260.103 Disaster Preparedness Planning and Response: The Texas Medical Association recognizes the challenges and issues in all hazards disaster planning and the need to promote ongoing physician participation in state and local planning and response to ensure local readiness and protection of each community and our patients. To that end, TMA will:
1. Work with the Texas Department of State Health Services (DSHS) in statewide disaster planning and advocate for a strong role for county medical societies (CMSs) in local planning, drills, and other related activities;
2. Identify a member of TMA’s Board of Trustees or the member’s designee to serve as a liaison to the commissioner of health and the state’s emergency coordinator to ensure consideration of medical needs during terrorism, public health emergencies, and natural disasters, and to identify specific needs and special services to support the medical needs of high-risk populations including bariatric patients and shelter evacuees during a disaster;
3. Work with DSHS state and regional officials to establish state-level communications and assist local health departments or other appropriate agencies in expanding the mechanism for apprising physicians of essential information on newly recognized outbreaks and potential emergencies;
4. Work with DSHS in the event of a pandemic or other infectious disease disaster to ensure that plans minimize the negative impact on the health care community; and
5. Monitor state laws governing practice and liability under these various disaster declarations and advocate for any needed legislative changes to address these issues.
Local Planning and Role of County Medical Societies
Because most disasters and emergencies are confined to a limited geographic area, planning and preparation must consider the local population, the local health care community, and available public health resources. CMSs can play an essential role in communicating with public health officials and with the health care community about planning and helping to coordinate a response when a local disaster occurs. TMA should help CMSs fulfill that role. TMA encourages CMSs to:
1. Improve physician awareness of state-required disease reporting, and state and local public health support systems;
2. Work with local public health departments to ensure physicians know how to have direct access to the local public health authority for guidance on confirmation and treatment of patients as needed during natural and biological disasters;
3. Educate their members on the essential aspects of terrorism and disaster medicine through continuing medical education programs at state society meetings and articles in state society journals and newsletters, with special focus given to training on incident command structure, basic and advanced disaster life support, and triage for physicians and health care providers;
4. Work with the local health department to compile and maintain a contact list of physicians (both member and nonmember) in the community and to ensure that physician-friendly reporting mechanisms are in place and that a two-way flow of information exists to provide incentives for physician collaboration, and maintain a database of volunteer physicians by promoting the state Texas Disaster Volunteer Registry and the federal Emergency System for Advance Registration of Volunteer Health Professionals, and tracking member participation in other disaster response organizations (e.g., local health facility response, Texas Medical Rangers, Medical Reserve Corps, Disaster Medical Assistance Teams, Texas National Guard);
5. Encourage local communities to identify a designated infection control practitioner who could provide basic infection control guidance to prevent exposure to or transmission of infectious diseases in the community and for special high-risk populations;
6. Maintain an ongoing relationship with their local or regional public health departments; CMSs should consider inviting the local or regional public health director to give a public health update to the society at least annually and to advocate for the local board of public health to appoint a CMS representative as a consultant to the board;
7. Provide a venue for physician education, work with local sponsors of continuing medical education, and identify members who are particularly interested and may become peer leaders and educators;
8. Participate in practice drills and exercises that involve local health departments and local emergency response.
Information for Physicians
As state and local disaster planning and preparedness evolve, physicians must have access to current information, particularly relating to public health emergencies involving bioterrorism and emerging infectious disease. TMA can assist with information that will:
1. Ensure that physicians understand the circumstances in which quarantine is appropriate and how to carry out complementary, previously determined roles in their practices regarding surveillance, health care, and public information;
2. Encourage medical educators at all levels to participate in training physicians in the essentials of disaster and terrorism medicine relevant to their practice and specialty;
3. Encourage physicians and their staff organizations to advocate for these disaster planning measures in their health care facilities;
4. Encourage DSHS and the Texas Department of Emergency Management to provide updates and information on resources for physicians for disaster planning; and
5. Encourage individual physicians to have a strategic plan for everything from evacuating their office building and protecting employees during a communicable disease outbreak to maintaining continuity of their practice and communication with their families, and provide templates and guidelines for these types of plans to physicians (CSPH Rep. 1-A-17).