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Public Health and Law Enforcement Response to the 2011 Joplin, Missouri Tornado
Dr. Joseph Costa, D.H.Sc., PA-C
Health Policy and Management
MPH 525
Allison Erickson
April 2013
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Table of Contents
Chapter
Page
1. Introduction ..................................................................................................................................3
Natural Disasters ..................................................................................................................3
Tornados ..............................................................................................................................3
2. Public Health and Law Enforcement Agencies ...........................................................................5
Public Health Response .......................................................................................................5
Law Enforcement and Emergency Response ......................................................................6
3. Public Health and Law Enforcement Collaboration ..................................................................10
Coordinated Efforts ............................................................................................................10
4. Volunteer Agencies ....................................................................................................................12
Missouri Volunteer Policy .................................................................................................12
Impact on Joplin Recovery ................................................................................................12
5. Recommendations ......................................................................................................................15
References ...................................................................................................................................128
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Chapter 1
Introduction
Natural Disasters
What Are They?
Natural disasters are known to take many forms from hurricanes to tornadoes, floods to
droughts. According to the Institute of Oceanography (n.d.), “A natural disaster is the
consequence or effect of a natural, hazardous event, occurring when human activities and natural
phenomenon become enmeshed.” These disasters have been researched and studied for hundreds
of years in an attempt to allow preparedness from the local, state, and Federal authorities and
agencies. It is well known that natural disasters are complicated. Although researchers and
scientists have become grossly educated regarding these phenomena, there is a mutual respect for
how Mother Nature operates. Many natural disasters have been shown to be predicable given the
vast amount of technology available, which aids in preparedness. However, the disasters that
lack in predictability create chaos, confusion, and the need for rapid and efficient response from
both government and public health officials.
Tornados
Joplin, Missouri
On Sunday, May 22, 2011, an Enhanced Fujita-5 (EF-5) tornado catastrophically struck
the city of Joplin, Missouri. The Federal Emergency Management Agency (FEMA) (2011)
reports that the tornado had excess winds of 200 miles per hour (mph), with a three-fourths mile
wide base that traveled for six miles. As of May 27, 2011 there were a total of 161 fatalities with
approximately 1,371 injuries and was reported as the most deadly United States tornado since
1947 (FEMA, 2011). The city was flooded with emergency responders to begin rescue
operations and provide medical care and shelter for the Joplin residents. “The tornado
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overwhelmed the capabilities of the City of Joplin, Jasper County, and Newton County, requiring
a massive response from Federal, State, country, local, private sector, non-profit, and voluntary
organizations” (FEMA, 2011, p. 3). There were over 400 personnel from public safety
organizations deployed to assist the community of Joplin with response and recovery operations.
Kathleen Sebelius, the Department of Health and Human Services (HHS) Secretary, declared a
public health emergency for the city of Joplin on Monday, May 23, 2011. The exploration of the
Joplin tornado recovery effort will be accomplished through examining how different Federal
and state preparedness plans offered a foundational support, as well as how public health and law
enforcement agencies coordinated together.
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Chapter 2
Public Health and Law Enforcement Agencies
Public Health Response
Agencies and Policy
Due to the community wide destruction the tornado caused the citizens of Joplin, public
health agencies and officials stepped in. As Teitelbaum and Wilensky (2013) indicate, “The
public health community enters a disaster situation and establishes prevention and control
measures, collects critical data to support response, and works to meet short- and long-term
needs of the population” (p. 238-239). Although many of the public health and medical
professionals that respond to natural disasters come from Nongovernmental Organizations
(NGOs), which will be discussed later, there are federal agencies responsible for effectively and
efficiently aiding in the response to natural disasters.
After the September 11th attacks on America, the United States preparedness
infrastructure had not fully taken shape (Teitelbaum & Wilensky, 2013). The Federal
government embarked on a massive restructuring of responding to United States disasters,
including natural disasters. This reorganization established the Department of Homeland
Security (DHS) that focused on Federal preparedness and protection of the citizens of the United
States. Under the DHS, the main office in charge of addressing public health preparedness is the
Office of Health Affairs. The Medical Readiness Office, a subsection of the Office of Health
Affairs, is responsible for working with the first responder community, providing health and
medical security, and overseeing the health components of a contingency plan (Teitelbaum &
Wilensky, 2013). Similarly, FEMA, which is a part of DHS, is responsible, “for much of the
emergency disaster response activities at the federal level” (Teitelbaum & Wilensky, 2013, p.
