RHODE ISLAND by jizhen1947

VIEWS: 31 PAGES: 142

									                Rhode Island

      Department of HEALTH
  Safe and Healthy Lives in Safe and Healthy Communities




  Emergency Operations Plan


Adopted by Executive Committee & Effective
                                                                                            RI Department of Health
                                                                                          Emergency Operations Plan

                                                                                                            In process

                         Rhode Island Department Of Health
                                    Emergency Operations Plan

                                             Table Of Contents
    I. Mission............................................................................................................ ..4

   II. Purpose .......................................................................................................... ..4

  III. Objectives ....................................................................................................... ..4

 IV. Responsibilities for Preparedness and Response .......................................... ..5

  V. Incident Command Structure .......................................................................... 16

 VI. Response........................................................................................................ 22

VII. Recovery/Evaluation ....................................................................................... 29

VIII. Mitigation ........................................................................................................ 30

 IX. Appendixes ..................................................................................................... 31

                A. Definition of Terms ............................................................................ 31

                B. Related Plans, Laws, Regulations, Authorities...................................44

                C. Incident Command System.................................................................45

                D. Selected ICS Forms............................................................................48

                E. Threat Condition Levels and Response..............................................55

                F. HEALTH Emergency Planning Matrix.................................................62

                G. Job Action Sheets...............................................................................64

                H. Center for Health Data Analysis..........................................................65

                I. Management Services Support - IT/Communications Support...........71

                J. Laboratory Support for HEALTH Emergencies...................................72

                K. Laboratory Support for HEALTH Emergencies Matrix........................76


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                                                                        RI Department of Health
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L. Medical Emergency Distribution System (MEDS)...............................77

M. Disease Outbreak................................................................................79

N. Smallpox Emergency..........................................................................80

O. Severe Acute Respiratory Syndrome (SARS).....................................81

P. Drinking Water Emergency..................................................................82

Q. Food-related Emergency.....................................................................85

R. Beach Water Quality............................................................................87

S. Food Recalls........................................................................................88

T. Radiological Event...............................................................................89

U. Asbestos-related Emergency...............................................................90

V. Chemical Emergency/Unusual Event..................................................91

W. Healthcare/Facility Emergency............................................................93

X. Mass Fatalities.....................................................................................95

Y. HEALTH Continuity of Operations/Continuity of Government.............96




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                                                              RI Department of Health
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I. Mission

       The primary mission of the Rhode Island Department of Health is to
prevent disease and to protect and promote the health and safety of the people
of Rhode Island. The Center for Emergency Preparedness and Response of the
Rhode Island Department of Health is dedicated to creating and promoting a
state of readiness and prompt response to protect the health of Rhode Islanders
during catastrophic events, large-scale disasters and emergencies. We
accomplish our mission by coordinating education, assessment, planning,
response and support services involving public health providers, private medical
providers, public safety agencies and government officials.

II.   Purpose
      A.     Provide an internal emergency response and operations plan for
             the Department of Health (HEALTH).

      B.     Address medical and public health issues that require an
             emergency response by HEALTH whether or not the Governor has
             declared a state of emergency.

      C.     Respond as the lead agency for Emergency Support Function 8
             (ESF 8 – Health and Medical Services) within the State Emergency
             Operations Plan (EOP).
             1. The State EOP and ESF 8 supporting plans are contained in
             state level documents.
             2. The Department of Health EOP provides guidance on internal
             operating systems and procedures to support ESF 8 activities.

      D.     Comply with the National Incident Management System (NIMS)

III. Objectives
      A.     Support State EOP and ESF-8

      B.     Minimize consequences of a public health emergency

      C.     Develop an all hazard approach to emergency preparedness

      D.     Comply with state and federal laws and regulations (see section VI:
             (Related Laws and Regulations)




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                                                            RI Department of Health
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IV. Responsibilities for Preparedness and Response
     A. Overview
          1. As designated by Homeland Security Presidential Directive-5
              (HSPD-5), it is the responsibility of the State to develop an
              approach for federal, state, tribal and local governments to work
              together to prepare for, prevent, respond to and recover from
              domestic incidents, regardless of cause, size or complexity.
           2. HEALTH will utilize NIMS core set of doctrine, principles,
              terminology, and organizational processes to enable effective,
              efficient and collaborative incident management at all levels and
              provide the framework for interoperability and compatibility.
           3. The above will be accomplished through education including
              NIMS training, interagency collaboration, exercises, and quality
              improvement.

     B. Governor
          1. Declare State of Emergency as deemed necessary

     C. Director of HEALTH or designee
           1. Assume overall responsibility of HEALTH’s response
           2. Establish the role of incident commander
           3. Assist with the overall response of the event
     D. Associate Directors
           1. Assume assigned roles within the incident command system

     E. Center for Emergency Preparedness and Response (CEPR)
          1. Develop and approve all hazard emergency preparedness and
              response plan.
           2. Assist with the coordination of resources and surge capacity
              necessary to perform the basic missions assigned to public
              health.
           3. Participate in the planning, design, and conduct exercises.
              Evaluate public health preparedness and response. Participate
              in after-action reviews.
           4. Recommend actions for improvements of plans and
              performance. Take required follow up actions.
           5. Assist HEALTH leadership in decision making regarding the
              initiation of ICS




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      6. Serve as Incident Management Team (IMT).
      7. Establish close working relationships and/or mutual-aid
         agreements with emergency management agencies, emergency
         medical services, healthcare providers, fire, law enforcement,
         and other federal, state, local, and tribal response organizations,
         Local Emergency Preparedness Committees (LEPCs),
         humanitarian/volunteer organizations, private business, and
         academic institutions.
      8. Participate in hazard and risk assessments.
      9. Plan and implement the Medical Emergency Distribution System
         (MEDS) including the Strategic National Stockpile (SNS).
      10. Serve as the RSS Facility Manager for the RI MEDS/SNS
          program.
      11. Coordinate hospitals’ emergency response to public health
          emergencies.
      12. Plan for smallpox hospital, including staffing of the hospital.
      13. Support RIEMA in mass casualty emergencies and other health
          related emergencies.

F. All Division and Centers
       1. Ensure readiness for response
      2. Identify critical functions for emergency response, which the
         division would provide.
      3. Possess a written emergency response plan specific to
         emergency events plan for response
      4. Provide for emergency manning of critical functions with limited
         manpower during 24-hour operations, 7 days a week (24/7).
      5. Identify external resources needed to operate in such
         conditions.
      6. Develop and maintain an alert system with which to call in
         personnel.
      7. Develop and maintain contact lists and points of contact for key
         partners external to the department.
      8. Develop and maintain a list of all personnel who are trained in
         the Incident Command System and will be made available as
         needed to serve in ICS positions during an emergency. The
         goal is to have at least three people available for each role
         within the ICS structure.



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     9. Develop and maintain a skills inventory for personnel. In
        particular identify licensed healthcare professionals and others
        with special expertise.

G.   All divisions that have responsibility for emergency planning or
     response activities

     1.   Coordinate preplanning with those offices and other agencies
          that provide support in an emergency.
     2. Develop and maintain a written plan, standard operating
        procedures and job action sheets for response to a emergency,
        in cooperation with the Emergency Response Planner.
          a) The standardized format will be followed
          b) Include a description of how planning will be coordinated to
             ensure that response plans are integrated and effective.
          c) Describe any specific needs that the office may have.
          d) Describe or outline types of messages that would be
             prepared and disseminated to key partners. Describe how all
             messages must be coordinated with the PIO.
          e) Provide copy of plan to the Emergency Response Planner.
     3. Conduct the following preparedness activities:

          a) Be prepared to provide the appropriate leadership within
             areas of expertise.
          b) Identify adequate numbers of personnel who could be
             assigned various emergency response roles, including those
             of Incident Commander, Operations Section Chief, and
             Planning Section Chief, as appropriate (plan for 24/7
             operations for a two-week period, at minimum).
          c) The senior manager in each office will
             1. Ensure each employee is trained to fulfill the role(s)
                assigned.
             2. Review with all employees the HEALTH EOP and all
                emergency-specific plans that may require their expertise
                and/or support. This includes job action sheets. (see
                page_____)




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3. Identify roles each employee might be expected to fill.
4. Inform each employee of expected roles during
   emergency responses.
5. Assess training needs.
6. Ensure each employee receives appropriate training.
7. Assess training needs for staff and work with the training
   unit in the Office of Management Services to coordinate
   and arrange appropriate training for staff.
8. Ensure an annual review and update of all emergency-
   specific plans, in coordination with the Emergency
   Response Planner, who will follow with a report to the
   CEPR Lead.
9. Design and conduct exercises to test plans, in
   coordination with CEPR and the department training
   officer. Exercises may be of limited scope to test
   selected functions within the office and may extend to
   exercises that involve other offices in HEALTH and
   organizations elsewhere in the state, yet sufficient in
   number and complexity to assess completeness of plans
   and preparedness of staff and the office.
10. Ensure drills of sufficient number and complexity are
   conducted each year to assess completeness of plans
   and preparedness of staff and the office.
11. Develop guidance, formats, and documents to be used
    by the entire department when needed and in
    coordination with CEPR.
12. Assess and compile the resources needed to
    communicate with key audiences in order to manage
    public health information in emergencies.
13. List supplies, equipment, references, and other resources
    needed to operate in an emergency and have them
    available at all times.
14. Ensure appropriate security actions are taken as outlined
    in APPENDIX – Threat Condition Levels and Response.
15. When activated for an emergency/response
   a) Carry out emergency response operations as
      described in the appropriate plans and ICS structure,
      utilizing appropriate forms and documentation.
   b) Review all appropriate emergency operations job
      action sheets and ensure appropriate actions are


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                    taken.

H. Center for Public Health Communications --MARIA doing
      1. Serve as the state agency for providing health information to the
         public and the media.
      2. Execute and coordinate the HEALTH’s Public Information
         Emergency Response Plan.
      3. Train phone response crew on risk communication messages
         and other information.
      4. Coordinate public health information with the State Government
         and other external agencies (JIC).
            a. Organize and manage the Department’s emergency
               communications response including the public health
               hotline, website, information meetings, media relations
               and other communications with the public. These
               positions are within the Logistic Section.
            b. Provide feedback, formal and informal, regarding the
               public’s response to the emergency, via the ICS
               command structure
            c.     Manage the Department’s website, including use in
                 emergencies.

I. Center for Health Information and Technology and Customer Service -
   sent to Lenny 4/20/2006

      1. Rapidly (within two hours) set up and maintain, both within the
         department and at remote locations, the necessary hardware,
         software and devices to be used for communication. This will be
         coordinated with Department of Information Technology (DoIT).
      2. Coordinate pre-event planning with CEPR and other Centers
         and Divisions.
      3. Plan, establish and maintain the hardware, software and
         devices for HEALTH’s emergency communications system.
         The system will be coordinated with the State’s Department of
         Information and Technology (DoIT). The system will be
         comprised of telephones (hardwired and wireless), radios,
         computer systems (with website technology), regular and
         Internet fax, blast fax, wireless technologies, and other
         electronic communication devices




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J.   Office of Management Services (discussed)

       1. Conduct the following preparedness activities:

             a) Plan, implement or coordinate training programs
                designed to provide HEALTH staff and other key public
                health professionals with knowledge, skills and learning
                resources to respond to bio-terrorism and other public
                health threats and emergencies.
             b) Develop plans to have government vehicles assigned to
                HEALTH to be available in emergencies.
             c) For large public health emergencies, develop emergency
                childcare plans for members of the Department, including
                the tracking and communications with family members (in
                the event schools are closed or work must be done on
                nights or weekends). Execute these plans as needed.
             d) Develop and maintain a master call list for all HEALTH
                personnel.

       2. When activated for an emergency:

             a) Assist in activating staff to perform ICS functions while
                allowing for the continuity of operations of the
                Department.
             b) Perform functions within ICS. This is likely to be for
                Logistics and Finance/Administration.
             c) Coordinate with the Department of Administration any
                personnel issues, including, but not limited to, the
                provision of overtime pay and the negotiation of union
                issues.
             d) Organize the logistical and life support needs of the
                department to operate 24/7.
             e) Organize food services as appropriate in accordance with
                purchasing rules and regulations.
             f) Coordinate power, heating and security requirements for
                all facilities the Cannon and Chapin Buildings, working in
                conjunction with the Department of Administration and
                the Capitol Police.
             g) Coordinate sleeping arrangements with RIEMA as
                needed.




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                                                       RI Department of Health
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K.   Center for Health Data and Analysis-Steve and Jay working on

       1. Coordinate pre-event planning with CEPR and other Centers
          and Divisions.
       2. During an event, provide Geographic Information System
          (GIS)/Decision Support Team to augment Planning Section staff
          and support the Operations Section, Coordinate GIS activities
          with other state agencies.
       3. See Appendix _______
L.   Division of Community Health and Equity- sent to ANA

       1. Identify special needs populations and pre-event, assist with
          coordination of plans to address healthcare and communication
          needs.
       2. Provide guidance and expertise during the event. This may
          include roles as Special Population Group Supervisor and
          Special Populations Unit Leader(s) under the Communication
          Branch Director.
       3. Provide technical assistance to state and local emergency
          responders for special issues in dealing with the needs of
          disabled and vulnerable people.
M.   Center for Epidemiology- updated by John F

       1. Conduct ongoing surveillance to detect the potential for disease
          outbreaks as early as possible, and implement control
          measures to prevent disease outbreaks.
       2. Conduct surveillance and epidemiological investigations of
          disease outbreaks.




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                                                      RI Department of Health
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     3. Provide guidance, expertise, and ICS roles for the control of
        disease outbreaks, including guidance and expertise for
        isolation and quarantine issues.
     4. Analyze and report findings to the Epidemiology Branch Director
        in emergency events.
     5. Support Strategic National Stockpile planning and
        implementation by projecting need and demand for MEDS
        clinics (from surveillance information and other data sources),
        and by providing medical history/ risk assessment forms and
        public information materials for MEDS clinics.
     6. Provide medical consultation to healthcare practitioners.
N.   Division of Environmental Health

     1. Office of Drinking Water Quality

        a) Provide expertise and ICS roles for drinking water
            emergencies.

        b) Provide support and/or ICS roles for radiological
           events, food-related emergencies, chemical
           emergencies/unusual events, healthcare facility
           emergencies, and COOP/COG operations.

        c) Provide support, guidance and/or ICS roles for
           disease outbreaks in regulated pools, water parks or
           hot tubs.

        d) Provide support and/or ICS roles for water-borne
           disease outbreaks.

        e) Provide support, guidance, and/or ICS roles for
           severe weather emergencies.

     2. Office of Environmental Health Risk Assessment

        a) Provide guidance, technical expertise, and/or ICS
           roles in chemical contamination emergencies.

        b) Provide support and/or ICS roles for drinking water
           contamination emergencies

        c) Provide support and/or ICS roles for radiation
           emergencies




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      3. Office of Food Protection

          a) Provide expertise and ICS roles for food-related
             emergencies.

          b) Provide expertise and ICS roles for beach water
             quality emergencies.

          c) Provide expertise and ICS roles for seafood
             contamination emergencies.

          d) Provide expertise and ICS roles for food recalls

          e) Provide support and/or ICS roles for drinking water
             contamination emergencies

          f) Provide support and/or ICS roles for radiation
             emergencies

          g) Provide support and/or ICS roles for disease
             outbreak emergencies

      4. Office of Occupational and Radiological Health

          a) Provide expertise and ICS roles for radiation
             emergencies.

          b) Provide expertise and ICS roles for asbestos-related
             emergencies

          c) Provide support and/or ICS roles for chemical
             contamination emergencies

O.   Division of Family Health
      1. Support communications with the public during emergencies
         with the family health hotline.
      2. Provide support for Strategic National Stockpile planning and
         implementation including:
          a) Receipt, storage and distribution of vaccines.
          b) Serve as the Distribution Coordination Unit for the Strategic
             National Stockpile.
          c) Develop requirements in consultation with the epidemiology
             Director and Community POD Group Supervisor
          d) Provide recommendations to Disease Control Director


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              regarding prioritized delivery schedules
          e) Coordinate with RSS Group Supervisor.
       3. Provide guidance and support to the Department of Education
          and the Department of Children, Youth and Families for
          planning for special arrangements for emergencies affecting
          children in schools, childcare facilities and other children’s group
          settings.

       4. Provide technical assistance and guidance regarding special
          needs of children and assist in developing public information
          messages and communications to providers and families.

       5. Assist Management Services in developing emergency
          childcare plans for members of HEALTH.

       6. Provide technical assistance to state and local emergency
          responders for special issues in dealing with the needs of
          disabled and vulnerable people.

P.   Division of Health Services Regulation reviewed by Ray R

              1. Office of Facilities Regulation
                 a) Regulate that healthcare facilities have developed
                    and will exercise appropriate emergency response
                    plans.
                 b) Respond to healthcare facility emergencies as
                    directed by the department/state Incident
                    Commander. This may include the monitoring and
                    reporting of the facilities functions and ability or
                    inability to maintain minimum safety levels
                 c) Provide leadership and/or support to Operations and
                    Planning as requested
              2. Office of Health Professions Regulation ok per Dr.
                 Krausman

                 a) Assist in the development of plans for rapid
                    credentialing of professional in an event.
                 b) Provide leadership and/or support to Operations
                    during an event.
                 c) Assist in the licensing of healthcare personnel during
                    emergencies.
                 d) Provides information about licensure of healthcare



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                    professionals, including contact information.
                 e) Pharmacy Board
                    i.   Support for Strategic National Stockpile planning
                         and implementation.
                    ii. Serve as the Site Coordination Unit.
                    iii. Assist distribution clinics by providing clinic set-up
                         templates, drug dispensing algorithms,
                         contraindications and other dispensing information
                         to distribution clinic sites.
                    iv. Advise MEDS/SNS Unit Leader

Q.   Division of Laboratories - has been updated by EVA

      1. Provide laboratory testing services in support of response to
         public health emergencies, as outlined in appendix
      2. Coordinate with local, state and federal agencies for testing and
         handling protocols for biological and chemical agents.
      3. Providing training for personnel in hospital and private clinical
         laboratories in recognizing and handling biological and chemical
         agents.
R.   Office of the State Medical Examiner - has been updated by B.
     O’Donnell 4/25
      1. Develop, maintain, and execute mass fatalities plan, in support
         of the state mass casualty plan.
      2. Investigate the emergency scene and resultant deaths to
         determine the manner and cause of death, as appropriate.
      3. Assure the orderly removal of the decedents from the scene.
      4. Conduct necessary autopsies and/or inspections of decedents
         to determine the manner and cause of death and to make
         positive identification of decedents.
      5. Collaborate with laboratory regarding specimen samples to
         assist rapid identification of possible bio-terrorism agent and
         other public health threat.
S.   Office of Legal Services sent to Hobson and Madoian 4/25

      1. Provide legal advice on emergency powers and operations.
      2. Review appropriate legal authorities needed for conducting
         emergency operations, exercises and other training activities.
      3. Recommend changes and upgrades to current laws and
         regulations in order to better facilitate emergency response
         actions and training activities.


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          4. Reviews requirements under the Health Insurance Portability
             and Accountability Act (HIPAA) and advises the Director as to
             its impact and application on departmental matters.
          5. Prepare draft orders for emergencies.
    T.   Employees
          1. Know and understand their role in an emergency/event
          2. Perform assigned roles and responsibilities as assigned in the
             HEALTH and/or Office Emergency Response Plan
          3. Maintain possession and wear HEALTH identification. Security
             may require positive identification before entering a state
             building during emergency events.
          4. Complete required National Incident Management System
             (NIMS) training.




