The Dangerous Delusion of American Exceptionalism

Ignoring the reality of our mediocrity is an existential threat

By Michael M. Barrick

Update 10:10 pm., March 11
The Secret Service, which is supposed to be an “elite” agency and the poster child of American Exceptionalism is embroiled in yet another embarrassing episode. Read here.

BRIDGEPORT, W.Va. – Before the phrase American Exceptionalism became widely used, and before our politicians were stumbling over one another to pledge their allegiance to the concept of American Exceptionalism, I wrote the book, “The Dangerous Delusion of American Exceptionalism.”Dangerous Delusion

It was published in 2011, but is as timely as ever. In fact, I direct you to this interview of me by nationally-known TV and radio host Tavis Smiley. His questions were timeless. I hope my answers were.

With hindsight, I think we might have been a bit ahead of our time in talking about American Exceptionalism. Additionally, at the time, a series of life-changing personal events coincided with the release of the book. So, we did not publicize it as we would have liked.

Those circumstances have changed. So has the discussion about American Exceptionalism. More and more people are now talking about the notion; most disturbingly, those who are, generally insist that America is exceptional.

They are wrong. Polling and headlines support the assertion. Ignoring these facts is very dangerous because it blinds us to our own mediocrity. This situation poses an existential threat to not only residents of the United States, but the entire planet.

First, let’s consider the polls. In the latest Rasmussen Reports poll, 62 percent of Americans think the nation is headed in the wrong direction. Most disturbingly, that number has remained consistent since at least 2010, at the time I was writing my book. According to the Gallup poll, less than half of Americans think the nation’s education system is in good shape. Meanwhile only about one in ten Americans think Congress is doing a good job.

When I was in school, exceptionalism meant getting an A+. To get below a 70 meant you got an F. So, when rating our nation, Americans give our nation an F, regardless of the topic. That is hardly exceptional.

A few examples help explain why this is the case. Our nation’s political officials – I simply cannot characterize them as leaders – are juvenile. So, our political institutions are paralyzed. To a few, that’s a good thing. However, if you drive on the roads, cross a bridge, send children to school, or go to get a driver’s license, you will experience something between frustration and fear. And, of course, we are now in our 14th straight year of war, with some congressional leaders just itching for a war with Iran.

As my dad told me more times than I can recall, “The rich get richer and the poor get poorer.” Indeed, we have rarely – if ever – seen such economic disparity in this nation.

Here in West Virginia, where I am intimately aware of emergency preparedness efforts, those charged with preparing for disasters – Local Emergency Preparedness Committees – have generally abdicated their responsibilities. The most obvious example of this is that these folks are not asking tough questions of the energy extraction industry even though they pose significant threats to public health and safety, as well as the environment.

Also in West Virginia, corruption at the local and state level is so rampant that one cannot keep up with the headlines.

In North Carolina, Governor Pat McCrory is nothing more than a puppet for one of the state’s richest men, Art Pope. This is particularly disappointing, as I knew the governor when he was the mayor of Charlotte. The man that excitedly stood in his office overlooking the city and passionately talked about improving the lives of children and the poor has seemingly sold his soul to live in the governor’s mansion. Indeed, his ethics are presently in question.

You, too, know of many examples.

Yet, I have hope. I believe that Americans are beginning to understand that, while we do, rightfully, aspire to be exceptional, we are not. This was made evident by the presence of about 7,000 workers at West Virginia’s state capitol last Saturday to protest actions by the legislature. When I was growing up in West Virginia, labor was always a strong and vital voice. It is good to see that again.

I am also hopeful because of the emerging influence of artists, poets, musicians and writers. Throughout history, they have been the change agents. In one community after another, artists are promoting the spirit of peace through the arts. Offering examples of exceptionalism through their work, they also challenge us to be exceptional in our own endeavors.

Last month, I was privileged to see such an artist in concert – Arlo Guthrie. While I was most interested in hearing his famous tune “Alice’s Restaurant,” I was most touched by his rendition of his father’s song, “This Land is Your Land.” Those not familiar with the history of Woody Guthrie may not know he wrote the song in response to unquestioning patriotism. That does not mean he was not a patriot. In fact, the opposite is true. He believed, I think, that America could be exceptional. I think he wanted it to be. Yet, he was a realist. He knew that until this nation offered genuine equal opportunity and justice to every American, we were not living up to our ideals.

Seventy years after he penned that song, it remains true that we have a long way to go to be exceptional. It is time we admitted it.

If you agree, and if you support the work of the Appalachian Preservation Project, the stories we tell on the Appalachian Chronicle, and the warnings we sound on this blog, I hope you’ll consider buying a copy of the book, which you can do here. Your purchase will not only enlighten you (I hope), it will also help support our work.

© Appalachian Preservation Project, LLC, 2015. The Barrick Report is a publication of the Appalachian Preservation Project. The Appalachian Preservation Project is a social enterprise committed to preserving and protecting Appalachia. If you wish to support our work, please consider becoming a member.

The Appalachian Preservation Project is also handling planning for the “Preserving Sacred Appalachia” Earth Day conference scheduled for April 20-21 in Charleston, W.Va. Learn about it here.

A Dirty Dozen Reasons to Oppose Fracking

Consequences – devastated lives, destroyed communities and devalued homes – are indisputable

By Michael M. Barrick

BRIDGEPORT, W.Va. – I first learned of fracking several years ago while living in North Carolina. What I learned from my initial research quickly convinced me that it presented risks to people and the environment and thus required further study. A few years later, in May 2012, I had my first exposure to fracking. Visiting a farm in Doddridge County, I had to dodge numerous huge trucks entering and exiting the narrow, one-lane road. Upon arriving, I learned from the owner that the trucks were a constant presence in their formally quiet hollow. It was all part of construction activities associated with building a well pad.

Later that day I got a disturbing introduction to fracking’s impact on a community’s quality of life. Climbing to the highest point on the property with several others, the customary, comforting sounds of nature – birds chirping, a light breeze rustling the leaves, a squirrel scampering up a tree – were interrupted by an ominous pounding. It was heavy equipment preparing the site for the well pad bringing the never-ending flow of trucks into the heretofore quiet valley.

A convoy of gas trucks rumble through downtown Weston, W.Va. at lunchtime. Photo by Michael Barrick

A convoy of gas trucks rumble through downtown Weston, W.Va. at lunchtime.
Photo by Michael Barrick

Then, a little more than two years after that, when I was working in a local hospital, I was called to the emergency department because a patient had presented with exposure to an unknown chemical. He had been injured at a well pad site. He and his clothes had been soaked by the frack fluid being used to fracture the rock thousands of feet below. He was complaining of burning eyes and skin. He did not know what chemical he had been exposed to, and there was no Material Safety Data Sheet (MSDS) on site so far as he knew, he told me.

Because we didn’t know exactly what we were dealing with, I asked him if I could ask him a few questions. He agreed. Essentially, the questions were phrased so that we could learn what we were dealing with, if it was likely we’d see it again, how many others workers could be exposed to it, and any other risks that it might pose. The worker understood his answers would benefit others; however, when his supervisor arrived from the field, he told the injured worker he should not answer any more questions. Intimidated, he clammed up. I had seen enough though. The young man was clearly in pain, the odor of the chemical(s) on his clothes nauseating, and his company representative didn’t want him talking. I suspected we were dealing with some bad stuff.

An uncontrolled gas well fire in Doddridge County.  Photo courtesy of Ed Wade Jr. and Wetzel County Action Group.

An uncontrolled gas well fire in Doddridge County.
Photo courtesy of Ed Wade Jr. and Wetzel County Action Group.

So, my first impression of the fracking industry was that “being a good neighbor” isn’t important to them. Extracting gas, regardless of the cost to people and the environment, is. This, combined with the history of the energy extraction industry in West Virginia and the science regarding fracking’s impact upon people and the environment, has caused me to conclude that fracking must be banned.

What is fracking?
Fracking is a slang word for hydraulic fracturing, the process of injecting a fluid consisting of water, sand and chemicals at high pressure into shale. This fractures the rock, releasing natural gas, which is then extracted. In West Virginia, the Marcellus shale, a layer of rock 3,500 – 8,000 feet below the surface, is the object of fracking. The vertical depth of the formation is about 150 feet. Whether recovered or left behind, the frack fluid presents problems. The wastewater contains not only the chemicals added to the water, but also heaving minerals and radioactive materials recovered as part of the extraction process.

West Virginia’s challenge: crony capitalism and inadequate disaster preparations
As I’ve written elsewhere, the crony capitalism practiced among West Virginia’s industrial leaders, politicians, courts and even law enforcement has enriched a few over the state’s 152 year history, but not without much human degradation and environmental destruction. Indeed, by the turn of the 20th century, three men – U.S. Senators Johnson N. Camden and Clarence Watson, as well as Judge A. B. Fleming – controlled all of the mines along the Monongahela River in West Virginia, as well as the railroad lines.

From these unholy alliances, we have had over a century of mining disasters, the Mine Wars of the 1920s, and tragedies such as the Buffalo Creek disaster in 1972, when a waste containment pond owned by Pittston Coal Company burst, allowing135 million gallons of water, sludge and mud to form a 30-foot high wall of debris that rushed through the valley below, killing 125 and displacing thousands.

While this history applies to the coal industry, it is safe to say that the natural gas industry holds as much sway over West Virginia’s political institutions today as coal barons ever did. And, it also has a history of tragedies. And, the shenanigans continue. The indictment of Don Blankenship for allegedly contributing to the unsafe conditions which led to the Upper Big Branch mining disaster than killed 29 miners, the indictment of former Freedom Industries President Gary Southern for his alleged role in the Elk River contamination in January 2014 and the $2.3 million civil penalty that XTO Energy is paying for illegally dumping fill material into streams and wetlands in Harrison, Marion and Upshur counties are all examples of why the energy extraction industry in general cannot be trusted. There is simply too much wealth under the Mountain State’s hills and valleys for it not to be exploited – at whatever the cost. That is our history.

