Minutes of the Meeting of the
Sarpy County Local Emergency Planning Committee
8 Aug 07
6:00 PM
The Sarpy County Local Emergency Planning Committee convened in open and public session on August 8, 2007 at 6:00 pm at the 55th Medical Group APU Classroom Building 4209. The following members or alternates were present according to the sign-in sheet: Bill Bowes, Ron Clark, Keith Deiml, Tom Dimitroff, Veon Dillon, Larry Fasnacht (for Steve Young), Jim Jenkins, Jason Johnson, Craig Stoker (for J.J. Kuzma), Larry Lavelle, Jane Nitchals, Jim Palensky, Maria Reiter, Lisa Rink, Jeff Reicks, Greg Wilch, Dick Williams, and Rolly Yost. Guests were Maj Tamara Yaselsky, 2Lt Sean Hoskins and Ms. Johni Mak from the 55th Medical Group (55MDG), Offutt AFB.
Advanced notice of the meeting was published in the Bellevue Leader and Papillion Times. Copies of Proof of Publication are on file in the Sarpy County Clerk’s Office. All proceedings were taken while the convened meeting was open to the attendance of the public.
Vice Chair Lavelle thanked the members for attending tonight’s meeting and called the meeting to order. The roll call was done by sign-in sheet. Secretary Reiter reminded members to sign in the far right column next to their name if an appointee. Alternates should print their names above the persons they are representing and initial in the far right column of the sheet. Guests were asked to sign in on a separate sign-in list for guests.
Vice Chair Lavelle asked Secretary Reiter to determine if the meeting had a quorum. Secretary Reiter did a head count and determined the meeting did not have a quorum of members present at opening. Vice Chair Lavelle decided to defer meeting minute approval and proceeded with the program portion of the meeting at the request of Mr. Jenkins.
PROGRAM: Mr. Jenkins provided an overview of the 55 MDG Hazard Management Plan and 55 MDG services and capabilities. The presentation included 55 MDG disaster preparedness and hazard management, Command and Control, on-base response, mass casualty management, civil support request process, review of medical response packages by civilian contractor Ms. Johni Mak, and a walk-through of the rapid response trailer with Maj Tamara Yaselsky. The 55 MDG uses a team approach for disaster casualty management which includes both active duty military and civilians. The ratio of active duty to civilian personnel in the 55 MDG is about 4 to 1. Contractors make up a third component. As time goes on, Mr. Jenkins noted that the 55 MDG is losing more active duty military personnel and gaining more civilians. A year ago, the 55 MDG added Civil Service personnel to the MDG disaster teams. This does not include contractors. If an incident were to occur, contractor personnel would want to help, but contractually cannot train with Civil Service personnel at this time. All Civil Service and non-contractor civilian personnel and active duty military are automatically assigned to a disaster team when they start working in the MDG. This enables personnel to know roles and responsibilities, disaster team locations, and what to do in the event of a disaster situation or mass casualty incident.
The 55 MDG conducts periodic recalls and can recall all personnel within one hour. The 55 MDG numbers approximately 700 personnel of which 420 are military personnel. The 55MDG is set up to provide outpatient services only and is not constructed to provide emergent-type interventions for critical illnesses. Mr. Jenkins stated that if a civilian ambulance shows up it’s probably a mistake and the 55 MDG will divert it downtown to Midlands or another location.
The 55 MDG clinical capabilities include surgical and pediatric outpatient services. There are no inpatient services. Patients requiring an overnight stay, ICU or cardiac support cannot be treated at the 55 MDG. There are four ambulances assigned to the base, two with the 55 MDG and two with the Aerospace Medicine Squadron on base. The Aerospace Medicine Squadron is housed in Bldg 527 on base and includes Flight Medicine, Bioenvironmental Engineering and Public Health personnel. Additional services include the Aerospace Physiology Unit (APU), Satellite Pharmacy by the Commissary and the Veterinary Clinic.
