# Presentation: 356779

## MRC Partnerships: Enhancing the Emergency Response Infrastructure

***Best Practices in Local Partnership Building***
***and Integration***
**Martha Bird-Middleton**
**Allegany County MRC**

**Allegany County**

**Medical Reserve Corps National Leadership Conference**
**July 9, 2004**

**Notes:**
I am Martha Bird-Middleton of the Western Maryland Area Health Education Center and I am the Coordinator of the Allegany County Medical Reserve Corps (MRC). I have a masters in public administration and have coordinated numerous community projects, including working with volunteers as outreach workers. However, working with the Allegany County MRC has been one of the most vital and worthwhile projects of my life. As many of you in the audience know, we and our MRC partners have all been learning new ways to work together to make our communities safer, better places to live. 

What is an AHEC? 

## What is an AHEC?

**The Western Maryland AHEC mission is to improve access to and promote quality in healthcare through educational partnerships.**

**Notes:**
Western Maryland AHEC is a grass roots organization established as a vital link between the academic resources of the University of Maryland, other major academic health centers, and local community organizations. Its ten professional caucuses enjoy a membership of over 600 health practitioners who support the training and education mission of the agency.

For the purposes of creating an MRC in Allegany County, Maryland, the Western Maryland AHEC in fall 2002 convened a group of key emergency response stakeholders from public health, government emergency services, hospitals, volunteer centers, and community and faith-based organizations to serve as the Allegany County’s MRC Advisory Committee. 

The Western Maryland AHEC received funding later that fall to establish a MRC. We were the only AHEC in the country to receive this funding. Prior to September 11 (9-11), AHECs have not necessarily been linked to emergency response. We have come a long way. 

At this year’s National AHEC Organization National Conference to be held in Baltimore in August, numerous presentations are being conducted on AHEC involvement in emergency response, including a panel to present on the Medical Reserve Corps.

## Allegany County MRC Mission

**Recruit and train health care and community volunteers ****	****to respond to disasters and public health emergencies. **
**Support the existing community health care ****	****infrastructure, enhance the county’s emergency ****	****response infrastructure, and provide public education. **

**Notes:**
The best practices we are identifying through this presentation are a product of the Western Maryland AHEC and Allegany County MRC missions, past endeavors, and successes and the lessons we continue to learn with the Allegany County MRC. Please note the Allegany County MRC mission statement. 

## Defining Best Practices in MRC Partnerships

**Identifying Key Local Partners**
**Building upon an Effective Advisory Committee**
**Recognizing the Unique Role an AHEC and MRC partnership can Play; Developing Trust & Credibility**
**Engaging Educational Institutions**
**Understanding the Evolving Roles of State and Local Government**
**Recognizing the Unique Role a MRC can Play in its Community.**

**Notes:**
Last year, at the national meeting in Chicago, I compared starting an MRC to creating a quilt. This is still a strong image for me as I hear about what you as fellow MRCs are doing. There is an inherent diversity in our Corps as we evolve to fit the needs in our home communities and, as we all know, there are unbelievable pieces to fit together to actualize our mission. I am now, and was then, impressed with the work and dedication of everyone in this room. 

Working toward Allegany County MRC sustainability has been key this year. We have learned that sustainability can be solidly built by partnering with an existing response mechanism. In our case, we have incorporated the MRC with our Citizen Corps Council under the LEPC– this has given our quilt a border/structure. Our centerpiece has always been liability coverage for MRC volunteers. Immunity for volunteers is key to successfully recruiting health professions. We continue to work with our attorney, a former county commissioner, to ensure immunity during deployment as we work in Year 3 to transition the Allegany County MRC into stability under the LEPC.

Locally, we have identified that a critical need during a Homeland Security situation is to have access to trained and directed volunteers who understand incident command structure and their roles within it. Since Allegany County is within Appalachian Western Maryland, the need for increasing the emergency response volunteer base in the region is clear as we rely heavily on volunteers for many emergency  services, for example, the volunteer fire departments. Both the MRC and Citizen Corps are working diligently to meet this need. Building upon key local partners, I serve as one of the Citizen Corps Council co-chairs. My fellow co-chairs are the Director of the Volunteer Center of Allegany County and the Director of the area AmeriCorps, Center for Volunteerism and National Service. This triad is proving a strong partnership. Naturally, the Volunteer Center and AmeriCorps Directors serve on the MRC Advisory Committee. 

