Volunteer Management Plan - storage.googleapis.com€¦ · Volunteer management or ensuring volunteer management is present is an expectation of local public health: Volunteer management

Volunteer Management Plan

Clark County Combined Health District

529 East Home Road Springfield, OH 45503 **** (937)390-5600www.ccchd.com

Clark County Combined Health District 1 Volunteer Management Plan

Table of Contents 1. Background 2

2. Purpose 2

3. Situations and Assumptions 2

4. Concept of Operations 3

4A. Pre-Incident: Coordination of Volunteers 5

Recruiting 5

Pre-Incident Training and Registration 5

4B. Alert Volunteers 6

4C. Activate Mobilization and Tracking 7

4D. Operations 8

4E. Volunteer Demobilization 8

4F. Debrief 9

Description of Change Table 10

Attachments 11

Attachment A: Public Health Priority Professions

Attachment B: Activation through Ohio Responds

Attachment C: West Central Ohio Medical Reserve Corps memberHandbook 2014

Attachment D: Volunteer Reception Center Plan

Attachment E: MRC Volunteer Registration Form

Attachment F: MRC Volunteer Health Information Form

Attachment G: Concepts and Principles of ICS

Attachment H: Volunteer Tracking

Attachment I: Clark County MRC Volunteer Exit Screening

Attachment J: ICS 221 Form


1. Background

Natural and man-made catastrophic events have demonstrated the need for volunteer healthcare professionals and lay

volunteers to supplement and enhance response and recovery capabilities during and after such events.

As a result, the Clark County Combined Health District (CCCHD) collaborates with Clark County Emergency Management

Agency (CCEMA) and other partners for volunteer management within Clark County and the surrounding areas.

Volunteer management or ensuring volunteer management is present is an expectation of local public health:

Volunteer management is the ability to coordinate the identification, recruitment, registration, credential verification,

training, and engagement of volunteers to support the jurisdictional public health agency’s response to incidents of

public health significance. Public Health Preparedness Capabilities: National Standards for State and Local Planning.

(2011, March 1). http://www.cdc.gov/phpr/capabilities (Capability 15).

2. Purpose

This plan guides how CCCHD will coordinate, notify, organize/assemble/dispatch, and demobilize volunteers during a

public health emergency and response.

Primary activities of CCCHD related to volunteer management include:

Coordination and administration of the Clark County Medical Reserve Corps (CCMRC)

o Volunteers are health and mental professionals, as well as lay persons

Participation in the Clark County Citizen Corps Corps Council

o Local volunteer managers meet together annually

Participation in West Central Ohio Region Medical Reserve Corp Coordinators

o Regional coordination resulting in sharing of resources, training, grant seeking.

This plan aligns with the concepts outlined in the West Central Ohio Medical Reserve Corp Member Handbook which is

also an attachment to this plan.

3. Situations and Assumptions

1 The Clark County Public Health Jurisdictional Risk Assessment identifies these hazards as priorities for planning:

Severe Thunderstorm Hazmat Spill Tornado

Severe Ice Flooding Biological Terrorism

Severe Winter Storm Pandemic Nuclear Terrorism

2 Volunteers would likely be called upon to staff and support the following large-scale public health response

functions:

Hospital surge capacity and capability needs

Alternate care sites/facilities

Point of dispensing sites for mass prophylaxis/vaccination emergencies

Shelters and hydration centers for incidents

First-aid, mass triage, or screening sites


This list is not comprehensive.

3 A Volunteer Reception Center (VRC) is designed for use by the Clark County Emergency Operations Center (EOC)

during the response and recovery phases of emergency to augment operations by soliciting volunteer assistance in

performing specified activities requested. The VRC is an assembly point location to process and register unaffiliated

volunteers and to serve as a check-in site for affiliated volunteers. The VRC serves as a way to document volunteer

registration, requests for volunteers, volunteer service hours, staffing costs and expenses incurred. The VRC plan is

Attachment D to this plan.

4 It may be necessary to request volunteers from other jurisdictions when an event is expected to surpass the local

capability to support local jurisdictions or the state emergency response. Indicators that may strain or could exceed

ordinary capabilities include high-impact events such as:

Highly infectious disease

Point of dispensing (POD) activation

Widespread CBRNE (chemical, biological, radiological, nuclear, and/or explosive) attack

Widespread and severe natural or human-made disaster

Events that require immediate support beyond available resources

5 Volunteer health, safety, security, and supervision will be a priority at all times.

4 Volunteers will be managed at the lowest organizational and jurisdictional level possible.

5 Volunteers may choose to decline a call to service at any time.

6 Requesting entities will identify a Volunteer Reception Center (VRC) or a main/central volunteer staging and training

area (live location or virtual) for initial intake or demobilization of volunteers. The use and movement of public

health volunteers across local and state jurisdictions will be tracked and reported by the requesting entity.

7 Volunteer accountability during mobilization, movement, and deployment will be maintained by the Resource Unit

or the Planning Section for the incident. Ohio Responds will indicate which volunteers were activated for the

response.

8 The Clark County MRC Coordinator is responsible for the management of volunteers associated with CCCHD.

9 This plan will be reviewed and updated as needed to ensure full compliance with the most recent version of national

and state program guidelines and standards. CCCHD’s Emergency Preparedness Coordinator (EPC) is responsible to

assure that review and revisions occur at least one time per year.

4. Concept of Operations

There are various phases to volunteer deployment and management

Pre Incident – Coordination of Volunteers

Phase 1 – Alert Volunteers

Phase 2 – Activate: Mobilization and Tracking Clark County Combined Health District 4 Volunteer Management Plan

Phase 3 - Operations

Phase 4 – Volunteer Demobilization

Phase 5 - Debrief

A. Pre-Incident: Coordination of Volunteers

Recruiting

1 The CCMRC Coordinator and Assistant will recruit both medical and non-medical volunteers. Attachment A lists

prioritized medically health related fields for recruitment. Recruitment of medical professionals occurs through

strategies including:

Presentations by the MRC Coordinator to school programs related to health, i.e nursing schools, schools of

pharmacy.

Setting up MRC vendor displays at professional conferences such as the Center for Disaster Mental Health

(CDMH)

Methodically approaching licensed personnel either based on a registry or directory, i.e. visiting pharmacies.

It is important to note that other recruiting methods non-specific to medical health professionals include social

media and word of mouth. The Clark County MRC has an account on Facebook.

2 The CCMRC will also accommodate non-medical volunteers. Lay volunteers are given duties that may be easily

completed without the need of a medical license and are integral in supporting the healthcare workers.

3 Recruitment of volunteers focuses on persons demonstrating skills or related experience to complete these tasks:

Assist clients with forms Evidence preservation Mental Health Assist with client education Evacuation MRDD Services Assist with flu clinics Greeter Registration Assist with health screenings Ham Radio Operation Security/Law Enforcement Computer Support Immunizations Supply/Stock Data entry Infectious Disease/Contact Tracing Strategic National Stockpile Management Decontamination Interpreter Services Surveillance Education and training Injured or deceased animals Trauma Environmental health Laboratory capacity Triage

4 In order to retain and engage volunteers, the CCMRC coordinator offers volunteer opportunities through CCCHD

programming. Additional trainings are offered online through MRC Train and tracked by the MRC Coordinator.

Pre-Incident Training and Registration

1 Registration: CCMRC has a volunteer registration form to collect demographic and other preliminary information.

This form may also be used to collect necessary info on CCCHD volunteers who are not affiliated with CCMRC. See

Attachment E for registration form. Attachment F is the Volunteer Medical Information Form.

2 Training: All CCMRC volunteers will be requested to participate in various exercises, lectures, and training

opportunities conducted by CCMRC or the West Central Region. These trainings will increase volunteer awareness

to various emergencies and disasters including incident management, CBRNE, mass vaccination and prophylaxis,

mental health, and disaster management.


All CCMRC volunteers are required to take the following Federal Emergency Management Agency (FEMA)

online trainings IS 100 and IS 700 to increase familiarity with Incident Command Structure (ICS).

If Spontaneous Unaffiliated Volunteers (SUVs) report to the VRC, they must review Risk Management: Concepts

and Principles of ICS , Attachment G, as part of the VRC Standard Operating Guidelines (SOGs) prior to ID badge

and check out.

Additional recommended trainings are outlined in the Member Handbook.

