Emergency Preparedness
Background
Santa
Cruz County has had more than its share of government declared disasters, 17 in
the last 25 years. It’s likely another will occur sometime soon. Now, in
addition to natural disasters, we are warned of impending disasters such as
bioterrorism. Our country has been at the second highest threat alert level
several times this year. The Grand Jury’s goal in this report was to assess
whether county agencies are adequately prepared to manage health and safety
issues resulting from a disaster.
Emergency
preparedness in Santa Cruz County has emerged from earlier Civil Defense
programs. It has expanded to include the following disasters: earthquakes,
fires, floods, tsunamis, bioterrorism, convergent refugees (people fleeing a
disaster from other counties), civil unrest, hazardous materials (HAZMAT) and
other large scale life-threatening situations.
Scope
The
purpose of this study is to assess preparedness of Santa Cruz County health and
human services agencies in the event of a disaster. Many agencies and groups
must collaborate to provide a swift, coordinated disaster response. Volunteer
organizations are critical to the success of county programs but are not within
the county’s jurisdiction. The Grand Jury includes volunteer organizations in
this study and refers to their roles without making recommendations to them.
In this study, the Grand
Jury evaluated the adequacy of current emergency plans, evaluated the Command
Post, and assessed communication and the availability of medical resources.
Other issues included: staffing, volunteer programs, and programs to warn the
public that rescue from outside the county and evacuation from the county may
be unavailable for up to 72 hours.
The
following entities are included in this review: the Santa Cruz County Office of
Emergency Services (OES) Health Services Agency (HSA), Emergency Medical
Services (EMS), and the County Board of Supervisors.
Glossary of Emergency Organization Roles: County emergency agencies receive some funding and direction from state and federal entities including the United States Department of Justice, Federal Emergency Management Agency (FEMA), and the Department of Homeland Security “Homeland Security”. OES must comply with state and federal guidelines. Homeland Security issues warnings and planning requests. OES is the liaison between government agencies in disaster relief efforts.
Once the President declares a disaster, FEMA mobilizes resources for recovery efforts in the area. FEMA then makes aid directly available to the public through a variety of federally funded programs.
During
an emergency, operations are coordinated at the Command Post located at De
Laveaga Park. When activated, the Command Post is staffed by the County
Administrative Officer who serves as Director of Emergency Services, the
Emergency Services Administrator serves as a Coordinator, a designated staff
person from the County Administrative Office serves as a Public Information
Officer, County Counsel serves as a Legal Officer and Risk Management provides
a staff person who serves as a Safety Officer. EMS also responds to disasters
at the Command Post. The EMS Emergency Coordinator reports to the Emergency
Services Administrator. Additionally, a Santa Cruz Chapter Red Cross (Red
Cross) representative and the Radio Amateur Civil Emergency Services (RACES) Officer have
Command Post seats.
County
Organizations:
The Office of Emergency Services is responsible for emergency planning and preparation for Santa Cruz County. OES assesses risks from disasters and develops operational contingency plans to address them. OES was created in 1980 and is currently co-located with the 911 emergency call center and the Command Post. This facility opened in 1996.
The Emergency Management
Council (Disaster Council), following State
guidelines, recommends emergency policy to the County Board of Supervisors. OES
provides staff to the Emergency Management Council. Red Cross is a member of
the Emergency Management Council along with the Radio Amateur Civil Emergency Services (RACES) Officer.
Emergency Medical Services manages pre-hospital
emergency services such as Basic Life Support and Advanced Life Support. Basic
Life Support care includes stabilizing a patient and transport to the hospital.
Staff may do airway management or defibrillation. Advanced Life Support
paramedics can also intubate, and administer emergency cardiac drugs.
The Disaster Designated
Medical Facilities supply additional medical care in an emergency. There are currently 14
facilities located throughout the county.
Volunteer
Organizations:
Community groups were originally formed to provide self-help when storms closed Highways 9 and 17 because county rescue operations were unable to locate people in need of rescue. Neighborhood coordinators work with radio operators, fire departments, schools, Red Cross and others to manage rescue information.