V. Incident Command Structure
    A. Overview

           i. HEALTH supports the National Incident Management System
              (NIMS) as an all-hazards approach to incident management.
              The NIMS is based on a balance between flexibility and
              standardization. The incident command structure has been
              adapted to meet the needs of public health, yet continues to
              follow the command and general staff structures. The ICS
              organization is flexible and will contract and shrink according to
              the needs of the incident. Not all positions need to be filled, but
              in general, all functions need to be considered as part of the
              organizational process.
          ii. ICS comes with a number of forms that provide a common
              guide to the information that is useful during an emergency.
              With each incident or event the appropriate forms will be
              completed. See Appendix ____ to ____ for examples

    B. ICS Structure
       The Organizational levels includes

                Organizational Level                        Title


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                 Incident Command                        Incident Commander
                 Command Staff                           Officer
                 General Staff (Section)                 Chief
                 Branch                                  Director
                 Division/Group                          Supervisor
                 Unit                                    Leader
                 Strike Team/Task force                  Leader

    Command Staff

                                    Incident Commander




       Liaison Officer                                              Safety Officer




 Public Information Officer




Operations Section        Planning Section      Logistics Section         Finance /
      Chief                    Chief                  Chief             Administration
                                                                        Section Chief




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Operations
                                                                            Operations
                                                                             Operations
                                                                           Section Chief
                                                                            Section Chief
                                                Epidemiology Branch
                                                      Director                                        Medical Care Branch
                                                                                                           Director

             Patient Tracking Group Supervisor
                                                                                                                                     Hospital Group Supervisor

               Investigation Group Supervisor
                                                                                                                                Nursing Home / ALF Group Supervisor

          Syndromic Surveillance Group Supervisor
                                                                                                                                   Health Center Group Supervisor

                                                Pre-Hospital Branch
                                                                                                                                Alternate Care Site Group Supervisor
                                                     Director

                                                                                                                                     Pharmacy Group Supervisor
              Municipal / 911 Group Supervisor
                                                                                    Mass Fatality Branch
                                                                                         Director                                   Home Care Group Supervisor
            Private Ambulance Group Supervisor


                                                                                                               Mass Fatality Site Group Supervisor
                                                    Disease Control
                                                    Branch Director
                                                                                                               Mortuary Services Group Supervisor

           Isolation/Quarantine Group Supervisor
                                                                                                                 Post Morgue Group Supervisor
               MEDS / SNS Group Supervisor
                                                                                                                Family Assistance Center Liaison
     RSS Unit Leader


Community POD Unit Leader

                                                Environmental Branch
                                                       Director


                       Radiation Group Supervisor                                                      Laboratory Branch
                                                                                                           Director
                         Air Group Supervisor

                                                                                                                                     Biological Group Supervisor
                        Food Group Supervisor

                                                                                                                                     Chemical Group Supervisor
                        Water Group Supervisor

                                                                                                                                     Forensics Group Supervisor




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                     Logistics


                                                                          Logistics
                                                                        Section Chief




                                    Personnel Support Branch Director                   Communications Branch Director


        Labor Pool Group Supervisor                                                                                 Message Development Group Supervisor


    Nutritional Support Group Supervisor                                                        Special Populations Unit Leader                        Writers Unit Leader


   Family / Staff Support Group Supervisor                                                        Design / Layout Unit Leader


    Billeting / Housing Group Supervisor
                                                                                                               Message Production / Distribution Group Supervisor

                                       Tech Support Branch Director
                                                                                                      Website Unit Leader                       Special Populations Unit Leader

       PC Support Group Supervisor
                                                                                                Materials Production Unit Leader           Emergency Information Hotline Unit Leader

Communications Technology Group Supervisor
                                                                                          Emergency Notification Systems Unit Leader

                                    Volunteer Support Branch Director
                                                                                                                    Information Monitoring Group Supervisor

       Registration Group Supervisor
                                                                                                   Media Watch Unit Leader                    Internal Communications Unit Leader

  Credentialing / Badging Group Supervisor
                                                                                                  Rumor Control Unit Leader                     Special Populations Unit Leader




                                             Supply Branch Director                           Transportation Branch Director




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Planning
                                                                                             Planning
                                                                                           Section Chief




                                        Situation / Information Analysis Branch Director                     Documentation Branch Director



             Epidemiology Group Supervisor                                                                                                    Form Preparation Group Supervisor



              Medical Care Group Supervisor                                                                                                  Event Documentation Group Supervisor



              Mass Fatality Group Supervisor                                                                                                                              Scribe

                                                                                                              Technical / Subject Matter Experts
            Disease Control Group Supervisor

                                                                                                                                                           Medical
               Laboratory Group Supervisor

                                                                                                                                                             GIS
              Prehospital Group Supervisor



           Special Populations Group Supervisor



            Environmental Group Supervisor




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Finance/Administration


                                                           Finance/Administration Section Chief



                                   Financial Records Branch Director                    Compliance Branch Director


         Time Group Supervisor                                                                                               Legal Group Supervisor


        Claims Group Supervisor                                                                                           Regulatory Group Supervisor


                                                                                                                           Licensure Group Supervisor
                                      Accounting Branch Director

                                                                                                                     Equipment Certification Group Supervisor
      Purchasing Group Supervisor


    MEDS / Vaccine Group Supervisor


       Supplies Group Supervisor




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VI. Response
    A. Situation and Assumptions
       1. Situation
             a) Emergencies occur which require a focused effort for a
                period of time by one or more divisions or offices within the
                Department.
             b) HEALTH will be the lead for all public health emergencies
                whether the State EOC is operational or not.
             c) Other agencies will look to HEALTH for leadership,
                expertise, and communications in the areas of public health
                information, mobilization and coordination of public health
                and medical resources in the community.
          2. Assumptions
             a) The normal work places of HEALTH, the Cannon and
                Chapin Buildings, remain viable as operating locations, and
                the Department will function primarily from these locations.
             b) If HEALTH’s normal work places are not viable, other
                appropriate work sites will be identified and activated, the
                HEALTH Continuity of Operations/Continuity of Government
                Plan (COOP/COG – appendix) will be activated, and the
                State EOC will be advised of the alternate location.
             c) Extension personnel may work at field sites or at the State
                Emergency Operations Center (EOC) to ensure close
                communication and coordination with the EOC and other
                state agencies.
             d) All personnel and offices in HEALTH may be called upon to
                assist in emergency response by HEALTH.
             e) Some emergencies may require reduction or temporary
                suspension of certain normal HEALTH operations. The
                Director or designee may suspend routine activities as
                deemed necessary to meet the scope of the incident and the
                need to continue certain operations within HEALTH.
    B. Timing
       1. As the lead state agency for the response to all public health
          emergencies, HEALTH must be prepared to address these events
          at any time.
       2. A Public Health Emergency is defined as any event that may pose
          an imminent threat to the public’s health and taxes the Department


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   of Health’s ability to respond. The response will require additional
   resources or diversion of the Department of Health’s staff and/or
   resources, may be a media event, and/or may be outside the
   normal scope of work /outside normal working hours.
3. The HEALTH Emergency Operations Plan (EOP) will be utilized to
   respond to public health emergencies. The response and
   leadership will be structured according to the Incident Command
   System (ICS).
4. The Center for Emergency Preparedness and Response (CEPR)
   on call person will be notified at ________ when there is an incident
   or when there is a question about the need in institute ICS
5. A public health emergency has been identified according to
   established triggers or there is an identified need for training or an
   exercise. CEPR will assist in the decision to active ICS and serve
   as the incident management team to guide the office(s) or
   Department through the ICS process.
6. Divisions within HEALTH that are initial responders to incidents will
   follow approved office specific emergency response plans. These
   plans define possible triggers/criteria for identifying those
   emergencies that require notification of the Director and activation
   of the HEALTH EOP and/or expand the ICS structure.
7. The ICS structure will be contracted or expanded as dictated by the
   needs and scope of the event. This may require staff being
   reassigned from normal duties and/or offices to support the
   emergency response.
8. The Director maintains executive oversight responsibility for all
   activities of the department, regardless of who is serving as
   Incident Commander (See job action sheets attachment______). In
   a large-scale event, the Director or designee confirms the
   appointment of an Incident Commander. The Incident Commander
   will have the authority to address all issues as they relate to the
   incident. There will be periodic consultations with the Director as
   needed.
9. The designated Incident Commander appoints persons to perform
   command and general staff functions within the ICS structure. The
   section chiefs will appoint the staff in their section. Responsibility
   for Incident Command is assigned based in part on the nature and
   scope of the event, and when possible, completed ICS 400
   education. Section chiefs should have a ICS 300, whenever
   possible.
10. HEALTH frequently learns of a public health emergency through
    the office that would lead the response to the emergency (for


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     example, water contamination emergencies are frequently reported
     to the Office of Drinking Water Quality). In this instance, the senior
     HEALTH official from the lead office will initiate any required
     emergency response. As soon as possible, this person will report
     the event to the Associate Director, the Director and CEPR.
  11. If the report to HEALTH of a public health emergency comes
     through the on-call system, the on-call administrator, or on-call
     physician will immediately contact the appropriate office to handle
     any emergent response, i.e., a fire in a nursing home and will also
     contact the Director or designee. CEPR will also be notified if there
     is a question regarding the initiation of ICS and/or to become the
     incident management team. A conference call may be used to
     discuss HEALTH’s response.
  12. HEALTH sets priorities for operations as a situation escalates,
      extends in time and de-escalates. Decision-making will be
      conducted by the Director or designee, consulting with the
      appropriate offices or individuals, and depending upon the situation
      and the scope of HEALTH’s involvement.
  13. As situations escalate and the State activates an emergency
      response, HEALTH must be prepared to coordinate emergency
      response activities within the State EOC/unified command structure
      and meet expectations as the public health and medical authority.
  14. The Director periodically reviews the situation with the Incident
      Commander and others as appropriate. Periodic briefings will be
      held to provide updates, to reassess the situation, to confirm or
      adjust guidance, and to make critical decisions. Reassignments for
      ICS functions and resource allocations are made, as necessary.
C. Procedure
  1. ICS is set up
  2. Director or designee appoints the incident commander (this will
     usually be a Department executive and/or someone with a training
     level of ICS 400).
  3. The incident commander calls a briefing with the command staff
     and selected general staff.
  4. CEPR staff will provide ICS folders with appropriate job action
     sheets and forms. Job action sheets and forms are also available in
     the shared folder in the Group Wise email named ICS Forms and
     on HEALTH’s website.
  5. Job action sheets will be read and appropriate actions and planning
     will followed as per the job action sheets.



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  6. A survey and hotwash will be conducted after each incident. Items
     for improvement will be determined, noting a timetable and
     assigned responsibility for each item for improvement.
D. Resource Management




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        E. Communications and Information Sharing


                        EMERGENCY COMMUNICATIONS SYSTEMS


EQUIPMENT          PURPOSE                CAPABILITY                   USERS                # UNITS
                                                                                           SYSTEM
PSN/Verizon      Routine            Cellular Voice, Email,        All Agencies           UNK
Cellular         Communications     Internet
Telephone        all agencies
                 Emergency
                 Communications
                 all agencies
                 State Police and
                 Local Police
                 Laptop Interface
Nextel           Routine            Cellular Voice, Push-to-      All Agencies,          Health 116
Administrative   Communications     Talk (PTT) Direct Connect,
                 all agencies       Group Call, Email, Internet                          EMA 59
                 Some                                                                    DEM 62
                 Emergency                                                               DOT 187
                 Communications

Nextel           Hospital           Push-to-Talk (PTT) Direct     All Hospitals          Hosp/MCI 50
Interagency      Communications     Connect, Group Call           Navy Ambulatory        units currently.
Hospital         System                                           Care Center            Expanding to
Communicatio     º Daily                                          Veterans Medical       one unit in each
ns System           Hospital                                      Center                 of the 39
                    Diversion                                     Narragansett           communities
                    Roll-Call                                     Indian Clinic
                 º Mass                                           Regional dispatch
                    Casualty                                      Centers
                    Coordination                                  Providence Fire
                                                                  Alarm
                                                                  HEALTH
                                                                  RIEMA
                                                                  State Airport
800MHZ           Emergency          Radio Voice, Individual &     State Agencies &       90
Trunked Radio    Communications     Group Call                    24Hr Public Safety
(RITERN)         ALERT &                                          Dispatch
                 WARNING
Civil Defense    Emergency          Radio Voice only              Local, State,          61
State Radio      Communications                                   Federal, Utility and
System           Pre & Post-                                      Volunteer
(CDSTARS)        Event                                            Agencies,
VHF                                                               Community
                                                                  Emergency
                                                                  Operations
                                                                  Centers (EOC’s)



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Hospital           Scene/Rescue        Radio Voice & All Call with   Hospitals              22 initially
Emergency          to Hospital         Alert Tone Notification       Navy Clinic
Administrative     Hospital to                                       Veterans Hospital
Radio (HEAR)       Hospital                                          HEALTH
VHF 155.340        Hospital to State                                 Regional Dispatch
& 155.280          Health & EMA                                      Centers
                                                                     Providence Fire
                                                                     EMA
Emergency          President to all    Tone Alert Voice & Text       State Police, EMA,     All radios, TV,
Alert System       media outlets       Warning                       All Media Outlets,     Cable Systems,
(EAS)              America’s                                         All Citizens           Highway Signs
Formally           Missing
Emergency          Broadcast
Broadcast          Emergency
System (EBS)       Response
                   AMBER Alert
                   National
                   Weather Service
                   to Media Outlets
Department         Unit to dispatch    Radio Voice                   Fire, Police, EMS      Unk
Specific           Unit to Unit        Tone Alert
VHF/UHF
Radios
Intercity Fire     Unit to Dispatch    Radio Voice                   Fire, EMS              Unk
                   (Cross Agency)
                   Unit to Unit
                   (Cross Agency)
Intercity Police   Unit to Dispatch    Radio Voice                   Police                 Unk
                   Unit to Unit
FEMA               FEMA Regions        HF-SSB Radio Voice            FEMA Regions           EMA 1
National Radio     to states                                         All States
System             State to State
(FNARS)
Satellite          Routine and         Cellular Voice                EMA                    EMA 3
Telephones         Emergency
                   Communications
                   all agencies
National           National,           Telephone style voice         State police, EMA,
Warning            Regional and                                      Newport, Westerly
System             State dedicated                                   and Woonsocket
NAWAS              warning system
                   National
                   Warning site
                   (NORAD) to all
                   State Warning
                   Points
RI Law             State Warning       Secure message system         State Police, EMA
Enforcement        System (SWS)                                      and all local police
Telecommunic                                                         departments
ations System
(RILETS) /
State Warning
System (SWS)



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Government   Provide priority    Dialup Voice and Data   NS/EP authorized    EMA 50 cards
Emergency    access to the                               personnel
Telephone    Public Switched
System       Network (PSN)
(GETS)       for National
             Security/Emerge
             ncy
             Preparedness
             (NS/EP)
             personnel
Satellite    Communications      Voice & Data            EMA & HEALTH        3 Units
Telephone    via secure
             satellite network
             independent of
             Public Switch
             Network (PSN)
             during unit to
             unit
             communications
             within same
             satellite service
             provider.




                                           28
     F. Safety

VII. Recovery/Evaluation
     A. Deactivation of the Department Operations Center
           1. Effective response measures leads de-escalation rather than
               abrupt termination of activities
           2. De-activate sections as activities and needs decrease and could
               be absorbed effectively by a supervisor, director, or chief. For
               example, as the prevalence of an outbreak stabilizes, begins to
               decrease, and/or shows no signs of re-emerging, roll back
               levels of activation
           3. Re-activate addition sections if circumstances change or
               escalate.
     B. Event Recovery
           1. Consider maintaining an ICS format to assure that all aspects of
               recovery are accounted for. The goal will be to return to
               normalcy as quickly and efficiently as possible.
           2. Assess damage and necessary immediate life support
               measures and address these issues immediately
           3. The Disaster Recovery and Clean Up Phase also covers those
              services dedicated to sanitation, food supply, environmental
              monitoring and other disease and health controls that may be
              needed. See individual emergency operation plans for specific
              offices
           4. Debriefing is discussed below in Evaluation.
           5. Consider need for staff Critical Incident Debriefing and arrange
               as needed.
           6. Determine long-term recovery planning which will identify
              strategic priorities for restoration, improvement, and growth.
     C. Evaluation
           1. Evaluation of Health’s performance as an all-hazard
               preparedness and response activities is important.
           2. Following events, incidents and exercises a critique/hotwash
               will be held to evaluate performance and identify opportunities
               for improvement.
           3. An after action report (AAR) will be completed and will include
               measurable improvements and assigned responsibilities.
           4. Areas of improvement will be retested/evaluated at future
               events/exercises to ensure continuous quality improvement.
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VIII. Mitigation
     A. Mitigation is any sustained action taken to reduce or eliminate long-term
        risk to people, property and the environment from the effects of both
        natural and man-made hazards.

     B. An efficiently managed hazard mitigation program can be a powerful
        resource in the combined efforts of the City, State, and Federal
        governments to end the cycle of repetitive disaster damage.

     C. Through thorough planning and coordination, HEALTH will work with
        healthcare agencies, private, public, tribal, and state agencies, groups,
        and individuals to minimize healthcare issues from disasters.

     D. HEALTH will also provide technical advice, identifies mitigation
        opportunities, form partnerships, and educate the public on hazards that
        may affect them.




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IX. Appendixes
                                 Appendix A
                              Definition of Terms
     Agency: A division of government with a specific function offering a
      particular kind of assistance. In ICS, agencies are defined either as
      jurisdictional (having statutory responsibility for incident management) or
      as assisting or cooperating (providing resources or other assistance).

     Area Command (Unified Area Command): An organization established
      (1) to oversee the management of multiple incidents that are each being
      handled by an ICS organization or (2) to oversee the management of large
      or multiple incidents to which several Incident Management Teams have
      been assigned. Area Command has the responsibility to set overall
      strategy and priorities, allocate critical resources according to priorities,
      ensure that incidents are properly managed, and ensure that objectives
      are met and strategies followed. Area Command becomes Unified Area
      Command when incidents are multi-jurisdictional. Area Command may be
      established at an emergency operations center facility or at some location
      other than an incident command post.

     Assistant: Title for subordinates of principal Command Staff positions.
      The title indicates a level of technical capability, qualifications, and
      responsibility subordinate to the primary positions. Assistants may also be
      assigned to unit leaders.

     Assisting Agency: An agency or organization providing personnel,
      services, or other resources to the agency with direct responsibility for
      incident management. See also Supporting Agency.

     Branch: The organizational level having functional or geographical
      responsibility for major aspects of incident operations. A branch is
      organizationally situated between the section and the division or group in
      the Operations Section, and between the section and units in the Logistics
      Section. Branches are identified by the use of Roman numerals or by
      functional area.

     Chain of Command: A series of command, control, executive, or
      management positions in hierarchical order of authority.

     Check-In: The process through which resources first report to an incident.
      Check-in locations include the incident command post, Resources Unit,
      incident base, camps, staging areas, or directly on the site.




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   Chief: The ICS title for individuals responsible for management of
    functional sections: Operations, Planning, Logistics,
    Finance/Administration, and Intelligence (if established as a separate
    section).

   Command Staff: In an incident management organization, the Command
    Staff consists of the Incident Command and the special staff positions of
    Public Information Officer, Safety Officer, Liaison Officer, and other
    positions as required, who report directly to the Incident Commander.
    They may have an assistant or assistants, as needed.

   Cooperating Agency: An agency supplying assistance other than direct
    operational or support functions or resources to the incident management
    effort.

   Deputy: A fully qualified individual who, in the absence of a superior, can
    be delegated the authority to manage a functional operation or perform a
    specific task. In some cases, a deputy can act as relief for a superior and,
    therefore, must be fully qualified in the position. Deputies can be assigned
    to the Incident Commander, General Staff, and Branch Directors.

   Dispatch: The ordered movement of a resource or resources to an
    assigned operational mission or an administrative move from one location
    to another.

   Division: The partition of an incident into geographical areas of operation.
    Divisions are established when the number of resources exceeds the
    manageable span of control of the Operations Chief. A division is located
    within the ICS organization between the branch and resources in the
    Operations Section.

   Emergency: Absent a Presidential declared emergency, any incident(s),
    human-caused or natural, that requires responsive action to protect life or
    property. Under the Robert T. Stafford Disaster Relief and Emergency
    Assistance Act, an emergency means any occasion or instance for which,
    in the determination of the President, Federal assistance is needed to
    supplement State and local efforts and capabilities to save lives and to
    protect property and public health and safety, or to lessen or avert the
    threat of a catastrophe in any part of the United States. (see public
    emergency)

   Emergency Operations Centers (EOCs): The physical location at which
    the coordination of information and resources to support domestic incident
    management activities normally takes place. An EOC may be a temporary
    facility or may be located in a more central or permanently established
    facility, perhaps at a higher level of organization within a jurisdiction.


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    EOCs may be organized by major functional disciplines (e.g., fire, law
    enforcement, and medical services), by jurisdiction (e.g., Federal, State,
    regional, county, city, tribal), or some combination thereof.

   Emergency Operations Plan (EOP): The ―steady-state‖ plan maintained
    by various jurisdictional levels for responding to a wide variety of potential
    hazards.

   Emergency Public Information: Information that is disseminated
    primarily in anticipation of an emergency or during an emergency. In
    addition to providing situational information to the public, it also frequently
    provides directive actions required to be taken by the general public.

   Emergency Response Provider: Includes Federal, State, local, and tribal
    emergency public safety, law enforcement, emergency response,
    emergency medical (including hospital emergency facilities), and related
    personnel, agencies, and authorities. See Section 2 (6), Homeland
    Security Act of 2002, Pub. L. 107-296, 116 Stat. 2135 (2002). Also known
    as Emergency Responder.

   Evacuation: Organized, phased, and supervised withdrawal, dispersal, or
    removal of civilians from dangerous or potentially dangerous areas, and
    their reception and care in safe areas.

   Event: A planned, non-emergency activity. ICS can be used as the
    management system for a wide range of events, e.g., parades, concerts,
    or sporting events.

   Federal: Of or pertaining to the Federal Government of the United States
    of America.

   Function: Function refers to the five major activities in ICS: Command,
    Operations, Planning, Logistics, and Finance/Administration. The term
    function is also used when describing the activity involved, e.g., the
    planning function. A sixth function, Intelligence, may be established, if
    required, to meet incident management needs.

   General Staff: A group of incident management personnel organized
    according to function and reporting to the Incident Commander. The
    General Staff normally consists of the Operations Section Chief, Planning
    Section Chief, Logistics Section Chief, and Finance/Administration Section
    Chief.

   Group: Established to divide the incident management structure into
    functional areas of operation. Groups are composed of resources
    assembled to perform a special function not necessarily within a single



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    geographic division. Groups, when activated, are located between
    branches and resources in the Operations Section.

   Hazard: Something that is potentially dangerous or harmful, often the root
    cause of an unwanted outcome.

   Incident: An occurrence or event, natural or human-caused, that requires
    an emergency response to protect life or property. Incidents can, for
    example, include major disasters, emergencies, terrorist attacks, terrorist
    threats, wildland and urban fires, floods, hazardous materials spills,
    nuclear accidents, aircraft accidents, earthquakes, hurricanes, tornadoes,
    tropical storms, war-related disasters, public health and medical
    emergencies, and other occurrences requiring an emergency response.

   Incident Action Plan: An oral or written plan containing general
    objectives reflecting the overall strategy for managing an incident. It may
    include the identification of operational resources and assignments. It may
    also include attachments that provide direction and important information
    for management of the incident during one or more operational periods.

   Incident Commander (IC): The individual responsible for all incident
    activities, including the development of strategies and tactics and the
    ordering and the release of resources. The IC has overall authority and
    responsibility for conducting incident operations and is responsible for the
    management of all incident operations at the incident site.

