Transcript United States Department of Health & Human Services Office of the Assistant Secretary for Preparedness and Response Disaster Response Federal Health and Medical in Support.

United States Department of
Health & Human Services
Office of the Assistant Secretary for Preparedness and Response
Disaster Response
Federal Health and Medical in
Support of the Radiation Disaster
LCDR John Gibbons
Regional Emergency Coordinator
Dr. Kenneth Sturrock
Regional Emergency Coordinator
CDR Ron Pinheiro
Supervisory Regional Emergency Coordinator
HHS/ASPR Region 8
Objective
Describe federal health and medical
disaster support coordinated through
ASPR to assist state, tribal and territorial
governments to a Radiological Disaster
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HHS
HHS Operating Divisions
Administration for Children and Families (ACF)
Administration for Community Living (ACL)
Agency for Healthcare Research and Quality (AHRQ)
Agency for Toxic Substances and Disease Registry (ATSDR)
Centers for Disease Control and Prevention (CDC)
Centers for Medicare and Medicaid (CMS)
Food and Drug Administration (FDA)
Health Resources and Services Administration (HRSA)
Indian Health Service (IHS)
National Institutes of Health (NIH)
Assistant Secretary for Preparedness and Response (ASPR)
Substance Abuse and Mental Health Services Admin (SAMSHA)
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ASPR Mission
Lead the nation in preventing, preparing for and
responding to the adverse health effects of public
health emergencies and disasters
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ASPR Headquarters
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Office of Emergency Management
(OEM)
─ Leads preparedness, response, and
recovery activities
─ Directs and manages the HHS’
Secretary’s Operation Center (SOC)
•
HHS Emergency Management Group
(EMG)
─ Staffed by HHS Operating Division and
ESF8 Partner representatives
─ Provides strategic guidance and
operational support to field operations
•
HHS Secretary’s Operations Center
(SOC)
─ Staffed 24/7 to maintain national
situational awareness
─ Base of Operations for EMG and OEM
during response
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HHS Regions
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Regional Emergency Coordinators
(RECs)
• HHS/ASPR Regional Representatives
• Preparedness
 Disaster preparedness planning with
State and Federal partners
• Response
 Assume leadership and command roles in field
operations
 Federal Health Official (FHO)
 Liaison Officers
• Recovery
 Support regional and national recovery operations
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Capabilities and Resources
All Disasters Are Local
Federal Response
State Response
Regional / Mutual Response Systems
Local Response, Municipal and County
Minimal
Low
Medium
High
Increasing magnitude and severity
Catastrophic
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Improvised HEU Device
Assumptions
•
Enormous Devastation
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Local medical
infrastructure
overwhelmed
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National casualty
distribution required
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Stafford Act Declaration
(Presidential
Declaration)
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Public Health
Emergency Declaration
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SPECTRUM OF SUPPORT: Response Operations
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REGULATORY WAIVERS
Social Security Act, Section1135 Waivers
Assists with Medical Surge Activities
• Professional Licensure
• Emergency Medical Treatment and Labor Act (EMTALA)
• Health Insurance Portability and Accountability Act
(HIPAA)
Emergency Use Authorization (EUA)
• Permits the FDA to authorize the use of an unapproved
medical product or an unapproved use of an approved
medical product
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Response Flow
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USPHS Teams
US Public Health Service (USPHS)
• Health and Medical Professionals in all disciplines
• 6500 active-duty uniformed officers
• Rapid Deployment Force Teams (RDF)
─ Team Capabilities: Low – mid acuity medical care
• Mental Health Teams (MHT)
• Applied Public Health Teams (APHT)
─ Team Capabilities: Epidemiology, Preventive Med, Environmental Health
• Service Access Teams (SAT)
─ Team Capabilities: Case management and human services (Patient
Movement)
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NDMS
A public / private sector partnership
HHS DHS DOD VA
National Disaster Medical System
A Nationwide Medical Response System to:
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Supplement state and local medical resources during
disasters or major emergencies
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Provide backup medical support to the military/ VA medical
care systems during an overseas conventional conflict
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NDMS
3 Major Components of NDMS
Medical Response
Patient Movement
Definitive Care
HHS Response Teams
DOD AE Evacuation
VA / DOD Federal
Coordinating Centers
DMAT,
IMSuRT, DMORT
HHS Patient Return
Contract
Public / Private
Participating Hospitals
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NDMS Medical Response
Over 7700 Intermittent Federal Employees
(3) - Incident Response Coordination Teams (IRCT)
(49) - Disaster Medical Assistance Teams (DMAT)
(3) - International Medical/Surgical Response Teams (IMSuRT)
(1) - Medical Specialty Enhancement Team (MSET)
