EIIP Virtual Forum Presentation — April 28, 2010

The 2010 Integrated Medical, Public Health, Preparedness and Response Training Summit
Learning, Preparing and Responding Together

Edward Teevan
Section Chief, Day to Day Management

Leslie Beck
Training Program Specialist

National Disaster Medical System (NDMS)
U.S. Department of Health & Human Services

Amy Sebring
EIIP Moderator

The following has been prepared from a transcription of the recording. The complete slide set (Adobe PDF) may be downloaded from http://www.emforum.org/vforum/HHS/2010ITS.pdf for ease of printing. Note: Due to the flooding in Nashville, the Integrated Summit is being rescheduled. Check the link to the Summit Web site below for current information.

[Welcome / Introduction]

Amy Sebring: Good morning/afternoon everyone. Welcome to EMforum.org. I am Amy Sebring and will serve as Moderator today. We are very glad you could join us.

Today we are going to learn about another upcoming conference, the 2010 Integrated Medical, Public Health, Preparedness and Response Training Summit, which will take place in Nashville, May 12-16. There is a link to the summit Web site, http://www.integratedtrainingsummit.org/, from our home page.

One thing I wanted to point out is that if you click on the tab for Presentations and Photos you can access presentations from last year’s summit as well as its predecessors. As you can see there is a great wealth of information posted there. http://www.integratedtrainingsummit.org/presentations_and_photos.php

Now it is my pleasure to introduce today’s guests:

[Slide 1]

Edward Teevan is the Section Chief for Day to Day Support for the National Disaster Medical System (NDMS), US Department of Health and Human Services. He is a national instructor on disaster training and the Incident Command System. Mr. Teevan has 30 years of experience in emergency preparedness on the local, State and Federal levels.

Leslie Beck is a Training Program Specialist with NDMS. She has extensive experience with the Integrated Training Summit and has been the program lead for the NDMS Summit for the past 10 years.

Welcome to you both, and thank you very much for being with us today. I now turn the floor over to Ed to start us off please.


Ed Teevan: Thank you, Amy. Good afternoon, everyone.

[Slide 2]

The ASPR mission, which falls under Health and Human Services, is to lead the nation in preventing, responding to, and reducing the adverse health effects of public health emergencies and disasters. With that division, is to take the nation to have it prepared, to prevent, respond to, and to reduce adverse health effects in public health emergencies and disasters.

As you can see in our slide, both coming under that is the National Disaster Medical System, and ESAR-VHP, the Emergency System for Advanced Registration of Volunteer Health Professionals.

Also with us is the Office of the Surgeon General, who serves as American’s chief health educator, providing Americans with the best scientific information available, and how to improve their health and reduce the risk of illness and injury, as forming focus areas, disease prevention, eliminating health disparities, public health preparedness and concerns, and improving health illiteracy.

On the bottom of that, you’ll see the Chesapeake Health Program. The Chesapeake Health Program is a 501C3 non-profit corporation that was established in 1990 to respond to the educational and training needs of federal agencies, in particular, that of the Department of Defense in a time of declining resources. A lot of those resources boil down to dollars and cents.

With that, one of CHP’s primary goals is the advancement of the federal and state and just-in-time training. For the past 10 years, CHP has organized and managed the HHS and DMS training summit, one of the pre-cursors to the Integrated Training Summit, which at the time had over 2,500 participants in 2008. CHP has over 15 years of experience with federal, state, and local FEMA, and VA partners, and designing and implementing fully-accredited emergency medical training programs—both just-in-time and the full-fledged ones.

[Slide 3]

You see here the Medical Reserve Corps—the national network of local groups of volunteers committed to improving the health, safety and resiliency of their communities. The MRC mission is to engage volunteers to strengthen that public health emergency response and community resiliency. Based on the last quarterly report, there were approximately 206,000 volunteers enrolled in 874 MRC units, and those are located in within all 50 states, District of Columbia, Guam, U.S. Virgin Islands, Palau, and Puerto Rico.

