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

Michael Chertoff: Poor Disaster Response Erodes Faith in Government

By Michael M. Barrick

CHAPEL HILL, N.C. – Poor disaster response erodes citizens’ faith in all of government, former U.S. Department of Homeland Security (DHS) Secretary Michael Chertoff said in a commencement address on May 17. Mr. Chertoff, who led DHS from 2005 – 2009 for President George W. Bush, made his remarks to the 20th graduating class of the Community Preparedness and Disaster Management certificate program of the University of North Carolina.

Mr. Chertoff also alluded to gaps in leadership, poor crisis communications and a lack of cooperation across agencies and disciplines as other core challenges facing those working in emergency and disaster management.

His remarks were delivered to those who are charged with overcoming those and other challenges. In addition to the graduates, several alumni were also present. Graduates and alumni represented numerous professions, including emergency management, fire service, law enforcement, emergency medical services, public health, hospitals, the military, the private sector, FEMA, volunteers, veterinarians and others.

Mr. Chertoff referred to Hurricane Katrina and more recent disasters such as the ship capsize in South Korea and the coal mine disaster in Turkey as examples of disasters that were made worse by poor response. He pointed out that when government doesn’t effectively meet one of its most basic functions – disaster preparedness and response – then people simply fail to trust government. That leads public reluctance to heed official warnings, and can also lead to safety and security problems due to the breakdown of order.

The United States is unique in its response because there is no chain of command for disaster response such as that which guides the military, Mr. Chertoff noted. As an example, he said, “The president can’t tell a governor what to do. In many instances, the governor can’t tell local responders what to do.” So, he continued, “That makes crisis communications all that more important.” Such communications don’t occur in a void, though, he noted. They are rooted in strong relationships among professionals, built upon cooperation and collaboration. It is also dependent upon people equipped and empowered to make decisions. “You must be decisive. You may make a mistake, but you are in a field that demands decisive leadership.”

With a nod to the mantra of the CPDM program, Mr. Chertoff added, “All disasters begin and end locally.” Consequently, he noted, the graduates are equipped to begin their careers in emergency management so long as they don’t lose sight of the key leadership roles they play in each of their communities.

About Mr. Chertoff
In addition to serving as DHS Secretary, Mr. Chertoff served as a Federal Judge on the U.S. Court of Appeals for the Third Circuit from 2003 – 2005 and Assistant Attorney General of the United States, Criminal Division from 2001 – 2003. Before that, he served as a federal prosecutor, investigating and prosecuting organized crime. Since leaving government service, Mr. Chertoff has co-founded The Chertoff Group, which specializes in risk identification, crisis management and strategic counsel on global security solutions.

About the UNC CPDM program
The CPDM graduate certificate program is the University of North Carolina’s comprehensive online disaster management program located in the Gillings School of Global Public Health. Developed in 2004 by one of the top departments of Health Policy and Management in the country, the CPDM certificate program has admitted over 350 students and has received high praise from professionals in the field.

UNCI am one of those graduates fortunate enough to be asked to speak to the benefits of the program at the commencement. I was privileged to share that, as a graduate of the program, “You are equipped to act in a crisis, even if it’s your first day on the job; you can build a coalition that is wide in scope, even if you are new to the community and not vested with official authority; and, you can lead efforts in your community to identify vulnerable citizens that will end up in our hospital anyway if we don’t prepare for their needs in a crisis.”

All of those have happened to me, just in the past 10 months at the hospital where I work in West Virginia.

I emphasized then – and now – that it is because of the UNC CPDM program that our hospital is able to lead healthcare system disaster response in our community, region and state. My own professional growth has accelerated because of the program. Of course, the program undeniably provided excellent instruction and practical use of basic emergency management processes, such as developing an HVA, writing an EOP, utilize HICS, and setting up a command center. But it offered something more – more vital perhaps. That is, confidence in a crisis, awareness of valuable community partners, and the knowledge to identify root causes to community risks.

