Kern County Department of Public Health
All Hazards Emergency Preparedness Plan
Volume One
DRAFT
Approved by:
_______________________________________
Matt Constantine,
Director of Public Health Services
________________________________________
Claudia C. Jonah, M.D., Health Officer
February, 2010
[revised: February, 2010]
i
Foreword
This document is designed as a plan and guidance tool to help the Kern County Department
of Public Health (KCDPH) identify the critical planning elements, procedures and
partnerships needed to implement an effective all hazards/public health emergency
response. Volume One of this document provides general guidance to the staff in preparing
for and responding to disasters and emergencies, in reducing morbidity and mortality, and
protecting the health of the citizens in their respective communities during a bioterrorist (BT)
attack, or any other serious public health threat or emergency.
Volume Two provides
guidance relating to the operation of Department of Public Health Department Operations
Center (DCO) during an emergency.
This includes, organization charts with specific
assignments and responsibilities related to KCDPH mission and job action sheets, along
with useful appendixes and resource lists.
In recent years KCDPH has responded to a number of biological incidents (e.g., pesticide
exposures, West Nile Virus, foodborne outbreaks and plague). Biological threats like the
highly contagious smallpox, pandemic influenza (H1N1) and SARS would most likely trigger
a large scale emergency response involving multiple local health care providers, hospitals,
the state lab, law enforcement and emergency management agencies, as well as numerous
other state and federal agencies. Depending on the extent of the event and the potential for
large scale morbidity or mortality, this Public Health All Hazards Emergency Plan is
designed to coordinate with broader, emergency plans at the county, regional, state and
federal level.
KCDPH has developed this All Hazards Public Health Emergency plan to strengthen the
public health infrastructure in Kern County and the region. The systems used for
bioterrorism disease surveillance, communication, interagency planning and community
mobilization are the same as those used to respond to other infectious disease outbreaks
and natural disasters.
Newly developed community partnerships for emergency
preparedness have served to improve efforts to organize and collaborate around emergency
preparedness. It has also strengthened systematic support for other public health issues
such as obesity, diabetes and flu vaccinations for the elderly and at risk populations.
[revised: February, 2010]
ii
To assist in clarifying this planning effort, references to state and federal laws and
regulations, descriptions of biological agents, and sample flowcharts and forms are included.
[revised: February, 2010]
iii
TABLE OF CONTENTS
i.
Foreword
ii. Table of Contents
I.
Introduction
A.
B.
C.
D.
E.
Purpose
Scope
Authority
Public Health Emergency Planning Team
Community Profile
II. Situations and Assumptions
A. Situation-Driven Response
B. Assumptions
III. Operation Plans
A. Roles and Responsibilities of the Local Health Department
B. Preparedness Phase
1.
2.
3.
4.
5.
6.
7.
Vulnerability Assessment and Mitigation
Surveillance
Epidemiologic Preparedness
Laboratory Capacity
Risk Communication and Public Education
Staff Training and Education
Special Needs and Fixed Populations
C. Response Phase
1. Command and Control (ICS) of a Public Health Emergency
2. Communication
3. Early Recognition and Surveillance
4. Investigation
5. Epidemiology
6. Evidence Management
7. Mass Immunization, Prophylaxis and Pharmaceutical Stockpiles
8. Surge Capacity
9. Mass Care/Shelter Operations
10. Provision of Mental Health Care
11. Mass Fatality Management
12. Finance and Accounting
D. Recovery and Environmental Surety Phase
1. Continued Surveillance
2. Environmental Surety.
3. Restoring Normal Operations
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IV. Plan Maintenance
A. Plan Evaluation and Revision Procedures
B. Drills and Exercises
C. After Action Reports/Improvement Plans
[revised: February, 2010]
v
TABLE OF CONTENTS (continued)
V. Appendices
Appendix A:
References to Laws and Regulations
Appendix B:
Partner Organizations Directory of Emergency Contacts
Appendix C:
Multi-Hazard Mitigation Plan and Vulnerability Assessment
Appendix D:
California Medical Mutual Aid Agreement
Appendix E:
Roles and Responsibilities of Emergency Response Partners
Appendix F:
California Health Alert Network (CAHAN )
Appendix G:
Emergency Medical Provider Call List
Appendix H:
Mass Prophylaxis & Strategic National Stockpile (SNS) Operational
Area Plan; Points of Distribution (P.O.D.s); Alternate Care Sites (ACS)
Appendix I:
Crisis Emergency Risk Communication Plan
Appendix J:
Reportable Disease Confidential Morbidity Report (CMR)
Appendix K:
Protocol for Submitting Biologic Samples to the State Laboratory
Appendix L:
Disaster Recovery Plan
Appendix M:
Laboratory Chain of Custody
Appendix N:
KCDPH Department Organizational Chart
Appendix O:
Care and Shelter Operations, Annex G, Kern County Emergency Plan
Appendix P:
Pandemic Influenza Response Plan
Appendix Q:
Hazard Specific Incidents (Flood, Fire, Earthquake, Biological Attack,
Pandemic Influenza)
Appendix R:
Readiness Assessment
Appendix S:
Special Needs & Fixed Populations
Appendix T:
Isolation & Quarantine/Community Containment Measures
Appendix U:
Mental Health Support
Appendix V:
Volunteers During an Emergency
Appendix W:
Acronyms & Glossary of Terms
[revised: February, 2010]
vi
I.
INTRODUCTION
A. Purpose
The purpose of this plan is to establish policies, methods and procedures to be used
by KCDPH and its emergency response partners in responding to all public health
hazards, threats, emergencies, including incidents of biological terrorism (BT) or
naturally occurring events like pandemic influenza. This plan is designed to be
incorporated into the Health Annex of the Kern County Emergency Plan and to
integrate with future county, regional, state and federal all hazards and hazard
specific plans as they develop.
B. Scope
This All Hazards Public Health Emergency Preparedness Plan is written to
encompass
broad aspects of emergency preparedness, active investigation, emergency
response, recovery, and continuity of operations during a major public health threat
or emergency such as a biological terrorism event or pandemic influenza occurring in
Kern County. Response to hazard specific threats and emergencies, such as fire,
flood, earthquake, and biological attack are covered in the Appendix ‘E’ of Volume
One.
C. Authority
Authority for all hazard and bioterrorism preparedness planning and emergency
response for local public health is contained in the California Health and Safety
Code, California Government Code and the California Penal Code, pertaining to the
detection, prevention, containment and treatment of unnecessary illness by order of
the Health Officer or declaration of the elected governing authority (see Appendix ‘A’:
References to Laws and Regulations).
D. Public Health Emergency Planning Team
KCDPH must maintain very close coordination and communication with certain
emergency response agencies and institutions within Kern County, and around the
State, in order to carry out its functions when a public health emergency or BT event
occurs. A critical element of this plan is the integration of KCDPH emergency
operations into Kern County’s Emergency Operations Plan. Furthermore, this
document will guide KCDPH in the use of the Incident Command System (ICS) while
maintaining compliance with California’s Standardized Emergency Management
System (SEMS) and the National Incident Management System (NIMS).
[revised: February, 2010]
7
Emergency planners from other public and private agencies in the county meet
monthly with KCDPH representatives at Disaster Medical Planning Group (DMPG)
meetings to ensure that all aspects of this plan are developed and maintained in
coordination with other emergency preparedness plans in the county. A key
responsibility of KCDPH is to recruit and maintain a strong dedicated team of highly
trained professionals who are charged with the responsibility to develop and maintain
a public health emergency response plan and commit to being involved in its
implementation.
The integration of KCDPH and its personnel into emergency planning operations is
critical. A list of agencies that need to be involved, such as fire department, law
enforcement, EMS and emergency management as well as their contact personnel
and information is maintained in the Office of Public Health Preparedness at KCDPH.
Additionally, the CDPH After-Hours Emergency Call-Down List is maintained to
ensure 24/7 coverage of and access to all KCDPH staff.
E. Community Profile
1. Kern County Boundaries
The County of Kern is located in the south central portion of California. It is
approximately 8,200 square miles. It is comprised of small to medium size high
desert communities, small mountain communities and small rural communities in
the greater southern San Joaquin Valley. The total county population as of
January 1, 2009, is estimated to be 834,000. It has one major city, Bakersfield.
This city has approximately 450,000 residents within the greater Bakersfield
area. The next largest city is Delano with a population of approximately 50,000.
Kern County is bounded by eight (8) adjacent counties, with the city of Los
Angeles located 100 miles south of Bakersfield.
2. Description of Kern County Department of Public Health
KCDPH, with over 430 employees, offers disease prevention programs and
services, as well as health promotion and public information, to all residents, but
primarily to low income and uninsured people. Our 11 outlying offices and main
office located in Bakersfield, provide a wide array of programs and services,
including: AIDS/HIV testing and prevention counseling, sexually transmitted
disease testing and prevention counseling, maternal child and adolescent health
programs, CLASP (Chlamydia prevention)
program, CCS program,
Epidemiology and Health Assessment, Lead Poisoning Prevention program, Well
Baby Exams, Health Officer’s Clinic, Public Health Nursing Services,
Immunizations program, Public Health Laboratory, Office of Public Health
Preparedness (All Hazards Planning), Health Promotion and Public Information.
Recently, a merger of the Environmental Services Department, Emergency
Medical Services Department and Animal Control Department within KCDPH is
in development. This may lead to further emergency responsibilities under the
Public Health Department.
[revised: February, 2010]
8
3. Hazard Analysis
In planning for public health emergencies, KCDPH must prepare not only for
man-made disasters, but naturally occurring disasters as well. In considering its
diverse community structure, geographic span and location, Kern County has
multiple areas of vulnerability to disasters. The Kern County Hazard Mitigation
Planning Committee was formed to analyze these vulnerabilities and identify
future risks posed to the County. This committee was comprised of key
government agency representatives and community stakeholders, including
KCDPH. The Committee released its Vulnerability Assessment in September
2005. The results of this assessment are reported in Appendix ‘C’ of this
document. KCDPH will utilize the assessment to make our emergency
preparedness exercises more relevant to local emergencies.
II. SITUATIONS AND ASSUMPTIONS
A. Situation-Driven Response
In today’s environment, bioterrorism and other public health emergencies threaten
the safety and health of the citizens of Kern County. The goal of the KCDPH during
a public health threat or emergency/biological event is to minimize the impact of
these adverse events on the population it serves, and reduce morbidity and mortality.
Release of a biological agent may be either overt or covert. Overt, or the deliberate
announced spread of a biological agent, would cause immediate concern for the
Health Officer and trigger rapid efforts to identify the agent and to initiate appropriate
response and crisis emergency risk communications to the public. Covert, or the
hidden release of these agents, will delay recognition and response time. Either
scenario can result in large scale widespread impacts that can quickly overwhelm the
public health, EMS and medical care system.
Detection, response and disease control of an infectious disease outbreak is most
likely to occur at the local, town or regional level. A BT event will require public
health leadership to coordinate with many agencies from the state and federal
government to effectively coordinate all response efforts, especially the FBI and
Homeland Security. A Joint Operations Center or Unified Command Center will most
likely be established to coordinate response activities.
B. Assumptions
1. KCDPH is responsible for the protection of the public health and welfare of the
citizens within its jurisdiction.
2. The cities and town(s) in Kern County are vulnerable to a naturally occurring
infectious disease emergency like, plague, West Nile Virus, Valley Fever,
pandemic influenza, and/or or a covert/overt terrorist attack.
3. A public health emergency may involve as few as one and as many as
thousands of exposed or infected humans or animals.
[revised: February, 2010]
9
4. The source of the illness may be within or outside city/county boundaries.
5. The use of a biologic agent or influenza may only be apparent days or weeks
after release or onset.
6. A response to the occurrence of a public health emergency is dependent on the
credibility, scope and nature of the incident.
7. A bioterrorist incident is a multi-disciplinary, multi-jurisdictional and potentially
international event, which will require broad interagency planning and response
approaches, as well as cooperative partnerships between the federal, state, local
cities and Kern County government.
8. KCDPH is part of a formal California Medical Mass Mutual Aid System, which
includes all counties in the state (see Appendix ‘D’: Mutual Aid Agreement).
9. BT releases are likely to be targeted at population centers, buildings or facilities
that conduct operations for government, transportation, key local industry,
schools, large gathering areas like shopping malls, concerts or churches, or the
media.
10. Upon discovering the use of a BT agent, the event automatically becomes a
criminal investigation under the jurisdiction of the FBI.1 Numerous other federal,
state and local agencies will also be involved in the investigation and prosecution
of the event. A Joint Operations Center or Unified Command Center would be
established to coordinate the response.
11. The community response to a public health emergency is likely to be associated
with high levels of anxiety, fear and hysteria. Crisis emergency risk
communications must include messages that encourage cooperation with
government instructions, as well as reassurance that the event is being managed
to prevent injury or death.
12. Depending on the size of the incident, regular public health services, as well as
routine commerce and community activities, may be reduced or temporarily
discontinued.
13. This plan may be activated by events occurring in other jurisdictions as well.
14. Hospital surge capacity is extremely limited and in some instances (pandemic
influenza) little or no medical mass mutual aid may be available.
[remainder of page left blank]
1
Although the FBI maintains jurisdiction of a criminal investigation, LHDs will continue to carry out the necessary public health
functions to investigate and contain the outbreak.
[revised: February, 2010]
10
III. Operation Plans
A. Public Health & Medical Response (Local, Regional, State, Federal):
Local Response (Operational Area):
Public health and medical response in Kern County is managed through the Kern
County Department of Public Health (KCDPH) in coordination with the Kern County
Emergency Medical Services Department that manages EMS for Kern County. KCDPH
manages the local response with resources within the Kern County Operational Area
(Kern OA).
Regional Response:
If additional medical or health resources are required beyond the capacity of the Kern
OA for an incident or event, a medical-health mutual aid request can be issued to the
Regional Disaster Medical-Health Coordinator (RDMHC) or Specialist (RDMHS)
assigned to OES Mutual Aid Region 5. OES Mutual Aid Region 5 includes the Counties
of Fresno, Madera, Kings, Tulare, Merced, Kern, and Mariposa.
If specific medical-health resources are needed for a particular incident or event beyond
the capability of the Kern Operational Area, the KCDPH DOC or Kern County
Emergency Operations Center (KCEOC) may request regional medical-health mutual
aid through the Region 5 RDMHC/RDMHS. The resource(s) needed must be specified.
The RDMHC-S will assess medical-health resources within Region 5, provide notice to
the California Department of Public Health (CDPH) and the California EMS Authority
(EMSA), and will deploy requested resources as available within Region 5.
If such resources are not available within Region 5, the RDMHC-S will issue the specific
resource requests to the State level.
OES Mutual Aid Region 5 (Fresno. Kern, Tulare, Kings, Madera, Merced,
Mariposa):
Mariposa
Merced
Madera
Fresno
Tulare
Kings
Kern
[revised: February, 2010]
11
State Response:
State response for medical-health mutual aid is managed through CDPH or EMSA
depending on the specific resource needs. CDPH and EMSA will issue the request(s)
to one or more of the adjoining medical-health mutual aid regions (Region 4, Region 3,
Region 1), or issue a statewide medical-health mutual aid request through all regions in
the State. In most cases involving this level of response, CDPH and EMSA will be colocated in the Joint Emergency Operations Center (JEOC).
State Mutual Aid Regions Map:
If State level response to the request is insufficient to match the resources needed, the
State can issue the request to the federal level.
[revised: February, 2010]
12
Federal Response:
Federal response is managed through the federal Health and Human Services (HHS)
and the federal Emergency Management Agency (FEMA). HHS is the lead agency for
medical-health resources nationally. This includes Centers for Disease Control (CDC)
resources and Strategic National Stockpile (SNS) resources managed by the CDC.
This also includes deployment of Disaster Medical Assistance Teams (DMAT), mobile
field hospitals, and other federal resources as needed and available.
Overall, it should be noted that regional, State and federal resources may not be
reasonably available in the case of an infectious agent outbreak where there is no
viable protection; and-or there is regional, statewide or national outbreak. While in most
cases, medical-health mutual aid will be available, in some cases it will not be. Selfsufficiency with maximizing local resources for the greatest medical good for the
greatest number is the goal depending on what resources are available to manage the
problem, incident or event. Effective public information and self-help instruction are
highly important in managing a response to a wide-spread infectious agent.
B. Roles and Responsibilities of the Kern County Department of Public Health
The Health Officer plays an integral, if not lead, role in a local biological event or
public health emergency, from the outset of suspicion that an event has occurred to
the end of the recovery period. The Health Officer will maintain maximum
performance of public health disease control activities, in order to minimize the
likelihood that the disease agent will rapidly spread to new segments of the
populations. The Health Officer will collaborate with local primary care physicians,
medical care providers and EMS for the provision of medical care services to
patients needing medical attention (see Appendix ‘E’: Roles and Responsibilities of
Emergency Response Partners).
For the purpose of preparedness and response to a biological event in Kern County,
the Health Officer has a key role and legal responsibility for disease reporting,
disease investigation and imposition of isolation and quarantine measures at the
local level (see Appendix A: References to Laws and Regulations). The Health
Officer, or person legally administering the office, exercises complete legal authority
over all operations conducted by Kern County Department of Public Health, in
accordance with assigned operational responsibilities contained in the Kern County
Emergency Plan and its annexes (Annex ‘E’, Kern County Emergency Plan).
In an effort to clearly identify and manage the different preparedness activities that
need to be addressed during the various stages of a public health emergency, this
plan is divided into 3 phases: (1) Preparedness Phase, (2) Response/Emergency
Phase, and (3) Recovery Phase. The following is a list of roles and responsibilities
by phase that the local Health Officer or designee(s) may be expected to assume
before, during, and after a public health emergency/BT event.
[revised: February, 2010]
13
1. During the preparedness phase, the Director of Public Health Services shall:

Develop strong community and regional partnerships that will enable BT and
public health emergency planning to integrate with the larger regional and
state Emergency Operations Plans.

Enhance communication among traditional and non-traditional public health
partners and ensure a system is in place to receive reports of immediately
notifiable conditions or suspicious findings, thus facilitating active public
health surveillance among traditional and non-traditional public health
partners for rapid detection of a biological event (see Appendix ‘F’: California
Health Alert Network (CAHAN), Outreach Letter).

Ensure that a public health crisis emergency risk communication plan is in
place and tested regularly.

Ensure the development of effective risk communication messages and their
integration into the public health crisis emergency risk communication plan.

Organize contact and call-down lists of key hospital personnel, public health
support, and volunteers in case of an emergency.

Establish and maintain standard operating procedures (SOPs) and policies
related to all aspects of BT response including notification and call-down
procedures, lab procedures and safe handling of specimens, chain of
custody, chain of command, as well as a detention plan for quarantine of
person(s), etc.

Maintain Internet service to connect to CAHAN. Additionally, a secure
system must be maintained to transmit confidential data, lab reports and
other critical information.

Ensure more than one mode of communication is available to transmit and
receive emergency communication and information.

Coordinate with other local emergency responders and schools to prepare
and deliver a public health emergency education campaign ready to be
launched prior to a biological event.

Ensure opportunities for staff training, volunteer training, and other forms of
workforce development that will ensure a qualified workforce and provide
safety equipment needed to protect personnel at appropriate response levels
(e.g. ICS training, PPE training, decontamination training, other drills and
exercises, etc.).

Establish partnerships with medical and community associates to develop
plans for alternate care sites in the event that medical facilities are
overwhelmed.

Ensure that Public Health stockpiles of supplies are adequate to meet the
initial Public Health response phase of a hazardous event.
2. During the response/emergency phase, the Health Officer in charge shall be
responsible for the following. He/She shall work with the local Emergency
Services Manager, and in consultation with the California Department of Public
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14
Health (CADPH), the State Epidemiologist in the CADPH Epidemiology Section,
and other key State and Local Emergency Managers to:

Ensure sufficient local epidemiologic capacity is available to investigate a
biological threat using objective tests to confirm the diagnosis.

Coordinate the investigation with local, state, and/or federal law enforcement
officials, including the FBI, as necessary.

Ensure a system for the rapid distribution of crisis emergency risk
communication materials during a public health threat, emergency or BT
event.

Activate crisis emergency risk communication plan(s) and provide information
on the nature of the emergency and protective action messages across
various media formats for the public to implement and adhere to.

Mobilize the necessary quantity of public health staff and volunteers to
efficiently respond to public health threats and emergencies (see Appendix
‘G’: Emergency Medical Provider Call List).

Mobilize local, regional, and/or state partnerships to set up and execute
appropriate necessary responses (e.g., alternate care site(s), mass point of
distribution clinic(s), mental health support, etc.) through the utilization of the
California Mass Medical Mutual Aid System.

Facilitate access to community mental health, social services, and other
necessary services to ensure universal accessibility for specific needs
population during a crisis.

Protect health and ensure safety of Kern County residents, KCDPH staff, and
volunteers in the case of a biological event by ensuring appropriate infection
control and worker safety precautions are being adhered to, as well as
enforcing laws and regulations such as quarantine and/or isolation.
3. During the recovery phase, the Health Officer shall work in consultation with
the California Department of Health Services, as needed, to:

Continue with response phase activities, as required, especially mental health
and critical stress management services for both public and health
responders.

Address and correct deficiencies in emergency response operation as may
be determined during the response phase.

Oversee environmental health remediation and monitoring, as necessary or
required, including proper handling and disposition of large numbers of
corpses.

Continue public health surveillance and monitoring of illness and death
resulting from a public health emergency.

Evaluate and assess response and remediation for biological event.

Assist staff, as needed, with completing required documentation of
expenditures for state and federal reimbursement purposes.
[revised: February, 2010]
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4. During the Evaluation and Maintenance phase, the Health Officer shall:

Participate in drills, exercises and other methods of plan evaluation with
emergency planning and response partners.

Modify the Kern County All Hazards/Public Health Emergency Preparedness
Plan to improve the effectiveness of the local response.

