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Day 4
A large number of people are showing up at the facility wanting to volunteer and donate supplies
Outcomes: ICS Tent-- |
·        Establish donations management policy ·        Clarify process for spontaneous unaffiliated volunteers
·        Just in time training

Day 5
There has been an incident of gang violence in the facility. Immigration officers are trying to identify and separate gang members, but there were multiple minor injuries and rising stress in the facility for both staff and refugees.
Outcomes: ICS, Medical & Human Svcs

-Emergency triage of injured and appropriate referral if needed
-Counselling for both refugees and staff as needed
-Safety training of volunteers

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Hello Everyone,
I have attached the daily briefing report for today (OCT14).
-Griselda

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Medical Tent_Daily Briefing Report OCT 14

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Hello Everyone,
I have attached the daily briefing report for OCT 13.
-Griselda

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Here's our daily brief. Thanks everyone!! - Ama

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With the large number of people showing up to volunteer and donate supplies, as the public health tent, it is our responsibility to ensure that the resources coming in will not endanger the refugees.  As volunteers arrive, they should be sent to medical for a brief screening.  Temperature and quick questionnaire about how they are feeling should cover it. Volunteers handling food should receive a crash course in proper hygiene.  The public health tent should gather all incoming supplies for inspection prior to distribution.  Food should be highly scrutinized, especially canned foods and perishables.  If need be, we should think about searching for a refrigeration truck to prolong the life of any perishable food items that come in.

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I think Hannah has an excellent idea here.

MY TOP PRIORITY WITH THE VOLUNTEERS: We need to make sure that we request the proper security and access to work areas for the volunteers, no point in having volunteers if they can’t get to where they need to go. We can do this by having appropriate personnel meet the volunteers as the gate and escort them in. The refugee map is on a military base, volunteers will not be able to enter unless they have proper identification or an escort. I have military base access to help with this. I'll also contact the base commander to see if they can send personnel to assist us in bringing the volunteers into the camp. Does anyone else here have the proper identification to access a military base?

-Hannah Wilson

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https://padlet.com/roberta_lavin/6vz4a2e3wz4fmyyt/wish/2337901722

was posted on time just in a different padlet

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Hello Everyone,
To ensure the safety of this vulnerable population, anyone volunteering needs to undergo clearance. They should have their credentials checked if they are providing any type of healthcare. If they are there for another reason, they will need a background check and have their personal information saved in the volunteer database. A badge will be provided to volunteers who have undergone vetting that will include who they are and what their role is within the camp. I also think we should set the clinic up into two separate areas. One area will just see those who have already undergone testing and just need follow up services such as reading the PPDs, medications, or other ongoing treatments. The other area will just be for new incoming refugees who have not been seen yet.---Christina Peralta

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A large number of people are showing up at the facility wanting to volunteer and donate supplies.

What happens now?

Now we have to determine whether the volunteers and donations are safe enough to enter the refugee camp.

What actions are taken?

We would start by assigning team members to gather the volunteers and do proper screening to ensure all are safe to help with the refugees.

Adding on to what everyone else already said: This may include security checks, vital checks (e.g. temperature), and checking for age since it may be a liability issue for smaller children to volunteer.

For food donations, we should also do a safety check for sanitation and expiration dates. We would only accept non perishable foods that have been unopened; no home cooked foods should be allowed unless it’s coming from a reputable place to prevent contamination. It’s important to know what ingredients are in each food item and where it is sourced to prevent allergies and food poisoning.

For other donation items like clothing, blankets, electronics, etc., they should also be checked for contamination and organized based on where it will be delivered. For example, clothing and blankets can go to the refugees, while medical supplies can go to the medical team for inspection.

Who is contacted?

We should contact the Planning and Logistics team to make a record of the available inventory and notify everyone or the additional supplies available. We would also contact the medical tent and people from our own tent to inspect the volunteers and determine who is eligible to help.

- Miley Nguyen

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Thanks for all the support everyone!!

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Expected Outcomes Day 3 (posted by Mary Pat)

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Expected Outcomes Day 3 (posted by Mary Pat)

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Keep up the great work!

The expected outcomes were met by the different tents. A list of supplies and other resources was submitted by the Medical Tent to the ICS Teams. The need to adjust the schedules for those deployed was discussed along with the need for additional personnel.
-Identification of how to request supplies
-Adjustment of schedule to meet demands
-Identification of need for additional personnel

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• 100 new refugees are arriving.

