Download Guidance for Sheltering Persons with Medical Needs PDF

TitleGuidance for Sheltering Persons with Medical Needs
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Total Pages111
Document Text Contents
Page 1

The California Department of Public Health

Guidance for Sheltering Persons
with Medical Needs

Page 2


Date Version Description

10/03/2011 0.1 INITIAL DRAFT

This work product was developed jointly by Hagerty Consulting, Inc. and The Highlands Consulting Group

LLC for the California Department of Public Health.

Hagerty Consulting, Inc.
1156 15th Street, NW Suite 850
Washington, DC 20005

The Highlands Consulting Group LLC
400 Capitol Mall, Suite 1540
Sacramento, CA 95814

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4.6. Job Action Sheets 1

Job action sheets provide the user with a series of actions to consider when serving in specific roles 2

within the shelter management structure. Part III: Medical Shelter Toolkit provides sample job 3

action sheets for potential medical shelter positions. The items listed in the tools are minimum 4

considerations for developing job action sheets. 5

The job action sheets provided are designed to be customized, although planning teams are 6

encouraged to maintain the prescribed format and terminology as a means of ensuring 7

standardization of each individual position’s primary function. The format also allows for the job 8

action sheets to be used to preliminarily document actions taken during the incident and assist in 9

developing a chronology of events, problems encountered, and decisions made. 10

Medical Shelter Job Action Sheets
Provides sample job action sheets for
potential functions within the medical
shelter organizational structure.

5. Site Considerations

5.1. Site Selection 11


Publicly owned structures should be considered for medical shelter sites; 13

A medical shelter should be accessible to at least two roadways; 14

The site should have limited entranceways and should be controllable for security; 15

Clinical care requirements for the facility must be determined. 16

Choosing a quality site for the medical shelter is essential. If possible, the chosen site will be 17

accessible to existing infrastructure or services. For example, locating a medical shelter near an 18

acute care facility may allow certain services to be shared between the sites. The following general 19

considerations should be made when selecting a site: 20

 General population shelter sites: Coordination should occur with the local mass care lead to 21
identify sites which have been selected as potential general population shelters and determine 22


• Identify key considerations for medical shelter site selection, including size considerations
• Understand the approach to site assessment
• Develop model site configuration

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their suitability for medical shelter operations. Jurisdictions should clearly communicate the 1

status of these facilities to ensure that they are not assumed to be available for both functions. 2

 Faith-based owned facilities and Community Centers: These facilities are often utilized for 3
shelters as they can generally accommodate a large number of persons and may have feeding 4

facilities on the premises; 5

 Armories and other public buildings: These structures are particularly well-suited for use as 6
shelters because they are publicly owned structures, which are easier to secure rapidly during 7

an incident; 8

 Schools: Schools including colleges and universities often make good medical shelters as they 9
can offer shelter to large numbers of persons; however, jurisdictions must take steps to 10

minimize the disruption of educational services. When a school is used as a shelter, it will be 11

used in accordance with school district policy and procedure. The restoration of educational 12

services in schools used as shelters is a vital ingredient to recovery of the disrupted community. 13

When school property is used, an agency representative should be assigned to coordinate the 14

sharing of resources between schools and school districts to ensure that the needs of students 15

are met prior to the re-establishment of educational services; 16

 Parks facilities and other open spaces: In some instances, jurisdictions may utilize recreational 17
park facilities or fairgrounds as a location for a medical shelter. Tents and other portable 18

structures may be utilized in open spaces such as parks or parking lots to establish a medical 19

shelter site. This approach is generally not recommended because use of temporary facilities 20

will increase logistical requirements such as utilities; 21

Other lodging facilities: This may include privately owned arenas, sports stadiums or gymnasiums. 22

Arrangements should be made in advance with owners or managers of potential sites for a medical 23

shelter; optimal attributes of medical shelters are identified by the Department of Justice, Americans 24

with Disabilities Act Accessibility Guidelines. These attributes include but are not limited to: 25

 Emergency power (fixed generators); 26
 Close proximity to emergency medical services; 27
 Heating and cooling capabilities; 28
 Refrigeration; 29
 Back-up or portable oxygen supplies; 30
 Water supply and waste disposal system; 31
 Food supply and preparation area for special diets; 32
 Accessible parking for transporting those with medical needs; 33
 Drop-off areas that are clearly marked, close to the entrance and have curb cuts (35 inches in 34

width); 35

 Entrance that is well marked with automatic doors (or less than 5 lb. resistance, appropriate 36
door handles and doorways, minimum width of 35 inches); 37

