Presidential Response

Tuesday, February 1, 2011 was a big day for Charlotte, NC. That’s when the Democratic National Committee announced the Democratic National Convention (DNC) would take over North Carolina’s Queen City during the first week of September 2012.

With the announcement came a sense of excitement and pride for residents of the greater Charlotte area, including the 500-plus employees of Mecklenburg EMS Agency (Medic) who are responsible for providing EMS service to all 542 square miles of Mecklenburg County, including the city of Charlotte.

After a few days of celebration, once the initial rush of excitement wore off, the realities associated with the task began to set in. In addition to maintaining daily operations at the busiest EMS agency in North Carolina, Medic leadership now had to set aside enough time and resources to plan for one of the most complicated special events an EMS agency can take on.

Medic started by designating Deputy Director Kevin Staley as the agency’s lead for the event. Staley has a master’s degree in public administration, is a certified emergency manager and has 25 years of EMS experience as a paramedic. He also has a great deal of experience interfacing with numerous state, local and federal agencies, including the U.S. Secret Service, Department of Homeland Security (DHS) and the North Carolina Office of EMS (NCOEMS). This experience, along with the many relationships he has built as a result of his work, would prove invaluable.

Staley did what every good leader does when faced with a monumental task: He enlisted some help. Michael Stanford, a 15-year EMS veteran and Medic’s supervisor of emergency preparedness and special operations, was brought on board to help share the load. The two would essentially eat, drink and sleep all things DNC for the next 16 months.

Despite the agency’s considerable experience with special events and disaster preparedness, the 2012 DNC was clearly unique. It combined all of the elements of a multi-day mass gathering with the complexities of a national special security event (NSSE) thanks to the fact that a sitting president would be on hand to accept the Democratic nomination. It didn’t take long to assemble a list of questions, which, when answered, could help the agency get a much clearer picture of what needed to be planned.

Medic quickly reached out to Denver EMS Assistant Chief James Robinson, as his agency had been down this road just four years earlier when the DNC was held in the Rocky Mountain state. Robinson graciously accepted an invitation to travel to Charlotte and share his experience with an audience that included Medic leadership, NCOEMS officials and leadership from various area hospitals and emergency responders.

Robinson presented a thorough summary outlining his agency’s experience from 2008, and he patiently answered every question the audience could muster. Although Medic’s team felt like they had more clarity regarding the impending task, the “drinking from a fire hose” effect was also kicking in. It was time to start leaning on the 30-plus years of experience and knowledge that existed within the agency and begin putting some plans on paper.

The Host City

Charlotte is the smallest city in modern times to serve as host to one of the national political conventions. Despite this, the city’s emergency responders had the training, resources and experience to take on this event.

Medic personnel regularly serve and train with their counterparts in and around the city of Charlotte; this includes the Charlotte Mecklenburg Police Department (CMPD) and the Charlotte Fire Department (CFD). In addition to daily emergency response, these agencies also serve together on several special operations teams including the Civil Emergency Unit (CEU), Advanced Local Emergency Response Team (ALERT) and Special Weapons and Tactics (SWAT) teams.

Charlotte also serves as a reception city for the National Disaster Medical System, requiring area emergency responders and hospital systems to regularly conduct group training exercises centered on receiving, stabilizing and distributing large numbers of evacuees. All of the experience, training and planning associated with each of these responsibilities greatly aided Medic in preparing to take on the DNC.

With an event the size and scope of the DNC, the trick isn’t figuring out what the pieces of the puzzle are; it’s figuring out how the pieces are going to fit together under challenging circumstances. There were literally dozens of federal, state and local agencies engaged in the planning process, in addition to two major hospital systems and various other local interests. Every one of these organizations knew their own roles and responsibilities, yet none of them could plan or work on an island. It was imperative that a framework for organizing, planning and communicating was established early on so that all of the pieces of the puzzle could start to align.

Planning Process

Since the DNC was designated a NSSE, the Secret Service and local law enforcement took the lead on event planning. Each agency was still responsible for their own area of expertise, but security concerns were clearly going to dictate much of the parameters that Medic would have to work within, and understandably so.