• How might you be able to assist the other tents?

To assist the other tents with an influx of 100 new refugees, the public health tent could assign members of our staff to help the medical tent triage the incoming people. We could assign some of our members to the human services tent to evaluate what kinds of needs or support they may need. In doing this, we will have our eyes on all aspects of the new arrivals and have a better opportunity to identify any public health issues that have just arrived.

Regarding the bed shortage, we ask for any available cots from nearby military instillations or homeless shelters. In the meantime, we could appeal to the local communities to begin food and clothing drives. To accommodate the need for additional food and water, we could have the public affairs officer make a public announcement through a press release asking for assistance from local and national businesses for resources.

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Hello Everyone,
I have attached the daily briefing report for OCT 12. Let me know if you have any additional suggestions.
-Griselda

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What happens now?
Now, it is in the IC system's best interest to start contacting other agencies in order to start outsourcing refugee families to other appropriate facilities that are equipped to handle the growing number of arriving people. Also, hospitals that are within the same region should be contacted to restock on only the supplies that are absolutely necessary to aid these people in recovery and refuge. If there are no more facilities willing to take in refugees as they come in, it would be wise to start expanding the current housing situation by contacting the hospital for more stretchers, beds, or anything to prepare the environment for greater influx of people. -Elijah Giles

Actions Taken:
Priority number one in this case would be to reassess staffing, supplies and bed status. Triage of patients with current staffing to assess for health statuses among refugees. The second priority is to send requests to Logistics Section Chief for supplies, beds and staffing to logistics branch to accommodate influx of refugees with safety in mind. Staffing request should include security staff as well. -Denise Mitchell

Who is contacted? To help with reaching out to nearby hospitals in the region, it might also be useful to get contact with the Department of Defense (DOD) agency because they can help coordinate patient reception, tracking, and management to nearby National Disaster Medical System (NDMS) hospitals, VA hospitals, and DOD military treatment facilities that are available to provide care for the increasing number of refugees. Also with contacting the DOD they can help provide us with clean water and food. With the influx of refugees I believe having enough food and water would be another priority. -Hannah Wilson

My priority would assessing the city’s resources and determine if there are other buildings that can be used to hold the refugees. Even if there are not enough beds, it’s important to have shelter. These buildings can be rec centers, empty gymnasiums, church rooms, etc. I would then assess the refugees and categorize them based on severity of needs. Then, get in contact with the medical tent to determine how resources should get distributed and which people need them most. -Miley Nguyen

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100 new refugees are arriving.
What do you need to manage this influx?

What happens now?

Initially, people who have not been screened should remain separate from those who have. We will need to make requests for more beds and medical supplies to perform physical assessments.

What actions are taken?

I think we should consider a scouting mission along the incoming path of the refugees to see how many people we should anticipate within the next few days/weeks. This will help us get a better understanding of the number of supplies that will be needed and reduce the number of requests for supplies. We will also need a pharmacist to help manage the large amount of diverse medications we are likely to administer. We will need infrastructure for medical/biohazard waste.

Who is contacted?

We will make all requests for supplies to the Head of the service branch, who will report directly to the chief of the logistics section.---Christina Peralta

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Hello everyone, I answered the first three questions from the tasks for 10/11. Please add any details you feel necessary.
How will you respond to requests for help from the ICS Commander?

The medical unit will respond to the ICS commander through the proper chain of command. This includes the medical staff reporting to the head of the service branch within the logistics section. The message will then be conveyed to either the Safety Officer, Public information Officer, or the Liaison Officer who will report the information directly to the ICS Commander.

What kind of illnesses or injuries might you expect?
Some expected illnesses and injuries include:

·        Tuberculosis, HIV, scabies, lice, measles, diphtheria, COVID 19

·        Water born infections (GI - vomiting/diarrhea) and mosquito born infections

·        Acute malnutrition and dehydration

·        Injury and disease (STDs) due to sexual violence

·        Cuts and wounds from debris

·        Infected wounds

·        Orthopedic injury and head injury

·        Hypothermia

·        Mental health issues - long term or situational due to stress and exhaustion

What is required to screen the refugees and when does that need to be done?
In the initial first 12 hours:
·        Vitals

·        Health Hx: dental, vision, medical, and mental health

·        Continue any ongoing medical therapies

·        Screening: COVID, pregnancy, TB

·        Giving patient education

Within the first 14 days:
·        Physical, vision, dental, mental health screening with referrals when needed

·        Follow up assessments for acute/chronic illness

·        Problem focused care
Thank you, Christina Peralta

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Hello ICS team,

I have attached a document for requested supplies for 10/12/22.

