HomeMy WebLinkAboutR12-001 Emergency Operations Plan, Appendix P Commissioner moved adoption of the following Resolution:
BOARD OF COUNTY COMMISSIONERS
COUNTY OF EAGLE, STATE OF COLORADO
Resolution No. 2012 - 00 I
RESOLUTION ADOPTING EAGLE COUNTY
EMERGENCY OPERATIONS PLAN, APPENDIX P
WHEREAS, Section 24 -32 -2107 of the Colorado Revised Statutes states each political
subdivision shall be within the jurisdiction of and served by the division and by a local or inter -
jurisdictional agency responsible for disaster preparedness and coordination of response;
WHEREAS, Section 24 -32 -2107 of the Colorado Revised Statutes states each county
shall maintain a disaster agency or participate in a local or inter jurisdictional disaster agency
that otherwise has jurisdiction over and serves the entire county;
WHEREAS, Section 24 -32 -2107 of the Colorado Revised Statute states each local and
inter jurisdictional disaster agency shall prepare and keep current a local or inter jurisdictional
disaster emergency plan for its area;
WHEREAS, the Eagle County Emergency Operations Plan was adopted by Resolution
No. 2010 -072 on June 29, 2010; and
WHEREAS, it is desirable to update and supplement the Eagle County Emergency
Operations Plan through the adoption of various appendices as detailed below.
NOW THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY
COMMISSIONERS OF THE COUNTY OF EAGLE, STATE OF COLORADO:
THAT, the Eagle County Emergency Operations Plan, Appendix P be adopted in the
form attached hereto as Exhibit "A" and incorporated herein by reference.
THAT, the Eagle County Emergency Operations Plan, Appendix P set forth herein
shall be effective as of January 3, 2012.
THAT, should any section, clause, provision, sentence or word in this Resolution be
declared by a court of competent jurisdiction to be invalid, such decision shall not affect the
validity of this Resolution as a whole or any parts thereof, other than the part so declared to be
invalid. For this purpose, this Resolution is declared to be severable.
THAT, the Board hereby finds, determines and declares that this Resolution is necessary
for the health, safety and welfare of the citizens of Eagle County.
MOVED, READ AND ADOPTED by the Board of County Commissioners of the County of
Eagle, State of Colorado, at its regular meeting held the day of 012.
COUNTY OF EAGLE, STATE OF
COLORADO, By and Through Its
BOARD OF COUNTY COMMISSIONERS
ATTEST:
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Clerk to the Board of * Jon Stavne
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County Commissioners Chairman
Peter F. Runyon
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Commissioner
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Sara J. Fisher
Commissioner
Commissioner seconded adoption of the foregoing resolution. The roll
having been called, the vot s follows:
Commissioner Stavney aineAlf
Commissioner Runyon Q
Commissioner Fisher a
This Resolution passed by vote of the Board of County Commissioners of the
County of Eagle, State of Colorado.
December 2011 Appendix P
Eagle County Emergency Operations Plan
PURPOSE
The purpose of the Eagle County Mass Fatality Incident Plan is to provide a concept of operations for a
coordinated response to an incident involving multiple fatalities by defining the roles and responsibilities
of various local, state, and federal agencies. This plan applies to all the agencies that may be involved in
mass fatality management within Eagle County which specifically includes but is not limited to:
• Eagle County Coroner's Office
• Eagle County Public Health
• Vail Valley Medical Center (VVMC)
• Local Funeral Homes
AUTHORITY
Under Colorado law C.R.S. 30 -10 -606 the Eagle County Coroner has statutory responsibility for the
investigation and determination of the cause and manner of all deaths and disposition of remains:
• Where no MD was attending or the MD will not sign a death certificate.
• All cases where the attending physician has not been IN ACTUAL ATTENDANCE within
30 days prior to death.
• All cases in which trauma may be associated with the death.
• Any patient who sustained a fracture, no matter how long ago.
• Deaths by suspected poison, chemical or bacteria, HAZMAT or radiation.
• Known or suspected suicide.
• Deaths due to contagious disease.
• Deaths due to self - inflicted or unexplained abortion.
• All operating room deaths during a medical procedure.
