Multi-Disciplinary Planning Committee
Members
Jim Anderson
Jamie Crouch
Jerry McCoy, BS, EMT-P/IC
Thomas A. Shaver, PEM, MEP
Bill Smith
Jack Stewart
Chris Swank
Rich Szczepanek
Jim VanBendegom
*Brenten Walker, BS, HCA, CCEMT-P, I/C
Bob Wilson, BS, EMT-P/IC
MMPC
Region 6
Montcalm County Emergency Management
CEMA
Ottawa County EMD
Kent County Emergency Management
Grand Valley State University
Ottawa Medical Control Authority
F & V Engineering
Life EMS Ambulance
Spectrum Health
*Committee chair
Objectives
1. Describe how health care facilities will work together to share personnel and resources under a
MEMS model and according to National Response Framework and National Incident Management
System guidelines.
2. Write a plan that will outline how these agencies will provide staffing for both flu and all other
health care patients
3. Write a technology and information system plan that includes implementation and integration of
data collection and data storage processes
4. Identify/catalog other vulnerable links in the public and private sector needed to support heath care
delivery.
Assumptions

Hospitals will not be able to share current resources.

We assume the CDC and MDCH will provide guidance for the response and delivery of health care
services based on the severity of the event, the fluidity of information, the availability of
pharmaceuticals, etc.

We assume staffing will be scalable based on that guidance.

We assume that hospitals will provide resources to staff ACSs, and that EMS agencies with public
health departments will collaborate to provide staffing for NEHCs, depending on the function of the
NEHCs.
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
We assume that the plan will serve as a coordination and prioritization matrix within an ethical
framework.

We assume the current social system will be challenged (shopping, funerals, medical supply delivery).

We assume there will be challenges in the communications arena (landline/cell, IP telephone
systems, networks, web, etc.) due to limited capacity.
Background
The Multidisciplinary Planning Committee of the Spectrum Health CDC Grant Project “How to Deliver
Essential Health Care Services During an Influenza Pandemic” is a group of individuals with extensive
backgrounds in emergency management, planning, response, information technology, EMS and health
care. Members of the team represent both the public and private sectors.
The Multidisciplinary Planning Committee has links to a number of other agencies and organizations that
have, to varying degrees, planned for (and in some cases responded to) a pandemic influenza event. The
Region 6 Homeland Security Governing Board and the Region 6 Bioterrorism Network, for example, are
working on a Regional Pandemic Influenza Response Plan. Two key planners responsible for developing
that plan sit on the committee. One of the emergency managers has developed a Pandemic Influenza and
Epidemiological Outbreak Plan along with a Mass Fatality Plan, and that emergency manager sits on the
committee.
The committee understands that a pandemic influenza event that reaches WHO Phase 6 does not mean
that conditions exist locally or in the Region that have resulted in health care agencies reaching or
exceeding capacity. The committee relied on the conclusions of another committee – the Pre-ED Triage
Matrix – to identify the levels of triage and response based on levels of impact on local and regional health
care services. These levels range from Level A (standard operating procedures) to Level E (significant
curtailment of services due to surge capacity overload).
A pandemic influenza event that results in massive numbers of infections and perhaps deaths will
significantly challenge all aspects of the health care community and the community as a whole. It will be
critical that all disciplines work together to ensure a coordinated, effective response to such an event.
Committee members recognized early on that adequately addressing the objectives assigned to our
committee was dependent on coordination with the committees working under this project as well as clear
direction from the project staff.
Each member of the team had individual preconceived ideas about how a pandemic influenza response
would be implemented. Those perspectives, however, were clearly similar across the board and
consensus was quickly reached that the basic premise of an effective response must be multidisciplinary in
nature.
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The Process
The Multidisciplinary Planning Committee met monthly according to the schedule determined by the
project staff. At the first meeting, the committee’s objectives were discussed and a plan of action
developed to address those objectives. Assumptions were derived out of inter- and intra-group
discussions. Final assumptions were forwarded to the Executive Committee where they were further
refined and returned to the committee.
Based on those assumptions, the committee faced the difficult process of sorting through all of the
reference materials and tapping into all of the significant expertise of the committee members of this and
other committees to develop conclusions regarding how to deliver essential health care services during a
pandemic influenza event.
The committee proceeded with the understanding that current planning levels and response capabilities
vary widely from jurisdiction to jurisdiction, agency to agency and discipline to discipline. A minimum level
of preparedness, however, is critical in each jurisdiction, agency and discipline to ensure the most
coordinated and successful response possible in the event of a pandemic influenza event that overwhelms
current patient care capacity.
Tasks were assigned to committee members based on their areas of expertise, and a task list was
developed. Team members addressed those issues, which were assigned to them and brought their
findings back to the team. The committee reviewed, evaluated and provided input for the conclusions
listed below.
CONCLUSIONS
Objective #1
Describe how health care facilities will work together to share personnel and resources under a
MEMS model and according to the National Response Framework (NRF) and National Incident
Management System (NIMS) guidance.
The Modular Emergency Medical System (MEMS) is designed to provide a systematic, coordinated and
effective medical response to a large-scale incident, such as a pandemic, where the number of casualties
significantly overwhelms a community’s existing medical capabilities. It establishes a framework to facilitate
augmentation of local response efforts through the organization of outside medical resources and available
assets into two types of expandable patient care modules, the Acute Care Site (ACS) and the
Neighborhood Emergency Help Center (NEHC).
There are six tiers of response defined in the MEMS model (see Tier Definitions below). These tiers,
based on the severity of the pandemic, delineate the levels of care provided at each tier.
According to this model, the key MEMS components are:

