AFSCME Information Highway

Source: Centers for Disease Control and Prevention, Coordinating Office for Terrorism Preparedness and Emergency Response (COTPER), February 2008

From the summary:
CDC's Coordinating Office for Terrorism Preparedness and Emergency Response (COTPER) has released its inaugural report on public health emergency preparedness. The report, Public Health Preparedness: Mobilizing State by State, highlights the progress that has been made in state and local preparedness and response, identifies preparedness challenges facing public health departments, and outlines CDC's efforts to address those challenges. Designed to increase accountability regarding the country's investment in preparedness activities, the report presents national data as well as state-specific snapshots for all 50 states and four directly funded localities: Chicago; Los Angeles County; New York City; and Washington, DC.
▪ Key Findings

Posted by Info Center at 12:31 PM in Emergency Management | Health Care | Permalink

Source: Democratic Caucus, U.S. House of Representatives, February 2008

In Congressional testimony last week, military officials confirmed America is vulnerable. The U.S. Armed Forces are strained to the breaking point, our National Guard and Reserves are stressed and depleted, and President Bush's latest budget cuts in half homeland security funds desperately needed by communities across the country. Nearly seven years after 9/11, and five years into a war in Iraq that continues to exhaust our troops with no end in sight, America may be at its most exposed. As Marine Maj. General Arnold L. Punaro said earlier this month, America now faces "an appalling gap in readiness for homeland defense."

Posted by Info Center at 12:35 PM in Emergency Management | Government | Military | Permalink

Source: Commission on National Guard and Reserves, Final Report to Congress and the Secretary of Defense, January 31, 2008
From an Associated Press story:
The U.S. military isn't ready for a catastrophic attack on the country, and National Guard forces don't have the equipment or training they need for the job, according to a report.

Even fewer Army National Guard units are combat-ready today than were nearly a year ago when the Commission on the National Guard and Reserves determined that 88% of the units were not prepared for the fight, the panel says in a new report released Thursday.

The independent commission is charged by Congress to recommend changes in law and policy concerning the Guard and Reserves.

Posted by Info Center at 11:02 AM in Emergency Management | Military | Permalink

Source: Michael H. LeRoy, Berkeley Journal of Employment and Labor Law, Volume 28, no. 2, 2007

The Thirteenth Amendment ban on involuntary servitude has new relevance as the United States grapples with national emergencies such as catastrophic hurricanes, flu pandemics, and terrorism. This article considers work refusal and coerced work performance in the context of life-threatening employment. Overwhelmed by fear, hundreds of police officers and health care workers abandoned their jobs during Hurricane Katrina. Postal clerks worked against their will without masks in facilities with anthrax. A report by Congress demonstrates concern that avian flu will cause sick and frightened medical personnel to stay away from work, thus jeopardizing a coherent response to a crisis. How far can the U.S. go in forcing reluctant civilians to perform essential jobs during a national emergency? The author explores solutions to his question by hypothesizing a large release of radiation--whether by terror attack, catastrophic accident, or major earthquake--in a vital Pacific port.

Posted by Info Center at 1:43 PM in Emergency Management | Laws/Legislation | Public Sector | Permalink

Source: National Governors Association

States are working more closely and more effectively with federal agencies than ever before to share information that could prevent terrorist attacks, but their relationship with the federal government in a number of other key security areas remains a work in progress, according to a new issue brief from the National Governors Association Center for Best Practices (NGA Center).

The brief examines the challenges facing state homeland security directors and highlights the results of an annual survey of the 56 state, D.C. and territorial homeland security directors who collectively comprise the Governors Homeland Security Advisors Council (GHSAC). GHSAC was created by the NGA Center in 2006 to provide a forum for state homeland security officials to share ideas and best practices and to review and analyze the impacts of federal homeland security activities on the states.

Full Document (PDF; 137 KB)

Posted by Info Center at 11:34 AM in Emergency Management | Permalink

Source: Colin P. Falato, Susan M. Smith, Tyler Kress, International Journal of Emergency Management Vol. 4, No. 4, 2007
(subscription required)

From a summary:
A recent study in the International Journal of Emergency Management suggests that the nation's federal and state governments should help local communities prepare for a range of large-scale disasters, United Press International reports. In analyzing local and federal response efforts, University of Tennessee researchers identified 902 disaster declarations made across the last 25 years related to hurricanes, fires, windstorms, earthquakes, tornadoes and floods.

