Introductions
– Instructor(s)
– Participants
• Name
• Agency
• What you hope to learn from today’s class
2
Housekeeping Issues
– Emergency Exits
– Restrooms
– Breaks
3
Course Description
This course introduces and focuses on the medical needs
component of mass care and sheltering in either a colocated or stand-alone shelter setting. This course will
mainly focus on which populations are expected in
medical needs shelters (MNSs) and outlines the criteria
for establishing, operating, and demobilizing a MNS. The
course also discusses how counties coordinate and share
resources throughout the region.
4
Course Objectives
At the end of this course, the participant will:
– Understand the purpose of a MNS
– Differentiate between which populations are served in
a MNS
– Understand the capabilities and limitations of MNS
– Understand the MNS triage criteria
– Understand roles and responsibilities in a MNS
– Discuss how counties coordinate for MNS in the
southern New Jersey region
5
Units in the Course
This course comprises the following units:
– Unit 1 – Medical Needs Sheltering
– Unit 2 – Types of Medical Needs Shelters
– Unit 3 – Medical Needs Shelter Standard Operating
Guideline (SOG)
– Unit 4 – Concept of Operations
– Unit 5 – Agency Roles & Responsibilities
– Unit 6 – Scenario
– Unit 7 – Course Summary
6
Knowledge Check
At the end of each unit, there will be a brief
knowledge check.
7
Unit 1 – Medical Needs Sheltering
PHOTO
8
Unit 1 – Medical Needs Sheltering
Unit Introduction
When disasters strike, a county’s diverse population
requires adequate care and sheltering. Individuals
with medical needs require more assistance than
those located within a community shelter, but how
do we care for them?
9
Unit 1 – Medical Needs Sheltering
At the end of this unit, the participant will:
– Describe the difference between Access and
Functional Needs and Medical Needs
– Describe the difference between medical needs and
nonmedical needs
– Define medical needs shelter
– Recognize why a MNS may need to be established
– Identify populations who should be sheltered in a
MNS
– Identify MNS agency, facility, and volunteer partners
10
Unit 1 – Medical Needs Sheltering
Access and Functional Needs
– Groups whose needs are not fully addressed by
community shelters, but who may be accommodated in a
community shelter with minor assistance.
Medical Needs
– Groups whose medical needs can not be accommodated in
a community shelter, but who are not critical enough for
transportation to a permanent healthcare facility.
This course will focus only on the medical needs aspect of
sheltering and mass care
11
Unit 1 – Medical Needs Sheltering
Who is included in the medical needs
population?
Individuals with no acute medical conditions but who
require some medical care and/or special assistance
beyond what is available in a community shelter.
12
Unit 1 – Medical Needs Sheltering
Who is not included in the medical needs
population?
Individuals with pre-existing health problems that do not
impede activities of daily living and do not exceed the
basic first aid capabilities of community shelters.
13
Unit 1 – Medical Needs Sheltering
What is medical needs sheltering?
The basic care and supervision of medical needs patients
by healthcare professionals outside of a hospital or acute
care environment.
14
Unit 1 – Medical Needs Sheltering
Who would you expect in a MNS?
– Hospice patients
– Wheelchair-bound person with additional medical
conditions
– Patients with draining wounds requiring frequent
dressing changes
– Patients who have undergone recent major surgery
– Home health patients
15
Unit 1 – Medical Needs Sheltering
Why would a county establish a MNS?
– A MNS may be activated during a widespread disaster
or a localized incident.
– A county may establish a MNS when patients with
medical needs arrive at a community shelter where
their needs cannot be supported.
16
Unit 1 – Medical Needs Sheltering
Why not just send people with medical needs
to a hospital?
– During an incident, hospitals and other healthcare
facilities could become overwhelmed.
– This surge can cause a strain on hospital resources and
personnel.
– Medical needs patients do not have acute conditions,
and thus a hospital is not the most appropriate
location for them.
