VHA Comprehensive Emergency Management Program VAMC Site Visit Agenda

Department of Veterans Affairs

Veterans Health Administration

Office of Public Health and Environmental Hazards, Emergency Management
Strategic Health Care Group

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**[Prior to Visit]{.underline}**

1\. Complete Pre-survey

2\. Obtain documents for on-site review

-   Hazards Vulnerability Analysis

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-   Standard Operating Procedures for priority hazards

-   Emergency Operations Plan for past 3 years

-   Resource Inventory

-   List of mutual aid agreements/contracts

-   Incident Management Team assignments

-   Key Personnel Resource Matrix

-   Last two After Action Reports for exercises

-   Minutes from last six EMC meetings

-   Organization chart for Emergency Manager and Emergency Management
    Committee

-   Last two annual program evaluation reports of the Emergency
    Management Committee

-   If an FCC facility, NDMS plan

**Day 1:**

+------------------+------------------------+--------------------------+
| Time             | Person/Committee       | Topic                    |
+------------------+------------------------+--------------------------+
| 8:00am - 8:30am  | VHA Assessment Team    | -   Arrive at VAMC and   |
|                  | and VAMC EPC           |     meet EPC             |
|                  |                        |                          |
|                  |                        | -   Obtain additional    |
|                  |                        |     documents for        |
|                  |                        |     on-site review --    |
|                  |                        |     TBA                  |
|                  |                        |                          |
|                  |                        | -   Discuss any changes  |
|                  |                        |     to assessment        |
|                  |                        |     schedule             |
|                  |                        |                          |
|                  |                        | -   Set up work area     |
+------------------+------------------------+--------------------------+
| 8:30am -- 9:00am | Leadership             | Opening Conference       |
+------------------+------------------------+--------------------------+
| 9:00am --        | Facility Designee or   | Tour of facility,        |
| 11:00am          | EPC/ED Director/Chief  | including;               |
|                  | of Pharmacy            |                          |
|                  | (incorporate           | -   Patient Reception    |
|                  | standardized questions |     area; ED (including  |
|                  | during tour)           |     patient triage,      |
|                  |                        |     evaluation and       |
|                  |                        |     treatment;           |
|                  |                        |     integration of       |
|                  |                        |     patient reception    |
|                  |                        |     and decon, internal  |
|                  |                        |     and alternate        |
|                  |                        |     triage)              |
|                  |                        |                          |
|                  |                        | -   Bottled water and    |
|                  |                        |     any other emergency  |
|                  |                        |     supply/equipment     |
|                  |                        |     caches;              |
|                  |                        |                          |
|                  |                        | -   VA All-Hazards       |
|                  |                        |     Emergency Cache      |
|                  |                        |     (including staff and |
|                  |                        |     family prophylaxis); |
|                  |                        |                          |
|                  |                        | -   Decon Equipment      |
|                  |                        |     Storage Facility     |
+------------------+------------------------+--------------------------+
| 11:00am --       | Associate Director     | -   Administrative       |
| 12:00pm          |                        |     activities and EMP   |
|                  |                        |     mission/objectives   |
|                  |                        |                          |
|                  |                        | -   Interface with       |
|                  |                        |     community            |
|                  |                        |                          |
|                  |                        | -   Leadership           |
|                  |                        |     succession           |
+------------------+------------------------+--------------------------+
| 12:00am - 1:30pm | VHA Assessment team    | Working lunch and        |
|                  |                        | document review. Please  |
|                  |                        | locate documents in a    |
|                  |                        | single location.         |
+------------------+------------------------+--------------------------+
| 1:30pm -- 2:30pm | EPC                    | -   Emergency Management |
|                  |                        |     Program overview     |
|                  |                        |                          |
|                  |                        | -   NIMS Integration     |
+------------------+------------------------+--------------------------+
| 2:30pm -- 3:30pm | EMC                    | Program-level            |
|                  |                        | facilitated discussion   |
|                  |                        | using VHA Emergency      |
|                  |                        | Management Guidebook     |
|                  |                        | process. Topics to       |
|                  |                        | include:                 |
|                  |                        |                          |
|                  |                        | -   Emergency Management |
|                  |                        |     Program overview     |
|                  |                        |                          |
|                  |                        | -   Annual work plan and |
|                  |                        |     schedule             |
|                  |                        |                          |
|                  |                        | -   EOP -- ICS           |
|                  |                        |     development          |
|                  |                        |                          |
|                  |                        | -   HVA analysis         |
|                  |                        |                          |
|                  |                        | -   SOPs                 |
|                  |                        |                          |
|                  |                        | -   Relationships --     |
|                  |                        |     agreements -         |
|                  |                        |     Fulfillment of       |
|                  |                        |     community missions   |
|                  |                        |                          |
|                  |                        | -   Training             |
|                  |                        |                          |
|                  |                        | -   Exercises            |
|                  |                        |                          |
|                  |                        | -   Organizational       |
|                  |                        |     learning             |
+------------------+------------------------+--------------------------+
| 3:30pm -- 4:00pm | Chief of Food          | -   Food services during |
|                  | Services, Chief of     |     emergencies          |
|                  | Dietary                |                          |
+------------------+------------------------+--------------------------+
| 4:00pm -- 4:30pm | Employee               | -   Employee welfare and |
|                  | Representative(s)      |     personal             |
|                  |                        |     preparedness         |
+------------------+------------------------+--------------------------+
| 4:30pm -- 5:15pm | DEMPS Coordinator      | -   Deployment support   |
+------------------+------------------------+--------------------------+
| 5:15pm -- 6:00pm | VHA Assessment Team    | Debrief from day and     |
|                  |                        | plan next day            |
|                  |                        |                          |
|                  |                        | -   Review activities of |
|                  |                        |     the day to ensure    |
|                  |                        |     goals were met       |
|                  |                        |                          |
|                  |                        | -   Identify additional  |
|                  |                        |     data needs for next  |
|                  |                        |     day                  |
+------------------+------------------------+--------------------------+