3 Verification: Updated license requirements will be submitted to or verified by Ohio Responds or the CCMRC

coordinator. CCCHD will use the Ohio Licenses Sites to verify all CCMRC credentials are up to date and reflect the

volunteer’s scope of practice. Professional licenses will be credentialed through license verification at Ohio License

Center https://license.ohio.gov/lookup/default.asp?division=86 or the Ohio EMS and Fire Verification on Ohio

Department of Public Safety.

4 Code of Conduct: Volunteers will agree to and maintain the Code of Conduct that is part of the West Central Ohio

Medical Reserve Corps Member Handbook (2014).

5 Verification and Credentialing: All volunteers will be managed by the Ohio Responds database. The database has

the ability for volunteers to upload credential information.

The CCMRC Coordinator oversees the update of credentialing every 6 months.

The CC MRC Coordinator also maintains hard copy files on the trained and credentialed volunteers.

Credentialing can occur through Ohio License Center https://license.ohio.gov/lookup/default.asp?division=86

or EMS and Fire Verification on Ohio Department of Public Safety.

6 Liability Coverage:

Ohio Revised Code 121.404 provides liability protection to registered CCMRC volunteers throughout the State

of Ohio during local, state or federally declared emergencies, disasters, drills and trainings.

CCCHD staff members are covered by general insurance coverage provided by the CCCHD.

7 Emergency Recruitment: Individuals critically sought during each emergency will have the ability to register with

the CCMRC at the time of the emergency. Registration will be administered and information will be entered into

Ohio Responds. Verification of credentials will also be done at this time.

8 Just In Time Training: Volunteers will be given any necessary just-in-time training prior to deployment. This training

may be included in the general situation report.

B. Alert Volunteers

1 The size and scope of each emergency will dictate the number and career track(s) of CCMRC volunteers.

2 Official CCMRC deployment notifications are made through one of two systems:

The Ohio Responds notification system

Mass email list maintained by the CCMRC Coordinator and assistant


https://license.ohio.gov/lookup/default.asp?division=86


3 All notifications will include the following:

Brief description of the emergency

Time and location for in processing

Operational period

Safety concerns (if applicable)

Contact information for CCMRC coordinator

4 Request for Additional Volunteers: Optimally, unaffiliated volunteers are registered and vetted through the Clark

County Volunteer Reception Center (VRC) which is described in the VRC Plan, an attachment to this plan. VRC Plan is

a component of the Clark County Emergency Operations Plan (EOP). The CCCHD supports the VRC, but United Way

is the lead agency.

Spontaneous unaffiliated volunteers (SUV). SUVs may be accommodated by the CCMRC depending on the scale and

magnitude of the emergency. The processes of the VRC include background checks for layperson SUVs. If this occurs

when the Volunteer Reception Center is not open, the following steps will be followed.

SUVs who have a professional license will be credentialed through license verification at Ohio License Center

https://license.ohio.gov/lookup/default.asp?division=86 or the Ohio EMS and Fire Verification on Ohio

Department of Public Safety prior to volunteerism. The MRC Coordinator or designee will be responsible for

this task.

SUVs who have professional license in another state may be asked to remain in the scope of a lay volunteer

until reciprocity and license verification can occur. The MRC Coordinator or designee will be responsible for

this task.

Lay persons who present as SUVs must submit their driver’s license or picture identification and at least one

personal or professional reference prior to volunteerism. The MRC coordinator may waive this requirement in

consult with the Planning Section Chief.

C. Activate Mobilization and Tracking

1 Rally point: Volunteers will present with a picture ID and receive a volunteer ID if needed or if unaffiliated. If the

VRC is open, MRC and all other volunteers will be asked to go through the VRC for activation and assignment. If the

VRC is not open, volunteers will be asked to report to a designated staging area potentially on scene. The CCMRC

coordinator will be responsible to stand a staging area/rally point for all volunteers on scene.

2 Assignment: Volunteers will accept the assignment either through the VRC or at the staging area.

If Volunteers are asked to report to the staging area, they will log in, fill out all necessary paperwork, and receive

assignment to a position and work location. They will receive a briefing which includes a safety briefing and a copy

of Risk Management Summary, a tool of the VRC.

If the VRC is open volunteers will receive a copy of the “Request for Volunteer” form (Attachment 21 in the VRC

Plan), which:

Identifies the volunteer

Identifies the supervisor for that assignment

Notes the expected hours of work Clark County Combined Health District 7 Volunteer Management Plan


3 Volunteers will subsequently report to the onsite supervisor which they have been assigned. Volunteers will

present their picture ID to the supervisor.

4 Once a volunteer arrives at assigned position and work location, the Supervisor will give the volunteer further

instructions. It is very important for every volunteer to sign in and out each day (including lunch) and keep track of

all hours worked on the required form, which must be signed by the Supervisor.

5 Before leaving the site, volunteers will brief replacement volunteers on all pertinent information needed to perform

the job and continue smooth operations.

Tracking

1 During volunteer deployment, volunteers must be accounted for from the initiation of assignments through

demobilization. Attachment H or a similar tool may be of use for tracking volunteers.

2 Depending on the situation, reporting protocols will be established for either a “once a day” or “every 12 hours”

tracking of volunteers.

3 The CCMRC coordinator will coordinate the required tracking mechanisms with the onsite Volunteer Coordinator at

the duty station.

D. Operations

1 The volunteers will operate under a group lead or supervisor which may or may not be part of a formalized Incident

Command Structure.

2 The CCMRC Coordinator will support the volunteers in an effort to make them successful at their specific duty and

job location under the direction of the supervisor. Both the CCMRC Coordinator and the Supervisor work together

to ensure that assigned activities are being accomplished.

E. Volunteer Demobilization

Demobilization - IAP

Volunteers mobilizing through the VRC should follow the SOGs for demobilization as outlined in the Volunteer Reception

Center Plan, (Attachment D).

1 Volunteers are to be demobilized based on evolving incident requirements, and in accordance to an incident-action

plan, or incident demobilization plan and should consider the following guidelines

Demobilizing after a shift 12 hours or less:

1 When the Supervisor recognizes that less personnel resources are needed due to a diminishing need, he/she would

first notify the Resource Unit under the Planning Section to ask that the volunteer be reassigned or demobilized.

2 If no reassignment is necessary, the Resource Unit will contact the CCMRC to facilitate the demobilization and assure

that the following items are accomplished.


Complete the CC- MRC Volunteer Exit Screening Form, Attachment I.

Assure that activities were completed or that report has been given from the volunteer to the replacement

personnel

Volunteers will complete out-processing paperwork to document time, location(s) and duties performed during

the operational period.

Assure all equipment pertaining to the task is returned by the volunteer.

Confirm contact information for the volunteer so that debriefing and monitoring can occur after the incident.

Inquire about any injuries and illnesses acquired during the response.

Inquire about any mental/behavioral health needs of the volunteer that may be due to participation in the

response.

Refer volunteer to medical and mental/behavioral health services as needed.

Demobilizing after a multiday assignment or a shift longer than 12 hours:

1 Use all of the above steps in addition to working with the Planning Section to complete the ICS 221 Form. (Attachment

J). Use of this form assists in accomplishing a safe return for volunteer or resource.

F. Debrief

1 The CCMRC Coordinator will gather feedback after the response and evaluate what worked well and what needs for

improvement existed. This feedback may be part of the After Action Report on the incident.


ics_forms_221.pdf

Date Description of Change Pages

Affected

Reviewed

or

Changed

by 11/04/2015 Document Developed All CC

11/14/2015 Added method of credentialing SUV’s 3 CConover

03/01/2016 Added “coordinator and assistant” to section talking about strategies to recruit medical personnel 3 CConover

08/23/2016 Added Table of contents

Removed “Draft”

2

all

CConover


Attachments

Attachment A: Public Health Priority Professions

Attachment B: Activation through Ohio Responds

Attachment C: West Central Ohio Medical Reserve Corps Member Handbook 2014

Attachment D: VRC plan

Attachment E: MRC Volunteer Registration Form

Attachment F: MRC Volunteer Health Information Form

Attachment G: Concepts and Principles of ICS

Attachment H: Volunteer Tracking

Attachment I: CC-MRC Volunteer Exit Screening

Attachment J: ICS 221 Form


Attachment A - Public Health Priority Professions

The CCMRC may take both medical and non-medical volunteers. Below are the professions heavily sought for the

CCMRC:

• Physicians (Allopathic and Osteopathic)