The planning process was organized among 20 subcommittees that reported to the NSSE DNC Executive Steering Committee. Medic served directly on eight of the subcommittees: Health and Medical, Crisis Management, Consequence Management, Multi-Agency Coordination Center, Civil Disturbance, Fire and Life-Saving, Public Affairs, and Airport. For the better part of 16 months following the DNC’s choice of Charlotte as the host city, Medic personnel were engaged with these subcommittees hammering out extensive plans to ensure emergency responders were prepared to handle virtually any situation that came their way.

There were several major variables Medic had to take into consideration when building the emergency medical coverage plans for this event. First and foremost was dealing with the necessary security constraints. There would be varying levels of security around the city of Charlotte, and the agency had to provide coverage both inside and outside of the secured zone. Plans had to be established for challenges like mobility and response in heavily congested areas, patient transfer out of the secured zones, and surge capacity should something unthinkable occur.

Another variable to contend with had to do with venue selection during DNC. Time Warner Cable Arena (TWCA) was tabbed early as the convention location. It was decided later that, in addition to TWCA, Bank of America Stadium, which is on the opposite side of Center City Charlotte, would serve as the location for President Obama’s acceptance speech on the last night of the convention. The secure zone that would be established early in the week of the DNC around TWCA would need to be moved to a perimeter around the stadium on the last day of the convention, and plans would need to be established to accommodate such a move.

Additionally, the schedules for the president and vice president would not be shared with emergency officials until the week of the DNC. Medic was tabbed to provide EMS coverage to any motorcades involving the president and vice president during the event in addition to dedicated standby coverage at any location either dignitary visited while in Charlotte. Plans needed to be in place to ensure around-the-clock coverage could be provided regardless of whether their time on the ground in Charlotte spanned 12 hours or 72.

Accommodating the anticipated crowds in the Uptown Charlotte area was another important factor in planning. Would 35,000 visitors show up in the Queen City the week of the event or 100,000? How would local residents, businesses and employees handle the constraints in the Uptown area the week of the DNC? There were also a number of events being planned in Uptown Charlotte during the DNC, like the CarolinaFest on the opening day of the event, which had the potential to draw thousands more visitors.

One of the more unique challenges was preparing to handle the various protesters who would likely be setting up shop in Charlotte. Denver EMS had to deal with large numbers of protesters during the 2008 DNC, and the Occupy Wall Street movement was still active across the country. Both federal and local officials widely anticipated a large presence by protesters during the DNC and it was imperative that agency personnel were well trained on how to safely navigate any medical emergencies where protesters were involved.

Last and most important was the need to anticipate how call volume would be impacted by the event. Everyone at Medic was clear that maintaining response standards to the 950,000 residents of Mecklenburg County was still the agency’s core function. Doing so while providing dedicated resources to support the needs of the DNC and creating surge capacity in case the unthinkable occurred posed some significant challenges.

Marshalling Resources

Medic is built to handle more than 110,000 calls annually, in addition to having resources aimed at handling large-scale events and providing disaster relief support to the surrounding region. Agency resources include 74 ambulances, four utility transport vehicles (UTVs) equipped for patient transport, two mass casualty buses capable of transporting up to 20 patients each, a mass casualty response vehicle that carries enough supplemental equipment to support a large-scale event and 12 EMS-equipped bikes for rapid response in difficult-to-access areas.

Despite these considerable resources, Medic officials knew the needs created by this event were bigger than any one EMS agency could handle. Medic reached out to North Carolina EMS Chief Regina Godette-Crawford and her team at the North Carolina Office of EMS for additional guidance and support.

By working with state officials and EMS counterparts across the region, Medic was able to leverage critical resources that would make contingency planning and surge capacity a reality without overcommitting the agency’s own resources. This support was a critical component to the agency’s success during the event.

The decision to adjust the agency’s regular staffing schedule was made and communicated a year in advance so employees had the chance to plan accordingly. Every employee critical to agency operations was informed they would be on a 12-on, 12-off schedule during DNC week, starting Saturday, September 1. This provided the agency with the personnel necessary to handle normal system demand, the secure zone, special teams and a certain level of surge capacity in the county.

