ESF 8. Public Health and Medical Services

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1 ESF 8 Public Health and Medical Services

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3 1 Introduction Emergency Support Function 8 ensures that the following services are provided to disaster victims and emergency response workers to supplement disrupted or overburdened local medical personnel and facilities: Public health and sanitation; Emergency medical, dental, and hospital services; Crisis counseling and mental health services; Animal and vector control; and Mortuary services. This ESF also refers to services, equipment, and personnel needed to protect the health of the public from communicable disease, contamination, and epidemics, including health and symptomatic monitoring, food and water inspections, immunization and mass prophylaxis delivery, laboratory testing, and animal health/disease management (as it pertains to potential or actual impacts on public health). Other essential tasks included within this support function involve providing professional personnel services and facilities to relieve victims and their families, first responders, and/or special needs populations of trauma and mental health conditions caused or aggravated by an emergency/disaster or its aftermath. Depending on the nature and severity of the incident, services and resources may be in demand for prolonged periods of time. Note: Refer to ESF 11 for information regarding incidents/disasters potentially or actually impacting the health of livestock, wildlife, and other animals without concern for impacts to human health. 2 Policies and Agreements During an emergency, the line of succession of authority is designated for managing and supporting ESF 8 activities: Polk County Health & Human Services Adminstrator/designee County Health Officer, Public Health Manager or representative as designated by the Administrator/designee or Health Officer, Polk County Emergency Management Director, and County Board of Commissioners. ESF 8-1

4 The direction and control of procedures in relation to the care of deceased victims will follow the chain of command detailed below: Medical Examiner/D.A. o Deputy Medical Examiner o As designated by Medical Examiner; Local funeral home director; and Oregon Health Authority representative. Victims will be identified by M.E. and work closely with the D.A. using accepted forensic methods, and this task will be supplemented by funeral home personnel and other coroners, if necessary. If circumstances warrant, the Public Health Department Administrator and/or County Health Officer may be assisted in the positive identification of victims through the Oregon Department of Human Services. Upon positive identification of victims, bodies will be released to funeral homes specified by the family of the deceased. If no preference is noted, bodies will be released to the local funeral home. The County EMD is responsible for coordinating declarations of local emergency/disaster (Oregon Revised Statute [ORS] ). Except as provided in ORS , proceedings for imposing public health measures may be initiated by filing a petition in the circuit court for the County in which the subject of the petition is located. The Polk County Health & Human Services Administrator/designee and/or Health Officer can request a public health emergency declaration by the EMD. As outlined in ORS , the authority of the local health administrator in an emergency is delineated as follows: The local public health administrator may take any action which the Oregon Health Authority or its director could have taken, if an emergency endangering the public health occurs within the jurisdiction of any local public health administrator and: The circumstances of the emergency are such that the department or its director cannot take action in time to meet the emergency; and Delay in taking action to meet the emergency will increase the hazard to public health. Point of Distribution (POD) sites have been designated for this jurisdiction, and written agreements have been established for usage of those sites. A POD Field Operations Guide template published by the Oregon Health Authority is at the disposal of the County and has been modified for use by Polk County Public Health.. Written MOUs have been signed for use of these locations.. Following is a list of formal agreements currently in place for Polk County: ESF 8-2

5 Current Memorandum of Understanding with the American Red Cross Willamette Chapter; Memorandum of Understanding with: o Salem-Keizer School District, West Salem High School o Central School District 13J o Polk County School District 2, LaCreole Middle School, Dallas High School; Memorandum of Understanding with Western Oregon University; and Inter-county Omnibus Mutual Aid Agreement (2005). 3 Situation and Assumptions The Health Department Administrator and/or Health Officer serve the executive body of Polk County by enforcing laws protecting the health of Polk County s people. Although many health-related problems are associated with disasters, there is an adequate local capability to meet most emergency and/or disaster situations. Special needs populations will be characterized and included in emergency response procedures and operations for the County, with support available from Public Health and Health Security, Preparedness and Response Program. When necessary, support will be available from the Oregon Health Authority, and other State and Federal agencies, through existing request processes through the County EOC, under the direction of the EMD The public may require guidance concerning how best to avoid health hazards created by a disaster or arising from conditions existing in the affected area during and following the incident. Public information and outreach activities will follow established County procedures and will be carried out using a Joint Information System (JIS) according to the ICS/NIMS. 4 Roles and Responsibilities Lead Agency Polk County Public Health Department Supporting Agencies/Entities Polk County Community Development Department West Valley Hospital Salem Hospital Assisted Living/Long-term Care Facilities in Polk County Emergency Management Services providers Polk County Fire Service Agencies Polk County Emergency Management Organization Willamette Valley Communications Center (Salem) Public Safety Chaplaincy of NW Oregon ESF 8-3

