CSIM Operating Guidelines

Southwest Virginia
Critical Incident Stress Management Team

Operating and Administrative Policies

MISSION STATEMENT

The Southwest Virginia Critical Incident Management Team will strive to support the efforts of our region’s emergency responders by providing critical incident stress management services and training to all providers including fire, rescue, police, Medflight, emergency room personnel, and others who may become traumatized in their efforts to provide care for people in their community. The region covered will include Lenowisco, Cumberland Plateau, and Mount Rogers Planning districts.

TEAM ADMINISTRATION

The Southwest Virginia Critical Incident Management Team will operate under the guidance and administration of the Southwest Virginia Emergency Medical Services Council. The team will consist of individuals who represent a broad array of healthcare and service professionals and volunteers including mental health counselors, nurses, emergency medical technicians, chaplains, administrators, police, fire fighters, rescue squad personnel, emergency department dispatchers, and others who have been trained in the CISD model of critical incident stress management.

The team will select a Clinical Coordinator who is a mental health professional and who has received Virginia CISM, ICISF CISM, or equivalent CISM training. The Clinical Coordinator’s job duties include but are not limited to:

maintaining a list of members and their contact information, arranging team meetings, and insuring retraining updates are conducted at least every four years
contacting and assigning members to participate in debriefing and diffusing crises involving health care, fire, police and rescue personnel
keeping records on each crisis in which the team participates, making semi-annual reports to the OEMS CISM Coordinator, and making quarterly reports to the EMS Council
recruiting members as needed to insure adequate coverage, screen new member applications, and make recommendations to the team concerning applications
appoint and delegate responsibilities to one or more Assistant Coordinators

The Assistant Clinical Coordinator is a mental health professional who has received Virginia CISM, ICISF CISM, or equivalent CISM training. The Assistant Clinical Coordinator’s job duties include but are not limited to:

assisting the clinical coordinator in maintenance of member contact information, record keeping, and member recruitment
coordinate debriefing or diffusing activities in the absence of or upon direction of the Clinical Coordinator
perform other duties as requested by the Clinical Coordinator

The regional council executive director (or a designated council staff member) shall serve as Administrative Coordinator. The Administrative Coordinator’s job duties will include but not be limited to:

maintaining all team records, updated mailing and telephone listings, updated guidelines and protocols, minutes, etc.
notifying team members about upcoming meetings and scheduling meeting facilities
preparation of meeting agendas
providing additional team support as requested by the Clinical Coordinator
processing reimbursement requests from CISM team members

Additional officers may be appointed by the Clinical Coordinator as needed. Additional officer titles and job descriptions will be described in the Operating and Administrative Policies by amendment or as an appendix to the policies.

MEETINGS

The team will meet at least two times each year to review membership, accept new applications for the team, provide training and updates and discuss recent CISM events to assess the success of the program. Meeting dates, times and locations will be determined by the Clinical Coordinator. Meeting notices will be distributed by the Administrative Coordinator as well as scheduling of facilities. The preferred means for notification is e-mail, and only those with no e-mail account will receive notice by postal mail.

Meetings will be conducted by Clinical Coordinator. The Assistant Coordinator will conduct the meeting in the absence of the Clinical Coordinator. Meetings will generally be limited to two hours and will be held in a central location to the team. A quorum will consist of the members in attendance. Each member in attendance will be eligible to vote. Proxy voting is not allowed.

Attendance at meetings will be documented and individuals who routinely miss meetings will be contacted to determine their interest in remaining on the team. Updated information will be disseminated to those members who have a legitimate reason for their absence but wish to remain on the team.

MEMBER REIMBURSEMENT

Team members may request travel reimbursement, at the current rate adopted by the Southwest Virginia EMS Council. This may include mileage, meals and items necessary for the comfort and support of the participants in the CISM event. This may include light snacks and refreshments such as fruits and bottled water. All meals and other items will require a receipt for the exact amount of the requested reimbursement. Expenses will be reimbursed for an approved activation when the following circumstances apply:

The round trip was greater than 20 miles
Request for reimbursement is submitted on an approved Southwest Virginia EMS Council travel voucher
No other entity is reimbursing the mileage

Team members may request reimbursement for related training completed. Such training must be approved by the team. Reimbursement decisions will be made based on availability of funding and will be decided on a case-by-case basis.

