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Santa Cruz County Grand Jury
Report
for 2002-2003
701 Ocean Street, Room 318-I
Santa Cruz, CA 95060
(831) 454-2099
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Emergency Preparedness
Background
Santa Cruz County has had
more than its share of government declared disasters, 17 in the last 25 years.
It’s likely another will occur sometime soon. Now, in addition to natural
disasters, we are warned of impending disasters such as bioterrorism. Our
country has been at the second highest threat alert level several times this
year. The Grand Jury’s goal in this report was to assess whether county
agencies are adequately prepared to manage health and safety issues resulting
from a disaster.
Emergency preparedness in
Santa Cruz County has emerged from earlier Civil Defense programs. It has
expanded to include the following disasters: earthquakes, fires, floods,
tsunamis, bioterrorism, convergent refugees (people fleeing a disaster from
other counties), civil unrest, hazardous materials (HAZMAT) and other large
scale life-threatening situations.
Scope
The purpose of this study
is to assess preparedness of Santa Cruz County health and human services
agencies in the event of a disaster. Many agencies and groups must collaborate
to provide a swift, coordinated disaster response. Volunteer organizations are
critical to the success of county programs but are not within the county’s
jurisdiction. The Grand Jury includes volunteer organizations in this study
and refers to their roles without making recommendations to them.
In
this study, the Grand Jury evaluated the adequacy of current emergency plans,
evaluated the Command Post, and assessed communication and the availability of
medical resources. Other issues included: staffing, volunteer programs, and
programs to warn the public that rescue from outside the county and evacuation
from the county may be unavailable for up to 72 hours.
The following entities
are included in this review: the Santa Cruz County Office of Emergency
Services (OES) Health Services Agency (HSA), Emergency Medical Services (EMS),
and the County Board of Supervisors.
Glossary of Emergency
Organization Roles:
County emergency agencies
receive some funding and direction from state and federal entities including
the United States Department of Justice, Federal Emergency Management Agency (FEMA),
and the Department of Homeland Security “Homeland Security”.
OES must comply with state and federal guidelines. Homeland Security
issues warnings and planning requests. OES is the liaison between government
agencies in disaster relief efforts.
Once the President
declares a disaster, FEMA mobilizes resources for recovery efforts in the
area. FEMA then makes aid directly available to the public through a
variety of federally funded programs.
During an emergency,
operations are coordinated at the Command Post located at De Laveaga Park.
When activated, the Command Post is staffed by the County Administrative
Officer who serves as Director of Emergency Services, the Emergency Services
Administrator serves as a Coordinator, a designated staff person from the
County Administrative Office serves as a Public Information Officer, County
Counsel serves as a Legal Officer and Risk Management provides a staff person
who serves as a Safety Officer. EMS also responds to disasters at the Command
Post. The EMS Emergency Coordinator reports to the Emergency Services
Administrator. Additionally, a Santa Cruz Chapter Red Cross (Red Cross)
representative and the
Radio Amateur
Civil Emergency Services (RACES)
Officer have Command Post seats.
County
Organizations:
The Office of Emergency Services is responsible for emergency planning
and preparation for Santa Cruz County. OES assesses risks from disasters
and develops operational contingency plans to address them. OES was created in
1980 and is currently co-located with the 911 emergency call center and the
Command Post. This facility opened in 1996.
The Emergency
Management Council (Disaster
Council), following State guidelines, recommends emergency policy to the
County Board of Supervisors. OES provides staff to the Emergency Management
Council. Red Cross is a member of the Emergency Management Council along with
the
Radio Amateur
Civil Emergency Services (RACES)
Officer.
Emergency Medical
Services manages pre-hospital
emergency services such as Basic Life Support and Advanced Life Support. Basic
Life Support care includes stabilizing a patient and transport to the
hospital. Staff may do airway management or defibrillation. Advanced Life
Support paramedics can also intubate, and administer emergency cardiac drugs.
The Disaster
Designated Medical Facilities
supply additional medical care in an emergency. There are currently 14
facilities located throughout the county.
Volunteer
Organizations:
Community groups were originally formed to provide self-help when
storms closed Highways 9 and 17 because county rescue operations were unable
to locate people in need of rescue. Neighborhood coordinators work with radio
operators, fire departments, schools, Red Cross and others to manage rescue
information.