In light of West Virginia’s political history, the last lines of defense against catastrophe so long as fracking continues are state and local disaster officials. Frankly, with a few notable exceptions, that is worrisome.

Let us consider Lewis County as an example. It is currently among the most active fracking counties in the state, with hundreds of fracking wells planned. The amount of truck traffic traveling along U.S. Rt. 33 through town and then west towards Glenville is significant. One can stand downtown and count literally dozens in just minutes. They travel along narrow roads, wearing out the surface, causing property damage and injuring other drivers. Yet, the county has disbanded its HAZMAT team, meaning that a spill of hazardous chemicals or materials associated with the industry will pose a threat to the public and environment until help from outside arrives. In the minutes of the meetings from the Lewis Upshur Local Emergency Planning Committee (LEPC) over the past year or two you will find little or no mention of fracking.

Sadly, that is likely the case in most of West Virginia’s counties. The LEPC is charged with conducting a Hazard Vulnerability Analysis (HVA) for its community, and then develop an Emergency Operations Plan based on that HVA. So, residents should be asking several questions. Have risk assessments for fracking been conducted by the various LEPCs in those counties where fracking is occurring or planned? If so, what conclusions were reached? If not, how could emergency response officials, let alone residents, possibly know what risks the county faces because of fracking? In Doddridge County, which has as much fracking activity as anywhere in the state, officials there were recently complacent – if not incompetent – about a fracking accident there.

All disasters begin and end locally. So clearly, with most local governments in West Virginia not aware of the dangers of fracking, let alone developing emergency plans for them, can the people of West Virginia count upon the state government to fill the gap? Hardly. While there are people at the Department of Environmental Protection that want to help, they are limited by statute in their roles and influence. Meanwhile, the West Virginia Department of Homeland Security and Emergency Management – again, staffed with some fine people – is prevented by law from holding LEPCs accountable. They have regional representatives that attend the meetings, but have no say over the LEPCs work – or lack thereof. That leaves the responsibility with the county commissioners, who are responsible for public health and safety. Unfortunately, they usually delegate that authority to the LEPC – meaning responsibility is abdicated to those unwilling or unable to reach a consensus on the importance of assessing the risks of fracking.

Clearly, West Virginia’s history of crony capitalism and the state’s dysfunctional disaster planning and response systems are all factors which only aggravate an already dangerous industry.

Fracking record is one of death and danger
In addition to West Virginia having a history which should cause us all to be concerned, so does the fracking industry. It is true that hydraulic fracturing has been used since the late 1940s to extract natural gas and petroleum from the earth. However, the drilling costs have decreased, making its use cost-effective and hence widespread. Companies are drilling at unprecedented depths, using technology that one gas company employee told me, “is beyond our knowledge to manage it.”

Dead and injured workers (here and here), explosions on fracking pads (here), dead and injured motorists (here and here), destroyed wells and streams (here), dead livestock (here) and sickened residents (here) are just some of the public health and safety risks associated with fracking. Indeed, the list is rather long. The negative by-products of fracking include:
1. Site Development and Well Pad Activity
2. Traffic Congestion
3. Water Use and Contamination
4. Air Pollution
5. Waste Disposal
6. Public Health Issues
7. Quality of Life Issues
8. Related Pipeline Development
9. Misuse of Eminent Domain
10. Climate Change
11. Potential Earthquakes
12. Industry Instability

One area significantly impacted by fracking in recent years is Wetzel County in West Virginia. Bordering both Pennsylvania and Ohio, the county is located in the heart of current Marcellus Shale development. Indeed, a group known as the Wetzel County Action Group has formed in response to the many hazards caused by fracking. One member is Bill Hughes, who offered a presentation to about 200 concerned residents at a grass-roots public forum in the Lewis County community of Jackson’s Mill last November. As he noted, he is an “unwilling expert” from his first-hand experience with the fracking industry.

Hughes, who is also a board member of the Wetzel County Solid Waste Authority, shared information on the production stages of fracking, and typical problems experienced by communities because of fracking, including traffic congestion and property damage, water pollution, and air pollution. His first-hand observations are reinforced by considerable research.

1. Site Development and Well Pad Activity
Hughes told residents what many had already begun to discover for themselves. Site preparation involved an invasion of huge earth-moving equipment, all burning diesel fuel. Literally hundreds of trucks hauling stone go back and forth. Others are ever-present, working to prepare the well pad, access roads and holding ponds.

Site development is just the beginning. Well pad activity inundates a community with congestion, as well as noise, air and water pollution. Activity on a completed pad includes the running of drill rig diesel engines, auxiliary pumps, generator sets and other equipment – all day, every day. Once drilling is complete, up to a dozen frack pumps are run daily, each with about 2,000 horsepower. Also, several dozen to a hundred trucks a day deliver sand. Meanwhile, fine silica dust is blown into the air while transferring the sand to holding containers.

A fracking truck accident in Wetzel County, W.Va. Photo courtesy of Ed Wade Jr. and Wetzel County Action Group

A fracking truck accident in Wetzel County, W.Va. Photo courtesy of Ed Wade Jr. and Wetzel County Action Group

Flaring, a method of releasing pressure, sometimes brightens the night sky for weeks. But first, as Hughes noted, “Raw gas is released into the air, combined with a witch’s brew of the leftover down-hole chemicals in the well bore used in the drilling and fracking process.”

Hughes also shared, “Once wells are put into production, emissions from well sites will continue for decades. Emissions are from fugitive emissions from all the pipe fittings, separators, heater-treaters, condensate storage tanks, combustion burners and small flash gas compressor engines.” The consequence, said Hughes, is “Both intentional and accidental releases will also put raw methane into the atmosphere.”

Of course, the gas has to be transported, so the gathering pipelines present their own set of challenges. Reported Hughes, “Valves, gauges, test ports, pig launchers, flanges and all fittings will have some uncontrolled fugitive emissions. Blow-downs and pigging of the pipelines will release large quantities of raw methane into the air.”

Finally, there are the compressor stations. Hughes explained, “Most gathering pipeline will be connected to larger pipes which will go to a compressor station. There will be dehydrating equipment, condensate storage tanks, truck loading racks and very large quantities of regulated pollutants.” He pointed out that these are noisy locations, citing a location in Wetzel County with over 30,000 horsepower of compressor engines. Some people living close to them have characterized the sound as a never-ending jet engine sitting on a runway next to their home.

All of this activity leads to the other risks. Indeed, Jake Hays and Adam Law, M.D., writing for the Environmental Health Policy Institute of Physicians for Social Responsibility (PSR), argue, “…the entire lifecycle of unconventional shale gas extraction is potentially polluting. This includes everything from clearing the land for the gas well pad, to initial hydraulic fracturing, subsequent recompletions, and the final capping of the well years or decades later after it is no longer productive.”

So, Hughes is not alone in his assertions. His first-hand accounts are supported by peer-reviewed research by physicians, scientists, public health officials and journalists. For instance, Barbara Gottlieb reported for PSR, “Besides water issues, other problems have been associated with hydraulic fracturing. The release of volatile organic compounds (VOCs) is one concern. Another is methane: Wellheads have leaked gases including methane, a greenhouse gas dozens of times more potent than carbon dioxide. In addition, local communities complain about the noise, vibration and diesel fumes from drilling operations and from the literally thousands of truck trips necessitated by the fracking process. In other places, earthquakes have been attributed to fracking, either from re-injecting the returned fracking fluid into abandoned mines or deep underground, or from the hydraulic fracturing itself.”

2. Traffic Congestion
According to Hughes, the problems with traffic congestion are many, including: damaged, dusty and muddy roads; broken electrical and phone lines; blocked roads and delays; dangerous big trucks; escorts and trucks driving left of center; signs and bridges damaged; large truck caravans; permanent loss of pasture, timber and farm land; and, increased demand on and delay of emergency services.

Trucks hauling solid waste from fracking sites line up at the Wetzel County landfill. Photo by Bill Hughes

Trucks hauling solid waste from fracking sites line up at the Wetzel County landfill.
Photo by Bill Hughes

In Lewis County, resident Barbara Volk warned county commissioners of the dangers associated with the fracking traffic and then just a few days later was hurt when her car was rear-ended by a fracking truck. Though the company has settled with her for the damages caused to her car, four months after the accident she continues to wait for the company to accept liability for her medical costs, loss wages and other damages.

3. Water Use and Contamination
According to industry officials, each well requires at least five million gallons of water to mix with the sand and chemicals used in the fracking process. That water comes from public sources – streams, creeks, rivers and even reservoirs. First, there is a fairness issue to consider, as private companies operating for profit are essentially hijacking the most precious of earth’s resources. Additionally, the potential of drought should cause us to have a conservationist approach to water use; instead, we act as if there is an unlimited supply. There is not, as people all over the nation and planet are learning. Furthermore, reduced stream and river volumes adversely impact aquatic life. Also, according to FrackCheckWV, “The loss of fresh(er) water from streams feeding our rivers means that some of the beneficial effect of dilution is lost. Pollutants from other industries (coal, power, etc.) are therefore more concentrated at our public water intakes on rivers. Public treatment plants do not remove most pollutants such as salts, chemicals and heavy metals. Thus the pollutants pass through the system and out our taps.”

Hughes lists numerous other problems with water use caused by fracking, including: muddy streams from gas operations runoff; spilled drill brine fluids; streams, springs and rivers contaminated by drill waste; erosion and sedimentation of streams; spilled and dumped drill mud or cuttings; and, disposal problems.

Hays and Law confirm Hughes’ observations, writing, “These fluids are laced with chemicals used as friction reducers, biocides, corrosion inhibitors, etc….” They continued, ‘Flowback water’ withdrawn from the well after the fracturing process, and ‘produced water’ returned to the surface with the natural gas, introduce other toxic substances. In addition to the toxins put into the ground, these returned waters contain heavy metals (e.g. lead, arsenic), naturally occurring radioactive materials (e.g. radon, uranium, chromium), bromide, and chloride (brine).” Additionally, say the scientists, “Containment of these returned waters remains a problem and recycling (i.e. reuse for other drilling operations) accounts for only a portion of these toxic fluids. Flowback and produced waters are often put in evaporation ponds, which have been known to leak, contaminating water and soil and leading to documented instances of fish and livestock deaths.”