(3) - National Veterinary Response Teams (NVRT)
(10) - Disaster Mortuary Operational Response Teams (DMORT)
(1) - Disaster Mortuary Operational Response Team – WMD
(1) - Victim Identification Center Team (VIC)
(3) - Disaster Portable Morgue Unit Teams (DPMU)
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NDMS Medical Response
“Mobile Emergency Room”
Disaster Medical Assistance
Teams (DMAT)
Team Capabilities:
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Acute/Primary Care
Patient Stabilization
Casualty Staging and Clearing
Equipped and Trained for Austere
Operations
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NDMS Medical Response
International Medical/Surgical Response
Team (IMSuRT)
Team Capabilities
• Provide triage and initial stabilization
• Provides definitive surgical care
• Provides critical care and evacuation capacity
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NDMS Medical Response
Disaster Mortuary Operational Response Team (DMORT)
Victim Identification Center Team (VIC)
Team Capabilities
• Assistance in search and recovery
• Victim identification
• Victim Identification Center
• Mortuary services
• Disaster Portable Morgue Unit (DPMU )
• CBRNE decontamination of remains
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Strategic National Stockpile
(SNS)
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HHS Repository of Medical Countermeasures (MCM)
─ Antibiotics, Chemical antidotes, Antitoxins, Vaccines, Antiviral drugs
─ Life-saving medical materiel
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Supplement and re-supply state and local public health agencies in the event
of an emergency
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Unknown Threat  Push Packages
─ 50-ton caches of pharmaceuticals, antidotes, and medical supplies
designed for rapid deployment
─ 12 hours of the federal decision to deploy
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Known Threat or Re-supply  Managed Inventory
─ Specific Items
─ 24 to 36 hours of a federal decision to deploy
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Federal Medical Stations
(FMS)
• Low Acuity Medical Care
• FMS-250 and FMS-50
• Managed by ASPR and CDC SNS Program
• Requires a building of opportunity and
significant “Wrap Around” services
• Can be used as Medical Shelters
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National Ambulance
Contract
Assets available per zone:
• Ground Ambulance
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300 ground ambulances
(ALS & BLS)
Air Ambulance
25 air ambulances,
helicopter and/or fixed wing
Para-transit capability
Ability to Transport 3,500
Individuals
Medical direction
provided by State or Local resources. If unable, a federal medical director
can be designated.
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Response Flow
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NDMS Patient Movement
• Provide Patient Movement
from the Disaster Area
• Utilize All Types of
Transportation
• Primarily Relies on
Aeromedical
• Significant role for
State DOH
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NDMS Definitive Care
Federal Coordinating Centers (FCCs)
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62 Facilities Concentrated in Major
Metropolitan Areas
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Patient Reception and Distribution to NDMS
Participating Hospitals
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NDMS Definitive Care
NDMS Participating Hospitals
• Network of approximately 1,800 non-federal hospitals
• Approximately 80,000 beds
• Re-imbursement at 110% of Medicare rate
• Third-party payer
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RITN Receiving Facility
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Expectations
• Catastrophic Event
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─ Overwhelmed local medical infrastructure and capacity
─ Majority of federal assistance into affected and
surrounding areas = Scarce Resources
RITN Facilities
─ Receive
─ Treat
─ Manage patients
Requests for support
─ will be routed through the established local  state 
federal emergency management systems
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Federal Support for RITN Facilities
• Regulatory Waivers
─ 1135
─ Emergency Use Authorization
• Technical Assistance
• Material and Supply Chain Support
• Personnel
─ USPHS Service Access Teams
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Take Home Message
• Uncharted territory
─ The views and opinions expressed in this
presentation are strictly that of the presenter and are
not necessarily the views of ASPR, the Department of
Health and Human Services, or the United States
Government
• Catastrophic Event and Scarce Resources
• HHS Spectrum of Support in Response
Operations
─ Flow into and out of affected area
─ Receiving facility support
• Strong Link to Local and State Emergency
Management
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Questions?
The HHS/ASPR Region 8 Team
CDR Ron Pinheiro
Supervisory Regional Emergency Coordinator
303-844-7273 o / 303-563-9400 c / [email protected]
LCDR John Gibbons
Regional Emergency Coordinator
303-844-7272 o / 303-335-6260 c / [email protected]
Dr. Kenneth Sturrock
Regional Emergency Coordinator
303-844-7249 o / 303-253-0566 c / [email protected]
Traci Pole
HPP Field Project Officer
303-844-7250 o / 202-657-7488 c / [email protected]
HHS Secretary's Operation Center (SOC)
866 447-7362 / 202-619-7800 / [email protected]
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