RECORDS

Records of all meetings will be maintained at the Council office with the Clinical Coordinator being responsible for routine inclusion of minutes. These records shall include any actions of the team, membership decisions, types of training provided, and attendance records. Additionally, the Clinical Coordinator will document all activations of the team to include the members activated, event location and brief description and the number of participants. Semi-annual reports will be submitted to the OEMS CISM Coordinator as required.

CONFIDENTIALITY

Within legal guidelines, CISM team members must assure confidentiality of any information shared during debriefings. Team members will hold as privileged any information related by participants in any intervention.

MEMBERSHIP

Applications for membership are available at the EMS office and through the Clinical Coordinator at meetings. The active team members present at the first regularly called meeting after an application has been received will review applications and decide on appropriateness of the applicant for inclusion. The following provisions apply to all members:

Members must be in good standing with their respective departments
Must have no history of barrier crimes that would prevent them from working in the health care industry. Currently the team does not conduct criminal background checks and relies on the membership to police itself in this regard.
Must be age 21 or older
Must have at least two years experience in their respective discipline
Must have completed a state approved CISM training event or be eligible for and currently arranging to attend a state approved CISM training event
Must be willing to abide by team rules, principles, guidelines and appropriate standards of conduct
Must complete a team membership application and provide proof of certifications and references
Must attend team meetings regularly

Mental Health Team Members or Clinicians shall have advanced training in the assessment and management of emotional problems.

Peer Team Members will typically be emergency service personnel who are familiar with the circumstances and stresses common in emergency work.

TEAM OPERATIONS

The CISM team will respond to situations of significant magnitude to reasonably cause an acute stress reaction involving fire, rescue, emergency room personnel, mental health personnel and/or police. Availability is 24 hours per day seven days per week. The team will be activated by a contacting the clinical coordinator or his designee and notifying of an event requiring the need for a CISM intervention. The coordinator will then ascertain the nature of the request and determine its appropriateness to the CISM model. Items of a civilian nature will be redirected to the local mental health authority.

The Southwest Virginia CISM Team can be activated at any time by calling Central Dispatch at (276) 676-6277.

Types of interventions offered by the team are as follows:

Defusing: Held shortly after a critical incident, these interventions are intended to allow individuals to vent and provide information concerning stress reactions and suggestions to deal with them.
Debriefing: These interventions are held within 24 to 72 hours of the incident. Such interventions provide a forum for individuals experiencing a critical incident to discuss their concerns. Participants learn about coping strategies and are informed about normal symptoms experienced after such critical incidents.

The Clinical Coordinator and/or designated Assistant Coordinator will determine the type and number of peer and mental health personnel needed for each CISM intervention.

AMENDMENT OF POLICIES

The Operational and Administrative Policies are determined by the Clinical Coordinator and designated Assistant Coordinator(s). Policies will be reviewed each year and revisions made as necessary.

Adopted 11-15-2006
Revised 5-31-2006
Revised 9-28-2006

TEAM CONTACT PROTOCOL

The Southwest Virginia Critical Incident Stress Management Team is available to EMS , Fire and Police agencies needing critical incident stress management year round. A variety of options are available to address specific needs. In order to activate the CISM TEAM, please use the following protocol:

Contact: Washington County Central Dispatch
Telephone: 276-676-6277
Time: Day or night, year round

The SWVAEMS Council should not be contacted to activate the CISM Team. This operational protocol is the official callout procedure. Central Dispatch will contact the on-call CISM team member per established callout protocol. To insure attention to your needs, please follow these guidelines.

If you have any questions about CISM, or would like to become involved, please contact the Southwest Virginia EMS Council at (276) 628-4151.