Region VIII Introduction to HSS RSF - Salt Lake County PP... · • Unit 2: Intro to the Health and Social Services (HSS) Recovery Support Function (RSF) ... Ensures recovery coordination

Region VIII Introduction to HSS RSF

Dr. Diana S. Hadzibegovic

Objectives

• Understand the mission of the Health & Social Services (HSS) Recovery Support Function (RSF)

• Understand the roles and responsibilities of the HSS RSF Field Coordinator • Understand HSS RSF Mission Scoping Assessments • Understand the importance of leveraging steady-state programs to support

recovery

2/18/2015 Byron R. Mason

Outline

Section I Recovery Concept • Unit 1: National Disaster Recovery Framework Orientation • Unit 2: Intro to the Health and Social Services (HSS) Recovery Support Function (RSF) • Unit 3: NDRF Federal Interagency Operations Plan

Section II – Recovery Operations • Unit 4: HSS RSF Operations • Unit 5: HSS RSF Mission Scoping • Unit 6: Leveraging FEMA Recovery Programs • Unit 7: Review

2/18/2015 Byron R. Mason

Unit 2 Intro to the Health & Social Services

Recovery Support Function

For the federal government to assist locally-led recovery efforts in the restoration of public health, healthcare and social services networks to promote the resilience, health and well-being of affected individuals and communities

HSS RSF Mission

1. Restore basic health and social services functions. Identify critical areas of need for health and social services, as well as key partners and at-risk individuals (e.g., children, those with disabilities, and others who have access and functional needs an populations with limited English proficiency) in short-term, intermediate and long-term recovery

2. Complete an assessment of community health and social service needs

and develop a comprehensive recovery timeline 3. Restore and improve the resilience and sustainability of the health and

social services networks to meet the needs of and promote the independence and well-being of community members in accordance with the specified recovery timeline

*Not solely a federal responsibility

HSS RSF Functions & Capabilities*

U.S. Department of Health & Human Services HSS RSF National Coordinator Provides significant engagement and management for the RSF Ensures recovery coordination and communication between Federal agencies and corresponding local, State and Tribal authorities and nongovernmental and private-sector organizations throughout all phases of a disaster

HSS RSF Members: Coordinating Agency

Department of Homeland Security: • Civil Rights and Civil Liberties • Corporation for National

&Community Service • Federal Emergency Management

Agency • National Protection &Programs

Directorate

H+SS RSF Members: Primary Agencies •Department of Education •Department of the Interior •Department of Justice •Department of Labor •Environmental Protection Agency

• Primary agencies have significant authorities, roles, resources or capabilities for a particular function within an RSF.

• Primary agencies orchestrate federal support within their functional area for an affected State and may lead interagency field assessment or support teams as necessary.

• American Red Cross • Department of Transportation • National Voluntary

H+SS RSF Supporting Organizations • Organizations Active in Disaster • Small Business Administration • Treasury • U.S. Department of Agriculture • Veterans Affairs

•Supporting organizations are entities with specific capabilities or resources that support the primary agency in executing the mission of the RSF •The principal distinction between a primary agency and a supporting organization is the frequency with which the agency may be expected to actively participate in an RSF operation

H&SS RSF Activities Pre-Disaster

Post-Disaster

• Develop strategies to address recovery issues for health, behavioral health and social services,

• Collaborate with ESFs 3, 6, 8 and 11 to plan response to recovery transitions,

• Incorporate planning for the transition from post-incident recovery operations to steady-state,

• Promote the principles of sustainability, resilience and mitigation.

• Maintain situational awareness during the response phase,

• Provide technical assistance in the form of impact analyses and supports recovery planning of public health, health care and human services infrastructure,

• Establish communication with RSF Federal, State, Tribal, local and private and nonprofit sector partners,

• Coordinate and leverage applicable Federal resources for health and social services

• Develop and implement a plan to transition from recovery to steady-state.

