O3) to document reported issue with assigned and deployed volunteer or their ICS supervisor

Respond to reported issue by either intervening or delegating the intervention to the appropriate party

Complete the Trouble Desk Information Form (VMS O3) with intervention details Notify Incident Integration Branch Director about significant issues that can’t be rapidly

and/or satisfactorily resolved Provide Trouble Desk Information Form (VMS O3) to the Incident Integration Branch

Director for the VMS Manager for review Ensure appropriate parties are updated as to the resolution of any significant issue Investigate Volunteer Incident Reports (VMS O4) (for adverse occurrences) and

intervene as indicated

Tools: Trouble Desk Information Form (VMS O3) Volunteer Incident Report (VMS O4) VMS General Message (VMS 213)


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On-site Volunteer Coordinator


Reports to the Incident Command System supervisor at the incident location

Reports to the VMS Incident Integration Branch Director for primary duties

Facilitates information exchange between the incident work site and the VMS Incident Integration Branch (see VMS Incident Integration Branch Director position description and job action sheet)

Responsible for assisting with receiving and out- processing volunteers at their incident work sites if tasked by Volunteer Processing Branch

Qualifications

Competencies: Operational level proficiency with ICS Operational level of proficiency with VMS Operational level of organizational skills and good interactive skills

(human resources experience is beneficial)


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On-site Volunteer Coordinator

Job actions Rev.9/7/06

Reports to: VMS Incident Integration Branch Director

Receive briefing from VMS Incident Integration Branch Director Receive briefing from on-site senior ICS supervisor Assist the Incident Integration Branch Director in obtaining information on positions available for

volunteer staffing Obtain volunteer assignments from VMS Incident Integration Branch Maintain a record of assigned volunteers deployed to sites and contact information for tracking,

transmit to VMS Volunteer Tracking Supervisor Greet and assist volunteers with sign-in and badging (if not already accomplished) Facilitate introduction to assigned supervisors for on-site orientation, assure volunteers receive a

specific task briefing from their ICS supervisors Assist with management of on-site volunteers Report the following information to the VMS Incident Integration Branch Volunteer Tracking

Supervisor: o arrival of volunteers at each shifto delivery of appropriate job-specific briefingo time and date of assignment completiono any change in volunteer location

Assist in orientating ICS staff involved with volunteers to the VMS operational procedures Provide ICS supervisors with Volunteer Performance Evaluation Form (VMS 226) Transmit completed Volunteer Performance Evaluation Form (VMS 226) to VMS Deployment &

Out-processing Leader; notify them if volunteer’s evaluation negates reassignment Assist with the re-assignment of volunteers if accomplished at the initial incident work site

(coordinate with VMS Assignment Supervisor) Facilitate information exchange between the volunteer deployment site and the Incident

Integration Branch Director for potential positions and other incident information Access the ‘Trouble Desk’ Supervisor for any significant issues involving volunteers Provide Volunteer Out-processing functions if assigned by VMS (see VMS Deployment & Out-

processing Leader Job Action Sheet)

Tools: Volunteer Performance Evaluation Tool (VMS 226) VMS General Message (VMS 213)

Job Action Sheet


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VMS Plans Section Chief


Reports to VMS Manager Provides planning support, facilitates planning meetings and maintains

volunteer and incident documentation for the VMS

Qualifications

Competencies: Operational level proficiency in ICS Operational level proficiency in VMS Expert level of proficiency in VMS Plans Section responsibilities,

processes, and specific procedures Operational level of proficiency with health and medical emergency



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VMS Plans Section ChiefJob Action Sheet



Receive briefing from VMS Manager Evaluate the completeness of the initial VMS Assignment List (VMS 203) and assume

staffing assignment duties for future operational periods, including the update of the VMS Organizational Chart (VMS 207)

Assign/supervise additional Plans Section personnel as indicated; schedule follow-on shifts Track/record chronology of VMS events Maintain a VMS Personnel Check-in List (VMS 211) at the Plans Section desk Archive all documented information Schedule, develop agenda, and conduct VMS briefings and incident planning meetings for

each operational period Coordinate VMS planning cycle with ICS planning cycle (with approval by VMS Manager) Develop initial VMS action plan and update action plan at each operational period for

distribution to all VMS section chiefs (action plan to contain VMS 203, 205, 206 and any supporting plans)

Create long-term, contingency, and alternate plans for the VMS operations Assist Logistics Section by projecting inventory for equipment and supplies needs Assist VMS Manager in establishing measures of effectiveness for the VMS, monitor

measures against the metrics and keep VMS manager informed Prepare the VMS Situation Report (VMS 209) at the direction of the VMS Manager and

attach a copy of completed Volunteer Position Requests Form (VMS O1) to relay VMS status summary information to ICS Logistics

Create demobilization plan for approval by VMS Manager Obtain approval of all plans by the VMS Manager Distribute documents to all VMS Section Chiefs and others as required to provide current

information needed for their position

Tools: VMS Situation Report (VMS 209) VMS Assignment List (VMS 203) VMS Staff Check-in List (VMS 211) VMS Organizational Chart (VMS 207) VMS General Message (VMS 213)

VMS Logistics Section Chief


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Reports to the VMS Manager Manages logistics in support of VMS Operations; this includes addressing

personnel, facilities, meals, transportation and communication needs Arranges facility support to VMS at the VMC site(s) Coordinates with ICS to provide needed logistics resources and services

Qualifications

Competencies: Operational level proficiency in ICS Operational level of proficiency with the VMS Expert level of proficiency in VMS Logistics Section responsibilities and

tasks (logistics experience is beneficial); ability to interact with medical personnel and apply their recommendations in establishing the VMS Medical Plan)


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VMS Logistics Section Chief



Receive briefing from VMS Manager Assign/supervise additional Logistics Section personnel as indicated; schedule follow-on shifts Set up VPOA and VMC using the VMS Mobilization Checklist (VMS L1), VMC Site Set-up

guidelines (VMS L2) and VPOA/VMC Signage requirements (VMS L3) Provide VMS tools and forms to appropriate VMS position Assure the maintenance of all areas of operation for the VMC & VPOA, in coordination with ICS Support badging process as indicated Ensure development of the VMS Communications Plan (VMS 205) and VMS Medical Plans

(VMS 206) Ensure provision of needed medical services to staff and volunteers at the VMC Provide for Inventory Control

o Conduct an initial inventory at the set up of the VMS/VMC o Complete an inventory review and create a needs/reorder log at least once per operational periodo Maintain continuous inventory monitoring, recording usage against remaining supplyo Develop minimum thresholds for re-order based on estimated time to receive orderso Establish inventory methods to differentiate equipment and supplies obtained through the VMS

from those obtained through the ICS systemo Project inventory needs (with VMS Plans Section assistance); Acquire projected inventory needso Enforce the use the VMS General Message (VMS 213) for equipment/supply requests

Provide or arrange the provision (through ICS Logistics Section) the following: o Communication equipment for VMS useo Information technology equipment and supporto Transport methods for moving volunteers to and from their assignment locations if indicated; use

the VMS Transportation Request Log (VMS L4) in coordination with the Deployment & Out-processing Supervisor

o Medical support to VMS staff and volunteers within the VMC per the VMS Medical Plan; arrange medical/psychological follow-up methods for VMS staff as indicated

o Food and fluids for volunteers and VMS staffo Security for the VMC siteo Equipment & supplies, as requested by Volunteer Processing Branch Director, for volunteers to

accomplish their assignments Maintain a list of available personnel, as indicated, for additional VMS staff & follow-on VMS

shifts Participate in all planning cycle meetings

Tools: VMS Mobilization Checklist (VMS L1) VPOA/VMC Set-up (VMS L2) VPOA/VMC Signage (VMS L3) VMS Communications Plan (VMS 205)

VMS Medical Plan (VMS 206) VMS Transportation Request Log (VMS L4) VMS General Message (VMS 213)

Job Action Sheet


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VMS Administration and Finance Section Chief


Reports to VMS Manager Supports VMS Operations by assisting in procurement, maintaining cost and

expense records, and processing workmen’s compensation related documentation and other claims or events that may serve as potential liability for the VMS

Qualifications

Competencies: Operational proficiency in ICS Operational proficiency in VMS Expert level of proficiency in VMS Administration and Finance Section

responsibilities, processes and specific procedures (experience with administrative and finance is beneficial)


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VMS Administration and Finance Section ChiefJob Action Sheet



Assign/supervise additional Finance Section personnel as indicated; schedule follow-on shifts

Account for and document VMS expenses using the Incident Expense Log (VMS A1)