The Regional Medical Coordination Center (MCC)

Acute Care Sites (ACS)

Neighborhood Emergency Help Center (NEHC)
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Tier Definitions
Tier 1 – Management of Individual Health Care Assets
The primary site of hands-on medical evaluation and treatment includes hospitals, integrated health care
systems, clinics, alternative care facilities, and private practitioner's offices, nursing homes with medical
services, hospice, rehabilitation facilities, psychiatric and mental health facilities, and Emergency Medical
Services. The Medical Reserve Corps and State and Federal health care assets that are co-located within
a jurisdiction also fall into Tier 1 because they may become local assets for emergency response
dependant upon the event.
Tier 2 – Management of the Healthcare Coalition
The Healthcare Coalition, as defined in the MEMS model, is comprised of health care facilities and other
health care assets described in Tier 1 that form a single functional entity to maximize medical surge
capacity and capability (MSCC) in a defined geographic area. In Region 6, this Healthcare Coalition is the
Regional Biodefense Network Coalition, which includes public health and Medical Control Authorities.
Tier 3 – Jurisdiction Incident Management
Jurisdiction Incident Management is the management level that effectively coordinates activities among the
multiple and disparate entities involved in response for that jurisdiction. Incident objectives and an overall
response strategy for the community are the responsibility of a variety of agencies meeting in or
coordinating with the Local Emergency Operation Center.
Tier 4 – Management of State Response and Coordination of Intrastate Jurisdictions
Tier 4 fully integrates public health and acute-care medicine with traditional response disciplines, and
develops management processes that facilitate integration between State-based and local or jurisdictional
authorities. This includes the State Emergency Operations Center (SEOC) in coordination with the
Community Health Emergency Coordination Center (CHECC).
Tier 5 – Interstate Regional Management Coordination
Tier 5 promotes the optimal distribution of available medical and public health resources in support of
overall MSCC. It enables affected states to share information, including incident goals and objectives
defined by management, so that a consistent response strategy can be implemented across state borders.
This could include activation of Emergency Management Assistance Compact (EMAC) resources.
Tier 6 – Federal Support to State and Jurisdiction Management
Federal health and medical assets (e.g., supplies, equipment, facilities, and personnel) are organized for
response to Federally-declared public health and medical emergencies or disasters under Emergency
Support Function #8 (ESF #8) of the National Response Framework. The Department of Health and
Human Services (HHS) is the Primary Agency for ESF #8 and coordinates all Federal public health and
medical assistance provided through ESF #8 in support of State, Tribal, and jurisdictional response efforts.
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Activation of MEMS