The Disaster Service Workers Program is comprised of trained volunteers, many with medical training, who enroll prior to an event and must take a loyalty oath.
The Community Emergency Response Team (CERT) concept was developed and
implemented by the Los Angeles Fire Department in 1985. The Whittier Narrows
earthquake in 1987 underscored the threat of a major disaster in California and
confirmed the need for training civilians to meet their local neighborhood’s
needs. The CERT program covers skills needed when emergency services are not
immediately available.
Red Cross Disaster Services focuses on meeting people's
immediate emergency needs. In a disaster, the Red Cross provides shelter, food,
and health services. Red Cross serves all of Santa Cruz County from around
Pescadero to Aromas and into the Santa Cruz mountains.
Amateur Radio Clubs Amateur Radio Emergency Services (ARES) and Radio Amateur Civil Emergency Services (RACES) both provide emergency communication during a disaster. The Federal Communications Commission (FCC) licenses radio operators and mandates emergency communication by radio operators. RACES originated as part of Civil Defense. ARES provides support to volunteer organizations.
Fieldwork
The
Grand Jury undertook the following fieldwork:
- Interviewed the
Watsonville hospital Emergency Services Director and toured the hospital
- Attended a meeting of
the Emergency Management Council
- Observed an annual
disaster drill from the Command Post at Emergency Services
- Interviewed the staff
at Emergency Services
- Interviewed the staff
of Emergency Medical Services at the Health Services Agency
- Interviewed the
Director of Disaster Services at Santa Cruz Red Cross
f.
Interviewed
the Emergency Services Administrator, Santa Cruz County Office of Emergency
Services
g. Attended a Mountain Community Resources Meeting – San Lorenzo Valley Community Group
h. Interviewed the RACES Officer
Additional Sources:
- County of Santa Cruz
Health Services Agency’s Bioterrorism Preparedness and Response -
Bioterrorism resources from the CDC Web site: http://www.bt.cdc.gov/
·
FEMA CERT program Web
site: http://training.fema.gov/EMIWeb/cert/overview.asp
·
911
SCCECC Communications Center Web site: http://www.sccecc.org/
- Aptos/La Selva Fire
District CERT Web site: www.aptosfire.com/cert.html
· Aptos Times article “Community Emergency Response Team” Jan. 1, 2003
- Red Cross Web site: http://www.sccredcross.org/
- Office of Emergency
Services Web site: http://scCounty01.co.santa-cruz.ca.us/oes/oesmain1.htm
· County of Santa Cruz Emergency Management Plan, April 2002
· Santa Cruz Emergency Medical Services Web site: http://www.santacruzhealth.org/phealth/ems/3ems.htm
·
Health
Services Agency Web site: http://www.santacruzhealth.org/
Findings
1. A threat assessment was recently completed by OES using a
Department of Justice grant. The assessment found that although there are not
many attractive terrorist targets in Santa Cruz County, there are plenty of
potential natural disasters. Monterey has possible targets but none compare to
San Jose, San Francisco or Los Angeles.
Potential convergent refugees fleeing from emergencies outside the
county—along with hazards that might come into the county such as radiation—are
issues that require planning.
Response: Santa Cruz County Board of Supervisors AGREES
2. Escape from a disaster is hindered by traffic. At capacity, only 1800 cars per hour per lane can travel on Highway 1. The population of Santa Cruz County as reported in the 2000 census was 255,602. Residents alone have 227,345 cars. Imagine the nightmare if everyone tried to leave a crowded location at the same time. (Santa Cruz County Transportation Commission) (2000 U.S. Census)
Response: Santa Cruz County Board of Supervisors AGREES
3. The County HSA is responding to medical issues specific to bioterrorism. A coordinated response will be conducted with fire, police, health care providers and other public agencies. Surveillance is being expanded to detect unusual or suspicious disease occurrences. Information about unusual diseases that might be the result of a bioterrorist attack is being distributed to emergency rooms and to medical personnel in the county. (cdc Web site)
Response: Santa Cruz County Board of Supervisors AGREES
4. The Command Post is in an isolated location but must get
information quickly about county issues.