6 American Red Cross and other volunteer organizations Health Resources and Services Administration, Region 6 Area Trauma Advisory Board (ATAB 2) Regional hazardous materials teams Oregon Health Authority Oregon Radiation Health U.S. Army National Guard, Nuclear, Biological, and Chemical Response Team 4.1 Specific Tasks Responsibilities of the County Health Department Administrator and/or the County Health Officer (or designee) are summarized below: Coordinating medical and public health-related resources in support of: o Public guardian and conservator services for incapacitated individuals o Medical laboratory services o Coordination of emergency counseling and mental health services with County Mental Health Department o Medical personnel, clinic staff, and facility support o Health and medical public information and rumor control o Community nursing o Health education and outreach o Medical and dental health clinic services o Collection, identification, storage, and dispatch of deceased victims; Coordinating information, incident status, and resource requests among private medical facilities, business, and industry for emergency medical services, laboratory, and sanitation services required in support of Countywide emergency operations; Maintaining a file of all written, typed, or verbal reports, decisions, policies, and directions as a legal record of emergency operations; and With support from the first responder community, gathering information concerning injuries and fatalities resulting from disaster occurrences and sharing this information with the County EOC as soon as it is available. Polk County Environmental Health is responsible for evaluating damage to water treatment facilities following disaster occurrences. Because of system vulnerability to numerous forms of contamination and because of the impact a prolonged shutdown of water treatment facilities could have on public health and welfare, completion of rapid and accurate damage assessment is essential. In addition, the Health Department Administrator and/or County Health Officer must be prepared to receive damage assessment reports from the various medical facilities in the County. Each facility administrator or designee will gather initial damage reports and identify which patients must be removed pending repairs. These data will be provided directly to the Health Department ESF 8-4

7 Administrator/Health Officer, who will then forward reports directly to the County EOC for evaluation and action. The Medical Examiner is responsible for managing and coordinating the following tasks throughout the duration of an emergency: Establish procedures for handling mass casualties and burial; Coordinate morgue services, body identification, and disposition of unclaimed bodies; Provide emergency information regarding mass casualties, body identification, and morgue operations for release through the County EOC; Determine the number of deaths and need for emergency body identification, mass morgue services, and burial operations; Establish contact with funeral homes for mass fatality transportation and facility support; Set up temporary morgue services; Provide security for possessions of deceased; Coordinate body identification and provide for notification of next of kin; and Coordinate burial of unclaimed bodies. Procedures specific to mortuary and morgue services during an emergency incident or disaster are not outlined in the current EOP or through the Polk County Public Health Department. Mass Care operations will be overseen by the EMD. 5 Concept of Operations The Health Department Administrator and/or County Health Officer (or designee) represents the public health and medical services function of the command structure at the County EOC. Response activities may be coordinated directly from the EOC or in conjunction with an AOC established at the health department and possibly a medical operations center established at an area hospital. Emergency health and medical support of business and industry will be requested through the Health Department Administrator and/or County Health Officer. The local health department will assist with Countywide coordination and direction of all medical and health-related services throughout the duration of an emergency. In the event of an incident involving hazardous materials, local public health and local emergency management, along with regional hazardous materials teams, will coordinate with other State agencies for removal of contaminated materials. ESF 8-5

8 Local hospital emergency departments, emergency medical services, and fire/rescue decontamination procedures will be followed. Upon receipt of official notification of an actual or potential emergency condition, the Health Department Administrator or Health Officer is responsible for receiving and evaluating all requests for health and medical assistance and for disseminating such notification to all appropriate health, medical, and mortuary services. A Medical Operations Center could function as a branch of the County EOC when the emergency involves significant medical and/or public health functions. The County EOC will maintain a designated health and medical liaison who will serve to coordinate ESF 8 and other related activities and resources among the County EOC, AOC, Medical Operations Center, and Joint Information Center (JIC) (if applicable). If a Medical Operations Center is established and equipped, training and exercises will be essential for all staff (primary, alternate, and supporting), and communications exercises will be critical to ensure interoperability between the County EOC, public health AOC, and Medical Operations Center. Currently, this Medical Operations Center concept is not included in procedures or plans supporting this EOP. Any procedures established to support the County EOP and ESF Annexes should be incorporated or referenced in the appropriate sections of this plan. Laboratory Services Polk County does not have local laboratory capability to support analysis of biological or chemical substances. However, hospital and private labs have capabilities for other routine laboratory analyses. The County will request assistance from the Oregon Health Authority and Oregon State Public Health Laboratory for incidents involving unusual or unknown substances. The Polk County Sheriff s Office, with support from the appropriate State agency, supports the collection and transportation of samples during criminal investigations. Maintaining and protecting a chain of evidence is critical throughout the duration of emergency response and recovery operations. Currently, procedures for providing secure transport of biological samples when dealing with a potential criminal investigation have not been developed or implemented for Polk County. Crisis Counseling The Polk County Mental Health Department is the primary agency responsible for overall coordination of mental health and crisis counseling resources and services. The Public Safety Chaplaincy of Northwest Oregon has been set up to support first responders during an emergency regarding crisis counseling and mental health needs. Additional services can be allocated through the Polk County Emergency Management Organization, can be requested following established operational procedures for the County EOC, and may include the American Red Cross, St. Vincent de Paul, and the Salvation Army. ESF 8-6

