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What Happens, Who is in Charge, and How It Works -
A Guide for Aging Services Providers

The NC Emergency Response Plan

What Disasters Might Affect NC?

Who is Available to Help?

The State Emergency Response Team (SERT)

The American Red Cross

The Role of the Area Agency on Aging

The Role of Local Aging Services Providers

Long-Term Care Facilities

The NC State Emergency Management Plan
North Carolina General Statute 166A relates to disaster response efforts. It establishes the authority and responsibilities of the Governor, state agencies, and local government for emergency management in North Carolina. The Department of Crime Control and Public Safety has the authority to direct and coordinate N.C.'s response to large emergencies and major disasters. It is the "parent organization" of the state's primary emergency response agencies, including:

• Division of Emergency Management
• State Highway Patrol
• NC National Guard
• NC Wing of the Civil Air Patrol

The Secretary of Crime Control & Public Safety is responsible to the Governor for all state emergency management activities. The Division of Emergency Management fulfills this role for the Secretary.

Also, the Red Cross has a Congressional mandate to do Disaster Response and Relief. They are identified as the State Relations Disaster Liaison. There are 78 local (NC) chapters.

The Division of Emergency Management developed a state Emergency Response Plan. That plan is divided into "function areas" with a lead agency who is responsible in each area. The plan applies to all state government departments and agencies which are tasked to provide assistance in a disaster or emergency situation.

The state has a State Emergency Response Team (SERT) made up of state departments, private volunteer organizations, and private non-profit organizations. The SERT leader is responsible for all state efforts.

What Disasters Might Affect North Carolina?
According to the plan, the following are the principal hazards to which the state of North Carolina is vulnerable:

• Tornadoes
  The entire state is vulnerable to the effects of tornadoes, and other severe weather associated with thunderstorms including damaging winds, hail, dangerous lightning and flooding.
• Hurricanes
  Hurricanes constitute threats in the form of high winds, wave action, storm surge, inundation and other flooding to coastal areas. Wind and water damage can extend to inland parts of the state. Excessive rainfall from hurricanes can result in extensive and damaging inland river flooding.
• Flooding
  Generally associated with other severe weather, flooding may be in the form of flash floods, main river floods, dam failure, or flooding from wind driven or wind held water. Flooding in one of these forms affects certain areas of the state each year.
• Winter Storms
  Snow and ice storms can affect any part of the state, although blizzards with extreme cold, snow and high winds are infrequent.
• Droughts
  Droughts occur and can affect the agricultural interests in any part of the state. Water shortages related to drought conditions can affect entire communities.
• Wildfire
  Fires can cause disastrous timber and agricultural losses. Dry foliage, terrain and climatic conditions for fires are elements of nature; however, most fires are caused by man. Increased risk of loss of life and property is presented where urban areas interface with forested areas. North Carolina ranks second only to California in forest fire potential.
• Earthquakes
  North Carolina’s vulnerability to earthquakes is moderate. The eastern part of the state is in seismic risk zone 1 and less vulnerable to earthquake damage than the western part, which is in seismic risk zone 2. The North Carolina coast, however, is possibly vulnerable to tsunamis that might result from seismic activity well out into the Atlantic Ocean.
• Fixed Nuclear Facility Accidents
  Three nuclear power plants operate in North Carolina. Seven others have 50-mile ingestion pathways that include parts of North Carolina. In all, seventy counties are affected.
• Hazardous Materials
  Individuals, businesses, and government agencies in North Carolina generate, store, and transport hazardous materials throughout the state. The Environmental Protection Agency (EPA) ranks the state eleventh in the generation of hazardous waste.
• Nuclear Threat/Attack
  As long as nuclear weapons exist, nuclear attack is a possibility. An attack upon the United States could subject all counties to radioactive fallout. According to the Department of Defense and the Federal Emergency Management Agency, North Carolina has several probable target areas. This could subject many counties to the direct effects of nuclear weapons. No county can expect immunity from the direct or indirect effects.
• Energy Emergency
  An energy emergency exists when there is an acute shortage of required energy resources to the extent that necessary services are threatened and the protection of public health is imperiled. A general energy emergency may involve all facets of multi-hazard planning to include alert and notification, response, evacuation, and sheltering of certain populations.
• Mass Casualties/Mass Fatalities
  Many of the hazards listed here may result in mass casualties and even mass fatalities. This would require special attention from health care facilities, medical examiners, and mortuary authorities.
• Terrorism
  Historically, North Carolina has not been a prime target for terrorism. The threat is worldwide; however, and it cannot be ignored. The US Military has been a frequent target for terrorists, and since North Carolina has a very significant military presence, the threat is increased. There are other targets as well. Terrorist activity may range from hostage situations to threats against fixed nuclear facilities.
• Foreign Animal (Livestock) Disease
  There is a possibility of widespread livestock disease (even epidemic) in North Carolina. Considering the large hog population, for instance, widespread disease in that industry could cause economic devastation in large portions of the state.
• Landslides
  According to the United States Geological Survey (USGS), landslides are a major geologic hazard that occur in all 50 states, cause $1-2 billion in damages and result in an average of more than 25 fatalities each year (USGS, 1997). Landslides are especially troubling because they often occur with other natural hazards, such as earthquakes and floods. Deadly manifestations of landslides are debris flows. Some landslides move slowly and cause damage gradually, but others move so rapidly that they can destroy property and take lives suddenly and unexpectedly. An example of the latter might be called a mudslide, mudflow, or a debris avalanche. Such a fast-moving landslide generally occurs during intense rainfall on saturated soil. It usually starts on a steep hillside as soil slumps or slides liquefy and accelerate to speeds as great as 35 miles per hour.
• Dam Failure
  There are 4600 dams in North Carolina. According to the Division of Land Resources, 1700 hundred of these pose a risk to public safety and property should failures occur. Communities continue to develop along the state’s rivers - many in potential dam-failure inundation zones. Further exacerbating the potential risk to citizens is the disrepair of many dams and difficulties involved in delivering timely warnings to the public.