240).
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Under the HHS, there were health agencies that aided in the recovery response to the
Joplin tornado. These agencies worked closely with Missouri’s health agencies to evaluate needs
and effectively provide resources and services. One agency in particular agency is the Office of
the Assistant Secretary for Preparedness and Response (ASPR). Teitelbaum and Wilensky
(2013) express, “ASPR is responsible for ‘preventing, preparing for, and responding to adverse
health effects of public health emergencies and disasters’” (p. 240). Additionally, the ASPR
supports the state and local capacity during an emergency, like a natural disaster. For the Joplin
tornado, specifically, many of the ASPR Hospital Preparedness Program (HPP) resources were
sent to the community. “Planning, training and exercises funded through the HPP for hospitals
and Federally Qualified Health Centers provided the infrastructure, in part, for the prepared
response that occurred during the tornado” (ASPR, 2012).
Continuing, ASPR was responsible for coordinating the services offered by other Federal
agencies and departments like the Centers for Disease Control and Prevention (CDC) and the
U.S. Food and Drug Administration (FDA). The CDC worked to provide information and
education to the citizens of Joplin regarding health protection during clean-up efforts (ASPR,
2011). An Incident Management Team from the FDA completed work on inspections of FDAregulated industries, like food processing facilities and medical device and pharmaceutical
manufacturers. These inspections were to ensure that FDA-regulated products were safe from
contamination and harm.
Law Enforcement and Emergency Response
Local Teams
Law enforcement, whether state or local, provide much needed calm and organization
after a devastating natural disaster. The teams that can be considered law enforcement include
police, state patrols, fire department, and National Guard. When disaster strikes, law
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enforcement works with numerous first responders from the community to ensure the safety,
health, and continuity of keeping the community functioning.
In addition to routine law enforcement, officers may be called on to assist with
search and rescue, body recovery, and the distribution of essential supplies to
survivors. Leaders of first responder organizations face unique challenges
including high operational tempo, long hours, and diminished resources (Center
for the Study of Traumatic Stress, 2013, p. 1).
There are numerous responsibilities that law enforcement agencies have when responding to a
natural disaster. Such responsibilities include search and rescue efforts, crime and loitering
prevention, and communicating with the community in an effective and efficient manner.
The EF-5 tornado that swept through the community of Joplin caused severe damage to
several facilities, including St. John’s Regional Medical Center. In addition to the structural
damage, the Empire District Electric Company of Joplin reported that 130 transmission poles had
been lost, leaving approximately 18,000 customer without power. “The extreme destruction
forced thousands of residents to find lodging with family or friends” (FEMA, 2011, p. 9). The
structural and electrical damage hindered the work of local enforcement agencies. In addition to
the hospital’s structural damage, limiting the use of ambulatory services, two of the fire
departments in Joplin were severely damage. This damage to the fire department also hindered
the local law enforcement’s ability to effectively perform necessary duties.
Strengths
Law enforcement agencies in and around the Joplin community were able to use
instrumental tools to effectively respond to the crisis. These tools and initiatives were within the
Missouri Homeland Security Region D counties and jurisdictions. According to FEMA (2011),
“The Region D Regional Homeland Security Oversight Committee provided grants for the
establishment and maintenance of regional response teams” (p. 12). Such grants, for example,
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were provided to the Southwest Missouri Incident Support Team (IST) allowing funding for
equipment, training, and other activities to help in the preparedness of a disaster. Additionally,
under the Region D Homeland Security Committee, city and county emergency management and
response agencies received new incident command systems. Through the structures of the
Region D Homeland Security, mutual aid agreements between the counties in Region D,
including the city of Joplin and Jasper County, were activated. Crawford County sent nurses and
portable vaccine refrigerators from the county health department. “Greene County sent 110
response personnel from the Sheriff’s Office, the Office of Emergency Management, the
Highway Department, Building and Development Services, and Public Information (FEMA,
2011, p. 13).
All the effort and coordination provided from surrounding counties is known as “The
Whole Community” response, which is part of the Presidential Policy Directive 8 (PPD 8) in
National Preparedness. According to FEMA (2011) this directive, “states that effective responses
to natural and man-made disasters require an ‘all-of-Nation’ approach that leverages all available
capabilities in a coordinated and efficient way” (p. 10). The Whole Community approach was
shown to be one of the primary reasons that emergency responders and law enforcement officials
were able to effectively perform their duties.
