MEDICAL RESEARCH SUPPLEMENTAL DISASTER PLAN

**1 [GENERAL SUPPLEMENT]{.underline}**

A.  [Definition of Functional Responsibilities]{.underline}

> 1\. The office of the Associate Chief of Staff for Research (ACOS) is
> designated to initiate and implement the disaster plan.
>
> 2\. The employees of the Office of the ACOS will directly assist the
> Administrative Officer (AO/ACOS).
>
> 3\. The remainder of the Medical Research employees will function as
> outlined below.

B.  [Notification System]{.underline}

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1.  The ACOS is notified in accordance with Attachment 1 A, Chapter 1,
    Station Disaster Plan, and he in turn will notify the AO/ACOS to
    activate the plan.

2.  Through the Office of the ACOS, all Medical Research personnel will
    be notified. Emergency procedure instructions will be in each
    laboratory area to supplement the other notification procedures. The
    Office of the ACOS will establish and maintain a current address and
    telephone number file on all Medical Research employees.

3.  All employees, upon being notified of disaster plan activation, will
    report to their regularly assigned posts of duty and secure all
    laboratories and offices, taking care to shut off all non-essential
    electrical equipment and gas sources. Those employees regularly
    assigned to premises outside the VA will report to the ACOS\'s
    office.

4.  Employees will then be notified of further assignments (e.g., to the
    workforce in the auditorium, to aid in removing patients from the
    area, to secure office and laboratories, etc.).

> C. [Assignment of Responsibility and Plan of Action]{.underline}

1.  The AO/ACOS and Research Secretaries will staff the Office of the
    ACOS during activation of the disaster plan.

2.  The AO/ACOS and aids will assist in the primary assessment of
    damages and casualties, and will make a written report to the Office
    of the **ACOS.**

**II [SPECIFIC SUPPLEMENT]{.underline}**

A.  [Mass Casualty Plan]{.underline}

> Research Office will implement Disaster Alerting Procedures as stated
> in Master Plan. As a supplement to phone notification, a runner will
> be used in all disasters. **Research personnel should report to the
> auditorium to serve in the work forces, etc.**

B.  [Internal Disaster]{.underline}

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1.  Research Office will implement Disaster Alerting Procedures as
    stated in the Master Plan.

2.  If necessary, Research Office will evacuate essential records.
    \'\]\'his is the responsibility of the Editorial Assistant, with a
    program support clerk as the alternate.

3.  If the disaster is located in the Research area:

    a.  [Non-Radioactive Disaster]{.underline}

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1.  The employee should report the disaster by activating the nearest
    operating fire alarm.

2.  The reporting employee should request the assistance of a fellow
    employee to stay by the alarm system and direct emergency crew to
    the location of the disaster.

3.  The reporting employee should return to the disaster area and:

    a.  If possible, carefully remove any injured employee in immediate
        danger;

    b.  Fight the fire, if possible; and

    c.  Evacuate others in the adjacent area.

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    a.  [Reactive Disaster]{.underline}

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1.  The involved employee must notify the Research Radiation Safety
    Officer, Cheryl Curington, 392-6293.

2.  The involved employee must notify the VA Medical Center Radiation
    Safety Officer, Dr. Shailendra Shukla, extension 6514.

3.  Confine the contamination to protect other personnel in the area.

4.  If the disaster is not in the Research area, all Medical Research
    employees will report to the auditorium for the work forces, etc.

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C.  [Civil Disturbance Preparedness]{.underline}

    1.  Research Office will implement Disaster Alertino procedures as
        stated in Master Plan.

2\. All employees will report to the auditorium for assignment.

C.  [Hurricane Instructions]{.underline}

    1.  Research Office will implement Disaster Alerting Procedures as
        stated in the Master Plan.

    2.  When a hurricane/high winds WARNING is issued, all departments
        shall:

        a.  Unplug all unnecessary electrical equipment and appliances.

        b.  Store all equipment in safe areas away from windows.

        c.  Assure that all equipment and supplies are removed from
            hallways

        d.  Assist where needed or as may become necessary

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3.  All personnel must follow established procedures, as well as any
    instructions that may be issued.

