I. PURPOSE - To provide for the health and medical welfare of the public during disasters or emergency situations.

II. SITUATION AND ASSUMPTIONS
· Experience demonstrates that most injured people are not taken to the hospital by trained, medical personnel.
· Emergency Medical Services (EMS) are the most critical within the first 15 to 30 minutes following a disaster or emergency.
· Mutual-aid assistance arrives after the first most critical time period of 15 to 30 minutes.
· Many injuries range from minor to severe will be self-treated due to a knowledge of first aid and or the perception that the EMS system is overburdened.

III. CONCEPT OF OPERATIONS
A. General
1. Emergency Public Health Services:
· Emergency operations for public health services will be an extension of normal duties.
2. Disease Control:
· One of the primary concerns of public health personnel is dis-ease control which involves the detection and control of disease causing agents and the purification of water.
· Primary considerations include the continuation of potable water treatment and the disposal of wastewater under disaster conditions.
· Medical facilities and restaurants need sanitation inspections during emergency disaster situations.
B. Management Concepts
1. Mitigation Activities:
· Mitigation shall be the prime concern of the Mid-Ohio Valley Health Department and its Director.
· Mitigation will best be carried out through the day-to-day func-tion of the immunization and Health Inspection Program.
2. Preparedness Activities:
· Local hospitals and the American Red Cross maintain inven-tories of medical supples, first aid dressings, and related medical supplies and equipment.
· Additional supplies and equipment can be obtained from local pharmacies or external sources.
· If response activities need to be extended over a short term period to meet public health requirements, the West Virginia Office of Emergency Services will be notified and will in turn alert other applicable agencies.




IV. ORGANIZATION AND ASSIGNMENT OF RESPONSIBILITY
A. Organization
1. Mid-Ohio Valley Health Department (MOVHD):
· Responsible for developing health and medical services plans
· MOVHD Administrative Division is primarily responsible for directing and coordinating emergency programs, eg:
· Management and distribution and use of health resources under control of the County
· Coordination with other public agencies to provide trans-portation, communication, non-health supplies, and sup- porting personnel.
· Issuance of health instruction to the general public.
· Damage assessment activities.
· Medical Service Advisory Council
· Composed of the Offices and Directors of the MOVHD
· Assists the Medical Director in planning and organizing emergency and disaster activities and the training of personnel.
· Medical Care Division
· Primary responsibility: directing and coordinating emer-gency programs for health operations, eg: hospitals, emergency treatment station, first-aid stations, litter and ambulance teams, blood banks, blood collection centers, and blood distribution.
· Public Health Division
· Primary responsibility: directing and coordinating emer-gency programs for:
· environmental health: waste disposal, refuse, food, water control, and vector control
· communicable diseases: epidemic intelligence, evaluation, prevention, and detection of biological war agents
· laboratory activities: examination of food and water, diagnostic tests, identification, registration, and disposal of the dead.
2. Region V Emergency Medical Services
· Wood County is located in the Region V Emergency Medical Services Agency which is primarily a funding agency with other responsibilities bearing on emergency and disaster responses:
· determines if there are enough ambulances in an area to meet the needs of the population
· determines if there are enough properly trained EMS personnel
· determines if the ambulances are properly equipped and maintained
· oversees training programs
· coordinate EMS communications
· oversees the allocation of ambulances and personnel during emergencies and disasters

3. West Virginia Department of Health
· Provides assistance to all areas of public health
B. Responsibilities
1. Treatment of Sick and Injured
· During a disaster or emergency an on-site Command Post (CP) and Triage area will be set-up by the person in charge of the operation where the most immediate threat of the sick and injured will occur.
· Fire service agencies have personnel trained in both first-aid and emergency medical treatment and may be assisted by:
· EMS Personnel
· Red Cross Personnel
· Health Department Personnel
· Private Citizens
· The sick and injured will be evaluated with those in the most urgent need of further treatment being transported to medical facilities.
2. Transportation of Patients to Medical Facilities:
· Camden Clark and St. Joseph's Hospitals are the major ambulance providers in Wood County.
· Normally dispatched through 911 Telecommunications Center.
· Have their own radio communication capability.
· The senior person on the first ambulance to arrive will assume the role of EMS Commander and Triage Officer.
· Direct the evaluation of patients coordinating with local hospitals.
· The senior person on the second ambulance to arrive will assume the role of Transportation Officer.
· Direct the distribution of patients coordinating with local hospitals.
· Volunteer and County operated ambulance providers will coordinate their efforts through the 911 Telecommunica- tions Center, the Transportation Officer, and the Triage Officer and/or the Office of Emergency Services.
· If Camden Clark and St. Joseph's Hospitals reach the cap-acity of patients that they can handle, they will direct the distribution of patients to other medical facilities.
· In the event that roads become impassable to local medi-cal facilities, EMS Communications will direct patients to neighboring medical facilities.
· Air National Guard Medical Transport will be requested through the Office of Emergency Services (OES).
3. Emergency Blood Services:
· Normal inventories of whole blood will be inadequate to meet the demands of a large scale disaster such as an enemy attack or terrorist incident.
· Blood banks can be destroyed in both enemy attacks or terrorist events.
· Due to the technical problems involved in storing blood, it is not feasible to store whole blood in quantities required for a large scale disaster, raising the need to:
· Coordinate efforts with the American Red Cross
· Train personnel in blood collecting techniques
· Stockpile blood substitutes
· After a disaster the Chief, Division of Medical Care will:
· Actively promote blood collecting programs.
· Coordinate the distribution of available stockpiles of whole blood and blood substitutes.
· Expand existing blood collection facilities.

V. DIRECTION AND CONTROL
· The Wood County Health Officer will be responsible for the direction and control of public health activities.
· The EOC will serve as the coordinating office for the Health Officer and will provide liaison with the Medical Officer and other related personnel.

VI. CONTINUITY OF GOVERNMENT
A. Lines of Succession
· County Health Officer
· Deputy Director of Emergency Health Services
· Chief of Medical Care Division
· Chief of Public Health Division

B. Indispensable Operating Records
· The Division Chief will be responsible for determining the records essential for post-attack assignment.
· The Division Chief will select individuals to fulfill assignments within the division since the Chief is familiar with qualified per- sonnel and the objectives of this Program.

VII. ADMINISTRATION AND LOGISTICS
A. Health Statistics
1. Vital Statistics:
· The health department will continue to collect vital statistics as under normal operating procedures.
2. Disease Statistics:
· Data related to disease outbreaks will be collected and forwarded to appropriate State and Federal officials.

B. Testing and Inspections
· All testing of materials will be accomplished under the normal procedures used by the health department.
· Inspection will be conducted in a normal fashion but with in-creased frequency.



VIII. PLAN DEVELOPMENT AND MAINTENANCE
The County Health Officer will work with the Emergency Services Director, other medical personnel, and the agencies specified in this Annex in its development and maintenance. The Plan must be reviewed, tested, and updated annually.















AUTHORITIES AND REFERENCES
1. Federal Civil Defense Act of 1950, Pub. L. 81 -920, as amended.
2. The Disaster Relief Act of 1974, Pub. L. 93-288, as amended. 3. Emergency Management and Assistance, 44 US Code 2.1 (October 1, 1980).
4. Federal Emergency Management Agency, Guide for All Hazard Emergency Opera-
tions, SLG 101.
5. West Virginia Emergency Services Act, Chapter 15, Article 5.