The stream on the left was polluted by runoff from fracking operations.  Photo courtesy of Ed Wade Jr. and Wetzel County Action Group

The stream on the left was polluted by runoff from fracking operations.
Photo courtesy of Ed Wade Jr. and Wetzel County Action Group

Yet, they note, “No suitable or concrete plans have been made for the treatment and storage of wastewater from shale gas extraction in the Marcellus Shale region.”

Hays and Law also contend, “Water contamination due to natural gas operations associated with hydraulic fracturing has been documented.” They reported, “A Duke University study in Pennsylvania that tested sixty-eight water wells found that groundwater near drilling areas contained methane concentrations seventeen times higher than wells where drilling was not taking place.”

4. Air Pollution
The silica dust which pours out of fracking sites in large clouds through the processing of sand are clear health hazards. These silica dust clouds have been associated with tuberculosis, chronic obstructive pulmonary disease, kidney disease and autoimmune disease.

The fracking process releases carbon dioxide, methane, nitrogen oxide, carbon monoxide, and benzene, among other pollutants. According to FrackCheckWV, “…one of the most toxic types of air pollution is insidiously invisible to our eyes. Volatile organic compounds, or VOCs, such as benzene and formaldehyde, are released both intentionally and unintentionally from gas collection and treatment equipment. These chemicals contribute to asthma-inducing smog, are toxic to our organs and significantly raise the risk of cancer to those who inhale them. While our eyes cannot detect these emissions, infrared photography has recorded dramatic clouds of black VOCs issuing from gas facilities.”

In addition, Hays and Law point out, “Significant air pollution emissions come not only from natural gas drilling and processing operations, but from transportation as well,” noting that roughly 4,000 truck trips occur at each well.

5. Waste Disposal
Of the five million gallons of water that is used at a fracking site, as much as three million or so is left over for disposal. Presently, the industry has few regulations to guide their disposal and because of a decision by Congress to exempt the industry from the Clean Water Act, the exact content and composition of the fracking fluid is considered proprietary. This means that local emergency response, public health, and environmental protection workers cannot develop appropriate and complete emergency response plans.

In addition, once the wastewater is disposed of, whether on site or at an undisclosed location, it then mixes with the earth’s hidden threats, such as arsenic, mercury, heavy metals and radioactive materials. All of this can then leach into ground and surface water supplies.

6. Public Health Issues
The public health sector has not prepared for the impact of fracking, argue Hays and Law. “The recent boom in shale gas production has left the public health community scrambling to catch up.” They explain, “Epidemiologic studies often require significant time and resources (e.g. prospective cohort studies), which have been far outpaced by the rate at which shale gas operations have developed. Environmental and health-related governmental agencies have lacked the capacity to adequately investigate public health considerations of shale gas extraction. There are political interferences as well, and currently there are no members on state and national advisory committees with recognizable public health expertise.”

7. Quality of Life Issues
Jill Kriesky, who has a doctorate in economics, authored the essay, “Socioeconomic Change and Human Stress Associated with Shale Gas Extraction” for PSR. Sharing a personal experience, she wrote, “Spending a few hours in towns in the active Marcellus Shale drilling region of Pennsylvania provides even a casual observer with sights and sounds of undeniable community change. Thousands of diesel-powered trucks carrying water, chemicals, and equipment to and from drilling sites roar through towns and rural landscapes, creating traffic jams and degrading already poor-quality road surfaces. Local hotel, temporary industry-built ‘man camps,’ and restaurants are filled with an influx of drilling teams from Texas, Oklahoma, and other points south and west, here only long enough to drill and frac, then move on to another site. A visitor who spends a little more time chatting with social service providers, town leaders, and long-time residents will hear about additional stressors that lie below the surface. Homelessness is on the rise among those who have long struggled near the economic margins, and are now forced from inexpensive housing by landlords seeking higher rents from gas workers.”

What she observed is common throughout the region. In Harrison and Lewis counties in North Central West Virginia, rental prices have grown exponentially to where even a small home or apartment rents for nearly $1,000. Some homes rent for double and triple that. As one hourly worker who makes just a little over minimum wage observed from his home in Weston, “This has become a town of haves and have-nots. There is no middle class left.”

Homeowners, too, are impacted. Property values decrease as much as 75 percent, making getting loans for mortgages or upkeep nearly impossible. It also precludes selling one’s land if one wants to get away from fracking operations.

8. Related Pipeline Development
While the gas industry would like to separate the issues of fracking and the development of at least five pipelines in West Virginia and surrounding states, the two issues are inseparable. One does not exist without the other. The destruction that the construction of a 42” pipeline would cause to mountains, streams, drinking water, endangered species and property values is directly connected to the existence of fracking. The pipelines, in particular the proposed 550-mile Atlantic Coast Pipeline and the somewhat shorter Mountain Valley Pipeline, are currently mapped to go through three national forests and some of the highest peaks of the Allegheny Front. Even industry officials have expressed doubts about this route. Alluding to one of its southern “alternate” routes, a Dominion Energy official wrote, “Of great significance is the jumbled arrangement of ridgetops south and east of Thorny Flat. The mountain ridges in this area . . . consist of a jumbled mass of peaks and ridge tops. Trying to cross this terrain with a 42-inch pipeline results in a combination of steep side slope traverses and up and down approaches to ridgetops, requiring heavy equipment winching on both sides of the ridge from a narrow staging area on top. . . . Slope restoration and stabilization would . . . be difficult to achieve…”

This is why Dominion and its partners have applied for a permit to go through the Monongahela National Forest (as well as the George Washington and Jefferson National Forests). However, as the National Forest notes on its website, “…the Monongahela straddles the highest ridges in the State. Elevation ranges from just under 1000′ to 4863′ above sea level. Variations in terrain and precipitation have created one of the most ecologically diverse National Forests in the country.”

So, regardless of where the companies attempt to cross the Allegheny Front, they will have problems. They will either have to use a route they consider undesirable, or go through land set aside for all U.S. citizens to enjoy. Perhaps the forest routes are preferable because the energy companies hope that once the permits are approved, oversight will end.

Despite the strategy of inevitability that the gas companies have adopted regarding the various pipeline projects, they are experiencing some stiff opposition to the proposed routes, but not just from environmentalists. At least one public health agency has been proactive. The Monroe County, W.Va. Board of Health, writing the Forest Service in opposition to the Mountain Valley Pipeline (MVP), asserted it “…is firmly opposed to the construction and installation of the Mountain Valley Pipeline through any route in Monroe County.”

The primary concern expressed by the board is due to the karst topography of the region. Writing for the board, Dr. J. Travis Hansbarger, argued, “Chemical, fuel and oil spills during construction will go unfiltered into caves, underground streams and drinking water.” He added, “Groundwater in karst areas can travel as quickly as a few thousand feet to over a mile a day.” Noting that the current proposed route for the MVP passes within a few hundred yards of a creek’s headwaters, he observed that the drinking water of roughly 4,000 people – including those in a nursing home, an assisted living facility, two medical clinics, several day care centers and three public schools – would be threatened. He also cited the industry’s history of explosions, arguing, “Serious questions have been raised about the possibility of evacuation routes for these public facilities should an explosion occur.” In fact, the state of West Virginia abandoned an evacuation disaster drill planned for the region a few years ago because it was apparently easier to abandon than conduct. In short, though the scenario was about the failure of the nearby Bluestone Dam, the conclusion is the same – the state does not have the capabilities to evacuate the region, regardless of the disaster. This leaves the entire population close to the pipeline in Monroe County – and presumably anywhere else – quite vulnerable.

9. Misuse of Eminent Domain
From the beginning, say landowners, the energy companies have bullied their way onto people’s land, generally through threatening the use of eminent domain. This is true for both fracking operations and pipeline development. Last September, hundreds of people turned out at Jackson’s Mill to hear from officials with Consol Energy explain how fracking would impact their communities. However, as Diane Pitcock from Doddridge County expressed, “We expected an open forum where we could ask questions. Many of us may have questions that other people haven’t thought of. But that isn’t going to happen tonight.” The lack of transparency led local residents to hold a forum of their own about six weeks later. It also left them wondering just exactly what the intentions of Consol are.

Joao Barroso makes a point with neighbors in Randolph County

Joao Barroso makes a point with neighbors in Randolph County

Meanwhile, in Randolph County, Joao Barroso has spent nearly a year doing battle with Dominion because the Atlantic Coast Pipeline (ACP) is mapped to pass through his property. Speaking to a community gathering in Mill Creek last autumn, Barroso vehemently disputed the company’s claims that it would improve the environment of his land or be fair to him economically. He also took issue with the way in which the company first dealt with him. “I was contacted by a gentleman in an extremely unprofessional way. His correspondence was terse. When I started asking him questions, he tried to intimidate me, mentioning eminent domain and the importance of the survey.”

He has held firm through the winter months and continues to negotiate with Dominion in ways – if successful – could lead to significant changes in the way landowners are compensated by gas companies, should the pipelines be approved.

10. Climate Change
According to Hays and Law, “In the atmosphere, methane contributes to global climate change, which in turn affects human health in a number of ways, including heat waves, extreme weather events, flooding, water contamination, sea level rise, expansion of insect ranges and populations, worsening air quality, crop damage, and social instability and conflict.” Indeed, methane from fracking traps nearly 90 times as much heat than carbon dioxide, according to the Intergovernmental Panel on Climate Change. In short, fracking is aggravating climate change.