 Path of wide and clear travel to registration, sleeping area, food area, toilet and shower area, 38
medical area, TV/computer area, phone/communication area, and quiet area; 39

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South Carolina 1

 Memorandum of Understanding between the Salvation Army (a Georgia Corporation) and 2
the South Carolina Emergency Preparedness Division 3

Texas 4

 Medical Special Needs Planning Toolkit 5

United States Department of Health and Human Services 7

 Medical Surge Capacity and Capability: A Management System for Integrating Medical 8
and Health Resources during Large-Scale Emergencies 9

 Medical Surge Capacity and Capability: The Healthcare Coalition in Emergency Response 10
and Recovery 11

 Medical Special Needs Evacuation, Reception, Sheltering and Repatriation Planning 12
Checklist 13

 Special Needs Planning Checklist 14
United States Federal Emergency Management Agency 15

 Guidance on Planning for Integration of Functional Needs Support Services in General 16
Population Shelters 17

 Lessons Learned Information Sharing, Mass Care: Shelter Compliance with the Americans 18
with Disabilities Act 19

United States Federal Medical Stations 20

 Concept of Operations, Federal Medical Stations Baseline 21
Washington 22

 Public Health - Seattle and King County Healthcare Coalition Toolkit 23

Primary Articles 24

Primary articles were consulted. Notable articles whose current practices were incorporated 25

include: 26

Bolster, C.J. Mobile Hospital Provides Care when Disaster Strikes: When Disaster Strikes, A Well-27

Thought-Out Plan Goes a Long Way in a Successful Deployment of Emergency Services 28

Bonnett, C.J., Peery, B.N., Cantrill, S.V., Pons, P.T., Haukoos, J.S., McVaney, K.E., Colwell, C.B. 29

Surge Capacity: A Proposed Conceptual Framework 30

Bridgewater, Aspinall, E.T., Booth, J., Capps, R.A., Grantham, H., Pearce, A.P., Ritchie, B.K. Team 31

Echo: Observations and Lessons Learned in the Recovery Phase of the 2004 Asian Tsunami 32

Clements, B., (2010). Functional Needs Support Services: A New Paradigm in Emergency Shelter 33

Populations 34

Clements, B., (2010). Meeting the Challenge: Public Health Emergencies & the Special Needs 35

Populations 36

Franco, C., Toner, E., Waldhorn, R., Maldin, B., O’Toole, T., Inglesby, T.V., Systematic Collapse: 37

Medical Care in the Aftermath of Hurricane Katrina 38

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Gavagan, T.F., Hurricane Katrina: Medical Response at the Houston Astrodome/Reliant Center 1

Complex 2

Kaji, A., Koenig, K.L., Bey, T., Surge Capacity for Healthcare Systems: A Conceptual Framework 3

Kelen, G.D., Kraus, C.K., McCarthy, M.L., Bass, E., His, E.B., Scheulen, J.J., Shahan, J.B., Brill, J.D., 4

Green, G.B., Inpatient Disposition Classification for the Creation of Hospital Surge Capacity: A 5

Multiphase Study 6

Klein, K.R., Nagel, N.E., Mass Medical Evacuation: Hurricane Katrina and Nursing Experiences at 7

New Orleans Airport 8

Millin, M.G., Jenkins, J.L., Kirsch, T., A Comparative Analysis of Two External Healthcare Disaster 9

Responses Following Hurricane Katrina 10

Saunders, J.M., Vulnerable Populations in an American Red Cross Shelter After Hurricane Katrina 11

Schultz, C.H., Koenig, K.L., State of Research in High Consequence Hospital Surge Capacity 12

Sanford, C., Jui, J., Miller, H.C., Jobe, K.A., Medical Treatment at Louis Armstrong New Orleans 13

International After Hurricane Katrina: The Experience of Disaster Medical Assistance Teams 14

WA-1 and OR-2 15

Schultz, Carl H., Koenig, Kristi L., Noji, Eric K., (1996). A Medical Disaster Response to Reduce 16
Immediate Mortality After An Earthquake 17

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