developing a healthcare coalition pediatric surge annex...charles macias pi key partners deanna dahl...

UnclassifiedFor Public Use

Access the recorded webinar here httpsattendeegotowebinarcomrecording6057161584090898178

Access speaker bios here httpsfilesasprtraciehhsgovdocumentsaspr-tracie-pediatric-surge-annex-webinar-speaker-biospdfContact ASPR TRACIE for a copy of the NHCPC 2019 Pediatric Workshop Summary

TRACIE HEALTHCARE EMERGENCY PREPAREDNESS

INFORMATION GATEWAY

Developing a Healthcare Coalition Pediatric Surge Annex

February 26 2020 ASPR

ASSISTANT SECRETARY ~-OR

PREPAREDNES S AND RESPONSE



llirL TECHNICAL IIPr RESOURCE$

__II_ ASS ISTANCE CENTER

J ~ INFORMATION ~ EXCHANGE

asprtraciehhsgov

1-844-5-TRACIE

askasprtraciehhsgov

ASPR AUIS1ANT bulllCUTtamp~ ~00

UIPAUDgt1111 ~gtIC UfPO~H HUtTHCdl h oUGpound NC1 HpoundhH0Npound~~

I NfORMAT IONGAIEWAf

ASPR TRACIE Three Domains

bull Self-service collection of audience-tailored materials

bull Subject-specific SME-reviewed ldquoTopic Collectionsrdquo bull Unpublished and SME peer-reviewed materials

highlighting real-life tools and experiences

bull Personalized support and responses to requests forinformation and technical assistance

bull Accessible by toll-free number (1844-5-TRACIE)email (askasprtraciehhsgov) or web form (ASPRtraciehhsgov)

bull Area for password-protected discussion amongvetted users in near real-time

bull Ability to support chats and the peer-to-peerexchange of user-developed templates plans andother materials

2

UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY

Resources bull ASPR TRACIE

o Pediatric Topic Collection o HCC Pediatric Surge Annex Template o HCC Pediatric Surge TTX Toolkit o Healthcare Coalition Select Resources Landing Page o Family Reunification and Support Topic Collection o Pediatric Issues in Disasters Webinar

bull AAP Resources o Pediatric Disaster Preparedness and Response Topical Collection

Pediatric Preparedness Exercises chapter o Pediatric and Public Health Exercise web page and Resource Kit

3



INFORMATION GATEWAY

ASPR ASSISTANT SECRETARY ~-OR


Jack Herrmann MSEd NCC LMHC Acting Director National Healthcare Preparedness Program HHS ASPR



Pediatric Surge Annex Requirements

In addition to core elements required for all annexesthe Pediatric Surge Annex must consider bull Local risks for pediatric-specific mass casualty

events bull Age-appropriate medical supplies bull Mental health and age-appropriate support

resources bull PediatricNeonatal Intensive Care Unit (NICU)

evacuation resources and coalition plan bull Coordination mechanisms with dedicated

childrenrsquos hospital(s)

2019-2023 Hospital Preparedness ProgramFunding OpportunityAnnouncement

HCCs must develop complementary coalition-levelannexes to their base medical surgetrauma masscasualty response plan(s) to manage a large number ofcasualties with specific needs

5



INFORMATION GATEWAY



John Hick MD Hennepin Healthcare amp ASPR Moderator



Webinar Objectives Setting Stage bull This webinar supplements the Pediatric Annex Planning Workshop at the 2019

National Healthcare Coalition Preparedness Conference bull Presenters will discuss guidance resources and lessons learned to help HCCs

develop a pediatric surge annex bull Agenda

o Overview of AAP and Pediatric Centers of Excellence o Deanna Dahl-Grove MD FAAP Associate Professor Pediatric Emergency Medicine

Rainbow Babies and Childrenrsquos Hospital Member AAP CoDPR Executive Committee o Christopher Newton MD Associate Professor of Surgery Division of Pediatric

Surgery Director of Trauma Care UCSF Benioff Childrenrsquos Hospital Oakland o Sarita Chung MD FAAP Director of Disaster Preparedness Division of Emergency

Medicine Childrenrsquos Hospital Boston Member AAP Council on Disaster Preparednessand Recovery

7



INFORMATION GATEWAY



Overview of AAP and Pediatric Centers of Excellence



bull bull

American Academy of Pediatrics DEDICATED TO THE HEALTH OF ALL CH~LDRENreg

ASPR TR AC IE ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY

American Academy of Pediatrics (AAP)

9


- _

Children amp Disasters DiiaS1 ir repare amp to rnect chdrens needs

Welcome 1iw tbull~~neR1ilttNigt-UOliigtilt0gtiurdOllc~--i~-bullbull 5t_-10lall_llltlbullILlnllIIJillibulltlnishCIltS_

ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH hoUGpoundNC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATION GATEWAY

American Academy of Pediatrics bull Most important contributions

o Pediatric disaster focus since 2005 o Pediatric experts who will review draft annexes or

certain sections o Models from other states (Chapter Contacts for

Disaster Preparedness) o Pediatric Disaster Care Centers of Excellence o Assistance with pediatric-focused exercises

bull NEW Council on Disaster Preparedness andRecovery o Those interested in membership can e-mail AAP

staff at DisasterReadyaaporg wwwaaporgdisasters

10


AAP Policy Statements bull Ensuring the Health of Children in Disasters bull Medical Countermeasures for Children in Public Health Emergencies Disasters

or Terrorism bull Providing Psychosocial Support to Children and Families in the Aftermath of

Disasters and Crises bull Chemical-Biological Terrorism and Its Impact on Children bull Supporting the Grieving Child and Family bull Disaster Preparedness in Neonatal Intensive Care Units bull Radiation Disasters and Children

11

I ls Your ED Pediatric Ready 1frac14~middothi 8a1te-~Pfgleel

En~ E~)C Arbull lor AI C hildr

Child1tmiddot 11 11 1tl 1lwi1 fo111 il i1middot- f1bullly 1111 1lw 1w11lA~I El) h1 lw 11middotad) lo providlmiddot o u h1uHli11g caremiddot urki1 1g

l0L7tlhcr W( ltan cmmrc that all EDs arc pcdiat1iltmiddot ready It is ~npk - pai-tilmiddotipatc in Uumiddot upcomin~ 2020 a-Mmiddot~~mcnt and lcmiddotan how yotu- ED (illl bLmiddot pcrli111r nmiddotndy

START OW to be PedsReady before taking the assessncnt lttartingjune 2020

011 (an hdp now lw doin~ the- frllowing-

~ Bnllkmn1k 1lw PedReadyorg rhsilr

~ Duw luad 11 c ~O 18 guidL Ii t1l s httpsftinyurlcornPcdsRcady

lti=gt~ Likmiddot amp sliae 11110 lmiddotdsR a d Faccbuuk JMgmiddot qiPcdsRcady

Supported by

iifm American College of i m Emtrgency Physicians ANANCflVG EMERGENCY CARpound -----v1--- EMERGENCY NURSES

ASSOCIATION

fttftfrtamp ietftlaquopound ~ed ~ ~c-1or Al ~

READY l11c 1m iquc needs of children and 1hcfr fomilics are oflcn ldi ouL of hospi11I disa -i1c1 plani To in1~1c pedinric disa~aer prepredness in1o your ED downloid 1he fu t C Disas1cr Prcparcd11css Chc-cklbt h1lpstinyurlconPedsReadyDisas1erPreparedness

American Academy of Pedia trics 4 DPDICATED TO THE HEALTf OF ALL C HI LDC PNbull ~

Supported in part by the US Department of Health and Human Services Health Resources and Services Administration Maternal and Child Health Bureau Emergency Medical Services for Children (EMSC) Program (cooperative agreement number UJ5MC30824)


UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY

ASPR - Pediatric Disaster Care Center of Excellence

bull One of 2 awardees - Eastern Great Lakes

bull Goal to harness the best practices around disaster preparedness and response shared with children and non-childrenrsquos hospitals and affiliates

bull Multi faceted approach working with hospitals and state partners to improve individual hospital preparedness regional pediatric capability expansion and alignment of state systems and programs

13


--

--

--

-

--

-

-

lIKIIIJ-fIC~IIUlllfOr03Nlil

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yen

Organization Chart Key Partners Charles Macias PI

Deanna Dahl Grove PI RAINBOW BABIES amp

CHILDRENrsquoS

Marie Lozon PI Stuart Braden PI

CS MOTT CHILDRENrsquoS

Ron Ruffling PI

CHILDRENS OF MICHIGAN

Julie Bulson PI Matthew Deneberg

MD PI HELEN DeVos

Brent Kaziny Meredith Rodriguez

EIIC

Amber Pitts Lauren Korte

Samantha Mishra

MI DEPT OF HEALTH

Christina Dew Tamara McBride Thomas Muldrow

OH DEPT OF HEALTH

Rachel Stanley PI Ellen McManus PI

NATIONWIDE CHILDRENS

Nathan Timm PI

CINCINNATI CHILDRENS

Michelle Moegling Elizabeth Cowen

Roth SR Project Managers

Corrine Friend

Project Coordinator

bull Departments of Health Emergency Medical Services and Emergency Management among other key state partners

bull EIIC - Emergency Services for Children Innovation and Improvement Center

14


Westem Region liance for Pediatric Emergency Manageme t

-ASPR ANT bull lCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY

Universities Facilities Seattle Childrenrsquos (UW) University of Oregon (OHSU) UC Davis UCSF Stanford Valley Childrenrsquos Hospital (Fresno) Loma Linda University CHLA (USC) Lindquist Institute (Harbor-UCLA) Cedars Sinai Rady Childrenrsquos (UCSD) University Medical Center (UNLV) Phoenix Childrenrsquos (ASU)