**Day 2:**

+-------------------+-----------------------+--------------------------+
| Time              | Person/Committee      | Topic                    |
+-------------------+-----------------------+--------------------------+
| 7:30am -- 8:15am  | EPC                   | -   Overview of previous |
|                   |                       |     day and current      |
|                   |                       |     day's plans          |
+-------------------+-----------------------+--------------------------+
| 8:15am - 9:45am   | EPC and/or Safety     | -   Decon and PPE set up |
|                   | Officer               |     and demonstration    |
+-------------------+-----------------------+--------------------------+
| 9:45am -- 10:15am | Chief of Medicine     | -   Ambulatory clinical  |
|                   |                       |     services             |
|                   |                       |                          |
|                   |                       | -   All-Hazard Emergency |
|                   |                       |     Cache (medical       |
|                   |                       |     device)              |
+-------------------+-----------------------+--------------------------+
| 10:15am - 11:00am | Nurse Executive,      | -   Alternate Care Sites |
|                   | Associate Chief Nurse |                          |
|                   | for Emergency Care,   | -   Home Care            |
|                   | Emergency Department  |                          |
|                   | Nurse Manager,        | -   Specialty outpatient |
|                   | Designated Learning   |     services             |
|                   | Officer, Mental       |                          |
|                   | Health Clinician      | -   Patient Mental       |
|                   |                       |     Health and Welfare   |
+-------------------+-----------------------+--------------------------+
| 11:00 am --       | Chief of Staff        | -   Connectivity with    |
| 12:00pm           |                       |     CDC and other        |
|                   |                       |     federal agencies     |
|                   |                       |                          |
|                   |                       | -   Staff expansion      |
|                   |                       |                          |
|                   |                       | -   Lab, blood bank, and |
|                   |                       |     diagnostic imaging   |
|                   |                       |     surge                |
|                   |                       |                          |
|                   |                       | -   Mass fatality        |
+-------------------+-----------------------+--------------------------+
| 12:00pm - 12:30pm | VHA Assessment Team   | -   Lunch                |
+-------------------+-----------------------+--------------------------+
| 12:30pm - 1:15pm  | Chief of Infectious   | -   Isolation            |
|                   | Diseases              |                          |
|                   |                       | -   Infection control    |
|                   |                       |                          |
|                   |                       | -   Connectivity with    |
|                   |                       |     public health        |
+-------------------+-----------------------+--------------------------+
| 1:15pm - 1:45pm   | Chief of Police       | -   Perimeter management |
|                   |                       |                          |
|                   |                       | -   Security personnel & |
|                   |                       |     PPE                  |
|                   |                       |                          |
|                   |                       | -   Communications       |
+-------------------+-----------------------+--------------------------+
| 1:45pm - 2:30pm   | Chief of Human        | -   Call-back policies   |
|                   | Resources             |     for critical staff   |
|                   |                       |                          |
|                   |                       | -   Manpower pools       |
|                   |                       |                          |
|                   |                       | -   Leave and overtime   |
|                   |                       |     policies             |
|                   |                       |                          |
|                   |                       | -   Authorities and      |
|                   |                       |     limitations          |
+-------------------+-----------------------+--------------------------+
| 2:30pm - 3:15pm   | Public Affairs        | -   Media Relations      |
|                   | Officer               |                          |
+-------------------+-----------------------+--------------------------+
| 3:15pm - 3:45pm   | Chief Financial       | -   EMP Budget           |
|                   | Officer               |                          |
|                   |                       | -   Emergency Funds      |
+-------------------+-----------------------+--------------------------+
| 3:45pm - 5:15pm   | VHA Assessment Team   | Debrief from day and     |
|                   |                       | plan next day            |
|                   |                       |                          |
|                   |                       | -   Review activities of |
|                   |                       |     the day to ensure    |
|                   |                       |     goals were met       |
|                   |                       |                          |
|                   |                       | -   Identify additional  |
|                   |                       |     data needs for next  |
|                   |                       |     day                  |
+-------------------+-----------------------+--------------------------+
| 7:00pm - 8:00pm   | AOD                   | -   Demonstrate cascade  |
|                   |                       |     callback of critical |
|                   |                       |     staff                |
+-------------------+-----------------------+--------------------------+