Maintain a log of VMS staff and hours worked Process worker’s compensation claims when indicated Process required legal and liability documentation related to any adverse

incidents involving volunteers Coordinate purchasing through the ICS Finance and Administration

Section or the emergency operations center (EOC) Provide ICS/EOC with VMS financial accounting records as requested Assure compliance with jurisdictional emergency purchasing procedures

and requirements Participate in all planning cycle meetings

Tools: VMS Incident Expense Log (VMS A1)


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APPENDIX B

ACRONYMS LISTStandardized Volunteer Management System for

Public Health and Medical Emergency Response & Recovery

AAR After Action ReportALS Advanced Life SupportAP Action PlanCEM Comprehensive Emergency ManagementCEMP Comprehensive Emergency Management ProgramCEO Chef Executive OfficerCFO Chief Finance OfficerCFR Code of Federal RegulationsCOBRA Consolidated Omnibus Budget Reconciliation Act (1985)CON OPS Concept of OperationsCOOP Continuity of Operations PlanningCP Command PostCRNA Certified Registered Nurse AnesthetistCSP Clinical Support PersonnelDHHS Department of Health and Human ServicesDECON DecontaminationDMAT Disaster Medical Assistance TeamDOC Department Operations CenterDoD US Department of DefenseDRC Disaster Recovery CenterED Emergency DepartmentEEG Exercise Evaluator GuidanceEM Emergency ManagementEMAC Emergency Management Assistance CompactEMC Emergency Management CommitteeEMI Emergency Management InstituteEMP Emergency Management ProgramEMS Emergency Medical ServicesEMSHG Emergency Management Strategic Healthcare GroupEMTALA Emergency Medical Treatment for Active Labor ActEOC Emergency Operations CenterEOP Emergency Operations PlanEPC Emergency Program CoordinatorEPM Emergency Program ManagerERT Emergency Response TeamERT-A Emergency Response Team- AdvancedESAR-VHP Emergency System for Advance Registration of Volunteer Health Professionals


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ESF Emergency Support FunctionESP Emergency Safety ProceduresEST Emergency Support TeamFBI Federal Bureau InvestigationFCC Federal Coordinating CenterFCO Federal Coordinating OfficerFEMA Federal Emergency Management AgencyFEP Facility Emergency PlanFIRST Federal Incident Response Support TeamFL Facility LeaderFPC Federal Preparedness CircularFRERP Federal Radiological Emergency Response PlanFRP Federal Response PlanGPMRC Global Patient Movements Requirements CenterGPRA Government Performance and Results Act (1993)GSA General Services AdministrationGWU George Washington UniversityHAZMAT Hazardous MaterialsHCF Health Care FacilityHCFA Health Care Financing AdministrationHCS Health Care SystemHEICS Hospital Emergency Incident Command SystemHHS Department of Health and Human ServicesHICS Hospital Incident Command SystemHIPAA Health Insurance Portability and Accountability ActHPT Human Performance TechnologyHRSA Health Resources and Services AdministrationHSEEP Homeland Security Exercise and Evaluation ProgramHSPD Homeland Security Presidential DirectiveHVA Hazard Vulnerability AnalysisIAP Incident Action PlanIC Incident CommanderICDRM Institute for Crisis Disaster & Risk Management (George

Washington University)ICP Incident Command PostICS Incident Command SystemIC/UC Incident Command or Unified CommandID IdentificationIEMS Integrated Emergency Management SystemIMP Incident Management PostIMS Incident Management SystemIMT Incident Management TeamINCMCE International Nursing Coalition for Mass Casualty EducationIR Incident ReviewIS Independent StudyISC Installation Support Center


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ISD Instructional Systems DevelopmentIT Information TechnologyJCAHO Joint Commission on Accreditation of Healthcare OrganizationsJFO Joint Field OfficeJIC Joint Information CenterJIS Joint Information SystemLEPCs Local Emergency Planning CommitteesLNO Liaison OfficerLO Learning ObjectiveNDMS National Disaster Medical SystemNVOAD National Voluntary Organizations Active in DisastersMAC Multi Agency CoordinationMACC Multi Agency Coordination CenterMACE Multi Agency Coordination EntityMaHIM Medical and Health Incident ManagementMCI Mass Casualty IncidentMCS Mission Critical SystemsMMI Modified Mercalli IntensityMOU Memoranda of UnderstandingMSCA Military Support to Civil AuthoritiesMSCC Medical Surge Capacity and CapabilityMSEL Master Sequence of Events ListNAICS North American Industry Classification SystemN/A Not ApplicableNCR National Capital RegionNFES National Fire Equipment SystemNFPA National Fire Protection AssociationNGO Nongovernmental OrganizationNIMS National Incident Management SystemNIIMS National Interagency Incident Management SystemNRCC National Response Coordination CenterNRP National Response PlanNSP Non-clinical Support PersonnelNVOAD National Voluntary Organizations Active in DisastersNWCG National Wildfire Coordinating GroupOEP Occupant Emergency PanOES Office of Emergency ServicesOSCAR Operating Status Checklist and ReportsOSHA Occupational Safety and Health AdministrationPA Public AssistancePCP Patient Care ProviderPM Program ManagerPOLREP Pollution ReportPIO Public Information OfficerPNP Private Non-ProfitPPE Personal Protective Equipment


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PRC Primary Receiving CenterPVO Private Voluntary OrganizationsR&D Research & DevelopmentRESTAT Resources StatusRF Radio FrequencyRNP Registered Nurse PractitionersROSS Resource Ordering and Status SystemRRCC Regional Response Coordination CenterSARS Severe Acute Respiratory SyndromeSBA Small Business AdministrationSDO Standards Development OrganizationsSEMS Standardized Emergency Management SystemSIMCELL Simulation CellSITREP Situation ReportSO Safety OfficerSOP Standard Operating ProcedureSSC Supply Service CenterSTART Simple Triage and Rapid TreatmentTCL Target Capabilities ListTOPOFF Top Officials (an exercise designed to test top officials in the U.S. government)TRAC2ES United States Transportation Command [USTRANSCOM]

Command and Control Evacuation SystemUC Unified CommandUM Unified ManagementUN United NationsUS&R Urban Search and RescueUSC United States CodeUSCA United States Code AnnotatedUSCG United States Coast GuardUSTRANSCOM United States Transportation CommandVA US Department of Veterans AffairsVHA Veterans Health AdministrationVAMC Veterans Affairs Medical CenterVISN Veteran’s Integrated Service NetworkWMD Weapons of Mass DestructionWMO World Meteorological OrganizationY2K Year 2000


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APPENDIX C

VMS IMPLEMENTATION ISSUES & RECOMMENDATIONSStandardized Volunteer Management System for


Introduction

In developing the Volunteer Management System (VMS) system description and concept of operations, it became evident that in many areas, multiple options are available when implementing the various components of the VMS. In most of these areas, the best option is dependent upon factors that may be location and/or jurisdiction specific. This annex explains the sometimes complex VMS issues, and provides recommendations on how to customize the VMS to specific needs.

Issue 1: VMS Integration into the Overall Incident Response [BACK to Systems Description][BACK to Concept of Operations]

Discussion: The goal of the VMS is the support of the incident response through volunteer management. The VMS relationship with the general Incident Command System (ICS) must therefore be cooperative, mutually beneficial, and clearly defined. The VMS in the current model provides resources in the form of medical and health personnel to fill human resource needs when ICS has exhausted its mechanisms (e.g. internal avenues such as call-backs or external avenues such as mutual aid) for acquiring adequate surge personnel or for obtaining specific technical needs that are in short supply. The VMS, therefore, serves primarily as a logistics element, and so the VMS should be directly integrated into the overall incident management team as a resource sub-function under a larger logistics function. Within the VMS itself, the VMS Incident Integration Branch of the VMS Operations Section is the functional element of the VMS that accomplishes its tactical coordination/integration with Incident Command. The VMS manager is responsible for the overall, strategic relationship between the VMS and the ICS logistics function where the VMS is assigned.

Several alternatives are available for integrating the VMS into the overall incident. The best option for any specific incident may depend in large part upon the existing incident management construct for the overall incident.

Options:

A. Integrate the VMS through the ICS Logistics Branch . In this case, the VMS provides support to incident operations through the ICS Logistics Section. It therefore meets the personnel needs dictated by on-site operational incident


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command, and relayed to the ICS Logistics Section to address. The VMS may work with the ICS Logistics Section in two different manners. The VMS may in certain circumstances by incorporated by the ICS

organization as a unit within the Logistics Section. The VMS may be maintained as a more independent organization reporting

through the Incident Integration Branch to the Logistics Section, Supply Unit, using a liaison (the Incident Integration Branch Director) to coordinate between the two entities.

