New Missions in Emergency Management

Deanna Lee

You're listening to Policy Currents. I'm Deanna Lee. In case you missed our last episode on November 15th, we announced that this show is coming to a close, and we're launching a new podcast right here in this feed in 2025. A trailer will be coming your way soon. Today, we have one final episode of Policy Currents for you.

Today's special episode focuses on emergency management, a topic that's very timely right now, just weeks after the devastating wildfires broke out in Los Angeles. However, I want to mention at the top that this conversation—as well as a separate intro by me that you'll hear in just a moment—was recorded well before the fires.

And before we get to that discussion, I also want to let you know that RAND's Santa Monica headquarters, just south of the Palisades fire, is safe. RAND is offering support to staff members who've been affected by this disaster, and our thoughts are with those colleagues; the firefighters, first responders, and emergency managers working to protect others; and everyone in the Los Angeles area.

Okay. Here's today's bonus episode, recorded in summer 2024.

Deanna Lee

When you think of emergency management, you probably envision firefighters battling a wildfire or a team of responders evacuating a family during a flood. But emergency management goes beyond disaster response and other traditional ideas of the field. In communities all over the U.S., emergency managers are increasingly asked to lead new missions. Responding to the COVID-19 pandemic, for example, and supporting Operation Allies Welcome: the resettlement of roughly 90,000 Afghan nationals in the United States after the withdrawal from Afghanistan. Recently published RAND research examines these new missions and how the field of emergency management is evolving by gathering stories, experiences and perspectives directly from emergency managers who are on the frontlines of crises. I recently sat down with the lead researcher on that project, Patrick Roberts, and one of the emergency managers that he and his colleagues interviewed, Mary Ellen Carroll, executive director of the Department of Emergency Management for the City of San Francisco. Here's that conversation.

Deanna Lee

Patrick, welcome.

Patrick Roberts

Thank you.

Deanna Lee

Mary Ellen, thanks for being here.

Mary Ellen Carroll

Thank you. Happy to be here.

Deanna Lee

Okay. I'd like to start by asking Patrick to tell us a little bit more about this study. Can you talk to us about why you wanted to talk to America's emergency managers? What were you trying to find out and what did you learn overall?

Patrick Roberts

We learned and saw that the scope of the field of emergency management was expanding. Emergency managers had long dealt with fires, floods, hurricanes, earthquakes, but we saw them taking on new kinds of missions: assisting with unhoused persons or homelessness, synthetic opioids crises, migration, pandemics. During COVID, emergency managers played a key role in helping set up vaccination centers and unstuck, unsticking supply chains. What did we learn? We learned that emergency managers lead through coordination and influence and problem solving and not just formal authority or not just command. They're really they're really problem solvers and coordinators. We learned that they lead like jazz musicians play, that they improvise according to the situation. They have notes and instruments, but they have to adapt them to the situation and to what everyone else around them is doing. And what we want to do with this project is really help others, help other emergency managers and their partners learn to improvise in that jazz musician suite, just like they do.

Deanna Lee

And Mary Ellen and I mentioned, you are one of the researchers that Patrick and his colleagues spoke to for this study. So tell us a little bit more about your background, how you got into the field and your experiences.

Mary Ellen Carroll

Thank you. Yeah, sure. And I could not agree more with how Patrick categorized our work and how we do it. So I've been the director for emergency management here in the city and county of San Francisco since 2018. But I've worked in the city for 20 years in different roles related to emergency management and and some security work. And my sort of winding path has really led me to be super prepared for what I was appointed to do. In 2018 I started in public health doing and coordination, program coordination, but all kind of disaster related there. I worked in disaster finance and helped to develop the first citywide training program for how the city would handle FEMA declarations and be prepared to get some money back. And then I spent seven years at the Public Utilities Commission, which is our water and power wastewater utility here in San Francisco, both local and regional. So I have public health, I have the finance, kind of admin side, and then I have infrastructure. And before that, before I started with the city, I worked in the nonprofit field in the area of mental health and housing. So all of those things are things that I deal with in this job and the parts that I didn't really expect to kind of pull on was my more kind of socioeconomic work and community work that I started in my career. But it has has turned out to be a big part of of what what I focus on these days. And so, you know, we're never bored. It's fascinating work. But it is something that I think my colleagues and I throughout the country are in constant debate about, especially since COVID, about whether or not me becoming the jack of all trades and the solver of all problems is a good or bad thing. I think it can be a good thing for cities because we are good at our job. We're good at being problem solvers and bringing people together. But we're not super resourced. And so we are, all of us who have been doing this work, especially in the last five years, but over the last ten, are pretty, pretty tired, I would say.

Deanna Lee

I can only imagine. And I think we're going to cover a lot of those issues that you touched on a bit later. You mentioned you're never bored. You mentioned being a jack of all trades. Can you describe a typical day on the job, if there is one?