   Incident Command Post (ICP): The field location at which the primary
    tactical-level, on-scene incident command functions are performed. The
    ICP may be collocated with the incident base or other incident facilities
    and is normally identified by a green rotating or flashing light.

   Incident Command System (ICS): a management system used to
    organize emergency response and designed to offer a scalable response
    to incidents of any magnitude. The system is designed to grow and shrink
    along with the incident, allowing more resources to be smoothly added
    into the system when required, and also the smooth release of resources
    when no longer needed.

   Incident Management Team (IMT): The IC and appropriate Command
    and General Staff personnel assigned to an incident.

   Incident Objectives: Statements of guidance and direction necessary for
    selecting appropriate strategy(s) and the tactical direction of resources.
    Incident objectives are based on realistic expectations of what can be
    accomplished have been effectively deployed. Incident objectives must be




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    achievable and measurable, yet flexible enough to allow strategic and
    tactical alternatives.

   Initial Action: The actions taken by those responders first to arrive at an
    incident site.

   Initial Response: Resources initially committed to an incident.

   Intelligence Officer: The intelligence officer is responsible for managing
    internal information, intelligence, and operational security requirements
    supporting incident management activities. These may include information
    security and operational security activities, as well as the complex task of
    ensuring that sensitive information of all types
    (e.g., classified information, law enforcement sensitive information,
    proprietary information, or export-controlled information) is handled in a
    way that not only safeguards the information, but also ensures that it gets
    to those who need access to it to perform their missions effectively and
    safely.


   Incident Command System (ICS): a management system used to
    organize emergency response and designed to offer a scalable response
    to incidents of any magnitude. The system is designed to grow and shrink
    along with the incident, allowing more resources to be smoothly added
    into the system when required, and also the smooth release of resources
    when no longer needed.

   Incident Management Team (IMT): The IC and appropriate Command
    and General Staff personnel assigned to an incident.

   Initial Response: Resources initially committed to an incident.

   Joint Information Center (JIC): A facility established to coordinate all
    incident-related public information activities. It is the central point of
    contact for all news media at the scene of the incident. Public information
    officials from all participating agencies should collocate at the JIC.

   Joint Information System (JIS): Integrates incident information and
    public affairs into a cohesive organization designed to provide consistent,
    coordinated, timely information during crisis or incident operations. The
    mission of the JIS is to provide a structure and system for developing and
    delivering coordinated interagency messages; developing, recommending,
    and executing public information plans and strategies on behalf of the IC;
    advising the IC concerning public affairs issues that could affect a
    response effort; and controlling rumors and inaccurate information that
    could undermine public confidence in the emergency response effort.


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   Jurisdiction: A range or sphere of authority. Public agencies have
    jurisdiction at an incident related to their legal responsibilities and
    authority. Jurisdictional authority at an incident can be political or
    geographical (e.g., city, county, tribal, State, or Federal boundary lines) or
    functional (e.g., law enforcement, public health).

   Liaison: A form of communication for establishing and maintaining mutual
    understanding and cooperation.

   Local Government: A county, municipality, city, town, township, local
    public authority, school district, special district, intrastate district, council of
    governments (regardless of whether the council of governments is
    incorporated as a nonprofit corporation under State law), regional or
    interstate government entity, or agency or instrumentality of a local
    government; an Indian tribe or authorized tribal organization, or in Alaska
    a Native village or Alaska Regional Native Corporation; a rural community,
    unincorporated town or village, or other public entity. See Section 2 (10),
    Homeland Security Act of 2002, Pub. L. 107-296, 116 Stat. 2135 (2002).

   Logistics: Providing resources and other services to support incident
    management. Logistics Section: The section responsible for providing
    facilities, services, and material support for the incident.

   Major Disaster: As defined under the Robert T. Stafford Disaster Relief
    and Emergency Assistance Act (42 U.S.C. 5122), a major disaster is any
    natural catastrophe (including any hurricane, tornado, storm, high water,
    wind-driven water, tidal wave, tsunami, earthquake, volcanic eruption,
    landslide, mudslide, snowstorm, or drought), or, regardless of cause, any
    fire, flood, or explosion, in any part of the United States, which in the
    determination of the President causes damage of sufficient severity and
    magnitude to warrant major disaster assistance under this Act to
    supplement the efforts and available resources of States, tribes, local
    governments, and disaster relief organizations in alleviating the damage,
    loss, hardship, or suffering caused thereby.

   Management by Objective: A management approach that involves a
    four-step process for achieving the incident goal. The Management by
    Objectives approach includes the following: establishing overarching
    objectives; developing and issuing assignments, plans, procedures, and
    protocols; establishing specific, measurable objectives for various incident
    management functional activities and directing efforts to fulfill them, in
    support of defined strategic objectives; and documenting results to
    measure performance and facilitate corrective action.

   Multi-agency Coordination Entity: A multi-agency coordination entity
    functions within a broader multi-agency coordination system. It may


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    establish the priorities among incidents and associated resource
    allocations, de-conflict agency policies, and provide strategic guidance
    and direction to support incident management activities.

   Multi-agency Coordination Systems: Multi-agency coordination systems
    provide the architecture to support coordination for incident prioritization,
    critical resource allocation, communications systems integration, and
    information coordination. The components of multi-agency coordination
    systems include facilities, equipment, emergency operation centers
    (EOCs), specific multi-agency coordination entities, personnel,
    procedures, and communications. These systems assist agencies and
    organizations to fully integrate the subsystems of the NIMS.

   Multi-jurisdictional Incident: An incident requiring action from multiple
    agencies that each have jurisdiction to manage certain aspects of an
    incident. In ICS, these incidents will be managed under Unified Command.

   Mitigation: The activities designed to reduce or eliminate risks to persons
    or property or to lessen the actual or potential effects or consequences of
    an incident. Mitigation measures may be implemented prior to, during, or
    after an incident. Mitigation measures are often informed by lessons
    learned from prior incidents. Mitigation involves ongoing actions to reduce
    exposure to, probability of, or potential loss from hazards. Measures may
    include zoning and building codes, floodplain buyouts, and analysis of
    hazard- related data to determine where it is safe to build or locate
    temporary facilities. Mitigation can include efforts to educate governments,
    businesses, and the public on measures they can take to reduce loss and
    injury.

   Mobilization: The process and procedures used by all organizations—
    Federal, State, local, and tribal—for activating, assembling, and
    transporting all resources that have been requested to respond to or
    support an incident.

   Mutual-Aid Agreement: Written agreement between agencies and/or
    jurisdictions that they will assist one another on request, by furnishing
    personnel, equipment, and/or expertise in a specified manner.

   National: Of a nationwide character, including the Federal, State, local,
    and tribal aspects of governance and polity.

   National Disaster Medical System (NDMS): A cooperative, asset-
    sharing partnership between the Department of Health and Human
    Services, the Department of Veterans Affairs, the Department of
    Homeland Security, and the Department of Defense. NDMS provides
    resources for meeting the continuity of care and mental health services


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    requirements of the Emergency Support Function 8 in the Federal
    Response Plan.

   National Incident Management System (NIMS): A system mandated by
    HSPD-5 that provides a consistent nationwide approach for Federal,
    State, local, and tribal governments; the private-sector, and
    nongovernmental organizations to work effectively and efficiently together
    to prepare for, respond to, and recover from domestic incidents,
    regardless of cause, size, or complexity. To provide for interoperability and
    compatibility among federal, State, local, and tribal capabilities, the NIMS
    includes a core set of concepts, principles, and terminology. HSPD-5
    identifies these as the ICS; multi-agency coordination systems; training;
    identification and management of resources (including systems for
    classifying types of resources); qualification and certification; and the
    collection, tracking, and reporting of incident information and incident
    resources.

   National Response Plan (NRP): A plan mandated by HSPD-5 that
    integrates Federal domestic prevention, preparedness, response, and
    recovery plans into one all-discipline, all-hazards plan.

   Nongovernmental Organization: An entity with an association that is
    based on interests of its members, individuals, or institutions and that is
    not created by a government, but may work cooperatively with
    government. Such organizations serve a public purpose, not a private
    benefit. Examples of NGOs include faith-based charity organizations and
    the American Red Cross.

   Operational Period: The time scheduled for executing a given set of
    operation actions, as specified in the Incident Action Plan. Operational
    periods can be of various lengths, although usually not over 24 hours.

   Operations Section: The section responsible for all tactical incident
    operations. In ICS, it normally includes subordinate branches, divisions,
    and/or groups.

   Personnel Accountability: The ability to account for the location and
    welfare of incident personnel. It is accomplished when supervisors ensure
    that ICS principles and processes are functional and that personnel are
    working within established incident management guidelines.

   Planning Meeting: A meeting held as needed prior to and throughout the
    duration of an incident to select specific strategies and tactics for incident
    control operations and for service and support planning. For larger
    incidents, the planning meeting is a major element in the development of
    the Incident Action Plan (IAP).


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   Planning Section: Responsible for the collection, evaluation, and
    dissemination of operational information related to the incident, and for the
    preparation and documentation of the IAP. This section also maintains
    information on the current and forecasted
    situation and on the status of resources assigned to the incident.

   Preparedness: The range of deliberate, critical tasks and activities
    necessary to build, sustain, and improve the operational capability to
    prevent, protect against, respond to, and recover from domestic incidents.
    Preparedness is a continuous process. Preparedness involves efforts at
    all levels of government and between government and private-sector and
    nongovernmental organizations to identify threats, determine
    vulnerabilities, and identify required resources. Within the NIMS,
    preparedness is operationally focused on establishing guidelines,
    protocols, and standards for planning, training and exercises, personnel
    qualification and certification, equipment certification, and publication
    management.

   Preparedness Organizations: The groups and fora that provide
    interagency coordination for domestic incident management activities in a
    non-emergency context. Preparedness organizations can include all
    agencies with a role in incident management, for prevention,
    preparedness, response, or recovery activities. They represent a wide
    variety of committees, planning groups, and other organizations that meet
    and coordinate to ensure the proper level of planning, training, equipping,
    and other preparedness requirements within a jurisdiction or area.

   Prevention: Actions to avoid an incident or to intervene to stop an incident
    from occurring. Prevention involves actions to protect lives and property. It
    involves applying intelligence and other information to a range of activities
    that may include such countermeasures as deterrence operations;
    heightened inspections; improved surveillance and security operations;
    investigations to determine the full nature and source of the threat; public
    health and agricultural surveillance and testing processes; immunizations,
    isolation, or quarantine; and, as appropriate, specific law enforcement
    operations aimed at deterring, preempting, interdicting, or disrupting illegal
    activity and apprehending potential perpetrators and bringing them to
    justice.

   Private Sector: Organizations and entities that are not part of any
    governmental structure. It includes for-profit and not-for-profit
    organizations, formal and informal structures, commerce and industry, and
    private voluntary organizations (PVO). Processes: Systems of operations
    that incorporate standardized procedures, methodologies, and functions
    necessary to provide resources effectively and efficiently. These include
    resource typing, resource ordering and tracking, and coordination.


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   Public Health Emergency: Any event that may pose a possible threat to
    the public’s health and taxes the Department of Health’s ability to respond.
    The response will require additional resources or diversion of the
    Department of Health’s staff and/or resources, may be a media event,
    and/or may be outside the normal scope of work /outside normal working
    hours.

   Public Information Officer: A member of the Command Staff responsible
    for interfacing with the public and media or with other agencies with
    incident-related information requirements.

   Publications Management: The publications management subsystem
    includes materials development, publication control, publication supply,
    and distribution. The development and distribution of NIMS materials is
    managed through this subsystem. Consistent documentation is critical to
    success, because it ensures that all responders are familiar with the
    documentation used in a particular incident regardless of the location or
    the responding agencies involved.

   Qualification and Certification: This subsystem provides recommended
    qualification and certification standards for emergency responder and
    incident management personnel. It also allows the development of
    minimum standards for resources expected to have an interstate
    application. Standards typically include training, currency, experience, and
    physical and medical fitness.

   Reception Area: This refers to a location separate from staging areas,
    where resources report in for processing and out-processing. Reception
    Areas provide accountability, security, situational awareness briefings,
    safety awareness, distribution of IAPs, supplies and equipment, feeding,
    and bed down.

   Recovery: The development, coordination, and execution of service- and
    site-restoration plans; the reconstitution of government operations and
    services; individual, private- sector, nongovernmental, and public-
    assistance programs to provide housing and to promote restoration; long-
    term care and treatment of affected persons; additional measures for
    social, political, environmental, and economic restoration; evaluation of the
    incident to identify lessons learned; post incident reporting; and
    development of initiatives to mitigate the effects of future incidents.

   Recovery Plan: A plan developed by a State, local, or tribal jurisdiction
    with assistance from responding Federal agencies to restore the affected
    area.




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   Resource Management: Efficient incident management requires a
    system for identifying available resources at all jurisdictional levels to
    enable timely and unimpeded access to resources needed to prepare for,
    respond to, or recover from an incident. Resource management under the
    NIMS includes mutual-aid agreements; the use of special Federal, State,
    local, and tribal teams; and resource mobilization protocols.

   Resources: Personnel and major items of equipment, supplies, and
    facilities available or potentially available for assignment to incident
    operations and for which status is maintained. Resources are described
    by kind and type and may be used in operational support or supervisory
    capacities at an incident or at an EOC.

   Resources Unit: Functional unit within the Planning Section responsible
    for recording the status of resources committed to the incident. This unit
    also evaluates resources currently committed to the incident, the effects
    additional responding resources will have on the incident, and anticipated
    resource needs.

   Response: Activities that address the short-term, direct effects of an
    incident. Response includes immediate actions to save lives, protect
    property, and meet basic human needs. Response also includes the
    execution of emergency operations plans and of mitigation activities
    designed to limit the loss of life, personal injury, property damage, and
    other unfavorable outcomes. As indicated by the situation, response
    activities include applying intelligence and other information to lessen the
    effects or consequences of an incident; increased security operations;
    continuing investigations into nature and source of the threat; ongoing
    public health and agricultural surveillance and testing processes;
    immunizations, isolation, or quarantine; and specific law enforcement
    operations aimed at preempting, interdicting, or disrupting illegal activity,
    and apprehending actual perpetrators and bringing them to justice.

   Section: The organizational level having responsibility for a major
    functional area of incident management, e.g., Operations, Planning,
    Logistics, Finance/Administration, and Intelligence (if established). The
    section is organizationally situated between the branch and the Incident
    Command.

   Span of Control: The number of individuals a supervisor is responsible
    for, usually expressed as the ratio of supervisors to individuals. (Under the
    NIMS, an appropriate span of control is between 1:3 and 1:7.)

   Staging Area: Location established where resources can be placed while
    awaiting a tactical assignment. The Operations Section manages Staging
    Areas.


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   State: When capitalized, refers to any State of the United States, the
    District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands,
    Guam, American Samoa, the Commonwealth of the Northern Mariana
    Islands, and any possession of the United States. See Section 2 (14),
    Homeland Security Act of 2002, Pub. L. 107-296, 116
    Stat. 2135 (2002).

   Strategic: Strategic elements of incident management are characterized
    by continuous long-term, high-level planning by organizations headed by
    elected or other senior officials. These elements involve the adoption of
    long-range goals and objectives, the setting of priorities; the establishment
    of budgets and other fiscal decisions, policy development, and the
    application of measures of performance or effectiveness.

   Strike Team: A set number of resources of the same kind and type that
    have an established minimum number of personnel.

   Strategy: The general direction selected to accomplish incident objectives
    set by the IC.

   Supporting Technologies: Any technology that may be used to support
    the NIMS is included in this subsystem. These technologies include
    orthophoto mapping, remote automatic weather stations, infrared
    technology, and communications, among various others.

   Task Force: Any combination of resources assembled to support a
    specific mission or operational need. All resource elements within a Task
    Force must have common communications and a designated leader.

   Technical Assistance: Support provided to State, local, and tribal
    jurisdictions when they have the resources but lack the complete
    knowledge and skills needed to perform a required activity (such as
    mobile-home park design and hazardous material assessments).

   Terrorism: Under the Homeland Security Act of 2002, terrorism is defined
    as activity that involves an act dangerous to human life or potentially
    destructive of critical infrastructure or key resources and is a violation of
    the criminal laws of the United States or of any State or other subdivision
    of the United States in which it occurs and is intended to intimidate or
    coerce the civilian population or influence a government or affect the
    conduct of a government by mass destruction, assassination, or
    kidnapping. See Section 2 (15), Homeland Security Act of 2002, Pub. L.
    107-296, 116 Stat. 2135 (2002).

   Threat: An indication of possible violence, harm, or danger.




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   Tools: Those instruments and capabilities that allow for the professional
    performance of tasks, such as information systems, agreements, doctrine,
    capabilities, and legislative authorities.

   Tribal: Any Indian tribe, band, nation, or other organized group or
    community, including any Alaskan Native Village as defined in or
    established pursuant to the Alaskan Native Claims Settlement Act (85 stat.
    688) [43 U.S.C.A. and 1601 et seq.], that is recognized as eligible for the
    special programs and services provided by the United States to Indians
    because of their status as Indians.

   Type: A classification of resources in the ICS that refers to capability.
    Type 1 is generally considered to be more capable than Types 2, 3, or 4,
    respectively, because of size; power; capacity; or, in the case of incident
    management teams, experience and qualifications.

   Unified Area Command: A Unified Area Command is established when
    incidents under an Area Command are multi-jurisdictional. (See Area
    Command.)

   Unified Command: An application of ICS used when there is more than
    one agency with incident jurisdiction or when incidents cross-political
    jurisdictions. Agencies work together through the designated members of
    the UC, often the senior person from agencies and/or disciplines
    participating in the UC, to establish a common set of objectives and
    strategies and a single IAP.

   Unit: The organizational element having functional responsibility for a
    specific incident planning, logistics, or finance/administration activity.

   Unity of Command: The concept by which each person within an
    organization reports to one and only one designated person. The purpose
    of unity of command is to ensure unity of effort under one responsible
    commander for every objective.

   Volunteer: For purposes of the NIMS, a volunteer is any individual
    accepted to perform services by the lead agency, which has authority to
    accept volunteer services, when the individual performs services without
    promise, expectation, or receipt of compensation for services performed.
    See, e.g., 16 U.S.C. 742f(c) and 29 CFR 553.101.




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                           Appendix B
         Related Plans, Laws, Regulations, Authorities

Rhode Island Municipal Mass Casualty Incident Communications Plan and
Protocol for the Nextel Hospital Communications Network, July 2005.

Rhode Island General Law, 23-8-4, Quarantine, 11/8/2005.

Rhode Island General Law, 23-8-18, Proclamation of General Quarantine,
11/08/2005.

Rhode Island General Law, 30-15-9, Emergency Management,
11/08/2005.

State of Rhode Island Emergency Operations Plan, April 2002.

State of Rhode Island Fatality Management Plan, draft, November 2005.

Incident Command System document NFES 2433. ICS Position
Descriptions and Responsibilities, Oct 1994.
http://www.wildlandfire.net/documents/pds.pdf

Incident Command System guides for Various Job Positions.
http://www.wildlandfire.net/groups.asp?catID=1&catName=Taskbooks

Homeland Security. National Incident Management System, March 1,
2004. Homeland Security Advisory System--Guidance for Federal
Departments and Agencies.
[online]:http://www.dhs.gov/dhspublic/display?theme=29

Wikipedia, The Free Encyclopedia [online]: http://en.wikipedia.org/wiki/
Incident_Command_System

Homeland Security Presidential Directive/Hspd-8, December 17, 2003.
[online]:http://www.whitehouse.gov/news/releases/2003/12/print/20031217
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                                           Appendix C
                                   INCIDENT COMMAND SYSTEM
                                   Review of Job Responsibilities
                                         Job Responsibilities                         Staff level
Incident Commander (IC)                   Responsible for all                Director or Division Director
                                           incident activities                May be delegated to an Office
                                           including development of            Chief
                                           incident objectives,               Is ultimately accountable
                                           strategies, and tactics,
                                           and release of resources
                                          Overall authority and
                                           responsibility
Safety Officer (SO)                       Monitors and assesses              Someone with an
                                           safety hazards or unsafe            understanding of the safety
                                           hazards or situations               issues associated with the
                                          Develops measures for               incident and the authority to
                                           ensuring personnel safety           intervene and/or stop
                                                                               processes that are unsafe
Liaison Officer (LNO)                    Coordinates with                    Knowledge and/or working
                                          representatives from                 relationship with outside
                                          cooperating and assisting            agencies. This could be
                                          agencies                             specific to the incident.
Public Information Officer (PIO)         Interfaces with press to            Training in media relations
                                          deliver messages to the
                                          public
                                         Provides concise and
                                          pertinent (coordinated)
                                          information to the media
Operations Chief                         Manages all incident                Leadership role with
                                          tactical activities and              knowledge/expertise in the
                                          implements the Incident              processes associated with the
                                          Action Plan (IAP)                    implementation of the
                                         Direct involvement in                response to the particular
                                          preparation of IAP for               incident
                                          period of responsibility
Logistics Chief                          Provides resources and              Leadership role
                                          services to support the             Knows the procedures
                                          incident/operations                  necessary to acquire the
                                                                               services/products to
                                                                               accomplish operation’s
                                                                               objectives/IAP
Planning Chief                           Collects, evaluates, and            Leadership role
                                          disseminates operational            Organized individual who is
                                          information as it relates to         able to think ahead about
                                          the incident                         what is needed or may be
                                         In larger incidents,                 needed during all phases of
                                          develops the Incident                an incident
                                          Action Plan (IAP) in the            Able to quickly gather
                                          planning meeting (based              necessary information to
                                          on IC’s incident                     formulate and communicate
                                          objectives)                          an initial plan


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                                                                         Updates plan as incident and
                                                                          information unfold
Finance/Administration Chief           Monitors costs related to        Disasters are expensive and
                                        the incident, provides            we might want to be
                                        accounting, procurement,          reimbursed at some time.
                                        time recording, and cost
                                        analyses.

