AAAHC has been surveying and accrediting ambulatory ...



ASCEmergency Preparedness ProgramEffective Date:Review/Revision Date(s): Describe your Surgery Center, your accreditation status, your staff, and the services you provide. Our Ambulatory Surgery Center (ASC) is a medical facility designed and equipped to handle surgery, pain management, and certain diagnostic procedures that do not require a stay beyond 24 hours. If you have multiple locations, please provide that information. If you are affiliated with another ASC and/or a hospital, please describe that affiliation here.Emergency Preparedness Program: The ASC has developed this Emergency Preparedness Program to meet the health, safety, and security needs of its staff, physicians, patients, and others in the facility during an emergency or disaster situation. The Emergency Preparedness Program consists of four core elements: 1.) the all-hazard Emergency Operations Plan (EOP) that is based on a Hazard Vulnerability Analysis (Risk Assessment), 2.) the Communication Plan, 3.) the Policies and Procedures based on the Emergency Operations Plan/Risk Assessment/Communication Plan, and 4.) a Testing and Training Program. Additionally appendices provide valuable supportive information for the Emergency Preparedness Program, the Emergency Operations Plan (EOP), the Policies and Procedures, and/or the Communication Plan. The emergency preparedness program is reviewed and revised, as appropriate, at least annually.Cooperation and collaboration: The ASC complies with all applicable Federal, State, and local emergency preparedness requirements. Cooperation and collaboration with Federal, State, and local emergency management processes and teams is imperative to the success of emergency management. The ASC is a member of the Indiana Federation of Ambulatory Surgical Centers (IFASC) and is able to gain valuable information and resources regarding emergency preparedness from IFASC. IFASC and its member ASCs are part of a healthcare coalition (HCC) comprised of emergency response organizations. The Indiana State Department of Health has designated ten districts and each district is a designated healthcare coalition in regards to emergency planning and preparedness. In the event of an emergency/disaster that affect the local, State, or Federal community, the ASC will work with the healthcare coalition and local emergency management officials to determine its role in the response process. At a minimum, the ASC will contact our local jurisdiction to make them aware of the ASC’s location, capabilities, potential services that could be provided to the community, and potential needs the ASC may have during an incident. This may include, but is not limited to, partner healthcare agencies within the community, the ASC’s healthcare network (if applicable), the local public health department, the county emergency management agency, and/or the district healthcare coalition. This cooperation/collaboration will be documented. (See appendix 1 for documentation). Emergency/Disaster Definition: The ASC recognizes it could be impacted directly or indirectly by an emergency and/or disaster situation. For the purposes of this emergency preparedness program an emergency is defined as an unexpected or sudden event that significantly disrupts the organization’s ability to provide care, or the environment of care itself, or that result in a sudden, significantly changed or increased demand for the organization’s services. A disaster is a type of emergency that, due to its complexity, scope, or duration, threatens the organization’s capabilities and requires outside assistance to sustain patient care, safety, or security functions. The emergency may have varying degrees of severity and can be a natural occurrence, technological event, or man-made; and it may affect the environment of care itself, or significantly change or increase the demand for the organization’s services. The emergency, whether internal or external, may escalate into a disaster that, due to its complexity, scope, or duration, threatens the organization’s capabilities and will require outside assistance to sustain patient care, safety, or security functions. Efficient implementation of the emergency operations plan will provide a clear direction, responsibility, and continuity of control for staff and administrators.All-Hazard Approach: The emergency preparedness program and associated plans, policies, and procedures follow an all-hazard approach based on the ASC’s specific location. An emergency can happen at any time and could affect patients, staff, visitors, a single building or an entire community. An all-hazards approach is used for response to any disruptive event or emergency in a manner that protects the health and safety of those affected by the incident and provides a coordinated effort incorporating the whole community in response to a large-scale disaster. It is understood, that this approach may not include every possible strategy and/or tactic to successfully respond to every situation and should be used to guide the ASC team as they adapt and improvise.Emergency Operations Plan: The ASC’s all-hazards Emergency Operations Plan (EOP) is a document reflecting the planning and preparing, as well as the approach to the management and response actions determined necessary to sustain efficient operations during an actual incident or during a variety of potential hazards. The ASC’s emergency operations plan (EOP) focuses on providing overall