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Karnes County Mass Care and Shelter Coordination Operations Management Plan

Executive SummaryKarnes County Mass Care and Shelter Coordination Operations Management Plan

In Karnes County Mass Care and Shelter Coordination Operations Management Plan Project report we discuss about The Karnes County Mass Care and Shelter Coordination has designed plans and operational strategy focused on the provision of guidance for the coordination and maximization of resources in order to effectively support mass care and shelter operations across the states and to also ensure the total populations that seek this care and shelter services are adequately and appropriately served. This plan is an adaptable framework that can be actualized amid a wide range of incidents, paying no concern to its size and degree. The plan also enhances the proficiency and sustainability of shelter operations and asset utilization over the populace by the improvement of information collection through effective technological means and enhancing the regular operating picture identified with the actuation and operation of shelters.

Any emergency or incident that occurs requires many jurisdictions and agencies. There are various different response plans used to technically address specific response needs with respect to the traverse jurisdictional boundaries to span through. The plans and operational strategies followed in this content basically follow strict rules and adherence to the County’s EMP expected to help the states and any close jurisdictions in bolstering sheltering plans and strategies to better oblige people with functional support needs and services in any related sheltering environments.

Integrating the policies and practices of this document requires that the Karnes County establishes a dynamic plan that requires a periodical update with explicit supplement, local and facility based planning to ensure the objectives are met and the technology focused can be effectively implemented to further enhance emergency communication and mass care.

Karnes County Mass Care and Shelter Coordination Operations Management Plan: Introduction

After a thorough review and research on Karnes County’s emergency plan, there were many areas that we observed with loop holes, but we decided to dedicate our time to areas which we found severely in need of fixing. With all the issues and disaster faced by the Karnes County, the motivation to provide services beyond basic care and sheltering continually lingered and the people’s welfare became an important factor. This has prompted the goal to provide proper mass care and shelter plan.

The County’s sheltering operation is designed to address Mass Care and Shelter Plan which includes adequate detail and depth of planning that is intended to reach different areas effectively, guide decision making and coordination of the services, and also help people with disabilities. The plan revolves around the operational strategy to achieve the objectives and also the responsibility of the County and the limitations. For every operation developed in the plans and operational strategies, some awareness to avert impending dangers and also solutions are clearly stated in this document. To successfully achieve all these goals successfully and efficiently, a technology is put in place to communicate when emergencies occur. However, we are focusing on the Communications and evacuations/ mass care.

Annex C: Shelter and Mass Care

Mass Care and Shelter Plan.  As outlined in the County’s EMP, Karnes City Fire Chief is the lead for coordinating official for Shelter Operations (ESF 6) with coordination with the American Red Cross (ARC) to operate and manage shelters.  The primary operational document that guides mass care and shelter operations within the County is the Shelter and Mass Care Annex.  As the primary operational plan for mass care and shelter services within the County, the Shelter and Mass Care Annex should include adequate detail and depth of planning in the following areas:

  1. Scope of sheltering services provided by the County.  The Shelter and Mass Care Annex introduces operational strategies that the County will use to coordinate a county-wide response to events that have the potential to create a need for mass care services.  Notably, the plan narrows the scope of services that it addresses to only the following: temporary feeding, basic medical care, and other essential life support services.
  2. Assumptions or key considerations for mass care and sheltering.  Within the annex, the plan lists principles that guide the development of the mass care strategy.
  3. A concept or concepts of operations with specific guidance for conducting operations.  The level of detail and actionable guidance within the Shelter and Mass Care Annex is of notable concern as the concepts lack the substance needed to provide clear actionable guidance that is needed to meet the and support the objectives.
  4. Roles and responsibilities.  The roles and responsibilities are clearly defined on a task by task basis.  The plan outlines responsibilities for each position by outlining key elements of the position.  This is beneficial to see how each individual role ties into the larger picture.
  5. Command, control, and coordination considerations for mass care and shelter operations.  The command, control and coordination of mass care and shelter sites in the plan is clear, although not as detailed, it is easy to follow.