• All unexplained or suspicious deaths.
• All industrial accidents.
• Deaths in the custody of law enforcement.
• Deaths in the care of a public institution.
• Deaths that occur within 24 hours of admission to a hospital or nursing care program.
• All deaths that occur in a nursing home or as part of a hospice program.
In the event of a mass fatality emergency /disaster, the deceased are placed in the custodial care of the
Eagle County Coroner's Office. The Eagle County Coroner's office will need to ensure collaboration and
coordination with all other ESF #8 partners to the emergency /disaster.
DEFINITION
Eagle County has defined a Mass Fatality Incident (MFI) as one that exceeds the capabilities of the
County Coroner due to the number of simultaneous fatalities. This definition includes consideration for
circumstances that surround deaths due to the direct relationship between the circumstances and the
capability to handle the deaths.
The Eagle County Coroner has identified the following situations and corresponding number of deaths as
meeting the definition of a Mass Fatality Situation:
• Six (6) or more deaths with suspicious circumstances,
• Eight (8) or more deaths from traumatic injuries,
Appendix P -1
prepared by Beverly Smart
December 2011 Appendix P
Eagle County Emergency Operations Plan
• Twenty (20) or more deaths from a common illness.
A Mass Fatality situation as defined above will require the activation of the Eagle County Emergency
Operatiolns Center (EOC) (see appendix.B).
ASSUMPTIONS
• is the duty of the Office of the Coroner to determine the circumstances, manner and cause of all
, sudden, or unusual aths.
• isposition iolent of human remains de requires a death certificate.
• ass Fatality Incidents can occur as the result of many different types of incidents, both naturally
occurring and human caused. Likely scenarios that may cause mass fatalities in Eagle County
include:
. o Severe weather,
o Deadly infectious agent,
o Air traffic accident /incident,
o Multiple vehicle traffic accidents,
o Derailment of trains carrying toxic chemicals,
o Derailment of trains with passenger cars,
o Dam failure and resultant flood inundation,
o Structural collapse,
o Watershed/drinking water contamination,
o Terrorist activity,
o Radioactive or chemical release,
o Shootings at schools or other public places.
• equests for resources for aid with mass fatalities will correspond with Federal Response Plan
$SF #8 ( www. fema.gov /r- n- r /frp /frpesf8.htm).
• County agencies, hospitals, and other healthcare entities have limited fatality surge space or
equipment.
• he risk of disease from human remains is low
• hose who physically handle remains may be at risk of blood borne or bodily fluid exposure
#equiring universal precautions and proper training for handling the dead.
• It is more important to ensure accurate and complete death investigations and identification of the
plead than it is to quickly end the response.
• there is a limited capacity to store bodies.
• Deaths not as a result of the MFI will continue to occur.
• he time to complete fatality management of an event may exceed six months to a year.
• uring extreme events such as wide spread disease outbreaks and natural disasters, support from
utside Eagle County may not be available.
• edia might be present on scene and must be managed.
• amily members may search for loved ones at the incident scene and impede operations.
EPIDtMIC ASSUMPTIONS
• Epidemics from a known pathogen (i.e. influenza) may result in mass fatalities. It may be
$ssumed that all fatalities that occur during an epidemic presumably have died of the epidemic
thus relieving the Coroner's office from investigating every death that is unattended by a
• t hysician.
he need to identify bodies that result from an epidemic outbreak will be minimal.
Appendic P -2
prepared by Beverly Smart
December 2011 Appendix P
Eagle County Emergency Operations Plan
• Standard practices for fatalities require a cause of death and/or autopsy by a physician or the
Coroner. Instances such as epidemics from a known pathogen may trigger a State or Federal
"State of Emergency" which may wave these standard practices due to the volume or presumed
cause of death.
• Federal or Military assistance in fatality management may not be available to local jurisdictions
in widespread incidents such as a pandemic.
• Widespread illness could result in sudden and significant shortages of personnel that provide
critical public safety services.
• Healthcare workers and other first responders will be at a higher risk of exposure.
• Vaccines and antiviral agents will likely be delayed and in short supply.