Mary Ellen Carroll

Yeah. I mean, there's there isn't a real typical day on the job necessarily. But I would say what is typical is that I am often either leading or participating in multi disciplinary, multi departmental types of discussions and meetings to solve very complex problems. And those can be related to some of our more typical types of emergency management issues that we deal with, like, related to seismic and challenge risks and earthquakes and working to try to figure out what's the best way for us to come up with a strategy to harden and lower risks in our tall buildings in our downtown area. Who's going to pay for it? How do you sell this to business and building owners? A very complex set of stakeholders, and I would call that kind of traditional work in a way, but I also spend a lot of time with my colleagues who are doing shelter and housing work. I am often in the room with law enforcement, with public health, with homelessness and housing providers, including my staff, as we work to try to really lead the city in coordination around our street, what we call street conditions. So both helping people who are either living on the street or experiencing crisis on the street, but also for the people that live around these conditions, which is also can be very traumatic for people that are living within that community. I also am responsible for 9-1-1 for the city of San Francisco. So all police, fire, medical and crisis calls comes through our 9-1-1 center. And so that's a 24/7 operation. A lot of the stuff that we do there has to do with with our staffing, which is a challenge and has been for all 9-1-1 centers for years. Cyber is a constant threat. So we do work closely with RDT, but we also think about consequence planning when it comes to cyber. And then we also happen to have EMS. We are also the EMS regulatory arm for the for the county. And so we work with fire and ambulance, private ambulance providers, hospitals. There's so many you know, like as an example, they're talking about complex problems. You know, we we struggle to to keep up with our standards around ambulance response times and how long ambulances stay in hospitals and working with hospitals to figure that out so that they stay off of diversion. But all the things that I'm talking about, especially when it comes to some of these socioeconomic and public health issues, they impact, they actually impact the hospital. And and one could even argue housing is is part of that also. So you know and then we also do regional coordination. And then also, you know, we have a meeting with the big city emergency managers, which is a group of emergency management directors throughout the country where we meet on a weekly basis and then we get together twice a year. So so it's really all over the place. We have, we struggle and we really try to stay with our sort of our more proactive type of work where we're working on something and trying to get to a solution. But we are also on a daily basis, almost having something that we are reacting to, right? That we didn't know we were going to be reacting to yesterday. But now it is a priority or it's an incident that's happened. So and then finally, I'll just say. Large events that are planned throughout the city. You know, any big city is going to have all kinds of fun things that people enjoy doing and whether it's big conventions or festivals or concerts. And so that's all, you know, all part of a day's work. I, I sometimes I say sometimes other people's joy is my pain, to be honest. It's kind of fun. Events we love and are so important to the health and sort of culture of the city. But they don't just happen magically. And those are things that we're involved in also.

Patrick Roberts

And some of the emergency managers we talked about said exactly the same thing, that they have to deal with unprecedented things all the time, that that's part of the job. And so one of the key skills is thinking creatively that that's what it takes to be a great emergency manager. Exactly along the lines of what Mary Ellen was telling us.

Deanna Lee

And let's let's maybe move on now to one of those unprecedented things, which was COVID. Obviously, the pandemic was a health crisis that we hadn't seen in 100 years in this country. And I'm sure Mary Ellen, it inundated your work for for some time. I'd like to hear from both of you about COVID-19 and how that shifted things. What was the role of emergency management during during that time and how was that different than anything you have had to respond to in the past? Patrick, if you'd like to go first and, you know, maybe talk about some of the perspectives of others you spoke to.

Patrick Roberts

Sure. I'll set the stage. Emergency management helped to manage logistics and unstick supply chains during during COVID-19 and helped coordinate efforts to vaccinate in some places once vaccinations were available. And FEMA, the Federal Emergency Management Agency, has authorities or legal powers through something called the Stafford Act and elsewhere to provide disaster relief. COVID-19 was a disaster in every state, tribe and territory, and that was new. Normally, a disaster is is regionalized at least, there's a hurricane or a flood in one location. But COVID was everywhere and it ebbed and flowed at different rates. And so that was something new. It was a national-level disaster. And the patterns were hard to predict, at least in the beginning. COVID was also a little different in that it required some some medical expertise. So it required public health doctors, epidemiologists to work with emergency managers and others. And it was a new kind of combination. So there's creative thinking there about how to how to build and renew those partnerships. One of the big moments in COVID was, and one of the surprises to some people, was the March 2020 decision to shift the lead federal agency from HHS, the Department of Health and Human Services, to FEMA. And that was that was a little bit unexpected and a little bit outside some of the plans. And that thrust FEMA at the national level into the lead. But emergency managers at the state and local level really, really followed suit in leading a lot of the supply chain efforts and logistics and coordinating aid. And we saw that happen happen around the country, including in San Francisco.

Deanna Lee

Mary Ellen, talk a little bit about your experiences in San Francisco during that time and the how you responded to this particular crisis.

