Welcome to Greene County Medical Center

Annex A - Direction, Control, and Coordination

PURPOSE
To provide for effective leadership, coordination, and unified response for a multi-harzard response or bio-emergency.

SITUATION/TRIGGERS for PLAN ACTIVATION
All Iowa counties are required by chapter 29C of Iowa Code to develop and maintain multi-hazard emergency response plans to cope with major disasters such as tornadoes, floods, airplane crashes, and dangerous hazardous materials releases.  These plans address many aspects of planning, including command and control functions, descriptions and operation of emergency communication systems, public health and medical care resources, and other key response elements that are relevant to bio-emergencies.  However, bio-emergency planning requires the consideration of factors not normally addressed in the jurisdiction's multi-hazard emergency response plan.

One of the main differences between most bio-emergencies and other natural disasters is the potential for widespread adverse effects on human health, along with disruption of critical human infrastructure brought about because of these health effects.   Another noteworthy difference is that a bio-emergency is not typically focused on a geographically discrete “incident scene,” but rather is understood gradually and as a result of the expertise and efforts of trained epidemiologists.   Unlike many categories of emergencies, the response to a bio-emergency will not usually be initiated through a call to 911.
The plan may be activated for any emergency response that has a need for public health expertise.

RESPONSE PARTNERS NEEDED TO IMPLEMENT THIS PLAN 1

Local elected official(s)

Local public health agency director (or other designated * LPHA emergency contact)

Public health nurse(s)

Environmental health officer(s)

Communicable disease specialist(s)

Local hospital(s) (includes emergency department contact and infection control practitioner, at a minimum)

Local health-care providers

Local Veterinarians

Local Laboratory Response Network (LRN) facilities

Emergency medical services director(s)

Public information officer

Law enforcement (sheriff and local police chiefs)

Fire chief(s)

School nurse(s)

School administrator(s)

Local emergency management coordinator

Representative(s) from labor organizations

Representative(s) from the business community

Representative(s) from civic and volunteer organizations

Local media

Amateur radio operators

Hazmat team coordinator (if applicable)

ATTACHMENT #1:  Organizational chart that clearly shows who is in charge and lines of communication and authority when a bio-emergency occurs.

ROLES AND RESPONSIBILITIES

Internal and External Initial Notifications
The threat or actual occurrence of a bio-emergency requires prompt notification of those individuals and agencies that may play a role in effecting a response.

ATTACHMENT #2 & 3:  Calling Trees for PH Staff and Community Partners for initial notification process.

Use of the Unified Command/Management System
During a bio-emergency of any size and scope, direction, control, and coordination of all aspects of the response is a major determinant of success, and becomes absolutely essential when the response includes multiple jurisdictions and/or agencies.  “Unified command/management” is a widely used and well-accepted incident management framework that is appropriate for use during a bio-emergency.  A basic premise of unified command/management, which is a variation of the incident management system,2 is that those agencies with jurisdictional responsibilities and authority at an incident will contribute to the process of:

1.Determining overall response strategies;
2.Selecting response objectives;
3.Jointly planning tactical activities and their application;
4.Ensuring integrated planning and application of operational requirements, including emergency measures and vaccine management/pharmaceutical dispensing;
5.Ensuring that span of control remains within acceptable limits (in general this means 5-7 people under direct management of the next level in the organizational structure);
6.Maximizing effectiveness of available resources and tracking their use throughout the incident period; and
7.Ensuring dissemination of accurate and consistent information.

A local emergency operations center (EOC) will be utilized to allow local, state, and federal decisions makers to communicate with each other.  The county multi-hazard plan has provisions for an EOC and a back-up EOC.

Responsible Local Agency
The GCMC public health agency is the lead local agency for responding to a bio-emergency.   The director of that agency, or a designee, is responsible for implementing the provisions of this plan.

Responsible State Agency
IDPH is the lead state agency for response to a bio-emergency.  IDPH will disseminate information concerning a bio-emergency to the local public health agency, including information on prevention and control.

Activities by Response Level

Threat of a Bio-Emergency
1.Meet with appropriate partners and stakeholders to review major elements of the plan.
2.Modify the plan as needed to address significant changes in the nature of magnitude of the threat.
3.Assess training levels and remedy deficiencies.

Actual Bio-Emergency
1.Activate the jurisdiction's communications plan (see Annex B).
2.Initiate and manage the jurisdiction's epidemiologic response (see Annex C).
3.Begin vaccine administration/pharmaceutical dispensing, if selected as a control and prevention measure.  If vaccine, pharmaceuticals, or other medical supplies are to be obtained through the Strategic National Stockpile program, coordinate with IDPH.
4.Notify key government officials and legislators of the need for additional monetary resources (if not already available).
5.Begin heightened surveillance at area hospitals and clinics.
6.Coordinate activities with neighboring jurisdictions.
7.Interface with appropriate counterparts at the state level.
8.Track all emergency-related expenses throughout the incident period.  These records are important for future planning and for obtaining reimbursement.

Post-emergency
1.Review the response to the emergency.
2.Identify any aspects of this plan that could not be executed, or that were inadequate in responding to the emergency, and amend the plan to reflect response lessons learned. If due to inadequate training, equipment, or personnel, seek authority and funding to remedy the situation.

ROLE OF THE CHIEF ELECTED OFFICIAL
The chief elected official of the community is responsible for protecting the health and safety of the citizens of the community during an emergency.   Specific responsibilities include:

1.Being prepared to answer the following questions during a bio-emergency—

a.What is the lead response agency, and who represents that agency?
b.Who is the public information officer?
c.What is the overall situation (e.g., areas affected, number of people affected, number of fatalities)?
d.Do we have enough resources to deal with the problem?  If not, who has these resources?  How will they be obtained?
2.Considering the need for a local emergency declaration in consultation with the local public health agency director and the county emergency management coordinator.
3.Obtaining copies of all press releases and summaries of all statements provided to the media in live or taped broadcasts.
4.Scheduling time with the local public health agency director, or a designee, to receive regular situation updates.
5.Participating in press conferences, in collaboration with the public information officer.

US Patent Numbers 7,720,998 B2, 7,836,207