9 Polk County Public Health has developed Appendix 7 Behavioral Health to augment the ESF 8 Public Health and Medical Response Plan. It has been reviewed and approved by PC Mental Health. Special Needs Polk County has a special needs population that may present unique and additional issues during emergency response operations. Seasonal demographics may pose other concerns during emergency response operations due to influx of tourists and part-time residents. Polk County Public Health has developed Appendix 8 Special Populations to augment the ESF 8 Public Health and Medical Response Plan. Mass Prophylaxis and Points of Dispensing Sites A County-specific Strategic National Stockpile (SNS) Plan has been drafted by the Polk County Health Department. The plan provides a general outline for ordering and receiving SNS assets, the authorities involved, and setting up a POD. Appendix 6 Strategic National Stockpile-Points of Distribution Field Operating Guide augments the ESF 8 Public Health and Medical Response Plan. The following definitions for first responder, essential staff, and support staff will be used in Polk County: First Responder - Local police, fire, and emergency medical personnel who first arrive on the scene of an incident or are the immediate providers of health care or security to potentially exposed individuals. Essential Staff Public Health Department staff. Support Staff - Persons performing other vital services (e.g., Public Works, clinic, and hospital employees, and others). Animal Health and Vector Control Utilization of existing procedures established for the Polk County Environmental Health Division, Polk County Farm Bureau, State Veterinary Services, Polk County Sheriff s Office Dog Control Division, and Polk County Extension Service will continue to occur during an emergency situation impacting this jurisdiction. Local capabilities to support this facet of ESF 8 are very limited, and additional assistance and resources will be requested from OEM by Polk County Emergency Management via the OERS. Formal plans and procedures for animal health and vector control have not been established for Polk County. However, the Oregon Animal Disease Emergency Management Plan has identified key regional and State roles and responsibilities that will most likely be implemented to support local response activities for Polk County. ESF 8-7

10 Mortuary Services Morgue capacity for Polk County is very limited. The Polk County Medical Examiner has primary responsibilities for managing and coordinating mortuary services during an emergency. In most instances, assistance would be requested from State and Federal agencies. Emergency Medical Facilities and Mass Care Hospital surge capacity plans are currently in development by HRSA Region 6. Procedures and information will be incorporated into this ESF when completed, and all staff will be formally trained on policies and procedures following the implementation of the plan. The Hospital Capacity website is an electronic tracking system for the status of medical resources (medications, supplies, staff, and ambulances) and bed capacity among local and regional hospitals/care facilities. The system is available to Polk County and would be used during an emergency incident to support ESF 8 and coordinated through the County EOC. If local and area hospitals become inundated during an emergency incident or disaster, a Medical Triage and Treatment Plan has been developed by HRSA Region 6 that provides procedures for preparing and operating an off-site triage site, supported by EMS partners Polk County does not maintain a roster of active and formerly active healthcare/medical personnel available to support emergency response activities. However, a draft State Volunteers Registry is currently maintained with information regarding active and formerly active healthcare/medical personnel who are available to support emergency response activities. 6 Supporting Plans and Procedures Strategic National Stockpile/Mass Prophylaxis Plan. Polk County Public Health Department. Approved Date: December Natural Disaster Response Plan. Polk County Public Health Department. Approved Date: December Pandemic Flu Plan. Polk County Public Health Department. Approved Date: December Crisis Communication Plan. Polk County Public Health Department. Approved Date: December Chemical Event Response Plan. Polk County Public Health Department. Approved Date: December Radiation Response Plan. Polk County Public Health Department. Approved Date: December Behavioral Health Response Plan. Polk County Public Health Department. Approved Date: December ESF 8-8

11 Medical Triage and Treatment Plan. HRSA, Region 6. Oregon Animal Disease Emergency Management Plan. Oregon Department of Agriculture, Animal Heath and Identification Division Appendix Appendix 1 Polk County Public Health Response Planning Roles and Responsibility Matrix ESF 8-9

12 APPENDIX 1 ESF 8-10

13 ESF 8-11

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