Monday, May 14, 2018

Addressing Emergency Department Psychiatric Boarding: A Continuum of Solutions Tuesday, May 15, 2018 | 12—1 p.m. Eastern Time

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Substance Abuse and Mental Health Services Administration

Addressing Emergency Department Psychiatric Boarding: A Continuum of Solutions

Tuesday, May 15, 2018 | 12—1 p.m. Eastern Time
People with behavioral health emergencies may board for days in hospital emergency departments waiting for a psychiatric bed. These environments are not conducive to providing safe and effective care for these individuals; however, solutions do exist. Because communities and organizations have different needs and capabilities, presenters will discuss a range of possible solutions to improve care for people with behavioral health emergencies and ways to use data to track results.

Register for Webinar

EM Exercises:, One important aspect of Emergency Management Planning. May 14, 2018

Like the critical\climatic scene in the film 'Gladiator', coming together as on.

International delegates to the National Level Exercise are briefed in May 2018. (Rich Cooper/HSToday)

InsideHS: Creating Local Partners to Bridge Post-Hurricane Islands
May 11, 2018  Rich Cooper

Day 5 coverage of NLE18 — don’t miss Day 1, Day 2, Day 3 and Day 4 coverage of the FEMA National Level Exercise

You could not ask for a more beautiful spring day on the Chesapeake Bay. Gorgeous blue skies, no clouds, low humidity and a gentle enough breeze to cool you while you took in the pleasant scents from the bay. I’m in Perry Point, Md., a small piece of land that is literally a peninsula situated at one of the northernmost parts of the Chesapeake Bay. 

Standing on the grounds of the Perry Point VA Medical Center, part of the U.S. Department of Veterans Affairs and the VA Maryland Health Care System, it is at first glance a pristine view of what “Bay Life” is all about. But as beautiful as the weather and surrounding 400 acres are, there is a real-world exercise underway that is anything but attractive. It’s another day in NLE18 and the assembled players are playing out another tragic scenario that no one ever wants to see happen.

Still reeling from the after-effects of fictional Hurricane Cora that struck the greater Washington, D.C., area as a Category 4 hurricane (which is nearly 100 miles away), Cora hit Perry Point and the surrounding areas of Cecil County, Md., as a Category 2 storm. In its aftermath, this area of the Chesapeake found itself with lots of debris and power problems, but also more than its share of transportation challenges. 

Railroad lines that pass through the area are silent because portions of rail lines have been severed by Cora’s wrath. Even many of the surrounding roads, including Interstate 95, are clogged with debris and emergency vehicles doing whatever they can to get roads open so recovery operations and commerce can begin again. On top of that, the tunnels in and out of Baltimore that could bring any number of supplies and resources into the area remain closed as they are still flooded. And that’s just for starters.

Today’s exercise is “two days” after the Cora strike. A fictional severe thunderstorm fueled by the warm air and waters of the bay has spawned a tornado that has struck the Perry Point VA Medical Center campus. Patients and staff are trapped in several collapsed buildings and members of the Cecil County Fire Department, the Maryland National Guard and other regional first responders are assembling to execute their life-saving attack on the structures.

Lights are flashing from stationed fire trucks, radios are squawking updates and directions to deployed units are given. Joining me as fellow observers of what is happening are nearly two dozen fatigue-wearing military personnel from Albania, Montenegro, Bosnia, Croatia, Macedonia and Taiwan. They are all part of a National Guard exchange program that shares emergency response practices with one another.


As a small group of National Guard officers explain what is happening around us, three first responders step out from the “collapsed” building, pulling a “victim” out on tarp litter. As they drag the weighted mannequin across the lawn to the medical triage tent for evaluation and treatment, the radio chatter announces that more victims have been found.

What follows are more units of first responders – all in different types of service uniforms, all working together, probably for the first time, to render aid however they can. Collectively they all work to familiarize themselves with the building structure and layout, while trying to ascertain where other victims might be found and what other resources they may need.

As this is happening, another group of responders are pulling another canvas litter out of the building – this time holding a real person, not a weighted mannequin. Trying to maintain her composure as four men carry her out (and not smile at the exercise-watchers as they look at her being dragged on the ground), she raises her head high enough so she doesn’t get her head banged on the ground.

Taking all of this in alongside the international observers is Brig. Gen. Sean Casey of the Maryland National Guard. In describing today’s exercise, on top of the events and aftermath that the fictional Cora strike has brought upon his home state, he says, “This is the absolute worst scenario for us. It’s bad enough what the storm [Cora] would do, but the storm surge that follows it would make what is a bad situation even worse.”

Adding another emergency like the fictional tornado strike, with supply lines already being stretched thin, limited highways in use, flooded tunnels preventing additional resources getting in, and battling physical exhaustion and fatigue of personnel who have been going nonstop for days, “this is what we have to be ready for.”

