Hazard Vulnerability Assessment TUOLUMNE COUNTY HEALTH CARE SAFETY

Hazard Vulnerability Assessment TUOLUMNE COUNTY HEALTH CARE & SAFETY COALITION NOVEMBER 8, 2018

Purpose �To identify the potential hazards vulnerabilities & risks �that relate to Tuolumne County’s public health EMS/Healthcare & behavioral/mental health systems �including human impact interruption of services & impact to infrastructure of these systems

Purpose (cont. ) �The assessment of risk is a process that determines the likelihood of adverse health effects in a population following exposure to a specified hazard �The results of the risk assessment can be used to: identify gaps in planning & capabilities develop priorities based on hazards that are most likely to occur & have the highest impact on public health

Purpose (cont. ) �Using the h. HAP (Health Hazard Assessment & Prioritization) tool, a risk score is developed for each identified hazard �Each risk score is independent of all other hazards �Risk score is defined as Risk Score = Probability x Severity x (System Impact – Mitigation)

h. HAP Tool �There a total of 7 risk components broken down into 4 categories Probability � Probability Severity � Hazard of Hazard Occurrence Severity Health System Impact � Hazard Impact on Public Health System � Hazard Impact on EMS/Healthcare System � Hazard Impact on Behavioral/Mental Health System Mitigation Capacity � Mitigation Capacity of Responder Agencies � Mitigation Capacity of Community Agencies

Risk Component #1: Probability of Hazard Occurrence �Estimated likelihood of each hazard occurring in a 25 year period. Score Definition Improbable (0) The probability of the occurrence of the hazard in the next 25 years is zero. Improbable (0) should not be used for terrorism related hazards. Remote (1) The hazard is not likely to occur within the next 25 years, but it is possible. Occasional (2) The hazard is likely to occur at least once within the next 25 years. Probable (3) The hazard is likely to occur several times within the next 25 years. Frequent (4) The hazard is likely to occur cyclically or annually within the next 25 years.

Risk Component #2: Hazard Severity � Potential of the hazard to have a negative effect on the physical or behavioral/mental health of individuals & population of the jurisdiction e. g. increase the number of ill, hospitalized, and/or deceased individuals Score Definition Not Applicable (0) There is no elevated health or medical impact associated with this threat. Negligible (1) The hazard presents a minimal threat to safety, health, and wellbeing of the surrounding community. Marginal (2) May cause minor injury, illness, property damage, and/or financial loss. Critical (3) May cause severe injury, illness, property damage, and/or financial loss. Catastrophic (4) May result in significantly elevated rates of severe disease, injury, hospitalizations, and deaths.

Risk Component #3: Hazard Impact on Public Health System � Potential negative impact of the hazard on the public health delivery system. Consider the effect of the hazard on causing the following impacts: Local Health Department staff physical or behavioral/mental health illness, injury, or death preventing employees from reporting to work Effect on business interruption Reliance on continuity of operations planning Interruption of critical supplies and resources Public health facilities damaged or temporarily relocated and/or unusable

Risk Component #3: Hazard Impact on Public Health System (cont. ) Score Definition Not Applicable (0) There is no anticipated effect or impact associated with this hazard. Negligible (1) The hazard presents a minimal threat to disrupt and/or prevent the day-to-day business operations of the public health system. Marginal (2) The hazard presents a minor threat to disrupt and/or prevent the day-to-day business operations of the public health system. Critical (3) The hazard presents a significant threat to disrupt and/or prevent the day-to-day business operations of the public health system. Catastrophic (4) The hazard presents a serious threat to disrupt and/or prevent the day-to-day business operations of the public health system.

Risk Component #4: Hazard Impact on EMS/Healthcare System � Potential negative impact of the hazard on the health care delivery system (e. g. EMS, hospitals, clinics, long-term care facilities) � Consider the effect of the hazard on causing the following impacts: Staff physical or behavioral/mental health illness, injury or death, thus preventing employees from reporting to work Effect on business interruption Reliance on continuity of operations planning Interruption of critical supplies and resources Healthcare facilities damaged or temporarily relocated and/or unusable Score Definition Not Applicable (0) There is no anticipated effect or impact associated with this hazard. Negligible (1) The hazard presents a minimal threat to disrupt and/or prevent the day-to-day business operations of the healthcare delivery system. Marginal (2) The hazard presents a minor threat to disrupt and/or prevent the day-to-day business operations of the healthcare delivery system.