17
Unit 1 – Medical Needs Sheltering
The following organizations/agencies are
community partners in medical needs sheltering:
–
–
–
–
–
–
–
–
County Office of Emergency Management
County Health Department
Local hospitals
Voluntary Organizations Active in Disaster (VOAD)
Community emergency response agencies
Other local and county agencies
Medical Reserve Corps
Community Emergency Response Team
18
Unit 1 – Medical Needs Sheltering
When considering the opening of a MNS,
certain guidelines must be followed to ensure
smooth operation. The following key points
should be remembered:
– A MNS may need to be established if population needs cannot be met
at a community shelter or if hospital resources are at risk for being
overwhelmed.
– Not all evacuees who have medical issues belong in a MNS. Some
belong in a community shelter while others belong in a hospital.
– Multiple participants assist in the activation and operation of a MNS.
These range from volunteers and hospitals to state and local agencies.
19
Unit 1 – Medical Needs Sheltering
Unit Summary
In this unit we discussed:
– The situations that may require a MNS activation
– What a MNS is and who typically requires a MNS
– What are considered medical needs, and what is
typically not considered medical needs
20
Knowledge Check
Question 1 – What are considered medical
needs?
Question 2 – Are individuals with access and
functional needs considered medical needs?
Question 3 – When might a county decide to
open a MNS?
Question 4 – Name a few examples of
individuals who are considered medical needs.
21
Unit 2 – Types of Medical Needs Shelters
Unit 2 – Types of Medical Needs Shelters
Unit Introduction
Once the need has been identified, counties must take
steps to activate one of two types of MNS. The type of
the MNS varies based on availability resources within the
county and the predetermined location of the MNS. This
unit will focus on the different types of MNS and how
they operate.
23
Unit 2 – Types of Medical Needs Shelters
At the end of this unit, the participant will:
– Identify and describe the two types of MNS
– Recognize what type of MNS may be opened in your
county
– Identify standard requirements for both types of MNS
24
Unit 2 – Types of Medical Needs Shelters
Several models for establishing and operating a
MNS exist:
– A MNS in a building that is independent from other
sheltering operations (stand-alone MNS)
– A MNS that is located in the same building or campus
as the community shelter (co-located MNS)
25
Unit 2 – Types of Medical Needs Shelters
Stand-Alone MNS
A stand-alone MNS is located at a facility that only
shelters evacuees with medical needs. The stand alone
MNS may be located at a non-traditional facility or other
location identified by the municipality/county
26
Unit 2 – Types of Medical Needs Shelters
Stand-Alone MNS
– May be located at an existing shelter that is not used
for community sheltering
– A suggested location is in a setting where there is a
medical infrastructure in place (e.g., at a college that
has a nursing program)
– Requires all support services (e.g., food, shelter
management, power) that are in community shelters
27
Unit 2 – Types of Medical Needs Shelters
Co-Located MNS
A co-located MNS is at a facility where the community
shelter is also located. The MNS may be a portion of the
shelter, or may be located in a room that is separate from
the community shelter.
28
Unit 2 – Types of Medical Needs Shelters
Co-Located MNS
– The community shelter operator arranges for general
shelter management services (e.g., food, registration,
sanitary services, etc.)
– The MNS is located in an adjacent room or building
and only allows medical needs patients to stay in that
area.
– The MNS may operate on an “appointment” basis.
29
Unit 2 – Types of Medical Needs Shelters
Comparison of Models
Stand-Alone MNS
Co-located MNS
Support Services (e.g.,
food, supplies, etc.)
Provided by the agency
operating the MNS
Provided by the community
shelter
Capacity
May be limited based on
staffing and resources
May be expanded using
resources from the community
shelter
Evacuee (patient)
Duration in MNS
Must stay in the MNS
throughout the duration of the
incident
May schedule “visits” into the
MNS for treatment and then
return to the community shelter
Transportation
May require transportation
between the MNS and the
community shelter
All evacuees are at the same
location
Staffing
County staff, hospital staff,
home health, VOAD
County staff, hospital staff,
home health, VOAD
30
Unit 2 – Types of Medical Needs Shelters
Despite the differences between the MNS
models, common elements exist:
– The footprint must be at least 2,000 square feet.
