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Building a Model of Hospital WMD Preparedness upon the Veterans Health Administration's Extensive Expertise in Managing Hazardous Materials and Wastes

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The purpose of this paper is to summarize information gained through a search of regulations and literature concerning the decontamination of patients who arrive at a hospital for treatment.

United States. Department of Veterans Affairs

2000-06
Disaster Mental Health Services: A Guidebook for Clinicians and Administrators

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"Each day disasters occur, and each year millions of people are affected. Whether natural or human-made, the extreme and overwhelming forces of disaster can have far-reaching effects on individual, local community, and national stability. Though disastrous events may last from seconds to a few days, effects on communities and individuals can continue from months to years during the extended process of recovery, reconstruction and restoration. Long-term recovery varies significantly due to the complex interaction of psychological, social, cultural, political, and economic factors. 'A major disaster is defined as any natural catastrophe, or regardless of cause, any fire, flood, or explosion that causes damage of sufficient severity and magnitude to warrant assistance supplementing State, local, and disaster relief organization efforts to alleviate damage, loss, hardship, or suffering'. Events associated with disaster are capable of causing traumatic stress when they cause or threaten death, serious injury, or the physical integrity of individuals. In the event of massive destruction occurring in the United States, a Governor may request a Presidential declaration. This request must satisfy the provisions of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (PL93-288, as amended by PL-100- 707). The Stafford Act provides the authority for the Federal Government to respond to disasters and emergencies in order to provide assistance to save lives and protect public health, safety, and property. High magnitude disasters can overwhelm state medical systems, posing public health threats related to food and water supplies, housing and weather exposure, and injuries."

United States. Department of Veterans Affairs

Young, Bruce H.; Ford, Julian D.; Ruzek, Josef I.

1998
Safety of Personnel Engaged in Research

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"This Veterans Health Administration (VHA) Handbook establishes policy for ensuring the safety of personnel engaged in research. It delineates range of risks to research personnel, defines hazard categories, provides general principles for ensuring safety in the major hazard areas, provides general principles for ensuring safety in the major hazard areas, outlines responsibilities of personnel at Department of Veterans Affairs (VA) medical centers, and provides key safety references."

United States. Department of Veterans Affairs

2002-06-07
Biosecurity Training: An Introduction to Biosecurity for VHA Research Laboratory Staff

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"This presentation provides an overview of biosecurity measures for VHA research laboratory staff. It includes the basic concepts of biosecurity, components of a biosecurity program, laboratories requiring increased security, and employee responsibilities for VHA biosecurity. Biosecurity is preventing unauthorized entry into laboratories, removal or misuse of microbiological agents or hazardous agents, and removal or misuse of sensitive materials. Training is necessary in order to: increase awareness of security concerns, increase employee understanding of required security measures that are designed to protect staff and VA resources, and prevent materials found in research laboratories from being used for unintended purposes such as bioterrorism. Biosafety is the Aministrative policies, work practices, safety equipment, and lab design that protects the worker and the environment. The components of a biosecurity program include institutional policies, a security plan, training, and evaluation. This entails physical security, personnel security and access control, information security, material control and accountability, vulnerability assessment, and emergency response plans."

United States. Department of Veterans Affairs

2005-04
Control of Hazardous Agents in VA Research Laboratories

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"This Veterans Health Administration (VHA) Handbook establishes policy and procedures related to select agents and toxins and the prevention and/or detection of terrorist events occurring in or originating from the Department of Veterans Affairs (VA) research laboratories. NOTE: The procedures contained in this Handbook apply to all Research and Development (R&D) laboratories located within VA facilities, including leased space, and to space within a VA facility leased to a private entity. VA research laboratories located in approved off-site facilities such as affiliate universities are expected to comply with all VA and other Federal laws and regulations regarding security of both research laboratory facilities and select agents and toxins."

United States. Department of Veterans Affairs

2005-10-21
Depleted Uranium & Health: Pocket Guide for Clinicians

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This pocket guide provides information on depleted uranium (DU), DU concerns, patients help, DU background information, and DU screening. Details on the Department of Veteran Affairs' DU follow up program and DoD DU resources are included.

United States. Department of Veterans Affairs

2007-05
Emergency Management Strategic Healthcare Group (EMSHG) Home Page [website]

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"Welcome to the Emergency Management Strategic Healthcare Group (EMSHG) Home Page. Here you can learn about our organization, its missions, accomplishments, and current activities relating to disaster response and recovery operations."