-Griselda

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It is October 12th. 100 more refugees have arrived and those on scene are working to find enough beds. As of now, 50 more beds are needed along with more medical supplies for physical exams and screenings. Today, the main objectives involve working with organizations to provide the resources needed as well as continuing to work with the Refugee Resettlement program. We will provide updates as we learn more. Thanks, Zoe Finlay, PIO.

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Response by Mireya Martinez (Safety officer)

10/12/22 Day 3

As the safety officer, I have contacted and delegated maintenance personnel and janitorial services to assure that the sanitation areas are clean and properly functioning. Additionally, I delegated an assistant to contact a contractor that provides portable bathrooms (porta potty dogs) and sinks. With that being said, this assistant is advised to request additional portable bathrooms (porta potty dogs)/sinks and more maintenance personnel/janitorial services to account for the 100 more refugees that are coming in along with the 500 that the facility currently have. Additionally, personnel have been delegated to identify all personnel coming into the facility with ID bracelets. Also, unaccompanied minors  have identification wristbands with the information that we have. Unaccompanied minors have yellow wrist bands, accompanied minors have green wrist bands, healthy adults have blue wristbands, people with special needs have purple wrist bands,and  patients who need medical attention have white wristbands in addition to their colored bed. People who do not show their wrist band or staff ID will not be allowed into the base and security guards have been contacted and delegated at every entrance port. French and Spanish speaking volunteers have been requested to the American Red Cross and other volunteer organizations. Additionally, an “over the phone” translator company has been contacted and have agreed to help. Biohazard bins/supplies, cleaning stations, PPE, and N-95 masks have been requested to FEMA and other outside resources. I have delegated professional personnel to properly dispose of the biohazard supplies. Lastly, I have requested for more medical professionals to account for the incoming 100 patients and to prevent burnout, near misses, and/or sentinel events. Is there anything else you all would suggest on my part?

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Expected Outcomes Day 2 (posted by Mary Pat)

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Expected Outcomes Day 2 (posted by Mary Pat)

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Great job with identifying major issues based on the injects. There are specific requirements for health screening within 12 hrs. and a more comprehensive health assessment at 14 days.

| ·        Assume DHS has done their portion which is outside the scope of the exercise ·        Plans are made for initial health screening with 12 hours (VS, history, medications, COVID screening based on exposure hx and symptoms, TB screening, pregnancy screening, patient education) ·        Plans are made for comprehensive health assessment within 14 days (Physical examine & vision screening, mental health screening, F/u assessment for acute or chronic conditions and medication, behavioral health referrals, dental screening, and problem-focused care) ·        Set up sick call system ·        Advise facility administration and arrange for admission to an Office of Refugee Resettlement program within 24 hours after arrival and ensure children meet criteria. ·        Afternoon report out to Incident Command Tent who then prepares morning report. ·        Players have packed an adequate go bag that has what they need for the first 3 days.

| ·        Human services are provided consistent with title 8 chapter 119 of the social services refugee resettlement program. ·        Coordination between medical, public health, and human services for required screenings and/or vaccinations prior to reunification.
| ·        Identify interpreter services ·        Train providers on use of interpreters

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Hi, Im Kylie and I arrived today. I am on the human services team.

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Hello Everyone,

Here is the daily briefing for 10/11/2022.

-Griselda

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What happens now?
Make sure that the 20 unaccompanied people are taken care of and make sure to assess their health.
Reach out to the immigrants and ask if anyone can translate between English and Spanish or English and French.
Calculate the amount of current supplies.

What actions are taken?
Request that doctors, nurses, and EMT’s be sent to provide care.
Request supplies such as food, medical supplies, medication etc.

Who is contacted?
Contact volunteer preparedness organizations.
Work with public health and with human services.
Work with organizations to reunite children with their families.
-Jonathan Barajas

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Hi. My name is Sarah. I arrived today for the human services team!

