Dietitian Deployment PanelCDR Mary McCormick, RD

CDR Graydon Yatabe, MPH, RDLCDR Merel Kozlosky, MS, RD

Dietitian Category Day, 21 JUNE 2012

Objectives

• Summarize structure, make-up, and missions of Commissioned Corps response teams.

• Describe deployment roles for dietitians and the value of dietitians on deployment teams.

• Identify skills and professional growth opportunities that can be gained from deployments.

RDFRapid Deployment Force

LCDR Merel Kozlosky, MS, RD

RDF – Facts and Figures• Tier 1 team• 5 RDF teams• 125+ officers per team• Scalable

– Can divide into smaller subunits– Can be augmented with Tier 3 officers

• Deploy within 12 hrs of activation• On-call 1 out of every 5 months• Deployments typically do not exceed 2 wks• Up to 2 wks of response team training per yr

RDF - Primary Activity Areas• Mass care (primary care, mental health, and

public health services for sheltered populations)• Point of distribution operation (mass

prophylaxis and vaccination)• Medical surge• Isolation and quarantine• Pre-hospital triage and treatment• Community outreach and assessment

RDF - Primary Activity Areas• Humanitarian assistance• On-site incident management• Medical supplies management and distribution• Public health needs assessment and

epidemiological investigations• Worker health and safety• Animal health emergency support

RDF - Structure• Command• Planning Section• Admin/Finance Section• Logistics Section• Operations Section

– Medical Services Branch– Pharmacy Branch– Preventive Medicine Branch– Ancillary Services or Intake, Consult, and

Discharge Branch

RDF – Rosters as of 1 APR 2012• RDF #1 = 3 RDs

– LCDR Kozlosky, LCDR Mero, LT Blood

• RDF #2 = 3 RDs– CDR Fitzpatrick, LCDR Digennaro, LCDR Wolcoff

• RDF #3 = 1 RD– CDR Frost

• RDF #4 = 3 RDs– CAPT Sipe, CDR Banks, LCDR Kim

• RDF #5 = 5 RDs– CDR Little, CDR Moser, LCDR Interpreter,

LCDR Mahrt, LT Holliday

RDF – Personal Experience• Preventive Medicine Branch Director (2009 – Present)

• Food Safety/Nutrition (2006 – 2009)

• RDF Deployments– Operation Lone Star (2011)

– Inauguration (2009)

– Hurricane Ike – FMS College Station (2008)

– Independence Day on the Mall (2008)

• RDF Training– State of Tennessee and Metro Nashville Public Health

Departments (2010)

– Fort AP Hill (2009)

– RDF Response Team Workshop (2006)

Hurricane Ike – FMS College Station

Hurricane Ike – FMS College Station

Operation Lone Star• Rio Grande Valley in Texas• Serving medically underserved and vulnerable population• Non-disaster / non-emergency setting• Split RDF team into 4 sites

Operation Lone Star – Nutrition Counseling and Wellness Center

Operation Lone Star – Epidemiology Project

• Multi-disciplinary– Epidemiologists, Dietitian, Admin/Finance,

Local Volunteers

• Data collection– Household survey– Medical record data

• Reports

Home away from home…

RDF - Gains• Team training

– Hone disaster response skills– Know who you will deploy with– Increases comfort level of deployment

• Expanded skill sets– Clinical and Food Service– Epidemiology– Preventive Medicine

• Leadership opportunities• Networks and collaborations• Upholding mission to protect, promote, and advance

the health and safety of our Nation

APHTApplied Public Health Team

CDR Graydon Yatabe, MPH, RD

APHT - Team Structure and Function

The goals of APHTs are to:

1. Assist a community and its officials to reestablish essential public health services when local resources are overwhelmed or disrupted, and

2. Support and augment local, state, territorial, tribal, or international health programs in providing public health services for affected populations and emergency response workers.