– The MNS must have power and backup generator
power, and must be climate controlled.
– The MNS must be ADA compliant.
– The MNS must be staffed 24 hours a day with
rotating staff in defined operational periods.
– The scope of care is identical.
31
Unit 2 – Types of Medical Needs Shelters
Unit Summary
In this unit we discussed:
– Various models for a MNS
– The benefits and drawbacks of each MNS model
– The responsibilities related to shelter support services
32
Knowledge Check
Question 1 – What are the two MNS models?
Question 2 – Compare and contrast the two
MNS models discussed in this unit.
Question 3 – What is the minimum square
footage for a MNS?
Question 4 – When a MNS is not located with a
community shelter, who must provide shelter
support services?
33
Unit 3 – Medical Needs Shelter SOG
Unit 3 – Medical Needs Shelter SOG
Unit Introduction
In this unit we will explore how a MNS is coordinated in
counties in Southern New Jersey. The county MNS SOG is
the document that guides MNS operations. We will
examine the various elements of the SOG and discuss the
importance of each piece.
35
Unit 3 – Medical Needs Shelter SOG
At the end of this unit, the participant will:
– Understand how the SOG guides MNS operations in
the county
– Be familiar with various tools that are included in the
SOG appendices
– Recognize the conditions in which a MNS may be
activated
36
Unit 3 – Medical Needs Shelter SOG
The county MNS SOG provides
operational guidance for
setup, operation, and
demobilization of the MNS.
37
Unit 3 – Medical Needs Shelter SOG
Sections of the SOG
–
–
–
–
–
–
Background
Purpose
Planning Assumptions
Concept of Operations
Roles and Responsibilities
Plan Maintenance
38
Unit 3 – Medical Needs Shelter SOG
SOG – Background, Purpose
These sections provide a general setting for the SOG and
background information regarding what a MNS is and
when the use of a MNS is appropriate.
39
Unit 3 – Medical Needs Shelter SOG
SOG – Planning Assumptions
This section outlines the conditions that are assumed to
exist if a MNS is activated within the county.
40
Unit 3 – Medical Needs Shelter SOG
SOG – Concept of Operations
This section outlines how the MNS will be activated,
operated, and demobilized. This section also outlines
how resources and the facility will be coordinated to
support the MNS.
41
Unit 3 – Medical Needs Shelter SOG
SOG – Roles and Responsibilities
This section assigns responsibility for various elements
related to the MNS.
42
Unit 3 – Medical Needs Shelter SOG
SOG – Plan Maintenance
This section establishes how the SOG will be updated,
how training will occur, and how exercises will be carried
out as part of a regular schedule.
43
Unit 3 – Medical Needs Shelter SOG
The SOG is supported by a
series of appendices that
provide documentation and
job aids to assist in
operating a MNS.
44
Unit 3 – Medical Needs Shelter SOG
Appendix 1 – Acronyms
This section provides a list of acronyms that are used
throughout the SOG.
45
Unit 3 – Medical Needs Shelter SOG
Appendix 2 – Triage Guidelines
This appendix provides a standard set of guidelines for
triage to determine if evacuees:
– Can stay in the community shelter
– Require care in the MNS
– Have an acute condition or one that requires a
transfer to a hospital
46
Unit 3 – Medical Needs Shelter SOG
Appendix 3 – Staffing and Organization
This section provides detailed
guidance regarding the
qualifications and
responsibilities of MNS staff.
47
Unit 3 – Medical Needs Shelter SOG
Appendix 4 – MNS Site Locations
This appendix outlines where the primary and secondary
MNS sites are located.
48
Unit 3 – Medical Needs Shelter SOG
Appendix 5 – Memorandums of Agreement
This section contains relevant agreements that are in
place that are relevant to medical needs sheltering.