The Disaster Service Workers Program is comprised of trained
volunteers, many with medical training, who enroll prior to an event and must
take a loyalty oath.
The Community Emergency Response Team (CERT) concept was developed and
implemented by the Los Angeles Fire Department in 1985. The Whittier Narrows
earthquake in 1987 underscored the threat of a major disaster in California
and confirmed the need for training civilians to meet their local
neighborhood’s needs. The CERT program covers skills needed when emergency
services are not immediately available.
Red Cross Disaster
Services focuses on meeting
people's immediate emergency needs. In a disaster, the Red Cross provides
shelter, food, and health services. Red Cross serves all of
Santa Cruz
County from around Pescadero to Aromas and into the Santa Cruz mountains.
Amateur Radio Clubs
Amateur Radio Emergency Services
(ARES) and
Radio Amateur
Civil Emergency Services (RACES)
both provide emergency
communication during a disaster. The Federal Communications Commission (FCC)
licenses radio operators and mandates emergency communication by radio
operators. RACES originated as part of Civil Defense. ARES provides support to
volunteer organizations.
Fieldwork
The Grand Jury undertook
the following fieldwork:
- Interviewed the
Watsonville hospital Emergency Services Director and toured the hospital
- Attended a meeting of
the Emergency Management Council
- Observed an annual
disaster drill from the Command Post at Emergency Services
- Interviewed the staff
at Emergency Services
- Interviewed the staff
of Emergency Medical Services at the Health Services Agency
- Interviewed the
Director of Disaster Services at Santa Cruz Red Cross
g.
Interviewed the Emergency Services Administrator, Santa Cruz County
Office of Emergency Services
h.
Attended a Mountain Community Resources Meeting – San Lorenzo Valley
Community Group
- Interviewed the RACES
Officer
Additional
Sources:
- County of Santa Cruz
Health Services Agency’s Bioterrorism Preparedness and Response -
Bioterrorism resources from the CDC Web site:
http://www.bt.cdc.gov/
·
FEMA CERT program Web site:
http://training.fema.gov/EMIWeb/cert/overview.asp
·
911 SCCECC Communications Center
Web site:
http://www.sccecc.org/
Findings
- A threat assessment
was recently completed by OES using a Department of Justice grant. The
assessment found that although there are not many attractive terrorist
targets in Santa Cruz County, there are plenty of potential natural
disasters. Monterey has possible targets but none compare to San Jose, San
Francisco or Los Angeles. Potential convergent refugees fleeing from
emergencies outside the county—along with hazards that might come into the
county such as radiation—are issues that require planning.
- Escape from a disaster
is hindered by traffic. At capacity, only 1800 cars per hour per lane can
travel on Highway 1. The population
of
Santa Cruz County as reported in the 2000 census was 255,602.
Residents alone have
227,345
cars. Imagine the nightmare if everyone
tried to leave a crowded location at the same time. (Santa
Cruz County Transportation Commission) (2000
U.S. Census)
- The County HSA is
responding to medical issues specific to bioterrorism. A coordinated
response will be conducted with fire, police, health care providers and
other public agencies. Surveillance is being expanded to detect unusual or
suspicious disease occurrences. Information about unusual diseases that
might be the result of a bioterrorist attack is being distributed to
emergency rooms and to medical personnel in the county. (cdc Web site)
- The Command Post is in
an isolated location but must get information quickly about county issues.
An aerial view of a disaster site using a Civil Air Patrol plane, Coast
Guard helicopter, a Fire Services plane, or a helicopter volunteered by a
local citizen, would help in developing an appropriate plan. Currently,
there is no way to transmit an aerial view to the command Post.
- The Grand Jury
observed that many computers at the Command Post were non-functional during
the annual disaster drill. Since our visit, newer computers with
maintenance contracts arrived at the Command Post.
- EMS would like access
to information when at the Command Post. For instance, the California
Highway Patrol’s (CHP) website may indicate calls for road closures.
Hospitals need this information if a patient must be transported over the
hill to a trauma center and Highway 17 is closed. A new software system is
needed so that this type of information can be quickly and easily
distributed to the Command Post.