4.  All employees not considered essential for immediate operations or
    manning the work forces may be administratively excused by the
    Medical Center Director when imminent storm warning is issued.

5.  The work force in the auditorium will be activated by the Assistant
    Personnel Officer when notified by the Command Center that winds
    have reached destructive force.

6.  [Inspection of the Facility]{.underline}

> a\. All Personnel **MUST BE ALERT** to unusual conditions during the
> storm. Be alert for:
>
> 1\) Small leaks in the ceiling.
>
> 2\) Seepage of moisture in the ceiling or around windows.
>
> 3\) Anything that seems abnormal.
>
> b\. Report these conditions immediately, as they arc a strong
> indication that this is a danger area.
>
> c\. Move all patients from this area immediately.

E.  [Civil Defense Take Shelter Plan]{.underline}

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1.  Research Office will implement disaster Alerting Procedures as
    stated in Master Plan.

2.  Alert Research Personnel of need for their area for shelter. Request
    they stop their ongoing work and require them to extinguish open
    flames and put away chemicals that could create a problem.

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F.  [Bomb Threat Plan]{.underline}

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1.  Research Office will implement disaster Alerting Procedures as
    stated in Master Plan.

2.  AO/ACOS will activate search teams to inspect Research areas. **Lab
    personnel will be requested to examine their lab carefully for
    packages, etc.**

    a.  If package container is found, personnel should contact the Bomb
        Alert Command Post, extension 6649. Do not move or disturb the
        package.

    b.  If a package is not found, personnel should tape a tiece of
        white paper on their lab door indicating the area has been
        inspected, lock the door and evacuate the building.

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G.  [Utilities Failure Action Plan]{.underline}

> 1\. Utilities affected:
>
> a\. Electrical h. Oxygen
>
> b\. Emergency Electrical i. Gas
>
> c\. Heat j. Vacuum
>
> d\. Water k. Telephone
>
> e\. Steam l. Deionized Water
>
> f\. Air Conditioning m. Elevators
>
> g\. Cold Room and Freezer Units

3.  Procedures

> a\. Cascade notification system is in place that involves the AO/ACOS
> or other office staff and the Research Service Bioengineer.
>
> b\. Depending on the utility failure or scheduled outage, the Research
> Office or the Bioengineer notifies the individual laboratories
> affected by phone or by placing an appropriate notice on the door of
> each lab stating the type of failure and duration of failure or
> planned outage.
>
> c\. The affected laboratories then put their own backup plans into use
> (i.e., use other sources of deionized water, delay III ongoing
> experiments, place frozen material in other freezer or ultralow
> freezer, etc.)

The program staff, under normal conditions, will constitute a planning
and training group. In the event the Take-Shelter Plan is activated,
they will serve on the Command Post Team in social work offices, rooms
A0303, A030a, and A030b. They will set up immediate inventories of
supplies and materials establish ration proportions, set up radiation
exposure teams and limits of exposure. They will establish contact with
Civil Defense authorities by telephone (374-5222). The program staff
will select and train Shelter Managers. The Radiation Control Officer
(RCO) will assure that a sufficient number of Radef Monitors are in the
responsibility of the RCO to maintain an up-to-date listing of Shelter
Managers and Radef monitors as listed in attachment 6A.

