Disaster Preparedness in Clinton County

  • By Cliff Caron

The Boy Scout motto is “Be Prepared”. Along with other meritorious activities, being prepared earns the successful scout a badge. If the Boy Scout creed carried over into adult life, the Clinton County Emergency Services team would merit a badge for its diligence. SB recently spent time at the Emergency Services Center (ESC) at PARC discussing the County’s ability to respond to and recover from any crisis.

Three pivotal team members of Clinton County’s E-Team include Paula Calkins-Lacombe, Director of the Clinton County Health Department; Ed Lydon, Assistant Vice-President of Facilities and Campus Development at CVPH Medical Center and Jim King, Director of Clinton County Emergency Management. Along with other team members, these three have developed and implemented emergency response protocols for disasters of all forms and causes — natural and man made.

“The training of emergency medical squads is critical in enabling us to respond,” Jim King explained. “It allows us to handle the situation seamlessly.” He further described the importance of the connection among groups and how the integrated communications system was essential to the handling of emergency incidents. When a crisis occurs, the county implements the Incident Command System which creates an effective synergy among the different agencies, in turn allowing a smooth, almost invisible, response.

In 1994 Clinton County spent four million dollars on a state-of-the-art communications system that was then far superior to any-thing else in New York State. Jim King believes the system retains its excellence today. All entities are able to communicate over the same network rather than each using its own system. The system uses wireless microwaves with back-up power, totally inde-pendent of the telephone network which, according to Jim, “is usually the first to go in a storm”. This unique communications system is live 24/7 and, to date, has never failed Clinton County, even during the Ice Storm in 1998. Jim went on to explain that there are 162 “talk groups” within the county, including the hospital, fire departments, the Sheriff’s department, highway departments as well as several town groups.

Defining a disaster is critical in determining how to respond. In natural disasters — where there is a serious loss of community in-frastructure such as roads, power and communications — the Emergency Management team is strategic in defining the incident man-agement system and implementing the proper response.

When the disaster involves any pandemic disease such as influenza or smallpox, then the Clinton County Health Department is paramount in assessing the crisis and directing the correct procedure to isolate and contain the problem. Whatever the nature of the disaster, the county’s ability to respond and resolve it, rests in the integrated nature of the Emergency Management Program. Devel-oping a successful partnership among the agencies and groups within the region has served Clinton County well. Groups in the partnership include government agencies such as the DOT and law enforcement, the Red Cross, veterinarians, and local businesses.

In the event of a major crisis, the ESC houses a “war room” known as the Emergency Operations Center. Within this command site, all of the groups involved can communicate directly with their own departments by dedicated telephones and computers. This arrangement allows each member of the response team to function within the parameters established, and to cross communicate needs and solutions with each other. While the ESC houses the facilities needed to direct a response, it acts in the role of facilitator to the varied entities involved in the crisis response and resolution. As Jim King put it, “We don’t tell them what to do — we don’t know their command structure. We just want to be sure that all the parties come together and get the job done.”

Ed Lydon explained, “We all function under the incident command structure. The hospital’s disaster plan is based on this sys-tem. Jim initiates the overall command system, then all of the participating entities put their piece in place — like a puzzle — and everything comes together.”

In the event of a national disaster, the Federal Emergency Management Agency (FEMA) gets involved. Ed stated, “The medical arm of FEMA is the Veterans Administration. CVPH is a designated hospital in times of national crisis.” In response to the tragedy of September 11th, FEMA notified CVPH, which then went into a national disaster mode, communicating on an hourly basis until the alert was downgraded.

The CVPH emergency department has two levels of alert response. At the first level, hospital staff — both medical and support — are relocated to assist the emergency staff in responding to the crisis. All hospital personnel are put on notice that they might be calling on to assist in various departments. In a second, more serious level alert, medical staff is shifted to the areas where they are needed to handle the flow of incoming casualty victims. At this response level, off-site facilities are closed in order to increase the number of medical staff available to maintain a high level of emergency treatment capability for extended periods of time. The pre and post-operative staffs and the OR facilities of the elective surgery department are re-assigned to handle victims. If the number of injured is great, the CVPH emergency response staff can access the Sports Medicine and Rehabilitation Center on the New Base at PARC for treating casualties. The Air Force designed the gym with back-up power to so it could be used to handle mass casualties and to provide bed space.