- In a localized
emergency, Santa Cruz County can get outside help. However, if a
disaster affects a larger area, county residents will be on our own for some
time. In any case, parts of Santa Cruz County are isolated and terrain
restricts access. Supplies and resources will go to larger metropolitan
areas first. It is impossible to cache all of the supplies and equipment
needed in the event of a major disaster.
- An emergency may
require an urgent need for medication. There is no cache of emergency
medications including antibiotics in the county as hospitals and pharmacies
obtain them as needed. A medication cache requires rotation of stock before
expiration dates.
- With only two
emergency hospitals in the county, staff, resources and beds are inadequate
to deal with a disaster. In an emergency, Disaster Designated Medical
Facilities supply medical care for patients with minor injuries to prevent
overloading hospital emergency rooms. Disaster Dedicated Medical Facilities
are asked to have materials on hand to care for 50 patients for three days;
however, they have not made that financial commitment.
- Homeland Security has
given two small grants for first responders, administered by OES. Local
officials identify the emergency needs of the community and request support
from both the state and the federal government. FEMA is a funding
contributor but the State OES, and the County OES, coordinate local disaster
relief efforts. (OES Web site) (Emergency Management Plan)
- Budget cuts are
expected to hurt. General Services is going through a horrific budget
process right now. The Grand Jury heard that budgets are likely to be
smaller—probably countywide. EMS has some state funding but most
funding is from the county. EMS applies for grants when possible and
recently received a trauma grant. When staff is out on vacation or due
to illness, work must be delegated to the department head, as there is no
staff relief.
- Most of the money for
emergency services after 9/11 has been for equipment and training, not
staffing. Approximately $8000 has come to the county for a CERT
program. The administrative cost to set up the program was about $800, which
was spent on the first meeting.
- Emergency planning
staff is limited. Each county in California has the same disaster
planning requirements, regardless of size. Large counties with more
staff have less trouble fulfilling state mandated activities. Santa
Cruz County, the second smallest county geographically in the state, has
fewer staff. OES and Emergency Services each have a staff of three,
comprised of a manager plus two staff. According to staff, this is
inadequate.
- Currently, there are
small Homeland Security grants to be administrated by OES. Writing proposals
and administration of the grants is time consuming. Although 80% of new
issues involve homeland security, there is no new staff.
- Civilians can be
recruited and trained as CERT teams that, in essence, will be auxiliary
responders. CERT teams can provide immediate assistance to victims in their
area, organize spontaneous volunteers who have not had training, and collect
disaster intelligence that will assist professional responders with
prioritization and allocation of resources following a disaster. Training
was made available nationally by FEMA in 1993. A new FEMA grant is earmarked
for a Santa Cruz area CERT program. (FEMA CERT Web site)
- Aptos/La Selva Beach
Fire District is currently recruiting and training CERT volunteers to safely
help themselves, and their neighbors in an emergency. Training topics
include: disaster fire suppression, hazardous materials, disaster medical
operations, light search and rescue operations, disaster psychology and team
organization. A new CERT program is also forming in San Lorenzo Valley.
(Aptos Fire Web site)
- The Disaster Service
Workers Program insurance funding has been recently reinstated in the State
budget. During a disaster, trained volunteers are authorized to work under a
declared state of emergency. EMS has a list of skilled people they can call
upon to do medical work. RACES members also qualify as Disaster Service
Workers.
- Santa Cruz Red Cross
receives no money from the American Red Cross or from federal agencies such
as FEMA or Homeland Security. Funding from United Way is only available
through the next 18 months due to a change that allows payment for fixed
shelters only. Although some materials come from the American Red Cross,
Santa Cruz Red Cross must do local fundraising to make up for the lack of
federal funding.
- Red Cross Disaster
Services provides shelter and food to disaster victims, supplementing the
county’s mobile canteen services and offering shelter for 100-1000 people.
Red Cross sheltered 1700 people at the Santa Cruz County Fairgrounds after
the 1989 Loma Prieta earthquake. Emergency supplies in moveable containers
are located throughout the county such as at the airport, and fire stations.
Some of the sixty-seven local nurses who volunteer with Red Cross work on
pandemic
and other disasters.
