FACILITY NAME STREET ADDRESS CITY, CA ZIP MEDICAL POINT OF DISPENSING (POD) INCIDENT ACTION PLAN REVISED: FACILITY INFORMATION CURRENT AS OF: Due to the dynamic nature of a public health event, this Incident Action Plan is subject to change on short notice. Contact the City Emergency Management Department for updated incident-specific plans. v.6.30.11 BASIC PLANNING ASSUMPTIONS: MEDICAL POD ACTIVATION IMPORTANT: This incident action plan includes strategies, tactics, and procedures for non-emergency and emergency medical PODs. ASSUMPTIONS AND DEFINITIONS FOR MEDICAL PODS: 1. To qualify as an NON-EMERGENCY public health event requiring POD activation, the circumstances must meet one of the following two requirements: The Los Angeles County Department of Public Health notifies the City of Los Angeles Emergency Management Department of the need to activate at least one (1) POD with a minimum of fourteen (14) days notice. -OR The public health event does not present an imminent life threat. 2. To qualify as an EMERGENCY public health event requiring POD activation, the circumstances must meet one of the following two requirements: The Los Angeles County Department of Public Health notifies the City of Los Angeles Emergency Management Department of the need to activate at least one (1) POD with less than 48 hours notice. -OR The public health event presents an imminent life threat. 3. Only the Los Angeles County Public Health Officer has the authority to declare a public health emergency. 4. The City of Los Angeles supports Los Angeles County Department of Public Health in implementing and managing PODs by providing non-clinical resources including, but not limited to: facilities (when available) along with corresponding Incident Action Plans security and traffic control officers (as necessary) non-clinical staff barricades, tables, chairs, and other non-public health specific supplies v.6.30.2011 CITY OF LOS ANGELES MEDICAL POD PLAN – PUBLIC SAFETY SENSITIVE DOCUMENT ICS FORMS & ATTACHMENTS CHART This plan includes strategies, tactics, and procedures for non-emergency and emergency medical PODs. The chart below indicates the ICS forms and attachments applicable to all medical PODs, and those that are specific to emergency or non-emergency PODs. Unified Command should keep only those forms and attachments that are applicable to the public health event and remove all others. ICS FORMS 202 Event Objectives 203 Organization Assignment List 204 Assignment List: Form Distribution Group 204 Assignment List: Registration/Screening Group 204 Assignment List: Dispensing Group 204 Assignment List: Evaluation Group 204 Assignment List: Question & Answer Group 204 Assignment List: Flow Control Group 204a Assignment List Attachment: Diagram 204 Assignment List: Law Branch – Exterior Security Group 204a Assignment List Attachment: Diagram 204 Assignment List: Law Branch – Interior Security Group 204a Assignment List Attachment: Diagram 204 Assignment List: Law Branch – Security Group v.6.30.2011 FOR USE AT ALL MEDICAL PODS FOR USE AT EMERGENCY MEDICAL PODS FOR USE AT NONEMERGENCY MEDICAL PODS X X X X X X X X X X X CITY OF LOS ANGELES MEDICAL POD PLAN – PUBLIC SAFETY SENSITIVE 204 Assignment List: Law Branch – Traffic Control Group 205 Communications Plan (Radio) 205T Communication Plan (Telephone) 206 Medical Plan 213 General Message: Demobilization Planning 214 Activity Log 230 Daily Meeting Schedule X X X X X X X FOR USE AT ALL MEDICAL PODS ATTACHMENTS Operational Worksheet POD Layout and Client Flow Diagram of POD Layout and Client Flow General Briefing Safety Briefing POD Supply Delivery and Emergency Vehicle Access POD Client Parking POD Staff Transportation POD Staff Parking Transportation Details Incident Commander Checklist Facility Map & Transportation Diagram ICS 202 EVENT OBJECTIVES FOR USE AT FOR USE AT NONEMERGENCY EMERGENCY MEDICAL PODS MEDICAL PODS X X X X X X X X X X X X EVENT NAME/LOCATION X OPERATIONAL PERIOD CONTROL OBJECTIVES 1. Provide a safe and accessible environment for people in an affected community to obtain prophylaxis within reasonable driving/walking distance. 2. Los Angeles County Department of Public Health will dispense mass prophylaxis safely and efficiently, with support from the City of Los Angeles, and within a time frame defined by the nature of the public health emergency and the availability of the prophylaxis. 