Mary Ellen Carroll

Yeah. And again, you know, definitely agree with everything that Patrick said, and it was certainly close to our experience. We we did follow the lead initially, and throughout, of public health, obviously, because this was such an unknown. And one could argue is still somewhat unknown as far as where we're going with this and kind of how this is going to end and what it will look like in retrospect. But so we activated our emergency operations center very early in January, mostly around kind of communications. We, San Francisco, as you know, has very close ties to China and has a huge Chinatown and, of course, a large Asian population. And so it was really critical that we got ahead of some of the rhetoric and misinformation that was out there about this mystery illness and sort of, you know, what to do about it and to ensure that we were able to mitigate any sort of hateful and and ethnic-based misinformation about what was happening. I think the other things that were different about it, just to answer your question, were it was just this is so definitely the fact that this was not only in the United States, everybody, this was the entire planet was experiencing this at the same time. I worked on the pandemic plan at the Department of Public Health back in the beginning of my career in emergency management. And let me tell you, like, we did not get to this level of specificity about what these challenges were. And just like the physical challenges of being together and that that risk, San Francisco did stay, we stayed in person throughout and took over our convention center in order to do that and have the kind of space that we needed. But the other thing was this never-ending nature of it and the length of it. This was never anything I don't think many people contemplated. And, you know, how do you do that? So we activated what we called our COVID command center. We ended up going into kind of a unified command with health and with our human services agency, because housing and shelter was such a huge part of the challenge and mission for us, and feeding. And we were there for 18 months under a COVID, what we call COVID command. Physically at the Moscone Center here in San Francisco. It was, you know, the challenge of a lifetime and a career. Also the privilege for many of us to be able to to serve the city in that way. And it not only changed us as emergency managers, as city workers, as public servants, as humans, but as, I think, it really changed the way we look at how we do our work. Radically. You know, we will we won't be the same, I think, again, not only from our perspective, but again, circling back to the beginning question about what our day to day is, let me tell you, it's a lot different since COVID and it has not. It's not less work. It's more work. Different, right? but we across the board emergency managers really shy and I think and and took the took the helm and really got things done. We're able to convene and coordinate, build collaboration. And so that was noted.

Deanna Lee

So you say your your day to day work now even has changed because of COVID. Is that because the way you're planning for things has changed? Or can you talk a little bit about what some of those shifts were?

Mary Ellen Carroll

Yeah. So of course, the scope is is expanded. But I would say the way that we approach and I can speak, I am only going to speak for San Francisco here, but one of our biggest lessons was around who we serve and how we serve people, and and when I say that, really around community. And historically, emergency management has been, you know, about fighting fires and, you know, supporting other events like, say, a terrorist attack or whatever. So it's very like law enforcement, fire, focused. And a lot of people really started in this field, retired from those two fields and expertise, and we still need those that kind of expertise. But, you know, what we learned during COVID is that when it comes down to it, you've got to be able to reflect. I think the biggest lesson is that we didn't we were not reflecting the communities that we needed to serve. And we were failing because of that. We were failing. And so what we did in San Francisco is we had a equity officer that came in to work with our command. We started pulling people from very specifically who worked for the city but were from community. And I think I used the example in our conversation around, you know, at a certain point we had like 3 or 4 minibus drivers that we recruited because when they weren't driving busses, which by the way, the routes weren't running, you know, people weren't taking busses so much, they were leaders in their community in different ways. And so they were able to come on and do a lot of the outreach for us around education and other things. And so since then, just I mean, I could go on about this, but I will say, like concretely, what we've done is we have as we've had attrition in some of our positions, we have changed those positions to be very focused on community, less stringent on like the emergency management, you know, ICS stuff, but rather with it with a mission that is and responsibilities that are more about how do you engage and reach out to a community. And that, you know, helps us to get people that are more from those communities and reflective of that. So we have a community programs team now that we never had before, and we expect that we'll continue to see that grow. And I think that was one of the that was one of the big things that changed about COVID or changed us, that COVID changed.

Patrick Roberts

And I think we found in the overall project that the best emergency managers were able to adapt to figure out what communities aren't being served and to pivot to create new organizations, new structures. And maybe they lasted after COVID and some of them did. Maybe some of them were COVID-specific. That creativity was what the best emergency managers brought. One of the challenges we found in our report was that public health and emergency management weren't always used to working together before COVID. So there were some challenges. There was a learning curve. One of the people we spoke with, described it as having chess players thrown in with basketball players and being asked to play together. But the best emergency managers were able to adapt and do what San Francisco and Mary Ellen did to create a unified command center, a COVID command center, and put people in the same room and work together on on these problems. That exemplifies the kind of creativity we saw.

Mary Ellen Carroll

That's that is such a great analogy. And I could not I could not agree more. It was funny because it took, it was really hard to get public health into unified command in many ways because we had we basically were all physically in this one place, but we have an EOC and then they had their department operation center DOC. So we had two planning, two commands, two logistics, you know, and it was just not working. And so we were like, this is this is a model, we think this will work. Please trust us. Let's try this. And, you know, at first it was hard, but then very quickly it came together. And then it was interesting when it was time to end it, you know, this unified command and go back to our, you know, our normal operations, our normal emergency operations, to be honest. They were like, no, we can't, we can't stop. So we learned so much from each other. And but but yeah, it was definitely public health has a certain way of of operating and we have a different way of operating, neither of which was perfect for this particular situation. We both had to adapt separately and for each other and I feel like in San Francisco we've really, really succeeded with that partnership here.

Deanna Lee

It sounds like it. In thinking about your experience with COVID, but I'm sure this applies to a lot of other areas beyond public health crises, I'm curious about balancing planning and preparedness with response and recovery. I imagine that is a constant push and pull, if you will. Can you talk a little bit about that, Mary Ellen? And, you know, do you just have to accept some trade offs?