B. Integrate the VMS through an Emergency Operations Center (EOC) resource dispatching and tracking function. Certain jurisdictions may choose to have the VMS integrate through the EOC as it provides support to ICS for personnel that ICS Logistics cannot obtain readily. The size and scope of an incident may extend beyond the primary incident or single incident site, and therefore dictates that the VMS be managed through the EOC rather than a single ICS Logistics Branch. EOCs can be structured in a variety of ways: either modeled on the NRP Emergency Support Function structure, or through a more ICS oriented structure that uses task groups within the EOC operations or logistics sections. If this option is selected, it is important that the Incident Integration Branch of the VMS Operations Section still interacts directly with the appropriate ICS personnel for the purpose of effective information exchange.

Either Option A or B can be effective for any particular jurisdiction and situation. What is important is that the specific integration method must be selected, delineated, and disseminated by the jurisdiction so that all understand where and how the VMS relates to the ICS and its incident management team.

[BACK to Systems Description][BACK to Concept of Operations]


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Issue 2: Technical Expertise in VMS Management Positions [BACK]

Discussion: An incident with demands for public health and medical resources may require specialized volunteers to provide the surge capacity and capability needed for the response. For example, a large number of physicians and nurses may be requested to assist in a jurisdiction with a very severe health impact. In these situations, the VMS credentialing and assignment functions may require technical expertise in determining that ICS needs are met by appropriately selected volunteers. A concern may exist that this technical screening expertise can only be provided by the already limited numbers of public health and medical personnel available to assist in the incident. This concern is minimized by the VMS system design, with its incorporated ICS tenets. This provides a flexible structure which can function with strategically positioned “health and medical expertise” in only a few positions, such as command staff, or as positioned resources (e.g. Technical Specialists). The individuals who staff these positions can therefore provide the necessary expertise or level of assistance in decision-making that will allow non-medical or health personnel to work effectively within defined roles, deferring to the expert when needed.

Options:

A. Staffing VMS management positions with expert personnel . Selecting VMS management positions, such as VMS Manager or Volunteer Processing Branch Director, to be staffed by personnel with public health and/or medical expertise. This allows certain key positions to address liability concerns and exert expert judgment in assigning volunteers to technical or ‘high-trust’ positions. It is important to note that this option places more work upon other VMS Command and General staff positions if this expert judgment is frequently required and only a limited number of staff possess health/medical expertise. It will require well-defined position descriptions for all non-expert VMS positions to ensure correct skill sets for all other VMS personnel.

B. Appoint a Qualified Technical Expert to the VMS Command Staff . Assigning a Technical Expert (Senior Advisor) as a member of VMS Command Staff can provide the needed expertise on public health and medical issues. This conveys greater flexibility for staffing all other VMS positions. The Senior Advisor could be called upon to address situations where public health and medical expert judgment is required, leaving VMS Command and General Staff free to focus on managing the VMS itself.

C. Staff multiple VMS positions with qualified public health and medical staff . Staffing many VMS management positions within VMS Command and the Volunteer Processing Branch (Assignment and Credentialing) with personnel qualified to conduct public health and/or medical expert decision-making is an option, although inefficient and difficult to achieve. This may be desirable if qualified Public Health and Medical staff are readily available and most of the volunteer positions to be staffed require some level of expert-judgment and/or


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screening abilities. This could occur if all the volunteers requested by ICS are to be placed in ‘high-trust’ positions or must be highly qualified for specialized, high-stakes.

D. Configure ‘roster’ categories for volunteers to minimize need for VMS expert judgment. In addition to the above staffing suggestions, minimizing expert judgment needs may be addressed by appropriately categorizing applicants for credential screening. Categories can be established that enable the Credentialing Supervisor to sort all incoming volunteers into distinct groups based on their ability to perform certain tasks. The categories are delineated by necessary volunteer credentials, qualifications and other determinants. The task of sorting volunteers will also be facilitated by ICS providing the VMS with specific position qualifications and necessary credentials for each type of personnel request. This can facilitate the process for non-medical VMS staff to screen volunteers readily and accurately categorize them based upon clearly defined parameters. This is further addressed under “Issue 3.”

2A. Issue: Liability coverage for personnel exercising expert judgment in selecting and assigning volunteers to highly skilled and/ or “high-trust” response positions.

Public officials exercising appropriate authority during emergency response are, in most jurisdictions, immune from personal liability when acting in an official capacity (exceptions exist, usually described as “gross negligence” and “willful misconduct”). Medical and public health experts from the private sector may be concerned that they are incurring liability for providing expert judgment in selecting and assigning volunteers beyond their home healthcare organization. This issue should be addressed during VMS development. Clearly defined qualifications for the technical experts and how their advice is used should be defined, so that concerns about liability may be managed. The technical experts, for example, may be asked to provide “advice only” to the VMS. Action upon that advice, which is provided in good faith, is the responsibility (and therefore the liability) of the involved public officials. Alternatively, the technical expert position may be developed as a position where qualified personnel become temporary public health or public safety employees, according them the liability coverage (in most jurisdictions) that is inherent to acts by public officials. Local legal experts should always be consulted for guidance on issues such as this. See Issue #12 for further liability discussion.

[BACK]


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Issue 3: Volunteer Registration Strategies [BACK]

Discussion: The objectives of the registration process encompass efficient processing, accurate data collection, and provision of clear information to potential volunteers. This must be conducted in a streamlined, organized fashion in order to rapidly fill high-priority assignment requests.

The mechanics of registration should be considered during the VMS development planning. A flow “bottleneck” may be created during the registration procedure, since obtaining and entering adequate, accurate information about each volunteer is time consuming. The options have technology, cost, and manpower implications.

Options:

A. Promoting pre-registration wherever possible : This allows the presenting volunteer to rapidly scan their data and confirm it as accurate or make corrections. It also may provide a signed release, contact information for confirming credentials, and other time-saving measures.

B. Self-registration : By providing a large bank of computers and a simple program and directions, applicants may be able to rapidly enter their own data. A firewall must be in place so they cannot access any other data from those computers.

C. Registration personnel entering data directly from applicants : This is likely to be a very time-consuming approach, and can create inaccuracies in name spelling and other critical data; if this is the only process available, it may be best that the data entry is done from a form that is hand-completed by the applicants – block lettering and printing should be encouraged by the form to minimize inaccuracies.

D. Use of scan sheets and applicant review of scanned entries : This method may be the most efficient and cost-effective. Applicants fill out their data on a scan sheet, the sheet is scanned into the database and the applicant quickly reviews the entered information to confirm accuracy.

How the registration of volunteers is organized into volunteer lines or streams may also affect the efficiency of meeting incident volunteer demands. For incidents where a high volume of volunteer applicants is anticipated, options exist to efficiently and effectively accomplish these objectives. The process can therefore be configured in multiple ways to minimize the processing time for volunteers and the efforts required of the VMS staff.

Options:

A. Processing streams based on categories of presenting volunteers: This prioritization is designed to accomplish the most rapid path to screening and approving a large number of volunteers. Volunteers may be categorized


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according to how rapidly they can have their identity and credentials confirmed after registration. Volunteer applicants who are pre-registered with VMS or who are affiliated with a volunteer organization whose registration and credentialing processes are acceptable to VMS (as established prior to any incident) may require less time and effort to confirm their credentials. A “fast-track” processing stream may therefore be established for these volunteers, getting them rostered into categories for assignment in a rapid fashion. For example, volunteers affiliated with certain agencies may have the registration data already collected and adequately verified by the agency, such that it can easily be transferred to the VMS database. In some jurisdictions, this information may already be contained within the VMS database and will only require brief review and update/confirmation. The next category of volunteers who can be rapidly processed are those that require only minimal credentialing: for example, administrative and unskilled labor for non-sensitive positions that operate under supervisions. At the opposite extreme is the processing of spontaneous, unaffiliated volunteers (individuals or groups) for high-trust or high-skill positions, which will require the most time and effort intensive credentialing. Creating a separate processing stream for these volunteers would allow other volunteer categories to be registered and assigned more quickly, and therefore permit the VMS to meet the majority of ICS personnel requests more efficiently. An important consideration when processing affiliated volunteers is that accepting data from other agencies requires a degree of trust in the process undertaken by those agencies/organizations. This trust is only possible through efforts pre-incident by the agency or organization in question to provide their methodology to the VMS for review and assessment. The VMS may elect to inform volunteer organizations about its registration requirements during preparedness activities, and promote their compliance with requirements.