**3. CIVIL DEFENSE WARNING AND ALERT SIGNALS.**

> *• Warning.*
>
> *o External.* The national alert signal is a wavering tone of short
> blasts - it means that actual attack against this country has been
> detected and the population is to take protective action immediately.
> The City of Gainesville has no Civil Defense siren alert system. The
> city\'s alert is presently signaled by mobile police sirens throughout
> the city, commercial radio or television networks
>
> *o Internal.* The Director, or responsible official, shall inform the
> Graphic control Operator, extension 6616. Graphic Control operator
> will sound alarm through fire alarm system. Signal will be a rapid
> 5-5-5-5 repetitive chime, transmitted by the fire alarm system. All
> patients will be returned to their ward for head count and instruction
> for evacuation procedures
>
> . *• Alert.*

-   *External.* National signal is a steady blast or tone for three to
    five minutes. City of Gainesville signal will be over commercial
    communication networks or by phone

-   *Internal.* Same procedure as stated in \"warning\" above. Rapid
    succession of chimes for second time will be signal to evacuate all
    occupants of the medical center to shelter areas in the basement

> *• Attack Without Warning.*

-   There will be no alarm signal. A blinding flash means attack has
    come

-   Drop to floor; cover head with hands

-   Lie against wall or under desk or other large object to safeguard
    against flying glass or other debris. DO NOT look at flash as it can
    cause blindness

-   After the blast, go to nearest shelter area where organization
    personnel will arrange for first aid, food

> and water, sleeping arrangements and registration, and will
> disseminate information as available. In the event of attack, the
> following shall apply: After ALERT signals, further instructions will
> be broadcast by radio. After TAKE COVER signals, further instructions
> will be given orally to personnel
>
> in shelter areas by the Organization
>
> *• Attack with Warning,* see *attachment 6A*

**4. EVACUATION**

> • At the sound of the warning signal, all ambulatory patients on wards
> will be assembled. On second alert signal they will be evacuated to
> basement floor. Bed-fast or seriously ill patients that cannot be
> moved from their beds will be rolled into interior corridors or away
> from the windows if they must remain on portable medical gases. These
> patient must be abandoned, as shelter accommodations cannot support
> the seriously ill. All drapes and Venetian blinds must be closed to
> minimize flying glass from windows.
>
> • Employees will assist all visitors, outpatients, and admission
> applicants to shelter areas in basement.

**5.** **SHELTER LOCATIONS. (See attachment 6B)**

+-----------------------------------------+----------------------------+
| Command Post                            | Phone                      |
+-----------------------------------------+----------------------------+
| > Room A030 Social WorkOffice           | 6067/6599                  |
+-----------------------------------------+----------------------------+
| > Room A030a Social WorkOffice          | 6067/6650                  |
+-----------------------------------------+----------------------------+
| > Room A030b Social WorkOffice          | 6066/6649                  |
+-----------------------------------------+----------------------------+

  ----------------- --------------- ---------- ------ ----------------- ----- ------------
  Patient and                                                                 
  employee shelter                                                            
  shall consist of                                                            
  six basic areas                                                             

  **Area A**                        A036              Auditorium              2650 sq. ft
  (Theater area)                                                              
  shall include the                                                           
  following rooms                                                             

                                    A036a             Stage                   730 sq. ft

                                    A024-a&B          Volunteer               215 sq. ft

                                    A030c             General office          60 sq. ft

                                    A036b             Storage                 67 sq. ft

                                    A029              Stage Storage           220 sq. ft

                                    \*CB-5            Corridor                775 sq. ft.

  80% usable floor                                                            4717 sq. ft.
  space                                                                       (gross)

  \*only half of                                                              3774 sq. f.t
  cooridor will be                                                            (net)
  used Area A -- 94                                                           
  people                                                                      

  **Area B**                        B032a             MAS Office              180 sq. ft.
  (Locker Room                                                                
  area) area shall                                                            
  include the                                                                 
  following rooms                                                             

                                    B032              EMP Office              180 sq.ft.

                                    B033              Female Lounge           290 sq. ft.

                                    B055              Staff Lockers (F)       1055 sq. ft.

                                    A056              Female Toilet           835 sq. ft.

                                    A057              Male Toilet Area        600 sq. ft.