APHT - Team Structure and Function

• Tier Two

• Response Time: 36 hours

• Approximately 50 Officers per team (not regional teams)– Multi disciplinary staffing including Command Staff – One team on-call each month– Pre-event, response and/or recovery missions– Mirror and support local health department programs

APHT - Team Structure and Function

• Scalable response– Deploy only what is needed based on Mission Assignment– Team structure grows/shrinks to address need

• Augmentable– Subject matter experts

APHT - Team Structure and Function

APHTCommand

Staff

Epidemiology Surveillance

Group

Environmental Public Health

Group

Preventive Services

Delivery Group

APHT - Team Structure and Function

• Epidemiology and Surveillance Group – Data collection and data analysis– Community health status profile– Contact tracing

• Preventive (Medical) Services Group– Health statistics information dissemination– Vaccinations– Public health or medical education & recommendations– Alert or advise local providers, officials, & public

APHT - Team Structure and Function

• Environmental Health Group– Adequate and safe water supply– Availability of safe, nutritious food– Access to adequate shelter – Environmental & occupational hazard assessment

APHT - Team Structure and Function

CommandCommanderDeputy CommanderLiaison OfficerIT PersonnelSafety Officer

Preventive Services Delivery GroupPhysician (preventive or occupational medicine) Public Health Nurse or Practitioner

Health Educator

Epidemiology/Surveillance GroupEpidemiologist

Environmental Health GroupIndustrial HygienistDisaster Response EngineerEnvironmental HealthFood Safety InspectorHazardous and Solid Waste ConsultantVeterinarian

SAT, MHTNIST, RIST, CAP

CHASMCDR Mary McCormick, RD

Services Access Team (SAT) (2006)

• Tier 2 – deploy within 36 Hours, typically for up to 2 weeks

• Comprised of 10 USPHS officers, although more or less may deploy, as needed

• FunctionsNeeds assessmentClinical care coordinationTransition management & re-integrationNew role: coordinate patient movement (ASPR)

Mental Health Team (MHT) (2006)

• Tier 2 – deploy within 36 Hours, typically for up to 2 weeks

• Comprised of 26 USPHS officers, although more or less may deploy, as needed

• FunctionsNeeds assessment & treatmentScreening – suicide risk, stress reactions, substance abuse,

etc.Specialized counselingPsychological first aid, crisis intervention

National Incident Support Team (2009)

• Tier 1 – deploy within 12 hours, up to 2 weeks• Comprised of 72 USPHS officers, although more

or less may deploy, as needed• Functions

Ongoing event needs assessmentSupport & direction for incoming response assetsLiaison with State, Tribal & local officialsOn-site incident managementDemobilization support

Regional Incident Support Team (2009)

• Tier 1 – deploy within 12 hours, usually 1-3 days, NTE 30 days/year

• Comprised of 12 - 30 USPHS officers, although more or less may deploy, as needed

• FunctionsRapid event needs assessmentSupport & direction for incoming response assetsLiaison with State, Tribal & local officialsOn-site incident management

Capitol Area Provider Team

• Tier 2 – deploy within 36 Hours, typically <3 days• Comprised of 5 USPHS officers• Augment the Office of the Attending Physician

(OAP); deploy only in support of NCR events• Functions

First responder & primary care, BLS, ACLSPre-hospital triage & treatmentPoint-of-distribution operation (i.e. – vaccination)Medical surgeOn-site incident management

Community Health and Service MissionsCHASM

• WHAT (concept)• WHAT (services rendered)• WHO• HOW• WHERE• WHEN

2010 – Operation Nexus2011 – Operation Foothold2012 – 2 missions planned

Interactive Q&A

• Questions about deployment teams?

• Barriers to being on deployment teams?

• What can the Dietitian PAC Readiness Subcommittee do to support you?

For more information, seeResponse Team Fact Sheets at…

http://ccrf.hhs.gov/ccrf/current%20teams.htm