"Launch MedStar"

Those of us who live in Coeur d'Alene, Idaho, are accustomed to regularly seeing a yellow, green and white helicopter arriving and departing from Kootenai Medical Center's rooftop landing zone. The helicopters, Eurocopter model EC-135, are used as medical transport helicopters by Northwest MedStar and operate from bases in Spokane, Tri-Cities, and Moses Lake, Washington. In addition to the helicopter flight crew, MedStar's on-board medical team includes both a registered nurse and a registered respiratory therapist.

It is common to be listening to our local emergency medical service radio frequency (155.805 MHz, designated "EMS-3") and hear an outlying volunteer fire department on-scene commander, an emergency medical technician, or a paramedic call in to Kootenai County central dispatch and say, "Put MedStar on standby." If that message is soon followed by another that says, "Launch MedStar," it is almost always because the victim of accident or illness has a critical medical condition that requires faster delivery to an area hospital than surface ambulance service can provide. In some instances, MedStar will be requested because the victim is in an area inaccessible to surface ambulances.

There is risk in operating medical transport service helicopters. The Seattle Post Intelligencer reports in its Friday, September 30, 2005, edition that an Airlift Northwest medical helicopter with one pilot and two nurses but no patient went down in the Puget Sound north of Edmonds late Thursday night killing all three on board. (Whitecaps note: This was not a MedStar helicopter.)

To minimize the risks to patients, flight crews, and people on the ground, Northwest MedStar has provided portable GPS equipment to northern Idaho first-responders. Northwest MedStar also provides site-specific training to first responders so they can clearly, concisely, and effectively communicate and work with incoming MedStar teams. Examples of what first-responders need to know is available on the Technical Information pages of Northwest MedStar's webpage. The information available there includes:

• How first-responders on the ground should direct the helicopter to the landing zone and report the condition of the landing zone to the helicopter
• Safety procedures that must be followed in the landing zone
• Determining patient destination and loading the patient into the aircraft

This post is not a commercial promotion for Northwest MedStar. Rather, it is intended to inform readers about one very critical element of emergency medical service response in northern Idaho.

More information about MedStar is available at the Deaconess Medical Center Emergency Air Service webpage.

For those interested in monitoring MedStar's radiocommunications, obtain their authorized operating frequencies at the FCC Callsign Query webpage. Type "WNCT261" (without the quotation marks) in the red Callsign block and then click on the Submit Query block. It's a 19-page file that should automatically download. Be patient; it takes a few seconds.

Are Secretary Michael Chertoff's Days Numbered?

Will Department of Homeland Security Secretary Michael Chertoff be fired or "allowed" to resign for failing to act appropriately and quickly in response to Hurricane Katrina? I think there's a good chance he will.

Undersecretary Mike Brown, the former head of the Federal Emergency Management Agency (FEMA) was sacrificed as decreed by BOHICA, the Capital Beltway god of executive insulation and plausible deniability. Finally acknowledging the top bureaucrats at FEMA had the collective emergency management skills of Wile E. Coyote, the Bush administration jettisoned Undersecretary "You're doin' a heck of a job, Brownie" Brown and appointed a qualified emergency administrator to replace him.

So why would Chertoff, Brown's boss, get the boot if the FEMA delay-of-game penalty has already been assessed against Brown? Because Chertoff had the authority to initiate a federal response without waiting for requests from state and local governments. That authority is in the National Response Plan which Secretary Chertoff invoked on August 30, 2005, when he designated Hurricane Katrina as an "incident of national significance."