© Michael Barrick / The Barrick Report, 2014. Contact him at

The New Reality: Hospitals Must Pay More for Disaster Preparedness

Disaster response is a cost of doing business

By Michael M. Barrick

The new reality about disaster response for hospitals is this: If you are going to be in business to care for the sick and injured– whether one at a time or in a mass casualty incident – get ready to pay for it. That’s the message as hospitals learn that federal grant funding for disaster preparedness is being reduced. The lack of terrorist attacks on the homeland and changing priorities in Congress has caused the grant money to slow to a trickle.

MoneyThis is causing hand-ringing in some hospitals. It shouldn’t. This news isn’t surprising. It is a discussion that has been going on for years in emergency management circles. In short, it should not be a surprise to hospitals that incurring the costs of patients – whether they come in one at a time or in groups – rests with the hospitals. So be it; disaster response is now a cost of doing business.

The timing couldn’t be better. Deregulation is the mantra of hospital leaders across the nation. Those of us in hospital leadership positions now have an opportunity to demonstrate that we can do the right thing without micromanagement from the government. We know the right thing to do. We’ve been trained. We’ve adopted NIMS and HICS. We’ve exercised. We’ve worked with more and more partners. We’ve learned about and drilled the NDMS and SNS. We continue to improve. So, this reduction in grant funding for disaster preparedness is a critical moment. Improvement will continue only with continued funding. Dithering over the matter is not an option. Grant money may dry up; disasters, however, will keep on happening.

The cost of caring for those injured in disasters is shifting more and more to hospitals. Whether one thinks that’s right or wrong, it is the new reality. The hospitals that budget for it now will be ready in the future. Let’s all hope we live in a community with hospital leaders that understand this new reality.

© Michael Barrick / Barrick Report, 2014.

More than Water Tainted by Elk River Spill

Mistrust in Government is the Long-Term Consequence

By Michael M. Barrick

CHARLESTON, W.Va. – A full month after the Elk River in West Virginia was contaminated by the coal-mining cleaning chemical 4-methylcyclohexane methanol, nobody in authority is willing or able to answer the most fundamental question – is the water safe?

While we are waiting for that most basic question to be answered, something far more dangerous than a chemical spill has occurred – the public is losing faith in those charged with protecting their lives, health and safety.

While in Charleston recently to discuss this event with lawmakers and emergency management experts, I ran into more than a little frustration. The politicians feel the heat from home. It didn’t hurt that the spill occurred simultaneously with the opening of the legislative session. It has dominated their work from the opening gavel and will until it adjourns. Yes, legislation has and will be passed. Yet, with a state capitol full of delegates and senators beholden to the energy industry, we simply can’t expect much in the way of meaningful action. Unfortunately, for West Virginians, this is our legacy.

For generations, our elected officials have allowed corporate trusts and coal companies to own the state capitol. This is ironic, as it is known for being “the people’s capitol.” Promises by lawmakers that this time those responsible will be held accountable, is a refrain we’ve heard – repeatedly – after every coal mine disaster and gas field explosion. Business, meanwhile, goes on as usual.

So, while we don’t know how safe the water supply is in the Kanawha Valley, we can be sure of this – it is safer than the democracy that is in the hands of those under the gold dome along the Kanawha River.

© Michael Barrick, 2014.

A Failure of Will: A Century of Death in the West Virginia Coal Mines

From Monongah to Upper Big Branch, Profits Trump Safety

By Michael M. Barrick

BRIDGEPORT, W.VA. – Nearly four years after 29 coal miners died at Massey Energy’s Upper Big Branch mine in Raleigh County, W.Va., the Mine Safety Health Administration (MSHA) has reported it has finished implementing the corrective actions designed to make the coal mining industry safer. It is not a new story. It is what we’ve heard after every coal mining disaster. One can only hope that this time, the changes will be lasting and effective.

For the families, it is a painful – unbearable even – reminder of the cost of mining coal in the Mountain State. Adding to the tragedy is the survivors’ knowledge that their fathers, sons, brothers and grandfathers died needlessly, their deaths easily preventable – if only Massey Energy, which owned the mine, had not put profits above lives.

