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1/01/2012  
working on revision 10/10/2019


 






RECORD OF CHANGE  
CHANGE # DATE OF CHANGE DATE ENTERED CHANGES MADE BY:
(SIGNATURE)
#1 Oct. 20, 2003 Oct. 20, 2003 Tim Mahone
#2 Jan, 2006 March, 2006 R3 Group @ Retreat
#3 January 2007 R3 Group @ Retreat
#4 June 2008 June 2008 R3 Group @ Retreat
#5 December 2008 December 2008 Angela Woosley
#6 October 2010 October 2010 Angela Woosley after R3EPP meeting
#7 January 2012 January 2012 Region 3 Partnership meeting






 
 

SCOPE / ACKNOWLEDGEMENTS / DISCLAIMER
SCOPE: 
This plan was designed for use by hospitals within Region 2 and is supported by Emergency Management, Regional Hospitals and Public Health Departments within the Green River District Health Department authority.

• 7 EMA
• 7 EMS/911 – there are two services within Webster County
• 5 Hospitals – including an acute mental health hospital
• 1 District Public Health with seven county health centers
• 1 Comprehensive Mental Health Centers

For a total of 21 votes, with a quorum of 11.  
Chair will only vote in the event of a tiebreaker.

ACKNOWLEDGEMENTS:
The Region 2 Emergency Preparedness Partnership Response Plan was developed by Deaconess Henderson Hospital Henderson, Union County Deaconess Henderson Hospital, Ohio County Hospital, Owensboro Medical Health System, River Valley Behavioral Health and Hospital, Area 3 Emergency Management, area EMS Services and the Green River District Health Department under the guidance of the KY Hospital Association and the KY Department of Public Health.

DISCLAIMER:

The Region 2 Emergency Preparedness Partnership serving as the facilitating agency for Region 2 Area Hospitals, recognizes the need to assist and coordinate efforts among area hospitals to ensure a uniform response to community and individual hospital needs during a recognized complex mass casualty disaster situation which may be due to a natural or man-made event such as a weapon of mass destruction (WMD) that affects a partial or total community's ability to provide a safe and effective environment of care.  As such, hospitals within Region 2 area of the State of Kentucky have developed and agreed upon the following principles for responding to such a situation:

REGIONAL HOSPITAL PLAN APPROVALS
REQUIRES ANNUAL UPDATE
NAMES / SIGNATURES:

_____________________________________________________________ DATE: _____________________________
Bruce Begley
President (CEO) Phone #_____________________________
Deaconess Henderson Hospital (Henderson)


_____________________________________________________________ DATE: _____________________________
Patrick Donahue
Administrator Phone #_____________________________
Deaconess Henderson Hospital (Union)

_____________________________________________________________ DATE: _____________________________
Jeff Barber
CEO Phone #_____________________________
Owensboro Medical Health System

_____________________________________________________________ DATE: _____________________________
Gayle DiCesare
CEO                           Phone#____________________________
River Valley Behavioral Health

_____________________________________________________________ DATE: _____________________________
Blaine Pieper
CEO                                                            Phone #_____________________________
Ohio County Hospital

______________________________________________________________ DATE: _____________________________
Debbie Fillman
Director  Phone #_____________________________
Green River District Health Department

REGIONAL HOSPITAL PLAN APPROVALS
MISSION / PURPOSE

Mission:
To coordinate medical activities, efforts and resources of Region 2 health care providers in a crisis event; to improve the ability to provide emergency medical and emotional care, and treatment of casualties resulting from a natural or manmade disaster, including biological, chemical or radiological incidents that may occur as a result of war or terrorism; to help ensure the continued provision of routine emergency and medical care for the population in general.


Purpose:
To compliment each individual facility's Emergency Response Plan for the purpose of ensuring optimal utilization of resources and disaster support to the public health of Region 2. 


Health Care Providers in Region 2 have many responsibilities as a part of our routine duties.  Among these include the responsibility to react to and assist in possible scenarios of emergencies that could range from an extremely limited geographically isolated situation to a county, a district wide problem or could encompass the entire region.










 
MISSION/PURPOSE 
SITUATIONS:
Disasters, which result from natural or technological hazards, may occur in Kentucky at any time. Such disasters can vary in kind, geographic location, length of warning, number of casualties and requirements for recovery.  In addition, biological and chemical warfare have become a reality and must be prepared for.
  
