Polk County Public Health Emergency Plan

Critical section? No

Security level: Unclassified

Version: 4.2

Version history: See record of changes for generic history for all documents prior to 6/24/2008.
2008-06-24 (tjb) Moved from html-based to sql-based.
2009-05-22 (tjb) Updated contact information.
2009-08-27 (tjb) Added general references.

Purpose:
Introduction and Title Page.

Scope:
Applies to anyone who reads or references this document.

Guideline:
"A goal without a plan is just a wish."
- Antonie de Saint-Exupery (French writer 1900-1944)

"Plans are worthless, but planning is everything."
-Dwight D. Eisenhower (US General 1890-1969) in a speech to the National Defense Executive Reserve Conference in Washington, DC on November 14th, 1957.

This document serves and the Local Public Health Agency Bioterrorism Plan for Polk County, Missouri. It also serves as the Pandemic Influenza Plan and the All-Hazards response plan for public health.

This plan is maintained by the Polk County Health Center.
(417) 326-7250
(417) 326-2766 (fax)
www.polkcountyhealth.net
1317 W Broadway St, Bolivar, MO 65613

Michelle Morris, Administrator
mmorris@polkcountyhealth.net

Theron Becker, Emergency Planner
tbecker@polkcountyhealth.net

Exceptions:
None

References:
Benenson, Abram S, editor. Control of Communicable Diseases in Man - Fifteenth Edition. 1990. American Public Health Association.

Beyond the Beltway: Focusing on Hometown Security. September 2002. Harvard University, John F Kennedy School of Government.

Bioterrorism Reference Cards. 2002. Centers for the Study of Bioterrorism & Emerging Infections.

Communicating in a Crisis: Risk Communication Guidelines for Public Officials. 2002. US Department of Health and Human Services.

DePaolo, Joseph T. Disaster Circus: A New Model for Disaster Response. October 2001. National Safety Council.

Department Situation Room Glossary. August 2002. Department of Health and Senior Services, Center for Emergency Response/Terrorism.

Emergency Response to Terrorism Job Aid - Edition 1.0. May 2000. Federal Emergency Management Agency, United States Fire Administration, National Fire Academy, and United State Department of Justice - Office of Justice Programs.

Georgetown and Johns Hopkins Universities, The Center for Law and the Public’s Health. The Model State Emergency Health Powers Act. December 21, 2001

Griffith, Carl and Vulpitta, Rick. Effective Emergency Response Plans. October 10, 2001. National Safety Council.

Khan, Ali S, MD; Levitt, Alexandra M, MA, PhD; Sage, Michael J, MPH. Biological and Chemical Terrorism: Strategic Plan for Preparedness and Response. April 21, 2000. Centers for Disease Control, Morbidity and Mortality Weekly Report.

Landesman, Linda Young, DrPH, MSW. Public Health Management of Disasters - The Practice Guide. 2001. American Public Health Association.

Local Public Health Assessment. October 15, 2002. Missouri Center for Emergency Response & Terrorism. Surveyor Theron Becker, Surveyed Michelle Morris, Polk County Health Center.

Mass Casualty Disaster Plan Checklist: A Template for Healthcare Facilities. Association for Professionals in Infection Control and Epidemiology, Inc. Center for the Study of Bioterrorism and Emerging Infections.

Osterholm, Michael T, PhD, MPH; Schwartz, John. Living Terrors - What America Needs to Know to Survive the Coming Bioterrorist Catastrophe. 2000. Michael T Osterholm & John Schwartz.

Sidell, Frederick R, MD; Patrick, William C, III; Dashiel, Thomas R; Alibek, Ken, MD; Layne, Scott, MD. Jane’s Chem-Bio Handbook - Second Edition. February 2003. Jane’s Information Group.

Critical section? No

Security level: Unclassified

Version: 3.0

Version history: 2008-06-24 (tjb) moved from html-based to sql-based.
2009-08-27 (tjb) added old, hard-copy plan.

Purpose:
Preserve record of changes to entire plan prior to 6/24/2008.

Scope:
Entire document.

Guideline:
2002 - Influenza Pandemic Plan
Created in response to local influenza pandemic tabletop exercise by Michelle Morris and Kermit Hargis.

2003-02-11 Public Health Emergency Plan
Created in response to bioterrorism preparedness grant by Theron Becker.

2003-02-20 0 Cover Letter, 1 Executive Summary, 2 Title Page, 3 Table of Contents, 4 Distribution List, 5 Record of Changes, 6 Forward, 7 Promulgation Statement, 8 Glossary, 9-0 Basic Plan, 9-1 Roles & Responsibilities Chart, 9-1-A Staff Training Record, 9-2 Hazard Analysis, 9-3 Mutual Aid Agreements, 9-4 Homeland Security Advisories, 9-5 Planning Model, 9-6 Suspicious Mail Alert, 9-A Direction & Control, 9-B-0 Info Tech & Communications, 9-B-1 Staff Contact List, 9-C-0 Public Info, 9-C-1 HSAS, 9-C-2 Public Info Sys, 9-C-3 PreFormatted Messages, 9-D Surveillance, 9-E Investigation, 9-F Secondary Tx Prevention, 9-G Isolation & Quarantine, 9-H Mass Prophylaxis, 9-I Mass Patient Care, 9-J Mass Fatality, 9-K Nuclear & Chemical, 9-L Foodborne & Waterborne, 9-M Volunteer Mgmt, 9-N Recovery

2003-03-05 1 Title Page, 2 Executive Summary, 3 Table of Contents, 5 Record of Changes, 7 Glossary, 8-0 Basic Plan, 8-1 Roles & Responsibilities Chart, 8-3 Mutual Aid Agreements, 8-7 Forms, A-0 Direction & Control

2003-03-09 0 Cover Letter, 1 Title Page, 2 Forward, 3 Table of Contents, 4 Distribution List, 5 Record of Changes, 7 Promulgation Statement

2003-03-11 0 Cover Letter, 4 Distribution List, 7 Glossary, 8-0 Basic Plan, 8-1-A Staff Training Record, 8-2 Hazard Analysis, 8-3 Mutual Aid Agreements, 8-4 Forms, A-0 Direction & Control, A-1 Homeland Security Advisories, A-2 Planning Model, A-3 Suspicious Mail Alert, B-0 Info Tech & Communications, B-1 Staff Contact List, C-0 Public Info, C-1 HSAS, C-2 Public Info Sys, C-3 PreFormatted Messages, D-0 Surveillance, D-1 Cat A Agents, D-2 Cat B Agents, D-3 HASS Sites, E-0 Investigation, F-0 Secondary Tx Prevention, F-1 Vets Conservation, G-0 Isolation & Quarantine, H-0 Mass Prophylaxis, I-0 Mass Patient Care, J-0 Mass Fatality, K-0 Nuclear & Chemical, L-0 Foodborne & Waterborne, M-0 Volunteer Mgmt, N-0 Recovery

2003-03-12 8-5 Maps, H-0 Mass Prophylaxis, H-1 Resources, H-2 Sites

2003-04-04 7-3 Mutual Aid Agreements

2003-04-14 0 Cover Letter, 1 Title Page, 3 Table of Contents, 4 Distribution List, 5 Record of Changes, 6 Promulgation Statement, 7-0 Basic Plan, 7-1 Roles & Responsibilities Chart, 7-1-A Staff Training Record, 7-2 Hazard Analysis, 7-3 Mutual Aid Agreements, 7-4 Forms, 7-5 Maps, A-0 Direction & Control, A-1 Homeland Security Advisories, A-2 Planning Model, A-3 Suspicious Mail Alert, B-0 Info Tech & Communications, B-1 Staff Contact List, C-0 Public Info, C-1 HSAS, C-2 Public Info Sys, C-3 PreFormatted Messages, D-0 Surveillance, D-1 Cat A Agents, D-2 Cat B Agents, D-3 HASS Sites, E-3 Investigation, F-0 Secondary Tx Prevention, F-1 Vets Conservation, G-0 Isolation & Quarantine, H-0 Mass Prophylaxis, H-1 Resources, H-2 Sites, I-0 Mass Patient Care, J-0 Mass Fatality, K-0 Nuclear & Chemical, L-0 Foodborne & Waterborne, M-0 Volunteer Mgmt, N-0 Recovery, Z Glossary

2003-04-16 Plan Cover

2003-04-18 C-0 Public Info, E-0 Investigation, F-0 Secondary Tx Prevention, G-0 Isolation & Quarantine, H-0 Mass Prophylaxis, L-0 Foodborne & Waterborne, M-0 Volunteer Mgmt

2003-04-30 C-0 Public Info

2003-05-01 7-3 Mutual Aid Agreements

2003-05-21 D-0 Surveillance

2003-05-29 0 Cover Letter, 1 Title Page, 2 Forward, 4 Distribution List, 5 Record of Changes, 7-0 Basic Plan, 7-1 Roles & Responsibilities, 7-1-A Staff Training Record, 7-2 Hazard Analysis, 7-3 Mutual Aid Agreements, 7-4 Forms, A-0 Direction & Control, B-0 Info Tech & Communications, B-1 Staff Contact List, C-0 Public Info, C-1 HSAS, C-2 Public Info Sys, C-3 PreFormatted Messages, D-0 Surveillance, E Investigation

2003-06-02 3 Table of Content, C-3 PreFormatted Messages, C-3-A Anthrax, C-3-B Children, C-3-C Emergency Management, C-3-D Health Department, C-3-E Miscellaneous, C-3-F Plague, C-3-G School, C-3-H Self Protection, C-3-I Smallpox, C-3-J Tularemia, D-1 Cat A Agents, D-2 Cat B Agents, D-3 HASS Sites, E-0 Investigation, F-0 Secondary Tx Prevention

2003-06-03 7-3 Mutual Aid Agreements, C-3 PreFormatted Messages, C-3-A Anthrax, C-3-B Botulism, C-3-C Children, C-3-D Emergency Management, C-3-E Health Department, C-3-F Miscellaneous, C-3-G Plague, C-3-H School, C-3-I Self Protection, C-3-J Smallpox, C-3-K Tularemia, C-3-L VHF, F-1 Vets Conservation, F-2 Infection Control Grid, G-0 Isolation & Quarantine, G-1 Laws, G-2 Designated Facilities, H-0 Mass Prophylaxis, H-1 Resources

2003-06-04 H-2 Sites

2003-06-05 H-1 Resources, H-2 Sites, H-4 PCMRC Call List

2003-06-06 I-0 Mass Patient Care, H-5 Orders Protocols, I-0 Mass Patient Care, J-0 Mass Fatality, K-0 Nuclear & Chemical, L-0 Foodborne & Waterborne, M-0 Volunteer Mgmt, N-0 Recovery

2003-06-12 Z Glossary

2003-06-13 3 Table of Contents, A-0 Direction & Control, B-1 Staff Contact List, H-3 SNS Chart

2003-06-16 5 Record of Changes

2003-06-17 7-4 Forms, 3 Table of Contents, 4 Distribution List

2003-06-19 I-0 Mass Patient Care, I-1 County Health & Medical, J-0 Mass Fatality, J-1 County Mortuary Operations, J-2 County Mortuary Resources, K-0 Nuclear & Chemical, K-1 County Hazmat, K-2 County Response Diagram, K-3 Hazmat Agencies, K-4 Operation Actions, K-5 Radiological, K-6 Hazmat Protection Guide, K-7 Stockton Watershed

2003-07-07 3 Table of Contents, 4 Distribution List, 6 Promulgation Statement, 7-0 Basic Plan, 7-4 Forms, 7-2 Hazard Analysis

2003-07-08 7-3 Mutual Aid Agreements, 7-1-A Staff Contact List, C-3 Anthrax, C-4 Botulism, C-5 Children, C-6 Emergency Management, C-7 Emergency Sheltering, C-8 Evacuation, C-9 Health Department, C-10 Isolation & Quarantine, C-11 Mass Medication Distribution, C-12 Miscellaneous, C-13 Plague, C-14 Schools, C-15 Self Protection, C-16 Smallpox, C-17 Tularemia, C-18 VHF, D-1 Cat A Agents, D-2 Cat B Agents, D-3 HASS Sites, E-0 Investigation, E-1 Lab Submission Protocol, H-2 Sites, H-3 SNS Chart, H-4-A PCMRC List, I-1 Health & Medical, J-0 Mass Fatality, J-1 Mortuary Operations, J-2 Mortuary Resources, K-1 Hazmat, K-2 Response Diagram

2003-07-09 5 Record of Changes, C-02 Public Information Systems, L-0 Foodborne & Waterborne Outbreaks, L-1 Food Terrorism, L-2 Department of Agriculture Contact List, M-0 Volunteer Management, M-1 Volunteer Application

2003-07-10 F-1 Veterinarians & Conservation Agents

2003-07-11 3 Table of Contents, H-0 Mass Prophylaxis

2003-07-30 0 Cover Letter, 1 Title Page, 5 Record of Changes, 7-1-A Staff Training Record

2003-08-12 0 Cover Letter, 1 Title Page, 4 Distribution List, 7-0 Basic Plan, 7-1 Roles & Responsibilities Chart, 7-1-A Staff Training Record

2003-08-13 7-2 Hazard Analysis

2003-08-14 7-3 Mutual Aid Agreements

2003-08-15 A-4 Expenditure Form, B-2 Phone Log, B-3 Info Release, D-4 HASS Form, D-5 SASS Form, E-2 Response Form, F-3 Universal Precautions, H-6 DEA 222, H-7 History Forms, H-8 SNS Forms, H-9 SNS Labels, H-10 SNS Pt Info, K-8 Chem Emer Notification, K-9 KI Dose, K-10 Rad Custody Chain

2003-08-19 A-0 Direction & Control, A-1 Homeland Security Advisories, A-4 Expenditure Form, A-5 CMH Report Chart, A-6 Competencies, B-0 Info Tech & Comms, B-1 Emer Contact List, B-1-A Staff Contact List, B-1-B Other Contact List, B-1-C Special Needs List, B-2 Phone Log, B-3 Info Release

2003-08-20 5 Record of Changes, C-00 Public Info, C-01 HSAS, C-02 Public Info Sys, C-07 Emer Sheltering, C-08 Evacuation, C-10 Iso & Quarantine, C-11 Mass Med Dist, C-12 Misc, C-15 Self Protection, C-19 Public Info Forms

2003-08-21 3 Table of Contents, 5 Record of Changes, B-1 Emer Contact List, B-1-A Staff Contact List, B-1-B Other Contact List, B-1-C Special Needs List, C-19 Public Info Forms, D-3 Sentinel Sites, D-4 HASS Form, D-6 Reportable Diseases, E-0 Investigation, E-2 Response Form, F-2 Inf Control Grid, G-0 Isolation & Quarantine, H-00 Mass Prophy, H-01 Resources, H-02 Sites, H-04-A MRC List, I-1 Health & Medical, I-2 Mass Decon, J-0 Mass Fatality, K-04 Operation Actions, K-05 Radiological, L-0 Food & Water, M-0 Volunteer Mgmt, M-1 Vol App

2003-08-22 1 Title Page, 5 Record of Changes

2009-09-09 0 Cover Letter, 3 Table of Contents, 4 Distribution List, 7-0 Basic Plan, 7-1-A Staff Training Record, 7-2 Hazard Analysis, A-6 Competencies, B-1 Emergency Contact List, B-1-A Staff Contact List, B-1-B Other Contact List, B-1-C Special Needs List, B-1-D LPHA Contact List, C-00 Public Information, C-03 Anthrax

2003-12-02 B-0 Information Technology, B-1 Emergency Contact List, B-1-D LPHA Contact List

2003-12-04 5 Record of Changes, 7-0 Basic Plan

2004-01-09 3 Table of Contents, 5 Record of Changes, 7-5 Maps

2006-06-28 Response Plan for Disasters, Public Health Emergencies, and Pandemics
Created in response to pandemic influenza grant by Theron Becker.

2008-06-01 Migrated plan to SQL-based. All subsequent changes are recorded on each section.

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 2.0

Version history: 6/24/2008 moved from html-based to sql-based

Purpose:
Provide a signature page to authorize the contents of this emergency plan document.

Scope:
Applies to all persons utilizing this emergency plan.

Guideline:
"Treat all disasters as if they were trivialities but never treat a triviality as if it were a disaster."
- Quentin Crisp (English author 1908-1999)

The Polk County Health Center (PCHC), in conjunction with local governmental officials and cooperating private and volunteer organizations, has developed a Public Health Emergency Plan that will enhance its emergency response capability. This document is the result of that effort.

This plan, when used properly and updated annually, can assist the PCHC in accomplishing one of its primary responsibilities - protecting the lives and property of citizens. The planning and response activities are aimed at prevention, minimizing health, social and economic impacts using education and communications, vaccination, prophylaxis, isolation and quarantine, and closure of public facilities.

This plan and its provisions will become official when it has been signed and dated below by the concurring officials. An original copy of the signatures will be maintained at the Polk County Health Center (1317 W Broadway St, Bolivar, MO)



Administrator



Board of Health President

Exceptions:
None

References:
None

Critical section? Yes

Security level: Unclassified

Version: 2.1

Version history: 2008-06-24 (tjb) moved from html-based to sql-based.
2009-08-27 (tjb) Added confidentiality statement.

Purpose:
Describe security levels utilized within this document.

Scope:
Applies to all documents utilized by the Polk County Health Center.

Guideline:
Each document is categorized within one of the following categories to maintain security of responders and response activities during a disaster or emergency. These categories roughly follow National Security Guidelines.

UNCLASSIFIED - Unclassified documents are identified by a gray header and can be viewed and shared with the general public without risk of breach of confidentiality or security risks. Unclassified documents may also be identified by lacking one of the headers described below.

CONFIDENTIAL - Confidential documents are identified by a blue header and would cause "damage" to security or breach community confidentiality if released to the general public. Government employees and emergency responders may access confidential documents by completing a request form and receiving a username and password. The request form may be obtained at http://www.polkcountyhealth.net/requestaccess.php.

SECRET - Secret documents are identified by a red header and are not currently used.

TOP SECRET - Top secret documents are identified by a yellow header and would cause "exceptionally grave damage" to security or breach individual confidentiality if released to the general public. Only health department employees may access top secret documents.


CONFIDENTIALITY STATEMENT
Unauthorized disclosure, copying, distribution, or use of the contents of this document is strictly prohibited. If you have received this document in error, please notify the Polk County Health Center immediately at the following email address emergency@polkcountyhealth.net or by calling (417) 326-7250.

Exceptions:
None.

References:

Critical section? No

Security level: Unclassified

Version: 1.3

Version history: 2008-06-27 (tjb) Moved from html-based to sql-based.
2008-11-03 (tjb) Updated member list.
2008-11-04 (tjb) Updated member list.
2008-11-18 (tjb) Added Coroner to member list.

Purpose:
Facilitate a group of stakeholders to maintain this emergency plan.

Scope:
Applies to all portions of the plan and any individual interested in the planning process.

Guideline:
"Men often oppose a thing merely because they have had no agency in planning it, or because it may have been planned by those whom they dislike."
- Alexander Hamilton (US lawyer & politician 1755-1804)

The planning committee was formed in 2007 and meetings were originally well-attended. Recently, this group merged with another effort by Citizens Memorial Healthcare (CMH). This group now meets every other month and is also called the Multi-Agency Meeting. Below are the goals of this effort.

Planning and preparedness activities should be integrated with other entities and should collaborate to reduce duplication and to maximize the impact of funding and time. The planning committee should be responsible for articulating strategic priorities and overseeing the development of and execution of applicable emergency plans. The committee should assure that planning is: 1) progressing, 2) integrated and coordinated, and 3) involves all major stakeholders. The final goal of the planning committee is to create a plan that is easy to use, gives step-by-step guidelines, and contains a minimum amount of surpuflous information.

Contact Polk County Health Center (PCHC) Emergency Planner or CMH Safety Director for the next meeting time and location.

Current Community Health Planning Committee members:

CMH (Citizens Memorial Healthcare), Emergency Services Director (Robin Bobinmyer)
CMH, Marketing Director (Tamera Heitz-Polk)
CMH, Prehospital Director (Steve Keller)
CMH, Safety & Security Director (Jeff Miller)
CMH, Safety Director (Sherry Welch)
CMH, Security Director (Wes Flack)
City of Bolivar, Emergency Management Director (Kermit Hargis)
FSD (Family Services Division), Family Support Division (Nathan Stamburski)
PCEMA (Polk County Emergency Management), Director (Rick Lewis)
PCEMA, Assistant Director (Jim McManigle)
PCHC (Polk County Health Center), Emergency Planner (Theron Becker)
Polk County Coroner (Roy Harms)
SBU (Southwest Baptist University), Health Services Director (Nancy Hodges)
SGCHD (Springfield-Greene County Health Department), Public Information Officer (Jaci McReynolds)
SGCHD, Volunteer Coordinator (Rebecca Ray)

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 2008-11-03 (tjb) Created section for better section organization.

Purpose:

Scope:

Guideline:

Exceptions:

References:

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 6/27/08 moved from html-based to sql-based.

Purpose:
Provide meeting minutes of committee meeting.

Scope:
Applies to this specific meeting.

Guideline:
Time: 9am-10am

Location: CMH Community Room #3

Agenda:
Thanks and introductions
Overview of existing plan
History
Online version
Security schemes and request for access forms
Parts
Front matter
Activation and authority
Planning committee
Internal planning
Surveillance sub-plan
Investigation sub-plan
Public information sub-plan
Disease containment sub-plan
Mass prophylaxis sub-plan
Volunteer sub-plan
External planning
External communications sub-plan
Appendices
Suggestions and comments discussion
Recruitment of other committee members

Attendees:
Jeff Miller, CMH
Michelle Morris, PCHC
Nancy Hodges, SBU
Nathan Stamburski, FSD
Tamera Heitz-Peek, CMH
Theron Becker, PCHC

Minutes:
Introductions were made.
Theron Becker discussed planning efforts by PCHC.
Prior to 2000, all planning was contained within the County Emergency Operations Plan.
In 2000, a specific influenza plan was created by Kermit Hargis and Michelle Morris.
In 2002, PCHC received bioterrorism funding, Theron Becker was hired, and a public health emergency plan was created.
This year, PCHC received pandemic influenza money and the plan update included a move to an online, web-based plan.
Jeff Miller discussed planning efforts by CMH.
Earlier this year, there was a major update to their plan which is now an electronic document with internal clickable links.
After the previous tornado season, changes were made with regard to surge capacity.
After the SNS exercise in June, changers were made with regard to dispensing medication to their staff, families, and patients.
Nancy Hodges briefly discussed planning efforts by SBU.
Theron Becker gave a detailed overview of the Health Department online plans.
Everyone was encouraged to go to www.polkcountyhealthcenter.com to obtain a password to access the online plans.
Plan areas discussed were:
1.3 Plan activation and authority
1.4 Planning committee
2.4 Surveillance sub-plan
2.5 Investigation sub-plan
2.6 Public information sub-plan
2.7 Disease containment sub-plan
2.8 Mass prophylaxis sub-plan
2.9 Volunteer sub-plan
3.1 External communications sub-plan
The function of the committee was discussed and the format of subsequent meetings. It was agreed that each meeting will pick a topic and discuss and decide details, nuts, and bolts of that area. The topic for next meeting was communication issues.
Theron Becker asked everyone to feel free to recruit committee members or invite anyone they thought might add to the group or benefit from attending. Jeff Miller suggested inviting ham radio members to the next meeting.
A quick discussion of amateur radio capabilities concluded the meeting.

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 6/27/08 moved from html-based to sql-based.

Purpose:
Meeting minutes.

Scope:
This meeting only.

Guideline:
Time: 9am-10am

Location: CMH Community Room #3

Agenda:
Introductions
Overview of communication capabilities by all agencies
Day-to-day communication procedures
No impairments
Cell phones non-functional
Land-line telephones non-functional
etc.
Communication types:
Confidential information (i.e. patient information)
Voice
Data
Fax
Emergency communication procedures

Attendees:
Gary Harrison, Polk County Amateur Radio Operator
Jaci McReynolds, Public Information Officer, Springfield-Greene County Health Center
Kermit Hargis, Director, Polk County/Bolivar Emergency Managment Agency
Nancy Hodges, School Nurse, Southwest Baptist University
Theron Becker, Emergency Planner, Polk County Health Center

Minutes:
(not actually part of the meeting, but background info to define some terms)
Public safety radio is low-band VHF in Polk County usually in the 144-160 MHz range. It is voice-only and the frequencies are owned by the agency using them. It includes four fire repeaters, two law enforcement repeaters, and many frequencies for law, fire, and ems.
2-meter amateur radio is low-band VHF in the 140-144 MHz range. It can be voice, data, etc. and the frequencies are public but for daily (non-disaster) traffic, the radio operator must have an amateur radio license.
Packet radio is analogous to an internet chat room but using radio instead of the internet. Users sit at a computer and type text that will be transmitted to all other users on that frequency using packet radio. It is not encrypted but the potential audience is amateur radio operators that happen to be on that frequency.
Slow scan TV (sstv) is the ability to transmit an image (such as a photo or scanned document) over radio. It is analogous to a fax machine that uses radio instead of telephone lines.
Overview of communication capabilities of critical agencies:
CMH = (As far as anyone knew attending this meeting) public safety radio & 2-meter amateur radio with packet and sstv.
Polk County Emergency Management = public safety radio, 2-meter amateur radio, & 6-meter amateur radio.
Bolivar Emergency Management = public safety radio, 2-meter amateur radio at fire station, & HF amateur radio at fire station.
Joint Information Center (CMH Admin building) = 2-meter amateur radio in the future.
Volunteer Management Center (Intervention Ministries) = 2-meter amateur radio.
Health Department = public safety radio & 2-meter amateur radio.
Southwest Baptist University = public safety radio & amateur radio operator employee (Coleen Rose).
Public Schools = Bolivar uses 400 MHz, we think. Humansville uses VHF-low band, we think. Other schools are unknown.
Municipalities = All should have public safety radio.
To our knowledge there is no agency with satellite phone or satellite internet capability in Polk County.
A brief discussion was had concerning hosting a class to prepare more members to get amateur radio licenses. It is possible to host a class in Bolivar if the need and desire is there.
Action items identified to increase inter-agency communications within the county:
Bolivar Emergency Operations Center has 2-meter radio with packet capability, but it is not yet installed. It should be installed and a dedicated computer found to utilize packet communications.
Health Department should purchase a 2-meter radio with the ability for packet (approx $750) and install it.
Some agency in Polk County should aquire a satellite phone. Jaci will approach the regional homeland oversight committee to see if they have something in mind for all 18 counties. Kermit visited with Robin Bobbinmeyer after the meeting about Robin talking with the Hospital Tier-1 group about the hospital aquiring one.
Radio frequencies and protocols should be created for voice, packet, and sstv. Old protocols exist in the county emergency operations plan and Jim McManigle was working on updating them. A call sign list should also be developed. The existing volunteer database maintained by the health department documents radio call sign for all responders and volunteers.

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 2008-11-03 (tjb) Created section for better section organization.

Purpose:

Scope:

Guideline:

Exceptions:

References:

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 6/27/08 moved from html-based to sql-based.

Purpose:
Meeting minutes.

Scope:
This meeting only.

Guideline:
Time: 9am-10am

Location: CMH Community Room #1

Agenda:
Introductions
Overview of previous communications meeting
Emergency Management update
Frequency assignments
Other communication planning needs
Next meeting's subject

Attendees:
Gary Harrison, Polk County Amateur Radio Operator
Jim McManigle, Polk County Amateur Radio Operator
Kermit Hargis, Emergency Management Director, City of Bolivar
Nancy Hodges, School Nurse, Southwest Baptist University
Tamera Heitz-Peek, Marketing Director, Citizen's Memorial Healthcare
Theron Becker, Emergency Planner, Polk County Health Center

Minutes:
City of Bolivar now has 2-m packet almost set up.
40-m and 80-m are set up
Once set up, this group should conduct regular exercises and tests of communication equipment.
State does a test every Monday
All participating agencies stated a monthly test should work
There are two different packet software programs available
WinPack - More advanced and has option for simple interface
FNPack - Simple interface but basic operations only
We do not know if WinPack can talk to FNPack
Items that need to be competed for communications plan:
Frequency assignments
EOC channels
City EOC will use Public Works
Agency - EOC channels
Inter-agency channels
Tactical channels
Should use ARES channel assignments
more - additional meeting will be set to discuss frequencies in depth
Kermit, Rick, Gary, Jim, and Theron
February 16th at City Hall at 10am
Operators
Repeaters and power plan
Satellite phones shot down by RHSOC
There is no state plan for HF radio use
Kermit is working on reverse 9-1-1 committee
Phone system is based on 10% of local calls available at a time and 70% long distance
weather radio may be only alternative
New cable channel 44 in Bolivar for community announcements via modem access
Overview on SEMA earthquake exercise in June
Missouri Power grid down
Without power, Social Services cannot provide any services such as food stamps
7.0 in SE MO
250,000 fatalities, 300,000 injuries
No airports or bridges in SEMO
SWMO will provide mass care, trauma/triage center, send support/resources
Next meeting
Update on pandemic influenza information (national, state, regional, local)
Public Information
Mass Care

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 6/27/08 moved from html-based to sql-based.

Purpose:
Meeting minutes.

Scope:
This meeting only.

Guideline:
Time: 1pm-2pm

Location: CMH Community Room #1

Agenda:
Introductions
Communications update
Pandemic influenza planning update
Public information messages
Mass care
Next meeting's subject

Attendees:
Gary Harrison
Jaci McReynolds
Jeff Miller
Jim McManigle
Mike Husmann
Nancy Hodges
Rebecca Ray
Rick Lewis
Theron Becker

Minutes:
Introductions were made.
3.1.3 Wireless Communications Plan was distributed.
Discussion followed with some justifications and recommendations for updates.
As the topic became more technical in nature, it was tabled for a smaller group to discuss further.
The request for the pandemic influenza planning update to be put on the agenda was made by Kermit Hargis. As he was not present, the topic was lightly covered and the difference between pandemic planning and other outbreak planning was described.
Primarily, the difference is the availability of medication and the absence of a mass prophylaxis response to pandemic influenza. Public information strategies will be the best reaction to pandemic influenza.
Jaci McReynolds discussed regional public information strategies and current regional and local efforts.
Messages will be based on the last four pandemic levels as described by the World Health Organization.
They must be flexible in the event and must be consistent throughout the region.
Beginning at phase 4 (we are currently in phase 3), PIO messages will start based on Ready-in-Three about 2-week food supply, family preparedness, etc.
A packet is being developed that a community could use with modification of their local information.
As noticed in the recent ice storm, many jurisdictions were passing information to the Springfield news media but the local Springfield news was more available and pressing, so it got most to all of the attention.
Kermit is working on implementing an 800-number for Polk County residents to get community-specific information.
The 800-number could have a recording for normal, day-to-day callers but would be manned (possibly CMH employees) in an event. CMH has 10 incoming phone lines, FYI.
A question was raised about using a local FM or AM station controlled and operated by an emergency agency to broadcast messages - similar to DOT uses for road construction zones.
It would be cheap, potentially no licensing at low power, and even in power failure if the transmitter was generator-powered citizens could still listen on battery or car radios.
Again a recorded, looped message could play regularly to be interrupted in an event.
Theron will look into the feasibility and requirements for a low-power FM station to be operated by an emergency agency.
Discussion was had about supplementing KYOO with generators, etc. instead of re-inventing the wheel. The group decided it might be better to have our own dedicated station.
An overview and discussion was had about Channel 44.
Another option discussed was information in handouts or flyers at prominent businesses such as Wal-Mart. Using a multitude of methods will reach the highest percentage of the population.
The regional Joint Information Center planning is still ongoing. Again, in the ice storm it was recognized that Polk County Emergency Management could not get information on Springfield news stations unless the information was passed through Greene County Emergency Management.
For information dissemination on SBU campus, the website and email are the primary methods.
CMH uses a calling tree format for staff and building information.
The next Polk County Joint Information Center Meeting will be April 12th at 1330 hours. Unknown location. A few from the group asked Jaci if we could invite ourselves to the meeting to discuss technical aspects of communication and information dissemination.
As we ran out of time, the Mass Care topic was tabled until next meeting.
The next Health Planning Meeting will be May 10th from 9am-10am at CMH Community Room 1.