Indeed, that is the blunt conclusion of the Governor’s Independent Investigation Panel (GIIP) that was convened following the underground explosion that took the lives of 29 miners. Among the panel’s findings are:
• The disaster was preventable because basic safety systems failed and/or were disregarded;
• These failure of safety systems was caused by a corporate culture by mine operator Massey Energy that put profits before safety;
• Massey Energy was able to operate with such a corporate culture because its dominant influence in the West Virginia coalfields allowed it to exert inordinate influence on West Virginia political officials responsible for ensuring mine safety; and,
• Those with regulatory oversight at both the state and federal levels failed in their roles as watchdogs.

In short, it is business as usual in the West Virginia coalfields. From the worst mining disaster in U.S. history, when more than 500 men and boys were killed in Monongah, W.Va. in 1907, to the most recent disaster at Upper Big Branch, the words of Mary Harris “Mother” Jones are as appropriate today as when she first spoke them roughly a century ago – “There is never peace in West Virginia because there is never justice.”

The last day of peace for the families of the miners at UBB was April 5, 2010. Just as miners were changing shifts in mid-afternoon at the UBB coal mine in this tiny mining community, an explosion roared through the mine. Instantly, the 29 miners working for Massey Energy were dead, families were devastated and communities of southern West Virginia were forever changed. So, while the government is not literally dropping bombs on coal miners as it did during the Coal War in the southern West Virginia coalfields in the 1920s, and companies may not employ private thugs to prevent union activity, the state is still not at peace. Coal operators have successfully pitted miners and others who benefit from coal mining against those who wish to stop the most egregious abuses, such as the UBB disaster and the death and destruction caused by Mountain Top Removal (MTR). Operators have convinced the public that any call for responsible mining is akin to calling for its abolition. That, of course, is nonsense; yet, profits are at stake, so perverting the truth is just another day at the office for the coal operators.

Our Culpability in Massey’s Failures
Indeed, it is that corporate culture of putting profits before people which led to the disaster. The GIIP report asserted, “Ultimately, 29 miners lost their lives in the Upper Big Branch mine because these safety systems failed in a major way. Massey Energy failed to maintain an adequate ventilation system at Upper Big Branch. The company failed to maintain its equipment. It failed to properly rock dust the mine. If those basic matters of safety are effectively practiced, there is no reason for miners to die as a result of explosions in 21st Century America” (73). Hence, one is rightfully outraged at Massey Energy and those responsible for oversight of them. However, death has been tolerated in the West Virginia coalfields for over a century now. It is tolerated not only by those making a profit from coalmining, but by all of us, unless we are serious about energy conservation and make our voices heard until mine disasters are not headlines, but history. We can – must – each examine our willingness to tolerate disasters. First though, we need to understand that the failure to aggressively pursue mine safety is not only inexcusable, it is as old as the industry. By comparing three mine disaster occurring over more than 100 years apart – Monongah in 1907, Sago in 2006, and UBB in 2010 – we will see that death has been tolerated in the West Virginia coalfields because of a failure of will. Preserving lives has simply not been as important as preserving profits – 100 years ago and still today.

On December 6, 1907, at about 10:30 a.m., two coal mines – connected underground – known as Monongah No. 6 and Monongah No. 8, were destroyed by a series of explosions that killed more than 500 miners. While the official count listed 358 miners and three rescuers dead, the use of subcontractors by miners to increase their production, as well as the number of funerals, have lead historians to conclude that the number of dead likely exceeds 500. Located just south of Fairmont, the mines – owned by the Fairmont Coal Company – rocked the earth, destroyed the mines’ infrastructure, and sent debris flying hundreds of yards above ground as it obliterated above-ground entrances and buildings.

The disaster affected every person in the town, which was built along the banks and hillsides surrounding the West Fork branch of the Monongahela River. Despite its small size and hard living, it was a diverse community, made up of nearby residents but also a vast number of immigrants from Central and Southern Europe. By 1905, Monongah had about 6,000 residents.