United States. Department of Veterans Affairs
Emergency Management Strategic Healthcare Group (EMSHG) FY-2002 Annual Report

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"EMSHG will be recognized as a premier provider of Comprehensive Emergency Management services and a benchmark organization in health care emergency management. EMSHG provides Comprehensive Emergency Management services to the Department of Veterans Affairs, coordinates medical backup to the Department of Defense, and assists the public via the National Disaster Medical System and the Federal Response Plan. […]Strategies and performance targets were developed for each of the seven strategic goals. During FY-2002, the EMSHG Senior Management Team (SMT) oversaw the implementation of the EMSHG Strategic Goals through partnerships with Area Emergency Managers (AEMs). This relationship was the basis for measuring progress in emergency management preparedness at the Veterans Integrated Service Network (VISN) and the VA Medical Center (VAMC) levels."

United States. Department of Veterans Affairs

2002
Chemical Warfare Agent Experiments Among U.S. Service Members

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This report examines the history of chemical warfare agent human experiments. Information on early experiments through and post World War 2, what agents were tested, and acute effects reported are also provided. "The US military personnel who participated in these Cold War experiments took great health risks in the service of their country. They deserve our respect and assistance for any health problems that were the result of toxic exposures during these military tests. Some of these exposures had the potential to cause substantial harm to the veterans' health, whereas some participants may not have been exposed to any toxic substance because they were used as controls in these experiments. Regardless, long-term psychological effects could have resulted just from participating in these experiments. Unfortunately, the records are not complete enough to determine the exact nature of the exposure in many of these veterans. Each veteran therefore has to be cared for as an individual and given a thorough clinical evaluation to identify all outstanding health problems. Fortunately, high quality health care does not depend on identification of etiologic factors. This is true for much of modern health care. For example, cancer diagnosis and effective therapy does not depend on the identification of a specific etiology."

United States. Department of Veterans Affairs

Kick, Russ

2006-07-31
[Department of Veterans Affairs] Suicide Data Report, 2012

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"In 2007, the Department of Veterans Affairs [VA] began an intensive effort to reduce suicide among Veterans. This effort had its roots in the Mental Health staffing expansion and the Joshua Omvig Bill, and it included both attention to Veterans in crisis as well as those determined to be at high risk for suicide. The effort also included the development of data systems to increase understanding of suicide among Veterans and inform both the VA and other suicide prevention programs. Information on the characteristics and outcomes of Veterans at risk for suicide is critical to the development of improved suicide prevention programs. […] All of these data collection systems have matured to the point where they can now begin to provide VA with information that can be used to both determine if the current suicide prevention program is having an effect, where gaps may occur, and provide direction for the future. This reports is an initial attempt to look at all of this information together in order to provide an overall picture of Veteran suicide to drive suicide prevention program development and improve outcomes for Veterans at risk for suicide. It is expected that reporting will be refined as time goes on and more data become available. This report contains a systematic overview of data obtained from the State Mortality Project, Suicide Behavior Reports for fiscal years 2009 -- 2012, and Veterans Crisis Line."

United States. Department of Veterans Affairs

Kemp, Janet; Bossarte, Robert

2012
Agent Orange: Information for Veterans Who Served in Vietnam

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Agent Orange was an herbicide used during the Vietnam War to kill unwanted plants and to remove foliage which hid enemy combatants. The U.S. used more than 19 million gallons of herbicides for defoliation, 11 million gallons of which consisted of Agent Orange. Agent Orange has been shown to cause various health problems due to trace amounts of TCDD (dioxin). This fact sheet describes how concerned veterans can obtain examinations with their veteran's benefits, and that they may be eligible for disability compensation for Agent-Orange related illnesses.

United States. Department of Veterans Affairs

2007-07
North Chicago VA Medial Center Lab Restroom Fire: After Action Report

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"On Friday, February 27, 2009 9:16 AM there was an activated fire alarm for the lab area in Building 133CA. VA [Department of Veterans Affairs] Police, Safety, and Engineering responded to area. Upon arrival we found that there was a single sprinkler head activated in the bathroom, room BD116 due to a fire in the prismatic lens cover of the light fixture. Fire was extinguished immediately by the sprinkler head. Great Lakes Fire Department arrived at location 9:28 AM[.]"

United States. Department of Veterans Affairs

2009-03-11
Emergency Management Program Guidebook: Example Exercise Critique/After Action Report

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This document is an example of an exercise critique or after-action report.