Who is Available to Help?
There are three separate organizational areas that are available to help:

• local
• state
• federal

Overall, getting prepared, warning, protection, and recovery are responsibilities that all groups work on together. Emergency operations are initiated wherever most appropriate for a rapid response to the situation.

Local Efforts:

City and county governments develop plans to respond to emergencies and disasters using resources to the extent of their capabilities, which includes local non-profits and other agencies. Counties are expected to enter into mutual aid agreements with each other, as necessary, to use most effectively their resources in response to emergencies and disasters. In other words, if one county had a need and another had available resources, those resources would be directed to where the need occurred. Local government is responsible for needs assessment and deciding whether and when to open shelters.

Local governments coordinate the opening and closing of shelters with the local chapter of the Red Cross. All shelters are managed in accordance with applicable American Red Cross regulations and procedures.

Responsibility for shelters at the local level normally rests with the local Department of Social Services and the local chapter of the Red Cross, supported by other local government agencies and volunteer groups.

County Commissioners may declare local states of emergency and request state assistance. All requests for state assistance are made through local Emergency Management. The Director of Emergency Management at the state may recommend the Governor issue an emergency proclamation.

State Efforts:

The state Emergency Operations Center (EOC) is located at 116 West Jones Street in Raleigh. This EOC is the primary location from which state operations will be conducted under the direction and control of the State Emergency Response Team (SERT) leader, usually the Director of the Division of Emergency Management.

The state EOC is manned seven days a week, twenty-four hours per day for normal day-to-day operations with one or more communications duty officers. The SERT/EOC (disaster response) is activated fully or partially depending on the level of emergency.

What are those levels?

• Activation Level 4
  Any disaster/emergency that is likely to be within the capabilities of local government and results in only minimal need for state assistance. State agencies that would take action as part of normal day-to-day responsibilities are notified. The EOC is not activated.
• Activation Level 3
  Any disaster/emergency that is likely to require the assistance of several state agencies. All emergency support function agencies are alerted; however, the EOC is activated and staffed only with Emergency Management personnel and essential state agencies.
• Activation Level 2
  Any disaster/emergency that will require large scale state and possibly federal assistance in recovery. The EOC is fully activated with 24-hour staffing from all State Emergency Response Team (SERT) members.
• Activation Level 1
  Any disaster/emergency that requires continued involvement of all SERT members after the event (e.g. hurricane, winter storm). The EOC is fully activated with 24-hour staffing from all SERT members. The Federal Response Plan is activated with deployment of the Federal Emergency Response Team to the state EOC for response and recovery activities.

SERT/EOC activation levels 3, 2, and 1 correspond to the Federal Emergency Management Agency's response levels 3 (minimal), 2 (moderate), and 1 (massive).

Shelters and related activities are coordinated by the state Division of Social Services.

Federal Efforts:

The American Red Cross has been designated the primary agency for federal emergency support. Requests for assistance go from county emergency management to state emergency management to the Federal Emergency Management Association (FEMA), now located under the Department of Homeland Security.

The State Emergency Response Team (SERT)
The SERT is comprised of senior representatives of state agencies, state level volunteer and non-profit organizations, and state level corporate associations who have knowledge of their organizations’ resources and have the authority to commit those resources to emergency response.

SERT operates from the State Emergency Operations Center. It is activated on a limited or full-scale basis as deemed appropriate by the SERT Leader. The SERT Leader is responsible to the Secretary of Crime Control and Public Safety and to the Governor for the overall operation of the SERT during activation. The SERT Leader is normally the Director of Emergency Management.