An aerial view of a disaster site using a Civil Air Patrol plane, Coast
Guard helicopter, a Fire Services plane, or a helicopter volunteered by a local
citizen, would help in developing an appropriate plan. Currently, there is no
way to transmit an aerial view to the command Post.
Response: Santa Cruz County Board of Supervisors PARTIALLY AGREES
Aerial information is a
valuable tool in the coordination and management of emergency events. We have recently developed and are in the
process of implementing an aerial reconnaissance capability with the Civil Air
Patrol where digital images can be radioed directly to the Emergency Operations
Center.
5. The Grand Jury observed that many computers at the Command Post
were non-functional during the annual disaster drill. Since our visit, newer computers with maintenance contracts
arrived at the Command Post.
Response: Santa Cruz County Board of Supervisors AGREES
All computers in the
Emergency Operations Center have now been upgraded.
6. EMS would like access to information when at the Command Post. For
instance, the California Highway Patrol’s (CHP) website may indicate calls for
road closures. Hospitals need this information if a patient must be transported
over the hill to a trauma center and Highway 17 is closed. A new software
system is needed so that this type of information can be quickly and easily
distributed to the Command Post.
Response: Santa Cruz County Board of Supervisors AGREES
7. In a localized emergency, Santa Cruz County can get outside
help. However, if a disaster affects a
larger area, county residents will be on our own for some time. In any case,
parts of Santa Cruz County are isolated and terrain restricts access. Supplies
and resources will go to larger metropolitan areas first. It is impossible to
cache all of the supplies and equipment needed in the event of a major
disaster.
Response: Santa Cruz County Board of Supervisors AGREES
8. An emergency may require an urgent need for medication. There is
no cache of emergency medications including antibiotics in the county as
hospitals and pharmacies obtain them as needed. A medication cache requires
rotation of stock before expiration dates.
Response: Santa Cruz County Board of Supervisors AGREES
9. With only two emergency hospitals in the county, staff, resources
and beds are inadequate to deal with a disaster. In an emergency, Disaster
Designated Medical Facilities supply medical care for patients with minor
injuries to prevent overloading hospital emergency rooms. Disaster Dedicated
Medical Facilities are asked to have materials on hand to care for 50 patients
for three days; however, they have not made that financial commitment.
Response: Santa Cruz County Board of Supervisors AGREES
10. Homeland Security has given two small grants for first responders, administered by OES. Local officials identify the emergency needs of the community and request support from both the state and the federal government. FEMA is a funding contributor but the State OES, and the County OES, coordinate local disaster relief efforts. (OES Web site) (Emergency Management Plan)
Response: Santa Cruz County Board of Supervisors
PARTIALLY AGREES
County OES is currently managing seven grants
related to Homeland Security totaling over $1.3 million, with additional grants
anticipated in the 2004 Federal fiscal year.
11. Budget cuts are expected to hurt.
General Services is going through a horrific budget process right
now. The Grand Jury heard that budgets
are likely to be smaller—probably countywide.
EMS has some state funding but most funding is from the county. EMS
applies for grants when possible and recently received a trauma grant. When staff is out on vacation or due to
illness, work must be delegated to the department head, as there is no staff
relief.
Response: Santa Cruz County Board of Supervisors AGREES
12. Most of the money for emergency services after 9/11 has been for
equipment and training, not staffing.
Approximately $8000 has come to the county for a CERT program. The
administrative cost to set up the program was about $800, which was spent on
the first meeting.
Response: Santa Cruz County Board of Supervisors AGREES
13. Emergency planning staff is limited. Each county in California has the same disaster planning
requirements, regardless of size. Large
counties with more staff have less trouble fulfilling state mandated
activities. Santa Cruz County, the
second smallest county geographically in the state, has fewer staff. OES and
Emergency Services each have a staff of three, comprised of a manager plus two
staff. According to staff, this is
inadequate.
Response: Santa Cruz County Board of Supervisors PARTIALLY AGREES
The County agrees with this finding in terms of the
number of positions, but does not believe that this staffing level is
inadequate.