Agency Consortium Corporate State Departments of Health State EMS and EM Health Care Coalitions (HCCrsquos) Western Peds Preparedness Partnership (WPPP) Poison Control Centers Burn Centers Consortium Ebola Biocontainment Centers (NETEC) AMR Ambulance Reach Calstar Air Medical Ambulance Kaiser Permanente Providence Healthcare

13 Million Children ~150 Active participants

15

D

ASPR

WRAP-EM Board of Directors (Representation from each state)

State Agency Liason Committee (Each State HPP EMS Emergency Management or PH Representative)

PIrsquos

Medical Director James Betts

Regional Operations Director

Coordination Center

Sub Group ldquoEEIrsquosrdquo

Gap Analysis Group

Sub Group ldquoSupply Chainrdquo

Patient Movement Tracking

Sub-Group ldquoSurge Plansrdquo

Sub-Group ldquoEvacuationsrdquo

Sub-Group ldquoNICU PICU Special Needsrdquo

Sub Group ldquoTracking and Reunificationrdquo

CBRN

Mental Health

Infections

Burns

Telehealth

MCI Trauma

EMSC Readiness

Deployable Assets

Education IT

Clinical SME Operational Support Staff

6 Area Coordinators

Sub Group ldquoCenter

Integrationrdquo

Sub Group ldquoDrillsrdquo

UnclassifiedFor Public Use 16



INFORMATION GATEWAY



Deanna Dahl-Grove MD FAAP Associate Professor Pediatric Emergency Medicine Rainbow Babies and Childrenrsquos Hospital Member AAP CoDPR Executive Committee



Eastern Great Lakes Pediatric Consortium for Disaster

OHIO -~shy~- Haylul

ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY

Eastern Great Lakes Pediatric Consortium for Disaster Response - Helping Coalitions Prepare to Care for Children in

Disasters

Michigan and Ohio Region serving nearly 7 million children and their families

18


Components of the Annex bull Concept of Operations activation notification and roles with

responsibility logistics (staff space supplies) special considerations (behavioral health decontamination etc)

bull Operations for Medical Care triage treatment

bull Transport

bull Tracking

bull Reunification

19


Why is this important bull gt80 of children are seen in community hospitals and 13 of those are remote or

rural hospitals

bull Unique characteristics and needs of children (weight based medication dosing imaging and radiation exposure equipment sizes by age or weight)

bull Caring for a critically ill child is rare for most providers

bull Day to day readiness to care for children o Makes it that much easier to respond in a disaster involving children o Appropriate child diagnoses can stay in the community (less travel for families) o Increased healthcare provider knowledge regarding pediatric emergency care may

decrease provider burnout

20


Eastern Great Lakes Workgroups bull Pediatric Assets Map

o Regional Coalition Surveys o Childrenrsquos Hospital Survey o EMS Survey o Facility Recognition o Supply Chain Survey

bull Telemedicine bull Legal and Policy Review bull Behavioral Health bull HazardVulnerability Analysis

Education Collaboration with the other COE

Quality Collaboration with the other COE

Pediatric Strike Teams Exercise Development Information Technology

Integration

21


Regional Healthcare Coalitions and Pediatric Annex

bull Healthcare Coalition Partners EMS (Fire and First Responders) EMAhealthcare public health in addition may include schoolschild careprograms ambulatory health and long-term care behavioral healthbusinesses

bull Creating the Pediatric Annex across the community with a lens on children and families

bull Emergency Spectrum of Care from first responders to emergencydepartments first line healthcare followed by the support fromhealthcare facilities to create a web of response to respond to needs dayto day and in a disaster

22


Pediatric Annex in Rural areas bull Connecting the community partners (revealing the pediatric assets and defining the

challenges)

bull Prehospital Pediatric Champion within emergency services (shared resource) to improve transport asset

bull Contacting the Pediatric Center (where the more critical children are referred)

bull Identifying a Pediatric Champion within a healthcare institution (shared resource)

bull Pediatric Center can offer education quality and tele (-medicine -health) support to increase the capability of staff day to day

bull Community can feel more empowered to support children and families in a crisis and increase the resilience to withstand a large event

23


Eastern Great Lakes Pediatric COE and Pediatric Annex

bull Creating a common facility recognition in the region using common language to assist pediatric champions at the institutions

bull Pediatric Champions to be supported by education and quality initiatives enhance the capability and capacity to care for children day to day and preparing for a disaster (httpsemscimprovementcenter)

bull Connecting the initiatives of prehospital Pediatric Champions in communities to create collaborative educational and quality opportunities across the emergency spectrum (httpswwwemsohiogovemsc-pediatric-careaspx)

24


Pediatric Readiness Enhanced by the Presence of a Pediatric Emergency Care Coordinator (Champion) bull Who is a Pediatric Emergency Care Coordinator (PECC) - physician nurse mid-

level (or other healthcare provider) with desire to improve pediatric emergency care at their institution with the support of hospital administration

bull What is the role of a PECC - support and identify education for staff quality improvement patient safety works collaboratively with EMS and ensure disaster plans incorporate children

bull May be a shared resource with small community facilities

bull Collaboration with Prehospital Pediatric Care Coordinators httpsemscimprovementcenterdomainshospital-based-carepediatric-readiness-projectreadiness-toolkitguidelines-administration-and-coordination-ed-care-children

25

Tier

Childrens Hospital

Childrens Hospital with PICU amp Pediatric Trauma Verification

Hospital bull Accredited as a Pediatric Hospita l andor a Verified Pediatric Trauma Cent er

Annually Regiona l Pediatric Disaster drills Conventional care Benchmarks The hospital exhibits the highest level of prepared ness exhibiting the ability to

Offer elcpert support and consu ltation to non- pediatric hospitals providing care for serious Iv in ju redill patients

Disaster TriggerContingency Care Indicator

For Burn victims consul t State Burn Surge Plan

middot The hospital RPAT has developed appropriate contingency policies amp processes to increase bed capacity by 50

Training Resources

PALSENCP

FEMA d isaster training

TNCC

ATLS

TierI

Pediatric Ready

Hospital w ith Pediatric ED and or Pediatric Unit staff by Pediatric

Nursing and Providers

Hospital bull Ped iatric providers 12 hrd ay at minimum

Annually incorpo rates p ediatric pat ient s as a part of a regional exercise Conventional Care Benchmarks The hospital exhibits the highest level of preparedness exhibiting t he a bi l ity to

Provide initia l assessment and stabilization airway management i nitial fluid resusc itation and pain management) for pediatric pat ients and preparation of patient(s) fo r safe transfer to a d es ignated facil ity as ind icated

Offer e xpert support and consultatlon to non-ped iatr ic hospitals providing care fo r serious Iv in ju red ill patients


For Burn victims consult State Burn Surge Plan

The hospital RPAT has developed appropriate contingency pol icies amp processes to increase bed capacity by 50

Training Resources

PALSENCP

Basic Disaster Tra in ing

ATLS

Tier Ill

Pediatric CapableStand by

Trauma Hospitals (non pediatric providers)

Hospital bull Adul t Tra uma Center accreditation

Annually incorporates pe d iatric patient s as a part of a regional exercise

Conventional Care Benchmarks The hospital maintains a high leve l of preparedness exh ibiting the ab il ity to

Prov ide initia l assessment and stabi lization (airway management initial f lu id resuscitation and pain management) for ped ia t ric pati ents and preparation o f p atient( s) for safe transfe r to a d es ignat e d facility


For Burn vict ims consult State Burn Surge Plan

The hospita l RPAT has developed appropriate contingency policies and processes to increase ped iatric surge ca pa city by 2 5

Training Resources

PALSENCP

Basic Disaster Train ing

TNCC

ATLS

Tier IV

General

Non- Trauma Hospitals without any Pediatric In-Patient Beds

Hospital bull All non-tert iary hospitals must be prepared to care for and accept pediatric patients

Annually inco rporates pediatric patients as a part of a regional exercise

Conventional Care Benchmarks The hospital mainta ins a base leve l of preparedness exhibiting the abi l ity to

Prov ide initia l assessment and stabi l ization (airway management inltial f lu id resuscitation and pa in management) for ped iatric pat ient s and preparation o f pa tient(s) for safe transfe r to a designated facility


For Burn vict ims consu lt St ate Burn Surge Plan

middot The hospita l RPAT (Regional Preparedness amp Allocation Team ) has developed contingency policiesprocesses to sust ain st abi lizing care for up to 23 hours

Training Resources

PALSENCP


ATLS

Facility Recognition for the Region



Education bull Collaborating with the WRAP-EM (Pediatric COE)

bull Delphi process of items to be included in competencies related to pediatricdisaster preparedness

bull Creating a crosswalk of competencies based on the information from 2014NCDMPH for healthcare professions

bull Vetting national resources to match the competencies and thus identify gaps

bull Create materials to close the gaps

bull Identify materials to be adapted for JIT and telemedicine support and includingbehavioral health

bull Education to be available on the EIIC website and ASPR TRACIE

27


Great Lakes Pediatric Consortium for Disaster


Strategy-Telemedicine Workgroup in a Disaster

bull HUBS- 6 pediatric specialty centers bull Each HUB will select a SPOKE center bull Collaborative selection process

o Project fulfillment o Network specifications o Personnel capabilities

28

Pediatric Disaster Preparedness Quality Collaborative (PDPQC)

Aim

By September 30 2020 100 of participating hospitals will have a hospital disaster plan that includes pediatric-specific needs