B. Processing streams based upon types of volunteers requested by ICS : This arrangement uses prioritization of requested types of incident volunteers as the organizational scheme for registration. ICS may require a certain type of volunteer with more urgency and/or in greater numbers than other types of volunteers. Processing streams can be established according to these types to expedite the registration and credentialing of volunteers with the requested skill-sets and credentials. The configuration of these processing streams must remain flexible as the incident parameters may change, causing the priorities for rapid screening of volunteer types to change as well.

C. A single processing stream with a high volume of registration staff : A larger number of registration positions may be staffed to meet the surge demands and increase the registration capacity. In this case, the credentialing process for complex or high-trust positions may act as the bottleneck, especially if a level of expert judgment is required from the credentialing supervisor or technical expert. If this is the case, a separate stream should be established for lengthy credentialing cases. [BACK]


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Issue 4: Credential Verification Strategies [BACK]

Discussion: The provision of medical care through accredited healthcare organizations in the U.S is highly regulated to assure the public that their care is provided by qualified practitioners. Despite the exigencies present during mass casualty and other medical emergencies, responding organizations carry the ethical responsibility to provide similar assurances to the public. Experience in past disasters has demonstrated examples of both fraudulent and incompetent medical providers, and so this is a very real issue. How “credentialing” is to be accomplished under emergency conditions, therefore, must be carefully considered.

At a minimum, all volunteers must have their true identity confirmed. This can be accomplished through examination of a current, government issued identification card (ID). Depending on how the volunteer will be utilized, other background information may be necessary. For some health and medical positions that are not highly technical or do not require advanced decision making or high degrees of trust, it may be acceptable to the VMS (and ICS) to confirm an applicant’s healthcare experience through a current healthcare facility ID, which provides an indication that the person is an active healthcare worker who understands issues related to medical care such as confidentiality. Some assignments that healthcare volunteers may fill are sensitive and/or high-trust positions that in normal times require formal credentialing24 and privileging25 processes to be completed. Volunteers being considered for these assignments should have their credentials more carefully examined. To best address the credentialing issues, it is helpful to understand credentialing and privileging as it relates to healthcare organizations during normal health delivery under everyday conditions. The Joint Commission for Accreditation of Healthcare Organizations (JCAHO) sets the common standard for credentialing and privileging healthcare providers for JCAHO-accredited facilities. JCAHO has also outlined emergency credentialing procedures (summarized

24 “Credentialing involves providing documentation that can authenticate and verify the certification and identity of designated incident command staff and emergency responders. This system helps ensure that personnel representing various jurisdictional levels and functional disciplines possess a minimum common level of training, currency, experience, physical and medical fitness, and capability for the incident management or emergency responder position they are tasked to fill.” (NIMS Integration Center) “Credentialing involves the collection, verification, and assessment of information regarding threecritical parameters, current licensure; education and relevant training; and experience, ability, and current competence to perform the requested privilege(s). Verification is sought to minimize the possibility of granting privilege(s) based on the review of fraudulent documents.” (JCAHO proposed “Hospital – 2007 Medical Staff Standards”)25 Privileging during normal times is the process where appropriately credentialed personnel (see credentialing) are granted permission to provide specified services within the healthcare organization. Incident privileging is the process where appropriately credentialed personnel are accepted into an incident (or by an incident resource such as a hospital) to participate as an assigned resource in the response. This process may include both confirmation of a responder’s credentials and a determination that an incident need exists that the responder is qualified to address (see Emergency Management Principles and Practices for Healthcare Systems).


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under “Option C” below). For day to day operations in healthcare facilities, JCAHO states,26 “In the course of the credentialing and privileging process, an overview of each applicant’s licensure, education, training, current competence, and physical ability to discharge patient care responsibilities is established.” JCAHO addresses three specific areas of credentialing for independent healthcare practitioners:

licensure, education and relevant training, and experience, ability, and current competence in performing the requested

privileges (see below).

JCAHO’s usual credentialing process 27

“The credentialing process requires that the hospital verifies in writing and from the primary source whenever feasible, or from a credentials verification organization (CVO), the following information:• The applicant’s current licensure at time of initial granting, renewal, and

revision of privileges, and at the time of license expiration• The applicant’s relevant training• The applicant’s current competence” (this includes querying the

National Practitioner Data Bank (NPDB), obtaining peer recommendations, determining if any challenges to licenses, registrations, or past privileges have occurred, or if any unusual liability actions have been taken).

It is also important to recognize that the VMS only performs identification and credentialing services. It does not conduct “privileging” for healthcare organizations receiving the volunteers unless that authority is specifically delegated to the VMS; otherwise, it remains a responsibility of the healthcare organization receiving the VMS-credentialed volunteers.

Options:

A. Primary source credential verification : Primary source verification, according to JCAHO, is “verification… obtained from the original source of the specific credential.” Access to State Health Professions Boards, professional credentialing and certification organizations, and educational institutions may be required. For physicians, JCAHO provides a list of equivalent sources for verifying medical school graduation and residency completion, board certification, and actions against physician’s medical license. Some manner of primary source credential verification may be preferred when processing volunteers who are to be assigned to ‘high-trust’ positions. In many States, basic

26 JCAHO Credentialing and Privileging Overview (MS 4), “Hospital – 2007 Medical Staff Standards” (JCAHO, Oakbrook Terrace, Illinois).27 Ibid.


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licensure for health professions is available electronically and accessible via the Internet, making licensure status relatively simple to verify. Verifying other aspects of a volunteer’s credentials are not as straightforward: completing a law enforcement ‘background’ check, accessing the National Practitioner Data Bank and the Inspector General Database (which could reveal any problematic issues documented for individual health care professionals), obtaining peer input and others. To accomplish this during a response, mechanisms for contacting these primary sources (or their equivalents) must be pre-established and confirmed (through testing) as reliable. It becomes obvious that primary verification usually requires multiple communication avenues and will most likely result in a processing delay. VMS may wish to consider a variation on the traditional approach to comprehensive primary source verification, and define the specific components of the credentials and qualifications of the volunteer that will be investigated primarily.

.B. Secondary source credential verification : This is an expedited credential

verification strategy, but retains a relatively strict credentialing standard. JCAHO allows for this path during normal credentialing activities if primary source verification is not available. According to JCAHO, “A reliable secondary source can be another hospital that has a documented primary source verification of the applicant’s credentials.”28 It can therefore act as an alternative to the lengthy process of primary source verification and be deemed equally acceptable under certain circumstances. Secondary source verification is accomplished by directly confirming current credentials and active privileges of a presenting volunteer with an accredited healthcare organization (the “primary source”). It is important to verify that the professional’s privileges at the reporting agency or organization be similar or identical to those to be performed by the volunteer position in the incident response. A single phone call to a recognized employer (such as a supervisor at a major hospital or organization) could therefore confirm the volunteer’s listed skills and qualifications in addition to authenticating their employment status. Since this secondary verification process is only as rigorous as the primary verification utilized by the reporting agency, it is important to identify likely primary sources for this process during the preparedness phase. In preparedness discussions with these potential reporting agencies or organizations, investigation of the procedures used for primary source verification can be accomplished. In addition, pre-arrangements to facilitate the secondary verification can be established (phone numbers, points of contact 24/7/365, etc.). This option may best be accomplished on a regional basis, defining and clearly establishing the secondary credential verification process with regional healthcare facilities.

C. Expedited emergency credentialing : The Joint Commission on Accreditation of Healthcare Organizations has developed a “disaster privileging” guidelines for healthcare organizations, for the purpose of granting disaster privileges when the

28 JCAHO Credentialing and Privileging (MS 4), proposed “Hospital – 2007 Medical Staff Standards”. JCAHO, Oakbrook Terrace, Illinois.


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organization’s emergency operations plan has been activated and the organization is unable to meet immediate patient needs. The VMS may elect to use this guidance as an expedited guideline for “emergency credentialing.” It is important to note that when VMS personnel are following these guidelines, they are performing credentialing, not privileging as noted in the discussion above. Recent JCAHO disaster privileging guidelines are summarized below.

