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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height="1.0972222222222223in"}

**October 30, 2008**

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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 VAMC EPC          |     > and 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 -- 11:00am  | Facility Designee or  | Tour of facility,     |
|                    | EPC/ED Director/Chief | including;            |
|                    | of Pharmacy           |                       |
|                    | (incorporate          | -   Patient Reception |
|                    | standardized          |     > area; ED        |
|                    | questions during      |     > (including      |
|                    | 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 -- 12:00pm | Associate Director    | -   Administrative    |
|                    |                       |     > 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  |
+--------------------+-----------------------+-----------------------+
| 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     |
|                    | Services, Chief of    |     during            |
|                    | Dietary               |     emergencies       |
+--------------------+-----------------------+-----------------------+
| 4:00pm -- 4:30pm   | Employee              | -   Employee welfare  |
|                    | Representative(s)     |     > and 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    |
|                     | Officer              |     > set up 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   |
|                     | Associate Chief      |     > Sites          |
|                     | Nurse for Emergency  |                      |
|                     | Care, Emergency      | -   Home Care        |
|                     | Department Nurse     |                      |
|                     | Manager, Designated  | -   Specialty        |
|                     | Learning Officer,    |     > outpatient     |
|                     | Mental Health        |     > services       |
|                     | Clinician            |                      |
|                     |                      | -   Patient Mental   |
|                     |                      |     > Health and     |
|                     |                      |     > Welfare        |
+---------------------+----------------------+----------------------+
| 11:00 am -- 12:00pm | Chief of Staff       | -   Connectivity     |
|                     |                      |     > with CDC and   |
|                     |                      |     > other federal  |
|                     |                      |     > agencies       |
|                     |                      |                      |
|                     |                      | -   Staff expansion  |
|                     |                      |                      |
|                     |                      | -   Lab, blood bank, |
|                     |                      |     > and diagnostic |
|                     |                      |     > imaging surge  |
|                     |                      |                      |
|                     |                      | -   Mass fatality    |
+---------------------+----------------------+----------------------+
| 12:00pm - 12:30pm   | VHA Assessment Team  | -   Lunch            |
|                     |                      |                      |
|                     |                      | -   Confirm time     |
|                     |                      |     > with BAH       |
|                     |                      |     > Project Leads  |
|                     |                      |     > for Thursday   |
|                     |                      |     > call           |
+---------------------+----------------------+----------------------+
| 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        |
|                     | Resources            |     > policies 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          |
|                   | Incident Management   |     > Management      |
|                   | Team                  |     > facilitated     |
|                   |                       |     > discussion,     |
|                   |                       |     > including tour  |
|                   |                       |     > of EOC and      |
|                   |                       |     > activation      |
+-------------------+-----------------------+-----------------------+
| 9:30am - 11:00am  | Chief Engineer and    | -   Continuity of     |
|                   | Key Staff             |     Operations        |
|                   |                       |     facilitated       |
|                   |                       |     discussion        |
|                   |                       |                       |
|                   |                       | ```{=html}            |
|                   |                       | <!-- -->              |
|                   |                       | ```                   |
|                   |                       | -   Emergency Power   |
|                   |                       |                       |
|                   |                       | -   Portable          |
|                   |                       |     > generators      |
|                   |                       |                       |
|                   |                       | -   Fuel              |
|                   |                       |                       |
|                   |                       | -   Medical gases     |
|                   |                       |                       |
|                   |                       | -   HVAC              |
|                   |                       |                       |
|                   |                       | -   Infection control |
|                   |                       |                       |
|                   |                       | ```{=html}            |
|                   |                       | <!-- -->              |
|                   |                       | ```                   |
|                   |                       | -   Water             |
|                   |                       |     conservation      |
+-------------------+-----------------------+-----------------------+
| 11:30am - 12:30pm | Safety Officer        | -   PPE Program,      |
|                   |                       |     > including       |
|                   |                       |     > respiratory     |
|                   |                       |     > protection      |
|                   |                       |                       |
|                   |                       | -   Shelter in place  |
|                   |                       |                       |
|                   |                       | -   Transportation of |
|                   |                       |     > staff           |
|                   |                       |                       |
|                   |                       | -   Decontamination   |
|                   |                       |                       |
|                   |                       | -   Relations with    |
|                   |                       |     > Fire, including |
|                   |                       |     > communications  |
+-------------------+-----------------------+-----------------------+
| 12:30pm - 1:00pm  | VHA Assessment Team   | -   Lunch             |
|                   |                       |                       |
|                   |                       | -   Call with BAH     |
|                   |                       |     > Project Leads   |
+-------------------+-----------------------+-----------------------+
| 1:00pm - 1:30pm   | Chief of Acquisitions | -   Sharing           |
|                   | and Materials         |     > Agreements      |
|                   | 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  |
|                   | of Staff, Chief of    |     > on medical      |
|                   | Medicine, Chief of    |     > surge and       |
|                   | ED, Nurse Executive,  |     > incident        |
|                   | Engineering, Safety,  |     > management      |
|                   | Police                |                       |
+-------------------+-----------------------+-----------------------+
| 4:00pm -- 4:30pm  | EPC and AEM           | -   Local Community   |
|                   |                       |     > and Regional    |
|                   |                       |     > Support         |
+-------------------+-----------------------+-----------------------+
| 4:30pm -- 5:15pm  | Associate Director,   | -   Patient Reception |
|                   | AEM, Patient          |     > Capabilities    |
|                   | Reception 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