Despite the passage of four full years since September 11, 2001, many small communities in the United States are struggling to meet the mandate for emergency preparedness and response that would enable them to function on their own in the hours or days before help arrives from regional, state, and federal sources. Readiness barriers include lack of clarity about who is responsible for preparedness and response planning, what elements of the planning and response processes are critical, how to coordinate with state and federal emergency management programs, and how to obtain and sustain funding. Whenever or whatever disaster or mass casualty event occurs, community and local response will be key to survival; communities must look to themselves and adjoining communities for answers.
This planning guide provides expert guidance on the emergency management planning process that is applicable to small, rural, and suburban communities. Its goal is to remove readiness barriers by providing all communities with strategies, processes, and tools for coordinated emergency management planning. The target audience is local leaders— including elected or appointed officials, health care providers and practitioners, public health leaders, and others who are responsible for initiating and coordinating the emergency management planning effort in towns, suburbs, and rural areas throughout the United States.
To develop this planning guide, the Joint Commission partnered with the Illinois Department of Public Health, the Maryland Institute of Emergency Medical Services Systems, and the National Center for Emergency Preparedness at Columbia University and convened two expert roundtable meetings in May and October of 2004.These roundtables addressed the issue of emergency management planning in small, rural, and suburban communities; synthesized the challenges; and framed potential solutions. This document reflects the extensive input received from roundtable participants.
Although no one planning tool or template can provide the breadth of guidance needed, this planning guide is offered as a multifunctional tool or template. It outlines 13 essential components of an effective community-based emergency management planning process and provides multiple planning strategies addressing each component. The components include the following:
- Define the community.
- Identify and establish the emergency management preparedness and response team.
- Determine the risks and hazards the community faces.
- Set goals for preparedness and response planning.
- Determine current capacities and capabilities.
- Develop the integrated plan.
- Ensure thorough communication planning.
- Ensure thorough mental health planning.
- Ensure thorough planning related to vulnerable populations.
- Identify, cultivate, and sustain funding sources.
- Train, exercise, and drill collaboratively.
- Critique and improve the integrated community plan.
- Sustain collaboration, communication, and coordination.
Each of the 13 sections includes supporting tools and provides links to Web sites that offer up-to-date information. The planning strategies are summarized at the beginning of each component section for ready reference. Thus, this guide can be used in a modular fashion to address discrete areas of interest to particular planning team members. Or it can be read cover to cover as a comprehensive guide to community emergency management planning.
This guide emphasizes two planning strategies that are of particular significance to small, rural, and suburban communities. The first is to enable people to care for themselves, and the second is to build on existing relationships.
Enable people to care for themselves
Planning that prepares the community to help itself can serve to reduce the potential surge in demand for services experienced during an actual emergency. The emergency plan needs to include a well-defined risk communication plan that contains information on the guidance that will be provided to the public and how that guidance will occur (for example, through distribution of fliers or other written material, or public service announcements on local radio and television stations). Some types of emergencies can be managed in homes with proper information, such as how to prevent and treat influenza in low-risk individuals during an outbreak in the community. For certain kinds of chemical exposure, the instruction to stay at home and take a shower rather than go to the hospital to be decontaminated is appropriate. Other types of emergencies will require mass evacuation, which is best supported by ongoing public communication, education, testing, and drills. Hurricane plans in Florida provide an excellent example of proactive, multilingual, and pervasive preparedness; evacuation signs are well recognized throughout communities in Florida.
Community awareness, education, and engagement can be supported not only through formal public health and public safety mechanisms and the local media, but also at a “grass roots” level through a range of community groups, such as civic organizations, religious groups, Boy/Girl Scout troops, and high school sport teams, among others. These groups provide not only information, but also social support for participation in the planning and response effort that will help individuals stay engaged over time, even during times of perceived “low risk” when apathy about preparedness can become pervasive.
Highly organized community preparedness efforts should also be supported. Communities whose residents have not yet experienced Community Emergency Response Teams (CERTs) may wish to consider offering this program. CERTs are funded by Congress through Citizen Corps program grants, which are made available to local communities. A key component of Citizen Corps, the CERT program trains citizens to be better prepared to respond to emergency situations in their communities. When emergencies occur, CERT members can give critical support to first responders, provide immediate assistance to victims, and organize volunteers at a disaster site.
The CERT program is a 20-hour course, typically delivered over a seven-week period by a local government agency, such as the emergency management agency or fire or police department. Training sessions cover disaster preparedness, disaster fire suppression, basic disaster medical operations, light search and rescue, and team operations. The training also includes a disaster simulation in which participants practice skills that they learned throughout the course.
Build on existing relationships
The time and resource requirements associated with emergency management planning, response, and recovery are considerable. Communities should carefully and creatively examine their current assets and expand upon them to best capitalize on their investment in preparedness. A key asset is the relationships that already exist among potential planning partners in the community; these relationships can serve as an important platform for building response capability.
Small communities located near military installations, nuclear power plants, hydroelectric dams, and other large-scale industrial entities are familiar with the extensive public education and collaboration required to maintain general public safety. Periodic joint meetings involving the local utility company, telecommunications company, water bureau, public health department, hospital, fire department, police, and emergency medical services (EMS) are not unusual in such communities, but in other communities there are longstanding walls that must be breached to facilitate collaborative planning. In such situations, it may be advisable to begin with natural allies who can quickly identify common ground. The following examples illustrate how to “call the first meeting” over a focused issue, then expand the work group into a broader, integrated community planning team:
- EMS leadership partners with the local hospital around first responder/first receiver communication issues, pulling in fire and police to initiate discussions about potential improvements. Further planning discussions expand the dialog and include the risks associated with certain types of communicable disease outbreaks. For additional expertise and operational information, the local health department, state laboratories, and bureau of primary health care clinics are brought to the table. The integrated community planning team builds from here to include broader areas of risk and response expertise respecting potential issues facing the community.
- A local municipality, in responding to the need to establish special needs shelters, has-through its department of human services and local nursing homes-identified all of the vulnerable disabled and elderly residents in institutions, but has not identified all those living in the community. The municipality establishes a work group that includes representatives from human services, nursing homes, the largest home health agency serving the community, the largest retail pharmacy serving the community, and the local postal service. They establish a preliminary plan for locating the vulnerable disabled and elderly in the community and, on the basis of this preliminary plan, are able to pull in representatives from local police, the 911 call facility, EMS, county mental health agency, and others to help refine the plan and address issues of service needs, communication strategies, transport, and medical equipment and supplies. Problem solving around this specific issue leads to collaboration on broader issues of emergency management planning in the community, and the integrated community planning team builds from there.
Finding dual uses for existing or emerging capabilities is also particularly critical for resource strapped small, rural, and suburban communities. A reverse 911 call system established by a community for law enforcement emergencies could also be used to communicate information about other types of emergencies. Motels and college dormitories can be utilized to provide additional bed capacity. Investments made by local public health departments in upgrading laboratory services for smallpox, Sudden Acute Respiratory Syndrome SARS, anthrax, and other specialized testing can buttress routine laboratory services in the community. Boats or school buses can provide alternative means of emergency transportation. Businesses with call-center capabilities, such as telemarketing and airline operations, can support community communication needs during a disaster.
By creating an informed and empowered citizenry, and by bringing to the table the full range of assets within the community including planning partners perhaps not previously considered, small, rural, and suburban communities can deepen and extend their capability to plan for and respond to all types of natural and man-made disasters.