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Disaster Medicine

Disaster Centers

By Lynn P. Roppolo, MD
Vol. 13, Issue 3, July 2004

Disaster Center is a loosely defined term but often tossed around more frequently in recent years, as if everyone knew exactly what it means.  If you ask any emergency physician knowledgeable in the field of disaster medicine about what exactly a "disaster center" signifies, you may get a variety of answers with no one being certain of a precise definition.  This article intends to provide section members with several examples of "disaster centers". This is not an all-inclusive list, but will hopefully give you a better understanding and appreciation of what this ambiguous term really means.

Prior to September 11th, more that 100 different governmental organizations had some form of responsibility in our federal disaster response.  Under the Homeland Security Act of 2002, the Department of Homeland Security (DHS) was created in hopes to strengthen and unify the mission of protecting the American homeland.1 The Office for Domestic Preparedness (ODP) is the principal agency of the DHS and is responsible for preparing the United States for acts of terrorism. In carrying out this mission, the ODP is the primary office responsible to providing training, funds for the purchase of equipment, support for the planning and execution of exercises, technical assistance and other support to assist states and local jurisdiction prevent, plan for, and respond to acts of terrorism.2 The ODP utilizes the capabilities of a number of specialized institutions in the design and delivery of its training programs.

The principles of comprehensive emergency management in disaster response are mitigation, preparedness, response, and recovery. There are numerous existing agencies (or "disaster centers") that provide resources to support all phases of emergency management.  

Mitigation

Under the DHS, the Emergency Preparedness and Response Directorate (EP&R) has built upon the existing Federal Emergency Management Agency (FEMA) Mitigation Division activities, such as mitigation planning .1 States and local jurisdictions operate mitigation programs, which may be funded by FEMA Mitigation Division programs, such as the Hazard Mitigation Grant Program (HMGP), for pre-disaster mitigation activities to reduce the impact of a disaster before it occurs, or post-disaster mitigation activities to reduce the impact of a future disaster during the recovery of a disaster.4

For public health emergencies, the Department of Health and Human Services (DHHS) Centers for Disease Control and Prevention’s (CDC) National Immunization Program provides leadership for the planning, coordination, and conduct of immunization activities to prevent and control vaccine-preventable diseases.3,5

Preparedness

ODP utilizes the capabilities of a number of specialized institutions, such as the members of the National Domestic Preparedness Consortium (NDPC), in the design and delivery of its programs.  The National Domestic Preparedness Consortium (NDPC) is the main vehicle through which ODP assists state and local emergency responders. The NDPC membership consists of 5 separate disaster centers that focus on training of emergency responders (and are listed below). Each center brings a unique set of assets to the domestic preparedness program.

The CDP (Center for Domestic Preparedness (CDP) in Anniston, Alabama) provides hands-on specialized training to state and local emergency responders in the management and remediation of WMD incidents. Located at the former home of the U.S. Army Chemical School, Fort McClellan, the CDP conducts live chemical agent training for the nation's civilian emergency response community. The CDP offers two training courses of instruction: WMD HAZMAT Technician and WMD Incident Command.  Contact the CDP at (256) 847-2132.

NMIMT (New Mexico Institute of Mining and Technology) offers live explosive training including the use of field exercises and classroom instruction. NMIMT is the lead NDPC partner for explosives and firearms, live explosives, and incendiary devices training. NMIMT offers one course of instruction, the Incident Response to Terrorist Bombing course. Contact NMIMT at www.emrtc.nmt.edu.

LSU (Louisiana State University (LSU) Academy of Counter-Terrorist Education) provides training to law enforcement agencies and focuses its efforts on the delivery of the Emergency Response to Terrorism: Basic Concepts for Law Enforcement Course, and the development and delivery of the Emergency Response To Domestic Biological Incidents Course. LSU offers two courses of instruction, Emergency Response to Biological Incidents and the Law Enforcement Response to WMD Incidents course. Contact LSU at www.ace.lsu.edu.