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 1.5

Version history: 2008-06-27 (tjb) Moved from html-based to sql-based.

2009-01-02 (tjb) Added minutes from notes found.

Purpose:
Meeting minutes.

Scope:
This meeting only.

Guideline:
Time: 9am-10am

Location: CMH Community Room #1

Agenda:
- Introductions
- FM broadcast station update
- Polk Co JIC update
- Pandemic influenza planning update
- Mass care
- Next meeting's subject

Minutes:
- FM broadcast station is not available
- 411 Phone line ordered
- - LEPC funding
- - call forwarding to admin bldg
- - recording
- no comms link with EOC from JIC
- Bolivar committee for public warning systems: Replace sirens? Radio? TV? Reverse 911? Weather radio? Proposal by Sept.
- Reviewed exercies.
- Isolation and quarantine orders are being drafted.
- No new developments with vaccine.
- PIO with consistant message is critical.
- Need more players at planning meetings: CMH schools, law enforcement, etc.
- Need annual PanFlu tabletop exercise
- June 5 MHA web-based exercise
- Organization-based preparedness (1/3 of workforce is sick)
- Annex L - Sheltering people and pets
- - Animal shelter commitment?
- Region D mass sheltering coordinator and assistant
- - Reviewing applications on 12th.
- - Funded for only 2 years.
- Volunteer special needs coordinator for Polk County is Frank Neese.
- Communications exercise.
- Weekly net
- Next topic (objectives and timeline)
- - Communications exercise
- - Tabletop panflu

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 2008-11-03 (tjb) Added section from meeting minutes.

Purpose:
Meeting Minutes

Scope:
This Meeting Only

Guideline:
10:00am to 10:50am

In Attendance: Patty Head, Robin Bobinmeyer, Jeff Miller, and Eric Derrickson

1. Discussion of Multi-Agency Drill for October 20, 2007—A tentative outline of the exercise was handed out.
- a. The place for the exercise will be determined. There are soccer games going on during September and October on Saturdays at the old airport. Eric is checking on the ball fields off of East Aldrich Road for the above date.
- b. Victims: Possible volunteers for victims will be solicited from CMH employees, Bolivar Technical Students, SBU students/service org., and first responder classes. Eric will start working toward about 50 victims. The Mulage/orientation will take place before the exercise begins, Victims will have cards and stickers to tell injuries etc. Preliminary discussions of 5 fatalities, 4 critical, 16 emergent care, 22 moderate were minimum numbers. An invitation of all users on the CMH System will go out.
- c. Participating Agencies will include CMH, Bolivar Emergency Management, Polk County Emergency Management, Bolivar Fire Department, Bolivar Police Department, and others will be invited to participate.
- d. Planning – Discussion of the planning of the exercise by hiring a planner. There are no Tier 1 funds available. Kermit is working with the University of Missouri for prices of planning the exercise. LEPC has some funds to help with this.
- e. Both the mass casualty trailer and the HazMat trailer will be activated. The HazMat trailer will go to the Hospital and the Mass Cas. Trailer will go to the scene.
- f. The EOC will be activated during this exercise.
- g. Look for Evaluators/Monitors and monitoring tools for things such as pyramid call lists % contacted etc.

2. Trailer Material—It was noted that the trailer for HazMat is in need of propane bottles for the water heaters and the scrub brushes may need replaced with brushes that are more Skin friendly. Following the October 20th Drill, an orientation for CMH – EMH and other local First Responders concerning the Hazmat and Mass Casualty Trailers will be scheduled. This orientation will take place so everyone that could be involved in a disaster when trailers are dispatched understands the trailer layout, equipment, use, and deployment process.

3. HazMed Concepts training. A few weeks before the exercise, training will take place at the Hospital. We are looking various training options and should have that in place for Late September.

4. Discussion of LEPC Donations----LEPC has received several donations from area businesses for equipment to complete some decontamination for the city. CMH will place level B HazMat suits at the Bolivar City Fire Department to help in this effort. CMH will still have ownership of the suits.

5. Next Meeting— The next regular meeting will tentatively be scheduled for September 10th at 10 am. Also several other meetings to work on the exercise should take place before this meeting.

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 2008-11-03 (tjb) Added section from meeting minutes.

Purpose:
Meeting minutes

Scope:
This meeting only.

Guideline:
Times: 10:00am to 11:00am

Location: CMH Cafeteria

Present: Kermit Hargis, Jim McManigle, Robin Bobinmyer, and Eric Derrickson

Minutes: The minutes from the last meeting were sent out prior to the meeting for review.

October Exercise Discussion: A meeting with Conne Burham will be set up for the first week in October. Kermit will notify Conne. The scenario details were discussed.

Evaluators were verified. Dave Hoover, Lorie Ficke, and another evaluator (Lorie is bringing this evaluator) will be present for the exercise.

The number of verified victims is 30 from the Boys Ranch according to Bob Walden. Bolivar Technical has been contacted and Robin is going to make another contact with Ida Junge for a number of victims. Eric is going to verify numbers on the Hospital Employee volunteer victims.

Theron Becker contacted the outlying fire departments to invite them to the exercise. We want to encourage Fire Departments to participate or observe to learn the decon trailers and equipment in case of an event.

Since the LEPC, in their meeting discussed making October there exercise month, it was decided to begin working on the next exercise as soon as this one is completed. An exercise committee will be appointed and work will begin.

Grant Partnerships: Many of the grants related to Homeland Security are now being put in place with the stipulation of working with Multiple Emergency Preparedness Agencies to encourage all emergency resources to work together. The possibility of working together on grants was discussed.

Hazard Vulnerability Assessment Review: CMH’s Annual Hazard Vulnerability Assessment was reviewed and discussed. The possibility of adding pandemic to the list was discussed. Also the ranking of earthquake possibly should be higher. County and city emergency management were given a copy of the Hazard Vulnerability Assessment.

Med/Surge Cache Location: The 250 med surge cache has found a CMH storage location. The old fleet management building has been approved by Mr. Babb. Rick Lewis had located two other buildings that were temporary possibilities that would work, but with this building, no storage MOU would be needed and it would be a more direct line of control.

HazMat Training: HazMed Concepts will be conducting hazardous materials training on September 27 and 28. The hospital personnel are currently being contacted for scheduling the class. The class size is limited to 30. After it is known who can attend, other community members will be invited.

Next Meeting will be November 5th at 10:00 A.M. in the CMH Cafeteria.

Meeting Adjourned

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 2008-11-03 (tjb) Added section from meeting minutes.

Purpose:
Meeting minutes.

Scope:
This meeting only.

Guideline:
Times: 10:00am to 11:00am

Location: CMH Cafeteria

Present: Theron Becker, Kermit Hargis, Jim McManigle, Robin Bobinmyer, and Eric Derrickson

Minutes: The minutes from the last meeting were sent out prior to the meeting for review.

Exercise Discussion: An overview of the November 10th exercise was discussed. About 40 to 45 victims are expected and will be meeting at the community rooms around 7 A.M. on November 10th. All but one evaluator is confirmed. The scenario will be provided to the LEPC for documentation of a hazardous materials decontamination drill.

Pandemic Webinar Exercise: The November 1 Pandemic Webinar was discussed. The main suggestions were use of ASC, community response, recovery plans, morgue arrangements, trigger points and SBU participation.

Interoperability of Communications: A discussion of a more desirable plan for cross agency communication was discussed. The V-Tac and M-Tac channels were discussed. At this time, the only channel all first responders have and can conveniently carry on the radios they have is the Fire Mutual Aid Channel. Kermit suggested working with a group and evaluate the possibility or what would be necessary to make V-Tac and M-Tac channels available for use at scenes. The use of these simplex channels would make it a simpler process, for example, to communicate in a multi-agency incident command.

Tier II Reports and Hazardous Material Risk Assessments: It was noted that 911 now has a list of hazardous materials that are reported to the county emergency management and where they are located. This tool could be used to protect first responders. Eric and Robin are to notify Steve Keller about this development, so that Pre-Hospital will access to that information through 911. Kermit will also send the information to Eric so that CMH can have a similar data base, perform risk assessments and have current information on common hazardous materials in the area.

Grant Partnerships: Eric is working with Simulation Education to obtain grant monies for a mass casualty and evacuation drill. Also within this grant some equipment could be included.

Med/Surge Cache: The 250 med surge cache will not be in place this year, but Missouri Hospital Association and the Region D Planner are optimistic that this will happen in the Spring of 2008.

MOU Coordination: Having coordination of MOU’s and the emergency agencies and those that the agreements are with was discussed. It was discussed at this time that several of the agreements are verbal and some agencies always help, but will not commit to signing an MOU. This process needs some work and the community needs education on this process for it to be effective.

Next Meeting will be January 7th at 10:00 A.M. in the CMH Cafeteria.

Meeting Adjourned

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 2008-11-03 (tjb) Created section for better section organization.

Purpose:

Scope:

Guideline:

Exceptions:

References:

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 2008-11-03 (tjb) Added section from meeting minutes.

Purpose:
Meeting minutes.

Scope:
This meeting only.

Guideline:
Times: 10:00am to 11:00am

Location: CMH Cafeteria

Present: Rick Lewis, Kermit Hargis, Jim McManigle, Robin Bobinmyer, and Eric Derrickson

Minutes: The minutes from the last meeting were sent out prior to the meeting for review.

Next Meeting will be March 3rd at 10:00 A.M. in the CMH Cafeteria.

Distribution of Materials at Event: The plan to have a table at the “Hey-Lady Have a Heart” was discussed. LEPC brochures, Ready-In-3 information, and Trauma Services will be distributed. Kermit also mentioned citizen’s volunteer group that may also be at the booth.

Grant Partnerships: Possibility of a fire grant for training is being explored. These grants have to have community partnerships. The grant would be for fire training equipment, primarily a fire extinguisher trainer. Also a grant for exercise planning mainly concerning evacuation is being researched. Preliminary information is being sent to the company for this grant.

Dates for LEPC/Multi Agency Drill: Since the LEPC designated October as exercise month, we are working to coordinate any other agencies that wish to participate. The possible dates are October 11th or 18th for the exercise.

Exercise Scenarios: A discussion of possible scenarios include evacuation, communications, influx from other area, and earthquake.

Evacuation Planning: Evacuation planning from small to large scale was discussed. Within the conversation was existing plans versus what plans need to have in them.

CSAT: CMH had to register through the Chemical Security Assessment Tool through the Department of Homeland Security/Chemical Facility Anti-Terrorism Division. The propane storage was over the threshold of the assessment. After the determination of the registration had been made, the next action could be a security risk assessment.

Communications: The hospital received some grant monies to replace the ED radio base station phone line connections with the tower with a wireless system for 2 channels. The new system will help with use radio capabilities that were not fully available before.

March 19 City Table Top Exercise: There will be a table top exercise on March 19 that the City of Bolivar will be hosting. Kermit will release details, but would like to have a representative from the hospital in the exercise and an operator to utilize the amateur radio equipment.

Communication Grant Monies: Rick shared information that the state has about $800,000 in grant money for communications that was left over from Homeland Security money a few years ago. The grant process is thought to be competitive bid. Eric is to contact Dave Hoover about the use of the funds that might be utilized to improve the current communication status.

The next meeting will be March 3 at 10 in the CMH Cafeteria.

Meeting Adjourned

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 2008-11-03 (tjb) Added section from meeting minutes.

Purpose:
Meeting minutes.

Scope:
This meeting only.

Guideline:
Times: 10:00am to 11:00am

Location: CMH Cafeteria

Present: Rick Lewis, Kermit Hargis, Patty Head, Jim McManigle, Robin Bobinmyer, Jeff Miller and Eric Derrickson

Minutes: The minutes from the last meeting were sent out prior to the meeting for review.

Exercises: The hospital is planning a drill in late June or early July that should involve fire and evacuation. The precise scenario has not been established at this time. Patty and Kermit stated that the City Fire Department and Emergency Management would like to be involved. A hazmat exercise is tentatively planned for October 18th. This drill will involve a common hazardous material and decontamination. Kermit committed it would be good to have the event occur outside the city limits for more outside agency involvement.

August City Exercise: The City of Bolivar is planning a scenario/functional exercise involving hostages in the City Court Room. The hospital may be involved from the standpoint of shipping and receiving injured.

March 19 City Table Top Exercise: There will be a table top exercise on March 19 that the City of Bolivar will be hosting. Kermit will release details, but would like to have a representative from the hospital in the exercise and an operator to utilize the amateur radio equipment.

Evacuation Planning: It was discussed that the best way for the hospital and healthcare facilities to survive an event was to defend in-place. If an event that occurred caused a decision to evacuate, the time frame and the distancing issue would be considered in the decision. In a large area evacuation such as the whole city, law enforcement would be in charge of the effort. Kermit will send out the draft for the city evacuation plan so that we may align the plans. Also looking to find out results of MoDOT studies on traffic flow to help with evacuation routes and traffic flow

Communication Grant Monies: Rick said they are waiting to hear for the possible grant money to purchase an interoperability communications link that would let multiple frequencies “talk to each other”. It also would have the capability of working as a repeater.

GroupCast System: The hospital is looking into the GroupCast system for employee notification during disasters. The system sends out a recorded call and can receive response and reports those responses.

Radioactive Materials: With the possible increase volume of radioactive materials, Kermit requested, if available, the route for deliveries and the amounts of materials we might be dealing with from the hospital and new cancer center. This would be helpful in an emergency situation.

Triage Process Training: Robin is looking at what triage system is appropriate for training local emergency responders. This triage system should be consistent between agencies, if possible, to keep everyone consistent.

Next Meeting will be May 5th, 2008 at 10:00 A.M. in the CMH Cafeteria.

Meeting Adjourned—11:10 A.M.

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 2008-11-03 (tjb) Added section from meeting minutes.

Purpose:
Meeting minutes.

Scope:
This meeting only.

Guideline:
Times: 10:00am to 11:00 am

Location: CMH Cafeteria

Present: Rick Lewis, Kermit Hargis, Theron Becker, Shane Duncan, Jim McManigle, Robin Bobinmyer, Jeff Miller and Eric Derrickson

Minutes: The minutes from the last meeting were sent out prior to the meeting for review.

Exercises: The hospital is planning a drill in late June or early July that should involve fire and evacuation. The precise scenario has not been established at this time. A hazmat exercise is tentatively planned for October 18th. This drill will involve a common hazardous material and decontamination. Kermit committed it would be good to have the event occur outside the city limits for more outside agency involvement.

The City of Bolivar will have an Exercise on Tuesday, September 23 at 6:00 p.m. for a hostage situation with 20 casualties. Steve Keller, Robin Bobinmyer and Eric Derrickson will discuss the ability of CMH to participate and to what degree. Activation of the Mass Casualty trailer may be an option.

March 19 City Table Top Exercise: Steve Keller and Eric Derrickson participated in this exercise and Kermit reported the opportunities for improvement which involved utilizing limited resources in the best way possible and looking for alternative resources that might be utilized.

MHA Tornado Exercise: Robin presented the results of a drill that MHA facilitated involving interoperability of communications. The drill was initiated and coordinated using the EMSystem. The HEAR radio system capabilities were also tested. The opportunities for improvement were audible notification was not possible on the computer that the EMSystem is primarily utilized on. Speakers were added to this computer. It was noted that some notification were just acknowledged without the correct action being taken. A decision chart was produced and implemented to help the clerk decide the severity of the incident and does further notification need to be made to activate supervisors, the EOC or any other appropriate activity.

Southwest Baptist University HazMat Incident: The Incident in the Science Building where a chemical cabinet fell over mixing several chemicals was discussed. The Fire Department was initially dispatched along with a CMH Ambulance and Crew. Two individuals were checked for complications of exposure and were cleared. The Hazardous Materials Team from Springfield was called in to clean up the spill. Everything was appropriately handled by shutting the building down, isolating the chemicals by shutting the doors and limiting the air flow.

Evacuation Planning: The community evacuation plan was discussed as it pertains to CMH. As far as the community wide evacuation, law enforcement would be in charge of this type situation. The LEPC Planning committee is working on the plan and integrating it with the CMH plan, County Plan, Health Department Plan, and ultimately to coordinate with region and state.

Communication Grant Monies: Rick reported that they received grant monies to purchase narrow band, FM, digital radios. This will help with more interoperability.

Mass Notification: The County is setting up with IRIS for a notification system to utilized mass calling technology. It will cost $8 per year for those who wish to have this service. They will be partnering with the city in this endeavor. The issue of marketing the system will be explored.

Triage Process Training: Robin recommends using the START system to educate and standardize the triaging process in the community. Eric and Robin and the LEPC will look into purchasing the training materials and set up a time for the training.

Next Meeting will be Monday, July 7, 2008 at 10:00 A.M. in the CMH Cafeteria.

Meeting Adjourned—11:05 A.M.

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 2008-11-03 (tjb) Added section from meeting minutes.

Purpose:
Meeting minutes.

Scope:
This meeting only.

Guideline:
Times: 10:00am to 11:00am

Location: CMH Cafeteria

Attendance: Theron Becker, Rick Lewis, Kermit Hargis, Jim McManigle, Jeff Miller, Robin Bobinmeyer, and Eric Derrickson

Region D Planning Updates—The Region D Hospital Planning Group met last month and they are currently working on several changes. With Region D being such a large geographic area and the way the highway systems are distributed, a plan to divide in smaller groups of hospitals within the region would help with resources, speed of assistance and self sustainability. There are natural divisions of four groups and CMH will participate in the TIER I group that involves Springfield and Branson and help facilitate the Northern Group of smaller hospitals.

MHA Grants—Several grants have been put in place through MHA. The list is as follows: Small Burn Supplies Cache, Emergency Oxygen Cart (40 E tanks w/tubing masks etc for 100 patients), Evacuation Equipment (Med Sleds and 6 handle carrying blankets), and a grant for $1250 of Amateur Radio Equipment. Jim McManigle will work with the hospital to get an idea of what can be purchased for that amount. CMH would use this to be able to become mobile. It was also suggested that the hospital encourage some individuals to get licensed for emergency situations. Also it was discussed to include Richard Roark in these meetings. The 911 organization is looking into a Global Positioning System (GPS) to track emergency units in the county. This would assist in dispatching as well as keeping track of mobile assets and resources.

Exercise Planning—CMH is planning a fire evacuation drill for August 4th. The scenario will be fire in a unit and the evacuation will take place at 3:30 p.m. to 4:00 p.m. the drill is planned to begin. Theron agreed to be an evaluator. Kermit agreed to evaluate also unless new fire chief Terry Lane would like to participate.

Robin and Eric are to get with Steve to find out the degree of participation in the City’s September 23rd drill. Kermit needs to know by August 6th for planning purposes. It was discussed as using this drill as a Mass Casualty and Influx exercise.

The LEPC has a Hazmat Exercise planned for October 18th. The exercise is looking at the possibility of using foam in the scenario to train for a possible ethanol fire/incident. The fire department do not have the correct foam to fight this type of fire, but may be able to get trained on this foam through LEPC education funds and possibility of replacing foam with correct type.

Triage Training—It was discussed to have consistent triage techniques between all agencies, a system and training needs to be put in place. Robin will be checking on systems. The START system was discussed as being the most used.


Evacuation Planning—A sub-committee of the LEPC has been discussing City and County Evacuation. A plan is in the works to be able to plan and execute the evacuation if would become necessary. We would include the possibility of evacuation of CMH facilities and once the county plan was known we can work to make sure adequate medical care remains until no longer needed as well as evacuation of all CMH facilities.

Special Needs Sheltering –With CMH being designated as the first choice for special needs sheltering, Debbie Black with Family Services has been working on a more formalized plan. Within the plan, to avoid overcrowding of the shelters, the committee will be working with group homes etc. to help them work together, know resources and plan. This should begin in July and August.

Health Department Mass Med MOU—Theron stated that the Strategic National Stockpile system may change and to be a part of this there most likely will have to be an MOU with each clinic, pharmacy, and place that may oversee mass medication distribution. Theron will keep everyone updated and may need a list of providers that would be involved in this possible situation.

Adjourned: 11:15 A.M.

Next Meeting: Even though Eric is leaving it was group consensus that the every other month meeting should continue. Robin and Jeff will coordinate the meetings. The Next scheduled meeting will be September 8th due to Labor Day.

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 2008-11-03 (tjb) Created section from meeting notes.

Purpose:
Meeting minutes.

Scope:
This meeting only.

Guideline:
Times: 10:00am to 10:45am

Location: CMH Cafeteria

Present: Jim McManigle, Theron Becker, Jeff Miller

Minutes:

- Discussion on the status of the amateur radio repeater.
- $300 donation check presented to Jim from Jeff on behalf of CMH for repairs to radio repeater.
- With current funds, amateur radio club can make quality repairs to existing equipment.

- Two CMH Security employees have tested and passed Technician Amateur Radio licenses.
- Jeff and Jim discussed a quick overview training on existing equipment for the new ham radio operators.

- CMH has purchased the most recent MHA equipment.
- Looking to install new ham radio in old ambulance for mobile command unit for CMH.
- Purchasing more handhelds for security.

- Sherry Welch is new safety officer for CMH.

- Discussion on migrating this meeting to be a health sub-committee of LEPC. All agreed.
- Jim will put the request on next LEPC agenda.
- Will keep same meeting date, time, and location.

- Theron will begin scheduling, keeping minutes, and sending reminders of this meeting.

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 2009-01-05 (tjb) Section created for 2009 meeting minutes.

Purpose:
No content

Scope:
No content

Guideline:
No content

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 1.5

Version history: 2009-01-05 (tjb) Created section for meeting agenda.

2009-01-05 (tjb) Updated with meeting minutes.

Purpose:
Meeting agenda and minutes.

Scope:
This meeting only.

Guideline:
Time: 10:00 am

Location: CMH Cafeteria

Present:
- Polk Co EMA: Rick Lewis, Jim McManigle
- City of Bolivar: Kermit Hargis, Terry Lane
- Polk Co Health: Theron Becker
- CMH: Wes Flack, Richard Young, Tamara Heiz-Peek, Steve Keller, Mike Sibley

Agenda:
- Introductions if needed
- LEPC Sub-Committee status
- Access to the Public Health Emergency Plan
- Health Department construction effect on capabilities
- CMH amateur radio update
- CMH MHA equipment update
- Open discussion

Minutes:
- CMH purchase a Yeaseu handheld ham radio. Also have a mobile radio.
- - Still unknown status for old ambulace to install radio and use for mobile DOC.
- - Might build portable case for mobile radio.
- MERC meeting
- - All hazmat training requests will be funded.
- - - For Polk Co: Hazmat Technician, Hazmat Medic, Hazmat Safety Officer
- - - Will go for state-wide bid
- - - Need 15 ppl per class
- Communications Trailer
- - MODOT sign-board size
- - generator
- - solar panel
- - stored at Sheriff's Office
- - 911 is custodian
- - mobile repeater
- - next request will be to add internet access to the trailer
- - will have training when it arrives
- - $33,000 per trailer spent (3 in region D)
- CERT
- - Polk Co Coordinator grat may be awarded in Feb
- - Will be temporary/part time position
- - New trailer for supplies with shelving
- - new equipment: burn pan, backboards, etc.
- - will have orientation once trailer is completed
- - Brighton Highway Assembly wants a class
- Moving backup JIC to EMA until PCHC construction is complete
- This year's EMA exercise will be on the Aviation Plan
- - In late summer
- - New Springfield terminal will bring more flights over Polk Co
- - Ft Leonard Wood making more low-level flights over Polk Co
- - LEPC Exercise Committee to decide fill/function/tabletop type
- City exercise this year
- - need mass casualty
- - working with CMH
- - Some sort of major fire with victim rescue (possibly at old high school)
- - triage
- - unknown timeframe
- - 2008 hostage exercise critique received
- - - CERT team worked well
- Steve Keller is now coordinating emergency management for CMH
- EMA has monitored frequency with Pl tone of 107.2
- Amateur radio technician class
- - 9am on the last Saturday of January
- Richard Young coordinating hazmat training for CMH
- - Eric Lattimer will probably do an operations-level class soon
- - CMH invited BCFD to ops class
- - BCFD doing own class in April and it will be open to everyone
- Next mtg: First Monday of March (2nd)
- Next agenda: Antiviral medication distribution

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 2.0

Version history: 2009-01-05 (tjb) Created section for agenda.

2009-03-23 (tjb) Updated section with meeting minutes.

Purpose:
Meeting agenda and minutes.

Scope:
This meeting only.

Guideline:
Time: 10:00am

Location: CMH Cafeteria

Agenda:
- Introductions (if needed)
- LEPC update
- Health Department construction update
- Antiviral Medication Distribution
- - Background
- - Local supplies
- - State and federal resources allocated for Polk Co
- - Current plan for distribution
- - Discussion
- Open discussion

Present:
- Citizen's Memorial Healthcare:
- - Tamara Heitz-Peek
- - Steve Keller
- - Nancy Nickos
- - Wes Flack
- City of Bolivar:
- - Kermit Hargis
- Family Support Division:
- - Nathan Stanburski
- Polk County Emergency Management Agency:
- - Rick Lewis
- - Jim McManigle
- Polk County Health Center:
- - Theron Becker
- Southwest Baptist University:
- - Nancy Hodges
- Springfield-Greene County Health Center:
- - Jaci McReynolds

Minutes:
Self-introductions were made.

An update on LEPC was made by Emergency Management.

An update on Health Department construction was made by the Health Department.

Discussion began on antiviral medication distribution. The background of general Strategic National Stockpile (SNS) procedures and antiviral allotments in Missouri was provided. Local pharmacy antiviral amounts on hand were generally discussed along with the absence of a local stockpile for healthcare providers. The current plan of distribution of antivirals through physician prescriptions and in-place pharmacy procedures was provided. Pros and cons of this process were discussed. The floor was opened for discussion of other alternatives. A few were presented and discussed. Consensus was reached that the current plan should remain. Draft MOUs should be created that include transportation, storage, allowed fees, etc. for each pharmacy to be signed when needed.
Handouts for the antiviral discussion included:
- Options for Local Public Health Agencies Antiviral Medication Distribution During an Influenza Pandemic
- Pandemic Influenza Selected Intervention Measures Decision Matrix
- Targeted Recipient Groups for Vaccine
- Polk County Public Health Emergency Plan - Section 2.8.1 SNS Ordering Procedures (CONFIDENTIAL)
- Polk County Public Health Emergency Plan - Section 2.8.2 Materiel Transportation (CONFIDENTIAL)

The floor was opened for other discussions. There were none.

The next meeting will be May 4th in a CMH Community Room. A topic idea for the next meeting was solicited, but had no response.

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 2.0

Version history: 2009-03-23 (tjb) Section created for agenda.

2009-05-04 (tjb) Updated agenda with H1N1.

2009-05-05 (tjb) Added minutes and present.

Purpose:
Meeting agenda and minutes.

Scope:
This meeting only.

Guideline:
Time: 10:00 am

Location: CMH Community Room 2

Agenda:
- Introductions (if needed)
- LEPC update
- Health Department construction update
- TOPIC H1N1
- - Current Situation
- - Anticipated Situation
- - Antiviral Distribution
- - - Pharmacy Meeting
- - - PCHC Licensed Distributor
- - SNS Ordering
- - - PPE for Emergency Responders
- - - CMH needs?
- - Public Information
- - - Hygiene
- - - Social Distancing
- - - Next year's vaccine
- - Questions and Answers
- Open Discussion

Present:
- Morgan Young
- Rick Lewis
- Jim McManigle
- Wes Flack
- Steve Keller
- Nathan Stamburski
- Michelle Morris
- Nancy Nickos
- Kermit Hargis
- Theron Becker

Minutes:
- Rick updated the group on LEPC upcoming training and exercise.
- Theron updated the group on Health Dept construction - will be occupying the new part of the building in the next few weeks.
- H1N1 update:
- - Current situation
- - - Pleasant Hope laid off 72 people in local pork processing plant.
- - Antivirals have been ordered and are in Polk County waiting for the pharmacies to need them.
- - PPE will be ordered from the SNS as soon as the inventory is loaded into the system.
- - - Once it is loaded, Theron will call Nancy and see if there are any needs at CMH. Otherwise, will order N95, gloves, goggles, surgical masks for each emergency responder to have two of each.
- - Public information messages
- - - Handouts at city hall, city pay checks, county pay checks, cmh infoweb, etc.
- - Social distancing
- - - CMH is moving febrile patients directly into rooms at their clinics instead of leaving them in waiting rooms.
- - - FSD is doing more phone client contacts to avoid office visits.
- - - PCHC will separate waiting room chairs by 3 ft. - July meeting topics:
- - Equipment resource list
- - - CMH tier 1, RHSOC, Health, etc.
- - - Hyperthermia, sun exposure education topics, cooling shelters, etc.

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 2.0

Version history: 2009-07-01 (tjb) Created Section for Agenda
2009-07-06 (tjb) Added minutes

Purpose:
Agenda and Minutes

Scope:
This meeting only

Guideline:
Time: 10 AM

Location: CMH Community Room 2

Agenda:
- Introductions (if needed)
- LEPC Update
- Health Department construction update
- - CMH location is probably most convenient for this meeting, but PCHC is available now that construction is complete
- H1N1
- Equipment Resource Lists
- - CMH
- - Health Department
- - Emergency Management
- - Coroner
- - Etc.
- Heat Warnings and Cooling Shelters
- Next meeting topic?
- Open discussion

Present:
Jaci McReynolds
Jamie Sharp
Kermit Hargis
Michelle Morris
Morgan Young
Nancy Hodges
Nancy Nickos
Rick Lewis
Steve Keller
Tamera Heitz-Peek
Wes Flack

Minutes:
- Aircraft emergency tabletop exercise is being planned by LEPC.
- Discussed available equipment for health/medical events in Polk County
- Bolivar is re-doing their plan for heat emergencies.
- - During heat advisory, they will direct people to places like Wal-Mart, Library, etc.
- - During heat warning, they will open one or two cooling centers
- Next meeting will be Sept 14 and will discuss flu vaccination clinics and the CERT program

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 2.0

Version history: 2009-09-14 (tjb) Created section for agenda.
2009-11-02 (tjb) Updated with meeting notes.

Purpose:
Agenda and minutes.

Scope:
This meeting only.

Guideline:
Time: 10:00 AM

Location: Polk County Health Center

Agenda:
- Introductions (if needed)
- LEPC update
- - Aircraft exercise report
- Seasonal flu vaccination clinics
- H1N1 vaccination planning discussion
- Next meeting topic?
- Open discussion

Present:
- Theron Becker, PCHC
- Michelle Morris, PCHC
- Nancy Nickos, CMH
- Johnna Brothers, CMH
- Kermit Hargis, City of Bolivar
- Michele Edwards, Pomme DeTerre Wellness
- Shannon Calvert, CMH
- Michael Cook, CMH
- Robin Sparks, Medicine Shoppe
- Nathan Stamburski, Family Support
- Wes Flack, CMH
- Jim McManigle, Polk Co EMA
- Rick Lewis, Polk Co EMA
- Robert Dickson, Polk Co EMA
- Kim Tarka, BPPC CMH
- Trisha Kobe, CMH
- Morgan Young, CMH PHS
- Kellie Burns, CMH PHS

Minutes:
- LEPC Update
- - Aircraft exercise report
- Seasonal flu vaccination clinic planning
- - Distributed syndromic surveillance reporting form
- - Public clinic will be Oct 2
- - CMH clinics will be Oct 12, 22
- - BFCC already started clinics
- - CMH doing employees at staff meetings
- - Pharmacies clinis will be Oct 23
- - Cannot order more vaccine - none available
- - CMH requested H1N1 handouts for flu clinics - PCHC will provide
- H1N1 vaccination discussion
- - Distributed vaccine storage guidelines
- - Lab testing discussion
- - - Which labs are doing testing? will send out labs
- - - H1N1 testing would be great but maybe not feasible
- - surveillance discussion
- - vaccine discussion
- - - priority groups
- - - vaccine coming to health department
- - - vaccine distribution planning
- - - - May distribute from health department to healthcare for employees
- - - - Pregnant and children in health department
- - - - Liability is astronomical for private providers for children
- - - - St Johns and Cox are requiring vaccination as a condition of employment
- - - - CMH will do own employees
- - - - CMH VFC clinics will be willing to store - actual administration to clients is unknown
- - - - Pharmacies probably not interested
- - - - Still have antivirals for uninsured
- Open discussion
- - Is MRSA still in Polk County? Yes

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 2009-11-02 (tjb) Created section.