• Public Health

• Health Care Services Impact

• Behavioral Health Impacts

• Environmental Health Impacts

• Food Safety and Regulated Medical Products

• Long-term Health Issues Specific to

Responders

• Social Services Impacts

• Referral to Social Services/Disaster Case Mgmt

• School Impacts (Children in Disaster)

Core H&SS RSF Recovery Missions

Public Health • Implementation of strategies to assess and monitor the public health, disease

surveillance and injury prevention of the impacted community in order to identify and mitigate health problems

• Assistance with the development and implementation of risk communications and public health messaging for the disaster

Health Care Services Impacts • Assessment of disaster-related structural, functional and operational impacts to

health care facilities; • Identification of health care needs that can no longer be met with community

resources due to the disaster; • Development of strategies to provide interim and long-term services while

damaged facilities are permanently repaired, replaced or restored; • Assessment of disaster-related structural, functional and operational impacts to

behavioral health facilities and programs; • Engagement with community partners to assess needs; identify best practices, and

connect the community to resources • Ensuring transition of Crisis Counseling Assistance and Training Program (CCP)

operations from ESF #6 to the HSS RSF; • Strategy development assistance; and • Development and dissemination of consistent messaging and guidance concerning

stress management and mitigation.

ENVIRONMENTAL HEALTH IMPACTS • Surveillance in declared communities to determine if post-disaster conditions may

cause adverse public health effects;

• Identification and mitigation of public health threats in sheltering, potable water and wastewater that can cause or exacerbate negative environmental health outcomes; and

• Provision of technical assistance (e.g., scientific data and models) and training

FOOD, DRUG, & REGULATED MEDICAL PRODUCT SAFETY

• Provision of TA on HHS/FDA-regulated biologics, device, drug, animal feed and human food establishments to protect public health;

• Provision of technical assistance by the USDA‘s Food Safety and Inspection Service (FSIS) to ensure safety of the nation’s supply of meat, poultry, and processed egg products;

• Assessment of an impacted community’s food supply networks to ensure food

safety; and

• Development and issuance of consistent public messaging and risk communications concerning post-disaster food handling and preparation.

LONG-TERM HEALTH ISSUES SPECIFIC TO RESPONDERS

• Determining which groups of responders should be included in a health care or disease registry program to monitor their long-term health;

• Establishing and implementing long-term tracking of responder health and, where appropriate, community health; and

• Providing TA to help determine the appropriate duration and content of long-term health tracking

SOCIAL SERVICES IMPACTS • Assessment of disaster-related structural, functional and operational impacts to

social services facilities;

• Assessment of disaster-related impacts to at-risk individuals;

• Identification of disaster-related social services needs that cannot be met with community resources due to the disaster

• Implementation of coordinated system(s) – Referral of individuals/families to social services; and – Strategic leveraging of Federal social services programs to mitigate social

disruption and transition individuals/families to self-sufficiency • Facilitating the direct delivery of the Federal Disaster Case Management Program

and the transition to the impacted state’s leadership of disaster case management to address unmet disaster-related recovery needs.

REFERRAL TO SOCIAL SERVICES/DISASTER CASE MANAGEMENT

CHILDREN in Disaster

Post-Disaster recovery concerns addressed under this mission include:

• Schools • Early Child Development • Head Start • Childcare • Health Care Needs of Children • Behavioral Health Impacts on Children • Social Services Needs of Children

• Established August 2011 • Based in Washington, DC • 6 FTEs:

– Division Director and HSS RSF National Coordinator – 5 Recovery POCs/Pre-designated HSS RSF Field Coordinators

HHS ASPR OEM Division of Recovery

•Lead the coordination of federal health and social services efforts to support communities’ recovery from emergencies and disasters •Promote pre-disaster health and social services recovery planning •Promote systematic improvements in public health emergency and disaster recovery planning and operations

HSS RSF Members: Coordinating Agency

Knowledge Check

The Department of Health & Human Services coordinates the HSS RSF

The US Dept. of Education is an H+SS RSF Primary Agency

The HSS RSF coordinates patient movement.

The HSS RSF provides medical response to a disaster area in the form of personnel, teams and individuals, supplies, and equipment.

