Sunday, November 29, 2015

Toward a catastrophic mass care response capability

I don't normally write controversial blog posts but this one will generate disagreement among my friends in the mass care community.

I want to talk about what we, as a nation, have to do to build a catastrophic mass care response capability. The two biggest disasters that we had in the last decade, Katrina and Sandy, revealed some significant mass care response issues that I don't think have been adequately addressed.

Since I'm not writing a book (yet) on catastrophic mass care response I'm going to focus on one issue in this response: Operational Coordination of Mass Care Services. "Operational Coordination" is the technical term for the capability to manage the resources brought into the disaster area. 

In a large disaster these resources would require thousands of 53' trailers. When the emergency managers of the affected jurisdictions start screaming for everything in the world and "the world" shows up, you need a lot of people on hand to tell the trucks where to go.

In a gross oversimplification (for clarity) of operational coordination during emergencies, everyone is either working in a multi-agency coordination system (i.e. an emergency operations center) or an incident command. A county EOC would acquire resources for one or more incident commands. When I helped coordinate mass care at the State EOC in Florida we acquired resources (personnel. equipment, teams and supplies) for county EOCs, state incident commands or voluntary agency incident commands (like the Salvation Army or Red Cross).

The Maryland State Emergency Operations Center during the response to Hurricane Sandy.
 When the Category 5 hurricane hits Miami (and it will) the state mass care team will have to decide what mass care resources are required (and in what quantities) and who will provide these resources, whether it be local, state, federal, voluntary agency or private sector. The process for achieving this task requires complex coordination. To be effective the mass care team needs a common understanding of the process and detailed, rehearsed procedures.

During the National Mass Care Exercises we conducted in Tallahassee from 2012-14 and in Texas in 2015 we worked to develop and rehearse this process. We, the national mass care community, are going to continue this process during the 2016 National Mass Care Exercise in Kansas City.

So we're working on fixing the problem of identifying mass care resources by type, kind and quantity and deploying them into the disaster area. But once we've ACQUIRED these resources in a catastrophic event the question becomes who is going to EMPLOY those resources?

The state mass care team isn't going to employ them. The counties and municipalities will be overwhelmed, and their EOCs will be focused on what they always are focused on: police, fire, medical and debris removal. In some hurricane prone states the locals and/or states establish evacuation shelters (at times in coordination with the Red Cross). But the post-event short term shelters are almost always managed by the Red Cross.

FEMA doesn't have a mass care capability except in certain narrow circumstances (see Federal Mass Care Resource Coordination). And no, providing truckloads of bottled water and shelf stable meals is not mass care but logistics. FEMA does logistics very well.

Mass Care is more than evacuation shelters and bottled water.The capabilities to feed hot meals in the community, shelter for weeks, distribute emergency supplies and help reunify families live almost exclusively within the voluntary agencies. And there are only three mass care voluntary agencies able to mobilize national resources to bring a significant mass care capability to bear in a catastrophic event: the Southern Baptists, the Salvation Army and the American Red Cross.

In the mass care arena (these agencies also bring significant recovery resources) the Baptists have an enormous national capability in field kitchens while the Salvation Army has significant feeding capabilities with their canteens and field kitchens. The Red Cross Disaster Relief Operation is the only mass care "incident command" that acquires and employs resources in the four mass care activity areas: feeding, sheltering, distribution of relief supplies and reunification.

The American Red Cross Disaster Relief Operation in Manhattan during the response to Hurricane Sandy.

The cheapest investment, as a nation, that we can make in our catastrophic mass care response capability is to improve the ability of the American Red Cross Disaster Relief Organization to manage the enormous amount of mass care resources that must be employed in a large scale event. There. I said it.

In discussions that I've had with individuals that I know and respect my suggestion provokes an emotional reaction. 

"That won't work. The Red Cross can't manage mass care in a catastrophic event."

And I reply: "What are the other choices? FEMA? The Counties? The State?"

A staggering quantity of mass care resources will be requested and will flow into south Florida (or whatever the disaster area happens to be) after a catastrophic hurricane. They must be managed and employed in a coherent fashion. 

The Red Cross has the capability to employ these resources but right now lacks the CAPACITY to do so in such a large event. In my view the solution is to take those actions necessary to increase the capacity of the Disaster Relief Operation to manage large events.

And FEMA has to help the Red Cross to do this.