As mentioned previously, two of the five fire departments were destroyed. Mutual and
automatic aid from other fire departments from Southwest Missouri arrived immediately after the
tornado hit. “The Southwest Missouri IST included a command-level officer who assisted with
fire response operations” (FEMA, 2011, p. 16). The command-level officer used the Joplin Fire
Department resources and the other fire personnel from surrounding communities to create a
service call center and develop teams of fire and emergency responders to districts within Joplin.
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Challenges
Continuing, the city of Joplin saw an influx of hundreds of law enforcement and
emergency responders from surrounding states. Although the help was needed, FEMA (2011)
presents that it caused difficulties in incident management. Through the Emergency Management
Assistance Compact (EMAC), within 24 hours of the tornado, more than 800 police cars, 300
ambulances, 400 fire trucks, and 1,100 first responders had arrived from Illinois, Kansas,
Oklahoma, and other surrounding states. As stated, the influx of mutual aid did benefit the
response operations to the disaster, but it also presented several challenges.
First, man responders self-dispatched to Joplin and began performing tasks
without coordinating with local incident command. Second, some responders
lacked the equipment and training to conduct operations, particularly search and
rescue, safely and effectively. Various search markings were used, rather than
standard search markings. Consequently, some structures were searched multiple
times as subsequent teams did not recognize the markings of the previous team(s)
at the site. (FEMA, 2011, p. 15).
Not only did these challenges create confusion, but it also posed a safety risk for the law
enforcement and emergency responder’s safety. Also, because of the rapid responses from
surrounding law enforcement agencies, the Incident Action Plan was continually shifting and
changing to accommodate the high numbers. This created a sense of disorganization among
many of the groups.
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Chapter 3
Public Health and Law Enforcement Collaboration
Coordinated Efforts
Rebuilding the Community
Public health officials and agencies, as well as law enforcement agencies must work
together in a coordinated and collaborative fashion effectively solve the concerns that arise after
a natural disaster. Federalism plays a key role in how both public health and law enforcement
agencies collaborate with one another after a natural disaster.
This means that police powers, including the powers to regulate health and safety,
are the responsibility of the states. The federal government supports public health
preparedness domestically, as it must build relations globally to ensure an
effective worldwide system for preparedness, information sharing, and
collaboration in preventing, detecting, reporting, and responding to public health
threats. (Teitelbaum & Wilensky, 2013, p. 245).
As aforementioned, the state of Missouri developed preparedness plans under the state’s
Regional Homeland Security plan. However, compared to a national standard of homeland
security, Missouri’s focuses on the unique needs of the state. In this case, Missouri has
preparedness plans specifically for tornado relief efforts. Even though these preparedness plans
have been developed and were put into action after the Joplin tornado, the state relied on public
health services from the national level. The following sections will indicate some of the specific
collaboration and coordination that occurred between public health and law enforcement
officials.
Because the death toll of the tornado was far more than the local coroners could handle,
the National Disaster Medical System Disaster Mortuary Operational Response Team (DMORT)
sent approximately 100 personnel to Joplin. In addition, the Family Assistance Center Team
assisted families in identifying victims and in returning remains to loved ones. The uses of a
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Disaster Portable Morgue Unit helped in efficiently and effectively identify victims and perform
autopsy (ASPR, 2011). Due to the fact that the hospital facilities were not to be used for autopsy
because of the structural damage, there was a temporary morgue established on the campus of
Missouri Southern State University (MSSU). With an increased number of coroners, “law
enforcement officers assisted fatality management operations by transporting bodies to the
morgue” (FEMA, 2011, p. 17). With this coordination, FEMA (2011) reported that DMORT
personnel and coroners were able to process two to three victims per day. Missouri Governor Jay
Nixon directed the Missouri Highway Patrol to take responsibility for identifying the status of
every individual on the missing persons list. With the coordination of public health officials and
law enforcement responsibility, the fatality management operation was completed by June 4,
2011 (FEMA, 2011).
Next, the Administration for Children and Families (ACF) provided technical assistance
supporting Missouri’s human services response efforts. This included restoration of child care
service and emergency child care to allow Joplin’s child care infrastructure to be rebuilt. The
tornado destroyed 17 child care centers; therefore, ACF coordinated Federal support to the
Missouri Department of Social Services to meet the needs of the children and families (ASPR,
2011). Also, the Substance Abuse and Mental Health Services Administration (SAMHSA)
worked alongside law enforcement and behavioral health authorities in establishing emergency
accommodations for patients in mental health facilities damaged by the tornado. “SAMHSA
worked with state authorities in Missouri, Oklahoma, and Kansas to make emergency
arrangements for patients in need of medication assisted substance abuse treatment services after
the clinic these patients used for treatment services was destroyed” (ASPR, 2011).