The 55 MDG Casualty Management Construct calls for receiving and treating minimal and delayed patients and is based on self-presenters. These are the folks that get out of the emergency management network, jump in their vehicles, and present on their own at the 55 MDG. They aren’t the patients brought in by ambulances. Immediate patients from a resulting mass casualty incident can only be stabilized for transport to another facility. The 55 MDG cannot do much more than that for those types of patients. During a mass casualty incident, the 55 MDG will notify Midlands and other facilities and obtain a bed count to see what’s available. A big enough event will result in activation of the Douglas County Emergency Operations Center and the 55 MDG has plans in place to work with them.
The Air Force equivalent to the National Incident Management System is AFIMS. The 55th Wing is really trying to transition to civilian-equivalent terms. The Battle Staff which is comprised of the Wing, Group Commanders and Senior Base Leadership is now referred to as the Commander’s Senior Staff. The Wing Operations Center is the Command Center or Command Post where the Wing Commander sits.
The medical control center used to be the Emergency Department. Now that the 55 MDG is a clinic, the Urgent Care Center will initially be in charge in an event and will dispatch the first ambulance. Once the ambulance arrives on scene, the senior medical person will assess the situation. As big as the situation is going to get is what the 55 MDG will respond to. Flight Medicine can also be dispatched to the scene. The Fire Chief is going to be the Incident Commander in most situations.
The Medical Control Center (MCC) is located within the MDG and all medical operations are run out of there. The 55 MDG Commander or one of the MDG squadron commanders can conduct operations out of the MCC. The Base Emergency Operations Center is located in Bldg 301 in Base Disaster Preparedness. If the 55 MDG had to respond on base, both ambulance and dispatch are notified. They will assess, call back to the Medical Control Center (MCC), if necessary dispatch Flight Medicine or the Initial Response Team (IRT) which consists of a couple of providers and technicians. The IRT manages anything dealing with aircraft, mass casualty situations and provides triage and treatment. If the IRT does not have adequate staff to provide care in the triage area, they will call the Rapid Response Team (RRT). The RRT has between 20-30 folks and is designed to care for victims before they are transported.
There are two designated Casualty Collection Points (CCP) on base and they are located in the two fitness centers. When patients cannot be directly transported from the scene, which is the number one goal, the victims can be staged and housed in the gyms pending transport. If there is an on-base incident which involves any suspicious characteristics, the 55 MDG will decontaminate everyone involved. The reason for conducting decontamination operations is self-presenters – those folks who slip out of the net of the incident commander. The 55 MDG will notify all disaster teams to assemble in their activation areas and will secure all facility entrances except the Urgent Care Center (former Emergency Room) in front of the facility. That way, no one gets in and no one gets out. This is done for all Chemical, Biological, Radiological, Nuclear, and Explosive (CBRNE) events just because of the unknown.
Regarding traffic management, the gate to the lower facility parking lot will be locked. The middle parking lot is the only way in and the exit by the UCC is the only way out. The MDG will set up decontamination, triage and treat patients, and arrange for outside transport for those patients it cannot treat. If outside ambulances are not available, the 55 MDG will stabilize and stage patients until transportation becomes available. The 55 MDG Manpower Team consists of personnel who walk patients around the facility. The Patient Administration Team accounts for all patients from the time they arrive to the 55 MDG until the time they leave. The 55 MDG always has a count of how many people are in the facility at any given time. There are also a couple of clinical teams. In the event of a mass casualty situation, the area where the clinical teams operate becomes the area where treatment will be provided. Every clinical team member knows the area, knows what the supplies are and where the equipment is at. There are ancillary teams as well including X-Ray and prescriptions. The APU Building is where the worried well will be staged initially. In this position, they are going to go one of a few ways. They are either going to be sent back to work if they are active duty, sent home if they are a dependent or a civilian, or sent to another facility downtown.
In order to provide military support in the event of a civilian incident, a civic leader must contact the Wing Commander or designee to request military support. The Wing Commander or designee can approve military resources to provide assistance for three reasons: to save lives, prevent human suffering, or mitigate great property damage. If you can meet one of those three conditions, the 55 MDG can respond with whatever assets we have. If there isn’t a disaster declaration within 72 hours, the Wing Commander has to pull military assets back. The 55 MDG has a lot of assets and resources and has participated in OMMRS exercises. We also conduct Air Show Major Accident Response Exercises where a lot of civilian folks come on base to participate, but the 55 MDG also has resources that go off base.