Unified Command                        Application of ICS when
                                        there is more than one
                                        agency with incident
                                        jurisdiction or when
                                        incidents cross political
                                        jurisdictions
                                        Develop common set of
                                        objectives and strategies
                                        and a single IAP
ICS Structure
                                    Command Staff                       Responsible for public affairs,
                               IC, PIO, Safety Officer, Liaison           health and safety, and liaison
                               Officer                                    activities within the incident
                                                                          command structure.
                                    Sections                            Responsible for a major
                               Operations, planning, logistics,           functional area of incident
                               and Finance/Admin                          management
                                    Branches                            Functional or geographical
                                                                          responsibility for major
                                                                          aspects of the incident
                                                                         Next division below
                                                                          Operations Section or
                                                                          Logistics Section
                                       Divisions                        Geographical area of
                               or                                         operations subunits of
                                       Groups                            Operation Branches
                                                                         Function areas of operations
                                                                          subunits of Operation
                                                                          Branches
                                       Units                            Subunits of planning,
                                                                          logistics, finance
                                                                         Functional responsibility for a
                                                                          specific incident
                                       Strike Team                      A set number of resources of
                                                                          the same type and kind
                                                                         Has an established minimum
                                                                          number of personnel

                                       Task Force                       Any combination of resources
                                                                          assembled to support a
                                                                          specific mission or operational
                                                                          need.
                                       Single Resource                  Individual personnel and/or
                                                                          equipment and the operators



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                                 associated with them
   Technical Specialist        Provides knowledge and skills
       o Legal council           needed to perform a required
       o Medical advisor         activity to a section or
       o Government              jurisdiction that may have
           liaison               resources but lacks
                                 necessary expertise.
                                May be assigned to
                                 Command Staff or any
                                 General Staff Section




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                           Appendix D
                         Selected ICS Forms

Purpose: This annex provides some of the more common forms used
within the incident command system. These forms are also available in
the Disaster/Event Form shared folder in Group Wise, on the HEALTH
web page, and in the ICS folders, currently in the CEPR cabinet on the
second floor.


Form               Use
Number

201-2              Initial Briefing

201-3              Initial Incident Organization

202                Incident Objectives/Response Priorities

205-1              ICS Positions/Phone Numbers

208                Incident Schedule of Meetings

214                Unit Log

223                Health and Safety Message




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                                   Rhode Island Department Of Health
                                     Individual Section Action Plan
                                                                                                   HEALTH EOC Form 17
                                                                                            Individual Section Action Plan
            Responsibility – Section Chiefs, based on goals and objectives of incident commander

Incident:      _________________________                                                 Date:       ___________
Section/Position:    ___________________

 Officer:                                                      For Time Period:
 GOAL(S):                                                      OBJECTIVES/ACTIVITIES for Goal Achievement:
                                                               1


                                                               2.


                                                               3.


                                                               4.


                                                               5.


                                                               6.


 Resources Needed:                                                  Obtained from/time:
 1.

 2.

 3.

 4.

 5.

 6.

 Goal(s) Completed/Status                                           Reported to/time:




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Signature: ______________________________ Position: _______________________ Time: ______________




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                                 Incident Action Plan
                                                                         HEALTH EOC Form
                                                                     Operational Period Matrix
Goals and objectives set by Incident Commander
                                                                               EOC Chart - No
Event Name __ HEALTH Response to ______________________________

Operational Period (Start Date/Time) _____ (Stop Date/Time) _

Operation      Start                 Key Goals/Objectives/Tasks                          Notes
al Period     Date/Tim
                 e
1                               1.                                               1.




2




       Approved By Incident Commander (for written IAPs ) (IC Initials): _________




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1. Incident Name                          2. Meeting Date/Time
                                                                       MEETING SUMMARY

3. Meeting Name
4. Meeting Location
5. Facilitator
6. Attendees
7. Notes (with summary of decisions and action items)




8. Prepared by:                                   Date/Time




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                   RI DEPARTMENT OF HEALTH
                 SECTION PERSONNEL TIME SHEET

Date:_________

Hours: From:____________ To:____________

#      (Please Print)     Title        Signature   Time In   Time      Total
     Employee/Volunteer                                       Out      Hours
           Name
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16


Certifying Officer:_______________
       Date/Time:____________________

      Original=TIME UNIT LEADER (Finance Section) every 12 hours



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               Rhode Island Department Of Health
                        Activity Time Log
                                                                   (ICS Form 214)
                                                                   Activity time log

                     HEALTH RESPONSE TO
Name:                                     ICS Position:

                           Activity Log

 Date   Time                              Activity




                 Prepared by (Name and Position)




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                           Appendix E
             Threat Condition Levels And Response


 I.    Purpose:

       A. Provide information on the Homeland Security Advisory System
          (HSAS), the federal and state threat condition color- coding
          system.

       B. Provide the corresponding recommended responses within
          HEALTH for each threat level.

 II.   HSAS definition:

       A. A tool to combat terrorism. Threat Conditions characterize the
          risk of terrorist attack. Protective Measures are the steps that
          will be taken by government and the private sector to reduce
          vulnerabilities. The HSAS establishes five Threat Conditions
          with associated suggested Protective Measures.

       B. Color-coded Threat Level System is used to communicate
          with public safety officials and the public at-large through a
          threat-based, color-coded system so that protective measures
          can be implemented to reduce the likelihood or impact of an
          attack. Raising the threat condition has economic, physical, and
          psychological effects on the nation; so, the Homeland Security
          Advisory System can place specific geographic regions or
          industry sectors on a higher alert status than other regions or
          industries, based on specific threat information.

III.   General guidance. The critical factor in using this system is
       noticing a change to the status and the reason for that change.
       Upon any change the Department of Health should be notified and
       in turn will:

       A. Conduct an internal assessment of the affects. This may
          require a meeting of critical personnel with the Director and
          Department of Administration and or Capitol Police to determine
          appropriate courses of action.

       B. Notify all personnel in the Department. Reiterate guidance and
          necessary actions




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      C. Notify all partners. This notification should include the reason
         for the change and the recommendations from the Department.

IV.   HSAS Levels:

      A. Low Condition – Green

         1. Federal Guidance. Low risk of terrorist attacks. The
            following Protective Measures may be applied:

            a. Refine and exercise preplanned protective measures

            b. Ensure personnel receive training on HSAS,
               departmental, or agency-specific protective measures

            c. Assess facilities regularly for vulnerabilities and taking
               measures to reduce them.

         2. HEALTH Activities.

            a. Routine preparedness activities. All offices evaluate
               emergency needs and plan accordingly.

            b. Routine building security measures. All personnel wear
               ID badges, doors locked during non-business hours, all
               personnel question and assist personnel without badges.

            c. All offices have prepared recall and notification
               procedures for personnel.

         3. HEALTH Recommendations for External Partners.

            a. Conduct routine preparedness activities.

            b. Maintain normal security levels.

            c. Establish and operate surveillance systems to notice
               abrupt changes that would indicate a disease or other
               event.

      B. Guarded Condition – Blue

         1. Federal Guidance. General risk of terrorist attack.
            Recommended actions:



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      a. Refine and exercise preplanned protective measures

      b. Ensure personnel receive training on HSAS,
         departmental, or agency-specific Protective Measures

      c. Assessing facilities regularly for vulnerabilities and take
         measures to reduce them

      d. Checking communications with designated emergency
         response or command locations
      e. Review and update emergency response procedures
      f. Provide the public with necessary information.

   2. HEALTH Activities.

      a. Routine preparedness activities. All offices evaluate
         emergency needs and plan accordingly.
      b. Routine building security measures. All personnel wear
         ID badges, doors locked during non-business hours, all
         personnel question and assist personnel without badges.
      c. All offices have prepared recall and notification
         procedures for personnel

   3. HEALTH recommendations for external partners.

      a. Conduct routine preparedness activities.
      b. Maintain normal security levels.
      c. Establish and operate surveillance systems to notice
         abrupt changes, which would indicate a disease or other
         event.

C. Elevated Condition – Yellow

   2. Federal Guidance. Significant risk of terrorist attacks.
      Recommended actions:

      a. Refine and exercise preplanned protective measures
      b. Ensure personnel receive train on HSAS, departmental,
         or agency-specific Protective Measures
      c. Assess facilities regularly for vulnerabilities and take
         measures to reduce them
      d. Check communications with designated emergency
         response or command locations
      e. Review and update emergency response procedures
      f. Provide the public with necessary information.


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         g. Increase surveillance of critical locations and
            coordinate emergency plans with nearby jurisdictions
         h. Assessing further refinement of Protective Measures
            within the context of the current threat information
         i. Implement as appropriate, contingency and emergency
            response plans.


      2. HEALTH Activities.

         a. Routine preparedness activities. All offices evaluate
            emergency needs and plan accordingly.
         b. Routine building security measures. All personnel wear
            ID badges, doors locked during non-business hours, all
            personnel question and assist personnel without badges.
         c. Assume all offices have prepared recall and notification
            procedures for personnel.
         d. Increase vigilance of surveillance programs.

      3. HEALTH recommendations for External Partners.

         a. Conduct routine preparedness activities.
         b. Maintain normal security levels.
         c. Establish and operate surveillance systems to notice
            abrupt changes that would indicate a disease or other
            event.
         d. Increase surveillance within health programs.
         e. Increase security level for facilities. Increase numbers of
            security personnel/patrols.
         f. Coordinate with local law enforcement for increased
            patrols.
         g. Increase monitoring of facilities and public assets (food
            and water resources).

D. High Condition – Orange

      1. Federal Guidance. High risk of terrorist attacks.
         Recommended actions:
         a. Refine and exercise preplanned Protective Measures
         b. Ensure personnel receive training on HSAS,
            departmental, or agency-specific Protective Measures
         c. Assess facilities regularly for vulnerabilities and taking
            measures to reduce them
         d. Check communications with designated emergency
            response or command locations


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         e. Review and update emergency response procedures
         f. Provide the public with necessary information.
         g. Increase surveillance of critical locations
         h. Coordinate emergency plans with nearby jurisdictions
         i. Assess further refinement of Protective Measures within
            the context of the current threat information
         j. Implementing, as appropriate, contingency and
            emergency response plans.
         k. Coordinate necessary security efforts with armed forces
            or law enforcement agencies
         l. Prepare to work at an alternate site or with a dispersed
            workforce
         m. Restrict access to essential personnel only.

      2. HEALTH Activities.

         a. Routine preparedness activities. All offices evaluate
            emergency needs and plan accordingly.
         b. Routine building security measures. All personnel wear
            ID badges, doors locked during non-business hours, all
            personnel question and assist personnel without badges.
         c. Activate prepared recall and notification procedures for
            personnel as needed.
         d. Increase vigilance of surveillance programs. Increase
            specific security measures with Capitol Police.
         e. Analyze upcoming events for security/health implications.

      3. HEALTH Recommendations for External Partners.

         a. Conduct routine preparedness activities.
         b. Maintain normal security levels.
         c. Establish and operate surveillance systems to notice
            abrupt changes that would indicate a disease or other
            event.
         d. Increase surveillance within health programs.
         e. Increase security level for facilities. Increase numbers of
            security personnel/patrols.
         f. Coordinate with local law enforcement for increased
            patrols.
         g. Increase monitoring of facilities and public assets (food
            and water resources).

E. Severe Condition – Red




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1. Federal Guidance. Severe risk of terrorist attacks.
   Recommended actions:
   a. Refine and exercise preplanned Protective Measures
   b. Ensure personnel receive training on HSAS,
      departmental, or agency-specific Protective Measures
   c. Assess facilities regularly for vulnerabilities and take
      measures to reduce them
   d. Check communications with designated emergency
      response or command locations
   e. Review and update emergency response procedures
   f. Provide the public with necessary information.
   g. Increase surveillance of critical locations
   h. Coordinate emergency plans with nearby jurisdictions
   i. Assess further refinement of Protective Measures within
      the context of the current threat information
   j. Implement as appropriate, contingency and emergency
      response plans.
   k. Coordinate necessary security efforts with armed forces
      or law enforcement agencies
   l. Take additional precaution at public events
   m. Prepare to work at an alternate site or with a dispersed
      workforce
   n. Restrict access to essential personnel only.
   o. Assign emergency response personnel and pre-
      positioning specially trained teams
   p. Monitor, redirect or constrain transportation systems
   q. Close public and government facilities; and
   r. Increase or redirect personnel to address critical
      emergency needs.

2. HEALTH Activities.

   a. Routine preparedness activities. Control all access to
      HEALTH facilities.
   b. All personnel wear ID badges.
   c. Activate all offices, prepare as needed recall and
      notification procedures for personnel.
   d. Increased vigilance of surveillance programs. Increase
      specific security measures with Capitol Police.
   e. Analyze upcoming events for security/health implications.
   f. Consider limiting the work force.
   g. Consider mobilizing certain parts of the Department for
      emergency operations.

3. HEALTH Recommendations for External Partners.


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a. Conduct routine preparedness activities.
b. Maintain normal security levels.
c. Establish and operate surveillance systems to notice
   abrupt changes that would indicate a disease or other
   event.
d. Increase surveillance within health programs.
e. Increase security level for facilities. Increase numbers of
   security personnel/patrols.
f. Coordinate with local law enforcement for increased
   patrols.
g. Increase monitoring of facilities and public assets (food
   and water resources).
h. Consider redirecting resources and mobilizing
   emergency facilities and plans.




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                                             Appendix F
                    Health Emergency Planning Matrix
Legend: L = Lead Office/Agency                       S = Support
Office/Agency
                                                        Env              Fam
   Planning Req’mt         State    Central Management Health            Hlth     HSR       Labs DP&C ME
                                   Dir Legal Mgt CHIC
                                   Ofc         Svcs
                           L-
State EOP                  RIEMA                            S-Planning             S

                           L-
State Mass Casualty        RIEMA                            S-Planning             S                     S


HEALTH Personnel Recall
Plan                               S     S     L        S       S         S        S         S    S      S



HEALTH EOP Maint.                  S     S    S         S   L-Planning    S        S         S    S      S

Annex F – Public Affairs
Support                             L


Annex G – GIS/Decision
Support                                            L-Hlth
                                                   Stats

Annex H – Management
Services Support                               L


Annex I – Lab Support                                                                        L


                                                                         S – S – Pharm,           S–
Annex K - RI MEDS                        S    S             L-Planning Vaccine Hlth Prof         Comm
                                                                                 Reg              Dis

Annex L – Disease                                                                                L-Com
Outbreak                                 S                   S-Food                          S     Dis


                                                                                                 L-Com
Annex M – Smallpox                                                              S-Hosp BT          Dis


                                                                                                 L-Com
Annex N – SARS                                                                                     Dis


                                                            L-DWQ, S-
Annex O – Drinking Water                                      EHRA,
                                                               Food
Annex P – Food-related                                       L-Food

Annex Q - Beach Water
Quality                                                      L-Food




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Annex R – Food Recalls                                                                       L-Food
                                                    


                                                                      Env                                Fam
   Planning Req’mt                   State        Central Management Health                              Hlth     HSR         Labs DP&C ME
                                                 Dir Legal Mgt CHIC
                                                 Ofc         Svcs

                                                                                             L- Occ
Annex S – Radiologic                                                                         Hlth, S-
Event                                                                                         Food,
                                                                                             EHRA
Annex T – Asbestos-
related                                                                                     L-Occ Hlth

Annex U – Chemical                                                                           L-EHRA,
Event                                                                                       S-Occ Hlth

Annex V – HC Facility
Emerg                                                                                                           L-Fac Reg

Annex W – Mass Fatalities                                                                                                               L

Annex X- HEALTH
COOP/COG                                           S          S           S             S   L-Planning    S         S          S    S   S

                                                                                 L-Com
Hlth Info to Public                                                               Affair

Emerg Affecting Children                                                                                  L

Coord Multi-Institution
Resp.                                                                                                           L-Fac Reg

Coord Hospital Response
                                                                                                                L-Hosp BT
Emerg Licensing HC                                                                                              L-Hlth Prof
Personnel                                                                                                          Reg

ICS Finance & Admin                                                       L

                                                                     L-Pers &
ICS Logistics                                                          Trng




* Lead Office = Office most likely to be assigned to roles in operations and planning




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                                   Appendix G
                              Job Action Sheets


G-1   Director

G-2   ICS Incident Commander

G-3   All Offices/Sections

G-4   ICS Operations Section Chief

G-5   ICS Planning Section Chief

G-6   ICS Finance/Administration Section Chief ICS

G-7   ICS Logistics Section Chief

G-8   State EOC Liaison

G-9   ICS Safety Officer

G-10 Information Officer

G-11 Legal Advisor

G-12 Legislative Liaison Officer




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                                  Appendix H
                     Center for Health Data and Analysis
                    Geographic Information Systems - GIS

Decision support employing Geographic Information Systems (GIS) will be
coordinated by the HEALTH GIS program located within the Office of Health
Statistics. The GIS program will provide decision support in surveillance,
operations, and communications during emergency response, including the
creation and dissemination of spatial information between various local, state,
federal agencies, and to the media and public.

The GIS will assist the HEALTH enterprise in the preparedness and
responsiveness throughout any emergency situation on a 24/7 basis; which
includes, a fail-safe mobile PC laptop loaded with Environmental System
Research Institute’s (ESRI) Arc/INFO ArcGIS 8.x software. Also, the HEALTH
GIS laptop will be in full compliance with the RIEMA Command Center for
interoperability of network and communications, the HEALTH GIS data catalog
for spatial data processing while working in conjunction with the Consequences
Assessment Tool Set (CATS) and the Hazard Prediction and Assessment
Capability v3.2 (HPAC) provided.

Although planning for every conceivable emergency scenario is not possible, the
role of GIS in emergencies can be exhibited prior to the actual event, during the
event, and in a post-event environment. This response system will be able to
serve the various programs and offices within HEALTH for the decision support
objective regardless of the event phase.

Specific Emergency Guidance Summaries:
MEDS/SNS:

   1. GIS will provide the spatially related database support for the MEDS
      Program Coordinator for operations and planning. This can be achieved
      statewide as a function displaying the various municipal and hospital
      distribution sites and surrounding regional information like road networks,
      infrastructures, or other state and local facilities.

   2. Allow for on-the-fly decision support for the logistical and contact
      information related to the flow of medical push packages and/or the from
      the federal agency to the general populace of the state.

   3. Assist in HEALTH Communications to the media/public throughout the
      outbreak investigation of the disease by the means of mapping and/or
      similar related output.



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Disease Outbreak, Smallpox, SARS

   1. Support the Office of Communicable Disease with the geographic
      surveillance and epidemiological evaluations for SARS, Smallpox, and all
      other investigations as needed.

   2. Allow for on-the-fly decision support for the logistical and contact
      information related to statewide healthcare facilities and healthcare provider
      licensures.

   3. Assist in HEALTH Communications to the media/public throughout the
      outbreak investigation of the disease by the means of mapping and/or
      similar related output.

Drinking Water

   1. Support the Office of Drinking Water Quality with the geographic
      surveillance and water quality evaluations for the various drinking water
      basin regions and supplier locations including the bordering states of MA
      and CT.

   2. Assist in HEALTH Communications to the media/public throughout the
      event by the means of mapping and/or similar related output.

Food-related, Beach Water Quality, Food Recall

   1. Support the Office of Food Protection with the geographic surveillance of
      the food product, food quality, food establishments, and water quality
      evaluations for the various licensed bathing beaches in the various regions
      throughout the state. Assists in HEALTH Communications to the
      media/public throughout the event by the means of mapping and/or similar
      related output.

Radiologic, Asbestos-related

   1. Support the Office of Occupational & Radiological Health with the
      geographic surveillance and radiological and Asbestos environmental
      quality evaluations.

   2. Utilize the Ingestions Pathways Exercise as a guide and implements the
      GIS document containing the multiple state’s information and the regional
      Nuclear Reactor locations and evacuation radii grids.

   3. Assist in HEALTH Communications to the media/public throughout the
      event by the means of mapping and/or similar related output.


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Chemical

   1. Supports the Office of Health Risk Assessment with the geographic
      surveillance and quality evaluations for the various hazardous regions
      during a chemical emergency or unusual event.

   2. Assist in HEALTH Communications to the media/public throughout the
      event by the means of mapping and/or similar related output.

Healthcare Facility

   1. Support the Office of Facilities Regulation with the geographic surveillance
      and the health care facility and assisted living residence evaluations on a
      statewide basis.

   2. Assist in HEALTH Communications to the media/public throughout the
      event by the means of mapping and/or similar related output.

Mass Fatalities

   1. Support the Office of Medical Examiner with geographic surveillance, the
      quality of HEALTH operations, and the evaluations for the various regions
      affected by the mass fatalities and casualties.

   2. Assist in HEALTH Communications to the media/public throughout the
      event by the means of mapping and/or similar related output.




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       Center for Health Information and Communication (CHIC)
                             Office of Health Statistics

                 Decision Support for Health Emergencies
              Rapid Reporting / Syndromic Surveillance System

Development of the rapid reporting / syndromic surveillance system (RRSSS) is a
collaborative effort between the Office of Health Statistics and HRSA bio-terrorism
grant staff. The primary function of the RRSSS will be to provide essentially real-
time surveillance of hospital emergency department (ED) utilization for the purpose
of bio-terrorism and disease outbreak surveillance. Activities include statistical
analysis of data using automated algorithms, automated reports, and immediate
notification of key personnel if an alert is triggered. In the event of an emergency,
the rapid reporting system will continue to be a real-time data source of patient
demographics, syndromic data, and patient tracking information that will support
emergency planning and operations.

When established, the RRSSS will collect surveillance data from ED patient logs
and pass the data through established statistical filters for evidence of possible
bio-terrorist activity or other health emergencies. The collected data will also be
available for other needs during a HEALTH response to a bio-terrorism event or
other health emergency. The system for real-time data collection and statistical
filtering is to be developed under contract to an external vendor. Prior to issuing
an RFP for system implementation, the specifications of the system will first be
established under a design contract with the Public Health Informatics Institute
(proposed). The RRSSS is in the early stages of development and currently not
available for decision support to the HEALTH response effort.

Specific Emergency Guidance Annexes:

Annex L       -Disease Outbreak
Annex M       -Smallpox Emergency
Annex N       -Severe Acute Respiratory Syndrome (SARS)
Annex O       -Drinking Water Emergency
Annex P       -Food-related Emergency
Annex S       -Radiological Event
Annex T       -Asbestos-related Emergency
Annex U       -Chemical Event

In the event of an emergency in an Annex listed above, the proposed rapid
reporting/syndromic surveillance system will have the capacity to:




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Provide demographic information of patients presenting to emergency
departments in Rhode Island in near real-time to assist in identifying the location
of an event/threat and/or affected subpopulations.

Provide clinical data, including chief complaint, of patients presenting to
emergency departments in Rhode Island in near real-time to assist in the
identification of event/threat.

Provide emergency department census data in real-time to identify specific
emergency department capacity and for the purpose of patient tracking.




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            Center for Health Information and Communication (CHIC)
                                  Office of Health Statistics

                      Decision Support for Health Emergencies
                         Emergency Response Informatics

This newly proposed activity will design and establish a system of emergency informatics to be
put into place as part of HEALTH’s standard response to a bio-terrorism (BT) event(s) or other
emergency. The system will be operated under the Decision Support effort led by the Office of
Health Statistics, in coordination with the HEALTH Informatics Program in CHIC, and will support
surveillance, operations, and communications activities during an emergency, as well as have
utility for ongoing critical Departmental functions. When operational, the emergency informatics
response will comprise the appropriate computer hardware, software, communications/display
peripherals, data files, generically defined data bases, and an epidemiologist/data analyst staffing
plan to be integrated into the support functions of the HEALTH Emergency Operations Plan
(EOP). A smaller-scale, more focused model for this function is the emergency response system
developed to support Geographic Information Systems needs following a bio-terrorist attack or
other emergency. A critical partner to CHIC in this activity is the Office of Information Systems
(OIS), which is preparing to support the HEALTH EOP with computer hardware and software and
will incorporate the needs identified by this function in their decision-making.

Emergency Response Informatics will be a universal support function for all health emergencies
and relates to all Specific Emergency Guidance Annexes.

This activity is currently under development. HEALTH has identified a proposed
consultant/contractor organization, the Public Health Informatics Institute, to perform a needs
assessment and preparedness plan for emergency informatics. This activity will be the first task
within a broader set of contract deliverables and will be guided by an oversight committee
including staff from CHIC, OIS, and BT, and epidemiologic and analytic staff in HEALTH
programs. The resulting plan will address the following issues at a minimum:

        The hardware and software to be ready for deployment
        Support for connectivity and communications needs
        Critical IS applications required for business continuity
        Disaster recovery
        Staff support for emergency informatics
        Existing HEALTH data files to be readily available
        Support for visual display, printed reports, etc.
        Staff training associated with preparedness

In the course of development, the emergency informatics activity will be incorporated into future
tabletops and staged exercises and will be revised per review and feedback from these events.




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                                           Appendix I
          Management Services Support – IT/Communications Support

Emergency-specific annexes describe in summary fashion for each types of
public health emergency how HEALTH responds, including who the lead office is,
the causal event, the role and actions taken by the lead office, which offices
provide support and actions taken by support office(s).

Lead Office          Office Name: Office of Information Systems
                     Voice: 222-1010, 222-4963
                     FAX: 222-3551
                     24 Hour: 272-5952 (Through On-Call Administrator)
                     Chief: Robert Childs

Causal Event         Brief description of the type of emergency.
                     Incidents requiring the establishment of computer networks including the
                     provision of workstations, servers, and networks, Internet and other
                     communication devices and support for software applications.
Role / Actions of    Brief description of the actions that would be taken by the lead office.
Lead Office                Assist in planning, establishing and maintaining hardware software and
                             devices for computer network services including the provision of
                             wired/wireless workstations, servers, routers, and peripheral equipment
                           Establish and maintain Internet connectivity
                           Establish and maintain email capabilities
                           Install and support software applications

Support Offices      List of supporting offices and brief description of the actions that would be taken
                     by the supporting offices.
(Not including       Department of Administration, Office of Library and Information Services, CIO:
standard support     Tom Collins, 222-5756 – provides statewide network and Internet connectivity
such as from         support, remote access and additional IT support.
Mgt. Services,       Statewide Communications Work Group, Chair: Howard Boksenbaum, 222-
Director’s office,   5708, coordinates a statewide communications (radio, wired/wireless
Legal and            telephone, state computer networks)
OPHA)
References           Important references.
                     Bob Childs, W: 222-1010, H: 623-0401 Cell: 823-7377
                     Bryan Barrette, W:222-4963, H: 949-2342, Cell: 265-1350, Page: 482-6249




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                                 Appendix J
                 Laboratory Support for Health Emergencies

The Division of Laboratories is composed of three Sections, and each Section
consists of multiple specialty laboratories. The Sections and the specialty
laboratories are capable of supporting Health in the event of a specific
emergency. The following is a brief description of the support that a Section
Laboratory can offer Health in the event of a specific emergency known in this
document as an Annex.

FORENSIC SECTION

In the event of a (Drinking water), (Food-related), or (Chemical event) emergency
that may result in personal injury or death, the Forensics Laboratories have
capabilities to do the following;

1. Identification of perpetrator (If Applicable)-The genetic identification
   capabilities of the Forensic Biology Unit-including DNA and CODIS-
   would be used to identify the perpetrator(s) on the basis of DNA
   recovered from evidence found at the scene(s). DNA Analysis would be
   performed using STR and PCR technology. Results would be matched
   against known suspects or the CODIS database.

2. Identification of Victims and Body Fragments- DNA Analysis would
    be performed on unidentified victims and body fragments using STR and
    PCR technology. Results would be matched against known DNA
    standards from the victims.

3. Cause of Death – Toxicology factors contributing to the cause of death
   would be determined in the Forensic Toxicology Unit by analysis of
   tissue recovered from victims.

4. Collection and Documentation of Evidence – Analysts in the Forensic
   Biology/DNA Unit would assist local law enforcement in the collection,
   documentation and storage of evidence.

CAPACITIES

Both the Forensic Biology/DNA and Forensic Toxicology Units are capable of 24-
hour operation. Throughput has been reduced recently by staff reductions in both
of these units. Depending on the extent of the ―mass disaster‖ and the
requirements of the medical examiner and law enforcement agencies, out-
sourcing and/or reassignment of trained personnel from other laboratory sections
may be required.



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ENVIRONMENTAL SECTION

The Environmental section consists of the following laboratories: Organic
Chemistry, Inorganic Chemistry, Air Pollution, Food Chemistry, and the
Bio-monitoring/Chemical Terrorism Response.

The Organic Chemistry Laboratory can assist Health in the following
emergencies by identifying and measuring the concentration of toxic organic
chemicals in drinking water or other environmental samples:

       Drinking Water Emergency
       Chemical Event

For a complete listing of specific tests, refer to the RI HEALTH Laboratory
Security and Emergency Response Plan.

The Inorganic Chemistry Laboratory can assist Health in the following
emergencies by identifying and measuring the concentration of inorganic
substances in drinking water or other environmental samples:

       Drinking Water Emergency
       Chemical event

For a complete list of specific tests, refer to the RI HEALTH Laboratory Security
and Emergency Response Plan.

The Air Pollution Laboratory can assist Health in the following emergencies:

       Radiological
       Chemical

The Air pollution lab maintains wind speed and direction monitors in various
locations in the State. In the event of an incident that can spread by air currents,
they can advise Health as to the direction and speed at which a toxic or
radiological cloud is heading .

The Food Chemistry Laboratory can assist Health in the following emergencies:

       Food-related (including seafood contamination)
       Food recalls

The Food Chemistry laboratory can detect and measure the concentration of
chemical substances and toxins in food.




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The Bio-monitoring/Chemical Terrorism Response Laboratory can assist Health in
the following emergencies:

      Disease Outbreak
      Chemical Event

The Chemical Terrorism Response Laboratory maintains validated methodology to
detect toxic metals and cyanide in blood or urine specimens. Additional capability
of testing for agents of chemical terrorism will be implemented in the upcoming
year.

BIOLOGICAL SCIENCES SECTION

The Biological section consists of the following laboratories: BT/Special
Pathogens, Public Health Microbiology, Serology, Virology and Molecular Biology.

The BT/Special Pathogens Laboratory can assist Health in the following
emergencies:

      Disease Outbreak Isolate and Identify Select agents,
                                   Mycobacteria and other non-enteric
                                   Special pathogens.

The Public Health Microbiology Laboratory can assist Health in the following
emergencies:

      Drinking Water             Isolate and identify microorganisms including
                                 select agents associated with waterborne
                                 diseases.
      Food-related               Isolate and identify microorganisms including
                                 select agents associated with foodborne
                                 diseases.
      Food recalls               Isolate and identify microorganisms including
                                 select agents associated with foodborne
                                 diseases.


The Serology Laboratory can assist Health in the following emergencies:

      Disease outbreak           On human samples serologic methods (IgM-
                                 Elisa, IFA) are available for the following
                                 infections:
                                 Arbovirus( West Nile, EEE, ST,Louis, Dengue
                                 and other viruses)
                                     Measles, Mumps and Rubella


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                                     Syphilis
                                     HIV virus, Chlamydia and Gonorrhea

                                 Animal serology tests are available for the
                                 following agents:
                                     Brucellosis, and Pseudo-Rabies

      SARS outbreak      IgM capture Elisa test for SARS virus


The Virology Laboratory can assist Health for the following emergencies:

       Disease outbreak         Isolation and identification of Arboviruses using
        tissue
       culture and RT -PCR methods
       Identification of Rabies infected tissue by DFA methods
       Pandemic Flu-Isolate and subtype Influenza Viruses


      Smallpox event Rule out smallpox by testing samples of lesions for
                               Varicella-Zoster and Herpes Viruses.


The Molecular Biology Laboratory can assist Health in the following emergencies:

      Disease outbreak      Norwalk virus RT-PCR method

      Smallpox event        Rule out Varicella/Vaccinia virus by PCR methods

      SARS Outbreak        Identification of Virus by RT-PCR

      Drinking water      Ricin, Staph enterotoxin B by time resolved
                                        fluorescence PCR


      Food-related       Genetic characterization of bacterial isolates by
                           PFGE methods for tracking foodborne outbreaks.




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                                                  Appendix K
                 Laboratory Support for HEALTH Emergencies Matrix


  Laboratory Support for HEALTH Emergencies Matrix




                                                                               Bio-monitoring




                                                                                                                                    Air Chemistry
     Emergency




                                                                                                Inorganics



                                                                                                             Chemistry
                                                                   Molecular




                                                                                                                                                    Forensics
                                                                                                                         Organics
                                       Serology


                                                   Virology
                              PH Lab
                     BT Lab




                                                                                                               Food
 Disease
 Outbreak            X        X        X           X               X           X

 Smallpox
  Event                                            X               X

  SARS
 Outbreak                              X                           X

 Drinking
  Water                       X                                    X                            X                        X                          X

   Food-
  Related                     X                                    X                                           X                                    X

  Beach
  Water
  Quality                     X

   Food
  Recalls                                                                                                      X


Radiological

 Asbestos-
  Related

 Chemical
  Event                                                                        X                X                        X          X               X




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                                       Annex L
                 Medical Emergency Distribution System (MEDS)

Lead Office       Emergency Planner, Division of Environmental Health
                  Voice: 222-6868
                  FAX:      222-6953
                  24 Hour: 272-5952 (Through On-Call Administrator)
                  Chief:    Greg Banner

Causal Event      Large event overwhelming the medical resources of health
                  facilities within the state.
Role / Actions    Conduct planning to organize the MEDS program.
of Lead Office    Serve as the operational leader for any MEDS activation.

Support           Division of Health Services Regulation, Office of Health
Offices           Professional
                  Regulations, Pharmacy Unit (Lead), Division of Disease
(Not including    Prevention and Control, Office of Communicable Diseases
standard          (Support)
support such      Serve as the Site Coordination Unit. Plans for the operation of
as from Mgt.      emergency distribution clinics throughout the state. Develop the
Services,         needed products for these clinics, provides training and
Director’s        operational guidance during activation.
office, Legal     Division of Family Health, Vaccine Program.
and OPHA)         Serve as the Distribution Coordination Unit. Coordinate the
                  logistical
                  tracking of all supplies and coordination with all delivery points.
                  Interface with MEDS supply resources to request needed assets.
                  Division of Environmental Health, Emergency Planning.
                  Serve as the RSS Facility Manager. Oversee all teams’ activities
                  at the RSS Facility.
                  Office of Management Services.
                  Designate a HEALTH Liaison to interface with the Strategic
                  National Stockpile Technical Assistance Response Unit (TARU),
                  the personnel
                  component of an SNS deployment.
                  Division of Health Services Regulation.
                  Organize and manage a Department of Health team which will
                  provide
                  medications as needed for the warehouse unit, Department of
                  Health
                  facilities, and as available for other state workers in the vicinity of
                  Capitol Hill.



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References   ―Receiving, Distributing, and Dispensing the National
             Pharmaceutical Stockpile: A Guide for Planners.‖ Version 9-
             Draft. CDC. April 2002.

             RI State Medical Emergency Distribution System plan. (Working
             Draft)




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                                         Appendix M
                                      Disease Outbreak

Lead Office         Communicable Disease
                    Voice: 222-2577
                    FAX:        222-2478
                    24 Hour: 272-5952 (Through On-Call Administrator)
                    Assistant Medical Director: Dr. Bandy

Causal Event        Outbreak of communicable disease
Role / Actions of   Provide overall leadership for disease surveillance and control, medical
Lead Office         epidemiology and evaluation activities associated with the outbreak
                    investigation and response.
Support Offices     Director’s Office
                    Provide overall leadership, assure intra-departmental coordination, and
                    promote inter-departmental cooperation. Serve as primary liaison to the
                    Governor’s Office, EMA, and the EOC/JIC, as activated. Serve as primary
                    liaison to the media, through Health Communication and Information. Develop
                    public information messages and distribute them through appropriate media
                    channels.

                    Division of Family Health
                    Operate the 1-800 call-in center at the appropriate level of effort to meet
                    current public demand for information about the disease, its prevention and
                    control. Be prepared to order and distribute medication, supplies and
                    equipment for Public Health Clinics, hospitals and other distribution sites.

                    Division of Health Services Regulation,
                    Be prepared to address outbreak control issues related to the licensure of
                    healthcare facilities or healthcare providers. Manage utilization of National
                    Pharmaceutical Stockpile.

                    HEALTH Laboratory
                    Coordinate specimen collection with all agencies, conduct analysis of
                    specimens, and coordinate this analysis with appropriate agencies (local,
                    State, Federal).

                    Division of Environmental Health
                    Assist the Director’s Office in its liaison to EMA and the EOC/JIC

                    Legal Services
                    Research the emergency powers of the Director of Health and prepare
                    emergency orders for use in an emergency. Prepare to assist the Division of
                    Disease Prevention and Control in the enforcement of isolation or quarantine,
                    as may become necessary to prevent the spread of disease in the RI
                    community


References          Centers for Disease Control and Prevention Advisories
                    General Laws of Rhode Island




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                                         Appendix N
                                    Smallpox Emergency

Lead Office         Communicable Disease
                    Voice: 222-2577
                    FAX:        222-2478
                    24 Hour: 272-5952 (Through On-Call Administrator)
                    Assistant Medical Director: Dr. Bandy

Causal Event        Smallpox outbreak in Rhode Island
Role / Actions of   Provide overall leadership for smallpox vaccination efforts in the state. Initiate
Lead Office         intense, active surveillance and investigation of smallpox cases (including the
                    identification, vaccination, and management of persons exposed to smallpox),
                    activate a smallpox hospital, and activate a dedicated transport system for
                    smallpox victims.
Support Offices     Director’s Office
                    Provide overall leadership, assure intra-departmental coordination, and
                    promote inter-departmental cooperation. Serve as primary liaison to the
                    Governor’s Office, EMA, and the EOC/JIC, as activated. Serve as primary
                    liaison to the media, through Health Communication and Information. Develop
                    public information messages and distribute them through appropriate media
                    channels.

                    Division of Family Health
                    Operate the 1-800 call-in center at the appropriate level of effort to
                    meet current public demand for information about smallpox, its
                    prevention and control.
                    Division of Health Services Regulation,
                    Assist healthcare facilities with smallpox prevention and control issues.
                    Request that hospitals and nursing homes activate plans to limit access to
                    patients, to heighten security, to vaccinate staff and patients, to recognize,
                    isolate, diagnose, and report smallpox cases, and to ready such patients for
                    transport. Assist in standing-up a smallpox hospital.

                    Division of Environmental Health
                    Assist the Director’s Office in its liaison to EMA and the EOC/JIC

                    Legal Services
                    Research the emergency powers of the Director of Health and prepare
                    emergency orders for use in a smallpox emergency. Prepare to assist the
                    Division of Disease Prevention and Control in the enforcement of isolation or
                    quarantine, as may become necessary to prevent the spread of smallpox in the
                    RI community


References          Centers for Disease Control and Prevention Interim Smallpox Response Plan
                    and Guidelines
                    General Laws of Rhode Island




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                                         Appendix O
                    Severe Acute Respiratory Syndrome (SARS)

Lead Office         Communicable Disease
                    Voice: 222-2577
                    FAX:        222-2478
                    24 Hour: 272-5952 (Through On-Call Administrator)
                    Assistant Medical Director: Dr. Bandy

Causal Event        Numerous SARS cases beginning to be observed in RI
Role / Actions of   Provide overall leadership for SARS surveillance and control measures, public
Lead Office         information, provider information and healthcare facility infrastructure and
                    support.
Support Offices     Director’s Office
                    Provide overall leadership, assure intra-departmental coordination, and
                    promote inter-departmental cooperation. Serve as primary liaison to the
                    Governor’s Office, EMA, and the EOC/JIC, as activated. Serve as primary
                    liaison to the media, through Health Communication and Information. Develop
                    public information messages and distribute them through appropriate media
                    channels.

                    Division of Family Health
                    Operate the 1-800 call-in center at the appropriate level of effort to
                    meet current public demand for information about SARS, its
                    prevention and control.
                    Division of Health Services Regulation,
                    Assist healthcare facilities with SARS prevention and control issues. Be
                    prepared to address outbreak control issues related to the licensure of
                    healthcare facilities or healthcare providers.

                    Division of Environmental Health
                    Assist the Director’s Office in its liaison to EMA and the EOC/JIC

                    Legal Services
                    Research the emergency powers of the Director of Health and prepare
                    emergency orders for use in a SARS emergency. Prepare to assist the Division
                    of Disease Prevention and Control in the enforcement of isolation or quarantine,
                    as may become necessary to prevent the spread of SARS in the RI community

                    Medical Examiner’s Office
                    Prepare to perform autopsies on SARS victims who fall under the jurisdiction of
                    the Chief Medical Examiner

References          Centers for Disease Control and Prevention SARS Advisories




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                                Appendix P
                         Drinking Water Emergency


Lead Office    Office of Drinking Water Quality
               Voice: 222-6867
               FAX:       222-6953
               24 Hour: 272-5952 (Through On-Call Administrator)
               Chief:     June Swallow, PE

Causal Event   Natural Disaster (Hurricane, Flood, Winter Storm etc.)
               Power Outage
               Mechanical Failure
               Radiological & Chemical Contamination
               Disease Outbreak
               Transportation Accident




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                 R
             A) Under Chapter 46-13 of the General Laws:
                 o
                As the primary state agency for enforcement of state and federal
                 l
                laws covering public drinking water, take the following actions:
                 e
                 Provide oversight of the assessment of the situation and
                   remediation activities.
                 /
                 Provide guidance with respect to public health.
                 Provide technical assistance as appropriate
                 A
                 Take enforcement actions, as necessary.
                 c
                 t
                 i
                 o
                 n
                 s

                 o
                 f

                 L
                 e
                 a
                 d

                  O
                  f
                  f
                  i
                  c
                  e
Support          Office of Environmental Health Risk Assessment
Offices          Provides health risk advice and guidance on water
                 contamination.
(Not including   Office of Food Protection
standard         Assists in notifying food establishments affected by water
support such     contamination and ensures safety of prepared food products.
as from Mgt.     Division of Disease Prevention and Control
Services,        Assists in responding to and investigating disease outbreaks
Director’s       as a result of or in response to, natural disasters which could
office, Legal                                     result in
                 contaminated water supply. Develops and distributes information
and OPHA)                                         to the
                 professional medical community
                 Division of Laboratories
                 Provides laboratory analytical support for microbiological
                 and chemical analyses of drinking water.



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             Division of Family Health
             Ensure the family health hotline has current information on the
             Emergency. Provide technical assistance and guidance in
             developing messages related to children in schools, childcare
             facilities, and other children’s settings and to populations with
             special needs.
             Division of Health Services Regulation
             Ensure that the appropriate information is passed to any facilities
             affected by the event.
             Office of the Medical Examiner (In the case of death)
             Investigate of the emergency scene and resultant deaths to
                                            determine the
             manner and cause of death; assure the orderly removal of the
                                            decedents
             from the scene; conduct necessary autopsies and/or inspections
                                            of
             decedents to determine the manner and cause of death.

References   ―Water Emergency Response Plan for the State of Rhode Island‖
             State Guide Plan Element 723, Report Number 81, May 1993
             From the Division of Planning, RI Department of Administration

             Emergency Resource Directory for Water Supply Management
             List of public water system emergency response plans available
             Water emergency response checklist
             List of major public water systems and officials in charge, by town
             Centers for Disease Control & Agency for Toxic Substances and
             Disease Registry Resource Index




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                                           Appendix Q
                                   Food-related Emergency

Lead Office          Office of Food Protection
                     Voice: 222-2749
                     FAX: 222-4775
                     24 Hour: 272-5952 (Through On-Call Administrator)
                     Chief: Ernest Julian, PhD

Causal Event         Foodborne Disease Outbreak
                     Transportation Accident
                     Fire
                     Flood
                     Sewage back-up
                     Power Outage
                     Contaminated waters involving seafood/shellfish

Role / Actions of    The Office of Food Protection aims to limit the number of ill during a foodborne
Lead Office          outbreak through one or more of the following: embargo of the suspect food
                     product, closure of food establishment presenting an imminent health hazard,
                     traceback of contaminated food product, notification of appropriate federal and
                     state agencies, the food industry, and consumers, and implementation of
                     control measures to prevent further illness.

                     In the event of a fire, flood, transportation accident, power outage, or sewage
                     back up, the Office of Food Protection will send an Environmental Health Food
                     Specialist to the scene to investigate the potential contamination of food or
                     water. (Please note that the scene must first be deemed safe prior to sending a
                     Food Specialist to investigate).

                     Will work in conjunction with DEM and appropriate federal agencies in an
                     emergency involving contaminated waters (oil spill, sewage overflow, etc.) to
                     ensure that affected shellfish/seafood is unavailable for public consumption.

Support Offices      Division of Disease Prevention and Control, Office of Communicable Diseases
                     – Responsible for the epidemiologic aspects of the foodborne outbreak
(Not including       investigation, e.g. interviewing cases and developing a case definition,
standard support     formulation and testing of hypotheses, and recommendation of control
such as from         measures.
Mgt. Services,
Director’s office,   Division of Laboratories - Identifies the agent (biological, chemical, viral,
Legal and            parasitic, etc.) or extraneous material in suspect product or waters.
OPHA)
                     Division of Drinking Water Quality – Assists the Office of Food Protection in
                     responding to a food-related emergency when the public water supply is also
                     affected.

                     Division of Facilities Regulation – Assists the Office of Food Protection during a
                     power outage at a nursing home.




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References   Food Code. RI Department of Health, Office of Food Protection. 1994.

             ―Procedures to Investigate Foodborne Illness‖. Fifth Edition. International
             Association for Food Protection. 1999.
                                                               th
             ―Control of Communicable Diseases Manual‖. 17 ed. American Public Health
             Association. 2000

             FDA ―Traceback of Fresh Produce and Other Commodities‖.
             ―Guide to Investigating Foodborne Outbreaks‖, RI Department of Health, Office
             of Food Protection (Draft)

             RI Department of Health, Office of Food Protection. Program Policy and
             Procedure Manual. ―Emergency Preparedness‖.




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                                           Appendix R
                                      Beach Water Quality

Lead Office          Beach Monitoring Program, Office of Food Protection/Env. Health
                     Voice: 222-2750
                     FAX: 222-4775
                     24 Hour: 272-5952 (Through On-Call Administrator)
                     Chief: Ernest Julian, Ph.D.

Causal Event         Closure of a licensed bathing beach due to a known event or elevated levels of
                     pathogen indicators.
Role / Actions of    Notification of the facility and the public of a beach closures. Public notification
Lead Office          methods include: a 24-hour hotline, posting of signs/flags, HEALTH’s Beach
                     Monitoring website, and a press release.


Support Offices      Office of Environmental Health Risk Assessment
                     Provides guidance on events/issue relating to water contamination.
(Not including
standard support     Division of Disease Prevention and Control
such as from         Assists in the response and investigation to disease outbreaks at bathing
Mgt. Services,       beaches.
Director’s office,
Legal and            Division of Laboratories
OPHA)                The sanitary microbiology lab analyzes water samples for pathogen indicators.

References           Beaches Environmental Assessment and Coastal Health Act. (P.L. 106-284)

                     National Beach Guidance and Required Performance Criteria for Grants.
                     USEPA, June 2002

                     Rhode Island Department of Health Beach Monitoring Quality Assurance
                     Project Plan (final draft submitted to USEPA April 28, 2003)




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                                           Appendix S
                                            Food Recalls

Lead Office          Office of Food Protection
                     Voice: 222-2749
                     FAX: 222-4775
                     24 Hour: 272-5952 (Through On-Call Administrator)
                     Chief: Ernest Julian, PhD

Causal Event         Adulterated or misbranded product resulting in a food recall.

Role / Actions of    During a food recall, the Office of Food Protection, in conjunction with the FDA
Lead Office          and/or USDA, ensures the safety of the public’s health by removing an
                     adulterated or misbranded product from commerce as soon as possible.

Support Offices      Division of Laboratories – Identification or verification of the agent (biological,
                     chemical, etc.) or extraneous material in the suspect product.
(Not including
standard support
such as from
Mgt. Services,
Director’s office,
Legal and
OPHA)
References           USDA Food Safety and Inspection Service. ―Food Recalls‖. 2002, Dec.

                     FDA Center for Food Safety and Applied Nutrition. ― FDA Recall Policies‖. 2002,
                     June.

                     RI Department of Health, Office of Food Protection. Program Policy and
                     Procedure Manual. ―Food Recalls‖.

                     RI Department of Health, Office of Food Protection. ―Consumer Product
                     Complaint Investigation & Recall Checklist‖. 2003 (Draft)




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                                        Appendix T
                                     Radiological Event

Lead Office        Office of Occupational & Radiological Health
                   Voice: 222-2438
                   FAX: 222-2456
                   24 Hour: 272-5952 (Through On-Call Administrator)
                   Chief: Marie Stoeckel, MPH
                   Supervisor: John Ferruolo

Causal             Accidental or willful releases of radioactive materials resulting in
Events             potential public exposure; accidents at facilities possessing
                   radioactive materials; transportation accidents involving
                   radioactive material releases; appearance of radioactive material
                   in unexpected places.

Role / Actions     For major events, under the state emergency operations plan for
of Lead Office     radiological emergencies, the office will advise the Governor or his
                   representative (RIEMA) regarding the potential hazard to the
                   population and the appropriate protective actions to be taken. For
                   lesser events, staff will evaluate the scope of the hazard, provide
                   regulatory oversight and/or technical assistance to responsible
                   parties, assure appropriate controls to protect the public health
                   and safety, and take enforcement actions, as necessary.

Support            Office of Drinking Water Quality
Offices            Collects water samples under the Ingestion Pathways Plan

                   Office of Food Protection
                   Collects milk and food samples under the Ingestion Pathways
                   Plan

                   Office of Risk Assessment
                   Provide health risk advice
References         Section 23-1.3-2 of the General Laws

                   Rules and Regulations for the Control of Radiation

                   RI Emergency Operations Plan for radiological emergencies

                   RI Ingestion Pathways Plan
Please note that the lead state agency, whenever the state emergency plan is placed into
operation, is RIEMA, which assesses the severity of the situation and calls in the appropriate
state and federal agencies, including DEM, FEMA, EPA and NRC.




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                                   Appendix U
                          Asbestos Related Emergency

Lead Office      Office of Occupational & Radiological Health
                 Indoor Air Quality Program
                 Voice: 222-3601
                 FAX: 222-2456
                 24 Hour: 272-5952 (Through On-Call Administrator)
                 Chief: Marie Stoeckel, MPH
                 Supervisor: Alfred J. Cabral, Supervising Industrial Hygienist

Causal Event     Accidental or willful environmental discharge of asbestos
                 containing material resulting in potential public exposure.

Role / Actions   Evaluate scope of asbestos hazards. Provide technical advice to
of Lead Office   property owner/manager on actions to prevent public exposure.
                 Furnish lists of certified asbestos consultants and licensed
                 asbestos contractors to fully evaluate scope of hazards and
                 perform abatement. Oversee completion of asbestos abatement
                 and elimination of public health risk.

Support          Office of Occupational Health- OSHA consultation program-
Offices          Provide technical advice on worker safety requirements.

                 Office of Environmental Health Risk Assessment- Serve in
                 determining risk to exposed persons.

References       Chapter 23-24.5 of RI General Laws- Asbestos Abatement

                 RI Rules and Regulations for Asbestos Control [R23-24.5ASB]

                 40CFR763 Subpart E- Asbestos Containing Materials in Schools

                 40CFR61-National Emissions Standards for Hazardous Air
                 Pollutants

                 29CFR 1926.1101 Asbestos in Construction Standard




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                                            Annex V
                           Chemical Emergency/Unusual Event

Lead Office          Office of Environmental Health Risk Assessment [OEHRA]
                     Voice: 222-3424
                     FAX: 222-6953
                     24 Hour: 272-5952 (Through On-Call Administrator)
                     Chief: Robert R. Vanderslice, Ph.D.
Causal Event         Accidental release of hazardous chemical(s);
                     Transportation accident releasing hazardous chemical(s);
                     Deliberate criminal release of hazardous chemical(s).
                      R
                  B) OEHRA provides information to state and local authorities and the press on
                      o
                     health risks of chemical exposures during a public health incident or emergency
                      l
                     involving known or suspected exposure to hazardous chemicals. OEHRA is not
                      e
                     equipped to provide emergency response or sampling.
                      /
                      A
                      c
                      t
                      i
                      o
                      n
                      s

                      o
                      f

                      L
                      e
                      a
                      d

                     O
                     f
                     f
                     i
                     c
                     e
Support Offices      Office of Occupational and Radiological Health
                          Provides additional technical support, particularly with regard to OSHA
(Not including            exposure standards, policies, procedures and appropriate protective
standard support          actions.
such as from
Mgt. Services,
Director’s office,
Legal and
OPHA)
References           ATSDR Hazardous Substances Information [ToxFAQ; Toxicological Profiles,
                     etc.]
                          http://www.atsdr.cdc.gov



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    http://www.atsdr.cdc.gov/toxpro2.html
EPA Extremely Hazardous Substances [EHS] Chemical Profiles
   http://www.epa.gov/swercepp/ehs/ehslist.html
EPA Integrated Risk Information System [IRIS]
   http://www.epa.gov/iris/index.html
NIOSH Chemical Agent Information
   http://www.cdc.gov/niosh/topics/emres/chemagent.html




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                                          Appendix W
                               Healthcare Facility Emergency
Lead Office            Office of Facilities Regulation
                       Voice:        401-222-2566
                       FAX:          401-222-3999
                       24 Hour:      401-272-5952             (Through On-Call Administrator)
                       Chief:        Raymond Rusin  Nextel: 401-639-0854
Causal Event           Natural disaster (Hurricane, flood, extreme storm causing damage, etc.)
                       Any immediate facility closure or evacuation
                            (Fire, bomb-threat, bankruptcy or owner walk-away, etc.)
                       Disease outbreak
                       Power outage or Mechanical failure
                       Radiological or chemical contamination
Role / Actions of      Under Chapter 23-17, 17.4 Assisted Living, and 17.11 The Emergency Skilled Nursing
Lead Office            and Intermediate Care Facilities Act of the General Laws, and Social Security Act,
                       Section 1864 Agreement of federal law:
                            As the primary state agency for licensure, certification, and enforcement of state
                                 and federal laws covering health care facilities and assisted living residences,
                                 take the following actions:

                           Provide oversight and assessment of the situation and remediation activities as
                           needed;
                           Provide monitoring and guidance with respect to public health & safety;
                           Provide technical assistance to facility, as appropriate;
                           Coordinate resident/patient relocation or temporary out-placement with appropriate
                           entities;
                           Initiate appropriate enforcement actions.
Support Offices        Division of Health Services Regulation-
                           Organize and manage professional licensing/credentialing as needed.
(Not including
standard support       Division of Disease Prevention and Control
such as from Mgt.          Assists in responding to and investigating disease outbreaks.
Services, Director’s
office, Legal and      Division of Food Protection
OPHA)                      Assists assuring alternative food & water sources.

                       Office of Environmental Health Risk Assessment
                            Provides health risk advice and guidance.

                       Division of Laboratories
                           Provides laboratory analytical support for microbiological & chemical analyses as
                           needed.

                       Office of the Medical Examiner (In the case of death[s])
                            Investigate emergency scene & resultant death(s) to determine the manner &
                            cause of death; assure the orderly removal of the decedents from the scene;
                            conduct necessary autopsies and/or inspections of decedents to determine the
Support Offices:            manner & cause of death.
   Continued
                       Department of Human Services
                          Provide support from Long term care program and Division of Individual &
                          Family Support.

                       Department of Elderly Affairs – LTC Ombudsman Program


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             To assist with resident/patient relocation & placements and supports.
References




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  Appendix X
  Mass Fatalities


Under development




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                                          Appendix Y
 HEALTH Continuity of Operations/Continuity of Government (COOP/COG)

Lead Office          Director’s Office/Incident Commander
                     Voice: 222-2231
                     FAX: 222-6548
                     24 Hour: 272-5952 (Through On-Call Administrator)
                     Chief: Dr. Patricia Nolan

Causal Event         Bio-terrorism Event
                     Natural Disaster
                     Utility/Building Systems/Information Systems Failure
Role / Actions of    Assembles the Executive Committee to assess the situation and determine if:
Lead Office                       Services must be curtailed
                                  Extended operations or shelter-in-place operations are required
                                  Relocation to an alternate facility is required
                     Activates a HEALTH EOC and assigns support staff
                     Assigns ICS Operations Section and Planning Section responsibilities
                     Activates Notification/Recall of personnel as required directing them to:
                                Return to work at their normal or emergency work locations with in
                                    HEALTH
                                Report to an alternate location
                                Remain at home
                     Advises RI EMA and the Governor’s Office of:
                                HEALTH’s ability to maintain operations
                                Decision to shelter-in-place or relocate
                     Requests Assistance from RI EMA as required
                     Provides overall direction for relocation activities
                     Approves all messages to the public
                     Directs HEALTH recovery operations at termination of event

Support Offices                      c) Office of Emergency Planning – Environmental
                                         Health Division
(Not including       Writes and maintains the (COOP/COG) plan. May assist in directing
standard support     evacuation and relocation operations.
such as from
Mgt. Services,                           d) Management Services
Director’s office,   Secures emergency maintenance, utilities, and information systems support.
Legal and            Arranges additional security protection for building and personnel. Arranges for
OPHA)                sufficient potable water and food to support extended or shelter-in-place
                     operations. Secures transportation as required to relocate operations to an
                     alternate facility.

                                      e) All HEALTH Physicians, Nurses, and Paramedics
                     Provide emergency life-saving and comfort care for injured personnel until can
                     be transported for definitive care.

                                      f) All Divisions and Offices
                     Account for all assigned personnel and provide status reports to
                     Director/Incident Commander. Activate limited/extended operations as directed
                     by the Director. Regularly updates Director/Incident Commander on ability to



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maintain operations. Secures, protects, and prepares for relocation all critical
resources. Activate personnel recall as directed by the Director/Incident
Commander.




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                     Rhode Island Department of Health
                      Incident Command System (ICS)
                            Emergency Response
                             Job Action Sheet
                                                                         Command Staff

                               Director of Health/Designee

Reports to: Incident Commander
Emergency Operations Center Location: __________ Telephone: ______________________
Name of Event:______________________Date and Time ICS role instituted:_____________

Mission: Establish the role of the Incident Commander and assist with the overall
response. This position has the ultimate responsibility, but delegates authority to the
Incident Commander.

Immediate:

            Read this entire Job Action sheet and review organizational chart.
            Obtain a briefing from Incident Commander.
            Consult with the initial Incident Commander and may convene executive
             committee to assess the situation and determine level of response and
             notifications
            Designate the lead office, as appropriate, and person to serve as Incident
             Commander.
            During the initial consultation with the Incident Commander, provide
             direction for developing an initial Incident Action Plan using the
             appropriate ICS forms.
            In consultation with the Incident Commander may designate:
                  Operations section chief
                  Planning section chief
                  Logistics and finance/administration section chiefs
                  Public information officer
                  Safety officer
                  State EOC liaison
                  Legislative liaison and legal advisor (as necessary)
                  Other site/team leaders as necessary

Intermediate:
     
           Ensure the Governor & Senior Advisor are notified of the situation
           Ensure the Governor’s Press Office is alerted
           In consultation with the Incident Commander, makes initial decisions as to
              key activities:
                  Programs/Offices within department to suspend/reduce activities
                  Reallocation of personnel to support emergency functions


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                   Initial messages and communications activities with public and
                    partners
                  Key data/reports which need to be tracked by the plans section
                    chief
             Schedule of meetings / briefings
                  Establish routine briefings with Incident Commander

Extended:

             Direct activation of the HEALTH Recall/emergency notifications systems
              as appropriate
             Establish 24/7 operation as required
             Observe all staff, for signs of stress. Report issues to Safety Officer.
              Provide rest periods and relief for staff. Consider need for CISM.
             Participate in post event critique/hotwash




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                   Rhode Island Department of Health
                    Incident Command System (ICS)
                          Emergency Response
                           Job Action Sheet
                                                                     Command Staff

                                 Incident Commander

Reports to: Incident Commander
Emergency Operations Center Location: __________ Telephone: _________________
Name of Event:______________________Date and Time ICS role instituted:_________

Mission: Organize and direct HEALTH’s Emergency Operation Center (EOC). Give
overall direction for emergency and operation.

Immediate:

    Read this entire Job Action Sheet and review organizational chart
    Obtain full briefing of the incident
    In Consultation with the Director, designate as needed:
                Operations section chief
                Planning section chief
                Logistics
                Finance/administration section chiefs
                Public information officer
                Safety officer
                State EOC liaison
                Legislative liaison
    Distribute the section packets which contain Job Action Sheets for each position
     and any forms pertinent to a section & positions
    Determine if unified command is needed at RIEMA and make necessary
     assignments
    In consultation with the Director, develop objectives for developing the initial
     Incident Action Plan using the appropriate ICS forms
    Consult with the initial Incident Commander (as appropriate) and convene the
     Executive Committee to assess the situation, determine level of response and
     notifications
    Designate a person to provide direct support to the Incident Commander ( i.e.
     scribe)
    Confer with Section Chiefs to identify & consider necessary Health Department
     Services
    Consider and assign communication responsibilities to agency staff, external
     agencies and public and media
    Assure that contact has been established and resource information shared with
     relevant external agencies
    Determine operational location(s) of key personnel


                                         100
                                                                    RI Department of Health
                                                                  Emergency Operations Plan

                                                                                In process

    Ensure the Governor & Senior Advisor are notified of the situation
    Ensure the Governor’s Press Office is alerted
    Direct activation of the HEALTH Recall/emergency notifications systems as
     appropriate
    Evaluate existing public health law and regulations, as needed


Intermediate:

     Authorize resources as needed or requested by Section Chiefs, through the
      Administration Section Chief
     Designate routine briefings schedule with Section Chiefs to receive status
      reports and update the action plan regarding the continuance and/or termination
      of the action plan
     With the Director’s authorization, establish 24/7 operation as required and
      designate back-ups for all positions in case 24/7 operations are required
     Consult with the Director regarding elevation or delegation of the Incident
      Commander role, as appropriate to the situation, as the emergency unfolds
     Ensure HEALTH Staff are appraised of situation and expected actions
     Promote specialized and general surge capacity for medical needs during a
      major incident
     Ensure updates are provided to the Governor & staff, RI EMA, HEALTH staff as
      appropriate (may delegate some or all notifications to Planning Section Chief
      and Public Information Officer)
     Approve media releases submitted by PIO
     Notify State EOC when command function is activated & operational
     Provide State EOC with the name and contact info for the designated HEALTH
      Incident Commander
     Identify external resources needed to assist with response
     Make recommendations to the Director to adjust departmental policies and
      procedures as necessary
     Ensure appropriate security actions are taken
     Ensure Finance chiefs alerts all staff to sign in and out and record activities and
      known costs associated with the emergency response operations and provide to
      the Finance/Administration Chief as requested

Extended:

     Maintain logs, with dates and times, of all notifications
     Observe all staff for status and signs of stress. Consider need for CISM
     Provide for rest periods for staff
     Prepare end of shift report and update with incident tracking board (when
      utilized) for oncoming Incident Commander
     Plan for the possibility of extended deployment
     Participate in the critique/hotwash after the incident




                                          101
                                                                   RI Department of Health
                                                                 Emergency Operations Plan
                                                                               Reviewed: 6/06

                                                                               In process

                    Rhode Island Department of Health
                     Incident Command System (ICS)
                           Emergency Response
                            Job Action Sheet
                                                                       Command Staff

                                      Liaison Officer

Reports to: Incident Commander
Emergency Operations Center Location: __________ Telephone: ________________
Name of Event:______________________Date and Time ICS role instituted:________

Mission: Coordinates with representatives from cooperating and assisting agencies

Immediate:

     Receive appointment from Incident Commander
     Read this entire Job Action sheet and review organizational chart
     Obtain a briefing from Incident Commander and participate in planning meetings
      to formulate and evaluate Incident Action Plan (IAP)
     Designate staff to assist, e.g. scribe, as needed
     Notifies Incident Commander when section is activated & operational
     Keep Incident Commander and Director of Health and other agencies and
      organizations updated on changes in response to incident
     Ensure Rhode Island Emergency Management Agency has been alerted about
      the incident (401-946-9996)

Intermediate:

     Coordinate information provided to state government officials
     Coordinate with major organizations outside the community’s medical and health
      response system
     Respond to requests and complaints from incident personnel regarding
      interagency issues
     Relay any special information obtained to appropriate personnel in the receiving
      facility (i.e., information regarding toxic decontamination or any special
      emergency conditions)
     Keep agencies supporting the incident aware of the incident status
     Monitor the incident to identify current or potential inter-organizational problems
     Coordinate with HEALTH Public Information Officer
     Regularly update the Incident Commander, through the Planning Section, on all
      activities

Extended:

     Document all activities and any known costs associated with the emergency
      response operations and provide to the Finance/Administration chief as


                                          102
                                                               RI Department of Health
                                                             Emergency Operations Plan

                                                                           In process

    requested
   Observe all staff, for signs of stress
   Report any safety concerns or issues to Safety Officer.
   Provide rest periods and relief for staff
   Prepare end of shift report and present to oncoming PIO and Liaison Officer
   Plan for the possibility of extended deployment
   Participate in post event critique/hotwash




                                      103
                                                                   RI Department of Health
                                                                 Emergency Operations Plan
                                                                                 Reviewed: 6/06

                                                                               In process

                    Rhode Island Department of Health
                     Incident Command System (ICS)
                           Emergency Response
                            Job Action Sheet
                                                                       Command Staff

                             Public Information Officer (PIO)

Reports to: Incident Commander
Emergency Operations Center Location: __________ Telephone: _________
Name of Event:____________________Date and Time ICS role instituted:_______

Mission: The department spokesperson and person responsible for releasing
information regarding the incident to the media or other agencies and the public. Only
one PIO is appointed per incident although assistants may be appointed as necessary.

Immediate:

    Receive appointment from Incident Commander (IC)
    Read this entire Job Action sheet and review organizational chart
    Identify restrictions in contents of news release information from Incident
   Commander
    Establish a Public Information area away from Incident Command Post and
      other activity areas
    Obtain a full briefing from the IC regarding the incident and participate in
      planning meetings to formulate and evaluate the IAP

Intermediate:

    Ensure that all news releases have the approval of the Incident Commander
    Issue an initial incident information report to the news media
    Inform on-site media of the accessible areas which they have access to, and
     those which are restricted
    Coordinate safety and access issues with Safety Officer
    Contact other at-scene agencies to coordinate released information with
     respective PIOs/JIC. Inform Liaison Officer of action
    Arrange for interviews, teleconferences, video conferences, satellite broadcasts,
     Web site revisions, broadcast faxes etc., upon approval by IC or governor
    Monitor incident as to the need to modify or change public alerts or risk
     communications
    Approve initial and updated scripts for interviews, hot lines and Web sites
    Direct ongoing evaluation of message contents

Extended:

    Review progress reports from Section Chiefs as appropriate
    Notify media about incident status


                                          104
                                                                RI Department of Health
                                                              Emergency Operations Plan

                                                                            In process

 Observe all staff, for signs of stress. Report issues to Safety Officer. Provide
  rest periods and relief for staff
 Prepare end of shift report and present to oncoming PIO
 Plan for the possibility of extended deployment




                                       105
                                                                    RI Department of Health
                                                                  Emergency Operations Plan
                                                                              Reviewed: 6/06

                                                                                In process

                     Rhode Island Department of Health
                      Incident Command System (ICS)
                            Emergency Response
                             Job Action Sheet
                                                                        Command Staff

                                        Safety Officer

Reports to: Incident Commander
Emergency Operations Center Location: __________ Telephone: ______________________
Name of Event:______________________Date and Time ICS role instituted:_____________


Mission: Develop and recommend measures for assuring HEALTH personnel safety
(including psychological and physical, and to assess and/or anticipate hazardous and
unsafe situations.

Immediate:

               Receive appointment from Incident Commander.
               Read this entire Job Action sheet and review organizational chart.
               Obtain a briefing from Incident Commander.
               Establish Safety Command Post in proximity to the EOC
               Review the Incident Action Plan (IAP) for safety implications
               Consider safety needs of all HEALTH staff responding to a potentially
                hazardous site.

Intermediate:

             Exercise emergency authority to stop and prevent unsafe acts
             Keep all staff alert to the need to identify and report all hazards and
              unsafe conditions and insure that all accidents involving personnel are
              investigated and actions and observations documented
             Arrange with Logistics to secure areas as needed to limit unauthorized
              access
             Advise the Incident Commander and Section Chiefs immediately of any
              unsafe, hazardous situation
             Establish routine briefings with Incident Commander
             Establish routine briefings with Administration Section Chief
             Have all staff sign in and out and record activities and known costs
              associated with the emergency response operations and provide to the
              Finance/Administration Chief as requested
             Coordinate with the safety staff from other agencies regarding health and
              safety issues, e.g. health and safety issues at shelters.

Extended:




                                           106
                                                      RI Department of Health
                                                    Emergency Operations Plan

                                                                  In process

 Observe all staff, for signs of stress. Report issues to Incident
  Commander. Provide rest periods and relief for staff. Consider need for
  CISM.
 Prepare end of shift report and present to oncoming Safety Officer
 Plan for the possibility of extended deployment
 Participate in post event critique/hotwash




                              107
                                                                    RI Department of Health
                                                                  Emergency Operations Plan
                                                                                  Reviewed: 6/06

                                                                                In process

                      Rhode Island Department of Health
                       Incident Command System (ICS)
                             Emergency Response
                               Job Action Sheet
                                                                        Command Staff

                                 Planning Section Chief

Reports to: Incident Commander
Emergency Operations Center Location: __________ Telephone: _________
Name of Event:_____________________Date and Time ICS role instituted:_______


Mission: Identify and establish data elements and data sources. Implement data
collection and analysis procedures so that trends and forecasts can be identified related
to the incident. Organize and direct all aspects of Planning Section operations. Ensure
the distribution of critical information/data. Compile scenario/resource projections from
all section chiefs and perform long-range planning. Document and distribute Incident
Action Plan (IAP) and measure/evaluate progress.

Immediate:
    Receive appointment from Incident Commander and obtain packet containing
     Section’s Job Action Sheets
    Read this entire Job Action sheet and review organizational chart
    Activate the Planning Section Branch Directors and distribute Job Action sheets
    Obtain a briefing from Incident Commander
    Brief Branch Directors
    Notify Incident Commander when Section is activated & operational
    Develop a daily Incident Action Plan (IAP), with input from the Operations
     Section Chief, appropriate to the situation and based on the objectives set by the
     Incident Commander
    Develop Section Action Plan (SAP)
    Develop a means of collection, authentication, and analysis of data, and the
     synthesis and dissemination of information concerning local and regional health
     and medical issues

Intermediate:

      Establish information requirements and reporting schedule
      Ensure standardization of data collection
      Set operational periods (e.g. 8, 12, 24 hr)
      Develop a daily situation report appropriate to the situation
      Provide regular situation updates to the Incident Commander, the HEALTH State
       EOC Liaison, the HEALTH Public Information Officer and the Director of
       HEALTH
      Conduct and facilitate planning meetings



                                           108
                                                                    RI Department of Health
                                                                  Emergency Operations Plan

                                                                                In process

     Ensure other HEALTH offices are regularly updated on the emergency situation
     Identify key data that needs to be tracked during the operation
     Develop a system to track key data and make it available to other offices
     Determine need for specialized resources to support incident
     Activate the GIS/Decision Support Team as necessary to support planning and
      operational functions
     Establish specialized collection systems, e.g. weather, surveillance information,
      etc.
     Develop a system for recording lessons learned and making immediate
      improvements
     Develop a system to receive copies of and track all external communications
      products
     Assemble and disassemble task forces and strike teams not assigned to
      Operations

Extended:

     Document all activities and know costs associated with the emergency response
      operations and provide to the Finance/Administration Section Chief as requested
     Organize After Action meetings and compile an After Action Report
     Review progress reports from Section Chiefs as appropriate
     Notify media about incident status
     Observe all staff for signs of stress. Report issues to Safety Officer. Provide rest
      periods and relief for staff, as needed.
     Prepare end-of-shift report and present to oncoming PIO and Planning Chief
     Plan for the possibility of extended deployment
     Participate in post-event critique/hotwash




                                          109
                                                                    RI Department of Health
                                                                  Emergency Operations Plan
                                                                                Reviewed: 6/06

                                                                                In process

                    Rhode Island Department of Health
                     Incident Command System (ICS)
                           Emergency Response
                            Job Action Sheet
                                                                                Planning

               Situation/Information Analysis Branch Director

Reports to: Planning Section Chief
Planning Command Center Location: ________________ Telephone: ___________
Name of Event:_____________________Date and Time ICS role instituted:_______


Mission: Ensure accurate and timely analysis and interpretation of data for the incident,
including preparation of reports and trend analysis.

Immediate

    Read this entire Job Action Sheet
           Obtain briefing from Planning Section Chief
        Work with Planning Section Chief to select data elements required by the
           Incident Action Plan (IAP) and the Section Action Plan (SAP) and
           determine essential reports
        Assign Planning Group Supervisors
        Assign specific personnel to interpret data received
        Assure all data equipment is in working order and required supplies are
           available
        Communicate data analysis equipment needs to Planning Section Chief

Intermediate

      Maintain communication with data analysis staff to identify issues
      Communicate to Planning Section Chief any issues with data
      Maintain a log of all data requests received and staff assigned to each task
      Immediately report to the Planning Section Chief any issues which can’t be
       resolved by your Branch with current resources
      Notify Planning Section Chief of data that has not been received in a timely or
       correct fashion
      Review assembled data and finalize interpretations and reports
      Compute projections for situation (disaster or response) based upon the data
       received
      Communicate report findings and projections to Planning Section Chief

Extended

    Brief Planning Section Chief on status of data analysis activities



                                           110
                                                                RI Department of Health
                                                              Emergency Operations Plan

                                                                            In process

 Document all actions, decisions, and interventions
 Prepare end-of-shift report and present to oncoming Situation/Information
  Analysis Branch Director
 Observe all staff for signs of stress, and report concerns to Planning Section
  Chief
 Plan for the possibility of extended deployment
 Participate in post-event critique/hotwash




                                       111
                                                                        RI Department of Health
                                                                      Emergency Operations Plan
                                                                                      Reviewed: 6/06

                                                                                    In process

                     Rhode Island Department of Health
                      Incident Command System (ICS)
                            Emergency Response
                             Job Action Sheet

                                                                                    Planning

                         Documentation Branch Director

Reports To: Planning Section Chief
Planning Command Center Location: ________________ Telephone: ___________
Name of Event:_____________________Date and Time ICS role instituted:_______

Mission: Maintain accurate and complete incident files, including a complete record of
the major steps taken to resolve the incident, as part of the overall IAP and planning
function, provide duplication services to incident personnel, store incident files for legal,
analytical, and archival purposes.

Immediate:

 Read this entire Job Action Sheet
 Obtain briefing from Planning Section Chief
 Assign form Preparation and Event Documentation Group Supervisors and a Scribe
  as needed
 Set up work area
 Brief specific personnel to collect, receive, collate, or enter data received
 Assure that all data equipment is in working order, and required supplies are
  available
 Communicate data equipment needs to Planning Section Chief
 Provide duplication services to incident personnel
 File, maintain, and store incident files for legal, analytical, and historical purpose

Intermediate:

 Maintain communication with Form Preparation Unit Leader and the Event
  Documentation Unit Leader to identify issues
 Develop Incident Briefing report (ICS Form 201) and Incident Action Plan (IAP) and
  attachments
 Begin organization of incident files
 Establish duplication service and respond to requests
 Retain and file duplicate copies of official forms and reports
 Accept and file reports and forms submitted by ICS units
 Check on accuracy and completeness of records submitted for files
 Correct errors or omissions by contacting appropriate ICS Units
 Provide duplicates of forms and reports to authorized requestors
 Prepare incident documentation for Planning Section Chief when requested



                                             112
                                                                   RI Department of Health
                                                                 Emergency Operations Plan

                                                                               In process

 Report staffing needs/replacements to Planning Section Chief
 Immediately report to the Planning Section Chief any issues that can not be
  resolved by the Branch with current resources
 Notify Planning Section Chief of data that has not been received in a timely fashion

Extended:

 Brief Planning Section Chief on status of data collection and Branch activities
 Prepare end of shift report and present to oncoming Incident commander and the
  incoming Documentation Branch Director
 Observe all staff for signs of stress. Report issues to Planning Chief. Provide rest
  periods and relief for staff, as needed.
 Prepare end-of-shift report and present to incoming PIO and Planning Chief
 Plan for the possibility of extended deployment
 Participate in post-event critique/hotwash




                                          113
                                                                  RI Department of Health
                                                                Emergency Operations Plan

                                                                              In process

                    Rhode Island Department of Health
                     Incident Command System (ICS)
                           Emergency Response
                            Job Action Sheet

                                                                        Administration

                    Administration/Finance Section Chief

Reports to: Incident Commander
Emergency Operations Center Location: __________ Telephone: _________
Name of Event:_____________________Date and Time ICS role instituted:_______


Mission: Monitor the utilization of financial assets and human resources. Ensure the
documentation of expenditures relevant to the emergency incident. Authorize
expenditures to carry out the IAP and ensure appropriate documentation.

Immediate:

     Receive appointment from Incident Commander. Obtain packet containing
      Section's Job Action Sheets
     Read this entire Job Action Sheet and review organizational chart that has been
      activated
     Obtain briefing from Incident Commander
     Appoint Human Resource and Finance Unit Leaders
     Inform team leaders of incident name
     Obtain unique finance code for incident from the Finance Officer
     Confer with Appointed Unit leaders and insure the formulation and
      documentation of an incident-specific section action plan as approved by the
      Command Staff
     Distribute the corresponding Job Action Sheets with incident specific tasks
     Establish an Administration Section Operations Center near the Logistics Center
      and ensure adequate documentation/recording personnel

Intermediate:

    Approve a "cost-to-date" incident financial status in agreement with the IC and
     summarize financial data as often as required by the nature of the incident,
     relative to personnel and hours worked, supplies and miscellaneous expenses
     including facilities and equipment
    Obtain briefings and updates from Incident Commander as appropriate.
    Relate into financial status reports
    Schedule planning meetings with unit leaders to discuss updating the section's
     incident action plan and termination procedures
    Authorize utilization or diversion of financial resources



                                          114
                                                                   RI Department of Health
                                                                 Emergency Operations Plan

                                                                               In process

    Ensure that all staff sign in and out and record activities and known costs
     associated with the emergency response operations

Extended:

    Observe all staff for signs of stress
    Provide rest periods and relief for staff. Review issues with the Safety Officer
    Coordinate response regarding staff work related issues, assignments and
     questions and work with HR Director as appropriate
    Coordinate injury or incident reporting procedures and protocol with Safety
     Officer
    Create end of shift report for Incident commander and the oncoming
     Administration Section Chief
    Plan for the possibility of extended deployment
    Participate in post event critique/hotwash
    Other concerns




                                          115
                                                                     RI Department of Health
                                                                   Emergency Operations Plan

                                                                                 In process
                                                                                  Reviewed: 6/06




                     Rhode Island Department of Health
                      Incident Command System (ICS)
                            Emergency Response
                             Job Action Sheet

                                                                           Administration

                           Compliance Branch Director

Reports to: Finance Section Chief
Emergency Operations Center Location: __________ Telephone: _________
Name of Event:_____________________Date and Time ICS role instituted:_______

Mission: Monitor the compliance of Rhode Island Department of health employees
during a declared emergency response on issues related to regulations, liability,
licensures/certification, medication and medical device regulation, public health legal
interpretation, equipment certification, and responder certification for specialized
equipment.

Immediate:

    Receive appointment from Incident Commander. Obtain packet containing
     Section's Job Action Sheets
    Read this entire Job Action Sheet and review organizational chart that has been
     activated
    Obtain briefing from Incident Commander
    Appoint Legal Unit Leader, Regulatory Unit Leader, Licensure Unit Leader, and
     Equipment Certification Unit Leader
    Inform team leaders of incident name
    Confer with Appointed Unit leaders and insure the formulation and
     documentation of an incident-specific section action plan as approved by the
     Command Staff
    Distribute the corresponding Job Action Sheets with incident specific tasks
    Establish an Administration Section Operations Center near the Logistics Center
     and ensure adequate documentation/recording personnel

Intermediate:

    Approve a compliance strategy in agreement with the IC and summarize and
     document compliance as often as required by the nature of the incident
    Obtain briefings and updates from Incident Commander as appropriate.
    Relate into financial status reports
    Schedule planning meetings with unit leaders to discuss updating the section's
     incident action plan and termination procedures




                                            116
                                                                   RI Department of Health
                                                                 Emergency Operations Plan

                                                                               In process

    Ensure that all staff sign in and out and record activities and submit compliance
     documents associated with the emergency response operations



Extended:

    Observe all staff for signs of stress
    Provide rest periods and relief for staff. Review issues with the Safety Officer
    Coordinate response regarding staff work related issues, assignments and
     questions and work with HR Director as appropriate
    Coordinate injury or incident reporting procedures and protocol with Safety
     Officer
    Create end of shift report for Incident commander and the oncoming
     Administration Section Chief
    Plan for the possibility of extended deployment
    Participate in post event critique/hotwash




                                          117
                                                                 RI Department of Health
                                                               Emergency Operations Plan
                                                                             Reviewed: 6/06

                                                                             In process

                   Rhode Island Department of Health
                    Incident Command System (ICS)
                         Emergency Response
                           Job Action Sheet

                                                               Administration/Finance

                         Accounting Branch Director

Reports To: Administration Section Chief
Administration Command Center Location:____________ Telephone: __________
Name of Event:_____________________Date and Time ICS role instituted:_______


Mission: Provide organizational support for procurement resources and track the
utilization and availability of assets for the response.

Immediate:

 Read this entire Job Action Sheet
 Obtain briefing from Administration Section Chief
 Review IAP and SAP and assign staff (Procurement, Accounting, Cost
Reimbursement)
 Establish a Finance Unit Center
 Assign codes for all resources expended during the response
 Implement County Wide Emergency Procurement Process for effecting rapid
procurement of major equipment or leases
 Establish a mechanism for rapid review of requests and approval / release of fiscal
resources for emergency procurement

Intermediate:

 Request Procurement Specialist and Human Resource Unit Leader
 Maintain cost- to date reports and submit to the Administration Chief
 Maintain a requisition log, identifying all contracts initiated or activated during
emergency response
 Maintain a line of communication with Unit Leaders in Logistics or Operations
Sections
 Advise Administrative Section Chief of any special procedures to be followed during
this event
 Immediately report to the Administration Section Chief leader issues that can not be
resolved by your unit with current resources

Extended:




                                         118
                                                                  RI Department of Health
                                                                Emergency Operations Plan

                                                                              In process

 Brief Admin Section Chief about finance matters, and prepare an end of shift report
  for the oncoming unit leader
 Observe all staff for signs of stress, and report concerns to Administration Section
  Chief. Provide rest periods and relief for staff
 Document all actions, decisions and interventions
 Prepare end of shift report and present to oncoming Medical Care Unit Leader
 Plan for the possibility of extended deployment
 Participate in post event critique/hotwash
 Other concerns




                                         119
                                                                    RI Department of Health
                                                                                  Reviewed 5.06
                                                                  Emergency Operations Plan

                                                                                In process

                      Rhode Island Department of Health
                       Incident Command System (ICS)
                             Emergency Response
                               Job Action Sheet

                                                                        Command Staff

                              Logistics Section Chief

Reports to: Incident Commander
Emergency Operations Center Location: __________ Telephone: _________
Name of Event:_____________________Date and Time ICS role instituted:_______

Mission: Organize, direct and coordinate those operations associated with maintenance
of the physical environment (facilities), security, personnel deployment (movement) and
provide for adequate levels of shelter and supplies to support the mission’s objectives.

Immediate:

 Receive appointment from Incident Commander.
 Read this entire Job Action sheet and review organizational chart
 Obtain a briefing from Incident Commander
 Assign Unit Leaders and distribute Job Action Sheets
 Establish Logistics Section Center in proximity to Incident Command Center
 Notify Incident Commander when section is activated & operational
 Poll departmental offices as to immediate requirements and needs
 Develop systems for emergency supply of critical items as identified
 Organize and assemble staff to maintain critical communications systems and facility
  utilities.
 Anticipate logistical needs through information from the planning section

Intermediate:

 Coordinate security requirements for all health facilities. Secure areas as needed to
  limit unauthorized personnel access
 Establish emergency communications at remote locations rapidly and as needed.
 Identify staff to interface with the Strategic National Stockpile Technical Assistance
  Response Unit (TARU), as needed
 Update Section staff of new developments and receive Section status reports
 Obtain information and updates regularly from unit leaders and officers; maintain
  current status of all areas
 Review IAP and estimate section needs for next operational period or shift
 Initiate contact with liaison to RIEMA for EMS, Fire and Police assistance when
  necessary
 Prepare to manage large numbers of potential volunteers. Coordinate activities with
  Volunteer Branch Leader



                                           120
                                                                     RI Department of Health
                                                                   Emergency Operations Plan

                                                                                 In process

 Confer with PIO to establish areas for media personnel
 Obtain supplies as requested by Planning or Operations
 Organize logistical and life support needs of the Department for 24/7 operation,
  including sleeping areas and food services
 Execute plan for coordinating emergency manning issues (e.g., overtime and
  hazardous work environment)
 Execute emergency childcare plans for Department employees as required
 Organize personnel relief measures, medication and equipment re-supply
 Coordinate resource acquisition, rapid transport of personnel and equipment,
  temporary and long-term storage of supplies, for ongoing maintenance of equipment
  as indicated
 Establish routine briefings with Incident Commander
 Organize food services as appropriate in accordance with purchasing rules and
  regulations.
 Coordinate sleeping arrangements with RIEMA as needed

Extended:

 Remain informed about requests for assistance from organizations within their area
  of responsibility
 Have all staff sign in and out and record activities and known costs associated with
  the emergency response operations and provide to the Finance/Administration Chief
  as requested
 Maintain documentation of all actions and decisions on a continual basis –forward
  completed unit activity log to Administrative Section Chief
 Participate in the development and execution of the demobilization and make
  recommendations to IC as necessary
 Observe all staff for signs of stress, report issues to Safety Officer. Consider need for
  CISM
 Provide rest periods and relief for staff
 Prepare end of shift report and present to oncoming Incident Commander and
  Logistics Section Chief
 Plan for the possibility of extended deployment
 Participate in post-event critique/hotwash




                                            121
                                                                   RI Department of Health
                                                                 Emergency Operations Plan
                                                                               Reviewed: 6/06

                                                                               In process


                    Rhode Island Department of Health
                     Incident Command System (ICS)
                           Emergency Response
                            Job Action Sheet
                                                                               Logistics

                           Personnel Support Director

Reports To: Logistics Section Chief
Logistics Command Center Location: ______________ Telephone: _____________
Name of Event:_____________________Date and Time ICS role instituted:_______

Mission: Assure the provision of logistical, subsistence and equipment support for
incident response staff.