11. Potential Earthquakes
In Oklahoma, which is also a “land-rush” state because of fracking, an unprecedented level of earthquakes is being experienced. Historically, the state would experience about only two earthquakes annually of at least 3.0 magnitude. However, in 2014, the state experienced 567 such quakes. According to the Washington Post, “Scientists implicated the oil and gas industry – in particular the deep wastewater disposal wells that have been linked to a dramatic increase in seismic activity across the central United States.” While industry officials try and pressure state scientists to downplay the connection and outraged citizens write demanding action to the problem, “Both the U.S. Geological Survey (USGS) and the Oklahoma Geological Survey have confirmed a connection between the recent oil and gas boom and a sharp uptick in seismic activity in Texas, Colorado, Arkansas, and Ohio, as well as Oklahoma,” according to the Post article.

Clearly, with this evidence, West Virginia emergency planners now need to add earthquakes to their Hazard Vulnerability Analyses. In light of the convoluted nature of the Mountain State’s emergency preparedness efforts, that is almost certainly too much to expect at this time.

12. Industry Instability
Finally, the industry is not as stable as it would have the public believe. Officials planning a “cracker” plant near Parkersburg have said recently that they are reconsidering their plans. The plant, if built, would convert gas liquid into polyethylene, used in many plastic products. In short, like any industry, the gas extraction business is not immune from market forces – most of which are beyond its control. The geopolitical situation that has developed as a result of Russia’s aggression in Europe and growing instability in the Middle East is impacting the livelihoods of those hourly workers trudging in the mud every day for Halliburton, Dominion and the others. So, just as quickly as a coal miner would find himself turned out of his home when the steel industry began its decline, so too will a gas field worker find himself in a home with a $1,500 monthly rent payment – or mortgage – and no paycheck to cover it, when forces far beyond his control put him on the unemployment line.

The benefits of fracking are championed daily by the energy extraction industry. It boils down to two messages – “We create jobs,” and “Gas is clean.” We have already seen that the energy industry cares about producing jobs only when it is to their benefit. Even though this industry will create, at best, a generation of limited employment, we are already witnessing layoffs within the industry. Why? Because, at the moment, other energy products – oil in particular – are less expensive. So, the two benefits cited by the gas industry simply are not reliable. What is reliable, though, is the science that reveals that there at least a dozen dirty reasons to oppose fracking, because it is not “clean.”

So, as the Physicians for Social Responsibility did five years ago, we call for “…a moratorium on the use of hydraulic fracturing until such time as impartial federal agencies such as the U.S. Environmental Protection Agency develop and implement enforceable rules that provide adequate protection for human health and the environment from fossil fuel extraction processes that use hydraulic fracturing.”

In the interim, perhaps West Virginia University could fulfill its mission of serving the people of West Virginia by sending its public health students to the field to study fracking. It could implement a training program for emergency preparedness officials. Our political system could use a shot of ethics. Perhaps WVU or another state university or college would establish an Institute of Political Leadership from which would come the state’s future political leaders. There, they would be trained not in ideology, but in the fine art and dirty work of governance and compromise.

The people are waiting. Our institutions – industrial, political and educational – need to catch up. The Forest Service was overwhelmed with letters expressing opposition to the pipelines dissecting our national forests. Roughly 125 people in Monroe County stood in unison when county commissioners there tried to end a meeting with pipeline officials who were not answering questions. In Lewis County, more than 200 responded to a call to learn about fracking and its dangers.

Elise Keaton

Elise Keaton

Meanwhile, gas company officials are counting upon West Virginians to remain “docile,” as one gas company official said in a local paper. Elise Keaton with the Greenbrier River Watershed Association thinks that is a mistake. She said, “Clearly, he is not from here. We may seem ‘docile,’ but if that man was being completely honest with these folks about just a few jobs, decreased property values, loss of land, dangers from leaks and explosions he would probably see a different reaction.”

Knowledge is powerful. For now, the energy companies seem to be bulldozing through West Virginia and neighboring states with fracking activities and pipeline route preparations. Yet, as more West Virginians and all of those who care about social and environmental justice learn about the dirty dozen reasons to oppose fracking, it just may be the people who are moving earth (and heaven) to rescue what is left of “Wild and Wonderful” West Virginia.

© Appalachian Preservation Project, LLC, 2015. The Appalachian Chronicle is a publication of the Appalachian Preservation Project. The Appalachian Preservation Project is a social enterprise business committed to preserving and protecting Appalachia. If you wish to support our work, please consider becoming a member.

The Appalachian Preservation Project is also handling planning for the “Preserving Sacred Appalachia” Earth Day conference scheduled for April 20-21 in Charleston, W.Va. Learn about it here.

Michael M. Barrick is an experienced freelance journalist based in West Virginia. He holds a post-graduate certificate in Community Preparedness and Disaster Management from the University of North Carolina Gillings School of Global Public Health.

Physicians for Social Responsibility
Dangers of Fracking
Wetzel County Action Group

After Action Review of Elk River Spill is Long Overdue

Though West Virginia officials remain silent, Kanawha and Putnam County officials have conducted an instructive assessment

By Michael M. Barrick

CHARLESTON, W.Va. – On January 9, 2014, at about 10 a.m., fire departments in Kanawha County, the home to West Virginia’s state capital, where dispatched to two locations because reports of a “chemical odor” were being called in by citizens. It was at least four hours before emergency response officials realized they had a major public health crisis on their hands – the water for 300,000 people served by the Elk River was unsafe for human use.

It wasn’t until about 2 p.m. that Mike Dorsey, the emergency response coordinator for the West Virginia Department of Environmental Protection, determined that the release of the coal-mining cleaning chemical 4-methylcyclohexane methanol (MCHM) at a site owned by Freedom Industries along the Elk River had reached the water intake of the West Virginia American Water Company.

Elk River Basin in West Virginia

Elk River Basin in West Virginia

As disturbing as that incident was, what is equally disturbing is that the state of West Virginia has yet to publish an After Action Review, as promised by Governor Earl Ray Tomblin early last May. The delay is unconscionable. We do not know what lessons have been learned, so we can’t know what measures need to be taken to prevent such an event again. We do not know how to improve the response of appropriate agencies and organizations, and we don’t know what steps – if any – private industry has taken to improve their emergency operations plans.

While the event was certainly complex, Mountain State citizens have the right to expect that the report would have been concluded in a timely manner. It will be interesting to see if the report will be released before the anniversary in an effort to appease groups such as the Ohio Valley Environmental Coalition (OVEC), which is planning a month-long focus based on the theme, “Water Unites Us!” Even if the report is published in the next couple of weeks, OVEC, other groups and all citizens should be skeptical, for the long delay suggests that political considerations may be hindering its release.

KPEPC After Action Report
In the interim, though, citizens can turn to the After Action Report (AAR) of the Kanawha Putnam Emergency Planning Committee (KPEPC). The report, titled “West Virginia American Water Incident” was published Nov. 17. Kanawha and Putnam counties are two of the nine counties that were impacted by the spill. The two counties have a merged Local Emergency Planning Committee (LEPC) that conducted a thorough review of nine capabilities of the KPEPC Emergency Management Plan (EOP) relevant to the spill. While the KPEPC is clear in stating that the AAR is not intended to be an overview of the whole event (as the state’s should be), it nonetheless offers solid insight into numerous lessons learned and corrective actions that should be taken.

The Executive Summary states, “On January 9, 2014 a leak of MCHM into the Elk River contaminated the drinking water for most of the residents of Kanawha and Putnam Counties. Both Kanawha and Putnam Counties activated their Emergency Operations Centers (EOCs). For approximately the next 30 days the EOCs were involved in commodity distribution.”

The AAR assessed the following nine capabilities:
1. Planning
2. Public Information and Warning
3. Operational Coordination
4. Environmental Response/Health and Safety
5. Mass Care Services
6. Public Health and Medical Services
7. On-scene Security and Protection
8. Public and Private Services and Resources
9. Community Resilience

The AAR also states, “The purpose of this report is to provide supportive corrective actions in relation to the KPEPC (Emergency Management) Plan. Our goal is to identify actions taken and to identify strengths to be maintained and built upon, identify potential areas for further improvement, and support implementation of corrective actions.”

According to the report, once initial responders traced the odor, “…Freedom Industries employees characterized the event as a small spill that was under control.” Later, however, Dorsey “called (the) Kanawha County Office of Emergency Management reporting that the spill was more than originally thought.”

It continues, “When representatives from Charleston and Kanawha County Offices of Emergency Management arrived they were told the spill was more significant and that product was entering the water.” A West Virginia American Water company representative initially “…stated they thought they would be able to treat the contaminated water by using extra activated carbon in the treatment process which had already been initiated.”

However, the report notes, “Freedom Industries employees could not or would not give an estimate of the amount of product released. Initially, Freedom Industries only reported that they had a leak of Crude MCHM. Several times over the course of the incident the estimated quantity of material leaked increased. In addition, it became clear that the material leaked also contained other chemicals besides MCHM.”

Not surprisingly, communications issues were identified. “One of the challenges of this incident was the role of social media in shaping public opinion,” notes the report. It continues, “This was both good and bad. While many agencies attempted to use social media to provide information to the public, there was a great deal of misinformation or completely false information.”

To address this challenge, the report concludes, “Agencies should develop internal policies and procedures for use of social media to relay critical information. In addition, agencies should consider assigning staff members to monitor social media and when misinformation or incorrect information is presented, to be ready to counter with correct information.”

It notes also, “An issue during this incident was that there were inconsistent messages. A Joint Information Center (JIC) should have been established. …All officials and personnel involved in an incident, regardless of their home jurisdiction or discipline must ensure that any public statement is coordinated, in advance, with the other members participating in Joint Information System.”

It adds, “During the incident various departments from within the WV state government were in charge of the Public Information component of the incident. It was not clear how county governments could be engaged in the process. There is the need, however, for a method to enable county agencies to be kept in the loop of critical information.”

There were also command and control issues. The report notes, “To maintain command and control it is critical that an incident command post be identified. According to the Kanawha Putnam Emergency Management Plan, the Incident Command Post is a facility or area from which the IC (Incident Commander) and command staff operates. Ideally, the Incident Command Post will be located in a safe area away from the incident scene, yet close enough that the command staff can still safely observe tactical operations. In this incident that was not a clear ICP.”