                                    A058              Staff Lockers (M)       1210 sq. ft.

                                    D100M             SPD Dressing            150 sq. ft.

                                    D100L             SPD Toilet &            130 sq. ft.
                                                      Shower                  

                                    B065              Vending Area            355 sq. ft.

  70% usable floor                                                            4985 sq.ft.
  space                                                                       (gross)

  Area B -- 87                                                                3490 sq. ft.
  people                                                                      (net)

  **Area C** (SPD                   D099              Office Area             322 sq. ft.
  and EMP) area                                                               
  shall include the                                                           
  following rooms                                                             

                                    D099A             Chief                   132 sq. ft.

                                    D099B             Assistant Chief         99 sq. ft.

                                    D100              Processing Stores       2170 sq. ft.
                                                      Area                    

                                    D100A             Case Carts              400 sq. ft.

                                    D100C             Equipment Storage       695 sq. ft.

                                    C100D             Prep. Cool Room         1209 sq. ft.

                                    D100E             Preparation Area        1804 sq. ft.

                                    D100G             Decontamination         1015 sq. ft.
                                                      Area                    

                                    D100P             Celan Receiving         1263 sq. ft.
                                                      Area                    

                                    D100R             Cart Wash Room          88 sq. ft.

                                    C071              Patient Clothing        336 sq. ft.
                                                      Storage                 

                                    D072              Soiled Linen            420 sq. ft.

  50% usable floor                                                            9953 sq.ft.
  space                                                                       (gross)

  Area C -- 124                                                               4977 sq. ft.
  people                                                                      (net)

  **Area D** (EMP,                  C080b             EMP Linen Room          375 sq. ft.
  Electric Shop&                                                              
  Carpenter Shop)                                                             
  area shall                                                                  
  include the                                                                 
  following rooms                                                             

                                    C086a             Electric Shop           900 sq. ft.

                                    C087              Carpenter Shop          3298 sq. ft.

  40% usable floor                                                            4573 sq.ft.
  space                                                                       (gross)

  Area D -- 46                                                                1829 sq. ft.
  people                                                                      (net)

                                                                              

                                                                              

  **Area E**                        A022              Lab                     400 sq. ft.
  (Radioisotope                                                               
  area) shall                                                                 
  include the                                                                 
  following rooms                                                             

                                    A023              Lab                     380 sq. ft.

                                    A020              Radioisotope            230 sq. ft.
                                                      Storage                 

                                    A021              Lab                     170 sq. ft.

                                    A019              Lab                     450 sq. ft.

                                    A017a             Office                  105 sq. ft.

                                    A017b             Chief, Nuclear          200 sq. ft.
                                                      Medicine                

                                    A017c             Office                  105 sq. ft.

                                    A016              Low Level               914 sq. ft.
                                                      Radioisotope            

                                    A013              Radioisotope Lab        354 sq. ft.

                                    A014              Secretary,              136 sq. ft.
                                                      Radioisotope            

                                    A015              Radiation Safety        154 sq. ft.
                                                      Officer                 

                                    A018              Reading Room            260 sq. ft.

                                    A012              Cardiology Lab          420 sq. ft.

                                    A06               General Lab             500 sq. ft.

                                    A02               Bio Chemical            441 sq. ft.

                                    A03               Lab                     410 sq. ft.

                                    A04               Lab                     190 sq. ft.

                                    A05               Lab                     190 sq. ft.

  50% usable floor                                                            6009 sq.ft.
  space                                                                       (gross)

  Area E -- 75                                                                3005 sq. ft.
  people                                                                      (net)

  **Area F**                        D103              Lab                     190 sq. ft.
  (Radioisotope                                                               
  area) shall                                                                 
  include the                                                                 
  following rooms                                                             

                                    D104              Lab                     190 sq. ft.

                                    D105              Lab                     190 sq. ft.

                                    D106              Lab                     190 sq. ft.