Purpose:
Agenda and minutes

Scope:
This meeting only

Guideline:
Time: 10:00am

Location: Polk County Health Center

Agenda:
- Introductions (if needed)
- H1N1 vaccine update
- Open discussion

Present:
- Theron Becker, PCHC
- Kermit Hargis, City of Bolivar
- Robert Dickson, Polk Co OEM
- Rick Lewis, Polk Co OEM
- Cynthia Johnson, Big Springs Care Center
- Nancy Nickos, CMH
- Nathan Stamburski, FSD
- Nancy Hodges, SBU
- Susan Fitzwater, BFCC
- Michelle Morris, PCHC

Minutes:
- An update on H1N1 vaccine distribution was provided
- - Review of priority groups established by CDC
- - Vaccine being shipped to the health department weekly
- - Health department conducting several smaller public vaccination clinics
- - Vaccine will be provided to several healthcare providers (i.e. CMH) to vaccinate their staff

Exceptions:
None

References:

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 2009-11-02 (tjb) Created section.
2010-02-26 (tjb) Correction to present list.

Purpose:
Agenda and minutes

Scope:
This meeting only

Guideline:
Time: 10:00am

Location: CMH Community Room

Agenda:
- Introductions (if needed)
- LEPC update
- H1N1 update
- Next meeting topic?
- Open discussion

Present:
- Theron Becker, PCHC
- Robert Dickson, Polk Co EMA
- Rick Lewis, Polk Co EMA
- Wes Flack, CMH
- Cindie Johnson, Big Springs
- Nathan Stamburski, FSD
- Kermit Hargis, City of Bolivar
- Michelle Morris, PCHC
- Tamera Heitz-Peek, CMH
- Nancy Nickos, CMH
- Morgan Young, CMH
- Nancy Hodges, SBU

Minutes:
- LEPC update
- - HMEP grant is being requested for $1,000
- - Prioritized hazmat training at the last meeting
- H1N1 update
- - Have given about 150 doses at the health department
- - anticipated 1200 doses coming in this week
- - a lot of mist is available
- - over 6 mo old (600 doses this week)
- - PCHC clinics (1,000 ppl on the lists)
- - - Doing evening and Sat clinics on a call-in basis
- - Difficulty getting pregnant women in to get shots
- - BPD wants shots this week
- - CMH will request amount needed shots this afternoon
- - More than enough mist available
- - 90-100 ppl per evening clinic
- - most emergency services personnel have gotten the vaccination if they wanted it
- - CMH visitation rules discussion
- - Ministerial alliance sent email to all pastors requesting greeters not shake hands and use hand sanitizers
- - City sharing info with employees weekly and not allowing to report to work until 24-hours fever free. Hand sanitizers around city hall. No major absenteeism.
- - city having questions from employees about when to get vaccinated
- - Have anyone interested call PCHC to be put on the appropriate list
- - FSD doing business by phone as much as possible. Signage in office about fever and installing a drop box.
- - Prehospital employee absenteeism related to children being sick, not medics. Deconing ambulances daily.
- - ER requesting Pts wait in car with cell phone when they are busy.
- - Walk-in clinic opening Nov 9th.
- - PCHC still has antivirals

- Next meeting idea: HEALTH RESPONSE TO HAZMAT

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 2010-02-26 (tjb) Created section.

Purpose:

Scope:

Guideline:

Exceptions:

References:

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 2010-02-26 (tjb) Created section from meeting notes.

Purpose:
Agenda and minutes

Scope:
This meeting only

Guideline:
Time: 10:00am

Location: Polk County Health Center

Agenda:
- Introductions (if needed)
- LEPC update
- N1N1 update
- Health Response to Hazmat
- Open discussion

Present:
- Theron Becker, Polk County Health Center
- Rick Lewis, Polk County EMA
- Jim McManigle, Polk County EMA
- Kermit Hargis, City of Bolivar EMA
- Wes Flack, CMH
- Tamera Heitz-Peek, CMH
- Nathan Stamburski, FSD

Minutes:
- LEPC update
- - Upcoming hazmat trainings
- - Spring or summer for methanol and mass casualty exercises
- N1N1 update
- - CMH still has under 14 rule (probably through January)
- Health Response to Hazmat
- - PCHC:
- - - Exposure surveillance
- - - Public information
- - - Mass prophylaxis
- - - SNS ordering
- - - Environmental impact monitoring
- - Emergency Management:
- - - WISER
- - - Hazmat training through SEMA website (CMH wants to send personnel to training)
- - - Updating evacuation plans (Bolivar just updated their plans and will share)
- - - Taney Co has 100-bed mobile hospital
- - - Response time for hazmat team from Springfield
- - FSD:
- - - Debbie Black moving to state employee
- - - Mass care only
- - CMH:
- - - Did decon exercise
- - - Still working on putting decon trailer in service - water heater still not working
- - - Updating JIC, should meet next month
- - - Regional JIC through DMAC
- - Bolivar:
- - - Updated emergency plan and will distribute
- Open discussion
- - 20 below wind chills coming this weekend - what is the status of shelters?
- - Polk County has no warming centers - we don't have the funds to support utility bills
- - Advise citizens to go to Walmart, Health Dept, Etc (designated locations) to warm
- - If person looses heat in the night, they must rely on friends, relatives, and neighbors
- - Red Cross has shelter in Springfield at Kansas and Chestnut
- NEXT TOPIC:
- - Severe Weather
- - Employee and non-employee participation when sirens go off
- - Flu season / H1N1 update
- - Tuberculosis

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 2.0

Version history: 2010-02-26 (tjb) Created section for agenda.
2010-03-05 (tjb) Updated section with meeting minutes.

Purpose:
Agenda and minutes

Scope:
This meeting only

Guideline:
Time: 10:00am

Location: Polk County Health Center

Agenda:
- Introductions (if needed)
- LEPC update
- H1N1 update
- Severe weather
- - Public building policies
- Open Discussion

Attendees:
- Theron Becker, Polk County Health Department
- Rick Lewis, Polk County EMA
- Robert Dickson, Polk County EMA
- Kermit Hargis, City of Bolivar EMA
- Nancy Hodges, SBU
- Jeff Miller, CMH
- Nathan Stamburski, FSD
- Wes Flack, CMH
- Tamera Heitz-Peek, CMH

Minutes:
- LEPC update
- - Need to schedule trainings (hazmat classes)
- - Hazard mitigation meeting last week: county-wide plan with all disciplines
- - Emergency management office has moved locations
- H1N1 update
- - Quieter
- Severe weather
- - Public building policies
- - PCHC: building maps
- - Family Support Division: siren sounds, everyone is moved to breakroom. Had a drill last month. Can we make visitors do anything?
- - Schools: If parents come, they let kids go
- - Probably a liability issue letting visitors do what they want
- - City Hall: Barely have room for employees in basement. Police Department is off limits. Shelters are all privately owned.
- - CMH: Directs visitors to designated areas. Let them leave, but must be in areas. Six drills per week.
- - SBU: Architects determined zones. Safety and security. Have not tested new alerting system.
- Open Discussion
- - CMH has new call system for employees
- - Bolivar EMD will continue to send anticipations for severe weather via email
- - Earthquake response is the same: under tables, in doorways
- - Keep meetings at health department
- - Unknown next topic
- - Mass casualty drill, use mass casualty trailer, need casualties in May (11th at 7pm) unknown location, 40-50 casualties.

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 2010-05-28 (tjb) Created section from minutes.

Purpose:
Agenda and minutes

Scope:
This meeting only

Guideline:
Time: 10am

Location: Polk County Health Center

Agenda:
- Introductions (if needed)
- LEPC update
- Open Discussion

Attendees:
- Theron Becker, Polk County Health
- Tamera Heitz-Peek, CMH
- Morgan Young, CMH

Minutes;
- CMH updates
- PCHC updates

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 2.0

Version history: 2008-06-27 (tjb) Moved from html-based to sql-based.

2009-01-14 (tjb) Added AAR instructions from DHSS.

Purpose:
Provide checklist to maintain monthly activities to facilitate plan updates and exercises. Additionally, instructions for submission of After Action Reports (AAR) to MO DHSS CERT are included.

Scope:
All personnel responsible for plan updates and exercises.

Guideline:
"A good plan, violently executed now is better than a perfect plan next week."
- George S. Patton (US general 1885-1945)

Once per month certain updates and procedures are conducted to maintain readiness and a current plan. The monthly checklist is below.

MONTHLY CHECKLIST:
- Update contact information for all staff members in Elliott credentialing database.
- Update online credentialing database from Elliott machine.
- Public safety radio test. Either a handheld or mobile radio will call Health Base on PCHC's VHF radio frequency for a radio check.
- Two-meter ham radio test. Two ham radio operators will conduct a radio check using PCHC owned radios.
- IRIS staff text message test. Message: "TEST - Monthly text pager test. Please contact Theron upon receipt."
- Online database backups.
- Internal emergency test. According to the schedule below, an internal emergency drill will be conducted bi-monthly on the first Tuesday. Each drill should last no longer than 30 minutes.
-- February - Personal home stockpiles. General inventory of each employee's food and water at their residence. Could their families survive for 3-5 days without outside assistance (including utilities)?
-- April - Tornado. Employees get to assigned positions for a tornado warning. A head count should be conducted to account for all staff.
-- June - Scenario discussion. A scenario will be presented for discussion by the group. The scenario may include events such as a medical emergency in the building, building evacuation given 15 minutes warning, extended absenteeism of critical staff, etc.
-- August - Agency stockpiles. General inventory of agency's food and water stockpiles. Could the staff survive for 1-2 days at the health department without outside assistance (including utilities)?
-- October - Fire. Smoke detectors should be tested. Employees evacuate building and meet at designated location. A head count should be conducted to account for all staff.
-- December - Personal vehicle preparedness. General inventory of each employee's equipment and supplies in their vehicle. Could each employee manage mishaps, such as flat tire or being stranded in their car for up to 24 hours?

Received via email from Paula Woodsmall on 1/14/09:
Effective immediately, all AARs should be forwarded to generic email aarreview@dhss.mo.gov. The timeframes and process, in conjunction with HSEEP requirements, will be:
- 60 days after exercise: LPHAs submit AARs to CERT.
- 30 days after submittal: CERT returns Improvement Plan-Progress Report (IPPR) to LPHA.
- 120 days after IPPR: CERT reminds LPHA to return IPPR.
- 180 days after IPPR: Due date for LPHA to return IPPR to CERT.

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 1.5

Version history: 2008-09-03 (tjb) Migrated ARES HTML page to SQL and added some net results.
2008-09-29 (tjb) Added 2008-05-14 net.
2008-10-01 (tjb) Added 2008-10-01 net.
2008-11-05 (tjb) Added 2008-11-05 net.
2009-02-25 (tjb) Added 2009-02-25 net.
2009-06-16 (tjb) Added 2009-06-15 net.
2009-06-25 (tjb) Added 2009-06-17 net.
2009-08-27 (tjb) Added 2008-11-07 net.

Purpose:
Each Wednesday a net is held to improve familiarization with communication equipment and voices of other communication volunteers in the area. The net is held on the Bolivar repeater (147.06 MHz + 107.2). This documents the weekly ARES check-in net results.

Scope:
Applies to amateur radio operators while operating on the Polk County ARES net.

Guideline:
Format:
(date of net) (time of net)
(callsign) - (name) in (location)
- (announcements)

2007-05-09 1000 hrs
KH6VO - Jim in Bolivar
WB0JEN - Mike in Branson
KA5YTH - Theron in Buffalo
KB0TQL - Kermit in Bolivar
K0BC - Gary in Bolivar
KD0AON - Eric in Bolivar
KD0CZQ - Dave in Willard
W0OA - Kenny in Windsor
- Social gathering at Bongos Thursday @ 1830
- Next ARES net May 16th @ 1400

2007-05-16 1400 hrs
KH6VO - Jim in Bolivar
KA5YTH - Theron in Buffalo
KC0CII - Jim in Ozark
WD0CZQ - Dave in Willard
KD0AUN - Eric in Bolivar
- Next ARES net May 23rd @ 1200

2007-05-23 1200 hrs
KH6VO - Jim in Bolivar
KA5YTH - Theron in Buffalo
KD0AOG - Sam in Halfway
KD0AOH - Chandra in Halfway
KD0AOM - Jack in Bolivar
- Next ARES net May 30th @ 1600

2007-05-30 1600 hrs
KH6VO - Jim in Bolivar
KA5YTH - Theron in Bolivar
KD0AON - Eric in Bolivar
KD0AOH - Sam in Bolivar
KD0AOL - Amy in Bolivar
- Next ARES net June 6th @ 1100

2007-06-06 1100 hrs
KH6VO - Jim in Bolivar
KD0AOM - Jack in Bolivar
K0BC - Gary in Brighton
KA5YTH - Theron in Buffalo
- Next ARES net June 13th @ 0900
- Social gathering @ El Rodeo June 14th @ 1830

2007-06-13 0900 hrs
KH6VO - Jim in Bolivar
WB0JEN - Mike in Bolivar
KA5YTH - Theron in Bolivar
KD0AOJ - Susan in Bolivar
KD0AOI - Jeff in Bolivar
K0BC - Gary in Bolivar
WB0CZQ - Dave in Willard
KD0AON - Eric in Bolivar
KD0AOM - Jack in Bolivar
- Next ARES net June 20th @ 1600
- Social gathering @ El Rodeo tomorrow @1830
- Social net every Wednesday @ 2030
- Earthquake exercise June 19th-21st

2007-06-20 1600 hrs
KH6VO - Jim in Bolivar
KD0AOM - Jack in Bolivar
KD0AFH - Rick in Bolivar
W0DRJ - Dee in Bolivar
KC0BFG - Walt in Marshfield
K0BC - Gary in Bolivar
N0TLI - Richard in El Dorado Springs
KA5YTH - Theron in Bolivar
KD0AOG - Sam in Bolivar
WD0CZQ - Dave in Willard
KD0AON - Eric in Bolivar
- Next ARES net June 27th @ 1000
- All future ARES nets will be at 1000 hours
- Field day is Saturday and Sundat @ Glenstone and St Louis

2007-06-27 1000 hrs
KH6VO - Jim in Bolivar
M0FYR - Bob in Osceola
KC0BFG - Walt in Marshfield
WB0JEN - Mike in Bolivar
KA5YTH - Theron in Halfway
WD0CJQ - Dave in Springfield
? - Ron in ?
K0BC - Gary in ?
KD0AON - Eric in Bolivar
- Next ARES net July 11th @ 1000 (we will skip July 4 net)

2007-07-25 1000 hrs
KH6VO - Jim in Bolivar
KA5YTh - Theron in Buffalo
- Next ARES net next Wed @ 1000

2007-08-01 1000 hrs
KH6VO - Jim in Bolivar
KA5YTH - Theron in Buffalo
KD0AON - Eric in Bolivar
KB0TQL - Kermit in Bolivar
- Please vote August 7th
- Next ARES net August 8th @ 1000

2007-08-08 1000 hrs
KH6VO - Jim in Bolivar
KA5YTH - Theron in Buffalo
WB0JEN - Mike in Bolivar
KD0AON - Eric in Bolivar
KD0AOG - Saim in ?
WD0CZQ - Dave in Willard
- Next ARES net August 15 @ 1700
- Social gathering canceled - will be held August 16th @ 1830 @ Bongos @ Silo Ridge

2007-08-22 1000 hrs
KH6VO - Jim in Bolivar
KA5YTH - Theron in Buffalo
K0BC - Gary in Bolivar
WB0JEN - Mike in Bolivar
WD0CZQ - Dave in Willard
- Next ARES net August 29th @ 1000
- Hamfest in Joplin this weekend

2007-09-05 1000 hrs
KH6VO - Jim in Bolivar
W0JVV - Johnathan in Bolivar
KA5YTH - Theron in Buffalo
K0BC - Gary in Bolivar
WB0JEN - Mike in Springfield
K0MOZ - Fred in Springfield
WB0QFU - Bruce in Collins
- Next ARES net September 12th @ 1700
- Local community radio act
- Social gathering is first Thursday at Smith's at 1830

2007-12-05 1000 hrs
KH6VO - Jim in Bolivar
KA5YTH - Theron in Buffalo
K0BC - Gary in Bolivar
KD0AFH - Rick in Bolivar
KC0FDF - ? in Wheatland
KD0CZQ - Dave in Bolivar
- Next ARES net Dec 19 @ 1000
- No net on Dec 12th
- Monthly social gathering canceled for December

2007-12-19 1000 hrs
KH6VO - Jim in Bolivar
KD0FDS - Dick in Wheatland
K0BC - Gary in Bolivar
KA5YTH - Theron in Buffalo
KD0AOO - Ken in Springfield
KD0AFH - Rick in ?
- Next ARES net 12/26/07 @ 1000

2007-12-26 1000 hrs
KH6VO - Jim in Bolivar
KC0EMJ - ? in Buffalo
K0BC - Gary in Bolivar
KA5YTH - Theron in Buffalo
KD0AOO - Ken in Springfield
KD0AON - Eric in Bolivar
W2WFD - David in Willard
WB0NYD - ? in Springfield
N0VYF - ? in ?
KC0KDM - Shirly in Buffalo
KC0QON - Don in Peculiar
- Next ARES net 1/2/8 @ 1000

2008-01-02 1000 hrs
KH6VO - Jim in Bolivar
KA5YTH - Theron in Bolivar
KD0AFH - Rick in Bolivar
KD0AON - Eric in Bolivar
- ARES meeting 1/10/8 @ 1830 @ Simon B's
- Next ARES net 1/9/8 @ 1000

2008-01-16 1000 hrs
K0BC - Gary in Bolivar
KA5YTH - Theron in Buffalo
W2WFD - Dave in Willard
KD0AOM - Jack in Bolivar

2008-01-30 1000 hrs
K0BC - Gary in Bolivar
KA5YTH - Theron in Buffalo
KD0AFH - Rick in Bolivar
KD0AOJ - Susan in Bolivar

2008-02-20 1000 hrs
KH6VO - Jim in Bolivar
KA5YTH - Theron in Buffalo
K0BC - Gary in Bolivar
KD0DNC - Rick in Warsaw
- Next net Wed @ 1000
- 3/12 at 1830 at senior center - storm spotters class
- 3/15 ham fest in Mt Vernon
- 2/19 at 1300 comms check exercise

2008-03-05 1000 hrs
KH6VO - Jim in Bolivar
KA5YTH - Theron in Buffalo
KD0AON - Eric in Bolivar
- Next net @ 1000 on Wed next week
- 3/12 spotters class at senior center
- 3/19 earthquake exercise
- this Sunday daylight savings

2008-05-14 1000 hrs
KH6VO - Jim in Bolivar
KA5YTH - Theron in Bolivar
K0BC - Gary in Bolivar
KD0AOG - Sam in Bolivar
KD0AON - Eric in Bolivar

2008-09-03 1000 hrs
KH6VO - Jim in Bolivar
K0BC - Gary in Bolivar
KA5YTH - Theron in Bolivar
KD0AFH - Rick in Bolivar
KD0AOJ - Susan in Bolivar
? - Jack in ?
- tomorrow @ 1830 @ El Rodeo: social gathering

2008-10-01 1000 hrs
KH6VO - Jim in Bolivar
WB0JEN - Mike in Bolivar
KA5YTH - Theron in Bolivar

2008-11-05 1000 hrs
KH6VO - Jim in Bolivar
KA5YTH - Theron in Bolivar
WB0JEN - Mike in Bolivar
- ARES meeting week from tomorrow at Simon B's

2008-11-07 1000 hrs
KH6VO - Jim in Bolivar
WB0JEN - Mike in Bolivar
K0BC - Gary in Bolivar
KA5YTH - Theron in Buffalo
KC0CZQ - Dave
- next net 11/14 at 1000
- ARES meeting 11/19 at 1830 at Simon B's
- Lebannon ham festival 11/10 at Cowen Center

2009-02-25 1000 hrs
KH6CO - Jim in Bolivar
KA5YTH - Theron in Buffalo
KD0AFH - Rick in Bolivar
K0BC - Gary in Bolivar
NoJTP - Omer in Fair Play
- Lake Area Amateur Meeting March 12th at 1830 at Godfather's Pizza
- Storm Spotters Class March 31st at 1830 at Senior Center

2009-06-15 1200 hrs
KD0ILB - ? net control
KH6VO - Jim at EOC
KA5YTh - Theron at Health Dept

2009-06-17 1000 hrs
KH6VO - Jim in Bolivar
KA5YTH - Theron in Bolivar
KD0AOJ - Sue in Bolivar
K0BC - Gary
N0OCP - Joy in Springfield
KD0AFH - Rick in Bolivar

2009-06-26 1200 hrs
K0ILB - Larry in Bolivar
KA5YTH - Theron in Bolivar

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version:

Version history:

Purpose:

Scope:

Guideline:

Exceptions:

References:

Critical section? No

Security level: Unclassified

Version: 2.0

Version history: 6/24/2008 moved from html-based to sql-based.

Purpose:
Describe the application of the Missouri Sunshine Law and this emergency plan.

Scope:
Entire document.

Guideline:
According to RSMo 610.021(18), operational guidelines and policies developed, adopted, or maintained by any public agency responsible for law enforcement, public safety, first response, or public health for use in responding to or preventing any critical incident which is or appears to be terrorist in nature and which has the potential to endanger individual or public safety or health is except from the Missouri Sunshine Law.

Full disclosure of the Polk County Health Center Emergency Plan would impair its ability to protect the safety or health of persons and public interest in nondisclosure outweighs the public interest in disclosure of these records. Unclassified portions of the emergency plan may be obtained from www.polkcountyhealth.net.

Exceptions:
None

References:
RSMo 610.021(18)

Critical section? No

Security level: Unclassified

Version:

Version history:

Purpose:

Scope:

Guideline:

Exceptions:

References:

Critical section? No

Security level: Unclassified

Version:

Version history:

Purpose:

Scope:

Guideline:

Exceptions:

References:

Critical section? Yes

Security level: Unclassified

Version: 1.0

Version history: 2008-10-10 (tjb) Moved from 2.2.1 to 2.2.2. Moved from HTML-based to SQL-based.

Purpose:

Scope:

Guideline:
Originally developed by Columbia University School of Nursing - Center for Health Policy.

Exceptions:

References:

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 2008-10-10 (tjb) Moved from HTMl-based to SQL-based.

Purpose:

Scope:
Occupations in which employees set broad policies, exercise overall responsibility for execution of these policies, of direct individual departments or special phases of the agency’s operations, or provide specialized consultation on a regional, district or area basis. Includes department heads, bureau chiefs, division chiefs, directors, and deputy directors.

Guideline:
CORE COMPETENCY 1. Describe the public heath role in emergency response in a range of emergencies that might arise. (e.g., “This department provides surveillance, investigation and public information in disease outbreaks and collaborates with other agencies in biological, environmental, and weather emergencies.”)
- COMMUNICATE public health information, roles, capacities and legal authority accurately to all emergency response partners (other public health agencies, other health agencies, and other government agencies) during planning, drills and actual emergencies. (This includes contributing to effective community-wide response through leadership, team building, negotiation and conflict resolution.)
- EVALUATE/REVIEW the public health laws of the jurisdiction on a regular schedule to assess that they are current and up-to-date in regards to bioterrorism (BT) events.

CORE COMPETENCY 2. Describe the chain of command in emergency response.
- DESCRIBE the chain of command and management system (incident command system) for emergency response in the jurisdiction.
- MAINTAIN regular communication with emergency response partners. (Includes maintaining a current directory of partners and identifying appropriate methods of contact in emergencies.)
- MAINTAIN agreements with partners from within the jurisdiction and from other jurisdictions to allow the public health agency to secure assistance and other resources.

CORE COMPETENCY 3. Identify and locate the agency emergency response plan (or the pertinent portion of the plan).
- ENSURE that the agency (or agency unit) has a written, updated plan for major categories of emergencies that respects the culture of the community and provides for continuity of agency operations.
- IDENTIFY the needed components of a public health BT response plan that is integrated with overall emergency response plan for the agency.
- ENSURE that all BT plan components are developed by appropriate and knowledgeable staff by applying the following competencies:
- INTEGRATE the agency’s BT response plan into the Incident Command or Unified Command System used by other responders (such as Fire, Police, and EMS) in the jurisdiction.
- DEFINE modifications to the agency’s internal command notification and coordination structure required for BT response.
- DESIGN BT-specific protocols for enhanced surveillance, including activating additional personnel (e.g., infection control practitioners, public health nurses, epidemiologists, and data entry clerks from other institutions, jurisdictions and/or agencies.)
- ESTABLISH emergency communications roles and responsibilities for BT response.
- ESTABLISH protocols for handling and distribution of the National Pharmaceutical Stockpile.
- ESTABLISH protocols to address public health surge capacity, including use of volunteers.
- IDENTIFY pharmaceutical, veterinary, or other resources required for consultation by the agency or jurisdiction during BT response.
- USE risk assessment of potential biological, chemical or radiological hazards in the community to determine the roles and responsibilities of those involved in public health BT response.
- GENERATE regulations that provide the authority to conduct risk assessments in BT events.
- GENERATE plans to conduct risk assessments in public health emergencies.
- SPECIFY safety measures to be taken by public health responders in a BT event, including use of personal protective equipment.
- DISSEMINATE notifiable disease information, reporting requirements and procedures to healthcare providers on a periodic basis.
- ENSURE that laboratories within the jurisdiction or agency have BT response plans:
- IDENTIFY Level A laboratories serving the jurisdiction or agency.
- ENSURE Level A laboratories can conduct “rule-out” testing, specimen packaging and handling, and referral of suspected biological threat agents to a higher level laboratory.
- MAINTAIN contact and location information for Level B/C laboratories in the BT lab response network serving the jurisdiction.
- MAINTAIN written plans for 24/7 availability of specific staff and specialists required during a BT event.
- IDENTIFY specific resources needed for response to critical biologic agents. (Category A, B, C.)

CORE COMPETENCY 4. Describe his/her functional role(s) in emergency response and demonstrate his/her role(s) in regular drills.
- IDENTIFY your functional role in the agency’s BT response plan.

CORE COMPETENCY 5. Demonstrate correct use of all communication equipment used for emergency communication (phone, fax, radio, etc.).

CORE COMPETENCY 6. Describe communication role(s) in emergency response within the agency, using established communication systems:
- ESTABLISH a public health communication infrastructure that receives and transmits data and information for decision support during a BT event.
- ESTABLISH secure communication pathways for use in a BT event, including computer security policies and safeguards against data loss.
- ESTABLISH redundant communication mechanisms for immediate and reliable voice and secure data communication during a public health emergency.
- TEST protocols for BT-specific communication and agency interaction at regular intervals with BT response partner agencies.

CORE COMPETENCY 6A. Describe communication role(s) in emergency response with the media and with the general public.
- ENSURE development and delivery of accurate event-specific, science-based risk communication messages to the public, to health care providers, to the media, and to the response community during a BT event.

CORE COMPETENCY 6B. Describe personal communication role(s) in emergency response with family or neighbors.
- ENSURE that the agency (or agency unit) regularly practices all parts of emergency response.
- CONDUCT workforce BT preparedness programs.
- EVALUATE every emergency response drill to identify needed internal/external improvements.
- ENSURE that knowledge/skill gaps identified through emergency response planning, drills and evaluation are filled.

CORE COMPETENCY 7. Identify limits to own knowledge, skill, and authority, and identify key system resources for referring matters that exceed these limits.

CORE COMPETENCY 8. Recognize unusual events that might indicate an emergency and describe appropriate action (e.g., communicate clearly within the chain of command.)
- IMPLEMENT the public health emergency response plan.
- IMPLEMENT your individual BT response functional role.

CORE COMPETENCY 9. Apply creative problem solving and flexible thinking to unusual challenges within his/her functional responsibilities and evaluate effectiveness of all actions taken.
- USE the agency BT Incident Command management structure.
- ACTIVATE emergency public health and infection control measures specific to the BT event.
- ACTIVATE enhanced active surveillance protocols to track the scope of the exposure or outbreak.
- IDENTIFY persons potentially exposed to a specific BT agent in need of public health and/or medical intervention.
- ACTIVATE the laboratory BT response plan.
- ENSURE functioning of a system for rapid rule-out testing, referral, identification, confirmation, and characterization of biological threat agents, including rapid reporting of results, during a BT event.
- PROVIDE public health support as needed for victims and responders within the jurisdiction’s response.
- ACTIVATE a call-down roster using 24-hour contact information to reach BT response staff and consultants.
- COMMUNICATE the need for assistance during a BT event to appropriate resources.
- USE the agency’s BT-specific public information plans, protocols and materials in a BT event.
- USE established communication systems for coordination among the response community during a BT event.
- ACTIVATE redundant communication mechanisms for immediate and reliable voice and secure data communication during a public health emergency including two-way emergency communications.
- USE event-specific information and scientific principles of risk communication to inform the public, the media, health care providers, and the response community during a BT event.
- DESIGNATE a media spokesperson during a BT event.
- PERFORM your individual communication responsibilities during a BT event.
- APPLY appropriate science-based public health measures to ensure continued population protection appropriate to the biological threat involved.
- EVALUATE every emergency response to identify needed internal/external improvements.
- ENSURE that knowledge/skill gaps identified through emergency response evaluation are filled.

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 2008-10-10 (tjb) Moved from HTML-based to SQL-based.

Purpose:

Scope:
Occupations in which employees collect, investigate, describe, and analyze the distribution and determinants of disease, disability, and other health outcomes, and develop the means for their prevention and control; investigates, describes and analyzes the efficacy of programs and interventions, advising local health departments and the health care community on outbreak investigations, immunization data, disease identification, reporting, and prevention. Includes individuals specifically trained as epidemiologists, and those trained in other disciplines (e.g., medicine, nursing, environmental health, veterinary medicine) working as epidemiologists under job titles such as nurse epidemiologist.

Guideline:
CORE COMPETENCY 1. Describe the public health role in emergency response in a range of emergencies that might arise. (e.g., "This department provides surveillance, investigation and public information in disease outbreaks and collaborates with other agencies in biological, environmental, and weather emergencies.")

CORE COMPETENCY 2. Describe the chain of command in emergency response.
- MAINTAIN regular communication with emergency response partners. (Includes maintaining a current directory of partners and identifying appropriate methods for contact in emergencies.)

CORE COMPETENCY 3. Identify and locate the agency emergency response plan (or the pertinent portion of the plan).
- GENERATE a public health bioterrorism (BT) response plan for epidemiology and surveillance that is integrated with the emergency response plan for the agency by applying the following competencies:
- DEFINE modifications to the agency’s internal command notification and coordination structure that are required for BT response.
- ESTABLISH protocols for handling and distribution of the National Pharmaceutical Stockpile.
- MAINTAIN written plans for 24/7 availability of specific staff and specialists required during a BT event.
- DESIGN BT-specific protocols for enhanced surveillance, including activating additional personnel (e.g., infection control practitioners, public health nurses, epidemiologists, and data entry clerks from other institutions, jurisdictions, and/or agencies).
- GENERATE plans to conduct risk assessments in public health emergencies.
- ESTABLISH written policies and procedures for rapid specimen identification and electronic reporting of results.
- ESTABLISH emergency communications roles and responsibilities for BT response.
- ESTABLISH data collection protocols that systematically monitor community health indicators (e.g., aberrations in utilization trends or syndromic surveillance.)
- ENSURE a system is established and functioning that provides rapid rule-out testing, referral, identification, confirmation, and characterization of biological threat agents including rapid reporting of results, during a BT event.
- CONDUCT workforce BT preparedness programs in epidemiology and surveillance.
- IDENTIFY specific resources needed for BT response to crucial biologic agents (Category A, B, C).
- USE risk assessment of potential biological, chemical, or radiological hazards in the community to determine roles and responsibilities of those involved in public health BT response.