Jane Nitchals asked if the EOC Medical Table is activated would the 55MDG use the Red Cross Patient Forms that the area hospitals have used in the past. Mr. Jenkins said that if the EOC Medical Table is activated and staffed and there is a situation on base, the Red Cross Patient Forms would be used. During the Air Show MARE, the 55MDG did that. Ron Clark asked about the next National Disaster Medical System (NDMS) drill. Mr. Jenkins said there may be some realignment on NDMS. Mr. Jenkins explained that if an event happens around the country, NDMS provides for patients to be transported to a designated NDMS site like Atlanta, San Antonio, or Omaha. The 55 MDG is the NDMS Coordinator. The Air Force is reviewing the 55 MDG status because it is no longer a full running hospital with inpatients and ICU, so that might not be the case anymore. Mr. Jenkins anticipates some changes over the next year. Ron Clark stated that NDMS still has a civilian base. Mr. Jenkins said that NDMS in the Omaha area includes 18 partner hospitals. Mr. Jenkins receives a weekly bed report from each of those facilities. Bed counts average 300 open beds and fluctuate seasonally. Omaha is a viable place and if an event occurs, patients will be sent to locations closest to the event. If something happened in Kansas City, Denver, or Minneapolis, Omaha is on the list as a receiving site for patients. There has been considerable planning for such an event, but Mr. Jenkins does not know if the 55 MDG will remain as the NDMS Coordinator. Regarding Ron’s question about exercising NDMS, Mr. Jenkins agreed that it should be exercised. However, he plans to get additional information first on future direction before committing to an exercise. There has been some discussion with landing planes at Eppley Airfield instead of Offutt. The Omaha Airport Authority concurs with the proposal and the Civic Auditorium could be used to pre-stage patients. However, there are no buildings at Eppley for patient use when they first come off the plane, and Eppley cannot guarantee they will have a dedicated building for that purpose.
Jim Jenkins introduced Ms. Johni Mak who is the 55 MDG CBRNE Medical Contractor. Every base in ACC has one and she is responsible to oversee all Medical Group CBRNE programs and packages. One of her jobs is to work with the local community, work with local Hazardous Materials Teams, and conduct decontamination training. Ms. Mak also has a bioenvironmental engineering background. Ms. Mak described the CBRNE packages which are based on the same concept of operations (CONOPS) to sustain 300 patients in the first 24 hours, making sure they are stable. She listed existing packages – Patient Decontamination, Laboratory, Immediate Medical Response, In-Patient capabilities at other bases which we don’t have in the 55 MDG, Pharmaceutical Support and Threat Agent. Employment options include a lot of MOUs and understanding what the community can work with us on. Every decontamination capability in the AF is trained exactly the same and is used for those patients that present here at the 55 MDG and don’t go through gross decontamination at the scene. There is a lot of capability surrounding the Laboratory Package.
Ms. Mak showed different equipment for the packages. Captain Palensky asked about field testing for biologics. He stated that there is no field detector for biologics that is any more than presumptive; samples have to be cultured in a laboratory for definitive result. Ms. Mak said that there is a bioassay kit but it is only presumptive; samples still must be confirmed by laboratory analysis. Ms Mak then showed locations of basic assets across the United States. Ms. Mak asked if anyone was familiar with the Guardian program. It is a detection system across the base that gives a better idea of any kind of specific contaminants in the air. When it alarms, it indicates the need for additional testing and base response. She showed which bases in ACC have the system. There is a great deal of communication among all base teams; in many cases the teams respond as one working together.
Chief Bowes asked if the 55 MDG resources could be utilized off-base. Ms. Mak stated that resources could be provided to save lives, prevent human suffering, or mitigate great property damage. The initial call would be made through the Fire Department. Jeff Reicks asked if it would take an hour to respond. Greg Wilch stated that it would take an hour if recall was done during non-duty hours. Ms. Mak clarified that it would take one hour to get entire 55 MDG recalled to respond during off-duty hours. If on-duty, teams are activated through the Medical Control Center and EOC. Some teams are on a 20-minute recall status off-duty.
