National Disaster Medical System Partnership Overview

1. National Disaster Medical System Partnership Overview

2. NDMS Structural Changes

3. NDMS Structural Changes

4. NDMS Structural Changes

5. NDMS Structural Changes

6. NDMS Structural Changes

7. DHS in NDMS • Roles of DHS • Lead Agency for NDMS • Chair Senior Policy Group & Directorate Staff • Activation of NDMS • Responsibility for Medical Response Component • Medical Response Operations • Systems Development and Training • Field Medical Response • Strategic National Stockpile

8. DHS in NDMS (cont’d) • New Opportunities for NDMS • Cross-fertilization of response teams • NDMS • US&R (IST/MST) • Better communications support (MERS) • Focus primarily on medical response

9. DHS in NDMS (cont’d) • New Initiatives and Priorities for NDMS • Medical Surge Capacity • Field Hospital Initiative • Expanded Staff Initiative • Enhanced Medical Response Team Readiness • Re-categorization of Teams • Response Time Enhancement • NRP/CIRA • Assist in SNS “23 City” Initiative

10. DHS in NDMS (cont’d) • New Initiatives and Priorities for NDMS (cont’d) • NDMS Memorandum of Understanding Revision • Changes to Patient Movement Components • Evolution of Definitive Care Components

11. DoD in NDMS • Coordinate Patient Movement • Coordinate Definitive Patient Care • Initiate and Coordinate Regional Exercises

12. DoD in NDMS • 1. Coordinate Patient Movement • DoD is lead for patient movement in collaboration with other federal agencies • “911 Call” for medical crews; provides seamless continuity of care for patients in homeland incident during transport • When requested, coordinates transportation medical assets to include: • AE Kits • Patient Movement Items • Civilian Reserve Air Fleet in Homeland Incident

13. DoD in NDMS • 1. Coordinate Patient Movement (Cont) • Global Patient Movement Requirements Center (GPMRC) located at Scott AFB (St Louis) • Performs Medical Regulating • Coordinates the “Lift-Bed” plan • Transportation Command Regulating and Command and Control Evacuation System (TRAC ES) • Combines transportation, logistics, and clinical decision elements into seamless patient movement; capable of assessing/prioritizing requirements, assigning proper resources; distributing relevant data 2

14. DoD in NDMS • TRANSCOM Regulating and Command & Control Evacuation System (TRAC ES) Benefits: • Seamless transition from peacetime to natural disaster, contingencies and wartime • In-transit patient visibility • Integrates modes of transportation for patient movement • Advanced planning capabilities to develop precise plans and projections in resource constrained environments • Effective use of existing transportation resources • Promotion of Stakeholders • Patient well-being • Point-to-point delivery system • Safe and efficient transportation • Critical airlift returned to operational users • Projects limitations and patient movement “bottlenecks” • Situational awareness for networked participants 2

15. DoD in NDMS • Coordinate Definitive Patient Care • Twenty Six (26) Federal Coordinating Center Areas of Responsibility in CONUS • 10 Air Force FCCs 7 Army FCCs 9 Navy FCCs • Bed Reporting • DoD Sponsored 2003 FCC Survey (Self-Assessment) • DoD Sponsored 2004 FCC Readiness Status Report (Operational Status) • Medical Inter-Agency Coordination Group (MIACG) Evans Army Medical Center

16. DoD in NDMS • 3. Initiate and Coordinate Regional Exercises • Ft Lewis Area Exercise (Oct 2003) • Lifesaver 2004 - Southeast Region of CONUS (Mid-May) • Various Local DoD FCC Exercise/Training • USNORTHCOM

17. VA in NDMS • Components of the NDMS • Medical response to a disaster area in the form of teams, supplies, and equipment • Patient movement from a disaster site to unaffected areas of the nation • Definitive medical care at participating hospitals in unaffected areas

18. VA in NDMS • VA assists DoD in coordination • Of the 67 FCCs, 43 VA FCCs manage 48 Patient Reception Areas • Bed reports – typically 19K – 24 K ‘available beds’ from VA FCCs

19. VA in NDMS FCC Coordinators NDMS Directorate Representative

20. VA in NDMS • FCC Coordination Group – chairmanship • Lifesaver Exercise • Training dollar$ to VA FCCs • WMD NDMS Pharmacy caches • MIACG

21. VA in NDMS • VA participation in ‘Response’ • Increased ‘priority’ for active duty access for Operation Iraq Freedom • Hurricane Isabel • Northeast power outage • Alert Level Orange during Christmas ‘03

22. Veterans Health Administration 21 Veterans Integrated Service Networks

23. VA in NDMS VA Teams • Disaster Emergency Medical Personnel System (DEMPS) • Emergency Medical Response Team (EMRT) • Medical Emergency Radiological Response Team (MERRT)

24. VA in NDMS DEMPS(Disaster Emergency Medical Personnel System) • Nationwide registry • Full-time VA employees • Volunteers for deployments • Currently being populated

25. VA in NDMS Medical Care Assets • 162 hospitals • > 800 ambulatory care clinics • 130 nursing homes • 40 domiciliaries • 73 home care programs • 206 counseling centers

26. VA in NDMS Pharmaceutical Preparedness • Pharmaceuticals are key component to national response capability for WMD • VA’s National Acquisition Center plays central role in preparedness • Several Federal assets • Strategic National Stockpile • WMD/NDMS caches • VAMC caches • Vendor Managed Inventory (VMI)

27. VA in NDMS Deployments • All major presidential declared disasters • e.g. Hurricanes Andrew, Floyd, Northridge Earthquake, 9/11 Terrorist Attacks • On-site support to high-threat events • e.g. NATO 50, Olympics, Inauguration, Papal Visit, Super Bowl

28. VA in NDMS Radiological Emergencies • EO 12657 • Federal Radiological Emergency Response Plan (FRERP) {transitioning to NRP} • Nuclear power plants • Accidents involving radiological injuries

29. HHS in NDMS • HHS has transitioned into a supporting role within NDMS, but remains the lead for Emergency Support Function #8. Specifically, HHS will provide: • Technical assistance through the Secretary’s Command Center (SCC); • Supplement NDMS deployments with Commissioned Officers as necessary; and • Provide emergency bed reporting of non-NDMS hospitals.

30. Role of the ASPHEP • Created by legislation (Bioterrorism Act) in Fall 2002 • Directs and coordinates HHS’s efforts to prevent, prepare for, respond to, and recover from, the public health and medical consequences of a disaster or emergency. • Coordinates implementation of the Initial National Response Plan (I-NRP) and Emergency Support Function (ESF) #8. • Coordinates Federal-level response planning for public health and medical consequences of terrorism events or natural events and disasters.

31. HHS Secretary’s Command Center • 24 hour state-of-the- art information and operations center with specialized technologies • Provides a single focal point for information sharing, command and control, communications, and information collection • Facilitates coordination of HHS components and resources under emergency and non-emergency conditions.

32. Ongoing Initiatives • Surge Capacity Planning • Hospital Tracking • Strategic Planning • Computer Based Modeling • National Security Special Events • Summer Olympics (Athens, Greece) • G-8 Summit (Sea Island, GA) • RNC & DNC (New York City & Boston) • Exercises • Top Officials (TOPOFF) III CPX & Forward Challenge (May 2004) • Determined Promise 2004

33. Questions?