The Emergency Response System in South Carolina

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The Emergency Response System in South Carolina
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Acknowledgements

• South Carolina Area Health Education Consortium
  (AHEC)
• Funded by the Health Resources and Services
  Administration.
• Grant number 1T01HP01418-01-00
• P.I. David Garr, MD, Executive Director AHEC
• BT Project Director Beth Kennedy, Associate
  Program Director AHEC
• Core Team
• BT Co-director Ralph Shealy, MD
• BT Project Manager Deborah Stier Carson, PharmD
• BT CME Director William Simpson, MD
• IT Coordinator Liz Riccardone, MHS
• Web Master Mary Mauldin, PhD
• P.R Coordinator Nicole Brundage, MHA
• Evaluation Specialist Yvonne Michel, PhD
• Financial Director Donald Tyner, MBA

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Acknowledgment

• This material has been prepared for SC AHEC
  Bioterrorism Training Networkby
• Ralph M. Shealy, M.D., FACEPCo-Director of SC
  AHEC Bioterrorism Training Network
• Medical Director for Operations, Charleston
  County EMS
• Medical Director, Charleston County Rescue Squad

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Objectives

• Outline the Emergency Response System that is
  currently in place in South Carolina
• Describe the main features of the Incident
  Command System and why it works well in a
  disaster setting
• Describe the role of the Emergency Operations
  Center
• Explain how the community healthcare provider can
  bring value to the Emergency Response System

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A Terrorism Attack is a Community Disaster
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Disaster

• Imminently threatens public health and safety.
• Cannot be handled using routine measures.
• Disrupts essential services.
• A community health emergency!

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What mechanisms are already in place to respond
to a community emergency in South Carolina?
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• Disaster planners need to have realistic
  expectations of the health care delivery system.
• Health professionals must bring their knowledge
  and experience to the Emergency Response System

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First, understand the threat!
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Natural Disasters

• Weather
• Flood
• Hurricane
• Tornado
• Winter storm
• Geophysical
• Earthquake
• Tidal wave
• Volcanic Eruptions

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Man Made Disasters Unintentional

• Structural Collapse
• Transportation Accident
• Hazardous Material Spill
• Industrial Accident
• Explosion

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Man Made DisastersDeliberate

• Civil Disturbance
• War
• Terrorism

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Types of Terrorism

• Small arms
• Explosive
• Incendiary
• Chemical
• Biological
• Radiation

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Disasters

• Man-made
• Unintentional
• Structural Collapse
• Transportation Accident
• Hazardous Material Spill
• Industrial Accident
• Explosion
• Intentional
• Crime
• Civil disturbance
• War
• Terrorism
• Small arms
• Explosive
• Incendiary
• Chemical
• Biological
• Radiation

• Natural
• Weather
• Flood
• Hurricane
• Tornado
• Winter storm
• Geophysical
• Earthquake
• Tidal wave
• Volcanic Eruptions

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Phases of Disaster Management

• Preparation
• Planning
• Training
• Exercising
• Response
• Recovery
• Mitigation

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Federal Response Plan

• The Federal Response Plan assists state and local
  government when a disaster overwhelms their
  ability to
• Save Lives
• Protect Public Health
• Protect Public Safety
• Protect Property
• Restore Communities
• Robert T. Stafford Disaster Relief and Emergency
  Assistance Act

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FEMA

• FEMA is the lead federal agency for disaster
  management.
• FEMA Helps People Before, During, and After a
  Disaster.

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Emergency Support Functions

• Federal Response Plan describes twelve Emergency
  Support Functions and designates the lead federal
  agency responsible for each function.
• Community health functions ESF 8

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Emergency Support Functions

• ESF 1 Transportation
• ESF 2 Communications
• ESF 3 Public Works and Engineering
• ESF 4 Fire Fighting
• ESF 5 Information and Planning
• ESF 6 Mass Care

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Emergency Support Functions

• ESF 7 Resource Support
• ESF 8 Health and Medical Services
• ESF 9 Urban Search and Rescue
• ESF 10 Hazardous Materials
• ESF 11 Food
• ESF 12 Energy

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State Plans Mirror FRP

• SC has an EPD that operates through an EPD in
  each county.
• The SC Emergency Response Plan mirrors the
  Federal Response Plan.

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Extraordinary Governmental Powers In a Declared
Emergency

• Military, Civil Defense And Veterans
  AffairsS.C. Code of Laws, Section 25, Chapter
  4, and Code of Regulations, 58-101
• The Emergency Health Powers ActSC Code of
  Laws, Title 44, Chapter 4

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South Carolina ESFs

• Transportation
• Communications
• Public Works Engineering
• Firefighting
• Information Planning
• Mass Care Emergency Welfare Services

• Resource Support
• Health Medical Services
• Search and Rescue
• Hazardous Materials
• Food Services
• Energy
• Law Enforcement

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South Carolina ESFs

• Volunteer Services
• Military Support
• Evacuation Traffic Management
• Animal response
• Specific Impact Hazards
• Nuclear Power Plants
• Hurricane Preparedness

• Earthquake Preparedness
• Dam Failure Preparedness
• Civil Disturbance
• Terrorism Incident
• Emergency Repatriation

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State and Federal Response in South Carolina

• SC Law Enforcement division (SLED) is lead agency
  for state homeland security.  
• FBI has responsibility for federal crisis
  management
• FEMA has responsibility for federal consequence
  management.