The National Response Plan which Chertoff activated includes a "Catastrophic Incident Annex to the National Response Plan (CIA-NRP)". That annex clearly recognizes that events such as Hurricane Katrina may, "...result in sustained national impacts over a prolonged period of time" that "...almost immediately exceeds resources normally available to State, local, tribal, and private-sector authorities in the impacted area..." The annex goes on to provide that, "Recognizing that Federal and/or national resources are required to augment overwhelmed State, local and tribal response efforts, the CIA-NRP establishes protocols to preidentify and rapidly deploy key essential resources (e.g., medical teams, urban search and rescue teams, transportable shelters, medical equipment caches, etc.) that are expected to be urgently needed/required to save lives and contain incidents." Beyond-the-Beltway translation: When the situation clearly exceeds the locals' resources and abilities, the feds don't need to wait for an invitation from the State, local, or tribal governments.

And here's the clincher: "Only the Secretary of Homeland Security or designee may initiate implementation of the CIA-NRP." (emphasis mine) Translation: Chertoff had full authority to override the delay that has been attributed to Undersecretary Brown's FEMA, and Chertoff didn't do it. In fact, once Chertoff implemented the National Response Plan in Hurricane Katrina, he had an obligation to determine if it was a "catastrophic incident." The circumstances surrounding Katrina clearly met the definition of "catastrophic incident" in the CIA-NRP. Thus, Chertoff was negligent or incompetent in failing to formally make the "catastrophic incident" declaration or in failing to execute after making it. Either way, he was as culpable as the designated sacrificial virgin bureaucrat, Undersecretary Michael Brown.

Journalists in Natural Disasters: Participate or Report?

In his column headlined The role of journalism in the midst of disasters on Sunday, September 25, 2005, Seattle Times executive editor Mike Fancher leads with a question many news consumers have often asked: "Wouldn't it be better if journalists put down their notebooks and cameras to actually help during a disaster?"

Mr. Fancher's article has some thoughtful information for both journalists and news consumers.

In particular, he referred readers to the Dart Center for Journalism website. The website has front page links to "tips & tools" for journalists covering natural disasters. Two of the online pieces include Covering Disasters and First Responders, a guide for the journalist who is the first "first responder" to arrive on the scene.

We news consumers can easily forget that first responders may be disaster victims themselves. There was extensive news coverage describing how employees of the New Orleans Police Department became victims of Hurricane Katrina and how many of them continued to perform selflessly. Yet there were few if any stories about how victim journalists carried on with equal courage. The absence of stories about journalist victims is unsurprising; it would probably be viewed as unseemly if journalists were to report on their own victimization. But there were journalists who suffered great personal loss. Here's a link to how we can help them.

Using the Freedom of Information Act

On September 20, 2005, the US House of Representatives, Committee on Government Reform, transmitted for public release its report number 109-226, A CITIZEN'S GUIDE ON USING THE FREEDOM OF INFORMATION ACT AND THE PRIVACY ACT OF 1974 TO REQUEST GOVERNMENT RECORDS.

This report updates the earlier citizen's guide and is the definitive reference for people who want to exercise their right to information under the federal Freedom of Information Act.

At a time when agencies at all levels of government are trying harder to conceal rather than reveal information, it is important that the public know what tools are available to thwart unreasonable secrecy.

Elder Abuse and Neglect

The population in the United States is living to be older. Importantly, the aging population is enjoying a better quality of life until they die.

Well, some of them are. Unfortunately, some are not. Those of us who grew up with loving, caring parents and grandparents and who had the opportunity to return that love and care to them in their declining years have difficulty accepting that some children and grandchildren abuse and neglect them.

Elders, like all other elements of our population, can be abused and neglected. But with the elderly, the abuse and neglect sometimes goes undetected longer. Elders are sometimes almost the invisible among us because they are no longer in the workforce, they may not be as active socially, and sadly, they may be seen as a burden to family members who support them.

It is important for our population to better understand elder abuse and neglect so it can be reduced if not eliminated. Toward that end, the US Department of Justice, Office of Justice Programs, published an Issues and Practices report entitled Our Aging Population: Promoting Empowerment, Preventing Victimization, and Implementing Coordinated Interventions.

It is long, 313 pages, but worth reading selectively if not completely.