3. Deploy sufficient staff to meet the POD demands (based on nature, location, and size of the Public Health emergency), and adjust the Organization Assignment List (ICS 203) as necessary. WEATHER FORECAST FOR OPERATIONAL PERIOD v.6.30.2011 CITY OF LOS ANGELES MEDICAL POD PLAN – PUBLIC SAFETY SENSITIVE GENERAL / SAFETY MESSAGE See General Briefing & Safety Briefing. OTHER INFORMATION PREPARED BY DATE/TIME ICS 203 ORGANIZATION ASSIGNMENT LIST COMMAND STAFF CITY INCIDENT COMMANDER COUNTY INCIDENT COMMANDER SAFETY OFFICER PUBLIC INFORMATION OFFICER PUBLIC INFORMATION OFFICER EVENT NAME/LOCATION OPERATIONAL PERIOD LOGISTICS SECTION City County County County City AGENCY REPRESENTATIVES SECTION CHIEF County SUPPLY UNIT UNIT LEADER STAFF STAFF STAFF STAFF RUNNER RUNNER County County County County County County County PARKING LOT UNIT PLANNING SECTION SECTION CHIEF County DOCUMENTATION UNIT UNIT LEADER STAFF UNIT LEADER STAFF STAFF STAFF STAFF STAFF County County County County County County PERSONNEL UNIT UNIT LEADER STAFF STAFF STAFF County County County OPERATIONS SECTION SECTION CHIEF DISPENSING GROUP County CLINICAL BRANCH BRANCH DIRECTOR County FORM DISTRIBUTION GROUP GROUP SUPERVISOR STAFF STAFF STAFF STAFF STAFF v.6.30.2011 County County County County County County GROUP SUPERVISOR DISPENSING TEAM 1 LEADER STAFF STAFF STAFF STAFF STAFF RUNNER DISPENSING TEAM 2 LEADER STAFF County County County County County County County County County County CITY OF LOS ANGELES MEDICAL POD PLAN – PUBLIC SAFETY SENSITIVE STAFF STAFF County County REGISTRATION & SCREENING GROUP GROUP SUPERVISOR STAFF STAFF STAFF STAFF STAFF STAFF STAFF RUNNER County County County County County County County County FLOW CONTROL GROUP County County County County County County County County EVALUATION GROUP v.6.30.2011 County County County County County QUESTION & ANSWER GROUP GROUP SUPERVISOR STAFF County County LAW BRANCH DIRECTOR City EXTERIOR SECURITY GROUP GROUP SUPERVISOR STAFF STAFF STAFF STAFF STAFF STAFF STAFF GROUP SUPERVISOR STAFF STAFF STAFF STAFF STAFF STAFF RUNNER STAFF STAFF STAFF STAFF RUNNER County County County County County County County County GROUP SUPERVSIOR STAFF STAFF STAFF STAFF STAFF City City City City City City INTERIOR SECURITY GROUP GROUP SUPERVSIOR STAFF STAFF STAFF STAFF STAFF STAFF City City City City City City City TRAFFIC CONTROL GROUP GROUP SUPERVISOR STAFF STAFF STAFF CITY OF LOS ANGELES MEDICAL POD PLAN – PUBLIC SAFETY SENSITIVE City City City City ICS 207 ORGANIZATION CHART EVENT NAME/LOCATION OPERATIONAL PERIOD Incident Commander LACDPH Public Information Officer LACDPH Incident Commander LA CITY Safety Officer LACDPH Assistant PIO LA CITY Operations Section Chief LACDPH Planning/Intelligence Section Chief LACDPH Clinical Branch Director LACDPH Form Distribution Group Supervisor LACDPH Form Distribution Staff LACDPH Interior Security Group Supervisor LA CITY Question & Answer Staff LACDPH Form Distribution Staff LACDPH Form Distribution Staff LACDPH Dispensing Team 1 Leader LACDPH Dispensing Team 2 Leader LACDPH Nurse LACDPH Nurse LACDPH Nurse LACDPH Nurse LACDPH Nurse LACDPH Nurse LACDPH Nurse LACDPH Nurse LACDPH Nurse LACDPH Nurse LACDPH Runner LACDPH Runner LACDPH v.6.30.2011 Nurse LACDPH Staff LACDPH Nurse LACDPH Staff LACDPH Nurse LACDPH Staff LACDPH Nurse LACDPH Staff LACDPH Nurse LACDPH Staff LACDPH Runner LACDPH Staff LACDPH Supply Unit Leader LACDPH Staff LACDPH Staff LACDPH Staff LACDPH Armed Law Enforcement LA CITY Traffic Control Officer LA CITY Armed Law Enforcement LA CITY Armed Law Enforcement LA CITY Traffic Control Officer LA CITY Unarmed Security LA CITY Armed Law Enforcement LA CITY Traffic Control Officer LA CITY Unarmed Security LA CITY Armed Law Enforcement LA CITY Unarmed Security LA CITY Unarmed Security LA CITY Unarmed Security LA CITY Unarmed Security LA CITY Flow Control Group Supervisor LACDPH Staff LACDPH Personnel Unit Leader LACDPH Armed Law Enforcement LA CITY Form Distribution Staff LACDPH Evaluation Group Supervisor LACDPH Traffic Control Group Supervisor LA CITY Exterior Security Group Supervisor LA CITY Form Distribution Staff LACDPH Dispensing Group Supervisor LACDPH Documentation Unit Leader LACDPH Law Branch Director LA CITY Question & Answer Group Supervisor LACDPH Logistics Section Chief LACDPH Staff LACDPH Staff LACDPH Staff LACDPH Staff LACDPH Runner LACDPH Runner LACDPH Staff LACDPH Staff LACDPH Parking Lot Unit Leader LACDPH Staff LACDPH Staff LACDPH Staff LACDPH Staff LACDPH Staff LACDPH Staff LACDPH Staff LACDPH This is a general organization chart; the specific number of positions in each group or unit may change depending on the site-specific IAP. CITY OF LOS ANGELES MEDICAL POD PLAN – PUBLIC SAFETY SENSITIVE DOCUMENT ICS 204 ASSIGNMENT LIST FORM DISTRIBUTION GROUP EVENT NAME/LOCATION PILL POD OPERATIONAL PERIOD VACCINE POD OVERALL STRATEGIES Assist clients in completing screening form(s), answer client questions about the form(s) and the POD. Ensure all applicable sections of the form(s) are completed; clarify any confusing or miscellaneous marks on the form(s). Communicate with flow control group to facilitate client movement into the POD. OPERATIONS PERSONNEL