Before the September 11th tragedy, planning for a response to a terrorist attack was a low priority for the ESC group. Since September 11th disaster preparedness has been accelerated. Now public health concerns are at the forefront our local first line of defense.

Because of the tragedy, the Clinton County Legislature has put together a emergency response group referred to as HAZ-MAT/WMD — the acronym for Hazardous Materials Team/Weapons of Mass Destruction. In order to respond correctly to any bio-logical or chemical crisis, the County is acquiring new equipment that was previously unavailable at the local level.

There is a new responsibility placed on the County to deal with acts of terrorism. “Even the definition of terrorism is expand-ing,” Ed observed.

Higher security is evident at the U.S./Canadian border, as well as around nuclear energy plants. ESC members expressed their belief that our dangers are not over and the best prevention is the ability to react to an incident in a timely fashion and to be able to contain it.

Both the Clinton County Public Health Department and CVPH Medical Center pay critical roles in any response team. The ability to treat victims of bio-terrorism, as well as immunizing both the emergency workers and the public, would become paramount in these situations.

Paula Calkins-Lacombe is leading a task force to manage any biological crisis — whether terrorist-related or naturally occurring. Since the attacks on the World Trade Center and the anthrax scare, a committee was formed to assess Clinton County’s vulnerability to biological disaster and its ability to respond. The group’s initial mandate is focused on the following:

1. Communication to ensure that both the public at large and the medical community are informed of the dangers and the prevention activities in place.

2. Surveillance and response systems were implemented in early October to identify patterns which could indicate a possible terrorist threat. To create an effective response system, all reports come through the 911 emergency manangement dispatch which allows for simultaneous notification to all of the different law enforcement agencies as well as the Clinton County Health Department.

3. Identification and outreach to community partners was instituted following the anthrax scare to enlist community groups to participate in an overall disaster response.

Several videoconferences targeting county health professionals and law enforcement agencies were held by the Centers for Dis-ease Control. Future plans include the creation and distribution of a disaster resource book, increased training through the Incident Command System, a multi-partner biological exercise and a more comprehensive outreach program through all sectors of the region. Cooperation to combat biological threats is expanding to Vermont and Canada, where future meetings are scheduled to discuss and formulate joint response protocols. This new Emergency Management Team will focus on both the health and law enforcement aspect of any situation.

The importance of a coordinated effort across borders is critical to responding effectively to a threat. Paula explained, “We need to understand the logistics involved.”

“We’ve just received a directive from accreditation authorities,” Ed explains, “telling us that all of the area hospitals and emer-gency management people need to sit down at the same table to develop a regional response to any crisis.” He surmises that Franklin, Essex and Clinton Counties could be designated one region, adding, “Fletcher Allen is our level one trauma center even though it is not in New York State.”

Paula recalled recent incidents with West Nile virus and rabies. “Those cases taught us that there are no borders.” She continued, “Rabies outbreaks have occurred in Vermont, Canada and New York State, while the West Nile virus is affecting the entire Eastern seaboard. These problems have shown us that we need to regionalize, and the events of September 11th have taken that to another level.”

CVPH and the County Health Department are in daily communication to identify any cluster of patient symptoms that might suggest a biological or pandemic attack.

“We have many classifications of disaster,” explained Jim King. “And, the nature of the disaster will dictate which partners need to be involved in its resolution. Managing disaster preparedness is a never-ending process.” Training sessions are routine at the Emergency Services Center as are meetings between the response groups and state legislators.

The tragic events of September 11th have clearly demonstrated the need to have a well orchestrated response program. The ded-ication and commitment of the people involved in the safety of Clinton County residents left SB with the secure knowledge that while we cannot prevent every threat, there is a team of professionals behind the scenes that give us the freedom and luxury to lead our normal lives.

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