Disaster Volunteer Utilization Plan: Planning Template

Version 1: February 2013

Table of Contents

INTRODUCTION

I.Executive Summary

II.Purpose

III.Scope

IV.Notes/Changes Log

V.Definitions and Acronyms

BACKGROUND

VI.Planning Assumptions

General Assumptions

Volunteer Management Assumptions

VII.Triggers and Surge Strategies

Indicators and Triggers

Clinic Incident Command Team

VIII.Surge Strategies

Surge Strategies to Increase Patient Care

Clinic Surge Staff Strategies Based on Facility Impact

CONCEPT OF OPERATIONS

IX.General Volunteer Management

Initial Issues to Consider

Supervision of Volunteers

Tracking of Volunteers

Orientation and Training of Volunteers

Demobilization of Volunteers

X.Credentialed (DHV) Volunteers

Requesting of Credentialed Volunteers

Qualifications and Credentialing

Legal Responsibilities and Liabilities

Orientation and Training

Utilization Strategies

Demobilization

XI.Affiliated Volunteers

Requesting of Affiliated Volunteers

Qualifications and Credentialing

Legal Responsibilities and Liabilities

Utilization Strategies

Demobilization

XII.Spontaneous Volunteer Management

Qualifications and Credentialing

Legal Responsibilities and Liabilities

Utilization Strategies

INTRODUCTION

I.Executive Summary

This Disaster Volunteer Utilization Toolkit establishes recommended guidelines, procedures, and policies for the effective utilization of volunteers across the whole disaster lifecycle at community clinics. Due to the unique nature of various types of volunteers, the requesting, receiving, utilization, and demobilization process is categorized into specific sections for credentialed, affiliated, and spontaneous volunteers.

The toolkit does not address day to day use of volunteers in the clinic setting. Instead, the operational concepts reflected in the plan focus on potential large-scale disasters that can generate unique situations requiring novel responses when day-to-day resources are overwhelmed. Volunteer utilization strategies are designed to facilitate response to natural disasters, human caused events, and technological incidents. However, these concepts may be employed and practiced with preplanned special events conducted by the clinic on a seasonal or annual basis. Normal clinic use of volunteers should be considered and incorporated into the Disaster Volunteer Utilization Plan as deemed appropriate for your facility to establish a comprehensive plan for credentialed, affiliated, and spontaneous volunteer management.

II.Purpose

The purpose of the Los Angeles County Community Clinic Disaster Volunteer Utilization Plan is to provide a framework that strengthens the ability of Los Angeles County community clinics to rapidly and effectively respond to emergencies through the coordination and utilization of credentialed, affiliated, and spontaneous volunteers.

Recent natural and man-made catastrophic events have demonstrated the need for volunteer healthcare professionals and lay volunteers to supplement and enhance response and recovery capabilities during and after such events.

This plan aims to provide community clinics with resources regarding the use of volunteers, including information outlining the process of requesting, receiving, training, credentialing, utilizing, and demobilizing volunteers.

III.Scope

This plan is applicable within the Los Angeles County Operational Area, and is intended to be applicable to all hazards and scalable to the size and scope of an event. The plan covers the mobilization, coordination, and demobilization of spontaneous, affiliated, and credentialed volunteers through local Medical and Health Operational Area Coordinator (MHOAC) in community clinics.

