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. 

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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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.

The Century Mark

This is my 100th blog post!  To celebrate the occasion I’m going to stray from my regular format to reflect a bit…

I feel quite accomplished by this.  Many bloggers never reach this mark, some have surpassed it – even quicker than I did.  Certainly many have a bigger following than I do, but mine has steadily grown through these months (thank you!).  While I’ve not blogged every day (it’s been about a week since my last post), there were some days when I posted two or even three times.  If you are a regular reader, you know that most of my posts revolve around emergency management and homeland security topics and some discuss training and presentations.  I enjoy sharing what I find and what I have learned.  Sometimes it’s a quick post, linking to an article of interest or reblogging someone else’s post that I found fascinating.  Other times it’s something more in-depth.  I’m proud to be one of WordPress‘s top emergency management bloggers and I’m humbled by the company I keep.

Gold TrophyIn my time, WordPress’s ‘Freshly Pressed’ designation has eluded me, but I’m confident I’ll reach it some day (how is that determined, by the way?  I want to know!!!).  For my readers who aren’t familiar, the high gurus of WordPress select a few posts each day to be highlighted on their Freshly Pressed (commonly ‘FP’) page, which brings in literally hundreds of readers.  It’s a great way for a blog to gain long-term visibility.  It’s pretty much the Oscar of blogging… the Bloggy… is that a thing?  Wait… OK, just looked into that and it actually is!  www.bloggyaward.com.  Who knew?  Obviously not me!

My path to blogging started on May 19th of last year with Reinvention 101.  This first post was about an article in Entrepreneur.com of that same name.  The article reflected on Robert Downey, Jr‘s rise to a greater level of success than he previously had before making some poor choices in life.  In the article, they outline his progress through five important life lessons as he picked himself up, dusted off, and moved on to greater things:

1) Concentrate on getting ahead one step at a time;

2) Don’t be too proud to accept help;

3) Believe that in the end, your talent will enable people to overlook your past mistakes;

4) It’s never too late to develop self-discipline;

5) Don’t be afraid to play in an ensemble.

In my post I mentioned that I had learned these lessons.  Looking back I suppose I was right – I had learned them – but they weren’t all necessarily in practice to the best of my ability at that time.  I don’t think they are now, either, but it’s certainly gotten better, more focused, and more intentional.  Take a look at these lessons for yourself.  I think everyone can apply them to different times in their lives.  Businesses and organizations can apply them as well.  Greater success is ahead – believe it and believe in yourself!

So there you have it – a brief retrospective on my past 99 blog posts.  I greatly appreciate all my readers – the occasional drop-ins, those that wander by for a glance, and those who regularly follow me.  I’m hopeful that I share some quality content, some valid points of view, and some relevant lessons learned.  If you like my blog, please let me know.  Click the little ‘like’ button, follow me, and share posts with others.  I greatly welcome comments, so don’t be afraid to speak up.

Now back to your regularly scheduled program…

Thanks!  Tim Riecker

 

 

 

New York Recovery By the Numbers: Hurricane Sandy

New York Recovery By the Numbers

Release date: February 22, 2013.

Release Number: NR-177.

NEW YORK — Disaster assistance to New York survivors of Hurricane Sandy:
•$2.4 billion in National Flood Insurance Program payments made to policy holders
•Nearly $909.9 million in FEMA grants approved for individuals and households•$788.5 million for housing assistance
•$121.4 million for other needs

•$1.07 billion in SBA disaster loans approved for homeowners, renters and businesses
•$669 million approved in FEMA Public Assistance grants to communities and some nonprofit organizations that serve the public
•5.3 million cubic yards of debris removed (95 percent)
•268,290 people contacted FEMA for help or information
•179,516 housing inspections completed
•160,131 visits to Disaster Recovery Centers
•More than 500 voluntary agencies involved in recovery
•25 languages used to communicate assistance information to survivors