direction, control, and coordination of structures and processes to be used in the facility. The EOP is developed and approved by the ASC’s _________ committee (describe specifically the process in your ASC for this as well as how the governing board is involved) with input from leadership, staff and physicians. The plan and associated policies and procedures are reviewed and updated at least annually and/or as needed. Risk Assessment: The plans and policies and procedures are based on a risk assessment that considers the facility and the community. This process is used to assess and document potential hazards that are likely to impact our geographical location, the community, our facility, and patients and identifies gaps and challenges that should be considered when developing the emergency preparedness program. The ASC makes every effort to include any potential hazards that could affect the facility directly and indirectly for the geographical area in which it is located. Indirect hazards could affect the community, but not the actual ASC building, and may result in an interruption of necessary utilities, supplies, or staffing. The ASC uses a process called a Hazard Vulnerability Analysis (HVA) to conduct this risk assessment (see appendix 2 for HVA tool). This process is to help evaluate vulnerability to specific hazards by putting each hazard in perspective using categories of probability, impact, and preparedness/response capabilities. The ASC will use the HVA to help make risk based choices to address the highest vulnerabilities, to mitigate hazards, and to create plans/policies and procedures to address the greatest risks. Hazard identification can be related, but not limited, to natural events such as weather-related, earthquakes, floods, and/or epidemics; man-made events such as, but not limited to, utility disruption, information system/technology failure, fire, supply shortage, infrastructure damages, internal/external threats to staff/patients, mass casualty incidents, and hazardous materials. The ASC has developed policies and procedures for the top ## hazards identified on the HVA. The HVA will be conducted by the ASC in collaboration with the local emergency management officials and the district healthcare coalition. Describe how your ASC complies with this- do you have documentation that you sent and got approved by the HCC and/or EMA? Do you have a copy of the HCC HVA with documentation that your HVA is in alignment? Mitigation: Once potential risks/hazards have been identified, hazard mitigation will occur to eliminate or reduce the probability of the event, or reduce the event’s severity or consequences, either prior to or following an emergency or disaster.Preparedness: The emergency operations plan addresses how the ASC will meet the needs of patients, staff, and others present in the ASC if essential services break down as a result of the emergency/disaster. These preparedness activities are based on the facility information, the HVA, and the ASC’s ability to continue providing care and services. Coordination and collaboration with the district healthcare coalition also is an important component in preparedness. Preparedness includes training staff on their role in the emergency, testing the plans and policies and procedures, and revising the program/plan/policies as needed. Response: The plans and policies and procedures include the response activities to be taken immediately before (for an impending threat), during, and after an emergency/disaster event to address the immediate and short-terms effects of the incident.Recovery: These activities and programs are implemented during and after the ASC’s response and are designated to return the ASC to its usual state or a “new normal”. Training and Testing Program: The staff, individuals providing on-site services under arrangement, and volunteers will be trained upon hire (during orientation) and annually. Training also will be provided when new or revised plans and/or policies and procedures are implemented. This training will be consistent with their expected roles. If additional training is needed for any individual to achieve their expected roles (such as member of incident management team) this will be provided. Training may consist of, but not limited to, PowerPoint presentation, web-based education, instructor-led education, written materials, continuing education seminars, certification programs, and demonstrations and return competency reviews. Supervisors/managers are accountable for assuring staff are orientated/trained regarding the overall emergency preparedness program and, as appropriate, for job and task specific responsibilities for emergency management. Individual personnel are accountable for learning and following job and task specific procedures for emergency response. All training related to emergency preparedness will be documented and maintained in an education file. Staff will be asked to demonstrate knowledge of the emergency operations plan and associated policies and procedures by, but not limited to, participating in exercises/drills, responding to questions during staff meetings, and/or taking written quizzes. In order to ensure the Emergency Preparedness Program, EOP, and associated policies and procedures are effective, exercises will be conducted. The ASC will participate in two exercises per year. One exercise will be a full-scale exercise (that assesses the ASC’s functional capabilities by simulating a response to an incident that impacts its