## Recognizing the Unique Role an AHEC & MRC Partnership can Play Developing Trust & Credibility.

**    *****Renewal: embracing a broader perspective.***
**Renew relationships with your natural partners!**
**Be flexible; it is as important as being strategic!**
**Listen to what’s happening locally!**

-               **Governor’s Wellmobile**
**The Governor’s Wellmobile, is coordinated through the School of Nursing, University of Maryland, Baltimore. **

**Notes:**
Via coordination of the Allegany County MRC, the Western Maryland AHEC has gained a new perspective on our community. We are now in partnership working intensively with the Allegany County Emergency Operations Center (EOC) and Local Emergency Planning Committee (LEPC), American Red Cross, and The Salvation Army– to name a few. These past two years the MRC has participated in Local Emergency Planning Committee (LEPC) activities, including input and participation in drills. Recently, the LEPC formally adopted the MRC incorporating the Corps, within their Bylaws, under the Citizen Corps Council. This has been approved by the County, which means the Allegany County MRC will have a permanent home and sustainability.

Back to how an AHEC can enable a MRC by its existing partnerships and infrastructure: As an AHEC, the MRC has been able to utilize our network and resources, most specifically, as an integral component in the community’s existing healthcare network the AHEC natural community partners include Community Hospital and Health Systems; Public Health Departments; Private Health Practitioners; Community Health Centers; Geriatric Care Providers; Public School Systems; Governor’s Wellmobile; and Federal, State, and Local Public and Non-profit Organizations.The Allegany County MRC is also are interacting (as a natural partner) with newer programs within the Allegany County Health Department (ACHD). For instance, the ACHD Bioterriorism (BT) Coordinator and BT Nurse and serve on the MRC Advisory Committee and MRC staff serves on committees/workgroups at the health department. The County’s Local Health Officer sits on the Western Maryland AHEC Board of Directors.  

This year the Western Maryland AHEC has looked to our infrastructure and mission to see how we can contribute sustainability for the MRC. Since the AHEC has 10 health professional caucuses which includes, among others: doctors, nurses, social workers, and counselors, the AHEC is establishing an interdisciplinary Emergency Preparedness Caucus, utilizing the AHEC infrastructure, to support recruitment and training of health professionals for the Allegany County MRC, which coincides with the AHEC mission. The Allegany County Coordinator for the Governor’s Wellmobile, a local nurse, as well as the Director of this Statewide program, serve on the Advisory Committee. The Coordinator has volunteered to work with the MRC and AHEC staff to set up the Emergency Preparedness Caucus. 

## Identifying Key Partners & Building upon an Effective Advisory Committee

**Partnerships work when we have****:**
**Clear objectives**
**Define membership and roles**
**Share resources (share information about funding                ****	****opportunities, past successes and pitfalls, consult with ****	****one another on grant opportunities, etc.)**
**Create clear and open communication channels**
**Expect mutual accountability**
**Promote not only the project but also one another**
**Humor! **
** **

**Notes:**
Fortunately, in Allegany County we have an active, progressive Advisory Committee who has supported the MRC from the beginning.  For instance, the MRC recently sponsored a free emergency preparedness focused Who Turned Out the Lights seminar for seniors at Western Maryland Health System (WMHS). Seminar sponsors included Western Maryland AHEC Dietetic Caucus; the Geriatric and Gerontology Education and Research Program (GGEAR), University of Maryland Baltimore (UMB); Allegany County Citizen Corps Council/Local Emergency Planning Committee; The Western Potomac Chapter American Red Cross; Volunteer Center of Allegany County RSVP Program; Allegany County Health Department, and the WMHS Wellness Center. 

## MRC Advisory Committee & Partners

**Allegany College of Maryland**
**Allegany County Board of Education**
**Allegany County Health Department**
**Allegany County Citizen Corps Council**
**Allegany County Local Emergency Planning Committee (LEPC)**
**Allegany County Medical Society**
**Allegany County Office of Emergency Services & Communications (EOC)**
**AmeriCorps - Center for Volunteerism**
**American Red Cross, Potomac Chapter**
**Department of Natural Resources**
**Emergency Management Systems - Regions 1 & 2**
**Frostburg State University**
**Governor’s Wellmobile, University of Maryland**
**Johns Hopkins Bloomberg School of Public Health/MidAtlantic Public Health Training Center**
**Maryland Institute for Emergency Medical Services Systems (MIEMSS)**
**Potomac Council Boy Scouts of America**
**The Salvation Army**
**Thomas B. Finan Center**
**University of Maryland School of Nursing**
**Volunteer Center of Allegany County**
**Western Maryland Health System**
**Western Maryland Area Health Education Center**
**Western Maryland Health System Chaplain Program**
**Western Maryland Critical Incident Stress Management (CISM) Coordinator**
**Western Maryland Community Crisis Response Team (CCRT) Coordinator**