Posted by Info Center at 12:09 PM in Emergency Management | Local Government | Permalink

Source: American Red Cross and Council for Excellence in Government, October 2007

From the press release:
The nation's RQ (Readiness Quotient) -a barometer of the public's preparedness for a weather emergency, natural disaster or terrorist attack-inched up nearly a point from 15 months ago, according to a report released today by the American Red Cross and the Council for Excellence in Government.

The nation's collective level of preparedness has increased to 4.14 out of a possible 10, compared to 3.31 in June 2006. The survey found that the biggest gains were in the public's level of preparedness awareness, but more work needs to be done to engage people in taking preparedness actions.
See also:
• National results
• Test Your RQ
• Online education module
• 2006 report

Posted by Info Center at 12:17 PM in Emergency Management | Permalink

Source: Trust for America's Health and American Academy of Pediatrics, Issue Brief, October 2007

From the summary:
The American Academy of Pediatrics (AAP) and Trust for America's Health (TFAH) issued a report in October 2007, Pandemic Influenza: Warning, Children At-Risk, which finds that children and teens between the ages of 0-19 account for nearly 46 percent of all H5N1 "bird" flu deaths. The report also identifies gaps in U.S. preparedness for treating and caring for children during a possible pandemic flu outbreak.

Posted by Info Center at 11:03 AM in Children | Emergency Management | Pandemic Influenza | Permalink

Source: National Association of County and City Health Officials (NACCHO), August 2007

From http://www.naccho.org/press/releases/pr2007_09_10.cfm:
Federal funding received by local health departments for all-hazards emergency preparedness fell 20 percent last year, according to a new report by the National Association of County and City Health Officials (NACCHO). The report says that continued cuts in funding provided through the Centers for Disease Control and Prevention (CDC) threaten important, hard-won advances made in recent years in response planning to natural disasters, bio-terrorism events, emerging infectious diseases, and other public health emergencies.
See also:
National Preparedness Month

Posted by Info Center at 1:03 PM in Emergency Management | Health Care Workers | Public Sector | State & Local Finance | Permalink

Source: Report to Congressional Requesters, United States Government Accountability Office, GAO-07-781, August 2007

An influenza pandemic is a real and significant potential threat facing the United States and the world. Pandemics occur when a novel virus emerges that can easily be transmitted among humans who have little immunity. In 2005, the Homeland Security Council (HSC) issued a National Strategy for Pandemic Influenza and, in 2006, an Implementation Plan. Congress and others are concerned about the federal government's preparedness to lead a response to an influenza pandemic. This report assesses how clearly federal leadership roles and responsibilities are defined and the extent to which the Strategy and Plan address six characteristics of an effective national strategy. To do this, GAO analyzed key emergency and pandemic-specific plans, interviewed agency officials, and compared the Strategy and Plan with the six characteristics GAO identified.

Posted by Info Center at 12:31 PM in Emergency Management | Pandemic Influenza | Permalink

Source: Center for Infectious Disease Research & Policy, and the Pew Center on the States, 2007

From the press release:
Public health planners have a new tool to help them prepare for an influenza pandemic. Pew and the Center for Infectious Disease Research & Policy are announcing the launch of www.PandemicPractices.org, a new online resource that highlights promising ways communities are preparing for a flu pandemic.

PandemicPractices.org brings together more than 130 peer-reviewed practices from four countries, 22 states and 33 counties. Compiled as a tool to save communities and states time and resources, the database enables public health professionals to learn from one another and to build on their own pandemic plans. Using PandemicPractices.org, they can examine and download pandemic flu planning materials and use or adapt them to fit local needs.

Posted by Info Center at 11:57 AM in Emergency Management | Pandemic Influenza | Permalink

Source: David N. Sundwall, Robert T. Rolfs, Utah Department of Health, August 28, 2007

An influenza pandemic as severe as the 1918 pandemic could cause nearly a million Utahns to become ill and result in over 350,000 outpatient doctor visits, 80,000 hospitalizations, and 16,000 deaths over the course of a year. Critical assumptions used in developing this plan included: 1) outbreaks would probably occur widely across the state and nation, limiting the ability to share resources among jurisdictions; 2) vaccine would not be available until several months had elapsed; 3) shortages of critical medicines (including antiviral medications) and other supplies would occur; 4) capacity to provide medical care would be severely stressed or exceeded; and 5) absenteeism rates and fear would stress the abilities to maintain business continuity and to provide for essential community services including police, fire, water, food, transportation and sanitation.