As If Katrina Didn't Give Us Enough to Worry About...

...Russ Kick with TheMemoryHole.org raises a very interesting question: What happened to the Level 3 biohazard labs in the path of Hurricane Katrina? What happened to the biohazard material and infected animals from those labs?

Hopefully, the answers to the questions were answered before the hurricane by those laboratory managers who were responsible for their labs' disaster preparedness and recovery plans. Hopefully, the truthful answer is that all the biohazardous material and infected animals were removed to safe and secure environments.

What Went Wrong in St. Charles Parish?

On Saturday, September 17, 2005, The Spokesman Review published an article headlined Red tape frustrates law officers by staff writer James Hagengruber.

The article reported how benevolent employees in Idaho's Shoshone and Bonner County sheriffs departments had gathered money and supplies which they intended to personally deliver to Louisiana law enforcement agencies dealing with Hurricane Katrina. Shoshone and Bonner county deputies were also offering to perform law enforcement duties in Louisiana. According to Shoshone County Sheriff Reynalds, the employees were responding to a call for assistance from Louisiana's St. Charles Parish Sheriff Greg Champagne. The article described how things went badly wrong once the Idaho officers arrived in Louisiana.

The newspaper story did not explain one detail crucial to understanding the apparent snafu: How was Sheriff Champagne's request communicated to Bonner and Shoshone counties?

That detail is important, because the State of Idaho has agreed to follow a specific national emergency procedure in place to facilitate, not frustrate, precisely the kind of interstate cooperation the Shoshone and Bonner deputies wanted to deliver to their law enforcement counterparts in St. Charles Parish. It is an interstate compact that Idaho codified at Idaho Code Title 46, Chapter 10. The compact, known federally as the Emergency Management Assistance Compact (EMAC), was passed by the US Congress in 1996 as Public Law 104-321.

Here is the EMAC request message sent by the Ohio Emergency Management Agency to the Ohio State Highway Patrol. It is an example of how that state's EMAC coordinator processed a Louisiana request for law enforcement officers.

On the other hand, a September 14, 2005, online letter from the National Sheriff's Association Katrina Relief Coordinator to that group's members suggested that the EMAC had not worked as well as everyone expected.

Procedures like the EMAC work best when they are followed. Did the Idaho Bureau of Homeland Security, Idaho's EMAC coordinator, receive Louisiana's EMAC request and then send a message similar to Ohio's to all Idaho law enforcement agencies? It should have. The agencies, including Shoshone and Bonner County Sheriffs Departments, should have responded with specific information about what people and supplies they could provide. If the Bonner and Shoshone County Sheriffs Department's offer of assistance was accepted, they would have been given specific instructions what to send and how to proceed.

Did that happen? If not, where did it break down? Did the Idaho Bureau of Homeland Security not send out the message? Were Sheriffs Savage and Reynalds unaware of Idaho Code 46, Chapter 10, and the procedures imposed by the EMAC?

It's important for Idaho to find out if something went wrong somewhere in Idaho and fix it. The next disaster could be here, and it would behoove Idaho's public administrators to know the process and procedures for obtaining and coordinating assistance under EMAC.

On Vacation

On vacation from Thursday, September 8, through Sunday, September 18.

Bureaucratic Struggles

It appears that Department of Homeland Security (DHS) Secretary Michael Chertoff recognized several months ago that one of DHS's subordinate agencies, the Federal Emergency Management Agency (FEMA), had been operationally crippled when it was absorbed by DHS.

For a better understanding of how Chertoff hoped to restore FEMA's response capabilities, see the Library of Congress, Congressional Research Service's 29-page report entitled Department of Homeland Security Reorganization: The 2SR Initiative released on August 19, 2005. Pages CRS-8 through CRS-11 under major headings Operations and Preparedness discuss FEMA.