• Physician assistants

• Nurses (Advanced Practice Registered Nurses (APRNs) including Nurse Practitioners, Certified Nurse Anesthetists, Certified Nurse Midwives, and Clinical Nurse)

• Certified nursing assistants

• Emergency Medical Technicians and Paramedics

• Phlebotomists

• Medical assistants

• Radiologic Technologists and Technicians

• Respiratory therapists

• Physical therapists

• Occupational therapists

• Pharmacists and pharmacy technicians

• Mental health professionals

• Marriage and Family Therapists

• Social workers

• Cardiovascular Technologists and Technicians

• Diagnostic Medical Sonographers

• Medical Records and Health Information Technicians

• Medical and Clinical Laboratory Scientists (Technologists)

• Medical and Clinical Laboratory Technicians 3

• Dentists and dental hygienists

• Administrative workers

• Chaplains

• Veterinarians


Attachment B –Activation Procedure via Ohio Responds

1. Access Ohio Responds via www.ohioresponds.odh.ohio.gov

2. Enter username and password

3. Select “Messages” tab at top of the page

4. Click “Compose” (under “Messages” of orange bar)

5. Click on “Communication Type” drop down box and select from the list depending on alert (i.e., actual, exercise, test, drill)

6. Click “Add Recipients” button and select “Organizations”

7. Click on the “+” next to the “Medical Reserve Corps” on the list

8. Scroll down to “Clark County – MRC” and click the “+” button. Check the box next to “Base User,” then press the “Select” button on the bottom right of window (this will populate in the recipient box of the message screen).

9. Fill in “Subject” line for message

10. Type in message to be sent via e-mail

11. If sending phone message, you have 2 options (only use for EMERGENCIES):

a. Check the “Phone” box and type a short message

b. Click on “Update Recorded Message” button:

* Select “Record Audio” and follow prompts

* You will record your message and click “Save” button to affix recording to alert

12. Using the “Advanced Delivery Options,” select 5 minutes from the “Delivery Delay” drop down

13. Leave “Send Time” on “Immediately”

14. “Priority” can remain on “Normal” or select “High” from drop down for emergencies

15. Leave the next 4 items set as they are

16. For “Do Not Contact If,” select the 1st and 3rd box.

17. For “Request a Response,” select “No.” Reply information will be provided in message.

18. Saving Template = You may choose to save template or not

19. Select “Preview and Test” at bottom of screen to review alert (if edit is needed, press “Edit” button in upper right and make corrections)

20. If satisfied, press “Send” button to send alert to volunteers


WCO MRC 2014

1 https://www.ohioresponds.odh.ohio.gov/

Member Handbook

Revised July 2014

Serving

West Central Ohio

Medical Reserve Corps

Champaign Clark

Darke Greene

Miami Montgomery

Preble Shelby

Attachment C


WCO MRC Handbook 7/14

2

Table of Content History Page 3 Roles Page 3 Mission Statement Page 5 Structure Page 5 Membership Page 6 Code of Conduct and Confidentiality Page 7 Meetings and Training Page 8 Member Standards Page 9 Family Readiness Page 9 Legal and Liability Issues Page 10 Deployment and Deactivation Page 12 Appendix B: Just-In-Time Training Page 14 Signature Page for Code of Conduct Page 15 Signature Page for Statement of Understanding Page 16 Electronic version available at www.WestCentralOhioMRC.org.


http://www.westcentralohiomrc.org/


3

History

In the wake of the September 11, 2001 terrorist attacks, thousands of Americans responded by volunteering their talents and skills to help others. Many more Americans asked, “What can I do to help?”

During his 2002 State of the Union address, President George W. Bush called on all Americans to make a lifetime commitment of at least 4,000 hours – the equivalent of two years of their lives – to serve their communities, the nation and the world. President Bush created the USA Freedom Corps to help Americans answer his call to service and to foster a culture of service, citizenship and responsibility.

Citizen Corps is the component of USA Freedom Corps that creates local opportunities for individuals to volunteer to help their communities prepare for and respond to emergencies by bringing together local leaders, citizen volunteers and the network of first responder organizations, such as fire departments, police departments and emergency medical personnel.

The Medical Reserve Corps is the component of the Citizen Corps that will bring together local health professionals and others with relevant health-related skills to volunteer in their community. These volunteers will assist local, existing community emergency medical response systems as well as provide a group of readily trained and available resources to help a community deal with pressing public health needs and improvements.

Roles The initiatives in all communities share the common goal of engaging volunteers in helping their communities prevent, prepare for and respond to crime, disasters, pressing public health needs and emergencies of all kinds. The following are actual duties performed by MRC volunteers in each county:

Champaign:

Completed food history questionnaires during foodborne illness outbreak

Assisted with LEPC county exercise.

Clark:

Flu clinics

Rabies vaccination clinics

School Vision/Hearing and BMI screenings

Guard Care



4

Shelter Staffing

Participates in County Drills/Exercises

MRC Administrative Duties

Health Fairs

Youth Risk Behavior Surveys

Flood Response Darke:

Participates in County Drills/Exercises

Assists in HD delivery of mass vaccine clinics - Flu & Tdap.

Available for shelter staffing Greene:

Nutrition and Fitness Promotion

Dental Screening

Shelter Staffing

Immunization Clinics Miami:

Immunization Clinics, Seasonal and Mass, both medical and non-medical positions

Nutrition and Fitness Promotion at various health fairs Montgomery:

Mass vaccination clinics

School vaccination clinics

Exercise Support staff and victims

MRC administration duties

Sheltering staff

Preble:

Mass vaccination clinics

Shelter Support

CERT/MRC cooperative programs Shelby:

Flu clinic’s 1. Vaccinating, 2. Traffic outside, 3. People traffic inside, 4. Registration 5. Paperwork

Assist clerical with data entry during clinics and daily activities

Assist school nurses with hearing and vision screenings



5

West Central Ohio Medical Reserve Corps

Mission Statement

The mission of the West Central Ohio Medical Reserve Corps is to provide medical and non-medical volunteers who can support in the effort to improve the health, safety, and welfare of the community in which they live.

Structure of the Medical Reserve Corps

Each County MRC is organized under their local Health District and in collaboration with their County Emergency Management Agency and the Ohio Citizen Corps Council. The Citizen Corps Council is a component of USA Freedom Corps established by President George W. Bush in 2002. National Medical Reserve Corps office is located at the Office of the United States Surgeon General. Administration for the program is provided by the Coordinator. When the County MRC is mobilized (for an exercise or an actual event), command and control is provided through the County EMA or local municipality designate, and other agencies, depending on the nature of the event.



6

Membership Requirements

MRC members must be at least 18 years of age. United States citizenship is not required, however, proof of valid residence must be presented upon completion of the MRC Application. Members are required to maintain a valid Ohio Driver’s license (or valid Ohio photo I.D.) and remain free of felony and serious misdemeanor convictions. The MRC member must be signed up on Ohio Responds and it is required to update your profile annually.

MRC members who are not working in the medical field are required to provide references for the MRC’s assistance during evaluation. Assignments will be based on range of experience, desired types of assignments, and actual open assignments in the event of deployment.

MRC members who are working as medical care personnel are required to hold a current license and/or certification to provide medical care and must work within the scope of their licensure. Assignments within the MRC will be made according to a member’s current level of licensure/certification and experience. If licensed upon admission to the MRC, members are required, as a minimum, to maintain the level of licensure/certification that qualified them to join the MRC or notify the Coordinator of status change. MRC members are required to provide proof of re-licensure/recertification when credentials expire. The MRC will not pay for re-licensure or recertification fees, although exceptions may be made when certifications are obtained as part of a MRC training course

Members are required to sign a “Code of Conduct” (See Code of Conduct – Page 6) and must abide by it during their service in the MRC.

Members are required to adhere to the policies in this handbook & the policies established by the MRC unit’s housing authority. Both during trainings and when mobilized.

The MRC does not discriminate with regard to race, gender, ethnicity, or physical capability. MRC members may, however, be assigned responsibilities that are appropriate given their race, gender, ethnicity, or physical capabilities (for example, a male may be assigned to care for male patients and a Spanish-speaking member may be assigned to assist Spanish-speaking persons).

Members are required, within reason, to participate in meetings, exercises and actual mobilizations. Members who miss an inordinate number of meetings, exercises or events may be dismissed from the MRC or placed at a lower response level. A yearly refresher course may be required.