The next level as we come up is the ESAR-VHP, which is on the state level. This is a federal program established in implemented guidelines and standards for the registration, credentialing, deployment of medical professionals in the event of a large-scale emergency. September 11 showed us the fact that you get a lot of volunteers, even currently with Haiti, there were a lot of volunteers who wanted to step forward and there was no way to track them or keep them up to date. With ESAR-VHP, that allows us to keep that in our particular venue.

On the National Disaster Medical System, currently there are over 7,000 intermittent employees. We work with the VA, the Department of Defense, and the Department of Homeland Security. We have teams such as the Disaster Medical Assistance Team (which most of you may be familiar with), the Disaster Mortuary Team, which works with the medical examiners, the National Veterinary Response Teams.

We have specialty teams, such as International Medical Surgical Teams. All of these teams work with or for the state and the locals. It’s a pyramid effect where if the locals can’t handle it, it goes back to the state. If the state says, "We’ve exhausted our resources," it comes to the federal level, and the federal level says, "What do you need?"

It used to be, "I need a DMAT or a DMORT". Now we’re asking for more tailored effect. What is your issue? What do you need? Let us help you. State and locals, you’re the boss. We’re here to assist you.

The Office of Force Readiness and Deployment—its full time employees are the U.S. Public Health Service. Their mission is to protect, promote and advance the health and safety of our nation. There are approximately 6,000 active duty, full-time, well-trained, and highly qualified professionals. There are dentists, doctors, nurses, environmental health officers, veterinarians, researchers, and health science officers.

There are 41 teams for the Commission Corps Readiness and Response, as well as 5 rosters of multi-disciplinary augmentees. In case of emergencies and disasters, all of these can kick into gear and we’re able to move forward in responding to your needs on the state and local level.

[Slide 4]

What we had prior to the ITS was each agency was having their own national training sessions. It wasn’t effective as far as from a money back. With the support of CHP, these organized into a joint training session that was held last year in 2009. Networking became the key factor, where people recognized that "Oh, you work across the hall from me." or " I’ve seen you such-or-such another venue." Players, responding to your needs, began to find out that all our neighbors were there.

The integrated training summit is a platform to provide depth of public health, medical, disaster response and preparedness training for all who are a part of the overall National Disaster Response Network. We use the word "disaster", but we also respond to events such as the Super Bowl, if requested, other sporting events, National Republican and Democratic Conventions, as well as currently with the inauguration of the Presidents.

In the first annual ITS, there was over 3,200 registrants. It was a free training open to the public. Unfortunately, the budget monster raised its ugly head, and it has come up that this year we were supposed to, under a co-sponsorship, charge people for attending these events including what Leslie will talk about, some of the workshops. This will allow this particular event to be self-sustaining in the future.

[Slide 5]

Since 1987, the NDMS has co-sponsored an educational event for medical disasters. In 2005, NDMS became the only sponsor for the NDMS Conference. Again, budget raises its head, and we are unfortunately charging people this year, and as Leslie may mention, we are getting an excellent response because we have delivered what we feel to be an excellent product.

In 2007, we redesigned the conference to become a summit. This summit included 10 specialized tracks which offer approximately 60 sessions.

[Slide 6]

On this next slide you’ll see specific programmatic training. We have offered invitational training to NDMS members. Currently, NDMS employees will avail themselves of the ICS 300 and 400 that will be specific leadership training for these people to make sure they hear the same message to deliver back to their teams.

There is an Incident Response Coordination Team. This IRCT goes out and is a forward-facing management team that interfaces between HHS in Washington, D.C. and the teams out in the field. One thing I would like to note—the VA, which is an NDMS partner, is currently hosting their annual National Emergency Management training on May 11, from 8 to 5.

With that, I’ll hand this over to Leslie.