Both mines were less than 10 years old and were producing in excess of 12,000 tons of coal a day by the time of explosion. They were also considered state-of-the art. “Mines No. 6 and 8 both employed the most up-to-date, sophisticated ventilation systems.” (McAteer 64). John Nugent, the Immigration Commissioner for the State of West Virginia affirmed an advertisement made by The Consolidated Coal Co., Inc. seeking immigrant help. The mines, the company claimed, were, “Practically free from explosive gases.” (McAteer 74).

Obviously, the advertisements were mistaken or false. Thus, the all-too cozy relationship between operators and those charged with regulating them was formed. As the UBB GIIP reports, that has remained unchanged a century later. While the exact cause of the Monongah explosion was never determined – as much for political as scientific reasons – there was no mistaking that the influence the mining owners enjoyed with local and state politicians ensured that the operators’ interests – profits – always trumped the miners’ interests – a safe working environment. “What has to be said is that the rescue efforts were not successful and the equipment provided to miners to ensure their escape was inadequate” (McAteer 264).

When the explosion occurred, 19 coal cars (each loaded with two tons of coal), being pulled out of the bowels of the mine broke free and crashed 1,300 feet back into the mine portal. The runaway cars broke lose electrical wiring, destroyed structures and ultimately disrupted the ventilation system. “At that instant, from deep within the mine an explosion rumbled, a terrible explosive report rocketing out of both mines, rippling shocks through the earth in every direction. …A second explosion followed immediately, and at the No. 8 mine entrances explosive forces rocketed out of the mine mouth like blasts from a cannon, the forces shredding everything in their path” (McAteer 116).

Blaming the Victims
Even though an exact cause was not immediately known or even determined, it was not long before the miners themselves were made the scapegoats. Fairmont Coal Company President C. W. Watson immediately capitalized on the anti-immigrant feelings of the time, telling the New York Times almost immediately after the disaster that “…he could not account for the ignition of the dust unless it had been through careless use of an open lamp” (McAteer 158).

Conversely, Clarence Hall, a leading expert on mine explosions at the time, was in nearby Pennsylvania when the catastrophe occurred. He stated, “When I enter a mine these days it is with fear and trembling. We seem to know so little of these gas and dust explosions. Sometimes I feel the poor miner has not a ghost of a show for his life when he enters a mine.” (159)

Tragedy upon Tragedy
There were no organized rescue teams in U.S. mines at the time. However, the dangers to the rescuers, along with the reality that the effort was a recovery effort for dead miners allowed for time to organize miners and volunteers. Of course, rescue efforts – such as repairing the ventilation systems in the hopes of removing the deadly gases from the mines – were heroic, if unsuccessful. It soon became apparent to the rescuers and stunned families of the miners gathering on the Monongah hillsides that the force of the blast, the lack of oxygen, and the instability of the mine combined for a horrible reality – virtually all those in the mine had perished. Recovered bodies were a horrid site to behold. Mine explosions “…inflict multiple-system life threatening injuries on many persons simultaneously. When the explosion is of a high order of magnitude, it can produce a defining supersonic, overpressurization shock wave” (131). Injuries include damaged or destroyed lungs, blunt force trauma to the head and body, ruptures of the middle ear and eye, and damage to internal organs. Those that survive those injuries generally die from suffocation as lethal gases are released following the explosion. Rescuers, too, were at great risk. In addition to the instability of the mine and lack of oxygen, rescuers had no personal protective equipment or breathing devices. “Imagine a handful of reckless, bedraggled men going into the cavern with lanterns with sulfurous fumes in their faces dragging out the charred bodies of men, some with their faces burned off. That is what Monongah looked like. …In some instances the bodies were perfectly preserved and recognition was immediate; in other cases, the bodies were so badly disfigured or mutilated, identification was impossible.” (143).

