Impediments to me in Disaster Management, Planning, and Guideline Production
- Administrative services, until November 2006, were provided to me at a .5 EFT level. Since November 2006, until April 2008, Administrative services were provided at near 1.0 EFT level.
- In February 2005, Community Health Services, in collaboration with the Department of Family Services and Housing, established the full-time permanent position of Coordinator, Community Disaster Management based on my recommendation.
- In October 2006, the incumbent Coordinator, Community Disaster Management left the Program for opportunity elsewhere. The position was vacant until January 2008.
- To this day, there are no other positions in direct support of the WRHA Disaster Management Program.
Medical Director Support to the Program
Given the complex milieu of the health care sector there is a paramount need to effectively liaise and communicate to all key stakeholders on matters pertaining to disaster management. A principal component of any disaster management communication strategy would be to have reliable and credible individuals who assist in fulfilling this goal. Within the health care sector Physicians are well suited and positioned to fulfil this role as they have a broad understanding of the health care sector, are generally respected and perceived to be credible, and are in a good position to enlist the cooperation and input from other physician and allied health leaders.
Other WRHA programs, which include a medical/clinical component, are directed by a Program Director with the added expert leadership of a Medical Director.
Medical Director duties in support of programs are rationalized according to program needs. Generally, however, a Medical Director would serve the Program administratively/operationally and in leading research in areas specific to the supported program.
There was no support to engage a physician to take on the required position of Medical Director Disaster Management in answer to my recommendation.
Conceptual Disaster Management Program Structure (Staffing)
In order to boost regional all-hazards planning and readiness and to more fully address:
- the issues surrounding disaster management across the Winnipeg Health Region as indicated throughout these notes;
- making greater headway in the establishment of Regional guidelines and plans concerning each of the standardized emergency colour codes; adverse weather; telecommunications, water, HVAC, power, and other utility failures; communicable, infectious, and epidemic diseases;
- the necessity to provide guideline implementation assistance to the acute care, long term care, and community health services sectors on a regular basis;
- the critical importance of providing a regional training and exercise design capability to assist sectors in the design, conduct and evaluation of their own exercises; and
- the establishment of a regular test routine for Region-wide plans,
I proposed to Senior Management, a Program structure to include a Medical Director, a Planning Specialist, Acute and Long Term Care Specialists, and a Training and Exercise Design Specialist resembling the organization chart at Chart 4 below. No support was won.
CHART 4 – Conceptual Disaster Management Program Organization
Although the WRHA supported the implementation of ICS, the establishment of the RDOC, and, most recently, the development of a full-scale, mass-casualty exercise scheduled to be conducted in spring of 2008, my Program had otherwise no budget line and did not participate in the annual business planning process. Funds required to properly manage the operation of the Program and to provide on-going training across the Region to senior managements and other personnel who would be assuming roles and responsibilities in response to and recovery from disaster events (including the outbreak of a Pandemic Influenza) were only available on an ad hoc basis and sometimes not at all.
Moreover, resources required for Disaster Management all-hazards activity (including planning and readiness for Pandemic Influenza) were not included as annually budgeted activities at each sector and at all program areas of the WRHA.
The imperative to provide a core response and recovery capability in the face of inevitable disasters is recognized federally by the (new) Emergency Management Act and likewise provincially by Emergency Management Acts across the country. These acts and other related legislation provide the basis for establishing federal, provincial/territorial, municipal/local authority compliance with the requirements to dedicate resources and effort to pre-disaster activities such as mitigation and preparedness. The Health Sector, however and unfortunately, is not included in the definition of a “local authority” in these Acts and is consequently left to implement disaster management strategy voluntarily and at its own whim.
In WRHA, there was acknowledgement of the importance of disaster management and associated responsibilities. Likewise, in the Province of Manitoba, a robust Office of Disaster Management in support of Regional Health Authorities is maintained which requires reporting from Regional Health Authorities on Disaster Management Performance Deliverables. Nevertheless, few other incentives to organizational commitment exist save the Canadian Council on Health Services Accreditation requirement to meet disaster management standards and criteria for accreditation purposes.