Joint Commission on Accreditation of Healthcare OrganizationsStandards: summary of standards addressing disaster privileging29

JCAHO Standard A-5 addresses volunteer eligibility to act as licensed independent practitioners. It stipulates identification confirmation through a valid government-issued photo identification issued by a state or federal agency (e.g., driver’s license or passport) and at least one of the following: A current picture hospital ID card that clearly identifies professional

designation A current license to practice Primary source verification of the license Identification indicating that the individual is a member of a Disaster

Medical Assistance Team (DMAT), or MRC30, ESAR-VHP31, or other recognized state or federal organizations or groups

Identification indicating that the individual has been granted authority to render patient care, treatment, and services in disaster circumstances (such authority having been granted by a federal, state, or municipal entity)

Identification by current hospital or medical staff member(s) who possesses personal knowledge regarding volunteer’s ability to act as a licensed independent practitioner during a disaster

A similar modified process for the assignment of disaster responsibilities for volunteers that are not independent practitioners exists at Standard HR.1.25. Even in a disaster, the integrity of two parts of the usual credentialing and privileging process must be maintained:1. Verification of licensure

29 ibid30 MRC – Medical Reserve Corps units comprise of locally-based medical and public health volunteers who can assist their communities during emergencies, such as an influenza epidemic, a chemical spill, or an act of terrorism. The MRC Program was formed in 2002, in cooperation with the White House’s USA Freedom Corps, as one of the charter programs of Citizen Corps. Pre-identifying, training and organizing medical and public health professionals to strengthen their communities through volunteerism is at the core of the MRC concept. MRC volunteers offer their expertise throughout the year by supporting local public health initiatives, such as immunization and prevention activities. When an emergency community need occurs, MRC volunteers can work in coordination with existing local emergency response programs.31 ESAR-VHP – The Emergency System for Advance Registration of Volunteer Health Professionals (ESAR-VHP) program, created by the Health Resources and Services Administration (HRSA), allows for the advance registration and credentialing of healthcare professionals needed to augment a hospital or other medical facility to meet increased patient/victim care and increased surge capacity needs.


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2. Oversight of the care, treatment, and services provided[BACK]

Issue 5: Rostering Strategy for Credentialed Volunteers [BACK to Volunteer Processing Branch][BACK to Incident Integration Branch]

Discussion: When applicants have had their identity confirmed and offered credentials verified, the volunteer is then rostered to appropriate categories to be considered as a match for available response positions. How the rostering categories are structured is important for efficient matching of volunteers to available positions. The VMS has been structured with a four-tier rostering strategy that is designed to match easily to the described competencies and credentials for the positions open to staffing by volunteers.

Option: Volunteer credentialing and rostering categories for Public Health and Medical Categories (assumes identity has been confirmed):

#1. Categorization by professional classification (standardized by nationally recognized, common healthcare/public health titles); examples include:

Physician Registered nurse Licensed professional nurse Nurses aid Respiratory therapist Respiratory technician Public health epidemiologist Public health provider Paramedic Emergency Medical Technician Pharmacist Lab technician Manual labor Administration Mental health services provider Etc.

#2. Job category within each professional classification (standardized by nationally recognized roles/specialization within the professional classification) some examples are listed below:

Physician: primary care, emergency medicine, infectious disease, critical care, pulmonary, renal, toxicology, other medical, trauma surgeon, general surgeon, burn surgeon, eye surgeon, plastic surgeon, orthopedic surgeon, hand surgeon, other surgeon, anesthesia, radiology, radiation oncology, psychiatry, other

RN: CEN, CRNA, NP, Critical Care Nurse, General, Pediatric, Dialysis, Operative, PACU, Orthopedic, Other


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Etc.

#3. Functional characteristics within each job category (credentials/skills/abilities that differentiate professionals across each functional category and/or job; these provide an assessment of the level of supervision, the orientation (administrative versus clinical) within a job category, customized according to pre-plan for incident types)

Advanced Healthcare Services – Independent (i.e., High-trust, High-skill and/or Unsupervised – healthcare, epidemiology, expert strategic or tactical advice, clinical management positions, surgeons taking patients to the operating room, etc.)

Advanced Healthcare Services under supervision (i.e., medical, nursing, respiratory therapy, public health interviewing, etc.)

Basic Healthcare Services under supervision (i.e., vital signs, intake information, surveys, wound care assistance, etc.)

Administrative services - Healthcare Administrative services - ICS Manual labor – heavy lifting (over 10 pounds) Manual labor – light lifting, courier, etc. Support services under supervision (other tasks as indicated).

#4. Specific job competencies required: any specific medical, public health or ICS skills that are critical to the job performance beyond the skills directly related or always encountered in the relevant job categories. Examples include: airway management, IV insertions and phlebotomy for med/surge nurses, decontamination using PPE for emergency department staff, vital signs for technicians, emergency department triage for emergency nurses, supervisor – clinical services, supervisor – support services, etc. Any other specific competencies can also be delineated here, such as language abilities and non-medical competencies.

The rostering strategy is presented in Figure 8. An example application for the rostering strategy is presented in Figure 9.

Credentialed volunteers may be rostered in multiple categories; but when a rostered volunteer has been assigned, the VMS must take care to indicate that the assigned volunteer is now no longer available from any of the other roster categories in which he or she was also placed, until their assignment is complete. Once their assignment is complete, their name will re-appear as available in all appropriate roster categories.


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Figure 8. The four-tiered rostering strategy that can be applied to any type of volunteer groups

Figure 9. An example of the application of the rostering categorization for a medical/surgical Registered Nurse who is competent to start IVs and speaks the Spanish language.


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Issue 6: Equipment and Training Strategies [BACK]

Discussion: Volunteer public health and medical workers may require personal protective equipment (PPE) or other medical equipment for effective and safe performance of their assigned responsibilities.32 ICS and the VMS must jointly determine who will be providing the assigned volunteers with PPE and specify the types of PPE and training required. The VMS can provide equipment and just-in-time training on the equipment as an extension of the ICS authority and responsibility for the incident response. This may ensure that volunteers are receiving adequate PPE before they enter a hazardous environment. In addition, training (and even fit-testing) may be required for the necessary PPE. VMS should establish the mechanisms for this process in conjunction with ICS. Finally, the provision of this training by VMS should be documented within the VMS database for each volunteer. Options:

A. ICS responsible for equipment issue and training : In this option, all equipment and supplies are provided directly by ICS or the agency requesting volunteers, and generally would occur when the volunteers arrive either at their designated worksite or at a central location prior to being transported to their worksite. The training for each piece of equipment issued should be conducted when the volunteers receive it. This may include the appropriate fit-testing for respiratory protection beyond surgical masks, associated training for specialized equipment, and any necessary information on supplies.

B. VMS responsible for equipment issue and training : The ICS can delegate the authority to the VMS to provide equipment/supplies and the associated training to the volunteer prior to the transfer to their designated worksite. The VMS issues specific equipment to the volunteer as directed by the ICS. This may vary between volunteers, based upon the volunteer’s worksite and assigned tasks. It is important to note that this option requires ICS logistics to deliver all equipment/supplies to the VMS and may require a substantial storage capacity for this equipment and/or supply cache. It may also require the VMS to have staff members that are qualified to conduct fit testing and training for all dispensed equipment. While this increases the task effort for the VMS, this approach may assure consistent and complete equipment issuance and training, and promote improved documentation of equipment dispensing and adequate training. This process is conducted under the authority of the ICS, and the maintenance of

32 Currently, standards of PPE for healthcare workers are regulated by the Food and Drug Administration (FDA). See Personal Protective Equipment (PPE) and Patient Care (May 9, 2006) at http://www.fda.gov/cdrh/ppe/index.html, accessed August 30, 2006. Workplace health and safety regulations defined by OSHA also state that PPE must be provided to employees and specifies the circumstances in which PPE is required. See Personal Protective Equipment (PPE) at: http://www.osha.gov/SLTC/personalprotectiveequipment/index.html, accessed August 30, 2006. The CDC provides guidelines for the appropriate PPE selection and its use in relation to infectious disease processes. See Personal Protective Equipment (PPE) in Healthcare Settings (May 20, 2004) at: http://www.cdc.gov/ncidod/dhqp/ppe.html, accessed August 30, 2006.


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http://www.cdc.gov/ncidod/dhqp/ppe.html

http://www.osha.gov/SLTC/personalprotectiveequipment/index.html

http://www.fda.gov/cdrh/ppe/index.html


records, any required medical screening follow-up, and other PPE-related post-incident issues remain the responsibility of ICS unless otherwise assigned and resourced (it is important to note the OSHA requirements for maintaining personnel records for the 30 years following a worker’s potential exposure to a hazardous material; while it is not clear that OSHA considers volunteers to be employees, the VMS/ICS should treat them the same as paid workers in this regard).33

C. A combination of VMS and ICS equipment dispensing and training. For example, a standard PPE kit (gloves, surgical mask, hand sanitizer) and review of donning and doffing procedures for standard PPE as well as for basic infection control procedures can be provided to all volunteers at the assignment briefing in the VMS. Additional specialized equipment/PPE needed to accomplish assigned tasks is then provided at the worksite. This option ensures all volunteers possess some minimum level of personal protection prior to leaving the VMS processing site, safeguarding them during unintended patient encounters that occur before receiving their briefing and equipment issue at assigned work sites.

