Hurricane Response Pre-Scripted Sub Tasks

ESF #8 Prescripted Mission Assignments to HHS from FEMA

HHS has ESF #8 pre-scripted mission assignments in place with FEMA which provide mutually agreed upon language to expedite deployment of response assets and allow HHS to be proactive in moving personnel and equipment/supplies in anticipation of a declaration:

• Public Health Services
• Medical Care and Support
• FMS – Federal Medical Stations
• Personnel Augmentation at Existing Health Care Facilities
• NDMS Patient Evacuation
• NDMS (includes DMAT, VMAT, DMORT)
• Food and Product Safety Inspection
• Worker Health and Safety
• Behavioral Health Care
• Environmental Health -Hazard Identification and Control Measures
• Mortuary Operations Assistance – non-NDMS
• Veterinary Medical Support (Non-NDMS)
• Emergency Prescription Assistance and Medical Equipment Replacement
• Program (EPAP)
• Technical Assistance
• Activation to NRCC (Pre-declaration and Post-declaration)
• Activation to RRCC (Pre-Declaration and Post-Declaration)

ESF-8 Pre-Scripted Sub-Tasks

The following ESF-#8 Pre-Scripted Sub-Tasks represent potential requirements that may be sub-tasked by HHS to ESF-#8 Federal Partners and HHS operating and staff divisions.

 DHS/FEMA

• Establish and operate ashelter collocated with a Federal Medical Station at (location) from (Start Date to (End Date) to support non-medical care givers and family members accompanying patients being treated at the FMS.

 DHS/Coast Guard

• Request Coast Guard provide all weather rotary wing aircraft lift support from [Location Name] to [Location Name].  Capability must provide all weather, all terrain patient evacuation, search and rescue, hospital ship lifeline missions, forward surgical team transport, medical logistics re-supply, medical personnel movement, and disaster/humanitarian relief support.

 DHS/FEMA/LOG

• Provide, all non-medical logistic and base operating support for deployed medical personnel and support personnel to include food, shelter, fuel, ground transportation, and line item resupply for (location) from ( Start Date) to (End Date).
• Provide site preparations if required for deployed Federal Medical Station at (location).  Each site will be cleared and leveled to allow construction of the FMS
• Provide a National Medical Resupply system to ESF# 8 assets within one week following the deployment of the first FMS or NDMS asset. A system will be established in the affected area to insure the capability to fill requisitions within 24 hours of receipt.
• Provide [Base/Location Name] as a FEMA MOB center to support forward distribution of supplies / equipment to affected area. Provide billeting (barracks facilities are acceptable) and life support, to include meals and hygiene facilities, for  [Number]  personnel; marshalling area for up to  [Number]  trucks and trailers;  [Number]  sq. feet of covered storage; office and desks space for  [Number]  personnel; and  Materiel Handling Equipment (MHE)/lift capability to offload (type of supplies/equipment) from (type vehicles/aircraft).
• Provide (base name) as an Operational Staging Area to support forward distribution of supplies / equipment to affected area. Provide marshalling area for up to [Number] trucks and trailers; [Number]  sq. feet of covered storage; and Materiel Handling Equipment (MHE)/lift capability to offload [type of supplies/equipment] from [type vehicles/aircraft].
• Provide capability to conduct fuel distribution operations at [Number] different points.  Each point must provide the capacity to issue [Number] gallons of diesel fuel and/or [Number] gallons of unleaded gasoline. Fuel points must have appropriate nozzles to provide retail re-supply to first responders and commercial ground vehicles. Points must be operational [date/time] at [Location Name].
• Establish and operate [Number] Distribution centers for issue of emergency relief supplies for [Number] days.

 DOT

• Department of Transportation to provide on demand transportation to support federal teams and resources as directed by FEMA Region [Number] for Hurricane [Name].  Any tasks will include duration and cost estimate and POCs, and will be on a FEMA task order form.
• Provide rail and commercial air transportation for emergency evacuation of patients from hospitals and other locations as directed.  This evacuation also includes transportation from temporary hospital(s) staging areas, including airports.  All transportation requirements will be coordinated and directed out of (location).

 DOJ

• Provide security/police officers to furnish 24 hour security for Federal Medical Stations and medical base operating camps at (location) from (Start date) to (End Date).
• Provide police escorts for medical ground transportation, medical personnel teams, medical re-supply shipments, and points of medical evacuation at departure and receiving hubs.
• Provide security/police officers embedded with deployed Disaster Medical Assistance Teams (DMATs) to secure operations. 