7

Code of Conduct and Confidentiality

Code of Conduct: The purpose of this code is to establish standards of

conduct for all volunteers by identifying those acts or actions that are compatible with the best interest of the individuals served by this agency. Failure to comply with these standards could result in your dismissal from the MRC.

I will treat all individuals served by this agency with the same care andcompassion.

I will not accept either directly or indirectly, any gift, gratuity, or anything ofvalue from clients served by this agency.

I will not discuss controversial topics such as, religious beliefs, politicalviews, nor offer medical advice outside of my role.

I will not report for duty while under the influence of an intoxicant orcontrolled substance, nor will I consume any such substance duringworking hours.

I shall be neat and clean, and dress in a manor appropriate to the natureof my assignment.

I understand that smoking is not permitted in buildings, or on the groundsof buildings operated by this agency.

I understand that this agency will not provide a locked spot for valuables,such as purses, and is not responsible for loss or theft of personal items.

I understand that it is against the policy of this agency, and illegal understate and federal law for any volunteer, male or female, to sexually harassanother volunteer.

Accurately recording time worked is the responsibility of every volunteer. Iagree to sign in and sign out for every volunteer shift.

I will exercise care and follow all operating instructions, safety standards,and guidelines when using equipment, machines, tools, etc, that belong tothis agency or belong to the facility being used by this agency. If anyequipment, machines, tools or medical supplies appear to be damaged,defective, or in need of repair, I will notify the supervisor immediately.

Confidentiality Statement: In the course of volunteering with this agency, I recognize that it is my responsibility to maintain the confidentiality of all information that identifies a client, or discloses any information about the client; and to comply with the Health Insurance Portability and Accountability Act (HIPAA) standards.

I agree that I will not share any information I may obtain in verbal or written form. I also agree that I will not share any client information even if the information is available through other means. I further acknowledge that the confidentiality policy applies after termination as a volunteer with this agency.



8

MRC Meetings and Trainings

The Medical Reserve Corps has several training opportunities. The Ohio Medical Reserve Corps has recommended courses and optional courses. Membership meetings will be held at the Coordinators discretion. Check with your Coordinator to see what is available in your area. All MRC members are required to have one Ohio approved class at a minimum of every three years. Additional trainings vary per county. Members may attend trainings in surrounding counties.

Trainings Recommended Trainings:

1. Introduction to Medical Reserve Corps – learn basic function and missionof the MRC. After completion of the course and proof of licensure,members will be issued an MRC ID badge.

2. Communicable Diseases – learn about common diseases that are easilyspread.

3. Family Readiness – learn how to prepare your family for a disaster.4. Psychological First Aid – learn how to deal with the emotional aspects of a

disaster. In-class or on-line5. Incident Command Structure/National Incident Management System

(ICS/NIMS) 100 and 700 – learn command structure to be used in adisaster. In-class or on-line (www.fema.gov)

6. Other classes as designated by the County MRC Coordinator.

Other learning opportunities: 7. Volunteer Reception Center Training – learn how volunteers will be

mobilized during a disaster8. Points of Dispensing (POD) Training – learn how medications or

vaccinations will be given to a large number of people at once9. Basic Disaster Life Support/Advanced Disaster Life Support (BDLS/ADLS)

– medical personnel can learn the altered standard of care during adisaster. Cost associated with course.

10. Needs of Children in Disasters – learn how to address the special needsof children during a disaster. Cost associated with course

11. Pandemic Influenza Training – learn how, when, where to respond in apandemic

12. CPR/First Aid – learn how to administer basic first aid and cardio-pulmonary resuscitation

13. Blood Borne Pathogens – learn the risk of exposure and how to usepersonal protective equipment


http://www.fema.gov/


9

MRC Member Standards

Members must be appropriately trained and licensed or certified for the duties to which they will be assigned as part of the MRC. The Coordinator will maintain files on each member and is responsible for periodic audits to ensure licenses and certifications remain current.

The Coordinator may encourage members to be vaccinated against Hepatitis B and have had a Tetanus booster within the last 10 years. Documentation of waiver for vaccination may be needed. Members should have a current (within 12 months) negative TB test or documentation of a past positive and treatment regimen. Follow up will be on a case by case basis.

Family Readiness

In order to respond to an event, you and your family must be prepared for a disaster. This includes having a family communication plan, evacuation plan, food, and water. Trainings will be provided to you. For additional ideas of things you can do, feel free to contact your local coordinator. American Red Cross and Ohio Department of Health are wonderful resources to develop what works best for your situation.

Suggested Resources for Readiness preparation are listed below:

Ready.GOV– http://www.ready.gov/

CDC– http://emergency.cdc.gov/

FEMA– http://www.fema.gov/

American Red Cross– http://www.redcross.org/prepare


http://www.ready.gov/

http://emergency.cdc.gov/

http://www.fema.gov/

http://www.redcross.org/prepare


10

Legal and Liability Coverage

Ohio Revised Code Section 121 404 was repealed effective on July 3, 2012.

This change was the result of Ohio EMA and the Ohio Department of Health(ODH) taking over management and administration of the Ohio Responds volunteer database from the Ohio Community Services Council. Ohio Revised Code Sections 5502.281 and 3701.04 now take the place of Section 121.404 and have essentially the same language. These statutes require that the Ohio Department of Health (ODH) and the Ohio Emergency Management Agency (OEMA) jointly share the responsibilities of the statutes. The limited liability protection for registered volunteers during an emergency declared by the state or political subdivision or in disaster-related exercises, testing or other training activities) remains the same.

ORC 3701.04 (B) The director (of health), in accordance with Chapter 119 of the Revised Code, shall adopt rules jointly with the executive director of the emergency management agency to do both of the following, as required by section 5502.281 of the Revised Code: (1) Advise, assist, consult with and cooperate with agencies and politicalsubdivisions of this state to establish and maintain a statewide system forrecruiting, registering, training and deploying volunteers reasonably necessary torespond to an emergency declared by the state or a political subdivision;

(2) Establish fees, procedures, standards and requirements necessary forrecruiting, registering, training and deploying the volunteers.

ORC 5502.281 (A) The executive director of the emergency management agency, jointly with the director of health shall do both of the following: (1) Advise, assist, consult with, and cooperate with agencies and politicalsubdivisions of this state to establish and maintain a statewide system forrecruiting, registering, training, and deploying the types of volunteers reasonablynecessary to respond to an emergency declared by the state or a politicalsubdivision;

(2) Establish fees, procedures, standards, and requirements necessary forrecruiting, registering, training, and deploying the volunteers as required underthis section.

. . . (C) A volunteer registered under this section is not liable in damages to anyperson or government entity in tort or other civil action, including an action upona medical, dental, chiropractic, optometric, or other health-related claim orveterinary claim, for injury, death, or loss to person or property that may arise



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from an act or omission of that volunteer. This division applies to a registered volunteer while providing services within the scope of the volunteer’s responsibilities during an emergency declared by the state or political subdivision or in disaster-related exercises, testing, or other training activities, if the volunteer’s act or omission does not constitute willful or wanton misconduct. (D) As used in this section:(1) “Registered volunteer” means any individual registered as a volunteerpursuant to procedures established under this section and who serve without payor other consideration, other than the reasonable reimbursement or allowance forexpenses actually incurred or the provision of incidental benefits related to thevolunteer’s service, such as meals, lodging, and child care.

(2) “Political subdivision” means a county, township, or municipal corporation inthis state.

.



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Procedures for Deployment and Deactivation

In the event of a public health or medical emergency, MRC members will likely be activated through a five phase system. The MRC coordinators will use the OHIO Responds System to activate and inform MRC volunteers. The phases of MRC Activation are as follows: Phase 1: Alert Phase 2: Activate Phase 3: Operations Phase 4: Deactivation Phase 5: Debrief

Phase 1: MRC Alert Notification During this phase, if time allows, the MRC Coordinator will alert the MRC members about the status of a disaster situation, most likely by e-mail, phone, or mass media. This will give the volunteer a sense of what has occurred and the likelihood of their future involvement in the response. If an emergency develops quickly, Phase 1 may be skipped and phase 2 initiated first. Notification via media release to respond to the Volunteer Reception Center (VRC).

Phase 2: Activation Waiting for the activation call ensures that they receive the appropriate information about where to report and receive event-specific training. When volunteers come to the Volunteer Reception Center you will receive information about the situation, help that is requested and appropriate gear to have. MRC badge needs to be displayed.

Phase 3: Operations This is the phase of actual volunteer service for those volunteers able to respond to the disaster.