49
Unit 3 – Medical Needs Shelter SOG
Appendix 6 – County Support Service Providers
This appendix contains listings and contact information
for staff and other resources that may assist in medical
needs sheltering.
50
Unit 3 – Medical Needs Shelter SOG
Appendix 7 – Supply Lists
This appendix contains a
list of medical supplies that
are needed to operate a
MNS. These supplies are
located in the MNS trailer.
51
Unit 3 – Medical Needs Shelter SOG
Appendix 8 – Site Forms
This appendix contains relevant forms needed to
operate the MNS. Examples of items included
are evacuee (patient) intake forms and triage
forms
52
Unit 3 – Medical Needs Shelter SOG
Appendix 9 – Waivers
This appendix contains a series of pre-scripted
waivers that may be needed to operate the MNS
53
Unit 3 – Medical Needs Shelter SOG
Appendix 10 – Sample Media Release
Operation of the MNS will require outreach to the public.
This appendix contains media releases that may be used
during medical needs sheltering operations.
54
Unit 3 – Medical Needs Shelter SOG
Unit Summary
In this unit we discussed:
– The MNS SOG and supporting appendices
– Tools that are available for MNS activation, operation,
and activation
55
Knowledge Check
Question 1 – What is the purpose of the MNS
SOG?
Question 2 – Where in the SOG will you find
supporting tools to assist with MNS
operations?
Question 3 – What is the purpose of the Roles
and Responsibilities section?
Question 4 – Where in the SOG are triage
guidelines located?
56
Unit 4 – Concept of Operations
Unit Introduction
In this unit we will examine the concept of operations in
greater detail, keeping in mind the SOG document and
the role it plays in MNS operations. We will discuss
activation, setup, operation, and demobilization of the
MNS. Specific operations may vary slightly based upon
the size and scope of the incident as well as resources
available for the MNS.
58
Unit 4 – Concept of Operations
At the end of this unit, the participant will:
– Be familiar with operations associated with a MNS
throughout the entire process
– Understand the importance of prompt and
effective triage of evacuees
59
Unit 4 – Concept of Operations
MNS Staffing
The MNS is staffed by a team of medical and nonmedical
personnel who collectively work together to operate the
MNS.
60
Unit 4 – Concept of Operations
MNS Staffing
MNS Site
Coordinator
Administrative
Section Chief
Administrative Support
Case Manager
Operations
Section
Chief
Logistics
Section Chief
Resource Manager
Security Officer(s)
Triage Officer (RN or higher)
RN (1)
LPN (1)
Evacuee (Patient) Care
Technician (3)
Pharmacy
Mental Health Counselor
EMS Transport Crew
Clergy
61
Unit 4 – Concept of Operations
MNS Staffing
MNS Site
Coordinator
Administrative
Section Chief
Administrative Support
Case Manager
Operations
Section
Chief
Logistics
Section Chief
Resource Manager
Security Officer(s)
Triage Officer (RN or higher)
RN (1)
LPN (1)
Evacuee (Patient) Care
Technician (3)
Pharmacy
Mental Health Counselor
EMS Transport Crew
Clergy
62
Unit 4 – Concept of Operations
MNS Staffing
Administrative
Section Chief
Administrative Support
Case Manager
MNS Site
Coordinator
Logistics
Section Chief
Resource Manager
Security Officer(s)
Operations
Section
Chief
Triage Officer (RN or higher)
RN (1)
LPN (1)
Evacuee (Patient) Care
Technician (3)
Pharmacy
Mental Health Counselor
EMS Transport Crew
Clergy
63
Unit 4 – Concept of Operations
MNS Staffing
MNS Site
Coordinator
Administrative
Section Chief
Administrative Support
Case Manager
Operations
Section
Chief
Logistics
Section Chief
Resource Manager
Security Officer(s)
Triage Officer (RN or higher)
RN (1)
LPN (1)
Evacuee (Patient) Care
Technician (3)
Pharmacy
Mental Health Counselor
EMS Transport Crew
Clergy
64
Unit 4 – Concept of Operations
MNS Staffing
Administrative
Section Chief
Administrative Support
Case Manager
MNS Site
Coordinator
Logistics
Section Chief
Resource Manager
Security Officer(s)
Operations
Section
Chief
Triage Officer (RN or higher)
RN (1)
LPN (1)
Evacuee (Patient) Care
Technician (3)
Pharmacy
Mental Health Counselor
EMS Transport Crew
Clergy
65
Unit 4 – Concept of Operations
Activation
There are several instances in which a MNS may be
activated.
