��OES Regions�&�FOAC

Fire Captain Richard Licon

Los Angeles County Fire Department

Emergency Medical Services Bureau

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OBJECTIVES

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• Overview of California OES Regions
• A Breakdown of the 3 OES Administrative Regions
• A Breakdown of LA County Operational Area

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• Provide the Role of the Regional Disaster Medical Health Coordinator and Specialist

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• Provide the purpose of the FOAC

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• Provide the responsibilities of the FOAC

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• Describe the implementation process for FOAC activation

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Overview of California Regions

California is divided into 3 OES Administrative Regions

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• Coastal

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• Inland

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• Southern

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These 3 Administrative Regions are then sub-divided into six Mutual Aid Regions I-VI

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Coastal Region

Region II

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• 16 Counties

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• 151 Incorporated Cities

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Inland Region

Regions III, IV and V

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• 31 Counties

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• 123 Incorporated Cities

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Southern Region

Regions I and VI

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• 11 Counties

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• 226 Incorporated Cities

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Southern Region I

5 Counties

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• San Luis Obispo
• Santa Barbara
• Ventura
• Orange County
• Los Angeles County

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Los Angeles County

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Los Angeles County is then divided again into the Operational Areas

A through H

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In 1997 the County Board of Supervisors Adopted�

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• “Inter-Region Cooperative Agreement”

For

• Emergency Medical and Health Assistance

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The County of Los Angeles Department of Health Services (DHS) EMS Agency

serves as the

“Regional Disaster Medical Health Coordinator” (RDMHC)

for

Region I

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DHS then tasked the Local Emergency Medical Services Agency (LEMSA) and the

LA County Fire Department with developing the

“Ambulance Mutual Aid Resource Plan”

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The RDMHC will also use this plan to coordinate ambulance resources throughout Region I and even between both Regions I and VI

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This can be fulfilled by either

• Immediate Need
• Strike Team Response

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• The LEMSA handles the licensing of all ambulance companies that operate in Los Angeles County

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3 EOA PROVIDERS

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The request for ambulances will be based on a response tier

Level I and Level II

per

DHS Ref 519.3

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LA County Fire will follow the

New MCI Response Matrix

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Level I (1^st alarm)

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• An MCI in which the number of ambulances required for the incident is 10 or less

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• This will be fulfilled by the normal day to day operational area ambulances

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Level II (2^nd alarm)

• An MCI in which the number of ambulances required for the incident exceeds the number of ambulances available through the 911 Provider

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Or is greater than 10 (11 or more)

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• This will be handled through the Los Angeles County Fire Department’s FOAC

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3^rd Alarm & MICI Major

• 3^rd ALARM
• An MCI with a range of 31-50 patients
• 5 additional ambulances to total 20

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• MCI MAJOR
• An MCI with 51+ patients
• 5 additional ambulances to total 25

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FOAC

FIRE

OPERATIONAL

AREA

COORDINATOR

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Purpose of the FOAC

• Provide the maximum number of ambulances in the shortest amount of time

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• Provide a single point ordering system

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• Continuous coordination throughout the incident

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Purpose of the FOAC

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• The Coordination of both Public and Private ambulance providers

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• The coordination of Fire and Medical & Health OES Mutual Aid processes with the RDMHC

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FOAC Responsibilities

• Contact:
• The three EOA Providers
• Central Dispatch Operations
• Other participating fire agencies

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• Complete a Survey of Ambulance Availability for Response

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FOAC Responsibilities Cont.

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• Monitor Ambulance Availability for the LA Operational Area throughout an incident's duration

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• Coordinate with the RDMHC or RDMHS in the event of a request from Region VI for a response

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FOAC Responsibilities Cont.

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• Determine if the request is Immediate need or Strike Team configuration

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• Update the Medical Alert Center (MAC) and the Ambulance Providers with the status of the incident and when they return to normal operations

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FOAC Responsibilities Cont.

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• Perform Quarterly FOAC Drills
• Participate in the Fire / EOA Ambulance Provider meetings
• Function as an Ambulance Licensing Hearing Board Officer

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Request For FOAC

Any Incident Commander can make this request once their jurisdictional ambulance resources have been exhausted and there is still a need for additional ambulances.

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FOAC Activation

An MDC alert will be sent to the 3 EOA Providers and Central Dispatch Operations

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Informational Briefing

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The FOAC will fill out a Briefing Sheet and provide this information to the participants on the conference call

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Ambulance Worksheet

• The FOAC will request the number of units available for response to the incident within two-time frames and log this on the Ambulance Worksheet

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• 30 Minute Response (first)

And then a

• 60 Minute Response (second)

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Unit ID Roster

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Each of the ambulances that the FOAC has allocated to the incident, shall be logged on the Unit ID Roster

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Level II

• In the event that the three EOA Providers have exhausted their resources and the need for additional units have not been fulfilled, they will then contact their licensed back up providers to do a survey of available units

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Field Supervisor

• In the event of a FOAC Activation, a Field Supervisor from the Jurisdictional Provider area will respond to the incident to act as a Liaison between the IC/Staging and the incoming ambulances

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Ambulances assigned to an incident are tied to that incident until released by either the Incident Commander or the Staging Manager

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Out of County

In the event the response is out of the LA Operational Area, the EMT’s or Paramedic Crews shall operate within their Scope of Practice and under LA County Protocols

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Billing

This is a whole process in itself.

Just know that any FOAC Activation within the LA Operational Area (LA County) ambulance providers will bill the patients or their insurance carrier directly and that LA County Fire, other requesting Fire Agencies, DHS or the LEMSA are not responsible for collecting any transport fees

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• Add the new form 1059

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FOAC Procedures

• Obtain information from dispatch to complete the Briefing Sheet
• Call the conference call number, enter access code, then enter Host code.
• Identify yourself and begin a roll call and document who is on the call.
• Begin reading the information on your Briefing Sheet
• Speak slowly enough so they can write it down

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FOAC Procedures Continued

• Begin with the jurisdictional EOA provider and confirm what they have already on scene/enroute
• Obtain how many ambulances available for a 30 minute and 60-minute response from each provider
• Dispatch the appropriate number of ambulances requested dividing them amongst the providers
• Log how many sent, and how many remaining
• Log any special information in the NOTES column
• Log only the responding Unit Numbers on the Unit Log under the appropriate 30/60 min time slots

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FOAC Procedures Continued

• If dispatch was not listening in on the conference call, call them and provide how many ambulances from each provider are responding
• Ex: Care sending 10, McCormick sending 5, AMR sending 2 for a total of 17

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Some Examples of Actual�FOAC Activations

There was a FOAC activation request by the Monrovia Fire Department with a request for 25 ambulances

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Another FOAC Activation

There was a FOAC activation

request by

the San Gabriel Fire Department

with a request for

25 ambulances

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Another FOAC Activation

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Nipsey Hustle Funeral Procession

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A request was made by LA City Fires Metro Dispatch for 20 ambulances to respond into LA City

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For additional information on the FOAC go to:

LA County DHS Website under

Pre-Hospital Care Manual

REF 519.3

Mass Casualty Incident Transportation Management

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THANK YOU

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