Unit 4 HSS RSF Operations

NDRF and HSS RSF Implementation

Byron Mason, HHS\ASPR\OEM Division of Recovery

NDRF and HSS RSF Implementation

Byron Mason, HHS\ASPR\OEM Division of Recovery

• ESF #6 and/or ESF #8 activation • Stafford Act Declaration:

– Includes both FEMA Public Assistance and Individual Assistance; – State or Tribe requests assistance with H+SS recovery efforts; – FCO/FDRC issues a Mission Assignment to the Coordinating Agency; and – Health and social services recovery activities involve more than one H+SS RSF

Primary Agency • HHS Secretary declares a Public Health Emergency

H+SS RSF Activation Triggers

Post-Disaster, Post-Activation

Pre-Deployment HSS RSF Activities • Maintain Situational Awareness of ESF activity

– Primarily, but not limited to: • ESF 3, 6, 8, 10 and 11

– Join ESF 8/Public Health & Medical briefs – Join FEMA Daily Ops Briefs and VTC

• Convene HSS RSF • Participate in “National” NDRF briefs

Byron Mason, HHS\ASPR\OEM Division of Recovery

Byron Mason, HHS\ASPR\OEM Division of Recovery

Post-Disaster, Post-Activation, Pre-Deployment

HSS RSF Coordinating Agency Activities: • HHS Recovery Coordination Group • HHS Human Services Coordination Group (HSCG) • Federal Disaster Behavioral Health Group (FDBHG)

HSS RSF Field Coordinator •Federal lead for all HSS RSF related matters at the field level

•Appointed by the HSS RSF National Coordinator

•May be staffed by the Coordinating Agency or by a Primary Agency

•May be multiple HSS RSF Field Coordinators for single disaster

RSS Implementation

Field Coordination

RSS Development

Mission Scoping

• Managing personnel assigned by FEMA to support the H+SS RSF • Identifying HSS RSF Primary Agencies and Supporting Organizations

needed to support HSS RSF field operations • Inter-RSF coordination to ensure prioritization of health and social

services needs across sectors (e.g., housing, infrastructure) • Engaging FEMA’s Disability Integration Specialist and DHS/CRCL to

assure that the needs of at-risk individuals and individuals with access and functional needs are incorporated in to H+SS RSF recovery planning

HSS RSF Field Coordinator Roles and Responsibilities

• Conduct Mission Scoping Assessments in partnership with state, tribal, territorial, or insular area counterparts to identify unmet disaster recovery needs that warrant continued health and social services recovery support through the HSS RSF

• Developing the HSS RSF Mission Scoping Assessment Report (MSAR); or developing HSS RSF content for a unified MSAR

• Establishing HSS RSF mission-specific task forces to address issues identified in the HSS RSF MSAR

H+SS RSF Field Coordinator Roles + Responsibilities

• Developing HSS RSF content for the Recovery Support Strategy (RSS) • Coordinating implementation of HSS RSF missions identified in the RSS

H+SS RSF Field Coordinator Roles + Responsibilities

• On-Site • Remote Support • Episodic Deployment

– May be staffed by different FTEs over the course of the mission, as needed

– HHS ensures that there is an appropriate transition between staff to avoid negative impacts to the recovery mission

HSS RSF Coordinator

Knowledge Check

The HSS RSF Field Coordinator is appointed by FEMA.

The HSS RSF Field Coordinator position is always staffed by the HSS RSF Coordinating Agency.

The HSS RSF Field Coordinator may provide field support remotely.

Unit 5 HSS RSF Mission Scoping

• Establish Pre-Disaster Health and Social Services Baseline • Analyze Post-Disaster Impacts to Core HSS RSF Recovery Missions • Align HSS RSF to State/Tribe/Territorial/Insular Area Structure • Expand beyond the State/Tribe/Territorial/Insular Area ESF desk • Leverage HSS RSF partners’ resources and knowledge

Conducting the HSS RSF Mission Scoping Assessment

• Document total population of declared state (or tribe) and counties/parishes • Specify key demographics at state (or tribe) and county/parish levels • Describe pre-disaster health and social services infrastructure in declared

counties/parishes

Analyze Baseline Data in relation to disaster impacts to: • Identify disaster impacts with recovery implications • Determine state/tribe/local capacity to address the need

Establish Pre-Disaster Health and Social Services Baseline

• ESF 3, 6, 8, 10 and 11 Sit-Reps • Incident Action Plans • FEMA Individual Assistance data • ACF-administered Federal Immediate