As a result of a sudden incident
In anticipation of an incident
66
Unit 4 – Concept of Operations
Activation
The decision to activate the MNS will likely be a joint
decision between the Office of Emergency Management
(OEM) and the Health Department. It may be based upon
requests to shelter medical needs evacuees (patients) who
arrive at a shelter, or it may occur in anticipation of a slowmoving hazard such as a winter storm or hurricane.
67
Unit 4 – Concept of Operations
Activation
Once the decision is made to activate the MNS, a MNS Site
Coordinator will be designated.
The MNS Site Coordinator is responsible for overseeing all
on-site operations at the MNS.
68
Unit 4 – Concept of Operations
Activation
Once the MNS is activated, the MNS trailer will be transported to
the MNS site. Staff will meet the trailer at the site to set up the
MNS.
The standard size of the MNS trailer cache is 25 beds. Additional
evacuees (patients) can be accommodated if resources and
staffing are sufficient to support.
Representatives from the County and facility will conduct a preincident walk through, noting any existing damages
69
Unit 4 – Concept of Operations
Activation
The county Emergency Operations Center (EOC) will also be
activated to assist with the coordination of MNS operations.
Depending on the county’s structure, the MNS will be
overseen by either Emergency Support Function (ESF) #6 –
Mass Care or ESF #8 – Health and Medical.
70
Unit 4 – Concept of Operations
Notifications
Once the MNS is activated, the county OEM will need to
notify several agencies/organizations:
-
Medical Reserve Corps
Community Emergency Response Team
Emergency Medical Services
Medical Coordination Center
New Jersey Department of Health
County Public Information Officer
New Jersey Office of Emergency Management
Other stakeholders as necessary
71
Unit 4 – Concept of Operations
Registration
When evacuees (patients) enter
the MNS, one of the first activities
that needs to be accomplished is
registration. Registration forms
are available in the SOG Appendix.
72
Unit 4 – Concept of Operations
Triage
The Triage Officer is located at the point of registration.
When an evacuee (patient) enters the shelter, the Triage
Officer determines if the evacuee:
– Can be safely sustained in a community shelter (Tier 1)
– Requires services available in a MNS (Tier 2)
– Has a condition that requires transport to an acute care hospital
(Tier 3)
73
Unit 4 – Concept of Operations
Tier 1 – Community Shelter
Individuals who are independent prior to the disaster or
emergency. Some of these individuals may have pre-existing
health problems that do not impede activities of daily living
and do not exceed the basic first aid capabilities of
community shelters.
74
Unit 4 – Concept of Operations
Tier 1 – Community Shelter – Examples
–
–
–
–
–
–
–
–
–
Epilepsy when controlled
Controlled insulin-dependent diabetes
Hemophilia
Ostomies with self-care
Vision or hearing impairments
Prosthesis
Dry wounds requiring basic maintenance by evacuee
Asthma, if controlled
Functional needs: Wheelchair-bound person or person with other
mobility-related disabilities without other medical needs who is able
to use the shower or facilities with minimal assistance
– Conditions controlled by self-administered medications
– Persons requiring dialysis
75
Unit 4 – Concept of Operations
Tier 2 – Medical Needs Shelter
Evacuees (patients) who have no acute medical conditions
but require some medical care and/or special assistance
beyond what is available in a community shelter.
