Housekeeping Items

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Housekeeping Items

• Welcome
• Emergency Exits
• Restrooms
• Introductions

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Todays Agenda

• Welcome Introductions
• Federal Medical Reserve Corps
• Santa Clara County MVDR Program Updates and
  Program Enhancements
• Training Exercises
• Medical-Health Mutual Aid System
• State and Local Resource Introduction
• Membership Forum
• Oath for New Members

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The Santa Clara County Medical Health System

• 9th Largest EMS System in the Nation (JEMS 2004)
• Resident Population of 1.8 million
• Daily Population of 2.0 million
• 1,312 square miles
• Close to 2/3 Rural
• 15 Municipalities

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Why Was the MRC Created?

• The MRC program was created after President
  Bushs 2002 State of the Union Address, in which
  he asked all Americans to volunteer in support of
  their country. The MRC is comprised of organized
  medical and public health professionals who serve
  as volunteers to respond to natural disasters and
  emergencies. These volunteers assist communities
  nationwide during emergencies and for ongoing
  efforts in public health.

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What is the difference between the MRC regions,
states, and units?

• The United States is divided into 10 MRC
  regions, which contain any number of local MRC
  units. Personnel at the state level coordinate
  with the 10 MRC Regional Coordinators and those
  at the local level. MRC units represent those at
  the local level, as they are responsible for
  implementing volunteer capabilities for emergency
  medical response and public health initiatives to
  match specific community needs.

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Medical Reserve Corps Website

• www.medicalreservecorps.gov

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Medical Volunteers for Disaster Response

• A Federally Recognized Medical Reserve Corps Unit

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Santa Clara County CMRS System
CBOs
EMA
EMS
Hospitals
CMRS
Fire
PH Dept.
Law
Clinics
Schools
CMRS
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The Santa Clara County Medical Health System

• (2) Level I and (1) Level II Trauma Centers
• 11 Emergency Departments
• 12 Hospitals
• Public Health Laboratory
• Disease Outbreak Teams

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The Santa Clara County Medical Health System

• 12 Fire Service Providers
• 7 Private Ambulance Service Providers
• 3 Permitted Air Ambulance Service Providers
• 14 Public Safety Answering Points

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The Santa Clara County Medical Health System

• 1300 Emergency Medical Technicians
• 700 Paramedics
• 50 Critical Care Transport Nurses
• 40 Mobile Intensive Care Nurses
• 367 Medical Volunteers

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Medical Health Resources

• ChemPacks
• Strategic National Stockpile
• Personal Protective Equipment Caches
• Local Pharmaceutical Stockpile

• BioDetection System (BDS)
• BioWatch
• Essence
• Field Treatment Site Trailers

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It May Not Be Enough!
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What is MVDR?

• Medical Volunteers for Disaster Response is a
  medical volunteer registry program serving Santa
  Clara County.
• MVDR registers and screens medical professionals
  to help deliver volunteer resources during a
  declared disaster or public health emergency.

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What Do Volunteers Do?

• Volunteers will be assigned duties that are
  within the scope of their current professional
  license and skill set
• Medical professionals who register as MVDR
  volunteers will support and assist the Public
  Health Department in providing care during a
  declared disaster or public health emergency

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Who Can Volunteer

• All medical professionals that are currently
  licensed to practice in the state of California.
• Includes registered physicians, nurse, physician
  assistants, dentists, pharmacists, veterinarians,
  paramedics, E.M.Ts, mental health professionals,
  and other
• MVDR also welcomes all medical professional
  medical students, including nursing students, MD
  students, social work students, public health
  students, and other health/medical profession
  students.

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Current Volunteers

• We currently have over 360 sworn volunteers
• 67 Physicians
• 190 Nurses
• 73 Misc (DDS, EMT, CSW, PSY, etc.)
• We have over 280 interested volunteers

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How Much Time is Expected?

• MVDR is completely voluntary. At the time of a
  public emergency or declared disaster, each
  volunteer can decide whether or not they can
  participate in that specific emergency event.
• MVDR is activated only when the SCC Public Health
  Department is in need of assistance to provide
  mass vaccinations, mass casualty care, or other
  critical public health services in a public
  health emergency.

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Non-Sworn Disaster Service Workers

• Level I
• Spontaneous volunteers.
• Emergency Credentialing
• Not a DSW (in advance)
• Just-in-Time Training
• Last to be used to fill emergency needs.
• May attending training sessions.
• Not uniformed.