Hence, it recommends, “During future incidents, an ICP needs to be established early during the incident response.” It continues, “In addition to not having a clear Incident Command Post, it was not apparent who had been named the overall Incident Commander. At the same time, however, it is clear that this incident should have been operating under a Unified Command.” It adds, “During all emergencies/incidents ensure that an Incident Commander is clearly identified. When necessary establish a Unified Command structure to better integrate the response capabilities of all involved agencies.”

Confusion about MCHM was also a challenge. “During the initial response phase of the incident there was a lack of information and misinformation regarding Crude MCHM. Different agencies were using slightly different versions of the Material Safety Data Sheet (MSDS) for Crude MCHM. Even worse was that the MSDS lacked information related to human health threats associated with the product.”

The report’s writers were also critical of Freedom Industries. “One of the most challenging aspects of this incident from both a response and a public notification aspect is that Freedom Industries, Inc. was not reliable in their releasing information. During the first week or so of the incident the amount of chemical released changed multiple times. Then it was released that in addition to the Crude MCHM additional chemicals were leaked.”

The logistics of distributing water and others supplies presented challenges. “Many community organizations, volunteer fire departments, and governmental agencies were involved in the distribution of commodities during the incident. In most cases these sites stepped forward offering to provide assistance as water distribution locations.

“Some of the locations worked well and other presented challenges. Part of the selection process should include access and security considerations at each location.

“In the future, FEMA and the state are going to require the direct delivery of FEMA resources (i.e. trailer loads of water) directly to the distribution points. The practice will not allow for dropping trailers at a central location in the county and then relocating the trailers by county assets. FEMA wants the state to be responsible for all movement of the FEMA assets.”

The report recommends that emergency planners, “Develop a list of locations and contacts to potentially be used in future incidents. For each of the locations develop maps showing locations and provide directions.”

Also concerning was the impact upon vulnerable populations and the response of the public in general. “Public housing, assisted living, apartment complexes and other densely populated residential areas present many challenges…the residents in these buildings also have access or functional needs.”

Additionally, notes the report, “A great deal of money has been spent on educating the public on the importance of building self-sufficient for a minimum of 72 hours. Regardless of the amount of money thrown at the problem, the public does not comprehend or is unwilling to take any action.” Furthermore, “It was difficult to get the populous to start thinking about providing water on their own. Even when water was available in all of the stores and when the water was deemed safe, the population expected free water.”

Despite the many challenges and lessons learned, some positive capabilities were identified, including:
• Great support from community agencies. Local agencies provided manpower and resources to distribute over 15 million bottles of water;
• Support provided to the community by WV American Water;
• Cooperation between Federal, State, County and local agencies and businesses;
• Quick delivery of emergency supply of bottled and tanker loads of water by WV American Water within 4 hours;
• First arriving emergency supply of water by WV Division of Homeland Security and Emergency Management within 30 hours; and
• Social media and flow of public information disseminated through the media.

The officials responsible for this report are to be commended for a thorough and transparent assessment. Hopefully, the State of West Virginia will follow their lead.

© Appalachian Chronicle, 2014. Barrick is a lead author for an upcoming book by Springer Publishing on disaster evacuations and is a member of a consortium of Emergency Management experts with West Virginia University, the University of Colorado-Denver, the University of Oklahoma, and the University of South Carolina. He holds a Certificate in Community Preparedness and Disaster Management from the University of North Carolina School of Public Health and is the Safety Officer/Emergency Management Coordinator for Stonewall Jackson Memorial Hospital in Weston, W.Va. He writes from his home in Bridgeport, W.Va.

To learn more about the KPECP AAR, you can contact:
City of Charleston, Office of Emergency Management
Grant Gunnoe

Kanawha County Office of Emergency Management
Dale Petry

Putnam County Office of Emergency Management
Frank Chapman

Kanawha Putnam Emergency Planning Committee
Larry Zuspan, Administrator

Kanawha Putnam Emergency Planning Committee
Dr. Matt Blackwood, Chair of the Board of Directors

Incompetence and Complacency Increase Dangers from Fracking

Gas leak in Doddridge County, W.Va. is a sentinel warning

By Michael M. Barrick

The leak of approximately 120 gallons of natural gas liquids into the air in Doddridge County, W.Va. on October 9 should serve as a sentinel warning to those supporting the fracking industry and all of those impacted by it.

While it is true that the leak in the Smithburg area of Doddridge County is not related to fracking, that is not the point; rather, what we need to consider is the incompetence and complacency that led to the leak – and the response to it by those charged with protecting the public health and safety. In short, it shows that the gas industry cannot be trusted, and emergency response officials have a lot to learn and improve upon.

A vapor cloud led to a massive traffic jam, injuries to at least two workers, complacent remarks from gas company officials and admissions by emergency officials that they experienced serious communications breakdowns.

This is concerning, considering the rush by gas companies to build fracking sites all over northern West Virginia, in particular in Doddridge County. Naturally, gas company officials claim that fracking is safe. The evidence is quickly mounting to the contrary. From mutated amphibians to workers exposed to carcinogens – and much more – fracking is being proven to not be worth the jobs it is creating.

In response to the accident in Smithburg, a gas company official was quoted in the Clarksburg Exponent Telegram as saying, “During routine loading of natural gas liquids (NGLs) to a tractor-trailer at what’s called a ‘load out’ facility, a leak occurred.” Note the use of the word “routine.” That is a deliberate attempt to downplay the incident. For the workers injured, for the homes evacuated, and for the motorists stranded, it was anything but routine. This is the type of language we can expect from gas companies and all of those in the fracking industry as they destroy the environment and kill people.

The only response to such language is, “cowpatties.”

The gas official was also quoted as saying, “Two employees at the facility were evacuated by medical professionals. However, no one was injured.” Really? A first responder at the scene had a different response. The newspaper reported that he said, “…that two employees were treated at the scene for difficulty breathing.”

Who do you believe?

Also of concern is the acknowledgment by the director of the Doddridge County Office of Emergency Services (OES), Pat Heaster. He told the newspaper that he was not notified of the incident. For those unfamiliar with emergency response, that is an inexcusable lapse. It is the director of OES who is responsible for coordinating disaster response in a county. It is hard to do that when you don’t know there is a disaster.

It is also maddening that he blamed technology. “We’ve had problems with dispatch reaching pagers due to the topography and antennas. We must determine want went wrong with communications.” While technology is a problem in West Virginia, there are still landline telephones. And, one would suspect that police officials or other knows where he lives and from where he works. They certainly could have notified him.

Heaster promised that the Local Emergency Planning Committee (LEPC) would meet next week and discuss the problem. If the Doddridge LEPC operates as most others in West Virginia, I would not hold my breath. Or then again, maybe we should.

© Michael Barrick, 2014. Barrick is the founder of the Appalachian Preservation Project, LLC. He also works in healthcare as an emergency manager and holds a post-graduate certificate in Community Preparedness and Disaster Management from the University of North Carolina Gillings School of Global Public Health. He can be contacted via email at

Stubborn and Conflicted Public a Major Challenge to Disaster Evacuation

Public expects officials to be prepared for disasters, but often ignores directives

By Michael M. Barrick

“No one thought about leaving town ‘til death stared them in the face.”
– “Wasn’t That a Mighty Storm,” by Eric Von Schmidt

The decision to evacuate is often referred to as “a career killer” within the disaster management field. That is with good reason. Millions of people are often impacted by the decision. If the decision to evacuate turns out, in hindsight, to be a mistake, the politicians will hear about it at the polls. Knowing this, elected officials will quickly dismiss a cabinet level appointee and/or their functionaries without hesitation. Hence, a political decision affects future policy decisions, as subsequent disaster officials may hesitate to order an evacuation for fear of committing career suicide. In short, a management decision to not order an evacuation could potentially be a misapplication of policy because of political considerations or pressure.

The folk song about the Great Galveston Hurricane of 1900, referenced above, identifies the first core challenge facing the public health sector – the public. Though the song recalls a tragedy before modern communications and the 24/7 weather forecasting cycle, the public’s tendency to ignore warnings remains on full display. Just in the early months of 2014, Atlanta was paralyzed because the public failed to pay attention to the forecast which warned of the ice storm that left tens of thousands of Georgians stranded on roadways. Two weeks later, another winter storm, again predicted far in advance, left thousands stranded in the snow in and around Raleigh, North Carolina’s capital.

This first core challenge, however, is not without cause. It is related to the second core challenge – the public’s distrust of government. This applies not only to government, but also the politicians we elect to lead it and the employees to whom we entrust it. This is made evident by the fact politicians and the public alike refer derisively to public sector employees as “bureaucrats.” Unfortunately, the public has cause for being skeptical. Also in early 2014, 300,000 West Virginians learned that their water was unsafe to drink because their drinking supply – the Elk River – had been contaminated by the coal-mining cleaning chemical 4-methylcyclohexane methanol. The finger-pointing that began immediately after the incident could not engender confidence in public officials – both elected and appointed. Such distrust was only exacerbated, when, months following the spill, virtually nobody in authority was willing or able to answer the most fundamental question – is the water safe?

Cleary, these two core challenges are not only connected, they are also complicated. Even as hundreds of thousands of Georgians were making individual decisions about how to react to the forecasts of severe and dangerous weather – decisions that led thousands of people, including children, to be stranded – the mayor of Atlanta and governor of Georgia were harshly criticized for failing to provide clear leadership in anticipation of the ice storm. While one could argue that a resident living in the southeastern United States should anticipate many problems associated with an ice storm, the angry reaction to inaction by elected officials demonstrates that the public does have an expectation that government officials will provide guidance in anticipation of and response to disasters. The public may choose to ignore such warnings, yet the expectation is that warnings will be issued. Consequently, these two core challenges are intertwined. The public is not easily persuaded, but it still expects to be courted – even while death stares them in the face.