operations and its given community). This exercise will be community-based if possible and may be completed in collaboration with the district healthcare coalition (HCC), the Local Emergency Planning Council (LEPC), and/or the District Planning Council (DPC). If no appropriate community-based exercise is planned, the ASC may conduct this full-scale exercise as an individual facility-based exercise. If an actual event occurs in which the ASC activates its EOP, it is exempt for one-year following the actual event from engaging in a community or facility based full-scale exercise.The ASC will conduct, at a minimum, an additional exercise annually, such as a facilitated table-top exercise or an operations-based exercise (functional or full-scale) that is based on an identified risk. (See appendix 3 for samples of exercises that can be completed by the ASC.)The ASC will appoint an individual(s) (not involved directly in the exercise) or contract with an outside agency to provide evaluators/observers during the exercise. This person should have a check-list of things to evaluate performance of the facility against its written plan. This process is not to penalize any particular person, but to analyze the systems established and determine their effectiveness. The following areas may be evaluated depending on the scope and complexity of the exercise/incident: Incident Command Function, Communication, Resource Management, Safety and Security, Utility Management, and Patient Care and Support Areas. . During an actual event, the Incident Management Team will analyze the center’s response and recovery tasks. The ASC will use the information received from the evaluators/observers to analyze the exercise (See appendix 3 for examples of exercise observation tools.) Following a debriefing/hotwash, a written After Action Report (AAR) will be completed for each drill, exercise, or response to an actual event. (See appendix 4 for an example AAR template.)This AAR will describe what was supposed to happen and what occurred; identify problems that arose, the strengths of the ASC to build on, and lessons learned; and develop a plan with timelines to address those problems. This information will be used to revise the ASC’s emergency preparedness program/EOP/Communication Plan/Policies and the need for additional training as needed. Any changes made to the program/plan/policies will be tested in the next planned exercise to assure the change had the intended outcome. Documentation of exercises must be available for review at any time for a period of no less than three years.In order to continue our commitment to emergency preparedness, the training and testing program will be reviewed at least annually. Revisions will be made as appropriate. Integrated Health Systems – Applies only if you are part of a Healthcare system that include multiple facilities that are each separately Medicare certified. If that is the case, you can elect to have unified and integrated emergency preparedness program and should state that here. If elected you must Demonstrate that your facility actively participated in the development of the unified and integrated emergency preparedness program.Make sure that the program is developed and maintained to account for your facility’s unique circumstances, patient populations, and services offered.Demonstrate that your facility is capable of implementing an effective emergency operations plan and response.Include an EOP that meets the CMS requirements, including a risk assessment, a communication plan, and specific policies and procedures. You must also actively participate in drills/exercises.Acronyms and DefinitionsAAAHCAccreditation Association for Ambulatory Surgery CentersAAAHC has been surveying and accrediting ambulatory surgery centers since our founding in 1979.The AAAHC?holds Medicare deemed status from the Centers for Medicare and Medicaid Services (CMS). Accreditation surveys can be combined with, or independent of, Medicare surveys.Review AAAHC policies and procedures and current Standards in the Accreditation Handbook for Ambulatory Health Care or the Accreditation Handbook for Medicare Deemed Status Surveys.AARAfter Action ReportThe After Action Report is a document that describes the incident (or exercise) and findings related to the facility’s response. This involves a focused, post-incident/exercise review to capture observations and performance. It should include a synopsis of what happened, who was involved, objective review of the facility response regarding strengths and areas for improvement, and an improvement plan. If the AAR is related to an exercise, then the scope and objectives should also be included.ASCAmbulatory Surgery CenterModern health care facilities focused on providing same-day surgical care, including diagnostic and preventive procedures.CFRCode of Federal RegulationsThe Code of Federal Regulations is a codification (arrangement of) the general and permanent rules published in the Federal Register by the executive departments and agencies of the Federal Government.CfCConditions for CoverageCMS Conditions for Coverage (CfCs) outline the rules and regulations that ambulatory surgery centers must meet in order to begin and continue participating in the Medicare and Medicaid programs. These health and safety standards are the foundation for improving quality and protecting the health and safety of beneficiaries. CMS also ensures that the standards of accrediting organizations recognized by CMS (through a process called "deeming") meet or exceed the Medicare standards set forth in the CfCs.CMSCenter for Medicare and Medicaid ServicesThe Centers for Medicare & Medicaid Services, CMS, is part of the Department of Health and Human Services (HHS). It administers programs for Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and the Health Insurance Marketplace.DPCDistrict Planning CouncilThe District Planning Council (DPC) program was developed to assist each of Indiana’s ten Homeland Security Districts in planning, organizing and managing critical emergency response activities on a regional basis. It brings together multiple jurisdictions, disciplines and agencies into a formal organizational structure to focus on common strategic goals and objectives.EMAEmergency Management AgencyIn Indiana, each county has an EMA. The EMA is managed by a director (full or part time). The EMA’s role is to analyze, plan, make decisions, and assignment of resources to mitigate, prepare for, respond to, and recover from the effects of all hazards. During a community wide incident, the EMA may operationalize an Emergency Operations Center (EOC) and task various Emergency Support Functions (ESFs) to assist. The most commonly used ESF related to health care is ESF-8 (Public Health and Medical Services) which is frequently coordinated by the local health department. EMSEmergency Medical ServicesA network of services coordinated to provide aid and medical assistance from primary response to definitive care, involving personnel trained in the rescue, stabilization, transportation, and advanced treatment of traumatic or medical emergencies.EMPEmergency Management ProgramA program that implements and sustains the mission, vision, and strategic emergency management goals and objectives of the organization. It provides the management framework for the EM program and defines EM’s role within the larger organization. The EM program promotes a balanced comprehensive approach that incorporates mitigation, preparedness, response and recovery into a fully integrated set of activities. The “program” applies to all areas within the organization that have roles in responding to a potential or actual emergency.EOPEmergency Operation PlanThe Emergency Operations Plan (EOP) provides the structure and processes that the organization utilizes to respond to and initially recover from an event.FEFunctional ExerciseFunctional exercises are designed to validate and evaluate capabilities, multiple functions and/or sub‐functions, or interdependent groups of functions. FEs are typically focused on exercising plans, policies, procedures, and staff members involved in management, direction, command, and control functions. In Fes, events are projected through an exercise scenario with event updates that drive activity at the management level. An FE is conducted in a realistic, real‐time environment; however, movement of personnel and equipment is usually simulated.FSEFull-Scale ExerciseFSEs are typically the most complex and resource‐intensive type of exercise. They involve multiple agencies, organizations and jurisdictions and validate many facets of preparedness. FSEs often include many players operating under cooperative systems such as the Incident Command System or Unified Command. FSE include the activation of the incident command system, activation of the Emergency Operations Plan, and deployment of resources. HCCHealthcare CoalitionA collaborative network of healthcare organizations and their respective public and private sector response partners that serve as a multi‐agency coordination group to assist with preparedness, response, recovery and mitigation activities related to healthcare organization disaster operations. During response, healthcare coalitions should represent healthcare organizations by providing multi‐agency coordination in order to provide advice on decisions made by incident management regarding information and resource coordination for healthcare organizations. This includes coordinated plans to guide decisions regarding healthcare organization support.HFAPHealthcare Facilities Accreditation ProgramThe Healthcare Facilities Accreditation Program is a nationally recognized accreditation organization with deeming authority from CMS.HICSHospital Incident Command SystemThe Hospital Incident Command System (HICS) is a management system based on the National Incident Management System (NIMS) that consists of a flexible organization structure and time-proven management principles. The system includes defined responsibilities and reporting channels and uses common language to promote internal and external communication and integration with community responders. HICS can be utilized for emergency incidents or for planned events.HVAHazard Vulnerability AnalysisA systematic approach to identifying all hazards that may affect an organization and/or its community, assessing the risk (probability of hazard occurrence and the consequence for the organization) associated with each hazard, and analyzing the findings to create a prioritized comparison of hazard vulnerabilities. The consequence, or “vulnerability,” is related to both the impact on organizational function and the likely service demands created by the hazard impact.HVACHeating, Ventilation, Air ConditioningThe technology of indoor environmental comfort. Its goal is to provide thermal comfort and acceptable indoor air quality.ICIncident CommanderThe individual responsible for all incident activities, including the development of strategies