June 2013

The General Staff module is designed for all Community
Clinic and Health Center (CCHC) staff with disaster response roles and especially those who will not require additional NIMS and ICS training, because they will work in a response management position or in the Clinic
Command Center.

This module will help CCHC staff to understand:
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What is an emergency?
Our CCHC’s responsibilities and how we will manage our response
What the CCHC will ask of you and other staff
How we fit into the overall community and government response
What you should do for your home and family

 An emergency is an unexpected or sudden event that significantly disrupts the organization’s ability to provide care, or the environment of care itself, or that results in a sudden, significantly changed or increased demand for the organization's services.
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The terms “disaster” and “emergency” are frequently used to describe the same event

 A natural disaster is caused by a natural hazard (e.g. volcanic eruption , earthquake , or landslide ) that affects human activities
 Man-made disasters are caused intentionally or by accident (e.g., terrorism, chemical spills, train derailments)
 An Influenza Pandemic is an outbreak of disease that occurs when a new flu virus appears that can spread from person-to-person

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Agricultural
Earthquakes
Epidemics
Floods
Hazardous Materials
Hurricanes
Infrastructure Failure
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Mudslides
Nuclear
Pestilence
Riots
Terrorism
Transportation
Volcanoes
Wild Fires

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Ensure immediate safety of CCHC occupants: patients, staff and visitors
Respond to health care needs of disaster victims
Maintain essential healthcare services or restore them as rapidly as possible
Provide accurate information to clients
Perform other emergency roles if resources are available
Assist community to return to normal status

 CCHC are not hospitals
 CCHC do not operate 24/7
 Many have limited staff and facilities
 May have limited equipment and supplies
 May be the only health care provider in a community
 Facility may be affected by emergency
 Staff may be affected by emergency

 Plan: develop written plans, policies and procedures for responding to emergencies
 Use the Incident Command System to manage emergencies
 Train and exercise
 Build relationships with other community response organizations

 All CCHC staff should:
– Understand and follow the CCHC’s emergency response policies, procedures and plans
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Understand their likely response roles and responsibilities
Participate in training, drills and exercises
– Follow safety rules to prevent injuries and illnesses
– Prepare their family for emergencies and for the possibility of your absence

 Managers and supervisors will:
– Ensure that staff participate in trainings, drills and exercises
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Ensure that each department’s procedures are consistent with the
CCHC plan
– Represent their departments in development of CCHC emergency plans and procedures
– Communicate importance of CCHC and home preparedness to staff
– Ensure staff receive up-to-date information

 During work hours:
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Ensure safety of patients, visitors and other staff
Implement evacuation and shelter-in-place procedures
Ensure own safety
Notify emergency responders, e.g., fire, police, EMS, health department
May need to stay beyond clinic’s normal hours
 During off hours
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Ensure safety of self and family
Report availability to clinic

The Incident Command System (ICS)
Under ICS, the day-to-day management structure based on organizational best practices , of the CCHC changes to meet the requirements of the emergency.

 Ensures efficient, clear communication through the use of common terminology
 Provides a flexible framework that applies to all phases of incident management regardless of cause, size location or complexity
 Organizational structure includes only functions and positions needed to achieve the incident objectives

• Development of an Incident Action Plan (IAP) which is used to provide all incident supervisory personnel with direction for taking actions based on the objectives identified in the plan during the operational period
• IAP includes measurable strategic operations to be achieved within the operational period
• Management by objectives are used to accomplish response tactics on IAPs

At every level of the ICS organization, individuals in primary responsibility have distinct titles to help clarify the activities undertaken by specific personnel.
The agency executive is responsible for establishing overall priorities, providing strategic and policy direction, and delegating authority to the Incident
Commander to manage the incident.