In the event of full activation (Level 2 or Level 1), all SERT agencies will be represented in the Emergency Operations Center on a 24-hour basis. The Division of Emergency Management provides support staff for the SERT. Upon activation of the SERT, agencies are authorized, in coordination with the SERT Leader, to initiate and continue actions according to the state Emergency Response Plan, including designating identified support agencies for tasks.

When SERT is de-activated, emergency management moves from the response phase to the recovery phase. At that time, a federal Disaster Field Office is established by the Federal Emergency Management Agency. The purpose is to register victims for various types of assistance. It is set up near the disaster site (normally in Raleigh), and staffed with reservists who have necessary expertise. North Carolina Emergency Management and other state agencies also assist. NCEM personnel will remain at the Disaster Field Office as long as necessary to coordinate longer-term assistance to disaster victims.

The American Red Cross
The Red Cross has been helping disaster victims for many years. The American Red Cross has local chapters that are charged with knowing their local communities and working with local government and local agencies to plan for and respond to disaster situations.

Our state Emergency Response Plan identifies the following responsibilities for the Red Cross:

• Support the management and coordination of sheltering, feeding, supplemental disaster health services, emergency first aid, distribution of emergency relief items, and other services to the disaster-affected population.

• Establish and operate mass care shelters and feeding facilities for victims requiring these services.

• Provide casualty and illness information to appropriate authorities.

• Within its agreements, coordinate the provision of relief efforts by any and all volunteer organizations actively engaged in providing assistance to disaster victims.

• Coordinate the recruitment and assignment of personnel for mass care operations.

• Coordinate registration of shelter residents.

The Role of the Area Agency on Aging
The AAA functions as a liaison between the state Division of Aging and Adult Services (on the SERT team) and local aging services providers. Counties must conduct an initial needs assessment and report their findings and needs to the state. The state then compiles information to determine how to respond. Gathering information is critical to the process. The AAA will ask local providers to compile information such as:

• numbers of older adults affected
• the identification and location of frail older adults in the community
• the potential needs of those individuals
• the ability of the agency to respond to those potential needs
• what local resources are available
• how much will be needed in the county
• how much could be re-allocated
• the needs of the agency
• etc.

That information will be passed on to the DAAS. As they continue to need updates and as they find resources, DAAS will contact the AAA. The AAA, in turn, will contact local aging agencies.

During past disaster response efforts, DAAS was able to identify unspent dollars for programs that were then re-allocated to counties in need. Providers in parts of the state not affected by the disaster offered their unspent funds for the relief effort. Volunteers mobilized at the state were able to be sent where they were needed.

Additionally, for the state to ask for federal disaster assistance, they have to have evidence of the need. They cannot presume that needs are present. They must have credible evidence. Local aging agencies can provide that evidence based on their assessment of local needs.

The Role of the Local Aging Services Providers
Local aging services providers are in the best position to:

• help older adults and their families prepare
• assess needs before a disaster
• gather information after a disaster (see AAA role above)
• assist older adults on a personal level

Of particular importance are those identified frail individuals living alone in the community that are homebound or who have special medical needs. Those individuals need to have a clear understanding of the importance of having a disaster plan. The American Red Cross suggests that people plan for being without assistance for 4-5 days if they do not or cannot go to a shelter. Are your frail and homebound older adults prepared for that?

And, your agency is best suited to work with local county commissioners to help them understand the need for preparing and setting aside funds for special needs shelters.

Long-Term Care Facilities
It is imperative that long-term care facilities plan for potential disaster situations. Their residents are some of the most frail seniors in the community. Many residents have serious medical conditions with attendant needs. Staff not present at the time of a disaster strike may not be able to come in to assist.

Ombudsmen work with facilities to develop disaster plans that are reasonable and workable. Perhaps it would mean coordination with the local hospital. Perhaps the facility could house frail community members on a temporary basis with local aging resources to help. Perhaps the power company could be alerted to the need to restore power to the facility on a high priority. Perhaps the facility could purchase a generator or could share the cost of a generator with another facility not in the immediate area. Perhaps individuals with four-wheel drive could be recruited to transport staff to work. There are many ways to plan for the safety of residents.

If you don't plan, you may find yourself planning as events are happening.

Have you become familiar with legislation related to special needs sheltering?

SB 34 (1999) Waiver of Rules for Health Care Facilities

H27 (1999) Limited Immunity From Liability for Facilities

Volunteer Protection Act of 1997

Institute of Government on the Volunteer Protection Act

GS 1-539.10 Immunity From Civil Liability for Volunteers

GS 90-21.14 Emergency Treatment or First Aid - Liability

More Information on Volunteers in a Disaster

As aging network professionals, it is our responsibility not to forget these vulnerable seniors as we plan for disasters.