and tactics and the ordering and the release of resources. The IC has overall authority and responsibility for conducting incident operations and is responsible for the management of all incident operations at the facility and/or site. ICSIncident Command SystemA standardized management construct specifically designed to provide for the adoption of an integrated organizational structure that reflects the complexity and demands of single or multiple incidents, without being hindered by jurisdictional boundaries. ICS is the combination of facilities, equipment, personnel, procedures, and communications operating within a common organizational structure, designed to aid in the management of resources during incidents. It is used for all kinds of emergencies and is applicable to small as well as large and complex incidents. ICS is used by various jurisdictions and functional agencies, both public and private, to organize field-level incident management operations. IDHSIndiana Department of Homeland SecurityThe Department of Homeland Security (IDHS) was created in 2005 through the combination of several existing agencies aimed at emergency management, domestic security and public safety by providing statewide leadership that is responsive to Hoosiers’ concerns, and expertise for the enhancement of public and private partnerships and the support of local, state and federal collaboration. The goal is to protect Indiana’s citizens, property and economy.IFASCIndian Federation of Ambulatory Surgical CentersThe Indiana Federation of Ambulatory Surgical Centers, Inc. was incorporated on June 23, 1987. The Indiana Federation of Ambulatory Surgical Centers was one of the first state associations and continues to function successfully. The Federation's Board of Directors is made up of strong individuals who volunteer their "free" time to keep the organization a worthwhile investment for its members.IMTIncident Management TeamThis is a term used in HICS. It is what you would call the team that is in charge of strategic and tactical decisions regarding an incident. This must include an Incident Commander at a minimum and may also include Operations Section Chief and Logistics Section Chief for the ASCs. Other IMT positions may be included depending on the scope of the incident and the availability of staff to fill positions.IPImprovement PlanThe IP identifies specific corrective actions, assigns them to responsible parties, and establishes target dates for their completion. The IP is developed in conjunction with the After‐Action Report.ISDHIndiana State Department of HealthThe Indiana State Department of Health supports Indiana's economic prosperity and quality of life by promoting, protecting and providing for the health of Hoosiers in their communities.To mitigate the loss of life, the Public Health Preparedness and Emergency Response (PHPER) Division assists Public Health entities, Health Care Providers, and Hoosiers to respond to and recover from all hazard incidents by identifying, developing, refining, and executing plans in a timely manner.JASJob Action SheetsGuidance documents for each HICS Command and General staff position to assist with describing the position’s responsibilities, reporting relationship, needed forms, and potential action steps based on time period.LEPCLocal Emergency Planning CouncilLocal Emergency Planning Committees (LEPCs) must develop an emergency response plan, review the plan at least annually, and provide information about chemicals in the community to citizens. Plans are developed by LEPCs with stakeholder participation. MAAMutual Aid AgreementWritten or oral agreement between and among agencies and/or jurisdictions that provides a mechanism to quickly obtain emergency assistance in the form of personnel, equipment, materials, and other associated services. The primary objective is to facilitate rapid, short‐term deployment of emergency support prior to, during, and/or after an incident.MACCMulti-Agency Coordination CenterEach district Healthcare Coalition (HCC) meets periodically to discuss plans and develop preparedness response activities. If an incident occurs (or during an exercise), each HCC will “stand-up” (may be virtually) a multi-agency coordination center (MACC). This most likely will be the district healthcare (hospital) chairperson, a designated officer, or the business operations manager. Their role during an incident or exercise is to coordinate the information for the healthcare coalition. It is important to share information with the MACC in order for everyone to have a common operating picture. The MACC also is available for asking questions regarding support agencies and requesting medical resources. The HCC through the MACC may not actually have medical resources to provide, but can provide suggestions for what agencies or organizations to contact. MHzMegahertzOne MHz represents one million cycles per second. This notation is referenced to the 800 MHz radios that some organizations use for communication.MOUMemorandum of UnderstandingThis document describes an agreement between two or more parties. It expresses a convergence of will between the parties, indicating an intended common line of action. It is often used in cases where parties either do not imply a legal commitment or in situations where the parties do not wish to create a legally enforceable agreement.NIMSNational Incident Management SystemA set of principles that provides a systematic, proactive approach guiding government agencies at all