OPERATIONS SECTION CHIEF BRANCH DIRECTOR GROUP SUPERVISOR FORM DISTRIBUTION STAFF PREPARED BY: v.6.30.2011 DATE/TIME: CITY OF LOS ANGELES MEDICAL POD PLAN – PUBLIC SAFETY SENSITIVE DOCUMENT ICS 204 ASSIGNMENT LIST REGISTRATION/SCREENING GROUP EVENT NAME/LOCATION PILL POD OPERATIONAL PERIOD VACCINE POD OVERALL STRATEGIES Assist clients in completing screening form(s), answer client questions about the form and the POD. Ensure all applicable sections of the form(s) are completed; clarify any confusing or miscellaneous marks on the form. Mark the top right corner of the form(s) D or E, depending on whether the client should be directed to the Dispensing or Evaluation (contraindication) stations. Specific directions regarding contraindications will be provided by supervisors. OPERATIONS PERSONNEL OPERATIONS SECTION CHIEF BRANCH DIRECTOR GROUP SUPERVISOR REGISTRATION/SCREENING STAFF PREPARED BY: v.6.30.2011 DATE/TIME: CITY OF LOS ANGELES MEDICAL POD PLAN – PUBLIC SAFETY SENSITIVE ICS 204 ASSIGNMENT LIST DISPENSING GROUP EVENT NAME/LOCATION PILL POD OPERATIONAL PERIOD VACCINE POD OVERALL STRATEGIES Review the client form and ensure their answers indicate they can receive the prophylaxis. If client form indicates contraindications, direct client to a flow control monitor. If clients cannot or will not receive standard medication, direct them to the Evaluation Station. Give the standard medication to the client with the corresponding drug information sheet. In the event of additional questions or side effects, instruct the client to call the LACPDH phone number on the information sheet. Collect screening form. Direct client to exit or to Question & Answer Station if they have additional questions. OPERATIONS PERSONNEL OPERATIONS SECTION CHIEF BRANCH DIRECTOR GROUP SUPERVISOR TEAM 1 LEADER TEAM 2 LEADER DISPENSING STAFF TEAM 1 PREPARED BY: v.6.30.2011 TEAM 2 DATE/TIME: CITY OF LOS ANGELES MEDICAL POD PLAN – PUBLIC SAFETY SENSITIVE ICS 204 ASSIGNMENT LIST EVALUATION GROUP EVENT NAME/LOCATION PILL POD OPERATIONAL PERIOD VACCINE POD OVERALL STRATEGIES Assess the client form and ensure the answers, and other assessment observations or questions, indicate the client should be receiving alternate prophylaxis. Select the appropriate course of action: Give standard or alternative medication/dosage, OR do not give medication. If giving the medication: Give the standard or alternative medication to the client with the corresponding drug information sheet. If informing client NOT to take the medication: Explain the risk factors associated with the medication and the expectation of life-threatening complications with the preventative treatment. Collect screening form. Direct client to exit or Question & Answer station. OPERATIONS PERSONNEL OPERATIONS SECTION CHIEF BRANCH DIRECTOR GROUP SUPERVISOR EVALUATION STAFF PREPARED BY: v.6.30.2011 DATE/TIME: CITY OF LOS ANGELES MEDICAL POD PLAN – PUBLIC SAFETY SENSITIVE ICS 204 ASSIGNMENT LIST QUESTION & ANSWER GROUP EVENT NAME/LOCATION PILL POD OPERATIONAL PERIOD VACCINE POD OVERALL STRATEGIES Answer client questions regarding the disease agent, symptoms, treatments, and purpose of preventative medications. Provide fact sheets regarding the applicable disease agent if available. Instruct clients to call LACPDH phone number on the drug information sheet in the event of additional questions or issues related to the medication. Direct clients to exit. OPERATIONS PERSONNEL OPERATIONS SECTION CHIEF BRANCH DIRECTOR GROUP SUPERVISOR QUESTION & ANSWER STAFF PREPARED BY: v.6.30.2011 DATE/TIME: CITY OF LOS ANGELES MEDICAL POD PLAN – PUBLIC SAFETY SENSITIVE ICS 204 ASSIGNMENT LIST FLOW CONTROL GROUP EVENT NAME/LOCATION PILL POD OPERATIONAL PERIOD VACCINE POD OVERALL STRATEGIES Queue clients outside to prevent clients from entering the facility who may not be able to receive prophylaxis. Only allow clients inside the facility as space and available prophylaxis allow. Queue clients at designated locations to maintain an orderly flow. Control the rate of client flow to prevent lines between or at stations. NAME FLOW CONTROL POST LOCATION SIGNATURE OF FLOW CONTROL GROUP SUPERVISOR v.6.30.2011 DESCRIPTION OF FUNCTIONS AND DUTIES SIGNATURE OF OPS CLINICAL BRANCH DIRECTOR CITY OF LOS ANGELES MEDICAL POD PLAN – PUBLIC SAFETY SENSITIVE ICS 204a ASSIGNMENT LIST ATTACHMENT DIAGRAM OF FLOW CONTROL GROUP EVENT NAME/LOCATION PILL POD OPERATIONAL PERIOD VACCINE POD FC = Flow Control Monitor Post See ICS 204 - Assignment List: Flow Control Group PREPARED BY v.6.30.2011 DATE/TIME CITY OF LOS ANGELES MEDICAL POD PLAN – PUBLIC SAFETY SENSITIVE v.6.30.2011 CITY OF LOS ANGELES MEDICAL POD PLAN – PUBLIC SAFETY SENSITIVE ICS 204 ASSIGNMENT LIST LAW BRANCH – EXTERIOR SECURITY GROUP EMERGENCY MEDICAL POD EVENT NAME/LOCATION PILL POD