Mary Ellen Carroll

Yeah, I mean, we definitely had to for COVID, but we have been and we have been successful. And I will just say that it was only in the last year. So this in like end of '23 and then the rest of '24 that we've really been able to kind of dive back into the planning part of this work, maybe a little bit before that, but think about it, since early 2020 that was put to the side. And so, and it is really, and we did, there's a lot that happened during COVID that helped us build a bench that you could absolutely argue helped us be--and we are in many ways--more prepared for anything after going through COVID. So much, so many lessons, important lessons learned. I think COVID is was a very unique type of incident and we have to be ready to deal with infrastructure incidents, you know, acts of violence, a lot of other things that, cyber, that we that are that are super critical and has very significant impacts. So it's a trade off. But I think a lot of us have been pretty diligent in standing up to say like we have to carve out some time or this staff is only going to be doing that kind of work. Getting back to our exercises and that sort of thing. So. It's absolutely a trade off. And it is it is one of the issues that, you know, we don't want to have, you know, we here we are in San Francisco, you know, well overdue for a big earthquake, many would argue. And we don't have an excuse to not be ready. I'm sorry. You know, we still have to do that important work. And I'm proud to say that we are back at it here, even as we do all these other things. But it takes a toll. I think that's the thing that it takes a toll. It is. I don't know any other kind of field of work right now that has such a diverse scope of work and heavy load to carry.

Patrick Roberts

And many emergency managers we spoke with talked about how COVID highlighted the need to reach out to communities and emergency management's role and its potential to really link government services to particular communities, for example, in COVID we saw some examples of some vaccination sites that were really beautifully constructed, well built, but they might not have reached the communities that need to be served. And so there are some pivoting, some creating new organizations, new outreach processes. And that was a kind of learning we saw in COVID. And many of the people we spoke with said it was really important for emergency managers to train the community to prepare for a major event, whether a disease outbreak or an earthquake, and not just the people with emergency management in the job title. This is the role emergency management can play.

Mary Ellen Carroll

Yeah. And just to double back on that, what where that really was so crystal clear for us is before there were vaccines available, we did just that. We had beautiful, very elegant mass testing locations. But. The folks that were most impacted and and getting the disease were not utilizing those spaces for a variety of reasons. And so when we got to the vaccine phase, we learned and we pivoted and we had we had two different. Two different approaches that we gave the same amount of resources to, which was large scale because vaccine, it is important that you get people and as many people as possible vaccinated. But we also had a community-based approach that was much smaller scale and led by community. We let them tell us how to do it and they were the voices to their own communities about how to get there and amazingly, you know, after about a year or so, we had our minority communities had a higher vaccine rate than our majority white community in San Francisco, which was something else when you think about where we started. So that's just a concrete example of what so many of us learned during this and that we continue that we know we have to make sure we don't make those mistakes in any other event.

Deanna Lee

Learning and pivoting seems to be a theme so far in our conversation, to be sure. Let's move on. I want to talk about another new mission for emergency managers that is highlighted in the new RAND report. That's Operation Allies Welcome. The U.S. withdrawal from Afghanistan, which began in 2021 and lasted through the formal end to U.S. operations there in September 2022 led to the resettlement of roughly 90,000 Afghan nationals. Patrick, can you talk about the role emergency management played in this effort and what the greatest challenges were for emergency managers?

Patrick Roberts

Yes, some people were surprised that emergency management had a role in Operational Allies Welcome. But when the U.S. began its withdrawal from Afghanistan, there was an effort to bring these Afghan allies of the United States to the United States for safety. And there was a plan for the State Department and the larger federal government to evacuate them quickly and bring them to the United States. And this evacuation occurred if you remember, with almost no public notice, it sort of happened. There was some some private planning beforehand, but your local emergency management didn't know about it, I didn't know about it. And you read about it in news and it's happening. And sure enough, Afghan people were put on planes to come to the United States, two major entry points, Dulles airport and elsewhere. But there wasn't that much of a plan to figure out what to do with them after they got to the United States. So really, literally as planes are in the air, some leading emergency managers and others were assembled on calls. And the government, the White House government leaders at the federal level said we need to figure out what to do with these folks and how to care for them, how to really find a place for them in the United States, because we're evacuating them. We're taking in these refugees after this U.S. withdrawal. And so emergency managers stepped in. They raised their hand. Emergency managers, we found throughout our research are people who said yes to things. When there was an open call, a conference call, you know, time and time again, something that that didn't fit the playbook about who handles it: fire, health, police; emergency managers raise their hand, and they did here in an Operation Allies Welcome and said we can help. So what did they do? Well, emergency managers in states, localities, nonprofit organizations around the country helped link evacuees with essential services for food, shelter, vaccination; now remember COVID is still going on; medical care, education, translators. And this happened with almost no no notice. And a big a big mission was really housing. And so emergency managers know how to work with community partners and work with legal authorities and resources for securing housing for people after a disaster. A lot of housing is is affected and we need to rehouse people. They did some of the same things here with refugees from Afghanistan. And it wasn't just emergency managers. It was all the usual local partners, you might suspect. Public health, social services, school districts, nonprofit organizations, religious groups. But emergency managers in many places, los Angeles, for example, really important fulcrum, an important coordinator in connecting Afghan refugees to it, to services they need and rehousing them and getting integrated.

Deanna Lee

Mary Ellen, I don't think you had any direct involvement with Operation Allies Welcome, but have you faced anything similar, had any similar experiences perhaps with resettlement of large groups related either to the housing crisis or immigration? Any any parallels?