Region 2 in Kentucky is exposed to many hazards, all of which have the potential to disrupt the community, cause damage and cause casualties.  
Possible natural hazards include:
• Floods
• Flash floods
• Tornados
• Winter storms
• Earthquakes
• Forest and brush fires 
• Drought.  
There is also the threat of war related incidents and terrorist activities using weapons of mass destructions involving:
• Nuclear (Radiological)
• Biological
• Incendiary
• Chemical or conventional weapons
• Explosives
Other disaster situations could develop from:
• Hazardous materials accident
• Major transportation accident
• Civil disorder.  
• Terrorist Incident  



ASSUMPTIONS


ASSUMPTIONS: 
It is possible that outside assistance will be available in most major disaster situations, and plans are being developed to facilitate coordination of this assistance. However, it is necessary for Region 2 to plan for and to be prepared to carry out disaster response and short-term recovery operations on an independent basis. 

The following assumptions may be made for Region 2:

• A major man-made, biological, technological, or natural disaster incident may cause an immediate demand for health care 
services in excess of normal demand.
• A disaster incident may threaten to or actually destroy or seriously damage a health care facility.  This may necessitate
          evacuation of patients or residents receiving care at that facility. 
• A disaster incident can give rise to emotional and psychological issues to both delivery service personnel and to the injured.
• A disaster incident can give rise to secondary sources of infection and disease if proper medical steps are not taken in time.
• There is a shortage of beds in Region 2 for treating burns, radiological contamination, and/or isolation needs.
• This plan may be activated in level of response and / or phases.













CONTROL OF PLANS / DRILLS / REVIEW PROCESS




CONTROL OF PLANS:
The chair of the Region 2 Emergency Preparedness Partnership will maintain control and security of the plans.


DRILLS: 
Within a 3-year period, the Region 2 Emergency Preparedness Partnership will utilize drill techniques as follows:
1. Tabletop Exercises: one annual.
2. Functional: sections of the plan will be tested hands-on during the three-year period.
3. Full Scale: with Region 2 Partnership
4. Exercise Schedule.

Region 2 Emergency Preparedness Partnership will comply with any directives from Center for Disease Control & Prevention (CDC), Kentucky Department of Public Health (KDPH) and the Kentucky Hospital Association (KHA) for exercises.

The Region 2 emergency Preparedness partnership has developed an officer position of Training Coordinator/Resource Tracking.  It is this person's responsibility to acknowledge training needs within the region, help communicate upcoming trainings, help utilize resources for exercises, drills, etc. and keep partnership informed.

Within this regional group is an established Regional Training Coordinator (RTC) funded by Green River District Health Department.  The RTC will assist in the execution of any exercises developed by the partnership or directed by state/national agencies.

PERIODIC REVIEWS:  

A formal revision will be done annually.

 
ACTIVATION OF RESPONSE PLAN


ACTIVATION LEVELS:

A. Advisory Level:  This level may be activated when symptomatic trends and / or information from sources has resulted in an increased need to communicate among facilities regarding a heightened level of surveillance and awareness.  This level may last 24-48 hours and may be expanded as needed.
B. Partial Activation: This level is activated prior to lab and or other confirmation of a Mass Casualties Incident.  This level of activation is determined by the affected facility / facilities which will determine the sections of this plan needed to respond to the situation.  
C. Full Activation: This level is activated by the confirmation of a Mass Casualties Incident resulting in the need for the activation of the complete Health Care EOC / County EOC and the implementation of the Region 2 Emergency Preparedness Response Plan.

Note: Any level of activation could result in an expanded level of activation.
                       
 
COMMUNICATION NOTIFICATION PROCEDURE DURING A CRISIS SITUATION

Local Health Department would be notified through the Emergency Management notification system, the Health Alert Network, State Agencies or Local Health Care Providers.

METHODOLOGY:
 
1. Landline phone systems

2. Cellular phone systems

3. Green River SatCom System: incorporates 21 SatComs in the seven counties; installed in hospitals, health centers, ambulance service/ dispatch centers, Emergency Operations Centers, mobile applications are being utilized but may be packed and ready to respond.