• Deaths will be occurring at multiple locations such as hospitals, other treatment facilities and at
home. Processes and procedures will be significantly different from a single site Mass Fatality
Event.
• On average an infected person will transmit the infection to two other people
• The typical incubation period (interval between infection and onset of symptoms) for influenza is
approximately two (2) days.
PLAN ACTIVATION TRIGGERS AND PROCEDURES
The Eagle County Coroner will be responsible for the activation of this plan and will provide oversight
and coordination of resources and accomplish the recovery and identification of the deceased. The
Coroner will be responsible for notifying staff of the activation of this plan. Staff will be notified by both
phone and email. The Coroner will first notify hospitals and healthcare providers in the area, followed by
the emergency services departments including Fire Departments, law enforcement agencies, and
Ambulance districts. The Coroner will then notify trained personnel and volunteers of the situation and
activation of this plan. After notifying all staff and emergency responders the Coroner will then notify
potential service providers such as: the Red Cross, Greif Counselors, local chaplains, and other providers.
Should additional resources be required, support will be requested through the Eagle County EOC. The
EOC may request assistance from appropriate local medical and law enforcement agencies and/or may
request assistance from the State of Colorado Emergency Operations Center for support in the
identification, recovery, and preservation of remains.
MASS FATALITY INCIDENT MANAGEMENT
A Mass Fatalities Incident will be managed as a Unified Command Incident with the Coroner or designee
and other situational appropriate agency representatives.
Upon the arrival at the Incident Command Post (ICP) The Eagle County Office of the Coroner will
coordinate with the Incident Commander in the preparation of the Incident Action Plan (IAP) which will
incorporate specific details to address all mass fatality management issues and concerns.
PROTOCOLS FOR HANDLING MASS FATALITIES
The Eagle County Public Health Director or designee in consultation with the County Medical Officer
will review the County Coroner's plans, procedures, and protocols for the proper handling, storage and
sanitary management of mass fatalities and provide medical feedback as appropriate.
The Mass Fatalities Operation Plan includes:
Appendix P -3
prepared by Beverly Smart
December 2011 Appendix P
Eagle Cdunty Emergency Operations Plan
• body substance precautions,
• pecimens needed to determine cause of death,
• disposition -of- deceased requirements for each of the five CDC Category A Agents as identified
in the table below,'
Inhalatio n Anthrax Body Substance Blood, CSF for culture or Cremation
Precautions; Minimal other tests
Contact
Brucellosis Body Substance Blood for culture or other Cremation
Precautions; Minimal tests
Contact
Pneumo i . c Plague Body Substance Sputum, blood or lymph node Cremation
Precautions; Minimal aspirate for culture or other
Contact tests
Smallpofc Body Substance Initial vesicular /pustular Cremation
Precautions; Minimal fluid/scabs; then clinical
Contact history and picture
Tulare a Body Substance Blood for culture or other Cremation
Precautions; Minimal tests
Contact
STAFING NEEDS AND ASSIGNMENTS
Depending upon the extent and number of deceased during the MFI the Coroner may employ the
assistange of additional personnel to begin documentation required during an MFI such as:
• ] dentification and Tracking of fatalities supported by using:
o Law enforcement personnel,
o Funeral home personnel,
o Coroner and deputies,
o Others as deemed appropriate by the Coroner.
• Oeath Certificate completion supported by using:
o Coroner and deputies,
o Local Public Health Agency personnel,
1 Guidance concerning other agents (i.e. influenza, bubonic plague) as identified by CDPHE on an event-
by -event basis will be disseminated via the public health HAN network to emergency response partners.
Appendix P -4
prepared by Beverly Smart
December 2011 Appendix P
Eagle County Emergency Operations Plan
o Eagle County Registrars,
o Others as deemed appropriate by the Coroner.
LOCAL HEALTH DEPARTMENT RESPONSIBILITIES
The Eagle County Public Health Director or designee will:
• Notify the Eagle County Coroner's Office of confirmed or suspected disease threat through direct
phone communications or through (911) dispatch. Requests for enhanced surveillance from the
Coroner's Office are made if there is
o Increase in death data,
o Unusual illness /death.