- Red Cross conducts
town hall meetings and provides speakers and training to neighborhood
groups. Topics include sheltering in place,
disaster and pets, seniors, disabled, and HAZMAT. Red Cross conducts
disaster training using volunteer trainers at community colleges. Red Cross
also conducts shelter drills and is working on a disaster compliance plan.
- Funding and project
coordination of community groups are tied to a number of entities. For
example, community group neighbors are working with a FEMA grant to raise
the elevation of their houses to be above flood levels.
- OES is interested in
establishing and working with more community groups. OES and Red Cross will
help train community groups interested in mobilizing their own disaster
planning efforts. Community groups help fill some gaps of OES functions in
planning and relief efforts. They also provide needed eyes in the field for
information flow.
- Consistent and
accurate information will reduce public panic and rumors. To address this
issue, EMS is preparing fact sheets on how to manage specific emergency
situations such as; shelter in place, food and water safety and hygiene, and
others regarding power outages and evacuations tips. Currently information
can be sent to the media, read over phone, or put in libraries.
- Recently, the phone
company agreed to reinstate the basic first aid page in the phone book.
However, it is currently somewhat hard to find and incomplete.
Conclusions
- The county should plan
for the most likely emergencies. The most urgent issue may be the potential
for convergent refugees fleeing from a disaster outside the county. Money
from Homeland Security would help county agencies achieve a greater level of
preparedness.
- Overall county
emergency planning is good. However because of the potential number of
different types and variations of disasters the county cannot plan for every
possible emergency.
- Digital cameras for
use in the field by aircraft could transmit emergency information to the
Command Post.
- The facility and
hardware at the Command Post are now adequate but communication software is
poor. Communications software is needed to support shared information. A
portable system would allow access from the primary site and remote
locations.
- A centralized cache of
emergency medications is needed to supply medical facilities.
- Staffing at OES is
inadequate to handle an increasing workload. The time constraint of
fulfilling the grant process may negatively impact staff needs in other
areas. For example, staff needs have increased with heightened alerts and
the recent HAZMAT concern.
7.
A federal grant for CERT volunteer training is needed.
8.
Additional support from government agencies is needed for volunteer
programs such as Disaster Service Workers, RACES, and Red Cross.
9.
Programs that support and encourage volunteers, such as community
groups, should be pursued.
10.
EMS needs to improve public awareness that residents will probably be
“on their own” until outside help is received. People need to have
enough medication available before the need arises. Information should be
distributed through the following methods:
·
Post fact sheets on web site.
·
Send fact sheet inserts with
PG&E bills.
·
Distribute fact sheets to
students at schools.
- The emergency
information page in the phone book needs to be revised for easy access and
provide emergency instructions for home or work, including advice on keeping
a supply of medication.
Recommendations
- OES should acquire
digital cameras for the Command Post for use in the field with a wireless
method of transmitting the images.
- OES should purchase
communications software for the Command Post that will function during
emergency situations and facilitate information access and sharing.
- EMS should establish a
local supply of enough emergency medications to last for at least three days
to be kept at a central location. Stock should be rotated as needed.
- OES should add staff
to write grant proposals and implement grants. OES should possibly share
this staff with EMS. EMS should, at a minimum, maintain staffing.
- The county should
obtain funding from FEMA for CERT training programs.
- The Board of
Supervisors should encourage formation and success of community groups by
providing lists, training opportunities and information about properties
from the county Assessor’s Office and parcel maps.
- EMS should develop a
public awareness campaign with a broader distribution of information to
prepare citizens to be self-sufficient for at least seventy-two hours.
Information should be circulated as outlined in conclusion 10, including
working with the telephone company to improve emergency information and
utility companies to mail emergency information inserts.
Responses Required
Entity |
Findings |
Recommendations |
Respond Within |
Santa Cruz County
Board of Supervisors
|
15-21 |
5, 6 |
60 Days
(Sept. 2, 2003) |
Santa Cruz County Office
of Emergency Services |
1, 2, 4, 5 7, 10, 12-14, 22 |
1, 2, 4 |
90 Days
(Sept. 30, 2003) |
Santa Cruz County Emergency Medical
Services |
3, 6, 8, 9, 11, 13, 23, 24 |
3, 7 |
90 Days
(Sept. 30, 2003) |