An Unholy Alliance
Motivated by the example of John D. Rockefeller, who in the late 19th Century controlled much of the world’s oil resources, financiers from outside of West Virginia collaborated with well-connected Mountain State elected officials, judges, municipal leaders and state and local law enforcement to extract coal from its mountains, leaving not even the dignity of the coal miners intact. “The fact that the Fairmont companies, led by the Monongah mines, paid lower wages across the board meant that the three mines could sell their coal at a lower rate and thereby capture an increasing share of the markets, threatening the wages and unionization in the other states” (McAteer 101). Indeed, by the turn of the 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.

Meanwhile, the company fought efforts to compensate the surviving family members of the dead miners. This is not surprising, as “In the early 1900s, families of miners who died in a mine accident or disaster had nothing in the way of economic protection and little legal recourse following a mine disaster. This was especially true in West Virginia where the coal interest was entwined with every facet of the state’s political, economic, social and legal systems” (McAteer 212).

Companies also vigorously – and successfully – opposed unionization efforts for decades. “The powerful elite of West Virginia on both Democrat and Republican side of the aisle united in their opposition to union organization efforts, and after seeing the success of the Fairmont Consolidation Company, the southern West Virginia mine operations that wished to build on the success met in secret to decide on some general plan of resistance to union encroachments based on the successful strategy employed at Monongah” (McAteer 113).

So, politicians debated and dithered. Meanwhile, miners continued to die at alarming rates. In fact, “On November 20, 1968, the Farmington Mine, a mine not five miles from the Monongah mine in the same Pittsburgh seam owned by the same company, Consolidation Coal Company, exploded, trapping seventy-eight miners” ( McAteer 262). Though federal legislation followed that disaster – the Federal Coal Mine Safety and Health Act of 1969 – the unholy alliance between coal officials and West Virginia elected leaders continued.

The Monongah mines operated until 1961, when the supply of coal was exhausted. Much progress would be expected over the 55 years since the deadly explosion. Indeed, some was made, but not enough. This was proven four years before UBB, at the Sago Mine on January 2, 2006, when an explosion ripped through the mine in Upshur County near Buckhannon. That disaster claimed 12 lives. All but one of the 12 men had survived the blast, but were trapped and later died of carbon monoxide poisoning.

Hence, pledges from politicians that a disaster like that at UBB won’t be allowed to happen again simply ring hollow. After Sago, then-West Virginia Governor Joe Manchin III (and now the state’s junior U.S. senator) pledged to have West Virginia lead the nation and world in mine safety. An independent investigation was held, laws were passed – and business continued as usual.

Understandably, surviving relatives looked for meaning in the disaster. John Groves, a brother of Jerry Groves, a miner killed at Sago, said, “Even though he’s gone now, he’s going to be helping people, because we’re going to be, through him, working to make sure that a disaster like this never happens again” (Sago GIPP 10). With all due respect to Mr. Groves and his family, it would seem that his brother died in vain. While such a statement may sound harsh and even disrespectful of a fallen miner, it’s not; in fact, the opposite is true. It is only when we acknowledge that these miners have died in vain – have died needlessly because their deaths were preventable – will we quit rationalizing and demand that we do what we are capable of doing – making the industry much safer.

Another Preventable Disaster
While the Sago disaster was not caused by safety violations as blatant as those discovered at UBB, it nevertheless was rooted in the unholy alliance – and just plain mediocrity by enforcement officials. Testimony suggests that the company – International Coal Group – did not do all that was required by law to minimize the dangers presented by lightning strikes. Also, the seals used to isolate the impact of an explosion failed. And, the emergency operations plan/command center was characterized by confusion and inept leadership. Indeed, in an infamous memorable statement, the governor and others reported to waiting family members that all the miners had survived. This was based on poorly executed rescue and communication plans.