Once staffing, scheduling and resource allocation were planned out, attention moved to other critical functions that would impact the agency’s success. One such area was logistics. Despite Medic’s large fleet, operating a 12-on, 12-off schedule while simultaneously deploying so many resources was going to make handling the logistics functions a challenge. There would not be a ready line of trucks for crews to utilize; the logistics team needed to design a different process for handling this transition so crews were not waiting on them. The solution was a face-to-face vehicle turnover process that enabled a vehicle to be cleaned, restocked and checked off within 10 minutes.

Deployment

As the Democratic National Convention approached on September 1, the various command centers dedicated to supporting the event were brought on line.

Medic leadership had responsibilities in several, including the CMPD Command Center, Multiagency Coordination Center (MACC), Joint Medical Operations Center (JMOC), Joint Operations All Hazards Center (JOC/AHC), Joint Information Center (JIC), Mecklenburg County’s Emergency Operations Center (EOC) and the Interagency Communications Center (ICC).

On September 2 a distinct secure zone was erected in Uptown Charlotte and the deployment strategy Medic had spent months designing with the agency’s counterparts began to materialize. Twelve paramedic bike teams and four paramedic UTV response teams began operating inside the secure zone. There were also six ambulances and two operations supervisors strategically positioned in the secure zone, in addition to two ALS teams assigned to TWCA to support the hospital special events staff positioned there.

Nine highly trained paramedics were assigned to CEU teams under the direction of CMPD. These teams were responsible for ensuring protests remained peaceful and responding to any outbreak of civil disturbance. Paramedics on the CEU teams provide rapid medical support to officers and civilians who become ill or injured during a protest or civil disturbance. Six tactical paramedics were also deployed with the CMPD SWAT team at strategic locations throughout the city.

Teams located inside the secure zone did not leave the area except for shift changes. Any patients requiring medical attention inside the secure zone were either treated by one of the two hospital special event staffs on site or transferred to a waiting Medic unit at one of the Secret Service check points for transport to an area hospital.

Outside of the secure zone Medic deployed 55 ambulances to handle the day-to-day needs of Mecklenburg County, along with any patient transfers from inside the DNC secure zone. The agency also strategically positioned its two mass casualty buses and mass casualty response vehicle to respond to any major events that might occur.

By all accounts the 2012 DNC was a huge success. There were no serious security breaches, the protests didn’t materialize into anything violent or unmanageable, and Medic was able to successfully handle the call volume and extra responsibilities that came with hosting the DNC. Call volume for the week of the DNC was up nearly 25% over the same holiday week the year prior (1,895 vs. 1,532), yet the agency was still able to maintain county contract compliance with regard to response times.

Even more important was, for the most part, Medic’s employees thoroughly enjoyed the opportunity. A post-DNC employee survey provided excellent feedback to agency leadership regarding things that worked and didn’t work throughout the experience. Morale was up overall, teamwork was increased and communication was improved. Building on these gains is an important target for agency leadership in the coming months.

Being the host city for the Democratic National Convention was an enormous amount of work, but it was also an extremely rewarding undertaking. Having the opportunity to put years of training and experience to use on the national stage is a rare opportunity, and one everyone at Mecklenburg EMS Agency is very grateful for.

There were many takeaways from the experience. At the end of the day it was the relationships, partnerships, training and teamwork that made the 2012 DNC such a successful endeavor for the emergency responders of Charlotte, NC. Stay focused on these key ingredients and any event will likely yield the same results.

Training Considerations

Training was another important consideration that had to be built into the pre DNC preparation. Field personnel received refresher training on treating penetrating trauma, blunt force trauma, burns, blast injuries and response to chemical, biological, radiological, nuclear and high-yield explosives (CBRNE). Leadership also reviewed with employees the principles of unified/incident command and the agency’s mass casualty response plan.

From a purely DNC perspective, employees needed to be briefed on deployment plans, security constraints, radio traffic guidelines, road closures, protocol adjustments and the intricacies of treating patients among protesters. In all, Medic field personnel received an additional 14 hours of DNC-related training in the four month period leading up to the event.

Kristin Young is public relations manager and Jeff Keith is deputy director for Mecklenburg EMS Agency.

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