Overall this plan is adequate to guide the decision making and overall coordination of shelter and mass care services during an emergency or disaster within a shelter environment. Currently, the Mass Care and Shelter Plan does not contain a strategy or strategies for providing mobile or fixed site mass care services outside of a shelter site. This is an area for future consideration especially as it pertains to homebound people or incidents where the population requires some level of governmental support but not at reception centers/shelters.

There are areas for improvement within the Shelter Mass Care Plan specifically for people with disabilities and others with access and functional needs.

First, there is the potential for additional clarification around the process of identifying the accommodative services required at mass care sites. The operational strategy for reception center operation includes using registration and health services information and requests for affirmative accommodation to identify the services needed to ensure all are able to participate in the client briefing. However, there is a limited explanation of how visual aids are used and what it means within the plan to say “spoken and written information being the same”. Furthermore, the plan should include the other available services that are provided for people who are visually impaired, people who are illiterate, cognitively impaired, or people who do not speak English. Finally, the plan should outline the requirements that the City has set for interpreters, including ASL interpreters or Certified Deaf ASL interpreters and outline redundancy considerations if a certified interpreter is unavailable.

The plan does not include an operational strategy for conducting pre-disaster site assessments of mass care sites to endure compliance with ADA guidance such as the ADA Toolkit for mass care and shelter operations.

The list of accommodations and considerations when setting up and operating receptions centers is incomplete and vague. The plan would benefit from additional detail about defining access signage and interpersonal communication assistance. Additionally, there is no mention of way finding for visually impaired. The only accessibility specially mentioned is wheelchair accessible main entrance.

In the operational strategy to operate reception centers the plan does not address individuals using durable medical equipment, mobility devices, or other access and functional needs equipment and ensure they do not have any unmet needs. There is no detail and no reference to other detailed department-level SOPs that provide guidance or expectations on the interagency coordination process, the training or tools that  personnel has to access accessibility (checklist, survey), and the documentation and accommodations for unmet needs.

The operational strategy for reception center operations states that the ARC will provide basic mass care services and resources at the reception center, including; registration; feeding/hydration; comfort kits and/or basic hygiene supplies; and blankets during cold weather responses. However, the plan does not provide a detailed assignment to an agency or agencies to provide functional needs support services such as durable medical equipment or personal assistive services.

The operational strategy for reception center does not address the need for mental health intervention Shelter Officer or on-scene personnel should consider requesting staff. Changes to daily routines may trigger stress reactions. It is best practice to proactively request behavioral and mental health staff.” While it is agreed that it is best practice to be proactive and request behavioral and mental health staff, the plan should include language in this section. This section should state that when there is a fatality or other signs of stress, Shelter Officer will request BH staff. We also recommend that the plan should indicate that BH staff will automatically be assigned to a Reception Center when it is opened. The Reception Center has the greatest potential for seeing traumatic response to the event, as it is often the first opportunity disaster victims have to access mental and behavioral health resources.

The operational strategy for reception center operations states that the ARC will provide medical services and that PDPH MRCs does not currently have the capacity to support all no-notice events. No further plan is identified as to how medical needs, either acute or chronic are taken care in the Reception Center setting nor does it discuss how displaced individuals with chronic medical needs (ex. oxygen support) will be accommodated. It is not best practice to utilize EMS and healthcare services for individuals who do not have acute medical conditions or do not meet hospital or emergency criteria. However, if these medical needs are not accommodated at some point (i.e. individual runs out of the portable O2 supply), they may have deterioration of their condition that does require EMS services.

To prevent the unnecessary surge into the healthcare system and in order to allow individuals to maintain their health and independence, there should be a system within the Reception Center that identifies medical needs and has a process to ensure these medical needs are met. Either by prioritizing individuals who may be at risk for decompensation and getting them into the healthcare system or preferably by fast tracking them to smedical shelter or general population shelter where these needs can be met. This would require developing a triage algorithm or medical checklist to rapidly assess and transport individuals to the appropriate setting.

The plan does not appear to address wrap around services such as accessible showers, accessible toilets or handwashing stations or other services that consider access and functional needs (telephone banks that are brought in for calling out). There are no MOUs or cooperative agreements or with vendor lists for equipment, supplies (other than SNS medications), personnel services, and any other assets that may be needed.

Finally, the plan contains no information as to how personal assistive services will be accommodated in the shelter setting.

