Dietitian Deployment Panel
CDR Mary McCormick, RD
CDR Graydon Yatabe, MPH, RD
LCDR Merel Kozlosky, MS, RD
Dietitian Category Day, 21 JUNE 2012
Objectives
• Summarize structure, make-up, and missions
of Commissioned Corps response teams.
• Describe deployment roles for dietitians and
the value of dietitians on deployment teams.
• Identify skills and professional growth
opportunities that can be gained from
deployments.
RDF
Rapid Deployment Force
LCDR Merel Kozlosky, MS, RD
RDF – Facts and Figures
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Tier 1 team
5 RDF teams
125+ officers per team
Scalable
– Can divide into smaller subunits
– Can be augmented with Tier 3 officers
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Deploy within 12 hrs of activation
On-call 1 out of every 5 months
Deployments typically do not exceed 2 wks
Up to 2 wks of response team training per yr
RDF - Primary Activity Areas
• Mass care (primary care, mental health, and
public health services for sheltered populations)
• Point of distribution operation (mass
prophylaxis and vaccination)
• Medical surge
• Isolation and quarantine
• Pre-hospital triage and treatment
• Community outreach and assessment
RDF - Primary Activity Areas
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Humanitarian assistance
On-site incident management
Medical supplies management and distribution
Public health needs assessment and
epidemiological investigations
• Worker health and safety
• Animal health emergency support
RDF - Structure
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Command
Planning Section
Admin/Finance Section
Logistics Section
Operations Section
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Medical Services Branch
Pharmacy Branch
Preventive Medicine Branch
Ancillary Services or Intake, Consult, and
Discharge Branch
RDF – Rosters as of 1 APR 2012
• RDF #1 = 3 RDs
– LCDR Kozlosky, LCDR Mero, LT Blood
• RDF #2 = 3 RDs
– CDR Fitzpatrick, LCDR Digennaro, LCDR Wolcoff
• RDF #3 = 1 RD
– CDR Frost
• RDF #4 = 3 RDs
– CAPT Sipe, CDR Banks, LCDR Kim
• RDF #5 = 5 RDs
– CDR Little, CDR Moser, LCDR Interpreter,
LCDR Mahrt, LT Holliday
RDF – Personal Experience
• Preventive Medicine Branch Director (2009 – Present)
• Food Safety/Nutrition (2006 – 2009)
• RDF Deployments
– Operation Lone Star (2011)
– Inauguration (2009)
– Hurricane Ike – FMS College Station (2008)
– Independence Day on the Mall (2008)
• RDF Training
– State of Tennessee and Metro Nashville Public Health
Departments (2010)
– Fort AP Hill (2009)
– RDF Response Team Workshop (2006)
Hurricane Ike – FMS College Station
Hurricane Ike – FMS College Station
Operation Lone Star
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Rio Grande Valley in Texas
Serving medically underserved and vulnerable population
Non-disaster / non-emergency setting
Split RDF team into 4 sites
Operation Lone Star –
Nutrition Counseling and Wellness Center
Operation Lone Star –
Epidemiology Project
• Multi-disciplinary
– Epidemiologists, Dietitian, Admin/Finance,
Local Volunteers
• Data collection
– Household survey
– Medical record data
• Reports
Home away from home…
RDF - Gains
• Team training
– Hone disaster response skills
– Know who you will deploy with
– Increases comfort level of deployment
• Expanded skill sets
– Clinical and Food Service
– Epidemiology
– Preventive Medicine
• Leadership opportunities
• Networks and collaborations
• Upholding mission to protect, promote, and advance
the health and safety of our Nation
APHT
Applied Public Health Team
CDR Graydon Yatabe, MPH, RD
APHT - Team Structure and Function
The goals of APHTs are to:
1. Assist a community and its officials to reestablish
essential public health services when local resources are
overwhelmed or disrupted, and
2. Support and augment local, state, territorial, tribal, or
international health programs in providing public health
services for affected populations and emergency response
workers.