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Chapter 4
Volunteer Agencies
Missouri Volunteer Policy
VOAD
Missouri’s Voluntary Organizations Active in Disasters’ (VOAD) main goals is to,
“increase disaster recovery cooperation, coordination, communication, education, and to improve
legislation dealing with disaster response, recovery and mitigation” (State Emergency
Management Agency (SEMA), 2012). VOAD focuses its efforts on making sure every individual
impacted by a disaster or tragedy receives the care and resources they need. However, a large
part of VOAD strives for establishing effective and less duplicative services before a disaster
strikes a community, or group of communities. Members of VOAD obtain membership if
involved with any non-profit voluntary organization with a constitutional reference that supports
an organized disaster response program.
Impact on Joplin Recovery
Specific Volunteer Efforts
The aftermath of the tornado created a mass number of volunteers from Missouri and
across the United States. FEMA (2011) indicates that many of the volunteers were motivated to
help Joplin with the recovery efforts through television broadcasts. However, “Many of these
[volunteers] lacked the training, supplies, and affiliations necessary for disaster response
operations” (FEMA, 2011, p. 18). To help with coordination and responsibilities of all volunteer
organizations and personnel, AmeriCorps personnel from six teams helped establish and manage
a Volunteer Reception Center on the MSSU campus. In its first 16 hours of operation, the
Volunteer Reception Center received more than 3,000 volunteer intake forms. “By August 4,
AmeriCorps’s volunteer management efforts had registered more than 46,778 people who
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performed more than 178,000 hours of volunteer work” (FEMA, 2011, p. 18). Additionally,
AmeriCorps established a Missing Persons hotline on the campus of MSSU. After the United
Way’s information line became overwhelmed with the call volume for information about
resources and services post tornado, AmeriCorps provided an additional remote call support to
service phone calls. As the building blocks of the Whole Community approach, AmeriCorps
created strong illustration at how volunteer organizations support the organizations from the
Federal, state, and local level.
Due to the vast amount of Joplin residents displaced from their homes, the American Red
Cross provided shelter, food, and health services. To be precise, the American Red Cross (2011)
reports that 3,414 individuals stayed in the shelter, 179,752 comfort and clean up kits were
distributed, 85,339 meals were served, 21 emergency response vehicles were utilized, and 6,488
mental health consultations and 5,696 health services consultations were performed. In addition,
the American Red Cross provided blood donations to a hospital in Pittsburg, Kansas to help
Joplin tornado victims.
Next, FEMA (2011) praises the work of voluntary organizations that helped establish a
mass shelter for hundreds of animals displaced by the tornado. By collaborating with state and
local organizations, the volunteer agencies were able to start animal search and rescue the day
following the tornado. One such agency that provided an immense amount of services was the
Humane Society of Missouri. “The Joplin Humane Society and Joplin Animal Control
established an animal shelter on the MSSU campus. This shelter was co-located with an
American Red Cross shelter, which allowed victims to shelter with their pets” (FEMA, 2011, p.
18). The Missouri Volunteer Veterinary Corps (MOVVR) sent three veterinarians to care for the
animals at the shelter on MSSU’s campus. In total, there were 1,308 animals rescued through the
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efforts of these volunteer organizations. Of the 1,308 rescued, 823 pets were returned to the
owner. The remaining animals were put up for adoption, which placed the remaining pets in
permanent homes.
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Chapter 5
Recommendations
This author sees the importance for both public health and law enforcement authorities to
coordinate efforts in rebuilding a community after a disaster strikes. After a disaster occurs,
especially one like the Joplin tornado, this author understands that there will be devastation,
confusion, chaos, and a strong need for rebuilding. In order to preface this section, this author
must indicate, first and foremost, that there can be as much policy as humanly possible, but that
will not solve an individual’s or family’s immense despair and grief after a natural disaster.
Nevertheless, preparedness policy is a vital part in rebuilding a community.