14. Currently, there are small Homeland Security grants to be
administrated by OES. Writing proposals and administration of the grants is
time consuming. Although 80% of new issues involve homeland security, there is
no new staff.
Response: Santa Cruz County Board of Supervisors AGREES
15. Civilians
can be recruited and trained as CERT teams that, in essence, will be auxiliary
responders. CERT teams can provide immediate assistance to victims in their
area, organize spontaneous volunteers who have not had training, and collect
disaster intelligence that will assist professional responders with
prioritization and allocation of resources following a disaster. Training was
made available nationally by FEMA in 1993. A new FEMA grant is earmarked for a
Santa Cruz area CERT program. (FEMA CERT Web
site)
Response: Santa Cruz County Board of Supervisors AGREES
16. Aptos/La Selva Beach Fire District is currently recruiting and training CERT volunteers to safely help themselves, and their neighbors in an emergency. Training topics include: disaster fire suppression, hazardous materials, disaster medical operations, light search and rescue operations, disaster psychology and team organization. A new CERT program is also forming in San Lorenzo Valley. (Aptos Fire Web site)
Response: Santa Cruz County Board of Supervisors AGREES
17. The Disaster Service Workers Program insurance funding has been recently reinstated in the State budget. During a disaster, trained volunteers are authorized to work under a declared state of emergency. EMS has a list of skilled people they can call upon to do medical work. RACES members also qualify as Disaster Service Workers.
Response: Santa Cruz County Board of Supervisors AGREES
18. Santa Cruz Red Cross receives no money from the American Red Cross
or from federal agencies such as FEMA or Homeland Security. Funding from United
Way is only available through the next 18 months due to a change that allows
payment for fixed shelters only. Although some materials come from the American
Red Cross, Santa Cruz Red Cross must do local fundraising to make up for the
lack of federal funding.
Response: Santa Cruz
County Board of Supervisors
The County has no jurisdiction over the Red Cross
and defers to that agency to respond to this finding.
19. Red Cross Disaster Services provides shelter and food to disaster
victims, supplementing the county’s mobile canteen services and offering
shelter for 100-1000 people. Red Cross sheltered 1700 people at the Santa Cruz
County Fairgrounds after the 1989 Loma Prieta earthquake. Emergency supplies in
moveable containers are located throughout the county such as at the airport,
and fire stations. Some of the sixty-seven local nurses who volunteer with Red
Cross work on pandemic* and
other disasters.
Response: Santa Cruz
County Board of Supervisors
The County has no jurisdiction over the Red Cross
and defers to that agency to respond to this finding.
20. Red Cross conducts town hall meetings and provides speakers and
training to neighborhood groups. Topics include sheltering in place***, disaster and pets, seniors,
disabled, and HAZMAT. Red Cross conducts disaster training using volunteer
trainers at community colleges. Red Cross also conducts shelter drills and is
working on a disaster compliance plan.
Response: Santa Cruz
County Board of Supervisors
The County has no jurisdiction over the Red Cross
and defers to that agency to respond to this finding.
21. Funding and project coordination of community groups are tied to a number of entities. For example, community group neighbors are working with a FEMA grant to raise the elevation of their houses to be above flood levels.
Response: Santa Cruz
County Board of Supervisors AGREES
22. OES is interested in establishing and working with more community
groups. OES and Red Cross will help train community groups interested in
mobilizing their own disaster planning efforts. Community groups help fill some
gaps of OES functions in planning and relief efforts. They also provide needed
eyes in the field for information flow.
Response: Santa Cruz
County Board of Supervisors AGREES
23. Consistent and accurate information will reduce public panic and
rumors. To address this issue, EMS is preparing fact sheets on how to manage
specific emergency situations such as; shelter in place, food and water safety
and hygiene, and others regarding power outages and evacuations tips. Currently
information can be sent to the media, read over phone, or put in libraries.
Response: Santa Cruz
County Board of Supervisors AGREES
24. Recently, the phone company agreed to reinstate the basic first aid
page in the phone book. However, it is currently somewhat hard to find and
incomplete.