Disaster Case Management data* • SAMHSA-administered Crisis Counseling

and Training Program data*

•Health Care Services Impacts •Public Health •Behavioral Health Impacts •Environmental Health Impacts •Food, Drug, and Regulated Medical Product Safety •Social Services Impacts •Referral to Social Services / Disaster Case Management •Long-term Recovery Impacts to First Responders •Children in Disaster

Analyze Post-Disaster Impacts to Core Recovery Missions Areas

Pre-Disaster Recovery Planning at the State Level

The Denver UASI identified the following 14 Recovery Support Functions, which help guide the recovery process: Damage Assessment Economic and Community Recovery Hazard Mitigation Assistance to Individuals, Households and Small Businesses Behavioral Health Consumer Protection Donations Management Debris Management Public Health Volunteer Coordination Housing Infrastructure Environmental Recovery Historic and Cultural Resources

Correlation (FEMA RSFs and CO RSFs)

Federal RSFs State RSFs

Community Planning and Capacity Building (FEMA) And Economic Development (Economic Development Administration)

Damage Assessment (Colorado OEM) Economic and Community Recovery (DOLA Division of Local Government) Hazard Mitigation (Colorado OEM)

Health and Social Services (Health and Human Services)

Assistance to Individuals, Households and Small Businesses (DOLA Division of Local Government) Behavioral Health (CDPHE Office of Emergency Preparedness and Response) Consumer Protection (DORA Division of Insurance) Donations Management (Colorado OEM) Debris Management (CDPHE Hazardous Materials and Waste Management Division) Public Health (CDPHE Office of Emergency Preparedness and Response) Volunteer Coordination (Colorado OEM)

Housing (Housing and Urban Development) Housing (DOLA Division of Housing)

Infrastructure Systems (U.S. Army Corps of Engineers)

Infrastructure Systems (Colorado OEM)

Natural and Cultural Resources (Interior) Environmental Recovery (CDNR) Historic and Cultural Resources (Colorado OEM)

Identify Cross-Cutting Issues in the Field

Infrastructure Systems •Are systems that support healthcare facilities’ continuity of operations prioritized in recovery? •Are there mitigation opportunities?

Economic •Prolonged unemployment may have behavioral health implications •Parents without childcare may not be able to return to work

Community Planning & Capacity Building Are health &social services partners represented in community planning discussions?

Housing •Are internally displaced disaster survivors able to access services? •Healthy homes initiatives (asbestos, lead, mold)

Natural & Cultural Resources •Environmental justice •Environmental health hazards

Post-Disaster Planning at the State Level CO floods 2013

Duration: Sep 9 2013 to June 2014 Fatalities: 8 dead, 6 missing Damages: Estimated over $1 billion

Disaster emergencies have been declared by the governor in 14 counties (highlighted) in Colorado

• Encourage state/tribe partners to establish inter-departmental/inter-governmental work groups or task forces – Ensure that applicable H+SS RSF Primary Agencies and Supporting

Organizations are engaged • Encourage involvement of branches/offices that oversee/license health and social

services facilities in recovery discussions, in order to promote mitigation • When possible, connect state/tribe departments with case management

programs to the Federal Immediate Disaster Case Management Program or State Disaster Case Management Program

Expand beyond the ESF desk

Mission Scoping Assessment Report

• Snapshot of Emerging Health and Social Services Recovery Issues

• Recovery issues and priorities validated by State

• Pre-decisional & resource noncommittal

• MSAR RSS

Which HSS RSF Primary Agencies are needed?

Mission Scoping/RSS Discussion Questions

Unit 6 Leveraging FEMA

Recovery Programs to support Health &

Social Services Recovery

• Determine if additional HSS RSF members are needed in the field to assist in the development and completion of the HSS RSF MSAR

• Discuss potential leveraging of HSS RSF Coordinating Agency, Primary Agencies, and Supporting Organizations programs

• Identify individuals that can provide subject matter expertise to inform local recovery decision-making

Leverage HSS RSF Resources and SME

The Stafford Act constitutes the statutory authority for most Federal disaster response activities especially as they pertain to FEMA and its programs. • Authorizes FEMA Individual Assistance • Authorizes FEMA Public Assistance • Authorizes FEMA Federal Insurance &

Mitigation Administration

Robert T. Stafford Disaster Relief and Emergency Assistance Act, (as amended, and Related Authorities as of April 2013)

What is Disaster Assistance?