Pointing to response crews that are bringing more victims out of the building, Casey adds, “All of these people need to meet their counterparts and be ready to do their part.” He then described how just over 2,000 players – Maryland National Guard, civilians, public safety, emergency management, private sector and more – were playing in Maryland as part of the NLE18 exercise.

In speaking with him, Casey relayed a deep sense of pride at the efforts that were being showcased in the exercise. But coupled with that pride you also detect a sense of concern that any leader would have for the unknown time, event and location when they will be called upon and really tested.


That readiness aspect, along with meeting people in practice, rather than actual game time was echoed by Dawn Ivancik, the emergency manager for the VA Maryland Health Care System. Projecting readiness as well as resolve, she is the only emergency manager for what is a major regional healthcare facility in the state of Maryland (and mid-Atlantic). But at no time does she ever give a sense that she is alone in her job.

Like other emergency managers, she knows that lives are dependent upon her, her decisions as well as the resources and relationships she possesses. “You can’t do this job alone. I may be the only emergency manager for this facility, but I regularly train and exercise the staff here on what we need to do for any number of scenarios.”

She then described doing monthly tabletop exercises with Medical Center staff as well as regular engagements with her Veterans Administration counterparts, the Cecil County Sheriff’s Office, and Cecil County Fire, as well as other surrounding jurisdictions.

In identifying the tools at her disposal, she shared, “We have dual-use vehicles here that if we need to move people in a conventional way or in a hospital ambulatory fashion, we can do that, and the staff here know how to do those things. Evacuating them is the last resort and last thing we want to do, but we have to be ready to do it.”

As we discuss the exercise, Ivancik eludes to the fact that the facility she has emergency stewardship over is in fact a peninsula – a stretch of land that is almost entirely surrounded by water. In taking in that geographic condition, I remark to her that the Cora/NLE18 exercise has probably literally created a number of new remote islands in the surrounding area as the conventional supply lines and resources that have always been there are now cut off and inaccessible.

“Exactly!” she replied. “That’s why doing an exercise like this with search and rescue, the National Guard, Cecil County Fire, as well as the people here [Perry Point VA Medical Center] are essential for us.”

Motioning toward the window as National Guardsmen and local fire and rescue personnel continue to move equipment and people in the exercise, she noted that her job is “to help look after our veterans who have already given us so much.”

“I want to make sure we are ready to give them even more when we are called upon to do so. That’s why I have to make sure we’re ready because none of us can afford to be alone on any island. We need to have practice and relationships.”

As she relays her response, two of her VA colleagues chime in from the side of the room and share that the Perry Point VA Medical Center team is indeed ready for whatever may come their way.  And they credit Dawn for what she’s done to make sure they all know what to do when they are called upon to do “more.”

That ability to know what to do and be ready to take on “more” at a moment’s notice is something Brig. Gen. Casey also relayed during the exercise. As we watched the Guardsmen work with the other exercise participants, he shared that his retirement from the National Guard was on the horizon in a year or so.

“He doesn’t know it yet, but tomorrow my second-in-command is going to take over for the rest of the exercise as I’m going to be ‘hit by a bus,’ which then puts him in charge,” Casey said.

He smiled as he said this, knowing it would be a helluva curve ball tossed at his team. But in sharing that detail with me, Casey relayed confidence as to how his team would react to the sudden (and fictionally dramatic) change in his exercise “status.” (And this is a fictional “hit by a bus” scenario. No one is going to put the brigadier general in front of a bus to be struck; at least I hope not. It’s just his intent to switch from being a “player” to an “observer” for the remainder of the NLE18 exercise.)
In hearing him describe the exercise surprise that was yet to be sprung, I asked if he thinks his second in command knows what might be coming.

Replying with a smile, Casey said, “I think he knows something’s coming but he doesn’t know what it is yet.”
“But that’s the point of exercises like this. Everyone must be ready to step up and do the next job. That’s how you succeed in tough conditions.”

Which explains why practice and relationships make all the difference in the world and how you can survive on unexpected islands or when leadership and conditions unexpectedly change.

It’s about possessing confidence, skill and collaboration, and when those three ingredients are added to any mix things always get better. And Maryland has a lot already in its mix, and showed today that they’re ready to go.