Will usually be a 8 hour shift

Security will be provided

Wear comfortable, non-offensive clothing, long pants, and closedtoe shoes

Backpack or small bag with personal items (e.g. medications,glasses)

Do not bring valuables

Volunteers for the MRC may not bring weapons to any event

Just-In-Time training will be offered during the operations phase. This will ensure specific procedures are followed and will take place at the job



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assignment location. Background information on the event or situation will be provided to ensure safety.

Procedures will vary for different types of emergencies, so pre-event training for all volunteers is not practical. Just-In-Time training ensures that specific procedures are fresh in the mind. All MRC volunteers are provided with Just-In-Time training at a centralized location or at the Point of Dispensing (POD) site before assisting in an event. This Just-In Time training serves as an orientation. Training should give the appropriate background needed in order to safely and effectively participate in a response. All emergency responders operate from a centralized command system. For the purposes of volunteer service, each volunteer reports to only one supervisor. All POD volunteers should receive preventative medicine or vaccine if needed (Appendix B – Just-In-Time Training).

Phase 4: Demobilization When a volunteer is mobilized the plan for demobilization begins. When a volunteer is no longer needed there is a plan for sending that person home. During a disaster, if volunteer availability permits, those in the MRC may be asked to serve for more than one shift. Deactivation occurs after the last MRC volunteer shift has ended. It is important that you officially check out after your shift.

Phase 5: Debrief This phase occurs after the disaster is over. MRC leadership will be gathering feedback and information from all volunteers who respond to the event to collect their thoughts on the MRC process, as well as to evaluate what worked and didn’t work about the response effort.

Remember your decision to participate in response efforts is voluntary. MRC volunteers are provided with the appropriate training before a response, they are never asked to perform duties they are not licensed or that they feel uncomfortable doing. When you get a request for assistance, evaluate whether you are in a position to help. If you feel that you are able to help, notify your family of your intentions.



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Appendix A – Just-In-Time Training

1) MRC specific informationa. mobilization and demobilizationb. MRC go kitc. Credentialingd. volunteer support

2) Refresher overviewa. Agent specific information refresherb. Infectious disease control refresherc. Blast injury refresherd. Secure sitee. Environmental hazard refresher

3) Site specific safety concernsa. site hazardsb. first aidc. emergency existsd. escape routese. shelter in placef. securityg. secondary meeting site

4) Where to report; which site to go to5) Overall operations process6) Communications7) Logistics at the site

a. Supplies you should bringb. Supplies available at the sitec. time tracking

8) Check in and check out procedures9) Criminal-epidemiology investigation

10) General medicala. (hygieneb. IVc. first aidd. Medical waste & disposal at the site

11) ICS refresher.12) List of organizational chart: Who answers to whom?13) Scope of duties; Job action sheet overview; Job types available andassignments; Job action sheets.



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Code of Conduct: The purpose of this code is to establish standards of conduct for all volunteers by identifying those acts or actions that are compatible with the best interest of the individuals served by this agency.

I will treat all individuals served by this agency with the same care and compassion.

I will not accept either directly or indirectly, any gift, gratuity, or anything of value from clients served by this agency.

I will not discuss controversial topics such as, religious beliefs, political views, nor offer medical advice outside of my role.

I will not report for duty while under the influence of an intoxicant or controlled substance, nor will I consume any such substance during working hours.

I shall be neat and clean, and dress in a manor appropriate to the nature of my assignment.

I understand that smoking is not permitted in buildings, or on the grounds of buildings operated by this agency.

I understand that this agency will not provide a locked spot for valuables, such as purses, and is not responsible for loss or theft of personal items.

I understand that it is against the policy of this agency, and illegal under state and federal law for any volunteer, male or female, to sexually harass another volunteer.

Accurately recording time worked is the responsibility of every volunteer. I agree to sign in and sign out for every volunteer shift.

I will exercise care and follow all operating instructions, safety standards, and guidelines when using equipment, machines, tools, etc, that belong to this agency or belong to the facility being used by this agency. If any equipment, machines, tools or medical supplies appear to be damaged, defective, or in need of repair, I will notify the supervisor immediately.

Confidentiality Statement: In the course of volunteering with this agency, I recognize that it is my responsibility to maintain the confidentiality of all information that identifies a client, or discloses any information about the client; and to comply with the Health Insurance Portability and Accountability Act (HIPAA) standards. I agree that I will not share any information I may obtain in verbal or written form. I also agree that I will not share any client information even if the information is available through other means. I further acknowledge that the confidentiality policy applies after termination as a volunteer with this agency. I, (Print your name)___________________________________ have read this document, and agree to provide volunteer services in accordance with these standards.

________________________________________ _____________ Volunteer Signature Date



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PERSONAL STATEMENT OF UNDERSTANDING

Name: _____________________________________________

I am an applicant for a member of the _______________ County Medical Reserve Corps (MRC). I understand there are certain conditions I must accept as a member of the MRC. 1. Availability I am available and able to serve on disaster assignments for as long as the need arises. I am also willing to assist with Public Health Initiative assignments as the need arises. The length of these assignments will vary depending on the type of work I am needed for. I understand that these assignments could involve high pressure work situations in adverse conditions such as long and irregular hours, erratic and inappropriate food, eating and sleeping conditions; extreme heat, cold or dampness; crowds, noisy environment, and exposure to dust or other allergens. 2. Work Performance I am willing to comply with directives issued by the Medical Reserve Corps. I will uphold and follow the policies outlined in the member handbook and the organizations that support the MRC. I understand that I may be released from an assignment and/or removed from the Medical Reserve Corps for a violation of policy or a personnel/performance issue. 3. Insurance Coverage It is strongly suggested that MRC members ensure they have adequate health insurance to protect themselves against financial loss should an accident or injury require medical care or result in loss of wages. 4. Status I understand that I must keep my Ohio Responds profile up to date at a minimum yearly and attend a refresher classes at least every three years to maintain eligibility for state liability coverage. I understand that I may be asked to undergo a background check and licensure verification initially and throughout my MRC membership. I verify that within the last year I have not been convicted of a felony or of a misdemeanor resulting in imprisonment. I fully understand the mandatory requirements indicated above and certify that I am able to comply with them. If these statements are found to be incomplete or untrue, I understand that I will be removed from the MRC. By signing this statement I confirm that I have received the member handbook and agree to abide by the contents therein. Signature: _______________________________ Date: ___________________________________


Clark County Emergency Management Agency

Volunteer ReceptionCenter

A Section of the Clark County EmergencyOperations Plan

Tab A to ESF #7 – Resource Management

Revised

November 2015

The purpose of the plan is to describe the organizational structure to ensure themost efficient and effective intake, processing and deployment of unaffiliatedvolunteers, registered volunteers, and trained medical professional volunteersduring and after a disaster.

Attachment D


TABLE OF CONTENTS

AGENCIES ........................................................................................................... 2 1. Primary Agency .......................................................................................... 2 2. Core Agencies ............................................................................................ 2 3. Support Agencies ....................................................................................... 2

INTRODUCTION .................................................................................................. 2 4. Purpose ...................................................................................................... 25. Scope ......................................................................................................... 26. Situation ..................................................................................................... 3 7. Assumptions ............................................................................................... 38. Policies ....................................................................................................... 4

CONCEPT OF OPERATIONS .............................................................................. 5 9. General VRC Concept ............................................................................... 5 10. Activation of Plan .................................................................................... 5 11. Notifications ............................................................................................ 512. EOC Coordination .................................................................................. 6 13. Specific VRC Concept ............................................................................ 6

ROLES AND RESPONSIBILITES ........................................................................ 7 14. The United Way of Clark, Champaign and Madison Counties ................ 7 15. Clark Combined Health District Medical Reserve Corps (MRC) ............. 7 16. Clark County Emergency Management Agency (EMA) .......................... 8 17. United Senior Retired and Senior Volunteer Program (RSVP) ............... 8

GLOSSARY .......................................................................................................... 9 18. Definitions ............................................................................................... 919. Acronyms ................................................................................................ 9

APENDECIES ..................................................................................................... 10 20. Attachment 1 – Signature Page of Primary/Core Agencies .................. 11 21. Attachment 1 – Volunteer Request Form.............................................. 12 22. Attachment 1 – ICS Form 213 Resource Tracking ............................... 13


AGENCIES

1. Primary Agency

1.1. United Way of Clark, Champaign and Madison Counties (United Way)

2. Core Agencies

2.1. Clark County Combined Health District (CCCHD)

2.2. Clark County Emergency Management Agency (EMA)

2.3. United Senior Services (USS)

3. Support Agencies

3.1. Medical Reserve Corps (MRC)

3.2. Retired and Senior Volunteer Program (RSVP)

INTRODUCTION

4. Purpose

4.1. The purpose of the plan is to describe the organizational structure to ensure the most efficient and effective intake, processing and deployment of unaffiliated volunteers, registered volunteers, and trained medical professional volunteers during and after a disaster.