Disaster assistance is financial or direct assistance to individuals and families whose property has been damaged or destroyed as a result of a federally-declared disaster, and whose losses are not covered by insurance. It is intended to assist survivors with critical expenses that cannot be covered in other ways. This assistance is not intended to restore damaged property to its condition before the disaster.

Individual Assistance

• Housing Assistance Temporary Housing (a place to live for a limited period of time): Financial assistance may be available to rent a different place to live, or a government provided housing unit when rental properties are not available. Search for information about housing rental resources.

• Repair: Financial assistance may be available to homeowners to repair damage from the disaster to their primary residence that is not covered by insurance. The goal is to make the damaged home safe, sanitary, and functional.

• Replacement: Financial assistance may be available to homeowners to replace their home destroyed in the disaster that is not covered by insurance. The goal is to help the homeowner with the cost of replacing their destroyed home.

• Permanent or Semi-Permanent Housing Construction: Direct assistance or money for the construction of a home. This type of help occurs only in insular areas or other locations specified by FEMA, where no other type of housing assistance is possible.

Individual Assistance

Other than Housing Needs

Disaster-related medical and dental expenses. Disaster-related funeral and burial expenses. Clothing; household items (room furnishings, appliances); tools (specialized or protective clothing and equipment) required for your job; necessary educational materials (computers, school books, supplies). Fuels for primary heat source (heating oil, gas). Clean-up items (wet/dry vacuum, dehumidifier). Disaster-related damage to a vehicle. Moving and storage expenses related to the disaster (moving and storing property to avoid additional disaster damage while disaster-related repairs are being made to the home). Other necessary expenses or serious needs as determined by FEMA. Other expenses that are authorized by law.

Individual Assistance

Crisis Counseling Assistance and Training Program •Section 416 of the Stafford Act authorizes FEMA to fund mental health assistance and training activities in Presidentially declared major disaster areas. •This support is available through the Crisis Counseling Assistance and Training Program (CCP) •HHS’ Substance Abuse and Mental Health Services Administration's (SAMHSA) works with FEMA through an interagency agreement to provide technical assistance, consultation, and training for State and local mental health personnel, grant administration and program oversight.

Individual Assistance Data

Key CCP Principles •Strengths Based—CCP services promote resilience, empowerment, and recovery. •Anonymous—Crisis counselors do not classify, label, or diagnose people; no records or case files are kept. •Outreach Oriented—Crisis counselors deliver services in the communities rather than wait for survivors to seek their assistance. •Conducted in Nontraditional Settings— Crisis counselors make contact in homes and communities, not in clinical or office settings. •Designed to Strengthen Existing Community Support Systems—The CCP supplements, but does not supplant or replace, existing community systems.

Individual Assistance Data

FEMA Public Assistance - Eligibility

Cost

Work

Facility

Applicant

Emergency Work A. Debris Removal B. Emergency Protective Measures

Permanent Work

C. Road Systems and Bridges D. Water Control Facilities E. Buildings, Contents, and Equipment F. Utilities G. Parks, Recreational, and Other

FEMA Public Assistance Categories of Work

PA Policies Relevant to H+SS RSF Core Recovery Mission areas •9523.10 Eligibility of Vector Control (Mosquito Abatement) (9/12/06) •9523.15 Eligible Costs Related to Evacuations and Sheltering (4/6/07) •9525.4 Emergency Medical Care and Medical Evacuations (02/03/14) •9525.16 Research-related Equipment and Furnishings (5/9/11) •9526.1 Hazard Mitigation Funding Under Sec. 406 (Stafford Act) (3/30/10) •9580.100 Fact Sheet: Mold Remediation (11/7/06) •9580.104 Fact Sheet: Public Assistance for Ambulance Services (1/2/09) •9580.106 Fact Sheet: Pandemic Influenza Fact Sheet (11/25/09) •9580.107 Child Care Services (3/20/13) •9580.210 Fact Sheet: Personal Assistance Service In Shelters (11/16/12)

FEMA Public Assistance

Authorities under section 404 of the Stafford Act •The Hazard Mitigation Grant Program (HMGP) provides grants to states and local governments to implement long-term hazard mitigation measures after a major disaster declaration. •The purpose of the HMGP is to reduce the loss of life and property due to natural disasters and to enable mitigation measures to be implemented during the immediate recovery from a disaster.