United States. Department of Veterans Affairs

2009-09-08?
Joint Action Plan for Supporting Veterans During Their Transition from Uniformed Service to Civilian Life

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"On January 9, 2018 President Trump signed Executive Order (EO) 13822 directing the Department of Veterans Affairs (VA), Department of Defense (DoD). and the Department of Homeland Security (DHS) to address the complex challenges faced by our transitioning uniformed Service members and Veterans. The EO requires VA, DoD, and DHS to submit to the President a Joint Action Plan that describes actions to provide seamless access to mental health care and suicide prevention resources for transitioning Service members. The EO specifically emphasizes access to services during the critical first years period following discharge, separation, or retirement from military service. Additionally, the EO requires that within 180 days of the date of the Order, the Secretary of Defense, the Secretary of Veterans Affairs, and the Secretary of Homeland Security submit to the President, a status report of the implementation of the Joint Action Plan detailing how the proposed reforms have been effective in improving mental health care for all transitioning uniformed Service members and Veterans. While the ultimate goal remains zero suicides, this Plan seeks systematic reductions in the number of Veteran suicides with progress measures by year-after-year reduction to zero. Recognizing that sometimes the warning signs for suicide do not appear until a Service member transitions from military to civilian life, this Plan seeks to eliminate the gaps in access to mental health and suicide prevention services. This Plan also seeks to eliminate barriers to care. [...]"

United States. Department of Veterans Affairs

2018-04-18
VA National Suicide Data Report 2005-2015

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"This report provides information on suicide mortality for the years 2005-2015. It incorporates the most recent mortality data from the joint VA [Veterans Affairs]/DoD Joint Suicide Data Repository and includes information for deaths from suicide among all known Veterans of U.S. military service. Data for the joint VA/DoD Suicide Data Repository were obtained from the National Center for Health Statistics' National Death Index (NDI) through collaboration a with the DoD. Data available from the NDI include reports of mortality submitted from vital statistics systems in all 50 U.S. states, Washington, D.C., and Puerto Rico. This report builds upon prior analyses of Veteran suicide and provides additional and updated information on all known suicides among Veterans living in the United States from 2005 to 2015. Findings include direct comparisons of Veterans' suicide rates with those of analogous non-Veteran populations, calculations of suicide rates among high-risk subgroups (e.g., Veterans diagnosed with mental health and opioid use disorders), and comparisons of Veterans with and without recent receipt of VHA [Veterans Health Administration] services. Rates of suicide were calculated by calendar year to facilitate comparison with national statistics and reports from other agencies."

United States. Department of Veterans Affairs

2018-06
Physical Security Assessment for Department of Veterans Affairs Facilities: Recommendations of the National Institute of Building Sciences Task Group to the Department of Veterans Affairs

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In May 2002, at the request of the Department of Veterans Affairs (VA), the National Institute of Building Sciences (NIBS) assembled a Task Group of volunteer experts and a project team representing the healthcare, facility, security, and cemetery sectors to advise VA on what major emergency and disaster threats should be guarded against and how best to evaluate its facilities' vulnerabilities against these threats. The recommendations provided in this document serve as a collective deliberation of the Task Group to provide a plan for VA to assess systematically the vulnerability of its facilities and provide mitigation solutions in order to remain an effective part of the national emergency service during a national or local emergency.

United States. Department of Veterans Affairs

2002-09-06
National Inter-agency Incident Management System (NIIMS): Operational System Description, Position Descriptions & Procedures Manual for General Use

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"The National Interagency Incident Management System (NIIMS) has been developed to provide a common system that emergency service agencies can utilize at local, state, and federal levels. NIIMS consists of five major sub-systems that collectively provide a total systems approach to all risk incident management. The sub-systems are: Incident Command System (ICS), Training, Qualifications and Certification System, Publications Management, and Supporting Technologies."

United States. Department of Veterans Affairs
National Inter-Agency Incident Management System (NIIMS) Management Section: Position Descriptions & Procedures Manual for General Use

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"The Incident Manager is responsible for the overall management of all incident activities including the development and implementation of strategy and for approving the ordering and release of resources. The Incident Manager may have a deputy. The deputy's responsibilities will be as delegated by the Incident Manager.