4.2. A VRC is designed for use by the Clark County Emergency Operations Center (EOC) during the response and recovery phases of emergency to augment current operations and serve as a force multiplier by soliciting volunteer assistance in performing specified activities requested.

4.3. A Volunteer Reception Center (VRC) is an assembly point location to process and register unaffiliated volunteers, and to serve as a check-in site for affiliated and medical volunteers.

4.4. The goal is to match volunteers’ skills and qualifications to agencies needing assistance in response to a disaster. The VRC serves as an efficient way to document volunteer registration, requests for volunteers, volunteer service hours, staffing costs, and expenses incurred.

5. Scope

5.1. All jurisdictions and response agencies are able to request and use the VRC in efforts to mitigate an activate disaster response and recovery mission, through Clark County EMA.


5.2. The primary location of the VRC is at the Heritage Center Discovery Hallbuilding, located at 117 South Fountain Avenue, in Springfield, Ohio.Memorandums of Understanding (MOU) are held by the United Way forthe primary location.

5.3. A secondary VRC location is the Learning Resource Center at Clark StateCommunity College, 570 East Leffel Lane, in Springfield, Ohio.Memorandums of Understanding (MOU) are held by the United Way forthe secondary location.

6. Situation

6.1. Persons not directly affected by a disaster will want to assist other people.These volunteers may come from within the affected area. They may alsocome from the region, state or other parts of the country, depending on thesize and severity of the disaster.

6.2. Volunteers represent a potential resource; however, volunteers whorespond spontaneously to on-scene operations and without appropriatetraining and qualifications, can easily overwhelm the capabilities of firstresponders and other support agencies and delay response and recovery,or injure themselves or others tying up additional resources.

6.3. Volunteers can be used to conduct response and recovery activities suchas; mass care operations (sheltering, feeding, bulk distribution), supportspecial needs populations, manage and track resources, assist in searchand rescue, assist in traffic control, and assist affected homeowners incleaning up after a disaster, among many other functions.

6.4. There are risk factors that need to be taken into account in order toeffectively utilize volunteers. All jurisdictions or agencies who intend toutilize volunteers need to:

6.4.1. Understand some costs may be associated.

6.4.2. Make requests through the EOC.

6.4.3. Be responsible for and provide “just-in-time” training and safetybriefing.

6.4.4. Provide supervision of volunteer resources

7. Assumptions

7.1. Local governments will support volunteer management and utilizationefforts through requests of personnel resources.

7.1.1. In order for the Medical Reserve Corp (MRC) section of the VRCto be activated, there must be representation from the Clark


County Combined Health District (CCCHD) to oversee this component.

7.1.2. The United Way and CCCHD will use the Clark County VRC Manual for set up and operations of the VRC.

8. Policies

8.1. When multiple volunteer resources are requested, the Clark County EOC will establish priorities, based on location or missions that are most critical. The EOC will communicate those priorities to the VRC to fill in sequential order, if possible.

8.2. The EOC will send completed Volunteer Request Forms (see attachment 2) by e-mail or fax to the VRC

8.3. Each primary and support agency will maintain written agreements in the form of Memorandums of Understanding (MOU) as necessary with any other agency that is required in support VRC functions; for example, use designated facilities.

8.4. Each agency and requesting jurisdiction is responsible for any costs associated with use of this Plan.

8.5. All VRC volunteers are covered for liability under the Good Samaritan Law. In addition to that, the following also apply:

8.5.1. All spontaneous volunteers registered with Ohio Responds, will also be covered under ORC 5502.281 and Chapter 2305;

8.5.2. All affiliated volunteers will be covered by their parent organization (for example: Red Cross, Emergency Management, etc.); and

8.5.3. Each agency is responsible for maintaining their policies and SOPs regarding this plan.

8.6. All agencies with responsibilities in this plan, will keep track of their department finances to include but not limited to; timesheets (including any overtime), compensation amounts, material and supply costs, etc. when activated by the EOC.

8.7. Agencies will forward this information on to the EOC, as requested, for estimating cost of the disaster as a whole, as well as any cost recovery efforts if applicable.


CONCEPT OF OPERATIONS

9. General VRC Concept

9.1. Ultimate responsibility for the coordination of volunteers rests with theClark County EMA through the EOC. Coordination of volunteers requirescooperative effort by the Clark County EMA, the Lead CoordinatingAgency (United Way), and all support agencies listed.

10. Activation of Plan

10.1. The VRC is activated through the Clark County EOC by any requestingagency having response or recovery responsibilities, including: a localpolitical jurisdiction, an Incident Commander, or as forecasted by ClarkCounty EMA.

10.2. Activation will further be contingent on a declaration of emergency by ClarkCounty Board of Commissioners.

10.3. When the EOC requests to activate the VRC, the United Way will notify theVRC Staff and other support agencies tasked with specific implementationroles. Reasons for activating the VRC may include, but are not limited tothe following:

10.3.1. When the nature of the disaster and/or media coverage makes theconvergence of unaffiliated volunteers likely; and

10.3.2. When shortages of workers require augmentation of staffingsupport from outside resources.

10.4. The Clark County EMA may request state-level assistance through theOhio Emergency Operations Center if a VRC needs to be activated butlocal resources are unavailable to establish one.

11. Notifications

11.1. The EOC will call the United Way Executive Director, the CCCHD HealthCommissioner and MRC Coordinator as soon as practical to placeagencies on standby to ensure that the VRC can be opened and staffed intime to effectively recruit and screen volunteers.

11.2. The EOC will call the United Way Executive Director, the CCCHD HealthCommissioner and MRC Coordinator to formally activate the VRC.

11.3. Coordination between the VRC and the EOC is by direct radiocommunication if possible, through cell phones, WebEOC or any othermeans available as necessary.


11.4. Contact with VRC volunteer staff will be made by United Way. The Clark County mass notification system can be used or direct contact can be made directly by the United Way.

11.5. Notification to solicit volunteers to assist in disaster response and recovery activities through the VRC will be made through media outlets, if necessary, by the County Public Information Officer (PIO).

12. EOC Coordination

12.1. The ESF #7 (Resources) Representative in the EOC will serve as the liaison between the United Way’s VRC Manger, on-site operations, and the EOC .

12.2. A good and constant flow of information and updates as requested for effective management of VRC and on-site operations.

12.3. Volunteer Request Forms are available in the EOC for communicating the request for volunteers to the VRC. (See attachment 2)

12.4. All Resources and personnel that have been requested through the EOC will be tracked using WebEOC or ICS form 213. ( See attachment 3)

13. Specific VRC Concept

13.1. Standard Operating Guidelines (SOGs) have been pre-established in the VRC Manual. Manuals are in the possession of all Core, Primary, and Supporting agencies. This will guide the VRC staff in coordination and set-up of all aspects of VRC operations: including the following stations:

13.1.1. Orientation

13.1.2. Registration

13.1.3. Assignment

13.1.4. Safety & Risk Management

13.1.5. ID Badge & Checkout

13.2. Through the VRC, each eligible volunteer will be assigned, based on their qualifications and availability.

13.3. Specific job training will be done onsite by requesting agency/jurisdiction.

13.4. All agencies and volunteers will follow the concepts and principals of ICS.

13.5. Any information going to the public needs to be coordinated with the PIO located in the EOC.


13.5.1. General procedures and responsibilities for emergency public information are detailed in the Clark County Emergency Operations Plan (EOP), ESF# 15 – Public Information Plan.

ROLES AND RESPONSIBILITES

14. The United Way of Clark, Champaign and Madison Counties

14.1. The United Way is the lead agencies for set-up and operations of the VRC.

14.2. Develop and maintain all required records, documentation, and forms to operate VRC, to include: activation checklists and SOGs for all positions in the VRC.

14.3. When requested of the EOC, UW will activate and operate a VRC to process volunteers during a disaster, and direct all activities of staff, volunteers, and other personnel in the VRC operation according to the VRC Manual.