Jane Nitchals asked a question about the decontamination procedures. What she has found is that her hospital and other hospitals decontaminate people (2-3 times a year) due to industrial accidents. She mentioned two incidents that happened on base, one over a year ago which was an industrial accident resulting from a groundwater cleaning project and involved potassium permanganate. The base sent personnel to Midlands and Midlands decontaminated them. Recently there was an incident where a fire extinguisher exploded and sprayed everybody and the base sent them to Midlands to be decontaminated. Jane asked if the base just sent civilians to Midlands and why the base didn’t provide decontamination. Jane stated that someone from Offutt called and told the Midlands ER in both instances that they were sending people to Midlands to be decontaminated. The personnel were transported in two private vehicles and it appeared that their supervisors arranged for that. Jane said that Midlands was happy to provide assistance and even wrote up the last incident as an exercise because it involved eight people. A question was asked about the date of the last incident. Jane responded that it occurred on 12 Jul. Greg Wilch said there was a day last month when the Fire Department resources were overstressed. He and Jim Jenkins promised to check into it. Mr. Jenkins told Jane that if something like this happens again to please call the 55 MDG back right away. He will provide a phone number for Jane to post in the Midlands ER to call in the event of any potential future incidents.
Jim said the 55 MDG was interested in exercising, sending their equipment downtown, going through the process of getting authorization and getting 55 MDG personnel involved in responses. Larry Lavelle said that the community has drilled and exercised with the 72nd CST. He asked if the community could rely on the 55 MDG resources if the 72 CST assets become overstressed. It seems the call tree is pretty quick to the commander of that unit to provide a heads up that a request has already been upchanneled to the governor so that the team can start getting assembled and be on the road rolling out of Lincoln quickly. Is there a similar mechanism for the 55 MDG. Mr. Jenkins said it doesn’t matter who asks as long at the Wing Commander approves the request. Offutt cannot call the CST directly because they are a state resource and Offutt is a federal resource.
Ms. Mak said that the Bioenvironmental Engineering Team is identical to the CST. The only difference between those two teams as far as capabilities is they do have a mobile laboratory. Larry thought that their laboratory on wheels was a huge benefit for them and every state that has a CST. Ms. Mak said it was and that the laboratory is a confirmatory laboratory. The group then went out to tour the MDG Rapid Response Trailer.
The business portion of the meeting resumed after the members completed a tour of the 55MDG Rapid Response Trailer.
BOARD REPORTS:
Chairman Report: Vice Chair Lavelle reported that he received no written or verbal information on any reportable HAZMAT incidents in Sarpy County during the last quarter. He thought there might be one early in the morning that resulted in the closure of east and westbound interstate traffic shortly after 8:30 A.M. However, no HAZMAT requests were made for the incident. The interstate reopened shortly after 5:00 P.M.
Vice Chairman: No Report
Information Coordinator: Coordinator Rink informed the members that the Spill Response and Deployment Course would be held in Omaha the last week in August. She will send additional information through e-mail. Sarpy County and the City of Bellevue need volunteers for the 20 Aug Radiation Emergency Preparedness exercise. Coordinator Rink asked the members to let her know if they were interested in participating in the exercise. Secretary Reiter mentioned an e-mail sent out by Red Cross requiring exercise participants to attend training in order to participate in the actual exercise. Coordinator Rink said that the training would be held on Tuesday, 14 Aug and was important for exercise volunteers to attend.
Secretary: Secretary Reiter did a recount of members present and proceeded with review and approval of the meeting minutes because the meeting now had a quorum. Dick Williams motioned to approve the 23 May meeting minutes without any changes. Greg Welch seconded the motion. All were in favor, none opposed and motion passed unanimously.