Provide or arrange for staff training to acquire the necessary skills,
development and enhancement, as indicated by previous performance during
drills and/or exercises.
5. Kern County Department of Public Health, Health Officer Chain of
Command
In order to ensure continuity in the operation of a public health-related
emergency response in Kern County, the following chain of command will be in
effect at KCDPH:
Rank
Title
1.
Director of Public Health Services
2.
Health Officer___________________________
3.
Deputy Health Officer for Disease Control
4.
Deputy Health Officer for Clinics
5.
Administrative Services Officer______________
______
The Director of Public Health Services will maintain a current After Hours Emergency
Call Order list to ensure 24-7 accessibility to KCDPH employees (see Standard
Operating Procedures for Disasters and Emergencies, Appendix ‘A’).
PREPAREDNESS PHASE
C. Preparedness Phase
1. Vulnerability Assessment and Mitigation
Kern County has recently updated its Multi-Hazard Mitigation Plan and
Vulnerability Assessment. This assessment identified hazards and vulnerabilities
within the jurisdiction. KCDPH will analyze this assessment to search for
information and data that will be used to extract public health-related hazards,
identify the level of risk associated with each hazard, and ensure that our
programs and plans are congruent to mitigation of those hazards.
2. Surveillance
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16
Well developed surveillance and epidemiologic capacity is the foundation on
which local health departments will detect, evaluate, and design effective
responses to terrorism events.
Public Health surveillance in Kern County is primarily based on a passive
disease reporting system. All health care providers, laboratories, hospitals,
school health nurses and other entities send reports to KCDPH, Disease Control
Program based on required state laws and regulations (Appendix A: References
to Laws and Regulations, Specific Sections of the California Code of
Regulations, Health and Safety Code and Penal Code). Suspected potential
infectious patients are contacted and further examined to determine the level of
threat they pose to the community. If determined to be life threatening, the Health
Officer can issue an order of isolation to that person and an order of quarantine
to anyone who may have had contact with that person. These orders may be
endorsed by the court, and are enforceable by the County Sheriff.
KCDPH, in collaboration with the California Department of Public Health (CDPH),
informs and educates physicians, hospitals and laboratories, on the reporting
requirements for all current disease reporting on an annual basis and as new
reporting requirements are implemented. California Morbidity Report (CMR)
cards are sent as a follow-up to telephone calls to report diseases.
a. Non-traditional Syndromic Surveillance
KCDPH and its emergency response partners have or will develop nontraditional surveillance (informal surveillance) systems that include:






Hospital Emergency Department and Intensive Care Unit Admissions
First Responders, EMS/911 calls
Poison Control Center telephone call-ins
Pharmacy Surveillance
School and Workplace Absenteeism
Unusual trends in animal morbidity/mortality from veterinarians or
others

Sentinel Surveillance Sites

Private Medical Laboratories
A laboratory Reportable Significant Findings form is used to supplement
physician CMR reports which allow verification of diagnosis (Appendix I:
Laboratory Reportable Significant Findings Form).
3. Epidemiologic Preparedness
KCDPH is responsible for disease follow-up of suspected or probable reported
cases of disease or suspicious epidemiologic findings in Kern County. In
addition, KCDPH provides consultation to physicians or other health care
providers, on case diagnosis and management, health alerts, public health
surveillance summaries, and clinical and public health recommendations and
policies, including isolation and quarantine measures if needed. Details of the
[revised: February, 2010]
17
KCDPH plan for surveillance and epidemiologic response are located in the
Epidemiologic Response Plan (Measure #3).
4. Laboratory Capacity
Laboratory diagnosis is a critical step in the timely control of a BT event. KCDPH
Laboratory (hereafter referred to as the KCDPH Laboratory) is the public health
laboratory providing support to health care providers in Kern County. It will be
responsible for providing diagnostic expertise and specimen handling for KCDPH
in disease investigations. Results of laboratory testing will be promptly shared
with the County Health Officer, the Director of Disease Control and the California
State Public Health Laboratory.
The State Laboratory is a Bio-Safety Level 3 laboratory. During a biological
event, specimen packaging and transport must be coordinated with the State
Laboratory, local law enforcement, and the FBI, which will maintain a proper
chain of custody over specimens from the time of collection. The State Lab
accepts samples at the request of the FBI, Highway Patrol or any County Public
Health Laboratory. The sending entities are responsible for ensuring that the
samples sent to the State Laboratory do not contain any radiological, chemical,
or explosive properties.
Laboratory Resource
Level
Services Provided
Fresno County Public
Health Laboratory
2
Chemical & Biological Agents
Identification
Tulare County Public
Health Laboratory
2
Biological Agents Identification
California Public Health
Laboratory, Richmond
3
Biological & Chemical Agents
Identification
Centers for Disease
Control & Prevention
Laboratory, Atlanta
3
Biological & Chemical Agents
Identification
The above table is to identify additional laboratory resources with their
corresponding levels and Bioterrorism-related services provided.
KCDPH has submitted its health department’s contact information to the
California State Laboratory, Richmond, California.
The KCDPH Laboratory will comply with CDC specified protocols for safely
controlling, handling and processing the specimen (Appendix L: Protocol for
Submitting Biologic Samples to the State Laboratory).
Information on laboratory testing, including proper collecting, handling, shipping,
transporting, and submission procedures, can be obtained by contacting the
Director of the KCDPH Laboratory.
[revised: February, 2010]
18
5. Risk Communication and Public Education
To ensure consistent, reliable and continuous flow of information to the public
and the media during an emergency, KCDPH has designated the Director of
Health Promotion and Public Information as the Public Information Officer (PIO).
The PIO will be responsible for dealing with media inquiries on behalf of KCDPH
and for issuing press releases and news conferences as necessary. All efforts
will be coordinated with the Kern County PIO.
KCDPH has identified the following resources for translation services
Panational, Inc., Phone (800) 556-1316
Language Line, Phone (800) 237-8434
LifeSigns, Inc., Phone (661) 327-3783, (800) 633-8883
The following information dissemination vehicles available for use by KCDPH
have been identified:










Mass Media: Television, Radio and Ham Operators
Reverse 911 Telephone
211 Telephone Service
Door-to-door leaflets
U.S. Mail
Broadcast fax
Town Hall meetings
Internet, List-serve email
Newspapers
Partner organization mailing lists i.e., Kern County Network for
Children, Kern County Superintendent of Schools, Aging and Adult
Services Department
The Health Promotion and Public Information (HPPI) Division has established
media contacts and relationships with local and regional media channels to
ensure effective public messages during a crisis.
The following procedures have been put in place to secure needed resources
(space, equipment, and people) to operate a public information operation center
during a public health emergency if needed:

The Education Center, located on the first floor in the Main Office of KCDPH
has been designed to be the media center for public health emergency
communications with the media.

The center has multi media connectivity with two satellite downlink dishes,
two channels for internal distribution on the cable television throughout the
building, as well as closed circuit programming on two dedicated channels.

The KCDPH PIO reports to the County EOC when an emergency or public
health threat is determined by the Health Officer.
[revised: February, 2010]
19

A designated Health Educator in the Health Promotion and Public Information
Division is appointed as the backup to the department PIO and serves as the
PIO in the DOC at the main office building, to assist in developing media
release information.

The building has upgraded the communications capability to include
microwave technology that is connected to the County Emergency
Communications Center through the County Information Technology Services
Department (ITSD)
Appendix J: Crisis Emergency Risk Communication Plan is provided in the
addenda section of this document to add and develop BT/Public Health
Emergency risk communication information.

The Education Center has been wired, and equipment purchased, to facilitate
installation of a Phone Bank that can be initiated when an event occurs that
overwhelms current capacity of staff to respond to incoming calls from the
public
.
6. Staff Training and Education
Effective emergency responses require that employees know the emergency
protocols and procedures laid out in this Plan as well as when and how to use
them. The public health workforce is ready with a wide range of technical
expertise across a number of disciplines. However, their medical and public
health skills may not include the specialized knowledge of emergency
preparedness protocols such as mass prophylaxis procedures, the use of
personal protective equipment, and how the Incident Command System (ICS)
functions.
The primary focus of any emergency response training program for public health
professionals is to train and qualify employees at various levels of the incident
management system so that they will be able to recognize and appropriately
respond to incidents of varying sizes, types, and complexities. Emergency
leadership qualifications and training are developed to grow individuals who can
confidently lead a multidisciplinary response organization or operate a Point of
Distribution (POD) site or other facility unique to emergency response operations.
Additional technical competency training is recommended in this Emergency
Response Training section to encourage the cross-training and increased
flexibility of the public health workforce in times of a mass emergency.
This Plan shall be used as a text for employee response trainings. The
section address policy and system issues related to becoming competent in
emergency preparedness. The chart discusses the knowledge/skill-specific details
that emergency response personnel need in order to be technically competent in
important areas related to emergency response preparedness.
Brief policy documents (attached as appendices to this chapter) detail:
• Level (qualification by incident Types 1, 2, 3, or 4).
• Scope (number of employees) trained in incident management leadership
[revised: February, 2010]
20
•
and emergency protocols and procedures.
Response training and exercises (annual or multi-year program) to attain
the needed levels and scope of qualifications.
A. Incident Type: A Measure of Size and Complexity
The size and depth of the ICS organization is tailored to respond to the needs
of the emergency. Emergencies are "typed" according to the size and
complexity of the needed response. Incidents are typed as 1, 2, 3, or 4, where
Type 1 is the largest and most complex and demands greatly increased
number of responders, significant diversity of objectives and issues, and the
most experienced and capable leaders. A table which outlines the
characteristics of each incident Type and gives examples of each is included
as Appendix 3A. The level of ICS training depends on the Type of incidents
that the employee will be expected to respond to and the roles and
responsibilities the employee will be expected to assume in an emergency.
The goal of KCDPH is to respond up to the level of a Type 3 incident.
B. Incident Management Leadership Qualification Type
Response leaders are expected to apply ICS processes. They need the
training, experience, and leadership skills to match the magnitude and
complexity of the incident or event. The most intricate ICS qualification and
certification standards are used by agencies with the most experience
applying ICS to major incidents (an example of an agency's qualification
handbook is at
http://www.fs.fed.us/im/directives/fsh/5109.17/5109.17_10.doc).
The Kern County Department of Public Health has adopted a simplified
qualification system that will be refined and perhaps aligned with the
developing national qualification and certification system as experience is
gained. ICS training and experience (exercises and actual operations) desired
for key response leadership positions according to Incident Types is outlined
in Chart 6-E. So, for example, a Type 3 Operations Section Chief is assigned
to the KCDPH DOC, has ICS training through the I-300 level, and meets the
Department's leadership criteria for serving in that position in a Locally
Significant Type 3 incident.
C. Response Exercises
In addition to classroom presentations, emergency response exercises allow
response personnel to build relationships with one another and to become fully
familiar and confident with the procedures, facilities, and systems used during
an actual emergency. Response personnel also benefit from the exercise
preparation process. Evaluating the exercise after its completion gives critical
feedback for improving training, plans, policies, and relations.
Exercise formats include:
Orientation Exercise - Although may be used to introduce a new plan, it is the
only exercise that does not require application of a plan, policy, or standard
procedures. Orientation exercises allow work units, departments, agencies or
[revised: February, 2010]
21
multiple agencies to discuss the challenges posed by an emergency or
challenging event. Orientations help identify relevant issues, partners, and
policies. They often reveal the need for more preparation. For example, a
group responsible for logistic support might analyze logistic challenges during
a large scale communicable disease event.
Drill - Rehearsal of a specific function under the Plan or agency procedures,
e.g., the Department emergency call-down system or the set-up of a massvaccination clinic.
Tabletop Exercise (TTX) - Convenient method for introducing emergency
response personnel to scenario-related problems and situations, and enables
them to discuss creative approaches to addressing them. This is a good way
to find out whether necessary policies and procedures exist to handle specific
situations that may arise during an event. Tabletop exercises may be held for
one ICS function, for the whole response organization, or for a part of the
formal department organization.
Functional Exercise - Trains by simulating an actual event and involving all
participating components of organizations having a role in the response. The
exercise is designed to test the performance of personnel, communications,
and facilities under realistic conditions and working relationships toward
attaining a set of objectives. Functional exercises include:
•
•
Command post exercise (CTX) of operations at a command post.
Field exercise (FTX) of a field operation such as a mass vaccination
clinic.
Full-Scale Exercise - Combines drill and functional exercise elements of a
response to an event and tests the relationships between these elements. For
example, a response may have a number of different field operations led by a
command organization, with several command organizations reporting to
activated department and city/county emergency operation centers. It is the
most complex kind of exercise, and is often the culmination of a series of
tabletop and functional exercises.
D. Response Training and Exercises
We train as we anticipate to operate. General training objectives promote:
1. Safety of responders and the public during response to avoid
making the incident worse.
2. Technical and management competence in applying ICS and the
plan to quickly develop health and medical activities for and
appropriate and effective response.
3. Partnership building with medical providers, hospitals, other
emergency providers, and community partners to provide seamless
coordination during an emergency event.
[revised: February, 2010]
22
Chart footnote: NIMS ICS Curriculum to determine equivalent training:
I-100 Introduction to ICS: organization, terminology, and common responsibilities for
those requiring minimum understanding; self-taught in 1-2 hours.
I-200 Basic ICS: Basic principles, organization, facilities, resource terminology, and
common responsibilities; 8-16 hours of instruction and exercises.
I-300 Intermediate ICS: More description of detail and operation of ICS including
resource management, duties of all positions, and incident and event planning; 12-24
hours of instruction and exercise.
I-400 Advanced ICS: Large scale organization development, roles and relationships of
primary staff, planning/operational/logistic/fiscal considerations for large and complex
incident and event management, Area Command (AC), and Multi-Agency Coordination
System (MACS); 8-16 hours of instruction and exercise.
I-402 ICS for Executives: Orientation for executives, administrators, and policy makers.
Provides basic understanding of the system (like I-100) for those who are not part of the
on- scene ICS organization, however have responsibility to delegate authority to ICs and
establish or implement policy that would govern operations; 1-2 hours of instruction.
Position-Specific Courses: Specialized courses related to the position that an individual
is qualifying for; it is desirable that ICs also have experience and training in Operations and
Planning; 8-24 hours of instruction and exercises.
S-420 Command and General Staff Exercise Course: Human behavior and interaction
skills required for effective inter-functional relationships at an incident. Students have basic
position training and experience; grouped by IMT; 24-40 hours of coached instruction and
exercises.
S-520 and S-620 Advanced exercise courses designed for Type 1 IMT members.
IS-700 Describes the key concepts and principles underlying NIMS. Identifies the benefits
of using ICS as the national incident management model. Describes when it is appropriate
to institute an Area Command and to institute a Multi-agency Coordination System.
Describes the benefits of using a Joint Information System (JIS) for public information.
Identifies the ways in which NIMS affects preparedness. Describes how NIMS affects how
resources are managed. Describe the advantages of common communication and
information management systems. Explains how NIMS influences technology and
technology systems. Describes the purpose of the NIMS Integration Center.
IS-800 The National Response Plan (NRP) provides a framework to ensure that we can
all work together when our Nation is threatened. This course introduces you to the purpose
of the National Response Plan (NRP), how to locate information within the NRP, the
concept of operations upon which the plan is built, roles and responsibilities of the key
players, and the organizational structures used to manage these resources, including a
description of the field-level organizations and teams activated under the NRP and the
incident management activities
addressed by the NRP.
E. Incident Type and Characteristics
[revised: February, 2010]
23
Type 4
Initial Response
• Small incident or initial response to larger incident
• Typically one operational period (IC issues verbal orders)
• Single or a few resources
• Command, General Staff positions normally not activated
• Usually routine operation unless rapidly expands to Type 3, 2, 1 incident
Type 3
Extended Response
• Larger incident, requiring significant response efforts, of serious
potential, resolved fairly quickly
• May require multiple operational periods - if so, written action plan
• Several single resources to several strike team/task forces
• Some Command and General Staff activated; usually no Division/Group
Supervisors (unless required by span-of-control considerations); may
use staging area
Type 2
Regional Response
• Regionally significant incident
• Multiple operational periods; written action plan
• Many resources, combined as task forces/strike teams. As many as 200
persons on front line, up to 500 overall (e.g., MCP, RSP, Mass
Vaccination/Prophylaxis Operations)
• Most/all Command and General Staff, and many functional unit
• Likely activation of County/City EOCs
Type 1
National Response
• Nationally significant incident
• Multiple operational periods; written action plan
• Numerous resources, extensive field ops. Hundreds, perhaps thousands
of persons on front line, many more in support roles
• Command and General Staff, and functional unit positions activated
• Likely activation of County/City EOCs, ICs, AC and MACS
[revised: February, 2010]
24
F. Public Health Worker Emergency Readiness Competencies
The CDC-funded publication, Bioterrorism & Emergency Readiness:
Competencies for All Public Health Workers, and Columbia University School
of Nursing Center for Health Policy's website
(http://www.nursing.hs.columbia.edu/institute-centers/chphsr/index.html),
were used as guides in developing public health worker preparedness
competencies, along with creating local trainings, exercises, and drills. The
basic competencies include:
CORE COMPETENCY 1. Describe the public health role in emergency
response in a range of emergencies that might arise.
CORE COMPETENCY 2. Describe the chain of command in emergency
response.
CORE COMPETENCY 3. Identify and locate the agency emergency
response plan (or the pertinent portion of the plan).
CORE COMPETENCY 4. Describe his/her functional role(s) in emergency
response and demonstrate his/her role(s) in regular drills.
CORE COMPETENCY 5. Demonstrate correct use of all communication
equipment used for emergency communication (phone, fax, radio, etc.).
CORE COMPETENCY 6. Describe communication role(s) in emergency
response:
• Within the agency using established communication systems.
• With the media.
• With the general public.
• Among personal contacts (e.g., with family, neighbors, etc.).
CORE COMPETENCY 7. Identify limits to personal knowledge/skill/authority
and identify alternate solutions.
CORE COMPETENCY 8. Recognize unusual events that might indicate an
emergency and describe appropriate action (e.g., communicate clearly within
the chain of command).
CORE COMPETENCY 9. Apply creative problem solving and flexible
thinking to unusual challenges within his/her functional responsibilities and
evaluate effectiveness of all actions taken.
G. Evaluation: Assessments of training effectiveness follow Donald Kirkpatrick's (1994)
four-level model.
Level 1: Reactions - program evaluations measure how participants felt about the
training
Level 2: Learning - team and self assessments measure increases in skills,
[revised: February, 2010]
25
knowledge and attitudes (usually through pretests and post tests).
Level 3: Transfer - team and self assessments measure whether newly acquired
skills, knowledge and attitudes are being used in the everyday environment of
the learners (may need to use methods for long-term evaluation).
Level 4: Organizational Results - organizations measure increased productivity,
decreased costs, increased competency and quality of responses in various
emergency situations (e.g., exercises, real life events), etc.
H.
Health Specific Training
a. KCDPH staff will be provided opportunities by the Office of Public Health
Preparedness for professional skills development training required for
effective response to an emergency specific to health departments.
Examples of areas of training include, but are not limited to, the following:









Biological Agent-specific training and epidemiological functions
Worker Safety and Decontamination
Interfacing with Law Enforcement
Epidemiology and Public Health Surveillance
Crisis Emergency Risk Communications
Volunteer Training
Public Employee as an Emergency Responder
Laboratory Activities (e.g., specimen collection/handling/transport)
Disaster Health Services and Shelter Assignments
b. Furthermore, training in ICS/NIMS will be available through the Kern County
Office of Emergency Services, California Office of Emergency Services and
other educational providers as needed.
7. Specific Needs and Fixed Populations (see Appendix ‘S’)
During a public health emergency, certain segments of the population may have
specific needs or require targeted services to ensure their protection.
a) KCDPH has identified the specific populations currently within the
department’s area of responsibility. The list of provider service organizations
is listed in Appendix ‘S’.
b) KCDPH has identified resources available to work with local schools,
assisted-living facilities, long-term care facilities and social services to identify
the specific needs of each population/institution and the specific types of
assistance they would need in a public health emergency. KCPDH maintains
a community resource manual which lists these resources. The manual is
available through the department or on its website, www.co.kern.ca.us.
[revised: February, 2010]
26
Emergency Response Phase
D. Emergency Response Phase
1. Command and Control of a Public Health Emergency
In the event of a BT attack or a major public health threat or emergency, the Kern
County Health Officer and Director of Public Health Services, assume a
significant amount of authority and responsibility within the Kern County
Emergency Operations Center. Command and Control of any incident is vested
in and recognized as the responsibility of the jurisdiction and Operational Area
where the incident or event occurs. The scope of operations can expand to
involve public health in the Incident Command System/National Incident
Management Systems/Unified Command System (ICS/NIMS/UCS). The ICS is a
command structure used to organize multiple disciplines with multi-jurisdictional
responsibilities in an emergency under one incident commander. The NIMS is
used for all involved agencies to contribute to the process of developing overall
incident objectives, selecting strategies, joint-planning of tactical activities, and
integration of tactical operations. Public health workers and officials will
contribute their expertise and guidance by helping to determine the overall
objectives of the response as well as helping to plan and conduct integrated
tactical operation.
Under NIMS, a multiple-agency command post may be established at the County
Emergency Operations Center to integrate response resources and personnel.
The KCDPH Department Operations Center (DOC) will be deployed in an event
where public health issues occur. KCDPH DOC is located on the first floor,
utilizing the conference rooms.
a. ICS
On the next page is a sample of DOC positions that may be filled during an
emergency. The DOC is expandable so not all positions will necessarily be
filled:
[remainder of page left blank]
[revised: February, 2010]
27
DOC
Director
Liaison Officer
Information Officer
Assistant Liaison Officer
(EMS)
Information Group
Supervisor
Information Triage
Unit
Information Content
Creation Unit
Information
Dissemination Unit
Legal Officer
Planning
Section Chief
Operations
Section Chief
Situation Unit
Deputy Ops Chief
Resource Unit
Continuity
Of Operations
Documentation Unit
Technical Specialists
Safety Officer
Treatment
Branch
Logistics
Section Chief
Finance
Section Chief
Deputy Ops Chief
Service Branch
Investigation &
Enforcement Branch
Communications Unit
Procurement Unit
Information
Technologies
Cost Unit
EMS
Branch
Alternate Care Site
Group
Epidemiology &
Surveillance Group
Hospital Group
Mass Prophylaxis
Group
Laboratory Testing
Group
Ambulance Group
Animal Care
Group
Environmental Health
Group
Time Unit
Support Branch
Supply Unit
Personnel Unit
Claims Unit
Ground Support Unit
Pharmaceutical &
Medical Supplies
Restriction Exclusion
& Clearance Group
Facility-Based
Isolation Group
Home-Based
Isolation Group
[revised: February, 2010]
28
ICS (continued)

In Kern County, the County Health Officer shall exercise executive
authority over public health emergency operations and response in
accordance with the mission(s) and assignment(s) specified in this plan.

The public health official who may designated the role of Incident
Commander or as a member of the Unified Command System will be
determined at the time of the incident by the County Health Officer, or
his/her designee.

An incident without an address will most likely not require a “field” incident
command post. The IC will be selected on the basis of primary authority
for overall control of the incident. The County Health Officer, in charge,
will make the decision to initiate and further implement public health
response plans.
b. Emergency Operations Center (EOC)

The Kern County Office of Emergency Services (KCOES) maintains the
Kern County Emergency Operations Center (EOC), which is used to
coordinate response activities to emergencies and disasters that are
beyond the reasonable control of a field command post.

The local EOC, the site from which municipal emergency exercise
direction and control will take place, is usually established at 2601
Panorama Drive, Bakersfield.

KCDPH shall staff the EOC with the County Health Officer or Director of
Public Health Services, or his/her designee.

The Public Information Officer for KCDPH will develop and maintain
communication systems with the KCDPH DOC in conjunction with the
County PIO at the Joint Information Center (JIC) in the EOC, if activated.
The Director of Health Promotion and Public Information, or another
designee will be assigned to the JIC.
c. Department Operations Center (DOC)

The DOC shall be activated any time the Health Officer or Director of
Public Health Services is summoned to the EOC and/or during a public
health emergency as defined by the Director. DOC staff/size will be
based on need.

Information about the current public health emergency will be provided by
designated KCDPH staff, so answers to all questions will be consistent.
At least one telephone line (661) 336-0615 will be designated as the
outgoing line for required communication with outside authorities. At
least one other telephone line (661) 336-0562 will be left as an incoming
[revised: February, 2010]
29
line for outside local and state authorities. These two numbers will not be
made public.
Redundant communication systems with designated public health staff and
emergency contacts have been established to ensure timely notification and
response, including cell phones, portable radios, the Internet, County
microwave system and courier if necessary.
2. Communication
Upon confirmation of a public health emergency, the KCDPH Director of Public
Health may notify the Kern County Director of Emergency Services (Kern County
Fire Chief), Chairman of the Board of Supervisors, Kern County Sheriff and/or
the County Administrative Officer.
The Director of KCDPH or Health Officer will notify and gather senior KCDPH
staff to brief them about the situation, discuss and prepare a response plan,
notify all relevant response partners and activate the DOC if appropriate.
The following are modes of communication specific to a public health emergency.

The Director of KCDPH and the Health Officer may use their cell phones to
converse/text with staff and other Kern County Departments. They may use
the internet and intranet as well.

Community Action Partnership of Kern (CAPK) operates a countywide
informational 211 phone line that can provide important information about an
emergency to the public. Calls can be routed to Public Health for specific
health information that requires medical advice.

The California Health Alert Network (CAHAN) is a statewide information and
communication system that links State and Local health agencies. KCDPH
may utilize the CAHAN system for sending and receiving health emergency
messages. CAHAN securely facilitates communication of critical health,
epidemiological and bioterrorism-related information on a 24/7 365 days a
year basis to KCDPH employees, health organizations and other partners
throughout California. During a public health emergency, CAHAN will be
used to ensure secure electronic exchange of critical State and local
information regarding clinical, laboratory and environmental data between the
State and local levels.

In addition to being a key asset in the initial notification of an event, CAHAN
also allows KCDPH to transmit vital real time surveillance, epidemiologic and
other relevant information to the state health director/department. With the
specific protocol to be developed, during a BT event, the State CAHAN
coordinator will have the ability to disseminate information from the CDC to
the KCDPH DOC for use in coordinating a rapid and appropriate response to
the event.
[revised: February, 2010]
30

KCDPH is in the process of expanding the CAHAN network to provide rapid
communication dissemination to local emergency response partners.
Through the use of CAHAN, KCDPH can communicate with the following
response partners:
Additional KCDPH response partners to be included in the CAHAN
system are being identified and will be added, but are not limited to
the following: local medical providers, school nurses, local hospitals
and primary care facilities.

