State Disaster Response: Systems and Programs

This chapter outlines key points in understanding state-level emergency response functions within the United States, focusing on medical and public health operations. Emergency response systems vary from country to country. As compared to other countries, the United States, because of its federalist system, has more power delegated to lower levels of government and has less of a formally structured system directed from the national level. This form of government has certain advantages in that it empowers state and local governments, but it also has disadvantages because of the challenges in creating integrated systems across and among the states. In practice and law, many responsibilities and authorities for emergency management reside with the states. Nonetheless, a number of federal statutes, regulations, and systems provide a common framework on which states build their emergency management programs; there are more similarities than differences in state and local governmental structures, and federal funding and training have driven common practices that translate well between the states.

State and local emergency management organization

State and local emergency management, as with other governmental functions, usually falls within the authorities of the executive branch of government, and elected leaders (mayors or governors) are statutorily responsible for effective emergency preparedness and response. There is usually a designated office or agency, within state or substate jurisdictional areas, responsible for specific emergency management duties. At lower jurisdictional levels, these duties may often be collateral and performed by volunteer or part-time staff; at higher levels, these become full-time responsibilities. A great part of local emergency management responsibilities involves coordination among first-response organizations, such as police departments, fire and emergency services, and emergency medical service(s) (EMS) organizations, all of which routinely practice “emergency management” while they respond to the scenes of local incidents. At the state level, this coordination occurs among such organizations as the State Department of Health, Highway Patrol, and Transportation and Safety. Throughout the country, there is a robust capability for local scene management, which can be augmented if needed by additional support from higher levels of government. Because coordination and management become more complex, the higher the level of government, there is likewise more variability at higher levels.

At the state level, there are commonly separate Homeland Security and emergency management agencies. The State National Guard also has a significant role in emergency response. These three organizations provide overlapping leadership for emergency management activities. Homeland Security offices generally address the broader political, law enforcement, and security issues involved in the prevention and investigation of human-made events. Emergency management offices may be subordinate, but, usually, they are separate and they focus on all-hazard planning, consequence management during and after a disaster, and recovery and mitigation operations. The National Guard usually has the most robust state-level resources (material and personnel) for emergency response operations. National Guard units can be mobilized by the governor, and they possess a wide variety of useful equipment and skills. These key state offices may be organized differently, or they may have different relationships, but even if structurally not aligned, they often work very closely with one another. In some states, all three organizations are subordinate to one secretary or assistant secretary who in turn reports directly to the governor. Other state-directed but related functions might also interact and have significant effects on emergency management activities. These include the state police, prison system, statewide 911 systems, and sheriff departments. Regardless of the organizations and structures involved, the State Emergency Management Agency (SEMA) is the focal point for planning and organizing emergency management within the state. An Internet search of state governments will often show the organizational structures involved with emergency management, most of which provide preparedness and planning links, tools, and products. The largest cities in the United States (e.g., New York City, Chicago, and San Antonio) often have large emergency management agency (EMA) staffs, programs, and capabilities equal to those of some states.

One of the key challenges facing every state or local EMA is the plethora of offices and partners that it must try to organize, for both planning and operations, organizations over which, for the most part, the EMA has no authority. The lack of a day-to-day system that provides a clear management structure results in challenges in planning for, or responding to, emergencies. At the state level, these stakeholder organizations include other state agencies, nongovernmental organizations (NGOs), and critical private industry (such as the entire private health care system). Below the state level, the complexity is in the different organizational structures, which account for all the important collaborates—hospitals, utility companies, local chapter of the American Red Cross, etc. In most cases, there will be different fire districts, police districts, school districts, and health districts, and each may have different jurisdictional or catchment boundaries. In some states, there are sometimes no intermediate jurisdictional levels between the state and communities, meaning that the only local EMA partners the state may have are the hundreds of community EMAs—an obvious span of control problem.

The solution to all these organizational issues is to build partnerships and response structures to coordinate across the various stakeholder offices. In many cases, the states have deliberately created regional command and control offices to subdivide their territory. For example, New York is divided into five Emergency Management Regions. A state often uses these subordinate structures to deliver grant funding, which incentivizes local consensus building and cooperation. To understand the local structure, it is usually a matter of understanding the partnerships in the area more so than the individual agencies or offices.

State EMAs operate with a day-to-day staff working on key issues, such as grants, mitigation programs, plans development, communications, and training. There are a variety of programs and funding streams, from federal sources and those internal to the states, which coalesce at the EMA from where they are then distributed to partners and local agencies. The primary focus of the state EMA is to prepare state and local response organizations to be rapidly notified, activated, and mobilized to respond to all emergencies. For actual contingencies and response, emergency operations plans (EOPs) have been put into writing, detailing the most critical information and procedures for the jurisdiction. All states have EOPs, and these are usually aligned to the National Response Framework.

All of the EMAs are heavily involved in emergency response training, using both local and national programs. These range from individual courses to large training events for organizations and response units. The Minnesota Homeland Security and Emergency Management website shows an example of their training opportunities.

Once an emergency or disaster has occurred, and often even prior to the event (as in the case of hurricanes, tornados, or other extreme weather) the State EMA, operating out of an emergency operations center (EOC), takes the lead in managing state response. The state EOC serves as the conduit for coordinating outside assets from the federal government, other states, or mutual aid within the state. One of the key tools used by the states is their participation in the Emergency Management Assistance Compact (EMAC). EMAC is the system of mutual aid between the states for any assets that they would lend during emergencies, including their National Guard. This important program is activated every year across the country.

The states generally parallel federal organization in that they assign state agencies as the lead for specific functions, which are typically called Emergency Support Functions (ESFs). Sometimes at the state level, these are renamed State Support Functions (SSFs). ESF/SSF8, for example, usually performs the function concerned with public health and medical issues. Some states have additional SSFs addressing unique or frequent challenges within the state.

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Aug 25, 2019 | Posted by in EMERGENCY MEDICINE | Comments Off on State Disaster Response: Systems and Programs
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