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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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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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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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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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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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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.
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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
-6.html
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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
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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
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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
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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
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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
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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
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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:
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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:
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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
122
RI Department of Health
Emergency Operations Plan
In process
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:
124
RI Department of Health
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
127
RI Department of Health
Emergency Operations Plan
In process
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.
131
RI Department of Health
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.
133
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