[BACK]

33 "Access to Employee Exposure and Medical Records," 29 CFR1910.1020.


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Issue 7: Site Privileging and Volunteer Badging [BACK]

Discussion: A badge for assigned VMS volunteers can be important for both the volunteers and the VMS. The badge serves as a means of identification and can also be used for incident access purposes. The possession of a VMS badge indicates that a volunteer has been screened, processed and assigned through an officially managed system. The VMS badge should clearly identify the bearer as a VMS-processed volunteer. It should display both a photo and the name of the volunteer, in addition to a unique identifying number that could be used for volunteer tracking.

ICS maintains the responsibility of granting the assigned and badged volunteers access privileges to incident sites. In some instances, this can be accomplished by accepting the VMS badge for site-access and other incident purposes. In other cases, ICS may have a separate and distinct process for indicating site privileging. It is the responsibility of ICS (or the agency requesting volunteers) to define the type of site privileging procedure that will be used at particular locations.

Options:

A. VMS is responsible for providing the site access badge : The VMS can be tasked with managing the ICS site privileging mechanism for assigned volunteers in addition to providing them with a VMS badge. In this case, the details of ICS site privileging procedures will need to be carefully relayed to the VMS through VMS Incident Integration. The Volunteer Processing Branch will then use the information to fulfill both the badging and site privileging function. This may be the most appropriate option if ICS is forced to process and badge a high volume of professional responders and is reluctant to take on the site privileging for a growing number of assigned volunteers. It is important to note that this option does require careful coordination between ICS and the VMS in order to ensure that volunteers are properly marked for site access throughout the duration of their assignment period. Those in charge of perimeter control for ICS should be briefed on this arrangement.

B. ICS responsible for providing the site access badge : The VMS provides assigned

volunteers with a VMS badge but all site-privileging responsibilities are relegated to ICS. ICS will need to define the strategy for indicating site access privileges for assigned volunteers (another badge, armbands, stickers etc…) and appoint the responsibility of site privileging to either the ICS Volunteer Supervisor or to a designated function located at the entry to the incident perimeter (if applicable). In these cases, ICS personnel will be required to ‘greet’ the incoming assigned volunteer and walk them through the site privileging process. This ensures more rigorous ICS security measures and minimizes any confusion that may arise between ICS and VMS about the privileging details.

[BACK]


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Issue 8: Volunteer Recruitment Strategies [BACK]

Discussion: Incidents that require an extensive surge of health and medical personnel may necessitate an effective volunteer recruitment capability. This volunteer recruitment function should work closely with the ICS or EOC Public Information Officer (PIO) during incident response. Volunteer recruitment in the preparedness phase focuses on the pre-registration of volunteers who believe they will be able to respond to incidents, but in reality many pre-registered volunteers may not be immediately available for the response when an incident occurs. An effective approach to augmenting the number of volunteers during the response phase is a carefully designed, needs-based recruitment campaign to help enlist just-in-time volunteers through requests to professional resources (healthcare organizations, professional associations, etc.) at the time of anticipated need. These contacts, however, should be established during the preparedness phase. Several options exist for how volunteer recruitment is managed in the VMS.

Options:

A. Activating the Volunteer Recruitment Unit under Volunteer Processing Branch Director. This option assigns the responsibility for volunteer recruitment to the Volunteer Processing Branch Director within the VMS. This approach may work best when Volunteer Processing is under pressure to recruit a limited additional number of qualified volunteers to rapidly meet ICS personnel needs. Because the Volunteer Processing Branch is ultimately responsible for assigning the most suitable volunteers to available positions, the volunteer recruitment function can represent an extension of its assigned tasks. The Incident Integration Branch would provide the description of the needed volunteers for the media message, just as they do for positions to be filled from a current volunteer pool.

B. Establishing a separate Volunteer Recruitment Branch under the VMS Operations Section. If volunteer recruitment will be an extensive assignment, it may be best to establish it as an additional branch under the VMS Operations Section Chief, and staff it accordingly.

C. ICS develops and disseminates the media message in conjunction with the VMS . The VMS Manager is responsible for both the senior liaison and public information functions. The manager would then be the VMS position most suited to work with ICS when providing any input to an ICS disseminated recruitment message.

[BACK]


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Issue 9: Managing Volunteers Already Active in the Incident [BACK to Incident Integration Branch][BACK to ICS Support to the VMS]

Discussion: Bystanders or witnesses to an incident may begin providing assistance as volunteers before trained public safety personnel arrive. Bystander assistance has the potential to be helpful, but can also create risks when these individuals are untrained and/or unprotected. Once a formal incident management system is in place, it is important that volunteers still active on the incident site be identified/recognized and either released or incorporated into the ICS management structure. In addition, ICS may have recruited volunteers from outside the incident area prior to the establishment of the VMS. The issue of accountability and processing of volunteers in these situations may be addressed in an organized manner through several different approaches. Options:

A. ICS maintains all responsibility for volunteers active in incident operations prior to VMS operations. An early decision to be made by the incident commander or operations section chief is whether ICS will remain solely responsible for the accountability and supervision of volunteers already present at the time of VMS mobilization. For short-lived incidents or for incidents where the volunteers are known to the ICS responders, this may be desirable. For others, it may be better to implement a strategy for the volunteers to be processed through the VMS before continuing as workers within the incident response.

B. ICS relieves volunteers for processing and badging through the VMC . This maintains accountability and the security parameters for the incident site, which are enforceable primarily through incident and site-specific badging. This processing and badging is also consistent with standard incident management under NIMS, where all resources committed to an incident are registered and tracked. For volunteers already participating in the response but are to be processed by the VMS, several processing strategies are possible:

Volunteers relieved of duty and sent to the VMC : This volunteer cohort may be processed in an expedited fashion separate from other arriving volunteers. The temporary removal from the site may be a useful strategy to allow for re-evaluation of the volunteers’ appropriateness for their assigned tasks and re-assignment, demobilization, or change in supervision as indicated. This option is available when the tasks being performed by volunteers can be temporarily suspended or taken over by others without causing adverse impact on response operations.

VMS staff deploy to locations where volunteers are engaged in assigned responsibilities: This can be very time intensive for the VMS, but may be appropriate for a small number of key volunteers who are assigned to critical response activities, or who were recruited by ICS and badged prior to VMS


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mobilization. An alternative to this approach is that ICS personnel collect the registration and credentialing information from active volunteers, and relay this information to the VMS for processing at the VMC.

Volunteers are registered and processed at the end of their initial shift : This option is similar to that presented under option A, where the ICS assumes responsibility for the credentials of volunteers working in the early hours of an incident response. Volunteers are briefed by their assigned supervisors on the need for processing prior to leaving after their current incident assignment shift is completed.

In each of the above options, any information that ICS has already obtained on deployed volunteers should be provided to VMS in an appropriate manner. Ideally, a level of interoperability has been pre-established between the ICS and VMS information management technologies.

[BACK to Incident Integration Branch][BACK to ICS Support to the VMS]


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Issue 10: On-site Volunteer Coordinator [BACK]

Discussion: The On-site Volunteer Coordinator represents an optional position that can be useful in some situations. This position may be most beneficial when large numbers of volunteers are placed in specific worksites. The individual assigned to the position may be provided by either the VMS or ICS (see options below). The On-site Coordinator can be used to assist with the arrival, briefing, and training of volunteers at a work site and with their out-processing at the completion of their assignment. The On-site Coordinator may also serve to facilitate information exchange between the worksite and the VMS Incident Integration Branch. Finally, they may act as an ongoing point of contact for both VMS volunteers and ICS supervisors to help facilitate interaction with the VMS Trouble Desk if necessary or to address any on-site issues involving volunteers.

Options:

A. The On-site Coordinator(s) as a VMS position : The On-site Coordinator could remain a VMS functional position reporting to the Incident Integration Branch. It may be a mobile position with the VMS On-site Coordinator traveling between worksites to facilitate information exchange and to assist where and when needed. This option may require transportation for the On-site Coordinator.