Immediate:

          Read this entire Job Action Sheet
          Obtain briefing from Logistics Section Chief
          Establish Staff Support Unit center
          Review the IAP and SAP and assign specific personnel as required
          Communicate your telephone number to the IAP and other Section Chiefs

Intermediate:
       Establish a log and document all requests for support
       Identify and request support or resources needed from outside agencies and
          report to Logistics Section Chief
       Prepare to assist with equipment salvage and or recovery
       Plan for subsistence resources (e.g. food, water, rest space, hygiene
          supplies)

Extended:
       Brief Logistics Section Chief about status of Personnel Support Unit’s
          activities and prepare for on coming unit leader
       Observe all staff closely for signs of stress and fatigue; provide for personal
          staff rest periods and relief and report concerns to Logistics Section Chief
       Assist staff with logistical and personal concerns; act as facilitator when
          appropriate
       Document all actions, decisions and interventions
       Plan for the possibility of extended deployment
       Prepare end of shift report and present to oncoming Personnel Support
          Branch Director
       Plan for the possibility of extended deployment
       Participate in post event critique/hotwash



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                           Emergency Operations Plan

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   Other concerns




                     123
                                                                    RI Department of Health
                                                                  Emergency Operations Plan
                                                                                  Reviewed: 6/06

                                                                                In process


                    Rhode Island Department of Health
                     Incident Command System (ICS)
                           Emergency Response
                            Job Action Sheet

                                                                                Logistics

                        Technological Support Director

Reports To: Logistics Section Chief
Logistics Command Center Location: ________________Telephone: __________
Name of Event:_____________________Date and Time ICS role instituted:_______

Mission: Organize and coordinate IT asset support to insure functioning of internal and
external communications and data-related equipment.

Immediate:

        Read this entire Job Action Sheet
        Obtain briefing from Logistics Section Chief
        Review IAP and SAP and assign specific personnel to tasks
        Establish a Communications Center
        Communicate your telephone and fax number to the ICP and other Section
        Chiefs
        Assess current status and inventory of the internal and external
         communication resources, (e.g. telephone, Nextel, Internet, blackberries, fax
         machines, beepers, wireless laptops, radios, ISDN lines for video
         conferencing) and make a list of work to be done
        Establish or maintain the system for receiving communication from external
         agencies
        Meet with Communication Team unit staff to review IAP and SAP, and assign
         specific personnel to tasks

Intermediate:

        Maintain a log of all communication requests received and forward all new
         requests to Logistics Section Chief
        Immediately report to the Logistics Unit leader issues that cannot be resolved
         by your unit with current resources
        Work with IT to facilitate hardware, equipment and software installation
        Insure there are adequate supplies, equipment and materials to produce
         communication products

Extended:



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                                                          Emergency Operations Plan

                                                                        In process

 Brief Logistics Section Chief about status of computers, communication
  requirements and prepare report for on coming unit leader
 Document all actions, decisions and interventions
 Plan for the possibility of extended deployment
 Observe all staff, for signs of stress. Report issues to Logistics Chief.
  Provide rest periods and relief for staff
 Prepare end of shift report and present to oncoming Medical Care Unit
  Leader
 Plan for the possibility of extended deployment
 Participate in post event critique/hotwash
 Other concerns




                                   125
                                                                 RI Department of Health
                                                               Emergency Operations Plan
                                                                           Reviewed 6/06
                                                                            In process


                   Rhode Island Department of Health
                    Incident Command System (ICS)
                          Emergency Response
                           Job Action Sheet
                                                                             Logistics

                            Supply Branch Director

Reports to: Logistics Chief
Logistics Command Center Location: _______________ Telephone: ____________
Name of Event:_____________________Date and Time ICS role instituted:_______

Mission: Organize and supply response specific equipment and supplies
Immediate:

     Read entire Job Action Sheet
     Obtain briefing from Logistics Chief
     Inventory equipment and supplies and project needs based upon requests from
      the Operations Section
     Submit inventories and requests to Logistics Chief

Intermediate:

    Obtain approved vendor access instructions and required accounting information
    Work with Finance to identify alternate methods for procurement and document
     suggestions to Logistics Chief
    Document all actions, orders and deliveries

Extended:

    Prepare End Shift Report and Present to Logistics Chief
    Observe all staff, for signs of stress. Report issues to situation/information
     analysis director. Provide rest periods and relief for staff
    Prepare end of shift report and present to oncoming Medical Care Unit Leader
    Plan for the possibility of extended deployment
    Participate in post event critique/hotwash
    Other concerns




                                         126
                                                                    RI Department of Health
                                                                  Emergency Operations Plan
                                                                                  Reviewed: 6/06

                                                                                In process

                    Rhode Island Department of Health
                     Incident Command System (ICS)
                           Emergency Response
                            Job Action Sheet

                                                                       Command Staff

                             Operations Section Chief

Reports to: Incident Commander
Emergency Operations Center Location: __________ Telephone: ______________
Name of Event:_____________________Date and Time ICS role instituted:_______

Mission: Activate and coordinate any units that may be required to achieve the goals of
the Incident Action Plan (IAP). Direct the preparation of specific unit operational plans
and request, identify, and dispatch resources as necessary.

Immediate:

      Receive appointment from Incident Commander
      Read this entire Job Action sheet and review organizational chart
      Obtain a briefing from Incident Commander
      Establish Operations Section Center in proximity to the Incident Command Post.
      Notify Incident Commander when section is activated & operational
      Review Emergency Operations Plan and all emergency response checklists
      Appoint Operations Section Branch Directors
      Brief all Operations Section Branch Directors on current situation and develop
       the Section’s Initial Action Plan
      Add additional (or delete) tasks and distribute Job Action Sheets
      Identify and report to Liaison Officer and/ or Finance/Administration Section Chief
       any tactical resources needed to achieve the goals of the Incident Action Plan
       (IAP)
      Coordinate IT and data entry needs with Logistics and Planning Section Chiefs

Intermediate:

      Execute all emergency response operations described in appropriate plans
      Ensure appropriate security actions are taken
      Create and manage a system for organizing and coordinating all department
       response activities
      Provide operational guidance, tracking the status of assignments and activities
      Determine operational shortfalls and issues and find internal solutions to issues
       and/or raise issues to the HEALTH Incident Commander
      Brief the Incident Commander routinely on the status of the Operations Section
      Coordinate all activities with the Incident Commander and Planning Section Chief
      Coordinate requests for other HEALTH assets with the Logistics and



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                                                                   Emergency Operations Plan

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      Finance/Administration Section Chiefs
     Coordinate any requests for outside assets (most such requests should be
      passed to the State EOC for action)
     Ensure coordination with the EOC liaison
     Provide input to the periodic IAPs
     Develop a system to receive and review all external communications products
      prior to dissemination
     Coordinate with GIS Subject Matter Export for GIS support to emergency
      operations
     Have all staff sign in and out and record activities and known costs associated
      with the emergency response operations and provide to the
      Finance/Administration Chief, as requested

Extended:

     Oversee all operations activities at the direction of the Incident Commander
     Maintain documentation of all actions and decisions on a continual basis
     Maintains a log of all actions and communications
     Observe all staff for signs of stress. Report issues to Safety Officer. Provide rest
      periods and relief for staff, as needed.
     Plan for the possibility of extended deployment
     Participate in post-event critique/hotwash




                                           128
                                                                    RI Department of Health
                                                                  Emergency Operations Plan

                                                                                In process
                                                                                        Reviewed: 6/06


                    Rhode Island Department of Health
                     Incident Command System (ICS)
                          Emergency Response
                            Job Action Sheet

                                                                             Operations

                         Epidemiology Branch Director

Reports to: Operations Section Chief
Operations Command Center Location: _______________ Telephone: __________
Name of Event:__________________Date and Time ICS role instituted:__________

Mission: Interpret pattern of disease, coordinate investigation, develop appropriate
standardized tool to use in case investigations.

Immediate:

 Read entire Job Action Sheet
 Obtain briefing from Operations Section Chief
 Assign patient Tracking, Investigation, and/or Syndromic Surveillance Group
  Supervisors as needed.
 Establish contact with Medical Consultant as needed
 Utilize standardized interview tool (questionnaire) or other data collection tool
 Assess staffing needs and availability
 Instruct appropriate staff in use of interview (or data collection) tools
 Establish and communicate any individual branch goals and objectives.

Intermediate:

 Update and/or tailor standardized questionnaire (or tool(s) as needed
 Relate information back to Medical Consultant and Operations Section Chief
 Establish and maintain ongoing contact with Planning Section Chief to coordinate
  data and analysis of information
 Evaluate feedback from staff using tool
 Obtain up to date information from neighboring jurisdictions, including the CDC and
  other states’ Health Departments


Extended:

 Document all action decisions and intervention
 Observe all staff for signs of stress. Report issues to Operations Section Chief.
  Provide rest periods and relief for staff, as needed.
 Prepare end-of-shift report and present to incoming Epidemiology Branch Director
 Plan for the possibility of extended deployment


                                           129
                                                 RI Department of Health
                                               Emergency Operations Plan

                                                             In process

 Participate in post-event critique/hotwash




                                        130
                                                                      RI Department of Health
                                                                    Emergency Operations Plan

                                                                                  In process
                                                                                   Reviewed: 6/06




                     Rhode Island Department of Health
                      Incident Command System (ICS)
                           Emergency Response
                             Job Action Sheet

                                                                               Operations

                           Pre-Hospital Branch Director

Reports to: Operations Section Chief
Operations Command Center Location: _______________ Telephone: __________
Name of Event:_____________________Date and Time ICS role instituted:_______

Mission: The Pre-Hospital Branch Director establishes an organized patient care scene
that allows EMS and operational medical care to provide optimal medical services to the
affected population in the pre-hospital setting. It encompasses the initial victim
interaction with first responders through patient arrival at a definitive care site. EMS and
operational medicine assets (medical assets attached to rescue operations such as
Special Weapons And Tactics (SWAT), urban search & rescue (US&R) teams, HAZMAT
teams) must coordinate closely on scene, and processes to promote this are defined.

Immediate:

   Read entire Job Action Sheet
   Obtain briefing from Operations Section Chief
   Establish contact with Medical Consultant as needed
   Utilize standardized interview tool (questionnaire) or other data collection tool
   Assess staffing needs and availability
   Instruct appropriate staff in use of interview (or data collection) tools

Intermediate:

 Relate information back to Operations Section Chief
 Proactively establishe pre-hospital command system for coordinating pre-hospital
  medical response.
 Provide adequate communications to report to health care providers, through a
  single ―disseminator,‖ that an incident is evolving, and the nature and location of the
  event. Updated reports are communicated at regular intervals.
 Develop and maintain communication from pre-hospital providers directly to
  receiving facility for patients being transported to them from the incident
  (coordinated directly with Acute Medical Care Function and supported by
  Communications and MHLIF if necessary).
 Proactively create standard protocols for pre-hospital triage and treatment, with
  recognition and explanation provided for jurisdiction based variances in practice
  within a region.


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                                                               Emergency Operations Plan

                                                                             In process

 Develop internal EMS safety component to delineate field hazards and implement
  personnel protective policies (coordinated with Medical and Health Management.

Extended:

 Document all action decisions and intervention
 Observe all staff for signs of stress. Report issues to Operations Section Chief.
  Provide rest periods and relief for staff, as needed.
 Prepare end-of-shift report and present to incoming Pre-Hospital Branch Director
 Plan for the possibility of extended deployment
 Participate in post-event critique/hotwash




                                        132
                                                                      RI Department of Health
                                                                    Emergency Operations Plan

                                                                                  In process
                                                                                          Reviewed: 6/06




                     Rhode Island Department of Health
                      Incident Command System (ICS)
                           Emergency Response
                             Job Action Sheet

                                                                                 Operations

                         Disease Control Branch Director

Reports to: Operations Section Chief
Operations Command Center Location: _______________ Telephone: __________
Name of Event:____________________Date and Time ICS role instituted:________


Mission: The Disease Control Branch Director intervenes to control, arrest, or
minimize the threat of chemical, biological, radiation, and other hazards. It is the most
important function in directly addressing two of the three general medical and health
objectives in mass casualty response:

Immediate:

   Read entire Job Action Sheet
   Obtain briefing from Operations Section Chief
   Establish contact with Medical Consultant, as needed
   Assess staffing needs and availability
   Brief Branch staff


Intermediate:

 Reduce hazard exposure: avoid or minimize the hazard exposure to patients and
  the population
 Increase hazard resistance: maximize patient and population resistance to the
  hazard impact.
 Though some activities listed here (e.g., environmental decontamination and
  cleanup of hazards) may not be a direct function of the Medical and Health
  Response System, critical input into these activities from the health and medical
  communities may be required.

Extended:

  Document all action decisions and interventions
  Observe all staff for signs of stress. Report issues to Operations Section Chief.
   Provide rest periods and relief for staff, as needed.



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                                                               RI Department of Health
                                                             Emergency Operations Plan

                                                                           In process

 Prepare end-of-shift report and present to incoming Disease Control Branch
  Director
 Plan for the possibility of extended deployment
 Participate in post-event critique/hotwash




                                       134
                                                                     RI Department of Health
                                                                   Emergency Operations Plan
                                                                               Reviewed: 6/06
                                                                                 In process

                    Rhode Island Department of Health
                     Incident Command System (ICS)
                          Emergency Response
                            Job Action Sheet

                                                                              Operations
                         Environmental Branch Director


Reports to: Operations Chief
Operations Command Center Location: _______________ Telephone: __________
Name of Event:______________________Date and Time ICS role instituted:______

Mission: Environmental Branch Director oversees testing and monitoring of key
environmental indicators for evidence of a hazard to humans. This could include water
quality evaluation, radiation monitors, chemical detectors, and other environmental
monitoring. While much of this is actually performed by non-medical and non-health
entities, collaboration with health experts may be required to maximize effectiveness of
ongoing surveillance, and for developing focused monitoring during an incident.

Immediate:

 Read the entire Job Action Sheet
 Obtain briefing from Epidemiology director
 Direct staff for field assignments and brief on expected data to be collected and
  methods for collection

Intermediate:

 Redirect staff assignments as needed
 The branch director will be responsible for testing and monitoring of key
  environmental indicators for evidence of a hazard to humans
 Provide for water quality evaluation, radiation monitors, chemical detectors, and
  other environmental monitoring as needed
 Collaborate with medical experts to direct to maximize effectiveness of ongoing
  surveillance, and for developing focused monitoring during an incident.

Extended:

  Prepare end of shift report for the operations chief and on coming Environmental
   Branch Director
  Plan for the possibility of extended deployment
  Observe all staff, for signs of stress. Report issues to situation/information analysis
   director. Provide rest periods and relief for staff
  Plan for the possibility of extended deployment
  Participate in post event critique/hotwash



                                           135
                           RI Department of Health
                         Emergency Operations Plan

                                       In process

 Other concerns




                   136
                                                                      RI Department of Health
                                                                    Emergency Operations Plan
                                                                                 Reviewed: 6/06
                                                                                  In process


                    Rhode Island Department of Health
                     Incident Command System (ICS)
                          Emergency Response
                            Job Action Sheet
                                                                                Operations

                          Medical Care Branch Director

Reports to: Operations Chief
Operations Command Center Location: _______________ Telephone: __________
Name of Event:____________________Date and Time ICS role instituted:________

Mission: The Medical Care Director oversees the coordination of assets and
information between medical care resources, and the development and implementation
of standardized evaluation and treatment protocols as indicated by the type of injury or
illness in the incident. This function encompasses all facility based, organized medical
interventions to meet the medical needs of the affected population. “Facilities” could
include alternate treatment sites, including definitive care capabilities set up at the site
to screen and medically release victims. The facilities would also include hospitals,
nursing homes, clinics, alternative care sites, and home care during a public health
emergency. The operations chief would appoint Unit Leaders for each of these areas
including a Pharmacy Unit Leader. The operations chief will implement and coordinate
the operational functions, sub-functions, and processes, at the tactical level, that
comprises the primary response interventions in a mass casualty event.

Immediate:

   Read entire Job Action Sheet
   Obtain briefing from Operations Chief
   Establish contact with Epidemiology Branch Director as needed
   Appoint and provide oversight to Unit Leaders for hospitals, nursing homes, clinics,
    alternate care sites, home care, and pharmacies during a public health emergency
   Establish a check-in process for assets and personnel so that accountability is
    maintained.
   Assess staffing needs and availability
   Coordinate assets and information between medical care resources
   Coordinate with Logistics to ensure housing, equipment, and support for Medical
    Branch personnel

Intermediate:

 Develop and implement standardized evaluation and treatment protocols as
  indicated by the type of injury or illness in the incident.
 Relate information back to Epidemiology Branch Director and Operations Chief



                                            137
                                                                   RI Department of Health
                                                                 Emergency Operations Plan

                                                                               In process

 Establish and maintain ongoing contact with Planning Section to coordinate data
  and analysis of information
 Oversee efforts to meet the medical needs of the incident so that there is adequate
  capability for both surge capacity and specialized medical care


Extended:

 Document all action decisions and intervention
 Prepare end of shift report for Operations Chief and incoming Medical Care Branch
  Director
 Plan for the possibility of extended deployment
 Observe all staff for signs of stress. Report issues to Operations Chief. Provide rest
  periods and relief for staff, as needed
 Prepare end-of-shift report and present to oncoming Medical Care Branch Director
 Plan for the possibility of extended deployment
 Participate in post event critique/hotwash




                                          138
                                                                    RI Department of Health
                                                                  Emergency Operations Plan
                                                                              Reviewed: 6/06

                                                                                In process

                    Rhode Island Department of Health
                     Incident Command System (ICS)
                          Emergency Response
                            Job Action Sheet

                                                                             Operations

                         Mass Fatality Branch Director

Reports to: Operations Section Chief
Administration Command Center Location: ________Telephone: ______________
Name of Event:______________________Date and Time ICS role instituted:______

Mission: Address requirements of processing fatalities. Assure safety of workers,
catalog and protect personal items, maintain chain of custody, and respect for cultural
traditions

Immediate:

   Read Job Action Sheet
   Report to/obtain briefing from the Operations Section Chief
   Assign staff for body recovery, mortuary services, post-morgue services, and
    decedent’s family assistance
   Brief staff and share Incident Action Plan (IAP) and Section Action Plan (SAP)
   Request IT and data entry needs with the Logistics Chief
   Identify hazards/risks at the scene and/or on the bodies

Intermediate:

   Coordinate needs, custody, and requirements with emergency response leadership
    on scene. This includes EMS, fire, and law enforcement
   Ensure security
   Provide appropriate PPEs to staff
   Coordinate need for outside resources with Logistic Section Chief and Liaison
    Officer
   Establish on-scene fatality collection site
   Assure chain of custody is maintained
   Assign a staff member to obtain and provide information to the families and legal
    representatives of the deceased and provide grief services
   Coordinate activities with funeral directors

Extended:

 Coordinate activities with Family Assistance Center
 Document all action decisions and intervention




                                          139
                                                                RI Department of Health
                                                              Emergency Operations Plan

                                                                            In process

 Observe all staff for signs of stress. Report issues to Operations Section Chief.
  Provide rest periods and relief for staff, as needed.
 Prepare end-of-shift report and present to incoming Mass Fatality Branch Director
 Plan for the possibility of extended deployment
 Participate in post-event critique/hotwash




                                        140
                                                                          RI Department of Health
                                                                        Emergency Operations Plan
                                                                                      Reviewed: 6/06

                                                                                      In process

                      Rhode Island Department of Health
                       Incident Command System (ICS)
                            Emergency Response
                              Job Action Sheet

                                                                                    Operations
                             Laboratory Branch Director


Reports to: Operations Chief
Name of Event:_____________________Date and Time ICS role instituted:_______

Mission: Provide laboratory testing services in support of response to public health emergencies.
Maintains the line listing of all laboratory testing results.


Immediate:

   Read entire Job Action Sheet.
   Obtain briefing from Operations Chief
   Assign Biological, Chemical, and/or Forensic Group Supervisor(s) as needed.
   Establish contact with appropriate branch directors and testing laboratories.
   Establish contact with Planning/Intelligence Section to coordinate test result data.
   Coordinate with local, state and federal agencies for testing and handling protocols
    for biological and chemical agents.

Intermediate:

 Coordinate IT needs through Logistics Section.
 Document all diagnostic values.
 Communicate all test results to the Epidemiology Branch Director and
  Planning/Intelligence Section.

Extended:

 Same as above.
 Prepare end of shift report for oncoming Lab Branch Director and Operations Chief.
 Plan for the possibility of extended deployment.
 Document all action decisions and intervention
 Observe all staff for signs of stress. Report issues to Lab Branch Director. Provide
  rest periods and relief for staff, as needed.
 Participate in post event critique/hotwash




                                              141
        RI Department of Health
      Emergency Operations Plan

                    In process




142

								
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