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South Carolina Joint Terrorism Task Force

• FBI Weapons of Mass Destruction (WMD) Coordinator
  in each of South Carolinas five FBI Regions.
• Local law enforcement officials and your regional
  FBI WMD Coordinator are key players in planning
  for a WMD event.

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Effective Disaster Management

• Strong personal relationships between critical
  community leaders
• Trust and confidence in each others competence
  during the preparation phase BEFORE the disaster
  occurs.

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Incident Command System

• Enables multiple agencies from multiple
  jurisdictions to work together effectively
• Large scale operation
• Everyone has some degree of authority and
  responsibility

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Incident Command System

• National Interagency Incident Management System
  (NIIMS)
• Used by federal, state, local governments,
  private sector organizations
• Standard operating procedure for fire service

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Incident Command System

• Federal law mandates for hazardous materials
  incidents
• SC law mandates for mutual aid
• Relatively new for law enforcement
• Hospital Emergency Incident Command System (HEICS)

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Incident Command System

• Managers responsible for a function interacts
  with counterpart in partnering organization
• Improves communications and functional
  effectiveness

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Incident Command System

• Organized system of roles, responsibilities, and
  procedures
• Procedure-driven system
• Business management principles
• Who is in charge?" and Who is responsible?

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ICS Basic Principles

• Front line operations require support
• Single recognized leader (Incident Commander)
• Consolidated plan of action.
• Lines of authority.

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ICS Basic Principles

• Span of control.
• Individual has only one supervisor.
• Delegate responsibility and authority
• Tasks assigned on the basis of training,
  qualifications, equipment.

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Incident Commander

• Under South Carolina law, the senior fire officer
  at the scene of an emergency involving the
  protection of life or property has authority to
  direct the operation. (SC ST SEC 6-11-1420)
• Under Federal law, any incident involving
  terrorism is under the jurisdiction of the FBI

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Incident Commander (IC)

• Responsible for management of on-scene emergency
  incident operations
• Must be trained to assume these duties, not by
  virtue of rank or position within the
  organization
• Will operated from a designated Command Post,
  which may be remote from the site

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ICS Command Staff

• Safety Officer monitors safety of all personnel
• Liaison Officer coordinates with assisting
  agencies not involved in the command structure
• Public Information Officer (PIO) coordinates all
  media activities

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ICS Sections

• Operations
• Planning
• Logistics
• Administration

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ICS Unified Command

• All involved organization and jurisdictions
  contribute to objectives, strategies, and
  priorities
• Influence reflects exposure to risks, involvement
  of personnel and resources, possession of
  essential qualifications, and statutory
  authority.
• Still but one Incident Commander.

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Emergency Operations Center

• Critical community leaders assemble in a secure
  location to make joint decisions face-to-face.
• The County EOC is the community nerve center
  during an emergency.
• The South Carolina EOC is operated by the
  Emergency Management Division, Office of the
  Adjutant General.
• This model is used nationwide.

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EOC Staff

• Rescue (ESF 9)
• HazMat (ESF 10)
• Federally managed food relief (ESF 11)
• Public Utilities (ESF 12)
• Emergency Preparedness Division
• Political leaders
• Local Government Administration
• Law enforcement
• Legal
• Finance
• Veterinary Medicine, Animal Services
• National Guard, Military
• Mortuary Services
• Public Information Officer, Rumor Control, Media

• Transportation (ESF 1)
• Communications (ESF 2)
• Public Works (ESF 3)
• Fire service (ESF 4)
• Planning (ESF 5)
• Damage Assessment (ESF 5)
• Information Technology (ESF 5)
• Food, Shelter and Support (ESF 6)
• Red Cross, Salvation Army, School Districts,
  Chaplains, Department of Social Services
• Facilities Management (ESF 7)
• Human Resources (ESF 7)
• Procurement (ESF 7)
• Medical community (ESF 8)
• Hospitals
• Mental Health
• Public Health
• EMS
• Health Professionals

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EOC Model

• Means of teaching collaboration between
• Healthcare professionals
• Hospitals
• Public health
• Mental health
• EMS
• Law enforcement
• Community government

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The Best Defense Against Bioterrorism

• Those responsible for public health and safety
  need to
• establish working relationships,
• formulate effective plans, and
• exercise those plans
• prior to the onset of an outbreak.

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What role can YOU play?

• Begin now to work collaboratively with other
  healthcare professionals inside and outside your
  discipline, with hospital administrations, and
  with other community leaders to meet your
  responsibilities during a community health
  emergency.

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What role can YOU play?

• Learn about your County Emergency Operations
  Center.
• Get to know your County EPD Director.
• Be certain that healthcare professionals and
  hospital leadership are part of your County EOC
  team.

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What role can YOU play?

• Get to know your DHEC District Director and
  District Epidemiologist
• Get to know your local law enforcement leadership
  and FBI WMD Coordinator.

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What role can YOU play?

• Accept the reality that you will likely
  participate in some community-wide disaster
  before the end of your professional career.
• Encourage your colleagues to do the same.

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QUESTIONS?
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