4. Miscellaneous hospital-based systems (i.e. Fast Command, CANOPY)

5. Health department can utilize “Blast-Fax” capabilities if possible.

6. E-Mail / Internet Sources

7. Amateur Radio Network (i.e. HAM)

8. Runners (if necessary)

9. Region 2 hospital communications state-wide bed and patient tracking systems utilizing WebEOC.

10. Region 2 has a unique website:  www.greenriverdistrict.com or greenriverdistrict.org

11. WebEOC

12. GETS (both landline and wireless)

13. CANOPY – this system allows inter-agency data communication.

14. Voice Over IP – works in conjunction with the CANOPY system

15. Health Alert Network (HAN)

NOTE:  In the event that mass communication system REMAINS ACCESSIBLE, the affected agency shall notify the proper agencies or designate an agency to do so for them.  If mass communications BECOME UNAVAILABLE, agencies will revert to a daisy-chain method using the following call tree: 
Note:  Any agency may contact any portion of the tree at any time deemed necessary.
 
COMMUNICATION NOTIFICATION PROCEDURE DURING A CRISIS SITUATION FLOWCHART
















 
COMMUNICATION NOTIFICATION METHODS DURING A CRISIS SITUATION

Information Tracking (Communication)

   Electronic Bed Tracking
WebEOC is widely available with limited use. This system may be utilized for determining bed status, operations of the Emergency Department of patient tracking.  It is being drilled by KHA with R2's involvement  routinely..

  Monitoring of Emergency Department & outpatient visits:
Currently only labor intensive manual monitoring is being done, and that electronic surveillance programs are currently being investigated by the state.

  General Public Education:
In conjunction with the establishment of the Green River District Health Department's EOC there will be a Joint Information Center (JIC) established   with Public Information Officers (PIO) from each of the hospitals, the District Health and Emergency Management. The JIC will release any/all public health information notifications.
With the establishment of joint information centers and EOCs communication will be released through this establishment.

  Public Relations:
With the establishment of the Green River Emergency Operations Center the Joint Information Center (JIC) will develop a release to keep the public and media notified as to the incident. Red Cross representatives will assist in setting up reception areas for family and friends. Information will be released through the ICS, EMA (EOC), and the PR representative in this order. 
Region 2 partnership has one representative PIO.
  *  CANOPY
CANOPY allows the Regional Partnership to be able to communicate data without the need for outside internet.  This is yet   another method for communicating bed availability, resource needs/sharing, etc.

 
HOSPITAL NOTIFICATION NUMBERS DURING A CRISIS SITUATION



Directory being established.




























PUBLIC HEALTH NOTIFICATION NUMBERS DURING A CRISIS SITUATION

GREEN RIVER DISTRICT HEALTH DEPARTMENT CONTACTS

Green River District Health Department Communication Chain of Command:
District Office: Director    270-686-7747
Environmental Director/Deputy                     270-686-7747 ext. 3064
Director of Nursing 270-686-7747 ext. 3062
Support Services Director 270-686-7747 ext. 3060
Director of Finances/IT 270-686-7747 ext. 3053

Local Health Departments:

Daviess County 270-686-7744
Henderson County 270-826-3951
Webster County 270-639-9315
Union County 270-389-1230
Mclean County 270-273-3062
Hancock County 270-927-8803
Ohio County 270-298-3663
GRDHD District Office 270-686-7747
24/7 1-800-928-7123 or 270-686-8123 after hour answering service who contacts on call supervisor

 
EMERGENCY MANAGEMENT NOTIFICATION NUMBERS DURING A CRISIS SITUATION

Region 2 Emergency Management Contacts
AREA 3 EMERGENCY MANAGEMENT AGENCIES
EMA Directors

Daviess Co. Director Office (270) 685-8448 Ohio Co. Director Office (270) 298-4400
Fax (270) 685-8464 Fax (270) 298-4408
24 Hour # (270)-685-8448 24 Hour # (270) 298-4411/4413

Hancock Co. Director Office (270) 927-1310 Union Co. Director Office (270) 389-3975
Fax (270) 927-1313 Fax
24 Hour # (270) 389-0406
24 Hour # (270)-927-8200 (270)-389-4357

Henderson Co. Director Office (270) 831-1235 Webster Co. Director Office (270) 667-6255
Fax (270) 831-1250 Fax (270) 667-2424
24 Hour # (270)-827-8700 24 Hour # (270) 667-2011
(270) 639-5012

McLean Co. Director Office (270) 273-3235 Area 3 Manager Office (270) 889-6004
Fax (270) 273-3236 Fax (270) 889-6005
24 Hour # (270)-273-5213 24 Hour # (270) 792-1704

State Duty Officer 1-800-255-2587

Note: Numbers are subject to change. Note:  Emergency contact  (911)
 
SECURITY PROCEDURES DURING A CRISIS SITUATION

SECURITY: 

1. Level of activation will be determined by the nature or intensity of the event and its effect upon an individual agency.

2. Member agencies will follow the National Incident Management System (NIMS).

3. Each facility has in place “lock-down” procedures / policies that would go into activation.

4. Member agencies should provide signage/plans for alternate entry procedure.

5. Security personnel will be posted if needed/possible

6. Agencies will provide emergency measures to secure and control air intake and exhaust systems.

7. Identity of responding agency representatives will be verified before they will be admitted for service.

8. Member agencies will confirm professional credentials as needed, according to their established procedures.

9. EMA is to maintain current MOA's with community resources. 

10. Agencies may be required to utilize distance barriers or heavy equipment to prevent unauthorized entrance to property. 





 
EDUCATION / PUBLIC RELATIONS DURING A CRISIS SITUATION

EDUCATION AND PUBLIC RELATIONS:

Public health education programs will be activated as needed during an emergency event.  Designated staffs to implement educational programs are as follows:

• Green River District Health Department will be the lead agency in addressing disease issues and providing educational materials for both local health care providers and the general public.
• Green River District Health Department will be the coordinating agency working with each facility's public relations personnel regarding disease issues.
• Hospitals will be lead agencies in addressing patient information and issues relating to their facilities.
• American Red Cross will be assigned the task of addressing patient information off-site for family members of those in ARC shelter operations.
• RiverValley Behavioral Health will supplement staffing for the Kentucky Community Crisis Response Board through the auspices of the American Red Cross.
• Green River District Health Department, in conjunction with the appropriate Emergency Management agency, will coordinate Special Medical Needs Shelters.
• Ideally shelters of both types – general population and special needs, could be co-located to share valuable resources.
• A  Joint Information Center (JIC) will be established as quickly as  possible for regional events.  
• Region 2 has developed a PIO subcommittee with representatives from each of the agencies involved wit the partnership.

Each facility will assign a staff member to track patient identification, patient information and patient location.  It will be the responsibility of this assigned staff to provide updated patient information to American Red Cross on a regular scheduled basis.

American Red Cross Contact Information:

Cardinal Chapter         Big Rivers Chapter                     Louisville Chapter
300 Cetner Street                       416 W. 3rd Street      510 East Chestnut Street
Henderson, KY  42420                       Owensboro, KY  42301      Louisville, KY
270-826-2775         270-683-2438      502-561-3642
County Served: Union & Webster         County Served: Daviess,      County Served: Ohio*
Henderson         Hancock, McLean
www.redcrosscardinal.org                       Ohio*
        1-800-621-4982
       www.bigriversredcross.org
Ohio County residents in need of shelter have a choice of any shelter in any county.
Disaster victims needing financial (or similar) assistance must go through the Louisville Chapter.
volunteers can be members of the chapter of their choice.

NOTE: Education program are in the process of being developed by Green River District Health Department and the implementation process will be added to the regional plan at that time.  Plans are also in development to implement a region-wide community educational campaign prior to an actual event.
 
MEDIA CONTACT NOTIFICATION DURING A CRISIS SITUATION


The following media avenues will be utilized to provide information regarding the event and regularly scheduled updates.

Media Avenues:
Resource Listing Attached

• Local TV stations
• Local Radio stations
• Closed-circuit TV systems in facilities
• Region 2 Website:  greenriverdistrict.com or .org
• Community Outdoor Warning Systems or COWS as activated by local EM director
• Emergency Alert System (EAS)  as activated by local/regional EM via the National Weather Service
• On-Call System
• JIC/PIO


Media Notification Numbers:
Resource listing Attached.

• Media contact will be made through either the Incident Command System (ICS) or Emergency Operation Center (EOC) in charge of the event.
• All contact should be made with the designated Public Information Officer (PIO) of the ICS or EOC using a properly formatted Emergency Alert Message.
• Any information to be given out will only be by the PIO representative of the Agency in charge of the event. 
• Information distribution will utilize the Joint Information Center when established.



 
PERSONAL PROTECTION EQUIPMENT PROCEDURE DURING A CRISIS SITUATION

PERSONAL PROTECTION EQUIPMENT: 

• Personal Protection Equipment (PPE) is available for responding clinicians at each facility. Inventory of PPE is adequate for Routine Daily operation. However if an Event involving a Bio-Terrorism the situation might require additional supplies of PPE within 24 hours of recognition of an occurrence.  Region 2 Emergency Preparedness Partnership currently has stocks in the Owensboro Riverport Authority for equitable distribution among the district.  Officers in conjunction with Emergency Management may release the warehoused stocks.
• Each Facility and Response Agency is responsible for providing for family care and well-being during an event
• PPE guidelines are posted in each facility.
• Depending upon the function of the member agency, equipment inventory should include an adequate supply of:
 Gloves
 Masks
 Face Shields
 Gowns
 Sharps Safety engineered equipment and containment
 Respiratory protection
 If additional equipment is required, the local Emergency Management Agencies are available to support & supplement the member agencies.
 If the magnitude of the event warrants, the Strategic National Stockpile may be requested through District Health by calling 1-800-928-7123 or 270-686-8123.

PROPHYLACTIC TREATMENT:

Facilities have the capability of providing short-term antibiotic prophylactic treatment for each staff. Plans would be activated as needed in the event of a Bioterrorism exposure/event.
 Plan includes making available prophylactic treatment for staff family members.
 The future goal is to provide for short-term antibiotic prophylactic treatment for the affected staff's immediate family. (Pharmaceutical caches being developed by state assigned committees)
 In the event of a large scale disaster, a request for the Strategic National Stockpile (SNS) would be placed by Green River District Health Department District Director to the Kentucky Commissioner of Public Health who would in turn contact the Governor to request the SNS if deemed necessary.
 In the event it is deemed necessary to vaccinate for Smallpox, Green River District Health Department would activate the Post-event Smallpox Vaccination Plan.


 
DECONTAMINATION PROCEDURE DURING A CRISIS SITUATION



DECONTAMINATION:

• Incident Command Officer would be the responsible party to initiate, notify and coordinate gross decontamination procedures in the event of an emergency.

• Emergency Management Agencies maintain a list of local emergency decontamination capable agencies. Resources are available through Task Force 3.

• These capabilities would be utilized under the direction of Emergency Management.

• Each facility has some capability to provide decontamination on site.  Plans are in place to activate the decontamination process and would be determined by the event at each facility.  Increasing that capability will be an ongoing priority utilizing acquired funding. 

Kentucky has a regional response system with 14 teams to provide response to hazardous materials and WMD events.
Task Force 3, a Green River Regional Response team, has developed a capability to provide decontamination for up to 500 people.
 

ISOLATION CAPABILITIES DURING A CRISIS SITUATION

Isolation:
 
1. There are 41 isolation / negative pressure beds available in Region ?.  Facilities would utilize available beds until maximum capacity is reach. 

2. Facilities would follow CDC guidelines for transmission based precaution procedures.

3. Triage and ambulatory patients exceeding facility capacity will be diverted to other acute care facilities that have not met surge capacity.



 
QUARANTINE PROCEDURES DURING A CRISIS SITUATION


QUARANTINE

NOTE: KRS 214.020 states: when the Cabinet for Health Services believes that there is probability that any infectious or contagious disease will invade this state, it shall take such action and adopt and endorse such rules and regulations as it deems efficient in preventing the introduction or spread of such infectious or contagious disease or diseases within this state, and to accomplish these objects shall establish and strictly maintain quarantine and isolation at such places as it deems proper.


1. The State Epidemiologist will serve as the coordinator of isolation or quarantine activities in the event of an outbreak in Kentucky. Local and/or state statutes regarding public health authorities for isolation and quarantine of potentially infected and incubating persons shall be followed.
2. When necessary, federal public health statutes for the control of infectious diseases may be enacted to assist local and state authorities in implementing the necessary outbreak control measures.
3. In the event of a Smallpox outbreak, symptomatic contacts will be placed under surveillance for symptoms at their home or in designated areas for 14 days after successful vaccination.
4. A state of quarantine will be instituted only as a last resort to control a smallpox outbreak situation when other previously listed containment measures have failed or are falling behind the accrual of new cases.
5. KY laws establish adequate authority for the Governor to institute quarantine measures at local, county, or state level in a declared emergency.
6. If quarantine is indicated, the governor of Kentucky, in consultation with the Secretary of Health, Commissioner of Health and the State Epidemiologist, as well as federal authorities, will be responsible for declaring this state of emergency and marshalling resources to implement the quarantine plan.

NOTE: Specific locations of isolation/quarantine will be determined by public health authorities and will be based on the events that precede such an occurrence.  Local Public Health and Emergency Management will act, as liaisons, to identify sites that meet specific need under the direction of the state public health authority.

 
SURGE CAPACITY PROCEDURES DURING A CRISIS SITUATION 

       Surge Capacity

Notification process of a potential surge event would be activated by the responding agency.

1. Green River District Health Department's DOC, would be activated after notification by the initial responding agency. 
2. Hospital facilities would activate plans to begin the process to determine early discharge, as well as initiating communication between each hospital in the region and if necessary other region within the Tri-State area.
3. Hospitals would activate plans to call in additional staff as needed.
4. Each facility has MOA's for Diversion and will be evaluated and reviewed annually. The facility Diversion Plan or Procedures will be activated and coordinated with the County EOC. EMSystems will be used.
5. Green River District Health Department will provide and update regional (MRC) medical volunteer database as needed. Which will coincide with the state database, ESARVIP.
6. Area Emergency Management agencies will provide and update Community Emergency Response Teams (CERT) database as needed.
7. Hospitals would activate plans to develop areas for additional beds/cots as needed. Approx 129 Medical and 12 Mental Health beds with the ability for additional beds – 250 with ACS and 25 in state surge trailers.
8. Hospitals would activate plans with medical suppliers to obtain needed medications/supplies during the event. 
9. Plans will be activated to begin the process of transferring stable patients to Medical Facilities or other hospitals/health care facilities outside of the affected area. Initially Consideration will be given to the usual referral sectors.
A. Decision will be made by County EOC responsible for designating facilities for shelters, which may be utilized for surge bed capacity.
B. Tracking of patient identification and information will be assigned to designated staff from each facility. 
C. Designated staff at each facility will also be responsible for tracking bed status and will provide this information on a regular scheduled basis to the County EOC. 
10. Hospital Emergency Administrative Radio System will be utilized to provide rapid communication to EMS units to allow them to determine a destination immediately.  
11. Surveillance information from Emergency Departments, Urgent Cares and incident site triage center will be shared with the County EOC for the distribution of available equipment, bed capacity and the diversion of non-critical / ambulatory patients to established locations off site of the facility.
12. Each facility has in place plans in accordance with Joint Commission and/or State Licensure for the accommodation of special needs populations.  This plan would be activated by each facility as needed. (See Provision of Care Policy)
13. Each facility will coordinate interpreter services according to facility requirements. 
14. Upon the request of OMHS, RiverValley Behavioral Health Hospital will provide inpatient treatment for adult psychiatric patients per MOA/MOU..
 
ESSENTIAL SERVICES PROCEDURES DURING A CRISIS SITUATION
Note: EMA will coordinate needed resources such as transportation, equipment, manpower and other needed essentials during a 
         declared event.

ESSENTIAL SERVICES
1. Each facility will have in place MOAs and plans with the following agencies to provide back-up essential services if needed.
2. Each facility will activate plans to request delivery of additional supplies and set forth thru MOA's. Transport and needed resources are through the EMA / EOC.
3. American Red Cross may be utilized to provide shelters and other supported services as needed.
4. Each EMA region and the EMA within the community will be activated for resource mgt. 
5. Each hospital has in place contingency plans to maintain essential services, utilities, and resources.
6. Each EMS Service has Mutual Aid Agreements fro the assistance, response and need for equipment.  The responding services have GPS units in each ambulance for Mutual Aid response (used for locating addresses and latitude/longitude during MCI/Disaster response).



 
MEDICAL WASTE / BURNS/ MASS CASUALTY/ NATURAL DEATH SURGE PROCEDURES DURING A CRISIS SITUATION


EMS Services within Region 2 have established a standard triage tag system that will be utilized throughout the region.

MEDICAL WASTE:

1. Medical Waste created by a surge event would be disposed of according to facility procedures.  In the event normal procedures for the disposal of medical waste are not an option, then each facility would activate “Bag and Contain” procedures.  Waste would be contained in a secured area of each facility until disposal is possible. 

2. Emergency Management would be notified of the need for the expedient and safe disposal of medical waste that will be generated at each affected facility from the emergency event.

                        BURNS:

1. All agencies within the Region 2 areas will function to the best of their capabilities in the care and treatment of burn patients.
2. It is known that current capabilities are limited with severe burns.
3. Area hospitals may transfer burn patients in accordance with the attending Physician's wishes and regional capabilities. This includes all types of burns.
 

MASS CASUALTY:

1. Mass Fatalities 
A. Each agency will utilize facility morgue capacity.  Cold Body Storage units are being made available to each acute care hospital within Region 2.

B. Each County Emergency Operation Plan (EOP), along with the county Coroner and their plans, have in place pre-designated alternate morgue sites to be utilized once facility capacity is reached. This plan is activated and coordinated by the County Coroner who has a representative sitting in the EOC when the EOC is activated by the EMA during an event and is a part of the planning.

2. County Coroner and/or Emergency Management will activate plans for refrigeration units/trucks if needed.

3. County Coroner will request DMORT if needed through state and local EOC if necessary. 
    
                       NATURAL DEATH SURGE:

                       A.  Central Collection
1. Region 2 will have two Central Collection Points for the dead humans in an event of large magnitude such as a 
pandemic.  These two collection points are:  Glenn Funeral Home – Owensboro, KY and Benton-Glunt Funeral Home and Tapp Funeral Home (co-owned) - in Henderson, KY.
2. Region 2 will have located in both Daviess and Henderson Counties, two Family Assistance Centers.  Current 
Discussions include use of the Community Colleges (located in Owensboro and Henderson) and local churches to assist with these operations and counseling.

                      B.  Transfer Plan
                       1.  Resources throughout the region will be utilized to transport the deceased to the Central Collection Points relying 
                            heavily upon those funeral homes closed during the pandemic.
                       2.  Use of a dispatch system for transport is being discussed.

                       C.  Burial Plan
                       1.  Two dedicated areas will be stipulated by city/county governments during a pandemic.  These will be the burial sites 
                             for all deaths during this timeframe.  One site in each county:  Daviess and Henderson unless more are needed.
3. GPS and locator chips will be used with a pre-diagramed layout of the area to be used for body identification and
                             tracking.
                       4.  Patient Identification Tubes will collect demographic documentation and place with each dead body.


 
RECOVERY PHASE AFTER A CRISIS SITUATION


RECOVERY:

Once the emergency event has been determined to be under control, Region 2 will begin to recover from the activation of this regional plan with respect to the following areas:

A. Communication: The Green River District Health's DOC in consultation with County Emergency Management, local and state authorities will communicate to affected facilities the need to begin recovery from the activation of this plan and to return to a normal state of operations.

B. Facility Decontamination: If necessary affected facilities will activate plans to decontaminate facilities as needed and to begin the process to allow facility employees and civilians to reenter facility once decontamination has been completed.

C. Patient Retransfer: Affected facilities will activate in-house plans for the retransfer of patients to the facility of origin prior to the activation of this plan.

D. Mental Health Counseling: Services will be available for access by both staff, responders and the public as outlined in each County EOP.  The Kentucky Community Crisis Response Board working through the American Red Cross as supplemented by RiverValley Behavioral Health will provide staff for Crisis Interventions.
E. Region 2 defines first responder as: Anyone who can arrive on-scene for event.
F. Lessons Learned: Once the situation is stable, a lessons learned/critique process would be conducted for affected facilities. If the event required Emergency Management involvement, then Emergency Management would be the coordinating agency for the critique process regarding the Regional Plan.  Each facility has plans in place to conduct an internal critique process. Suggested critique changes may be presented to the Region 3 Partnerships for approval and implementation of the plan.  A written After Action Report (AAR) will need to be completed and submitted to the partnership and to state officials.

 
RECOVERY PHASE AFTER A CRISIS SITUATION
CONTINUED



Food & Water:

Member agencies will be capable of meeting all needs for 72 hours. KY Emergency Management
 will coordinate additional logistical support 

Radiological Patients:

The regional members should expect to handle 150+ radiological patients; existing decontamination and surge plans will be utilized

Communication:

During crisis events, Regional members will utilize the communication notification procedure.






 

APPENDICES


Region 2 PIO numbers

Brenda Dossett, Chair
270-827-7160

CeCe Robinson
270-298-7411

Pam Moran
270-827-7161

Gordon Wilkerson
270-688-2175

Lisetta Whitworth
270-852-5587

Mary Kay Lamb
270-689-6500

Bob Walters
812-433-5557


Angela Woosley
270-852-5480

Don Crask
270-852-

Brad Ayer
270-860-8250

Barbara Taylor
270-688-2177

Sandra Arison
270-927-1310

Larry Koerber
270-831-1235

Lora Wimsatt
270-852-7700

Beck Glenn
270-926-0123