It is recognized that MEMS would be activated during a significant incident (such as a pandemic) in
which routine health operations’ capacity has been exceeded. This would be done consistent with
local and state emergency operation centers.
Activation and operations of MEMS is consistent with the Incident Command System (ICS), Fire
Incident Command Model, Hospital Incident Command System (HICS) or Incident Management
System (IMS), which is utilized nationally by the emergency response community and consistent
with the National Incident Management System (NIMS).
The State of Michigan maintains parameters and guidelines to assist with MEMS activation
consistent with Incident Command. The CHECC in coordination with the SEOC may activate
MEMS to meet activities outlined in ESF #8.
The flowcharts below delineate lines of authority and lines of communications during a pandemic
influenza event. These are the standard flowcharts for multi-casualty events as shown in the MEMS
model.
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ACS Flow Chart
From Hospital
or PreHospital Site
via EMS
From NEHC
or
Community
START
Patient Care Process
Gather all required
information and track
patients
Assign patient
beds
If patient’s
condition
changes, where
do they go?
Morgue
Home
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Other Care
Site
Hospital
6
The following flowchart was developed by the Multi-Disciplinary Planning Committee to demonstrate the
overall coordination of information and activities between NEHCs, ACSs, public health, hospitals and local
and state emergency operations centers during a pandemic event.
Command
and
Control
Governor
SEOC
EOC
Communication
CHECC
MCC
Public
Health
Hospital
NEHC
ACS
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Objective #2
Write a plan that will outline how these agencies will provide staffing for both flu and all other
health care patients.
The committee felt it was prudent to look beyond staffing and address supplies, equipment and facilities to
support staff assigned to pandemic flu activities. (See “Guidelines for the Development of a Pandemic
Influenza Resource Plan” below). Acute Care Sites (ACS), if/when established, are opened by one or
more hospitals and are operated and staffed under the purview of those hospitals. It is recognized that
hospitals may not have sufficient personnel to staff an ACS adequately, and therefore must develop plans
to recruit and train additional licensed and non-licensed volunteers to augment their staff at the ACS.
Hospitals must also recognize that while staffing an ACS will pose a significant challenge, it is imperative,
considering the mission of health care, that the ACS be staffed. Hospitals should seek to recruit volunteers
from local Medical Reserve Corps, EMS agencies, doctors’ offices and medical clinics and other sources,
perhaps including (but not limited to) veterinary, mortuary, and pharmacy staff. Hospitals should work
closely with their public safety partners (police, fire, emergency management, etc.) to facilitate volunteer
recruitment, vetting and credentialing.
Neighborhood Emergency Help Centers (NEHC), when established, are operated and staffed under the
purview of public health agencies. The national MEMS model gives considerable responsibility to local
health departments to address a wide variety of operations including triage, treatment, and other clinical
activities. Regionally, public health has essentially zero capacity, experience or expertise to perform many
of the functions described in the MEMS NEHC model. Additionally, the MEMS model suggests recruitment
of individuals that, simply put, are very unlikely to be available. However, it is expected the NEHC concept
may be utilized regionally by public health for mass vaccination, drug distribution, or patient education.
Local health departments must communicate with their hospitals and providers (including EMS) to
determine how other NEHC functions, as defined by MEMS, can be addressed in their community. One
possible adaptation is the shifting of clinical operations, such as triage and treatment, the ACSs.
During a highly lethal pandemic flu event, the focus of health care will necessarily change from care of the
individual to care of society. The ethics of health care will be redefined by the need to prioritize health care
delivery based on a pre-established prioritization matrix. Conventional health care for non-flu illnesses and
injuries must be continued, while care of individuals with the flu will be relegated to non-conventional care
methodologies such as home care or admission to an ACS. NEHCs may be opened to triage patients and
dispense pharmaceuticals. Emergency Medical Services agencies may employ non-transport protocols.
Hospitals may control emergency department access and establish triage sites apart from those in the
emergency departments.
It is understood that responding to and recovering from a pandemic influenza outbreak will require
participation in a pre-developed plan.
There should exist, in each state, a pandemic influenza plan that is universally followed by each
hospital, public health department, EMS agency, doctor’s office and medical clinic. That plan
must delineate the procedures to be followed at each stage of a pandemic flu outbreak. Those
procedures must address mass care, distribution of pharmaceuticals, EMS transportation, triage
guidelines, 911 centers, etc.
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GUIDELINES FOR THE DEVELOPMENT OF A PANDEMIC INFLUENZA RESOURCE PLAN
I.
PURPOSE
Identify private medical staffing, equipment and facility resources that could be used to enhance
and/or supplement the regional medical surge capacity during a pandemic influenza or other largescale health event. This includes staffing support for ACS and NEHC operations. NEHC
operations may include distribution of antiviral medication and/or administration of immunizations.
II.
SCOPE
Private physician offices, freestanding clinics, specialized patient care facilities, outpatient service
providers, other patient care providers and dentists all have critical staffing, equipment, and
facilities that could be used to provide both local and regional patient surge capacity. These
resource groups need to be identified, provided with awareness information and guidance
necessary to incorporate the resources into pre-pandemic influenza and patient surge planning
initiatives.
III.
DEFINITIONS