The County should evaluate the need for mass care service provision outside of shelter sites using fixed site or mobile service delivery. If these plans exist elsewhere, then the County should consider expanding the strategies contained in the Mass Care and Shelter Plan to include these options.

Each agency named in the mass care and shelter plan should develop adequate plans, policies, procedures, and tools to execute each assigned responsibility within the Mass Care and Shelter Plan and then develop the organization/staffing, equipment, training, and exercises to fulfill those plans.

The County should enhance information collection to include all aspects of access and functional needs and delineate the process for how this is done, what is done with information and how these FNSS will be provided.

The County should develop a pre-event operational strategy to address the assumptions, objectives, tasks, and assignments for the assessment of mass care sites that addresses the following elements:

  • Detail related to ADA accessibility and process for ensuring all facilities opened to the public are accessible.
  • Define criteria used to survey facilities.
  • If deficiencies exist, list deficiencies to be corrected.
  • Ensure all MOUs are up to date.
  • Develop a mechanism for requesting modifications to make facilities accessible.
  • Develop a quick check list to use when facility is opened to rapidly survey the facility again to ensure facility is still functional and meets ADA requirements.
  • Assign responsibility to shelter personnel to ensure facility remains ADA compliant during use and can identify deficiencies to be corrected.

The County should consider establishing a standard of not using a facility as a public shelter if it is not ADA compliant.

OEM should update messaging to contain language that all functional needs support services are available at shelters, not just durable medical equipment.

OEM should provide more specific detail as to how communication processes in the cease and vacate function ensures effective communication to people with disabilities and others with access and functional needs.

The Mass Care and Shelter Plan should provide additional detail as to how the City will provide functional needs support services in the shelter setting. Need to develop resource management plan (if not already in place) that details where these resources are located or if from a vendor how they are procured, how they deployed and tracked, how they are assigned, who is responsible for them when assigned, how they are replaced and demobilized.

The County should develop job aids to provide tips and processes for providing personal assistive services and identify and train the staff that will provide these services. If there are no specific assignments for personal assistive services then these service arrangements need to be developed and assigned, or if needed, MOUs/contracted developed to assure delivery of services.

The County should revise language in its plans to reflect how it will accommodate personal assistive services and not segregate those who require PAS to other facilities. Note: While it is recognized that the best scenario to maintain continuity of care is to ensure personal assistive services accompany an individual to the shelter setting, this does not equate to excluding someone from a general population setting because they do not bring their PAS with them.

The County should continue to work with American Red Cross and other support agencies to develop processes for securing functional needs support services and wrap-around services for shelter operations.

The County should identify community stakeholders (ex. people with disabilities or agencies that support disability populations) that can be involved in the planning process to determine the functional and access needs of the community.

The County should identify vendors and other entities (private sector partners, faith based groups, VOADs) that can potentially provide FNSS, including personal assistance services and develop contract/MOUs to ensure availability.

The County should identify local and regional governmental resources for acquiring FNSS and work with regional partners to coordination FNSS use.

The County should continue to develop a planning process for resource and asset allocation from other local and regional partners, including private sector partners, especially for FNSS and include these partners in the development of mass care plans, in trainings and exercises.

The County should examine this critical area of mass care management and build stronger and more robust case management services in the shelter setting.

The County should develop and detail the process for ensuring all necessary services for individuals to maintain their independence, health and other support services are in place when transitioning back to home. This includes home health services, access to medical and social services by accessible transportation, keeping utilities up and running, and providing access to social networks that assist with activities of daily living (ex. shopping, taking person to doctor’s appointment).

The County should bring additional case management agencies to the planning process as well as disability individuals or disability support agencies to identify specific needs when transitioning home and strategies for meeting these needs.

The County should Pre-identify housing that is ADA accessible and meets the needs of the specific disability or access/functional need and ensure set-aside availability for these housing locations.

The County should consider establishing criteria for ranking and prioritizing shelter activation based on facility capability and include that language in the Mass Care and Shelter Plan and the Compiled Shelter Matrix.