Response: Santa Cruz
County Board of Supervisors AGREES
The County agrees with the finding that the
information has been reinstated and appreciates the phone company’s
partnership.
Conclusions
- The county should plan
for the most likely emergencies. The most urgent issue may be the
potential for convergent refugees fleeing from a disaster outside the
county. Money from Homeland Security would help county agencies achieve a
greater level of preparedness.
- Overall county
emergency planning is good. However because of the potential number of
different types and variations of disasters the county cannot plan for
every possible emergency.
- Digital cameras for use
in the field by aircraft could transmit emergency information to the
Command Post.
- The facility and
hardware at the Command Post are now adequate but communication software
is poor. Communications software is needed to support shared information.
A portable system would allow access from the primary site and remote
locations.
- A centralized cache of
emergency medications is needed to supply medical facilities.
- Staffing at OES is
inadequate to handle an increasing workload. The time constraint of
fulfilling the grant process may negatively impact staff needs in other
areas. For example, staff needs have increased with heightened alerts and
the recent HAZMAT concern.
7.
A
federal grant for CERT volunteer training is needed.
8.
Additional
support from government agencies is needed for volunteer programs such as
Disaster Service Workers, RACES, and Red Cross.
9.
Programs
that support and encourage volunteers, such as community groups, should be
pursued.
10.
EMS
needs to improve public awareness that residents will probably be “on their
own” until outside help is received.
People need to have enough medication available before the need arises.
Information should be distributed through the following methods:
·
Post
fact sheets on web site.
·
Send
fact sheet inserts with PG&E bills.
·
Distribute
fact sheets to students at schools.
11.
The
emergency information page in the phone book needs to be revised for easy
access and provide emergency instructions for home or work, including advice on
keeping a supply of medication.
Recommendations
- OES should acquire digital cameras for the Command Post for use in the field with a wireless method of transmitting the images.
Response: Santa Cruz
County Board of Supervisors
This recommendation has been implemented. Digital cameras have been
acquired with grant funds and a method of transmitting digital images from the
field directly to the Emergency Operations Center has been developed, tested
and is projected to be fully implemented by the end of calendar year 2003.
- OES should purchase
communications software for the Command Post that will function during
emergency situations and facilitate information access and sharing.
Response: Santa Cruz
County Board of Supervisors
This recommendation will be implemented. While “communications”
software is not a priority need, OES is in the process of acquiring incident
management software for the Emergency Operations Center through Homeland
Security Grant funding. As well, these
grants will provide funds for acquisition of the same software in each of the
city’s Emergency Operations Centers, County Fire’s Emergency Communications
Center, as well as the Sheriff’s Office and City of Santa Cruz incident command
vehicles to allow all emergency management team members a vastly improved
ability to share and manage real-time information and resources. Acquisition, installation and training is
scheduled to be completed by the end of calendar year 2003.
3. EMS should establish a local supply of enough emergency medications to last for at least three days to be kept at a central location. Stock should be rotated as needed.
Response: Santa Cruz
County Board of Supervisors
This recommendation is being
implemented. HSA maintains an inventory of
selected medications held by local pharmacies. This inventory shows very
limited supplies of agents that might be needed in a disaster or bioterrorist
event.
The Strategic National Stockpile (SNS) is
maintained at regional sites in the nation, and should be available within 24
hours to our county for a bioterrorist or disaster event. The county's
All-hazards Response Plan includes procedures to access the SNS.
HSA, through its EMS/Homeland
Security funding and in consultation with the Emergency Medical Care Commission
and our ambulance partner, AMR-West, is establishing a cache of equipment and
medical supplies, including selected emergency medications, in support of our
rapid response capability. Numerous items already have been ordered from the
current HSG grant. HSA, with continued grant support, will work with adjacent
counties and local medical institutions to identify and build up a supply of
critical medications, and to rotate the stock in a timely manner to prevent
expiration and wastage. This plan is a deliverable within our Bioterrorism
Response Plan.
- OES should add staff to write grant proposals and implement grants. OES should possibly share this staff with EMS. EMS should, at a minimum, maintain staffing.