Additional information on CAHAN is located in Appendix F.
3. Early Recognition and Surveillance
Traditional local reporting sources (e.g., physicians, hospitals, schools,
laboratories, etc.) are required to report suspected, probable, or confirmed cases
of BT-related diseases, listed under Category I Diseases on the Confidential
Morbidity Report (CMR) Form PM-110 (Appendix K: Reportable Disease
Confidential Morbidity Report Form), by telephone on the day of recognition or
upon strong suspicion to KCDPH at phone number: (661) 868-0544. Reports
can be made after hours by calling (661) 868-4055. The State Web CMR system
is currently in the installation phase.
The KCDPH Epidemiologist will work in collaboration with the KCDPH Director
and other individuals, where required (e.g., reporting physician, laboratory, etc.),
to determine whether or not an unusual event has occurred or is occurring. If an
unusual event has occurred, an epidemiological investigation will be conducted
by KCDPH officials to determine the potential cause and population at risk,
decide on medical prophylaxis/treatment measures with diagnosing physician.
During this process, the Epidemiologist will keep the KCDPH Director apprised
and the Director will decide whether or not to activate the DOC.
Law enforcement may be notified in order to begin a criminal investigation, public
health surveillance may be expanded, and enhanced reporting may be
implemented. Depending on the nature and scope of the event, the EOC may be
activated.
4. Investigation
The Surveillance/Enforcement Branch within the DOC may expand to conduct
necessary investigations. Disease Control personnel will likely be assigned to
the epidemiological investigation and help recommend the best course of action
to take to control the situation.
This same Branch of Operations, within the DOC, will conduct investigations and
inspections necessary should the emergency involve an environmental
component such as a food born incident or an emergency involving safe water
etc…
a. Site of release
[revised: February, 2010]
31
Should it be determined that a Biological agent has been released, the site of
release immediately becomes a crime scene. Public Health officials will be
required to coordinate with the Kern County Sheriff’s Department, Bakersfield
Police Department or other local police departments and the FBI in the
forensic epidemiologic investigation. The local FBI special agent becomes the
lead investigative agent. Kern County’s FBI contact is available at 901 Tower
Way, Suite 207, Bakersfield CA 93301 or phone (661) 323-9665.
b. Protection of Public Health Staff and other First Responders During
Investigation
In the event of a BT emergency, KCDPH staff and other responders from
various agencies will assist with performance of public health disease control
activities. At the same time, other non-public health healthcare workers may
perform primary care to ill patients. It is very likely that there will be some
overlap in these functions.
All KCDPH employees will have ongoing training in the appropriate universal
precautions to limit the likelihood of becoming infected in the course of
performing their emergency response duties during a BT event. The Office of
Public Health Preparedness is responsible for ensuring trained staff prior to
responding.
When warranted, Personal Protective Equipment (PPE) will be issued to
KCDPH staff at risk of having contact with infected individuals or those
suspected to be infected. Prior to issuance, PPE must have been sized and
fitted properly in order to ensure adequate protection.
The KCDPH will develop internal departmental guidelines and protocols for
isolation precautions and cleaning, decontaminating and disinfecting all public
health staff and equipment as necessary.
5. Epidemiology
The process is outlined in the Kern County Epidemiological Response Plan
(Measure 3). Responsibility for managing the epidemiological activities will be
assigned to the Director of Health Assessment and Epidemiology. If the DOC is
activated, epidemiological activities will fall under the Operations Branch.
6. Evidence Management
Preliminary testing occurs in a physician’s office, medical clinic, hospital
emergency department or at a laboratory collection point. Commercial or
hospital labs may make definitive identification of an organism. For unusual
organisms, the specimen is sent to the KCDPH Lab which may have the ability to
test/identify biological substances, but will prepare and package the specimen for
delivery to the Regional Reference Lab (Tulare County Public Health Lab),
and/or the State Lab to make definitive identification (Appendix ‘I’).
[revised: February, 2010]
32
The Regional Reference Lab in Tulare accepts samples at the request of the FBI,
CHP or local HazMat Teams. Samples are collected and screened under their
direction and are delivered under chain of custody conditions. This procedure
ensures chain of custody is preserved throughout, and is described in Appendix
‘L’ and ‘M’.
7. Mass Immunization, Prophylaxis and Pharmaceutical Stockpiles
KCDPH has planned for the immunization/prophylaxis of the entire population in
the department’s operational area (Kern County) of responsibility. In the event
that mass immunization or prophylaxis is required, KCDPH will follow the Mass
Prophylaxis and Strategic National Stockpile (SNS) Operational Area Plan
(Appendix ‘H’).
8. Surge Capacity
Hospital surge capacity and hospital response will be guided by the Kern County
Med-Alert – Mass Casualty Hospital Zoning System, which is coordinated by
KCDPH Emergency Medical Services Division. This Zoning System divides the
8,200 square miles of Kern County into 9 geographic zones. Each general acute
care hospital serves as the hub for mass casualty care for their zone. Mass
casualty surge initially begins at hospitals. Once facility capacity is exceeded,
external triage is mobilized, followed by external treatment and holding if
necessary based upon demand. Each hospital has been issued mass care
shelters, cots, generators, HVAC units and lighting to manage external mass
care operations. Pre-designated Alternate Care Sites (ACS) are located at
designated colleges and schools within each zone and can be activated by the
EOC to serve as a release valve to address surge capacity limits for hospitals.
These alternative care sites would provide for minor illness or injury treatment,
and provide a basis for control of casualty flow with the objective of getting
patients to the correct level of care needed. In the event of a pandemic influenza
outbreak these ACS may be activated for several weeks and staffed with
volunteers.
Resources needed for each zone are requested through the EOC. The EOC
may deploy medical and mental health resources from other zones less
impacted; or if unavailable, refer medical-health resource requests to the Region
5 Regional Disaster Medical Health Specialist (RDMHS), which is an extension of
State-level medical mass mutual aid system. If the region cannot fill the resource
request, the request is referred to the medical-health branch of the State
Emergency Operations Center (EOC). The State EOC can fill the resource
request by pulling from other regions in the State or refer the request to the
federal level. All medical-health resource requests beyond the Kern County
operational area level are carefully coordinated with the Kern County EOC.
Other resource requests that are not medical-health related are referred to a
specific DOC (such as the Law DOC or Fire DOC) or to the Kern County EOC.
Given the constantly changing environment of emergency preparedness, further
work in surge capacity planning is underway with hospitals, physicians, clinics
and managed care providers. KCDPH, in conjunction with local Disaster Medical
[revised: February, 2010]
33
Planning Group (DMPG) partners, have completed a Readiness Assessment
(Appendix ‘P’) to guide in this process.
9. Mass Care
The KCDPH will coordinate with County Human Services Department and the
Red Cross for shelter operations to ensure that adequate and safe mass care
provisions exist.
The mass care function deals with the actions that are taken to protect evacuees
and other victims from the effects of any emergency. These actions include, but
are not limited to, providing temporary shelter, food, water, clothing and other
essential life/health support needs to those people that have been displaced from
their homes because of an emergency or public health threat. The Kern County
Operational Area Emergency Plan, Annex ‘G’, (Appendix ‘O’ in this plan), gives
detailed specific actions and site locations for Mass Care and Shelter Operations.
a. Care and Shelter Operations
KCDPH responsibilities in a mass care operation include:
 The KCDPH DOC will ensure sanitation and safety of food and water
supplies at designated shelter sites.
 The KCDPH DOC will coordinate nursing services at the local designated
shelter sites.
 The DOC Public Information Division, in cooperation with local and state
officials and the media, will coordinate distribution of homecare and
shelter in place instructions specific to the emergency. These instructions
may include basic care instructions, a description of the disease process
and its complications, and should be available in the languages of the
target populations. Depending on scale, this information may be
distributed through the County EOC, under the JIC.
 KCDPH DOC will have an Emergency Medical Services Branch, under
the Operations Section which will assume responsibility for planning and
staffing Alternate Care Sites (see Appendix ‘O’).
 Additional alternate sites for mass care services in the event of a BT
event/ Public Health Emergency are listed in the SNS Plan (Appendix
‘H’). Specific addresses and locations are confidential and located in the
plan.
b. Quarantine and Isolation
In the State of California, the local Health Officer has broad powers to
preserve the public health and prevent the spread of disease within their
jurisdictions, and in times of a declared public health emergency, retains the
authority to issue order of quarantine or isolation to individuals suspected of
having or being exposed to a potentially life threatening disease that may be
easily spread to other humans (Appendix ‘A’: References to Laws and
Regulations).
[revised: February, 2010]
34
The Health Officer may issue isolation/quarantine orders in the following
instances:



Person(s) is/are infected or exposed, or reasonably believed to be;
Person(s) is/are determined to pose a significant threat to the public’s
health;
If isolation or quarantine is necessary and is the least restrictive
alternative to protect public health;
The issues listed below are outlined in this All Hazards Public Health
Emergency Response Plan so that once the decision has been made to
implement isolation and/or quarantine measures, KCDPH will be prepared to
carry out the order(s).








The Health Officer will take the lead role in Kern County for ordering and
carrying out isolation and quarantine measures.
KCDPH DOC Investigation/Enforcement Branch will activate the
appropriate isolation groups to coordinate the process for isolation and
quarantine with local hospitals, other acute care facilities and any other
facility designated for these measures, as determined to be necessary by
the Health Officer.
The KCDPH DOC Incident Commander will approve primary and
secondary sites and facilities for quarantined individuals.
The KCDPH DOC in communication with the County EOC will coordinate
with other public and private organizations in Kern County to ensure
adequate quantities and types of resources, such as food, medicine,
shelter and basic social services, which can and will be made available to
sustain quarantine conditions for an extended period of time if necessary.
During a pandemic influenza there may be a severe shortage of people
and supplies, and the Board of Supervisors may take “any means
necessary” to control the outbreak (Health & Safety Code Section
101025).
The KCDPH DOC in communication with the County EOC will ensure
qualified medical personnel are present who can enter the quarantine
area to transfer supplies and provide care.
The County EOC will coordinate with law enforcement officials to ensure
citizen compliance with quarantine orders.
The KCDPH DOC Planning Chief will assist in evidence gathering with
the Kern County Sheriff and other local law enforcement agencies if a
quarantine order is appealed.
The Kern County and Bakersfield City Fire Departments and hospitals
have been trained by Kern County Fire Department, developed plans and
performed drills to ensure timely deployment of effective decontamination
in a field setting. Although decontamination may not be a direct
responsibility of Public Health, KCDPH staff must ensure that the
capability exists and that staff and patients can be decontaminated in a
timely matter during a BT event. Public Health Nurses have been trained
in decontamination measures and the proper use of personal protective
equipment.
[revised: February, 2010]
35
10. Provision of Mental Health Care
Availability of mental health providers, clergy, and other counselors to families is
of critical importance. The KCDPH has worked with the Kern County Mental
Health Department (KCMH) in organizing mental health providers and local crisis
intervention teams to respond to a local emergency or disaster. KCMH has
developed a Kern County Mental Health Crisis Intervention and Response Plan.
A list of support services has been prepared by KCMH to distribute to families
during a BT event, or other disaster, to help them deal with the effects of a public
health emergency. KCMH has also participated in all county-wide and KCDPH
exercises. A list of staff trained in Critical Incident Stress Management is
maintained by Public Health. This will be the responsibility of the Mental Health
Group within the KCDPH- DOC.
11. Mass Fatality Management
In Kern County, mass fatality management is the direct responsibility of the Kern
County Sheriff/Coroner’s Office. Although mass fatality management may not be
a direct responsibility of Public Health, we must ensure that the mass fatality
management capability exists. The Coroner’s Office develops and maintains a
countywide plan for mass fatality management in the Annex of the County’s
Operational Area Emergency Plan that will be implemented when necessary. In
addition to this local plan, Kern County is also involved in regional planning
activities. Kern County is part of the California Office of Emergency Services
Region V. Should an emergency be of such magnitude as to require resources
beyond the County’s capabilities, the Regional Coroners Mutual Aid Coordinator
will organize and dispatch resources within the Region to the emergency area.
KCDPH will work with the Coroner’s Office to issue certified death certificates to
those victims who are properly identified and given an official cause of death.
Death certificates will be processed by the Office of Vital Records within 48 hours
and provided to the designated funeral director and family upon request. Usual
fees for the certified copies will apply.
12. Finance and Accounting
This section is critical for tracking costs incurred by KCDPH during Public Health
Emergency. Without careful accounting and recording of justified costs and
expenses, reimbursement is often difficult, if not impossible. The tracking of
these expenses should begin at the outset of a public health emergency. The
KCDPH Administrative Services Officer (ASO) shall keep the KCDPH Director
aware of the authorized budget, expenditure log and process transactions, track
accounts and secure access to more funding as necessary and feasible. This
will be done through the Finance Section of the DOC when activated.
The following are examples of the financial responsibilities to be addressed
during a public health emergency:

The Finance Section will coordinate with the Plans Section regarding incident
related financial issues, like purchasing supplies or travel costs so this
information can be accounted for in the Plans Meetings.
[revised: February, 2010]
36

The Finance Section will ensure that all incident-related personnel time
records are accurately maintained on both internal and external staff.

The Finance Section will coordinate with the Plans Section on all incident
related business management issues needing attention and follow-up at the
Plans meeting before each Operational Period.
[remainder of page left blank]
[revised: February, 2010]
37
Recovery and Environmental Surety Phase
E. Recovery Phase and Environmental Surety
Recovery is the effort to restore basic infrastructure and operations, and the social
and economic life of a community back to normal safety standards. For the short
term, recovery entails restoring the necessary basic human needs following a public
health emergency to an acceptable standard, while providing for enhanced public
health systems. Once stability is achieved, the jurisdiction can begin public health
recovery efforts for the long term.
1. Ongoing Surveillance
During
the
recovery
phase
of
a
biologic
event,
the
DOC
Investigation/Enforcement Branch, under the Operations Section will participate
in ongoing public health surveillance and monitoring of illness and death resulting
from a biological event, as described in the response phase.
2. Environmental Surety
Re-entry criteria into a contaminated area during the recovery phase will be
determined immediately following the incident (if applicable) by the Local Fire
Department and Environmental Health HAZMAT teams, as well as County and/or
City Building Inspectors. This information will be relayed through the County
EOC to all concerned and responding parties.
It can be expected that the California Department of Health Services and/or CDC
will consult with the KCDPH field personnel (if necessary) as re-entry and
environmental decontamination criteria begin to be established. The
Environmental Services Division’s Hazmat teams, in the field, will make
recommendations to the Field Incident Commander regarding re-entry
considerations and environmental surety to outside agencies in a public health
emergency/BT event.
Environmental decontamination (DECON), or clean-up, if necessary, can occur
well after the event. Environmental DECON has the advantage of being very
well planned and is usually executed by an environmental contractor. The steps
in environmental decontamination are:







Comprehensive review of the event including documentation of impacts in the
environment, ownership of the property and legal responsibility
Development of a plan for assessment and environmental testing.
Development of a safety plan for cleanup workers
Performance of environmental assessment and testing
Interpretation of results and development of comprehensive decontamination
or cleanup plan including criteria for re-entry and post clean-up monitoring of
workers and the environment
Performance of decontamination or cleanup
Interpretation of results and decision about re-entry
[revised: February, 2010]
38
PLAN MAINTENANCE
IV. PLAN MAINTENANCE
The development of this written All Hazards public health emergency response plan is
only the first step in the overall planning process. A plan is a living document that grows
and changes to meet the needs of the community and can be adapted to reflect the
changing needs of the community. A plan’s ability to adapt to a constantly changing
environment and circumstances is a direct function of how well it is maintained.
Successful plan maintenance is achieved through regular review, training, and drills &
exercises and updating.
A. Plan Evaluation and Revision Procedures
1. Goal of Plan
a.
Plan update: The plan is dated as reviewed/revised within one year of
submission. This plan will be updated at such time as may be necessary, but,
in no case, less than annually every January.
b.
Authority, Signatures and Acknowledgement
1. List of agency representatives participating in the plan’s development
and to whom the plan applies and acknowledgements by the agencies
participating in the planning process.
2. Statement signed by authorities acknowledging adoption, or support, of
the plan and including citations of applicable statutes or administrative
rules governing the plan’s creation and use (this item is dependent upon
local and state legal practice).
d. Table of Contents: Sets forth sections and subsections with an
appropriate pagination scheme. Ideally, this scheme should be consistent
with the Local and State Civil Defense Emergency Management Agency’s
Emergency Response Plan.
e. Purpose/Introductory Material: Sets forth
plan/overview and introduction to the plan.
f.
the
purpose
of
the
Situation and Assumptions:
1. Description of situations likely to affect local emergency response unique vulnerabilities and distinguishing characteristics that may affect
the circumstances of an emergency event.
2.Consideration of availability and surge capacity of personnel, treatment
facilities, laboratories, redundant communications, pharmacologic
supplies and security; in relation to scope and duration for anticipated
events.
3. Acknowledgement of mutual aid agreements, if available.
g. Role(s) and Responsibility: In table or other format, a description of the
emergency response responsibilities of the local emergency agency(ies)
or team(s). This table indicates the primary and secondary support roles
[revised: February, 2010]
39
for local, state and federal asset acquisition. Describe roles and
responsibilities for ESF-8 functions [Emergency Support Function 8:
Health and Medical Support].
1. List, table or other format indicating the necessary roles to be filled
during response operations and detail of the specific functions of each
role.
2. Identification of the KCDPH response roles and associated response
functions for:
i. Command and Control
ii. Communication
iii. Early Recognition and Surveillance
iv. Investigation
v. Epidemiology
vi. Sample Testing, including:
1. Evidence of current packaging and shipping
regulations on infectious substances and dangerous
goods.
2. Capability to transport specimens/samples to a
confirmatory reference lab on nights, weekends, and
holidays.
vii. Evidence Management
viii. Mass Prophylaxis and Immunization
ix. Mass Patient Care
x. Mass Fatality Management
xi. Environmental Surety
xii. Mental Health of Public Health Emergency Response
Personnel
h. Concept of Operations:
direction.
What should happen, when and under whose
1. Description of organizational structure to be used for coordinating
response (typically Incident or Unified Command System).
2. Overall approach to organizing and coordinating the response to a
public health emergency, accounting for existing emergency response
structures and facilities (as noted above).
3. Description of anticipated operational activities including each agency’s
role and responsibilities.
4. Preliminary Circumstance Matrix to indicate when “to consider
deploying specific response activities and procedures” (an example is
provided in BtPREP, Template F-1) to detail outbreak investigations.
[revised: February, 2010]
40
5. Surge Capacity: Expected Outcome to delineate response
capability/capacity of local, state, federal and private resources (e.g.,
defining the limits of present capabilities, internal agency surge capacity,
and determining when to ask for higher order support based on models or
past experience; how far can an agency or partner manage with present
human and physical resources before asking for outside/jurisdictional
assistance).
6. Identification of the KCDPH response roles and associated response
functions for:
i. Command and Control
ii. Communication
iii. Early Recognition and Surveillance
iv. Investigation
v. Epidemiology
vi. Sample Testing
1. Evidence of current packaging and shipping
regulations on infectious substances and dangerous
goods.
2. Capability to transport specimens/samples to a
confirmatory reference lab on nights, weekends, and
holidays.
vii. Evidence Management
viii. Mass Prophylaxis and Immunization
ix. Mass Patient Care
x. Mass Fatality Management
xi. Environmental Surety
xii. Mental Health of Public Health Emergency Response
Personnel
i.
Activation Circumstances
1. Activation/Execution matrix or narrative description (activated from
initiation to resolution).
2. Identification of indicators that suggest a possible bioterrorist event has
occurred.
3. Response actions to be taken, by whom and how documented.
j.
Event Sequence Following Activation – Standard Operating Procedures
(SOPs), decision matrix, flow chart, decision tree or other format describing
the following.
1. Who – responsible agency(ies)
2. What – type of activity(ies)
3. Where – location of activity(ies)
4. When – timing of the activity(ies)
[revised: February, 2010]
41
5. How – procedures to be followed
k. Tribal/International/Military Installations and Neighboring Jurisdictions:
The KCDPH will submit evidence of efforts to coordinate with neighboring
jurisdictions, and if applicable, with tribal/international/military installations to
do the following tasks:
1. Identify the installations or neighboring jurisdictions the KCDPH
jurisdiction shares borders with.
2. Jointly participate in disaster planning meetings (e.g., city-state-tribal
collaboration or city-state-international collaboration). Evidence includes
one or more of the following:
i. Invitation from the KCDPH to installations or neighboring
jurisdictions to participate in planning process.
ii. Meetings notes or minutes.
iii. Indicate installation or neighboring jurisdiction part of KCDPH
response plan development committee.
iv. If available, mutual aid agreement.
3. Health alert messages
v. Evidence includes sample health alert messages that have
been shared by the KCDPH with the installations or
neighboring jurisdictions.
4. Epidemiological data
vi. Evidence includes epidemiological data shared by the KCDPH
with the installations or neighboring jurisdictions.
5. Laboratory data
vii. Evidence includes a description of how lab samples would be
tested and results shared with installations or neighboring
jurisdictions.
6. Mutual aid across borders and boundaries. Evidence includes one or
more of the following:
viii. A description on the process by which the KCDPH is working
to develop a mutual aid agreement with the installations or
neighboring jurisdictions;
ix. If available, mutual aid agreements;
x. If your state health department is responsible for all mutual aid
agreements, submit appropriate reference to these
agreements.
l.
Appendices
1. Notification tree/activation information:
i. Whom to notify and at what level (alert, standby, report, etc.)
[revised: February, 2010]
42
ii. Responsible party(s) for notification, alerts, mobilization
iii. Pertinent contact information (EOC, phone, cell, fax, etc.)
iv. Method of notification
v. Where to report
2. Communication plan
vi. Interdepartmental
vii. Media relations
viii. Public Information
ix. Joint Information Center
x. Partner Notification (How sending, receiving, and interacting
with the Health Alert Network)
xi. Essential Service Designation
3. Information on specific agents of terrorism
4. Supporting and/or reference documents, as needed
m. Quarantine & Isolation
1. The statutory or regulatory process in the jurisdiction to order individual
quarantine and isolation.
2. The statutory or regulatory process in the jurisdiction to order mass
quarantine and isolation.
2. Plan Updating
As positions, assignments and the environment surrounding a plan change, it
must be updated to reflect new information. Updating of this plan will be
preceded by an appraisal of its contents, a test or exercise, or a real event, and a
critique of the plan. Execution of this plan in response to an actual event will be
considered a test and will require a written critique (after action report and
corrective action plan) to be submitted to the KCDPH Director. Those items
subject to frequent change shall be reviewed annually for possible updating, and
shall include, but are not limited to:






Community and facility notification and alerting lists
Identity and contact numbers for response personnel
Inventories of critical equipment, supplies and other resources
Memoranda of Understanding/Agreement (MOU/MOA)
Applicable laws and statutes
Communications and response
3. Plan Revision
[revised: February, 2010]
43
The following policies apply to the assessment and updating of the plan:

It is the responsibility of the KCDPH Director and the Office of Public Health
Preparedness to coordinate the review and update of this plan.

In conducting the plan review and update, KCDPH Director and the Office of
Public Health Preparedness will seek input and feedback from the agencies
that play a role in the execution of this plan. These agencies include the
following:





Kern County Emergency Medical Services
Kern County Environmental Health Services
Kern County Animal Control
Kern County Office of Emergency Services
Disaster Medical Planning Group/Local area hospitals

If necessary, KCDPH Director and the Office of Public Health Preparedness
will conduct meetings, working groups or workshops to complete the annual
review and revision of this plan.

The KCDPH Director and the Office of Public Health Preparedness shall
serve as the office of record for this All Hazard Public Health Emergency
Preparedness and Response Plan and supporting materials. This office shall
maintain files relative to the planning effort and shall keep an inventory of
emergency public information and other planning and training materials.

As changes are made, dated and approved, the relevant change pages will
be provided to all individuals and agencies that hold copies. It is the
responsibility of the copy holder to keep individual copies current.

