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HomeMy WebLinkAboutMINUTES - 03132012 - C.71RECOMMENDATION(S): Recognize the Contra Costa County Medical Reserve Corps (CCMRC) as an officially-designated County Volunteer Program. FISCAL IMPACT: No general fund impact. Financial support of the CCMRC is primarily through grants and awards including the Department of Homeland Security, Urban Area Security Initiative Citizen Preparedness and Hospital Prepared Program Grant. BACKGROUND: The Medical Reserve Corps Program (MRC), a specialized arm of the Citizen Corps, was created following the terrorist attacks of September 11, 2001. A national network of volunteers dedicated to ensuring hometown security, the MRC is comprised of organized medical and public health personnel, as well as non-medical individuals, who donate their time and expertise to prepare for and respond to disasters of all kinds. MRC volunteers work in coordination with existing local emergency response programs and also supplement existing community public health initiatives, such as outreach and prevention and immunization programs, working to match specific needs. APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 03/13/2012 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, District I Supervisor Gayle B. Uilkema, District II Supervisor Mary N. Piepho, District III Supervisor Karen Mitchoff, District IV Supervisor ABSENT:Federal D. Glover, District V Supervisor Contact: Patricia Frost, 646-4690 I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown. ATTESTED: March 13, 2012 David Twa, County Administrator and Clerk of the Board of Supervisors By: June McHuen, Deputy cc: Tasha Scott, Demetria Gary, Juliene Latteri C.71 To:Board of Supervisors From:William Walker, M.D., Health Services Director Date:March 13, 2012 Contra Costa County Subject:Recognition of Contra Costa County Medical Reserve Corps as a County Volunteer Program BACKGROUND: (CONT'D) The Contra Costa County Medical Reserve Corps (CCMRC) project began in 2009, and in May 2009 was officially registered with the Office of the U.S. Surgeon General in the Department of Health and Human Services, and was recognized as part of the Department of Homeland Security’s Citizen Corps. The CCMRC is led by an experienced emergency physician who has vast experience in disaster and austere medicine, and currently has 218 registered volunteers who have completed orientation and training. Lead oversight of the CCMRC is provided by Contra Costa Health Services Emergency Medical Services with support from the Public Health Division. The attached report describes the Contra Costa County Medical Reserve Corp in greater detail. CONSEQUENCE OF NEGATIVE ACTION: Not applicable. CHILDREN'S IMPACT STATEMENT: Not applicable. ATTACHMENTS G:\C&G DIRECTORY\NON CONTRACTS\2012\CCMRC Program Description.doc Page 1 of 5 Contra Costa County Medical Reserve Corps Program Description January 2012 Contra Costa County Emergency Medical Services (EMS), a division of the Contra Costa Health Services Department (CCHS), requests from the Office of the County Administrator recognition of the Contra Costa County Medical Reserve Corps (CCMRC) as an official Program of Contra Costa County. A. Description/background: The need for trained supplemental medical and public health personnel to assist with emergency operations was highlighted after the terrorist attacks of September 11, 2001. The Medical Reserve Corps Program (MRC), a specialized arm of the Citizen Corps, a national network of volunteers dedicated to ensuring hometown security, was created after President Bush’s 2002 State of the Union Address in which he asked all Americans to volunteer in support of their country. The Medical Reserve Corp is comprised of organized medical and public health professionals, as well as non-medical individuals, who serve as volunteers who want to donate their time and expertise to prepare for and respond to emergencies and promote healthy living throughout the year. MRC volunteers work in coordination with existing local emergency response programs and supplement existing community public health initiatives, such as outreach and prevention and immunization programs, working to match specific community needs. The MRC Program provides the structure necessary to deploy personnel to an emergency as it pre-identifies volunteers, validates credentials and provides ongoing training opportunities. The Contra Costa County Medical Reserve Corps Project began in 2009 and has progressed to a sustainable program. The mission of the CCMRC is to improve the health and safety of the community by training, organizing and utilizing public health, medical and