                                    D123              Lab                     190 sq. ft.

                                    D123a             Lab                     190 sq. ft.

                                    D122              Glass Wash              190 sq. ft.

                                    D114              Lab                     190 sq. ft.

                                    D113              Cage Wash               190 sq. ft.

                                    A01               Bio Chemical            190 sq. ft.

                                    D124              Lab                     190 sq. ft.

                                    D125              Office                  190 sq. ft.

                                    D01a              Office                  190 sq. ft.

                                    D121              Bio Chemical            190 sq. ft.

                                    D120              Equipment Storage       190 sq. ft.

                                    D117              Lab                     190 sq. ft.

                                    D116              Pre & Post              190 sq. ft.
                                                      Operative               

                                    D112              Animal O.R.             190 sq. ft.

                                    D111              Bio-Engineering         190 sq. ft.
                                                      Shop                    

                                    D108 &108a        Offices                 190 sq. ft.

  40% usable floor                                                            6877 sq.ft.
  space                                                                       (gross)

  Area F -- 69                                                                2751 sq. ft.
  people                                                                      (net)

                                                                              
  ----------------- --------------- ---------- ------ ----------------- ----- ------------

+-----------------------------------------------------------------------+
| Summary:                                                              |
|                                                                       |
| -   Shelter A -- 94 people                                            |
|                                                                       |
| -   Shelter B -- 87 people                                            |
|                                                                       |
| -   Shelter C -- 124 people                                           |
|                                                                       |
| -   Shelter D -- 46 people                                            |
|                                                                       |
| -                                                                     |
|                                                                       |
| -   Shelter E -- 75 people                                            |
|                                                                       |
| -   Shelter F -- 69 people                                            |
|                                                                       |
| Total -- 495 people                                                   |
+-----------------------------------------------------------------------+

6\. **SHELTER ASSIGNMENTS.**

> Ward employees will take blankets and pillows from wards when
> proceeding to shelters. Portable radios, recreation supplies and any
> coffee pots, cups, or containers that can be used to ration water or
> food distribution will be taken to the shelter areas by other
> employees.
>
> Wards on fourth and fifth floors will evacuate patients and employees
> to Shelter Area A (theater) using elevators P5, P3, and S1.
>
> Wards on second and third floors will evacuate patients and employees
> to Shelter Area B (locker room area) using elevators S2, P6, and P4.
>
> • First floor employees, visitors, and public will occupy Shelter Area
> C, E and F using stairs to get to
>
> • Employees in BuildingsTl through T10, Building 11 and Building 12
> will occupy Shelter Area C, E and F, using either the dock entrance at
> rear of the medical center or east entrance on basement level to enter
> the medical center.
>
> • Basement employees will use Shelter Area D (EMP, Electric Shop & SPD
> Storage).

7\. **COMMUNICATIONS.** Engineering employees will take portable radios
to the Command Post for distribution to Shelter Managers.

8\. **SHELTER MANAGER RESPONSIBILITIES.** (see attachment 6A)

> • Census - Shelter Manager shall immediately establish a head count to
> ensure their shelter is not overcrowded. One occupant for each 40
> square feet is criteria for long shelter stays. See paragraph 5,
> Shelter Locations, for number of people to be accommodated.
>
> • Appoint teams to prepare and distribute food.
>
> • Appoint water unit to haul water from well and distribute.
>
> • Appoint team to create sleeping accommodations. Rotate sleeping if
> necessary.
>
> • Establish communication system with other Shelter Managers by use of
> walkie-talkie radios or runners.
>
> • Assign shelter guards to settle disputes.
>
> • Assign chores to various shelters to keep children amused or provide
> entertainment.
>
> • Obtain radiation clothing from Radiation Control Office for Utility
> System Operators use.
>
> 9\. **SHELTER SUPPLIES.**
>
> • *Food.*