United States. Department of Veterans Affairs
Rapid Contingency Plans for Responding to Victims of a Chemical Attack: Handling Casualties and Decontamination

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"All Americans are concerned about the potential threat of a chemical or biological terrorist attack. Such an attack could produce an overwhelming number of casualties, and nearby hospitals will be called upon to help manage both physical and psychological victims. Excellent descriptions are available of comprehensive decontamination and triage facilities designed to handle such mass-casualty situations. However, such facilities take time to fully implement. This brochure discusses more immediate steps that hospitals can take to protect their facilities and staff, and allow them to provide safe and effective care for victims. The recommendations contained in this document are intended to assist hospitals in quickly developing a contingency plan for responding to mass casualty incidents. 'This information is not intended as a substitute for more long-term planning involving building renovation, site preparation, specialized equipment purchases and corresponding training. The information in this brochure is not meant to be complete but to be a quick guide; please consult other references and expert opinion'. Regardless of a hospital's current decontamination capabilities, a plan can be quickly developed to handle mass casualties from a chemical or biological incident. Fear and panic are perhaps the greatest concern following a chemical or biological attacks. Fortunately, with some straightforward precautions and procedures, basic safety equipment and supplies, hospitals can develop the self-confidence and competency to respond to the emergency health care needs of victims from a terrorist attack, even before longer-term solutions can be implemented. This brochure also describes contingency plans for simple, easily and rapidly deployable decontamination procedures that can be quickly implemented. Because of the immediacy of effects from chemical warfare compared to biological warfare agents, this document focuses primarily on chemical agent victims (radiological incidents are not addressed)."

United States. Department of Veterans Affairs

2001-10
Department of Veterans Affairs: FY 2014-2020 Strategic Plan

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"Rapidly evolving technology across multiple disciplines, an increasingly unpredictable world, shifting social and demographic changes, and tight fiscal constraints drive the Department of Veterans Affairs (VA) to continually reassess how to efficiently and effectively provide the best services and benefits for America's Veterans. We serve a shrinking, but increasingly diverse, Veteran population. The number and complexity of disability claims continues to increase. Changes in health technologies, health legislation, and health care delivery systems will impact both public and private sector health care models. Technological advances in all disciplines are changing the way we communicate, learn, shop, travel, monitor our health, conduct warfare, and even memorialize the fallen. Our service to Veterans must reflect these changes. The VA Strategic Plan for FY 2014-2020 builds on our prior (FY 2011-2015) strategic plan. We will continue to significantly transform how we operate as a Department. We will keep the promises we have made to increase access, eliminate the claims backlog, and end Veteran homelessness. In addition, this plan places a stronger emphasis on defining success by Veteran outcomes; enhancing the quality of an access to benefits and services through integration with VA and with our partners; and developing our workforce with the skills, tools, and leadership to meet our clients' needs and expectations."

United States. Department of Veterans Affairs

2013-08-08
Gulf War Veterans' Illnesses Task Force Report

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"The Gulf War Veterans Illnesses Task Force (GWVI-TF) was formed to ensure that the Department of Veterans Affairs (VA) maintained a focus on the unique issues of Veterans of the 1990-1991 Gulf War. The Persian Gulf War is legally defined in title 38 U.S.C. § 101(33) as beginning on August 2, 1990, and ending on the date thereafter prescribed by Presidential proclamation or by law. While the term 'Gulf War Veterans' could refer to all Veterans of conflicts during this period, including Veterans of Operation Iraqi Freedom, and subsequent conflicts, the GWVI-TF target population is Veterans who were deployed on the Operation Desert Shield and/or Operation Desert Storm components of the 1990 - 1991 Gulf War, hereafter referred to as the Gulf War. In August 2009, the Secretary of VA directed a comprehensive review of the Department's programs to support this population of Veterans, develop an overarching action plan to advance their services, and ultimately improve their satisfaction with the quality of services and support VA provides. One year later, the GWVI-TF prepared its first annual report. The report broadly reviewed programs and efforts and identified seven areas where VA service improvement was necessary. The report also developed an initial roadmap to transform the care and services delivered to Gulf War Veterans."

United States. Department of Veterans Affairs

2012-03
Department of Veterans Affairs: Biosafety & Biosecurity Program [website]

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"The VA Office of Research and Development (ORD) has developed its Biosafety & Biosecurity Program to ensure the safety of individuals involved with research at Veterans Health Administration research laboratories and to protect the environment. The program strives to ensure the security and safety of all individuals, resources, information, biological agents, chemical agents and radiation materials/sources found within research laboratories. ORD's biosafety and biosecurity program functions in coordination with similar programs at individual medical centers. Activities at VA Central Office ORD involve developing VHA policy, issuing guidance, communicating training requirements and initiating training programs as well as working closely and coordinating with other Federal entities regarding biosafety, biosecurity and homeland defense."