76
Unit 4 – Concept of Operations
Tier 2 – Medical Needs Shelter – Examples
– Conditions listed in Tier 1 that are not evacuee (patient)controlled
– Wheelchair-bound person with medical needs
– Tracheotomy
– Feeding tube
– PICC lines
– Oxygen-dependent person and a person with other oxygen
issues
– Draining wounds requiring frequent sterile dressing changes
– Persons whose disability prevents them from sleeping in a cot
– Hospice patients
77
Unit 4 – Concept of Operations
Tier 3 – Acute Care Hospital Facility
Evacuees (patients) who need acute
medical care such as individuals
experiencing significant trauma,
injury, or acute medical
condition(s).
78
Unit 4 – Concept of Operations
Tier 3 – Acute Care Hospital Facility –
Examples
–
–
–
–
–
–
–
–
–
Evacuees (patients) who are ventilator dependent
Pregnancy (gestation >32 weeks or multiple/twin >30 weeks)
Pregnant women who are having contractions or are in labor
Persons reporting chest pain any time in the last 24 hours or are
suspicious of chest pain that is cardiac in nature
Acute altered mental status (e.g., lethargic, disoriented, etc.)
Comatose individuals
Uncontrollable or violent persons
Contagious conditions that require special precautions
Others requiring the intensity of service only provided at a
hospital
79
Unit 4 – Concept of Operations
Ongoing Operations
– Staffing will be organized in operational periods
(typically 12-hour periods).
– The county EOC will assist with resource location
and acquisition.
– If capacity exceeds the availability of resources,
mutual aid will be requested.
80
Unit 4 – Concept of Operations
Medical Care and Medical Direction
– The county will designate a Medical Director who
will put standing protocols in place for MNS
operations.
– MNS staff will provide care under written
protocols.
– Staffing Ratios
• Patient Technician ÷ Patient = 1:10
• Nurse ÷ Patient = 1:20
81
Unit 4 – Concept of Operations
Infection Control and Sanitation
– All staff members are trained and adhere to
standard precautions.
– The MNS will be disinfected at regularly scheduled
intervals.
– The MNS will be maintained through regular
cleaning, medical waste disposal, and trash
removal.
82
Unit 4 – Concept of Operations
Security
– The county will designate a law enforcement
entity to oversee MNS security.
– The MNS must have locking capabilities for
sensitive equipment and pharmacy supplies.
– All people within the MNS must have some sort of
visible identification.
– All MNS workers must be credentialed.
83
Unit 4 – Concept of Operations
Pharmacy Area
– A secure pharmacy location
will be identified for the
storage of evacuee (patient)
medication and other supplies.
– The area must have a lockable
door.
– A refrigerator is required for
certain medications (e.g.,
insulin).
84
Unit 4 – Concept of Operations
Mutual Aid
– Mutual aid resources may be requested through the
county EOC when the situation overwhelms the
county’s capabilities.
– Each county has a MNS trailer that can be utilized
throughout the region if needed.
85
Unit 4 – Concept of Operations
Demobilization
– The decision to close the MNS will be a joint decision
between the county and the MNS Site Coordinator.
– All supplies will be replenished and the facility will be
returned to pre-incident status.
– The representatives from the county and facility will
conduct a post-incident walk-through, noting any
damages that have occurred.
86
Unit 4 – Concept of Operations
Unit Summary
In this unit we discussed:
– How a MNS is established and how ongoing
operations occur
– The importance of effective triage in the MNS
– The staffing resources needed within the MNS
– Various elements of the MNS
87
Knowledge Check
Question 1 – When should registration and
triage occur?
Question 2 – What are some of the
considerations for a pharmacy area?
Question 3 – An evacuee presents to the shelter
with chest pains. What is your course of
action?
Question 4 – What is the role of the MNS Site
Coordinator?
88
Unit 4 – Agency Roles & Responsibilities
Unit 5 – Agency Roles & Responsibilities
Unit Introduction
Now that you have a basic understanding of the reasons
why a MNS would be utilized, it is important to know
how people from a variety of organizations and agencies
work together to provide a MNS.