APHT - Team Structure and Function
• Tier Two
• Response Time: 36 hours
• Approximately 50 Officers per team (not regional teams)
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Multi disciplinary staffing including Command Staff
One team on-call each month
Pre-event, response and/or recovery missions
Mirror and support local health department programs
APHT - Team Structure and Function
• Scalable response
– Deploy only what is needed based on Mission Assignment
– Team structure grows/shrinks to address need
• Augmentable
– Subject matter experts
APHT - Team Structure and Function
APHT
Command
Staff
Epidemiology
Surveillance
Group
Environmental
Public Health
Group
Preventive
Services
Delivery Group
APHT - Team Structure and Function
• Epidemiology and Surveillance Group
– Data collection and data analysis
– Community health status profile
– Contact tracing
• Preventive (Medical) Services Group
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Health statistics information dissemination
Vaccinations
Public health or medical education & recommendations
Alert or advise local providers, officials, & public
APHT - Team Structure and Function
• Environmental Health Group
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Adequate and safe water supply
Availability of safe, nutritious food
Access to adequate shelter
Environmental & occupational hazard assessment
APHT - Team Structure and Function
Command
Commander
Deputy Commander
Liaison Officer
IT Personnel
Safety Officer
Preventive Services Delivery Group
Physician (preventive or
occupational medicine)
Public Health Nurse or Practitioner
Health Educator
Epidemiology/Surveillance Group
Epidemiologist
Environmental Health Group
Industrial Hygienist
Disaster Response Engineer
Environmental Health
Food Safety Inspector
Hazardous and Solid Waste Consultant
Veterinarian
SAT, MHT
NIST, RIST, CAP
CHASM
CDR Mary McCormick, RD
Services Access Team (SAT) (2006)
• Tier 2 – deploy within 36 Hours, typically for up
to 2 weeks
• Comprised of 10 USPHS officers, although more
or less may deploy, as needed
• Functions
 Needs assessment
 Clinical care coordination
 Transition management & re-integration
 New role: coordinate patient movement (ASPR)
Mental Health Team (MHT) (2006)
• Tier 2 – deploy within 36 Hours, typically for up to 2
weeks
• Comprised of 26 USPHS officers, although more or
less may deploy, as needed
• Functions
 Needs assessment & treatment
 Screening – suicide risk, stress reactions, substance abuse,
etc.
 Specialized counseling
 Psychological first aid, crisis intervention
National Incident Support Team (2009)
• Tier 1 – deploy within 12 hours, up to 2 weeks
• Comprised of 72 USPHS officers, although more
or less may deploy, as needed
• Functions
 Ongoing event needs assessment
 Support & direction for incoming response assets
 Liaison with State, Tribal & local officials
 On-site incident management
 Demobilization support
Regional Incident Support Team (2009)
• Tier 1 – deploy within 12 hours, usually 1-3 days,
NTE 30 days/year
• Comprised of 12 - 30 USPHS officers, although
more or less may deploy, as needed
• Functions
 Rapid event needs assessment
 Support & direction for incoming response assets
 Liaison with State, Tribal & local officials
 On-site incident management
Capitol Area Provider Team
• Tier 2 – deploy within 36 Hours, typically <3 days
• Comprised of 5 USPHS officers
• Augment the Office of the Attending Physician
(OAP); deploy only in support of NCR events
• Functions
 First responder & primary care, BLS, ACLS
 Pre-hospital triage & treatment
 Point-of-distribution operation (i.e. – vaccination)
 Medical surge
 On-site incident management
Community Health and Service Missions
CHASM
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WHAT (concept)
WHAT (services rendered)
WHO
HOW
WHERE
WHEN
 2010 – Operation Nexus
 2011 – Operation Foothold
 2012 – 2 missions planned
Interactive Q&A
• Questions about deployment teams?
• Barriers to being on deployment teams?
• What can the Dietitian PAC Readiness
Subcommittee do to support you?
For more information, see
Response Team Fact Sheets at…
http://ccrf.hhs.gov/ccrf/current%20teams.htm