IV.
Pandemic: Is a global disease outbreak.
Pandemic Influenza: Occurs when a new influenza virus emerges for which people have
little or no immunity.
Private Physician Offices/Groups: An independent or group of physicians that have
joined together to provide specialized care, outpatient care, and treatment at their privately
owned facilities.
Hospital Based Physician Offices: Physician/groups that provide specialized care,
outpatient care and treatment facilities, but are directly connected to a hospital system.
Private Dentist Offices: A privately owned dentist office that may have staffing support
that could be utilized and support patient surge initiatives.
Michigan Department of Community Health (MDCH): The State governmental
department that is responsible for overseeing public health operations throughout
Michigan.
Modular Emergency Medical System (MEMS): A patient surge (force multiplier) system
that has been developed to enhance local patient surge capabilities during a biological
attack or public health emergency.
Acute Care Site (ACS): One of two types of MEMS facilities that will be used to provide
additional hospital surge capacity during a large-scale public health emergency. The ACS
would be used to provide supportive care to like groups of patients at a facility. An ACS
would normally be connected to a hospital.
Neighborhood Emergency Health Center (NEHC): A facility that would be established
in an area to provide information, patient triage, self-care support, and possibly
medication, vaccines, or immunizations based on the incident and public needs. As
described in Objective #2, it is expected that the function of NEHCs regionally are likely to
be limited to vaccine/drug distribution and patient education.
STAFFING RESOURCES
Based on needs, availability, and incident, lesser-trained personnel may have critical patient care
skills that could be used based on the legal authority, rules, and guidelines.
 Physicians
 Physician Assistants
 Nurse Practitioners
 Nurses – RN
 Nurses – LPN
 Nurse Assistants
 Medical Assistants
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

Technicians (IV, Respiratory, EKG,EMS, Surgical, etc)
Support Staff
Sources for Staffing Resources – develop and maintain up-to-date contact lists
 Private physician offices/groups
 Volunteer assets (MRC/AMRC)
 State licensing bodies
 State and local medical societies
 Medical and clinical staffing companies
 Dental offices
 Nursing/EMT/Medical Assistant/CNA schools
V.
EQUIPMENT RESOURCES