Texas A&M (Texas A&M University (National Emergency Response and Rescue Training Center or NERRTC), delivers a set of courses to prepare public officials, emergency medical services, law enforcement, fire protection, and public works for the threat posed by weapons of mass destruction. Additionally, Texas A&M has developed an Interactive Internet WMD Awareness Course for emergency responders. Texas A&M also provides technical assistance to state and local jurisdictions in the development of WMD assessment plans. Course information:  http://www.teex.com/campus.

NTS (Department of Energy's Nevada Test Site) conducts large-scale field exercises using a wide range of live agent stimulants as well as explosives. NTS develops and delivers a Radiological/Nuclear Agents Course. NTS, in coordination with ODP, is establishing the Center for Exercise Excellence. The Center will allow NTS to train jurisdictions in the planning and conduct of exercises, tailored to the unique threats faced by participating jurisdictions. The Center will provide a new component of the overall exercise training program, meeting those special exercise needs as the state and local jurisdictions define their exercise priorities. Contact NTS at www.nv.doe.gov/nts/.

FEMA provides preparedness education and training for emergency personnel through the National Emergency Training Center, which includes the Emergency Management Institute and the National Fire Academy, and the Noble Training Center, the only hospital facility in the US devoted to medical training for hospital and healthcare professionals in disaster preparedness and response.6

Through the Office of Workforce Policy and Planning, a component of CDC’s Public Health Practice Program Office, the Centers for Public Health Preparedness (CPHP) were established to train the public health workforce to respond to bioterrorism, infectious disease outbreaks, and other health emergencies.  Three types of CPHPs exist: Academic Centers for Public Health Preparedness, such as the Center for Public Health & Disasters at UCLA; Specialty Centers for Public Health Preparedness, such as the National Emergency Response and Rescue Training Center; and Advanced Practice Centers for Public Health Preparedness.7

Response

The local jurisdiction has responsibility for the emergency response, restoring critical infrastructure, and ensuring continuity of critical services.  These activities are coordinated through the local Emergency Operations Center (EOC). NDMS serves as the lead Federal Agency for medical response under the National Response Plan and involves a partnership within the Department of Health and Human Services (HHS), Department of Defense (DoD), and the Department of Veterans Affairs (VA).  These Federal resources are called upon to assist not replace local response efforts.8 

Recovery

One other form of disaster center deserves mentioning.  If you search for disaster centers under the Department of Homeland Security website you will be pleased to find the disaster "recovery centers" sponsored by FEMA who are now under the DHS.  These centers are temporary centers established in close proximity to the disaster and serve as an excellent resource for recovery assistance to those directly afflicted by an actual disaster.  Individuals can meet face-to-face with representatives from Federal, State, local, and volunteer agencies.9

Finally, there are several other organizations that may claim to be a disaster center because of the presence of faculty who are "specialized" in this field.  Unfortunately, no defining criteria or requirements currently exist for an organization or institution to be called a disaster center.  Thus, some of these centers are excellent, while other centers are questionable and a direct result of the wave of enthusiasm in disaster medicine that emerged after September 11th.

  1. Department of Homeland Security Organization.  Emergency Preparedness and Response.  http://www.dhs.gov/dhspublic/display?theme=51&content=206
  2. Hazard Mitigation Grant Program. http://www.fema.gov/fima/hmgp/
  3. CDC, National Immunization Program. http://www.drspock.com/faq/bio/0,2004,CDC_NIP+BIO,00.html 
  4. Homeland Security Act of 2002. http://www.dhs.gov/interweb/assetlibrary/hr_5005_enr.pdf
  5. ODP. http://www.ojp.usdoj.gov/odp/welcome.html
  6. Emergency Management Institute. http://www.training.femhttp://www.dhs.gov/interweb/assetlibrary/hr_5005_enr.pdfa.gov/emiweb/
  7. CDC. Office of Workforce and Planning. http://www.phppo.cdc.gov/owpp/cphp.asp
  8. NDMS. http://ndms.dhhs.gov/
  9. FEMA Disaster Recovery Centers. http://www.fema.gov/about/drc.shtm
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