Targeted Hospitals

Rural Critical Access Community Suburban Non-Pediatric Urban

Time Commitment

Nine 2-week modules including participation in the ASPR COE Regional Exercise (July 30th)

1-2 hrsweek for ~20 weeks (40 hours total)

Links Intent to Participate Link (RedCap) httpstch-redcaptexaschildrensorgREDCapsurveyss=TYHJTNWPPE

For more information visit httpsemscimprovementcentercollaborativespediatric-disaster-preparedness-quality-collaborative

Application

bull Site Recruitment (Jan 1 - Apr 1)

bull Intent to Participate (Jan 1 - Apr 1)

bull Formal Application (March 1 - Apr 1)

bull Environmental Scan (Apr 1 - May 15)

Internal Coordination

bull Module 1 Establish a Pediatric Champion (May 18 - 31)

bull Module 2 Review Current Policies and Previous Drills (Jun 1 ndash 14)

bull Module 3 Tabletop Exercise (provided) (Jun 15 ndash 28))

RegionalCoalition Building

bull Module 4 Regional Coalition Building (Jun 29 ndash Jul 12)

bull Module 5 Regional Coalition Exercise History (Jul 13 ndash 26)

bull Module 6 Participate in ASPR COE Regional Exercise (Jul 30)

Tracking ampReunification

bull Module 7 Patient Tracking amp Reunification (Aug 10 ndash 23)

bull Module 8 CreateUpdate a Tracking amp Reunification Plan (Aug 24 ndashSept 6)

bull Module 9 Lessons Learned and Sustainability Planning (Sept 7 ndash 20)

Learning Session 1 (Jun 26)

Learning Session 2 (Aug 7)

Final Learning Session (Sept 25)

Official Launch (May 15)

29 UnclassifiedFor Public Use


Michigan Emergency Preparedness Regions Map


Harnessing Regional CoalitionsHarnessing Regional Coalitions

bull 8 regionsstate bull Ohio home-rule state

plans are regional (and county based)

bull Information prehospital triage reunification HVA of children and of schools

30


Mapping Pediatric Assets bull Hospitals

o Identify each hospitals current capacity for pediatrics (NICU medical floor ED etc)

o Assign hospitals to facility tier based on current capacity

o Apply the concepts of Pediatric Readiness to the tiering - pediatric capability expansion

bull Supply vendors for pediatric specific equipment

bull Transport (EMS and specialized transport capabilities)

bull Behavioral health resources

bull Long term care facilities that care for children

31

Pediatric Strike Teams

Duration of Deployment

11 logistical and Supply Needs

I Financia l management

I

P-DART Deployment

Mission specific plan

Planning and Operational Templates Improvement with testing evaluation and exercises



Eastern Great Lakes Pediatric Consortium for Disaster Response 32



INFORMATION GATEWAY



Christopher Newton MD Associate Professor of Surgery Division of Pediatric Surgery Director of Trauma Care UCSF Benioff Childrenrsquos Hospital Oakland



COE Overview of ASPR Project Plan bull Plans (summary)

A Gap Analysis B Infrastructure (plans policy and system alignment) C ldquoAccess the expertsrdquo D Education E ldquoReadinessrdquo projects

34


Project Status ndash In Process bull Focus groups established bull Operational staff Area coordinators and regional manager bull Website Library

o Policies plans drill templates educational material o EMSC-EIIC TRACIE AAP integration

bull Expanded scope and collaborations o Interstate communication and coordination o Integration with state level EOClsquos o Agency steering committee o Interstate legal and policy challenges

35


21st Century National Disaster Medical System Framework A Tiered Response Structure

Tier Three Federal Response

Tier Two Regional Response

Tier One State Local Territory Response

Disaster response coordinating entity at the localstate regional and federal lfvels

bull Medical Response Teams

bull Medical Logistics

bull Patient Evacuation

bull Definitive Care

bull Civilian Disaster Hospitals

bull Federal Disaster Hospitals (DOD or VA)

bull Regional HHS Representation

bull LocalStateTribalTerritorial Health Departments

bull Access to Specialty Care Trauma Burn Pediatric Radiological Infectious Disease

bull Hospital and Health Care Associations

bull Hospitals and Other Health Care Facilities


bull Emergency Management Agencies

bull Emergency Medical Services

01-24-2020


Where Does the Peds COE Fit in

Courtesy ndash Kevin Yeskey MD Principal Deputy Assistant Secretary for Preparedness and Response 36


Pediatric Surge Annex Template bull Purpose and Scope bull Overview HCC Resources bull Access and Functional Needs bull CONOPS

o Activation notification roles logistics (staff space supplies) special considerations operations

bull Transportation Tracking Reunification

bull Deactivation and Recovery

bull Appendices

37


What Are the Key Outcomes bull Determining surge inpatientreferral resources bull Determining surge pediatric transport resources bull Preparing to provide care-in-place at non-pediatric centers

o Awaiting transportation o Delays weather access issues (flooding road damage etc)

bull Process for involving pediatric experts in transport prioritization and care in-place decisions

bull Establishing pediatric safe area and reunification process bull Assuring childrenrsquos needs are recognized and met throughout

the response

38


PEDIATRIC UNIQUE CHALLENGES

bull Medical Issues o Resource limited o Familiarity with kids

pharmacy anesthesia vents etc

o Specialty equipment needs o ldquoHigh expectationsrdquo medical care

39



bull ldquoTwo for the price of onerdquo phenomena o Injured parents that will not leave their child

bull Expectations of immediate treatment for the child bull ldquoExpectantrdquo and ldquodelayedrdquo become very difficult

categories

40


PEDIATRIC UNIQUE CHALLENGES bull Whose child is this phenomena

o Separated family members Transport to different facilities

o No history and no consents o No ldquohomerdquo for discharge o No one to help care for the child o Need for security and child safe space o Difficult reunification if child does not know where heshe lives

41


Three Tiers to Consider

1 What happens every day in all phases of care Limits 2 What current pediatric resources can be flexed or

supplemented 3 What are the things you would usually NOT consider

unless in a crisis

42


What Happens Every Day bull How are sick injured children handled in the coalition

EVERY DAY o Where are they taken o Who provides care and what training do they have o What equipment is available o Where are they transferred to o How are transfer decisions madewho is involved o What transport assets do we use

43


bull Public Health bull Primary Care Offices bull Specialty Clinics bull Mental Health Services bull Social Services CPS bull School Health Services

Pediatric Experience Training bull Critical Care bull ALS bull BLS

44


Tier 2 Flex bull Then scale up ndash and figure out your breaking points

when systems have to change from daily to disaster bull Advice

o Do not exaggerate your daily capabilities and resources o ldquoEmbrace your gapsrdquo o What can be developed that is NOT currently robust

45


PamptltArtc hatithtJG ~ampet Ensur11n9 Emergeny care tor All Children

ASPR AUIS1ANT bulllCUTtamp~ ~OO



bull Trauma Center Level (including pediatric) bull Pediatric VerificationRecognition System bull Pediatric Emergency Care Coordinator bull Equipment and Medications bull Pediatricians on Staff bull Pediatric Ward bull Family Medicine bull Nursing Training in Pediatric Care

Capacity AND Capabilities bull NICUPICU Level bull EDNICUPICU Capabilities ECMO

ventilator noninvasive bull Tertiary Specialty anesthesia surgery bull Transfer Capability

46


Tier 3 Crisis bull Outside of standard practice

o Adult care resources o ldquoCross trainedrdquo healthcare workforce

APPrsquos clinic staff school nurses etc o Altered timetables and flow

Facility decompression follow up plans return precautions bull Transport out of area bull Mutual aid teams bull Telehealth

47


Discussion

bull Logistics o Space o Staff o Stuff

48


Space bull Conventional pediatric care

o Consider outpatient sector as well bull Contingency pediatric care

o Adult care areas o Procedural and post-op areas

bull Crisis pediatric care o Cot-based care

bull Bed considerations bull Safety considerations bull Space is usually NOT the

limiting factor in pediatric planning

49


Staff bull Conventional

o Pediatric nursing and physician staff bull Contingency

o Other appropriate providers with Just in Time training support

bull Crisis o Most appropriate provider with

external expertise (eg family physician providing pediatric critical care)

bull Training o Pre-event vs Just in Time

bull Support o Telemedicine telehealth o Parents caregivers volunteers

bull Supplemental o Staff sharing supplementation o Agreements with other facilities o Know the options and priorities

bull Extension o Numbers of patients o Patient selection (age conditions) o Type of care provided o Top of license practice o ldquoCrisis Credentialingrdquo process

50


Staff bull What is important in the Annex

o Usual staffed pediatric inpatient resources o Community pediatric staffpersonnel ndash summary o MRCother resources ndash summary and activation process o Coalition staff sharing agreements o Other staff sharing agreementspotential resources o Sources of telemedicinetelehealth pediatric support for staff o Coalition-level training resources (if any)

51


Stuff (Supplies) bull lt8 years is critical cut-off for pediatric-sizing (or weight based) bull Many supplies CANNOT be substituted for (eg endotracheal tubes) bull Baseline planning ndash how many patients from infant to children lt8 years

should hospitals be prepared to manage (based on trauma level) bull AAP and other lists (Preparedness Planning in Specific Practice Settings) bull Drug formulation considerations bull Dietary considerations (infant formula) bull Annex

o Baseline expectations of facilities o Regional resources ndash equipment caches etc