Hurricane Katrina has focused political attentions on FEMA's reduced capability for timely response to catastrophic natural disasters. That condition was created by FEMA's being folded into DHS, a department created principally to deal with terrorism and only incidentally with natural disasters. FEMA's administrator, Undersecretary for Emergencies, Preparedness, and Response Michael Brown, has taken the heat for that, however it seems clear from Secretary Chertoff's reorganization proposal (the 2SR Initiative) that the dilution of FEMA's power and authority had been recognized long before Katrina hit the Gulf coast.

I would expect that the 2SR Initiative will get renewed and speedy attention by Congress. It seems inevitable that Michael Brown will soon depart from his Undersecretary position with DHS. Hopefully his replacement will be chosen for his or her qualifications and experience in managing emergencies, preparedness, and response. But then, we need to remember that Undersecretary Brown was confirmed by the US Senate, and that body was aware of his qualifications when it voted to confirm him. I wonder how Idaho's US Senators, Craig and Crapo, voted?

More Information Needed

The Spokesman-Review staff writer Taryn Brodwater's September 3, 2005, article headlined Trouble obtaining warrant frustrates officer reported the Kootenai County Sheriff's Department (KCSD) was publicly expressing its frustration that the Kootenai County Prosecuting Attorney's Office (KCPA) had not responded promptly to two KCSD requests for an arrest warrant for a Kootenai County violent sex predator who had failed to register his change of address as required under Idaho Code 18-8311(1).

But there was some important information missing from the newspaper story, information that would have helped readers better determine who fumbled the ball and why it was fumbled.

The story did not explain why the KCSD even sought an arrest warrant when Idaho Code 19-603.3 permits a peace officer "...to make an arrest in obedience to a warrant delivered to him, or may, without a warrant, arrest a person: 3. When a felony has in fact been committed and he has reasonable cause for believing the person arrested to have committed it." The offender named in the story, Daron Lee Barwick, had in fact committed a felony when he failed to register within the five day period prescribed by law. The KCSD clearly had evidence beyond reasonable cause to believe Barwick had committed that felony.

The article ought to have explained if either the KCSD or the KCPA has a policy requiring an arrest warrant be obtained before an arrest can be made for felony failure to register under 18-8311(1). For example, has the KCPA told the KCSD it will not accept probable cause (reasonable cause) arrests for 18-8311 violations? Or does KCSD policy require an arrest warrant be obtained before an 18-8311 offender can be arrested?

If, as KCSD spokesman Captain Ben Wolfinger suggested, getting a noncompliant violent sex predator into custody was such a priority for the KCSD, why didn't the KCSD make the arrest on probable cause (reasonable cause) rather than letting a warrant application languish for almost two weeks in the prosecutor's office? Or why didn't the KCSD Sergeant, the Captain, or the Sheriff present himself at the KCPA and do some desk pounding to get the warrant application processed more quickly?

On the other hand, if the KCPA requires agencies to submit warrant applications for 18-8311 violations, if the KCPA will not accept probable cause (reasonable cause) arrests for these violations, this should also have been reported, because it validates the KCSD's reported frustration.

Update: United States Government Response to the Aftermath of Hurricane Katrina

Here is the Department of Homeland Security's (DHS) September 2, 10 a.m., Press Release.

It gives a pretty complete summary of what each federal agency under DHS coordination is doing in response to Hurricane Katrina.

Hurricane Katrina and the National Response Plan

Until a few days ago, when we thought of homeland security, we thought first about response to terrorism. Hurricane Katrina's effects on not just the southeastern United States but on the entire nation should remind us that homeland security also includes response to all hazards, including natural disasters.

"In Homeland Security Presidential Directive (HSPD)- 5, the President directed the development of a new National Response Plan (NRP) to align Federal coordination structures, capabilities, and resources into a unified, all-disciplines, and all-hazards approach to domestic incident management."

Late Tuesday, August 30, 2005, the Department of Homeland Security declared Hurricane Katrina to be an "incident of national significance". This understated declaration triggered the NRP.