• Collaborate with the Coroner's Office on necessary protocols for :
o Processing deceased patients, including determination of the cause of death,
o Recovery and decontamination of personal property,
o Personal protective equipment required for staff and others handling the bodies and/or
potentially contaminated property,
o Prophylaxis and/or immunizations/biologic requirements for involved staff. These
decisions will be influences by the type of biologic agent involved.
• Consult with the Coroner's Office and Office of Emergency Management on sites for temporary
mortuary facilities and appropriate disposal of bodies (burial or cremation).
• Collaborate with the County Coroner's Office on methods and procedures for data sharing and
reporting of fatality data to the Eagle County Public Health department on a regular basis (as
determined by the nature and magnitude of the event).
• Determine if the system for the issuance of death certificates needs to be augmented in order to
meet the needs of the incident.
• Consult with the County Coroner's Office on the need for local mass burial if maximum morgue
capacity is reached. The protocol for such an event includes the following:
o The County Coroner will request mutual aid through the Emergency Operations Center
o The Public Health Director or designee will participate in establishing criteria for
determining and documenting the cause of death and protocols for safely handling and
transporting bodies, if this has not been done prior to the occurrence of death.
o The Public Health Director or designee will work with The Eagle County Department of
Environmental Health to suppress potential vectors originating from inaccessible human
corpses or animal carcasses.
LOCATION
Taking into consideration the location and geographic terrain, the Mass Fatality portions of the Incident
Action Plan will include the following:
1. GRIDDING — Establish a system for documenting the exact location of the remains, personal
effects and evidence through sketches, photographs, flagging and GPS coordinates.
2. RECOVERY — Supervise the removal of remains, personal effects and evidence from the
mass fatality site to a secured holding site.
HUMAN REMAINS MANAGEMENT
Appendix P -5
prepared by Beverly Smart
Decemb r 2011 Appendix P
Eagle C unty Emergency Operations Plan
STAFFING NEEDS, ASSIGNMENTS AND EQUIPMENT
Eagle C Office of the Coroner will:
• Assume notification responsibilities for morgue investigation and technical staff, including the
Following:
o Clerical and Support Staff
o Technical Specialists
o Forensic Odontologist
o Forensic Anthropologist
o Fingerprinting
o DNA collection
o Death Certificate Coordinator
o Decedent Tracking Staff
o Victim Decontamination Staff
o X -ray
o Storage
o Receiving
o Shipping
o Embalming, if desired
• ('oordinate with state, county, and local agencies in the acquisition of all necessary equipment
3.nd supplies for the extent and quantity of body management,
• Oversee documentation requirements
• Maintain relationships with external /community partners, including but not limited to:
o Joint Information Center (JIC),
o ESF #8,
o ICS personnel,
o Office of Emergency Management,
o Funeral Directors,
o Faith -based Organizations,
NORM MORGUE CAPACITY
Depending on the size and nature of the incident, the Coroner will determine if a temporary morgue site is
needed iz another location.
VVMC does not have the morgue capacity that allows for long -term storage of the deceased.
• The following protocols will be implemented to the greatest ability of VVMC at the time of the
s ccurrence:
o Determine and administer appropriate personal protective equipment required for staff
and others handling the bodies and/or potentially contaminated property.
o Determine and administer prophylaxis and/or immunizations/biologic requirements for
involved staff. These decisions will be influenced by the type of biologic agent involved.
o Security will be deployed to control access to any temporary morgue holding areas
established on VVMC property outside of the emergency department.
• Locations will be considered for temporary holding of fatalities until Coroner can assume control
of the remains, including:
o Emergency Department Orthopedic Overflow room (if incident does not also include
mass casualties /traumas),
Appendix P -6
prepared by Beverly Smart
1
December 2011 Appendix P
Eagle County Emergency Operations Plan
o Hospital Decontamination Tent sans decontamination equipment (provided that patient
decontamination is not necessary for response),
o Under cover of the employee parking structure.
• Capacity and manner of storage of personal belongings will include:
o Security evidence collection bags will be used to secure all valuables of the deceased and
will be labeled with patient identifier.
o All other personal belongings will go into VVMC belongings bag and labeled with
patient identifier.
