DMAT San Diego CA-4
A Level 1 Disaster Medical Assistance Team.
affiliated with the National Disaster Medical System
Founded 1991
Co-Sponsored by: UCSD Medical Center & International Relief Teams
Mailing Address: 200 West Arbor Drive, San Diego, CA 92103-8676

DMAT CA-4 Information Line: 619-543-6216
eMail address of Newsletter Editor, Jake Jacoby:     ca4cdr@san.rr.com
DMAT CA-4 WEB site: http://www.dmatca4.org

March 2003 Newsletter
****  Volume 12,  Number 3  ****
CONTENTS
Calendar Of Events..........................................Page 1
Commander's Log............................................Page 1
February Team Meeting Minutes........................Page 2
In Memoriam -Tom Shepardson............................................Page 4
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CALENDAR
Next Team meeting --
Wed., March 26, 2003 @ 1800 hrs.

Where?  CA-4 Operations Center
8540 Production Avenue, Suite B, San Diego
Location is in Miramar Area, 1.8 miles E of I-805 exit at Miramar Rd. Turn N  on Production Avenue, 1/2 block on the left. (Remember, we have no mail box at the Ops Center, so never use this address for mailing purposes)

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Commander's Log
DMAT CA-4 had its best representation ever at the NDMS Annual Meeting held in Reno,NV March 8th thru 12th. Twenty-seven team members were in attendance.  Here is the  list of attendees:
Chavez, Rachel        Domino-Snyder,Valerie
Fitzgerald, Beverly        Griffin, Larry
Harker, Larry     Hicks, Toni
Jacoby, Jake Markland, Jo
Ontiveros, Sara     Perkins, Chuck
Perkins, Peggy    Polk, Deanna
Pregent, Susana     Prepas, Robbie
Reeves, Mark      Ruiz, Salvador
Rymer, Therese    Snyder, Ed
Soderberry, Robbin    Sohmer, Michael
Spuhler, Kevin   Steinberg, Craig
Thoreson, Jack  van den Hout, Carla
Wahrenbrock, Zona    Welsh, Mary     Wood, James
CA-4 had included funding  for 15 members in the Federal budget,   and 5 in our state budget. Additionally, some team funds will be used  for some of the rest, while 3 members were able to obtain funding from employers to attend on their own.  Much thanks needs to be extended to the Sharp and Scripps Healthcare Systems, for supporting some of their key employees' attendance.
   In addition, a new level of involvement was attained. First,
Thérèse Rymer, our Deputy CDR, was involved for almost a year on the planning committee for the conference, which had uniformly outstanding topics and lectures, and chaired many of the sessions.  She was honored with a Commendation fron NDMS. She  presented a talk on Occupational Health Considerations and Programs for a DMAT, and  was also a  panel participant in the final summation report of the ongoing smallpox sessions from each track, reporting  EMS issues and the smallpox vaccination program.  Michael Sohmer was present to accept his CA-4 Member of the Year Award. He also participated in a panel entitled "What About the Drugs?" presenting lessons learned from the Super Typhoon Pongsona deployment to Guam with the pharmacy experience of others at Ground Zero. Jake Jacoby gave a presentation entitled "Tropical Deployments: Lessons Learned from the Guam/Super Typhoon Pongsona  and St. Croix/ Hurricane Georges deployments." On the final morning,  he was also a participant in a Panel organized by Jeff Rubin of CA EMSA, on  agency interactions in responding to a catastrophic (fictitious) California earthquake in the LA area.
   Team member Karen van Hoesen, ED physician at UCSD,  gave a well-received lecture on Hazardous Marine Creatures, an appropriate heads up to folks who deploy to the Tropics.
    CA-4 alumni were active as well.  Marianne Ingels, a former CA-4 member who is now living in Oklahoma City, and on the OK-1 team, delivered a fact-filled overview, History of Toxic Disasters, which started as far back as the Middle Ages in discussing the grain contamination resulting in St. Anthony's Fire. Numerous other natural and man-made toxic disasters were discussed, from Bhopal, India to Lake Nyos in the Cameroons. 
   Chris Ho
, an emergency medicine physician who graduated the UCSD ED residency 2 years ago,  has been traveling and working in numerous areas, but will be returning to San Diego  in July and rejoining our team ( we hope). He gave an experience-laden presentation on Cold Weather and Altitude deployment considerations.
    Service awards were given to the team for its role in 3 activations during the year: Salt Lake City Winter Olympics, Avian Influenza Outbreak in Virginia, and the Super Typhoon Pongsona deployment this past December. 
* The disposable medical supplies used up or left in Guam during the December deployment to Guam finally arrived on March 21st, and we will need to get them repackaged in our supply chests and ready for our next ALERT or deployment during April, when we are again 1st up for the Western US.. Some of the packaging will be done as part of our next meeting.
* The order of zippered team sweatshirts, short sleeved T shirts, and  the newest item, long sleeved T shirts, has arrived. First priority will be to make sure those of you who "reserved" these items can purchase them..  and then we will open the sales up to the rest of the team. All items are resold at our cost.
* With the move of the DMATs from the Dept.of Health and Human Services to the Dept of Homeland Security, the question of what will happen to our standard khaki BDU uniform has not been answered. Those members who are in the process of purchasing and preparing the marques for the khaki uniforms should NOT get the USPHS tape made up. Hold off on that for awhile until a new guideline is issued by NDMS.  The move, effective March 1st, occurred without enough time for a new policy to be developed. So stand by on that one.
*  Chris Galindo, designer of the Rough and Ready 2000 T shirt logo,  is now hard at work preparing some new designs and a new look for our team logo. More on that when the drafts are ready.
* State Franchise Tax Exemption: Just three weeks ago, I received a letter from  the State of California Franchise Tax Board which notified me that, even though we had  filed Exempt State Income tax Forms for the last two years, we had never been granted tax deferral status by them, and I was given four weeks to complete the application for it. Turns out that not only were we supposed to get Tax exempt status from the IRS and the CA Secretary of State,  and the State Board of Equalization,  we needed to complete still another application with the State of CA Franchise Tax Board.  In reviewing this situation with our attorney, it turns out that it was not ever applied for. The application was  5 pages long, (not bad, considering the length of the NDMS applcation) but required  copies of just about all the official documents we have ever received, filed, or sent out, plus additional documentation of two years worth of budgets, financial reports and balance sheets,  the application fee, and copies of "stuff we send to members."  The final Fed Ex box weighed 2.8 pounds.  I finshed it just in time to Fed Ex it to Sacramento by the March 25th deadline. This will take 90 days to process.
* For those members wanting to get reimbursed by our team for their incurred expenses in attending the NDMS Annual Meeting, up to the $750.00 maximum, you will need to submit a reimbursement request,as reviewed at the last team meeting, If you want to complete your request for reimbursement at the team meeting, make sure you bring all your original  receipts.
 