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Command Staff provide information, safety and liaison services for the incident command system (ICS) organization and operating guidelines referred to as span of control
Command Staff positions include:
– Public Information Officer (PIO)
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Liaison Officer
Safety Officer
Each of these positions have only one supervisor/ unity of command
Command Staff positions report directly to the Incident
Commander (IC)

The Incident Commander oversees incident operations from the incident command post/clinic command center, is
ALWAYS staffed in ICS and responsible until authority has been delegated to another person .
When a new Incident Commander assumes command, the outgoing Incident
Commander should be demobilized to avoid confusion.

As Safety Officer, I ensure the safety of staff, patients and visitors impacted by and responding to the incident .

As Public Information Officer, or PIO, I am the conduit of information for internal and external stakeholders, including staff, visitors, families and news media .

As Liaison Officer, I am the main contact for other agencies responding to the incident such as the local health department, other CCHCs, hospitals, fire and EMS providers, law enforcement and others

 Each response management function is reflected in the ICS structure:
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Operations
Planning
Logistics
Finance/Administration
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The title for General Staff position is “Section Chief”
The General Staff report directly to the Incident Commander
(IC)

I ensure clinical operations for incident response and recovery activities. I develop and implement strategies and tactics to carry out the incident objectives
Tactical resources are always classified as one of the following during an incident: assigned, available and out of service

I prepare and document the
Incident Action Plan, collect
And evaluate information,
Maintain resources status, and maintain documentation for incident records.

I organize and direct the provision of support and services for incident operations including communications, supplies, equipment, and medical support.

I monitor the utilization of financial assets during response and recovery and account for incident costs and losses. I handle claims related to property damage, injuries or fatalities.

The Incident Command System provides:
– A coordinated response
– Clear chain of command
– For example: Situation Unit Leader, but no Planning Section Chief assigned, leader should report to Incident Commander
– Safe response and recovery operations
– Span of control on incidents with a ratio of one supervisor to five reporting elements .
-Prioritize leadership responsibilities such as ensuring safe work practices

The ICS management structure expands and contracts to meet the needs of the incident
– The Incident Commander is always activated to:
 Assess the impact of the event on the CCHC
 Determine the level of activation of the Emergency Operations Plan and ICS
Incident Management Team positions
 Emergency operations plan is based on functions
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ICS is developed in a top-down manner
Positions are activated ONLY if needed
Organized approach for incident managers to obtain resources
 Incident managers begin planning for the demobilization process as soon as possible to facilitate accountability of the resources

 Management is responsible for managing the emergency
 May report to a different supervisor
 May be asked to perform duties different from their day-to-day responsibilities

– The incident Command System (ICS) is a proven incident management system that is based on organizational: a. Best Practices.
b. Strengths.
c. Structures.
d. Hierarchy.

Post-Test Questions:
You know the Answers!
– The ability to communicate within ICS is absolutely critical. To ensure efficient, clear communication, ICS requires the use of: a. Agency-specific codes.
b. Common terminology.
c. Radio codes.
d. Technical language.

Post-Test Questions:
You know the Answers!
– The Incident Command System provides a
______________ framework that applies to all phases of incident management regardless of cause, size, location or complexity.
a. Rigid.
b. Complicated.
c. Straightforward.
d. Flexible.

Post-Test Questions:
You know the Answers!
– Every incident must have a verbal or written Incident
Action Plan. The purpose of this plan is to provide all incident supervisory personnel with direction for : a. Taking actions based on the objectives identified in the plan during the operational period.
b. Maintaining documentation and tracking resources assigned to the incident.
c. Monitoring the number of resources that report to any one supervisor.
d. Obtaining and maintaining essential personnel, equipment and supplies.

Post-Test Questions:
You know the Answers!
– Select the TRUE statement: a. ICS positions may be combined in order to save on staffing or achieve a higher level of efficiency.
b. ICS encourages the use of unique position titles in order to better meet the specific incident needs.
c. ICS organizational structure should include only the functions and positions needed to achieve the incident objectives.
d. ICS recognizes that an Incident Commander may not be necessary if an Operations Section Chief is assigned.