While individual agency roles and responsibilities may
differ slightly based upon the county, there are common
elements across the region. In this unit we will discuss
these common elements.
90
Unit 5 – Agency Roles & Responsibilities
At the end of this unit, the participant will:
– Be familiar with the roles and responsibilities of
agencies involved in a MNS
– Describe how these agencies and organizations
work collaboratively for a MNS
91
Unit 5 – Agency Roles & Responsibilities
County Office of Emergency Management
– Provides overall command and control for the MNS
– Integrates the MNS into community shelter planning
– Activates the EOC and coordinates operations through
either ESF #6 or ESF #8
– Provides resource support for MNS operations
– May provide staff to assist at the MNS
– Coordinates with other county agencies and
organizations for MNS issues
92
Unit 5 – Agency Roles & Responsibilities
County Health Department
– May provide overall direction for the MNS portion of
the community shelter
– Designates a Medical Director
– Oversees medical staffing and credentialing
– May represent the MNS at the county EOC
– Typically oversees on-site MNS operations
93
Unit 5 – Agency Roles & Responsibilities
Emergency Services Organizations
–
–
–
–
Serves as a potential staffing source for the MNS
Can assist with setup and tear down of the MNS
EMS may transport evacuees (patients) to the MNS
EMS provides an on-site standby crew
94
Unit 5 – Agency Roles & Responsibilities
Voluntary Organizations Active in Disaster (VOAD)
– Provides staffing support for the MNS
– Assists with management functions within the MNS
– Assists with setup and tear down of the MNS
95
Unit 5 – Agency Roles & Responsibilities
Medical Reserve Corps (MRC)
– Provides medical staffing support for the MNS
96
Unit 5 – Agency Roles & Responsibilities
Community Emergency Response Team (CERT)
– Provides nonmedical staffing support for the MNS
– Can assist with setup and tear down of the MNS
– Can fulfill general staffing positions within the MNS
97
Unit 5 – Agency Roles & Responsibilities
Local Hospital or Hospital System
– Can be a source of staffing resources
– May assist with locating and securing pharmaceuticals
– May provide transportation resources for evacuees
(patients) to and from the MNS
– May fill other roles as needed
98
Unit 5 – Agency Roles & Responsibilities
Medical Coordination Center (MCC)
– Provides situational awareness regarding the status of
MNSs throughout the region
– Tracks the deployment of the MNS and adjusts
resources around the region as needed
– Assists in filling local resource requests that arrive
from national suppliers and other locations
– Is a direct link to the New Jersey Department of
Health
99
Unit 5 – Agency Roles & Responsibilities
Other Agencies/Organizations
– May play a support role for the MNS
– Can be a source of staffing within the MNS for both
medical and nonmedical personnel
– May assist with resource support within the MNS
100
Unit 5 – Agency Roles & Responsibilities
Unit Summary
In this unit we discussed:
– Examples of roles and responsibilities for a variety of
county agencies and organizations
– Possible sources of MNS support – both staffing and
material resource support
101
Knowledge Check
Question 1 – In your county, what is the role of
the OEM?
Question 2 – In your county, what is the role of
the Health Department?
Question 3 – What is the role of the MCC in
MNS operations?
Question 4 – How will you use voluntary
agencies in MNS operations?
102
Unit 6 – Scenario
Unit Introduction
In this unit we will discuss a real-life scenario in which a
MNS may be required. Keep in mind what we have
learned thus far in the course. Frame your answers in
the context of your role in your respective
agency/organization.
104
Unit 6 – Scenario
At the end of this unit, the participant will:
– Understand the process of activating, operating, and
demobilizing a MNS
– Describe unique challenges associated with MNS
– Understand various roles and responsibilities
– Describe their role within their agency/organization
related to MNS
105
Unit 6 – Scenario
Scenario
A low-pressure system
develops near the Cape
Verdes Islands, and the
National Hurricane Center
believes this area of
disturbance has the
potential to develop into an
organized storm.