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Minutes of February Team Meeting 
Monthly Team Meeting for February was called to order shortly after 1800 hours on Wednesday Feb 26th by Team CDR Jake Jacoby at the DMAT CA-4 Operations Center.. Introductions of new members, new faces and new   attendees were made.
Old business:

a.) Tom Shepardson - "Father of DMORT" was eulogized. See below.

b.) Rough & Ready Ukraine update (possibly moot due to Iraq war)- "Originally 9 CA-4 members going but increased to 15 out of total of 120. Main security is California Air Guard but some Guard members may not be able to go due to war duties.  If the Rough & Ready event is canceled the $100 visa payment to Ukraine govt. will either be returned or   forfeited."  [Status uncertain]. If forfeited, DMAT CA-4 will try to budget reimbursements into next year's budget if funds are not available to do so this fiscal year.

c.) Smallpox immunization plan per conference call - "Directive to immunize DMAT members under Phase I . Phase II would include health care workers and Phase III for the general public.  Jake recommended e-mailing Therese Rymer if team member is interested in smallpox vaccination.

d.) Team informed  that if a team is federalized for deployment, receives smallpox vaccination and then has an adverse reaction...the team member would be covered by Federal Workman's Compensation under this scenario.    as long as they were rostered at least 7 days in advance, and then go their vaccination from the County on the date they were federalized.
   DMAT members are under NO obligation to get smallpox vaccination. It is entirely voluntary.  If NOT vaccinated, however, then a team member could conceivably be NON-deployable for a smallpox-related DMAT mission. However, if such an event were to occur, it is suspected that everyone and their uncle will want to get vaccinated at that point.

e.) LAST CALL for intermittent appointment forms.

f.)  Procedures for getting reimbursed for travel to and training expenses for the annual meeting in Reno, NV were reviewed. "Save all airline expense receipts w/dollar amounts (boarding passes unacceptable), hotel expenses only (no movies, room service, massages, etc.) PLUS conference registration, up to $750. per person." Must use DMAT CA-4 Travel Reimbursement Form #2". The five or six members who are funded through the state  will also need to sign a travel form from UCSD, and those getting reimbursed through that mechanism may take a little longer to get their reimbursement checks.

