California Disaster Medical Response System: Emergency Medical Services Authority Program Update

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California Disaster Medical Response System
Emergency Medical Services Authority Program
Update

• Disaster Medical Services Division

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Disaster Medical Services System
Emergency Management
Public and Environmental Health
Emergency Medical Services
Disaster Impacted Communities and Victims
First Responders (Fire and Police)
Mental Health
Health Care System
Disaster Medicine
Care and Shelter
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Californias EMS System

• Emergency Medical Services are responsible for
• Emergency health care response and treatment
• Transportation for acute medical or traumatic
  problems
• Day-to-day disaster medical system management
  and coordination
• EMS The intersection of public safety public
  health

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EMS Must Be Quick

• In most disasters, 98 of EMS activities are
  over in 8 hours
• Ambulance and hospital capacities must be able to
  rapidly surge
• EMS functions in the rescue and recovery phase
  of a disaster

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EMS Authority Mandate

• Coordinate and integrate statewide activities for
  EMS
• Respond to medical disasters, mobilize and
  coordinate medical mutual aid
• Coordinate disaster planning and preparedness
  through various agencies
• Assist OES with EMS component of State Emergency
  Plan

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EMS Authority Mandate

• Provide leadership, regulation, and advocacy for
  quality, rapid and efficient patient care
• Work with local EMS agencies and EMS providers,
  both public and private
• Develop standards for trauma system review Local
  EMS Agency trauma system plans
• Establish minimum standards for California Poison
  Control System

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31 Local EMS Agencies Serve California 7
Regional (34 Counties) 24 Single County
Del Norte
Del Norte
Siskiyou
Modoc
Lassen
Shasta
Trinity
Humboldt
Tehama
Plumas
Butte
Mendocino
Sierra
Glenn
Yuba
Nevada
Colusa
Sutter
Placer
Lake
Yolo
El Dorado
Sonoma
Napa
Alpine
Sacramento
Amador
Mono
Solano
Calaveras
Marin
San Joaquin
Tuolumne
Contra Costa
San Francisco
Alameda
Stanislaus
Mariposa
San Mateo
Santa Clara
Merced
Santa Cruz
Madera
San Benito
Fresno
Inyo
Tulare
Monterey
Kings
Kern
San Luis Obispo
San Bernardino
Santa Barbara
Ventura
Los Angeles
Riverside
Orange
Imperial
San Diego
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EMS Infrastructure
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California EMS Infrastructure

• Ambulance services and first responders
• Ambulances gt 3600
• Private 73
• Public 27
• gt2200 staffed daily
• EMT I about 70,000
• Paramedics 14,500

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California EMS Infrastructure

• Hospitals and trauma centers
• 450 hospitals
• 84 private
• 303 EDs
• 63 trauma centers
• 54 Levels I-III

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DMS System Components

• Capacity and Capabilities
• Existing healthcare services and field
  deployable medical assets
• Integrative Processes
• Command (manage), control and communication
  within SEMS
• Training and Exercises
• Enhance medical provider readiness

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EMSA Capacity Building-Rapid Tiered, Response

• 25 Ambulance Strike Teams (AST) with Disaster
  Medical Support Vehicles (DMSU)
• Mission Support Team (MST)
• Three California Medical Assistance Teams
  (CAL-MAT)
• California Medical Volunteers (Registry)
• Three Mobile Field Hospitals (MFH)

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Ambulance Strike Teams
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Ambulance Strike Teams

• Effective management of multiple medical
  transportation resources
• 25 DMSUs purchased to augment 25 statewide ASTs
• Training program for AST leaders

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Ambulance Strike Teams at Del Mar
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California Medical Assistance Teams (CAL-MAT)
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California Medical Assistance Teams

• Three deployable teams
• MD, FNP, PA, RN, LVN, RT, Pharm.D., Mental Health
  Specialist, EMT EMT-P, logistics and admin
  specialists
• Self-supporting for 72 hours (equipment, supplies
  and shelters)
• Volunteer training paid in disasters

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CAL-MAT at Del Mar
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California Mobile Field Hospitals
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Mobile Field Hospitals

• Three 200 bed Mobile Field Hospitals
• ER, OR, ICU, Med/Surg and negative pressure
  capability
• 72 hour on-site set-up
• Vendor managed warehousing and maintenance
• 18 million available

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Mobile Field Hospitals
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California Medical Volunteers
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California Medical Volunteers

• Register, identify, notify, deploy, and tracking
  medical and health volunteers during a disaster
  deployment as individuals or groups in accordance
  with SEMS/NIMS
• System administration at the state and local
  group level
• Powerful notification engine capable of
  calling-up tens of thousands of volunteers

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Mission Support Teams
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Mission Support Teams

• Manage assigned personnel and teams - provide,
  safety, security and oversee health welfare
• Establish a system of re-supply for medical field
  operations resources
• Interface/assist impacted jurisdictions
• Ability to operate in mobile or fixed facilities
  four MST support vehicles

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Constraints

• Private ownership of health care system
• Costs to hire a CAL-MAT for a First Responder
  role one team (40 members) for 24/7 coverage
  170K per day!
• Relative size of EMS Authority vs. emergency
  responsibilities (EOCs, field, volunteer mgmt.)
• Legislative denial of three positions for
  pre-event coordination and liaison during
  response

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Future Directions

• Integrated disaster response system
• 24/7 EMSA/CDPH Medical and Health Coordination
  Center (alert, notification, limited pre-event
  resource identification)
• Development of multiple response profiles for
  mobile medical assets
• Aggressive volunteer marketing recruitment
• Ongoing training and exercises

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Future Directions

• Plans, policies and procedures
• California Disaster Medical Response Plan
  Medical Mutual Aid Annex draft Disaster Medical
  Operations Manual
• Medical Mutual Aid Agreements
• Medical Shelter Toolkit (updates)
• Enhanced information management systems

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Questions? Anne M. Bybee Disaster Medical
Specialist anne.bybee_at_emsa.ca.gov 916-322-4336 x
407