14.4. Activate 2-1-1 Information and Referral as a hotline for volunteer and public information.

14.5. Provide EOC with updates on VRC activities.

14.6. Monitor resource needs for sustaining VRC operations.

14.7. Work with EMA, EOC, and other agencies to provide additional security, mental health screeners, and medical screeners as outlined in the VRC Manual.

14.8. Contribute to the planning, development, maintenance, and exercise of the VRC Plan and its related materials.

14.9. Maintain all written MOUs in regard to VRC operation.

14.10. Track all activities, including expenses related to operation of the VRC.

14.10.1. Provide all documentation used in VRC activation to EMA upon the closing of the VRC.

15. Clark County Combined Health District – Medical Reserve Corps (MRC)

15.1. Contribute to the planning, development, and maintenance of this VRC Plan and its related materials.

15.2. Provide for and oversee MRC component of VRC during activation.


15.3. Oversee credential checking of registered MRC volunteers.

15.4. Oversee assignment of MRC volunteers to ensure they are assigned to appropriate tasks.


16. Clark County Emergency Management Agency (EMA)

16.1. Activate the United Way to set-up, manage, and demobilize the VRC as the lead agency.

16.2. Responsible for the resource requests for, and coordination of, volunteers through the implementation of a VRC.

16.3. Coordinate with other agencies and organizations via the EOC for maximum utilization of limited resources.

16.4. Work with other agencies to provide security, mental health screener, medical screener, and other resources as requested by VRC.

16.5. Use Volunteer Request Forms (see attachment 2) to communicate requests for volunteers with the VRC Manager.

16.6. Track requests with form 213 (see attachment 3)

16.7. Coordinate with the Public Information Officer (PIO) to develop news releases upon activation of the VRC, soliciting volunteers, and other emergency communication.

16.8. Request state-level assistance to support VRC operations, if necessary.

17. United Senior Services - Retired and Senior Volunteer Program (RSVP)

17.1. Provide VRC staff to United Way.

17.2. Provide additional office space, supplies, or other resources (if requested) of United Way, if possible.

17.3. Contribute to the planning, development, maintenance, and exercise of the VRC Plan and its related materials.



GLOSSARY

18. Definitions

18.1. Unaffiliated volunteer – An individual who comes forward following adisaster to assist with disaster-related activities during the response orrecovery phase without pay or other consideration. These volunteers arenot affiliated or pre-registered with any disaster relief organization.However, unaffiliated volunteers may possess training, skills andexperience that can be useful in the relief effort. Unaffiliated volunteersmay also be referred to as spontaneous or convergent volunteers.

18.2. Registered Volunteer – One who is already associated with a serviceagency or disaster relief organization and has been trained for a specificrole or function. Examples of affiliated volunteer groups includeVolunteers in Police Services (VIPS), American Red Cross (ARC) or localVoluntary Organizations Active in Disasters (VOAD) groups.

18.3. Medical Volunteer – Is associated with the Medical Reserve Corps (MRC),group of credentialed and trained medical and public health volunteerswho are equipped to respond to a local or national disaster. Any personwho would like to volunteer for a medical assignment must be registeredwith the MRC. If an individual is not a registered MRC volunteer, they canstill participate in a non-medical capacity.

18.4. Disaster – Hazard, large scale local emergency or incident.

19. Acronyms

19.1. CCCHD - Clark County Combined Health District

19.2. EMA – Emergency Management Agency

19.3. EOC – Emergency Operations Center

19.4. ESF – Emergency Support Function

19.5. ICS – Incident Command System

19.6. MOU – Memorandum of Understanding

19.7. MRC – Medical Reserve Corps

19.8. PIO – Public Information Officer

19.9. SOGs – Standard Operating Guidelines

19.10. VRC – Volunteer Reception Center


APENDECIES Attachment 1 - Signature Page Attachment 2 – Volunteer Request Form Attachment 3 - 213 (tracking) Form


20. Attachment 1 – Signature Page of Primary/Core Agencies

__________________________________________________ ________________

Executive Director, United Way of Clark, Champaign and Date

Madison Counties

__________________________________________________ _________________

Health Commissioner, Clark County Combined Health District Date

__________________________________________________ _________________

Director, Clark County Emergency Management Agency Date

__________________________________________________ _________________

Executive Director, United Senior Services Date


21. Attachment 1 – Volunteer Request Form


22. Attachment 1 – ICS Form 213 Resource Tracking


Clark County Medical Reserve Corps

VOLUNTEER REGISTRATION

Please print clearly. Today’s date

Title: Dr. Mrs. Mr. Ms. Are You Interested in Volunteering for future Events? Yes No

Last Name First Name Middle

Home Address Apt. No.

City State Zip Code County of Residence

Home Phone ( ) Work Phone ( ) ext_______

Mobile Phone ( ) Fax Number ( ) Email Address

Occupation Specialty

Professional License Current? ____ Yes ____ No ___ NA State(s) where licensed to practice ____________

Full time Part time Retired Student License/Certification #________________________

Employer Address

City State Zip Code Work Phone, Ext ____________________

Birth date Place of Birth Age Gender Male Female

Social Security Number (optional)

Marital Status Spouse’s Name

Driver’s License Number State Issued DL Expiration Date

Are you an employee of a local health department? Yes No If so, which one?

What is the highest level of education you have completed?

PPeerrssoonnaall CCoonnttaacctt IInnffoorrmmaattiioonn

WWoorrkk CCoonnttaacctt IInnffoorrmmaattiioonn

Attachment E


Name Relationship Address City State Zip Code

Daytime Phone Number ( ) Evening Phone Number ( )

Please check off your preferred tasks during an emergency: Assist clients with forms Evidence preservation Mental Health

Assist with client education Evacuation MRDD Services

Assist with flu clinics Greeter Registration

Assist with health screenings Ham Radio Operator Security/Law Enforcement

Computer Support Immunizations Supply/Stock

Data entry Infectious Disease/Contact Tracing Strategic National Stockpile

Decontamination Interpreter Services Surveillance

Education and training Injured or deceased animals Trauma

Environmental health Laboratory capacity Triage Other, please describe

Do you speak or read a language other than English? Yes No If so which one?

Do you have any disaster/emergency response experience? Yes No If so, describe

Do you have any public health response experience? Yes No If so, describe

Do you have any disaster or crisis training or experience? Yes No If so, describe

Please check all current training or volunteer opportunities that apply:

Advanced Disaster Life Support (ADLS) American Red Cross

Advanced Trauma Life Support (ATLS) Disaster Medical Assistance Team

Basic Cardiac Life Support (BCLS) Disaster Mortuary Operational Response Team

Basic Disaster Life Support (BDLS)

Basic First Aid

CERT training

Cardiopulmonary Resuscitation (CPR)

Critical Incident Stress Debriefing (CISD)

Hazmat Awareness Level training

Incident Command Structure (ICS)

Pediatric Life Support (PALS)

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Unified Command Structure (UCS)

WMD Awareness Level training Other Certifications or training:

Are you part of an emergency/disaster plan with another organization? Yes No Are you willing to attend the mandatory Medical Reserve Corps trainings? 2 hours each. Yes No ___ Please indicate when you are available for training:

Sunday Morning Afternoon Evening

Monday Morning Afternoon Evening

Tuesday Morning Afternoon Evening

Wednesday Morning Afternoon Evening

Thursday Morning Afternoon Evening

Friday Morning Afternoon Evening

Saturday Morning Afternoon Evening

Have you ever been convicted of a felony? Yes No Have you ever been convicted of a misdemeanor? Yes No Are you willing to submit to a background check if position merits? Yes No Do you give permission to add your information to the OMRC Statewide Data Base System? Yes No

The Clark County Health Department recognizes its responsibility to volunteer staff to assure fair and equal treatment and will not discriminate on the basis of color, religion, sex, age or national origin or against any qualified handicapped individual, or disabled veteran. I understand that I am applying for an unpaid volunteer position and that this is not an application for or contract of employment. I further agree that as a volunteer I may not accept payment for my services and that I will incur the cost of transportation. I will also take required training when applicable. The statements made on the registration are true, complete and accurate to the best of my knowledge. I understand that any misrepresentation, omission of information, or misleading and incomplete data shall result in disqualification from consideration or dismissal as a volunteer. The Clark County Combined Health District reserves the right to disqualify or reject any volunteer.