52


Special Considerations COE Programs bull Behavioral Health

o Psychological support provisions (telehealth access) o ldquoPsy-Startrdquo screening tool

bull Decontamination ID o Subject matter expert access o Poison control centers

bull Evacuation o ldquoTRAINrdquo tool (needs to resource matching) o SME triage and matching support

bull Special Needs Children Plans o Family school supported plans and education

53



INFORMATION GATEWAY



Sarita Chung MD FAAPDirector of Disaster Preparedness Division of Emergency Medicine Childrenrsquos Hospital Boston Member American Academy of Pediatrics (AAP) Council on Disaster Preparedness and Recovery



Pediatric Identification and Tracking

bull Coalition processsystem for patient tracking

bull EEI for tracking bull Unidentified patient process ndash EEI ndash

(clothing haireye color ageheightweight gender scarsbirthmarks tattoos jewelry)

bull Interface with Family Assistance Center

Parentrsquos Name(s) Contact Number Familyrsquos Address Childrsquos Name Childrsquos Medical Record Number Childrsquos Birth Date Childrsquos Age Patient Identifiers Hair Color Eye Color Clothing Shoes Jewelry Other Name of SchoolGrade Teacherrsquos Name(s) Pets ndash Name Type of Animal(s)

55


American 101demy of Pediatrics 111111- lll lllflo 1HrL11 o u~c1u1uu

ASPR

v1SampCHUSETTS CE~ERAL HOSlITAL

com ro DISASTER ~1rn1mr

ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H I NfORMATIO N GATEWAY

Pediatric Reunification bull Process

o Intake and information collected o Caregiver notification ndash hospital vs school vs

public process (FAC) o Threshold policy for associating child and family

membercaregiver o Release process o Documentation o Countyparish services interface

wwwaaporgen-usadvocacy-and-policyaap-health-initiativesChildren-and-DisastersPagesfamily-separation-reunificationaspx

56


~n110121 bull na Menial Hea11n enlern ndA ncles OUtpalem Facrmes

Emergency Medi-ca-I S~e=~~~ --- ~ middotsectsect rv1ces ~ bull

Horne eallhAgencles ~ - middot middot imiddotJ_-----Lo-ng--erm--c-e- Hospitals

He1111 Centerlt i i bull ~ bullg) Skillod Nursinj Focilitie

R ol Heolih Cenlergt y ~ bull bull l HospiceCra CorrmJriy le Ceol bullbull bullmiddotfllj communlly Partner

Emergency M middot A Acodemic nslllliono anagemenl Agencies ii J i 1Ti ~on-pro

Phytlcl~ns Prirruy Cere Spocialils

- ~olcreer

middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddotmiddoti ~middotmiddotmiddot_ Public Health Departments lacat Govemrnerl

E~clec Officills FiroOpartmenls

Polie Oportmenl

Community Reunification Partners bull Goal is to prevent duplication of effort

57


Pediatric Safe Area bull Secure unidentified area for unaccompanied pediatric patients

who are medically cleared bull Secure location away from but close to the ED (and near

bathrooms) bull Staff

o Reassure children o Medical presence

bull Age appropriate o Supplies o Food

58


Pediatric Security bull Ensure scene safety bull Anticipate 4-5 family members per child ndash

need for crowd control bull Security reinforcement at ndash Pediatric safe areas ndash Reunification centers

59


Pediatric Behavioral Health bull Annex

o Resources ndash community regional strike teams o Access ndash how do patientsfamilies access services o Coordination ndash who is responsible for disaster-related BH services

and how do coalition partners integrate with that entity

bull Consider o Psychological support provision o Identificationtriageassessment of at-risk individuals o Risk communicationanticipatory guidance

60


Pediatric Decontamination bull Expectations of all facilities bull Capabilities of facilities (emphasis on

pediatric facilities when present) o Factors to address Supervision direction Safety ndash carrying slipstrips Privacy Hypothermia Age-appropriate support anxiety reduction

(keep children wparents)

61


Pediatric Infectious Outbreaks bull Consistent with regional plans bull Coalition expectations and capabilities

o Including frontline facilities bull Assessment and treatment centers for

pediatric patient bull Referral and transport process bull Parentcaregiver issues ndash PPE accompanying

during transport etc bull Pandemicepidemic considerations as needed

62


Pediatric Evacuation bull Consistent with overall coalition plans

o Pediatric-specific issues based on coalition baseline capability bull Emphasis on PICU and NICU support ndash relocation and evacuation

o Horizontal and vertical bull Level 23 NICU require significant planning bull Transport resources

o Car seats o Pediatric immobilization ndash ambulances o Isolettes o Neonatal baskets sleds etc o Critical care transport ndash pediatric specialty general

63



INFORMATION GATEWAY



Moderator Roundtable John Hick MD



Question amp Answer

65


Contact Us

asprtraciehhsgov 1-844-5-TRACIE askasprtraciehhsgov

66



Resources

Jack Herrmann MSEd NCC LMHC Acting Director National Healthcare Preparedness Program HHS ASPR13


John Hick MD Hennepin Healthcare and ASPR Moderator

Webinar Objectives Setting Stage



American Academy of Pediatrics

AAP Policy Statements

Slide Number 12


Organization Chart

WRAP-EM Groups

WRAP-EM Organization Chart

Deanna Dahl-Grove MD FAAP Associate Professor Pediatric Emergency Medicine Rainbow Babies and Childrenrsquos Hospital Member AAP CoDPR Executive Committee13

Eastern Great Lakes Pediatric Consortium for Disaster Response - Helping Coalitions Prepare to Care for Children in Disasters13

Components of the Annex

Why is this important

Eastern Great Lakes Workgroups


Pediatric Annex in Rural areas


Pediatric Readiness Enhanced by the Presence of a Pediatric Emergency Care Coordinator (Champion)


Education



Harnessing Regional Coalitions

Mapping Pediatric Assets


Christopher Newton MD13Associate Professor of Surgery Division of Pediatric Surgery Director of Trauma Care UCSF Benioff Childrenrsquos Hospital Oakland13

COE Overview of ASPR Project Plan

Project Status ndash In Process


Pediatric Surge Annex Template

What Are the Key Outcomes

Pediatric unique challenges


Pediatric unique challenges13


What Happens Every Day

Tier 1

Tier 2 Flex

National PRP

Tier 3 Crisis

Discussion

Space

Staff

Staff

Stuff (Supplies)

Special Considerations COE Programs

Sarita Chung MD FAAP13Director of Disaster Preparedness Division of Emergency Medicine Childrenrsquos Hospital Boston Member American Academy of Pediatrics (AAP) Council on Disaster Preparedness and Recovery13


Pediatric Reunification

Community Reunification Partners

Pediatric Safe Area

Pediatric Security

Pediatric Behavioral Health

Pediatric Decontamination

Pediatric Infectious Outbreaks

Pediatric Evacuation

Moderator Roundtable

Question amp Answer

Contact Us


llirL TECHNICAL IIPr RESOURCE$

__II_ ASS ISTANCE CENTER

J ~ INFORMATION ~ EXCHANGE

asprtraciehhsgov

1-844-5-TRACIE

askasprtraciehhsgov

ASPR AUIS1ANT bulllCUTtamp~ ~00




bull Self-service collection of audience-tailored materials

bull Subject-specific SME-reviewed ldquoTopic Collectionsrdquo bull Unpublished and SME peer-reviewed materials

highlighting real-life tools and experiences

bull Personalized support and responses to requests forinformation and technical assistance

bull Accessible by toll-free number (1844-5-TRACIE)email (askasprtraciehhsgov) or web form (ASPRtraciehhsgov)

bull Area for password-protected discussion amongvetted users in near real-time

bull Ability to support chats and the peer-to-peerexchange of user-developed templates plans andother materials

2






3



INFORMATION GATEWAY














5



INFORMATION GATEWAY













7



INFORMATION GATEWAY






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Nathan Timm PI




Corrine Friend

Project Coordinator



14







15

D

ASPR



PIrsquos



Coordination Center


Gap Analysis Group







CBRN

Mental Health

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Burns

Telehealth

MCI Trauma

EMSC Readiness

Deployable Assets

Education IT


6 Area Coordinators


Integrationrdquo





INFORMATION GATEWAY







OHIO -~shy~- Haylul



Disasters


18





bull Transport

bull Tracking

bull Reunification

19



rural hospitals





20








Integration

21






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challenges)






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24







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Tier

Childrens Hospital








Training Resources

PALSENCP


TNCC

ATLS

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Pediatric Ready










Training Resources

PALSENCP


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Tier Ill










Training Resources

PALSENCP


TNCC

ATLS

Tier IV

General









Training Resources

PALSENCP


ATLS











27







28


Aim


Targeted Hospitals


Time Commitment





Application





























30










31





I

P-DART Deployment








INFORMATION GATEWAY








34





35





















01-24-2020









bull Appendices

37






the response

38






39





categories

40





41





unless in a crisis

42




43




44





45









46






47


Discussion


48








49











50




51





52







53



INFORMATION GATEWAY












55



ASPR









56









- ~olcreer



Polie Oportmenl


57







58




59






60





61






62






63



INFORMATION GATEWAY






Question amp Answer

65


Contact Us


66



Resources









Slide Number 12


Organization Chart

WRAP-EM Groups












Education

















Tier 1

Tier 2 Flex

National PRP

Tier 3 Crisis

Discussion

Space

Staff

Staff

Stuff (Supplies)