[Slide 7]

Leslie Beck: Thank you, Ed. I’ll now just go into some summit information. As Amy stated, the 2010 Integrated Training Summit will be held at Gaylord Opryland, in Nashville, Tennessee from the 12th to the 16th. Currently, we have 2,878 people registered. This slide breaks down the registration types. When you go in to register you have to pick who your home would be. That’s where we get these numbers.

HHS employees are 1,752. Other federal departments include the NDMS partnership, FEMA, DHS, VA, DOD—479. State personnel are 92. General registrants, which make up all other people, is 377. Again, as Ed was stating, we do charge registration fees this year. They are charged on a sliding scale depending on what group you’re coming from. There are fees for the main training summit and fees for the individual workshops, which are post-event.

[Slide 8]

Our main training summit starts on the 12th and begins with an opening ceremony. We offer 3 general sessions, 6 joint sessions, 40 focus area sessions, and 99 poster sessions. We also have demonstrations which will be Wednesday through Friday, and a demonstration of the Disaster Medical Assistance Team base of operations in a 50-bed FMS (Federal Medical Station).

Also, we are sponsoring a run walk to integrate the Surgeon General’s mission of increasing exercise and fighting obesity. There was also be free blood pressure screenings available for those who are in attendance. There will be a static display on the 14th at the National Airport. This will consist of a demonstration of the aircraft use in disaster medical operations detachment and flight line safety. Again, we will be bussing people to the airport on May 14th. That is open to all attendees.

[Slide 9]

After our main summit, we go into post session workshops. Workshops range between 2-16 hour courses, and of course, their price varies depending on how long the workshop is. Currently, we are offering 25 workshops throughout the week. They will begin Friday at 1:00, and end on Sunday at 5:00 P.M.

In addition, the Chesapeake Health Education Program (CHP) is solely sponsoring an exhibit hall which will be open the extent of the event. It is not endorsed by NDMS or HHS, but it is co-located with the Summit.

[Slide 10]

Here is a breakdown of how we’re doing our sessions. We used to call them tracks, but now we call them focus areas. There are going to be 5 generic topics, and then 2 sessions per topic going on simultaneously. The ESF8 Integration focus area—they will have sessions that will address the integration of HHS assets with state and local governments, tribal entities, non-governmental organizations, and will show how being integrated with all of these folks allow for a more successful response.

Healthcare systems sessions will emphasize major issues of planning and delivering hospital services and healthcare mass casualty and mass effect disasters. Leadership sessions will cover elements of leadership and highlight the principles of goal-setting, communication, development and execution of plans, outcome evaluations and motivation.

Public health and clinical care services sessions will reflect on the multi-disciplinary and multi-cultural workforce and people involved when a community’s capabilities and capacities are met. It kind of goes with scarce resources, which is next. These lessons are observed, new approaches, and proposed standards of practice will be examined as well.

Scarce resource management and medical evacuation—these sessions will outline the importance of collaboration and coordination of scarce resources and medical evacuations between local, state, and federal partners.

[Slide 11]

Here’s a breakdown of when people are registering, they have to pick their primary interest within these broad areas. You’ll see ESF8 Integration is number 1 at 28%. Critical care is 22%. Leadership is 21%. Healthcare systems is 18%, and scarce resources is 6%. If someone doesn’t fall within those categories, what their interests would be, they are, of course, the 5%, other.

[Slide 12]

Our general session this year—our first general session is the National Level Initiative. This will go into the Healthcare Security Strategy and the Recovery Framework. That is scheduled for mid-morning on the 12th. Our second session is the 13th, and this basically addresses the private/public partnership and that’s the Integration of Emergency Management—the Challenges and the Rewards.

Our 3rd general session is on the 14th, and this focuses on our international partnerships. It’s Pandemic Influenza Response in North America.

[Slide 13]

The next slide basically shows the different accreditations we submit for our sessions. You can easily see the different disciplines that come, heavily health focused, of course. Most of these sessions are accredited by multiple disciplines so if you’re an ER doctor, you have multiple choices to go to. You’re not just stuck in one focus area—you can basically go to any of the areas and still get your accreditation.