 DOL

• Request monitoring of occupational health effects and injury to ensure the safety of federal responders providing are or otherwise rendering assistance at (Location) from (Start Date) to (End Date).

 VA

• Request VA provide available medical support augmentation to include (X#) of (specify types of physicians), (X#) of (specify types of registered nurses), (X#) of LPNs, and (X#) of (specify types of other ancillary or support personnel) for (facility) from [Start Date] to [End Date].  Request that VA identify available personnel within 24 hours, and coordinate transportation to ensure that these personnel arrive at [Location Name] within 48 hours.
• Request VA staff and operate a Federal Medical Station, to include the following quantities and types of medical personnel: (X#) of (specify types of physicians), (X#) of (specify types of registered nurses), (X#) of LPNs, and (X#) of (specify types of other ancillary or support personnel) to support patient care at [Location Name] from (Start date) to End Date).  Request that VA identify available personnel within 24 hours, and coordinate transportation so ensure that these personnel arrive at [Location Name] within 48 hours.
• Request VA provide (X#) VA Medical Center (VAMC) beds to care for (X#) displaced patients from   (Start Date) to (End Date).  Request that VA identify and report available VAMC  beds within 18 hours.
• Request VA provide assistance for procurement of medical items.  Support to include arranging for transportation and shipping from source to [Location Name].  Request that VA process the request through the VA National Acquisition Center (NAC) within 18 hours.  
• Request VA provide and staff available mobile health clinics to provide primary medical care for (X#) of patients at (Location) from (Start Date) to End Date).  Request that VA identify available mobile health clinics within 24 hours, and  coordinate their movement to ensure that these assets arrive at [Location Name] within 48 hours.
• Request VA activate FCCs in FEMA region(s) X, Y and Z.  FCC patient reception plans are to be implemented within 6 hours, including alert of patient reception teams (PRT).  Preparations are to be made to receive patients within 2 hours of notification of incoming patient evacuation missions.  All activated FCCs are authorized reimbursement of up to $10,000 per FCC for expenses related to preparations for patient reception.  Those FCCs that are notified of incoming missions necessitating PRT utilization are authorized reimbursement of up to $250,000 per FCC for expenses relating to the receipt, triage, disposition, tracking and transportation of patients.

 CDC

• Deploy epidemiological surveillance teams, two personnel per evacuation center, to monitor conditions with local and state authorities.  Objective is to provide guidance and implement procedures to reduce the possibility of disease outbreaks
• Deploy one, two person team from NIOSH to help coordinate workers safety recommendations and information dissemination.  Be prepared to deploy up to 6 teams to the affected area for a period of no longer than 60 days.
• Deploy personnel to provide technical support and expertise in the characterization of complex, unknown, and multiple-contaminant worker exposures. 
• Deploy _ Federal Medical Stations, in 250 bed configuration with medical supplies to support non-acute, non-surgical, non-traumatic, non-chronic patients for a period of no less than 72 hours.  Establish a medical resupply system to continue operations for a period not to exceed 60 days.
• Deploy up to six two person epidemiological teams in support of local and state authorities to monitor health care facilities.  Working with local authorities determine current status of health care facilities to conduct out patient treatment, inpatient treatment and surgical care.  Assist the facility and make recommendations to improve the capability.  Provide assistance for this requirement for no less than 60 days.
• Deploy up to 6 environmental health teams, two personnel per team to evaluate, make recommendations and provide assistance to reestablish water systems in the affected area.
• Deploy up to 6, two person environmental health teams to evaluate environmental conditions in the affected area.  Provide consultation and recommendations to improve the situation to return the area to normal, precautions to consider, information to the public on potential hazards.  Work in collaboration with local authorities and the LFA EPA. (chemical, radiation, sanitation, water quality, solid waste disposal)
• Deploy up to six surveillance teams, two personnel per team to conduct vector surveillance and make recommendations to local authorities for vector control measures and techniques.  Be prepared to coordinate aerial spraying.  Be prepared to conduct pre spraying population interviews and post spraying interviews.
• Deploy assets from the Strategic National Stockpile (SNS) and supporting personnel. For example, a 12-hour Push Package with team of subject matter experts known as a Technical Advisory Response Unit (TARU).
• Deploy epidemiology/surveillance teams to assess the public health consequences of the natural disaster, including risk assessment and available resources.
• Deploy up to 6,  two-person veterinary surveillance teams to support ESF-6 and ESF-11 authorities to evaluate, make recommendations and provide assistance to temporary shelters and existing veterinary clinical care facilities.  Determine if existing veterinary facilities are able to conduct routine out-patient and in-patient treatment and surgical care.  Assist the facilities and make recommendations to improve the capability.  Provide assistance to this requirement for a period not to exceed 60 days.
• Deploy up to 6, two-person veterinary public health surveillance teams to rapidly determine and report event-related morbidity, mortality, and environmental exposures of service and companion animals to the local Incident Command, and make recommendations for treatment and mitigation.