The KCDPH Director and the Office of Public Health Preparedness shall
maintain a list of plan holders to insure all parties receive appropriate
changes.
B. Drills and Exercises
The KCDPH will participate in both internal and external emergency response drills
and exercises used to test the effectiveness and readiness of this All Hazards Public
Health Emergency Response Plan. KCDPH OPHP will develop an internal schedule
of drills and exercises to be completed every year.
C. After Action Reports
After action reports will be written immediately following every exercise, which will
detail the exercise and areas of concern that need to be addresses in the next
training cycle and exercise period. The completed reports with be sent to the Health
Officer and the Director of KCDPH within 30 days following every drill or exercise.
The report will include the areas where this plan needs to be revised to be current
with emergency response activities required by the department.
[revised: February, 2010]
44
Appendix ‘A’
References to Laws and Regulations
Health Officer’s Practice Guide (2007)
California Department of Health Services
I. INTRODUCTION.
The practice guide was created to provide guidance to local Health Officers in California
when responding to bioterrorism as well as to actual or suspected cases of naturallyoccurring communicable disease. It discusses mechanisms that are available or not
available prior to the calling of a local or statewide emergency. If a local emergency has
been called, the user of this practice guide should also review the guide entitled, “Authority
1
and Responsibility of Local Health Officers in Emergencies and Disasters.” This practice
guide is a collaborative effort by several offices of the County Counsel and City Attorneys. It
serves merely as a starting point and will hopefully help trigger a more detailed analysis and
discussions between Health Officers and their legal counsel.
While the users of the guide may want to turn to the particular area of the guide that
specifically addresses the proposed action to be taken, such as ordering a mass quarantine,
it is important that the user also refer to other general topic areas that are applicable to all
Health Officer activities. The first of such topic areas can be found in Section II, “General
Authority of the Health Officer,” which gives an overview of the general statutory powers of
Health Officers. Because there is no specific statutory authority for many of the particular
orders that a Health Officer may wish to make, the authority for these actions will ultimately
flow from the Health Officer’s general authority to “take measures as may be necessary to
prevent the spread of the disease or occurrence of additional cases.”
Health Officers must exercise their power in a manner that is consistent with the protections
afforded to individuals under the United States and California constitutions. Any Health
Officer order must have an adequate justification if it impacts or limits liberty, freedom of
movement, bodily integrity, privacy or property. The necessity of the order should be
balanced against the extent of the infringement on the individual’s rights. The justification for
the order becomes more demanding as the individual interests at stake become more
significant. What is sufficient in one set of circumstances may not be sufficient in another.
These protections are discussed in the Section III, “Constitutional Parameters Limitations
Impacting Authority of the Health Officer.”
Other general topic areas include: (1) “Enforcement Of Health Officer Authority,” which
presents a discussion on the types of preliminary procedural considerations that should be
analyzed when issuing Health Officer orders; (2) “Interjurisdictional Coordination and
Cooperation,” for those events when the Health Officer may need to coordinate with various
federal, state and local agencies, and (3) “Confidentiality Of Health Information” and “Media
Resources and Management,” both of which address the Health Officer’s release of
confidential health information in carrying out public health activities.
[revised: February, 2010]
45
II. GENERAL AUTHORITY OF THE HEALTH OFFICER.
A. HEALTH OFFICER DEFINED.
For purposes of the Communicable Disease Prevention and Control Act, the term “Health
Officer” is defined to include county, city and district Health Officers, and city and district
2
health boards, but does not include advisory health boards. Although the county Health
Officer is not defined specifically as the “local health officer” in statutes dealing with
communicable disease control, several Health and Safety Code sections define the two
terms interchangeably, e.g., “health officer” or “local health officer,” each of which includes
his or her designee.
3
B. SOURCES OF HEALTH OFFICER AUTHORITY.
1. Appointment by the Governing Body.
The position and powers of the Health Officer derive from statute, but the appointment of
4
each Health Officer is based upon the actions of the local governing body. The statutes
5
authorize the appointment of a Health Officer in each county and city and the purpose for
6
which each position is filled by the local authority. The Health Officer is required to observe
and enforce (1) local orders and ordinances pertaining to the public health; (2) orders
prescribed by the State Department of Health Services (DHS); and (3) statutes relating to
the public health. Health Officers appointed by county Boards of Supervisors can act as a
city Health Officer, if the city by ordinance, resolution, or contract designates the county
Health Officer to be the city Health Officer.
7
2. Local Ordinances and Resolutions.
Under the California Constitution, cities and counties may enforce within their limits “all local,
8
police, sanitary, and other ordinances and regulations not in conflict with general laws.” The
governing body of each city and county is required by statute to take measures necessary
for the preservation and protection of the public health, including the adoption, if indicated,
9
of ordinances and resolutions not in conflict with the general laws. It is the duty of the
Health Officer to enforce these ordinances and resolutions.
3. State Statutes.
The Health and Safety code contains the statutes pertaining to communicable disease
prevention and control as well as the authority of the Health Officer.
10
4. DHS Regulations and Orders.
Title 17 of the California Code of Regulations contain the regulations of DHS applicable to
11
Health Officers. In addition to the regulations, DHS may issue direct orders to Health
Officers. The Health Officer must, when required by DHS, act to enforce all DHS orders,
12
rules and regulations. When the public health is menaced, the Health Officer’s actions may
[revised: February, 2010]
46
13
be controlled and regulated by DHS. DHS regulations and orders set the minimum
measures to be observed by the Health Officer. The Health Officer may take more stringent
measures where circumstances require. For a more extensive discussion of the powers of
DHS, see Section V, “Interjurisdictional Coordination and Cooperation.”
C. HEALTH OFFICER AUTHORITY TO INVESTIGATE AND REPORT DISEASE.
DHS is mandated to create a list of reportable diseases and conditions. Specified providers
of health care and under certain circumstances, individuals are required by regulation to
14
report those diseases and conditions to the Health Officer and Health Officers in turn, must
15
report specified diseases to DHS. In addition, Health Officers may require providers of
health care in their respective jurisdictions to disclose a disease that is not listed in the DHS
regulations.
16
17
Health Officers are also the agent of DHS for conducting certain studies and undertaking
18
investigations and actions as directed by DHS. Health Officer’s disclosure of information is
governed by the California Code of Regulations (CCR),
19
the Health Insurance Portability
20
and Accountability Act of 1996 (HIPAA), the Confidentiality of Medical Information Act
contained in California Civil Code §56.10, and may be subject to various other confidentiality
statutes, some of which are described in Section VI, “Confidentiality Of Health Information.”
The primary purpose of these reporting requirements is to alert Health Officers to the
21
presence of disease within their jurisdiction. Upon receiving a report of communicable
disease, Health Officers shall take whatever steps as may be necessary for the investigation
and control of spread of the disease, condition or outbreak reported. Under DHS
regulations, the Health Officer must provide for an examination of the person or animal in
order to verify the diagnosis, existence, or outbreak of the disease, investigate the source
and take appropriate steps to prevent or control the spread of the disease.
22
In circumstances involving an “immediate menace to the public health” caused by calamity,
such as flood, storm, fire, earthquake, explosion, accident, or other disaster, the Health
Officer may close the area where the menace to public health exists.
23
D. HEALTH OFFICER AUTHORITY TO PREVENT AND CONTROL COMMUNICABLE
DISEASE.
In order to receive state funding, Health Officers must provide: "Communicable disease
control, including availability of adequate isolation facilities, and the control of acute
communicable diseases..., based upon provision of.... appropriate preventive measures for
24
the particular communicable disease hazards in the community." To fulfill this requirement,
Health Officers are authorized to control contagious, infectious, or communicable disease
and may “take measures as may be necessary” to prevent and control the spread of disease
25
within the territory under their jurisdiction. This statutory provision alone can authorize all
[revised: February, 2010]
47
manner of measures taken by Health Officers, provided that the measures are necessary to
prevent the spread of disease. In the sections of this practice guide that address specific
measures, the section will commence with a discussion of this general authority, followed by
a discussion of the statutes that specifically authorize the particular measure. For example,
the general authority can be cited to support the imposition of isolation or quarantine.
26
However, the Health Officer has additional statutory authority to isolate and quarantine,
including on a mass level so long as the quarantine is not imposed on another city or county
27
without the consent of DHS. This is discussed with more detail in Section VIII, “Limiting the
Movement of Individuals and Groups.”
This general authority may also include the ability to close or restrict public assemblies or
gatherings, require evacuation, examination, inspection, vaccination, decontamination,
disinfection, property destruction or commandeering, and to compel assistance. Each of
these potential actions will be addressed more directly in the sections that follow.
Commencing January 1, 2007, during an outbreak of communicable disease, or when there
is imminent and proximate threat of such an outbreak, the Health Officer may request that
health care providers within his or her jurisdiction disclose inventories of critical supplies,
equipment, drugs, vaccines and other products that may be used for the prevention of the
transmission of the disease. The Health Officer must maintain the confidentiality of this
information.
28
E. HEALTH OFFICER’S JURISDICTIONAL TERRITORY AND ENFORCEMENT OF
HEALTH OFFICER ORDERS.
The Health Officers’ general powers authorize him or her to act in the unincorporated areas
29
of the county
and those of the city Health Officer authorize action within the city’s
30
borders. A city may by ordinance, resolution or contract authorize the enforcement of
public health laws by the county Health Officer within the city. A county may contract with a
city for the enforcement of public health laws by the city in county’s jurisdiction. City and
county Health Officer enforcement authority in each other’s jurisdiction may be authorized
by agreement.
31
The enforcement of the communicable disease control laws is generally initiated by an order
from the Health Officer that an individual act or refrain from acting in a particular manner. An
32
individual must comply with the Health Officer’s orders, or risk civil or criminal sanctions.
These sanctions can include up to and including fines and imprisonment, depending upon
the nature of the circumstances. Issues of enforcement are addressed in more detail in
Section IV, “Enforcement of Health Officer Authority.”
F.
HEALTH OFFICER POWERS, DUTIES AND RESPONSIBILITIES
CIRCUMSCRIBED BY CONSTITUTIONAL LIMITATIONS.
ARE
Although Health Officers are statutorily mandated to take all necessary measures to prevent
33
the transmission of disease, and with it the attendant authority to enforce orders, such
power is not unlimited. Because the Health Officer’s exercise of authority may impact, curtail
or impair an individual’s protected rights and liberties, constitutional considerations may
arise. See Section III, “Constitutional Limitations Impacting Authority of the Health Officer.”
[revised: February, 2010]
48
G. HEALTH OFFICER AUTHORITY TO DECLARE A HEALTH OR LOCAL EMERGENCY.
In situations involving hazardous and or medical waste release that is an immediate threat
to the public health, or whenever there is an imminent and proximate threat of the
introduction of any contagious, infectious, or communicable disease, chemical agent, noncommunicable biologic agent, toxin, or radioactive agent, Health Officers may declare a
34
“local health emergency.” The Health Officer cannot declare a local emergency under the
Emergency Services Act
35
unless expressly granted that authority by the local governing
36
body. Few California counties have granted such short term authority to its Health Officer.
Any formal declaration of local emergency or local health emergency issued by a Health
Officer must be ratified by the local governing body within a very limited number of days to
remain effective.
The declaration of a local health emergency authorizes other political subdivisions and state
agencies to provide mutual aid. It also provides immunity to physicians, hospitals, nurses,
and other specified persons providing medical care at the express or implied request of the
Health Officer.
37
Notes:
1
Authority and Responsibility of Local Health Officers in Emergencies and Disasters, D.
David Abbott [Emergency Preparedness Office] and Jack S. McGurk, (Chief of
Environmental Management Branch), Department of Health Services, State of California
(September 30, 1998).
2
California Health and Safety Code, (hereinafter, “H&S”), §120100 et seq.
3
H&S §120115(k), 17 California Code of Regulations (hereinafter, “C.C.R.”), §§2501 and
2641.50.
4
Pursuant to H&S §101025, the board of supervisors of each county derives authority to
preserve and protect the public health in the unincorporated areas of each county by
ordinance, regulations, and orders not in conflict with general law. The county health officer
position is authorized by H&S §101000. The governing body of a city derives authority to
preserve and protect the public health by regulation and adoption of ordinances, regulations,
and orders pursuant to H&S §101450. The city health officer position is authorized by H&S
§101460, which also provides authority for the city to make such an appointment.
5
6
7
H&S §§101000, 101460.
H&S §§101025,101030;101375,101400;101405,101415,101450, and 101470.
H&S §§101375, 101400.
8
California Constitution, Article, (hereinafter, “Cal. Const., art.”), XI, Section 7 “A county or
city may make and enforce within its limits all local, police, sanitary, and other ordinances
and regulations not in conflict with general laws.”
9
H&S §101025.
10
Division 105 of the H&S, starting at §120100. Division 105 consists of several 'Parts',
entitled (1) “Administration of Communicable Disease Prevention and Control,” (2)
“Immunizations,” (3) “Sexually Transmitted Disease,” (4) “Human Immunodeficiency Virus
(HIV),” (5) “Tuberculosis,” (6) “Veterinary Public Health and Safety,” and (7) “Hepatitis C.”
These statutes can be accessed online at “www.leginfo.ca.gov/calaw”.
[revised: February, 2010]
49
11
See 17 C.C.R. §2500 and following. Under H&S §100275, DHS is authorized to adopt
regulations for the execution of its duties.
12
13
H&S §§120130, 120145, 120190, 120195, 120200, 120210, 120215 and 120175.
H&S §100180.
14
H&S §120130, under which DHS must establish and publish a list of reportable diseases
and conditions. The list is found in 17 C.C.R. §2500 and includes the reporting of any
unusual disease and outbreaks of any unlisted disease.
15
H&S §120130 mandates the Health Officer to report diseases as required by DHS. 17
C.C.R. §2500(g) requires the Health Officer to report information to DHS as requested. 17
C.C.R. §2500(d) mandates the Health Officer to report health care provider reports to DHS.
Unless there is a written authorization, the information requested does not include drug and
alcohol records protected by the Part 2 of Title 42 of the Code of Federal Regulations,
(hereinafter, “C.F.R.”).
16
H&S §120175.
17
17 C.C.R. §2501. The Health Officer is required to conduct morbidity/mortality studies at
DHS request.
18
17 C.C.R. §2502. The Health Officer is the agent of DHS when conducting
morbidity/mortality investigations and exercising DHS investigation and action powers
granted by Government Code (hereinafter, “Gov.”), §11181. DHS is also authorized to
conduct such studies pursuant to H&S §100325. Gov. §11181 permits DHS inspection of
books, records and other items. Therefore the Health Officer acting at DHS direction and
has the same authority to inspect records.
19
17 C.C.R. §2500(f) and (g). The Health Officer may report to the DHS in confidence
certain confidential medical information, other than drug and alcohol information, unless
written authorization for such information is obtained.
20
45 C.F.R., Parts 160 and 164.
21
If the disease is not yet present within the Health Officer’s jurisdiction, the Health Officer
may take preventative steps to control spread of disease into the jurisdiction. H&S §120175
and 17 C.C.R. §2501.
22
17 C.C.R. §2501
23
24
25
Penal Code (hereinafter, “Pen.”), §409.5.
17 C.C.R §2501.
H&S §120175.
26
H&S §120130 (c); H&S §121365 (g) provides specific authority for the local health officer
to require isolation.
27
The authority to require a mass quarantine is implied by a reading of H&S §120175
(control of contagious, infectious and communicable disease) in conjunction with H&S
§120205. The Health Officer may impose mass quarantine as directed by DHS pursuant to
H&S §§120145 and 120195.
28
29
30
31
32
H&S §120176 (added by Stats. 2006, c. 874 (SB 1430)).
H&S §101030 (for a county Health Officer).
H&S §101470 (for a city Health Officer).
H&S §§101375, 101400, 101405 and 101415.
H&S §100182 and Pen. §409.5(c).
[revised: February, 2010]
50
33
34
35
In re Martin (1948) 83 Cal.App.2d 164, 167.
H&S §101080.
Gov. §§8550 et. seq; H&S §101310.
36
As noted in the Introduction, this guide is intended only to address those circumstances
arising prior to the formal Declaration of Emergency. DHS has published a comprehensive
document for such circumstances. See: Authority and Responsibility of Local Health Officers
in Emergencies and Disasters, D. David Abbott [Emergency Preparedness Office] and Jack
S. McGurk, (Chief of Environmental Management Branch), Department of Health Services,
State of California (September 30, 1998).
37
H&S §101085(b) (added by Stats. 2006, c. 874 (SB 1430)).
[remainder of page left blank]
[revised: February, 2010]
51
Appendix ‘B’
Partner Organizations Directory of Emergency Contacts
Partner Organizations
Primary
Contact
Name
24-Hour
Contact
Phone
Number
E-mail
FEDERAL, STATE, AND LOCAL GOVERNMENT
Chairman, Board of
Supervisors
Kern County Administrative
Officer
Kern County Counsel
Kern County Emergency
Services Manager
Jon McQuiston
(661)868-3680office
Elissa Ladd,
Interim
(661) 868-xxxx
Bruce Devilbiss
Nick Dunn, Kern
Co. Fire Chief
(661) 397-7xxx
Kern Co. Department of
Environmental Health
Matt Constantine
Director
(661) 862-8717
Kern Co. Department of Mental
Health
Kern Co. Department of
Agriculture & Measurement
Standards
Steve Waterman,
Interim Director
(661) 868-6609
Xxx, Director
(661) 868-6319
Kern Co. Office of Emergency
Services
Georgianna
Armstrong,
Manager
(661) 391-7xxx
Kern Co. Emergency Medical
Services Dept.
Ross Elliott,
Director
(661) 868-5210
Mayor, City of Bakersfield
Harvey Hall
(661) xxx-xxxx
David Gelios or
Mark Abe
661-9665
Donny
Youngblood,
Sheriff
(661) 391-7531
Bakersfield Police Dept.
Scott McDonald,
Lt.
396-3719
Regional Disaster Medical
Health Specialist (RDMHS)
Ed Moreno, M.D.,
Fresno Co. Public
Health Dept.
(559) xxx-xxxx
FBI (Bakersfield)
Kern County Sheriff
[revised: February, 2010]
52
Regional Disaster Medical
Health Coordinator (RDMHC)
Ed Hill
Kern Co. EMS
(661) 868-5211
blindr@co.kern.ca.us
California Office of Emergency
Services
TRADITIONAL EMERGENCY FIRST RESPONDERS
Emergency Medical
Services/Paramedics
Kern County EMS
Dept., Russ Blind,
Senior Emergency
Services Mgr.
(661) 868-5211
blindr@co.kern.ca.us
(661) 325-9025
spalumbo@kms.org
911 Dispatch
Kern County Association of
Chief’s of Police
Kern County Association of Fire
Chief’s
Kern Co. Fire Dept. Haz Mat
Kern Co. Environmental Health
Services/Haz Mat
PUBLIC HEALTH, CLINICAL, and MEDICAL
Kern County Medical Society
Sandi Palumbo,
Executive
Director
Local Hospitals
1.
Kern Medical Center
Dr. Chris Dong,
ChrisEMD@aol.com
2.
Kern Medical Center
Evelyn Elliott,
Pharm. Director
elliotte@kernmedctr.com
3.
Bakersfield Mercy Hospital
Rhetta Michelli,
RMichelli@CHW.edu
4.
Mercy Hospital South West
5.
San Joaquin Hospital
Bob Easterday,
EasterRB@SANJOAQUIN.AH.ORG
6.
San Joaquin Hospital
Sue Lewis,
lewisps@sanjoaquin.ah.org
7.
Bakersfield Memorial Hospital
Bruce Peters,
bgpeters@chw.edu
8.
Bakersfield Rehab Hospital
Brandon Neal,
brandon.neal@healthsouth.com
9.
Bakersfield Heart Hospital
Brian Pasqua,
brian.pasqua@medcath.com
[revised: February, 2010]
53
10. Ridgecrest Regional Hospital
11. Kern Valley Hospital, Lake
Isabella
Carol Bradshaw,
carolbradshaw@kvhd.org
12. China Lake NWC
e.haynesrams@nhtp.med.navy.mil
13. Medical Center at Edwards Air
Force Base
14. Delano Regional Medical Center
Ed Lewandowski,
lewae@drmc.com
15. Delano Regional Medical Center
Joe Aguire
aguij@drmc.com
17. Hall Ambulance
Tom McGinnis,
McGinnisT@HallAmb.com
18. Delano Ambulance
Patsy Carpenter,
carp@arrival.net
19. Liberty Ambulance
Peter Brandon,
pbrandon@poulincorp.com
20. CARE Ambulance
Anthony Bohn,
amb@care-ems.com
21. Kern Ambulance
David Greek,
dgreek@kvd1.com
16. Local Ambulance Companies
22. Kern Co. Dept. of Public Health
23. Kern County Office of
Emergency Services
Claudia Jonah,
M.D., Health
Officer
Georgianna
Armstrong,
661-868-0310
garmstrong.KCFD_PO.KCFD_DOM
24. Kern High School District
dwindes@khsd.k12.ca.us
25. Kern High School District
lvasquez@khsd.k12.ca.us
26. Kern High School District
Steve Alvidrez,
Chief
salvidrez@khsd.k12.ca.us
27. Bakersfield City Fire
Brian Perry, Capt.
bperry@ci.bakersfield.ca.us
28. Bakersfield City Fire
Department
Garth Milam,
Chief
Gmilam@ci.bakersfield.ca.us
29. Bakersfield MMRS
Brian Perry, Capt
Bperry@ci.bakersfield.us
30. Kern County Dept. of Public
Health
Lucinda Wasson,
Dir. of Nursing
WASSONC.kcdph_po.kcdph_dom
Marie Farrell,
Marie_Farrell@firstclass1.csubak.edu
31. Bakersfield College
32. Cal State University, Bakersfield
[revised: February, 2010]
54
33. National Health Services Clinics
Mary Collignon,
mcollignon@nhsinc.org
34. National Health Services Clinic
aoendo@nhsinc.org
35. Kern County Mental Health
Dept.
.MH2PO2.MHDOMAIN
36. Houchin Blood Bank
Greg Gallion,
CEO
gallion@hcbb.com
37. Red Cross of Kern County
Jennifer Perfect
jperfect@KernRedCross.org
38. Red Cross of Kern County
Lorraine Castro,
Exec. Dir
lcastro@kernredcross.org
39. Kern County Fire
Nick Dunn,
Deputy Chief
Ndunn.KCFD_PO.KCFD_DOM
40. Kern Medical Center
Sr. Pharmacist
@kernmedctr.com
41. Kern County EMS Dept.
Ross Elliott,
Director
elliottr@co.kern.ca.us
42. Kern County EMS Dept.
Russ Blind, Sr.
EMS Coord.
blindr@co.kern.ca.us
43. State Office of Emergency
Services
Roy_Manning@oes.ca.gov
44.
45. Clinica Sierra Vista
Susan Ashe,
asches@clinicasierravista.org
46. Tehachapi Hospital
emr@tvhd.org
47. Tehachapi Hospital
kim@pacificrx.net
48. Tehachapi Hospital
mtn2sea@earthlink.net
49. Kern Medical Center
Toni Smith, Dir.
Of Nursing
smitht@kernmedctr.com
50. Bakersfield City Fire Dept.
Tyler Hartley,
Captain
thartley@ci.bakersfield.ca.us
51. Kern Co. Emergency
Communications Center
Walt Moulton,
WMoulton.KCFD_PO.KCFD_DOM
66. Kern Valley Hospital, Lake
Isabella
Wayne Watrous,
wcw81451@aol.com
67. Mercy South West Hospital
Yvonne
Chambers,
ychamber@chw.edu
[revised: February, 2010]
55
Private Laboratories
Local Pharmacies
Community Health
Centers
Kern Faculty Medical
Group
Clinica Sierra Vista
Steve Schiling,
Executive Director
Waghi Michael, Ph.D.
National Health Services
Executive Director
Drummond Medical Group
Bakersfield Family Medical
Group
Local Veterinarians
Active Duty Military
Hospitals
Neighboring County
Health Departments
Kings County Public
Health
, Director
San Luis Obispo County
Public Health
Tulare County Public
Health
Los Angeles County Public
Health
Ray Bullick, Dir. Public
Health
, MD, Health Officer
Alonzo Plough, Ph.D.,
Dir. Emergency
Preparedness
San Bernardino County
Public Health
Santa Barbara County
Public Health
[revised: February, 2010]
56
Ventura County Public
Health
SPECIAL POPULATIONS
Steven Waterman,
Director
Kern County Mental Health
Agencies
Home Health Care
Provider Agencies
Nursing Homes/Assisted
Living Facilities
Senior & Adult Services /
Community Centers
Kris Grasti , Director
Kern Co Aging & Adult
Services
Partner Organizations
Primary Contact
Name
24-Hour Contact
Phone Number
E-mail
SPECIAL POPULATIONS (cont’d)
Kern County Department of
Human Services
Funeral Directors Association
Correctional Institutions
Jimmy Toh, PHN
Tribal Government
Representatives
Glen Basconcillo
OTHER LOCAL RESOURCES
County/Cities Public Works /
Sanitation / Utilities
Emergency Alert System
(e.g., Reverse 911 or Voice
Activated Siren)
American Red Cross
Elaine Castro,
Executive Director
Salvation Army
[revised: February, 2010]
57
CAPK 211 Phone System
Local Transit Organizations /
Providers of Transportation
(e.g., Buses, Dial-A-Ride)
Kern County Superintendent
of Schools
Universities/Colleges/Schools
of Public Health
Other <describe>
[remainder of page left blank]
[revised: February, 2010]
58
Appendix ‘C’
Multi-Hazard Mitigation Plan and Vulnerability Assessment
Kern County Department of Public Health will conduct the Hazard Mitigation and
Vulnerability Assessment in accordance with Section 4.2 of the Kern County Operational
Area Emergency Operations Plan, Natural Health Hazards. If upon completion of the
assessment by Public Health and Environmental Health Services Department, it is
determined that an event has the potential to cause a public health threat that could cause
wide spread illness or death, these agencies will notify the County Director of Emergency
Services of the pending danger and develop a Proclamation of Emergency. That
proclamation shall be approved by the County Counsel, County Administrative Officer (CAO)
and the Chairman of the Board of Supervisors.
The threats that are of greatest concern are vector borne (insect) illness (West Nile Virus,
Plague, Lyme disease, and encephalitic diseases), animal diseases (Mad Cow), pandemic
influenza, and man made bioterrorism. The latter two are of greatest concern as they have
the greatest potential to rapidly expand in the population, there may be no known cure for
some illnesses, and pose the greatest concern for loss of life.
[remainder of page left blank]
[revised: February, 2010]
59
Appendix ‘D’
California Medical Mutual Aid Agreement
[remainder of page left blank]
[revised: February, 2010]
60
[revised: February, 2010]
61
Appendix ‘E’
Roles & Responsibilities of Response Partners
Enclosure G-1
SUPPORTING ORGANIZATIONS AND RESPONSIBILITIES
IN KERN COUNTY
THE DIRECTOR OF THE DEPARTMENT OF HUMAN SERVICES is the Shelter and Care
Services Branch Coordinator for Kern County. The Director will oversee all aspects of
shelter operations during time of disaster. The Department of Human Services will call on
many private and public agencies and departments in carrying out its responsibilities to
house and feed the victims of declared disasters. Other agencies involved in this task are
listed herein.
AMERICAN RED CROSS - Lead agency for sheltering.
SALVATION ARMY - Provide assistance in shelter and feeding.
LOCAL LAW ENFORCEMENT AGENCIES - Provide security at Mass Shelters and
transportation as available.
GENERAL SERVICES - Provide equipment and supplies.
COUNTY PERSONNEL - Assist in the provision of personnel for Mass Shelter operations.
KERN COUNTY SUPERINTENDENT OF SCHOOLS - Provide facilities, transportation and
support.
RACES - Provide communications assistance at Mass Shelters.
PUBLIC HEALTH DEPARTMENT - Provide medical and nursing services to Mass Shelters.
MENTAL HEALTH - Provide counseling services to emergency personnel and victims at
mass shelters.
[remainder of page left blank]
[revised: February, 2010]
62
APPENDIX ‘E’
(Health Annex of County Emergency Plan):
Roles and Responsibilities of Emergency Response Partners
For Local Public Health Threats/Emergencies
Emergency Partners
State DPH
Health Care
Providers/
Local Labs
Community
Health Centers
Media
Public Works