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Unit 6 – Scenario
Scenario
The system develops into a
tropical storm, and early
projections indicate the
storm will intensify and
likely will impact the MidAtlantic region, specifically
the Delmarva peninsula and
the New Jersey coast.
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Unit 6 – Scenario
Scenario
Although the storm’s
projected landfall is more
than 72 hours away, the
Governor of New Jersey has
ordered mandatory
evacuations of low-lying
areas and the barrier islands
along the coast.
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Unit 6 – Scenario
Scenario
Evacuations are in progress,
community shelters are
opening, and the county
EOC is beginning to receive
requests to open a MNS, as
evacuees are arriving at
community shelters with
medical needs.
109
Unit 6 – Scenario
At this point, the request has been made for a
MNS. What are your next steps?
110
Unit 6 – Scenario
How will you decide upon the appropriate
location for the MNS?
111
Unit 6 – Scenario
What MNS model has your county decided
upon during pre-planning efforts?
112
Unit 6 – Scenario
What resources may be at your disposal, and
how will you acquire them?
113
Unit 6 – Scenario
What notifications will you make once the MNS
and the MNS trailer have been activated?
114
Unit 6 – Scenario
Who will arrive to set up the MNS?
115
Unit 6 – Scenario
Where will triage take place? What types of
evacuees (patients) will you accept into the
MNS?
116
Unit 6 – Scenario
How many evacuees (patients) do you
anticipate the MNS being able to
accommodate? What procedures are in place
should the MNS become overwhelmed?
117
Unit 6 – Scenario
How will you obtain and restock medical and
general supplies within the MNS?
118
Unit 6 – Scenario
At what point will you decide to demobilize,
and who will make the call?
119
Unit 6 – Scenario
Unit Summary
In this unit we discussed:
– The situation and conditions that may require
activation of the MNS
– How your organization or agency would contribute to
a MNS operation
– Sources of assistance within the MNS process
120
Unit 6 – Course Summary
Unit 7 – Course Summary
Unit Introduction
In this course we have discussed the purpose for, the
operation of, and your agency’s/organization’s role in
medical needs sheltering in the county. In this unit we
will briefly review the pertinent concepts related to MNS.
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Unit 7 – Course Summary
Topics Covered in the Course
During this course we have covered:
–
–
–
–
–
What medical needs are
The basics of medical needs sheltering
The importance of the MNS SOG within the county
The roles that various agencies play in a MNS
How a MNS is accomplished in the County
123
Unit 7 – Course Summary
What Are Medical Needs?
Individuals with no acute medical conditions but who
require some medical surveillance and/or special
assistance beyond what is available in a community
shelter.
124
Unit 7 – Course Summary
Typical evacuees (patients) include:
– Hospice patients
– Wheelchair-bound person with additional medical
conditions
– Patients with draining wounds requiring frequent
dressing changes
– Patients who have undergone recent major surgery
– Home health patients
125
Unit 7 – Course Summary
Medical Needs Sheltering
The basic care and supervision of medical needs patients
by healthcare professionals outside of a hospital or acute
care environment.
The MNS can be:
– A stand-alone facility
– Co-located with a community shelter
126
Unit 7 – Course Summary
The MNS SOG
– Outlines the activities that need to occur for a
successful MNS operation
– Describes roles/responsibilities of organizations
– Is accompanied by supporting appendices that contain
tools for MNS operations
– Describes how counties in the region coordinate MNS
operations
127
Unit 7 – Course Summary
MNS Operations in Each County
– MNS operations may differ slightly than what is
described in this course.
– Each county has the same starting point as a result of
the Southern NJ MMES Project.
– Triage guidelines and the standard of care is uniform
across the region.
128
Final Exam
The final exam comprises of 15 multiple choice
questions that cover a variety of topics
discussed in this course. You have as much
time as needed to complete the exam.
129
Course Completion
You have successfully completed the Southern
New Jersey MMES Project Medical Needs
Shelter Orientation Course.
130