 FDA  

• To augment state and local staff, we request <number> FDA investigators (consumer safety officers) to perform inspections of establishments serving food at retail in <location> for conformance to appropriate food safety standards.   Such establishments may include restaurants, school and hospital cafeterias; day care center food service establishments, temporary shelters, among others.  This additional staff is requested to begin these activities on/about <date>; completion is expected to occur on/about <date>.
• To augment state and local staff, we request <number> FDA investigators (consumer safety officers) to perform sample collections of human and/or animal foods, human and/or animal drugs, biologics and medical devices for subsequent analyses.  This additional staff is requested to begin these activities on/about <date>; completion is expected to occur on/about <date>.
• To augment state and local staff, we request <number> FDA investigators (consumer safety officers) to perform inspections of pharmacies and other establishments offering human and/or animal drugs, biologics and medical devices at retail to assist in assuring such drugs, biologics and medical devices have been stored under appropriate conditions and are fit for use.  This additional staff is requested to begin these activities on/about <date>; completion is expected to occur on/about <date>
• To augment state and local staff and facilities, we request FDA analysts (including microbiologists, chemists, biologists and other disciplines as appropriate) to analyze samples of foods, drugs, cosmetics and/or medical devices for attributes, as necessary, to assist in providing assurance that these commodities are fit for use.  We request these analyses take place in FDA fixed site and/or mobile laboratories with staff and facilities available to begin these activities <date>; completion is expected to occur on/about <date>.
• To augment state and local staff, we request FDA investigators (consumer safety officers) with expertise in this area to conduct assessments (field tests) of facilities where diagnostic x-ray and mammography equipment are installed, to help assure the equipment is operating within acceptable radiation emission limits.  This additional staff is requested to begin these activities on/about <date>; completion is expected to occur on/about <date>.
• To augment state and local staff, we request FDA subject matter experts to address issues that impact whether human and/or animal drugs, biologics, human and/or animal foods, and medical devices are appropriate for use; and/or to provide guidance on what steps, if any, may be employed to restore human and/or animal drugs, biologics, human and/or animal foods and medical devices to a condition whereby they would be fit for use.  We request this expertise begin on/about <date>; completion is expected to occur on/about <date>.
• To augment state and local staff, we request FDA investigators (consumer safety officers) or other FDA staff with food safety expertise, provide training in food safety preparation, handling and storage to volunteers and/or other appropriate disaster response personnel.  This additional staff is requested to begin this training on/about <date>; completion is expected to occur on/about <date>.
• To augment state and local staff, we request <number> FDA investigators (consumer safety officers) to conduct inspections of establishments which prepare, pack or hold, human and/or animal food, human and/or animal drugs, biologics, cosmetics and/or medical devices to help to assure such commodities are safe, effective and/or otherwise fit for use.  This additional staff is requested to begin this training on/about <date>; completion is expected to occur on/about <date>.

 IHS

• The Indian Health Service (IHS) has a requirement to support the National Response Framework “Tribal Annex” with personnel to address public health and medical support for the American Indian/Native Alaskan (AI/NA).  To create the capability IHS will request Agency personnel to act as Liaison Officers at the Regional Response Coordination Centers (RRCC) and the Joint Field Office (JFO) location as appropriate. This additional staff is requested to begin these activities on/about <date>; completion is expected to occur on/about <date>.
• IHS will have a requirement to open existing Mobilization Centers (Nashville and Albuquerque) with personnel and prepare for the deployment of IHS Teams to support the AI/AN Community and other non-tribal communities. This additional staff is requested to begin these activities on/about <date>; completion is expected to occur on/about <date>.
• IHS will pre-stage Rapid Needs Assessment Team and Primary Care Task Force personnel in an effort to provide immediate engagement in the necessary response efforts in the AI/AN Community and other non-tribal communities. This additional staff is requested to begin these activities on/about <date>; completion is expected to occur on/about <date>.