Mary Ellen Carroll

Yeah. I mean, I would say and again, this is this is not so much our direct experience in San Francisco but several of my colleagues in big cities New York, D.C., Philadelphia, Chicago, Denver, have been the receiving jurisdiction for busloads, planeloads of asylum seekers. And that is that really should be a whole show unto itself because it has been an extreme, like a heavy, heavy carry for those cities, because there is no there isn't really there hasn't traditionally been a playbook for that and there is no funding or resources for it. And all of us have existing challenges with housing and people experiencing homelessness and needs on the street. So it's a super challenging issue for those states. We have been, you know, we have plans for should that happen. But I would also say that we've been you know, it's not exactly the same thing, but it's certainly similar in just being called in to put plans together for, and I think this may be, you know, going into a future topic, but like extreme weather situations, if there's, you know, emergency managers to do temporary housing, to do respite sites, cooling sites, depending where you are, warming sites, you know. It has been, from what I have heard and and listened to from my colleagues, one of the most, challenging doesn't quite...but distressing situation in the way that they're such people, you're right, Patrick, people who are emergency managers do step up. But it isn't our area of expertise, you know? So figuring out how best to do this who do we partner with? Was not always. I think all those cities probably know it a lot better now. But that's not a that's not a natural partner for us in our day-to-day. I mean in San Francisco we've done, over the last few years opened an emergency center for for the opioid crisis and also for addressing illegal drug markets in the city. I mean, had you told me that was going to be part of my job when I was appointed, I would have said, you're crazy. But those are things that we we have participated in and and help support, if not led.

Deanna Lee

Thank you both. And you are right, Mary Ellen, you were teasing a future topic. Your mention of weather related events. I think we'd be remiss if we didn't touch on climate change a bit, even though that's not a new mission for emergency managers, responding to disasters like hurricanes, floods and wildfires. It's probably, you know, could be called your bread and butter or at least traditionally. But climate change has increased the frequency and the severity of these events. So I'm sure that it's playing a large role in the evolution of the field. Mary Ellen, let's start with you. You mentioned earthquakes. You're a leader in a disaster prone state, I think it's fair to say. So how have you seen climate change and weather related events change things in your work? And what's the approach to addressing these more frequent, more severe and even compounding disasters?

Mary Ellen Carroll

Yeah, absolutely. So it's it's one of the one of the compounding factors to our increased work and scope because because these types of events are happening more often and and in different ways. So in California, you know, fires, I would say, probably are one of the number one, you know, obviously issues that we have experienced over the last few years, devastating fires that not only impact a region economically, but affects housing, the long term recovery issues, but also environmentally with the types of air quality events that we have had over the last few years, including during COVID, one of the weirdest days ever. I think it was September 9th or 19th, I always forget when when the light like the sky, barely the sun really didn't come out. The sky was like a strange orange all day. It was very apocalyptic. So how does it impact us? Well, we are a very you know, we're an urban city that is surrounded on three sides by water. So so a lot of planning issues for us on sea rise is something that we have to think about. But also we provide support to our neighbors who are not in the same urban environment as us. We've opened shelters for people and we certainly garden to support our regional partners in their both their response and recovery. And you know, we now definitely a fire like fire season has a different sense for anybody in California. And our it used to be when you lived in a place that maybe fires would happen. Now, every single Californian is is impacted by fires because ultimately those fires create this really bad air quality. In effect, like, I'm a backpacker, and like I never used to think, now I have to make sure I do my backpack thing, if I really want it to happen, like before mid-July, because I can't tell you how many times, you know, you just it's not safe to go back country or all this area, you know? And my my vacation schedule is the least of the problem but just it does impact our our lives. Right. And in San Francisco specifically, heat is really an issue in air quality. And my colleagues in other parts of the country laugh. But like in San Francisco, three days of 85 degrees or over and we activate our emergency protocols because of the built environment that we have here. You know, we're just not built for that kind of heat. And so our buildings are ten, 15, sometimes 20 degrees hotter than it is outside. And that means people die during heat. And we also have heat islands within the city. So, you know, it could be if you're out by the ocean, you could have 20, 30 degree difference within the county and, you know, seven by seven area, which is what, San Francisco, seven miles by seven miles. So we have started doing actual things. We have an extreme weather resilience program where we provide air, air conditioning units and air filtration units to community organizations so that we can make sure that elderly and children and people who are vulnerable when they go to the places that they always go, those places will be safe for them. We're looking to hopefully do something similar with we've done a few libraries, want to do more there. So we have to think very practically about how to help people now, while we think about, okay, what are we going to do, you know, 25 years from now when, you know, the sea level has now moved into the Embarcadero area of downtown? So it's a combination of things. And I, my frustration around it is I think that from an emergency management perspective, we know the impacts of climate change, we are experiencing them now. The crisis is now. I do feel like sometimes when we look at it from the larger planning, it's like, we're planning for the future, but we're just we're little too late. I mean, we just have so much to catch up, to do. And then finally, what I'll say about it is that when connecting community with with climate change and response, is we are really using environmental justice data to align our outreach to which communities we should be outreaching when it comes to climate impact, because those are the communities that tend to be the most vulnerable and also are tend to also be in areas of the city that are hotter, that have less trees, that don't have the amenities that other parts of the city have. So it's really fascinating, engaging work and also very scary, you know, when you think about it. We even in the Bay Area have, it even overlaps with our drug and street conditions issues because we've it's been very hot everywhere in the country this summer. It's been very hot except up to San Francisco. And so we literally have people that are coming from outlying areas to come just to escape the heat. And that includes people who are experiencing homelessness, who have addiction issues and who just, you know, so so it even if it's just sort of intermittent, it does impact our our world. And I think we're going to you know, this whole issue of climate refugees that we know is happening already and will continue to happen is like we're getting little tastes of it.