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By: the entire human services and disaster management team!

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hello, my name is Martha and I'm reporting  duty on10/11

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hello, my name is Martha and I'm reporting  duty on10/11

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Hi, this is Sophie Reynolds and I'm reporting today, 10/11.

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Hi, this is Sophie Reynolds and I'm reporting today, 10/11.

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Hello my name is Ethan Sandifer I’m part of the medical reserve core and I arrive today 10/11/22

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Hello, my name is Michael Garcia and my role during this exercise is Nurse. I look forward to working with you all

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Information to be shared with the public regarding yesterday and today: On October 10th at 9:00 am, an unexpected caravan of immigrants arrived at the southern boarder following a hurricane and massive flood. As of October 11th, 500 families have arrived in New Mexico. 10 families have been separated and some family members have been released to live with U.S relatives. Safety and identification for the 20 unaccompanied minors will be established promptly. All local, State, and Federal agencies have been made aware of the situation and assistance has been requested to help with reuniting minors with their families. Emotional and professional support will be brought in to counsel individuals who have experienced traumatic events. French-speaking nurses, doctors, and interpreters will be brough to the scene as some individuals are French-speaking. The American Red Cross and Salvation Army have provided food, water, and daily necessities. Professional inspectors have determined the food and water to be safe to consume. FEMA has been contacted to assist with setting up shelter camps and identifying each individual. PPE has been requested including 150 hair caps, shoe caps, gowns, and goggles. Sanitation stations have been set up and maps have been posted showing hazardous/unsafe areas of the city for the individuals to avoid. – Zoe Finlay, PIO

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Hello, this is Andrea Barry and I arrive today. I was assigned to the Human Services & Disaster Case Management team.

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Hello. my name is Sara Apodaca and I am reporting on 10/11.

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Sorry for the late intro everyone, I'm Michael McGrath and my role as part of the medical reserve corp starts today 10/11.

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Hi gang, I'm at UNMH all day, but have pulled up the module on the computer I'm primarily working on. I'll be on and off of the computer all day and will try to check in periodically!
~sal

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Hello everyone, my name is Hannah Wilson and I will be reporting on October 11th. Looking forward to working with you all.

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What happens now?

• When the immigrants first arrive at the camps a triage leader would develop an organizational plan sufficient to handle the influx of people who need to be cared for. Priority assignments would be distributed throughout the camp for the most efficient plan of care. Alongside this, interpreters would need to be there to overcome the challenge of language barriers between peoples. Triage personnel would aid in the healthcare process with a blend of professionals such as nurses, doctors, EMT personnel, etc. During this process, the medical supply coordinator would be involved to provide the necessary supplies.

What actions are taken? Who is contacted?

• Many healthcare professionals would be contacted; along with what is mentioned above, social services, interpreters, security personnel, volunteers, and mental health professionals would be needed to provide efficacy, and provide what is needed for the immigrants within the medical tent. FEMA and the state, territory, or tribal government could provide direct and financial disaster assistance to U.S. citizens, non-citizen nationals, and qualified non-citizens.

Disaster assistance may include money for temporary assistance, personal property loss, and other serious disaster-related needs or expenses not covered by insurance or other means.

Draw internal incident command structure.

• (Overview image provided above).

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I am impressed with today's activities day and hope you feel you are able to learn something from this process.  It was great to see everyone introduce themselves and speak to their roles during the exercise.  All the teams identified priorities to be able to care for the immigrants and protect themselves.  Because the teams did a great job, the ICS team was able to do an excellent summary.

Tomorrow I will send out the inject in the morning. Thank you for your engagement.

Here is the list of expected outcomes from the first day: Some of these were alluded to and in a real event there would documentation.
·       Federal and state assistance is approved

·       NM DOH Mass migration plan is activated

·       Staff act in their pre-identified roles

·       Predetermined command structure should be established with positions identified

·       Staff are trained in pre-identified roles

·       Staff engages in pre-identified communication system (PA, radios, etc)

·       MRC and other volunteers are contacted and should report as soon as possible but not later than 24 hours

Temporary refuge camps are established

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Who is in charge of your unit?

• After reviewing the chat for our exercise our team leader Griselda Barajas is in charge of our unit.