Pediatric Safe Area

Pediatric Security






Question amp Answer

Contact Us






3



INFORMATION GATEWAY














5



INFORMATION GATEWAY













7



INFORMATION GATEWAY






bull bull




9


- _










10





11










Supported by


ASSOCIATION











13


--

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yen



CHILDRENrsquoS



Ron Ruffling PI



MD PI HELEN DeVos


EIIC


Samantha Mishra

MI DEPT OF HEALTH


OH DEPT OF HEALTH



Nathan Timm PI




Corrine Friend

Project Coordinator



14







15

D

ASPR



PIrsquos



Coordination Center


Gap Analysis Group







CBRN

Mental Health

Infections

Burns

Telehealth

MCI Trauma

EMSC Readiness

Deployable Assets

Education IT


6 Area Coordinators


Integrationrdquo





INFORMATION GATEWAY







OHIO -~shy~- Haylul



Disasters


18





bull Transport

bull Tracking

bull Reunification

19



rural hospitals





20








Integration

21






22



challenges)






23






24







25

Tier

Childrens Hospital








Training Resources

PALSENCP


TNCC

ATLS

TierI

Pediatric Ready










Training Resources

PALSENCP


ATLS

Tier Ill










Training Resources

PALSENCP


TNCC

ATLS

Tier IV

General









Training Resources

PALSENCP


ATLS











27







28


Aim


Targeted Hospitals


Time Commitment





Application





























30










31





I

P-DART Deployment








INFORMATION GATEWAY








34





35





















01-24-2020









bull Appendices

37






the response

38






39





categories

40





41





unless in a crisis

42




43




44





45









46






47


Discussion


48








49











50




51





52







53



INFORMATION GATEWAY












55



ASPR









56









- ~olcreer



Polie Oportmenl


57







58




59






60





61






62






63



INFORMATION GATEWAY






Question amp Answer

65


Contact Us


66



Resources









Slide Number 12


Organization Chart

WRAP-EM Groups












Education

















Tier 1

Tier 2 Flex

National PRP

Tier 3 Crisis

Discussion

Space

Staff

Staff

Stuff (Supplies)






Pediatric Safe Area

Pediatric Security






Question amp Answer

Contact Us



INFORMATION GATEWAY














5



INFORMATION GATEWAY













7



INFORMATION GATEWAY






bull bull




9


- _










10





11










Supported by


ASSOCIATION











13


--

--

--

-

--

-

-


r~---- ~~-~ lt___) ~--



~~middot

yen



CHILDRENrsquoS



Ron Ruffling PI



MD PI HELEN DeVos


EIIC


Samantha Mishra

MI DEPT OF HEALTH


OH DEPT OF HEALTH



Nathan Timm PI




Corrine Friend

Project Coordinator



14







15

D

ASPR



PIrsquos



Coordination Center


Gap Analysis Group







CBRN

Mental Health

Infections

Burns

Telehealth

MCI Trauma

EMSC Readiness

Deployable Assets

Education IT


6 Area Coordinators


Integrationrdquo





INFORMATION GATEWAY







OHIO -~shy~- Haylul



Disasters


18





bull Transport

bull Tracking

bull Reunification

19



rural hospitals





20








Integration

21






22



challenges)






23






24







25

Tier

Childrens Hospital








Training Resources

PALSENCP


TNCC

ATLS

TierI

Pediatric Ready










Training Resources

PALSENCP


ATLS

Tier Ill










Training Resources

PALSENCP


TNCC

ATLS

Tier IV

General









Training Resources

PALSENCP


ATLS











27







28


Aim


Targeted Hospitals


Time Commitment





Application





























30










31





I

P-DART Deployment








INFORMATION GATEWAY








34





35





















01-24-2020









bull Appendices

37






the response

38






39





categories

40





41





unless in a crisis

42




43




44





45









46






47


Discussion


48








49











50




51





52







53



INFORMATION GATEWAY












55



ASPR









56









- ~olcreer



Polie Oportmenl


57







58




59






60





61






62






63



INFORMATION GATEWAY






Question amp Answer

65


Contact Us


66



Resources









Slide Number 12


Organization Chart

WRAP-EM Groups












Education

















Tier 1

Tier 2 Flex

National PRP

Tier 3 Crisis

Discussion

Space

Staff

Staff

Stuff (Supplies)






Pediatric Safe Area

Pediatric Security






Question amp Answer

Contact Us










5



INFORMATION GATEWAY













7



INFORMATION GATEWAY






bull bull




9


- _










10





11










Supported by


ASSOCIATION











13


--

--

--

-

--

-

-


r~---- ~~-~ lt___) ~--



~~middot

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CHILDRENrsquoS



Ron Ruffling PI



MD PI HELEN DeVos


EIIC


Samantha Mishra

MI DEPT OF HEALTH


OH DEPT OF HEALTH



Nathan Timm PI




Corrine Friend

Project Coordinator



14







15

D

ASPR



PIrsquos



Coordination Center


Gap Analysis Group







CBRN

Mental Health

Infections

Burns

Telehealth

MCI Trauma

EMSC Readiness

Deployable Assets

Education IT


6 Area Coordinators


Integrationrdquo





INFORMATION GATEWAY







OHIO -~shy~- Haylul



Disasters


18





bull Transport

bull Tracking

bull Reunification

19



rural hospitals





20








Integration

21






22



challenges)






23






24







25

Tier

Childrens Hospital








Training Resources

PALSENCP


TNCC

ATLS

TierI

Pediatric Ready










Training Resources

PALSENCP


ATLS

Tier Ill










Training Resources

PALSENCP


TNCC

ATLS

Tier IV

General









Training Resources

PALSENCP


ATLS











27







28


Aim


Targeted Hospitals


Time Commitment





Application





























30










31





I

P-DART Deployment








INFORMATION GATEWAY








34





35





















01-24-2020









bull Appendices

37






the response

38






39





categories

40





41





unless in a crisis

42




43




44





45









46






47


Discussion


48








49











50




51





52







53



INFORMATION GATEWAY












55



ASPR









56









- ~olcreer



Polie Oportmenl


57







58




59






60





61






62






63



INFORMATION GATEWAY






Question amp Answer

65


Contact Us


66



Resources









Slide Number 12


Organization Chart

WRAP-EM Groups












Education

















Tier 1

Tier 2 Flex

National PRP

Tier 3 Crisis

Discussion

Space

Staff

Staff

Stuff (Supplies)






Pediatric Safe Area

Pediatric Security






Question amp Answer

Contact Us



INFORMATION GATEWAY













7



INFORMATION GATEWAY






bull bull




9


- _










10





11










Supported by


ASSOCIATION











13


--

--

--

-

--

-

-


r~---- ~~-~ lt___) ~--



~~middot

yen



CHILDRENrsquoS



Ron Ruffling PI



MD PI HELEN DeVos


EIIC


Samantha Mishra

MI DEPT OF HEALTH


OH DEPT OF HEALTH



Nathan Timm PI




Corrine Friend

Project Coordinator



14







15

D

ASPR



PIrsquos



Coordination Center


Gap Analysis Group







CBRN

Mental Health

Infections

Burns

Telehealth

MCI Trauma

EMSC Readiness

Deployable Assets

Education IT


6 Area Coordinators


Integrationrdquo





INFORMATION GATEWAY







OHIO -~shy~- Haylul



Disasters


18





bull Transport

bull Tracking

bull Reunification

19



rural hospitals





20








Integration

21






22



challenges)






23






24







25

Tier

Childrens Hospital








Training Resources

PALSENCP


TNCC

ATLS

TierI

Pediatric Ready










Training Resources

PALSENCP


ATLS

Tier Ill










Training Resources

PALSENCP


TNCC

ATLS

Tier IV

General









Training Resources

PALSENCP


ATLS











27







28


Aim


Targeted Hospitals


Time Commitment





Application





























30










31





I

P-DART Deployment








INFORMATION GATEWAY








34





35





















01-24-2020









bull Appendices

37






the response

38






39





categories

40





41





unless in a crisis

42




43




44





45









46






47


Discussion


48








49











50




51





52







53



INFORMATION GATEWAY












55



ASPR









56









- ~olcreer



Polie Oportmenl


57







58




59






60





61






62






63



INFORMATION GATEWAY






Question amp Answer

65


Contact Us


66



Resources









Slide Number 12


Organization Chart

WRAP-EM Groups












Education

















Tier 1

Tier 2 Flex

National PRP

Tier 3 Crisis

Discussion

Space

Staff

Staff

Stuff (Supplies)






Pediatric Safe Area

Pediatric Security






Question amp Answer

Contact Us









7



INFORMATION GATEWAY






bull bull




9


- _










10





11










Supported by


ASSOCIATION











13


--

--

--

-

--

-

-


r~---- ~~-~ lt___) ~--



~~middot

yen



CHILDRENrsquoS



Ron Ruffling PI



MD PI HELEN DeVos


EIIC


Samantha Mishra

MI DEPT OF HEALTH


OH DEPT OF HEALTH



Nathan Timm PI




Corrine Friend

Project Coordinator



14







15

D

ASPR



PIrsquos



Coordination Center


Gap Analysis Group







CBRN

Mental Health

Infections

Burns

Telehealth

MCI Trauma

EMSC Readiness

Deployable Assets

Education IT


6 Area Coordinators


Integrationrdquo





INFORMATION GATEWAY







OHIO -~shy~- Haylul



Disasters


18





bull Transport

bull Tracking

bull Reunification

19



rural hospitals





20








Integration

21






22



challenges)