Post-Test Questions:
You know the Answers!
– Which of the following would you expect to see in an Incident Action Plan?
a. Detailed cost estimates for implementing the proposed activities.
b. Listing of all staff members currently deployed
(activated) to the incident.
c. Measurable strategic operations to be achieved within the operational period.
d. A schematic showing all communication equipment in use in the CCHC.

Post-Test Questions:
You know the Answers!
– Incident Action Plans (IAPs) depend on
_________________ to accomplish response tactics.
a. Integrated communications.
b. Organizational resources.
c. Management by Objectives.
d. Common terminology.

Post-Test Questions:
You know the Answers!
– One ICS principle relates to the supervisory structure of the organization and pertains to the number of individuals or resources one incident supervisor can manage effectively. This operating guidelines is referred to as: a. Delegation of authority.
b. Span of control.
c. Form follows function.
d. Unity of command.

Post-Test Questions:
You know the Answers!
– From what facility does the Incident Commander oversee incident operations?
a. Incident Command Post/Clinic Command Center.
b. Heliports.
c. Labor Pool and Credentialing Unit.
d. Staging Area.

Post-Test Questions:
You know the Answers!
– ________________ means that each individual involved in incident operations will be assigned to only one supervisor.
a. Span of Control.
b. Unity of Command.
c. Supervisor Authority.
d. Unified Command.

Post-Test Questions:
You know the Answers!
– At every level of the ICS organization, individuals in positions of primary responsibility have distinct titles. Using specific
ICS position titles serve three important purposes?
• The use of distinct titles allow for filling ICS positions with the most qualified individuals and not by rank, seniority or title.
• Standard position titles are useful when requesting qualified personnel.
• _______________________ a. Titles provide a common standard for all users b. Distinct titles help to clarify the activities undertaken by specific personnel c. Position titles help to maintain the normal lines of authority within d. Prestige associated with certain titles helps to motivate responders

Post-Test Questions:
You know the Answers!
– Which position is the one that is always staffed in ICS?
a. Operations Section Chief.
b. Incident Commander.
c. Public Information Officer.
d. Safety Officer.

Post-Test Questions:
You know the Answers!
– When command is transferred, all personnel in the Clinic
Command Center should be informed of: a. The qualifications of the incoming Incident Commander.
b. The limits of the Incident Commander’s scope of authority.
c. The effective time and date of the transfer of command.
d. The Incident Commander’s cell phone number.

Post-Test Questions:
You know the Answers!
– The Agency Executive is: a. Responsible for overseeing the allocation and assignment of emergency resources.
b. Responsible for managing the incident along side the
Incident Commander.
c. Responsible for coordinating with other agencies through the Liaison Officer.
d. Responsible for establishing overall priorities, providing strategic and policy direction, and delegating authority to the Incident Commander to manage the incident.

Post-Test Questions:
You know the Answers!
– What positions make up the Command Staff?
a. Public Information Officer, Liaison Officer, Safety
Officer.
b. Safety Officer, Logistics Section Chief, Public
Information Officer.
c. Medical Care Branch Director, Safety Officer, Liaison
Officer.
d. Liaison Officer, Public Information Officer, Agency
Executive.

Post-Test Questions:
You know the Answers!
– The basic Incident Command System (ICS) principle is that the Incident Commander is responsible until the: a. Five management functions are activated.
b. The next operational period has begun.
c. Event or incident has demobilized.
d. Authority is delegated to another person.

Post-Test Questions:
You know the Answers!
– Which Command Staff position serves as the conduit of information for internal and external stakeholders, including the CCHC personnel, the media, and other organizations seeking information?
a. Public Information Officer.
b. Liaison Officer.
c. Resource Unit Leader.
d. Safety Officer.

Post-Test Questions:
You know the Answers!
– Which Command Staff position monitors safety conditions and develops measures for assuring the safety of all assigned personnel?
a. Public Information Officer.
b. Liaison Officer.
c. Operations Section Chief.
d. Safety Officer.

Post-Test Questions:
You know the Answers!
– Which Command Staff position serves as the primary contact for supporting agencies and organizations that are assisting at or responding to an incident, but is not participating within the ICS/Clinic Command Center structure?
a. Public Information Officer.
b. Liaison Officer.
c. Planning Section Chief.
d. Safety Officer.