COMMITTEE REPORTS

a.)  Administrative Officer: (Zona Wahrenbrock)- Invite to new applicants was extended to finish paperwork plus get digital photos for I.D. cards...98 "current" dues paying members in system. Still few people who deployed to Guam who are in arrears on their dues.

b.) Commo - deferred.

c.) Financial report (Jake Jacoby) - "Had to use team funds to pay federal component of rent for January and February, but it will be reimbursed by VWI from the NDMS Budget.  Balance in team account approx. $7,000 ."  Jake reminded team members to make sure that he has current e-mail addresses on file.  Currently the team is "under-budget" so opportunity exists to purchase items for team based partially upon team member recommendations for equipment and/or supplies.

d.) Fund-raising committee (Susana Pregent.)- Considering emergency preparedness training [Submitting bids/proposals for funding?]

e.)  Logistics (Chuck Perkins) - Pallet of medical supplies needs  to be inventoried and stock confirmed within 10 days of receipt. Need to complete inventory of the one pallet received  recently and report the receipt of it.

f.)  Nursing Director (Peggy Perkins) - Peggy identified a need for a "Skills Day'; i.e., an opportunity for skills assessment of the nurse members of the team.  A written packet is to be handed out at the June 2003 meeting.  Applicable members will be given one month to study the handout materials. Goal is to learn to use equipment (demonstrate proficiency),  know and understand deployment procedures, paperwork, narcotics procedures, etc.

g.)  Pharmaceutical (Michael Sohmer) - Michael reported that he talked to Mark Gonitzke pharmacist at CCRF re: pharmaceutical cache being sent on deployment w/MST versus a team's "own" cache.   DMAT CA-4 has ready access to pharmaceutical cache due to working relationship w/UCSD.  Bill received for pharmaceuticals shipped to Guam for December deployment = $61,840.00 .  Michael noted that DMAT teams that don't have pharmaceutical cache "agreements" with a sponsor such as UCSD may have high up-front costs as evidenced by the nearly $62K "tab" for the Guam mission.  Michael reminded Jake of availability of CA-4 pharmacists available to augment other teams if needed...Jake (to paraphrase) said: "Been there, done that...we sent Susana & Ken to WTC with CA-2."  In a nutshell, we've got that base covered.  Michael indicated that 24 vials of Cro-Fab were "left" in Guam and perhaps should have been retrieved to the mainland. [Add that   to your after-action report, Michael.Value of the Cro-Fab is $19,900.]

h.) Safety committee - no discussion

i.) Supply committee - no discussion

j.) Tactical team - deferred.

k.) Training -   recommendation by Jake for every current team member to take at least FIVE classes of the on-line training program by July 1st.
l.) Website - It was noted that the team website is improving

NEW BUSINESS
Question to Team CDR  re: war casualties - any potential DMAT involvement? Jake explained that Miramar could be a "receiving center" for casualties (i.e., wounded military repatriated to their home community).  DMAT could  assist with receiving patients, re-triaging them for possible deterioration during their flight, and getting them transferred to the local NDMS hospital beds.  It was noted that the USNS Mercy could be used for a civilian disaster.

Gene Adkins (VMAT "stowaway") floated the idea of a membership manual for CA-4 and asked if any volunteers.  Web site could fulfill this idea.

Copies of the "NDMS Clarification of Provisions of P.L. 107-188 Public Health Security and Bioterrorism Preparedness and Response Act of 2002" was handed out to team members and were reviewed.  The intention of the law is to provide NDMS members the "same job protection and reemployment rights as military reservists in the Federal System".  Open discussion ensued weighing pros and cons of the "perceived but not absolute" protection(s) afforded to deployed DMAT members under this law.  General consensus seems to be that common sense and good judgment ultimately determine whether or not a specific team member has problems (or not) with an employer prior to or subsequent to a deployment-related work absence.