Response: Santa Cruz
County Board of Supervisors
This recommendation will be considered as part of the 2004-05 budget
hearings. It may be that additional staff is needed, but the County is currently unable to finance
the cost to add staff since existing grant funds are very restrictive on
providing funding for staff resources and County financial resources are
extremely limited.
Emergency Medical Services program staff focuses
specifically on oversight of the emergency medical response infrastructure in
the County. Sharing the staff would not be effective since the EMS mission is
significantly different from that of the Office of Emergency Services.
5. The
county should obtain funding from FEMA
for CERT training programs.
Response: Santa Cruz
County Board of Supervisors
This recommendation has been implemented. The Office of Emergency
Services has recently been awarded a CERT grant from the Governor’s Office
which is in final contract review. The
grant agreement will be recommended to the Board of Supervisors in September.
OES has also transmitted a Notice of Intent to submit an application for 2003
CERT grant funds. Grant application
packages are scheduled to be delivered to OES in September.
6. The
Board of Supervisors should encourage formation and success of community groups
by providing lists, training opportunities and information about properties
from the county Assessor’s Office and parcel maps.
Response: Santa Cruz
County Board of Supervisors
This recommendation has been implemented. The County fully supports
development and involvement of community groups in emergency planning
activities. The Office of Emergency
Services and its partner agencies make every effort to provide these groups
with applicable information in support of their efforts.
- EMS should develop a
public awareness campaign with a broader distribution of information to
prepare citizens to be self-sufficient for at least seventy-two hours.
Information should be circulated as outlined in conclusion 10, including
working with the telephone company to improve emergency information and
utility companies to mail emergency information inserts.
Response: Santa Cruz
County Board of Supervisors
This recommendation is being
implemented. Focus Area F under the Federal
Bioterrorism Planning Grant process stipulates numerous deliverables related to
Public Information and Communication in disaster situations. A statewide
process is under development, in part through new centers established at UCLA
and UC-Berkeley, to help local agencies address this requirement. Print, radio,
television and advertising vehicles are being expanded to quickly alert the
public to safety and public health issues.
Our County, in partnership with the Santa Cruz
Sentinel, will be preparing a newspaper insert for delivery to all households
in the county that will contain the types of information called for in this
recommendation. Fact Sheets including Food and Water Safety, Evacuation, and
Shelter in Place are available and can be quickly reproduced and distributed,
depending on the nature of the disaster and the self-help modalities that will
be most effective. Video productions are being developed at national and state
levels to aid in public education via television in the event of a terrorist or
natural disaster. Resource materials are available now on federal, state and
local websites for individual residents to access and these can also be adapted
for mass distribution as flyers. A
community TV broadcast is being developed in September to further educate the
public.
With
scores of possible scenarios for natural disasters as well as chemical,
biological, radiological and blast attacks by terrorists, it is not possible to
provide specific guidance for every possibility. However, resource materials
are being developed at multiple levels of government that can be disseminated
quickly for the most likely events.
The
First Aid and Survival Guide in the SBC Smart YELLOW Pages (B1 - B6) represents
six pages of excellent, though limited, information. The Bioterrorism
Preparedness Plan will address the Grand Jury recommendations to enhance this
and other methods of educating and informing the public about supplies and
medications to have on-hand in emergencies.
Responses Required
|
Entity |
Findings |
Recommendations |
Respond
Within |
|
Santa Cruz County Board of Supervisors |
15-21 |
5, 6 |
60 Days (Sept. 2, 2003) |
|
Santa Cruz County Office of Emergency Services |
1, 2, 4, 5 7, 10, 12-14,
22 |
1, 2, 4 |
90 Days (Sept. 30, 2003) |
|
Santa Cruz County
Emergency Medical Services |
3, 6, 8, 9, 11, 13, 23, 24 |
3, 7 |
90 Days (Sept. 30, 2003) |
Note:
Santa Cruz County Board of Supervisors responded for Santa Cruz County Office
of Emergency Services and Santa Cruz County Emergency Medical Services.