23






24







25

Tier

Childrens Hospital








Training Resources

PALSENCP


TNCC

ATLS

TierI

Pediatric Ready










Training Resources

PALSENCP


ATLS

Tier Ill










Training Resources

PALSENCP


TNCC

ATLS

Tier IV

General









Training Resources

PALSENCP


ATLS











27







28


Aim


Targeted Hospitals


Time Commitment





Application





























30










31





I

P-DART Deployment








INFORMATION GATEWAY








34





35





















01-24-2020









bull Appendices

37






the response

38






39





categories

40





41





unless in a crisis

42




43




44





45









46






47


Discussion


48








49











50




51





52







53



INFORMATION GATEWAY












55



ASPR









56









- ~olcreer



Polie Oportmenl


57







58




59






60





61






62






63



INFORMATION GATEWAY






Question amp Answer

65


Contact Us


66



Resources









Slide Number 12


Organization Chart

WRAP-EM Groups












Education

















Tier 1

Tier 2 Flex

National PRP

Tier 3 Crisis

Discussion

Space

Staff

Staff

Stuff (Supplies)






Pediatric Safe Area

Pediatric Security






Question amp Answer

Contact Us



INFORMATION GATEWAY






bull bull




9


- _










10





11










Supported by


ASSOCIATION











13


--

--

--

-

--

-

-


r~---- ~~-~ lt___) ~--



~~middot

yen



CHILDRENrsquoS



Ron Ruffling PI



MD PI HELEN DeVos


EIIC


Samantha Mishra

MI DEPT OF HEALTH


OH DEPT OF HEALTH



Nathan Timm PI




Corrine Friend

Project Coordinator



14







15

D

ASPR



PIrsquos



Coordination Center


Gap Analysis Group







CBRN

Mental Health

Infections

Burns

Telehealth

MCI Trauma

EMSC Readiness

Deployable Assets

Education IT


6 Area Coordinators


Integrationrdquo





INFORMATION GATEWAY







OHIO -~shy~- Haylul



Disasters


18





bull Transport

bull Tracking

bull Reunification

19



rural hospitals





20








Integration

21






22



challenges)






23






24







25

Tier

Childrens Hospital








Training Resources

PALSENCP


TNCC

ATLS

TierI

Pediatric Ready










Training Resources

PALSENCP


ATLS

Tier Ill










Training Resources

PALSENCP


TNCC

ATLS

Tier IV

General









Training Resources

PALSENCP


ATLS











27







28


Aim


Targeted Hospitals


Time Commitment





Application





























30










31





I

P-DART Deployment








INFORMATION GATEWAY








34





35





















01-24-2020









bull Appendices

37






the response

38






39





categories

40





41





unless in a crisis

42




43




44





45









46






47


Discussion


48








49











50




51





52







53



INFORMATION GATEWAY












55



ASPR









56









- ~olcreer



Polie Oportmenl


57







58




59






60





61






62






63



INFORMATION GATEWAY






Question amp Answer

65


Contact Us


66



Resources









Slide Number 12


Organization Chart

WRAP-EM Groups












Education

















Tier 1

Tier 2 Flex

National PRP

Tier 3 Crisis

Discussion

Space

Staff

Staff

Stuff (Supplies)






Pediatric Safe Area

Pediatric Security






Question amp Answer

Contact Us


bull bull




9


- _










10





11










Supported by


ASSOCIATION











13


--

--

--

-

--

-

-


r~---- ~~-~ lt___) ~--



~~middot

yen



CHILDRENrsquoS



Ron Ruffling PI



MD PI HELEN DeVos


EIIC


Samantha Mishra

MI DEPT OF HEALTH


OH DEPT OF HEALTH



Nathan Timm PI




Corrine Friend

Project Coordinator



14







15

D

ASPR



PIrsquos



Coordination Center


Gap Analysis Group







CBRN

Mental Health

Infections

Burns

Telehealth

MCI Trauma

EMSC Readiness

Deployable Assets

Education IT


6 Area Coordinators


Integrationrdquo





INFORMATION GATEWAY







OHIO -~shy~- Haylul



Disasters


18





bull Transport

bull Tracking

bull Reunification

19



rural hospitals





20








Integration

21






22



challenges)






23






24







25

Tier

Childrens Hospital








Training Resources

PALSENCP


TNCC

ATLS

TierI

Pediatric Ready










Training Resources

PALSENCP


ATLS

Tier Ill










Training Resources

PALSENCP


TNCC

ATLS

Tier IV

General









Training Resources

PALSENCP


ATLS











27







28


Aim


Targeted Hospitals


Time Commitment





Application





























30










31





I

P-DART Deployment








INFORMATION GATEWAY








34





35





















01-24-2020









bull Appendices

37






the response

38






39





categories

40





41





unless in a crisis

42




43




44





45









46






47


Discussion


48








49











50




51





52







53



INFORMATION GATEWAY












55



ASPR









56









- ~olcreer



Polie Oportmenl


57







58




59






60





61






62






63



INFORMATION GATEWAY






Question amp Answer

65


Contact Us


66



Resources









Slide Number 12


Organization Chart

WRAP-EM Groups












Education

















Tier 1

Tier 2 Flex

National PRP

Tier 3 Crisis

Discussion

Space

Staff

Staff

Stuff (Supplies)






Pediatric Safe Area

Pediatric Security






Question amp Answer

Contact Us


- _










10





11










Supported by


ASSOCIATION











13


--

--

--

-

--

-

-


r~---- ~~-~ lt___) ~--



~~middot

yen



CHILDRENrsquoS



Ron Ruffling PI



MD PI HELEN DeVos


EIIC


Samantha Mishra

MI DEPT OF HEALTH


OH DEPT OF HEALTH



Nathan Timm PI




Corrine Friend

Project Coordinator



14







15

D

ASPR



PIrsquos



Coordination Center


Gap Analysis Group







CBRN

Mental Health

Infections

Burns

Telehealth

MCI Trauma

EMSC Readiness

Deployable Assets

Education IT


6 Area Coordinators


Integrationrdquo





INFORMATION GATEWAY







OHIO -~shy~- Haylul



Disasters


18





bull Transport

bull Tracking

bull Reunification

19



rural hospitals





20








Integration

21






22



challenges)






23






24







25

Tier

Childrens Hospital








Training Resources

PALSENCP


TNCC

ATLS

TierI

Pediatric Ready










Training Resources

PALSENCP


ATLS

Tier Ill










Training Resources

PALSENCP


TNCC

ATLS

Tier IV

General









Training Resources

PALSENCP


ATLS











27







28


Aim


Targeted Hospitals


Time Commitment





Application





























30










31





I

P-DART Deployment








INFORMATION GATEWAY








34





35





















01-24-2020









bull Appendices

37






the response

38






39





categories

40





41





unless in a crisis

42




43




44





45









46






47


Discussion


48








49











50




51





52







53



INFORMATION GATEWAY












55



ASPR









56









- ~olcreer



Polie Oportmenl


57







58




59






60





61






62






63



INFORMATION GATEWAY






Question amp Answer

65


Contact Us


66



Resources









Slide Number 12


Organization Chart

WRAP-EM Groups












Education

















Tier 1

Tier 2 Flex

National PRP

Tier 3 Crisis

Discussion

Space

Staff

Staff

Stuff (Supplies)






Pediatric Safe Area

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Question amp Answer

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11










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18





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Training Resources

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27







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Application





























30










31





I

P-DART Deployment








INFORMATION GATEWAY








34





35





















01-24-2020









bull Appendices

37






the response

38






39





categories

40





41





unless in a crisis

42




43




44





45









46






47


Discussion


48








49











50




51





52







53



INFORMATION GATEWAY












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56









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Polie Oportmenl


57







58




59






60





61






62






63



INFORMATION GATEWAY






Question amp Answer

65


Contact Us


66



Resources









Slide Number 12


Organization Chart

WRAP-EM Groups












Education

















Tier 1

Tier 2 Flex

National PRP

Tier 3 Crisis

Discussion

Space

Staff

Staff

Stuff (Supplies)






Pediatric Safe Area

Pediatric Security






Question amp Answer

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CBRN

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Education IT


6 Area Coordinators


Integrationrdquo





INFORMATION GATEWAY







OHIO -~shy~- Haylul



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18





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bull Tracking

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Training Resources

PALSENCP


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ATLS

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Training Resources

PALSENCP


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27







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Targeted Hospitals


Time Commitment





Application





























30










31





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P-DART Deployment








INFORMATION GATEWAY








34





35





















01-24-2020









bull Appendices

37






the response

38






39





categories

40





41





unless in a crisis

42




43




44





45









46






47


Discussion


48








49











50




51





52







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56









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Polie Oportmenl


57







58




59






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61






62






63



INFORMATION GATEWAY






Question amp Answer

65


Contact Us


66



Resources









Slide Number 12


Organization Chart

WRAP-EM Groups












Education

















Tier 1

Tier 2 Flex

National PRP

Tier 3 Crisis

Discussion

Space

Staff

Staff

Stuff (Supplies)






Pediatric Safe Area

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MI DEPT OF HEALTH


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14







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ASPR



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Gap Analysis Group







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Education IT


6 Area Coordinators


Integrationrdquo





INFORMATION GATEWAY







OHIO -~shy~- Haylul



Disasters


18





bull Transport

bull Tracking

bull Reunification

19



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20








Integration

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24







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Training Resources

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ATLS

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Training Resources

PALSENCP


TNCC

ATLS

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Training Resources

PALSENCP


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27







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Targeted Hospitals


Time Commitment





Application





























30










31





I

P-DART Deployment








INFORMATION GATEWAY








34





35





















01-24-2020









bull Appendices

37






the response

38






39





categories

40





41





unless in a crisis

42




43




44





45









46






47


Discussion


48








49











50




51





52







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56









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Polie Oportmenl


57







58




59






60





61






62






63



INFORMATION GATEWAY






Question amp Answer

65


Contact Us


66



Resources









Slide Number 12


Organization Chart

WRAP-EM Groups












Education

















Tier 1

Tier 2 Flex

National PRP

Tier 3 Crisis

Discussion

Space

Staff

Staff

Stuff (Supplies)