-   Canteen and Nutrition and Food stock will be inventoried and
    distributed in portions of approximately 600 calories per day

-   Fresh fruit and vegetables that would spoil in a short period of
    time will be distributed for consumption first

-   Canned goods, cereal, and dried foods that will last indefinitely
    can be saved for later distribution

-   Avoid salty foods as they increase consumption of water

-   If emergency generator is operating, frozen food distribution can be
    delayed. If generator is knocked out, distribute frozen foods for
    early consumption

> *• Water.*

-   Water may be available from the emergency well by the NHCU

-   Water is normally rationed at one quarter per person per day. With
    use of well, this can be increased

-   Water should be tested periodically. If contaminants are found, two
    teaspoons of household bleach per 10 gallons of water will make it
    safe to drink. Also, two drops of iodine in 10 gallons of water can

> be used. Water should be allowed to set for several hours until
> chlorine or iodine smell has disappeared

-   Utility System Operators would need radiation protective clothing
    and exposure periods will need to be closely controlled

> *• Medical Supplies.*

-   Since SPD, the warehouse, and the ENT Clinic are all within or near
    the sheltered areas, ample medical supplies will be available. The
    Orthopedic Laboratory will be pressed into service for emergency
    operations, if necessary

> *• Utilities.*

-   All utility lines will be left open as they continue to operate. If
    all city fed utilities are disrupted, the following will be
    available:

> *• Electricity.* The medical center will have an ample supply of
> electricity from the emergency generator to *operate* essential
> equipment. Underground fuel oil tanks of 60,000 gallons total capacity
> will keep the generator operating for several weeks
>
> *• Water.* Water supplies from irrigation well should provide ample
> emergency water
>
> *• Sewage.* Sewage lines should not be affected. Commodes could still
> be used, if wastewater is conserved and used for flushing. Sinks, tubs
> and floor drains would be usable
>
> *• Boilers.* Boilers could be run for short periods from fuel oil
> reserves until water level in boilers runs low. Operators would need
> radiation protective clothing and exposure periods will need to be
> closely controlled

10\. **CASUALTIES.**

Deaths occurring during shelter period would be handled as follows.

-   If emergency generator is operating, bodies will be placed in Morgue
    refrigerator and Research refrigerator.

-   If power is not available to keep refrigerated boxes cold, or deaths
    are too numerous for refrigerator capacities, bodies will be moved
    to sub-basement for burial. Bodies can be exhumed later for proper
    burial

> when outside radiation reaches a safe level.

11\. **RADIATION CONTROL [OFFICER.]{.underline}**

The Radiation Control Officer or alternate, will ensure Radiation
Clothing is available and monitor exposure periods.

12\. **GENERAL [INFORMATION.]{.underline}**

In the event of a threatened attack \"initial alert,\" the Secretary of
Veterans Affairs will initiate the Headquarters National Emergency
Alerting network (Cascade). Each designated official will see that the
message is communicated as required by the Cascade Chart and to those VA
elements for which they are responsible.

During a period considered as an \"advanced alert\" it is contemplated
that nonessential employees would be advised not to report for work, but
to monitor the Emergency Radio Broadcast System for general information
and guidance. It is possible that a Crisis Relocation Plan for the
general public may be directed as a strategic measure.

In the post-attack period, all other VA employees would follow the
instructions issued over the Emergency Radio Broadcast System and
attempt to contact the nearest VA facility. Department of Veterans
Health System personnel are encouraged to make themselves available for
other emergency duty and cooperate with local, state, and national
authorities until such time as recalled to VA duty.

Plans for reconstitution of the Federal Government have been designated,
following a hierarchy established by a series of Uniform Federal
Regional Council Centers. The Federal Regional Centers maintained by the
Federal Emergency Management Agency play an important role in this
continuity of Government Plan. VA liaison representatives to the FEMA
Regional Directors constitute our tie to these centers in addition to
our interagency coordination at their relocation site.

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