The disaster started at about 6:30 a.m., when a methane ignition in a sealed area of the mine caused the explosion, propelling smoke, dust, debris and lethal carbon monoxide into the working sections of the mine. Those who died did so awaiting rescue. While it is true that a lighting strike was recorded within five miles of Sago at the time of the explosion, no definitive cause has been determined. However, what is clear is that several safety precautions – beginning with seals that should have contained the explosion to failed communications systems and equipment – turned the explosion into a disaster.

Just four years later, the scene would be repeated at the UBB mine. Only this time, unlike Monongah and Sago, there was no question as to the cause of the tragedy. At the time of the tragedy, the mine was owned and operated by Performance Coal Company, a subsidiary of Massey Energy. According to the GIPP report, “The explosion was the result of failures of basic safety procedures identified and codified to protect the lives of miners. The company’s ventilation system did not adequately ventilate the mines. As a result, explosive gases were allowed to build up. The company failed to meet federal and state safe principal standards for the application of rock dust. Therefore, coal dust provided the fuel that allowed the explosion to propagate through the mine. Third, water sprays on equipment were not properly maintained and failed to function as they should have. As a result, a small ignition could not be quickly extinguished” (4). In short, Massey’s safety systems failed and both federal and state inspectors “…did not provide adequate and proper oversight” (4).

The Coalmining Culture
The loss of 29 men – despite the promises of the governor and other officials – occurred because the coalmining culture in West Virginia has not changed in a century. It was Massey strategy to “litigate away” inspection violations and purposely mislead inspectors. Additionally, government officials charged with ensuring mine safety ignored documentation, overlooked dangerous situations, failed to force improvements – in short, were mediocre at best and negligent at worst in doing their work.

Massey’s operating principles included political influence peddling without regard for campaign finance laws. “What is factual and well documented is that Massey Energy Chairman and CEO Don Blankenship had a long history of wielding or attempting to wield influence in the state’s seats of government” (UBB GIPP 85). Blankenship spent at least $3 million of his personal fortune to unseat Supreme Court Justice Warren McGraw, trumping up accusations that the judge was “soft” on sex offenders. With another “friend” already on the court, Blankenship had literally purchased justice in West Virginia. He now had few, if any, obstacles to stand in his way of ignoring safety laws and using fraudulent business practices to put competitors out of business.

And, state inspectors knew that UBB was troublesome. Even though the West Virginia Office of Miner’s Safety and Training (WVMHST) is notoriously understaffed, inspectors considered conditions at UBB so perilous that inspectors were on site at the mine for about 85 days in the year preceding the disaster, and had issued 330 violations totaling nearly $155,000 in penalties.

Inspectors can only do so much, though. “The state’s failure at Upper Big Branch does not stop with safety issues inside the mine. The inability to protect the lives of miners is also a political failure – a failure by the state’s government to nurture and support strict safety standards for coal miners. If miners’ lives are to be safeguarded, the cozy relationship between high-ranking government officials and the coal industry must change, as must the relationship between the enforcement agency and the industry it regulates” (UBB GIIP 89).
Indeed, “…Massey is equally well known for causing incalculable damage to mountains, streams, and air in the coalfields; creating health risks for coalfield residents by polluting streams, injecting slurry into the ground and failing to control coal waste dams and dust emissions from processing plants; using vast amounts of money to influence the political system; and, battling government regulation regarding safety in the coal mines and environmental safeguards for communities” (92). Indeed, for the first decade of this century, Massey had the distinction of having the worst mine safety record in the United States. The 29 killed at UBB brought the company’s total deaths to 54 for the decade.

Even at the time of the disaster, Massey employees seemed to delay in their response. Though the explosion occurred just after 3 p.m., the first call for an ambulance was not made until nearly 4:30. Initially, the mine dispatcher called company officials, who in turn activated their own rescue teams and notified state and federal officials. It was not until the early morning hours of Tuesday, April 13 that all of the miners’ bodies had been recovered.