OPERATIONAL PERIOD VACCINE POD SECURITY MEASURES AND STRATEGIES Security staff should be positioned where they serve as a visible deterrent and should regularly patrol the facility. All unused doors will remain locked with exit-only access via the panic bar. Develop a plan to verify staff credentials to grant access to restricted areas. Indoor restrooms should be restricted to POD and facility staff only. Upon POD closing, security staff should remain at the facility until all supplies and biohazard waste are removed and staff have checked out. Security staff will complete a final check of the facility to ensure the facility is locked and cleared. NAME SECURITY POST LOCATION FUNCTION(S) NUMBER OF ARMED OFFICERS NUMBER OF UNARMED OFFICERS TOTAL OFFICERS: SIGNATURE OF EXTERIOR SECURITY GROUP SUPERVISOR v.6.30.2011 SIGNATURE OF LAW BRANCH DIRECTOR CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE ICS 204a ASSIGNMENT LIST ATTACHMENT DIAGRAM OF LAW BRANCH – EXTERIOR SECURITY GROUP EMERGENCY MEDICAL POD EVENT NAME/LOCATION PILL POD Post Location Armed Officers (A) OPERATIONAL PERIOD VACCINE POD Unarmed Officers (U) See Emergency POD ICS 204 - Assignment List: Law Branch – Exterior Security Group PREPARED BY v.6.30.2011 DATE/TIME CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE ICS 204 ASSIGNMENT LIST ATTACHMENT LAW BRANCH – INTERIOR SECURITY GROUP EMERGENCY MEDICAL POD EVENT NAME/LOCATION PILL POD OPERATIONAL PERIOD VACCINE POD SECURITY MEASURES AND STRATEGIES Security staff should be positioned where they serve as a visible deterrent and should regularly patrol the facility. All unused doors will remain locked with exit-only access via the panic bar. Develop a plan to verify staff credentials to grant access to restricted areas. Indoor restrooms should be restricted to POD and facility staff only. Upon POD closing, security staff should remain at the facility until all supplies and biohazard waste are removed and staff have checked out. Security staff will complete a final check of the facility to ensure the facility is locked and cleared. NAME SECURITY POST LOCATION FUNCTION(S) NUMBER OF ARMED OFFICERS NUMBER OF UNARMED OFFICERS TOTAL OFFICERS: v.6.30.2011 CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE EMERGENCY MEDICAL POD SIGNATURE OF INTERIOR SECURITY GROUP SUPERVISOR EVENT NAME/LOCATION ICS 204a ASSIGNMENT LIST ATTACHMENT DIAGRAM OF LAW BRANCH – INTERIOR SECURITY GROUP PILL POD Post Location Armed Officers (A) SIGNATURE OF LAW BRANCH DIRECTOR OPERATIONAL PERIOD VACCINE POD Unarmed Officers (U) See Emergency POD ICS 204 - Assignment List: Law Branch – Interior Security Group PREPARED BY v.6.30.2011 DATE/TIME CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE EMERGENCY MEDICAL POD v.6.30.2011 CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE ICS 204 ASSIGNMENT LIST LAW BRANCH – SECURITY GROUP NON-EMERGENCY MEDICAL POD EVENT NAME/LOCATION PILL POD OPERATIONAL PERIOD VACCINE POD SECURITY MEASURES AND STRATEGIES Security staff should be positioned where they serve as a visible deterrent and should regularly patrol the facility. All unused doors will remain locked with exit-only access via the panic bar. Develop a plan to verify staff credentials to grant access to restricted areas. Indoor restrooms should be restricted to POD and facility staff only. Upon POD closing, security staff should remain at the facility until all supplies and biohazard waste are removed and staff have checked out. Security staff will complete a final check of the facility to ensure the facility is locked and cleared. NAME FUNCTION(S) NUMBER OF ARMED OFFICERS NUMBER OF UNARMED OFFICERS TOTAL OFFICERS: SIGNATURE OF SECURITY GROUP SUPERVISOR v.6.30.2011 SIGNATURE OF LAW BRANCH DIRECTOR CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE EVENT NAME/LOCATION ICS 204 ASSIGNMENT LIST LAW BRANCH – TRAFFIC CONTROL GROUP PILL POD OPERATIONAL PERIOD VACCINE POD TRAFFIC CONTROL MEASURES AND STRATEGIES NAME LOCATION FUNCTION(S) NUMBER OF OFFICERS TOTAL TRAFFIC CONTROL OFFICERS: SIGNATURE OF TRAFFIC CONTROL GROUP SUPERVISOR v.6.30.2011 SIGNATURE OF LAW BRANCH DIRECTOR CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE ICS 205 COMMUNICATIONS PLAN (RADIO) SYSTEM/CACHE PREPARED BY v.6.30.2011 EVENT NAME/LOCATION CHANNEL FUNCTION OPERATIONAL PERIOD FREQUENCY/TONE ASSIGNMENT REMARKS DATE/TIME CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE ICS 205T COMMUNICATIONS PLAN (TELEPHONE) EVENT NAME/LOCATION NAME POSITION OR RESPONSIBILITY CITY POD DESK PREPARED BY v.6.30.2011 OPERATIONAL PERIOD PHONE # NOTES Provide City assistance and support to Incident Commanders and Volunteer Coordinators. DATE/TIME CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE ICS 206 MEDICAL PLAN EVENT NAME/LOCATION PILL POD OPERATIONAL PERIOD