Deanna Lee

Patrick, are there any other lessons you took away from your conversations with other emergency managers about climate change specifically, or how they're dealing with the effects of it?

Patrick Roberts

We have climate change, we have wildfires seeming to burn--wildfire season is no longer even a discrete season in some places this year round, we also have urbanization or people building more and more expensive things in risky locations or in areas maybe where they didn't build before. The wildland-urban interface, as they call it, for wildfires, but also in coastal or river river locations. And we also have maybe changing expectations among the public for the government or authorities to be there after disaster and even to make them whole. And so all of this means that emergency managers are just busier than ever and have more and more complex demands. Scholars sometimes call crises on top of crises, compound disasters. So they compound. They they they fuzed together. You know, you have a hurricane during COVID. And so you have to you have to manage both and adjust your procedures for both. Scholars even talk about something called a polycrisis, which is where you have multiple disasters on top of each other. And the sum, the effects of this crisis is worse than the just the sum of the parts, which would lead to something like like social destabilization. And there are debates as to whether we've arrived at that, you know, maybe, maybe not in the United States. But but it's certainly a possibility out there. It's a danger. And emergency managers are at the center of managing these these dangers where different kinds of emergencies are stacked on top of each other in in time and location.

Mary Ellen Carroll

One, Patrick, just to respond to that, one of the things that I've changed in in how we are approaching our planning is we are prioritizing regional coordination and relationships because I think that the likelihood of us having a major event and six, ten, 20, 30 other places in the country having a major event at the same time are likely and therefore federal resources or even within the state of California, resources being really spread very, very thin. And so one of the things that we're looking at is trying to just really focus on that.

Deanna Lee

Absolutely. And I'm sure it's something that you'll have to continue to focus on for many years. Also Mary Ellen, just a side note, I'm sure everyone will be wondering how in the world you have time to go backpacking. But I'm really glad that you do make the time because I think that's important.

Mary Ellen Carroll

It's terrible, actually. They make me take this really heavy sat phone with me and it's like the worst like five extra pounds, which I think...

Deanna Lee

That should be par for the course in your field, though, right? You're prepared for anything?

Mary Ellen Carroll

Yes. Yes, I guess so.

Deanna Lee

Okay. So we've discussed a lot of the crises that you deal with, the challenges that you deal with as emergency managers. And these events, these incidents are often the most stressful and scary times of people's lives. But how does the work affect emergency managers themselves? I'm sure that stress and burnout are happening at really high rates in this field. Mary Ellen, is this something you've seen a lot of firsthand or maybe even you've experienced it yourself if you feel comfortable sharing?

Mary Ellen Carroll

Yeah, absolutely I am, I'm more than happy to talk about it because I think it is important to talk about. I absolutely worry all the time about my staff and often worry about myself. I and but I'm very intentional about taking the time, for instance, to go backpacking or I'm also a surfer. So I, I also try at least annually to like, go away somewhere, like go surfing and, you know. There's times where there's a voice in me where it's like, an emergency. You know, a person responsible, with my responsibility shouldn't leave or shouldn't go that far. And that's ridiculous. So first of all, anything could happen to me at any second. So, you know, and life will go on, as will the Department of Emergency Management, San Francisco will be fine. And I have a great team. And so I, I am not a control freak. And I let my team have experiences and step up and and fill the space. And they are trusted by the administration here so I can leave. And I think that's important not to have such a such a sense of self that, you know, an overly important sense of self that I can't leave. Because first of all, it's going to help me stay the course. And secondly, it's what I want other people to do. And so I try to model that. It really has taken a toll on folks. I've seen people leave the field, you know, because of it and just try to do something a little less intense. Not only do we do this work, but, you know, we're on call 24 seven. And so, you know, how we deal with it is I you know, for me, I'm very active and I make sure I do the things that, you know, ground me and keep me healthy both in my mind and my body. And and that's a priority for me. And I encourage that in in everyone that works for me that they that they do that too. Again, I have seen people leave the field or go to, you know, positions that are a little less intense. And I, I really encourage that for folks if that's what they need to do. And sometimes I think it may be for a long term for a young person who might need to go back and forth, you know, from a position where you're on call and doing response a lot versus a position that you're more in long term planning and not getting called to that. The challenge I think, for many of us is that we haven't talked about this line is that, you know, emergency management departments or offices are usually very small compared to most other, you know, organizations like fire departments, police departments, public health departments. And so. So everybody, again, getting back to that jack of all trades, like everybody's on call. Everybody has a role when something happens and there's just less people to go around. And and, you know, that's one of the issues that we're struggling with at the national level is like, that's great, because I do think it's I think it's amazing that, you know, it's wonderful to be called upon to serve at such a level. And for all of these really important and complex issues that are so critical to saving lives in many ways, but also like helping our cities and our jurisdictions. But it would be easier if we had more resources and we just don't. So I think the answer to that is we have to spread, you know, our expertise to other other types of disciplines so that they know how to do this work also. But it's critical, we should be talking about it all the time. It takes a toll. And, you know, and then the final thing I'll say is that we all, as a human race, are carrying trauma from the pandemic that, you know, we haven't dealt with collectively or probably a lot of us, individually. And so, you know that just when people act weird or, you know, need a little space or whatever I just try to remember that, that there's a lot of people that aren't totally okay. You know, we've been through a lot.