Blaming it on God
Nobody speaks to the corporate culture which allowed this preventable disaster to occur better than Blankenship. Holding to the theory put forth by Massey that high levels of methane or natural gas just suddenly burst in through the mine’s floor (despite evidence to the contrary), he coldly said to the National Press Club on July 22, 2010 – less than three months following the accident, “The politicians will tell you we’re going to do something so this never happens again. You won’t hear me say that. Because I believe that the physics of natural law and God trump whatever man tries to do. Whether you get earthquakes underground, whether you get broken floors, whether you get gas inundations, whether you get roof falls, oftentimes they are unavoidable, just as other accidents in society” (UBB GIIP 70). Yet, 94 years previously, Coal Age magazine asserted, “The next time you are about to say, ‘Accidents will happen,’ stop and think first; then you won’t say it. Only weaklings and incompetents evade responsibilities in this age of industrial safety and efficiency” (UBB GIPP 74).

Conclusion – ‘A Completely Predictable Result’
A little more than a year after the UBB disaster, Massey Energy was sold to coal giant Alpha Natural Resources. Massey no longer exists, at least by that name. However, the inclusion of former Massey COO Chris Adkins in the new company – responsible for of all things, safety – calls into question if the corporate culture that drove Massey to put profits before people has changed with the sale. Blankenship retired, unapologetic and landing softly under his multi-million dollar golden parachute.

While he enjoys retirement, the families of 29 men continue to suffer the consequences of the deaths of their loved ones. Their experience will last a lifetime; the millions they are receiving for their deceased family members is an insult as much as compensation. Hence, Blankenship’s comments that the disaster was God’s fault is insulting not only to the families, but to God. As the GIIP report concluded, “…we can mine coal safely. Disasters are not an inevitable part of the mining cycle. There are not preordained numbers of miners who have to perish to produce the nation’s energy. While we are all in God’s hands, the safety and health of our miners is also in the hands of the mining community” (UBB GIPP 107)

Ultimately, the GIIP issued 11 findings and 52 recommendations to implement them. To a large extent, it is like a recurring nightmare. After each disaster, findings and recommendations are issued. Then, a year or few later, another report is issued in response to yet another disaster. As important at the multiple findings and recommendations are, the first two findings – if not addressed – will lead to more deaths. The first finding is that the disaster was man-made and preventable; the second finding states that the explosion occurred because of the failure of basic safety practices. “The April 5, 2010 explosion was not something that happened out of the blue, an event that could not have been anticipated or prevented. It was, to the contrary, a completely predictable result for a company that ignored basic safety standards and put too much faith in its own mythology.” (108)

Anticipating that their findings may be ignored, the GIIP – led by J. Davit McAteer, who has devoted his life to improving coal mining safety – placed the solution squarely where it belongs. “Our recommendations are of no value unless adopted by industry and governments for it is only then that miners will have a better chance to return home safe and sound to their families each day….we as a nation and the mining industry have shown that we know how to mine safely. We are obliged to do that.” (3)

Hence, the challenge is to develop mitigation efforts that allow for reasonable compromise. While honoring the work of the coal miner, we must also identify people and companies responsible for devastating the land of West Virginia without regard for human dignity and the care of creation, and oppose their willingness to accept compromises in safety. We must be relentless in educating ourselves about this issue; and, we must demonstrate our commitment by limiting our consumerism and energy use.

© Michael Barrick, 2014.

Works Cited
David McAteer, Monongah: The Tragic Story of the 1907 Monongah Mine Disaster (Morgantown, W.Va: West Virginia University Press, 2007).
Upper Big Branch: The April 5, 2010 explosion: a failure of basic coal mine safety practices (Shepherdstown, W.Va: Governor’s Independent Investigation Panel, May 2011).
The Sago Mine Disaster: A preliminary report to Governor Joe Manchin III (Buckhannon, W.Va: Governor’s Independent Investigation Panel, July 2006).