[Slide 14]

We are already starting to do logistics for 2011. We will be in Dallas, Texas, from May 1-5 2011. Planning will begin as soon as this conference is done—we will start beginning 2011.

[Slide 15]

For questions and answers, I will turn this over to Amy who will be our moderator, who will assist with the question and answer period.

Amy Sebring: Thanks very much to you both for providing that overview. Now, to proceed to our Q&A.

[Audience Questions & Answers]

Amy Sebring:
Leslie, are you having any keynote speakers?

Leslie Beck: Great question. Yes. Actually, the Surgeon General, Vice Admiral Regina Benjamin will be our keynote speaker, and that will begin on the 12th. She will kick it off. The presentation begins with the 4 partners that we just talked about—NDMS, OFRD, MRC and ESAR-VHP—they will have a quick 5-minute opening of the heads of those program offices, and then Dr. Benjamin will come on and do our keynote.

Amy Sebring: Do you get fairly good attendance from the MRC participants?

Leslie Beck: I think this year we have about 700. They are included in the count for the HHS employees, and from MRCs this year, I think it’s about 750—a large number.

Amy Sebring:
Ed, I understand that NDMS does an exercise every year. I think they are having one at the moment. Are you involved in that, or know anything about that?

Ed Teevan: Yes. I wasn’t involved—I was here in Washington. They just completed an exercise in College Station, Texas. It featured approximately 300 NDMS employees, the intermittent employees from approximately 6 teams. Currently, the scenario for the field exercises is an earthquake scenario with a pediatric spin to it. They prepared themselves under that.

The training goes for approximately one week with the teams arriving, undergoing some training, undergoing some walkthroughs, and then they actually do the exercise. The next day they do a hot wash to see what’s good and what’s bad. After action reports are collected, and the top several things on the after action report are pegged for either the next exercise (because this year we are doing regional exercises) or it will be at the top of the list for next year’s trainings.

Amy Sebring:
Leslie, I noticed on your agenda the feature on the pandemic flu. Do you try to address current topics each year from the experience of the previous year?

Leslie Beck: We do. We try to focus on at least one of the issues from the previous year to bring it into the current year’s summit. H1N1 was huge, so that is one of our general sessions. We try to do 3 different things with our general sessions. We try to do a private/local/state response type of environment. Then, we do an international environment, which happened to be the H1N1 this year, which was great, and then one that is more of the federal perspective.

We try to hit them all because of course our audience is vast. With MRC, we have the local. With ESAR-VHP, we have the state. With us, we have our intermittents. With OFRD, we have our full-time feds. We try to hit them all within the 3 days.

Avagene Moore: Ed, with more emphasis on more public health and related discipline involvement in national and community preparedness, how is this impacting interaction and training for state and local emergency managers?

Ed Teevan: From the state and local managers, we have regional emergency coordinators that are in each of the 10 FEMA regions. HHS has adopted the plan to mirror those as opposed to reinventing the wheel. The emergency managers are able to reach out to the Health and Human Services Regional Coordinators, as well as having these RECs going out and reaching out to the emergency managers, depending on whether they are private and/or public emergency managers.

At that point, they can coordinate for training or be apprised of training in that area. Evaluations are done of what we can do to help training, augment what they have, and make it a coordinated response depending on the event or the disaster.

Isabel McCurdy: Being Canadian, I was wondering if there is any international involvement in this summit?

Leslie Beck: Our H1N1 right now is our big international one. I think about 10 people from Canada are coming. One of our RECs (Regional Emergency Coordinators) is detailed up to Canada currently. He is working with the health department, and I think they are bringing about 10 people from their health department to the Summit.

Dr. Tam is our speaker. She will speak on her perspective on H1N1 when it hit Canada. We have one of the health community leaders from Mexico speaking, and of course, we have someone in the U.S. as well. We do have representation on our H1N1 committee from Canada.