Deanna Lee

Absolutely. Patrick, can you tell us what you heard from other emergency managers?

Patrick Roberts

Yeah, we found that the potential for stress and burnout is widespread because the nature of the work, the increasing pace. The emergency managers we spoke with had different strategies for for dealing with that. One is to communicate, talk about it, be okay you know, in some spaces, talking about stress, the potential for burnout and ways they they addressed it. Some people took time for themselves and encouraged their staff to take time for themselves because sometimes you need to see that from the top for for people to feel that permission to do that. Taking time away, you know, even during a crisis can be important. Getting sleep when people are working 24, 18 hour days, taking some time away to get sleep; journaling, even micro journaling. One leader we spoke with talked about going to a class at some point, continuing ed, you know, class and heard about micro journaling and thought, well, that's nice, but I'm not a poet. I'm a manager, I'm a crisis leader, you know, I don't journal. But then during the height of COVID-19 and in a really stressful position, making key decisions about how to allocate scarce resources and in a tense environment, he turned to micro journaling. He couldn't take time off. He needed to make these decisions, needed to save lives. He started essentially processing key moments during the day in journals of less than a page, and he did that every day, and he said that helped a lot. It really helped him process, get out his feelings, get out his thoughts, and then look back over time and see how they changed and how they developed. And and just that process, he said, was really important and helpful, micro journaling during during COVID. And he's continued it a well after other people had creative outlets that they pursued in addition to their job at the systems level. And the the best solution seemed to be relieving people, giving them some time away. Creating staffing systems so you can relieve people, let them go home, take a break. But as Marilyn said, that's not always possible. It's least not always easy if there's not a lot of staff there to begin with. And so figuring out how to cross-train people, maybe have some other organizations take on emergency management-like coordinating functions, things like this, or some things that people have tried and we saw them do to relieve the pressure on staff, even in smaller staffs.

Mary Ellen Carroll

That's so interesting. I was like, oh micro journaling. I was getting ready to write something down, but as you described it, I did that and I'm not a big journaler, but during COVID, I did keep, I won't say how many, but I have quite a few. And I would stop during critical moments because I was like, I got to write this down. It's stuff you can't even imagine, you know? And it's funny, I have not been able to really peer into those journals quite yet. I'm not ready, but that's so interesting to talk about I'm going to share that with folks. I think that's a good, something I guess I was doing and I didn't realize.

Deanna Lee

Let's talk a little bit about the future of the field. I think in a lot of ways that's what this research was looking at, you know, the evolution of emergency management. So how do you both see the field evolving? What are the biggest challenges and maybe the biggest opportunities?

Mary Ellen Carroll

Well, Patrick, you talked to everybody, why don't you start?

Patrick Roberts

Yeah, I can set the stage for what we found. The challenges, particularly for these these new kinds of missions and the new environment, I think that trust and communication and then some broader social organizations elements. In trust and communication, just found that emergency managers have to work at better communication with partners and the public. They're good at it but when you have new kinds of missions, you have new kinds of partners and new publics. And so you can't rely on the same old procedures, the same old routines, the same old meeting cadence or communication strategy necessarily. You might have to shift, you might have to adapt. So better communication and then ultimately from that communication, better trust with the partners and the public. And again, because they might be different partners for a hurricane than for disease, than for dealing with the effects of synthetic opioids or what have you. You might have to create new kinds of trust relationships with partners and the public. It's not it's not just a general thing. So that's a challenge. It's something emergency managers can do, but it's a challenge. There's some broader organizational social environment issues that that in some ways are harder. In the report, we list strategies that emergency managers can take, drawing on these on these interviews for: How do you better communicate? How do you build trust with your partners in the public? There are things they can do. The broader challenges in the environment, things like misinformation, disinformation, which Mary Ellen talked about, and emergency managers can combat it but but it's not easily solved. It's out there, or resistance to change in routines and procedures in government organizations or other nonprofit or private sector partners. They have their own routines. So getting them to change, adapt, take on new routines that takes time and effort. Also, lack of diversity or resulting inequities. There are things emergency managers can do, but where that's present, that narrows the solution set. And so being conscious about about stepping outside that and then these workforce stressors that came up again and there are things you can do, but there are these staffing and resource constraints and the nature, fast paced nature of the job that that created a challenge.

Patrick Roberts

We also, in especially COVID-19 and Operation Allies Welcome, but some of the other missions, there were supply chain challenges. We all know about PPE and other supply chain shortages during COVID-19 and during Operation Allies Welcome it was really housing. You know, how do we house all these new arrivals right away? We need, you know, adequate housing right away. And that happens after major, major disasters as well. And and these are specific shortages but but I think they're more generalizable to new missions because they occur when you can't rely on your usual policies and procedures, and you can't just rely on your neighbors, you know, your neighbors help out, your communities help out. But the communities or even the general market alone isn't enough. And Mary Ellen solution of "we need more regional solutions," that's one way, one way to approach it because the community might not have enough resources in that in that acute moment for for housing or PPE or supply chain or whatever the nature of the disaster is. So that's kind of a generalizable challenge that that these new missions present.