SURGE MORGUE CAPACITY
Capacity of the surge morgue will be established by the Office of County Coroner in partnership with
VVMC. The policies, procedures and agency responsibilities will be defined in a Memorandum of
Understanding (MOU), inter - agency agreement, or contract signed by all partnering agencies, and will
include the following sections:
Location, including assessment
o Disaster site management of human remains with proper documentation on site, including
sketches, photographs, flagging and GPS, preliminary documentation procedures, proper
removal and refrigerated storage until transportation can be arranged.
o Access and access controls for supplemental or temporary morgue operations.
• Triggers for activation and demobilization morgue capacity.
If the incident requires a temporary morgue location separate from the normal location of human remains,
the Coroner will determine where to establish the temporary morgue. Possible locations include:
• Warehouse
• Airplane hangar
• Fair ground building
The temporary location must have the required equipment and personnel as listed above (see Staffing
Needs, Assignments and Equipment).
PROCEDURES FOR HUMAN REMAINS STORAGE
Procedures for human remains storage are as follows:
• Establish an on scene processing station,
• Mark body bags with a patient identifier, time of death and case number of the deceased (to be
obtained by the Coroner),
• Body stacking and/or placing bodies in freezing temperatures is not recommended unless
permission is explicitly given by the Coroner.
INFECTION CONTROL POLICY
The infection control policy of each organization cover by this plan shall be followed and will include but
shall not be limited to:
• Personal protective equipment will be required by all staff and others handling the bodies and/or
potentially contaminated property.
Appendix P -7
prepared by Beverly Smart
Decemb r 2011 Appendix P •
Eagle County Emergency Operations Plan
• proph immunizations and/or biologic requirements for staff if a biologic agent is involved
n the incident will be adhered to by all personnel.
• Precautions should be adhered to for all personnel handling human remains to prevent risk of
flood borne pathogens or body fluid exposure.
RECOMMENDED SUPPLY LIST
• $0 Human remain pouches
• 150 Personal plastic Zip -lock bags
• 20 Waterproof marking pens
• 100 White bed sheets
• $0 ea. Small, medium, and large leather or working gloves
• $0 Rubber or latex gloves
• 3 Camera(s) with additional memory cards
• $0 Files
• 30 Pens
• 15 Pads of paper
• 1 Measuring tape
SECURITY
In order to keep the incident and surrounding operation areas secure, a security perimeter using cones,
ropes, o4 tape is needed, as well as staff to ensure no unauthorized personnel enter the incident or
operatio is site. There will be established entry and exit points with staff maintaining restricted access.
Media, bystanders, and nonessential personnel will not be allowed into the restricted areas.
Identificiition badges will be issued to appropriate personnel. If possible the ID badges should be made
site specific for the Family Assistance Center (FAC), temporary morgue, Incident Command (IC) center,
etc. Thee will be an access log or database that is kept up to date and maintained. Unauthorized
personnel will be immediately removed from the scene.
PSYCIOSOCIAL CONSIDERATIONS
It is assumed that an incident resulting in mass fatalities will also have a large number of survivors and
responders who will have prevailing mental health concerns. The following services will be provided to
survivors:
• ranslators
• ounselors
• mergency medical services
• ong -term medical services
• Information regarding long -term counseling
In order to mobilize the different services the Coroner will notify the agencies of the incident and request
assistance. Providers who are able to help will then report to the EOC and be directed to the proper
location by the IC. If the requested agencies cannot provide assistance then the Coroner will request
referrals ]to additional agencies that may be able to provide assistance. The Coroner will also request that
agencies]] spread the word about the incident to similar service providers and have them contact the
Coroner lif they are able to help. The services can be provided in various locations including:
Append' P -8
prepare by Beverly Smart
December 2011 Appendix P
Eagle County Emergency Operations Plan
• Schools
• Conference rooms
• Additional rooms in the Family Assistance Center
All staff handling decedents should be properly trained for handling the dead and made aware of the
stress associated with handling human remains. The psychological impact of a MFI limits the use of
volunteers. Based on their training volunteers may be used in non - recovery operations such as assisting in
the Family Assistance Center or relieving law enforcement officials in every day routine work. Staff that
is properly trained for handling the dead should be rotated in and out of active work to allow for rest in a
designated area. The Incident Commander (IC) will be in charge of scheduling a rest period at regular
intervals for the staff members as well as ensuring that the staff is properly rotated. The following
services will be made available to the staff members on scene or in the designated rest area:
• Local chaplains
• Counselors
• Food and water
• Medical services
FAMILY ASSISTANCE CENTER
During a Mass Fatality Incident, family members of the injured or deceased will need a place they can
receive support and be away from possible media problems. The purposes of the Family Assistance
Center (FAC) are to:
• Provide relatives of victims a location to receive information regarding the incident or victim.