 

WARNINGS:

From 2000 to June 2015, a total of 118 severe weather events were cataloged by the National Weather Service for Karnes County (National Weather Service, 2015).  Of those 118, 21 would have been considered severe events requiring siren activation (Hail, Tornado, Funnel Cloud, and Severe Thunderstorm). Severe weather events are identified as the leading cause of death from natural and manmade disasters (Subcommittee on Disaster Reduction, 2000). Currently, 60% of the permanent population of Karnes County does not receive these notifications from outdoor warning sirens. These notifications in other parts of the country have been credited with saving lives and property (Subcommittee on Disaster Reduction, 2000) and “inadequate warnings are one of the primary factors contributing to the number of deaths and injuries caused by hazard events such as tornadoes”(Rodriguez, Diaz, & Aguirre, 2004). Karnes county emergency plan has identified four outdoor sirens covering approximately 40% of the permanent population of the county (plan). In fast acting events, outdoor emergency alert systems are the fastest, most efficient means to inform the public that a threat is imminent. The 40% coverage, combined with no other means identified for early warning, has shown itself as a major gap to excellence in the Karnes County Emergency plan. This section will provide multiple solutions for gap closure.

The easiest, yet least cost effective, solution to this problem is adding more sirens to the protection grid and upgrading the current sirens. A high powered, omni-directional siren with a 128-133 decibel output can be heard at 70db out to approximately 6200 feet away, or approximately 1.17 miles, using ideal atmospheric conditions (Sentry Siren, 2014). Current sirens, through the published information available through the Karnes County Emergency Plan, seem underpowered compared to more advanced omni-directional sirens or high powered rotational models. While 100% coverage of the county’s rural population may be financially unattainable, the public safety of most of the workers in the county should be referenced in the financial decision making. Most workers in the Eagle Ford Shale area are in rural areas of the county (Commission, 2015) many of which are outside or in modular buildings with minimal resistance to the elements. If the cost of the 100% upgrade is beyond the means of the county government, upgrading the existing sirens to high powered omni-directional sirens and the addition of 5 more sirens will protect an additional 55% of the population, bringing the grand total to 95% coverage of the permanent population. Just simply upgrading the existing network will cover 85% of the permanent population. See figure 1 with recommended locations which cover both the permanent population and covers the multiple RV parks and temporary housing facilities that support the migrant workers. Non-disaster preparedness grants are available from the Department of Homeland Security/ FEMA for Public Notification and Warning Systems, including sirens and IPAWS upgrades to assist in offsetting costs due to preparedness.  The locations were chosen with respect to public/ private land ownership, ease of access for preventative maintenance and repair, coverage of permanent and temporary worker domiciles, and power availability.

A new communication tool has been implemented in recent years with the rise of the Smartphone. A “wireless emergency alert” system has been put into place nationally and can be used by local jurisdictions for emergency alerts (Bush, 2006).   The alert is a simple text-like message of less than 90 characters informing members of the public of alerts issued by the president, imminent threat alerts, and Amber Alerts. The alerts are location specific, based on the local wireless communication companies identified cell towers for a local jurisdiction. This allows for targeted messaging to the public that is most affected. The system is not based on phone numbers- so a temporary worker assigned to the Eagle Ford oil fields, with a phone number from another area or state will still receive the message.   Many local jurisdictions have begun to use the system for weather related emergency messages (FEMA-IPAWS division, 2015). With this technology, the local EAS operator will request a wireless activation as well as their normal EAS protocol, if the National Weather Service has not performed the actuation already (FEMA, 2014). The use of wireless activation is controversial (Dresden, 2015; Mantle & Padilla, 2013), so the use of this feature should be limited to only the most dire/ rapidly developing emergencies if using this service at the local level. The requirement to use this technology at the local level is qualifying as a local alerting authority with the Integrated Public Alert and Warning System (IPAWS).   Karnes County is not an IPAWS authorized user as of October 2, 2015 (FEMA-IPAWS division, 2015). A comprehensive overhaul of the Karnes County emergency response software will be required to ensure functionality within the IPAWS-OPEN environment. This upgrade may be an opportune time to upgrade the sirens as noted above. This will allow Karnes County to be in local control this effective resource to protect the personnel who are unprotected by outdoor weather sirens. If Karnes County performs the required upgrades to software and siren hardware required to become an IPAWS authorized user, this gap will immediately be closed.