What roles do you think you might need?

• We will need a vast diversity of professionals to facilitate a smooth tabletop exercise. Some of these include: nursing professionals, doctors, physicians,
medical reserve corps, interpreters, team leads, nurse practitioners, social support roles, public health professionals, EMTs, volunteers, and security personnel.

Who do you need to coordinate with outside of the facility?

• Besides the professions listed above, emergency service professionals such as the police, skilled interpreters, volunteers, logistic services, operation services, and safety operators from the ICS would be needed.

The facility is in a rural area without adequate housing and food service for staff.  Personnel?

• Volunteer services, emergency personnel, USDA forest services, USDA rural development programs, social workers, and human service professionals.

Other resources?

• Donation services such as food pantry, clothing, basic toiletries, and water would be a priority when considering what is the most important. Also, heating services, mental health professionals, and interpreters would be important.

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Hi everyone my name is Troy Harbaugh and my role during the exercise is Nurse! I am looking forward to working beside you all
beginning my role on 10/10/22.

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Hello everyone! Tried to incorporate and synthesize available briefs and data into this ICS Brief.

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Hello everyone my name is mikayla carpenter and I am assigned as the physician on this exercise and I am looking forward to working with you all!

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Hello everyone my name is mikayla carpenter and I am assigned as the physician on this exercise and I am looking forward to working with you all!

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Answer to question 1: What happens now?

First, begin communication with the group of people, by first finding a responding staff member who speaks Spanish, to prevent misinformation and promote clear, concise communication. Ensuring scene safety for the immediate responders is very important in determining the courses of action be taken. First, emergency treatment should be attended to by appropriate personnel, for those who need immediate treatment and would most likely not survive the transport to the camps, without immediate emergency interventions (placing a tourniquet on arterial bleeding, etc.). Second, the group of people should be identified, and an initial head count should be made to ensure that none of the members of the arriving group are lost in the transition to the camps. Next, transport should be arranged, either as one large group on a bus or as divided, smaller, groups led by pairs of responding personnel with access to communication, via walkie-talkie or phone, with the rest of the responding personnel. As the scene develops, ensure that communications are made to the receiving refugee camp about priority interventions that need to be made upon arrival, such as heaters, towels, and blankets, for those experiencing hyperthermia from the flood.

Question 2 What actions are taken?

First action to take is to make sure everyone obtains the adequate refuge/camps and it’s also important to keep families together specially if there are children so as not to aggravate the situation further. We want to make sure that there are enough supplies for everyone who has arrived, and we also need to start thinking about extra supplies for future immigrant caravans that have yet to arrive. Patient assessment need to be done as soon as possible and those requiring immediate care need to be looked after by healthcare professionals. Accommodations and services must be provided for those with disabilities and language barriers. We might also want to start thinking about disease surveillance within the refugee/migrant camps and the need for medicines and other medical supplies.

Question 3: Who is contacted?

The incident commander should be contacted since they oversee management of incidents and command staff to create a smooth and organized response. It would also be important to contact human services and disaster case management to provide emergency assistance, shelter, and human services since most are likely to be injured and helpless. The authority or government in the area should also be contacted so that the incident is reported to the higher ups and so that there is a flow of communication between incident command and the government. This would also help in providing updates about the situation to the government and from the government.

Question 4: Draw an internal incident commander structure

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Hi my name is Kylie Kull and I am set to arrive tomorrow (10/11). I am on the Human Services and Disaster Case Management team.

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Hi everyone, if I am correct, I believe we need to get a summary of the situation related to health and safety as well as establish our planned objective, list what actions we have currently done and plan to do, and list resources that we need (including quantity). With the go ahead from the ICS Tent Coordinator, I can disseminate the summary of the situation to the public. I believe that one of our objectives should be providing basic shelter, food, water, and sewage disposal for the migrants. We could request those items from organizations that we are working with. Thanks! - Zoe Finlay

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Hello my name is Moncerrat Marcial and I am an initial team member in the human services and disaster case management tent.

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Hi everyone,
I’m Miley and I’ll be reporting for duty tomorrow 10/11. Looking forward to working together!

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Hello All,
My name is Denise, I am in the public health tent, I will be on scene on 10/11.

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Hello! My name is Mollie Browne, and I am the Team Lead for Health Services & Disaster Case Management.