• Protect families from media and curious onlookers.
• Allow investigators and Coroner access to the families to obtain information more easily.
The Coroner will be responsible for informing the family of the death the victim or appointing a
responsible person able to handle the stress of informing families of the victims' death. Only the Coroner
or the one person appointed by the Coroner can inform families of death in order to avoid incorrect
information transfer. Any information not involving the death of a victim will be given to the families by
the coordinator of the FAC, being either the Incident Commander (IC) or the IC appointed staff member
in charge of the FAC. In order to ensure information accuracy all information must reach the families
through the one person in charge of the FAC or the Coroner /Coroner appointed staff member. The FAC
will also have different services available to the families including:
• Grief counselors
• Local chaplains
• Translators
• American Red Cross personnel
• Salvation Army
The service providers will report to the IC at the Emergency Operations Center (EOC) when first arriving
on scene. After reporting to the IC they will be briefed on the incident, where the FAC is located, and
how to effectively travel there without disrupting the work being done by other staff members. If the
providers require anything additionally they will put in a request to the person in charge of the FAC once
they arrive at their proper location.
Appendix P -9
prepared by Beverly Smart
December 2011 Appendix P
Eagle County Emergency Operations Plan
The FAQ should be established as quickly as possible following a Mass Fatality Incident. The IC will be
responsiile for deciding the location and establishing the FAC. The IC will also be in charge of
coordinating the services in the FAC and sending relatives and staff to the correct location within the
FAC. If anther person is qualified and capable to coordinate the FAC including services and personnel
the IC cen give that person the authority to run the FAC, but still report to the IC. Emergency personnel
or the Coroner should meet with the families on a regular basis to keep them informed. Possible locations
for the FAC are:
• Hotel
• $chool
• Church
• (ponference center
VVMC SPECIFIC PROTOCOLS
Vail Valfry Medical Center will provide initial response for the specific management of fatalities within
its facility until the Coroner can resume command and control of each body, including but not limited to
the following:
• nsure VVMC Liaison actively participates in the incident Emergency Operations Center to
communicate needs /support capabilities with local authorities.
• Notify other area health care facilities for possible impacts from the event.
• Request additional body bags if needed.
• Request mental health support services
o Social Services
o Colorado West Regional Mental Health
o The Samaritan Counseling Center
• Oarticipate in the Joint Information Center (JIC) with other agency Public Information Officers
(PIOs)
COMIS✓IUNICATION
A Joint formation Center will be established as part of the Eagle County Emergency Operations Center
to coord nate the release of information regarding a Mass Fatalities Incident. At a minimum, the Eagle
County ommunications Department who will be in touch with the Coroner will be included.
DEMOBILIZATION
• The Coroner in conjunction with mortuary service will determine the need to open and close any
temporary morgue facilities.
PLAN EVALUATION
Revisioi Process
This plate will be reviewed on an annual basis with minor revisions made as necessary. Minor revisions
will be rthade as a result of changing laws at the local, state and federal level or by evaluating the process
of incidents across the country. Major revisions will be made every two to three years if no incident
occurs. If an incident does occur, however, the plan will be evaluated and revised as a part of the
debriefing based on how the event was handled and gaps discovered during the incident.
Appendix P -10
prepared by Beverly Smart
December 2011 Appendix P
Eagle County Emergency Operations Plan
The process will include input from partners in incidents including the VVMC, Public Health, The
Coroner's Office, Law Enforcement agencies, Mental Health and other service providers including clergy
and pastors
•
Appendix P -11
prepared by Beverly Smart
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