**Day 3:**

+------------------+------------------------+--------------------------+
| Time             | Person/Committee       | Topic                    |
+------------------+------------------------+--------------------------+
| 8:00am - 8:30am  | EPC                    | -   Overview of previous |
|                  |                        |     day and current      |
|                  |                        |     day's plans          |
+------------------+------------------------+--------------------------+
| 8:30am - 9:30am  | EOC Activation:        | -   Incident Management  |
|                  | Incident Management    |     facilitated          |
|                  | Team                   |     discussion,          |
|                  |                        |     including tour of    |
|                  |                        |     EOC and activation   |
+------------------+------------------------+--------------------------+
| 9:30am - 11:00am | Chief Engineer and Key | -   Continuity of        |
|                  | Staff                  |     Operations           |
|                  |                        |     facilitated          |
|                  |                        |     discussion           |
|                  |                        |                          |
|                  |                        | ```{=html}               |
|                  |                        | <!-- -->                 |
|                  |                        | ```                      |
|                  |                        | -   Emergency Power      |
|                  |                        |                          |
|                  |                        | -   Portable generators  |
|                  |                        |                          |
|                  |                        | -   Fuel                 |
|                  |                        |                          |
|                  |                        | -   Medical gases        |
|                  |                        |                          |
|                  |                        | -   HVAC                 |
|                  |                        |                          |
|                  |                        | -   Infection control    |
|                  |                        |                          |
|                  |                        | ```{=html}               |
|                  |                        | <!-- -->                 |
|                  |                        | ```                      |
|                  |                        | -   Water conservation   |
+------------------+------------------------+--------------------------+
| 11:30am -        | Safety Officer         | -   PPE Program,         |
| 12:30pm          |                        |     including            |
|                  |                        |     respiratory          |
|                  |                        |     protection           |
|                  |                        |                          |
|                  |                        | -   Shelter in place     |
|                  |                        |                          |
|                  |                        | -   Transportation of    |
|                  |                        |     staff                |
|                  |                        |                          |
|                  |                        | -   Decontamination      |
|                  |                        |                          |
|                  |                        | -   Relations with Fire, |
|                  |                        |     including            |
|                  |                        |     communications       |
+------------------+------------------------+--------------------------+
| 12:30pm - 1:00pm | VHA Assessment Team    | -   Lunch                |
+------------------+------------------------+--------------------------+
| 1:00pm - 1:30pm  | Chief of Acquisitions  | -   Sharing Agreements   |
|                  | and Materials          |                          |
|                  | Management             | -   Contracts for        |
|                  |                        |     restoration of       |
|                  |                        |     commodities and      |
|                  |                        |     services             |
+------------------+------------------------+--------------------------+
| 1:30pm - 2:30pm  | CIO                    | -   IT & Computing       |
|                  |                        |     Resiliency           |
|                  |                        |                          |
|                  |                        | -   Voice & Data         |
|                  |                        |     Communications       |
+------------------+------------------------+--------------------------+
| 2:30pm - 4:00pm  | EOC, including Chief   | -   Tabletop focused on  |
|                  | of Staff, Chief of     |     medical surge and    |
|                  | Medicine, Chief of ED, |     incident management  |
|                  | Nurse Executive,       |                          |
|                  | Engineering, Safety,   |                          |
|                  | Police                 |                          |
+------------------+------------------------+--------------------------+
| 4:00pm -- 4:30pm | EPC and AEM            | -   Local Community and  |
|                  |                        |     Regional Support     |
+------------------+------------------------+--------------------------+
| 4:30pm -- 5:15pm | Associate Director,    | -   Patient Reception    |
|                  | AEM, Patient Reception |     Capabilities         |
|                  | Team                   |                          |
+------------------+------------------------+--------------------------+
| 5:15pm -- 6:00pm | VHA Assessment Team    | -   Debrief from day and |
|                  |                        |     prepare for Exit     |
|                  |                        |     Conference           |
+------------------+------------------------+--------------------------+

**Day 4:**

  ------------------- ------------------------- --------------------------
  Time                Person/Committee          Topic

  8:00am - 8:30am     Meet with EPC             Overview of day's plans

  8:30am - 9:30am     Leadership                Exit Conference

  10:00am             Depart for airport        
  ------------------- ------------------------- --------------------------