Post-Test Questions:
You know the Answers!
– Select the TRUE statement: a. Upon arriving at the Clinic Command Center, the higher ranking person will either assume command, maintain command as is, or reassign command to a third party.
b. A lower ranking but more qualified person may not be designated as the Incident Commander.
c. Transfer of Command procedures are implemented at the
Clinic Command Center before the Incident Commander arrives at the Clinic. d. When a new Incident Commander assumes command, the outgoing Incident Commander should be demobilized to avoid confusion.

Post-Test Questions:
You know the Answers!
– Expansion of incidents may require the delegation of authority for the performance of Operations, Planning,
Logistics and Finance/Administration functions. The people who perform these management functions are called the: a. Deputy Staff.
b. Director Staff.
c. Command Staff.
d. General Staff.

Post-Test Questions:
You know the Answers!
– Which General Staff position conducts tactical operations, develops the tactical objectives, and directs all tactical resources?
a. Finance/Administration Section Chief.
b. Logistics Section Chief.
c. Operations Section Chief.
d. Planning Section Chief.

Post-Test Questions:
You know the Answers!
– Tactical resources are always classified as one of the following during an incident:
• ____________________ (choose one from below)
• Available
• Out of Service a. Active.
b. Checked-in.
c. Assigned.
d. Allocated.

Post-Test Questions:
You know the Answers!
– Which General Staff position prepares and documents the Incident Action Plan, collects and evaluates information, maintains resources status, and maintains documentation for incident records?
a. Finance/Administration Section Chief.
b. Logistics Section Chief.
c. Liaison Officer.
d. Planning Section Chief.

Post-Test Questions:
You know the Answers!
– Which General Staff position is responsible for ensuring that assigned incident personnel are fed, have communications, medical support, and transportation as needed to meet the operational objectives?
a. Finance/Administration Section Chief.
b. Logistics Section Chief.
c. Operations Section Chief.
d. Planning Section Chief.

Post-Test Questions:
You know the Answers!
– The Employee Health and Well Being Unit is responsible for: a. Providing emergency services to injured victims at the accident scene.
b. Providing medical screening, evaluation and follow-up of employees who are assigned to an incident.
c. Coordinating with public health services to determine where critical resources are deployed.
d. Authorizing purchases of needed medical supplies and services.

Post-Test Questions:
You know the Answers!
– Which General Staff position manages costs related to the incident, and provides accounting, procurement, time recording, claims/compensation and cost analysis?
a. Finance/Administration Section Chief.
b. Logistics Section Chief.
c. Operations Section Chief.
d. Planning Section Chief.

Post-Test Questions:
You know the Answers!
– Which Section is responsible for handling claims related to property damage, injuries, or fatalities?
a. Operations Section.
b. Planning Section.
c. Logistics Section.
d. Finance/Administration Section.

Post-Test Questions:
You know the Answers!
– Effective span of control on incidents may vary from three to seven, but which ratio of supervisor to reporting elements is recommended?
a. One supervisor to four reporting elements.
b. One supervisor to five reporting elements.
c. One supervisor to six reporting elements.
d. One supervisor to seven reporting elements.

Post-Test Questions:
You know the Answers!
– Chris Smith is assigned to be the Situation Unit Leader. No
Planning Section Chief is assigned. Who does Chris Smith report to?
a. Operations Section Chief.
b. Incident Commander.
c. Public Information Officer.
d. Chris has no direct supervisor.

Post-Test Questions:
You know the Answers!
– Emergency Operations Plans (EOP) are based on : a. Hazards.
b. Agencies.
c. Functions.
d. Cost.

Post-Test Questions:
You know the Answers!
– Incident managers begin planning for the demobilization process: a. When incident activities shift from response to recovery.
b. Right before the first resources are ready to be released.
c. As soon as possible to facilitate accountability of the resources.
d. After being requested by the Emergency Operations
Center.