State
Laboratory
Sheriff’s
Department

EMS/MMRS
OES/Fire/PIO
Department
Hospital
Function
Health Officer
/KCDPH
(Individuals, Departments, Agencies, or other Entities)
PREPAREDNESS PHASE
Vulnerability
Assessment &
Mitigation
P 
Surveillance
P 
Epidemiologic
Preparedness
P 
Laboratory
Capacity
Risk
Communication
and Public
Education
P 































 P 
CAHAN
P 
Staff Training &
Education
P 

Special
Populations
(e.g., non-English
speaking, elderly,
assisted living,
etc.)
P 











P=Primary Responsibilities



Note: Environmental Health and
Public Works are partners
relative to environmental, food
and water hazards
[revised: February, 2010]
63
APPENDIX E: Roles and Responsibilities of Emergency Response Partners
For Local Public Health Threats/Emergencies
Emergency Partners
Appendix E (pg.
2)
State DPH
Health Care
Providers/
Local Labs
Community
Health Centers
Media
Public Works
State
Laboratory
EMS/MMRS
Sheriff’s
Department
OES/Fire/PIO
Department
Hospital
Health Officer
of Health / LHD
Function
(Individuals, Departments, Agencies, or other Entities)
RESPONSE (EMERGENCY) PHASE
Command &
Control

 P P 

Communication
Activate HAN
Risk
Communication
Media Relations
Public Information
P
  P 
  P 
  P 







































Surveillance
Verify & Confirm
Diagnosis
Epidemiologic
Investigation
Analyze Data (Epi
Curve)
Determine End of
Outbreak
Laboratory
Diagnosis &
Specimen
Submission
Mass
Immunization &
Prophylaxis
Pharmaceutical
Stockpiles
P
P
P
P





P 



P 




 P




[revised: February, 2010]

64
APPENDIX ‘E’
Roles and Responsibilities of Emergency Response Partners
For Local Public Health Threats/Emergencies
Emergency Partners
Appendix E (pg.
3)
State DPH
Health Care
Providers/
Local Labs
Community
Health Centers
Media
Public Works
State
Laboratory
EMS/MMRS
Sheriff’s
Department
OES/Fire/PIO
Department
Hospital
Health Officer
of Health / LHD
Function
(Individuals, Departments, Agencies, or other Entities)
RESPONSE (EMERGENCY) PHASE (cont’d)
Quarantine &
Isolation
P 
 P 
 P 
Patient
Decontamination

Security & Crowd
Control


Mass Care



P



 P
  
RECOVERY PHASE
Continue
P 
Surveillance
 P
Protection &
Safety of First
Responders
Mass Fatality
Management
Re-Entry
Considerations &
Environmental
Surety
Finance &
Accounting


P
P 

P 


































Note: In terrorist events, Sheriff’s Department has primary responsibility for coordination of
criminal investigations and will coordinate with FBI, Office of Homeland Security.
[revised: February, 2010]
65
Appendix ‘F’
California Health Alert Network (CAHAN)
I.
PREFACE
The Kern County Department of Public Health (KCDPH) administers the Centers for
Disease Control and Prevention (CDC) Public Health Emergency Preparedness
grant. The grant outlines the following alerting and notification requirements for all
counties. CAHAN is the California statewide public emergency response system
created to meet grant goals:
Goal 2A.3.d. and Goal 6A.7.
Have or have access to information systems for 24/7/365
notification/alerting of the public health emergency response
system that can reach at least 90% of key stakeholders and is
compliant with PHIN Preparedness Functional Area Partner
Communications and Alerting.
KCDPH incorporates the use of the CAHAN system into its alerting and notification
protocols.
All employees of the County are Disaster Service Workers per California State law..
All KCDPH employees are required to be prepared to be available to report to work
in the event of a disaster or emergency.
II.
POLICY
All KCDPH employees shall have a current CAHAN account coordinated through the
Office of Public Health Preparedness, receive training in its use and confirm all
received alerts.
III.
PURPOSE
To establish consistent and current employee information available 24/7/365 for
notification and alerting purposes and to provide an efficient and effective method for
alerting and notifying all KCDPH staff.
IV.
PROCEDURES
A.
CAHAN Accounts and Profiles:
1.
At date of hire/transfer, all KCDPH employees and transfer employees
from other departments shall be issued a CAHAN account and input
their Profile information as outlined in Appendix A – CAHAN Profile
Information.
2.
All KCDPH employees shall keep their CAHAN Profile current with the
information listed in Appendix A – CAHAN Profile Information.
B.
C.
3.
Managers and Supervisors shall be responsible to ensure that all
employees within their division/program have been issued a CAHAN
account and are maintaining current Profile information.
4.
The Duty Health Officers and related positions shall maintain
additionally required emergency contact information as set forth in
Policy #___ Health Officers On Duty, Director Of Public Health
Services, and Department Public Information Officer Notification and
Processing Requests for Response.
CAHAN Alerting Priorities
CAHAN has the ability to send messages designated as high, medium, or low
priority. Each alerting priority can be received at pre-designated phone/email locations.
1.
All KCDPH employees are required to confirm alerts they have
received through CAHAN, regardless of source or alerting priority
(refer to D. CAHAN Notification below.)
2.
All KCDPH employees shall pre-designate the alerting priorities as set
forth in Appendix B – Alerting Priority Locations.
3.
High, Medium, and Low priority alerts are defined as:
a.
High priority alerts require immediate action by the recipient.
b.
Medium priority alerts may require some action in a set
amount of time as described by the message that was sent.
c.
Low priority alerts are primarily for your information and does
not necessarily require a direct or immediate response other
than what is described by the message.
CAHAN Training, Drills, and Exercises:
1.
All employees shall receive an overview of CAHAN and its purpose
during New Employee Orientation.
2.
Within the first week of hire/transfer, all new employees and transfer
employees from other departments shall receive training in CAHAN by
their supervisor or designee.
Training shall at minimum include:
a.
Alerting License User Manual
b.
Login and Password set up.
c.
Profile and Alerting Security Code set up.
d.
Confirming alerts practice.
3.
CAHAN drills and exercises shall be conducted periodically, no less
than 4 per calendar year, as tests, reminders, improvement in
response, or other concepts as determined by either Administration or
Divisions/Programs.
D.
a.
Divisions/Programs shall be required to drill and exercise the
effectiveness and response timing of their staff at least 2 times
per calendar year and report results to the Department
CAHAN Administrator.
b.
Administration/Department CAHAN Administrator shall be
required to drill and exercise with reminders to update Profiles,
instructions for CAHAN features, or other related concepts to
be determined.
c.
Drill and exercise After Action Reports and Improvement Plans
shall be reported to the Department CAHAN Administrator.
d.
Plans for Improvement are to be implemented and re-tested in
the following drill or exercise.
CAHAN Notification:
1.
All employees are responsible to read and confirm all alerts received
via CAHAN within a reasonable amount of time.
a.
b.
c.
d.
e.
Normal working hours – within 1 hour or less
After hours, not on-call – within 2 hours or less, unless they
are unavailable (e.g. traveling in remote location, flying in an
airplane, etc., see C.3. below.)
After hours, on-call – within 30 minutes or less
Work traveling – within 1 hour or less, unless they are
unavailable (see C.3. below.)
Vacation, Sick Leave, Leave of Absence, Medical Leave,
Military Leave, Jury Duty – not applicable
2.
Supervisors and Managers are responsible to be aware of their staff’s
work status or leave disposition at the time of a notification or alert.
3.
Situations where an employee is unable to confirm the CAHAN
notification or alert by telephone (i.e. driving, between cell towers,
etc.) and does not have reasonable access to the Internet (i.e.
traveling in a remote location, flying in an airplane, etc.), the employee
shall contact their supervisor or the Department CAHAN Administrator
to clear the alert. This technique is to be used as a last resort.
3.
Additional training may be necessary for improved response
compliance. Refusing or ignoring alert confirmation responsibilities
shall be subject to disciplinary actions.
4.
Divisions and Programs Managers and Supervisors shall be
responsible to identify CAHAN Roles for their Division/Program to be
able to efficiently and effectively contact all staff in the event of an
emergency or major disaster. Managers will work with the Department
CAHAN Administrator to structure their Roles if necessary.
CAHAN PROFILE INFORMATION
PROFILE
First Name
Last Name
WORK CONTACT
Work Location
Work Address
Work City
Work State
Work Zip/Postal Code
Work County
Work Email
Work Phone
Work Cell
Work Fax
Work Numeric Pager
Work Numeric Pager
Service
Work Alpha Pager Email
HOME CONTACT
Home Address
Home City
Home State
Home Zip/Postal
Code
Home County
Home Phone
Home Cell
MISCELLANEOUS
Professional Licenses
Specialties
Title
Degrees
CPR certification
CAHAN ALERTING LOCATIONS
HIGH PRIORITY
1 Work Phone
2 Work Cell
3 Work e-mail
If/when on-call add:
4 Home cell
5 Home phone
1
2
MEDIUM PRIORITY
Work phone
Work e-mail
If/when on-call add:
3 Work cell
4 Home cell
1
LOW PRIORITY
Work e-mail
If/when on-call add:
2 Work cell
2-1-1 System and Public Health risk information and emergency communication
PURPOSE
The 211 system is a public information telephone calling system that is administered in Kern
County through an interagency agreement between Kern County Department of Public
Health (KCDPH) and Community Action Partnership of Kern County (CAPK). CAPK was
designated by the California Public Utilities Commission (CPUC) as the 2-1-1 Calling
System provider for Kern County in January 2007.
CAPK, via the 2-1-1 system, has the capacity to expand communication capabilities in Kern
County by expanding its phone system throughout CAPK and remotely to other outside
locations.
Expanding the communication system meets the Centers for Disease Control and
Prevention (CDC) Public Health Emergency Preparedness grant requirements by providing
risk communication to the community, enhancing inter-operability of communication, and
approaching the ability to provide information to at least 1% of the population of Kern County
during an event.
BACKGROUND
CAPK was designated by the CPUC as the sole provider of 2-1-1 services in Kern County to
most effectively provide information and referral services to Kern County's population related
to health and human services. CAPK has developed a comprehensive database of
services, eligibility criteria, and service area. Information and Referral (I&R) Specialists
assist callers and the public via a web-based database.
2-1-1 provides an easy-to-remember, universal number for every citizen to access
comprehensive and specialized I&R services in their community. The mission of 2-1-1 is to
build America's capacity to strengthen the way people access help and engage in civic life.
2-1-1 has been successfully utilized to provide timely and accurate information to the
community, in the event of an emergency or disaster.
In a disaster or emergency scenario, 2-1-1 has the primary role to maximize access to
community resources and information in collaboration with Kern County Office of Emergency
Services.
Coordinating resources and communication expansion capacity in the event of an
emergency or disaster, strengthens both the County’s and CAPK’s commitment of providing
convenient and reliable access to information and risk communication to the residents of
Kern County.
[remainder of page left blank]
Appendix ‘G’
Emergency Medical Provider Call List
Kern Medical Center
1830 Flower Street
Bakersfield, CA 93305
(661) 326-2000
http://www.kernmedicalcenter.com
CEO
ED Director (326-2123)
Clinical Services
ED Manager
Paul Hensler
Eugene Kercher, MD
Toni Smith, RN
Brian Patrick, RN
henslerp@kernmedctr.com
kerchere@aol.com
smitht@kernmedctr.com
patrickb@kernmedctr.com
Jon Van Boening
Bruce Peters
Robert Marshall, MD
Terri Totzke, RN
Jennifer Cook, MSN
N/A
bgpeters@chw.edu
robert .marshall@chw.edu
Terri.Totzke@chw.edu
Jennifer.Cook005@chw.edu
Robert Beehler
Raymon Zurcher, MD
Debbie Hankins, RN
Sue Lewis, RN
N/A
zurcherRF@ah.org
HankinDA@ah.org
lewisps@ah.org
Office 869-6209
Russell Judd
Chris Bradburn, MD
N/A
cbradburn@msn.com
Bakersfield Memorial Hospital
420 34th Street
Bakersfield, CA 93301
(661) 327-4947
http://www.bakersfieldmemorial.org
President
COO
ED Director – ext.3333
Chief Nurse Executive
ED Manager – ext.3178
San Joaquin Community Hospital
2615 Chester Avenue
Bakerfield, CA 93301
(661) 395-3000
http://www.sanjoaquinhospital.org
CEO
ED Director
Clinical Services
ED Manager
Mercy Hospital
2215 Truxtun Avenue
Bakersfield, CA 93301
(661) 632-5000
http://www.mercybakersfield.org
President
ED Director – 805-8588
Clinical Services
ED Manager
Kim Horton, RN
Kerin Workman, RN
Kimberly.Horton@chw.edu
kerin.workman@chw.edu
Russell Judd
Chris Bradburn, MD
N/A
cbradburn@msn.com
yvonne.chambers@chw.edu
BRMolhook@CHW.edu
Mercy Southwest Hospital
400 Old River Road
Bakersfield, CA 93311
(661) 663-6000
http://www.mercybakersfield.org
President
ED Director – 805-8588
Clinical Services
ED Manager
Blake Molhook, RN
Bakersfield Heart Hospital
3001 Sillect Avenue
Bakersfield, CA 93308
(661) 316-6000
http://www.bakersfieldhearthospital.com
President
ED Director 316-6062
Clinical Services
ED Manager
Rich Priore
Amber Kelly, RN
Kathryn Chamberlin, RN
Rashel Campos, RN
N/A
amber.kelly@medcath.com
Kathryn.Chamberlin@medcath.com
rashel.campos@medcath.com
Office 661-316-6026
Delano Regional Medical Center
1401 Garces Highway
Delano, CA 93215
(661) 725-4800
http://www.drmc.com
Executive Director
ED Director – 721-5371
Clinical Services
ED Manager
Surita Els
Surita Els, RN
elssu@drmc.com
Kevin Chamas, MD
N/A
kevinjchamsa@yahoo.com
N/A
Ridgecrest Regional Hospital
1081 North China Lake Blvd.
Ridgecrest, CA 93555
(760) 446-3551
http://www.rrh.org
CEO
ED Director 310-564-2005
Clinical Services
ED Manager
Todd Rowland, RN
t.rowland@rrh.org
Kern Valley Healthcare District
6412 Laurel Avenue
Lake Isabella, CA 93240-1628
(760) 379-2681
http://www.kvhd.org
(760) 379-3719 –fax ED
CEO
ED Director
Clinical Services/DON/ED Manager
Tim McGlew
Manuel Sacapano, MD
Cynthia Burciaga, RN
timmcglew@kvhd.org
manuelsacapano@kvhd.com
cynthiaburciaga@kvhd.org
Tehachapi Valley Healthcare District
115 West E Street
Tehachapi, CA 93581
(661) 822-3241
(661) 823-3083 (fax)
http://www.tvhd.org
CEO
ED Director
Clinical Services 823-3049
ED Manager
Alan J. Burgess
Fil Barrozo, MD
Andrew Petty, RN
Regina Clark, RN
N/A
emmdeebee@earthlink.net
apetty@tvhd.org
emr@tvhd.org
Kaiser Permanente
5055 California Avenue
Suite 240
Bakersfield, CA 93309
(661) 864-3366
(661) 334-2078 (fax)
Medical Director 334-2006
Assistant Medical Director
Julia Bae, MD
Paul Fuller, MD
julia.bae@kp.org
paul.n.fuller@kp.org
Glen Goldis, M.D.
846-1300
ggoldiss@bfmc.com
Travis Welch
760-939-3151 office
760-030-1152 fax
Travis.welch@navy.mil
Bakersfield Family Medical Center
4580 California Avenue
Bakersfield, CA 93309
(661) 846-4964
http://www.bfmc.com
Medical Director
Naval Air Weapons Station, China Lake
1 Admin Circle, Stop 1003
China Lake, CA 93555-6100
Veterans Administration
Deputy Chief, Department of Psychiatry
and Mental Health
Andrew, Shaner, MD
Andrew.Shaner@va.gov
Assocaite Chief
Joel Rosanksy, MSW
Joel.Rosanky@va.gov
Lt. Mark Olson
Ryan Billings
mark.olson@edwards.af.mil
ryan.billings@edwards.af.mil
Ken Mylander
k_mylander@calcityfd-ca.us
Ron Fraze
Doug Greener
rfraze@ci.bakersfield.ca.us
dgreener@ci.bakersfield.ca.us
Nick Dunn
ndunn@co.kern.ca.us
95th Medical Group
Edwards Air Force Base
(661) 277-3214
(661) 277-4829 fax
Public Health Flight Commander (661)
277-3132
Ambulance Lead
California City Fire Department
21130 Hacienda Blvd.
California City, CA 93505
(760) 377-7003
Fire Chief
Bakersfield Fire Department
2101 H Street
Bakersfield, CA 93301
(661) 326-3911
http://www.bakersfieldcity.us/fire/index.htm
Fire Chief
Paramedic Liaison
Kern County Fire Department
5642 Victor Street
Bakersfield, CA 93308
(661) 391-7000
Fire Chief
ARVIN POLICE DEPT.
Delano Police Department
1022 12th Avenue
Delano, CA 93216
(661) 721-3377
web site
Chief of Police
Mark DeRosia
Shafter Police Department
201 Central Valley Highway
Shafter, CA 93263
(661) 746-6341
web site
Chief of Police
Charlie Fivecoat
California City Police Department
21130 Hacienda Blvd.
California City, CA 93505
(760) 373-8606
web site
Chief of Police
Linda Lunsford
Taft Police Department
320 Commerce Way
Taft, CA 93268
(661) 763-3101
web site
Chief of Police
Bert Pumphrey
Tehachapi Police Department
115 South Robinson Street
Tehachapi, CA 93561
(661) 822-2222 ext. 124
web site
Chief of Police
Bakersfield Police Department
1601 Truxtun Avenue
Bakersfield, CA 93301
(661) 327-7111
web site
Jeff Kermode
Jkermode@tehachapiPD.com
Chief of Police
@ci.bakersfield.ca.us
Kern County Sheriff's Department
Bakersfield, CA 93308
661
web site
Sheriff
Donny Youngblood
Under Sheriff
Hall Ambulance Service, Inc.
Hall Air Ambulance Service
1001 21st. Street
Bakersfield, CA 93301
Bus: (661) 322-8741
Dispatch: (661) 334-5410
Owner: Harvey L. Hall
Manager: John Surface
Marty Williamson
surfacej@hallamb.com
Delano Ambulance Service
403 Main Street
Delano, CA 93215
Bus: (661) 725-3374
Disptach: (661) 725-3374
Owner: Patsy Carpenter
Manager: Patsy Carpenter
carp@arrival.net
Liberty Ambulance Service
1325 West Ridgecrest Blvd.
Ridgecrest, CA 93555
Bus: (760) 375-6531
Dispatch: (661) 334-5410
Owner: Poulin Corporation
Manger: Peter Brandon
pbrandon@poulincorp.com
CARE Ambulance Service
11345 Kernville Road
Kernville, CA 93238
Bus: (760) 379-2681
Disptach: (661) 758-3200
Owner: Anthony Bohn
Manager: Anthony Bohn
amb@care-ems.com
Kern Ambulance Service
2324 7th Street
Wasco, CA 93280
Bus: (661) 758-3200
Disptach: (661) 758-3200
Owner: Arron Moses & Brandon
Wainright
Manager: Aaron Moses
acmoses@hotmail.com
95th Medical Group, Edwards AFB
30 Hospital Road
Edwards, AFB, CA 93524
Bus: (661) 277-2330
Owner: U.S. Government
Manager: Duty Officer
Capt. Mark Olson, Public Health Flight
Commander
Mark.olson@edwards.af.mil
China Lake Naval Air Weapons Station
Branch Medical Clinic
1 Administration Circle
China Lake, CA 93555
Bus: (760) 939-2085
Owner: U.S. Government
Manager: HM2 Scott Thomas
Travis Welch, emergency Management
Officer
Travis.welch@navy.mil
U.S. Borax Ambulance
14486 Borax Road
Boron, CA 93516
Bus: (760) 762-7616
Owner: U.S. borax
Manager: Duty Personnel
Mercy Air Services, Inc.
1670 Miro Way
Rialto, CA 92376
Bus: (888) 499-9495
Mojave Station: (661) 824-2605
Owner: Air Methods
Manager: Brandon Lang
blang@airmethods.com
Appendix ‘H’
Mass Prophylaxis & Strategic National Stockpile (SNS) Operational
Area Plan; Points of Distribution (P.O.D.‘s); Alternate Care Sites
(ACS)
Kern County has Strategic National Stockpile (SNS) Operational Area Plan, and will use it is
an
emergency
to
acquire
additional
medical
supplies,
equipment
and
medications/vaccines/antivirals, and as the guide for distribution of these assets throughout
the emergency. The SNS is a dedicated cache` of medical supplies, equipment and
medications/vaccines/antivirals that have been developed by the CDC for distribution to the
Operational Area (OA) in an event of such magnitude that will exceed the ability of existing
OA resources. It is prepositioned around the country so that the initial Push Package can be
delivered within 12 hours with the second larger shipment delivered over the next 12 hours.
Once the threat is fully assessed and it is determined that additional materials are needed,
they may be acquired through the private sector Vendor Managed Inventory (VMI).
The stockpile will be requested by the Public Health Department through the OA Medical
Health Operational Area Chief (MHOAC) at Kern County EMS to the Regional Disaster
Medical Health Specialist (RDMHS), to the Regional Disaster Medical Health Coordinator
(RDMHC), to the State Office of Emergency Services (OES). Once the shipment of supplies
is delivered to the State Receiving, Storage and Shipment (RSS) site, Public Health staff will
work with the members of the Disaster Medical Planning Group (DMPG) to arrange for
distribution to healthcare providers and first responders.
Public Health will utilize the Kern County SNS Operational Area Plan as the guide for
distribution to government organizations, schools, private businesses, state institutions
(hospitals & prisons), Native American communities, people with special needs, faith based
organizations and the community in general, as needed. Organizations with professional
medical staff and the ability to provide distribution to their employees, members, inmates or
clients, will be given the opportunity to participate as a Push Partner. This will allow the Push
Partner to designate a point of contact and inform Public Health in writing regarding the
number of people it is planning to provide medications, vaccines or antivirals for.
One method of distribution may include specially designated, pre-identified Points of
Distribution (POD’s) for the pre-identified first responders and Push Partner organizations.
These are locations throughout the OA where the medications, vaccines or antivirals will be
sent for pick up by Push Partners or for distribution to the general public. They most likely
will not be the same location on the same date.
If the event grows to the level that it exceeds the capacity of the existing hospitals to
respond by providing inpatient care, Alternate Care Sites (ACS) will be set up by the Public
Health Department at locations pre-identified and with employees from the organization
and/or volunteers from the Kern Medical Reserve Corps to operate the ACS. If the event
continues to escalate, additional requests for Medical Mutual Aid will be sent to the State
OES.
Appendix ‘I’
Crisis Emergency Risk Communications Plan (CERC)
OVERVIEW
The purpose of the Crisis Emergency Risk Communication (CERC) Plan is to provide
guidelines and protocols related to Kern County Department of Public Health (KCDPH)
communication activities before, during and after a disaster, emergency or public health
threat primarily, but not limited to, a bioterrorism-related event.
On a daily basis, the Director of Health Promotion and Public Information (HPPI) office is
responsible for communication activities and response to the news media. The Director is
the official Public Information Officer (PIO) who works with other divisions to fulfill public
information needs. In a non-emergency situation, daily PIO activities will follow those
outlined in the department’s Public Information Policy and Procedures guide.
The goal of the CERC Plan is to contribute to the well-being of the community in the event of
a disaster, emergency or public health threat by having prepared and consistent, timely and
easy-to-understand information messages and instructions. There is a need to be first, fast,
credible and accurate, in order to have the people comply with orders and instructions of the
government authorities, which ensure public safety. The plan proposes actions and activities
to be taken before, during and after a disaster, emergency or public health threat. It will be
reviewed and updated annually, or as needed.
SCOPE OF WORK
Components of the plan (CERC) may be used for any disaster, emergency or public health
threat, including any widespread event that threatens the public’s health. ’s PIO (under the
direction of the Director and/or his/her designee) will work individually and/or in concert with
appropriate emergency personnel and/or outside agencies to create and distribute
consistent, authoritative information to explain the event and prepare spokespersons. The
PIO will monitor the situation, monitor media coverage and provide timely and useful
information to the public. will coordinate and work with other agencies to ensure the
consistent exchange and distribution of messages and information. KCDPH will concentrate
its communication efforts on two areas: 1) emergency response; and 2) community and
partner awareness. Emergency response will cover how KCDPH is responding to the event.
Community awareness will focus on the collection and the distribution of information related
to the event. Public Information staff will track and report the incident in timely intervals.
Emergency response