## Bringing an Advisory Committee to the Table is only a Beginning

**An effective advisory committee has:**
**Philosophical buy-in/compatible goals**
**Management/leadership level buy-in**
**Active time contributions**
**Well-defined roles**
**Members feel valued and listened to**

**Notes:**
An effective, supportive Advisory Committee is KEY to the success of an MRC. In Allegany County, we hold regular monthly meetings and establish workgroups to address needs, for instance, the Community Crisis Response Team (CCRT) workgroup. 

The Local Emergency Planning Committee & EOC staff recommended we recruit the Western Maryland Critical Incident Stress Management (CISM) Coordinator to help us meet an identified gap in service in the community, which is to address the needs of secondary victims during an event. In June, we held our first two-day training for CCRT at the Finan Center in Cumberland and 16 participants signed up for deployment. CCRT, like the CISM team, will be deployed through the EOC. (The CISM Coordinator is now on the Advisory Committee and will mentor the oncoming CCRT Coordinator!!) 

## Engaging Educational Institutions

**139 Western Maryland public health and health care professionals participated in the Ma****rch 12, 2004 Severe Acute Respiratory Syndrome (SARS): What Every Public Health Professional Needs to Know training at Allegany College of Maryland. Pictured is featured speaker Rashid A. Chotani, MD, MPH, Director of the ****Global Infectious Disease Surveillance & Alert System (GIDSA) ****Center for International Emergency, Disaster & Relief Studies, ****School of Medicine & Public Health ****Johns Hopkins University. **

**The Allegany County MRC scientific training partner is the Mid-Atlantic Public Health Training Center, under the auspices of the Johns Hopkins Center for Public Health Preparedness and Johns Hopkins Bloomberg School of Public Health****. **
**Colleges & Universities, Community Colleges**

**Notes:**
139 Western Maryland public health and health care professionals participated in the March 12 Severe Acute Respirator Syndrome (SARS): What Every Public Health Professional Needs to Know training at Allegany College of Maryland. Pictured is featured speaker Rashid A. Chotani, MD, MPH, Director of the Global Infectious Disease Surveillance & Alert System (GIDSA) Center for International Emergency, Disaster & Relief Studies, School of Medicine & Public Health Johns Hopkins University. This program was brought to Western Maryland by the Allegany County Medical Reserve Corps, WMAHEC, Johns Hopkins Center for Public Health Preparedness, the MidAtlantic Public Health Training Center, and Allegany College of Maryland. The MRC financial in kind breakdown: $4,500 was contributed by our educational partners. Our share, the cost of distributing program material, some travel to planning sessions, and staff time. Each time we work in partnership, the more efficient we become in managing our resources. 

## Understanding the Evolving Roles of State and Local Government

_**Allegany County Immunity**_
**Request for MRC**
**Control & Direction (Local Tort: Annotated Code of Maryland) **
**“****A volunteer who, at request of the local government and under its control and direction, was providing services or performing duties.” **
** ****Person has to perform duties without actual malice.**
** **
_**Maryland State Immunity**_
**Performing services for or to the State **
**Satisfy the State Treasurer’s Regulations**
**“****Volunteer” is performing services to or for the State government... “(attached, note page 23)**
**      ****3.  Person has to perform within the scope of his/her duty and not be   ****	****grossly negligent or malicious.**

**Notes:**
Since immunity for volunteers is a most for MRC volunteers and the center of our quilt, let me explain how our current relationship to the State of Maryland and Allegany County can work. (Please note I am passing out the appropriate legal documents for you to have in hand as I speak. We are still crossing some T’s in this process. Please note the draft deployment schematic.)

## Recognizing the Unique Role a MRC can Play in its Community.

**The First Response to any Disaster **
**is a Local Response!**
** ****Training volunteers to be an Asset in an Event**
** ****Support to the Incident Command Structure **

**  ****Allegany County**

**Notes:**
In conclusion, Allegany County has adopted its MRC. Since its inception, the Allegany County MRC has served as a catalyst to bring new partners and resources into the emergency response community. As an AHEC, we now find ourselves embracing a broader vision of our mission as we support the Allegany County MRC’s ensuing growth and sustainability through the development of an Emergency Preparedness Caucus and by continuing to work with our educational partners to bring in training and resources, as requested, into the emergency response community.