Risk Component #5: Health Impact on Behavioral/Mental Health System �Potential negative impact of the hazard on the behavioral/mental health care delivery system/agencies �Consider the effect of the hazard on causing the following impacts: Staff physical or behavioral/mental health illness, injury or death, thus preventing employees from reporting to work Effect on business interruption Reliance on continuity of operations planning Interruption of critical supplies & resources Healthcare facilities damaged or temporarily relocated and/or unusable

Risk Component #5: Health Impact on Behavioral/Mental Health System (cont. ) Score Definition Not Applicable (0) There is no anticipated effect or impact associated with this hazard. Negligible (1) The hazard presents a minimal threat to disrupt and/or prevent the day-to-day business operations of the behavioral/mental health system. Marginal (2) The hazard presents a minor threat to disrupt and/or prevent the day-to-day business operations of the behavioral/mental health system. Critical (3) The hazard presents a significant threat to disrupt and/or prevent the day-to-day business operations of the behavioral/mental health system. Catastrophic (4) The hazard presents a serious threat to disrupt and/or prevent the day-to-day business operations of the behavioral/mental health system.

Risk Component #6: Mitigation Capacity of Responder Agencies � Mitigation capacity includes existing plans, resources, and other responder agency specific capacities that would be available to mitigate or lessen the impact of a potential hazard. � LHDs should assign a score from 0 -4 that reflects the collective readiness and response capacities of all potential responding agencies in the jurisdiction; whether it is one or several agencies that would be responding to a particular hazard. � For each hazard, consider the availability & status of: Agency/department(s) response plans Previous training and exercises Availability of back-up systems Existence of staff and systems to detect, assess, investigate, and respond to chemical, biological, radiological, or nuclear threats

Risk Component #6: Mitigation Capacity of Responder Agencies (cont. ) Score Definition Not Applicable (0) There are no resources available for responder agencies. Low (1) There is a low level of existing response capacity and/or resources available among responder agencies. Moderate (2) There are some existing response capacities and/or resources available among responder agencies. High (3) There is a significant level of response capacity and/or resources available among responder agencies. Extreme (4) There is a high level of response capacity and/or resources available among responder agencies.

Risk Component #7: Mitigation Capacity of Community Agencies �Mitigation capacity includes existing plans, partnerships, networks, trainings, and other community based resources that would be available during a response to mitigate or lessen the impact of a potential hazard.

Risk Component #7: Mitigation Capacity of Community Agencies (cont. ) �For each hazard, consider resources available in the community at large that are potentially available during the response to a given emergency such as: Existing communication & response plans available to local community/faith based organizations Networks & resources available by existing community & faith based organizations to maintain their business operations up & running during an event Agreements & partnerships within community agencies Level of coordination with state and local governmental agencies Local community based responder agencies (American Red Cross chapters, Community Emergency Response Teams, Medical Reserve Corp, etc. )

Risk Component #7: Mitigation Capacity of Community Agencies (cont. ) Score Definition Not Applicable (0) There are no resources available for community-based agencies. Low (1) There is a low level of existing response capacity and/or resources available among community agencies. Moderate (2) There are some existing response capacities and/or resources available among community agencies. High (3) There is a significant level of response capacity and/or resources available among community agencies. Extreme (4) There is a high level of response capacity and/or resources available among community agencies.

Wildfire 4 3 3 3 2 3. 00 Pandemic Flu 2 3 4 3 3 2 1 2. 63 Water Supply Disruption 2 3 3 2 1 2. 25 Infectious Disease 3 3 4 3 3 2. 25 Extreme Weather 3 3 3 3 1. 85 Vectorborne 3 3 3 2 2 1. 69 Drought/ Climate Change 3 3 3 2 2 1. 69 Communications/ 3 2 2 3 3 2 2 1. 50 Acts of Violence 3 3 2 2 3 3 2 1. 13 Small Casualty Haz. Mat Incident 2 2 2 3 2 1. 00 Information Systems Failure