Ensure the community understands the risk(s), its impact and KCDPH actions
Communicate how to respond to the event as it relates to individual and community
safety (e.g., what to do if a person is at work, out of town, at home or in their car)
Provide information on any quarantines, isolations, evacuation activities and shelter
locations
Work directly with the Emergency Operations Center (EOC) and any regional, state
or federal entities
Community awareness




Collect appropriate information from staff/other experts
Decide how the information will be made available to the public
Give proper consideration to which style/language of communication is most
appropriate for each targeted audience/community
Use a multi-layered, multi-ethnic approach to deliver messages and information
where appropriate
Key initiatives








Establish EOC link
o Prepare for onsite and/or offsite staffing, equipment, possible 24-hour
operation
Collect, prepare, exchange information with DOC and EOC
Prepare spokesperson(s)
Distribute information to media and other outlets
Activate internal information outlets
Monitor media/other coverage and messages
Document KCDPH actions
Evaluate accuracy, timeliness and effectiveness of information reported
[remainder of page left blank]
Appendix ‘J’: Reportable Disease Confidential Morbidity Report
(CMR)
Appendix ‘K’
Protocol for Submitting Biological Samples to the Regional & State
Laboratories
Suspicious biologic agents should be handled according to CDC and State guidelines.
These protocols are made available through the Centers for Disease Control and will be
updated accordingly. The KCDPH Laboratory Director will keep all hospital laboratories upto-date with any revisions. If a suspect bioterrorist agent is isolated from multiple cultures in
the Microbiology Laboratory, the KCDPH Laboratory Director must be notified immediately
for assessment of these samples and will determine if the Federal Bureau of Investigation
(FBI) and the Kern County Sheriff should be involved.
If a suspect bioterrorist agent is isolated from a single patient culture and there is no threat
or exposure related to that patient, then the isolate can be submitted to the Reference
Culture section for identification utilizing the state laboratory microbiology
requisition form.
If an implied threat accompanies samples and/or cultures, the Regional Public Health
Laboratory in Tulare County, State Public Health Laboratory in Richmond California and the
FBI must be notified immediately. The California Highway Patrol or the FBI will have
appropriate transport vessels readily available and all persons involved are available 24
hours/day, 7 days/week, 365 days/year to respond.
A Chain of Custody Form must accompany all submitted samples potentially associated
with a criminal investigation. The State Public Health Laboratory will supply these forms.
KCDPH Lab Director:
Michael Lancaster, Ph.D.
Office Phone: (661) 868-0400
Federal Bureau of Investigation (FBI):
Office Phone: (661) 323-9665
California Highway Patrol:
(800) 842-0200
(Source: California Public Health Laboratory)
[remainder of page left blank]
Appendix ‘L’
DISASTER RECOVERY PLAN
Kern County All Hazards Plan
Disaster Recovery Plan Annex ‘L’
June 2010
[page left blank intentionally]
Document Revisions
Page(s)
date
Table of Contents
1. DISASTER RECOVERY PROCEDURE
2. KCPHSD EMERGENCY TEAM CONTACTS
3. KERN COUNTY EMERGENCY TEAM SUPPORT
4. KCPHSD EMPLOYEE CONTACTS (non Emergency Management Team)
5. COMMUNITY PARTNER ORGANIZATIONS CONTACTS
6. TELEPHONE DIVERSION PROCEDURE (TBD)
7. RECOVERY SITE(S) (TBD)
8. INFORMATION TECHNOLOGY RECOVERY: Hardware/Software/Network/Data
9. INSURANCE – COUTY RISK MANAGEMENT/CAO
10. BANK/PURCHASING/PAYROLL DETAILS
11. FACILITIES LOCATIONS/LEASE IDENTIFIED
12. EMERGENCY PROCEDURES
13. DISASTER RECOVERY PLAN REVIEW / TESTING
14. Appendix ‘A’ Policies and Procedures
1. Disaster Recovery Procedure
In the event of a disaster or emergency leading to significant business interruption
the following procedures, contacts and suppliers are to be utilized as needed to
complete the recovery of mission critical operations. All Emergency Management
Team members listed within this plan are to be contacted by the Director, Health
Officer or their designee, as a matter of urgency in the event of operations disruption
which leads to a major loss of staff, communications/data or mission critical facilities.
Depending on the nature and duration of the disruption, appropriate and
proportionate action will be taken by the Director, Health Officer or their designee to
minimize negative impact on the department.
The Emergency Management Team members are listed in this Disaster Recovery
Plan in their line-of-authority order for decision making. In the absence of the
Director or Health Officer, the team members in the Department Operations Center
(DOC) nearest to the top of the list will have final approval on all decisions during an
emergency, i.e., if Emergency Team members 1 & 2 cannot be contacted then
Emergency Team member 3 will lead the emergency team (until such time as
members 1 or 2 can be contacted).
2. KCPHSD Emergency Management Team Contacts
1. Matt Constantine, Director, 868-0300, MATTC@co.kern.ca.us
2. Claudia Jonah, M.D., Health Officer, 868-0310, jonahc@co.kern.ca.us
3. Ross Elliott, Director, Emergency Medical Services, 868-5210
relliott@co.kern.ca.us
4. Rachelle Pilkington, Administrative Services Officer, 868-0303
rachellep@co.kern.ca.us
5. Cindy Wasson, Director, Public Health Nursing, 868-0400
wassonc@co.kern.ca.us
6. Donna Fenton, Chief Environmental Health Specialist, 862-8726,
DONNAF@co.kern.ca.us
7. Brian Pitts, Chief Environmental Health Specialist, 862-8704,
BRIANP@co.kern.ca.us
8. Guy Shaw, Director, Animal Control, 868-7102, ShawG@co.kern.ca.us
9. Steve Flores, Special Project Manager/Public Information Officer, 868-1284,
Sflores@co.kern.ca.us
3. KCPHSD/County Emergency Team Support
Full emergency team support arrangements and contact details are listed in the
relevant sections later on in the Disaster Recovery Plan.

Legal Counsel: Martin Lee, Deputy County Counsel, 868-3839,
Mlee@co.kern.ca.us

PIO: Steve Flores, Special Project Manager, 868-1284,
sflores@co.kern.ca.us

Recovery Sites/furnishings 1: TBD with General Services Department, Jeff
Frapwell, 868-3131 jfrapwel@co.kern.ca.us

Computer Support: Tom Beckett, 862-8742, Resource Management
Agency, Tbeck@co.kern.ca.us

Telephone System Support: Jackie Ambrose, Information Technology
Services Department, 868-2240, ambrosej@co.kern.ca.us

Utilities: TBD with General Services Department, Jeff Frapwell, 8683131 jfrapwel@co.kern.ca.us

Security: Donnie Youngblood, Kern County Sheriff,
YoungBlood@kernsheriff.com
4. KCPHSD Employee’s Contacts (non Emergency Management
Team)
It is essential to keep all employees informed of the recovery progress throughout
the Emergency situation. KCDPHSD personnel Office will keep a current list of all
employees in the department, which will be updated monthly.

Debbie Johnson, Fiscal Support Specialist, 8680338 johnsondeb@co.kern.ca.us

Betty Dennison, Administrative Coordinator, 868-0382,
dennisonb@co.kern.ca.us
5. Community Partner/Organizations Contacts
The Director shall keep all key community partner organizations informed as fully as
possible throughout the emergency situation, in order to maintain confidence and
minimize the possibility of revenue interruption. The list of Community Partner
Organizations is listed in Appendix ‘B’ of the All Hazards Plan. The Office of Public
Health Preparedness shall be responsible for maintaining and updating this list
annually and coordinating communications with partner organizations with the
Health Promotions and Public Information (HPPI) Division.
6. Telephone Diversion Procedure (TBD)
This procedure is to be followed if the Emergency situation is likely to lead to a loss
of telephone connectivity greater than 1 hour. The KCPHSD Director’s Secretary
shall initiate diversion at the direction of the Department Director. Contacts will be
made to Emergency Team members via CAHAN, email, cell phones, home phone or
personal cell phones if necessary, until every member is contacted. For busy lines
with a capacity issue (too many simultaneous calls) all calls will be diverted to the
KCPHSD receptionist PBX (661-868-xxxx)

661-868-XXXX, KCITSD Number to explain the situation and ask them to set
up a ‘Diversion Number’ (Estimated diversion time 1 – 4 hours)

For extended diversion, ITSD will provide additional phone support as
needed.

Fifty (50 additional phones are available in the main public health building on
Mt. Vernon Avenue in Bakersfield, to allow for phone surge capacity.
7. Recovery Site(s) (TBD)
In the event of loss of use/access to the main building located at 1800 Mt. Vernon
Avenue, Bakersfield, for a period of 24 hours or more, the department needs to find
fully furnished and equipped services office/suites for immediate occupation by all
public health employees, possibly on a shared time/space allocation if needed, to be
determined by the DOC. Availability of potential sites in Kern County is maintained
by County General Services Department, Property Management Division (Tel: 8683100)

Location 1, (address) TBA

Location 2, (address) TBA

Location 3, (address) TBA
8. Information Technology Recovery: Hardware, Software, Network,
Data
County Information Technology Services Department (ITSD) will make every effort
to provide same day delivery service for (#X tbd) desktop PC’s with Windows OS
and MS Office software. County Administrative Office and County Purchasing
will give the approval for emergency purchase of computers in the event of ‘total
loss’ of PC’s within the department, or for an adequate number of replacement
computers damaged by the disaster. The Health DOC will Inform County Risk
Management for potential insurance claims.

County Information Technology Services Department, William Fawns,
Director, 868-2000 fawnsb@co.kern.ca.us

Resource Management Agency, Tom Beckett, 862-8742, Resource
Management Agency, Tbeck@co.kern.ca.us

County Risk Management,
All critical data is regularly backed up every night from each PC/Server online by
County ITSD. To restore data visit www.itsd.com click on Login tab. Log in:
XXX@XXXX.com P/W: XXXXX then click on the computer name to be restored and
follow the online prompts.
Data Systems Restoration assistance will be provided by Tom Beckett, 862-8742,
Resource Management Agency, Tbeck@co.kern.ca.us
9. Insurance - County Risk Management/CAO
In the event of significant Business Interruption due to a disaster, it is essential to
make immediate contact with county Risk Management office to describe the loss of
the following:
Furniture, electronics, communications systems, equipment, physical facilities;
including park lots, exterior lights, fencing, auxiliary power generator,
automobiles and HVAC systems components.
10. Banking/Purchasing/Payroll Details
The County Auditor/Controller will make appropriate plans to continue to provide
necessary banking, purchasing and payroll provisions for all county employees
following a disaster.

Contact/Number: Public Health contact: Rachelle Pilkington,
Administrative Services Officer, 868-0302

County Auditor/Controller contact,
11. Facilities Locations/Lease Identified
Landlord: TBD by locations found by the General Services department, Property
Management Division to be adequate for relocation to temporary quarters.
Contact: General Services Department, Jeff Frapwell, 8683131 jfrapwel@co.kern.ca.us
12. Emergency Procedures
The following outline procedures cover some of the main foreseeable Business
Continuity Risks within the department:
12.1 Short Term (1 Day – 12 Weeks) Loss of Premises , Utilities, Connectivity
1. Convene DOC Team, Plans & Intell Section to plan for relocation
2. Contact CAO & General Services Department
3. Contact key county support departments (CAO, General Services,
Communications, County Counsel) and inform them of the Loss of
premises/communications/computer network and confirm recovery
4. Contact County General Services Department to locate and secure new
property
5. Recovery sites and make agreement to occupy (Location/Time/Date)
6. Contact Non-DOC team employees and implement temporary work policy
7. Divert incoming telephone lines (if necessary)
8. Order emergency computers (if needed)
9. Confirm recovery site location and convey move in date to employees
10. Move in to recovery site (divert phones to recovery site, recover data to
new PC’s & servers)
11. Attend to operational issues (mail divert, new phone numbers (possibly),
etc)
12.2 Long Term Loss of Premises (12 Weeks )
1. As per short term (above)
2. Contact General Services regarding long tern lease status (if needed)
3. Commence search for new premises (if necessary)
12.3 Infectious Disease Outbreak (Flu etc.)
1. Notify all staff of potential impact of outbreak
2. Implement Temporary Work Policy - if appropriate (include telephone
divert procedure)
3. Issue statement to key customers/clients/community partners
organizations to assure them of ongoing business operations
4. Employ temporary staff (as appropriate) or volunteers from the Kern
Medical Reserve Corps.
12.4 Death/Critical Illness (Management Team)
1. Convene Emergency Management Team
2. Contact CAO, Board of Supervisors, County Counsel and Risk
Management
3. Issue statement to key Individuals
4. Recruit staff (Permanent or Interim) as Appropriate
In the untimely event of Director Matt Constantine’s death or critical illness, Ross
Elliott, Director of Emergency Medical Services Department will assume the role
of Public Health Director (permanent or interim appointment, depending on long
term situation) until further determination of the Board of Supervisors. In the
event of the untimely death of Dr. Claudia Jonah, Dr. Portia Choi shall be the
Health Officer until further determination of the Board of Supervisors and the
Director.
12.5 Death/Critical Illness or Serious Injury at Work (Employees)
1. Member of Emergency Team to contact next of kin
2. Inform appropriate authorities (CAO, Board of Supervisors, Sheriff, County
Counsel, Risk Management)
3. Provide support to employees (send home if necessary)
4. Employ professional advisers as appropriate (Mental Health)
12.6 Major Negative Public Relations Incident
1. Convene Emergency Team
2. Contact CAO, Board of Supervisors, County Counsel (if necessary)
3. Contact County PIO
4. Communicate with media, employees and community partners
13. DISASTER RECOVERY PLAN REVIEW / TESTING
This Disaster Recovery Plan is reviewed and updated every six months (on or
around 1st day) or sooner if required by the Emergency Management Team.
Updates are made by the Office of Public Health Preparedness in conjunction with
the assigned Department Operations Center staff. The Disaster Recovery Plan is
tested at least once per year between September and April.
WARNING: It is company policy to view the Disaster Recovery Plan annually.
Please do not print this document as it is updated regularly. OPHP will be
responsible for reprinting and distribution of this plan.
14. DOCUMENT LAST UPDATED DATE - SEE VERSION INFORMATION ON
REVISIONS PAGE
Appendix ‘L’, Appendix ‘A’
Policies and Procedures
When the department experiences a disaster and develops plans for recovery from a
disaster, the following policies will be operational to expedite the recovery process.

Authorizations to purchase equipment

Communications with family

Family visits

Furloughs (pay, insurance)

Incidentals

Insurance assistance

Lodging

Maximum allowable time before a required break

Payroll

Per Diem expenditures (lodging, food)

Record keeping (time, expenses)

Travel at the recovery site

Travel between home / lodgings and the recovery site

Work authorizations (if out-of-country)

Work from home option

Reassignment of staff to mission critical functions
Authorizations to purchase equipment
The Director will determine who is authorized to purchase hardware, software, and
services at the recovery site and delegate that to the Finance Section Chief in the
DOC. In keeping with the business continuity approach, there will be at least two
people authorized to make needed local purchases.
Things to consider: Do different people have different limits? Can any responder
charge something costing $5, $10, $20, or $50? What's the limit and what is the
process to exceed the limit; who (by title) has to approve all purchases?
Communications with family
Public Health staff responders need to talk to the staff left behind. While most of us
now have cell phones and most cell phones have ‘free’ long distance, there are
those few staff who have avoided the opportunity to be available 24*7. There also
are limitations to available minutes on personal cell phones. All staff assigned a cell
phone by the department must have them in their possession at all times if they are
identified as a critical response staff person.
Things to consider: Will the organization provide cell phones for common/shared use
so responders can call home during the recovery phase? Will the organization pay
for ‘over-the-limits’ cell usage on personal phones for individuals doing business for
the county during the recovery phase? Using the county switchboard or PBX to route
calls from incoming numbers to home phones probably won't be an option: if the
building went away, the telephone switch went with it. If the building is still
operational will the phone switch be utilized to reroute phone calls the employee’s
home phone?
Family visits
If the recovery or work-away-from-home will last for more than a couple of weeks,
the department will make arrangements for the employee to make family visits,
‘home R&R.’
Things to consider: Who is considered ‘family’? Traditional families; non-traditional
families; immediate family members or extended - and how ‘extended’ is
‘extended,’?
Furloughs (pay, insurance)
Things to consider: What about staff who stay home? They are not assigned any
direct responder functions during the recovery phase, but they need to be available
when things return to normal. Will they be paid - full pay, partial pay? Will they keep
their benefits? Will they be forced to take unpaid leave or vacation time? Will the
organization continue the furloughed workers' benefits? Are there any union
considerations?
Incidentals
All staff who responds to the recovery will have incidentals - toiletries, laundry, and
dry cleaning as examples – provided by the department.
Insurance assistance
Typically, the employee handles all the insurance paperwork for the family.
County Personnel has HR staff who are insurance experts available all year long to
assist the employee with questions about their respective plans.
Things to consider: Should a responder worry that an insurance claim won't get filed
or paid while he or she is away from home? Will the responder know there is
someone close to home (e.g., an HR person) who can help deal with the insurance
companies?
Lodging
If responders are required to stay in the building overnight each will have designated
quarters to sleep in. That area will be determined at the time of the event by the
DOC. Some staff may be required to share space with other responders. The
number and individual assigned to each space will also be determined by the DOC.
Mangers may have more space than rank-and-file. The Logistics Section will make
lodging arrangements and assignment? For staff requiring lodging adjacent to the
buiding, the county will arrange payment for the days you are required to stay there
during the recovery.
Maximum allowable time before a required break
There are Type ‘A’ people who HAVE to ‘do it all.’ After about 36 hours, their ability
to make decisions deteriorates, as does their manual dexterity and physical abilities.
The department DOC will set limits on the maximum number of work hours before
an enforced rest period. The more stressful the situation and the specific recovery
job, the shorter the work period and the longer the needed break.
Payroll
This is more than just getting the checks cut. It means assuring that the checks get
to the responder's family, either directly or through direct deposit. Considering that
some left-behind family members have jobs, others are care givers - some are care
givers with jobs; stopping their routines to collect pay normally collected by the
employee spouse may not be an option. The county will make arrangements to
ensure that the recovery staff will receive their normal pay on the usual day of the
month.
Per Diem expenditures (lodging, food)
Each employee will be required to keep receipts of how much has been spent on
travel, food and lodging. Per Diem pay will be the same as the county adopted
rates, available in Personnel and the County Home website.
Record keeping (time, expenses)
Financial records must be kept by the Finance Section in the DOC, including
responder time and all financial expenditures. ICS forms will be used to collect this
information, and are available in the DOC All Hazards Plan, Standard Operating
Procedures Volume Two. They are also available online on the department shared
drive.
Travel at the recovery site
Local-to-recovery site transportation will be handled through the DOC. Rental
vehicles may be needed and coordinated through the DOC. Taxis mat also be
utilized if necessary. If recovery is performed in shifts, vehicles may be needed for
each shift.
Travel between home/lodgings and the recovery site
Personnel may be required to travel to and from the recovery site. How many
people can travel on the same conveyance, be it commercial carrier or private
vehicle will be determined by the DOC. If a commercial carrier is needed, the
Logistics Section in the DOC will make the arrangements. Transportation will be paid
by the county with a organization credit card or a P.O.
Work authorizations (if out-of-country)
If the responder has been requested through a Mutual Aid request to work out of the
county where he/she has residence, that person will be legally covered by the
county work at the recovery site.
Work from home option
If appropriate facilities are not available or found in a short period, the Director may
approve staff to work from their home until such time as adequate space, equipment,
furniture, communications and computers are found.
Reassignment of staff to mission critical functions
If the staff originally identified to fill a mission critical function is not available, another
staff member may be appointed if deemed necessary by the Director or the DOC, to
fill mission critical functions, such as positions in the DOC, or point of Distribution
(POD) operation centers.
Appendix ‘M’
KERN COUNTY PUBLIC HEALTH LABORATORY
SENSITIVE SAMPLES – RECEIPT & CHAIN OF CUSTODY
A. Michael V. Lancaster, PhD, Public Health Laboratory Director
December 12, 2008
I.
Introduction
All samples received by the KCPHL which require documentation for chain of custody
must be received by a Public Health Microbiologist, who must meet with the submittor
and assure that all necessary documentation is received and complete. All samples
must be accompanied by a properly completed sample requisition form. See below.
II.
Receipt for Property Received/Returned
A.
B.
C.
D.
E.
F.
III.
In addition to the sample requisition, initiate a “Receipt for Property
Received/Returned”. This form must be completed, signed, providing date and
time, upon the receipt of sample. Both laboratory and submitter will retain a copy
of the completed form.
This form must be completed, signed, and dated upon the release of sample to a
law enforcement official. Both laboratory and law enforcement will retain a copy of
the completed form.
Descriptive information must include at least the following information for each
item:
 Unique identifier for each item
 Number/quantity
 Type/description
If multiple items are received, all items must be listed on the form. Each item must
be assigned a unique identifier. The original identifier must be maintained on the
chain of custody records.
The name of the carrier/courier and the shipping/reference number must be
recorded if applicable.
Additional information may be attached as appropriate.
Chain of Custody
This form must be signed and dated whenever handling and /or transferring custody
within the laboratory. Initial receipt, storage, all handling and processing, and release
must be recorded.
(1)