Eligible Applicants and/or Sub-applicants: •State •Local governments •Indian tribes or other tribal organizations •Private non-profit organizations

Hazard Mitigation Grant Program

Unit 8 Course Review

National Disaster Recovery Framework

• Required by PKEMRA (post Katrina) • Part of the National Preparedness System • All-Hazards • No New Federal Funding or Authorities • Enhanced Coordination! • Established FDRCs • Established 6 Recovery Support Functions

• Community Planning + Capacity Building • Economic • Health + Social Services • Housing • Infrastructure Systems • Natural + Cultural Resources

Recovery Support Functions

•Does not place additional requirements on states, tribes, territories, or insular areas •States are encouraged, but NOT required to adopt the NDRF’s RSF structure

NDRF

Recovery FIOP • All-Hazards • Base Plan with 6 RSF Annexes • NIMS and ICS compliant • Describes Organizational field structure • FDRC and RSF activation + deployment

process • Role of the FEMA Hazard Mitigation Advisor

and FEMA Program Liaisons • Recovery Support Strategy (RSS)

development and implementation parameters

• FDRC and RSF demobilization and transition to steady-state timeline considerations

Key Operational Steps 1. Monitoring and Situational Awareness 2. Advance Evaluation 3. FDRC and RSF Activation/Deployment 4. Mission Scoping Assesment 5. Recovery Support Strategy (RSS)

Development 6. RSS Implementation 7. Transition + Return to Steady-State

Operations

Recovery FIOP

For the federal government to assist locally-led recovery efforts in the restoration of public health, healthcare and social services networks to promote the resilience, health and well-being of affected individuals and communities

HSS RSF

•Public Health •Health Care Services Impacts •Behavioral Health Impacts •Environmental Health Impacts •Food, Drug, and Regulated Medical Product Safety •Social Services Impacts •Referral to Social Services / Disaster Case Management •Long-term Recovery Impacts to First Responders •Children in Disaster

H&SS RSF Core Recovery Mission Areas

Members of H&SS RSF

Coordinating Agency Department of Health and Human

Services

Primary Agencies

1. American Red Cross (ARC) 2. Department of Transportation (DOT) 3. Department of Treasury (TREAS) 4. Department of Veterans Affairs (VA) 5. National Voluntary Organizations Active in Disaster

(NVOAD) 6. Small Business Administration (SBA) 7. U.S. Department of Agriculture (USDA)

1. Corporation for National and Community Services (CNCS) 2. Department of Education (ED) 3. Department of Homeland Security(DHS) 4. Department of Interior (DOI) 5. Department of Justice (DOJ) 6. Department of Labor (DOL) 7. Environmental Protection Agency (EPA)

Support Organization

HSS RSF Activities Pre-Disaster

• Pre-disaster recovery planning • Provide Technical Assistance (TA) • Develop RSF policy and doctrine • Develop relationships with Whole

Community partners • Capacity building

Post-Disaster • Federal Operations Support to FEMA • Field coordination of federal health

and social services disaster recovery operations

• TA / Subject Matter Expertise • Mission Scoping Assessment • Recovery Support Strategy

development and implementation

H+SS RSF Triggers • ESF #6 and/or ESF #8 activation • Stafford Act Declaration:

• Includes both FEMA Public Assistance and Individual Assistance; • State or Tribe requests assistance with H+SS recovery efforts; • FCO/FDRC issues a Mission Assignment to the Coordinating Agency; and • Health and social services recovery activities involve more than one H+SS RSF Primary Agency

• HHS Secretary declares a Public Health Emergency

CONOPS

Federal lead for all HSS RSF related matters at the field level

Responsibilities Include:

•Field Coordination

•Mission Scoping

•RSS Development

•RSS Implementation

HSS RSF Field Coordinator

Join Us!

Thank you for the opportunity to present to you today and to learn more about what you do

U.S. DEPT. HEALTH & HUMAN SERVICES ASPR/ OEM/ DIVISION OF RECOVERY [email protected] 202-205-4727 (DESK)