It was true in 1900 and it is true today. Emergency managers, in other words, must acknowledge they are serving a public that is stubborn and suspicious of governmental authority. These factors and the historical national devotion to individualism and property rights combine to further aggravate the public’s role in contributing to increased morbidity and mortality during disasters.

People everywhere – and certainly in the United States – are determined to continue to live in risk-prone areas. Admittedly, economic structures may leave the working class or impoverished with no alternative to living in a river valley; still, for whatever reason – whether stubbornness or powerlessness – the presence of people in areas prone to natural disasters is a challenge to disaster planning.

© Michael Barrick / The Barrick Report, 2014. Barrick is presently a lead author for an upcoming book by Springer Publishing on disaster evacuations and is a member of a consortium of Emergency Management experts with West Virginia University, the University of North Carolina, the University of Colorado-Denver, the University of Oklahoma, and the University of South Carolina. He holds a post-graduate Certificate in Community Preparedness and Disaster Management from the University of North Carolina Gillings School of Global Public Health. He offers consulting expertise on healthcare and community emergency preparedness.

Our Nation’s Gravest Threat – Mediocrity

We will solve nothing so long as we collectively shrug off challenges

By Michael M. Barrick

Does the Secret Service want President Obama dead? If you have even the slightest conspiracy theory streak guiding your thoughts, you might rightly think so in light of the ongoing security breaches at the White House and the juvenile behavior of the agency’s officers on foreign soil. However, I am not quite that paranoid. I am, though, quite disgusted and concerned. For, the root cause of the agency’s problems is incompetence. In short, it, like much of our society, has fallen prey to our gravest enemy – the momentum of mediocrity.

Let’s review.

This past Sunday’s Washington Post’s headline story announced, “Secret Service stumbled after shooting in 2011.” In summary, according to the article, a gunman shot several rounds at the White House on November 11, 2011. While some agents initially responded as trained – that is, recognizing and attempting to identify the threat – a senior officer ordered them to stand down, claiming no shots had been fired. Several days later, however, a worker at the White House discovered several locations where bullets had hit the White House on the south end of the second floor. As it turns out, someone had indeed opened fire at the president’s home from 700 yards away. Only by sheer dumb luck did the Secret Service eventually identify and arrest a suspect. He was captured only because he crashed his car leaving the scene. It took several days before he was arrested in Pennsylvania.

The following year, a team of Secret Service agents charged with protecting the president in Columbia during an overseas visit instead spent their time cavorting with prostitutes. Not only is this a completely inexcusable breach of their sacred duty, it left them open to blackmail.

Then, just last week, another man scaled the fence on the north end of the mansion, ran across the yard, entered the unlocked front door and gained entry to the presidential quarters.

These agents of the Secret Service clearly do not represent our brightest and best. Yet, they are supposed to. Whatever one thinks of President Obama, anyone who lived through the 1960s is acutely aware of the trauma inflicted upon the nation when the president is murdered. With terrorists unquestionably determined to destabilize our nation, there is no better way to accomplish that than to murder our president and his family. It is beyond comprehension that the Secret Service does not take such a threat seriously. Clearly they do not, no matter what its leaders say. It is obviously time to clean house, so that those living and working in the White House are protected as they should be.

The mediocrity is not limited to the national government though. It is also on display at the local and state levels as well.

West Virginia offers clear evidence of this.

This past summer, the Lewis County Firefighter’s Association and the Lewis County Commission decided to disband the county’s HazMat response team, even though two major highways run through it, crowded daily with trucks hauling materials, water and supplies for the fracking industry. The back roads are just as crowded and even more dangerous. Public officials simply shrugged their shoulders and have done nothing to correct the problem.

Yet, the Material Safety Data Sheet (MSDS) for Gas Pipeline Condensate reveals numerous potential health effects to the eyes and skin, as well as through ingestion and inhalation. There are also acute health and chronic health hazards. Additionally, medical conditions that are aggravated by exposure to it include respiratory, cardiovascular and nervous system conditions. Still, county officials do nothing.

Meanwhile, in the state capital of Charleston, no elected or appointed official is willing or able to hold those local officials accountable. Calls to those responsible for public health and safety, environmental protection and emergency management go unanswered or unattended. Every official I spoke with in Charleston regarding this matter said there is nothing they can do. This inaction is unconscionable in light of the fact that 300,000 West Virginians had their drinking water contaminated by a spill of the coal-mining cleaning chemical 4-methylcyclohexane methanol into the Elk River last January.

All of this can only be characterized as a momentum of mediocrity. Eventually, it will be deadly.

As we ponder these issues and wonder if there is any hope of reversing the trend, we might want to consider the thoughts of Derek Jeter, the New York Yankee baseball player who just retired after a stellar career. When Sports Illustrated asked him whether a teammate who was complacent about losing could change, Jeter replied, “I don’t think so. Either something means something to you or it doesn’t. I don’t think you can teach someone to have something mean something to them, do you know what I mean?”

Sadly, I think too few of us do. And that is why the momentum of mediocrity poses a grave threat – a greater threat even than the Islamic State, Iran, North Korea, Ebola or any of our other enemies or threats.

© Michael Barrick, 2014. Learn more about him here.

Adjusting the Mindset about Using Lethal Force in Hospitals

For those trained to save lives, the thought of taking one is unfathomable

By Michael M. Barrick

Those working in hospitals – whatever their position – have generally entered healthcare because they wish to improve and save lives. Consequently, the thought of using lethal force to stop a violent person – as recently happened in Pennsylvania – is unfathomable to most healthcare workers.

It is, however, the new reality.

This is the implicit truth for the hospital planning an “Active Shooter” drill. Considering the number of assaults, attacks and shootings in hospitals in recent years, any hospital serious about ensuring the safety and security of its patients, staff and visitors must prepare for the reality of a shooter in their facility. That also means they must also accept the reality that they or the police may have to use lethal force against the person presenting a threat.

So, to prepare for such a scenario – regardless of how remote one hopes or believes it is – requires the writing of a drill, functional exercise or perhaps even a full scale exercise involving the whole community.

Writing the plan is the “easy” part compared to adjusting our mindset about the potential need for “neutralizing” the threat. Of course, writing such an exercise is not easy, because the options available to healthcare workers are very limited when one considers how open and accessible most hospitals are. Faced with an increasingly violent society, hospital administrators, emergency managers, and community partners truly do face numerous obstacles in figuring out how to respond quickly and effectively to someone who poses a mortal threat. However, no matter how well-planned and executed an active shooter exercise may be, the first challenge is coming to terms with the fact that those charged with saving lives may have to take one.

How can we adjust our thinking to include that possibility? It begins with acknowledging that the possibility of such an event is real. Because such events are essentially random, it is a very difficult threat to rank in a Hazard Vulnerability Analysis (HVA). But ranked it must be. As with any risk identified in a HVA, many things must be considered. The first thing to acknowledge is that hospital staff may be reluctant to identify a threat, let alone react to it.

So, re-training our minds is the first step. Of course, this does not mean cavalierly accepting that we or police may have to use lethal force; rather, it demands of us that we truly begin with the first step of emergency management – mitigation. This includes robust training for ALL staff on crisis prevention and intervention. It includes training in self-defense. It includes training in recognizing potential threats. It means changes in policy to include intake questions which might help identify a domestic problem that could manifest itself within the hospital. It means ensuring that de-escalating a potentially violent situation is every employee’s priority.

Ultimately, it means including every possible employee in an active shooter exercise. As they see through such a drill the potential tragedy that could unfold, they will come to understand that the best way to avoid the unfathomable is to acknowledge that it can happen. From that acknowledgment will come two conclusions – the risk is real and it is dangerous to ignore it.

© Michael M. Barrick, 2014.

Key Assumption Guides Judge in New York City Case

Local government responsible for disaster planning – including for vulnerable populations

By Michael M. Barrick

Note: This is the second installment in a series of articles regarding emergency management and vulnerable populations. Read the first installment here. Additionally, I wish to thank James Farrell with the Upshur County, W.Va. Office of Emergency Management for first bringing this case to my attention.

Emergency planners are responsible for ensuring compliance to laws from various local, state and federal government agencies. This has been the case for roughly 40 years, but true collaboration and cooperation among emergency responders and planners didn’t start occurring until after the terrorist attacks of September 11, 2001 and then Hurricane Katrina four years later.Evacuation 1

Even today, planning and cooperation is sporadic at best. Lessons have been learned, but primarily the hard way – through mistakes caused by the lack of preparedness.

Apparently, many in the emergency preparedness community are slow learners. This has been made painfully obvious by Judge Jesse M. Furman, United States District Judge for the Southern District of New York. As I recently reported, advocates of the disabled successfully argued before Furman that New York City’s emergency planners violated the Americans with Disabilities Act (ADA) by failing to plan for and accommodate the needs of the city’s vulnerable populations during Tropical Strom Irene.

The failure amounted to “benign neglect” according to Furman. While some may consider the decision another case of federal overreach in local affairs, the millions of Americans who are disabled will no longer be ignored by emergency planners. Indeed, regardless of one’s political philosophy, one would hope that any and all emergency planners would carefully consider vulnerable populations as they plan for disasters that will impact their communities. First, because it is the humane and responsible course of action, but also because experience teaches that the needs of vulnerable populations prior to, during and following a disaster are extensive and real. The community healthcare structure will be impacted by meeting the needs of the disabled. The only question is whether the response will be proactive or, as is most common, reactive.

Case Background
The case was brought against the City of New York and then-Mayor Michael R. Bloomberg by the Brooklyn Center for Independence of the Disabled, the Center for Independence of the Disabled, New York, and two individuals. Prior to trial, Furman certified the lawsuit as a class action lawsuit on behalf of all disabled people – as defined by the ADA – in New York City.