Pediatric Safe Area

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MI DEPT OF HEALTH


OH DEPT OF HEALTH



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Corrine Friend

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14







15

D

ASPR



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CBRN

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Education IT


6 Area Coordinators


Integrationrdquo





INFORMATION GATEWAY







OHIO -~shy~- Haylul



Disasters


18





bull Transport

bull Tracking

bull Reunification

19



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20








Integration

21






22



challenges)






23






24







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Tier

Childrens Hospital








Training Resources

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Training Resources

PALSENCP


ATLS

Tier Ill










Training Resources

PALSENCP


TNCC

ATLS

Tier IV

General









Training Resources

PALSENCP


ATLS











27







28


Aim


Targeted Hospitals


Time Commitment





Application





























30










31





I

P-DART Deployment








INFORMATION GATEWAY








34





35





















01-24-2020









bull Appendices

37






the response

38






39





categories

40





41





unless in a crisis

42




43




44





45









46






47


Discussion


48








49











50




51





52







53



INFORMATION GATEWAY












55



ASPR









56









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Polie Oportmenl


57







58




59






60





61






62






63



INFORMATION GATEWAY






Question amp Answer

65


Contact Us


66



Resources









Slide Number 12


Organization Chart

WRAP-EM Groups












Education

















Tier 1

Tier 2 Flex

National PRP

Tier 3 Crisis

Discussion

Space

Staff

Staff

Stuff (Supplies)






Pediatric Safe Area

Pediatric Security






Question amp Answer

Contact Us







15

D

ASPR



PIrsquos



Coordination Center


Gap Analysis Group







CBRN

Mental Health

Infections

Burns

Telehealth

MCI Trauma

EMSC Readiness

Deployable Assets

Education IT


6 Area Coordinators


Integrationrdquo





INFORMATION GATEWAY







OHIO -~shy~- Haylul



Disasters


18





bull Transport

bull Tracking

bull Reunification

19



rural hospitals





20








Integration

21






22



challenges)






23






24







25

Tier

Childrens Hospital








Training Resources

PALSENCP


TNCC

ATLS

TierI

Pediatric Ready










Training Resources

PALSENCP


ATLS

Tier Ill










Training Resources

PALSENCP


TNCC

ATLS

Tier IV

General









Training Resources

PALSENCP


ATLS











27







28


Aim


Targeted Hospitals


Time Commitment





Application





























30










31





I

P-DART Deployment








INFORMATION GATEWAY








34





35





















01-24-2020









bull Appendices

37






the response

38






39





categories

40





41





unless in a crisis

42




43




44





45









46






47


Discussion


48








49











50




51





52







53



INFORMATION GATEWAY












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56









- ~olcreer



Polie Oportmenl


57







58




59






60





61






62






63



INFORMATION GATEWAY






Question amp Answer

65


Contact Us


66



Resources









Slide Number 12


Organization Chart

WRAP-EM Groups












Education

















Tier 1

Tier 2 Flex

National PRP

Tier 3 Crisis

Discussion

Space

Staff

Staff

Stuff (Supplies)






Pediatric Safe Area

Pediatric Security






Question amp Answer

Contact Us

D

ASPR



PIrsquos



Coordination Center


Gap Analysis Group







CBRN

Mental Health

Infections

Burns

Telehealth

MCI Trauma

EMSC Readiness

Deployable Assets

Education IT


6 Area Coordinators


Integrationrdquo





INFORMATION GATEWAY







OHIO -~shy~- Haylul



Disasters


18





bull Transport

bull Tracking

bull Reunification

19



rural hospitals





20








Integration

21






22



challenges)






23






24







25

Tier

Childrens Hospital








Training Resources

PALSENCP


TNCC

ATLS

TierI

Pediatric Ready










Training Resources

PALSENCP


ATLS

Tier Ill










Training Resources

PALSENCP


TNCC

ATLS

Tier IV

General









Training Resources

PALSENCP


ATLS











27







28


Aim


Targeted Hospitals


Time Commitment





Application





























30










31





I

P-DART Deployment








INFORMATION GATEWAY








34





35





















01-24-2020









bull Appendices

37






the response

38






39





categories

40





41





unless in a crisis

42




43




44





45









46






47


Discussion


48








49











50




51





52







53



INFORMATION GATEWAY












55



ASPR









56









- ~olcreer



Polie Oportmenl


57







58




59






60





61






62






63



INFORMATION GATEWAY






Question amp Answer

65


Contact Us


66



Resources









Slide Number 12


Organization Chart

WRAP-EM Groups












Education

















Tier 1

Tier 2 Flex

National PRP

Tier 3 Crisis

Discussion

Space

Staff

Staff

Stuff (Supplies)






Pediatric Safe Area

Pediatric Security






Question amp Answer

Contact Us



INFORMATION GATEWAY







OHIO -~shy~- Haylul



Disasters


18





bull Transport

bull Tracking

bull Reunification

19



rural hospitals





20








Integration

21






22



challenges)






23






24







25

Tier

Childrens Hospital








Training Resources

PALSENCP


TNCC

ATLS

TierI

Pediatric Ready










Training Resources

PALSENCP


ATLS

Tier Ill










Training Resources

PALSENCP


TNCC

ATLS

Tier IV

General









Training Resources

PALSENCP


ATLS











27







28


Aim


Targeted Hospitals


Time Commitment





Application





























30










31





I

P-DART Deployment








INFORMATION GATEWAY








34





35





















01-24-2020









bull Appendices

37






the response

38






39





categories

40





41





unless in a crisis

42




43




44





45









46






47


Discussion


48








49











50




51





52







53



INFORMATION GATEWAY












55



ASPR









56









- ~olcreer



Polie Oportmenl


57







58




59






60





61






62






63



INFORMATION GATEWAY






Question amp Answer

65


Contact Us


66



Resources









Slide Number 12


Organization Chart

WRAP-EM Groups












Education

















Tier 1

Tier 2 Flex

National PRP

Tier 3 Crisis

Discussion

Space

Staff

Staff

Stuff (Supplies)






Pediatric Safe Area

Pediatric Security






Question amp Answer

Contact Us



OHIO -~shy~- Haylul



Disasters


18





bull Transport

bull Tracking

bull Reunification

19



rural hospitals





20








Integration

21






22



challenges)






23






24







25

Tier

Childrens Hospital








Training Resources

PALSENCP


TNCC

ATLS

TierI

Pediatric Ready










Training Resources

PALSENCP


ATLS

Tier Ill










Training Resources

PALSENCP


TNCC

ATLS

Tier IV

General









Training Resources

PALSENCP


ATLS











27







28


Aim


Targeted Hospitals


Time Commitment





Application





























30










31





I

P-DART Deployment








INFORMATION GATEWAY








34





35





















01-24-2020









bull Appendices

37






the response

38






39





categories

40





41





unless in a crisis

42




43




44





45









46






47


Discussion


48








49











50




51





52







53



INFORMATION GATEWAY












55



ASPR









56









- ~olcreer



Polie Oportmenl


57







58




59






60





61






62






63



INFORMATION GATEWAY






Question amp Answer

65


Contact Us


66



Resources









Slide Number 12


Organization Chart

WRAP-EM Groups












Education

















Tier 1

Tier 2 Flex

National PRP

Tier 3 Crisis

Discussion

Space

Staff

Staff

Stuff (Supplies)






Pediatric Safe Area

Pediatric Security






Question amp Answer

Contact Us





bull Transport

bull Tracking

bull Reunification

19



rural hospitals





20








Integration

21






22



challenges)






23






24







25

Tier

Childrens Hospital








Training Resources

PALSENCP


TNCC

ATLS

TierI

Pediatric Ready










Training Resources

PALSENCP


ATLS

Tier Ill










Training Resources

PALSENCP


TNCC

ATLS

Tier IV

General









Training Resources

PALSENCP


ATLS











27







28


Aim


Targeted Hospitals


Time Commitment





Application





























30










31





I

P-DART Deployment








INFORMATION GATEWAY








34





35





















01-24-2020









bull Appendices

37






the response

38






39





categories

40





41





unless in a crisis

42




43




44





45









46






47


Discussion


48








49











50




51





52







53



INFORMATION GATEWAY












55



ASPR









56









- ~olcreer



Polie Oportmenl


57







58




59






60





61






62






63



INFORMATION GATEWAY






Question amp Answer

65


Contact Us


66



Resources









Slide Number 12


Organization Chart

WRAP-EM Groups












Education

















Tier 1

Tier 2 Flex

National PRP

Tier 3 Crisis

Discussion

Space

Staff

Staff

Stuff (Supplies)






Pediatric Safe Area

Pediatric Security






Question amp Answer

Contact Us



rural hospitals





20








Integration

21






22



challenges)






23






24







25

Tier

Childrens Hospital








Training Resources

PALSENCP


TNCC

ATLS

TierI

Pediatric Ready










Training Resources

PALSENCP


ATLS

Tier Ill










Training Resources

PALSENCP


TNCC

ATLS

Tier IV

General









Training Resources

PALSENCP


ATLS











27







28


Aim


Targeted Hospitals


Time Commitment





Application





























30










31





I

P-DART Deployment








INFORMATION GATEWAY








34





35





















01-24-2020









bull Appendices

37






the response

38






39





categories

40





41





unless in a crisis

42




43




44





45









46






47


Discussion


48








49











50




51





52







53



INFORMATION GATEWAY












55



ASPR









56









- ~olcreer



Polie Oportmenl


57







58




59






60





61






62






63



INFORMATION GATEWAY






Question amp Answer

65


Contact Us


66



Resources









Slide Number 12


Organization Chart

WRAP-EM Groups












Education

















Tier 1

Tier 2 Flex

National PRP

Tier 3 Crisis

Discussion

Space

Staff

Staff

Stuff (Supplies)