VACCINE POD AMBULANCE SERVICES Ambulance service will be provided by the Los Angeles Fire Department through the 9-1-1 system. HOSPITALS NAME ADDRESS PHONE HELIPAD (Y/N) BURN CENTER (Y/N) MEDICAL EMERGENCY PROCEDURES A staff person who has a reaction to the medication being dispensed will be assessed and treated by the Public Health Clinical Staff. The Clinical Branch Supervisor, or the Operations Section Chief if the Clinical Branch Supervisor is not available, will make the determination if 9-1-1 is to be called. If there is a Public Health Physician present, they shall direct all patient care until ambulance arrives. If a staff person suffers a medical emergency outside of the POD facility, care shall be rendered and 9-1-1 shall be called. The Public Health Clinical Staff may render care, but may not assume patient care responsibility. After 9-1-1 is called and an ambulance is dispatched, send a runner to the street to direct the ambulance crew to the patient. Staff should follow their internal workers compensation guidelines for on-the-job related illness or injuries. Notify City or County representatives of illness or injuries to their respective volunteers. Transport of a staff person to a hospital will be according to Los Angeles County Emergency Medical Services Protocol. If staff person refuses medical care and/or transport to the hospital, the refusal shall be documented on the Activity Log (ICS 214). The greatest source of liability for health care providers is a patient who refuses care with being explained to possible adverse consequences of that refusal. An ambulance may not be assigned to the POD. If one is assigned, the Operations Section Chief will brief Ambulance on POD operations. If ambulance must leave, they will coordinate with the Operations Section Chief. v.6.30.2011 CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE SIGNATURE OF MEDICAL UNIT LEADER v.6.30.2011 SIGNATURE OF SAFETY OFFICER CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE ICS 213 GENERAL MESSAGE DEMOBILIZATION PLANNING EVENT NAME/LOCATION TO: POSITION: FROM: POSITION: SUBJECT: DEMOBILIZATION PLANNING DATE: OPERATIONAL PERIOD TIME: MESSAGE Consider the following when planning for demobilization: The number of clients in line, the amount of prophylaxis left, and the through-put per hour. If the amount of available prophylaxis is projected to run out before the POD closing, a line monitor must be placed at the end of the line to advise clients that only those in line are guaranteed prophylaxis. If there is sufficient prophylaxis to last until POD closing, bring the line inside the facility and close the door if there is room for them. If the facility is not large enough to handle the line, place line monitors at the end of the line and advise the public the facility is closed. If the line is going to be closed due to the prophylaxis running out before POD closing, place a line monitor with information on other/future POD locations. Consider releasing volunteers first. Consider releasing entire units/groups at the same time. SIGNATURE: POSITION: REPLY DATE: v.6.30.2011 TIME: SIGNATURE/POSITION: CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE ICS 214 ACTIVITY LOG EVENT NAME/LOCATION OPERATIONAL PERIOD NAME AGENCY POSITION TIME SIGNIFICANT EVENTS GENERAL COMMENTS SIGNATURE v.6.30.2011 DATE/TIME CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE ICS 230 DAILY MEETING SCHEDULE DATE/TIME Start of shift Start of shift Start of shift Start of shift MEETING v.6.30.2011 OPERATIONAL PERIOD PURPOSE Incident Commander(s) gives general General Briefing POD operational information to workers Incident Commander(s) inform POD Community Profile workers about the community being Briefing served Safety Officer informs POD workers Safety Briefing about safety risks and procedures Section Chiefs and Group/Branch Just-In-Time Supervisors provide training to POD Training workers on their specific job assignment Evaluate inventory; determine whether additional supplies Situational can/should be ordered; evaluate Meeting potential for early POD closure based on supply and the number of people in line Closing Planning Meeting PREPARED BY EVENT NAME/LOCATION Plan for the demobilization of the POD ATTENDEES LOCATION All POD Staff All POD Staff All POD Staff All POD Staff Incident Commanders, Planning Chief, Operations Chief, Documentation Unit Leader, Supply Unit Leader Incident Commanders, Section Chiefs DATE/TIME CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE ATTACHMENT: OPERATIONAL WORKSHEET EVENT NAME/LOCATION OPERATIONAL PERIOD POSITION/UNIT/GROUP/TEAM Incident Commander Unified Command Safety Officer Public Information Officer Agency Representative GENERAL DUTIES Determine incident objectives and strategies. Overall management