[News items and e-mail "chatter" between DMAT members about Tucson reservist being fired from his job with Pep Boys underscores the perils of balancing DMAT duties with job responsibilities...we'll probably see continued discussion about this issue at the 3/26/03 meeting.]
***DMAT San Diego CA-4 is 1st UP for month of April***

Meeting was adjourned at 1958 hours.
--- Submitted by Ken Rogers


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In MEMORIAM: Tom Shepardson

REPRINT OF OER /Dr Kevin Yeskey's  ANNOUNCEMENT:
It is with great sorrow  that I announce the passing of Thomas "Tom" Shepardson, DMORT National Commander.  Early morning on Tuesday, February 18th, our friend and dear colleague, Tom, suffered a massive heart attack at his home in Fayetteville, New York.  Tom Shepardson was a man of strong
 conviction and dedication.  In response to the Homeland Security alert of Code Orange, Tom agreed to serve at the DHHS Office of Emergency Response in Maryland, assisting with the agency's Shuttle DMORT mission.  It was just last Saturday that Tom ended his service at OER.  He was preparing  to
attend the funeral services for his good friend and colleague, Fred Barry. Tom was saddened by Fred's passing and shared with us his appreciation for life and all the good things God has blessed him with.   And now, we all once again must grieve and lay to rest a man that has touched all our lives.  However, we will never forget the service and friendship and dedication Tom has shown us all.   I ask all of you to show a moment of
 silence for Tom and his family,  keeping them in your thoughts and prayers.
 as they go through this difficult time. 
 In lieu of flowers, the Shepardson family is asking for donations to be sent to the "Thomas J. Shepardson Scholarship Fund" care of Blessed Sacrament School, 3131 James Street, Syracuse, NY 13206 .

Tom Shepardson's deeds large and small are recalled
   Life of funeral director who helped create disaster response team  is saluted.

 By Luis Perez , Staff writer
    © 2003 The Post-Standard., January 29,2003.
  Thomas Shepardson spent a lifetime helping tens of thousands  grieving  the deaths of their loved ones.
Saturday,  mourners grieved Shepardson as he was laid to rest.

The Rev. James O'Brien, pastor of Blessed Sacrament Church on James  Street , expressed the community's condolences to Shepardson's family  "on behalf of all those nameless people that have been touched and  enlightened by Tom's kindness."
     Shepardson died Tuesday [Feb.18, 2003] of a heart attack,  his family said.  He was 59 years old..
   Mourners on Saturday stood in the back of the church after the pews  filled. They came to say farewell to the Syracuse funeral director who helped create a national disaster response team: D-MORT, or Disaster Mortuary Operational Response Team. The team collects and identifies  bodies after disasters,  most recently after the Sept. 11, 2001 , terrorist  attacks.
 D-MORT members from across the country attended the funeral dressed in their khaki-colored uniforms. Law enforcement and fire officials from  the city, county and state, in their dress uniforms, also honored  Shepardson.
 Honor guards lined the church's front entrance, and 10 clergy
 members stood at the altar.  Shepardson's children eulogized him. They spoke of his life as a shooting star that shone bright, but  was dimmed too soon. They talked about a man who saw so many others through their darkest moments with dignity and respect. And they urged others  who followed Shepardson's lead to continue his important work.

       "We have so much peace in the fact that my dad will be remembered  as such a beautiful person," said Laura Shepardson Lentz, his youngest.
      While his father helped tens of thousands across the country, Shepardson's best work was not done on center stage or on a grand  scale,  said his son Peter Shepardson.
 "It was those quiet times when it was just you and Tommy," he said.    Peter Shepardson said he took great comfort in learning from his  father.
 "I still need your fatherly advice," he said. "I will still ask you
 every day what to do."
Chris Shepardson was his father's partner at Frasier-Shepardson and Goddard-Crandall-Shepardson funeral homes. He talked about his father  as a  patriot.
 "He was proud of that (American) flag," Chris Shepardson said.
  Ever since Sept. 11, his father couldn't help but cry at hearing
 taps played, he said.   Shepardson started D-MORT at the county level, then brought it to  the state and finally the federal level, Chris Shepardson said.
 "He has left a lot of good men and women in his place," Chris
Shepardson said, directing his comments to many in the front rows. "He  may have started it. But you will continue it."
   Chris Shepardson was proud of his father's many accomplishments.   But  his proudest moment was when the U.S. government whisked his father  from a Cali fornia vacation to help at the Pentagon after terrorists flew  a  plane  into it, he said.
 "He was one of the only  men flying in the country that night,"
Chris  Shepardson said.
  When Shepardson came home, the family went out to eat at a local  restaurant. Shepardson was still dressed in his D-MORT jacket. Everyone  knew where he'd come from, and the bartender offered drinks on the  house that evening, Chris Shepardson recalled.
       "People don't forget the efforts you guys make," he said, again referring to the D-MORT team.
   Shepardson leaves a legacy of responding to national tragedies, of hard work, dedication, faith, love, family and friendship, Chris Shepardson  said.
  "My dad had an abundance of all of them," he said. "I love you
dad."
        Mourners rose for a standing ovation.

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