CORE COMPETENCY 4. Describe his/her functional role(s) in emergency response and demonstrate his/her role(s) in regular drills.
- IDENTIFY your functional role in the agency’s BT response plan.
- DEMONSTRATE readiness to apply professional skills to a range of emergency situations during regular drills. (e.g., Access, use, and interpret surveillance data; access and use lab resources; access and use science-based investigation and risk assessment protocols; identify and use appropriate personal protective equipment.)

CORE COMPETENCY 5. Demonstrate correct use of all communication equipment used for emergency communication (phone, fax, radio, etc.).

CORE COMPETENCY 6. Describe communication role(s) in emergency response: within the agency, using established communication systems, with the media, with the general public, and personal (with family, neighbors).
- DISSEMINATE notifiable disease information and reporting requirements and procedures to healthcare providers on a periodic basis.

CORE COMPETENCY 7. Identify limits to own knowledge, skill, and authority, and identify key system resources for referring matters that exceed these limits.

CORE COMPETENCY 8. Recognize unusual events that might indicate an emergency and describe appropriate action. (e.g., communicate clearly within the chain of command.)
- PARTICIPATE in continuing education to maintain up-to-date knowledge in areas relevant to emergency response (e.g., emerging infectious diseases, hazardous materials, diagnostic tests, etc.).
- IMPLEMENT your individual BT response functional role.

CORE COMPETENCY 9. Apply creative problem solving and flexible thinking to unusual challenges within his/her functional responsibilities and evaluate effectiveness of all actions taken.
- APPLY algorithms that trigger further epidemiological investigation.
- IDENTIFY the indicators, signs and symptoms for exposure to critical biologic agents (Category A, B, C) or to nuclear or chemical agents.
- ACTIVATE enhanced active surveillance protocols to track the scope of the exposure or outbreak.
- REQUEST implementation of the public health emergency response plan.
- COLLECT timely patient-based and health care utilization data on critical biological agents (Category A, B, C).
- IDENTIFY persons potentially exposed to a specific BT agent in need of public health and/or medical intervention.
- DEMONSTRATE proper safety and personal protection equipment procedures.
- USE established communication systems for coordination among the response community during a BT event, including those for privileged information.
- CONTRIBUTE to the development of accurate event-specific science-based risk communication to the public, the media, health care providers, and response community in a BT event.
- DEFINE algorithms that trigger further epidemiological investigation.
- APPLY appropriate science-based public health measures to ensure continued population protection appropriate to the biological threat involved, including follow up of those exposed, vaccinated, or quarantined.

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 2008-10-10 (tjb) Moved from HTML-based to SQL-based.

Purpose:

Scope:
Public Health staff with clinical education such as nurse, dentist, physician, employed to give direct clinical care in a PH program or whose functional role in an emergency includes such duties.

Guideline:
CORE COMPETENCY 1. Describe the public heath role in emergency response in a range of emergencies that might arise. (e.g., “This department provides surveillance, investigation and public information in disease outbreaks and collaborates with other agencies in biological, environmental, and weather emergencies.”)
- MAINTAIN regular communication with partner professionals in other agencies involved in emergency response. (Includes contributing to effective community-wide response through leadership, team building, negotiation, and conflict resolution.)

CORE COMPETENCY 2. Describe the chain of command in emergency response.

CORE COMPETENCY 3. Identify and locate the agency emergency response plan (or the pertinent portion of the plan).
- ESTABLISH protocols to address public health surge capacity.
- SPECIFY safety measures to be taken by public health responders in a BT event, including use of personal protective equipment.
- CONDUCT workforce BT preparedness programs.

CORE COMPETENCY 4. Describe his/her functional role(s) in emergency response and demonstrate his/her role(s) in regular drills.
- IDENTIFY your functional role in the agency’s BT response plan. (Including, as appropriate, protocols for administration of medication, equipment, and supplies.)
- DEMONSTRATE readiness to apply professional skills to a range of emergency situations during regular drills. (e.g., Access, use, and interpret surveillance data; access and use lab resources; access and use science-based investigation and risk assessment protocols; identify and use appropriate personal protective equipment.)

CORE COMPETENCY 5. Demonstrate correct use of all communication equipment used for emergency communication (phone, fax, radio, etc.).

CORE COMPETENCY 6. Describe communication role(s) in emergency response: within the agency, using established communication systems, with the media, with the general public, and personal (with family, neighbors).

CORE COMPETENCY 7. Identify limits to own knowledge, skill, and authority, and identify key system resources for referring matters that exceed these limits.

CORE COMPETENCY 8. Recognize unusual events that might indicate an emergency and describe appropriate action (e.g., communicate clearly within the chain of command).
- PARTICIPATE in continuing education to maintain up-to-date knowledge in areas relevant to emergency response (e.g., emerging infectious diseases, hazardous materials, diagnostic tests, etc.).
- IMPLEMENT your individual BT response functional role.

CORE COMPETENCY 9. Apply creative problem solving and flexible thinking to unusual challenges within his/her functional responsibilities and evaluate effectiveness of all actions taken. As appropriate to the specific emergency situation:
- IDENTIFY persons potentially exposed to a specific BT agent in need of public health and/or medical intervention.
- IDENTIFY the indicators, signs and symptoms for exposure to critical biological agent (Category A, B, C).
- COLLECT timely patient-based and health care utilization data on critical biological agent (Category A, B, C).
- ESTABLISH and/or SUPERVISE and/or PERFORM effective assessment, stabilization, diagnosis, and treatment or referral of victims of specific types of BT incidents involving a variety of agents, as appropriate to your functional role.
- ESTABLISH a system of triage for victims of BT events using incident-specific triage guidelines. and/or
- SUPERVISE the triage of victims of BT events using incident-specific triage guidelines. and/or
- TRIAGE victims of BT events using incident-specific triage guideline.
- ISOLATE and contain victims of a BT event as appropriate.
- PROVIDE public health support as needed for victims and responders within the jurisdiction’s response plan.
- USE proper safety and personal protection procedures and equipment.
- APPLY appropriate techniques for preserving possible evidence at an incident site or medical facility.
- USE established communication systems for coordination among the response community during a BT event.
- RECOGNIZE and TREAT the psychological impact of a BT event on victims and health care professionals, as appropriate to the event.

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 2008-10-10 (tjb) Moved from HTML-based to SQL-based.

Purpose:

Scope:
Occupations in which employees apply biological, chemical, and public health principles to control, eliminate, ameliorate, and/or prevent environmental health hazards. Includes environmental researcher, environmental health specialist, food scientists, soil and plant scientist, air pollution specialist, hazardous materials specialist, toxicologist, water/waste water specialist, sanitarian, and entomologist.

Guideline:
CORE COMPETENCY 1. Describe the public heath role in emergency response in a range of emergencies that might arise. (e.g., “This department provides surveillance, investigation and public information in disease outbreaks and collaborates with other agencies in biological, environmental, and weather emergencies.”)
- MAINTAIN regular communication with partner professionals in other agencies involved in emergency response. (Includes contributing to effective community-wide response through leadership, team building, negotiation and conflict resolution.)

CORE COMPETENCY 2. Describe the chain of command in emergency response.

CORE COMPETENCY 3. Identify and locate the agency emergency response plan (or the pertinent portion of the plan).
- GENERATE a public health bioterrorism (BT) response plan for environmental health staff that is integrated with the emergency response plan for the agency by applying the following competencies:
- DEVELOP protocols for risk assessment of potential biological, chemical or radiological hazards in the community to determine roles and responsibilities of those involved in public health BT response.
- DELINEATE protocols for patient decontamination and environmental remediation, including populations with special needs.
- MAINTAIN written plans for 24/7 availability of specific staff and specialists required during a BT event.
- SPECIFY safety measures to be taken by public health responders in a BT event, including use of personal protective equipment.
- CONDUCT workforce BT preparedness programs in environmental health.
- IDENTIFY specific resources needed for BT response to critical biologic agents (Category A, B, C).

CORE COMPETENCY 4. Describe his/her functional role(s) in emergency response and demonstrate his/her role(s) in regular drills.
- IDENTIFY your functional role in the agency’s BT response plan.
- DEMONSTRATE readiness to apply professional skills to a range of emergency situations during regular drills. (e.g., Access, use and interpret surveillance data; access and use lab resources; access and use science-based investigation and risk assessment protocols; identify and use appropriate personal protective equipment.)

CORE COMPETENCY 5. Demonstrate correct use of all communication equipment used for emergency communication (phone, fax, radio, etc.).

CORE COMPETENCY 6. Describe communication role(s) in emergency response: within the agency, using established communication systems, with the media, with the general public, and personal (with family, neighbors).

CORE COMPETENCY 7. Identify limits to own knowledge, skill, and authority, and identify key system resources for referring matters that exceed these limits .

CORE COMPETENCY 8. Recognize unusual events that might indicate an emergency and describe appropriate action (e.g., communicate clearly within the chain of command.)
- PARTICIPATE in continuing education to maintain up-to-date knowledge in areas relevant to emergency response (e.g., emerging infectious diseases, hazardous materials, diagnostic tests, etc.)
- IMPLEMENT your individual BT response functional role.

CORE COMPETENCY 9. Apply creative problem solving and flexible thinking to unusual challenges within his/her functional responsibilities and evaluate effectiveness of all actions taken.
- USE the agency BT Incident Command management structure.
- USE established communication systems for coordination among the response community during a BT event.
- CONTRIBUTE to the development of accurate event-specific science-based risk communication to the public, media, health care providers and response community during a BT event.
- APPLY appropriate science-based public health measures to ensure continued population protection appropriate to the biological threat involved.

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 2008-10-10 (tjb) Moved from HTML-based to SQL-based.

Purpose:

Scope:
Occupations with responsibilities to plan, design, and implement laboratory procedures to identify and quantify agents in the environment which may be hazardous to human health, biological agents believed to be involved in the etiology of diseases in animals or humans, such as bacteria, viruses and parasites, or other physical, chemical, and biological hazards. May be involved in research and the development or production of anti-microbial agents. Includes microbiologist, chemist, toxicologist, physicist, virologist, entomologist, and non-specified laboratory professionals. Laboratory staff with less than baccalaureate level education are not included.

Guideline:
CORE COMPETENCY 1. Describe the public heath role in emergency response in a range of emergencies that might arise. (e.g., “This department provides surveillance, investigation and public information in disease outbreaks and collaborates with other agencies in biological, environmental, and weather emergencies.”)

CORE COMPETENCY 2. Describe the chain of command in emergency response.
- MAINTAIN regular communication with partner professionals in other agencies involved in emergency response. (Includes contributing to effective community-wide response through leadership, team building, negotiation, and conflict resolution.)

CORE COMPETENCY 3. Identify and locate the agency emergency response plan (or the pertinent portion of the plan).
- GENERATE a bioterrorism (BT) response plan for the public health lab that is integrated with the emergency response plan for the agency, by applying the following competencies:
- PREPARE public health personnel responding to a BT event regarding procedures of crime scene preservation, proper handling, transportation and storage of criminal evidence.
- MAINTAIN written plans for 24/7 availability of specific staff and specialists required during a BT event.
- SPECIFY safety measures to be taken by public health responders in a BT event, including use of personal protective equipment.
- CONDUCT workforce BT preparedness programs, including hospital and lab staff in the community.
- IDENTIFY specific resources needed for BT response to crucial biologic agents (Category A, B, C).
- ENSURE that laboratories within the jurisdiction or agency have BT response plans.
- IDENTIFY Level A, B and C laboratories serving the jurisdiction or agency.
- ENSURE Level A laboratories can conduct “rule-out” testing, specimen packaging and handling, and referral of suspected biological threat agents to a higher level laboratory.
- ENSURE that Level B and Level C laboratories have the capacity and proficiency to identify and confirm biological threat agents and can refer specimens to higher level laboratories for further characterization.
- MAINTAIN contact and location information for Level B and Level C laboratories in the BT Laboratory Response Network serving the agency or jurisdiction.
- MAINTAIN ongoing training to ensure specimen security, including transportation of specimens, limiting access to reference cultures, isolates, etc.
- ESTABLISH written Laboratory Response Network approved protocols.
- MAINTAIN agent identification protocols to be used in the laboratory.
- ESTABLISH written policies and procedures for rapid identification and electronic reporting of results.
- DEFINE laboratory communication plans and protocols for disseminating information to emergency response partners during a public health emergency.

CORE COMPETENCY 4. Describe his/her functional role(s) in emergency response and demonstrate his/her role(s) in regular drills.
- IDENTIFY your functional role in the agency’s BT response plan.
- DEMONSTRATE readiness to apply professional skills to a range of emergency situations during regular drills. (e.g., Access, use and interpret surveillance data; access and use lab resources; access and use science-based investigation and risk assessment protocols; identify and use appropriate personal protective equipment.)

CORE COMPETENCY 5. Demonstrate correct use of all communication equipment used for emergency communication (phone, fax, radio, etc.)

CORE COMPETENCY 6. Describe communication role(s) in emergency response: within the agency, using established communication systems, with the media, with the general public, and personal (with family, neighbors).

CORE COMPETENCY 7. Identify limits to own knowledge, skill, and authority, and identify key system resources for referring matters that exceed these limits.

CORE COMPETENCY 8. Recognize unusual events that might indicate an emergency and describe appropriate action (e.g., communicate clearly within the chain of command.)
- PARTICIPATE in continuing education to maintain up-to-date knowledge in areas relevant to emergency response (e.g., emerging infectious diseases, hazardous materials, diagnostic tests, etc.)
- IMPLEMENT your individual BT response functional role.

CORE COMPETENCY 9. Apply creative problem solving and flexible thinking to unusual challenges within his/her functional responsibilities and evaluate effectiveness of all actions taken.
- ENSURE functioning of a system for rapid rule-out testing, referral, identification, confirmation, and characterization of biological threat agents including rapid reporting of results during a BT event.
- IMPLEMENT Laboratory Response Network approved protocols.
- FOLLOW written policies and plans in performing rule-out testing and referral in a BT event.
- USE established communication systems for coordination among the response community during a BT event.

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 2008-10-10 (tjb) Moved from HTML-based to SQL-based.

Purpose:

Scope:
The staff responsible for investigating sudden or violent deaths and for providing accurate, legally defensible determinations of the causes of these deaths.

Guideline:
CORE COMPETENCY 1. Describe the public heath role in emergency response in a range of emergencies that might arise. (e.g., “This department provides surveillance, investigation and public information in disease outbreaks and collaborates with other agencies in biological, environmental, and weather emergencies.”)
- MAINTAIN regular communication with partner professionals in other agencies, including law enforcement, involved in emergency response. (Includes contributing to effective community-wide response through leadership, team building, negotiation and conflict resolution.)

CORE COMPETENCY 2. Describe the chain of command in emergency response.

CORE COMPETENCY 3. Identify and locate the agency emergency response plan (or the pertinent portion of the plan).
- GENERATE a public health bioterrorism (BT) response plan for the medical examiner’s office that is integrated with the emergency response plan for the jurisdiction and includes a surge capacity plan.
- PREPARE public health personnel responding to a BT event regarding procedures of crime scene preservation, proper handling, transportation, and storage of criminal evidence.

CORE COMPETENCY 4. Describe his/her functional role(s) in emergency response and demonstrate his/her role(s) in regular drills.
- DEMONSTRATE readiness to apply professional skills to a range of emergency situations during regular drills. (e.g., Access, use, and interpret surveillance data; access and use lab resources; access and use science-based investigation and risk assessment protocols; identify and use appropriate personal protective equipment.)

CORE COMPETENCY 5. Demonstrate correct use of all communication equipment used for emergency communication (phone, fax, radio, etc.).

CORE COMPETENCY 6. Describe communication role(s) in emergency response: within the agency, using established communication systems, with the media, with the general public, and personal (with family, neighbors).

CORE COMPETENCY 7. Identify limits to own knowledge, skill, and authority, and identify key system resources for referring matters that exceed these limits.

CORE COMPETENCY 8. Recognize unusual events that might indicate an emergency and describe appropriate action (e.g., communicate clearly within the chain of command.)
- PARTICIPATE in continuing education to maintain up-to-date knowledge in areas relevant to emergency response (e.g., emerging infectious diseases, hazardous materials, diagnostic tests, etc.)
- IDENTIFY nuclear, biological, or chemical agents from signs, clinical history, autopsy, and other evidence.
- IMPLEMENT your individual BT response functional role.

CORE COMPETENCY 9. Apply creative problem solving and flexible thinking to unusual challenges within his/her functional responsibilities and evaluate effectiveness of all actions taken.
- HANDLE human remains appropriately, addressing safety, psycho-social, and forensic needs.
- USE event-specific information and scientific principles of risk communication to develop and deliver information to the public, the media, health care providers, and the response community during a BT event.
- ENSURE ongoing support for the psychological impact of a BT or weapons of mass destruction event on the families of victims.

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 2008-10-10 (tjb) Moved from HTML-based to SQL-based.

Purpose:

Scope:
Occupations which represent public health issues to the media and public, acts as a spokesperson for public health agencies, engages in promoting public health organizations by writing or selecting publicity material and releasing it through various communications media, prepares and arranges displays, makes speeches, and performs related publicity efforts. In addition to the job titles associated with media spokesperson, this category also includes titles associated with other aspects of public relations, media and information technology.

Guideline:
CORE COMPETENCY 1. Describe the public heath role in emergency response in a range of emergencies that might arise. (e.g., “This department provides surveillance, investigation and public information in disease outbreaks and collaborates with other agencies in biological, environmental, and weather emergencies.”)
- MAINTAIN regular communication with partner professionals in other agencies involved in emergency response. (Includes contributing to effective community-wide response through leadership, team building, negotiation and conflict resolution.)

CORE COMPETENCY 2. Describe the chain of command in emergency response.

CORE COMPETENCY 3. Identify and locate the agency emergency response plan (or the pertinent portion of the plan).
- GENERATE a bioterrorism (BT) response plan for the public health public information staff that is integrated with the emergency response plan for the agency by applying the following competencies:
- ESTABLISH emergency communications roles and responsibilities for BT response.
- MAINTAIN an up-to-date directory of materials and resources on bioterrorism.
- MAINTAIN written plans for 24/7 availability of staff and specialists required during a BT event.

CORE COMPETENCY 4. Describe his/her functional role(s) in emergency response and demonstrate his/her role(s) in regular drills.
- IDENTIFY your functional role in the agency’s BT response plan.
- DEMONSTRATE readiness to apply professional skills to a range of emergency situations during regular drills (e.g., Access, use, and interpret data; access and use appropriate resources.)

CORE COMPETENCY 5. Demonstrate correct use of all communication equipment used for emergency communication (phone, fax, radio, etc.).

CORE COMPETENCY 6. Describe communication role(s) in emergency response: within the agency, using established communication systems, with the media, with the general public, and personal (with family, neighbors).

CORE COMPETENCY 7. Identify limits to own knowledge, skill, and authority, and identify key system resources for referring matters that exceed these limits.

CORE COMPETENCY 8. Recognize unusual events that might indicate an emergency and describe appropriate action (e.g., communicate clearly within the chain of command.)
- PARTICIPATE in continuing education to maintain up-to-date knowledge in areas relevant to emergency response (e.g., emerging infectious diseases, hazardous materials, diagnostic tests, etc.)
- IMPLEMENT your individual BT response functional role.

CORE COMPETENCY 9. Apply creative problem solving and flexible thinking to unusual challenges within his/her functional responsibilities and evaluate effectiveness of all actions taken.
- USE the agency BT Incident Command management structure.
- COMMUNICATE decontamination and triage information on a specific BT event to partners in the response, as directed by PH Official or PH Incident Commander.
- COMMUNICATE the need for assistance during a BT event to appropriate resources as directed by PH Official or PH Incident Commander.
- DESIGNATE, or serve as, a media spokesperson during a BT event, as directed by PH Official or PH Incident Commander.
- USE established communication systems for coordination among the response community during a BT event, as directed by PH Official or PH Incident Commander.
- COORDINATE the development and delivery of event-specific information based on scientific principles of risk communication to inform the public, the media, health care providers, and members of the response community during a BT event.
- INITIATE appropriate and coordinated communication with the public, the media, and health care providers, and the response community during an incident.
- MAINTAIN the delivery of appropriate and accurate information to the public, the media, health care providers and the response community as required by the specific event.

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 2008-10-10 (tjb) Moved from HTML-based to SQL-based.

Purpose:

Scope:
Professional occupations not described above, such as health educators, legal professionals, financial officers, and others.

Guideline:
CORE COMPETENCY 1. Describe the public heath role in emergency response in a range of emergencies that might arise. (e.g., “This department provides surveillance, investigation and public information in disease outbreaks and collaborates with other agencies in biological, environmental, and weather emergencies.”)
- MAINTAIN regular communication with partner professionals in other agencies involved in emergency response. (Includes contributing to effective community-wide response through leadership, team building, negotiation, and conflict resolution.)

CORE COMPETENCY 2. Describe the chain of command in emergency response.

CORE COMPETENCY 3. Identify and locate the agency emergency response plan (or the pertinent portion of the plan).

CORE COMPETENCY 4. Describe his/her functional role(s) in emergency response and demonstrate his/her role(s) in regular drills.
- IDENTIFY your functional role in the agency’s BT response plan.
- DEMONSTRATE readiness to apply professional skills to a range of emergency situations during regular drills. (e.g., Access, use, and interpret data; access and use appropriate resources.)

CORE COMPETENCY 5. Demonstrate correct use of all communication equipment used for emergency communication (phone, fax, radio, etc.).

CORE COMPETENCY 6. Describe communication role(s) in emergency response: within the agency, using established communication systems, with the media, with the general public, and personal (with family, neighbors).

CORE COMPETENCY 7. Identify limits to own knowledge, skill, and authority, and identify key system resources for referring matters that exceed these limits.

CORE COMPETENCY 8. Recognize unusual events that might indicate an emergency and describe appropriate action (e.g., communicate clearly within the chain of command).
- PARTICIPATE in continuing education to maintain up-to-date knowledge in areas relevant to emergency response (e.g., emerging infectious diseases, hazardous materials, diagnostic tests, etc.).
- IMPLEMENT your individual BT response functional role.

CORE COMPETENCY 9. Apply creative problem solving and flexible thinking to unusual challenges within his/her functional responsibilities and evaluate effectiveness of all actions taken.

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 2008-10-10 (tjb) Moved from HTML-based to SQL-based.

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Technical occupations involve non-routine work and typically are associated with a professional field such as in the laboratory or clinical area, and involve extensive on-the-job experience. Support occupations involve structured work performed according to established policies, including laboratory support, clerical staff, and computer entry staff.

Guideline:
CORE COMPETENCY 1. Describe the public heath role in emergency response in a range of emergencies that might arise. (e.g., This department provides surveillance, investigation and public information in disease outbreaks and collaborates with other agencies in biological, environmental, and weather emergencies.”)

CORE COMPETENCY 2. Describe the chain of command in emergency response.

CORE COMPETENCY 3. Identify and locate the agency emergency response plan (or the pertinent portion of plan).

CORE COMPETENCY 4. Describe his/her functional role(s) in emergency response and demonstrate his/her role(s) in regular drills.
- IDENTIFY your individual functional role in the agency’s BT response plan.
- DEMONSTRATE the use of equipment (including personal protective equipment) and skills associated with his/her functional role in emergency response during regular drills.
- DESCRIBE at least one resource for backup/support in key areas of responsibility.

CORE COMPETENCY 5. Demonstrate correct use of all communication equipment used for emergency communication (phone, fax, radio, etc.).

CORE COMPETENCY 6. Describe communication role(s) in emergency response: within the agency, using established communication systems, with the media, with the general public, and personal (with family, neighbors).

CORE COMPETENCY 7. Identify limits to own knowledge, skill, and authority, and identify key system resources for referring matters that exceed these limits.

CORE COMPETENCY 8. Recognize unusual events that might indicate an emergency and describe appropriate action (e.g., communicate clearly within the chain of command.)
- IMPLEMENT your individual BT response functional role.

CORE COMPETENCY 9. Apply creative problem solving and flexible thinking to unusual challenges within his/her functional responsibilities and evaluate effectiveness of all actions taken.

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 1.5

Version history: 2008-06-30 (tjb) Moved from html-based to sql-based.
2009-09-03 (tjb) Added H1N1 specific language requested by DHSS.

Purpose:
Provide medication to the general public.

Scope:
Applied to all personnel involved in mass prophylaxis.

Guideline:
Planning for Mass Medication Dispensing is being done for three different scenarios with two types of medication. The scenarios are RING, ASSISTED, and INDEPENDENT. For each scenario, both types of medication (SELF-ADMINISTERED and ADMINISTERED) is also being planned for.

SCENARIOS:
- In the RING scenario, the outbreak has originated in the county with small number being infected. To contain the disease, assistance from outside the county can be relied on to assist opening private dispensing sites to vaccinate and/or treat those infected and their contacts.
- In the ASSISTED scenario, the outbreak has affected most of the residents of an area of the county. To contain the disease, assistance from outside the county can be relied on to assist opening public dispensing sites to vaccinate and/or treat the general population in that area.
- In the INDEPENDENT scenario, the outbreak has reached epidemic or pandemic proportions. To contain the disease, assistance from outside the county CANNOT be relied on to assist opening public dispensing sites to vaccinate and/or treat the general population of the county.

TYPES OF MEDICATION ADMINISTRATION:
- Examples of SELF-ADMINISTERED medication planned for include tablet, inhalation, suspension, etc.
- Examples of ADMINISTERED medication planned for include injection, smallpox vaccination, etc.

----H1N1 Vaccine Distribution----
Polk County Health Center will distribute H1N1 vaccine to their community by the following methods:

1. Polk County Health Center will conduct public vaccination clinics at the Polk County Health Center according to the process described in this plan.

2. Polk County Health Center will NOT make arrangements for direct shipment through the centralized distribution system to private providers.

3. The Polk County Health Center will receive the vaccine at one designated site in Polk County and will be responsible for providing further distribution to local providers in the community. Polk County Health Center will disseminate the vaccine to private providers according to DHSS/CDC guidance. Polk County Health Center will assure that all private providers receiving vaccine will sign the Provider Agreement supplied by DHSS.

Exceptions:
None

References:
Boss, Jon. LPHA Vax Distribution Statement. 2 September 2009.

Critical section? No

Security level: Unclassified

Version: 2.5

Version history: 2008-06-30 (tjb) Moved from pdf to sql-based.

2008-09-04 (tjb) Re-attached PDF.

2009-03-23 (tjb) Created links to PDF within online version but will display link text when printed.

Purpose:

Scope:

Guideline:
For the form for an actual event, see http://www.polkcountyhealth.net/emergency/plan/household-actual.pdf

For the form for an exercise, see http://www.polkcountyhealth.net/emergency/plan/household-exercise.pdf

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

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Bolivar R-I School District
- Not signed
- Use of facilities

Bolivar Technical College
- Not signed
- Resource sharing and use of students

Cedar County Health Department
- Signed 1/25/04
- Resource sharing and material transportation

Citizen's Memorial Healthcare Foundation
- Not signed
- Use of facilities, medication/vaccine storage, resource sharing, electronic medical records

Dade County Health Department
- Not signed
- Resource sharing

Dallas County Health Department
- Not signed
- Resource sharing

Fair Play R-II School District
- Signed 5/21/03
- Use of facilities

First Assembly of God Church
- Not signed
- Use of facilities

Halfway R-III School District
- Signed 5/23/03
- Use of facilities

Hickory County Health Department
- Signed 6/17/03
- Resource sharing and material transportation

Humansville R-IV School District
- Not signed
- Use of facilities

Marion C Early R-V School District
- Signed 1/9/03
- Use of facilities

Pleasant Hope R-VI School District
- Not signed
- Use of facilities

Polk County Sheriff's Department
- Not signed
- Resource sharing and material security

Southwest Baptist University
- Not signed
- Resource sharing and use of facilities

Springfield-Greene County Health Center
- Not signed
- Resource sharing

St Clair County Health Center
- Signed 7/11/03
- Resource sharing and material transportation

Exceptions:
None

References:
None

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 2008-09-04 (tjb) Moved from image file to SQL-based.

Purpose:
WHEREAS, the effects of disasters are frequently of such magnitude that outside support and assistance is required to alleviate suffering and
WHEREAS, the listed agencies desire to cooperate in rendering aid in the event of a disaster.

Scope:
THEREFORE, in consideration of mutual benefits to be derived, it is agreed that the listed agencies will cooperate in providing mutual aid in the event of a disaster as deemed necessary by administrators of both agencies.

Guideline:
THIS AGREEMENT, made and entered into this 25th day of January, 2004, by and between Polk County Health Center and Cedar County Health Department.

SIGNED:
Michelle Morris, Administrator, Polk County Health Center
Jackie Boyles, Administrator, Cedar County Health Department

Exceptions:

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Critical section? No

Security level: Unclassified

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Version history: 2008-09-04 (tjb) Moved from image-based to SQL-based.

Purpose:
WHEREAS, the effects of disasters are frequently of such magnitude that outside support and assistance is required to alleviate suffering and
WHEREAS, the listed agencies desire to cooperate in rendering aid in the event of a disaster.

Scope:
THEREFORE, in consideration of mutual benefits to be derived, it is agreed that the listed agencies will cooperate in providing mutual aid in the event of a disaster as deemed necessary by administrators of both agencies.

Guideline:
THIS AGREEMENT, made and entered into this 17th day of June, 2003, by and between Polk County Health Center and Hickory County Health Department.

SIGNED
Michelle Morris, Administrator, Polk County Health Center
Alisa Carter, Administrator, Hickory County Health Department

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Critical section? No

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Version history: 7/1/08 moved from html-based to sql-based.

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AAA - Area Agencies on Aging. AAAs in communities across the country plan, coordinate, and offer services that help older adults remain in their homes - if that is their preference - aided by services such as Meals-on-Wheels, homemaker assistance, and whatever else it may take to make independent living a viable option. http://www.swmoa.com/

AAR - American Association of Railroads is a subdivision of the Department of Transportation. AAR members include the major freight railroads in the United States, Canada, and Mexico, as well as Amtrak. Based in Washington, DC, the AAR is committed to keeping the railroads of North America safe, fast, efficient, clean, and technologically advanced. http://www.aar.org/

Abatement - The actions taken to reduce the amount, degree of the hazard, or intensity of the release or threatened release of a hazardous material.

Absorbent - A sold material that takes in liquids (like a sponge). Penetration can be capillary, osmotic, solvent, or chemical. Some of the materials typically used as absorbents are sawdust, clays, charcoal, and polyolefin types of fibers.

Absorption - The process of an agent being taken in by a surface (clothing, fabrics, wood, etc.) much like a sponge and water. A route of exposure. It occurs when a toxic material contacts the skin and then enters the bloodstream by passing through the skin.

Acceptable Risk - A risk judged to be outweighed by corresponding benefits, or one that is of such a degree that it is considered to pose minimal potential for adverse effects.

Access Corridor - A designated geographic area through which entrance into the “hot” or exclusion zone is permitted by mitigation personnel. Typically, the access corridor serves as, or is near, the decontamination corridor and borders the hot and warm zones.

Acetylcholine - A chemical compound formed from an acid and an alcohol which causes muscles to contract (neurotransmitter). It is found in various organs and tissues of the body. It is rapidly broken down by the enzyme cholinesterase (acetylcholinesterase).

Acetylcholinesterase - An enzyme (a protein produced in the cells) which stops (inactivates) the action of acetylcholine by separating the acetylcholine into its components of acetic and choline. This occurs as soon as acetylcholine has produced a muscle contraction. Nerve agents combine with acetylcholinesterase to prevent it from performing its inactivation of acetylcholine.