of the POD. Ensure safety of staff and clients. Be vigilant for unsafe activities and correct if found. Assure proper and accurate communications with media and public. A liaison representing an agency that has a particular interest and/or role in the POD. Planning Section Chief Documentation Unit Personnel Unit Collect, evaluate, and manage incident and resource information. Forecast POD status. Document POD throughput and types of prophylaxis dispensed. Check in and out personnel. Issue job action sheets. Oversee the condition of personnel. Logistics Section Chief Obtain and manage resources. Supply Unit Order, receive, store, and maintain pharmaceutical inventory. Ensure adequate POD supplies and resources. (Prepare vaccines if applicable.) Parking Lot Unit Direct clients to/through parking lot. Direct clients from parking lot to POD entrance. Operations Section Chief Clinical Branch Director Oversee all activities in the Clinical Branch (form distribution, registration/screening, dispensing, evaluation, flow control, and Question & Answer), and the Security Branch. Manage and direct all activities in form distribution, registration/screening, dispensing, evaluation, flow control, Question & Answer, and vaccine prep. Form Distribution Group Distribute forms at the queuing area. Registration/Screening Group Screen clients for special needs and review completed forms. Question & Answer Group Check registration/screening forms. Provide medication and medication instruction sheet to clients. Collect forms. Check registration/screening forms. Assess and dispense medication and medication instruction sheet to clients with identified risk factors. Assess clients with adverse reactions to the vaccines being dispensed, if it is a vaccination POD. Provide dispensing services to families. Issue referrals for clients needing additional medical care. Collect forms. Direct clients throughout the POD to ensure efficient flow. See ICS 204 Assignment List: Flow Control Group for specific assignments. Distribute additional information. Answer questions. Law Branch Director Manage law-related activities including security and traffic control. Dispensing Group Evaluation Group Flow Control Group Exterior Security Group Interior Security Group Security Group (Nonemergency POD) Traffic Control Group Deter crime. Ensure clients do not enter restricted areas. Respond to incidents and call for back-up as necessary. Direct street traffic to ensure effective traffic flow in the immediate area around the site. Specific duties will be provided on Job Action Sheets and at the Just-In-Time Training. v.6.30.2011 CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE ATTACHMENT: POD LAYOUT & CLIENT FLOW EVENT NAME/LOCATION OPERATIONAL PERIOD PILL POD VACCINE POD POD FOOTPRINT DETAILS Number of rooms designated for POD footprint POD Stations(s) Vaccine Prep Station (if applicable) – Must be adjacent to an electrical outlet that is capable of providing 85w, 115v, and a voltage draw of 1.3amps during operation and 6amps at kickoff, and located on the POD floor Designated space Estimated size in square feet Number of entrances/exits to/from the outdoors Number of entrances/exits to/from the POD Floor Number of electrical outlets INCIDENT COMMAND POST AND DESIGNATED STAFF-ONLY AREA Space designated for the Incident Command Post Space designated for POD staff briefings and breaks Additional space available for a staff rest area Designated staff entrance(s) and exit(s) Supply delivery area Accessibility Considerations POD CLIENT FLOW Description of POD Flow Accessibility Considerations PREPARED BY v.6.30.2011 DATE/TIME CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE ATTACHMENT: DIAGRAM OF POD LAYOUT AND CLIENT FLOW EVENT NAME/LOCATION OPERATIONAL PERIOD PILL POD PREPARED BY v.6.30.2011 VACCINE POD DATE/TIME CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE v.6.30.2011 CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE ATTACHMENT: GENERAL BRIEFING – TALKING POINTS FOR THE INCIDENT COMMANDER EVENT NAME/LOCATION OPERATIONAL PERIOD Thank you to everyone who will be helping today. Your time is very much appreciated. If you have not checked in with the Personnel Unit, you must do so immediately after the briefing. The purpose of the POD is to provide mass prophylaxis to the public in response to ____________. This is not a medical care facility. The POD is open to the public from ______ to ______. You will be notified if these times change. This operational period is ______ to ______. You are entitled to #____ of breaks for a time period of ____ minutes, and to #____ of lunch breaks. Only your POD supervisor can dismiss you for breaks and at the end of your shift. Please do not leave the facility without completing the check-out process with