• Level II
• Pre-event registration via CALMED system or EVC.
• Credentialed
• Not a DSW (in advance)
• Just-in-Time Training
• Used to fill needs after Level III and IV
  volunteers.
• May attending training sessions.
• No time commitments
• Not uniformed

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Sworn Disaster Service Workers

• Level III
• Credentialed
• Sworn DSWs
• Registry Only
• Primarily called to service in disaster events
  and attached to existing infrastructure.
• May or may not participate in training,
  exercises, and drills.

• Level IV
• All Level III plus
• Deployable with little notice
• Trained
• Established Team/Uniformed
• Regular exercises and team functions
• Meets MRC Core Competencies.
• May be called into service absent a disaster.

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MVDR Coordinator

• Craig Young
• Craig.Young_at_hhs.sccgov.org
• 408-885-2043

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CALMED
https//medicalvolunteer.ca.gov/
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CALMED

• Credential verification
• Information sharing and communication
• Alerting and activation preferences
• Mission/Time tracking
• Internet access benefits
• Personal information

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CALMED

• Monthly alerting exercises
• Exercise and Training information
• Updates
• Alert

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Training Exercises
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The California Medical-Health Mutual Aid System
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The Operational Area (OA)

• The entity designated to coordinate disaster
  response resources within the geographical
  boundaries of a county is the Operational Area
  (OA), which consists of all political entities of
  a County.

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Basic Premise

• All emergencies and disasters are local events.
• The lowest level of government is responsible for
  the responsible for the mitigation, response, and
  recovery related to events.
• In most cases, its not our emergency we are
  bringing dishes to the potluck

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Ground Zero

• Responsibility of local government
• Field response component

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Our Lane

• Medical Health Only Events
• Support to the EOC Medical-Health Branch
• Support to Municipal EOCs (Health Officer fills
  this role for cities)

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The Medical-Health Branch

• Medical Treatment Protocols
• Laboratory Testing
• Chempack Operations
• Medical-Health Mutual Aid Coordination
• Assistance to the Coroner in the safe handling of
  the deceased.
• Pandemic Influenza response

• Disease Investigation
• Isolation and Quarantine
• Mass Prophylaxis
• SNS
• Alternate Care Sites
• Protective Action Decisions
• Health alerts, warnings, and risk communication
  messaging.

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Medical-Health Branch

• Continuity of Public Health Operations
• Vital Registration (death records)
• Bioterrorism Medical-Health Response
• Multiple Casualty Incident Management
• Mass Care Incident Management
• Medical-Health Resource Management

• Field Treatment Sites
• Local Pharmaceutical Cache
• Bio-Defense System (BDS)
• Biowatch System
• Service as the Health Officer for all
  jurisdictions in the County.
• Emergency Medical Services Provision

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Mutual Aid Coordinators

• The Fire Operational Area Coordinator is the
  County Fire Chief (or designee)
• The Law Operational Area Coordinator is the
  County Sheriff (or designee).

• The Medical Health Operational Area Coordinator
  is the Health Officer (or designee)

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MHOAC

• The Medical-Health Operational Area Coordinator
  (MHOAC) is responsible for medical and health
  response. Normally this position is appointed by
  the County Public Health Officer or Board of
  Supervisors and will staff the medical and health
  branch in the OA EOC.

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State and National Level Mutual Aid

• SOC requests the Governor to request mutual aid.
• State Governor requests assistance.
• EMAC is mechanism
• FEMA is the doer under the Department of
  Homeland Security

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Daily Requests County EOC is Not Activated
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State and Local Resources
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Influenza Care Centers

• Surge Capacity Theory Reduce Input
• Too sick to be at home, to healthy to be in the
  hospital.
• No critical care, focus on supportive activities
  (oral/IV hydration, oxygen, basic pharms).
• 6 sites, 450 patients in each site, staffed by
  primarily MVDR personnel.
• Each ICC has a command structure coordinated
  under the Public Health DEOC.

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Chempacks

• Nerve Agent Antidote Kit
• 8 Kits Located in the County
• EMS Configuration Auto-injectors
• Holders may activate kit, then notify EMS.
• Fire Service may request SJFD and MOF kits via OA
  Mutual Aid, then notify EMS.
• Hospitals and subsequent kit allocations for fire
  departments through OA Medical-Health Coordinator
  (via EMS).