Webinar: Supporting the Emotional Wellbeing of First Responders, Emergency Managers & Disaster Relief Personnel (5/15/2018)

DHS Center for Faith & Opportunity Initiatives

Webinar: Supporting the Emotional Wellbeing of First Responders, Emergency Managers & Disaster Relief Personnel (5/15/2018)

Please register to receive a recording of this webinar.
Register Here
The DHS Center for Faith and Opportunity Initiatives (DHS Center), U.S. Department of Justice, Office of Justice Programs, U.S. Department of Health and Human Services, Substance Abuse and Mental Health Administration and the Federal Emergency Management Agency, are co-hosting a webinar on Supporting the Emotional Wellbeing of First Responders, Emergency Managers & Disaster Relief Personnel on Tuesday, May 15, 2018, from 1:00 p.m.-2:00 p.m. EDT. In support of Mental Health Month, this webinar will provide information and resources on how to respond to the emotional wellbeing of first responders, emergency managers and disaster relief personnel who support communities impacted by disasters. Although this webinar should not be taken as medical advice, it will provide information, resources and considerations to support mental health and emotional well-being during the response and recovery phase of a disaster. The webinar will also provide preparedness trainings and resources on this topic.
Date: Tuesday, May 15, 2018
Time: 1:00 – 2:00p.m. (ET)
Presenter Organizations include:       
  • New Brunswick Theological Seminary
  • U.S. Department of Justice, Office of Justice Programs
  • National Voluntary Organizations Active in Disasters, Emotional and Spiritual Care Committee
  • U.S. Department of Health and Human Services, Substance Abuse and Mental Health Administration (SAMHSA)
How to Join the Webinar:

Access critical, disaster-related behavioral health resources right from your phone with the SAMHSA Disaster App

The SAMHSA Disaster App helps responders focus on what really matters—the people in need.
  • Be ready—access resources for any type of traumatic event, including tip sheets; guides for responders, teachers, parents, and caregivers; and a directory of behavioral health service providers in the impacted area.
  • Be prepared—rely on and access pre-downloaded resources on your phone in case of limited Internet connectivity in the field.
  • Be confident—review key preparedness materials so you're confident you're providing the best support possible.
  • Share resources easily—send information to colleagues and survivors via text message, email, or transfer to a computer for printing.
Access critical, disaster-related behavioral health resources right from your phone with the SAMHSA Disaster App

UNISDR Public Comments Open. You have a voice, and at the table. Locally, Nationally, and Globally. May 14, 2018

Each of you have a voice.
As a member of the United National Global Compact (UNGC) you have a voice on local disaster risk reduction and resiliency strategies.
Step 1: Get actively involved locally,
Step 2: Get involved nationally,
Step 3: Get involved globally
      -Share your comments globally with the UNISDR listed below
Get involved to make the change and giant leap into the 21st Century for our next generation leaders.

Charles D. Sharp
Black Emergency Managers Association International

We stand as one
Eric Lives, In Me.

United Nations Office for Disaster Risk Reduction (UNISDR) - Public Review

Subject: [resilient-cities] Open for Public Review: Words into Action Guidelines on “Implementation guide for local disaster risk reduction and resilience strategies”

Dear colleagues,

Many of you may already be aware that the Words into Action Guidelines on “Implementation guide for local disaster risk reduction and resilience strategies” (2018 – public consultation version) is now available on PreventionWeb for public review. As an effort from the international DRR community brokered by UNISDR, this official public consultation version is a product of a long and detailed process of drafting, consultation and review.  The public review normally runs for three months to ensure that important aspects have not been overseen.  The publication will remain available for public review until mid-June.

Please feel free to share your comments here.
To download the publication (public consultation version), please visit:

About the publication:
The guide focuses on tackling underlying disaster risk drivers and strengthening good governance in disaster risk reduction (DRR) strategies, at all levels and across sectors and actors. The document advises local governments (authorities, planners and managers at city or other sub-national levels) on the mechanisms for developing and implementing a holistic and integrated DRR strategy that contributes to building resilience at the local level. It outlines what a local DRR and resilience strategy should look like, and what is needed to create and implement one.

The guide is divided into seven chapters:
1.       The introduction
2.       Chapter two highlights the role of subnational levels in developing local disaster risk reduction and resilience strategies and the importance of localizing DRR
3.       Chapter three delineates the main characteristics of a local disaster risk reduction and resilience strategy
4.       Chapter four introduces the enabling factors that generate the conditions for its development throughout an inclusive and participatory process
5.       Chapter five elaborates on the three core elements that aid in implementing a local disaster risk reduction and resilience strategy
6.       Chapter six includes a selection of case studies exemplifying some of the main themes covered in the guide
7.       Finally, chapter seven draws some conclusions.

Warm regards,

Mutarika (Mai) Pruksapong
Programme Officer
Office for Northeast Asia (ONEA) and
Global Education and Training Institute (GETI)
United Nations Office for Disaster Risk Reduction (UNISDR)
Incheon, Republic of Korea
T: +82-32-458-6552  | F: +82-32-458-6598/9 | Skype: mutarika_1 │


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