B. The On-site Coordinator(s) as an ICS position : The On-site Coordinator(s) may

be developed as an ICS position(s) with personnel assigned from the agency requesting volunteers. To function in this configuration, these ICS personnel must have an operational understanding of the structure and function of the VMS, and be operationally proficient in the On-site Coordinator’s volunteer management tasks. The ICS On-site Coordinator should therefore ideally be trained on the VMS and the specific On-site Coordinator position.


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Issue 11: Management of Volunteers post-VMS Demobilization [BACK to VMS Demobilization Textbox][BACK to VMS Demobilization in the Concept of Operations]

Discussion: Certain volunteers may continue working in an assigned incident position for ongoing response and recovery operations beyond the formal demobilization of the VMC and VMS. For example, ICS may request that specific volunteers continue providing volunteer services even though other volunteer activity has abated and the VMC/VMS is being demobilized. Despite this, all volunteers should receive the same level of out-processing benefits that are provided through the deployed VMS.

Options:

A. VMS maintains responsibility : The VMS can elect to maintain a rudimentary volunteer out-processing function within ICS in order to provide support and enable formal out-processing for remaining volunteers. This is useful because it ensures continuity in VMS operations and ensures that all volunteers are provided identical benefits and support. It requires VMS staff to remain available in order to fulfill this responsibility, until the very last volunteer has completed his or her assignment.

B. VMS transitions responsibility to ICS : The VMS can transfer this direct responsibility to an ICS position. ICS then conducts volunteer out-processing by using the suggested debriefing procedure, recovering equipment and obtaining feedback. This is useful when the VMS is no longer active and its managerial staff has resumed their routine (every day) positions or another position in incident recovery. In these cases, the ICS must assure that all the information collected during volunteer out-processing is forwarded to the position responsible for analyzing and archiving VMS documentation.


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Issue 12: Liability Issues for VMS Staff and for Volunteers [BACK]

Introduction

The liability risk for public health and medical volunteers has been a source of concern for potential volunteers for several decades. While actual experience has demonstrated that this is a relatively low risk compared to everyday medical practice, the concern should be addressed in the information provided to potential volunteers during the volunteer processing activities. This may require some significant investigation, with advice from local and state legal counsel, during the preparedness phase.

Discussion: Volunteer Liability

The federal Volunteer Protection Act of 1997 grants immunity from personal liability to those who volunteer for nonprofit organizations. 34 The law is intended to encourage volunteerism and facilitate volunteer organization recruitment by reducing the legal liability risks to individuals who choose to serve. The law preempts inconsistent state law to provide that volunteers would not be liable for harm if (1) they were acting in the scope of the volunteer activity; (2) they were properly licensed (if necessary); (3) the harm was not caused by willful or criminal misconduct, gross negligence, reckless misconduct, or a conscious, flagrant indifference to the rights or safety of the claimant; and (4) the harm was not caused by the volunteer operating a vehicle, vessel, or aircraft.

The law defines a volunteer as someone who provides service for a non-profit and is not compensated, other than being reimbursed for expenses or anything of value under $500 a year. The act defines non-profits as 501(c)(3)s under the 1986 Internal Revenue Service Code, and any not-for-profit organization geared for public benefit and operated for charitable, educational, religious, welfare or health purposes. The number of for-profit medical resources in many communities has grown over the past decade, and so an increasing amount of medical care during emergency response may be provided by these entities. Whether this liability is extended to those volunteers who are recruited and assigned through a non-profit or public entity (such as a VMS that is an extension of the local public health agency in that jurisdiction), but assigned to work in a for-profit facility during the time of the emergency requires a legal opinion beyond the scope of this project.

Good Samaritan legislation, charitable care statutes, and other specific provisions related to disaster relief efforts vary state by state but in general serve to provide some protection to medical professionals providing emergency assistance in a volunteer

34 Public Law 105-19; the Volunteer Protection Act of 1997. The text is available at: http://www.explorium.org/PL_105-19.htm, with explanation available at: http://www.npccny.org/info/gti2.htm, both accessed August 26, 2006.


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http://www.hotairballooning.org/info_volact_text.htm

http://www.hotairballooning.org/info_volact_text.htm

http://www.npccny.org/info/gti2.htm

http://www.explorium.org/PL_105-19.htm


capacity. See http://www.ama-assn.org/ama1/pub/upload/mm/395/goodsamaritansurvey.doc for State by State data current as of 09/22/05. Jurisdictions need to seek careful legal advice when defining the type and degree of liability coverage extended to public health and medical volunteers working for the incident response. Legal experts responsible for providing guidance to VMS Managers should review the State and Federal liability laws pertinent to volunteers in their community, and provide preparedness planning advice accordingly35.

Additional liability issues exist that are not specific to professional emergency response activities, such as liability related to driving mishaps. These are commonly not covered under State laws, and are not covered by the federal Volunteer Protection Act of 1997.

The Orientation Briefing and Acknowledgement of Responsibilities tool should provide a clear liability statement to the volunteers.

Discussion: VMS Management and Staff Liability Issues

How liability risks are covered for the VMS personnel is an additional issue that should be addressed when developing the system. Qualified legal assistance should also be sought for this issue when developing the local VMS.

Public officials exercising appropriate authority during emergency response are, in most jurisdictions, immune from personal liability when acting in an official capacity (exceptions exist, usually described as “gross negligence” and “willful misconduct”). Medical and public health experts from the private sector may be concerned that they are incurring liability for providing expert judgment in selecting and assigning volunteers beyond their home healthcare organization. This issue should be addressed during VMS development.

A range of measures can be instituted to reduce liability concerns for the overall VMS and for individual VMS staff. Liability risk for VMS management personnel and their technical experts may be more effectively managed with clearly defined qualifications for the technical experts and unambiguous delineation of how their advice is used. The technical experts, for example, may be asked to provide “advice only” to the VMS. Action upon that advice, which is provided in good faith, is the responsibility (and therefore the liability) of the involved public officials. Alternatively, the technical expert position may be developed as a position where qualified personnel become temporary public health or public safety employees, according them the liability coverage (in most jurisdictions) that is inherent to acts by public officials.

35 Are You Ready? What Lawyers Need to Know About Emergency Preparedness and Disaster Recovery (Video). American Bar Association, available through Public Entity Risk Institute bookstore at: http://www.riskinstitute.org/PERI/PTR/Are+You+Ready+What+Lawyers+Need+to+Know.htm, accessed August 29, 2006.


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http://www.ama-assn.org/ama1/pub/upload/mm/395/goodsamaritansurvey.doc

http://www.riskinstitute.org/PERI/PTR/Are+You+Ready+What+Lawyers+Need+to+Know.htm


Risks associated with the use of processed volunteers can be minimized by carefully developed credentialing strategies, assigning volunteers to appropriate duties, and supervision of volunteers while performing incident tasks. Using very clear criteria for the competencies and other qualifications that describe volunteer positions, together with closely correlated and verified volunteer qualifications, can be important in demonstrating due diligence in screening and assigning volunteers. Additionally, criminal background checks, clear activation and deactivation procedures, effective orientation and training, volunteer ID badges, written participation agreements (in the orientation briefing) stating roles and responsibilities, written volunteer assignment records, rules of conduct and termination, and post-incident debriefing can increase the likelihood of successfully integrating volunteers into response operations. 36

In addition, it is important to recognize that wherever the volunteer is assigned to work, there is a final privileging step to be taken by the receiving organization that confers some of the responsibility for accepting volunteers onto their response structure.

An excellent presentation on volunteer liability protection, with application to both volunteers and VMS staff, may be found on the Public Entity Risk Institute (PERI) web site.37 Local legal experts should always be consulted for guidance on these issues.

[BACK]

36 The Center for Law & the Public’s Health. Civil Legal Liability and Public Health Emergencies December 2004). Georgetown & Johns Hopkins Universities, available at: http://www.riskinstitute.org/NR/rdonlyres/82798B15-5F8F-434B-8595-B688ED5D1731/0/Civil_Legal_Liability_and_Public_Health_Emergencies_checklist.pdf, accessed August 26, 2006. 37 Reiss LR. Volunteerism and the Disaster Resource Gap: How Volunteer Liability Protection Can Enable Better Disaster Response (2006), available at: http://www.riskinstitute.org/PERI/PTR/Volunteerism+and+the+Disaster+Resource+Gap.htm, accessed August 30, 2006.