X Signature Date

Please return this form to:

Sandy Miller R.N. MRC coordinator for Clark County

Clark County Combined Health District [email protected]

529 East Home Rd. Springfield, Ohio 45504 (937) 390-5600 ext 262

or Fax (937) 390-5625

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mailto:[email protected]

WEST CENTRAL OHIO MEDICAL RESERVE CORPS

VOLUNTEER HEALTH INFORMATION FORM Please print clearly. Today’s date

Title: Dr. Mrs. Mr. Ms.

Last Name __ First Name Middle _____

Describe any restrictions/limitations you have on activities: ________________________________________________________________________________

_____________________________________

List all medications, vitamins, herbs and over the counter drugs you usually take: _______________

__________________________________________________________

_____________________________________

Please list any allergies or other medical conditions that a physician would need to be aware of: _ __________

___________________________________________________________________________

Please circle any vaccines you have received below :

Anthrax #1 #2 #3 #4 #5 #6 Booster (date) _________ MMR #1___________ #2____________

Smallpox (date) ___________ Hepatitis A #1________ #2________ Tetanus (date) ___

Hepatitis B #1_____ #2 _____ #3 _____ Typhoid (date) ___________ Yellow Fever (date): ____

Influenza (date) ___ Meningococcal (date) __________

Polio #1_________ #2___________ #3___________ #4___________ Tb skin test (date): ___

Emergency Contact : ____________________________Telephone number: ___________________

May we call your emergency contact person in the event of an emergency? Yes No

Please return this form to:

Sandy Miller, RN Clark County MRC Coordinator

[email protected] 529 E. Home Road

Springfield, Oh 45503 (937) 390-5600 ext 262

Fax (937) 390-5625

PPeerrssoonnaall CCoonnttaacctt IInnffoorrmmaattiioonn

Attachment F


Attachment G



Attachment H


Full Name:

Last First M.I.

Assignment:

Volunteer Assignment Site

Volunteer Responsibilities

Shift(s) Worked:

Phone: Email:

Was this your first deployment as a volunteer?

Yes No

Injury sustained or illness experienced during assignment?

Yes No

If yes, please describe illness/injury and treatment.

Did you feel safe during your deployment?

Yes No

If no, please explain.

Hazardous exposures or conditions?

What was the most difficult aspect of this assignment for you?

Do you have any mental/behavioral health needs as a result of this deployment?

Yes No

Would you like to talk to a mental health professional to discuss your experiences?

Yes No

What could have been done differently to make this a better experience for you as a volunteer?

What went well?

Questions/Comments:

Exit Interviewer:Signature Date

Clark County Combined Health District - MRC/CC Volunteer Exit Screening

Assignment Information

Exit Screening

Attachment I


DEMOBILIZATION CHECK-OUT (ICS 221) 1. Incident Name: 2. Incident Number:3. Planned Release Date/Time:Date: Time:

4. Resource or Personnel Released: 5. Order Request Number:

6. Resource or Personnel:You and your resources are in the process of being released. Resources are not released until the checked boxesbelow have been signed off by the appropriate overhead and the Demobilization Unit Leader (or Planning Sectionrepresentative).

LOGISTICS SECTION Unit/Manager Remarks Name Signature

Supply Unit

Communications Unit Facilities Unit

Ground Support Unit

Security Manager

FINANCE/ADMINISTRATION SECTION Unit/Leader Remarks Name Signature

Time Unit

OTHER SECTION/STAFF Unit/Other Remarks Name Signature

PLANNING SECTION Unit/Leader Remarks Name Signature

Documentation Leader Demobilization Leader

7. Remarks:

8. Travel Information: Room Overnight: Yes No Estimated Time of Departure: Actual Release Date/Time: Destination: Estimated Time of Arrival: Travel Method: Contact Information While Traveling: Manifest: Yes No

Number: Area/Agency/Region Notified:

9. Reassignment Information: Yes NoIncident Name: Incident Number: Location: Order Request Number:

10. Prepared by: Name: Position/Title: Signature:

ICS 221 Date/Time:

Attachment J


ICS 221 Demobilization Check-Out Purpose. The Demobilization Check-Out (ICS 221) ensures that resources checking out of the incident have completed all appropriate incident business, and provides the Planning Section information on resources released from the incident. Demobilization is a planned process and this form assists with that planning. Preparation. The ICS 221 is initiated by the Planning Section, or a Demobilization Unit Leader if designated. The Demobilization Unit Leader completes the top portion of the form and checks the appropriate boxes in Block 6 that may need attention after the Resources Unit Leader has given written notification that the resource is no longer needed. The individual resource will have the appropriate overhead personnel sign off on any checked box(es) in Block 6 prior to release from the incident. Distribution. After completion, the ICS 221 is returned to the Demobilization Unit Leader or the Planning Section. All completed original forms must be given to the Documentation Unit. Personnel may request to retain a copy of the ICS 221. Notes: • Members are not released until form is complete when all of the items checked in Block 6 have been signed off. • If additional pages are needed for any form page, use a blank ICS 221 and repaginate as needed.

Block

Number Block Title Instructions

1 Incident Name Enter the name assigned to the incident. 2 Incident Number Enter the number assigned to the incident. 3 Planned Release Date/Time Enter the date (month/day/year) and time (using the 24-hour clock) of

the planned release from the incident. 4 Resource or Personnel

Released Enter name of the individual or resource being released.

5 Order Request Number Enter order request number (or agency demobilization number) of the individual or resource being released.

Resource or Personnel You and your resources are in the process of being released. Resources are not released until the checked boxes below have been signed off by the appropriate overhead and the Demobilization Unit Leader (or Planning Section representative). • Unit/Leader/Manager/Other • Remarks • Name • Signature

Resources are not released until the checked boxes below have been signed off by the appropriate overhead. Blank boxes are provided for any additional unit requirements as needed (e.g., Safety Officer, Agency Representative, etc.).

6

Logistics Section Supply Unit Communications Unit Facilities Unit Ground Support Unit Security Manager

The Demobilization Unit Leader will enter an "X" in the box to the left of those Units requiring the resource to check out. Identified Unit Leaders or other overhead are to sign the appropriate line to indicate release.


Block Number Block Title Instructions

Finance/Administration Section Time Unit


Other Section/Staff


6 (continued)

Planning Section Documentation Leader Demobilization Leader


7 Remarks Enter any additional information pertaining to demobilization or release (e.g., transportation needed, destination, etc.). This section may also be used to indicate if a performance rating has been completed as required by the discipline or jurisdiction.

Travel Information Enter the following travel information: Room Overnight Use this section to enter whether or not the resource or personnel will

be staying in a hotel overnight prior to returning home base and/or unit. Estimated Time of Departure Use this section to enter the resource’s or personnel’s estimated time

of departure (using the 24-hour clock). Actual Release Date/Time Use this section to enter the resource’s or personnel’s actual release

date (month/day/year) and time (using the 24-hour clock). Destination Use this section to enter the resource’s or personnel’s destination. Estimated Time of Arrival Use this section to enter the resource’s or personnel’s estimated time

of arrival (using the 24-hour clock) at the destination. Travel Method Use this section to enter the resource’s or personnel’s travel method

(e.g., POV, air, etc.). Contact Information While Traveling

Use this section to enter the resource’s or personnel’s contact information while traveling (e.g., cell phone, radio frequency, etc.).

Manifest Yes No Number

Use this section to enter whether or not the resource or personnel has a manifest. If they do, indicate the manifest number.

8

Area/Agency/Region Notified Use this section to enter the area, agency, and/or region that was notified of the resource’s travel. List the name (first initial and last name) of the individual notified and the date (month/day/year) he or she was notified.

Reassignment Information Yes No

Enter whether or not the resource or personnel was reassigned to another incident. If the resource or personnel was reassigned, complete the section below.

Incident Name Use this section to enter the name of the new incident to which the resource was reassigned.

Incident Number Use this section to enter the number of the new incident to which the resource was reassigned.

Location Use this section to enter the location (city and State) of the new incident to which the resource was reassigned.

9

Order Request Number Use this section to enter the new order request number assigned to the resource or personnel.


Block Number Block Title Instructions

10 Prepared by • Name• Position/Title• Signature• Date/Time

Enter the name, ICS position, and signature of the person preparing the form. Enter date (month/day/year) and time prepared (using the 24-hour clock).


Documents

Volunteer Management Plan - storage.googleapis.com€¦ · Volunteer management or ensuring volunteer management is present is an expectation of local public health: Volunteer management