levels, the private sector, and nongovernmental organizations to work seamlessly to prepare for, prevent, respond to, recover from, and mitigate the effects of incidents, regardless of cause, size, location, or complexity, in order to reduce the loss of life or property and harm to the environment.Plain LanguageCommunication that can be understood by the intended audience and meets the purpose of the communicator. For the purposes of NIMS, plain language is designed to eliminate or limit the use of codes and acronyms, as appropriate, during incident response involving more than a single agency.PPEPersonal Protective EquipmentIncludes protective clothing, helmets, goggles, or other garments or equipment designed to protect the wearer's body from injury or infection. The hazards addressed by protective equipment include physical, electrical, heat, chemicals, biohazards, and airborne particulate matter.Surge (Medical)Medical surge is the ability to provide adequate medical evaluation and care during events that exceed the limits of the normal medical infrastructure of an affected community. It encompasses the ability of the healthcare system to survive a hazard impact and maintain or rapidly recover operations that were compromised.TJCThe Joint CommissionAn independent, not-for-profit organization, The Joint Commission accredits and certifies nearly?21,000 health care organizations and programs in the United States. Joint Commission accreditation and certification is recognized nationwide as a symbol of quality that reflects an organization’s commitment to meeting certain performance standards.TTXTabletop ExerciseA scenario‐driven interaction that permits evaluation of the EOP and/or Recovery Plan, or elements thereof, through orally provided action descriptions and application of plan guidance. It is used to have individuals and teams describe their roles and responsibilities through a presented scenario, and to evaluate the performance of these roles and responsibilities in a relatively low stress environment. Through the use of simulation techniques, emphasis is placed on information processing, collaboration and cooperation, decision‐making and team building in the context of a specified scenario. This format allows a significant amount of comment and coaching from the facilitator.Appendices If change number system, please make sure you change here also.Documentation of coordination/collaboration with local jurisdiction emergency management officials or attempt to coordinateHazard Vulnerability Analysis (HVA)2.1ASC HVA (Kaiser Permanente Tool2.2ASC HVA ToolExamples of exercises and observation tools 3.1Exercise Development Guide – EXAMPLE TABLETOP – Water Main Break3.2Exercise Development Guide – EXAMPLE TABLETOP –Utility Failure3.3Exercise Development Guide – EXAMPLE TABLETOP –Tornado3.4Exercise Development Guide – EXAMPLE TABLETOP –Severe Weather – Snow-Ice-Blizzard3.5Exercise Development Guide – EXAMPLE TABLETOP –Infectious Disease3.6Exercise Development Guide – EXAMPLE TABLETOP –Earthquake3.7Exercise Development Guide – EXAMPLE TABLETOP –Active Shooter3.8Exercise Development Guide – EXAMPLE Functional –Information Technology – Communication Drill3.9Exercise Development Guide – EXAMPLE Full-Scale –Mass Casualty Incident3.10Exercise Development Guide – EXAMPLE Full-Scale –EvacuationAfter Action Report (AAR) templateEmployee Contact ListHealthcare Coalition (HCC) and Local Contact Information6.1District Healthcare Preparedness MapTransfer Agreement(s)ASC Organizational ChartSuccession PlanHospital Incident Command System (HICS) Organization Chart and Job Action Sheets10.1Small Organization Incident Management Team Chart10.2HICS Job Action Sheets for Incident Command, Operations, and LogisticsResource Inventory ListCall-Back Ready KitDisaster Supply ToolkitBack-up Paper Medical Record (if have electronic charting)Alternate Care Site Agreement (s)Evacuation MapReferencesAgenciesAgency for Healthcare Research and Quality (AHRQ) : CDC - – EMA contacts: ISDH – Indiana Health Alert Network (IHAN): ISDH – Public Health Preparedness and Emergency Response: ISDH – Licensure information for ASCs: ISDH - Directory of ASCs: ISDH - Directory of Hospitals: ISDH - Directory of Public Health Departments: LEPC Secretary for Preparedness and Response (ASPR) 2017-2022 Health Care Preparedness and Response Capabilities Document (November 2016): .../2017-2022-healthcare-pr-capablities.pdf Health Insurance Portability and Accountability Act (HIPAA): After a disaster some HIPAA regulations may be relaxed in order to locate displaced persons or to gain important health information about disaster victims. Healthcare COOP and Recovery Planning – Concepts, Principles, Templates, and Resources Standards/RegulationsAccreditation Association for Ambulatory Health Care (AAAHC): CMS Survey & Certification Emergency Preparedness website: Healthcare Facilities Accreditation Program (HFAP): Joint Commission (TJC): Indiana Administrative Code (IAC): (see Rule 2)National Fire Protection Association (NFPA): Occupations Safety and Health Administration (OSHA): Website ResourcesASPR: ASPR TRACIE: Federal Emergency Management Agency: HICS Resources website: HICS for small hospitals (agencies): National Incident Management System: National Preparedness System (published by the US Dept. of Homeland Security FEMA): US Department of Health and Human Services: National Disaster Medical System (NDMS): Weather Service: ................
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