IV.Notes/Changes Log

Change Number / Date Entered / Posted By

V.Definitions and Acronyms

Volunteer / Someone who willingly provides his/her services without receiving financial compensation.
Credentialed Volunteer / An individual with some sort of medical or clinical qualification that is registered within the Disaster Healthcare Volunteer system
Affiliated Volunteer / An individual that is attached to a recognized voluntary or nonprofit organization and is trained for specific disaster response activities. Their relationship with the organization precedes the immediate disaster
Spontaneous Volunteer / An individual who comes forward following a disaster to assist in response efforts, without pay or other consideration. Spontaneous volunteers are not initially affiliated with a response or relief agency or pre-registered with an accredited disaster council.
DSW (Disaster Service Worker) / Any person registered with a disaster council or the Governor’s Office of Emergency Services for the purpose of engaging in disaster service pursuant to the California Emergency Services Act without pay or other consideration.
DHV (Disaster Healthcare Volunteer) / Any individual with medical, health, mental health, and other specialties that has been pre-registered in the DHV system. They have had their qualifications verified and are registered as DSWs. During emergencies, they are requested by and deployed to clinics and hospitals that need additional medical staff.
MHOAC (Medical and Health Operational Area Coordinator) / Each Operational Area has a MHOAC who serves as a 24-hour, seven days a week, single point of contact for disaster medical and health operations.
SEMS (Standard Emergency Management System) / The fundamental structure for the response phase of emergency management
NIMS (National Incident Management System) / A structured framework used nationwide to coordinate emergency preparedness and incident management among various federal, state, and local agencies.

CERT: Community Emergency Response Teams

EOC: Emergency Operations Center

FEMA: Federal Emergency Management Agency

ICS: Incident Command System

NVOAD: National Voluntary Organizations Active in Disaster

VOAD: Voluntary Organizations Active in Disaster

VRC: Volunteer Reception Center

BACKGROUND

VI.Planning Assumptions

This Plan is based on the following assumptions:

General Assumptions

  • Emergencies may result in:
  • Casualties and fatalities
  • Damage to public health and medical infrastructure, including hospitals, community clinics, skilled nursing facilities, and other licensed Health Care Facilities and providers
  • Exposure to hazardous materials or communicable/infectious disease agents
  • SEMS will be used to manage emergencies in California.
  • Emergencies involving the Public Health and Medical System will rely heavily on multi-agency coordination.
  • During a large-scale incident within the region, the response capabilities of individual jurisdictions likely will be exceeded and resources from both within and outside of the region will be required.
  • Analysis of regional and statewide threat scenarios indicates that significant numbers of individuals with medical or health needs will require assistance following a large-scale event.
  • Hospital and clinic response will be greatly affected by patient surge.
  • First responders, hospital and clinic employees, and other critical response personnel will be personally affected by the disaster and might be unable to report to their posts for days because of damaged transportation infrastructure or personal injury.

Volunteer Management Assumptions

  • Volunteer coordination operations follow the principles of SEMS and NIMS.
  • Volunteer coordination will require jurisdiction‐wide coordination among multiple government and non‐governmental organizations. State or federal resources will be integrated into the response process following SEMS.

Credentialed Volunteers

  • Volunteers affiliated with and deployed by the Los Angeles County will be registered as Disaster Service Workers (DSWs) before or at the time of the event.
  • Consistent with the principles of SEMS/NIMS and the Incident Command System (ICS), once a volunteer has been identified and deployed into a response incident, that volunteer comes under the operational command of the managing agency until such time as the resource is released from the incident response.

Affiliated Volunteers

  • State, tribal and local government agencies, the American Red Cross and other response agencies and external programs actively recruit and train volunteers pre-disaster to carry out a disaster role or function.
  • Government affiliated volunteers will be integrated into the response structure consistent with SEMS/NIMS and traditional response protocols.
  • Clinics will coordinate with NGO affiliated volunteer programs using SEMS/NIMS.

Spontaneous Volunteers

  • Most people who spontaneously decide to volunteer in response to a disaster will not know where to go or how to become engaged.
  • Following a disaster, spontaneous volunteers are likely to overwhelm the local jurisdiction and government sites, such as city halls and fire departments, possibly resulting in spontaneous community based organization assistance.

VII.Triggers and Surge Strategies

Indicators and Triggers

When any of the triggers listed below are reached at our clinic, we will activate the Incident Management Team and utilize the surge strategies outlined in the following section, based on the severity of the emergency.

□20% above average daily census

□Staff loss/unavailability of 15-30%

□Inability to transfer patients to hospitals

□EMS/MAC notification of a system wide surge

□Mayoral declaration of an emergency, or a federally declared disaster

Clinic Incident Command Team

The clinic’s Incident Command System (ICS) should be activated when any one of the above triggers is met.

See Appendix 5d for a blank ICS chart to fill in for your clinic

VIII.Surge Strategies

Surge Strategies to Increase Patient Care

The diagram below illustrates possible surge strategies that can be implemented in clinic surge situations. When there is an increase in the number of patients at the clinic, use the suggestions below to increase the clinic’s patient care capabilities. Begin with the box on the left, and move to the middle and right boxes as more patients come to the clinic.

/
  • Increase staff via requesting and assigning credentialed volunteers (DHV, DMAT, Disaster Service Workers), affiliated volunteers, and spontaneous volunteers
  • Establish unlicensed treatment areas (ex. Outpatient surgery rooms, parking lots, waiting rooms)
  • Establish temporary treatment areas (ex. Tents)

  • Reassign staff
  • Recall staff
  • Utilize staff from other clinic sites
  • Standing orders for licensed nursing staff
  • Standing orders for medical assistants

  • Cancel elective appointments
  • Process to extend normal outpatient clinic hours
  • Rapid patient discharge

Clinic Surge Staff Strategies Based on Facility Impact

Below, you will see a sample row of the Service Surge Strategy Matrix. This sample service is “triage,” so, during an emergency, they need to devote more resources to this service. They do this by increasing staff (“I.S.”), extending hours (“E.H.”), and requesting volunteers (“R.V.”).

A blank Clinic Surge Staff Planning Matrix can be found in Appendix 7, and should be filled out prior to an emergency event at the clinic. We recommend that clinics fill out two versions of this matrix; one for sudden onset events, such as earthquakes, and one for slow onset events, like pandemics. Once you have completed your matrices, insert them here for future reference. See page 12 of the Guidance Document for more instructions on how to fill out your matrix.

Normal Operations / Under Control / Modified Services / Limited Services / Essential Services
Service Strategy / Staff / #s / Service Strategy / Staff / #s / Service Strategy / Staff / #s / Service Strategy / Staff / #s / Service Strategy / Staff / #s
SAMPLE (TRIAGE) / N.O. / RN / 1 / I.S. / MD / 1
RN / 2
MA / 2 / I.S., E.H. / MD / 2
RN / 3
MA / 2 / R.V., E.H. / MD / 2
RN / 3
MA / 3 / R.V., I.S. / MD / 2
RN / 4
MA / 4

CONCEPT OF OPERATIONS

The concept of operations describes a strategy behind organizing the multiple volunteer management functions into a system.

IX.General Volunteer Management

Initial Issues to Consider

Consider whether or not the clinic can provide the following to its volunteers, or whether they need to provide it for themselves:

□Food and water

□Lodging

□Transportation to the clinic site

□Other supplies, such as personal protective equipment

Supervision of Volunteers

Volunteer Coordinators should check on volunteers regularly throughout their service at the clinic. They should make sure that volunteers are:

□Meeting performance standards

□Using supplies and equipment correctly

□Have been taking regular breaks and have access to food and water

□______

□______

□______

See the Volunteer Coordinator Job Action Sheet in Appendix 5b for more information.

Tracking of Volunteers

All volunteers should sign in upon arrival, and a volunteer coordinator should keep track of all volunteer actions using a HICS 253form (see Appendix 4a). A different HICS 253 form should be used for each different kind of volunteer (one for credentialed, one for affiliated, one for spontaneous).

The following information for each volunteer should be tracked:

□Mission/deployment (including incident name, location, etc)

□Date(s) of service

□Number of hours of volunteer service

□Role assigned during deployment

□Individual Performance Rating (ICS form 226)

□______

□______

□______

Use the Disaster Volunteer Registration Form (Appendix 3f) and HICS 253 and 252 forms (Appendix 4a and 4b) to properly and efficiently register and track your volunteers.

Use ICS 226 form (Appendix 4c: Individual Performance Rating) to evaluate your volunteers.

Orientation and Training of Volunteers

Volunteers should be oriented to the organization and the disaster situation. Orientation should cover:

□The agency’s disaster mission, key policies and procedures

□Safety instructions, what to do in case of accident or injury, and relevant environmental factors

□A tour of necessary facility sites

□A written description of their role

□______

□______

Read Appendix 3g: Disaster Volunteer Orientation Checklist for more instructions on how to orient volunteers.

See the “Orientation and Training” section under “Credentialed Volunteers” for more information on training DHVs.

Demobilization of Volunteers

Volunteer deployment protocols will be communicated by the onsite Volunteer Coordinator or designated representative. The Volunteer Coordinator will:

□Ensure the volunteer’s assigned supervisor affirms their dismissal from assigned duties

□Ensure volunteer has briefed any replacement staff, if appropriate, on all pertinent information needed to perform the job and ensure smooth operations

□Complete exit interview to educate volunteer on the possible physical and mental health reactions to disasters, and inform them of resources available

Use the “PsyStart Staff Self Triage System” form (in Appendix 3e) to assess the physical and mental health of each volunteer

□Complete tracking information for volunteer

Confirm that Appendix 3f: Disaster Volunteer Registration Form is completed for each volunteer

The number of hours worked should be noted using Appendix 4a: HICS 253 or Appendix 4b: HICS 252

□Complete Individual Performance Rating form for each volunteer

See Appendix 4c: ICS 226 for this form

□The clinic may ask volunteer to participate in a debriefing so as to better understand the volunteer experience. Clinics can use their own volunteer feedback form for this process.

□All post-deployment records must be properly collected and stored according to local guidance

□Depending on arrangements made at the time of deployment, the receiving clinic should arrange for transportation of volunteer back to point of departure, or request transportation from sending organization

X.Credentialed (DHV) Volunteers

Requesting of Credentialed Volunteers

Fill out the “Resource Request Medical and Health” form (Appendix 2b) and the supplementary “Disaster Healthcare Volunteer Personnel Request Form” (Appendix 2c) to request DHVs. These forms should be submitted to one of the following contacts (listed in order of preference):

ReddiNet (for clinics with access)

Los Angeles Emergency Medical Services Agency:

  • Email:
  • Fax: Medical Alert Center (562) 906-4300; DOC (562) 944-5248
  • Phone: Medical Alert Center (866)-940-4401

The Community Clinic Association of Los Angeles County (CCALAC)

  • Email:
  • Fax: (213) 250-2525
  • Phone: (213) 201-6500

Everbridge

CWIRS Radio: for County Comprehensive Centers

HAM Radio (Frequency List available by request)

This diagram illustrates the steps involved with requesting, transporting, receiving, training, utilizing, and mobilizing DHVs. The steps outlined in the “REQUESTING Operational Area” column on the far left includes the steps that clinics are responsible for.

Qualifications and Credentialing

All DHVs have been credentialed prior to deployment.

Legal Responsibilities and Liabilities

All DHVs have been sworn in as Disaster Service Workers, and therefore come with liability coverage through the county.

For more information, see page18 of the Guidance Document andAppendix 6a: Disaster Service Worker Registration FAQs.

Orientation and Training

The onboarding process for DHVs should include shadowing and/or mentoring for 1-2 hours, a tour showing volunteers storage and resource locations, reporting structures, and other important places.

Utilization Strategies

Fill out the matrix provided in Appendix 7, anddescribed on page12 of the Guidance Document, to determine how you will utilize your requested DHVs during an emergency.

Demobilization

□Inform the Department of Health Services Department Operations Center (DHS DOC) of the demobilization of each DHV, and ensure that the following forms are sent to the DHS DOC:

PsySTART Staff Self-Triage System form (Found in Appendix 3e)

ICS 226 Form (Individual Performance Rating) (Found in Appendix 4c)

XI.Affiliated Volunteers

Requesting of Affiliated Volunteers

To request affiliated volunteers from an outside agency, fill out the “Affiliated Volunteer Request Form” in Appendix 2d and send the form to the Community Clinic Association of Los Angeles County (CCALAC):

Email:

Fax: (213) 250-2525

Phone: (213) 201-6500

Qualifications and Credentialing

The credentialing of affiliated volunteers may vary depending on the affiliate organization in question, so specific qualifications desired or required for certain tasks should be denoted on the Volunteer Request Form.

Legal Responsibilities and Liabilities

Affiliate volunteers might not be sworn in as DSWs and therefore may or may not be covered by the county for liability purposes.Clinics receiving non-DSW volunteers should include the signing of a Liability Release Formin their onboarding process.