 Human Services 

• Deploy Human Services Technical Assistance Team (s) that will operate within the State Emergency Management Agency. The teams are comprised of 8-10 SMEs in Federal, State, local, Tribal and NGO resources for the delivery of human services (e.g. CMS, AoA, OD, ACF, ASPR and HHS staff divisions). The team will coordinate with State, Local and other Federal agencies to identify how government programs can be flexed to meet the needs of the disaster victims, implement waivers and expedite new enrollments for Federal benefits needed as a result of the disaster.
• Deploy human services SME Assessment Team(s) to the JFO to make recommendations for linking affected population groups with the most appropriate resources for addressing their human services need.  The SMEs will support ERT-A and RNA to assess the range of at-risk population and human services needs.

 DoD

• Assistance Requested:  Hurricane Season 2007 Support – Patient Transport and Strategic Airlift (Rotary Wing medevac/lift support)

Personnel and lift are required (date)_________ at (location)____________ for (number)__________ days to (location)_____________.

DOD should be prepared to provide the capability to provide all weather, all terrain evacuation, shore to ship capability, medical personnel movement, medical logistics re-supply, medical regulating, and support to disaster assistance/humanitarian relief operations for an estimated ____________________(number) personnel.

Personnel will work in (uniform type)_____________.  All protective clothing, if required, and equipment will be provided by ______________(Agency/Department).

• Assistance Requested:  Hurricane Season 2007 Support - Patient Transport and Strategic Airlift (Ground Ambulance/ambulance bus transportation)

Personnel and vehicles are required (date)_________ at (location)____________ for (number)__________ days to (location)_____________. 

DOD should be prepared to provide the capability to move ______________(number) personnel by ground transportation with accompanying medical attendants to move and anticipated_________(number) of casualties.

• Assistance Requested:  Hurricane Season 2007 Support - Patient Transport and Strategic Airlift (Coordination, Medical Regulating and Tracking Support)

Personnel and are required (date)_________ at (location)____________ for (number)__________ days to (location)_____________.

Joint Patient Movement Teams (JPMTs) are required (date)_________ at (location)____________ for (number)__________ days to (location)_____________.

Aeromedical evacuation liaison teams (AELTs) are required (date)_________ at (location)____________ for (number)__________ days to (location)_____________.

Contingency Aeromedical Staging Facilities are required (date)_________ at (location)____________ for (number)__________ days to (location)_____________.

DOD should be prepared to provide the capability to coordinate lift-bed planning in support of all patient movement, provide medical regulating assistance, provide assistance in tracking the movement of all patient movement utilizing TRAC2ES to move ______________(number) patients/casualties from (location)___________ to (location).

• Assistance Requested:  Hurricane Season 2007 Support – Surge Medical Capability and Installation Support to Civilian Agencies

Provide DOD medical personnel augmentation to support staffing of a Federal Medical Station for _______________________________________________-(description of type of medical capability) approximately_______(number of personnel) and are required (date)_________ for (number)__________ days to (location)_____________. 

Provide a DOD Installation in the vicinity of (location)__________________ to serve as a federal logistical staging area and mobilization center, beginning (date)______________for (number)_________days, until (date)_______________.

• Assistance Requested:  Hurricane Season 2007 Support – Surge Medical Capability Support to Civilian Agencies

Provide DOD personnel augmentation capability for________ (description of type of capability – i.e. surgical, medical, nursing, respiratory, mental health) support specifically, in support of, approximately____________(number of personnel), _____________(minimum type of personnel) and are required (date)_________ for (number)__________ days to (location)_____________. 

• Assistance Requested:  Hurricane Season 2007 Support – Mortuary Affairs/Fatality Management Support

Provide DOD personnel capability for victim identification in support of the recovery and identification of remains,  _______________________________________________-(description of specific type of capability/personnel) approximately_______(number of personnel), and are required (date)_________ for (number)__________ days to (location)_____________. 

• Assistance Requested:  Hurricane Season 2007 Support – Blood    Supply/Distribution Support

Provide blood banking/distribution/supply capability to (Facility(ies) as required from (Start Date) to (End Date).

Assistance Requested:  Hurricane Season 2007 Support – Vector Control.  Provide vector control capability including aerial spraying  (location) as required from (Start Date) to (End Date).