ACFD - Appleton City Fire Department.

Active Immunization - The act of artificially stimulating the body to develop antibodies against infectious disease by the administration of vaccines or toxoids.

Acute - Severe but of short duration.

Acute Care Center - A system that is designed, organized, equipped, and staffed specifically to provide inpatient medical services to treat patients who need inpatient treatment but do not require mechanical ventilation and those who are likely to die from an illness resulting from an agent of bioterrorism. The ACC should be an extension of a nearby medical facility (hospital) and transparent to the public.

Acute Effects - An adverse effect on a human or animal body, with symptoms developing rapidly. See Chronic Effects.

Acute Exposure - The adverse effects resulting from a single dose or exposure to a material. Ordinarily used to denote effects observed in experimental animals.

Acute Toxicity - Any harmful effect produced by a single short-term exposure that may result in severe biological harm or death.

Adenopathy - Swelling or morbid enlargement of lymph nodes.

Administer - The act of administering medication involves giving the client a single dose of prescribed medication. All personnel who are licensed to do so may administer medications.

Administrator - The person in charge of an institution, such as the chief executive officer, chairperson of the board, administrator, clinician in charge, or any equivalent position. (19 CSR 20-20.010)

ADS - Area Distribution Site for the SNS (state responsibility).

Adsorbent - A solid material that is capable of binding or “holding” gaseous or liquid materials by a specific chemical interaction. Adsorbents have had their surfaces “activated” in order to be capable of this type of interaction. Adsorptions are accompanied by evolution of heat and causes no swelling of the adsorbent material.

Adsorption - The process of an agent sticking to or becoming chemically attached to a surface.

Aerosol - Fine liquid or solid particles suspended in air; for example, fog or smoke. The dispersion of very fine particles of a solid or liquid in a gas, fog, foam, or mist.

AG - Attorney General or Adjutant General. The AG's Office aggressively prosecutes those who break criminal, environmental, and consumer protection laws and defends the state against legal actions. Missouri’s AG is Jeremiah W. (Jay) Nixon. 
http://www.ago.state.mo.us/

Agape Boarding School - The Agape Boys Ranch is a Private POD in Stockton, Cedar County.

Agency Representative - Individual assigned to an incident from an assisting or cooperating agency who has been delegated full authority to make decisions on all matters affecting that agency’s participation at the incident. Agency Representatives report to the Incident Liaison Officer.

Agent Dosage - The concentration of a toxic vapor in the air multiplied by the time that the concentration is present.

Air Purification Respirator - A device worn to filter particulates and contaminants from the air. An APR should only be worn in atmospheres where the type, size, and quantity of the contaminants are known and sufficient oxygen is present. 

Airbill - The name for the shipping paper on aircraft. The airbill is kept in the pilot’s possession and contains information about the quantity and weight of each hazardous package, the proper shipping name, and hazard class of the materials being transported. The shipping paper will also contain information about the shipper and consignee of the shipment. 

Aircraft Emergencies
- Alert 1 - In-bound aircraft with possible onboard dilemma. Emergency response forces maintain readiness at response station for further development.
- Alert 2 - In-bound aircraft with confirmed onboard dilemma. Emergency response forces respond to predetermined standby position(s) as defined by the nature of the in-flight urgency.
- Alert 3 - Aircraft crisis in progress. Emergency response forces proceed to incident site as defined by emergency protocols.
- Alert4/5 - Levels used by certain airports to identify additional levels of response tactics, such as bomb threats, hijacking, hostage crisis, etc.

Alcohol Foam - A type of foam developed to suppress ignitable vapors on polar solvents (those miscible in water). Examples of polar flammable liquids are alcohols and ketones.

Alcohol Resistant Foam - A foam that is resistant to “polar” chemicals such as ketones and esters which may break down other types of foam.

Alpha Particle - A positively charged particle of matter consisting of two protons and two neutrons (such as a helium-4 nucleus). The alpha particle has a marginal ability to penetrate other materials but a strong ability to ionize materials. Alpha particles are not an eternal radiation hazard but alpha-emitting nuclides inside the body as a result of inhalation or ingestion are a considerable internal radiation hazard.

Alpha Radiation - The least penetrating type of nuclear radiation; not considered dangerous unless alpha-contaminated or source emitter particles enter the body.

AMEDD - The U.S. Army Medical Department includes the Army's fixed hospitals and dental facilities; preventive health, medical research, development, and training institutions; and a veterinary command that provides food inspection and animal care services for the entire Department of Defense.
http://www.armymedicine.army.mil/

Alternative Care Site - Location for the delivery of medical care that occurs outside the acute hospital setting for patients who, under normal circumstances, would be treated as inpatients.  It may be a site to provide event-specific management of unique considerations that might arise in the context of a catastrophic mass casualty event, including the delivery of chronic care; the distribution of vaccines or medical countermeasures; or the quarantine, cohorting, or sequestration of potentially infected patients in the context of an easily transmissible infectious disease.
Types of Alternative Care Sites include:
- Neighborhood Emergency Health Center (NEHC)
- Acute Care Center (ACC)
- Special Needs Shelter
- Mass Care Shelters

Aluminum Alloy - A physical blend of metals with aluminum as the major constituent. Aluminum is a common material used for containerizing materials for transport because of its lightweight property.

Ambulatory - A patient capable of walking; one who is not bedridden.

Analysis - The chemical determination of the composition of a substance.

Anaphylaxis - The term used to denote the immediate, transient kind of immunologic (allergic) reaction characterized by the contraction of smooth muscle and dilation of capillaries due to the release of pharmacologically active substances.

ANFO - Ammonia Nitrate Fuel Oil - A blasting agent. An ammonium nitrate and fuel oil mixture commonly used as a blasting agent. 

Anhydrous - Being without water, especially water of crystallization.

ANSI - American National Standards Institute. The American National Standards Institute (ANSI) is a private, non-profit organization (501(c)3) that administers and coordinates the U.S. voluntary standardization and conformity assessment system.
http://www.ansi.org/

Anthrax - A disease of animals. The main sources of human infection are cattle and sheep. The organism that causes anthrax is Bacillus anthracis. Anthrax is a highly lethal infection caused by infection with the Gram-positive bacterium, Bacillus Anthracis. In naturally-acquired cases, organisms usually gain entrance through skin wounds (causing a localized infection), but may be inhaled or ingested. Intentional release by belligerents or terrorist groups would presumably involve the aerosol route, as the spore form of the bacillus is quite stable and possesses characteristics ideal for the generation of aerosols. 

Antibiotic - A substance that inhibits the growth of or kills microorganisms.

Anticholinergic - An agent or chemical that blocks or impedes the action of acetylcholine, such as the (also cholinolytic) antidote atropine.

Anticholinesterase - A substance which blocks the action of cholinesterase (acetylcholinesterase), such as nerve agents.

Anticonvulsant - An agent that prevents or arrests seizures.

Antidote - A substance which neutralizes toxic agents or their effects.

Antisera - The liquid part of blood containing antibodies.

Antitoxin - An antibody formed in response to and capable of neutralizing a biological poison; an animal serum containing antitoxins.

AOA - Air Operations Area is a location identified by the Federal Aviation Administration specifically for air transportation rules and enforcement. A safety fence and high levels of security often identify this region.

Appleton City R-II School - The Appleton City High School is a Public POD in Appleton City, St Clair County.

Approach Suit - Personal protective equipment used with SCBA which allows response personnel to operate in high-temperature atmospheres for short periods of time. NOTE: Direct flame impingement is not permitted when using this garment.

ARC - American Red Cross.
http://www.redcross.org/

ARDS - Adult Respiratory Distress Syndrome is a syndrome with the following simultaneous characteristics:
- Hypoxia due to intrapulmonary shunting of blood;
- Increased lung stiffness; and
- Chest x-ray evidencing diffuse infiltration. (19 CSR 20-20.010)

AREP - Aeromedical Regional Evacuation Point.

ARM - Aerial Radiological Monitoring supplements ground monitoring for detection of radiation following a nuclear attack.

Armaments - War equipment and supplies, such as guns, shells, bombs, electronic detection devices, missiles, and all other offensive and defensive equipment of a fort, ship, airplane, quick response vehicle, or the like, are armaments.

Arsenical - Pertaining to or containing arsenic; a reference to the vesicant Lewisite.

Arsine - A colorless, flammable, extremely poisonous gas with an odor like garlic. One of the blood agents.

Arthralgia - Severe pain in a joint, especially one not inflammatory in nature.

ASME - American Society of Mechanical Engineers makes recommendations on designs and materials to be used for handling hazardous materials. 
http://www.asme.org/

Asphyxia - Lack of oxygen and interference with oxygenation of the blood. Can lead to unconsciousness.

Asphyxiants - Substances that interfere with oxygen flow during normal breathing. There are two types of asphyxiants: simple and systemic. A vapor or gas that can cause unconsciousness or death by suffocation (lack of oxygen). Most simple asphyxiants are harmful to the body when they become so concentrated that they reduce (displace) the available oxygen in air (normally about 21%) to dangerous levels (18% or lower). Chemical asphyxiants, like carbon monoxide (CO), reduce the blood’s ability to carry oxygen or, like cyanide, interfere with the body’s utilization of oxygen.

Asphyxiation - Asphyxia or suffocation. Asphyxiation is one of the principal potential hazards of working in confined spaces. 

Assessment - The act of estimating the merit of a mitigation procedure. This evaluation should weigh the risk versus the overall objective of the incident. A proper assessment will consider hazards associated with each phase of operation. 

Assigned Resources - Resources checked in and available for assignment.

ASTM - American Society for Testing and Materials, an organization that devises consensus standards for materials’ characterization and use.
http://www.astm.org/

Ataxia - An inability to coordinate muscle activity during voluntary movement so that smooth movements occur. Most often due to disorders of the cerebellum or the posterior columns of the spinal cord; may involve the limbs, head, or trunk.

ATF - The Bureau of Alcohol, Tobacco, Firearms, and Explosives (ATF) is a law enforcement agency within the U.S. Department of Justice. Its unique responsibilities include protecting the public and reducing violent crime. ATF enforces the Federal laws and regulations relating to alcohol and tobacco diversion, firearms, explosives, and arson.
http://www.atf.treas.gov/

Atmospheric Container - A type of container that holds products at atmospheric pressure (760mm).

Atomization - The process of changing a liquid into a spray of very small drops. This physical action fragmentizes the liquid into atoms (the smallest possible particles).

Atropine - An anticholinergic used as an antidote for nerve agents to counteract excessive amounts of acetylcholine. It also has other medical uses.

ATSDR - Agency for Toxic Substances and Disease Registry. ATSDR is directed by congressional mandate to perform specific functions concerning the effect on public health of hazardous substances in the environment. These functions include public health assessments of waste sites, health consultations concerning specific hazardous substances, health surveillance and registries, response to emergency releases of hazardous substances, applied research in support of public health assessments, information development and dissemination, and education and training concerning hazardous substances.
http://www.atsdr.cdc.gov/

Austentic Stainless Steel - A stainless steel alloy consisting of chromium and nickel, thus giving more resistance to chemical corrosion.  

Exceptions:

References:

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 2008-09-04 (tjb) moved from HTML-based to SQL-based.

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Bacillus Anthracis - The causative organism of anthrax.

Bacteremia - The presence of bacteria in the blood.

Bacteria - Single-celled organisms that multiply by cell division and that can cause disease in humans, plants, or animals. Bacteria are small free-living organisms, most of which may be grown on solid or liquid culture media. The organisms have a structure consisting of nuclear material, cytoplasm, and cell membrane. They reproduce by simple division. The diseases they produce often respond to specific therapy with antibiotics. 

Baffle - A wall or screen for controlling the flow of air, water, etc., by hindering its movement or changing its course.

Barge - A large non-self-propelled (usually towed), flat-bottomed vessel used for carrying materials on waterways. 

Bartle Scout Reservation - The Bartle Scout Reservation is a Private POD in St Clair County. The H. Roe Bartle Scout Reservation, located in Osceola, Missouri, is home to over 6,600 Boy Scouts and 3,000 leaders each summer. The 4,200 acre reservation consists of three camps Lone Star, Sawmill, and Piercing Arrow and the Osage Wilderness Trail. The H. Roe Bartle Scout Reservation has been a summer home to Scouting and it’s honor camping program the Tribe of Mic-O-Say since 1929.
http://www.hoac-bsa.org/Camping/Bartle.html

Base - Location at which the primary logistics functions are coordinated and administered. The Incident Command Post may be located with the Base. There is only one Base per incident. 

Base Metal - Any of the metals on the lower end of the electrochemical series. Examples are aluminum and magnesium. 

BCFD - Bolivar City Fire Department.
http://www.equipmentintensive.com/bcfd.htm

BDO - Battle Dress Overgarment; multi-piece suit used by the military for protection against chemical warfare agents (also known as MOPP).

Belly Valve - Any type of tank valving located on the bottom of the tank.

BERT - Bioterrorism Emergency Response Team.

Beta Particles - High energy electrons emitted from the nucleus of an atom during radioactive decay. They normally can be stopped by the skin or a very thin sheet of metal.

Beta Radiation - A type of nuclear radiation that is more penetrating than alpha radiation and can damage skin tissue and harm internal organs.

Bill of Lading - A shipping paper for transportation by highway. This paper is typically the bill of sale and can give very valuable information about the exact weights and contents of containers, the shipper, and consignee of the shipments.

Binary Device - A chemical device divided into two sections, each containing precursor chemicals that combine and react to release a chemical agent.

Bioaccumulation - Absorption and storage of toxic chemicals from the environment in an organism, usually in body fat.

Biochemicals - The chemicals that make up or are produced by living things.

Biodegradation - The process of decomposing a substance by bacterial action.

Biohazard - Those organisms that have pathogenic effect on life and the environment and exist in normal ambient environments. These hazards can represent themselves as disease, germs, and viruses. A biological agent or condition that constitutes a hazard to humans or the environment.

Biological Agents - Pathogens (bacteria, viruses, or fungi) and toxins that have the potential to be exploited for warfare or terrorism. Bacterial - Anthrax, Brucellosis, E Coli, Plague, Q Fever, Tularemia. Toxins - Botulism, Mycotoxins, Ricin, Staph. Viral - Encephalitis, Smallpox, Viral Hemorrhagic Fevers. Living organisms that cause disease, sickness, and mortality in humans. Anthrax and Ebola are examples of biological agents. Refer to Guide 158 of the ERG. 
Any microorganism, virus, or infectious substance capable of:
1) Causing deleterious changes in the environment;
2) Damaging food, water, or equipment supplies; or
3) Causing diseases in humans, animals, plants, or other living organisms.

Biological Warfare - (See BW.)

Biological Warfare Agents - Living organisms or the materials derived from them that cause disease in or harm humans, animals, or plants, or cause deterioration of material. Biological agents may be used as liquid droplets, aerosols, or dry powders.

Biological Waste - Includes blood and blood products, excretions, exudates, secretions, suctioning, and other body fluids and waste materials saturated with blood or body fluids.

Bioregulators - Biochemicals that regulate bodily functions. Bioregulators that are produced by the body are termed "endogenous." Some of these same bioregulators can be chemically synthesized.

Bioterrorism - Intentional use of any microorganism, virus, infectious substance, etc. to cause death or disease in a human, animal, or plant in order to influence government or intimidate the population.

Blasting Agent - A material designed for blasting. It must be so insensitive that there is very little probability of accidental explosion or going from burning to detonation.

BLEVE - Boiling Liquid Expanding Vapor Explosion, an explosion associated with the sudden failure of a container whose contents are flammable liquefied compressed gas. An expanding vapor cloud is produced which can be ignited, causing a massive explosion and fireball.

Blister Agent - A chemical warfare agent which produces local irritation and damage to the skin (vesicant) and mucous membranes, pain and injury to the eyes, reddening and blistering of the skin, and when inhaled, damage to the respiratory tract. Substances that cause blistering of the skin. Exposure is through liquid or vapor contact with any exposed tissue (eyes, skin, lungs). Mustard (H), Distilled Mustard (HD), Nitrogen Mustard (HN) and Lewisite (L) are blister agents. 
Symptoms: Red eyes, skin irritation, burning of skin, blisters, upper respiratory damage, cough, hoarseness.

Blood Agar - A mixture of blood and nutrient agar, used for the cultivation of many medically important organisms.

Blood Agent - A chemical warfare agent which is inhaled and absorbed into the blood. The blood (cyanogen) carries the agent to all body tissues where it interferes with the tissue oxygenation process. Substances that injure a person by interfering with cell respiration (the exchange of oxygen and carbon dioxide between blood and tissues). Hydrogen cyanide (AC) and Cyanogen chloride (CK) are blood agents. 
Symptoms: Respiratory distress, headache, unresponsiveness, seizures, coma.

Blood Asphyxiant - A chemical that is absorbed by the blood and changes or prevents the blood from flowing or carrying oxygen to cells. And example is carbon monoxide poisoning. 

BNICE - Biological, Nuclear, Incendiary (or Infectious), Chemical, Explosive.

Boiler - A steam-generating unit used aboard a ship to provide steam for propulsion. A boiler is also used for heating as well as other auxiliary purposes. 

Boiling Point - The temperature at which the transition from the liquid to the gaseous phase occurs. At this temperature, vapor pressure of a liquid now equals the surrounding atmospheric pressure so that the liquid rapidly becomes a vapor. Flammable materials with low BPs generally present special fire.

Bolivar R-I High School - The Bolivar High School is a Regional Node and Public POD in Bolivar, Polk County.
http://www.bolivar.k12.mo.us/bhs/bhsjour/index.html

Bolivar R-I Middle School - The Bolivar Middle School is a Public POD in Bolivar, Polk County.
http://www.bolivar.k12.mo.us/bms/

Bonnet - A cover or cap to cover the openings in valve assemblies.

Booby Trap - A bomb or chemical arrangement designed to explode or react when an object is pushed, moved, or grasped. Booby traps are commonly found in clandestine drug labs to eliminate evidence of illicit activity. 

Boom - 1) To confine, extend, move, or manipulate (by means of logs or the like) a body of water.
2) A long spar projecting from a ship used variously to extend the foot of a sail or facilitate handling of cargo or mooring.
3) The horizontal part of a crane. 

Booming - The process of containing a spilled material on waterways, especially those that float on the surface of water, such as oil.

Bottom Loading - A method of placing materials into a tank from the bottom. Usually accomplished by use of a belly valve. 

Botulism - A highly toxic form of food poisoning. If untreated, the whole body becomes paralyzed, which leads to death by suffocation within a few days.  Botulinum toxins are a group of seven related neurotoxins (types A-G) produced by the anaerobic bacterium. They are typically formed in canned foods and subsequently ingested, although the spore form of the organism may occasionally gain access to the body through wounds or through the GI tract before germinating and producing toxin. Intentional release by belligerents or terrorists would likely involve aerosolization of pre-formed toxins, which could then produce disease via the inhalational route. Deliberate contamination of food supplies is also possible. Botulinum toxins act by blocking acetylcholine release at the neuromuscular junction and in the central and peripheral nervous systems. In the face of large numbers of casualties and/or in the absence of prompt, intensive, and long-term medical management, botulism can be thought of as a lethal agent.

BPD - Bolivar Police Department.

Branch - That organizational level having functional/geographic responsibility for major segments of incident operations. The Branch level between Section and Division/Group. 

Breach - The physical action of breaking or damaging a container. 

Break-Through Time - Refers to permeation testing of chemical-resistant suit materials (from one side to the other). “Break-through” will vary over time with the exposure to different chemicals and suit materials.

Breather Vent - A small vent in an otherwise airtight enclosure for maintaining equality of pressure within and without. Examples are oil tanks, transformers, crankcases, or instrument cases. 

Bronchitis - Inflammation of the mucous membrane of the bronchial tubes.

Brucella - A genus of encapsulated, non-motile bacteria (family Brucellaceae) containing short, rod-shaped to coccoid, gram-negative cells. These organisms are parasitic, invading all animal tissues and causing infection of the genital organs, the mammary glands, and the respiratory and intestinal tracts, and are pathologic for man and various species of domestic animals.

Brucellosis - Human Brucellosis is an infection caused by one of four species of gram-negative coccobacilli of the genus Brucella B Abortus and is normally a pathogen of cattle, while B are pathogens of goats, pigs, and dogs, respectively. Organisms are acquired by humans via the oral route, or via inoculation of skin lesions in persons with close animal contact. Intentional exposure by belligerents would likely involve aerosolization but could involve contamination of foodstuffs. 

BT - Biological Terrorism. (See Bioterrorism.)

Bubo - Inflammatory swelling of one or more lymph nodes, usually in the groin; the confluent mass of nodes usually suppurates and drains pus.

Buddy System - A system of organizing employees into work groups in such a manner that each employee of the work group is designated to be observed by at least one other employee in the work group.

Bulk Facility - A location or plant which stores or manufactures large quantities of chemicals (such as fuels).

Bulkhead - A name given to any vertical partition which separates different compartments or spaces from one another, such as on a ship or in a tank.

Bulk Tank - A storage container which holds large quantities of product, usually in excess of 2,000 gallons.

Bung - A stopper or cap to close the side or top of a drum or barrel.

Burn - Refers to either a chemical or thermal burn, the former may be caused by corrosive substances and the latter by liquefied cryogenic gases, hot molten substances, or flames.

Burn Degree
- 1st Degree- The mildest type of burn, limited to the most superficial layers of skin and characterized by redness and pain. Sunburn is and example.
- 2nd Degree- A penetration of the skin causing damage to both the epidermis and the underlying dermis. A second degree burn looks mottled or red, swollen, and somewhat wet. These burns are characterized by blister formation. An example is contact with boiling liquids.
- 3rd Degree- Also called full-thickness burns because they involve damage or destruction of the full thickness of the skin, from the epidermis down to the subcutaneous fat and sometimes underlying muscle as well. The skin appears charred, leathery, or pearly gray. Third degree burns are insensitive to painful stimuli because of destruction of the nerve endings for pain in the dermis.
- 4th Degree- A burn similar to the characteristics of the third-degree burn. However, when the muscle or bone is involved, the burn is sometimes categorized as fourth-, fifth-, or sixth-degree.

Butyl Rubber - A material commonly used in the manufacture of chemical protective clothing.

BW - Biological Warfare. The use, for military or terrorist purposes, of biological agents to cause death or incapacitation in humans, animals, or plants. The intentional use of biological agents as weapons to kill or injure humans, animals, or plants, or to damage equipment.

Exceptions:

References:

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 2008-09-04 (tjb) Moved from HTML-based to SQL-based.

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Guideline:
CAM - Chemical Agent Meter/Monitor.

CAMEO - Computer-Aided Management of Emergency Operations, a computer database storage-retrieval system of preplanning data for on-scene use at hazardous materials incidents.
http://www.epa.gov/ceppo/cameo/

CAP - Civil Air Patrol is a volunteer civilian Air Force group responsible for search and rescue, aerial radiological monitoring, and other activities as requested by the state.
http://www.capnhq.gov/

Carboy - A container, usually encased in a protective basket or crate, to ship hazardous materials, particularly corrosives. 

Carcinogen - Material that either causes cancer in humans, or because it causes cancer in animals, is considered capable of causing cancer in humans.

Carcinogenic - A material tending to cause cancer in animals or humans.

Cargo Plan - A plan giving the quantities and description of the various materials carried in the ship’s cargo tanks after the loading is completed.

Carrier - A person who harbors a specific infectious agent in the absence of discernible clinical disease and serves as a potential source or reservoir of infection for man. (19 CSR 20-20.010)

Cartridge Respirator - A respirator using various chemical substances to purify inhaled air of certain contaminative gases and vapors. 

CAS - Chemical Abstracts Service, an organization that indexes information and guides about particular substances. Assigned CAS numbers identify specific chemicals. 
http://www.cas.org/

Case - A person in whose tissues the etiologic agent of a communicable disease is present and which usually produces signs or symptoms of disease. Evidence of the presence of a communicable disease also may be revealed by routine laboratory findings. (19 CSR 20-20.010)

Casing - A covering put around something; a case. A steel pipe lining an oil well.

Catalyst - A material which alters the energy necessary to produce a chemical reaction. If the energy is lowered, the reaction proceeds more quickly (the typical use for a catalyst). If the energy necessary is increased, the reaction is slowed. The catalyst is not consumed by the chemical reaction.

Cathodic Protection - A chemical process used to reduce corrosion on metal and metal alloy containers. Techniques such as wrapping in plastic, painting the surface, or placing a sacrificial anode (such as magnesium) to protect underground pipes and storage tanks against electrolysis or deterioration are examples.

Causative Agent - The organism or toxin that is responsible for causing a specific disease or harmful effect.

Caustic - Burning or corrosive. A hydroxide of a light metal. Broadly, any compound having highly basic properties.

CBDCOM - Chemical and Biological Defense Command.

CBIAC - Chemical and Biological Defense Information Analysis Center. The CBIAC serves as the focal point for DOD Chemical and Biological Defense (CBD) scientific and technical information.
http://www.cbiac.apgea.army.mil/

CBIRF - Chemical/Biological Incident Response Force. The USMC's Command Planning Guidance (CPG) called for the development of a strategic organization -- manned, trained, and equipped -- to manage the consequence of the growing chemical- biological threat. The Chemical Biological Incident Response Force (CBIRF), activated in April of 1996, grew from that initiative. DOD currently has two units with bioterrorism response capabilities, the Army's Technical Escort Unit (TEU) and the Marine Corps' Chemical-Biological Incident Response Force (CBIRF). CBIRF is a task-organized, self-sustaining unit consisting of approximately 375 Marines and Sailors from a variety of Military Occupational Specialties. CBIRF is most effective when forward deployed in response to a credible threat or to protect events of national significance. CBIRF elements are capable of chemical/biological agent detection and identification, hazard prediction, advanced life saving and triage, evacuation of victims from contaminated areas, decontamination, incident site management, and security as authorized. CBIRF is a highly trained consequence management force tailored for short-notice response to terrorist-initiated chemical and biological incidents. This unit owns and maintains commercially available radiological, biological, and chemical defense equipment, general support equipment, and medical equipment.
http://www.cbirf.usmc.mil/

CBRNE - Chemical, Biological, Radiological, Nuclear, and Explosive.

CCHD - Cedar County Health Department.

CCMH - The Cedar County Memorial Hospital is a Private POD in El Dorado Springs, Cedar County.

CCP - Casualty Collection Point.

CCU - Coronary Care Unit.

CDC - The Centers for Disease Control and Prevention (CDC) is recognized as the lead federal agency for protecting the health and safety of people - at home and abroad, providing credible information to enhance health decisions, and promoting health through strong partnerships. CDC serves as the national focus for developing and applying disease prevention and control, environmental health, and health promotion and education activities designed to improve the health of the people of the United States.
CDC, located in Atlanta, Georgia, USA, is an agency of the Department of Health and Human Services. Dr. Julie L. Gerberding is the Director.
http://www.cdc.gov/

CDPHP - Division of Chronic Disease Prevention and Health Promotion. (See DHSS.)

Ceiling Exposure Value - The maximum airborne concentration of a biological or chemical agent to which a worker may be exposed at any time without protective equipment.

Cellular Asphyxiant - A material that upon entering the body inhibits the normal function of cells. Examples are CO, hydrogen cyanide, or hydrogen sulfide poisoning.

CEM - Comprehensive Emergency Management offers a framework for organizing and managing emergency protection efforts. There are four phases (mitigation, preparedness, response, and recovery) in the all-hazards approach. 

Central Nervous System - In humans, the brain and spinal cord, as opposed to the peripheral nerves found in the fingers, etc.

CERCLA - Comprehensive Environmental Response, Compensation, and Liability Act of 1980. Also known as the “Superfund” Act. 
http://www.epa.gov/superfund/action/law/cercla.htm

Cerebrospinal - Relating to the brain and spinal cord.

CERT - Center for Emergency Response and Terrorism.
http://www.dhss.state.mo.us/BT_Response/BT_Response.html

CERT - Community Emergency Response Team (FEMA and Citizen Corps). The Community Emergency Response Team concept was developed and implemented by the Los Angeles City Fire Department (LAFD) in 1985. The Whittier Narrows earthquake in 1987 underscored the area-wide threat of a major disaster in California. Further, it confirmed the need for training civilians to meet their immediate needs.
http://training.fema.gov/EMIWeb/CERT/

CES - Contract Epidemiology Specialist.

CFD - Collins Fire Department.

CFR - Code of Federal Regulations.
http://www.access.gpo.gov/nara/cfr/

CGI - Combustible Gas Indicator, an instrument used to detect flammable and combustible vapors.

Chain of Custody - Methodology of tracking specimen for the purpose of maintaining control and providing accountability. 

CHC - Community Health Centers. (Also known as Federally Qualified Health Centers.)

Chemical Agent - A chemical substance that is intended for use in military operations to kill, seriously injure, or incapacitate people through its physiological effects. Excluded from consideration are riot-control agents and smoke and flame materials. The agent may appear as a vapor, aerosol, or liquid; it can either be a casualty/toxic agent or an incapacitating agent.

Chemical Agent Symbol - A code usually consisting of two letters that is used as a designation to identify chemical agents. 
- Cyanides
- - AC - Hydrogen Cyanide
- - CK - Cyanogen Chloride
- Irritants
- - CN - Mace
- - CR & CS - Tear Gas
- - OC - Pepper Spray
- Lung Agents
- - CG - Phosgene
- - CL - Chlorine
- - PFIB - Pyrolized Teflon
- Nerve Agents
- - GA - Tabun
- - GB - Sarin
- - GD & TGD - Soman
- - VX - V Agent
- Vesicants
- - H - Mustard
- - L - Lewisite

Chemical Asphyxiant - Referred to as blood poisons, these are compounds that interrupt the flow of oxygen in the blood or the tissue in three ways: (1) They react more readily than oxygen with the blood. Carbon monoxide is the best-known example. (2) They liberate the hemoglobin from red blood cells, resulting in a lack of transport for oxygen. Hydrazine is one such asphyxiant. (3) They cause a malfunction in the oxygen-carrying capability of the red blood cells. Benzene and toluene are two of these.

Chemical Burn - A burn that occurs when the skin comes into contact with strong acids, strong alkalis, or other corrosive materials. These agents literally eat though the skin and in many cases continue to do damage so long as they remain in contact with the skin.

Chemical Contamination - The presence of a chemical agent on a person, object, or area.

Chemical Explosion - A chemical explosion is caused by the extremely rapid conversion of a solid or liquid explosive compound into gases, having a much greater volume than the substances from which they are generated. The entire process takes only a fraction of a second, produces extremely high temperatures (several thousand degrees), and is accompanied by shock and loud noise. With the single exception of nuclear explosives, all manufactured explosives are chemical explosions.

Chemical Name - The scientific designation of a chemical or a name that clearly identifies that chemical for hazard evaluation purposes.

Chemical Properties - A property of matter that describes how it reacts with other substances.

Chemical Protection Equipment - Protective clothing and respiratory protection available to shield or isolate a person from the chemical and physical effects of the chemical that may be encountered at a hazardous materials incident.

Chemical Protective Clothing Material - Any material or combination of materials used in an item of clothing for the purpose of isolating parts of the wearer’s body from contact with a hazardous chemical.

Chemical Protective Suit - Single or multipiece garment constructed of chemical protective clothing materials designed and configured to protect the wearer’s torso, head, arms, legs, hands, and feet.

Chemical Reaction - A process that involves the bonding, unbonding, or rebonding of atoms. A chemical change takes place that actually changes substances into other substances.

Chemical Stability - A characteristic of chemicals denoting their ability and likeliness for chemical or physical change.

Chemical Warfare - See CW. 

Chemical Warfare Agent - See CWA.

Chemnet - A mutual aid network of chemical shippers and contractors. It is activated when a member shipper cannot respond promptly to an incident involving chemicals.
http://www.chemnet.com/

Chemoprophylaxis - Prevention of disease by the use of chemicals or drugs.