Mary Ellen Carroll

Yeah, I would I would agree with all of that. I mean, a couple of things. So one is I was thinking about root causes. So we are seeing increased crises in our country and in our urban areas. And they you know, they didn't just come from nowhere. Right? They're they're rooted in you know, there's climate roots, there's housing policy and funding for that, health care and the lack thereof creates so much of this. And then just, you know, general racism and poverty and all of these things. And that is not something that an emergency manager can resolve. And in fact, many of these things are not even something that, you know, a local county can solve. We need more state and federal involvement and resources in many of these, and a way to look at this analytically to say like, okay, what is creating these kind of things? And is there a way that we can get, change the way things are so that we can have less of this in the future. But the thing is, it's not, there's no easy solution. So I really believe also that unfortunately, like it or not, all many disciplines and areas are going to have to be better at crisis management. They're going to have to be better at how we solve problems. And you've got to cross divide. So I will just say trust is huge. And I really appreciate you bringing that up. It is something that we know is hard. And we've had to change our way because as emergency managers, we're not super process-based, which by the way, like public health and emergency, that's a big place that we clash. Like we're not so much into, like we've developed process to make things a lot easier and so that we can actually like get through process faster so that can, that can be detrimental to building trust, right? Because we're just like, okay, there's an emergency, we're going to go in, this is how we're going to do it, period. And you know, that was part of what we learned in COVID. Like no you can't, you can't do it like that. So I don't know exactly what the answer is. But I do think for all of us having that in mind, that we understand that there will be trust issues that we have to overcome as we go through. But I would love to see that there is more of a definition, this is another thing, Patrick, that we talk a lot about at the national level, like what is emergency management? We have a PR problem. Nobody knows what we do. You know, how do you define it? You've heard these conversations. So, and that's probably true. You know that I think if we had a better way to describe what we do. And I think part of the problem is it's turned out like we can't really define it very well because it's grown so fast. But we need to be disciplined, I think, about that and figure that out a bit. And then, you know, maybe somehow market those skills, you know, with, with other, other people and and disciplines and figure out how to like, you know, spread this special sauce that we have a little a little broader and wider. So those are those are the things that I kind of think about with this. And they're they're not easy. These none of those things are easy fixes to these problems. But I think it's important that we're thinking about it and talking about it. So I do appreciate the opportunity to do so with you.

Patrick Roberts

And some of the specific recommendations in our project are things like provide some skills training and awareness to people in partner fields or other fields, you know, ICS training and courses or logistic and supply chain or prioritization ideas to people in neighboring fields. We've been working with FEMA's National Disaster and Emergency Management University to to expand and enhance their course offerings. That's one way to reach people in partner fields. You know, there are many others, too.

Deanna Lee

Okay. I have one final question for both of you. Mary Ellen, you mentioned maybe emergency management has a PR problem, so I'll give both of you, you and Patrick, an opportunity to do some PR. What's one thing or what's an important thing that you would like our listeners to understand about emergency management and how it impacts their lives and their communities?

Mary Ellen Carroll

So emergency managers are part of so many different factions of our society really. They, you could argue we're public safety, but we're also in community. We are part of overall planning and, you know, thinking about how do we create a future for our cities and our jurisdictions that we, you know, places that we want to live in. But we're not easy to identify. We don't have a uniform. And, you know, we're not sworn. We don't have usually like lots of degrees that describe what we are, but we are there serving you and making sure that all of the resources, the expertise and and things that are going to be needed before, during and after an event are well coordinated and executed. That's our job. And we also do a lot of communication, generally speaking, you know, when you see emergency alerts or information about how to, you know, what's going on, and that's generally emergency management is behind that. And if you're looking for an interesting career, you know, in problem solving that's analytical, that is increasingly diverse, that really allows you to sink your teeth into projects and has a lot of excitement, something to consider is going into emergency management, just to make that plug.

Patrick Roberts

You know, emergency managers are great problem solvers, coordinators, they're saving lives and protecting property before, during, after disasters. One of the things we wanted people to be able to get out of this report is to become better improvisers as emergency managers and as emergency manager partners. Better improvisers in two senses. One, the emergency managers as we spoke with, improvised through specific strategies. And you can learn from those strategies. You can take them and apply them to new disasters. So if in San Francisco, there was a new coordination center created that brought together public health emergency management and unified command, you can take that idea for for a new kind of crisis, whatever the next crisis will be, and create that new kind of unified command center. Don't just rely on the standard routines and procedures, but we also want the people who read this report to maybe learn to become improvisers in a second sense, to learn how to be that jazz musician as emergency manager, to learn that the practice and the skill of improvization and and not just play the sheet music and that that's harder to learn, but maybe more valuable in the end. And so that's that's what we hope the emergency managers of the future who who engage in this project will become.

Mary Ellen Carroll

I love it. And I'm so grateful that RAND is doing this really important work and taking the time to talk to so many of us. We're very grateful for that.

Patrick Roberts

It's been a real pleasure to talk to the emergency managers, the leaders, the real heroes who have led through so many different kinds of events.

Deanna Lee

That's it for today's episode. I'd like to thank our guests, Mary Ellen Carroll and Patrick Roberts, for taking the time to speak to us. The research we discussed today is available for free, as always, on rand.org. You can find links in the show notes at rand.org/podcast. Thanks for tuning in. RAND is a nonprofit institution that helps improve policy and decisionmaking through research and analysis.