United States. Department of Veterans Affairs
Military Speak from Operation Iraqi Freedom

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"In most fields of endeavor, a shorthand lexicon develops to promote the transfer of the most information in the shortest amount of time. The military lexicon is no exception. What is different is the amount of information that must be transmitted in a short amount of time due to operational considerations."

United States. Department of Veterans Affairs
Survey Assessment of Veterans Affairs Medical Centers' Emergency Preparedness

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This preparedness survey was conducted to all 143 Veterans Affairs facilities an its 21 Veterans Integrated Service Networks (VISNs). Its findings cover a broad range of capabilities and they are presented under ten emergency preparedness categories. The categories include: Program Committee, Coordinator and Administration; Planning; Direction, Control, and Coordination; Communication and Warning; Crisis Communication and Public Information; Resource Management; Operations, Procedures, and Mutual Aid; Logistics and Facilities; Training, Exercises, Evaluations, and Corrective Actions; Decontamination. LLIS Core Capability: Community Preparedness; Public Health; Healthcare; Community Preparedness

United States. Department of Veterans Affairs

2005-04-15
Disaster Mental Health Services: A Guide Book for Clinicans and Administrators

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The main goal of this document is to help organizations develop disaster mental health response strategies, disaster mental health team formation and maintenance, as well as strategies for interfacing wit the federal disaster response system.

United States. Department of Veterans Affairs

Young, Bruce H.; Ford, Julian D.; Ruzek, Josef I. . . .

2006
Disaster and Mental Health Services Team and Program Development

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This document presents guidelines for how the National Center for Post-Traumatic Stress Disorder's disaster mental health teams should be formed. Standing teams are formed before or shortly after a disaster occurs. Ad hoc teams are formed at disaster sites, often joining together several standing teams to provide a coordinated response.

United States. Department of Veterans Affairs

2006-01-01?
Safe and Responsible Use of Opioids for Chronic Pain: A Patient Information Guide

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From the Document: "Opioids are medicines that may be used to treat pain. Opioids also are called 'opiates' or 'narcotics.' Opioids can be dangerous, even when prescribed and taken responsibly. Taking opioids at any dose may be harmful. We want to make sure you have the information and strategies to keep yourself and others safe when using these medicines. [...] Opioids are not the most effective treatment for long-term, non-cancer pain. In fact, opioids are no longer recommended for the treatment of most patients with chronic pain. If prescription opioids are used, you will be given information on possible side effects, other risks, and monitoring needed for your safety. Over the past 20 years, we have learned several important things about using opioids for chronic pain."

United States. Department of Veterans Affairs

2018-10
National Strategy for Preventing Veteran Suicide 2018-2028

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From the Introduction: "The purpose of the National Strategy for Preventing Veteran Suicide is to provide a framework for identifying priorities, organizing efforts, and contributing to a national focus on Veteran suicide prevention over the next several years. Data and figures referred to in this strategy reflect the most current, publicly available data at the time of publication."

United States. Department of Veterans Affairs

2018?
PTSD 101 Courses: Understanding Military Culture

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"Understanding military culture is important when treating Veterans. This course presents important information regarding military demographics, branches, rank, status, and stressors. The author provides useful terminology and visuals to help the viewer understand military culture. Two programs created to help service members prevent and manage combat and operational stress are also described, Army Battlemind and Marine Corps Combat Operational Stress Continuum. Finally, additional Army and Marine Corps interventions are discussed, as well as assessment and treatment implications for clinicians."

United States. Department of Veterans Affairs

Watson, Patricia J.
Meeting the Ethical Challenges of a Severe Pandemic Influenza

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From the Document: "During a severe pandemic flu, the U.S. Department of Veterans Affairs, Veterans Health Administration (VHA) will be faced with extraordinary ethical challenges. [...] Goals of VA [Department of Veterans Affairs] pandemic planning and response are to protect our Veterans and staff, to keep vital VA operations going, to communicate effectively, and to contribute to the national response effort. Ethical challenges center on responsibilities, or the duty to provide care to patients, family and others in pandemic influenza; allocation of scarce resources; and restrictions to individual liberty that may be necessitated during a public health crisis such as a pandemic influenza outbreak."

United States. Department of Veterans Affairs

2010-09

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