CHEMTREC - Chemical Transportation Emergency Center provides emergency information on materials involved in transportation accidents. CHEMTREC can contact the shipper or producer of the material for more detailed information on the chemical released to facilitate response and cleanup actions.
http://www.chemtrec.com/

CHIME - Center for Health Information Management & Epidemiology, of the Missouri Department of Health and Senior Services.

Chine - A backbone; a spine.

Chlamydia - Chlamydia are obligatory intracellular parasites incapable of generating their own energy source. Like bacteria, they are responsive to broad spectrum antibiotics. Like viruses, they require living cells for multiplication.

Chloramphenicol - Used in the treatment of plague meningitis.

ChlorEP - The chlorine emergency plan, established by the Chlorine Institute, enables the nearest producer of chlorine to respond to an incident involving chlorine.

Chlorine - A choking agent that is typically a nonpersistent, heavy, greenish-yellow gas.

Chlorine Kits - Standardized kits commercially manufactured by contract with the Chlorine Institute to provide equipment to control or stop leaks in chlorine cylinders, tanks, and transportation tank cars.

Choking Agents - These agents exert their effects solely on the lungs and result in the irritation of the alveoli of the lungs. Agents cause the alveoli to constantly secrete watery fluid into the air sacs, which is called pulmonary edema. When a lethal amount of a choking agent is received, the air sacs become so flooded that the air cannot enter and the victim dies of anoxia (oxygen deficiency); also known as dry land drowning. Substances that cause physical injury to the lungs. Exposure is through inhalation. In extreme cases, membranes swell and lungs become filled with liquid (pulmonary edema). Death results from lack of oxygen; hence, the victim is “choked.” Phosgene (CG) is a choking agent.
Symptoms: Irritation to eyes/nose/throat, respiratory distress, nausea and vomiting, burning of exposed skin.

Chronic - Of long duration or having frequent recurrence.

Chronic Effects - An adverse health effect on a human or animal body with symptoms that develop slowly or that recur frequently due to the exposure of hazardous chemicals.

Chronic Exposure - Repeated doses or exposure to a material over a relatively prolonged period of time.

CIA - Central Intelligence Agency. The Central Intelligence Agency was created in 1947 with the signing of the National Security Act by President Truman. The National Security Act charged the Director of Central Intelligence (DCI) with coordinating the nation’s intelligence activities and correlating, evaluating, and disseminating intelligence which affects national security.
http://www.cia.gov/

CICU - Cardiac Intensive Care Unit.

Ciprofloxacin - Cipro. Antibiotic used in the treatment and prophylaxis of anthrax.

CIRG - The Critical Incident Response Group (CIRG) facilitates the FBI's rapid response to and the management of crisis incidents. CIRG was established in 1994 to integrate tactical and investigative resources and expertise for critical incidents which necessitate an immediate response from law enforcement authorities. CIRG will deploy investigative specialists to respond to terrorist activities, hostage takings, child abductions, and other high-risk repetitive violent crimes. Other major incidents include prison riots, bombings, air and train crashes, and natural disasters.
http://www.fbi.gov/hq/isd/cirg/cirgmain.htm

CISD - Critical Incident Stress Debriefing.

Classification of Chemical Agents - Chemical agents are classified according to their physical chemical state, use, and physical action.

Clean Air Act - A set of national standards for ambient air quality which defines the principal types and levels of pollution that should not be exceeded. This law requires states to develop “state implementation plans” for achieving the ambient air standards in each air quality control region in the state. 
http://www.epa.gov/oar/oaq_caa.html

Clean Water Act - Federal legislation to protect the nation’s water and set state water quality standards for interstate navigable waters as the basis for pollution control and enforcement. The main objective is to restore and maintain the chemical, physical, and biological integrity of the Nation’s waters.
http://www.epa.gov/r5water/cwa.htm

Clear Text - The use of plain English in radio communications transmissions. No ten codes or agency-specific codes are used when using clear text. 

Clinometers - Any of several instruments for measuring inclination, such as the heeling of a ship or portable tank.

Clostridium Botulinum - The organism that produces botulism toxin.

CLPHS - Center for Local Public Health Services.

Cluster - A group of individuals who manifest the same or similar signs and symptoms of disease. (19 CSR 20-20.010)

CMERCS - Civilian-Military Emergency Radio Communication System.

CMH - The Citizen’s Memorial Hospital is a Private POD in Bolivar, Polk County.
http://www.citizensmemorial.com/

CNS - Central Nervous System.

CO2 - Carbon dioxide gas.

Coagulopathy - A disease affecting the coaguability of blood.

Coccus - A spherically shaped bacteria.

Coccobacillus - A short, thick bacterial rod of the shape of an oval or slightly elongated coccus.

COE - The United States Army Corps of Engineers (USACE) is made up of approximately 34,600 civilian and 650 military men and women. The military and civilian engineers, scientists, and other specialists work hand-in-hand as leaders in engineering and environmental matters. Its diverse workforce of biologists, engineers, geologists, hydrologists, natural resource managers, and other professionals meets the demands of changing times and requirements as a vital part of America's Army.
http://www.usace.army.mil/

COG - Continuity of Government.

Cold Zone - The fully safe operating area surrounding the warm zone at a hazardous materials site. The Command Post and general staging areas are located in the Cold Zone. Area where the command post and support functions that are necessary to control the incident are located. This is also referred to as the clean zone, green zone, or support zone in other documents. (EPA Standard Operating Safety Guidelines, OSHA 29 CFR 1910.120, NFPA 472)

Collaborative Practice Agreement - A written agreement that states jointly agreed-upon protocols or written standing orders for the delivery of health care services.

Color - An outward warning sign indicating a chemical reaction or release. In humans, skin color can suggest exposure to certain types of materials. 

Colormetric Tubes - Glass tubes containing a chemically treated substrate that reacts with specific airborne chemicals to produce a distinctive color. The tubes are calibrated to indicate approximate concentrations in air.

Coma - A prolonged unconsciousness caused by disease, injury, or poison. A person in a state of coma cannot be roused, even by painful stimuli.

Combustibility - The ability of a substance to undergo rapid chemical combination with oxygen, with the evolution of heat.

Combustible - The state of something able to undergo rapid chemical combustion with oxygen.

Combustible Gas Indicator - An instrument used to detect flammable and combustible vapors. A CGI is characterized by a wheatstone bridge which burns present vapors and may indicate lower and upper explosive limits. 

Combustible Liquid - Liquids which have a flash point greater than 60.5°C (141°F) and below 93°C (200°F). U.S. regulations permit a flammable liquid with a flash point between 38°C (100°F) and 60.5°C (141°F) to be re-classed as a combustible liquid.

Communicable Disease - An illness due to an infectious agent or its toxic products and transmitted, directly or indirectly, to a susceptible host from an infected person, animal, or arthropod, or through the agency of an intermediate host or vector, or through the inanimate environment. (19 CSR 20-20.010)

Compatibility Group - Letters identify explosives that are deemed to be compatible. Class 1 materials are considered to be “compatible” if they can be transported together without significantly increasing either the probability of an incident or, for a given quantity, the magnitude of the effects of such an incident. 
A - Substances which are expected to mass detonate very soon after fire reaches them. 
B - Articles which are expected to mass detonate very soon after fire reaches them. 
C - Substances or articles which may be readily ignited and burn violently without necessarily exploding. 
D - Substances or articles which may mass detonate (with blast and/or fragment hazard) when exposed to fire. 
E&F - Articles which may mass detonate in a fire. 
G - Substances and articles which may mass explode and give off smoke or toxic gases. 
H - Articles which, in a fire, may eject hazardous projectiles and dense, white smoke. 
J - Articles which may mass explode. 
K - Articles which, in a fire, may eject hazardous projectiles and toxic gases. 
L - Substances and articles which present a special risk and could be activated by exposure to air or water. 
N - Articles which contain only extremely insensitive detonating substances and demonstrate a negligible probability of accidental ignition or propagation. 
S - Packaged substances or articles which, if accidentally initiated, produce effects that are usually confined to the immediate vicinity.

Command - The act of directing, ordering, and/or controlling resources by virtue of explicit legal, agency, or delegated authority. 

Command Post - A centralized base of operations established near the site of an incident. The location at which primary command functions are executed. 

Command Staff - Consists of the Safety Officer, Liaison Officer, and Information Officer, who report directly to the Incident Commander (IC). 

Communicable Disease - An illness due to a specific infectious agent or its toxic products which arises through transmission of that agent or its products from an infected person or animal or a reservoir to a susceptible host, either directly or indirectly, through an intermediate animal host, vector, or the inanimate environment. 

Communications Unit - Functional unit within the Service Branch of the Logistics Section. This unit is responsible for the incident communications plan, the installation and repair of communications equipment, and operation of the Incident Communications Center. Also may refer to a vehicle (trailer or mobile van) used to provide the major part of an Incident Communications Center. 

Community Awareness and Emergency Response - CAER. A program developed by the Chemical Manufacturers Association (CMA) to provide guidance for chemical plan managers to assist them in taking the initiative in cooperating with local communities developing integrated hazardous materials response plans. 

Compartment - A subdivision of a structure or design, a small chamber, receptacle, or container. A large container separated into smaller mutually isolated units.

Compartmentalized - Something separated into compartments or categories in a manner tending to preclude interrelationships. 

Compatibility - 1) The matching of protective chemical clothing to the hazardous material involved to provide the best protection for the worker.
2) The ability of two materials to be safely brought together during storage or spill. 

Compatibility Charts - Permeation and penetration data supplied by manufacturers of chemical protective clothing to indicate chemical resistance and break-through time of various garment materials as tested against a battery of chemicals. 

Comprehensive Environmental Response, Compensation, and Liability Act - Known as CERCLA or SUPERFUND, it addresses hazardous substance releases into the environment and the cleanup of inactive hazardous waste sites. It also requires those who release hazardous substances, as defined by the Environmental Protection Agency (EPA), above certain levels (known as “reportable quantities”) to notify the National Response Center. 

Concentration - The amounts of a chemical agent present in a unit volume of air or water; usually expressed in milligrams per cubic meter (mg/m3). In corrosives, the amount of acid or base compared to the amount of water present. Corrosives have “strength” and “concentration.” See Strength. 

Concentration Time - The amount of a chemical agent present in a unit volume of air multiplied by the time an individual is exposed to that concentration.

Condensation Point - That point where a gas or vapor changes into a liquid by cooling.

Conduits - Channels or pipes for carrying liquids long distances, such as an aqueduct. Tubes or underground passages for electric wires or cables. 

Cone Roof - Type of roof covering the top of a liquid storage tank. It may be open to the weather or enclosed in a weather-protection device such as a geodesic dome.

Confinement - Those procedures taken to keep a material in a defined or local area once released.

Conjunctiva - The mucous membrane investing the anterior surface of the eyeball and the posterior surface of the eyelids.

Conjunctivitis - Redness in the eye.

Consequence Management - Measures to alleviate the damage, loss, hardship, or suffering caused by emergencies. It includes measures to restore essential government service, protect public health and safety, and provide emergency relief to affected governments, businesses, and individuals. This role is assigned to FEMA in the FRP. Consequence management includes measures to protect public health and safety, restore essential government services, and provide emergency relief to governments, businesses, and individuals affected by the consequences of terrorism.

Consist - A rail shipping paper similar to a cargo manifest. It may contain a list of the cars in the train, in order, or a list of those cars carrying hazardous materials and their locations on the train.

Contact - A person or animal that has been in association with an ifected person or animal and through that association has had the opportunity to acquire the infection. (19 CSR 20-20.010)

Contagious - Capable of being transmitted from one person to another.

Contagious Disease - Infectious disease that can be transmitted from person to person.

Containment - The attempt to prevent or limit the spread of contamination by holding it in, enclosing, encapsulating, or by controlling it. Those procedures taken to keep a material in its container.

Contamination - The condition resulting from the deposit of radioactive material, biological agents, or chemical agents in or upon structures, areas, bodies of water, personnel and objects, or from failure of normal sanitary safeguards. This includes food, water, and medical supplies. The presence of undesirable substances or material which may contain infectious agents or their toxic products.

Contamination Reduction Zone - Commonly referred to as the warm zone, the area between the hot and cold zones. This is where decontamination takes place.

Continuous Sampler - A device used to obtain a sample of commodity without the tank being hooked up for unloading or otherwise opening the tank. Air monitoring devices, such as those used in many industrial workplaces, that siren or alert persons when a release has occurred or certain levels of exposure have been exceeded.

Control Zones - Designated areas at dangerous goods incidents based on safety and the degree of hazard. Many terms are used to describe control zones; however, in this guidebook, these zones are defined as the hot/exclusion/restricted zone, warm/contamination reduction/limited access zone, and cold/support/clean zone. (EPA Standard Operating Safety Guidelines, OSHA 29 CFR 1910.120, NFPA 472)

Controlled Free Pratique - Permission for a carrier to enter and U.S. port, disembark, and begin operation under certain stipulation conditions. 

Convulsions - Violent, involuntary contracting and relaxing of the muscles; a spasm. 

Cooperating Agency - An agency supplying assistance other than direct suppression, rescue, support, or service functions to the incident control effort (Red Cross, law enforcement, public works, etc.). 

Corrosive - A chemical that causes visible destruction of or irreversible alterations in living tissue by chemical action at the site of contact; a liquid that causes a severe corrosion rate in steel. A corrosive is either an acid or a caustic.

Corrosive Materials - A type of chemical, found in liquid or solid form, which causes visible destruction or irreversible alterations in human tissue at the site of contact.

Coupler - A device located at both ends of all railcars and locomotives in a standard location to provide a way to connect one railcar to another.

CP - Command Post.

CPCFR - Central Polk County Fire Rescue.
http://www.cpcfr.org

CPE - Chemical Protection Equipment.

CPG - Civil Preparedness Guides are FEMA publications that provide guidance in Civil Preparedness Emergency Management programs and activities. 

Cracks - Narrow splits or breaks in the container metal which may penetrate through the metal of the container. It may also be caused by fatigue. It is a major mechanism which could cause catastrophic failure. 

CRCPD - The Conference of Radiation Control Program Directors, Inc. (CRCPD) is a 501(c)(3) nonprofit professional organization whose primary membership is made up of radiation professionals in state and local governments who regulate the use of radiation sources.
http://www.crcpd.org/

Crisis Management - Measures to resolve the hostile situation, investigate, and prepare a criminal case for prosecution under federal law. This role is assigned to the FBI in the FRP. Crisis management includes measures to identify, acquire, and plan the use of resources needed to anticipate, prevent, and/or resolve a threat or act of terrorism.

Critical Pressure - The pressure required to liquefy a gas at its critical temperature.

Critical Temperature - The temperature above which a gas cannot be liquefied by pressure.

Cross Contamination - Secondary contamination caused when a person or object is contaminated by coming into contact with another person or object which has not been properly or fully decontaminated. Elements of contamination can be nuclear, biological, or chemical. Contamination that takes place when a person or piece of equipment that has been exposed to a substance contaminates another which had no direct contact. Often referred to a secondary contamination.

Cross Sectional - A representative sample. A drawing showing levels and profiles.

Cryogenic - Materials which exist at extremely low temperatures, such as nitrogen. Those gases that must be cooled to a very low temperature in order to bring about a change from a gas to a liquid.

Cryogenic Burn - Frostbite; damage to tissues as the result of exposure to low temperatures. It may involve only the skin, extend to the tissue immediately beneath it, or lead to gangrene and loss of affected parts. 

Cryogenic Cylinder - An insulated metal cylinder contained within an outer protective metal jacket. The area between the cylinder and the jacket is normally under vacuum. The cylinders have a small protective ring at the top to protect the valves and a foot ring which allows for handling with a special hand truck. The cylinders range in size from a dewar (similar to a small thermos) up to 24 inches in diameter and five feet high. Examples of materials found in these types of cylinders are argon, helium nitrogen, and oxygen.

CSF - Abbreviation for cerebrospinal fluid.

CSP - Community Shelter Plans provide locals with guidance on how, where, and when to shelter the population in the event of a national emergency. Now referred to as an In-Place Shelter Plan.

CSR - Code of State Regulations.

Culture - A population of microorganisms grown in a medium.

Cultures and Stocks - Includes etiologic agents and associated biological agents, including specimen cultures, wastes from production of biological agents, and serums and discarded live and attenuated vaccines.

Cumulative - Additional exposure rather than repeated exposure. For example, a one-hour exposure of HD followed within a few hours by another exposure of one hour has the same effect as a single exposure lasting for two hours.

Cutaneous - Pertaining to the skin.

CW - Chemical Warfare. The military use of chemical agents to kill, injure, or incapacitate humans or to cause adverse effects on materials.

CWA - Chemical Warfare Agents. A chemical substance which, because of its physiological, psychological, or pharmacological effects, is intended for use in military operations to kill, seriously injure, or incapacitate humans (or animals) through its toxicological effects. Excluded are riot-control agents, chemical herbicides, and smoke and flame agents.

Cyanide - A very poisonous compound that contains a nitrogen and a carbon atom and affects that ability of tissues to use oxygen.

Cyanogen Bromide - A colorless or white crystalline, volatile solid with a penetrating odor. One of the blood agents.

Cyanogen Chloride - A colorless gas or liquid with a pungent odor. One of the blood agents, its effects are similar to those of hydrogen cyanide.

Cyanogen Iodide - A colorless or white needle-like solid material with a very pungent odor and acrid taste. One of the blood agents.

Cryogenic Liquid - A refrigerated, liquefied gas that has a boiling point colder than -90°C (-130°F) at atmospheric pressure.

Cyanosis - A dark bluish or purplish coloration of the skin and mucous membranes due to deficient oxygenation of the blood, evident when reduced hemoglobin in the blood exceeds 5g per 100ml.

Cylinder - A container for liquids, gases, or solids under pressure. Ranges in size from aerosol containers found at home, such as spray deodorant, to the cryogenic (insulated) cylinders for nitrogen that can be approximately 24 inches in diameter and five feet high. All cylinders have a circular cross section with a valve arrangement at one end, and a majority will have a pressure relief device. Pressure ranges from a few pounds to several thousand pounds per square inch.

Exceptions:

References:

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 2008-09-04 (tjb) Moved from HTML-based to SQL-based.

Purpose:

Scope:

Guideline:
DA - Damage Assessment.

Dangerous Cargo Manifest - A list of the hazardous materials carried as cargo on board a vessel and the location of the hazardous material on the vessel kept with the captain.

Dangerous Water Reactive Material - Produces significant toxic gas when it comes in contact with water.

Dangerous When Wet - Materials that when exposed to water allow a chemical reaction to take place and often produce flammable or poisonous gases, heat, and a caustic solution. An example is sodium and water.

DAP - Disaster Assistance Program is provided by the federal government following a declared emergency or disaster.

DASV - Missouri Department of Agriculture, State Veterinarian.

DD - Disaster Declaration. 

DEA - The mission of the Drug Enforcement Administration (DEA) is to enforce the controlled substances laws and regulations of the United States and bring to the criminal and civil justice system of the United States, or any other competent jurisdiction, those organizations and principal members of organizations involved in the growing, manufacture, or distribution of controlled substances appearing in or destined for illicit traffic in the United States; and to recommend and support non-enforcement programs aimed at reducing the availability of illicit controlled substances on the domestic and international markets.
http://www.dea.gov/

Debridement - The cleansing of a wound by cutting away dead or infected tissue, foreign matter, etc.

Decay - The process by which an unstable element is changed to another isotope or another element by the spontaneous emission of radiation from its nucleus.

Decomposition Products - Products of a chemical or thermal break-down of a substance.

Decontamination - The process of removing hazardous substances from the body or equipment. The process of making any person, object, or area safe by absorbing, destroying, neutralizing, making harmless, or removing the hazardous material. The removal of dangerous goods from personnel and equipment to the extent necessary to prevent potential adverse health effects. Always avoid direct or indirect contact with dangerous goods; however, if contact occurs, personnel should be decontaminated as soon as possible. Since the methods used to decontaminate personnel and equipment differ from one chemical to another, contact the chemical manufacturer, through the agencies listed on the inside back cover, to determine the appropriate procedure. Contaminated clothing and equipment should be removed after use and stored in a controlled area (warm/contamination reduction/limited access zone) until cleanup procedures can be initiated. In some cases, protective clothing and equipment cannot be decontaminated and must be disposed of in a proper manner.

Decontamination, Gross - An emergency wash for victims or mitigation personnel when immediate action is required to remove a chemical. Also called primary decontamination. 

Decontamination, Secondary - Used after gross decontamination removes the major portion of the product. Depending on the incident, it may be the final stage. 

Decontamination, Tertiary - A third phase of decontamination usually accomplished at a medical facility to remove remaining minute quantities of contaminant. 

Decontamination Corridor - An exit passageway usually located at the edge of the exclusion zone (hot zone) where decontamination takes place. It leads through the warm zone and into the cold zone.

Decontamination Shower - An emergency shower common to industrial facility locations to remove product contamination.

Defensive Staging - Provides for all personnel to remain on the assigned apparatus, ready to respond or move at a moment's notice. It means stopping short of intersections, always having two means of egress from the staging area, having multiple staging areas, and generally being prepared for the unexpected.

Defibrillation - The use of direct current electric shock to terminate ventricular fibrillation and restore effective cardiac function.

Deflagration - A rapid burning process. Very fast combustion, up to 3,300 feet per second.

Degradation - Chemical - The molecular breakdown of the spilled or released material to render it less hazardous.
Suit - A chemical action involving the physical breakdown of protective clothing materials due to contact with a chemical.

Dehydration - The removal of water. 

Delivery Method - The manner in which an explosive or incendiary device was transported or positioned at the site of an explosives incident.

Demobilization Unit - Responsible for ensuring orderly, safe, and efficient demobilization of resources committed to the incident.  

DEQ - Division of Environmental Quality, of the Missouri Department of Natural Resources.

Designated Representative - Any person or group of persons appointed by the director of the Department of Health to act on behalf of the director or the State Board of Health. (19 CSR 20-20.010)

Desiting - The removing of chemical protection equipment. See Doffing.

Desorption - The reverse process of absorption. The agent will be "removed" from the surface (outgassing).

Detention - The temporary holding of a person, ship, aircraft, or other carrier, animal, or thing in a specific place for a period of time.

Detonation - An instantaneous chemical reaction. An explosion at speeds above 3,300 feet per second.

Detoxification, Rate of - The rate at which the body can counteract the effects of a poisonous chemical substance.

Dew Point - The temperature at which air, by cooling, becomes saturated with vapor and droplets begin to form.

DFO - Disaster Field Office is an administrative office established at the scene of a presidentially declared disaster. The office established in or near the designated area to support federal and state response and recovery operations. The Disaster Field Office houses the Federal Coordinating Officer (FCO), the Emergency Response Team, and where possible, the State Coordinating Officer and Support Staff.

DFS - Division of Family Services (Department of Social Services).

DHD - District Health Directors.

DHHS - Department of Health and Human Services.
http://www.hhs.gov/

DHSS - Department of Health and Senior Services.
http://www.dhss.state.mo.us/

Dilution - The application of water-to-water miscible hazardous materials. The goal is to reduce the hazard of a material to safe levels by reducing its concentration. 

Dilution Factor - Dilution of contaminated air with uncontaminated air in a general area, room, or building for the purpose of health hazard or nuisance control, and/or for heating and cooling.

Diphosgene - A choking agent that is a colorless liquid with an odor of newly mown hay.

Diplopia - The condition in which a single object is perceived as two objects.

Direct Contamination - The process whereby a spilled or released material physically contacts a person or thing. This is referred to as primary contamination. 

Disaster - A dangerous event that causes significant human and economic loss and demands a crisis response beyond the scope of any single agency or service such as the fire department or police. In legal terms, a disaster requires resources beyond those available locally. 
As defined in P.L. 92-288; any natural catastrophe … or regardless of cause, any fire, flood or explosion, in any part of the United States, which in the determination of the President causes damage of sufficient severity and magnitude to warrant major disaster assistance under this Act to supplement the efforts and available resources of States, local governments, and disaster relief organizations in alleviating the damage, loss, hardship, or suffering caused thereby.

Disinfection - The killing of pathogenic agents outside the body by chemical or physical means, directly applied. (19 CSR 20-20.010)

Disinfection, Concurrent - Disinfection immediately after the discharge of infectious material from the body of an infected person or after the soiling of articles with the infectious discharges. (19 CSR 20-20.010)

Disinfection, Terminal - The process of rendering the personal clothing and immediate physical environment of a patient free from the possibility of conveying the infection to others after the patient has left the premises or after the patient has ceased to be a source of infection or after isolation practices have been discontinued. (19 CSR 20-20.010)

Disinfestation - Any chemical or physical process serving to destroy or remove undesired small animal forms, particularly arthropods or rodents, present upon the person, the clothing, or the environment or an individual or upon animals and carriers.

Disinsection - The operation in which measures are taken to kill the insect vectors of human disease present in carriers and containers.

Dispatch - The implementation of a command decision to move a resource or resources from one place to another.

Dispatch Center - A facility from which resources are directly assigned to an incident. 

Dispersion - The spreading, scattering, or diffusing of a substance though air, soil, surface, or groundwater.

Distance - One of the three components of the time, distance, and shielding (TDS) response; it refers to the recommendation that one should maintain distance from a hazard if at all possible. Refer to the Emergency Response Guidebook (ERG) as an appropriate resource.

Distilled Mustard - One of the blister agents that in its normal state is a colorless or amber-colored oily liquid with the faint smell of garlic.

Distribution - The process of delivering SNS from a staging warehouse to dispensing sites, treatment centers, and other locations. For variety, this plan use the terms distributing and delivering interchangeably. 
The process of providing the SNS from a RSS or ADS to local public health agencies, treatment centers, community health centers, emergency medical system providers, or private physicians (state responsibility).

Dispense - The act of dispensing includes the selection and labeling of prepackaged medications ordered by the physician or advanced practice nurse to be self administered by the client (individual presenting at dispensing clinic). Only a physician, pharmacist, or a registered nurse may dispense medications.

Dispensing Site - The community location where the public receives prophylactic medicines (local responsibility).

Diversion - A term that can apply to a dam or dike used to change the flow or direction of a liquid.

DMAT - Disaster Medical Assistance Team.
http://www.mo1dmat.org/

DMORT - Disaster Mortician Response Team.

DMS - Division of Medical Services. (Department of Social Services.)

DNA - Deoxyribonucleic Acid.

DNR - Missouri Department of Natural Resources.
http://www.dnr.state.mo.us/

DOC - Department of Commerce, Department of Corrections, or Missouri Department of Conservation.

DOD - Department of Defense.
http://www.defenselink.mil/

DOE - Department of Energy provides technical assistance, equipment, and personnel to state governments in the event of a major radiological emergency. 
http://www.energy.gov/

Doffing - The process of taking off or removing (i.e. chemical protective clothing). 

DOJ - Department of Justice.
http://www.usdoj.gov/

Dome - The circular fixture on the top of a tank car that contains valves and relief devices.

Donning - The process of putting on (i.e. chemical protective clothing).

Dosage - The concentration of a chemical agent in the atmosphere (C) multiplied by the time (t) the concentration remains, expressed as mg-min/m. The dosage (Ct) received by a person depends upon how long he is exposed to the concentration. That is, the respiratory dosage in mg-min/m is equal to the time in minutes an individual is unmasked in an agent cloud multiplied by the concentration of the cloud.

Dose - The accumulated amount of a chemical to which a person is exposed. 

DOT - Department of Transportation.
http://www.dot.gov/

Downwind Distance - The distance a toxic agent vapor cloud will travel with the wind from its point of origin.

Doxycycline - Antibiotic used in treatment and prophylaxis of anthrax and plague. Used in the treatment of brucellosis.

DPI - Disaster Preparedness Improvement is a FEMA grant to states to maintain their natural disaster plan. 

DPS - Department of Public Safety.
http://www.dps.state.mo.us/

DRC - Disaster Recovery Center is a one-stop center for disaster victims to apply for assistance from many various state and federal agencies, as well as private groups. 

DRMS - Department Response Management System.

Drum - A cylindrical packaging made of metal, plastic, fiberboard, plywood, or other suitable materials used for containerizing liquids and solids. Metal and plastic drums can vary in size up to 23 inches in diameter and 34 inches high. Drums are sometimes called buckets, cans, or pails. 

Dry Bulk - A type of container used to carry large amounts of solid materials (more than 882 pounds, or 400 kilograms). It can either be placed on or in a transport vehicle.

Dry Chemical - A preparation designed for fighting fires involving flammable liquids, pyrophoric substances, and electrical equipment. Common types contain sodium bicarbonate or potassium bicarbonate.

DSC - Disaster Service Center is a facility in which disaster victims can obtain further assistance with their application preparation.

DSR - Department Situation Room.

Dusty Agent - A solid chemical agent that can be disseminated as an aerosol. CS (tear gas) is one example of a dusty agent.

Duty Officer - Division of Environmental Health & Communicable Disease Control person on call to receive and forward emergency calls outside normal working hours.

Dysarthria - A disturbance of speech and language due to emotional stress, brain injury, or paralysis, incoordination, or spasticity of the muscles used for speaking.

Dysphagia - Difficulty in swallowing.

Dyspnea - Shortness of breath, a subjective difficulty or distress in breathing, usually associated with disease of the heart or lungs; occurs normally during intense physical exertion or at high altitudes.

Exceptions:

References:

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 2008-09-04 (tjb) Moved from HTML-based to SQL-based.

Purpose:

Scope:

Guideline:
Escherichia Coli - Possible biological warfare agent.

E Type Coupler - A type of shelf coupler with a vertical restraint mechanism on the top and/or bottom. It serves to reduce the potential for coupler disengagement in a rail accident.

EAS - Emergency Alert System is a communication and warning system set up by the federal government in order for emergency messages to be broadcast via radio and TV stations.

Ebola - Possible biological warfare agent.

Ecchymosis - A purplish patch caused by extravasation of blood into the skin, typically larger that 3mm in diameter.

Ecosystem - A habitat formed by the interaction of a community of organisms with their environment.

ED - Emergency Department.

Edema - The swelling of body tissues resulting from fluid retention. The accumulation of an excessive amount of watery fluid in cells and tissues. Pulmonary edema is an excessive buildup of water in the lungs, for instance, after inhalation of a gas that is corrosive to lung tissue. An accumulation of an excessive amount of watery fluid in cells, tissues, or serous cavities.

EHCDP - Division of Environmental Health and Communicable Disease Prevention.

EHOM - Environmental Health Operations Manual.

EKG - Electrocardiogram, written record of the electric activity of a heart. 

El Dorado Springs R-II School - The El Dorado Springs High School is a Public POD in El Dorado Springs, Cedar County.
http://www.eldo.k12.mo.us/

Electrolyte - A substance that dissociates into ions when in solution and conducts electricity. In hazardous materials, usually any of several minerals lost due to perspiration during an incident. 

Electrolyte Imbalance - A chemical imbalance in the body due to the loss of minerals.

Ellett Memorial Hospital - The Ellett Memorial Hospital is a Private POD in Appleton City, St Clair County.

EMA - Emergency Management Agency. Also Emergency Management Assistance is a federally funded state administered program for the sate and local emergency management agencies.

EMCC - EMSystem Coordination Centers.

Emergency - As defined in Title V of P.L. 93-288, Section 102(1); any occasion or instance for which, in the determination of the President, federal assistance is needed to supplement state and local efforts and capabilities to save lives and to protect property and public health and safety for emergencies other than natural disasters.

Emergency Escape System - A minimum five-minute respirator allowing emergency evacuation from an area.

Emergency Management - Organized analysis, planning, decision making, and assignment of available resources to mitigate, prepare for, respond to, and recover from the effects of all hazards. 

EMI - Emergency Management Institute is a part of the National Emergency Training Center where emergency program managers, their staff, and other emergency management personnel can attend resident courses in emergency management. It is located in Emmitsburg, Maryland. 
http://www.training.fema.gov/emiweb/

EMP - Electromagnetic Pulse is an effect caused by lightning or nuclear burst that adversely affects radio and computer functions.