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Local Pharmaceutical Supply (LPS)

• Primarily antibiotics
• Primarily focused on Anthrax treatment
• Influenza supplies

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Mobile Field Hospital

• Three located in the State
• One housed in Santa Clara County
• Owed by EMSA and available through Medical-Health
  Mutual Aid System
• Transportation and set-up vendor managed
  (BlueMed)
• Critical Care, Basic Care, Supportive Care
• Self-Contained

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Mobile Field Hospital
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Disaster Medical Support Unit (DMSU)

• EMSA provided unit to support Ambulance Strike
  Teams/Medical Supply.
• County withdrew during contract negotiations.
• Existing and soon-to-be implemented local supply
  exceeds capacity of the DASU.
• Provisions handcuffed the County and providers.
• Available through Medical-Health Mutual Aid
  System.

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DMSU
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EMS Trailers

• 4 -16 foot Field Treatment Site (FTS) trailers
  already in service.
• AMR
• County Fire
• Gilroy Fire
• Mountain View Fire
• 1-12 foot MCI trailer in service (Sunnyvale)

• 4-16 foot FTS without backboards to be staged at
  hospitals to be determined.
• 3-12 foot trailers being reconfigured.
• MVDR Equipment
• PPE
• Cabana Support

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Cabana Trailer

• 16 foot trailer
• Four-room facility with power, climate control,
  and raised hard floor.
• Available through the EMS Duty Chief
• 12 foot Cabana Tender has tables, chairs,
  generators, office supplies, basic tools, etc.
• Homeland Security Grant (86K)

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Cabana Trailer Use

• Health Department /EMS Field Command Post
• Portable Cooling/Heating facility (evacuated
  patients).
• Annex to Field Treatment Site Trailers
• Expansion of the Public Health Operations Center.

• Alternate Care Site Platform
• First Aid Station
• Extended Field Operations
• Back Country Operations
• Public Information
• Available to partners

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Cabana Trailer
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Medical Volunteers for Disaster Response

• Registry of Personnel
• Moving towards an operational pool
• Opening to EMTs, paramedics, and allied health
  professionals.
• Sworn Disaster Service Workers (DSWs)
• Current volume between 300-400.
• Goal increase pool by 150 EMT/paramedics in six
  months.

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MVDR Continued

• Seeking Command Control personnel.
• Opportunities for Fire Service and Law
  Enforcement use of personnel.
• Integration into the EMS and Medical-Health
  System (actual events, training, and exercises).
• Core competencies Medical Reserve Corps
• Uniformed and deployable

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Field Treatment Sites

• Basic operations
• Set-Up and plot plan
• Coordination Systems
• Inventory
• Photo key
• Draft plan exercised at Golden Guardian in
  November.

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Electronic Patient Tracking System
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EMTrack

• Electronic patient tracking system
• Web based back end software
• PDAs and handheld scanners
• Junxion box (802.11b) wireless LAN
• Laptop PC

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EMTrack
Main Components
4 Port Battery Charger
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EMTrack Process
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Ambulance Strike Teams/Medical Task Force

• State Training and Operations Guide to be merged.
• Currently in final stages of revision.
• Changes support NIMS, prerequisites, SEMS,
  FIRESCOPE, and sync with Operational Area
  authorities.
• As soon as education portion is revised, training
  will begin across the state.

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Membership Open Forum
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Questions?
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Loyalty Oath Administration
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Disaster Service Worker Oath Administration

• I, (STATE YOUR FULL NAME), do solemnly swear that
  I will support and defend the Constitution of the
  United States and the Constitution of the State
  of California against all enemies, foreign and
  domestic that I will bear true faith and
  allegiance to the Constitution of the United
  States and the constitution of the state of
  California that I take this obligation freely,
  without any mental reservation or purpose of
  evasion and that I will well and faithfully
  discharge the duties which I am about to enter.

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I, (STATE YOUR FULL NAME), do solemnly swear
that I will support and defend the Constitution
of the United States and the Constitution of the
State of California
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against all enemies, foreign and domestic
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that I will bear true faith and allegiance to the
Constitution of the United States and the
constitution of the state of California
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that I take this obligation freely, without any
mental reservation or purpose of evasion and
that I will well and faithfully discharge the
duties which I am about to enter.
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