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Hello my name is Lauryn Wright and I am assigned to be a team member for incident command. I will be delegated a task by the incident commander.

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Hello!
My name is Jennifer Edmundson, and I am an initial person.

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Hi, My name is Sarah. I will be reporting on 10/11/2022. :)

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Hello Everyone, I am Rachael, I am assigned to the public health tent and will be arriving on scene on October 11th.

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Hello, my name is Elijah and I am an initial team member aiding in public health, arriving on October 10.

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Hey everyone. This is Juneid. I posted in the incident command tent that I will be working as the finance officer. As the finance officer, I will manage all financial aspects of the incident. For Day 1, I am waiting for objectives, activities, and resources to be listed so that I can provide cost implications. I will be in contact with other agencies and keep our incident commander updated.

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Hello. My name is Shannon Moritomo. I have been assigned as a member of the incident command team. I am open to any role there are left. Please let me know what other roles are available and I can take it.

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Hey everyone! My name is Omar and I am an initial team member. I will be reporting today (10/10/22)

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Hey everyone! My name is Omar and I am an initial team member. I will be reporting today (10/10/22)

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Hello Everyone,                                           My name is Jenean Carpenter.  I am assigned to the medical tent.  My part is a new nurse.  I will arrive October 13.                                                 Jenean

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Hello Everyone,                                           My name is Jenean Carpenter.  I am assigned to the medical tent.  My part is a new nurse.  I will arrive October 13.                                                 Jenean

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Hello everyone. This is Zoe Finlay. I posted in the Incident Command tent that instead of working on resources (that position is already taken!) I will take the position as the Public Information Officer. Thanks!

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Hello everyone. This is Zoe Finlay. I posted in the Incident Command tent that instead of working on resources (that position is already taken!) I will take the position as the Public Information Officer. Thanks!

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Response by Mireya Martinez (Safety officer) Also posted in the ICS tent. As the safety officer, I located all the medical tents on the base. Safety officers are contacted and set in each tent. Actions that should be taken would be to locate, safely shelter, and monitor minors until proper personnel arrive (i.e. CYFD). My next step would be to plan a meeting to discuss future procedures. Who is going to be our main incident commander?

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Hello! My name is Mario and my first report for the public health sector is on 10/10/22

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Can all the incident commanders meet in our tent?
https://padlet.com/roberta_lavin/dcqhf9n9lka297td

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Hello Everyone!
My name is Molly Osmera. I am assigned to the Medical Tent and will arrive on the 13th as a new NP. I look forward to working with you all.
-Molly

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Hi everyone, my name is Julie Kastendieck. I am part of the medical reserve corp and will be arriving October 11.

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Hello, My name is Mireya Martinez. I am a member of the incident command team. I would be open to taking on the safety officer role.

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Hi everyone! My name is Alexa Reyes and I am assigned to be part of the medical reserve corp. I begin my first day of play on 10/11/2022.

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Hi, My name is Tony Nguyen and I am also a team member. I will be reporting duty on 10/11/22.

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Hello everyone! My name is Gabrielle Vigil. My role is an interpreter and I arrive on 10/12.

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hello! I go by Sal be reporting for duty tomorrow 10/11

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Hello Everyone,

My name is Jonathan Barajas. I have been assigned the role of team lead for the public health group. My first day of report is on 10/10/2022

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Hello Everyone,
My name is Christina Peralta and I have been assigned as part of the medical reserve corps. My first day of play will be 10/11

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Hello, my name is Zoe Finlay and I am part of the Incident Command team. I believe we have an initial Incident Commander. I would be open to taking the Logistics Section role to provide resources and services needed to support the refugees. 

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Hello, my name is Zoe Finlay and I am part of the Incident Command team. I believe we have an initial Incident Commander. I would be open to taking the Logistics Section role to provide resources and services needed to support the refugees. 

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Hello, my name is Amber Smith and I am a team member of the Human Services and Disaster Case Management. I will be reporting for duty on 10-11-22.

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Hello, my name is Amber Smith and I am a team member of the Human Services and Disaster Case Management. I will be reporting for duty on 10-11-22.

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Hello Everyone,

My name is Griselda Barajas. I am the Team Lead for the Medical Tent. I begin play today (10/10/22). I look forward to working with you all.

-Griselda