Pediatric Safe Area

Pediatric Security






Question amp Answer

Contact Us








Integration

21






22



challenges)






23






24







25

Tier

Childrens Hospital








Training Resources

PALSENCP


TNCC

ATLS

TierI

Pediatric Ready










Training Resources

PALSENCP


ATLS

Tier Ill










Training Resources

PALSENCP


TNCC

ATLS

Tier IV

General









Training Resources

PALSENCP


ATLS











27







28


Aim


Targeted Hospitals


Time Commitment





Application





























30










31





I

P-DART Deployment








INFORMATION GATEWAY








34





35





















01-24-2020









bull Appendices

37






the response

38






39





categories

40





41





unless in a crisis

42




43




44





45









46






47


Discussion


48








49











50




51





52







53



INFORMATION GATEWAY












55



ASPR









56









- ~olcreer



Polie Oportmenl


57







58




59






60





61






62






63



INFORMATION GATEWAY






Question amp Answer

65


Contact Us


66



Resources









Slide Number 12


Organization Chart

WRAP-EM Groups












Education

















Tier 1

Tier 2 Flex

National PRP

Tier 3 Crisis

Discussion

Space

Staff

Staff

Stuff (Supplies)






Pediatric Safe Area

Pediatric Security






Question amp Answer

Contact Us






22



challenges)






23






24







25

Tier

Childrens Hospital








Training Resources

PALSENCP


TNCC

ATLS

TierI

Pediatric Ready










Training Resources

PALSENCP


ATLS

Tier Ill










Training Resources

PALSENCP


TNCC

ATLS

Tier IV

General









Training Resources

PALSENCP


ATLS











27







28


Aim


Targeted Hospitals


Time Commitment





Application





























30










31





I

P-DART Deployment








INFORMATION GATEWAY








34





35





















01-24-2020









bull Appendices

37






the response

38






39





categories

40





41





unless in a crisis

42




43




44





45









46






47


Discussion


48








49











50




51





52







53



INFORMATION GATEWAY












55



ASPR









56









- ~olcreer



Polie Oportmenl


57







58




59






60





61






62






63



INFORMATION GATEWAY






Question amp Answer

65


Contact Us


66



Resources









Slide Number 12


Organization Chart

WRAP-EM Groups












Education

















Tier 1

Tier 2 Flex

National PRP

Tier 3 Crisis

Discussion

Space

Staff

Staff

Stuff (Supplies)






Pediatric Safe Area

Pediatric Security






Question amp Answer

Contact Us



challenges)






23






24







25

Tier

Childrens Hospital








Training Resources

PALSENCP


TNCC

ATLS

TierI

Pediatric Ready










Training Resources

PALSENCP


ATLS

Tier Ill










Training Resources

PALSENCP


TNCC

ATLS

Tier IV

General









Training Resources

PALSENCP


ATLS











27







28


Aim


Targeted Hospitals


Time Commitment





Application





























30










31





I

P-DART Deployment








INFORMATION GATEWAY








34





35





















01-24-2020









bull Appendices

37






the response

38






39





categories

40





41





unless in a crisis

42




43




44





45









46






47


Discussion


48








49











50




51





52







53



INFORMATION GATEWAY












55



ASPR









56









- ~olcreer



Polie Oportmenl


57







58




59






60





61






62






63



INFORMATION GATEWAY






Question amp Answer

65


Contact Us


66



Resources









Slide Number 12


Organization Chart

WRAP-EM Groups












Education

















Tier 1

Tier 2 Flex

National PRP

Tier 3 Crisis

Discussion

Space

Staff

Staff

Stuff (Supplies)






Pediatric Safe Area

Pediatric Security






Question amp Answer

Contact Us






24







25

Tier

Childrens Hospital








Training Resources

PALSENCP


TNCC

ATLS

TierI

Pediatric Ready










Training Resources

PALSENCP


ATLS

Tier Ill










Training Resources

PALSENCP


TNCC

ATLS

Tier IV

General









Training Resources

PALSENCP


ATLS











27







28


Aim


Targeted Hospitals


Time Commitment





Application





























30










31





I

P-DART Deployment








INFORMATION GATEWAY








34





35





















01-24-2020









bull Appendices

37






the response

38






39





categories

40





41





unless in a crisis

42




43




44





45









46






47


Discussion


48








49











50




51





52







53



INFORMATION GATEWAY












55



ASPR









56









- ~olcreer



Polie Oportmenl


57







58




59






60





61






62






63



INFORMATION GATEWAY






Question amp Answer

65


Contact Us


66



Resources









Slide Number 12


Organization Chart

WRAP-EM Groups












Education

















Tier 1

Tier 2 Flex

National PRP

Tier 3 Crisis

Discussion

Space

Staff

Staff

Stuff (Supplies)






Pediatric Safe Area

Pediatric Security






Question amp Answer

Contact Us







25

Tier

Childrens Hospital








Training Resources

PALSENCP


TNCC

ATLS

TierI

Pediatric Ready










Training Resources

PALSENCP


ATLS

Tier Ill










Training Resources

PALSENCP


TNCC

ATLS

Tier IV

General









Training Resources

PALSENCP


ATLS











27







28


Aim


Targeted Hospitals


Time Commitment





Application





























30










31





I

P-DART Deployment








INFORMATION GATEWAY








34





35





















01-24-2020









bull Appendices

37






the response

38






39





categories

40





41





unless in a crisis

42




43




44





45









46






47


Discussion


48








49











50




51





52







53



INFORMATION GATEWAY












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Slide Number 12


Organization Chart

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Slide Number 12


Organization Chart

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Slide Number 12


Organization Chart

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Slide Number 12


Organization Chart

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Slide Number 12


Organization Chart

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Slide Number 12


Organization Chart

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Slide Number 12


Organization Chart

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Slide Number 12


Organization Chart

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Slide Number 12


Organization Chart

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Slide Number 12


Organization Chart

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Slide Number 12


Organization Chart

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Slide Number 12


Organization Chart

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Slide Number 12


Organization Chart

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Slide Number 12


Organization Chart

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Slide Number 12


Organization Chart

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Slide Number 12


Organization Chart

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Slide Number 12


Organization Chart

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Slide Number 12


Organization Chart

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Slide Number 12


Organization Chart

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47


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Slide Number 12


Organization Chart

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48








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Slide Number 12


Organization Chart

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Slide Number 12


Organization Chart

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Slide Number 12


Organization Chart

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Slide Number 12


Organization Chart

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Slide Number 12


Organization Chart

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53



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Slide Number 12


Organization Chart

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Slide Number 12


Organization Chart

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Question amp Answer

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Slide Number 12


Organization Chart

WRAP-EM Groups












Education

















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Slide Number 12


Organization Chart

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Slide Number 12


Organization Chart

WRAP-EM Groups












Education

















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Slide Number 12


Organization Chart

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Discussion

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Question amp Answer

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66



Resources









Slide Number 12


Organization Chart

WRAP-EM Groups












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60





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Slide Number 12


Organization Chart

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Question amp Answer

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Resources









Slide Number 12


Organization Chart

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Tier 1

Tier 2 Flex

National PRP

Tier 3 Crisis

Discussion

Space

Staff

Staff

Stuff (Supplies)






Pediatric Safe Area

Pediatric Security






Question amp Answer

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62






63



INFORMATION GATEWAY






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65


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66



Resources









Slide Number 12


Organization Chart

WRAP-EM Groups












Education

















Tier 1

Tier 2 Flex

National PRP

Tier 3 Crisis

Discussion

Space

Staff

Staff

Stuff (Supplies)






Pediatric Safe Area

Pediatric Security






Question amp Answer

Contact Us






63



INFORMATION GATEWAY






Question amp Answer

65


Contact Us


66



Resources









Slide Number 12


Organization Chart

WRAP-EM Groups












Education

















Tier 1

Tier 2 Flex

National PRP

Tier 3 Crisis

Discussion

Space

Staff

Staff

Stuff (Supplies)






Pediatric Safe Area

Pediatric Security






Question amp Answer

Contact Us



INFORMATION GATEWAY






Question amp Answer

65


Contact Us


66



Resources









Slide Number 12


Organization Chart

WRAP-EM Groups












Education

















Tier 1

Tier 2 Flex

National PRP

Tier 3 Crisis

Discussion

Space

Staff

Staff

Stuff (Supplies)






Pediatric Safe Area

Pediatric Security






Question amp Answer

Contact Us


Question amp Answer

65


Contact Us


66



Resources









Slide Number 12


Organization Chart

WRAP-EM Groups












Education

















Tier 1

Tier 2 Flex

National PRP

Tier 3 Crisis

Discussion

Space

Staff

Staff

Stuff (Supplies)






Pediatric Safe Area

Pediatric Security






Question amp Answer

Contact Us


Contact Us


66



Resources









Slide Number 12


Organization Chart

WRAP-EM Groups












Education

















Tier 1

Tier 2 Flex

National PRP

Tier 3 Crisis

Discussion

Space

Staff

Staff

Stuff (Supplies)






Pediatric Safe Area

Pediatric Security






Question amp Answer

Contact Us

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