COMMITTEE REPORTS:
Exercise: Vice Chair Lavelle reiterated that the upcoming exercise is the 20 Aug radiological exercise involving the Reception Center in Bellevue. Sarpy County Emergency Management Agency is the gatekeeper for the area’s Planning, Exercise and Training (PET) Calendar. Vice Chair Lavelle requested the members send updates of any future exercises or upcoming trainings to Lisa Rink. Secretary Reiter mentioned that a Tabletop Exercise would be held on 18 Sep from 1:00 P.M. – 4:00 P.M. at the Bellevue Fire Training Site as a prelude to the Transportation Community Awareness and Emergency Response (TRANSCAER) Training. The exercise has been approved in NEXS. Secretary Reiter told the members to let Phyllis Dutton know if they wanted to participate in the exercise.
Fiscal: Vice Chair Lavelle reported the transfer of the Sarpy County LEPC account from the long-standing bank to the SAC Federal Credit Union to avoid incurring monthly service charges. Secretary Reiter informed the committee that with the new account there are no more monthly service charges, the LEPC is listed as a non-profit organization, and there are four signatories who can carry out financial transactions on behalf of the organization. The four signatories are Chairman Wilson, Vice Chair Lavelle, Coordinator Rink and Secretary Reiter.
Secretary Reiter reported that the checking account balance is $772.75 and the required savings account balance is $5.00. Secretary Reiter has provided the new account number to Sarpy County EMA to facilitate electronic transfer and routing of reimbursement from the State directly into the account. Vice Chair Lavelle mentioned that in the past, the State would send reimbursements check to county government and it involved a lot of paperwork to transfer the money from the county general fund to the LEPC. He also mentioned that Coordinator Rink had spoken with her State counterpart to arrange the direct transfer of funds and didn’t anticipate any future problems.
Legislative: Vice Chair Lavelle said there were no updates. Secretary Reiter informed the committee that she attended the 10 Jul State Emergency Response Commission Meeting in Lincoln and there was no current or pending legislation before the Unicameral involving the LEPC.
Right-to-Know (Outreach): Ron Clark provided the report for Carol Zimmer. There were a total of 9 volunteers for the Sarpy County Fair. Volunteers handed out about half of everything: pencils, pens, pamphlets, magnets, stickers. All in all, Chairperson Zimmer was pleased with the outcome. She is in the process of collecting feedback from the volunteers. Ron said that Chairperson Zimmer is looking for things that could be done better, things that could be done differently, and things that could be added next year. She intends to present a complete report at the November meeting and thanked everyone for their participation and patience. Vice Chair Lavelle added his appreciation for all the help out at the fair, including the fan provided by the Sarpy County Building folks.
Response Plan: Vice Chair Lavelle advised that updates to the Local Emergency Operations Plan (LEOP) are due in October. He requested that members provide his agency with any changes, and that changes are being made as they are forwarded to him.
Training: Training information was provided earlier in the Information Coordinator’s report.
OLD BUSINESS: Secretary Reiter stated that Nancy Braswell provided a source for the Shelter-in-Place magnets; however the mini grant application needs State approval first before the magnets can be ordered. Secretary Reiter reminded the committee that the previous Information Coordinator had not initiated the process for State approval to expend the funds, only that the committee had voted to approve the idea. Vice Chair Lavelle indicated that the magnets handed out during the fair were from Sarpy County 911. He advised that his agency would initiate the approval process for Shelter-in-Place house magnets with the Sarpy County LEPC name and general EMA number.
Secretary Reiter asked everyone to make any contact information changes directly on the sign-in sheets.
NEW BUSINESS: None.
Vice Chair Lavelle advised that the e-mail distribution list for the Sarpy County LEPC has been cleaned up. Secretary Reiter mentioned that the next meeting would be held on 14 November at Sarpy/Cass Department of Health and Wellness at 6:00 P.M. Craig Stoker indicated that his organization and possibly the Red Cross would be unable to attend due to a conflict.
Vice Chair Lavelle called for a motion to adjourn the meeting. Rolly Yost made a motion to adjourn, seconded by Jeff Ricks. All were in favor, none opposed, and motion passed unanimously.
Respectfully Submitted,
MARIA REITER
Secretary
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Updated 02/13/07