Elk River Spill Preventable

Elected state officials must acknowledge and address core challenges

By Michael M. Barrick

BRIDGEPORT, W.Va. – The contamination of the Elk River in West Virginia by the coal-mining cleaning chemical 4-methylcyclohexane methanol was preventable. It is true that much analysis remains to be done, so an official report is at least months away. Yet, there is already overwhelming evidence that numerous opportunities were missed to prevent this event from happening. The official report – known as an After Action Report (AAR) – will identify clear causes and offer corrective actions. However, those recommendations will be meaningless unless and until the root causes which created the environment that allowed the incident to occur are addressed.

These root causes include inadequate mitigation efforts, lack of coalition building and communications, and bureaucratic gaps and overlaps. These constitute core challenges to emergency response efforts in West Virginia. Consequently, these must be addressed by the governor and legislature before the people of West Virginia can be confident that no stone is going unturned in identifying and preparing for any and all risks that threaten their life and safety.

Presently, that is simply not the case. True, there are scores of dedicated and competent individuals working within the various agencies and organizations that are responsible for responding to emergencies and disasters in West Virginia. That is all the more reason that these core challenges must be addressed. It is simply irresponsible and unacceptable that policy-makers fail to do all they can to equip and protect those charged with being the first at a disaster scene, not to mention the public they serve.

The first core challenge is the lack of mitigation activities. Mitigation – the first of four phases of emergency management – can do the most to reduce mortality and morbidity, because it will prevent the disaster in the first place. Yet, it is the most ignored stage of emergency planning due to political inertia, cost, the complexity of mitigation plans, and the public’s unwillingness to participate in or pay for mitigation. West Virginians have experienced firsthand, for too long, the consequences of ignoring mitigation efforts. The Sago and Upper Big Branch coal mine disasters are clear examples of this. Finally, natural gas fracking presents potential threats that we are yet to understand. Indeed, a gas company executive confided to me, “We have invented technology beyond our understanding of its impact.” While we all welcome the economic benefits that West Virginia derives from the energy industry, we should also demand that we thoroughly understand – and then mitigate – any dangers that fracking may present. We have not done that yet.

The second core challenge is a lack of coalition building and communications among and between emergency response agencies. Throughout West Virginia, Local Emergency Planning Committees (LEPCs) vary greatly in their readiness for community disasters. Some are well-run; others, such as in Barbour County, have been inactive for years. Also, statewide communication systems are inconsistent, inadequate and rarely interoperable.

The third core challenge is the startling gaps and overlaps in key emergency management sectors. Hospital regions, emergency management regions and public health regions all encompass different counties. In short, an emergency manager wanting to establish strong coalitions with colleagues will find such efforts unnecessarily burdensome. For instance, an emergency manager in Lewis County will find himself or herself working with colleagues in 10 counties in the West Virginia Homeland Security region. The Public Health region serving the county also includes 10 counties, but four of them are different than the Homeland Security region. Finally, the West Virginia hospital region in which Lewis County is located includes 14 counties, seven of which are not in the Homeland Security region. So, all told, the emergency manager based in Lewis County must be intimately familiar with colleagues in at least 17 counties. From a planning perspective, this is a nightmare.

So, this preventable event demands not only close scrutiny by lawmakers, but quick, clear and decisive action. The following steps would go a long way towards achieving such action. First, the governor and legislative leaders must demand that the AAR is comprehensive and transparent, and its corrective actions implemented without hesitation or fail. Any fines that can be imposed should be; and, higher fees for licensing and violations must be established. Stronger laws must be passed. Emergency response regions must be aligned to eliminate the gaps and overlaps. Penalties – such as eliminating grants – must be implemented for LEPCs that are not functioning as designed.

Those are short-term solutions that are relatively easy to implement if lawmakers have the will to do so. Still, heavy lifting remains. Policy makers must make mitigation a priority. Only when we do so will we stop the knee-jerk response and recovery operations. Additionally, the legislature should reward best practices and develop measures for effective coalition building and collaboration.

There are those who will say that these criticisms are unduly harsh and the solutions are impractical. However, there are roughly 300,000 Mountaineers in southern West Virginia who would vehemently disagree. I count myself among them. Let’s hope our state’s political leaders do as well.

© Michael Barrick, 2014.


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