EMS - Emergency Medical System is a system that provides care to the sick and injured. It commonly includes trained and licensed emergency care providers and specialized transportation vehicles. 

EMT - Emergency Medical Technician. 

Emulsification - The process of dispersing one liquid in a second immiscible liquid. The largest group of emulsifying agents is soaps, detergents, and other compounds whose basic structure is a paraffin chain terminating in a polar group.

Encephalitis - Inflammation of the brain.

Endothermic - A process or chemical reaction that is accompanied by absorption of heat.

Endotoxemia - Presence in the blood of endotoxins.

Endotracheal Intubation - Passage of a tube through the nose or mouth into the trachea for maintenance of the airway.

Enterotoxin - A cytotoxin specific for the cells of the intestinal mucosa.

Entry Suit - A type of suit that provides protection for brief entry into total flame environment at temperatures as high as 2,000 degrees F. This suit is not effective or meant to be used for rescue operations. Respiratory protection must be provided with fire entry suits.

EOC - Emergency Operations Center is a centralized location where direction and control information collection is evaluated and displayed, where coordination among response agencies takes place, and where resources are managed. The site from which civil government officials (municipal, county, state, and federal) exercise direction and control in an emergency.

EOD - Explosive Ordnance Disposal.

EOP - Emergency Operations Plan - An EOP is a document that (1) assigns responsibility to organizations and individuals for carrying out specific actions at projected times and places in an emergency that exceeds the capability or routine responsibility of any one agency; (2) sets forth lines of authority and organizational relationships and shows how all actions will be coordinated; (3) describes how people and property will be protected in emergencies and disasters; (4) identifies personnel, equipment, facilities, supplies, and other resources available for use during response and recovery operations; and (5) identifies steps to address mitigation concerns during response and recovery activities.

EOS - Emergency Operations Simulation is an activity designed to test or evaluate the capability of an individual function; it is centered in an EOC and simulates outside activity and resources; it also is referred to as a functional tabletop exercise. 

EPA - US Environmental Protection Agency.
http://www.epa.gov/

Epidemic - The occurrence in a community or region of cases of an illness, specific health-related behavior, or other health-related events clearly in excess of normal expectancy. Spreading rapidly and extensively by infection among many individuals in an area.

Epidemiology - The study of epidemics and epidemic diseases. 

Epistaxis - Profuse bleeding from the nose.

Epizootic - 1) Denoting a temporal pattern of disease occurrence in an animal population in which the disease occurs with a frequency clearly in excess of the expected frequency in that population during a given time interval. 
2) An outbreak (epidemic) of disease in an animal population; often with the implication that it may also affect human populations.

ERDCS - Emergency Response Data Collection System, a DHSS database to collect complaint and/or notification information relating to bioterrorism or disease outbreaks.

ERG - Emergency Response Guidebook. 

ERT - Emergency Response Team. 
Federal – An inter-agency team, consisting of the lead representative from each federal department or agency assigned primary responsibility for an emergency support function and key members of the Federal Coordinating Officer’s staff, formed to assist the FCO in carrying out coordination responsibilities.
State – An inter-divisional team, consisting of key representatives from each division and the director’s office assigned primary responsibilities in disaster activities.

Erythema - Redness of the skin due to capillary dilation.

ESE - Emergency Services Environment.

ESF - Emergency Support Functions – The Federal Response Plan (FRP) details 12 ESFs to coordinate operations during federal involvement in an incident: transportation, communications, public works and engineering, firefighting, information and planning, mass care, resource support, health and medical services, urban search and rescue, hazardous materials, food, and energy. A functional area of response activity established to facilitate coordinated federal delivery of assistance required during the response phase to save lives, protect property and health, and maintain public safety.

ESP - Environmental Services Program, of the Missouri Department of Natural Resources.

Etiological Harm - Involves exposure to a living microorganism or its toxins which causes or may cause human disease. Biological agents are the most obvious examples of etiological agents.

Etiology - The scientific study of origins, or causes, of disease. 

Evacuation - Dispersal of individuals from dangerous or potentially dangerous areas and their reception and care in safe areas.

Evaporation Rate - The rate at which a liquid changes to vapor at normal room temperature.

Excess Flow Valve - Valves installed in the liquid education lines beneath the manway over plate, in the vapor line in the bottom of the gauging rod, and in the test tube line of tank cars. They are designed to close automatically in the event of an external closure valve is broken off or removed during transit. Excess flow valves are a mandatory requirement on tank cars transporting flammable compressed gases. 

Exclusionary Valve - A one-way inlet or outlet valve. May be referred to as a check valve.

Exothermic - A process or chemical reaction that is accompanied by the evolution of heat.

Expansion Ratio - The amount of gas produced from a given volume of liquid escaping from a container at a given temperature.

Explosive - As defined by the US Department of Transportation, "A substance fitting into one of these two categories: (1) any substance or article, including a device, designed to function by explosion; or (2) any substance or article, including a device, which, by chemical reaction within itself, can function in a similar manner even if not designed to function by explosion."

Explosive Hazard Class 1 - Any substance or article, including a device, which is designed to function by explosion or which, by chemical reaction within itself, is able to function in a similar manner even if not designed to function by explosion.
Division 1.1 - Explosive with mass explosion hazard.
Division 1.2 - Explosive with projection hazard.
Division 1.3 - Explosive with fire, minor blast, or minor projection hazard.
Division 1.4 - Explosive device with minor explosion hazard.
Division 1.5 - Very insensitive explosives.
Division 1.6 - Extremely insensitive explosives. 

Exposure - Contact with, absorbtion, ingestion or inhalation of chemical, biologic, radiologic, or other physical agents by a human that results in biochemical, physiological or histological changes. (19 CSR 20-20.010)

External Floater - An indicating device located on the outside of some outside storage tanks to show the level of product contained inside. A bulk liquid storage tank whose roof moves relative to the liquid level inside the tank. 

Extremely Hazardous Substance - One of more than 300 EPA-designated chemicals and substances that are highly toxic and subject to the planning requirements of SARA (Superfund Amendment Reauthorization Act).

Exceptions:

References:

Critical section? No

Security level: Unclassified

Version: 1.0

Version history: 2008-09-04 (tjb) Moved from HTML-based to SQL-based.

Purpose:

Scope:

Guideline:
F Type Coupler - A type of shelf coupler with a vertical restraint mechanism on the top and bottom. It serves to reduce the potential for coupler disengagement in a rail accident.

FAA - Federal Aviation Administration.
http://www.faa.gov/

FAST - Field Assessment Team. 

FBI - Federal Bureau of Investigation.
http://www.fbi.gov/

FCC - Federal Communications Commission.
http://www.fcc.gov/

FCO - Federal Coordinating Officer is a person in charge of coordinating all federal agencies and their programs at the Disaster Field Office (DFO). It is usually someone appointed by the President in the affected region.
The senior federal official appointed in accordance with the provisions of P.L. 92-288, as amended, to coordinate the overall response and recovery activities. The FCO represents the President as provided by Section 303 of P.L. 93-288, as amended, for the purpose of coordinating the administration of federal relief activities in the designated area. Additionally, the FCO is delegated responsibilities and performs those for the FEMA Director as outlined in Executive Order 12148 and those responsibilities delegated to the FEMA Regional Director in Title 44 Code of Federal Regulations, Part 205.

FDA - US Food and Drug Administration.
http://www.fda.gov/

Febrile - Denoting or relating to fever.

FedEx - Federal Express.
http://www.fedex.com/

FEMA - US Federal Emergency Management Agency is an agency that consolidated emergency agencies and functions into one organization in 1979. It provides technical advice, funding, and program management for state and local emergency management agencies. 
http://www.fema.gov/

Ferrous Container - A container that is predominately made of iron.

FIA - Federal Insurance Administration, the component of FEMA that administers the National Flood Insurance Program (NFIP).

FID - Flame Ionization Detector.

Fill Valve - An inlet valve assembly used for loading product into a cargo tank.

Fire Point - The lowest temperature at which a liquid produces sufficient vapor to flash near its surface and continue to burn.

First Assembly of God Church - The First Assembly of God Church is a Public POD in Bolivar, Polk County.
http://www.firstagbolivarmo.org/

First Responder - Personnel, such as firefighters, police officers, and EMS teams, who have responsibility to initially respond to emergencies. They will be the first on the scene of an incident and will be responsible for the size-up and determining if additional resources are needed. Local police, fire, and emergency medical personnel who first arrive on the scene of an incident are the immediate providers of health care or security to potentially exposed individuals.

Fixed Site - Any building, structure, installation, equipment pipe or pipeline well, pit, pond, lagoon, impoundment, ditch, landfill, storage container, etc., where a hazardous substance has been deposited, stored, disposed of, placed, or otherwise comes to be located.

Flammable Liquid - A liquid that gives off readily ignitable vapors. Defined as a liquid with a flashpoint below 141 degrees F (DOT) or 100 degrees F (NPHA).

Flammable Solid - A solid (other than an explosive) that ignites readily and continues to burn. It is liable to cause fires under ordinary conditions or during transportation though friction or retained heat from manufacturing or processing. It burns so vigorously and persistently as to create a serious transportation hazard. Included in this class are spontaneously combustible and water reactive materials. Example: white phosphorous. 

Flash Point - The minimum temperature at which a liquid gives off vapor within a test vessel in sufficient concentration to form an ignitable mixture with air near the surface of the liquid.  Lowest temperature at which a liquid or solid gives off vapor in such a concentration that, when the vapor combines with air near the surface of the liquid or solid, a flammable mixture is formed. Hence, the lower the flash point, the more flammable the material.

Forging - The procedure for replacing a railroad car or the track after derailment.

Fomite - Objects, such as clothing, towels, and utensils that possibly harbor a disease agent and are capable of transmitting it.

FPH - The Fair Play High School is a Public POD in Fair Play, Polk County.

FQHC - Federally Qualified Health Centers (also known as Community Health Centers).

Francisella Tularensis - The causative agent of tularemia.

Frangible Disk - A part of a safety vent made of metal (lead or steel), plastic, rubber, or a combination metal. Under normal conditions the device is closed; once ruptured, the frangible disk does not re-close. Also called a rupture disk.

FRP - Federal Response Plan – Developed to help expedite federal support to disasters. Generally, the FRP is activated when the state's resources are not sufficient to cope with a disaster, and the governor has requested federal assistance.

Fuel Cells - A device that produces electricity directly from a chemical reaction between oxygen and a gaseous fuel such as hydrogen or carbon monoxide. A unity of a device that supplies the fuel typically for locomotion.

Fuel Tender - Any vehicle capable of supplying fuel to ground or airborne equipment.

Full Face Respirator - A respirator that covers the entire face from chin to hairline and from ear to ear. This provides an added eye protection and a better seal between the respirator body and the face.

Full Turnouts - Often called bunker gear or structural firefighting clothing, the protective clothing normally worn by firefighters during structural firefighting operations.

Fungi - Any group of plants mainly characterized by the absence of chlorophyll, the green-colored compound found in other plants. Fungi range from microscopic single-celled plants (such as mold and mildews) to large plants (such as mushrooms). Fungi are primitive plants which do not utilize photosynthesis, are capable of anaerobic growth, and draw nutrition from decaying vegetable matter. Most fungi form spores, and free-living forms are found in soil. The spore forms of fungi are operationally significant. Fungal disease may respond to various antimicrobial. 

Fusible Link - A piece of material (usually low-melting-point metals) designed to fail in a fire or under stress to activate a safety device such as a fire door. 

Fusible Plug - A safety mechanism found on multi-unit or “ton” containers. It is non-recloseable and functions by melting at a prescribed temperature to allow for the escape of excess pressure. 

Fusion Weld - A weld created by joining two or more metal surfaces together by melting. 

Exceptions:

References:

Critical section? No

Security level: Unclassified

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G Series Nerve Agents - Chemical agents of moderate to high toxicity that were developed in the 1930s. Examples are Tabun (GA), Sarin (GB), and Soman (GD).

GA - See Tabun.

Gamma Radiation - A high-energy, ionizing radiation that travels at the speed of light and has great penetrating power. Gamma rays can cause skin burns, severely injure internal organs, and have long-term, physiological effects.

GAR - Governor’s Authorized Representative.

Gathering Lines - Lines used to transport chemical products from different sources into a tank or distribution center.

Gauging Device - A device used to measure how much liquid is in the tank. Various types are used such as rotary gauge.

GB - See Sarin.

GD - See Soman.

GEDAPER - An acronym used to describe an incident analysis process developed by Dave Lesak. The steps include (1) Gathering information, (2) Estimating course and harm, (3) Determining strategic goals, (4) Assessing tactical options and resources, (5) Planning and implementing action, (6) Evaluating, and (7) Reviewing.

Gentamicin - Antibiotic used in the treatment of plague and tularemia.

GIS - Geographic Information System.

Good Samaritan Boys Ranch - The Good Samaritan Boys Ranch is a Private POD in Brighton, Polk County. The Good Samaritan Boys Ranch is a long-term treatment facility for boys who have been abandoned, abused, neglected, or suffer from complex psychological disorders.
http://www.ranchlife.org/

Gouging - The process of accidentally cutting a groove or hole in a tank’s exterior. Forming gouges can reduce the strength of a tank and may result in a spill or release of its contents. Gouges are not critical unless they cross a weld seam.

GPS - Global Positioning System.

Gross Decontamination - An emergency wash for victims or mitigation personnel when immediate action is required to remove a chemical, also called primary decontamination.

Grounding - A method whereby activities that may generate static electricity will be prevented from discharging a spark and thereby not produce an ignition point.

Exceptions:

References:

Critical section? No

Security level: Unclassified

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HA - Hazard Analysis. The process of identifying the potential hazards that could affect the jurisdiction and determining the probable impact each of these hazards could have on people and property.

HACCP - Hazard Analysis and Critical Control Point (FDA Program).

Half Face Respirator - A respirator that covers the nose, mouth, and chin. The mask consists of purifying elements such as filters, chemical cartridges, or canisters that can be attached directly or by use of a breathing hose, depending on the size and weight.

Halfway R-III School - The Halfway High School is a Public POD in Halfway, Polk County.

Halogens - A chemical family that includes fluorine, chlorine, bromine, iodine, and astatine.

Halon - Halogenated hydrocarbons used to suppress or prevent combustion.

HAN - Health Alert Network.

HASS - High Alert Surveillance System.

Hazard - A known or perceived danger. A dangerous event or circumstance that may or may not lead to an emergency or disaster.

Hazard Assessment - A process used to qualitatively or quantitatively assess risk factors or determine incident operations. 

Hazard Class - One of nine classes of hazardous materials as categorized and defined by the Department of Transportation.

Hazard Identification - A review of hazards and of locations and conditions associated with hazards in a particular area.

Hazard Zones - HAZARD ZONE A: LC50 of less than or equal to 200 ppm,
HAZARD ZONE B: LC50 greater than 200 ppm and less than or equal to 1000 ppm,
HAZARD ZONE C: LC50 greater than 1000 ppm and less than or equal to 3000 ppm,
HAZARD ZONE D: LC50 greater than 3000 ppm and less than or equal to 5000 ppm.

Hazardous Material - Hazmat. A group of substances that can cause harm to people or the environment upon release. 

Hazardous Substance - Any substance or mixture of substances that presents a danger to the public health or safety or the environment.

Hazardous Waste Manifest - The shipping document, originated and signed by the waste generator or an authorized representative, that contains the information required and must accompany shipments of hazardous waste.

HAZMAT - Hazardous Material. A group of substances that can cause harm to people or the environment upon release. 

Hazmat Foam - A special vapor suppressing mix which can be applied to liquids or solids to prevent off-gasing.  

HCFR - Hickory County Fire Rescue.

HCHD - Hickory County Health Department.
http://www.hickorycountymo.com/

HCS - Home and Community Services.

HD - See distilled mustard.

Head Shielding - Devices built into the jacket while others are visible either as “half head” or trapezoidal shaped plate of steel mounted on both ends of the tank car. Applied to the lower portion of both heads (some may cover the entire head) to protect them against punctures. 

Heat Cramp - A muscle cramp accompanied by pain and nausea, caused by loss of salt and water though excessive perspiration. 

Heat Exhaustion - A condition caused by excessive exposure to heat and characterized by cold, clammy skin and general symptoms of shock; heat prostration.

Heat Rash - An eruption on the body typically with little or no temperature elevation: prickly, heat. 

Heat Stress - A physical, chemical, or emotional factor (as trauma or fear) to which an individual fails to make a satisfactory adaptation. It causes physiologic tensions that may be a contributory cause of disease. The state or condition of strain and especially of intense constraining forces due to excessive heat exposure. 

Heat Stroke - Severe exhaustion and collapse or sudden illness caused by overexposure to heat, as from the infrared rays of the sun.

Hemadynamic - Relating to the physical aspects of blood circulation.

Hemaglutination - The agglutination of red blood cells; may be immune as a result of specific antibody either for red blood cell antigens per se or other antigens which coat the red blood cells, or may be nonimmune as in hemagglutination caused by viruses or other microbes.

Hematemesis - Vomiting of blood.

Hemolysis - Alteration, dissolution, or destruction of red blood cells in such a manner that hemoglobin is liberated into the medium in which the cells are suspended, e.g., by specific complement-fixing antibodies, toxins, various chemical agents, tonicity, alteration of temperature.

Hemoptysis - The spitting of blood derived from the lungs or bronchial tubes as a result of pulmonary or bronchial hemorrhage.

HEPA - High Efficiency Particulate Air (breathing filters).

Hepatoxin - A chemical that is injurious to the liver.

Herbicide - A chemical compound used to damage or kill plants including defoliants, desiccants, plant growth regulators, and soil sterilants.

Hermatopoletic - Referring to the process of blood formation in the body.

Hermitage R-IV School - The Hermitage High School is a Public POD in Hermitage, Hickory County.

HFR - Halfway Fire Rescue.

HHS - Health and Human Services (federal). 
http://www.hhs.gov/

High Order Explosive - Those materials which detonate at velocities above 3300 feet per second. Materials that require moderate heat and reducing agents to initiate combustion.

High Pressure Container - A container designed to withstand pressures from 100 to 3,000 psi.

High Strength, Low Alloy - HSLA. A lightweight, high-strength, corrosion-resistant metal typically aluminum or magnesium-based alloy. The versatility and low specific gravity of these materials has made them very popular for structural applications in aircraft, transportation, materials-handling, portable-tool, and equipment industries.  

HN - See nitrogen mustard.

Hoax Device - An inactive or dummy device designed and intended to appear as a bomb or explosive material.

Hold - The interior of a ship below deck (cargo deck of a ship), or the interior of a plane (cargo compartment). A place of temporary refuge or shelter.

Hopper Car - A freight car, either open or covered, designed for handling bulk commodities such as coal or grain. Hopper cars have floor sheets that slope from the car sides and ends to form a series of pickets, or hoppers, which when opened, can discharge the bulk lading by gravity though hopper doors operated from outside the car.

Host - An animal or plant that harbors or nourishes another organism.

Hot Zone - The total exclusion area around a hazardous materials incident. Entry is limited to personnel wearing special protective clothing. Clearance to enter the area must be approved by the Safety Officer or designee. Area immediately surrounding a dangerous goods incident which extends far enough to prevent adverse effects from released dangerous goods to personnel outside the zone. This zone is also referred to as exclusion zone, red zone, or restricted zone in other documents. (EPA Standard Operating Safety Guidelines, OSHA 29 CFR 1910.120, NFPA 472)

HRSA - Health Resources and Services Administration.

HSAS - Health Status Alert System.

HSAS - Homeland Security Advisory System.

HSC - Homeland Security Council.
http://www.whitehouse.gov/homeland/

HSEESS - Hazardous Substance Emergency Event Surveillance System.

HSL - Division of Health Standards and Licensure (DHSS).

HSLA - High Strength, Low Alloy.

Humansville R-IV School - The Humansville High School is a Public POD in Humansville, Polk County.
http://humansvillemo.com/school.html

HVAC - Heating, Ventilation, and Air Conditioning.

HWMP - Hazardous Waste Management Program, of the Missouri Department of Natural Resources.

Hydration - The combining of a substance with water.

Hydrogen Cyanide - A poisonous blood agent that is usually a gaseous compound and has a taste associated with bitter almonds.

Hydrolysis - The reaction of any chemical substance with water, moisture, or vapor by which decomposition of the substance occurs and one or more new substances are produced.

Hydrolysis, Rate of - The rate at which the various chemical agents or compounds are decomposed by water.

Hygroscopic - A substance that has the property of absorbing moisture from the air, such as silica gel.

Hypergolic - A term used to describe substances that spontaneously ignite upon contact.

Hypotension - Subnormal arterial blood pressure.

Hypovolemia - An abnormally decreased volume of circulating fluid (plasma) in the body.

Hypovolemic Shock - The failure of tissue perfusion caused by a deficient fluid volume in the body. 

Hypovolemic Cardiovascular Insufficiency - A condition pertaining to or characterized by hypovolemia.

Hypoxemia - Subnormal oxygenation of arterial blood.

Exceptions:

References:

Critical section? No

Security level: Unclassified

Version: 1.0

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IC - Incident Commander. (See IMS.)

ICP - Incident Command Post.

ICS - Incident Command System. (See IMS.)

ICT50 - Median Incapacitating Agent – The volume of a chemical agent vapor or aerosol inhaled that is sufficient to disable 50% of exposed, unprotected people (expressed as mg-min/m3).

ICU - Intensive Care Unit.

Idiopathic - Denoting a disease of unknown cause.

IDLH - Immediately Dangerous to Life and Health, the maximum levels to which a healthy worker can be exposed for thirty minutes to a chemical and escape without suffering irreversible health effect or escape impairing systems. Concentrations immediately dangerous to life and health.

IED - Improvised explosive device. A homemade device consisting of an explosive/incendiary and firing components necessary to initiate the device.

IEMS - Integrated Emergency Management System is the application of the Comprehensive Emergency Management (CEM) concept. It refers to the program which integrates or incorporates all available resources to the full range of hazards and the full range of functions related to the four phases of emergency management.

IFGP - Individual Family Grant Program is administered by SEMA and the Department of Social Services to provide relief assistance to disaster victims following a presidentially declared disaster.

IFPD - Iconium Fire Protection District.

IG - Instructor Guide.

Igloo - A specialized container used in air carrier operations. Each container may hold a variety of commodities. Air carriers load containers individually and then load packed containers into the aircraft.

Ignition Sources - Energy activators that allow chemical reactions (fire or explosion) to take place. Examples are light, heat, friction, or spark.

Ignition Temperature - The minimum temperature at which a material will ignite without a spark or flame being present. This is also the temperature the ignition source must be. 

IMA - Individual Mobilization Augmentee is a program offered to state and local governments where a military reservist is assigned to the emergency management agency to assist in whatever task needs to be done.

Immiscible - That which cannot be mixed. For example, water and gasoline are immiscible.

Immunization - The act of artificially stimulating the body to develop antibodies against infectious disease by the administration of vaccines or toxoids.
A treatment which renders an individual less susceptible to the pathologic effects of a disease or provides a measure of protection against the disease. (19 CSR 20-20.010)

Immunoassay - Detection and assay of substances by serological (immunological) methods; in most applications the substance in question serves as antigen, both in antibody production and in measurement of antibody by the test substance.

IMO - International Maritime Organization.

Impermeable - The state of a material that does not allow another substance to penetrate or pass though it. 

IMS - Incident Management System is a management tool designed to control field emergency response operations by establishing functional areas under the direction of an Incident Commander. The IMS is a combination of facilities, equipment, personnel, procedures, and communications operation within a common organizational structure with responsibility for the management of assigned resources to effectively accomplish stated objectives pertaining to an incident. The combination of facilities, equipment, personnel, procedures, and communications operating within a common organizational structure with responsibility for the management of assigned resources to effectively accomplish stated objectives pertaining to an incident.

In Line Respirator - A respirator hooked up to an air supply.

Incapacitating Agents - Produce temporary physiological and/or mental effects via action on the central nervous system. Effects may persist for hours or days, but victims usually do not require medical treatment. However, such treatment speeds recovery.

Incendiary Device - Any mechanical, electrical, or chemical device used intentionally to initiate combustion and start a fire.

Incident Action Plan - The strategic goals, tactical objectives, and support requirements for the incident. All incidents require an action plan. 

Incident Command System - The Incident Command System (ICS) is a management tool designed to control field emergency response operations by establishing functional areas under the direction of an Incident Commander (IC). The ICS is the combination of facilities, equipment, personnel, procedures, and communications operating within a common organizational structure with responsibility for the management of assigned resources to effectively accomplish stated objectives pertaining to an incident. 

Incident Commander - The Incident Commander (IC) is the person in overall control of the incident site. The IC leads the Incident Command System. He/she is the local individual responsible for the management of all incident operations.

Incompatibility - The inability to function or exist in the presence of something else such as when a chemical will destroy the container. 

IND - Improvised Nuclear Device.

Induration - The process of becoming extremely firm or hard, or having such physical features.

Industrial Agents - Chemicals developed or manufactured for use in industrial operations or research by industry, government, or academia. These chemicals are not primarily manufactured for the specific purpose of producing human casualties or rendering equipment, facilities, or areas dangerous for use by man. Hydrogen cyanide, cyanogen chloride, phosgene, chloropicrin and many herbicides and pesticides are industrial chemicals that also can be chemical agents.

Infectious Agents - Biological agents capable of reproducing in an infected host.

Infectious Disease - A disease caused by a living organism or other pathogen, including a fungus, bacillus, parasite protozoan, or virus. It may or may not be transmissible from person to person, animal to animal, animal to person, or insect to person. 

Infectivity - 1) The ability of an organism to spread. 
2) The number of organisms required to cause an infection to secondary hosts. 
3) The capability of an organism to spread out from the site of infection and cause disease in the host organism.

Inguinal - Relating to the groin.

Inhibitor - A substance that is capable of stopping or retarding a chemical reaction. To be technically useful, it must be effective in low concentration. (i.e., to stop polymerization).

Initial Downwind Vapor Hazard Area - Areas initially established to evacuate all unprotected personnel and to prevent other unprotected personnel from entering and thus encountering agent vapors or any other type of contamination.

Initiator - The substance or molecule (other than reactant) that initiates a chain reaction, as in polymerization.  

Inoculation - Introduction into the body of the causative organism of a disease.

Inorganic - Pertaining to or composed of chemical compounds that do not contain carbon as the principal element (except carbonate, cyanides, and cyanates). Matter other than plant or animal.

Intermodal Container - Freight container designed and constructed to permit it to be used interchangeably in two or more modes of transport (i.e., highway and rail or water and rail).

Intermodal Traffic - Combining road, rail, water, and air transportation of goods into an integration system.

Internal Belly Valve - A reference by some to the excess flow valve in a tank truck. It is designed to close automatically if the external belly valve is sheared off.

Internal Floater - Liquid bulk storage with a roof that moves in relation to the level of liquid within. It is covered at the top usually with a geodesic dome to shield from the weather.

Ionizing Radiation - High-energy radiation, such as an X-ray, that causes the formation of ions in substances through which it passes (gamma rays). Excessive amounts of ionizing radiation will cause permanent genetic or bodily damage. 

Irritant - A noncorrosive material that causes a reversible inflammatory effect on living tissue by chemical action at the site of contact as a function of concentration or duration of exposure.

Isolation - The separation of a person or group of persons from other persons, except the health staff on duty, in such a manner as to prevent the spread of infection. 
(1) When applied to a person or group of persons, the separation of that person or group of persons from other persons, except the health staff on duty, in such a manner as to prevent the spread of infection; or
2) When applied to animals, the separation of an animal or group of animals from persons, other animals, or vectors of disease in such a manner as to prevent the spread of infection. 
The separation for the period of communicability of infected individuals and animals from other individuals and animals, in places and under conditions as will prevent the direct or indirect transmission of the infectious agent from infected individuals or animals to other individuals or animals who are susceptible or who may spread the agent to others. (19 CSR 20-20.010)

IT - Information Technology.

IV - Intravenous.

IW - Information Warfare.

Exceptions:

References:

Critical section? No

Security level: Unclassified

Version: 1.0

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JIC - Joint Information Center is a centralized facility to coordinate briefings to the news media by representatives of key response organizations in a disaster or emergency.

JOC - Joint Operations Center.

Joint Information Center - JIC. A center established to coordinate the public information activities. It is the central point of contact for all news media at the scene of the incident. Public information officials from all participating agencies should locate at the JIC. Public information officials from participating state and federal agencies also may collocate at the JIC.

Joint Operations Center - JOC. Established by the lead agency as the focal point for management and direction of onsite activities, coordination/establishment of state requirements/priorities, and coordination of the overall response.

Exceptions:

References:

Critical section? No

Security level: Unclassified

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Kevlar - Special lightweight chemical-and fire- resistant clothing material.

Kingpin - A retaining device used to connect containers to wheels. On rail, a metal rod used to connect the container to “truck housing.” On highway, a metal rod on a trailer which connects to the “fifth wheel” of the spirit pulling the container.

Exceptions:

References:

Critical section? No

Security level: Unclassified

Version: 1.0

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L&D - Labor and Delivery.

Lakeland R-III School - The Lakeland High School is a Public POD in Deepwater, St Clair County.

Latent Period - Specifically, in the case of mustard, the period between exposure and onset of signs and symptoms; otherwise, an incubation period.

LCT50 - Median Lethal Dosage – The amount of liquid chemical agent expected to kill 50% of a group of exposed, unprotected individuals.

LD50 - Lethal Dose at which 50% of exposed subjects die. Lethal Dose 50. The amount of exposure required to cause death in 50% of the population.

LD90 - Lethal Dose 90. The amount of exposure required to cause death in 90% of the population.

LEOC - Local Emergency Operations Center.

LEOP - Local Emergency Operations Plan.

LEPC - Local Emergency Planning Committee is a local planning group appointed by the Missouri Emergency Response Commission (MERC) to fulfill the planning requirements for a local planning district under the Superfund Amendments and Reauthorization Act (SARA).

Lethal Chemical Agent - An agent that may be used effectively in a field concentration to produce death.

Level 1 Incident - Hazardous materials incidents that can be correctly contained, extinguished, and/or abated utilizing equipment, supplies, and resources immediately available to first responders having jurisdiction.

Level 2 Incident - Hazardous materials incidents that can only be identified, tested, sampled, contained, extinguished, and/or abated utilizing the resources of a Hazardous Materials Response Team, which requires the use of specialized chemical protection.

Level 3 Incident - A hazardous materials incident that is beyond the controlling capabilities of a Hazardous Materials Response Team (technician or specialist level); and/or requires the use of two or more Hazardous Materials Response Teams; and/or must be additionally assisted by qualified specialty teams or individuals. 

Level A Protection - The greatest level of skin, respiratory, and eye protection. A totally encapsulating chemical protective suit, meaning a full-body garment that is constructed of protective clothing material; covers the wearer’s torso, head, arms, and legs; has boots and gloves that may be an integral part of the suit, or separate and tightly attached; and completely encloses the wearer in combination with the wearer’s respiratory equipment. All components of the suit, such as relief valves, seam, and enclosure assemblies, should provide equivalent chemical resistance protection. The level of protective equipment required in situations where the material is considered acutely vapor toxic to the skin and hazards are unknown. Full-encapsulation, air-tight chemical suit with SCBA or SABA.

Level B Protection - The highest level of respiratory protection is necessary but a lesser level of skin protection is needed. Often referred to as a splash suit. The level of protective equipment required in situations where the environment is not considered acutely vapor toxic to skin but may cause respiratory effects. Chemical splash suit or full-coverage, non-airtight chemical suit with SCBA or SABA.

Level C Protection - The concentration and type of airborne substances are known and the criteria for air-purifying respirators are met. Level C protection is more common in industry than emergency response. The level of protective equipment required to prevent respiratory exposure but not to exclude possible skin contact. Chemical splash suit with air purifying respirator (cartridge respirator).

Level D Protection - A work uniform affording minimal protection, used for nuisance contamination only. Should be used only when the atmosphere contains no known hazard. The level of protective equipment required when the atmosphere contains no known hazard, when splashes, immersions, inhalation, or contact with hazardous levels of any chemical is precluded. Work uniform such as coveralls, boots, leather gloves, and hard hat.