the POD Personnel Unit and notifying your Supervisor. The POD Personnel Unit will be located ______. Photography is not permitted in the facility. Report any incidents immediately to your POD supervisor. Please do not speak with the media. If you see representatives from the media, notify your POD supervisor or the Public Information Officer (PIO). Please report any unsafe activities to your POD supervisor or the Safety Officer immediately. If you have not already received the prophylaxis and would like to do so during your shift, please coordinate with your supervisor before you leave your post to go through the POD. Please be mindful of your personal items. The Command Post and Break Room will not be locked or supervised. Neither the City nor the County are responsible for the loss of any personal items. If LAPD, LAFD or General Services Office of Public Safety on-duty personnel visit the POD to receive the medication/vaccine, please escort them to the front of the line. A Community Profile Briefing will be given by _____________. SIGNATURE v.6.30.2011 DATE/TIME CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE EVENT NAME/LOCATION OPERATIONAL PERIOD ATTACHMENT: SAFETY BRIEFING – TALKING POINTS FOR THE SAFETY OFFICER The Command Post is located _______________. The break room is located in the _______________. The weather for today is forecasted as ________________. All staff will monitor clients for signs of [heat/cold] exposure. Report any problems to the Safety Officer immediately. Security will be provided by [LAPD, General Services Office of Public Safety, contract security officers]. If criminal activity is observed, notify your supervisor or a security staff immediately. Keep the person/people under observation but do not try to intervene. In the event of civil unrest, remain in the building until police have secured the area. Security will provide further instructions based on the nature of the incident. Emergency exits are located _______________. If we need to evacuate the building, go directly to ____________ in a calm and orderly manner. Staff should direct clients to the appropriate emergency exits. Supervisors will take roll outside to confirm that all of the members of their unit/group have evacuated safely. Security will monitor the facility from a safe distance to make sure no one enters the building until the all-clear is given. If a fire alarm rings, evacuate the building immediately. In the event of an earthquake, drop-cover-hold on until the shaking ends. If instructed, evacuate the building. If you witness an emergency situation during the operation of the POD, wave yours arms in the air to alert your supervisor. This POD will generate medical waste (show examples of waste disposal containers and bags). Nonclinical City volunteers will not handle these containers. Vaccine POD only: If a needle stick occurs, report the incident to the Incident Commanders Review ICS 206 - Medical Plan and Client Injury Guidelines. If a client becomes ill or is injured: A client who has a reaction to the medication being dispensed will be assessed and treated by the Public Health Clinical Staff. The Clinical Branch Supervisor, or the Operations Section Chief if the Clinical Branch Supervisor is not available, will make the determination if 9-1-1 is to be called. If there is a Public Health Physician present, they shall direct all client care until ambulance arrives. If a client suffers a medical emergency outside of the POD facility, care shall be rendered and 9-1-1 shall be called. The Public Health Clinical Staff may render care, but may not assume client care responsibility. After 9-1-1 is called and an ambulance is dispatched, send a runner to the street to direct the ambulance crew to the client. If a client refuses medical care and/or transport to the hospital, the refusal shall be documented on the Activity Log (ICS 214). The greatest source of liability for health care providers is a client who refuses care with being explained to possible adverse consequences of that refusal. v.6.30.2011 CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE SIGNATURE v.6.30.2011 DATE/TIME CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE EMERGENCY MEDICAL POD ATTACHMENT: POD SUPPLY DELIVERY AND EMERGENCY VEHICLE ACCESS EVENT NAME/LOCATION OPERATIONAL PERIOD POD SUPPLY DELIVERY Delivery Truck Access Delivery Area Accessibility Considerations Resources Required EMERGENCY VEHICLE ACCESS Emergency Vehicle Access Potential Staging Area Accessibility Considerations Resources Required PREPARED BY v.6.30.2011 DATE/TIME CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE EMERGENCY MEDICAL POD ATTACHMENT: POD CLIENT PARKING EVENT NAME/LOCATION CLIENT PARKING AREA OPERATIONAL PERIOD TOTAL # OF # OF HANDICAP SPOTS SPOTS