Plan and Procedure

PacificCounty

Plan and Procedure

Manual

2009

Table of Contents

INTRODUCTION

Overview of the Medical Reserve Corps

Pacific County Medical Reserve Corps Strategic Plan

Purpose of the Medical Reserve Corps

Roles of Medical Reserve Corps

Situations

Assumptions

Local Plan Coordination

ORGANIZATION

Emergency Services

Public Health

Program Coordinator

MEDICAL RESERVE CORPS OPERATIONS

Volunteer Recruitment and Selection

MRC Volunteer Orientation

Credentialing

Volunteer Tracking

Activation

TRAINING AND EDUCATION

Training

Exercises

UNIFORMS AND EQUIPMENT

Uniforms

Identification Cards

Individual Equipment

Medical Equipment

Pharmaceuticals

POSITION DESCRIPTIONS

APPENDICES

INTRODUCTION

Overview of the Medical Reserve Corps

1. The Pacfic CountyMedical Reserve Corps (MRC) is a locally based, medicalpersonnel resource whose purpose is to augment, assist and support the existing medical and public health systems during disasters, public health emergencies, and other designated times of need.

1. The MRC began by a partnership with the Office of the Surgeon General in 2003.

1. The MRC consists of volunteer professionals from different disciplines, who can be called upon to assist the community in the event of a major disaster or large-scale public health emergency, including natural or man-made disasters or acts of terrorism.

1. As an “all-hazards” resource, the unit’s personnel and resources may be utilized in any type of natural or man-made emergency. Unit personnel will only be used in functional areas or assignments for which they are properly trained and equipped.

1. The Medical Reserve Corps may be used in large-scale, complex emergencies involving multiple jurisdictions and interagency operations or in smaller incidents involving a single jurisdiction or agency. MRC personnel and resources may be assigned to, but is not limited to, area hospitals, public health agencies, pharmacies and mass care facilities to augment and assist the staff of these healthcare facilities.

1. The Medical Reserve Corps unit will not replace or supplant existing emergency medical response systems or its resources. During emergencies, Medical Reserve Corps volunteers may provide an important "surge" capability to perform some functions usually performed by emergency health staff that has mobilized. They can also augment medical and support staff shortages at local medical or emergency facilities, such as an Alternate Care Facility.

1. The Medical Reserve Corps is designed to assist and supplement the existing emergency medical response and public health systems in emergencies. However, MRC personnel and resources may be utilized in non-emergency situations (i.e. public health initiatives, community health outreach programs), depending upon their availability and the approval of local Emergency Services.

PacificCounty Medical Reserve Corps Strategic Plan

Vision

The Pacific County Medical Reserve Corps will allow volunteers to use their professional expertise to improve the public health of their communities on an ongoing basis. During times of crisis and non-crisis, volunteers will supplement the existing public health infrastructure to improve overall preparedness and find ways to promote healthy behaviors, prevention of disease, provision of care in the community, and ultimately save lives.

Mission

To allow local volunteer medical and allied health professionals to contribute their skills and expertise to provide surge public health capacity.

Program Need

There is one health department in PacificCounty: Pacific County Public Health and Social Services Department. In early 2003, a commitment was made to improve the overall infrastructure volunteer capabilities for public health in PacificCounty. The Washington Region 3 Medical Reserve Corps was formed, which included Grays Harbor, Lewis, Mason, Pacific, and PacificCounty. Washington Region 3 MRC promotes individual and community emergency preparedness, by providing support to the region in an event of an emergency, such as natural disasters, environmental emergencies, or a communicable disease outbreak. Beginning in August 2009 the regional approach to the Medical Reserve Corps was disbanded, resulting in five individual Medical Reserve Corps. To date, there has been a strong emphasis on regional collaboration, standard operating guidelines, and specific target capabilities including mass dispensing/vaccination, training and exercises, emergency public information, community preparedness and participation.

One of the greatest challenges the Medical Reserve Corps continues to face is the need for pre-identified, credentialed and trained professionals to strengthen the ongoing efforts to mount a rapid and organized response to local emergencies. Therefore, volunteer management must be one of the priorities for public health. Without assistance from volunteers, it will be nearly impossible for current public health employees (approx. 100 or 200 in the region) to implement protective measures for the entire county population within a limited (2-4 days) timeframe.

Goals

The goal of the Medical Reserve Corps is to coordinate with local and regional partners to develop resources to support public health need in the community.

Objectives

1. To maintain a Medical Reserve Corps that is officially recognized by local, State and Federal governments.

1. To develop a cadre of qualified medical, non-medical, and public health volunteers that can, on a temporary/emergency basis, assist the region in a voluntary capacity during a public health crisis.

1. To provide a cadre of qualified personnel willing to volunteer time in non-emergency health promotion activities requiring medical knowledge or expertise.

1. To create a continuing education program for medical professionals as an incentive to maintaining membership on the Medical Reserve Corps. Such training shall include, but not be limited to, continuing education classes that will familiarize the volunteer with public health practice and the emergency preparedness plans of PacificCounty.

Program Activities

Program activities will primarily focus on the following areas:

1. Member Recruitment

Volunteer recruitment is an ongoing activity. Interested participants are directed to the MRC webpage housed by TCPHSS. Additionally, interest forms are distributed at various venues. Direct mail and e-mail outreach is being considered for selected, licensed populations (i.e. primary care physicians and nurses).

1. Member Development

A variety of training programs are offered to MRC volunteers. Possible sessions include:

• Introduction to MRC:

• Medical Reserve Corps competencies
• Registration on statewide database
• Required training (active vs. inactive status)
• Deployment - where MRC fits within the Pacific County Emergency Services plan

• Basic Preparedness: Are you ready?
• NIMS/ICS
• Special Populations: Behavioral Health, Children
• Points of Dispensing
• Public Health Preparedness for Health Professionals
• Local Health Department Volunteer Opportunities
• Pandemic Influenza 101
• Infection Control/Clinical Guidelines
• Distance Learning Opportunities:
• Risk Communication

1. Member Engagement

Frequent methods of communication are used to engage volunteers and keep them informed of upcoming events. A Pacific County Medical Reserve Corps website exists and used frequently to get information into the community.

1. Deployment and Response

MRC volunteers will prepared to deploy at anytime in response to a local disaster or emergency. In addition, volunteers will be available for non-emergency exercises and events in the community.

Program Evaluation

The MRC program is evaluated to provide information for improving and assessing program effectiveness. Volunteers and preparedness staff will be engaged in the evaluation design and implementation.

Program Sustainability

The MRC will be sustained through existing and newfound partnerships, through in-kind support, and by seeking new funding opportunities consistent with the MRC mission.

Purpose of the Medical Reserve Corps

1. When major disasters occur, local communities are quick to offer aid and assistance to their fellow citizens. However, as evidenced by the Oklahoma City bombing, WorldTradeCenter collapse, and Hurricane Katrina, an uncoordinated response and the urgent need for civilian volunteers can overwhelm and clog rescue efforts resulting in an increased risk of injury or death to volunteers.

1. The Medical Reserve Corps attracts professionals from various local healthcare disciplines to assist in this essential community service. Through acontinuous process, the MRC will provide continuing education and training to support its mission and enhance the volunteers’ abilities. MRC volunteers may include physicians, nurses, pharmacists, dentists, and other allied health professionals. Additionally, volunteers with administrative or support qualifications may be enrolled to assist the MRC in development and implementation.

1. The Medical Reserve Corps will maintain volunteers’ credentials, contact information, and other relevant information in a database. This information is critical when, volunteersare rapidly deployed to assist with the community’s response.

1. The Medical Reserve Corps has an integral role in the community’s disaster plans, Strategic National Stockpile (SNS), and other response plans. The role of the MRC is to:

1. Improve the community’s “surge capacity” (influx of ill or injured).

1. Enhance local Public Health with mass medication distribution.
2. Support local Public Health with mass immunizations, in the event of a public health emergency or bioterrorist event.

1. Provide emergency mental health initiatives(mass care for the worried well).

1. Assist in all other areas, as needed.

Roles of Medical Reserve Corps

1. Increase “Surge Capacity” of Community

1. In the event of a natural or man-made disaster, the federal government recommends that a hospital should be self-sufficient and able to manage 150-200 patients for up to 72 hours. It is estimated that it may take longer for state and/or federal assistance programs (e.g. Disaster Medical Assistance Teams, Metropolitan Medical Response Systems, etc) to arrive and set up.

1. In the event part or all of a hospitalbecomes disabled or incapacitated, the nearest hospitalsmight be several miles away by ground transfer. EMS agencies within this area are limited in resources and personnel and might not be able to manage the provisions of community emergency care and transportation to these nearest hospitals.

1. Hospitals should have established cooperative agreements with local Public Health and area businesses to utilize space in emergenciesto setup Alternate Care Facilities.

1. Medical Reserve Corps volunteersshould be trained and ready to respond to these facilities and assist in the provision of care, stabilization and transfer of patients.

1. Mass Prophylaxis (Immunizations)

1. In the event of a bioterrorist attack or other public health emergency in which mass immunizations are needed, there are currently not enough qualified and trained healthcare professionals available in the area.

1. Upon activation of the MRC, this void can be filled by simultaneously deploying multiple teams of personnel to establish and manage remote immunization sites.

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1. Teams would consist of physicians, nurses, pharmacists, and other allied health professionals, specially trained in mass immunization techniques with knowledge of establishedprotocols and policies.

1. Mass Medication Distribution

1. If mass medication distribution were required due to a public health emergency, the area does not have a process to identify and train additional healthcare providers.

1. Although there are a number of local pharmacists and pharmacies within this area, there is not a mechanism by which mass medication distribution can be accomplished in a manner that does not economically adversely affect these businesses.

1. Activation of the MRC will fill this void by deploying teams of physicians, nurses, pharmacists, pharmacy techs, etc. to assist with the receiving and distribution of medications and implementation of localStrategic National Stockpile (SNS) plans.

1. Emergency Mental Health Initiatives: Mass Care for the Worried Well

1. Catastrophic events result in an increase in the need for mental health evaluation and care to victims, rescuers and their families.

1. The Medical Reserve Corps will be able to assist with this matter through the Disaster Mental Health Services in conjunction with local services, such as the American Red Cross.

1. Mental Health professionals, clergy, pastoral counselors, physicians, nurses and other allied health professionals may be able to meet the mental and physical health needs of the community.

Situations

1. There are several emergency medical service agencies in the WA Region 3 coverage area providing Basic Life Support (BLS) and limited Advanced Life Support (ALS) capabilities. Many of these agencies are volunteer-based, with limited personnel resources. Physicians and/or nurses do not normally respond to emergencies in the field with EMS agencies.

1. There are only nine hospitals in the WA Region 3 area serving a population of approximately 469,000. Several of these hospitals are located in rural areas with limited capabilities. A large-scale emergency or disaster with mass casualties may severely tax the resources of these facilities.

1. Local public health does not have adequate staffing to execute large-scale mass immunization or prophylaxis operations, and will need assistance from volunteer medical personnel and other personnel in these and other public health operations.

1. There is one Disaster Medical Assistance Team (DMAT) within the state. The nearest DMAT is located in Seattle, Washington. However, out-of-area emergency medical resources may take at least 12-24 hours or longer to arrive in the area, depending upon availability

1. In addition, Disaster Medical Assistance Teams (DMATs) can only be activated in three ways:

1. By a presidential declaration of a disaster,

1. By request for major medical assistance from a State health official under provisions of the Public Health Service Act, or

1. In a foreign military conflict involving U.S. Armed Forces, where casualty levels are likely to exceed the capacity of the Department of Defense-Veterans Administration Medical System.

1. Historically, medical personnel spontaneously volunteer to assist in emergencies or disasters. Spontaneous volunteers may not be familiar with the organization and structure of the existing local emergency response system and, therefore, may not be as effective and efficient in the provision of emergency medical services as members of an organized response group. Additionally, well-qualified medical professionals are not put to their best use when they spontaneously volunteer for lack of verification of licensure or qualifications.

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Assumptions

1. Emergencies, especially those that are large-scale, may require medical response operations in austere environments for extended periods. Assistance from federal resources may require greater than 72 hours to arrive or may not be available.

1. Medical Reserve Corps personnel will need to have adequate equipment and supplies to operate for at least 72 hours.

1. Mutual aid agreements may or may notexist between political subdivisions and agencies across the greater Washington Region 3coverage area.

1. Adequate supplies of required medical equipment and pharmaceuticals may not be immediately available to medical personnel due to logistical disruptions or other limitations caused by an emergency.

1. Medical Reserve Corps volunteers will be well versed in the National Incident Management System (NIMS) and can be integrated into the existing emergency medical response system.

1. Area hospitals, emergency services organizations and public health agencies may or may not be aware of the organization and capabilities of the Medical Reserve Corps and may need the unit’s assistance in emergencies.

1. In a large-scale mass casualty event, the area’s only acute care hospitalmay be quickly overwhelmed and the traditional “treat and transport” mechanism may not be sufficient to minimize loss of life. Due to the potential delay in treatment at the hospital, patients may need to be triaged, periodically assessed and receive life-saving care at the scene of an emergency event. MRC personnel may be able to assist with field medical operations.

Local Plan Coordination

The operational procedures in this plan are consistent with, and complementary to:

• LocalCountyComprehensiveEmergency Services Plan
• Local Public Health Emergency Response Plan
• Local Public Health Strategic National Stockpile Plan
• State Department of Health ESF-8 Plan
• LocalEMS Mass Casualty Incident Plans
• LocalHospital Emergency Response Plans
• Local Chapter of the American Red Cross Disaster Services Plan
• WA State Comprehensive Emergency ServicesPlan.

ORGANIZATION

The Pacific CountyMedical Reserve Corpsencompasses a large geographic area and multiple diverse disciplines; therefore, the organizational structureneeds to be broad enough to meet the needs of the participating organizations, volunteers and communities served, yet remain manageable and efficient. To accomplish this, local Emergency Services and Public Health will work together to oversee the Medical Reserve Corps. In an effort to ensure the Medical Reserve Corps is meeting the needs of the region, a largergroupmay provide guidance and advice on the scope and operations of the Medical Reserve Corps.

Emergency Services

1. The local Emergency Services agencyis designed towill provide and directvolunteer services within the community during disasters.

1. Emergency Services has the responsibility of coordinating and overseeing emergency operations during disasters. Emergency Services,along with the Medical Reserve Corps Coordinator,will provide necessary leadership and decision-making forMedical Reserve Corps operations and activities, including but not limited to:

• Activation, deployment, and demobilization of volunteers.
• Management ofvolunteer operations during a disaster through coordination with the State Emergency Services Department (EMD).
• Assist in the development oflocal plans and policies that facilitate the activities of the volunteers.
• Identifying needs and priorities for the volunteer work.
• Developing plans that respond to needs and maximize resources.
• Ensuring alignment of the MRC work with local volunteer program purpose and mission.
• Overseeing the registration of volunteers as “emergency workers”.
• Ensuring accountability of the volunteer/MRC work and resources during disasters.

1. Emergency Servicesmay meet throughout the year with other partnering first responder agencies for the specific purpose of setting direction, reviewing progress, and making decisions in all aspects of volunteer programs. Emergency Services may wish to assign a Volunteer Coordinator to carry out the day-to-day leadership and operation of volunteers.

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