A relatively simple concept to implement would be a public awareness campaign regarding purchase and use of portable weather radios for all permanent and especially temporary residents of the county. While the Texas Department of Public Safety recommends key partnerships for a successful campaign (TX Dept of Public Safety, 2011), a more focused group could be the local RV/ Mobile Home Park and temporary housing facility owners/ operators. These permanent members of the community have a very direct interaction with the temporary members of the community through rent payments and, in some cases, living as neighbors.  A 1/3 letter sized handout that could be mailed with a rent bill or statement with the county’s campaign message to purchase and use a weather radio could be a sufficient front end campaign. Ideas from the Department of Public Safety literature could also come in handy of partnering with local hardware stores to run ad campaigns or have a pricing special on their inventory of weather radios. Additional resources for information dissemination partnerships could be the oil expedition companies themselves as they also have responsibility for safety of their employees.

EMERGENCY STRUCTURE:

The organizational structure of Texas’ emergency management team is standardized across the state. It is very similar to that of other states, with different names for the same position. At the top, the chief executive of the county is the County Judge, the highest elected official in county government. In addition to certain judiciary tasks, the county judge is responsible for civil defense, disaster relief and overall county welfare (TX Assn of Counties, 2015). All county department directors report to the County Judge in Karnes County, including the Emergency Management Coordinator (EMC).  The EMC in Karnes County has a staff of one emergency planner. The EMC becomes the Emergency Operations Center director when the EOC is activated. If the threat has only affected a town within Karnes County, the Mayor of the individual town becomes the Head of the emergency response organization, in lieu of the County Judge. The County Judge will then support the town Mayor as needed to assist.

The county has four levels of emergency response.

  • Level 4: Guarded (Blue) – Level 4 will be enacted when weather threats or other possible emergencies are forecasted in the next 24 hours.
  • Level 3: Elevated (Yellow) – Same as level 4, with a higher threat, but with no expectations of property damage or loss of life.
  • Level 2: High (Orange) – Threat that poses an expectation of loss of life or property and on a definite path to hit a populated area.
  • Level 1: Severe (Red)- The threat level is similar to level 2, however threat posed is imminent.

With each level, a page to county officials is made explaining the threat and the level. The Emergency Operations Center will be on limited activation at a Yellow threat and fully activated at Orange or higher. All reporting relationships to the County Judge are suspended when the EOC is in operation. The EOC Director is the center point of the structure, providing the County Judge with a single point person for execution of emergency duties (ANNEX N, Appendix 1, Tab A for the visual).

The emergency plan is very vague regarding their reliance on mutual aid agreements with other jurisdictions.  The plan is filled with “may need” and “Possibly” in regards to mutual aid. The county does not have a large amount of firefighting equipment nor sheriff’s office cruisers for deployment. Based on the list of equipment in Annex M, assistance would be needed for a small to medium scale evacuation. A mass care event would like require mutual aid, including medical flight resources, as there are only four EMS vehicles covering the entire county.

Conclusion

Achieving the plans and operational strategies proposed by the Karnes County requires the support of various agencies for required support, locally, tribally and even in the state level for the performance of mass care, shelter provision, and emergency assistance. Karnes County is designed to implement these programs to assist households and individuals majorly based for potential or related disaster incidents.

In providing mass care, Karnes County will effectively provide sheltering, emergency first aid, provision and collection of information, and distribution of emergency items. Karnes County is also responsible for the provision of emergency assistance and the document has proposed the necessary decisions related to providing assistance required by individuals, communities or families for immediate needs beyond the domain of the traditional mass care services and also providing other services which include reunification of families; the provision of aid and services; evacuation, emergency services, and sheltering; also the coordination of donated goods and services as well as the coordination of voluntary official help.

Human services is an important aspect that this mass care service specializes in and the plan includes the execution of disaster assistance projects to offer help to disaster victims recover their non-housing losses, including programs that buttresses the replacement of personal property, and help get disaster loans, crisis counseling and other disaster legal services as well as the federal and state benefits.

These would be achieved following all policies in accordance to regulatory bodies and a defined focus on the communication and evacuation as well as mass care.