First, this author finds that the PPD 8 provides a substantial framework for how states
should fashion preparedness policy. However, this author also finds that the states have an
opportunity to effectively develop the preparedness plan that best fits the needs of the
population. For example, the state of Missouri would not have a preparedness plan for hurricanes
due to being an inland state. Identifying the importance of collaboration between governmental
and non-governmental agencies and organizations is an area of the PPD 8 that this author
strongly supports. This author does understand, however, that many of the state wide
preparedness standards and policies lean on funding from the Federal government. For instance,
FEMA support directly relies on Federal government funding. Therefore, after many natural
disasters, states seek the funding from FEMA for recovery efforts. So, essentially, this author is
entertaining the idea that, although states have the power to regulate health and safety, much of
the preparedness policy a state has relies on the financial support from the Federal government.
Secondly, this author knows and understands that each disaster has its own unique set of
rebuilding requirements. Every time a natural disaster happens, as with the Joplin tornado, there
is an opportunity for a state to refine its preparedness plans. This is the same for the Federal
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government and agencies. Each disaster, whether natural or manmade, has a unique set of policy
preparedness plans. No one policy can suffice for all disasters. Therefore, this author strongly
believes that each local and state preparedness plan offers the most individualized plan for a
given community. The refining and changing of preparedness plans after a natural disaster
creates high preparation plans needed in the future.
As experienced after the Joplin tornado, authorities from the National, state, and local
government sought to repair the structural damage as efficiently as possible. From the research
this author read the state of Missouri and local counties effectively initiated recovery efforts after
the tornado hit. As aforementioned in the introduction, humans have only so much control over,
and knowledge of, Mother Nature. The preparedness plans that Missouri has in place regarding
tornado preparation include siren adherence, seeking appropriate shelter when a siren sounds,
and notifying appropriate authorities. Recently, this author supports the movement toward
tornado preparedness through social media. Allowing not only the tornado siren to be heard, but
also including text messaging and other forms of social media to spread a warning, this author
believes, will decrease death and injury toll.
Next, the work of volunteer agencies and personnel are essential when a disaster occurs.
After the tornado, hundreds of volunteers flooded the community to assist with shelter
development, food services, animal rescue, and mortuary aid. This author sees the importance of
volunteer agencies; however, there can also be a point where too many volunteers arrive to help.
As stated prior, the influx of volunteers created disorganization in rummaging through debris and
knowing which group had been in one particular location. Therefore, this author would propose
having a set limit in the amount of people who are able to enter the community to assist in
recovery. The limit would depend on the extent of the damage the disaster caused. This would be
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left in the hands of both law enforcement and public health agencies. Evaluating the personnel
representation from a public health organization and law enforcement from the community
would then allow the leaders of the community to delegate how many volunteers is necessary.
Also, this author recognizes that the size of the community that suffered from the disaster also
impacts the amount of volunteers needed.
Finally, the Joplin tornado brought devastation and destruction to the community.
Through coordinated efforts from public health and law enforcement officials, the city of Joplin
began regaining its strength hours after the tornado tore through the city. This author strongly
supports the educational opportunity a natural disaster can have on a state’s preparedness policy.
However, as aforementioned, policy can only add some organization and understanding in how a
community can prepare for a disaster. It is up to the responders after the disaster, both on a
governmental and volunteer basis that determines how the community will regain its strength
and rebuild itself.
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References
American Red Cross. (2011). Fast facts: Joplin Tornado Response. Retrieved from:
http://newsroom.redcross.org/2011/06/27/fast-facts-joplin-tornado-response/
Center for the Study of Traumatic Stress. (2013). Natural disasters: Optimizing officer and team
performance. Retrieved from: http://www.cstsonline.org/wpcontent/resources/CSTS_law_enforcement_natural_disasters.pdf
Federal Emergency Management Agency. (2011). The response to the 2011 Joplin, Missouri,
tornado: Lessons learned study. Retrieved from:
http://kyem.ky.gov/teams/documents/joplin%20tornado%20response,%20lessons%20lear
ned%20report,%20fema,%20december%2020,%202011.pdf
Institute of Oceanography. (n.d.) The science of natural disasters. Retrieved from:
http://sio.ucsd.edu/science/disasters/index.cfm
Office of the Assistant Secretary for Preparedness and Response. (2011). 2011 Joplin, Missouri
tornadoes. Retrieved from: www.phe.gov/emergency/news/sitreps/Pages/missouritornado2011.aspx
State Emergency Management Agency. (2012). Missouri VOAD. Retrieved from:
http://sema.dps.mo.gov/programs/voad.asp
Teitelbaum, J.B., & Wilensky, S.E., (2013). Essentials of health policy and law (2nd ed.).
Burlington, MA: Jones & Bartlett Learning.
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