The goals of this plan are, first, to minimize serious illness and death, and second, to limit societal disruption and economic losses. The plan is intended to coordinate with global and national plans developed by the World Health Organization (WHO) and the U.S. Department of Health and Human Services (DHHS). It outlines responsibilities and activities in six areas (Planning and Coordination; Public and Risk Communications; Surveillance, Investigation and Containment; Vaccine Management and Administration, Antiviral Medication Stockpiling and Use; Laboratory Testing, and Health Care and Emergency Response). It uses the three pandemic planning phases outlined by WHO (Inter-Pandemic, Pandemic Alert, and Pandemic Periods), the U.S. Federal Stages, and introduces Utah Pandemic Response Levels.

This plan outlines activities and responsibilities for government public health agencies and builds upon preparedness assets developed at federal, state, and local levels of government and in the private sector. The Plan incorporates work by several advisory bodies, including a Pandemic Influenza Planning Committee (2005-2006), the Pandemic Influenza Workgroup (2006-ongoing), and the Governor's Pandemic Influenza Taskforce, which met in 2006-2007 and developed recommendations that are included in and will set the stage for the next phase of this planning process.

See also:
Utah Department of Health's Pandemic Influenza Web site

Posted by Info Center at 6:04 PM in Emergency Management | Pandemic Influenza | Permalink

Source: Elaine Morley, Carol J. De Vita, The Urban Institute, August 31, 2007

The anniversaries of Hurricane Katrina and the attacks of 9/11 will likely bring renewed attention to our nation's preparedness to address large-scale disasters, whether natural or man-made. Indeed, in the years since these events, the media, policymakers, and the public have given considerable attention to this topic. However, attention has generally focused on preparedness for immediate and short-term responses to disaster. Such responses are, of course, critical. We suggest that attention also should be focused on longer-term recovery assistance following major disasters. Those who are directly involved in such traumatic events and suffer associated personal and property loss are likely to need assistance for years after the disaster--long after immediate and short-term response has ended. Much of the continued assistance needed falls within the realm of social services, such as mental health services, case management, and, for some, employment-related services.

Posted by Info Center at 4:41 PM in Emergency Management | Permalink

Source: John McQuaid, Mother Jones, August 2007

Eroding coastline, sinking land, rising seas; failing levees, poor evacuation planning; a city that would fill like a soup bowl if its flood defenses were breached. In 2002, Pulitzer Prize-winning reporter John McQuaid coauthored a series in the New Orleans Times-Picayune, where he'd worked for more than 20 years, that predicted the fate that would befall New Orleans 3 years later. Now, in a three-part series for Mother Jones, McQuaid reports that the initial surge of attention to strengthening the Gulf Coast's defenses has ebbed, once again, to complacency. And residents of the Gulf Coast are not the only ones who should be worried. As McQuaid reports, it's not just the levees that are broken-it's the entire political system by which we create disaster defenses. Climate change will bring more storms, floods, fires, and tornadoes, but Washington has done very little to get us prepared. Will it take another Katrina before the government acts?
Related:
Mother Jones' Full Coverage of Hurricane Katrina and its Aftermath

Posted by Info Center at 3:38 PM in Emergency Management | Permalink

Source: Patrick Thibodeau, Computerworld, August 28, 2007

Massive planning exercise will assess impact on staffing, telecommunications

What may be the largest pandemic planning exercise ever conducted in the U.S. is set to begin next month. The dry run will force financial services firms to operate with shrinking numbers of employees -- on paper, at least.

More than 1,800 organizations have signed up to participate in the three-week simulation, which is being sponsored by the U.S. Department of the Treasury and the Securities Industry and Financial Markets Association.