Amy Sebring:
Obviously, the integrated summit provides an opportunity for these major programs to get together and see who is working across the hall, but has this stimulated any effort, or is there any structure to continue that collaboration throughout the year?

Ed Teevan: Yes, we find that most people who wind up bumping into each other have also forwarded contact information saying, "Are you aware that these people within agencies (MRC, ESAR-VHP, NDMS), they talk among themselves and intra-agencies where they pick up contact information, and bring these reports and notes from sessions back?" They report back, and people have reached to all of us and said, "How can I get in touch with us?"

That is a year-long process. Throughout the year, we will have agencies contact us and want us train with us, or they with us, if we’re aware of the training.

Leslie Beck: That happens a lot, even for JPAC, training for some of our computer training for DOD. We’re doing a lot of training with them coming up. I think we, correct me if I’m wrong, did training with OFRD last year, and so the invitation is still out to the different groups throughout the year for other trainings—not just the summit.

Amy Sebring:
One of the things I noticed from last year’s program was a session on radiological—I’m sure that’s something that has been addressed over the years. Are there any sessions this year in terms of the concern of actual nuclear events?

Leslie Beck: I don’t have the program in front of me, unfortunately. My computer crashed. To the best of my knowledge, we did have an 8-hour session workshop with that and the participation was low. I think because we hit it heavy in the past, the past 3 years, I think people have already taken those sessions and workshops, so we plan on bringing it back in the following year to see what happens to it.

There could be something within the main summit, but there is nothing in the workshops. We did try to put it out there. It got limited response.

Amy Sebring:
Have you had information or sessions geared to the public information officer in health risk communications?

Leslie Beck: We do. We have workshops exactly for that currently—crisis and risk communication. MRC is sponsoring some PIO classes that are going to be there. Last year, we had evening sessions for that as well. This year we haven’t spoken with our PIO to see if we’re going to do that as an evening session, but they are throughout the program and at the workshops. We do cover that currently.

Amy Sebring:
Can you give us a round number on the fee for the main conference?

Leslie Beck: Sure. It’s a sliding scale, so I can go over it. HHS employees is $150 based on our co-sponsorship. For federal employees, it is $250. It’s past the early bird stage, so I think it’s $250. For general participants, it’s $500.

Amy Sebring:
Where do the MRC folks fit in there?

Leslie Beck: They are HHS employees, so they are part of the partnership.

Amy Sebring:
Do you plan to post the presentations from this year on the website?

Leslie Beck: Absolutely. We were trying to web-casting this year—it’s still up in the air, but we wanted to do a couple of live sessions by webcast. That’s still a possibility. Our training summit website (integratedtrainingsummit.org)—if we decide to do that, we’ll post it hopefully in the next week. We’re getting down to the wire so everything should be on there.

Avagene Moore: Along the same line as my earlier question, Ed, how successful is HHS and NDMS training and interaction with tribes and their organized groups? How extensive is the outreach and planning?

Ed Teevan: Currently, our reaching out to tribes has been limited. We’ve reached out to the RECs who have tribes in their areas and made this available. It comes under, more or less, working with the OFRD and the public health people who are in those areas. We’ve done nothing on any particular reservation or with any particular tribe, but that is always an option. It’s always available. I don’t think I’ve been in a meeting for any exercise that it hasn’t been on the table.

Leslie Beck: OFRD does that on a constant basis.


Amy Sebring: Time to wrap for today. Thank you very much Ed and Leslie. We appreciate your taking the time to be with us today and we hope that the Summit is a great success this year and you will be able to continue it on in the future.

Again, the recording should be available later this afternoon. If you are not on our mailing list and would like to get notices of future sessions and availability of transcripts, just go to our home page to Subscribe.

Thanks to everyone for participating today. Please join us next time.

We stand adjourned. Have a great day everyone!