Levels of Protection - Personal protective equipment is divided into four categories based on the degree of protection afforded.

Lewisite - A blister agent that is an alipathic arsenic compound. The pure form is colorless to brown or violet liquid with a fruity or geranium-like odor.

Liaison - An agency official sent to another agency to facilitate interagency communications and coordination.

Liaison Officer - The point of contact for assisting or coordinating agencies. 

Lined Tank - A tank with a lining applied in strips or sections and fastened to the inside of the tank after the tank is constructed. Rubber is the most commonly used lining in hazardous materials service. Glass, lead, nickel, polyurethane, and polyvinyl chloride are also used as linings. 

Liquid Agent - A chemical agent that appears to be an oily film or droplets. The color ranges from clear to brownish amber.

Liquid Line - Any of the piping used to accept or discharge liquid, as opposed to a vapor line.  

Liquid Valve - Usually two valves used to load or unload liquids from tank cars. Unloading occurs by pumping, by pressure generated from the contents, or by pressurizing the tank with air, nitrogen, or another gas. An education pipe reaches from the liquid valve to the tank’s bottom.

Local EOP - The local Emergency Operations Plan focuses on essential measures for protecting the public to include warning, emergency public information, evacuation, and shelter. Local EOPs should include a mechanism for emergency responders and managers to notify and activate state resources.

Local Government - Any county, city, village, town, district, or political subdivision of any State, and Indian tribe or authorized tribal organization, or Alaska Native village or organization, including any rural community or unincorporated town or village or any other public entity.

Longitudinal - Describes length; lengthwise. The distance from left to right or vice versa.

Low Order Explosives - Those materials that detonate at velocities below 3299 feet per second. Materials that require excessive heat and reducing agents to initiate combustion. 

LPD - Local Planning District, a geographic planning area established by the SERC to meet the requirements of SARA. These districts are usually established following existing governmental boundaries. 

LPHA - Local Public Health Agency.

LPHE - Local Public Health Emergency.

LRN - Laboratory Response Network.

Lymphadenopathy - Any disease process affecting a lymph node or lymph nodes.

Exceptions:

References:

Critical section? No

Security level: Unclassified

Version: 1.0

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Scope:

Guideline:
M258 Kit - A kit that detects and identifies vapor concentrations of nerve, blister, and blood agents.

M8 Chemical Agent Detector Paper - A paper used to detect and identify liquid V- and G-type nerve agents and H-type blister agents.

MAA - Mutual Aid Agreement.

MAC - Multi-Agency Coordination (Committee, Group, and Command are used in various jurisdictions).

MACS - The combination of facilities, equipment, personnel, procedures, and communications integrated into a common system with responsibility for coordination of assisting agency resources and support to agency emergency operations. (FIRESCOPE)

Macula - 1) A small spot, perceptibly different in color from the surrounding tissue .
2) Small, discolored patch or spot on the skin, neither elevated above nor depressed below the skin’s surface.

Macule - A small spot, perceptibly different in color from the surrounding tissue. A small, discolored patch or spot on the skin, neither elevated above nor depressed below the skin’s surface.

Manway - A large opening in the top of a railroad tank car. This allows access to the interior of the tank. The hinged cover plate functions during the loading and unloading processes. 

MAOPS - Missouri Association of Osteopathic Physicians and Surgeons.

Marion C Early R-V School - The Morrisville High School is a Public POD in Morrisville, Polk County.
http://mcearly.k12.mo.us/
 
Mass Care - Coordination of nonmedical mass care services to include sheltering of victims, organizing feeding operations, providing emergency first aid at designated sites, collecting and providing information on victims to family members, and coordinating bulk distribution of emergency relief items.
 
Mass Explosion - Explosion which affects almost the entire load virtually instantaneously.

Material Safety Data Sheet - MSDS. A compilation of health, reactivity, and flammability information on a chemical product. It is a legal document required by the OSHA Hazard Communication Standard.
 
Materiel - Contents of the 12-hour Push Package or the Managed Inventory of the Strategic National Stockpile.

MATTS - Mobile Air Transportable Telecommunications System.

Maximum Allowable Concentration - The maximum amount of chemical in a solution. May also be referred to as the solubility limit. 

Maximum Safe Storage Temperature - The highest storage temperature for specific chemicals such as organic peroxides, temperatures above which may result in slow decomposition or explosion.

MCFH - Division of Maternal, Child, and Family Health (DHSS).

MCI - Mass Casualty Incident.

MCIU - Medical Intensive Care Unit. 

MDA - Missouri Department of Agriculture.

Mechanical Explosion - A mechanical explosion may be illustrated by the gradual buildup of pressure in a steam boiler or pressure cooker. As heat is applied to the water inside the boiler, steam is generated. If the boiler is not equipped with some type of safety valve, the mounting pressure will eventually reach a point at which it will overcome the structural or material resistance of its container, and an explosion will occur. Such a mechanical explosion will be accompanied by high temperatures, a rapid escape of gases or steam, and a loud noise. Another example of mechanical explosion is that of a dust explosion in a grain elevator.

Mechanical Foam - A substance introduced into the water line by various means at a 6% concentration. Air is then introduced to yield foam consisting generally of 90 volumes air, 9.4 volumes water and .6 volumes foam liquid. It uses hydrolyzed soybean, fish scale, hoof and horn meal, and peanut or corn protein as a base. 

Mechanical Stressor - Any of a series of things or conditions that may place physical stress on a container. Example: A heavy weight placed on a barrel that is not capable of withstanding the load. Torque placed on a stationary object not produced to withstand a twisting action. 

Mediastinitis - Inflammation of the cellular tissue of the mediastinum.

Mediastinum - The median portion of the thoracic cavity, covered by the mediastinal pleura and containing all the thoracic viscera and structures except the lungs.
 
Medical Surge - The ability to provide adequate medical evaluation and care in events that severely challenge or exceed the normal medical infrastructure of an affected community (through numbers or types of patients).

Melting Point - The degree of temperature at which a solid substance becomes a liquid, especially under pressure of one atmosphere. This may also be referred to as the freezing point. 

Meninges - Any membrane; specifically, one of the membranous coverings of the brain and spinal cord.

MERC - Missouri Emergency Response Commission (See LEPC). Coordinates community-right-to-know information and training for hazardous materials incident response for first responders. 
http://www.sema.state.mo.us/mercc.htm

MERGIS - Missouri Emergency Response Geographic Information System.

MERS - Mobile Emergency Response System.

Methods of Dissemination - The way a chemical agent or compound is released into the atmosphere.

MFD - Morrisville Fire Department.

MHA - Missouri Hospital Association.
http://web.mhanet.com/

Microorganism - Any organism, such as bacteria, viruses, and some fungi, that can be seen only with a microscope.

Microscopy - Investigation of minute objects by means of a microscope.

Miosis - A condition where the pupil of the eye becomes contracted (pinpointed). This condition impairs night-vision. It is a possible indicator of a nerve agent.

Miscible - Mixable in any and all proportions to form a uniform mixture. Water and alcohol are miscible; water and oil are immiscible. 

MMRS - Metropolitan Medical Response System.

MODOT - Missouri Department of Transportation.
http://www.modot.state.mo.us/

MOHSAIC - Missouri Health Strategic Architecture and Informative Cooperative. 

MOHSIS - Missouri Health Surveillance Information System.

MONG - Missouri National Guard.
http://www.moguard.com/

Monitoring Badges - Instruments that detect or “count” radiation, such as alpha or beta particles or gamma rays or X-rays. 

MORET - Missouri Radiological Team. A group of state employees, volunteer nuclear engineers, and health physicists trained in radiation safety. 

Moribund - Dying; at the point of death.

MOU - Memorandum of Understanding.

Mouthpiece Escape Respirator - A disposable respirator equipped with inhalation and exhalation valves and a one-piece polypropylene body with a belt clip or neck strap. It is designed for emergency escape protection against a variety of toxic gases, such as acid gas, ammonia, chlorine, organic vapors, etc., depending on the type of chemical fill used. 

MPHA - The mission of the Missouri Public Health Association is to take the lead in the identification of public health needs and problems and to work collaboratively with others in initiating and supporting action for the improved health of all Missourians.
http://www.mpha.opg/

MRC - The Medical Reserve Corps (MRC) emerged from the call to service that President Bush put out during his 2002 State of the Union Address. It is a sub-segment of the Citizen Corps of the USA Freedom Corps. Medical Reserve Corps units are community-based and comprised of health care professionals who desire to serve as volunteers in their communities during emergencies, as well as with ongoing public health needs.
 http://www.medicalreservecorps.gov

MRI - Magnetic Resonance Imaging, a procedure similar to an X-ray that allows the determination of soft tissue damage.

MSA - Metropolitan Statistical Area.

MSDS - Material Safety Data Sheet, a compilation of health, reactivity, and flammability information on a chemical product. 

MSST - Maximum Safe Storage Temperature, the highest storage temperature for specific chemicals such as organic peroxides, temperatures above which may result in slow decomposition or explosion. 

Mucocutaneous - Relating to mucous membranes and skin.

Muscular Rigidity - Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor.

Mustard Agent - A clear-, yellow-, or amber-colored, oily liquid with a smell similar to garlic and usually classified as a blistering or vesicant chemical agent. Some examples include sulfur mustard and nitrogen mustard. Vesicants. (See Blister Agent.)

Mutagen - A material that induces genetic changes (mutations) in the DNA of chromosomes. Chromosomes are the “blueprints” of life within individual cells.

Mutagenic - Materials that characteristically induce mutation in an organism. 

Myalgia - Muscular pain.

Mycotoxin - A toxin produced by fungi.

Exceptions:

References:

Critical section? No

Security level: Unclassified

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NACCHO - The National Association of County and City Health Officials (NACCHO) is the national nonprofit organization representing local public health agencies (including city, county, metro, district, and Tribal agencies).
http://www.naccho.org/

NAERG - The North American Emergency Response Guidebook. See ERG - Emergency Response Guidebook. 

NAPH - Name, Address, Phone, and Health history form.

Narcosis - Stupor or unconsciousness produced by chemical substances. 

NAWAS - National Warning System is a land-line (hard wire) network for transmitting and receiving emergency information to federal, state, and local agencies that have NAWAS drops (phone). It was designed specifically for warning in the event of a national emergency; now it is used in transmitting and receiving other emergency information such as severe weather. 

NBC - Nuclear, Biological, and Chemical.

NCHS - National Center Health Statistics.

NDMS - The National Disaster Medical System (NDMS) is a federally coordinated system that augments the nation's emergency medical response capability. The overall purpose of the NDMS is to establish a single, integrated national medical response capability for assisting state and local authorities in dealing with the medical and health effects of major peacetime disasters and providing support to the military and Veterans Health Administration medical systems in caring for casualties evacuated back to the U.S. from overseas armed conflicts.
http://ndms.dhhs.gov/NDMS/ndms.html

Necrosis - Pathologic death of one or more cells, or of a portion of tissue or organ, resulting from irreversible damage.
 
Neighborhood Emergency Health Center - A community-based outpatient center that:
- Directs casualties and “worried well” away from emergency departments (EDs), allowing hospitals to continue to remain open in some capacity.
- Renders basic medical evaluation and triage, allowing medical providers to focus their efforts and make efficient use of limited resources.
- Provides limited treatment t people seeking aid, including stabilization care and distribution of prophylactic medications and self-help information.

NEMA - National Emergency Management Association is a national association of state emergency management directors.
http://www.nemaweb.org/

Neoprene - Any of a group of synthetic rubbers made from chloroprene. It is superior to natural rubber in resistance, etc.

Nephrotoxin - A chemical that is injurious to the kidneys.

Neurotoxin - A chemical injurious to the nervous system.

Nerve Agents - Substances that interfere with the central nervous system. Exposure is primarily through contact with the liquid (skin and eyes) and secondarily through inhalation of the vapor. Three distinct symptoms associated with nerve agents are pinpoint pupils, an extreme headache, and severe tightness in the chest. Substances that interfere with the central nervous system. Tabun (GA), Sarin (GB), Soman (GD), and VX are nerve agents. 
Symptoms: Pinpoint pupils, extreme headache, severe tightness in the chest, dyspnea, runny nose, coughing, salivation, unresponsiveness, seizures.

NEST - Nuclear Emergency Search Team.

NETC - National Emergency Training Center is located at Emmitsburg, Maryland, and houses the Emergency Management Institute (NMI) and the National Fire Academy (NFA).

Neurotoxin - A chemical injurious to the nervous system. 

Neutralization - The process of making a solution neutral by adding a base to an acidic solution or an acid to a basic solution.

NFA - National Fire Academy is located at the NETC and is a part of FEMA. The academy designs courses primarily for fire service personnel, offering some as part of its resident program and also have a field-training program. 
http://www.usfa.fema.gov/fire-service/nfa.cfm

NFIP - National Flood Insurance Program includes flood insurance and floodplain management programs administered by FEMA. 

NFPA - National Fire Protection Association.
http://www.nfpa.org/

NFPA 704 Diamond -

NGA - National Governor’s Association is an association of state governors who assist FEMA in identifying laws and regulations relating to natural, technological, peacetime, or attack emergencies.

NICU - Neonatal Intensive Care Unit.

NIOSH - National Institute for Occupational Safety and Health, a federal agency that tests and certifies respiratory protective devices, air-sampling detector tubes, and recommends occupational exposure limits for various substances.
http://www.cdc.gov/niosh/homepage.html

NIST - National Institute of Standards and Technology.
http://www.nist.gov/

Nitrogen Mustard - A blister agent that is a colorless or amber-colored oily liquid and has a faint geranium smell.

NMC - Network Management Control is imposed by a telephone company limiting incoming calls while allowing more outgoing calls.

NMRI - Naval Medical Research Institute.

NMRT - National Medical Response Team.

NOAA - National Oceanic and Atmospheric Administration administers scientific and research programs related to oceans and atmospheric conditions, specifically related to climatology and weather phenomena.
http://www.noaa.gov/

Node - The Strategic National Stockpile (SNS) will be delivered to the Receiving Storage Site (RSS). Mass prophylaxis needed for the region will be transported from the RSS to a node. At the node it will be sorted and sent on to Points of Distribution (PODs). Public PODs are locations (schools) where the general public will come to receive medication. Private PODs are locations (i.e. hospitals) where only those at that site will use the medication.   

Non-Ambulatory - A client that is not capable of walking; bedridden. 

Non-Persistent Agent - An agent that upon release loses its ability to cause casualties after 10 to 15 minutes. It has a high evaporation rate and is lighter than air and will disperse rapidly. It is considered to be a short-term hazard. However, in small, unventilated areas, the agent will be more persistent.

Non-Polar - See immiscible.

NPS - National Pharmaceutical Stockpile. (Now called the SNS or Strategic National Stockpile.)

NOS - These letters refer to not otherwise specified. The entries which use this description are generic names such as “Corrosive liquid, n.o.s.” This means that the actual chemical name for that corrosive liquid is not listed in the regulations; therefore, a generic name must be used to describe it on shipping papers.

Nosocomial - Denoting a new disorder (not the patient’s original condition) associated with being treated in a hospital, such as a hospital-acquired infection.

Noxious - A material may be harmful or injurious to health or physical well-being.

NPTN - National Pesticide Telecommunications Network, a 24-hour hotline (800-858-PEST) operated by the Texas Tech University School of Medicine providing information about pesticide safety, application, chemistry, and toxicology.

NRC - Nuclear Regulatory Commission is a federal agency that regulates and enforces peacetime nuclear laws, materials, and power plants. 
http://www.nrc.gov/

NRC - National Response Center, a communications center operated by the US Coast Guard that provides information on suggested technical emergency actions, and must be notified within 24 hours of any spill of a reportable quantity of a hazardous substance by the spiller. 

NRT - National Response Team.

Nuclear Explosion - A nuclear explosion may be induced either by fission (the splitting of the nuclei of atoms) or fusion (the joining together under great force of the nuclei of atoms). When fission or fusion occurs, a tremendous release of energy, heat, gas, and shock waves take place.
 
Nursing Protocols - Describes the steps to be taken in the nursing management of specific health problems. Includes strategies for obtaining historical and physician assessment data and plans of action. Nursing protocols do not need to be signed by a physician.
 
NWS - National Weather Service is an agency that provides population information regarding weather phenomena, especially in the area of forecasting.

Exceptions:

References:

Critical section? No

Security level: Unclassified

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Odor Threshold - The greatest dilution of a sample with odor-free water to yield the least definitely perceptible odor.

OER - Office of Emergency Response – formally Office of Emergency Preparedness (federal).

Off Loading Valve - An outlet valve for the discharge of product.

OHS - Office of Homeland Security. 
http://www.dhs.gov/

OMB - Office of Management and Budget.

Operational Period - The period of time scheduled for execution of a set of operation actions such as specified in the Incident Action Plan. 

OPI - Office of Public Information (DHSS).

OR - Operating Room.

Organic Vapor Analyzer - A type of monitoring equipment used to detect hydrocarbon and hydrocarbon derivatives. May also be referred to as a FID, or Flame Ionization Detector.

Organism - Any individual living thing, whether animal or plant.

Organophosphate - A compound with a specific phosphate group which inhibits acetylcholinesterase. Used in chemical warfare and as an insecticide.

Organophosphorus Compound - A compound containing the elements phosphorus and carbon whose physiological effects include inhibition of acetylcholinesterase. Man-made pesticides (malathion and parathion) and virtually all nerve agents are organophosphorus compounds.

Osceola R-I School - The Osceola High School is a County Node and Public POD in Osceola, St Clair County.
http://www.osceola.k12.mo.us/

OSHA - Occupational Safety and Health Administration.
http://www.osha.gov/
 
Outbreak or Epidemic - The occurence in a community or region of an illness(es) similar in nature, clearly in excess of normal expectancy and derived from a common or propagated source. (19 CSR 20-20.010)

OVA - Organic Vapor Analyzer, a type of monitoring equipment used to detect hydrocarbon and hydrocarbon derivatives. May also be referred to as a Flame Ionization Detector (FID).

Overpacking - The placement of the agent or its container within another container.

Oxidizer - Also referred to as an oxidizing agent, causes another substance to lose electrons. Oxygen is the most common oxidizer in our environment. Oxidizers are said to be reduced when they gain the electrons by the material that they are oxidizing. A chemical which supplies its own oxygen and which helps other combustible material burn more readily.

Oxygen Deficient - Defined by OSHA as ambient air containing less than 19.5% oxygen concentration.

Oxygen Enriched - Defined by OSHA as ambient air containing above 23.5% oxygen concentration. 

Exceptions:

References:

Critical section? No

Security level: Unclassified

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PA - Public Assistance is a program administered by SEMA to provide partial funding for damaged publicly-owned facilities during a presidentially declared disaster.

PAO - Public Assistance Officer is a SEMA staff member responsible for administration of the Public Assistance Program.

Pandemic - Denoting a disease affecting or attacking the population of an extensive region, country, continent; extensively epidemic.

Papule - A small, circumscribed, solid elevation on the skin.

Parasite - Any organism that lives in or on another organism without providing benefit in return.

Partner Decontamination - The process whereby the entry team members, upon exiting the hot or exclusion zone, will decontaminate (gross) each other, avoiding unnecessary or excessive chemical exposure to decontamination team members. 

Passive Immunity - Providing temporary protection from disease through the administration of exogenously produced antibody.

Pathogen - Any organism (usually living) capable of producing serious disease or death, such as bacteria, fungi, and viruses.

Pathogenic Agent - Biological agents capable of causing serious diseases.

PCHC - Polk County Health Center.
http://www.polkcountyhealthcenter.com/

Pathological Waste - Includes biopsy materials and all human tissues, anatomical parts that emanate from surgery, obstetrical procedures, autopsy and laboratory procedures, and animal carcasses exposed to pathogens in research and the bedding and waste from such animals.

PCMRC - Polk County Medical Reserve Corps.

PCSO - Polk County Sheriff’s Office.
http://www.polkcountymosheriff.org/

PDD - Presidential Disaster Declaration.

PDD39 - Presidential Decision Directive Number 39. Issued in June 1995, PDD-39, United States Policy on Counterterrorism, directed a number of measures to reduce the nation's vulnerability to terrorism, to deter and respond to terrorist acts, and to strengthen capabilities to prevent and manage the consequences of terrorist use of nuclear, biological, and chemical weapons.

PDS - Professional Development Series is a series of training courses to develop professional skills in emergency management.

PDWP - Public Drinking Water Program, of the Missouri Department of Natural Resources.

PEL - Permissible Exposure Limit. An occupational health term used to describe exposure limits for employees. Usually described in time weighted averages (TWA). Established by OSHA. PEL generally relates to legally enforceable Threshold Limit Values (TLV). 

Penicillin - Antibiotic used in treatment and prophylaxis of anthrax.

Percutaneous Agent - Able to be absorbed through the body.
 
Period of Communicability - The period of time during which an etiologic agent may be transferred, directly or indirectly, from an infected person to another person or from an infected animal to a person. (19 CSR 20-20.010)

Permeation - The process by which a chemical moves through protective clothing. A chemical action involving the movement of a chemical, on a molecular level, through intact material. 

Permeation Rate - The rate at which a chemical permeates a solid, such as fabric.

Persistence - A measure of the duration for which a chemical agent is effective. The property is relative and varies by agent, method of dissemination, and environmental conditions, such as weather and terrain.

Persistent Agent - An agent that upon release retains its casualty-producing effects for an extended period of time, usually anywhere from 30 minutes to several days. A persistent agent usually has a low evaporation rate, and its vapor is heavier than air. Therefore, its vapor cloud tends to hug the ground. It is considered to be a long-term hazard. Although inhalation hazards are still a concern, extreme caution should be taken to avoid skin contact as well.

Personal Protective Equipment - PPE. The equipment provided to shield or isolate a person from the chemical, physical, and thermal hazards that may be encountered at a hazardous material incident. PPE includes both personal protective clothing and respiratory protection. Adequate personal protective equipment should protect the respiratory system, skin, eyes, face, head, body, and hearing. 

Petechia - Minute hemorrhagic spots, of pinpoint to pinhead size, in the skin which are not blanched by pressure.

PETN - Pentaerythritol Tetra Nitrate; mainly used in the manufacture of detonating fuses (Primacord).

Pleasant Hope R-VI School - The Pleasant Hope Middle School is a Public POD in Pleasant Hope, Polk County.

pH - pH is a value that represents the acidity or alkalinity of a water solution. Pure water has a pH of 7. A pH value below 7 indicates an acid solution (a pH of 1 is extremely acidic). A pH above 7 indicates an alkaline solution (a pH of 14 is extremely alkaline). Acids and alkalis (bases) are commonly referred to as corrosive materials.

PHCP - Pre-Hospital Care Provider, a person with training below that of an emergency medical technician or paramedic who provides initial care to the sick and injured. 

PHFR - Pleasant Hope Fire Rescue.

Phosgene - A colorless gas that is a severe respiratory irritant. It smells like newly mown hay and imparts a metallic taste similar to tobacco smoke.

Physical Properties - A property of matter that describes only its condition, not the way it reacts with other substances. Examples are size, density, color, and electrical conductivity. 

Physiology - The science dealing with the normal function of living things or their organs. (i.e., physiology of the blood).  

Physiological Action - Most toxic chemical agents are used for their toxic effects, that is, to produce a harmful physiological reaction when applied to the human body externally, when breathed, or when taken internally. This reaction of chemical agents, within the body or on the body, is the physiological action.

PICU - Pediatric Intensive Care Unit.

PID - Photo Ionization Detector. A monitoring device which ionizes samples using ultraviolet light. Electrons “knocked” loose from the sample are collated and electronically amplified to provide the user with a signal or display value. 

PIH - Poison Inhalation Hazard. Term used to describe gases and volatile liquids that are toxic when inhaled. (Same as TIH)

PIO - Public Information Officer. A public official usually part of an emergency management group whose function is to coordinate emergency information releases to the media or to the public. 

Plague - Possible biological warfare agent. Plague is an infectious disease caused by the gram-negative, bipolar-staining bacterium. Naturally-occurring plague is most often acquired by the bite of a flea which had previously fed on infected rodents. In such cases, plague classically presents as a localized abscess with secondary formation of very large, fluctuant regional lymph nodes known as buboes (bubonic plague). Plague may also be transmitted via aerosol and by inhalation of sputum droplets from coughing patients. In such instances, a primary pneumonic form may develop and, in the absence of prompt therapy, progress rapidly to death within 2-3 days. Intentional release by belligerents or terrorist groups would presumably involve aerosolization, but could also involve the release of infected fleas. Plague may be considered a lethal agent. 

Plan of Action - A written document that consolidates all of the operational actions to be taken by various personnel in order to stabilize an incident.

Plugging - The use of compatible patches or materials to reduce or temporarily stop the flow of liquids from small holes, rips, tears, or gashes in containers. The repaired container may not be reused without proper inspection and certification.

POD - Point of Distribution – The Strategic National Stockpile (SNS) will be delivered to the Receiving Storage Site (RSS). Mass prophylaxis needed for the region will be transported from the RSS to a node. At the node it will be sorted and sent on to Points of Distribution (PODs). Public PODs are locations (schools) where the general public will come to receive medication. Private PODs are locations (i.e. hospitals) where only those at that site will use the medication.   

Polar - See miscible.

Polar Solvent Liquids - Those liquids that mix (are miscible) with water.

Polymerase Chain Reaction - PCR. An in vitro method for enzymatically synthesizing and amplifying defined sequences of DNA in molecular biology. Can be used for improving DNA-based diagnostic procedures for identifying unknown biowarfare agents.

Polymerization - A chemical reaction in which one or more small molecules combine to form larger molecules. A hazardous polymerization is such a reaction that takes place at a rate that releases large amounts of energy that can cause fires or explosions or burst containers. Materials that can polymerize usually contain inhibitors that can delay the reactions. This term describes a chemical reaction which is generally associated with the production of plastic substances. Basically, the individual molecules of the chemical (liquid or gas) react with each other to produce what can be described as a long chain. These chains can be formed in many useful applications. A well-known example is the styrofoam (polystyrene) coffee cup which is formed when liquid molecules of styrene react with each other or polymerize forming a solid, therefore changing the name from styrene to polystyrene (“poly” means “many”).

Port - 1) A place where ships and boats can load or unload or be sheltered from storms; a harbor.
2) An opening in the side of a ship to let in light and air or for loading and unloading.
3) The left side of a ship when facing the bow.
4) An opening in a container. 

Post Decontamination - Usually the period of time after decontamination when the person is allowed to rest and take fluids to replace the lost electrolytes. Sometimes the debriefing period. 

Post Incident Analysis - The termination phase of an incident that includes completion of the required forms and documentation for conducting a critique.  

PPE - Personal Protective Equipment. The equipment provided to shield or isolate a person from the chemical, physical, and thermal hazards that may be encountered. Includes both clothing and respiratory protection. Adequate personal protective equipment should protect the respiratory system, skin, eyes, face, head, body, and hearing. (See Levels of Protection)

PPM - Parts Per Million, typically used to describe very dilute solutions or airborne contaminants. Refers to the parts of one material in a whole of a million.

PPSCBA - Positive Pressure Self Contained Breathing Apparatus as defined in NFPA 1981. As opposed to a demand regulator used on older model SCBAs. 

Precursor - A chemical substance required for the manufacture of chemical agents.

Pre-Decontamination - The physical removal of excess layers of protective clothing (outer boots, gloves) prior to exiting the hot zone and entering the decontamination corridor. 

Pre-Disaster Response - Based on the potential or known threat of a natural disaster, e.g. a flood, preparatory actions taken by federal, state, or local governments to protect life and property and to minimize the effects of the event on response personnel and equipment. The actions facilitate the deployment of resources necessary for immediate response and initial recovery operations, as required.

Pre-Hospital Care Provider - A person with training below that of an emergency medical technician or paramedic who provides initial care to the sick and injured.
 
Prescription or Drug Order - A physician has the independent legal authority to administer or dispense drugs. This authority is delegated to another person through an order, prescription, standing orders, protocols, or collaborative practice agreement. An order is generally considered to be written on the client's record. A prescription generally refers to an order written on a separate piece of paper.

Pressure Relief Devices - A spring-loaded valve, generally used on a reciprocating pump for providing relief from excessive pressures (also weather pressures). Placed on the discharge side of the pump. In case of too much backpressure, the seat of the valve lifts and fluid is allowed to escape to the intake side of the pump.

Product Stressor - Any chemical which causes a reaction with or within the container in which it is stored. The reaction causing failure or possible failure of the container such as an acid in an unprotected aluminum tank. 

Prophylactic Drugs - The drugs that protect against biological threats, such as anthrax. 

Prophylaxis - The prevention of or protection treatment for disease. Prevention of disease or of a process that can lead to disease.

Prostration - A marked loss of strength, as in exhaustion.

Protection - In the context of chemical, biological, nuclear, or radiological exposure, protective measures may include masks, self-contained breathing apparatus, clothing, buildings, and so forth.

Protective Clothing - Includes both respiratory and physical protection. One cannot assign a level of protection to clothing or respiratory devices separately. These levels were accepted and defined by response organizations such as US Coast Guard, NIOSH, and US EPA. 
Level A: SCBA plus totally encapsulating, chemical-resistant clothing (permeation resistant). 
Level B: SCBA plus hooded chemical-resistant clothing (splash suit). 
Level C: Full or half-face respirator plus hooded chemical-resistant clothing (splash suit). 
Level D: Coverall with no respiratory protection.
 
Protocol - Describes the medical treatment to be included in the plan of care for a specific condition. This includes prescription medications and treatments that require a physician's signed order.

Proximity Suit - A suit that provides short duration and close proximity protection at radiant heat temperatures as high as 2,000 degrees F and may withstand some exposure to water and steam. Respiratory protection must be provided with proximity suits.

PSA - Public Safety Announcements.

PSC - Public Service Commission, of the Missouri Department of Economic Development.

PSI - Pounds of force per square inch.

PSIA - Pounds of absolute force per square inch.

PSIG - Pounds of force per square inch shown on a gauge.

Psychochemical - An agent, such as LSD, that incapacitates by distorting the perceptions and cognitive processes of the victim.

Public Information Officer - PIO. A public official usually part of an emergency management group whose function is to coordinate emergency information releases to the media or to the public. Official at headquarters or in the field responsible for preparing and coordinating the dissemination of public information in cooperation with other responding federal, state, and local agencies.

Ptosis - Drooping of the eyelids.

Pulmonary Edema - Swelling of lung tissue.

Pyrogenic - Causing fever.

Pyrolysis - A chemical decomposition or breaking apart of molecules produced by heating. 

Pyrophoric - Materials that ignite spontaneously in air below 130 degrees F (54 degrees C). A material which ignites spontaneously upon exposure to air (or oxygen).

Exceptions:

References:

Critical section? No

Security level: Unclassified

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Q Fever - Q Fever is caused by infection with the rickettsial organism, and is typically spread by inadvertent aerosolization of organisms from infected animal products, especially the placentas of parturient sheep and goats. Person-to-person transmission rarely, if ever, occurs. Intentional release by belligerents or terrorism groups would presumably involve aerosolization, and Q fever would likely be employed as an incapacitating agent, as its mortality rate is quite low (1-3%). 

QA - Quality Analysis.

QC - Quality Control.

QRV - Quick Response Vehicle.

QT - Quench Tempered, a sudden forced temperature change from extreme hot to cold.

Quarantine - A period of detention for persons or animals that may have been exposed to a reportable disease. 
Complete – Limitation of freedom of movement of persons or animals exposed to a reportable disease to prevent contact with the general populations.
Modified – Selective, partial limitation of freedom of movement of persons or animals determined on a basis of difference in susceptibility or danger of disease transmission. (Example: Exclusion of children from school.)
A period of detention for persons or animals that may have been exposed to a reportable disease. The period of time will not be longer than the longest period of communicability of the disease. The purpose of quarantine is to prevent effective contact with the general population. (19 CSR 20-20.010)