See also:
• U.S. Department of the Treasury press release
• FBIIC / FSSCC Pandemic Flu Exercise of 2007

Posted by Info Center at 5:59 PM in Emergency Management | Pandemic Influenza | Permalink

Source: Federal Emergency Management Agency (FEMA), Release Number: HQ-07-169, August 21, 2007

The Department of Homeland Security's Federal Emergency Management Agency (FEMA) has released a new reference guide that outlines existing legal requirements and standards relating to access for people with disabilities. A Reference Guide for Accommodating Individuals with Disabilities in the Provision of Disaster Mass Care, Housing and Human Services is the first of a series of disability-related guidelines to be produced by FEMA for disaster preparedness and response planners and service providers at all levels.

"Federal law is very clear about accommodating people with disabilities in emergencies and disasters. Everyone involved in emergency management needs to understand and know what their responsibilities are in preparedness, response and recovery operations," FEMA Administrator R. David Paulison said. "This Reference Guide is an important tool for emergency planners, responders and government agencies as they work toward meeting the needs of people affected by emergencies and disasters. FEMA is committed to ensuring that its programs and emergency operations meet the needs of people with disabilities."

The Reference Guide summarizes equal access requirements for people with disabilities within Disaster Mass Care, Housing, and Human Services functions. The Guide explains how applicable Federal laws relate to government entities and non-government, private sector and religious organizations.

Posted by Info Center at 5:07 PM in Americans With Disabilities Act | Emergency Management | Permalink

Source: Richard W. Niska, and Catharine W. Burt, Division of Health Care Statistics, Centers for Disease Control and Prevention, Advance Data From Vital and Health Statistics, Number 391, August 20, 2007

Objective--This study presents baseline data to determine which hospital characteristics are associated with preparedness for terrorism and natural disaster in the areas of emergency response planning and availability of equipment and specialized care units.

Methods--Information from the Bioterrorism and Mass Casualty Preparedness Supplements to the 2003 and 2004 National Hospital Ambulatory Medical Care Surveys was used to provide national estimates of variations in hospital emergency response plans and resources by residency and medical school affiliation, hospital size, ownership, metropolitan statistical area status, and Joint Commission accreditation. Of 874 sampled hospitals with emergency or outpatient departments, 739 responded for an 84.6 percent response rate. Estimates are presented with 95 percent confidence intervals.

Results--About 92 percent of hospitals had revised their emergency response plans since September 11, 2001, but only about 63 percent had addressed natural disasters and biological, chemical, radiological, and explosive terrorism in those plans. Only about 9 percent of hospitals had provided for all 10 of the response plan components studied. Hospitals had a mean of about 14 personal protective suits, 21 critical care beds, 12 mechanical ventilators, 7 negative pressure isolation rooms, and 2 decontamination showers each. Hospital bed capacity was the factor most consistently associated with emergency response planning and availability of resources.

Posted by Info Center at 2:19 PM in Emergency Management | Permalink

Source: Jeannie Thompson, RN, Vol. 60 no. 8, August 2007

Now two years and counting, we look back at lessons learned when Hurricane Katrina landed more than 300 miles away, and it became our responsibility to provide care to thousands of New Orleans' ill and injured.

Hurricanes Katrina and Rita revealed the flaws in hospital disaster-preparedness plans. Solutions include regular drills, plans to set up "surge hospitals" for mass casualties, staffing contingency plans to counter caregiver shortages, and standardized disaster-skill training.

Posted by Info Center at 4:22 PM in Emergency Management | Permalink

Source: Rx Response, 8/15/2007

From press release:
Health care organizations involved in the manufacturing, distribution and dispensing of pharmaceutical products came together today to announce the creation of Rx Response – a program designed to help support the continued delivery of medicines during a severe public health emergency. The partnership includes the American Hospital Association, American Red Cross, Biotechnology Industry Organization, Healthcare Distribution Management Association, National Association of Chain Drug Stores, National Community Pharmacists Association and the Pharmaceutical Research and Manufacturers of America.

Posted by Info Center at 11:35 AM in Emergency Management | Permalink

Source: Shawn Rhea, Modern Healthcare, Vol. 37 no. 32, August 13, 2007
(subscription required)

As hospitals plan for emergencies such as a flu pandemic, one challenge is how they’ll keep their supply shelves stocked.