Attachments
Receipt for Property Received/Returned
Chain of Custody
KERN COUNTY PUBLIC HEALTH LABORATORY
RECEIPT FOR PROPERTY RECEIVED/RETURNED
KCPHL ID #: ______________________ Date: ____________________ Page _____ of _____
[ ] Received from
[ ] Released to
[ ] Returned to
Name (print):
Organization:
Street
Address:
City, State:
Phone:
Description of Property (identifier, number/quantity, and type/description):
Received from:
(sign/date/time)
Received by:
(sign/date/time)
Attach Chain of Custody form. Attach additional pages as required.
KERN COUNTY PUBLIC HEALTH LABORATORY
CHAIN OF CUSTODY
KCPHL ID #: _______________________________________
Received By (print/sign):
Date: Time:
Organization
Reason:
Received By (print/sign):
Date: Time:
Organization
Reason:
Received By (print/sign):
Date: Time:
Organization
Reason:
Received By (print/sign):
Date: Time:
Organization
Reason:
Received By (print/sign):
Date: Time:
Organization
Reason:
Received By (print/sign):
Date: Time:
Organization
Reason:
Received By (print/sign):
Organization
Reason:
Attach additional pages as required.
Date: Time:
Appendix ‘M’
Kern County Department of Public Health Organization Chart
(revised March 2010)
Director of
Public
Health
Health
Officer:
over
Public
Health
Division
Administrative
Services
Public Health
Environmenta
l Health
Animal
Control
Emergency
Services
Health
Promotion &
Public
Information
Payroll
Personnel
Accounting
Contracts
Records
Room
H.O.C.
Field Nursing
Laboratory
Disease
Control
M.C.A.H.
C.C.S.
Haz Mat Unit
Inspection Units:
Land Fill
Restaurants
In-ground vessels
Above- ground
Vessels
Water Systems
Solid & Liquid
Waste
Vector Control
Shelter
Field
Operations
Rabies
Control
Emergency
Medical
Services
Public
Information
Officer
Reception
Office of
Public Health
Preparedness
Appendix ‘N’
Care & Shelter Operations
(Annex ‘G’ of Kern County Emergency Operations Plan)
CARE AND SHELTER OPERATIONS
CONTENTS
Page No. in County Plan
G.1 INTRODUCTION
393
G.2 OBJECTIVES
393
G.3 AMERICAN RED CROSS
393
G.4 CONCEPT OF OPERATIONS
394
G.4.1 Pre-Emergency Period
Normal Preparedness Phase
Increased Readiness Phase
G.4.2 Emergency Period
Pre-Impact Phase
Immediate Impact Phase
Sustained Emergency Phase
G.4.3 Post-Emergency Period (Recovery)
G.5 ORGANIZATION AND RESPONSIBILITIES
G.5.1
G.5.2
G.5.3
G.5.4
G.5.5
Local
Operational Area
Regional
State
Federal
G.6 POLICIES AND PROCEDURES
G.6.1 Mutual Aid
395
395
395
395
395
396
396
397
397
397
398
399
399
400
400
400
Page
G.6.2 Registration and Inquiry Operations
G.6.3 Lodging Operations
G.6.4 Feeding Operations
400
401
402
ENCLOSURE G-1 Supporting Organizations and Responsibilities
403
APPENDIX G - Hazard-Specific Responses
405
(Annex ‘G’ of County Emergency Operations Plan)
CARE AND SHELTER OPERATIONS
G.1 Introduction
This annex describes the organizational and operational policies and procedures required to
meet the food, clothing and shelter needs of people on a mass care basis during major
natural disasters and technological incidents. It also cites authorities and specifies the
public and private organizations responsible for providing mass care and welfare inquiry
services.
G.2 Objectives
The overall objectives of care and shelter operations are to:
o
o
o
o
o
Provide food, clothing, shelter and other basic necessities of life, on a mass care
basis, to persons unable to provide for themselves as a result of a disaster.
Provide an inquiry service to reunite separated families or respond to inquiries from
relatives and friends outside the affected areas.
Assure an orderly transition from mass care, to separate family living, to
post-disaster recovery.
Prepare for occupancy and operation of shelters.
Organize and manage shelters.
G.3 American Red Cross
The American Red Cross, as mandated by Federal Law 36-USC-3 and reaffirmed in Public
Law 93-288 (Federal Disaster Relief Act of l974), provides disaster relief in peacetime. At
the State level, the Statement of Operational Relationships between the American Red
Cross and California Office of Emergency Services (OES) and the Memorandum of
Understanding between the American Red Cross and the California Department of Social
Services establish the operating relationships between these agencies. The major care and
shelter responsibilities of the Red Cross in the emergency period are included in the
Statement of Operational Relationships and reiterated below.
Emergency mass care includes providing:
o
Emergency lodging for disaster victims in public or privately owned buildings.
o
Food and clothing for persons in emergency mass care facilities.
o
Food for disaster workers if normal commercial feeding facilities are not available.
o
Registration and inquiry service.
The Red Cross acts cooperatively with State and local governments and other private relief
organizations to provide emergency mass care to persons affected by disasters in
peacetime. There is no legal mandate for Red Cross involvement in a State of War
Emergency. However, by decision of Chapter Boards of Directors, the Red Cross Chapter
Disaster Committees in California may, if incorporated into the civil defense (war
emergency) plans of political subdivisions, serve as a component of civil defense to assist
with emergency mass care operations.
G.4 Concept of Operations
Peacetime emergency operations differ from possible war emergencies in that the level of
magnitude of even a catastrophic disaster (Level III) would be much less than in a war
emergency. In almost all peacetime disasters, the Red Cross will provide the bulk, if not all,
of the mass care services and schools and churches will fulfill the need for shelter. Usually,
persons will be able to evacuate in their private automobiles, so that transportation would be
available between the shelters and one or more central feeding facilities. Also, since the
majority of evacuees in peacetime disasters choose to stay with relatives, friends or in hotels
or motels, the percentage of persons going to public shelter will vary. Large area
evacuations will increase the percentage.
Care and shelter operations will usually be associated with the periods and phases indicated
below. Detailed operational concepts and emergency response actions associated with the
various types of emergencies are provided in Appendix G, Hazard-Specific Responses.
G.4.1 Pre-Emergency Period
The Pre-Emergency Period is divided into two phases as follows:
Normal Preparedness Phase
During this phase, emphasis will be placed on preparing supporting plans, Standard
Operating Procedures (SOPs), call-out lists of professional and volunteer personnel
and resource lists. Plans and procedures will provide for coordination and
communication channels with counterpart agencies and organizations of other
jurisdictions. Staff and volunteers will be trained and disaster plans will be exercised.
All training will conform to Standardized Emergency Management System (SEMS)
requirements.
Because the onset of some disasters can occur with little or no warning, possible
sites for shelter and mass feeding should be pre-selected and listings should be
maintained as separate components of this and other Contingency Plans.
Agreements should be concluded with appropriate persons, such as managers or
owners of hotels or restaurants. Arrangements and agreements for provision of
required resources and supplies should also be made in this period.
Increased Readiness Phase
This phase could begin upon receipt of an accredited earthquake prediction, the
forecast of a flood or a rapidly deteriorating international situation. Increased
readiness actions will include reviewing and updating plans, SOPs, call-out and
resource lists and accelerating training. Available resources will be mobilized and
volunteers alerted.
G.4.2 Emergency Period
The Emergency Period is divided into three phases as follows:
Pre-Impact Phase
Most actions to be accomplished during the pre-impact phase would be
precautionary and would be centered around taking appropriate counter- measures
to protect people should Kern County be impacted by an event such as a slow-rising
flood, a health endangering hazardous material incident, etc.
If it is the type of disaster that requires mass care, shelters and feeding facilities will
be opened, staffed and supplied. The Local Care and Shelter Branch Coordinator
will report to the Kern County Emergency Operations Center (EOC) if it has been
activated. Detailed information on shelter and feeding facilities will be disseminated
to the public through the Kern County Public Information Officer (PIO).
Immediate Impact Phase
If there has been ample warning, shelter, feeding and other care services will have
begun outside the threatened area. However, should an area that was perceived to
be safe be impacted, some evacuees may have to be transported to another lodging
facility and feeding operations may have to be transferred to another site.
If the disaster occurs without warning, the Kern County Care and Shelter Branch
Coordinator, in conjunction with the Red Cross, will rapidly assess the requirements
for shelter and mass feeding. They must also determine which of the pre-selected
facilities may have become inaccessible, damaged or destroyed and which are still
available for mass care. As normal communications facilities may not be functioning,
other means (such as amateur radio operators or person-to-person contact) may
have to be used to communicate with shelter managers and other mass care
personnel. Most emergency personnel, however, will be expected to report to preassigned duty stations.
Obtaining appropriate supplies and resources and
distributing them to the specified sites may require improvising solutions and
deviating somewhat from the original plan. In the case of a major disaster, shelters
may be required outside the local area and provided through mutual aid channels. In
addition, temporary feeding services may be requested to be provided by State
agencies and the military.
Sustained Emergency Phase
In the Sustained Emergency Phase, it may be possible for some displaced persons
to be moved to improved quarters, such as hotels or even to return to their homes.
However, shelter, mass feeding and welfare inquiry services will continue until they
are no longer required.
G.4.3 Post-Emergency Period (Recovery)
In the Post-Emergency Period, most of the basic needs of the population will have been
provided, and, if the disaster was large, the Federal and State governments will have
become heavily involved in providing financial aid to victims. Disaster Application Centers
(DACs) will be set up to coordinate the delivery of these services. Local officials and private
non-profit agencies still have responsibility for phasing out the mass care facilities and
assisting displaced persons in obtaining temporary housing and other aid.
G.5 Organization and Responsibilities
Table G-1 gives an overview of the statewide care and shelter organization down to the
Care and Shelter Branch Coordinator at the local level and shows the source of
management personnel for both peacetime and war emergencies. The responsibilities of
Care and Shelter Coordinators at the Local, Operational Area and Regional levels, the State
Care and Shelter Director, supporting State agencies and the private sector are discussed
on the following page.
G.5.1 Local
The Local Care and Shelter Branch Coordinator shall be the Director of the Department of
Human Services. The Coordinator has the responsibility for coordinating Kern County's
resources, requesting and responding to mutual aid forces and providing support to the Red
Cross. For peacetime disasters, the Coordinator should ensure that the head of the local
government has signed the proclamation designating the Red Cross as the official disaster
relief agency and make arrangements with other private non-profit organizations, such as
the Salvation Army, to assist in care and shelter. If there is no local Red Cross chapter or
other private organization in the immediate area able to open and operate mass care
facilities immediately after impact, the Care and Shelter Branch Coordinator should have
plans to perform this function until private organizations arrive on the scene.
[remainder of page left blank]
Table G-1
STATEWIDE CARE AND SHELTER ORGANIZATION
Level
Title
Source
State
State Care and Shelter
Director, Dept. of Social Services
Regional
Regional Care and
Shelter Branch
Coordinator
Department of Social Services
Representative
Operational Area
Operational Area Care
and Shelter Branch
Coordinator
Director of Human Services
Local
Care and Shelter
Director of Human Services
Branch Coordinator
_________________________________________________________________________
_
The organization will expand to meet the size of the emergency. In the case of a very large
peacetime disaster, there may be a requirement for a Mass Care Services Unit Coordinator
and assistants for Mass Care Centers (both local government designees) to assist the Care
and Shelter Branch Coordinator.
Local government and private organizations locally available to support care and shelter
operations are listed in Enclosure G-1, Supporting Organizations and Responsibilities.
G.5.2 Kern County Operational Area
The Kern County Director of Human Services shall be the Operational Area Care and
Shelter Branch Coordinator and will have the overall responsibility for coordinating care and
shelter operations within Kern County. The Coordinator will submit requests for support to
the Regional Care and Shelter Branch Coordinator.
G.5.3 Regional Operations
The OES Regional Care and Shelter Branch Coordinator (representative of the State
Department of Social Services) will coordinate care and shelter operations within the Region
and will submit requests for support to the State Director of Care and Shelter.
G.5.4 State Operations
The Director of the State Department of Social Services will serve as the State Director of
Care and Shelter and will have the overall responsibility for coordinating statewide care and
shelter operations and support requirements.
The Department of Social Services is responsible for:
o
o
o
Serving as the lead agency in coordinating State agency care and shelter response
to support local operations.
Providing departmental personnel and other resources to function in Disaster
Application Centers upon request of the Director of OES.
Coordinating the capabilities of County Social Services Departments (or similar
agencies) to respond to the disaster.
The following discussion cites other State agencies with varied capabilities and
responsibilities for providing support to such operations. All support will be dependent upon
availability and, in some instances, the proximity of the supporting agency's facilities to a
given jurisdiction or jurisdictions.
Several State departments have the capability of providing feeding equipment and prepared
food to locations throughout the state. They are:
o
o
o
o
Department of Corrections
Department of Forestry
Military Department (California National Guard)
Department of Education
Upon request, information to support the identification and location of persons by the
Welfare Inquiry Services will be provided by:
o Department of Motor Vehicles.
Assistance with welfare inquiry and arrangement for food to be delivered in the affected
areas can be provided by:
o Department of Aging.
G.5.5 Federal Operations
Federal support for care and shelter operations will be provided by those Federal agencies,
such as the Department of Agriculture and the Department of Defense, whose statutory
responsibilities include disaster response prior to a Presidential Declaration. Additional
assistance following a Presidential Declaration will be coordinated by the Federal
Emergency Management Agency (FEMA).
G.6 Policies and Procedures
G.6.1 California Medical Mass Mutual Aid
If local resources (both public and private) are inadequate to cope with the situation, support
will be requested through the appropriate OES Regional Office via the Response Inventory
Management System (RIMS). If the requirement cannot be met through resources available
within the counties in the region, the Regional Office will request assistance from the State
OES in Sacramento. State OES will then forward the request to the State Department of
Social Services for final action.
G.6.2
Registration and Inquiry Operations
The Red Cross has responsibility for Registration and Inquiry (Disaster Welfare Inquiry)
Operations. The Red Cross has trained Disaster Welfare Inquiry cadres, a system to recruit
volunteer workers and a tested program to handle mass inquiries. During most disasters, a
Registration and Inquiry Center is established in the Red Cross Chapter office located near
the disaster or in an office nearby. However, in large-scale disasters where the Red Cross
has established a Headquarters for Disaster Operations, the Center will be located there or
nearby.
There is often a delay between the onset of a disaster, the time that a Registration and
Inquiry Center can be set up and staffed and the time that it takes to identify residences that
may have been damaged or destroyed. A temporary moratorium on inquiries may be
declared up to 48 hours until the system becomes operational.
Communications are established between the Center and shelters, hospitals and Coroner’s
offices or morgues. Registration lists and location changes are sent to the Center daily, if
possible or more often if practical and necessary. Most inquiry and response information is
sent by FAX and/or RACES Packet Radio in order to provide a written record of the
communications. Although every effort is made to locate all victims, some persons whose
homes may have been damaged will evacuate but not register. For this reason, records will
seldom, if ever, be complete. Public information broadcasts advising people to register and
to notify relatives of their location, however, will assist inquiry operations.
G.6.3
Lodging Operations
In large disasters, all suitable buildings, other than those being used for other emergency
functions, may be used for lodging.
California State Education Code Section 40041.5, known as the Katz Bill, mandates that
public education facilities be made available for use as shelters during emergencies.
Schools are the most preferred facilities for lodging, as they are public facilities and can
accommodate a large number of persons. Churches are also appropriate, as they are often
large and often have feeding facilities on the premises.
Arrangements should be made in advance with owners or managers of many facilities for
use in large disasters and after small disasters that require a number of different sites.
Arrangements should also be made during a disaster; if possible, for backup shelter should
the threat change location (for example, a wind shift after a hazardous material incident).
In large disasters, commercial lodging facilities such as motels and hotels should be
reserved for the infirm that require above average comforts and conveniences.
When possible, most of the lodging operations will be performed by personnel normally
associated with the facility. In large disasters, the evacuees themselves, under the
supervision of the facility manager, are expected to assist with many, if not most, of the
operations. Pets will not be allowed in lodging facilities but will be cared for in animal
shelters or veterinarians' facilities.
Only minimal health needs will be attended to in lodging facilities. If possible, sick persons
will be transferred to medical facilities.
G.6.4
Feeding Operations
The Department of Human Services will be responsible for arranging, with the General
Services, the American Red Cross and /or the Salvation Army, for the feeding of disaster
personnel and emergency service workers at disaster sites and command centers. This
shall be coordinated through the Logistic Section of the Kern County EOC.
In most disasters, it is expected that centralized facilities will be set up for mass feeding and
that most of the feeding operations will be performed by personnel associated with that
facility. Where possible, the owners or managers of feeding establishments will manage the
mass feeding operations. Mass feeding schedules will be provided to Lodging Facility
Managers. Special diets will be provided as required.
Arrangements will be made with 24-hour restaurants and fast food outlets to provide
supplies of food initially, until mass feeding operations can be organized.
Government-provided food will be obtained, if possible, and food supplies donated in bulk
should be used to the extent possible.
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Appendix ‘O’
Pandemic Influenza Response Plan
Kern County Emergency Council adopted the Pandemic Influenza Preparedness Plan in
2007. The plan sets forth the specific details about which agencies will be responsible for
planning, organizing and initiating the emergency response when pandemic influenza
arrives. The plan is closely tied to the Kern County Strategic National Stockpile (SNS) Plan,
in that the SNS Plan contains specific details about how to order, receive, store and
distribute antiviral medications, vaccines and medical supplies from the CDC/State
Department of Public Health, which maintain the SNS materials.
Pandemic influenza presents the greatest potential for wide spread illness and death of any
public health threat, including natural disaster, or nuclear/biological weapon of mass
destruction. Because it can go undetected in the population for many weeks, it will already
be well established in the community before public health or the primary medical care
community will identify exactly what it is. The ability to rapidly spread from human to human
and sustain that transmission cycle over several waves and many months, makes pandemic
influenza the greatest challenge for public health and government to prepare for. Kern
County Department of Public Health has participated in the Disaster Medical Planning Group
(DMPG) since 2004 which coordinates response planning with numerous hospitals, clinics,
managed health care providers, law enforcement, fire and emergency responder
organizations. The Kern Medical Reserve Crops (KMRC) is also an active partner in
preparing for an all out public health response when pandemic influenza arrives, by
recruiting, credentialing and training medical professionals in the NIMS/SEMS/ICS
emergency operating systems.
It is a given that not every person in Kern county will receive medications or vaccines during
pandemic influenza, because of the length of time it takes the CDC and drug makers to
develop, manufacture and distribute an effective vaccine against a new virus strain. The
Kern County Emergency Council will be the final decision making group that will recommend
to the Board of Supervisors and the County Administrative Officer (CAO) the priority
distribution of limited resources (vaccines and antiviral medications) in the county.
The KCDPH is also responsible for developing a risk communications plan to prepare the
county, other stakeholders and the community for pandemic influenza. The Crisis
Emergency Risk Communications (CERC) Plan was prepared in 2006 and revised in 2009
to include key components for mental health support as well. Developing and disseminating
the CERC information before, during and after pandemic will be critical for maintaining order
in the community and connecting people who are sick with providers who can give them the
heath care they need.
APPENDIX ‘P’
HAZARD-SPECIFIC INCIDENCE
This Appendix includes Emergency Action Checklists to be accomplished as appropriate in
response to the events listed below. There is no significance in the order of checklist items
since many actions will have to be accomplished concurrently.
G-1 Response to a Major Earthquake
G-2 Response to Hazardous Material Incident
G-3 Response to Imminent/Actual Flooding
G-4 Response to Imminent/Actual Dam Failure
[remainder of page left blank]
Appendix ‘G-1’ of County Emergency Operations Plan
CARE AND SHELTER
EMERGENCY ACTION CHECKLIST
RESPONSE TO A MAJOR EARTHQUAKE
ASSIGNED
ACTION
RESPONSIBILITY
_______________________________________________________________
Determine which designated mass care
facilities and Welfare Inquiry Centers
will be needed and if they are functional.
Asst. Dir - Admin Bureau
Red Cross
Provide alternative communications where
needed to link mass care facilities, the
Emergency Operations Center and other key
facilities.
Communications
RACES
Coordinate with Red Cross and other
emergency welfare agencies (i.e.,
Salvation Army, church groups and
other service organizations).
Asst. Dir - Admin Bureau
Disaster Emergency
DOC Staff
Call up augmentation staff to provide
personnel for reception, medical care,
shelter and feeding of evacuees; contact
volunteers through local agencies.
Asst. Dir - Admin Bureau
DOC Staff
Red Cross
Evacuate and relocate any mass care
facilities which become endangered by
any hazardous conditions.
Law Enforcement
Assist in the evacuation of institutionalized
persons in threatened areas.
Law Enforcement
Request necessary food supplies,
equipment and other supplies to operate
mass care facilities.
Asst. Dir - Admin Bureau
Red Cross
Assist agencies with essential services
and other logistical support.
Asst. Dir - Admin Bureau
DOC Staff
Red Cross
Activate Registration and Inquiry System.
Asst. Dir - Admin Bureau
Red Cross
ASSIGNED
ACTION
RESPONSIBILITY
__________________________________________________________________
Maintain updated list of victims and
their locations.
Asst. Dir - Admin Bureau
Red Cross
Coordinate with the Sheriff's Department
to transport evacuees to Centers.
Asst. Dir - Admin Bureau
DOC Staff
Red Cross
Record and evaluate information regarding
requests, activities, expenditures,
damages and casualties.
Asst. Dir - Admin Bureau
Shelter Managers
Red Cross
Inform the Kern County Public Information
Officer of current information.
Asst. Dir - Admin Bureau
Red Cross
Continue to reassess needs and disaster
conditions.
Asst. Dir - Admin Bureau
Red Cross
Assist in activating and staffing
Disaster Application Centers.
Asst. Dir - Admin Bureau
Red Cross
Prepare, in cooperation with other
departments and jurisdictions, summary
reports as needed for transmission to
State OES.
Asst. Dir - Admin Bureau
Red Cross
Request assistance from the OES
Regional Care and Shelter Coordinator.
Director of Human Services
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Appendix ‘G-2’ of County Emergency Operations Plan
CARE AND SHELTER
EMERGENCY ACTION CHECKLIST
RESPONSE TO HAZARDOUS MATERIAL INCIDENT
ASSIGNED
ACTION
RESPONSIBILITY
__________________________________________________________________
Determine which designated mass care
facilities will be needed and if they
are functional.
Asst. Dir - Admin Bureau
Red Cross
Coordinate with Red Cross and other
emergency welfare agencies (i.e.,
Salvation Army, church groups and
other service agencies).
Asst. Dir - Admin Bureau
DOC Staff
Call up augmentation staff to provide
personnel for reception, medical care,
shelter and feeding of evacuees,
and sanitation.
Asst. Dir - Admin Bureau
DOC Staff
Red Cross
If evacuation is ordered, activate
mass care facilities in low risk areas.
Asst. Dir - Admin Bureau
Red Cross
Evacuate and relocate any mass care
facilities which become endangered by
any hazardous conditions.
Law Enforcement
Assist in the evacuation of institutionalized
persons in threatened areas.
Law Enforcement
Establish alternative communications
links where needed.
Communications
RACES
Request food supplies, equipment and
other supplies needed to support mass
care facilities.
Asst. Dir - Admin Bureau
Red Cross
Assist agencies with essential services
and other logistical support.
Asst. Dir - Admin Bureau
DOC Staff
Red Cross
ASSIGNED
ACTION
RESPONSIBILITY
_______________________________________________________________
Activate Registration and Inquiry System.
Asst. Dir - Admin Bureau
Red Cross
Coordinate with health and medical
authorities regarding handling requests
for information on the effects of the
hazardous material.
Asst. Dir - Admin Bureau
Red Cross
Record and evaluate information regarding
requests, activities, expenditures,
damages and casualties.
Asst. Dir - Admin Bureau
Shelter Managers
Red Cross
Keep the Kern County Public Information
Officer informed of current information.
Asst. Dir - Admin Bureau
Red Cross
Continue to reassess needs and disaster
conditions.
Asst. Dir - Admin Bureau
Red Cross
Assist in activating and staffing Disaster
Assistance Centers.
Asst. Dir - Admin Bureau
Red Cross
Prepare, in cooperation with other
departments and jurisdictions, summary
reports as needed for transmission to
State OES.
Asst. Dir - Admin Bureau
Red Cross
Request assistance from the OES
Regional Care and Shelter Coordinator.
Director of Human Services
[remainder of page left blank]
Appendix ‘G-3’ of County Emergency Operations Plan
CARE AND SHELTER
EMERGENCY ACTION CHECKLIST
RESPONSE TO IMMINENT/ACTUAL FLOODING
FLOODING EXPECTED
ASSIGNED
ACTION
RESPONSIBILITY
__________________________________________________________________
Determine which designated mass care
facilities and Welfare Inquiry Centers
will be needed and if they are functional.
Asst. Dir - Admin Bureau
Red Cross
Coordinate with Red Cross and other
emergency welfare agencies (i.e.,
Salvation Army, church groups and
other service organizations).
Asst. Dir - Admin Bureau
DOC Staff
Call up augmentation staff to provide
personnel for reception, medical care,
shelter and feeding of evacuees.
Asst. Dir - Admin Bureau
DOC Staff
Red Cross
Request food supplies, equipment and
all other supplies needed to support
mass care facilities.
Asst. Dir - Admin Bureau
Red Cross
If evacuation is ordered, activate
mass care facilities in low risk areas.
Asst. Dir - Admin Bureau
Red Cross
Activate Registration and Inquiry System.
Asst. Dir - Admin Bureau
Red Cross
Inform the Kern County Public Information
Officer of current information.
Asst. Dir - Admin Bureau
Red Cross
Receive, shelter and care for evacuees
and order needed supplies, equipment,
and support services.
Shelter Managers
Red Cross
Periodically poll mass care facilities
to determine evacuee load and support
requirements.
Asst. Dir - Admin Bureau
Red Cross
ASSIGNED
ACTION
RESPONSIBILITY
__________________________________________________________________
Request assistance from the OES
Regional Care and Shelter Coordinator,
as required.
Director of Human Services
WHEN FLOODING OCCURS
Complete preparatory actions in Flooding
Expected Checklist.
Asst. Dir - Admin Bureau
Red Cross
In cooperation with the Red Cross and
Salvation Army, assist with the registration of evacuees, the listing of
casualties and handling welfare
inquiries.
Shelter Managers
DOC Staff
In coordination with the Red Cross,
Salvation Army and State and Federal
agencies, locate and allocate emergency
and temporary housing.
Asst. Dir - Admin Bureau
DOC Staff
Provide alternative communications where
needed to link mass care facilities,
the Emergency Operations Center and
other key facilities.
Communications
RACES
Request food, supplies and equipment
needed by mass care facilities.
Asst. Dir - Admin Bureau
Red Cross
Prepare, in cooperation with other
departments and jurisdictions, summary
reports as needed for transmission to
the State OES.
Asst. Dir - Admin Bureau
Red Cross
Request assistance from the OES
Regional Care and Shelter Coordinator,
as required.
Director of Human Services
Appendix ‘G-4’ of County Emergency Operations Plan
CARE AND SHELTER
EMERGENCY ACTION CHECKLIST
RESPONSE TO IMMINENT/ACTUAL DAM FAILURE
(SEE: LAKE ISABELLA DAM FAILURE PLAN ANNEX)
DAM FAILURE IMMINENT
ASSIGNED
ACTION
RESPONSIBILITY
__________________________________________________________________
Determine which mass care facilities and
Welfare Inquiry Centers will be needed
and if they are functional.
Asst. Dir - Admin Bureau
Red Cross
Coordinate with Red Cross and other
emergency welfare agencies (i.e.,
Salvation Army, church groups and
other service organizations).
Asst. Dir - Admin Bureau
DOC Staff
Red Cross
Call up augmentation staff to provide
personnel for reception, medical care,
shelter and feeding of evacuees.
Asst. Dir - Admin Bureau
DOC Staff
Red Cross
Request food, equipment and other
supplies needed to support mass
care facilities.
Asst. Dir - Admin Bureau
Red Cross
Activate mass care facilities in
reception areas.
Asst. Dir - Admin Bureau
Red Cross
Activate Registration and Inquiry System.
Asst. Dir - Admin Bureau
Red Cross
Provide the Kern County Public Information
Officer with current information.
Asst. Dir - Admin Bureau
Red Cross
Receive, shelter and care for evacuees.
Shelter Managers
Red Cross
Order needed supplies, equipment,
and support services.
Asst. Dir - Admin Bureau
Red Cross
ASSIGNED
ACTION
RESPONSIBILITY
__________________________________________________________________
Periodically poll mass care facilities
to determine evacuee load and support
Asst. Dir - Admin Bureau
requirements.
Red Cross
Request assistance from the OES
Regional Care and Shelter Coordinator,
as required.
Director of Human Services
DAM FAILURE OCCURS
If not already accomplished, complete
preparatory actions from Dam Failure
Imminent Checklist.
Asst. Dir - Admin Bureau
Red Cross
In cooperation with the Red Cross and
Salvation Army, assist with the registration of evacuees, the listing of
casualties and handling welfare
inquiries.
Shelter Managers
DOC Staff
Determine number of evacuees who need
emergency and temporary housing.
Red Cross
In coordination with the Red Cross,
Salvation Army and state and Federal
agencies, locate and allocate emergency
and temporary housing.
Asst. Dir - Admin Bureau
DOC Staff
Provide alternative communications links
where needed.
Communications
RACES
Provide food, supplies and equipment
needed by mass care facilities.
Asst. Dir - Admin Bureau
Red Cross
Prepare, in cooperation with other
departments and jurisdictions, summary
reports as needed for transmission to
the State OES.
Asst. Dir - Admin Bureau
Red Cross
Request assistance from the OES
Regional Care and Shelter Coordinator,
as required.
Director of Human Services
APPENDIX ‘Q’
Special Needs and Fixed Populations, Provider Service
Organizations
KCDPH will engage community partners and advocates who have the expertise and
experience in working with people in Kern County with special physical and mental health
challenges in order to adequately prepare for emergency response before, during and after
a public health emergency. Those organizations may include the following:
Senior and Disabled Housing Complexes:

Kern County Department of Aging and Adult Services
Debbie Stevenson, Director
5357 Truxtun Ave, Bakersfield CA 93309
Phone: (661) 868-1000
Family Complexes for Disabled:

Kern Regional Center
3200 N Sillect Ave, Bakersfield CA 93308
Phone: (661) 327-8531
Long-term Care Facilities (e.g., Nursing Homes)
Group Homes/Assisted Living Facilities:

Kern County Department of Human Services
100 E California Ave, Bakersfield CA 93307
Phone: (661) 631-6000
Schools:

Kern County Superintendent of Schools
Dr. Larry Reider, Superintendent of Schools
1300 17th St, Bakersfield CA 93301
Phone: (661) 636-4630
Homeless:

Bakersfield Homeless Shelter
1600 E Truxtun Ave, Bakersfield CA 93305
Phone: (661) 322-9199
Non-English Speaking:

Spanish
● Filipino
● Punjabi
● Russian
● Burmese
KCDPH has identified the following resources for translation services
Panational, Inc., Phone (800) 556-1316
Language Line, Phone (800) 237-8434
LifeSigns, Inc., Phone (661) 327-3783, (800) 633-8883
Blind and Hearing Impaired Residents:

Center for the Blind and Visually Impaired
1124 Baker Street, Bakersfield CA 93305
Phone: (661) 322-5234

B-Glad Deaf Services
1527 19th St, Bakersfield CA 93301
Phone: (661) 327-3781
TDD only: (661) 327-5652
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GLOSSARY
Accessible
Having the legally required features and/or qualities that ensure entrance, participation, and
usability of places, programs, services, and activities by individuals with a wide variety of
disabilities.
American Red Cross
The American Red Cross is a humanitarian organization, led by volunteers, that provides
relief to victims of disasters and helps people prevent, prepare for, and respond to
emergencies. It does this through services that are consistent with its
Congressional Charter and the Principles of the International Red Cross Movement.
Assumptions (Management)
Statements of conditions accepted as true and that have influence over the development of
a system. In emergency management, assumptions provide context, requirements, and
situational realities that must be addressed in system planning and development and/or
system operations. When these assumptions are extended to specific operations, they may
require re-validation for the specific incident.
Assumptions (Preparedness)
Operationally relevant parameters that are expected and used as a context, basis, or
requirement for the development of response and recovery plans, processes, and
procedures. For example, the unannounced arrival of patients to a healthcare facility occurs
in many mass casualty incidents. This may be listed as a preparedness assumption in
designing initial response procedures. Similarly, listing the assumption that funds will be
available to train personnel on a new procedure may be important to note.
Assumptions (Response)
Operationally relevant parameters for which, if not valid for a specific incident’s
circumstances, the EOP-provided guidance may not be adequate to assure response
success. Alternative methods may be needed. For example, if a decontamination capability
is based on the response assumption that the facility is not within the zone of release, this
assumption must be verified at the beginning of the response.
Attack
A hostile action taken against the United States by foreign forces or terrorists, resulting in
the destruction of or damage to military targets, injury or death to the civilian population, or
damage to or destruction of public and private property.
Capabilities-based planning
Planning, under uncertainty, to provide capabilities suitable for a wide range of threats and
hazards while working within an economic framework that necessitates prioritization and
choice. Capabilities-based planning addresses uncertainty by analyzing a wide range of
scenarios to identify required capabilities.
Checklist
Written (or computerized) enumeration of actions to be taken by an individual or
organization meant to aid memory rather than provide detailed instruction.
Citizen Corps Council
Councils sponsored by government at local, state, tribal, territorial, and national level with
the mission of bringing community and government leaders together to involve community
members in all-hazards emergency preparedness, planning, mitigation, response, and
recovery.
Community
A political entity that has the authority to adopt and enforce laws and ordinances for the area
under its jurisdiction. In most cases, the community is an incorporated town, city, township,
village, or unincorporated area of a county. However, each State defines its own political
subdivisions and forms of government.
Contamination
The undesirable deposition of a chemical, biological, or radiological material on the surface
of structures, areas, objects, or people.
Dam
A barrier built across a watercourse for the purpose of impounding, controlling, or diverting
the flow of water.
Damage Assessment
The process used to appraise or determine the number of injuries and deaths, damage to
public and private property, and status of key facilities and services (e.g., hospitals and other
health care facilities, fire and police stations, communications networks, water and sanitation
systems, utilities, and transportation networks) resulting from a man-made or natural
disaster.
Decontamination
The reduction or removal of a chemical, biological, or radiological material from the surface
of a structure, area, object, or person.
Disaster
An occurrence of a natural catastrophe, technological accident, or human-caused event that
has resulted in severe property damage, deaths, and/or multiple injuries. As used in this
Guide, a “large-scale disaster” is one that exceeds the response capability of the Local
jurisdiction and requires State, and potentially Federal, involvement. As used in the Stafford
Act, a “major disaster” is “any natural catastrophe [...] or, regardless of cause, any fire, flood,
or explosion, in any part of the United States, which in the determination of the President
causes damage of sufficient severity and magnitude to warrant major disaster assistance
under [the] Act to supplement the efforts and available resources or States, local
governments, and disaster relief organizations in alleviating the damage, loss, hardship, or
suffering caused thereby.” (Stafford Act, Sec. 102(2), 42 U.S.C. 5122(2).
Disaster Recovery Center
Places established in the area of a Presidentially declared major disaster, as soon as
practicable, to give victims the opportunity to apply in person for assistance and/or obtain
information related to that assistance. DRCs are staffed by Local, State, and Federal agency
representatives, as well as staff from volunteer organizations (e.g., the American Red
Cross).
Earthquake
The sudden motion or trembling of the ground produced by abrupt displacement of rock
masses, usually within the upper 10 to 20 miles of the earth's surface.
Emergency
Any occasion or instance, such as a hurricane, tornado, storm, flood, tidal wave, tsunami,
earthquake, volcanic eruption, landslide, mudslide, snowstorm, fire, explosion, nuclear
accident, or any other natural or man-made catastrophe, that warrants action to save lives
and to protect property, public health, and safety.
Emergency Medical Services
Services, including personnel, facilities, and equipment required to ensure proper medical
care for the sick and injured from the time of injury to the time of final disposition (which
includes medical disposition within a hospital, temporary medical facility, or special care
facility; release from the site; or being declared dead). Further, EMS specifically includes
those services immediately required to ensure proper medical care and specialized
treatment for patients in a hospital and coordination of related hospital services.
Emergency Operations Center
The protected site from which State and Local civil government officials coordinate, monitor,
and direct emergency response activities during an emergency.
Emergency Operations Plan
A document that: describes how people and property will be protected in disaster and
disaster threat situations; details who is responsible for carrying out specific actions;
identifies the personnel, equipment, facilities, supplies, and other resources available for use
in the disaster; and outlines how all actions will be coordinated.
Emergency Support Function
In the NRF, a functional area of response activity established to facilitate the delivery of
Federal assistance required during the immediate response phase of a disaster to save
lives, protect property and public health, and maintain public safety. ESFs represent those
types of Federal assistance that a State will most likely need because of the impact of a
catastrophic or significant disaster on its own resources and response capabilities, or
because of the specialized or unique nature of the assistance required. ESF missions are
designed to supplement State and Local response efforts.
Evacuation
Organized, phased, and supervised dispersal of people from dangerous or potentially
dangerous areas.
• Spontaneous Evacuation. Residents or citizens in the threatened areas observe an
emergency event or receive unofficial word of an actual or perceived threat and,
without receiving instructions to do so, elect to evacuate the area. Their movement,
means, and direction of travel are unorganized and unsupervised.
• Voluntary Evacuation. This is a warning to persons within a designated area that a
threat to life and property exists, or is likely to exist in the immediate future.
Individuals issued this type of warning or orders are NOT required to evacuate;
however, it would be to their advantage to do so.
• Mandatory or Directed Evacuation. This is a warning to persons within the
designated area that an imminent threat to life and property exists and individuals
MUST evacuate in accordance with the instructions of local officials.
Evacuees
All persons removed or moving from areas threatened or struck by a disaster.
Federal Coordinating Officer
The person appointed by the President to coordinate Federal assistance in a Presidentially
declared emergency or major disaster. The FCO is a senior FEMA official trained, certified,
and well experienced in emergency management, and specifically appointed to coordinate
Federal support in the response to and recovery from emergencies and major disasters.
Field Assessment Team
A small team of pre-identified technical experts who conduct an assessment of response
needs (not a preliminary damage assessment) immediately following a disaster. The experts
are drawn from the Federal Emergency Management Agency, other agencies and
organizations (e.g., U.S. Public Health Service, U.S. Army Corps of Engineers, U.S.
Environmental Protection Agency, and American Red Cross) and the affected State(s). All
FAST operations are joint Federal/State efforts.
Flash Flood
Follows a situation in which rainfall is so intense and severe and runoff is so rapid that
recording the amount of rainfall and relating it to stream stages and other information cannot
be done in time to forecast a flood condition.
Flood
A general and temporary condition of partial or complete inundation of normally dry land
areas from overflow of inland or tidal waters, unusual or rapid accumulation or runoff of
surface waters, or mudslides/mudflows caused by accumulation of water.
Governor’s Authorized Representative
The person empowered by the Governor to execute, on behalf of the State, all necessary
documents for disaster assistance.
Hazard Mitigation
Any action taken to reduce or eliminate the long-term risk to human life and property from
hazards. The term is sometimes used in a stricter sense to mean cost-effective measures to
reduce the potential for damage to a facility or facilities from a disaster event.
Hazardous Material
Any substance or material that, when involved in an accident and released in sufficient
quantities, poses a risk to people's health, safety, and/or property. These substances and
materials include explosives, radioactive materials, flammable liquids or solids, combustible
liquids or solids, poisons, oxidizers, toxins, and corrosive materials.
High-Hazard Areas
Geographic locations that, for planning purposes, have been determined through historical
experience and vulnerability analysis to be likely to experience the effects of a specific
hazard (e.g., hurricane, earthquake, hazardous materials accident) that would result in a
vast amount of property damage and loss of life.
Hurricane
A tropical cyclone, formed in the atmosphere over warm ocean areas, in which wind speeds
reach 74 miles per hour or more and blow in a large spiral around a relatively calm center or
eye. Circulation is counter-clockwise in the Northern Hemisphere and clockwise in the
Southern Hemisphere.
Incident Command System
A standardized, on-scene, emergency management construct, specifically designed to
provide for the adoption of an integrated organizational structure that reflects the complexity
and demands of single or multiple incidents without being hindered by jurisdictional
boundaries. ICS is the combination of facilities, equipment, personnel, procedures, and
communications operating within a common organizational structure that is designed to help
manage resources during incidents. It is used for all kinds of emergencies and applicable to
both small and large and complex incidents. ICS is used by various jurisdictions and
functional agencies, both public and private, to organize field-level incident management
operations.
Incident Management Assistance Teams
Interagency teams composed of subject-matter experts and incident management
professionals. IMAT personnel may be drawn from national or regional Federal department
and agency staff according to established protocols. IMATs make preliminary arrangements
to set up Federal field facilities and initiate establishment of the JFO.
Joint Field Office
The Joint Field Office is the primary Federal incident management field structure. The JFO
is a temporary Federal facility that provides a central location for the coordination of Federal,
State, tribal, and local governments and private-sector and nongovernmental organizations
with primary responsibility for response and recovery. The JFO structure is organized,
staffed, and managed in a manner consistent with NIMS principles and is led by the Unified
Coordination Group. Although the JFO uses an ICS structure, the JFO does not manage onscene operations. Instead, the JFO focuses on providing support to on-scene efforts and
conducting broader support operations that may extend beyond the incident site.
Joint Information Center
A facility established to coordinate all incident-related public information activities. It is the
central point of contact for all news media at the scene of the incident. Public information
officials from all participating agencies should collocate at the JIC.
Joint Information System
Integrates incident information and public affairs into a cohesive organization designed to
provide consistent, coordinated, timely information during crisis or incident operations. The
JIS provides a structure and system for developing and delivering coordinated interagency
messages; developing, recommending, and executing public information plans and
strategies on behalf of the Incident Commander (IC); advising the IC about public affairs
issues that could affect a response effort; and controlling rumors and inaccurate information
that could undermine public confidence in the emergency response effort.
Jurisdiction
Multiple definitions are used. Each use depends on the context:
• A range or sphere of authority. Public agencies have jurisdiction at an incident
related to their legal responsibilities and authority. Jurisdictional authority at an
incident can be political or geographical (e.g., City, County, Tribal, State, or Federal
boundary lines) or functional (e.g., law enforcement, public health).
• A political subdivision (Federal, State, County, Parish, Municipality) with the
responsibility for ensuring public safety, health, and welfare within its legal authorities
and geographic boundaries.
Mass Care
The actions that are taken to protect evacuees and other disaster victims from the effects of
the disaster. Activities include providing temporary shelter, food, medical care, clothing, and
other essential life support needs to the people who have been displaced from their homes
because of a disaster or threatened disaster.
Multiagency Coordination Systems
Multiagency coordination systems provide the architecture to support coordination for
incident prioritization, critical resource allocation, communications systems integration, and
information coordination. The components of multiagency coordination systems include
facilities, equipment, personnel, procedures, and communications. Two of the most
commonly used elements are EOCs and MAC Groups. These systems assist agencies and
organizations responding to an incident.
Mitigation
Mitigation is the effort to reduce loss of life and property by lessening the impact of
disasters. This is achieved through risk analysis, which results in information that provides a
foundation for mitigation activities that reduce risk.
National Incident Management System (NIMS)
Provides a systematic, proactive approach that guides government agencies at all levels,
the private sector, and nongovernmental organizations to work seamlessly to prepare for,
prevent, respond to, recover from, and mitigate the effects of incidents, regardless of cause,
size, location, or complexity, in order to reduce the loss of life or property and harm to the
environment.
National Response Framework
A guide to how the nation conducts all-hazards incident management.
Nongovernmental Organization (NGOs)
An entity with an association that is based on the interests of its members, individuals, or
institutions. It is not created by a government, but it may work cooperatively with
government. Such organizations serve a public purpose and are not for private benefit.
Examples of NGOs include faith-based charity organizations and the American Red Cross.
Recovery
The long-term activities beyond the initial crisis period and emergency response phase of
disaster operations that focus on returning all systems in the community to a normal status
or to reconstituting these systems to a new condition that is less vulnerable.
Resource Management
Those actions taken by a government to (a) identify sources and obtain resources needed to
support disaster response activities; (b) coordinate the supply, allocation, distribution, and
delivery of resources so that they arrive where and when they are most needed; and (c)
maintain accountability for the resources used.
Regional Response Coordination Center (RRCC)
Coordinates Regional response efforts, establishes Federal priorities, and implements local
Federal program support until a Joint Field Office is established.
Scenario-Based Planning
Planning approach that uses a Hazard Vulnerability Assessment to assess the hazard’s
impact on an organization on the basis of various threats that the organization could
encounter. These threats (e.g., hurricane, terrorist attack) become the basis of the scenario.
Senior Official
The elected or appointed official who, by statute, is charged with implementing and
administering laws, ordinances, and regulations for a jurisdiction. He or she may be a
mayor, city manager, etc.
Service Animal
Any guide dog, signal dog, or other animal individually trained to assist an individual with a
disability. Service animals’ jobs include, but are not limited to:
• Guiding individuals with impaired vision;
• Alerting individuals with impaired hearing (to intruders or sounds such as a baby’s
cry, the doorbell, and fire alarms);
• Pulling a wheelchair;
• Retrieving dropped items;
• Alerting people to impending seizures; and
• Assisting people with mobility disabilities with balance or stability.
Special-Needs Population
A population whose members may have additional needs before, during, or after an incident
in one or more of the following functional areas: maintaining independence, communication,
transportation, supervision, and medical care. Individuals in need of additional response
assistance may include those who have disabilities; live in institutionalized settings; are
elderly; are children; are from diverse cultures, have limited proficiency in English or are
non-English speaking; or are transportation disadvantaged.
Standard Operating Procedure
A set of instructions constituting a directive, covering those features of operations which lend
themselves to a definite, step-by-step process of accomplishment. SOPs supplement
Emergency Operations Plans (EOPs) by detailing and specifying how tasks assigned in the
EOP are to be carried out. SOPs constitute a complete reference document or an operations
manual that provides the purpose, authorities, duration, and details for the preferred method
of performing a single function or a number of interrelated functions in a uniform manner.
State Coordinating Officer
The person appointed by the Governor to coordinate State, Commonwealth, or Territorial
response and recovery activities with FRP-related activities of the
Federal Government, in cooperation with the Federal Coordinating Officer.
State Liaison
A Federal Emergency Management Agency official assigned to a particular State, who
handles initial coordination with the State in the early stages of an emergency.
Storm Surge
A dome of sea water created by the strong winds and low barometric pressure in a hurricane
that causes severe coastal flooding as the hurricane strikes land.
Terrorism
The use or threatened use of criminal violence against civilians or civilian infrastructure to
achieve political ends through fear and intimidation rather than direct confrontation.
Emergency management is typically concerned with the consequences of terrorist acts
directed against large numbers of people (as opposed to political assassination or hijacking,
which may also be considered terrorism).
Tornado
A local atmospheric storm, generally of short duration, formed by winds rotating at very high
speeds, usually in a counter-clockwise direction. The vortex, up to several hundred yards
wide, is visible to the observer as a whirlpool-like column of winds rotating about a hollow
cavity or funnel. Winds may reach 300 miles per hour or higher.
Tsunami
Sea waves produced by an undersea earthquake. Such sea waves can reach a height of 80
feet and can devastate coastal cities and low-lying coastal areas.
Warning
The alerting of emergency response personnel and the public to the threat of extraordinary
danger and the related effects that specific hazards may cause. A warning issued by the
National Weather Service (e.g., severe storm warning, tornado warning, tropical storm
warning) for a defined area indicates that the particular type of severe weather is imminent
in that area.
Watch
Indication by the National Weather Service that, in a defined area, conditions are favorable
for the specified type of severe weather (e.g., flash flood, severe thunderstorm, tornado,
tropical storm).
LIST OF ACRONYMS
AAR - After Action Review
ARC - American Red Cross
ARES - Amateur Radio Emergency Service
CBRNE - Chemical, Biological, Radiological, and/or Nuclear Explosive
CCC - Citizen Corps Council
CEM - Comprehensive Emergency Management
CEO - Chief Executive Officer
CERT - Community Emergency Response Team
CFR - Code of Federal Regulations
COG - Continuity of Government
CONOPS - Concept of Operations
COOP - Continuity of Operations
CP - Command Post
CPG - Comprehensive Preparedness Guide
CSEPP - Chemical Stockpile Emergency Preparedness Program
DEOC - Department Emergency Operations Center
DHS - U.S. Department of Homeland Security
DMORT - Disaster Mortuary Operational Response Team
DNR - Department of Natural Resources
DOD - U.S. Department of Defense
DOJ - U.S. Department of Justice
DOT - U.S. Department of Transportation
EAS - Emergency Alert System
ECL - Emergency Condition Level
EM - Emergency Management
EMAC - Emergency Management Assistance Compact
EMAP - Emergency Management Accreditation Program
EMS - Emergency Medical Services
EOC - Emergency Operations Center
EOP - Emergency Operations Plan
EPA - U.S. Environmental Protection Agency
EPCRA - Emergency Planning and Community Right-to-Know Act
EPZ - Emergency Planning Zone
ESF - Emergency Support Function
FAA - Federal Aviation Administration
FAAT - Federal Emergency Management Agency (FEMA) Acronyms, Abbreviations, and
Terms
FAC - Family Assistance Center
FBI - Federal Bureau of Investigation
FCO - Federal Coordinating Officer
FDA - Food and Drug Administration
FEMA - Federal Emergency Management Agency
FHA - Federal Highway Authority
FIA - Federal Insurance Administration
FOG - Field Operations Guide
GIS - Geographic Information System
GPS - Global Positioning System
HAZMAT - Hazardous material(s)
HAZUS-MH - Hazards U.S. Multi-Hazard
HSEEP - Homeland Security Exercise and Evaluation Program
HSPD - Homeland Security Presidential Directive
IAP - Incident Action Plan; Initial Action Plan
IC - Incident Commander
ICP - Incident Command Post
ICS - Incident Command System
IMAT - Incident Management Assistance Team
JFO - Joint Field Office
JIC - Joint Information Center
LEOC - Local Emergency Operations Center
LEPC - Local Emergency Planning Committee
LL - Lessons Learned
MACS - Multiagency Coordination System
MOU - Memorandum of Understanding
MRC - Medical Reserve Corps
NEMA - National Emergency Management Association
NFIP - National Flood Insurance Program
NFPA - National Fire Protection Association
NGO - Nongovernmental Organization
NIC - National Integration Center
NIMS - National Incident Management System
NLT - Not Less Than
NPG - National Preparedness Guidelines
NPS - National Planning Scenarios
NRC - U.S. Nuclear Regulatory Commission
NRF - National Response Framework
NTSB - National Transportation Safety Board
NWS - National Weather Service
OSHA - Occupational Safety and Health Administration
PDA - Preliminary Damage Assessment
PIO - Public Information Officer
RACES - Radio Amateur Civil Emergency Services
REPP - Radiological Emergency Preparedness Program
RRCC - Regional Response Coordination Center
RRP - Regional Response Plan
RST - Regional Support Team
RTO - Recovery Time Objective
SBA - Small Business Administration
SCO - State Coordinating Officer
SERC - State Emergency Response Commission
SLG - State and Local Guide
SO - Senior Official (elected or appointed)
SOP - Standard Operating Procedure
TCL - Target Capabilities List
TOPPLEF - Training, Organization, Plans, People, Leadership, and Management
TS - Tropical storm
UC - Unified command
USDA - U.S. Department of Agriculture
USGS - U.S. Geological Survey
UTL - Universal Task List
VOAD - Volunteer Organization Active in Disaster
VIPS - Volunteers in Police Service
WMD - Weapons of Mass Destruction