Patient care equipment
Patient care support equipment
Ventilators
I.V. Poles, I.V. dispensing meters
Pharmaceuticals
Patient care beds
Sources for Equipment Resources
 Physician office list
 Dentist office list
 Equipment suppliers and vendors
 Colleges, universities, and training facilities
VI.
SUPPLIES RESOURCES





Patient beds
Laundry supplies
Patient and staff support resources
Food supplies for patients and staff
Housekeeping
Sources for Supplies Resources
 Joint hospital supply center
 Physician office lists
 Dentist office lists
 Private suppliers and vendors
 Regional medical supply resources
 Salvation Army, Red Cross, pantries
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VII.
FACILITY RESOURCES




VIII.
OTHER




IV.
Mortuary services
Security
Critical infrastructure
Community human service support
ASSUMPTIONS





V.
Offices
Schools
Patient Care Facilities with supportive equipment
Potential for use as ACSs, NEHCs, Points of Dispensation, or Influenza Clinics
A highly virulent, highly lethal pandemic influenza outbreak will quickly overwhelm our normal
patient care capacities and resources.
The non-pandemic influenza patients will still require treatment for acute and chronic diseases,
injuries, and illnesses.
Hospitals will experience staffing, equipment, and bed shortages during a pandemic Influenza
outbreak.
Alternate patient care facilities and standard may be needed to expand patient surge
capabilities.
The coordination and use of private physician staffing, equipment, and facilities could provide
additional surge capacity during a pandemic influenza outbreak.
PROCEDURES
Pre-Pandemic Influenza Phase
Identify, review, and establish critical contact information, for private physicians, dentists,
and their office staffing resources, equipment, facilities, organizational commitments and
patient care responsibilities. Local hospitals, public health departments, and emergency
management officials to coordinate the development of project awareness information,
establish resource and contact lists. Assist with the development of coordinated protocols,
emergency response plans, resources and assets. Identify critical concerns, issues, and
potential impact areas that can be addressed during the pre-pandemic Influenza phase.
Coordinate and provide guidance to ensure integration of critical staffing, equipment and
facility resources.
Special Note: Some physicians and physician groups are identified as resources for
specific hospitals and health care systems.
Pandemic Influenza Phase
Local Public Health, Emergency Management, and hospital officials (local coordination
team) should meet, discuss, and activate the local pandemic influenza coordinated
response plan. Once the need to activate the plan is identified, critical community partners
(private physicians, physician groups and volunteer assets (MRC)) should be notified and
alerted to the situation. The specific coordination protocols, procedures, and guidelines
should be activated. The local coordination team will monitor impact in their respective
area as well as updated state (MDCH) and federal (CDC) guidelines. Emergency Medical
Services, as well as private physicians and physician groups and patient care teams
should be updated on the needs of the incident on a regular basis.
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When the need for alternative patient care resources and support has been identified by
the local coordination team, all local support agencies will be notified. The coordination of
patient care resources such as staff, equipment, and facilities will be necessary to continue
patient care.
The Regional medical coordination center will be activated to monitor resources, assets,
and supplies and serve as the information exchange, integration and coordination center
for patient care information. The Regional medical coordination center will provide liaison
services between the local emergency operations centers, hospitals, and the Michigan
Department of Community Health (MDCH) coordination center.
Post-Pandemic Phase
The local coordination team will develop a “Return to Normal” deactivation plan and
timeline. This timeline will be used to coordinate the return to “Normal Operations” for
patient care facilities and treatment. The timelines will be developed based on local
impacts, resources, and guidelines as developed by state and federal officials. During the
post-pandemic phase, the local coordination team will collect and update impact data on a
regular basis. Documentation of the event, response capabilities, lessons learned
financial, and physical losses would be collected.
Objective #3
Write a technology and information systems plan that includes implementation and integration of
data collection and data storage processes.
Pre-Pandemic Planning and Preparedness
Prior to a pandemic, certain considerations and preparations have to be taken. The essential information
technology (IT) functions/services needed within health care facilities and agencies during a pandemic
need to be determined and a plan needs to be developed to establish how IT can support these functions
onsite or remotely. Specifically, IT staff needs to evaluate all of the critical operational technologies that
need to function during a pandemic. Additionally, all health care sites (ACS, NEHC, hospital, etc) and
agencies need to keep their individual IT operations up and running in order to take advantage of the ability
to communicate with all sites within their region.
The following is a summary of considerations that need to be made prior to a pandemic:



Regional drilling and/or testing of critical applications. Tests can be as simple as table limits within
an application assuring there is adequate capacity when there are large amounts of data being
input into a system at once.
Essential IT services have to be determined such as, electronic medical records (EMR), helpdesk
support, network support, phone support, software support, etc.
o Network Support: One of the most critical technologies during a pandemic is the Internet,
thus network outages must be avoided.
o Phone: Phones are going to be more important in a pandemic to avoid face-to-face
interaction.
o Software: Those critical applications that are needed, especially those used internally,
need to be assessed. Vendors need to be kept current on their upgrades since there may
be an 8-week time for no upgrades.
Agencies should pre-set policies for flexible worksites; all possible IT staff should work remotely
(social distancing).
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










IT personnel within agencies need to be considered essential agency personnel for initial
distribution of vaccines and antiviral drugs. Those IT personnel need appropriate infection control
training and have been previously fitted for proper personal protective equipment.
Agency internal and inter-agency applications used should be browser- (internet) based rather
than local workstation installs to avoid the difficult task of software distribution. Applications that
are specific for emergency alert, notification and information-sharing include:
o E-team
o EMSystems
o MIHAN
o CityWatch
There will be more demand on IT infrastructure. Besides data, all applications need to be
assessed for capacity such as licensure, bandwidth, and the number of workstations.
Limited capacity may require the implementation of a set schedule of communications to ensure
against infrastructure absorption.
o For example, VPN from 10:00 – 12:00 and teleconference from 12:00 – 1:00.
Prior to the pandemic, IT staff who are responsible for the network infrastructure at the hospital,
ACS, NEHC and all regional agencies need to compare individual agency technology plans and
develop a coordinated plan. That coordinated plan should include potential integration, capacities
and ‘touch-points’.
Partnerships need to be made with local utility companies, carriers, and software vendors
regarding support during an event should the network go down inside or outside of the established
hospitals, call centers, ACSs and NEHCs. These include
o Data circuits/relationships with data carriers
o Phone circuits/relationships with carriers
o Software/critical applications/relationships with their vendors.
o Call out technologies that need assessment.
o VPN connections
o Have a relationship with the data carriers and execute an agreement on protected
bandwidth
o The ability for essential IT services people to work remotely
Health care facilities in the region need to have protected bandwidth so inter-agency
communication is not interrupted.
The immediate ability to get additional capacity/bandwidth if needed.
All those who may be involved in data collection should receive training in software packages used
during the pandemic.
Key personnel must also be familiar with the paper chart and other manual record systems (see
examples below).
Organizations must also develop and be familiar with systems for communicating within and
among facilities, agencies, and organizations, etc. in the event of an IT system failure.
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During a Pandemic
IT personnel need to go into an “IT system stabilization mode” by halting all changes/updates/upgrades
(i.e. no Windows/MS Office updates, equipment installation, etc.). IT needs to avoid a systems failure
because the infrastructure and the provision of patient care are largely dependent on IT. In the event of an
IT system failure, paper back-up is the traditional option. By taking these precautions, IT significantly
reduces the possibility of a system break. IT at this point will maintain the operations of critical functions
such as EMR, helpdesk support, network support, phone support, software support, etc. Only
corrections needed for system failures should be attempted.
Failsafe/Back-up plans have to be created in the event a system failure happens, e.g. all communication
may have to happen via phone, fax, or Amateur Radio.
In the event of a system failure, charting and information collection will have to be done using the already
established paper chart system (Appendix 9 from the MEMS Model). A procedure will have to be