The plaintiffs argued that the city failed to adequately address the needs of people with disabilities in its planning for and response to emergencies. Essentially, the judge concurred, though he did acknowledge that New York City in many ways has a robust emergency preparedness program. Yet, Furman did conclude “…that the City has violated the ADA … by failing to provide people with disabilities meaningful access to its emergency preparedness program in several ways.” He listed six specific areas in which the city failed to comply with the ADA in emergency planning and response. Those include:

(1) “The City’s evacuation plans do not accommodate the needs of people with disabilities with respect to high-rise evacuation and accessible transportation;
(2) “its shelter plans do not require that the shelter system be sufficiently accessible, either architecturally or programmatically, to accommodate people with disabilities in an emergency;
(3) “the City has no plan for canvassing or for otherwise ensuring that people with disabilities — who may, because of their disability, be unable to leave their building after a disaster — are able to access the services provided by the City after an emergency;
(4) “the City’s plans to distribute resources in the aftermath of a disaster do not provide for accessible communications at the facilities where resources are distributed;
(5) “the City’s outreach and education program fails in several respects to provide people with disabilities the same opportunity as others to develop a personal emergency plan; and
(6) “the City lacks sufficient plans to provide people with disabilities information about the existence and location of accessible services in an emergency.”

Ruling Rooted in a Maxim of Disaster Management
Judge Furman, early in the text of his ruling, states clearly what all emergency planners hold as a maxim of disaster management. Said the judge, “The task of planning for, and responding to, emergencies and disasters is one of the most important, and challenging, tasks any government faces. Emergencies can take many forms — from power outages, to hurricanes, to terrorist attacks — and a government, particularly a local government, must be prepared for them to strike at almost any moment.” In short, as all experienced emergency planners know, “All disasters begin and end locally.”

Concept of ‘Benign Neglect’
Furman did acknowledge “Notably, there is no evidence that these failures are a result of intentional discrimination by the City against people with disabilities.” He added, though, “But, the ADA … seek(s) to prevent not only intentional discrimination against people with disabilities, but also – indeed, primarily – discrimination that results from ‘benign neglect.’” As a result, concluded Furman, the ADA requires “affirmative accommodations to ensure that facially neutral rules do not in practice discriminate against individuals with disabilities.”

Unique Remedy
Perhaps in part because of the lack of intentional discrimination, and because Furman, by his own admission is not expert in emergency management and preparedness, issued a unique remedy. He left it to the plaintiffs and defendants to develop a solution. He explained, “Given the complexity and potential expense involved, there is no question that crafting an appropriate remedy would be better accomplished by those with expertise in such matters and through negotiation, whether court-supervised or otherwise, than by Court order.” So, he ordered, “The parties are therefore directed to meet and confer – in person and with representatives of the Department of Justice, if the elect to participate – about the most productive means of resolving the question of remedies through alternative dispute mechanisms.”

However, Furman added, “…the Court will impose remedies if the parties cannot agree on them…”

Local Implications
This case is 119 pages long. The evidence presented in trial seems to support Furman’s decision. Of course, others may disagree and it may be some time before a final resolution to this case is determined. I strongly encourage emergency planners to take the time to read it. Because Furman’s ruling applies only to New York City, it would be tempting for emergency planners across the nation to pay scant attention to it. That would be a mistake. Furman’s ruling could well become the law of the land. However, one thing is certain now – most communities are probably no better prepared to meet the needs of the disabled in a disaster than is New York City.

That is my experience in West Virginia, which with an aging and relatively unhealthy population, has a high number of vulnerable people. This may be mitigated some by the rugged individualism that is characteristic of the people of Appalachia; still, when disaster strikes, the topography and geography of the mountains isolate the people from one another – and emergency responders – during a disaster.

As a member of a two-county Local Emergency Planning Committee, where I first learned of this case thanks to Mr. James Farrell, I began asking members what we were doing to define, identify and make contact with disabled people. I asked not to accuse local emergency planners of not doing their job, but because hospitals are required by its accrediting agency – The Joint Commission – to make provisions for vulnerable populations in its emergency plans. I wanted to gather information to determine what gaps and vulnerabilities we might have, as a hospital, to meet the needs of the disabled. What I learned instead was that not only does our hospital have its works cut out for it in preparing to meet the needs of the disabled, our entire community does. Then, as I traveled the state, and called upon my colleagues in other states, I discovered that local communities are doing very little, if anything, to plan and prepare for the needs of the disabled in a disaster.

There is no excuse for this. We have simply grown complacent.

ADA Definitions
The ADA defines a person as disabled if he or she has a physical or mental impairment that substantially limits one or more major life activities, or has a record of such impairment, or is regarded as having such an impairment. A physical impairment is defined by the ADA as “any physiological disorder or condition, cosmetic disfigurement, or anatomical loss affecting one or more of the following body systems: neurological, musculoskeletal, special sense organs, respiratory (including speech organs), cardiovascular, reproductive, digestive, genitourinary, hemic and lymphatic, skin, and endocrine.”

Needless to say, that is a rather comprehensive list. In fact, in New York City, it constitutes roughly 900,000 people. Here, in central West Virginia, as many as one in four people may fit that definition. But we don’t know where they are. Even in our little town of Weston, with just roughly 5,000 souls, we don’t know who in one of the low-income high rises needs oxygen or mobility assistance. We don’t know who will need medicines if they are isolated from pharmacies for days. We don’t know who will need assistance eating or drinking, or access to dialysis. In short, we don’t even know what we don’t know.

Again, while I find that disturbing and am confident we have folks here willing to honor their obligation to the most vulnerable among us, I am also fearful that we just aren’t taking it seriously. As of this writing, it has been roughly three months since I first suggested a questionnaire be sent to local authorities and agencies who deal with vulnerable populations to see if there are ways we can identify and locate them should they need and desire assistance when disaster strikes. Of the dozens it was sent to, only a handful of folks have responded.

So, many of those charged with caring for people in disasters may not want to tackle the shortcomings identified by Judge Furman in his ruling. However, most of those who are disabled or considered vulnerable almost certainly want and expect help during a disaster. Otherwise, folks would not have made a federal case out of it.

We can only hope that the parties on both sides of this case reach a remedy that will benefit not only the people of New York City, but disabled Americans everywhere. We must hope that. Otherwise, a judge who knows nothing about disaster preparedness and management will impose a remedy. That may be less than desirable, but it is more than doing nothing.

That is our choice as emergency planners. We all know disasters begin and end locally. We know that all those within our jurisdictions are our responsibility. Certainly, we don’t need a judge to tell us that. Or do we?

© Michael Barrick / Barrick Report, 2014.

Does Your Community Neglect Vulnerable Populations?

Ruling by federal judge forcing emergency managers to consider the question

By Michael M. Barrick

Note: This is the first installment in a series of articles regarding emergency management and vulnerable populations.

Are emergency managers in your community doing all they can to care for the most vulnerable among us? If not, then they are guilty of “benign neglect” according to U.S. Judge Jesse M. Furman of the Federal District Court of Manhattan. Ruling in a case brought by advocates of the disabled following Tropical Storm Irene, the judge concluded last year that New York City failed to meet the needs of its roughly 900,000 vulnerable citizens. According to the judge, the failure to meet the needs of its most vulnerable citizens resulted from poor planning in anticipating and responding to special needs, inadequate public communications, inadequate sheltering plans and locations, and other failures from flawed assumptions. He argued, “… a government, particularly a local government, must be prepared for (disasters) to strike at almost any moment.”

Taken together, this constituted “benign neglect” argued Furman. Though a fresh turn-of-words by the judge, the concept is not a new phenomenon. Lawmakers are reluctant – or ill-equipped – to enact laws that would mitigate the threat of natural disasters. For instance, following Hurricane Katrina and other hurricanes from the 2005 season, the U.S. Department of Transportation (DOT) concluded that two of the primary causes of poor evacuation decision-making and implementation were poor communication among principle stakeholders and the inability to meet the needs of vulnerable populations. Also cited were poor planning, inadequate response and rescue operations, and poor sheltering plans.

Nearly a decade later, it would seem little has been learned. Instead, inertia seemed to be the primary response to these findings. According to Judge Furman, the primary impediments to effective evacuation identified by the DOT remain. Why so? While one would hope that Judge Furman’s discoveries about New York City’s shortcomings in meeting the healthcare needs of its most vulnerable citizens is unique to those who brought suit, experience reveals otherwise. The conditions in New York are pervasive in urban and rural areas alike. As Furman noted, “The task of planning for, and responding to, emergencies and other disasters is one of the most important, and challenging, tasks any government faces.” Too often, those responsible for the health and safety of the public fail to understand the full scope of their jobs, in particular professional collaboration. The public has been neglected because those charged with guarding lives have neglected their most basic and sacred duties – to know what is required of them and do it. While there are many reasons for this, it adds up to benign neglect.

Furman concluded, “…the city’s plans are inadequate to ensure that people with disabilities are able to evacuate before or during an emergency; they fail to provide sufficiently accessible shelters; and they do not sufficiently inform people with disabilities of the availability and location of accessible emergency services.” Yet, Furman acknowledged, “… ultimately, there are limits to what the government can do on its own: Not only must a local government be prepared, but its residents must also prepare themselves.”

Nevertheless, Furman has ordered community planners to not only educate the public, but also to include vulnerable citizens, their allies and advocates in emergency planning. “One way in which emergency planners can help ensure that the needs of people with disabilities are incorporated sufficiently into emergency plans is to include people with special needs in the planning process,” argued Furman. He said also, “Planners must compensate for their increased vulnerability by addressing, specifically, the needs of people with disabilities during the planning process” and, “Emergency planners must plan ahead to effectively provide services and communities with people with disabilities before, during, and after an emergency.” Failure to do so has dire consequences, he asserted. “Indeed, the National Council on Disability … has opined that the failure to address the specific vulnerabilities of people with disabilities in emergency planning ‘often leads to increased injury and death rates among this segment of the populations during disasters.’”

So clearly, emergency managers do not have the luxury of assuming that residents will prepare themselves; in fact, argued Judge Furman, one cannot assume that residents even know how to prepare themselves. The question that remains to be answered, then, is, “Will residents, once educated, prepare themselves?” One hopes the answer is yes, but based on history must infer that the true answer is no. Any other conclusion can be tragic.

