Contributing to the Volunteer Solution for Preparedness

TheTexas Medical Rangers

A Proud Unit of the Texas State Guard

If a terrorist attack, disaster or other large scale public health emergency happens in Texas…

A few critically important questions:

Who will be there to help? Who will treat those affected? Will there be enough people to respond

adequately?

PREPARATION PROCESS

Understanding Scenarios

• Plans – planning process, organizing coordination• People – gap analysis, training• Products – equipment, supplies, facilities• Practice – individual, system of systems interfaces

Types of Agents/Casualties

Weapon Potential Casualties

Duration

Chemical (Nerve) 100’s hours/days

Biological 100’s to 10,000’s weeks/months

Radiation 100’s Hours/delayed

Nuclear 100,000’s Immediate/months

Explosive 10’s to 100’s Immediate/days

Mass vaccination begins on Day 17:Effects on epidemic as function of % of population vaccinated

Daily Arrivals to HCM

0.0

50.0

100.0

150.0

200.0

1 12 23 34 45 56 67 78 89 100

111

122

133

144

155

166

177

Day

Sm

allp

ox

Vic

tim

s

270k @ 80% 100k @ 60% 100k @ 40%

Modeling a Smallpox Outbreak in San Antonio

WHO ModelBiologic Attack: City of 1,000,000

Agent Number of People at

Risk

Deaths Incapacitated

Anthrax 180,000 95,000 30,000

Plague 100,000 44,000 36,000

Tularemia 180,000 30,000 95,000

Pandemic Flu Outbreak6-12 months

15% Attack

Rate

35% Attack Rate

Fatalities 87,000 207,000

Hospitalizations 314,000 733,000

Self-Care ill 21 million 50 million

15 Kiloton “Hiroshima” Homemade Terrorist Bomb

New York City

Population: 8 million (1.5 million Manhattan)

Dead: 1,000,000

Injured: 1,000,000

Many Volunteer Organizations Are Available for Disasters

Volunteers are the Key Cog in the Preparedness Machine• American Red Cross (non-medical)• PROTECT TEXAS Volunteers• Ready Texas Nurses• Voluntary Organizations Active in Disaster (VOAD)• Medical Reserve Corps [civilian style]• Texas Medical Rangers – a military Medical

Reserve Corps that is part of the Texas State Guard

PROTECT TEXAS Volunteers Emergency Public Health Response in Texas

• TDH Volunteer Program Coordinators organize recruitment, orientation and training activities– In each of the 8 regional health departments, and– Within many local health departments

• Program Coordinators work routinely with concerned– Health education, emergency management and other experts– Disaster response and other community organizations– City and county officials

• Overall coordination of the PROTECT TEXAS Volunteer Program is at the state level of TDH

PROTECT TEXAS Volunteer Program

www.tdh.state.tx.us/cphpr/protect/

www.texasnurses.org

www.nvoad.org

www.medicalreservecorps.gov

Are found all around the country

MissionTo serveTo serve the people of Texas by providing volunteer medical expertise of the highest reputation, and health service in support of public health emergencies, disasters, and other situations, at the call of the Governor.

TheTexas Medical Rangers

VisionTo be the most valuable, health-related,

statewide, volunteer organization in Texas and

The best Medical Reserve Corps in the Nation

ValuesResponsive, Professional, Adaptable

TheTexas Medical Rangers

Teams of organized, specially-trained volunteers from all health-related fields, including support skills, with verified licensure

The Medical Reserve Corps of the Texas State Guard

TheTexas Medical Rangers

A nationally recognized unit of the U.S. Surgeon General’s network of Medical Reserve Corps local volunteer citizen organizations.

• Not subject to authority of U.S. President.• Available for missions only within Texas, not

other states or foreign countries. • Available for missions expected to last a few

days to a few weeks.

TheTexas Medical Rangers

• No weapons, equipment, or supplies.• Just good people willing to be ready to give a little of

their time.• We support the plans of those authorities with

equipment, supplies and a short-term need for more people.

• Always at option of individual volunteer.• Most volunteer organizations are local, we can

support locally, regionally or statewide.

TheTexas Medical Rangers

(Characteristics Cont’d)

• Identifiable by military rank and uniform. • When on state active duty official mission.

– Texas HB 9 signed into law, effective 22 June 2003, provides immunity from civil liability.

– State Guard worker’s compensation.– Leave of absence (with or without pay).– Health Science Centers (state employees

maintain benefits and coverage).

(Characteristics Cont’d)

TheTexas Medical Rangers

GOVERNOR

ADJUTANTGENERAL

TEXAS ARMYNATIONAL GUARD

TEXAS AIRNATIONAL GUARD

TEXAS STATE GUARDCOMMANDER

------------------------------------------Texas Military Forces-----------------------------------

TEXAS MEDICALRANGERS

REGIONALGROUPS

TheTexas Medical Rangers

LEGEND

Company

Group

Headquarters

Groupsand

CompaniesEl Paso

Odessa/Midland

Amarillo

Lubbock

Laredo

Lower Rio Grande Valley

Corpus Christi

Victoria

Wichita Falls

Fort Worth

DallasTyler

College Station

Galveston

Houston

San Antonio

Fredericksburg Austin

Waco

TempleKilleen

TheTexas Medical Rangers

• 450 Volunteers Currently [Jan 2008]

• 1500 Volunteers desired eventually• Written into response plans by state, local

authorities and Texas Military Forces• Participating in exercises• Active program to train others • Participate in appropriate community events

TheTexas Medical Rangers

Operational Capabilities Target

Examples of Augmentation Service Missions

We are NOT First Responders

• Staff / Manage Acute Care Centers• Augment TDH, Metro Health Dept. Staff• Assist in Emer. Ops Centers / Staff Call Centers• Staff Mass Vaccination / Antibiotic Sites • Assist with Breakdown / Delivery of SNSP• Assist in Mass Triage / Mental Health Counseling• Veterinary and Dental Teams

TheTexas Medical Rangers

Missions Supported the 6th Civil Support Team (CST) in contingency

status for potential incidents during Super Bowl XXXVIII in Houston.

Supported a multi-state U.S. Northern Command sponsored UD04 exercise.

Participated in Operation Lone Star in the Lower Rio Grande Valley to provide medical care to thousands of indigent patients.

Provided medical expertise at the TXSG Health Risk Assessment Day at Camp Swift.

Participated in a multi-agency SNS exercise in Houston.

TheTexas Medical Rangers

“Come Ride with the Texas Medical Rangers”

Serving Texans with pride, competence and character

Houston: swc2.hccs.edu/texasmedicalrangers

Galveston: galvestontexasmedicalrangers.comStatewide: www.texasmedicalrangers.com

ContactInfo.

TheTexas Medical Rangers

Presenting of Texas Medical Rangers ColorsMarch 20, 2004

TheTexas Medical Rangers