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http://www.riskinstitute.org/PERI/PTR/Volunteerism+and+the+Disaster+Resource+Gap.htm

http://www.riskinstitute.org/NR/rdonlyres/82798B15-5F8F-434B-8595-B688ED5D1731/0/Civil_Legal_Liability_and_Public_Health_Emergencies_checklist.pdf

http://www.riskinstitute.org/NR/rdonlyres/82798B15-5F8F-434B-8595-B688ED5D1731/0/Civil_Legal_Liability_and_Public_Health_Emergencies_checklist.pdf


APPENDIX D

THE VMS INCIDENT PLANNING PROCESSStandardized Volunteer Management System for

Public Health and Medical Emergency Response & Recovery[BACK to Concept of Operations]

The overarching (control) objective for the VMS is providing qualified volunteers to meet ICS personnel requests, while addressing safety and accountability of volunteers as an extension of the ICS authority. While these control objectives will remain relatively constant, the volunteer personnel requests and other incident parameters are likely to change during the evolution of an incident, as will the number and type of available volunteers, the just-in-time training requirements, and many other incident factors. To effectively respond to those changing parameters, VMS action planning38

will be required. Generally, when an incident is complex, involves multiple agencies, or is expected to be of extended duration, then formal action planning should occur through the use of specific VMS forms and the conduct of certain meetings in a cyclical fashion.

The physical output of this planning process is a document which can be called the VMS Action Plan,39 which is utilized to guide the actions of the VMS for a defined period of time (a “VMS operational period”). The document is then updated through the iterative cycle of defined meetings for the next operational period. The VMS Action Plan itself provides an organized list of incident information as well as VMS objectives, strategies, tactics, assignments, and record of performance. The pertinent forms include:

VMS Objectives VMS Assignment List (VMS 203) VMS Organizational Chart (VMS 207) VMS Medical Plan (VMS 206) VMS Communications Plan (VMS 205) VMS Health and Safety Plan (VMS 208) – as requested by the VMS Command

VMS form 209 is not typically part of the VMS Action Plan but may be included as a general situation update and report on the performance of the volunteer management system.

It should also be noted that while the VMS Objectives are described in terms of a specific form in the list above, the current VMS model does not provide a form explicitly for the documentation of objectives. These can be recorded in any suitable

38 “Action planning,” more formally known as “incident action planning, is the collective term for activities that support the incident management process. It includes development of the incident action plan and support plans and accomplishing incident information processing. This is in contrast to preparedness planning, which is designed to ready a system for response. 39 There is only one “incident action plan” (IAP) at an incident; all other “action plans” are subsets of the IAP and their titles should be qualified accordingly (for example, the “PH&M-VMS action plan for XXX operational period”).


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format selected by the jurisdiction. The VMS control objectives should remain relatively constant throughout the incident.

Incident action planning is accomplished through a series of activities that compose the “VMS planning cycle.” Responsibility for the developing input to the VMS Action Plan is apportioned among the Command and General Staff, with Plans Section personnel coordinating the process and assembling the data. Among the key activities is the VMS Management Meeting, during which the operational period objectives are determined, along with the accompanying general strategies. This meeting is typically limited to a few persons within Command and General Staff (e.g., Command, Operations Section Chief, Plans Section Chief). A subsequent Planning Meeting develops general tactics to accomplish the objectives, designates resources to execute the tactics, and addresses logistical as well as administrative/financial concerns. This meeting is open to more of the Command and General Staff, and should include the Operations Section Branch Directors.40

The VMS Action Plan is completed and an Operations Briefing is conducted, providing VMS staff and all other relevant personnel with a current situation update and summary of the VMS Action Plan.

The major VMS planning cycle activities are depicted in the Figure 10.

40 The Management Meeting activities (determining objectives and strategy) can be combined with the Planning Meeting as indicated in NIMS, however, many organizations prefer to maintain a separate meeting for the establishment of objectives and general strategies.


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Figure 10. The use of the Planning “P” to demonstrate the cyclical nature of incident planning. Setting the planning cycle timing determines the timing of specific operational period tasks. Since it is important that the Operations Briefing precedes the start of the next VMS operational period, it is advantageous that this operational period coincide with the start of the largest work shifts of VMS personnel. New guidance from the VMS Action Plan is presented to the VMS staff, and the next shift can begin working from this guidance. The VMS planning cycle should also be timed to incorporate updated ICS information, including the overall ICS incident objectives.

For most incidents, the VMS action planning will be relatively straightforward, with pre-developed objectives, strategies, tactics and assignments (documented in pre-plans) that are directly applicable with little modification. Use of the action planning process, however, will maintain management discipline for the VMS, assure information dissemination to VMS personnel and provide an immediately available process for addressing unanticipated issues. It will also generate the reporting instruments that will keep ICS informed, present a professional view of the VMS, and create an information archive for after action review, research and improvement.


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The responsibilities of the VMS staff are summarized below:

[BACK to Concept of Operations]


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APPENDIX E

VMS TOOLS: FORMS & CHECKLISTSStandardized Volunteer Management System for


(TOOLS SHOULD BE DOWNLOADED AS SEPARATE FILES)

MANAGEMENT TOOLS 1 VMS ACTIVATION PROCEDURE (VMS M1)2 VMS NOTIFICATION & ACTIVATION MESSAGES (VMS M2)3 VPOA & VMC SITE SELECTION (VMS M3)4 VMS INITIAL EVENT LOG (VMS 201) 5 VMS ORGANIZATIONAL CHART (VMS 207)6 VMS PERSONNEL CHECK-IN LIST (VMS 211)7 VMS ASSIGNMENT LIST (VMS 203) VMS JOB ACTION SHEETS (APPENDIX A)8 VMS HEALTH & SAFTEY PLAN (VMS 208)9 VMS SITUATION REPORT (VMS 209)10 VMS GENERAL MESSAGE (VMS 213)11 VMS INCIDENT EXPENSE LOG (VMS A1)12 VMS DEMOBILIZATION & RECOVERY CHECKLIST (VMS M4)

LOGISTICS TOOLS 13 VMS MOBILIZATION CHECKLIST (VMS L1)14 VOLUNTEER MANAGEMENT CENTER SITE SET-UP (VMS L2)15 VPOA / VMC SIGNAGE (VMS L3)16 VMS TRANSPORTATION REQUEST LOG (VMS L4)17 VMS MEDICAL PLAN (VMS 206)18 VMS COMMUNICATIONS PLAN (VMS 205)

OPERATIONS: INCIDENT INTEGRATION TOOLS 19 VOLUNTEER POSITION REQUESTS FORM (VMS O1)20 VOLUNTEER POSITION DESCRIPTION TEMPLATE (VMS O1a)21 ASSIGNED VOLUNTEER SCHEDULING & TRACKING FORM (VMS O2)22 VMS TROUBLE DESK INFORMATION FORM (VMS O3)23 VOLUNTEER INCIDENT REPORT (VMS O4)24 INCIDENT INTEGRATION CHECKLIST (VMS O19)


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OPERATIONS: VOLUNTEER RECRUITMENT TOOLS25 VOLUNTEER RECRUITMENT REQUEST PROCESS/TEMPLATE (VMS O5)26 NOTIFICATION MESSAGES FOR PRE-REGISTERED VOLUNTEERS (VMS O6)

OPERATIONS: VOLUNTEER PROCESSING TOOLS

VOLUNTEER REGISTRATION & ORIENTATION TOOLS27 VMS ORIENTATION & ACKNOWLEDGEMENT OF RESPONSIBILITIES (VMS O7)28 VMS PUBLIC HEALTH & MEDICAL RISK STATEMENT (VMS O7a)29 VOLUNTEER REGISTRATION & CREDENTIALS FORM (VMS O8)30 VOLUNTEER RELEASE OF INFORMATION FORM (VMS O9)31 VOLUNTEER PROCESS CHECKLIST (VMS O10)

VOLUNTEER IN-PROCESSING TOOLS32 VOLUNTEER ASSIGNMENT SLIP (VMS O11)33 VMS EQUIPMENT ISSUE & RETURN FORM (VMS O12)34 VMS ASSIGNMENT BRIEFING TEMPLATE (VMS O13)35 VOLUNTEERS AWAITING ASSIGNMENTS (VMS O14)

VOLUNTEER DEPLOYMENT/OUT-PROCESSING TOOLS36 VMS OUTPROCESSING/REHABILITATION CHECKLIST (VMS O15)37 VOLUNTEER PERFORMANCE EVALUATION FORM (VMS 226)38 VMS EXPOSURE FORM (VMS O16)39 VOLUNTEER FEEDBACK FORM (VMS O17)40 RECEIPT FOR VOLUNTEERING (VMS O18)


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Documents

Issue 1: VMS Integration into the Overall Incident Response