Existing INGRESS (NOTE IF SIGNALIZED OR CROSSWALKS) EGRESS (NOTE IF SIGNALIZED OR CROSSWALKS) ITEMS IMPACTING TRAFFIC FLOW Additional Needed Existing Additional Needed PREPARED BY v.6.30.2011 DATE/TIME CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE RESOURCES REQUIRED EMERGENCY MEDICAL POD ATTACHMENT: POD STAFF TRANSPORTATION PLAN EVENT NAME/LOCATION OPERATIONAL PERIOD POD STAFF BUS TRANSPORTATION Bus Access Bus Drop Off Location Bus Pick Up Location Accessibility Considerations Resources Required PARKING RESERVED FOR FACILITY STAFF Facility Staff Reserved Parking Area Number of Spots Number of Handicap Spots (Existing/Needed) Accessibility Considerations Resources Required PREPARED BY v.6.30.2011 DATE/TIME CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE NON-EMERGENCY MEDICAL POD ATTACHMENT: POD STAFF PARKING PLAN EVENT NAME/LOCATION STAFF PARKING AREA OPERATIONAL PERIOD TOTAL NUMBER OF SPOTS NUMBER OF HANDICAP SPOTS ACCESSIBILITY CONSIDERATIONS Existing Additional Needed Existing Additional Needed Existing Additional Needed PREPARED BY v.6.30.2011 DATE/TIME CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE ATTACHMENT: TRANSPORTATION DETAILS EVENT NAME/LOCATION OPERATIONAL PERIOD FREEWAY, HIGHWAY, OR TOLL ROAD ACCESS FREEWAY/HIGHWAY/TOLL ROAD NEAREST ON-RAMP LOCATION NEAREST EXIT MAJOR CROSS STREETS STREET NAME DIRECTION STREET RUNS STREETS BORDERING THE PREMISES STREET IS IT A ONE-WAY? ARE THERE MEDIAN BARRIERS? IF SO, NOTE LOCATION OF TURN POCKETS. North side South side East side West side PUBLIC TRANSIT ACCESSIBLE WITHIN ¼ MILE OF THE FACILITY PROVIDER LINE NUMBER DIRECTION STOP LOCATION Bus Light Rail Subway v.6.30.2011 CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE ATTACHMENT: INCIDENT COMMANDER/POD MANAGER CHECKLIST √ Check-in with the POD Personnel Unit and put on the appropriate vest. Record your time of arrival: ________ Ensure all City and County Staff and Volunteers sign in on their respective sign in sheets. Meet with the Incident Commanders – Unified Command. Contact the City POD Desk at _______________ and report status and receive any last minute briefings. Review POD Plan. If you have any questions contact the POD Desk at _______________. Review with facility representative the locations of fire alarms, fire extinguishers and emergency exit routes. Adjust non-clinical staff if positions are unfilled due to staff absences. Act as the Public Information Officer (PIO) if that position is not filled. Act as Safety Officer if that position is not filled. Record all activities on the ICS 214 form. Ensure all City Staff and Volunteers complete an ICS 214. Bring all POD workers together and provide General and Safety Briefing. Record the time the briefings took place: ________ Ensure that adequate safety measures are in place. Meet with security branch to review strategies. Record the time set up was complete: ________ OPEN POD WHEN ALL STAFF ARE IN POSITION. Record the time the POD opened for service: ________ Once the POD is open to the public, monitor activities. Authorize release of information through the POD PIO. Meet with Section Chiefs at __________ and conduct Situational Meeting, or sooner if needed. Meet with Section Chiefs at __________ and develop a demobilization plan to include packing up equipment, releasing workers, and returning facility to working order. Consider plans for the transfer of power if the POD is to be open for more than one operational period. At the conclusion of the POD, collect ICS 214 form from all City staff and volunteers and conduct a facility inspection prior to the closing of the POD to assess damages or maintenance concerns caused by POD activation. If there are further operational periods, leave the tables and chairs. If there are no more operational periods, put away tables and chairs. Record the time the doors closed/operational period ended: _________ Record the time the facility closed: ________ Contact the POD Desk at __________ before you leave the facility. Record the total number of clients served: _______ COLLECT THE FOLLOWING ITEMS, AND RETURN TO THE CITY OF LA EMD POD DESK: ICS 214 COMPLETED BY ALL POD STAFF COPY OF CITY STAFF AND VOLUNTEER SIGN-IN/SIGN-OUT SHEET ALL FORMS CAN BE SENT TO THE CITY OF LA EMD: 200 N SPRING STREET, RM 1533 LA 90012 / MAILSTOP 988-1 NAME OF INCIDENT COMMANDER v.6.30.2011 SIGNATURE DATE/TIME: CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE EMERGENCY MEDICAL POD ATTACHMENT: FACILITY MAP & TRANSPORTATION DIAGRAM EVENT NAME/LOCATION v.6.30.2011 OPERATIONAL PERIOD CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE NON-EMERGENCY MEDICAL POD ATTACHMENT: FACILITY MAP & TRANSPORTATION DIAGRAM EVENT NAME/LOCATION v.6.30.2011 OPERATIONAL PERIOD CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE