EMS Under Fire?

First off, I’d like to give a greeting to all of you.  I’ve been absent from blogging for quite a few months now.  I spent much of last year working in New Jersey as part of a team managing waterway debris removal as the result of Hurricane Sandy.  It was a great experience and often challenging – but I had an opportunity to work with some outstanding people and do some good for the people of New Jersey.  I’m sure in future posts I’ll reflect on some lessons learned from that assignment. 

Since my return I’ve been spending time with family and getting my own business back up and running.  I’ve also re-started the pursuit of my graduate degree.  With all the writing I’ve been doing, I’ve found it challenging to get back into blogging, but have thought about it often.

Earlier this evening I had some inspiration in reading the most recent (January/February 2014) edition of Emergency Management Magazine, in which Jim McKay’s Point of View article (which I could not locate online) spoke about ‘Medics entering the warm zone’ during mass shootings.  This is a topic I’ve had some mixed feelings over for the last couple of months. 

While I understand the urgency to enter the area and save lives – which is the main goal of public safety – we’ve always been taught to do so SAFELY.  This new concept of EMS personnel entering a non-secure active shooter environment is in serious conflict with what we’ve been taught about responder safety.  Are we being too hasty? 

Most times I’ve seen this new concept referenced, it is noted that the medics are outfitted with ballistic vests and helmets and escorted by law enforcement.  A great idea – but is this equipment being made readily available to EMS?  Not to the folks I’ve been speaking to.  Most law enforcement don’t regularly travel with riot gear, aside from their ballistic vests which they usually wear when on duty.  Additionally, are there law enforcement resources available to escort medics so early on in a mass shooting incident?  Often times not.  It seems this concept is not well thought out. 

What about training?  Tactical medic classes have been available for the last few decades, but most medics are not trained as such.  I’ve heard of no movement in EMS training to include information on how to make entry into an unsecured shooting incident, or in law enforcement training regarding providing escort duty to unarmed EMS personnel.  In fact one of the only ‘doctrinal’ references comes from the US Fire Administration, although it doesn’t provide much information.  This entire concept, to be effective, efficient, and safe needs to be prepared for – planning, training, and exercises. 

I’m not alone among my EMS colleagues having experienced looking down the barrel of a shotgun when responding to a call.  It must be considered that responding to an active shooter is NOT that.  It’s much more serious.  I understand that this idea can save lives – but what happens when the first medic loses their life after making entry?  Let’s start with that thought in crafting this new approach.  A dead responder can’t save any lives. 

Infographic on Business Continuity After a Disaster

recoverydiva's avatarRecovery Diva

The folks at the CDC Foundation has prepared a really excellent interactive graphic. See this  Business Continuity infographic.

Since the Diva wanted to print it off and use it as a poster, the staff at the foundation were gracious enough to break it up into 3 pdf files so that it would print off.  If you want a copy of the 3 files to print, contact the Diva directly.

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Alan Weiss’ Weekly Morning Memo

From Dr. Weiss’ weekly e-mail to members…

This week’s focus point: The Boston tragedy demonstrated more than anything the basic goodness in people. Strangers helped others without hesitation. The requests of the authorities were accepted without whining or demands for exceptions. The capacity that we all possess to support, assist, and help others is extraordinary. Sometimes it takes trauma to highlight it, but the potential is there every day. It may be appropriate this week to think about donating time or money to a charity, coaching someone who needs help, or even giving someone a break trying to turn across traffic. We shouldn’t need catastrophe to bring out our true character.

Some great words to consider.

To my readers – sorry for my absence these last few weeks – I’ve been (and continue to be) on a disaster deployment. More to come!

Disaster Brokers

A brilliant and insightful blog post! A must read.

chrisrecovers's avatarRecovers

BCLC’s Richard Crespin writes about challenges in post-disaster corporate giving and local organizational efforts. Read the original article here. 

In eighth grade I had to pick an independent study project. It was the ’80s, the dawn of the Reagan Revolution, and it was cool to emulate Family Ties’ Alex P. Keaton (ok, maybe not cool, but cool enough for me), so I picked investing. This was before online brokers, before E-Trade, even before the Internet, so my dad took me down to the local Sears. That’s right. Sears. For some reason Sears had decided to offer financial services, so the local office of Dean Witter was squeezed between the lay-away desk and the lawn mowers.

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As I sat there, a kindly man in shirtsleeves and a tie explained capital markets. Brokers like him earned their money by knowing who wanted something (the buyer) and who had it (the seller). He served not only…

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In memoriam – Ape

Ape - Rest in Peace

Ape – Rest in Peace

Many around the nation are aware of the active shooter incident that occurred in central New York earlier this week.  This shooting occurred just a town east of where I live.

In this tragic event, four people, including an off duty corrections officer, were killed and two people were wounded.  As the incident came to a resolution, nearly a full day after it began, a special operations team entered a building where they suspected the shooter was hiding.  As the team searched the building, a Czech German Shepherd born on November 17, 2010 took point.  In the gunfire that was exchanged when the suspect was located, Ape, a K-9 member of the FBI since only February of this year was shot and killed by the suspect.

You can visit the Officer Down Memorial Page to pay your respects to Ape.

A Disasterous Trend: Cuts in Preparedness Funding

This post was initially inspired by an article from CBS News on funding cuts to disaster preparedness programs.  These cuts go further and deeper than the current sequester cuts we are now seeing.  These cuts are a dangerous and disastrous trend.  To quote the article…

“In fiscal year 2010, Congress appropriated $3.05 billion to FEMA for preparedness grants designed to strengthen “our nation’s ability to prevent, protect, respond to, and recover from terrorist attacks, major disasters and other emergencies, …. In fiscal year 2012, that appropriation was less than half that figure – $1.35 billion. The same trend could be seen in FEMA pre-disaster mitigation grants, which fell from $100 million in 2010 to $35.5 million two years later.”

Have all the terrorists gone away?  Has Mother Nature stopped having temper tantrums?  Have stupid people stopped doing stupid things?  I don’t think so!  So why the cuts?

Let’s put some things in perspective… On one hand, we do need to have a bit of fiscal prudence and restraint.  GAO reports have repeatedly shown that many state and local governments are simply not spending down the grant funds they have been allocated.  DHS grants are backed up several grant years with unspent funds.  That said, as we peel back the layers of the onion, there are certain facts that need to be mentioned.  Why aren’t they spending the money they have been given?  First, grant periods have generally been too short.  The most significant reason for this is the inefficiency of bureaucracy we live in.  Follow this trail… The federal fiscal year begins October 1st.  The budget gets passed at some undermined point around that.  DHS, along with all the other agencies, get their allocations.  They then need time to formulate their grant guidance for the funds going to states and locals.  By the time states see this grant guidance and their respective allocations it’s usually close to the end of the second quarter of the federal fiscal year.  States then have to formulate their own grant guidance as they pass through funds to locals.  All this bureaucracy delays the grant year about six months.  Recognizing that nothing could be done about the bureaucracy, DHS finally extended grant years only recently, giving folks a more reasonable amount of time to spend the money.

Another reason why grant funds are slow to spend is that in most cases the grantees don’t actually ask for the money, therefore they don’t have a budget prepared beforehand.  DHS distributes funds based upon a formula.  While an application exists, it’s nothing more than an afterthought and formality.  That leaves states and locals with a pile of cash and no plan on how to spend it.  Here lies the beginning of the breakdown in accountability.  Now most folks will say that it’s easy to spend money.  In government, not so much.  Especially when you consider a few factors: 1) every level of government has spending rules (accountability is a good thing, but that can get in the way of efficiency when RFPs have to be issued for darn near everything); 2) a great deal of equipment was purchased in the big push of funds immediately surrounding 9/11 – what else do we need?; and 3) grants are restricting what funds can be spent on (i.e. there are limits on personnel (salary) expenses, and the purchase of disposables and maintenance costs of equipment – which are of particular importance for exercises).

So governments don’t have a lot of time to spend the money and face a few obstacles in getting the money spent.  But how is this a factor of cuts?  One reason for these cuts is that Congress is seeing that states and locals have a lot of money left over going back several grant years.  Failing to realize the whys and wherefores of it all, they are simply giving less money (because, to them, it’s not needed – but nothing could be further from the truth!).  They are also looking to reduce spending overall, as the article cites, and that’s a hit that will impact nearly everyone.

Taking a look at the grantees, however, there are a few criticisms.  Better and more proactive fiscal planning needs to be implemented.  Costs should be forecasted out several years to better anticipate needs.  They may, sadly, have to trim programs and streamline operations (although most emergency management programs certainly are not living in the lap of luxury).  They also need to be more creative with the declining funds they receive, especially through partnerships and regionalization.  An area doesn’t need to be regarded as a UASI or Catastrophic Planning Zone to work cooperatively as a region, which should include some pooling of funds for collective projects.

