State Mass Care Coordination

The national mass care community needs to agree on a standard state mass care coordination process and then sell the concept to the emergency management community. I am sure that this is not a burning item on your priority list but here me out. Right now, responsibility for mass care coordination for most of the fifty states can be divided into one of three categories: 1) Let the Red Cross do it, 2) Let the Red Cross and FEMA do it, and 3) let a social service service state agency do it.

Emergency managers don't want to mess with mass care. This situation reminds me of the role of civil affairs in the Army. Civil Affairs consists of officers and soldiers who deal with civilians on the battlefield. The Infantry and Armor Officers who are In Charge don't want to mess with the civilians because they wouldn't take orders and were a drain on resources needed for combat operations. All of our tabletop and field exercises were full of combat units but civilians and their problems were nowhere to be seen. The civilians were assumed to be out of the exercise, taken care of by the civil affairs units.

Emergency managers are rightly concerned with life safety actions immediately after the disaster hits. But, as they say, after 72 hours you're not doing search and rescue, you're doing body recovery. Most big exercises end by 72 hours after the event, if they even last that long. Yet, at 72 hours, in disasters involving millions of people (which are the ones that most concern me) the mass care problems are only beginning.

The intent of a standardized state mass care coordination process is not to dictate to states how they should do business. When the Big One hits and the State starts screaming for help and people from other states or voluntary agencies or FEMA start streaming into the State EOC it would be very helpful if everyone used and understood a common process for mass care coordination. These new people are already dealing with an unfamiliar geography, a strange system and co-workers that they have never seen before. By giving them a nationally known and familiar process we can immediately increase their effectiveness. Preferably this process would have been taught in FEMA mass care courses and practiced in exercises like the National Mass Care Exercise. I've written about this in a previous blog post.

After the recent National Mass Care Exercise, held in Tallahassee in May, we came up with the diagram below to explain the coordination process that we utilized in the exercise. This diagram didn't spring forth from anyone's head fully formed. At least 30 or 40 members of the national mass care community nationwide made comments on various drafts. At first they said to add this and don't forget to include that.  Then they said the damn thing was too complicated and hard to understand. So we simplified the diagram and found someone in FEMA Headquarters who could draw pretty Power Point pictures. This is the result.

At the FEMA Region IV Individual Assistance Conference in Atlanta last week I briefed this diagram to the FEMA, state and voluntary agency attendees. They then broke up into groups and discussed the diagram. Some groups briefed that we needed to add this or include that. Others said that it was too complicated.

But we're making progress. We need to get the diagram out in front of people so that they can talk about it and maybe even think about how they can adopt it in their states.

To me there are a number of important features of the diagram that must be pointed out. First, and most importantly, the diagram establishes the critical role of the State Mass Care Coordinator (SMCC). FEMA has published a Job Title that establishes education and experience requirements for a Type 1 and Type 2 State Mass Care Coordinator. The National Mass Care Strategy recommends that states identify a State Mass Care Coordinator. FEMA needs to encourage this by sending identified State Mass Care Coordinators to training and exercises, like the National Mass Care Exercise.

A second important feature is the concept that the SMCC acquires, prioritizes and allocates resources and information to the supported agencies. In large events the SMCC is assisted in this coordination process through the establishment of Mass Care Task Forces, that operate in accordance with State Mass Care/Emergency Assistance Plans.

Finally, the diagram defines the supported agencies as the affected counties, the Mass Care Voluntary Agencies Field Headquarters (like the American Red Cross Disaster Relief Organization) and those state agencies that perform mass care (like a state Social Services agency that operates shelters). These Supported Agencies request and receive resources from the State EOC.

I am going to do my best to engage the national mass care community with the concepts incorporated into this diagram. The first step in the engagement is to get everyone to understand the existence and importance of the state coordination process. The second step in the engagement is to get everyone to understand the concepts represented in the diagram of the process and how they would apply to a disaster in their state. Finally, I want to get informed analysis and criticism of the diagram so that we can make it better.