established to update software applications with paper chart data once failed systems are restored.
Post Pandemic
IT personnel will return to normal operations mode. All system failures, if any, will need to be evaluated in
order to be avoided in the future. Firewall vulnerabilities, if created for emergency ACSs, need to be
closed.
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Appendix 9
Patient Information Intake and Documentation
NEHC
ACS
Other
Patient to complete:
** = Required Information
**Name ______________________Last ________________________First ________M.I.
**Date of birth____/____/____ Age____ Weight (stated)_____ lbs kgs. Gender M F
Address: Street ___________________________________PO Box or Apt_______________
City________________________State__________Zip_____________Phone_____________
**Emergency Contact:
Name_____________________________Phone#__________________________
Staff to Complete:
Triage Status Red Green Yellow ** Triage Tag Sticker ________________
Place sticker here
B/P_______/_______ Pulse________ Resp_________ Temp__________
History (brief):________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Allergies:____________________________________________________________________
Medications (current):__________________________________________________________
____________________________________________________________________________
Complaint:___________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Findings (assessment):________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Care Provided:_______________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Discharged to: Home
ACS
Hospital
Morgue
Shelter_______________________
Time out:_____________________
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ACS Multi-Disciplinary Progress Note
Location of ACS___________________________________________________
Medical Record - Progress Note
Patient Name_________________________
Chart # ____________
Vital Signs
Date/Time
Pulse
Resp.
B/P
Date
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Progress Notes
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Objective #4
Identify/catalog other vulnerable links in the public and private sector needed to support
health care delivery.
Communications
The following table provides various communications types and the vulnerabilities associated
with each.
Communications Type
Landlines
Cell Phones
Internet
Health Alert Network (HAN)
E-Team
800 MHz Radio – State System
Amateur Radio
City Watch System
Emergency Alert System (EAS/EMNET)
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Vulnerability
Infrastructure that has to be maintained
Adequate staffing
Up-to-date contact information
Infrastructure that has to be maintained
Adequate staffing
Up-to-date contact information
Access
Availability
Infrastructure that has to be maintained
Adequate staffing
Up-to-date contact information
Access
Availability
Infrastructure that has to be maintained
Adequate staffing
Up-to-date contact information
Access
Availability
Infrastructure that has to be maintained
Adequate staffing
Up-to-date contact information
Signal strength in buildings
Availability
Infrastructure that has to be maintained
Access
Availability
Infrastructure that has to be maintained
Adequate staffing
Up-to-date contact information
Access
Availability
Infrastructure that has to be maintained
Adequate staffing
Up-to-date contact information
Access
Availability
Infrastructure that has to be maintained
Adequate staffing
Up-to-date contact information
17
Communications uses (in order of preference):
Alert & Notification
1. Health Alert Network (HAN)
2. E-Team and/or EM systems
3. City Watch
4. Emergency Management Communications network (EAS) EMNET (ComLabs)
Urgent
1.
2.
3.
Communications
800 MHz
Existing VHF/UHF radios
Amateur radio
Reference/Guidance
1. World Wide Web
2. Microsoft share-point services
Normal Communications
1. Landlines
2. Cell phones
Essential Support Services
We assume that essential support services will have difficulty meeting demands (e.g. laundry, oxygen, food
medical supplies, etc.). It is noted that many health care facilities share vendors and many vendors are
state- and/or national-level providers.
Facilities and agencies would be well served by contacting vendors prior to emergencies to make sure that
adequate supplies are maintained. However, in the event of emergencies, local emergency management
officials will need to provide support to the health care system(s) in the event of shortages and challenges.
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