The uncomfortable reality is that benign neglect exists. Most onerous, it is, by definition, the failure of policy makers and emergency management experts to do what is required of them. They have failed to protect and care for the public’s health. Indifference and ignorance by policy makers, resignation by planners and managers in the face of regulatory and bureaucratic obstacles, and a body politic largely indifferent to the concept of emergency preparedness are all root causes of benign neglect.

Its existence is undeniable; its persistence disturbing. Its elimination, essential.

© Michael M. Barrick / The Barrick Report, 2014.

The Alphabet Soup of Hospital Disaster Exercise Design

Numerous oversight agencies force a comprehensive list of capabilities and objectives

By Michael M. Barrick

When a hospital participates in a community-wide exercise, one of its first tasks is to explain to its community partners the vast scope of capabilities and objectives a hospital must assess in order to satisfy the numerous agencies which have oversight responsibilities of hospital disaster preparedness.

Emergency checklistNot only are hospitals required by The Joint Commission (TJC) to have multiple drills annually, a reality that requires a great deal (but necessary) work by the hospital and community, they also must design disaster exercises that satisfy requirements of the U.S. Department of Health and Human Services (DHHS) and the U.S. Department of Homeland Security (DHS). Finally, the objectives of participating agencies must also be incorporated into the exercise. In fact, it is often the hospital’s exercise plan which must be subordinate to the overall community or regional plan. However, that does not mean the hospital does not need to write its own plan. Indeed, even though exercise partners might not first understand why the hospital writes its own exercise plan, once the partners see the various objectives and capabilities that a hospital must assess, they will understand.

Specifically, a hospital needs to incorporate the following standards or guidelines into a disaster exercise:
• TJC Emergency Management Standards and Elements of Performance
• Core Capabilities as identified in the Hospital Preparedness Program (HPP) of the Office of the Assistant Secretary for Preparedness and Response (ASPR) of the U.S. Department of Health and Human Services (DHHS)
• The NIMS Healthcare Implementation Objectives for Healthcare Organizations of the DHS
• Assessment of the exercise will be conducted according to the DHS Homeland Security Exercise Evaluation Program (HSEEP)

Of course, virtually any exercise will have objectives to assess effective implementation of the hospital’s Emergency Operations Plan (EOP). Because the EOP should include sections on crisis communications, as well as resources and assets, safety and security, staff management, patient management and utility management, implementation of the EOP should lead not only to internal responses, but communication and collaboration with community partners also.

For instance, a regional drill dealing with a water crisis could reasonably contain the objectives outlined below. While at first glance this may seem to be too many objectives to measure, the truth is that they simply account for actions which will likely be taken. And, the objectives could conceivably be boiled down to shorter expected actions or outcomes. Finally, it is important to list all possible objectives so that leadership, partners, and anyone else reading an exercise document can understand the complexity of a disaster situation. In any event, here is a list of objectives from an actual exercise.

EM.02.02.01: As part of its Emergency Operations Plan, the hospital prepares for how it will communicate during emergencies.

Elements of Performance (EP)
• EP 1: Staff notification of EOP activation
• EP 2: Staff notification of instructions and activities
• EP 3: Notification of external authorities
• EP 4: Communication with external authorities
• EP 5: Communications with patients and families
• EP 6: Communications with media
• EP 7: Communicate with providers of essential services

EM.02.02.03: As part of its Emergency Operations Plan, the hospital prepares for how it will manage resources and assets during emergencies.
Elements of Performance (EP)
• EP 3: Obtaining and replenishing non-medical supplies
• EP 6: Monitor quantities of resources and assets

EM.02.02.05: As part of its Emergency Operations Plan, the hospital prepares for how it will manage security and safety during an emergency.
Elements of Performance (EP)
• EP 7: Controlling entrance into and out of the facility

EM.02.02.07: As part of its Emergency Operations Plan, the hospital prepares for how it will manage staff during an emergency.
Elements of Performance (EP)
• EP 5: Managing staff support needs

EM.02.02.09: As part of its Emergency Operations Plan, the hospital prepares for how it will manage utilities during an emergency.
Elements of Performance (EP)
• EP 3: The hospital identifies alternative means of providing water needed for consumption and essential services
• EP 4: The hospital identifies alternative means of providing water needed for equipment and sanitary purposes
• EP 7: The hospital identifies systems that are essential, such as for heating and cooling, and steam for sterilization

EM.02.02.11: As part of its Emergency Operations Plan, the hospital prepares for how it will manage patients during an emergency.
Elements of Performance (EP)
• EP 4: The hospital plans for managing a potential increase in services for vulnerable populations
• EP 5: The hospital manages the personal hygiene and sanitation needs of its patients
• EP 7: The hospital identifies systems that are essential, such as for heating and cooling, and steam for sterilization

EM.03.01.03: The hospital evaluates the effectiveness of its Emergency Operations Plan.
Elements of Performance (EP)
• EP 7: Monitor the effectiveness of communication
• EP 8: Monitor resource allocation
• EP 9: Monitor management of safety and security
• EP 10: Monitor management of staff roles
• EP 11: Monitor management of utility systems
• EP 12: Monitor management of patient clinical and support activities
• EP 14: Document opportunities for improvement
• EP 16: Implement plans for improvement

Adoption (1) – “Adopt NIMS throughout the healthcare organization to include appropriate departments and business units.”
Preparedness: Planning (4) – “Participate in interagency mutual aid and/or assistance agreements, to include agreements with public and private sector and nongovernmental organizations.”
Preparedness: Training and Exercises (7) – “Promote and integrate, as appropriate, NIMS concepts and principles (i.e., the Incident Command System) into all healthcare organization-related training and exercises.”
Communications and Information Management (8) – “Promote and ensure that hospital processes, equipment, communication, and data interoperability facilitates the collection and distribution of consistent and accurate information with local and state partners during an incident or event.”
Command and Management (10) – “Manage all emergency incidents, exercises, and preplanned (recurring/special) events with consistent application of ICS organizational structures, doctrine, processes, and procedures.”
Command and Management (11) – “Adopt the principle of Public Information, facilitated by the use of the Joint Information System (JIS) and Joint Information Center (JIC) ensuring that Public Information procedures and processes gather, verify, coordinate, and disseminate information during an incident or event.”

1. Healthcare System Preparedness
2. Healthcare System Recovery
3. Emergency Operations Coordination

Capability 1: Healthcare System Preparedness
Function 2: Coordinate healthcare planning to prepare the healthcare system for a disaster
Coordinate with emergency management to develop local and state emergency operations plans that address the concerns and unique needs of healthcare organizations. Plans should encompass the ability to deliver essential healthcare services during a response.
• Task 2: Engage healthcare partners to coordinate healthcare planning efforts with local and state emergency operations planning to integrate healthcare organization priorities and unique needs into response and recovery operations.

Function 3: Identify and prioritize essential healthcare assets and services
Identify and prioritize healthcare assets and essential services within a healthcare delivery area or region (Healthcare Coalition area). Coordinate planning to protect and enhance priority healthcare assets and essential services in order to ensure continued healthcare delivery to the community during a disaster.
• Task 1: Identify and prioritize the essential healthcare assets and services of the community.
• Task 2: Coordinate planning and preventative measures to assist with the protection of prioritized healthcare assets and essential services.
Function 4: Determine gaps in the healthcare preparedness and identify resources for mitigation of these gaps
Perform resource assessments and develop plans to assist healthcare organizations address gaps associated with planning, training, staffing, and equipping that improve resource availability during response and recovery.
• Task 1: Perform a resource assessment by analyzing healthcare organization needs and evaluating exercises, training, and actual incidents or events to determine gaps and corrective action.

Function 6: Improve healthcare response capabilities through coordinated exercise and evaluation
Coordinate an exercise, evaluation, and corrective action program to continuously improve healthcare preparedness, response, and recovery. Exercises should assess and validate the effectiveness and efficiency of capabilities and the adequacy of policies, plans, procedures, and protocols.
• Task 1: Coordinate and implement capability based exercises that test disaster planning efforts.
• Task 2: Utilize a coordinated evaluation method to evaluate exercises and actual incident responses.
• Task 3: Address findings from gap analysis and subsequent corrective actions to revise planning, training, and exercises to minimize response gaps.

Capability 2: Healthcare System Recovery
Function 1: Develop recovery processes for the healthcare delivery system
Identify healthcare organization recovery needs and develop priority recovery processes to support a return to normalcy of operations or a new standard of normalcy for the provision of healthcare delivery to the community.
Task 1: Assess the impact of an incident on the healthcare systems ability to deliver essential services to the community and prioritize healthcare recovery needs.

Capability 3: Emergency Operations Coordination
Function 2: Assess and notify stakeholders of healthcare delivery status
Assess the incident’s impact on healthcare delivery in order to determine immediate healthcare organization resource needs and the status of healthcare delivery during an incident response.
• Task 1: During an incident, implement information sharing processes that supports ongoing communication to inform local incident management of the operational status and resource needs of healthcare organizations.
• Task 2: During an incident, implement information sharing processes that supports ongoing communication to inform healthcare organizations about the status of the incident and of healthcare delivery in the community.
• Task 3: During an incident, implement coordinated information sharing processes that provide relevant and timely healthcare messages to the community and other stakeholders through a Joint Information System (JIS).

Function 3: Support healthcare response efforts through coordination of resources
Coordinate resource allocation for healthcare organizations by assisting incident management with decisions regarding resource availability and needs.
• Task 1: Implement processes that assists local and state incident management to identify resource gaps and allocate available resources for healthcare organizations when requested during a response.

Undeniably, this is much to evaluate in any exercise. Nevertheless, if a hospital is going to deal with a water shortage, all of these elements will, at some point, come in to play. Yes, regulations require that these elements be measured; more importantly, it’s the right thing to do. Until all of the objectives are truly identified, the hospital won’t know its breaking point. Better to learn it in an exercise than during the real deal.

© Michael M. Barrick, 2014


Get every new post delivered to your Inbox.