non-medical volunteers to assist in or augment medical care during disasters, major disease outbreaks and community events. Lead oversight of the CCMRC is provided by CCHS’ Emergency Medical Services with support from the Public Health Division. A Steering Committee and Advisory Committee provided input into the development, mission, goals and objectives of the CCMRC. Page 2 of 5 B. Why the CC MRC is in the best interest of the County: In the wake of a catastrophic disaster or major disease outbreak, it is anticipated that large numbers of ill and injured people will seek medical care. This surge in demand for health care services has the potential to quickly overwhelm local health care resources. The CCMRC provides an asset to help address the health care surge by augmenting the number of licensed medical professionals to assist in the disaster response. These activities may include: 1. Assist with mass vaccinations or prophylactic medication dispensing, and 2. Support medical care in or near emergency evacuation shelters, and alternative care sites. The CCMRC works to develop trained individuals and structured teams capable of scalable responses such as: 1. Individual CCMRC members – augmenting or assisting in providing immediate support, and 2. Multiple MRC ‘sub-teams’ – augmenting or assisting in providing immediate or planned support (e.g. vaccine clinics at Points of Dispensing [PODs], First Aid stations, and shelter support). Although not yet at this level of response, the CCMRC plans to and is working toward supporting disaster healthcare operations during a prolonged event (e.g. Field Treatment Sites and prolonged shelter operations through MRC-acquired disaster caches. These supplies and equipment would allow for sustained or short term, self-sufficient, basic and advanced first aid, support to medical shelters, and a pharmaceutical cache to treat up to 1000 people). The CCMRC could also be mobilized to support and augment CCHS’ day-to-day, non- disaster-related activities. These include: 1. The provision of healthcare to the underserved and administration of immunizations to the community. 2. The simultaneous, multi-site, community-based flu vaccine clinics sponsored by Public Health. CCMRC members could also be deployed to CCHS-approved events to provide basic first aid at Health Fairs -including city or county sponsored Health/Emergency Preparedness Fairs, exercises and drills, mass vaccination clinics, community walkathon first aid support, and CPR/AED training sessions. CCMRC deployment and lines of authority in non-emergency and emergency events: Non-Emergency Event 1. The CCMRC Team Leader or his designee (an EMS Staff member who serves as Project Coordinator) receives requests for CCMRC event participation. 2. The CCMRC Team Leader reviews the event for appropriateness, evaluates need with capabilities, and vets requests with CCHS/EMS leadership, then solicits CCMRC volunteer participation. Page 3 of 5 3. The Team Leader or Project Coordinator selects, prepares and dispatches the members (as individuals or sub teams) to their assignment. 4. The members are led by an assigned unit leader who will then maintain accountability to the Team Leader or Project Coordinator. Emergency Event: 1. The County Emergency Operations Center (EOC) and the CCHS Department Operations Center (DOC) would formulate medical/health response priorities, including determining the need for CCMRC activation. 2. Once the need and its scope has been determined and relayed to the EMS Division. 3. The EMS Division, via the EMS Director and EMS Operations Chief will notify the Project Coordinator and the MRC Team Leader. 4. The mission objectives, response activities and team roles will be defined by CCHS/EMS. 5. The CCMRC Team Leader will, in turn, provide direction to CCMRC members, (individuals, sub teams or a team as a whole). C. Estimate of new staffing requirements: There are no new staffing costs anticipated. MRC is currently led by a CCHS emergency medicine physician experienced in disaster and austere medicine - both in the U.S. and abroad - as a volunteer. As noted above, an EMS staff member is assigned as Program Coordinator managing the day-to-day administration of the CCMRC. Other members of the CCMRC Advisory Council have volunteered their time as Plans, Operations, and Logistics Chiefs. A Training Officer has also been identified. If new staffing were required, the costs would be supported through grant funding. D. Total anticipated cost: The cost of the program is supported by: 1. Current EMS staff who provide administrative program oversight and support. 2. One contracted paid MRC support member working 20 hours per month. 