What can be approached regionally?  Most preparedness efforts fit well into that category: planning, training, and exercising.  Think about it, you work with your neighbors all the time and disasters don’t seem to stop at the county line, so why not make your cooperation more effective and efficient?  In the absence of regional catastrophic planning, which most areas don’t need to do, consider planning for some credible worst case scenarios and cascading impacts such as flooding and mass care.  Obviously regional mutual aid planning is essential.  How about working with your public health partners?  What about the private sector – how can you strengthen your relationships with them?  Regional planning conferences are a good start!  Regionalized training is obviously a no-brainer and regional exercises are essential making sure that the planning and training are effective and to give folks an opportunity to practice what they have learned.  Lastly, speaking as someone who has experience working for government and as a consultant, in many cases it’s actually more cost-effective and easier to coordinate regional preparedness activities by hiring a consulting firm, some of which have proven experience and expertise in working with the multiple stakeholders that a regional effort would include.

As we face reduced funding, we have to be more creative, cooperative, and communicate specific needs on a regular basis up the chain of government.  If you are with county or local government, let the state know what your needs are.  And don’t just tell them once – be sure to repeat yourself – not in an annoying wintertime house fly kind of way, but when the appropriate opportunity presents itself.  Make sure that you show justification for your needs through after action reports and documented strategies and plans.  Ask the State to take these needs up to federal partners – and when you have the opportunity to speak with these federal partners directly, take advantage of it; be they representatives of FEMA or your local representative of Congress or US Senator.  Remember to be specific and cite the need.  Don’t complain but be direct.  With funding that emergency management programs simply receive without asking being on the decline, we need to be proactive about receiving funds.

Emergency management and, to a greater degree homeland security, have been fortunate to have a good deal of funding over the last decade.  There has been so much money, though, with such short time lines, that things haven’t been done as well as they should have.  Now is the time to re-tool and reexamine how we do business.  Conduct needs assessments to determine what should be focused on and build upon community partnerships.  Consider what the community as a whole – the citizens – are willing to help in preparedness; as well as the private sector.  Whole-community partnerships have perhaps never been so important as they are now.

How to Replace Five Common Vital Records

I was sent the following from USA.gov on Friday.  It’s a good reminder to keep copies of these documents so you at least have a starting point and can reference the registration numbers of each.  I also keep copies of my driver’s license and credit cards (all front and back).

From a business perspective, you should also consider what documents you maintain copies of.  What records are vital to you?  Are the copies up to date?  Are they stored off-site?

 

How to Replace Five Common Vital Records

Vital records, like birth and marriage certificates and military service records are often necessary to access a variety of government benefits and services. But sometimes life happens and those vital records go missing. Maybe they were misplaced in a move, were stolen or got damaged in a fire.

USA.gov has information to help you find copies and replacements of your vital records so you can apply for whatever benefits and services you need.

Birth, Marriage and Death Certificates

These records come from the states. To find a copy, you’ll have to contact that state office where the life event occurred. Find the contact information for state and territory offices that can help you.

Passport

Report lost or stolen passports to the State Department right away by calling 1-877-487-2778. To report and replace the lost or stolen passport, you’ll have to submit forms DS-11 and DS- 64 in person at a passport agency or acceptance facility. If you lose a passport, and then find it again, you won’t be able to use it to travel. You should return the lost passport and request a new one.

Military Service Records

You often need copies of military service records to apply for a variety of government programs available for veterans, like health care, retirement or education benefits. The National Archives keeps copies of all veterans’ services records, and you can apply online to receive a copy of yours or an immediate family member’s if they are deceased. If you prefer to mail or fax a request for your records, you can download form SF-180. You can also find out how to replace lost military medals and awards.

Social Security Card

If you can’t find your Social Security card, you may not actually need to replace it. As long as you know your Social Security number, you will still be able to collect Social Security benefits, get a job and apply for many government benefits and services. However, if you do want to replace the card, you’ll need to gather documents proving your identity and citizenship to mail or take to a local Social Security office.

Green Card

If you have a U.S. Permanent Resident (Green) Card, you may need to replace it if it was lost, stolen or damaged or if your name or other biographical information has legally changed since it was issued. You can easily request a new one online. If you’re outside the United States and have lost your green card, you should contact the nearest U.S. consulate or immigrations office before you apply online for a new card.

If you need help getting copies of other vital records like tax returns or school records, you can find the information you need to replace them at USA.gov.