Posted by Info Center at 10:54 AM in Emergency Management | Pandemic Influenza | Permalink

Source: American Medical Association/American Public Health Association, A consensus report from the AMA/APHA Linkages Leadership Summit, July 2007

From the press release:
Today a coalition of 18 health organizations led by the American Medical Association (AMA) and American Public Health Association (APHA) released a consensus report with 53 strategic recommendations for legislators, government officials and organizational leaders to more effectively prepare for and respond to catastrophic emergencies. The recommendations, especially nine identified as “critical,” serve as a national call to action from medicine, dentistry, nursing, hospitals, emergency medical services (EMS), and public health. The recommendations seek to strengthen health system preparedness and response through increased funding, greater integration, continued education and training and ensured legal protections for responders.
…
Nine critical recommendations from the consensus report make up a call to action in four categories:

Public health systems must be appropriately funded to adequately respond to day-to-day emergencies and catastrophic mass casualty events;
Public health and disaster response systems must be fully integrated and interoperable at all government levels;
Health care and public health professionals should maintain an appropriate level of education and training; and
Health care and public health responders must be provided and assured adequate legal protections in a disaster.
+ Action Brief
+ Signed Pledge of Commitment

Posted by Info Center at 4:33 PM in Emergency Management | Pandemic Influenza | Permalink

Source: U.S. Department of Homeland Security, 2007

From the press release:
The U.S. Department of Homeland Security (DHS) announced today final Fiscal Year (FY) 2007 Homeland Security Grant Program (HSGP) awards totaling $1.7 billion, including a total of almost $411 million to the nation’s six urban areas at highest risk of a terrorist attack: New York City/Northern New Jersey; the National Capital Region; Los Angeles/Long Beach; the California Bay Area; Houston; and Chicago.

HSGP grants enhance the ability of states, territories, and urban areas to prevent, protect against, respond to and recover from terrorist attacks and other disasters. Including this funding, by the end of FY 2007, DHS will have invested $23 billion in local planning, organization, equipment, training, and exercises for state and local governments since September 11, 2001.

Posted by Info Center at 4:22 PM in Emergency Management | State & Local Finance | Permalink

Source: Elisabeth D. Root, Jacqueline B. Amoozegar, Shulamit Bernard, Agency for Healthcare Research and Quality, AHRQ Publication No. 07-0029-1, May 2007

From the overview:
To date, most health care preparedness planning efforts have been focused on hospital and first responder preparedness. Nevertheless, the elderly are particularly vulnerable to bioterrorism and other public health emergencies due to their complex physical, medical, and psychological needs. The potential role and question of preparedness on the part of nursing homes has emerged in local and national preparedness discussions. However, little is known about the extent to which nursing homes have planned for and/or been incorporated into regional planning efforts
To address this issue, a series of focus groups was conducted to collect information about disaster- and bioterrorism-related planning activities among nursing homes in five States—North Carolina, Oregon, Pennsylvania, Washington, and Utah—and southern California. The aims of the focus groups were to:
• Determine if nursing home administrators have prepared and trained staff on disaster plans, including bioterrorism response.
• Assess the special needs of the elderly population in nursing home settings during a public health emergency.
• Determine if nursing homes are able to accommodate patient flows from acute care hospitals or provide other resources.
• Assess the impact of State regulations on the ability of nursing homes to offer support and/or surge capacity.
Findings from this report can provide important insight into current nursing home preparedness activities as well as the potential role of nursing homes in larger local or regional preparedness efforts and the special needs of the nursing home population.

See also: Emergency Preparedness Atlas — U.S. Nursing Home and Hospital Facilities
The Agency for Healthcare Research and Quality (AHRQ) sponsored preparation of this atlas to support local/regional planning and response efforts in the event of a bioterrorism or other public health emergency. In the atlas, case studies in six areas illustrate the location of nursing homes relative to population and various emergency preparedness regions. There are also maps of the location of hospitals and nursing homes in all 50 States and the District of Columbia.
Download in sections (PDFs)

Posted by Info Center at 2:00 PM in Emergency Management | Health Care Workers | Permalink

Source: Leonard Matarese, Kenneth Chelst, Gayle Fisher-Stewart, and Albert Pearsall, Public Management, Vol. 89 no. 4, May 2007
(subscription required)

More than 15 years ago, authors Kenneth Chelst and Leonard Matarese described in an ICMA report the efficiencies and successes gained by the consolidation of police and fire departments. They defined the issues surrounding a police-fire merger, identified the key decisions that had to be made, developed a process to assess and overcome environmental barriers to a merger and presented a mathematical model for predicting the impact on costs and performance of a proposed police-fire merger. Specifically, they were addressing mergers where police officers and firefighters routinely worked together, rather than just administrative consolidations. Yet, in a post-9/11 environment, does consolidation continue to make sense? Is it an efficient use of human and financial resources? As this “age of terrorism” forces local governments to assess issues of interoperability and emergency management, while still competing for scarce resources, should emergency response organizations become combined under one public safety umbrella?