3. Small grants from the National Association of County and City Health Officials (NAACHO), Hospital Preparedness Program (HPP) Grant and CAERS providing funding for equipment, caches and training. 4. Liability/malpractice during periods of declared disasters is managed by multiple federal and state statutes. 5. Liability/malpractice associated with disaster-response training, as well as periods of declared disasters, is managed under Cal. Gov. Code § 8657. 6. Liability/malpractice during non-emergency activities is managed by the current County-contracted plan at no additional cost. Volunteers are covered parties as long as they are working on or behalf of the County. E. Available funding revenue: The financial support of the CCMRC is provided predominantly through grants and awards including the Department of Homeland Security (DHS), Urban Area Security Page 4 of 5 Initiative Citizen Preparedness grant (UASI), HPP, and NACCHO. These grants have provided funding for equipment purchases including the pharmaceutical cache maintained at the Contra Costa Regional Medical Center (CCRMC). F. Pros and cons of the request: The CCMRC has the full support of the Contra Costa Health Services Director, EMS and Public Health leadership. In order to be effective during times of crisis, volunteers must be organized and trained to work in emergency situations. The CCMRC is designed to provide that organizational structure and promote appropriate training of volunteers according to local community needs and vulnerabilities. The result is a collaborative, organized effort whose goal is preparing for large scale public health crises. The CCMRC brings volunteers together to supplement existing local emergency plans and resources. It has the capability to supplement existing emergency and public health resources and agencies such as Red Cross, CCHS Public Health, fire, police, and ambulance services. The MRC within Contra Costa has a proven record of mobilizing volunteers to augment and support healthcare events and services in the County. These activities include: 1. 2009-2010 drive-through H1N1 immunization clinics hosted by Public Health and multi-site one-day flu vaccine venues in November 2010. Fifty volunteers filled nearly 70 shifts at immunization clinics and almost as many volunteers staffed the flu vaccine venues. 2. Cost savings to the county by relying on volunteer MRC staffing for these events ranged from $19,000 to $27,000. 3. MRC staffing of information booths at Health Fairs and provide training in CPR to the community including students in schools, promoting community resiliency Volunteers have eagerly requested additional opportunities to offer their time and expertise to serve the Contra Costa community. The risks associated with MRCs are primarily focused in the area of volunteer liability and medical malpractice issues that are not well addressed on either the state or national level. These risks are not unique to Contra Costa. The risks are assessed as minimal based on our experience to date and the processes in place to aggressively mitigate these risks. The CC MRC program, in consultation with County Counsel, is taking the following proactive risk mitigation steps to substantially reduce exposure: 1. Clear lines of authority to assure accountability, 2. Competency-based curriculum development, training and testing of MRC members prior to deployment, 3. Standardized processes and protocols for MRC members who may be deployed to disaster and non-disaster events, 4. Deployment of MRC volunteers to events with appropriate CCHS oversight e.g. Public Health, Page 5 of 5 5. Mechanisms to address and reliably reduce risks associated with deployment e.g. evaluation and complaint processes, and 6. Close monitoring of proposed legislation introduced (by EMSA) to the State Legislature intended to address this issue. G. Negative consequences if not approved: The CCMRC currently has 218 registered volunteers who have completed orientation and training - investing thousands of hours into the development and implementation of this important program. Without formal approval from the Board of Supervisors as a recognized County volunteer program, the CCMRC would likely have to disband and a valuable disaster resource would be lost to the Contra Costa Community. Under the auspices of Public Health these volunteer health care extenders could not be developed to meet underserved areas in our health care system and provide community health education services beneficial to its constituents during non-disaster periods. MRCs add substantial value to overall Community resilience, especially during a time of difficult economic time and increasing public need.