Posted by Info Center at 10:27 AM in Emergency Management | Permalink

Public Administration Review, December 2006, Vol. 66 supplement

These mini-case studies explore the practice of collaborative management within a variety of public sector settings, focusing on the meritorious roles played by public managers – how they performed well and why their actions mattered.

Articles include:
- Amy K. Donahue, “The Space Shuttle Columbia Recovery Operation: How Collaboration Enabled Disaster Response.”
- Mary Belefski, “Collaboration at the U.S. Environmental Protection Agency: An Interview with Two Senior Managers.”
- Kurt Thurmaier, “High-Intensity Interlocal Collaboration in Three Iowa Cities
- Heather Getha-Taylor, “Preparing Leaders for High-Stakes Collaborative Action: Darrell Darnell and the Department of Homeland Security.”
- Kim Eagle and Philip Cowherd, “Collaborative Capital Planning in Charlotte-Mecklenburg County, North Carolina.”
- Tracy Yandle, “The Challenger Scallop Enhancement Company: Collaborative Management of a Natural Resource Based in the Private Sector.”
- Sharon Friedrichsen, “Collaborative Public Management in San Francisco.”
- Gerald Andrews Emison, “The EPA Bureaucrat Who Could.”
- David W. Sears and W. Robert Lovan. “Encouraging Collaboration in Rural America.”
- Brenda Bushouse, “West Virginia Collaboration for Creating Universal Prekindergarten.”
- Rob Alexander, “Kirk Emerson and the U.S. Institute for Environmental Conflict Resolution.”

Posted by Info Center at 11:41 AM in Dispute Resolution | Emergency Management | Management | Permalink

Source: William L. Waugh Jr. and Gregory Streib, Public Administration Review, December 2006, Vol. 66 supplement

Collaboration is a necessary foundation for dealing with both natural and technological hazards and disasters and the consequences of terrorism. This analysis describes the structure of the American emergency management system, the charts development of the Federal Emergency Management Agency, and identifies conflicts arising from the creation of the Department of Homeland Security and the attempt to impose a command and control system on a very collaborative organizational culture in a very collaborative sociopolitical and legal context. The importance of collaboration is stressed, and recommendations are offered on how to improve the amount and value of collaborative activities. New leadership strategies are recommended that derive their power from effective strategies and the transformational power of a compelling vision, rather than from hierarchy, rank, or standard operating procedures.

Posted by Info Center at 11:27 AM in Emergency Management | Permalink

Source: John J. Kiefer and Robert S. Montjoy, Public Administration Review, December 2006, Vol. 66 supplement

In this timely look at evacuation before, during and after Hurricane Katrina’s landfall in New Orleans, the authors trace the actions and interactions of the key players and highlight the strengths and weaknesses of their performance during the crisis. Though it was apparent that informal collaborative networks were necessary to deal with the disaster, this article suggests that they are never sufficient alone because networks, by definition, lack legal authority and diffuse public responsibility.

Hurricane Katrina revealed a lack of preparedness in disaster management networks covering the New Orleans area. This paper focuses on the operation of networks in preparing to evacuate residents in advance of a major disaster. There are two cases: the relatively successful evacuation of residents who left by private conveyance and the widely publicized failure to provide for those who could not or would not leave on their own. We trace the actions and inactions of various players to reach conclusions about the strengths and weaknesses of networks in the special circumstances of disaster preparation.

Posted by Info Center at 11:25 AM in Emergency Management | Permalink

Source: PA Times, December 2006, Volume 29, no. 12

Lexington, KY–The just-released 2006 Biennial Report from the National Emergency Management Association (NEMA) reveals ever-increasing responsibilities for state emergency management agencies; an on-going struggle for adequate federal funding and states leading the way in continuous improvement for their emergency management programs.

While all states have homeland security functions, most are tasking significant homeland security responsibilities to their state emergency management agencies.

Posted by Info Center at 5:27 PM in Emergency Management | Permalink