July 24, 2003
In this issue:
- CDC and HRSA Grant Applications Submitted
- Local Public Health Preparedness Grant Manager’s Update
- Minnesota Responds! Health Professional Volunteer Registry
- Laboratory Directory for Local Public Health
- Commissioner’s Terrorism and Health Task Force Meeting
- September Conference Registration Available Online
- Mental Health Preparedness
On July 1, 2003 the Minnesota Department of Health submitted cooperative agreement applications to the Centers for Disease Control for Public Health Preparedness and to the Health Resources and Services Administration (HRSA) for Hospital Bioterrorism Preparedness. The development of these cooperative agreements represented an intensive collaborative effort among MDH, local public health departments and hospitals. Upon approval of the applications by CDC and HRSA, the funding for the cooperative agreements will begin on August 31, 2003.
Public Health Preparedness Funding Formula for Community Health Boards
The Terrorism Preparedness Work Group and the Local Public Health Preparedness Review Group of the State Community Health Services Advisory Committee met twice during May and June to discuss the funding formula to Community Health Board for public health preparedness. This funding will cover the period from September 1, 2003 to August 31, 2004. The decision was made to proceed with a funding formula similar to last year’s, which is based on population, with a minimum of $20,000 per county.
Updated “Action List” Reporting Form and Revised Due Date
The due date for the final activity report (“Accountability Action List”) for the current period of the Public Health Preparedness Grant has been extended to August 31, 2003. Please note that MDH staff must have all community health board data summarized for our final report to CDC by September 5, 2003, so this is a very firm deadline. A memo announcing this deadline was mailed to Bioterrorism Coordinators and copied to CHS Administrators and Public Health Nursing Directors in early July.
You will need to download the document as an Excel spreadsheet, complete it,
and either email, fax or send it to your grant manager by August 31, 2003.
We were unable to implement an interactive web format this year for the final
report. We will continue to work toward that goal for next year.
Public Health Preparedness Grant Fourth Quarter Expenditure Report
The Public Health Preparedness Grant fourth quarter expenditure report form for community health boards will be available soon. Bioterrorism Coordinators, CHS Administrators and PHN Directors will be notified by email. The report is due September 30, 2003 for the period April 1, 2003 to August 31, 2003. The format will include a report that is similar to previous Public Health Preparedness Grant quarterly reports, we also need data indicating your percentage of expenditures by focus area to be compliant with CDC reporting requirements.
Public Health Preparedness Grant Funds Encumbrance and Expenditure Deadlines
The MDH expects that local agencies will have their Public Health Preparedness Grant funds fully encumbered by August 31, 2003, the end of the current grant period. This encumbrance requirement pertains to both your original grant award and the HAN/Smallpox amendment award (Grant Amendment #1). Final expenditure of the funds must occur by November 30, 2003.
If you foresee a problem for your CHB in meeting this encumbrance/expenditure
schedule, you must contact your grant manager before August 1, 2003 to discuss
your plans for use of the funding and other issues.
The MDH has been working to create a database of health care workers who wish to volunteer during a public health emergency. Called the “Minnesota Responds! Health Professional Volunteer Registry,” the registry will provide a database of volunteer health care workers needed for “surge capacity” in large-scale emergency situations.
MDH staff developed the registry with the Workforce Subgroup of the Commissioner’s Task Force on Terrorism and Health. Members of the Workforce Subgroup include community colleges and universities, professional associations and societies, hospital systems, health and hospital associations, local health departments, local clinics, state boards and agencies, voluntary service and planning agencies, and the Academic Health Center at the U of M. The Workforce Subgroup’s charge is to “make recommendations on identifying the workforce needed for a health response to terrorism, and on developing mechanisms to increase workforce capacity.”
This on-line registry site will be up and running in the near future. Health care workers in over 85 fields will be invited to volunteer by registering their names online in the database. MDH will collect names, contact numbers, and relevant information about training, background, and experience in various health care positions. From the home page, a volunteer will see an introduction, have an opportunity to view links, FAQs, and go to a main registry page. The introductory page will include a Tennessen Warning.
The main registry pages will include questions about work place, languages spoken, credentials, job titles, and skills. Supplementary registry pages will be provided for doctors, nurses, pharmacists, and dentists. Everyone will be given an opportunity to briefly describe the reasons they believe they are qualified to volunteer.
MDH will be marketing and promoting the registry around the state through
organizational newsletters and websites, presentations, working with regulatory
boards and volunteer centers, and going through the mass media.
The Bioterrorism Response Unit at the MDH Public Health Laboratory (MN-PHL) is developing a directory that will provide Local Public Health (LPH) with contact information, by county, for all of the local Level A clinical and public health laboratories that are part of the national Laboratory Response Network (LRN). This kind of directory may be helpful when LPH needs to respond to assessments of local public health capacity and when writing integrated response plans. The directory will be available electronically this fall.
The MN-PHL is closely connected to every local hospital-based clinical microbiology and public health laboratory in Minnesota. Through development and implementation of the Minnesota Laboratory System (MLS), the MN-PHL has built strong collaborative relationships with these laboratories. The MLS is an integrated network of public and private microbiology laboratories working together to address bioterrorism, and other threats to the public’s health.
The MN-PHL has assessed the microbiology capabilities of all the MLS laboratories, including laboratories in bordering states that serve Minnesota residents, to assess and identify the labs that have the capability to serve as Level A laboratories for the LRN.
This MLS has a robust communication system in place, much like the Health Alert Network, to communicate rapidly and inclusively throughout the network regarding laboratory critical alerts and specific information about organisms, specimen collection, resources, and training. With this MLS connection currently in place between our state and local laboratories, LPH agencies will not need to establish the communication system, which requires considerable time and resources that would be necessary to develop independent relationships with the local laboratories.
The Laboratory Response Network (LRN) is a national system put in place by the CDC for state public health laboratories. This system provides standardized protocols and reagents to identify bioterrorism agents and other organisms of public health importance across the country. The LRN is based on a pyramid-like organization with three levels of capacity. The first level, called the sentinel or Level A laboratories, represents the first line of laboratory defense and includes clinical, agricultural, and veterinary diagnostic laboratories. These laboratories can recognize, rule-out and refer suspicious organisms to the next level of the LRN, which includes the reference or Level B/C laboratories. These are all the state public health laboratories, which have technical capability and biological containment facilities at the BSL-3 level to perform identification and confirmatory testing for agents of bioterrorism. The peak of the pyramid includes the national or Level D laboratories, which perform more definitive characterization of bioterrorism or emerging infectious organisms using, if necessary, bio-containment at the BSL-4 level.
The LRN Level A or sentinel laboratories in Minnesota are defined as those laboratories which have the capability to ‘rule-out’ and ‘refer’ potential agents of bioterrorism to the Level B/C or reference laboratory at the MN-PHL. Level A laboratories at the local level should communicate with and refer all suspicious organisms to the MN-PHL. The MN-PHL is the only laboratory in Minnesota that functions as the primary LRN Level B/C reference facility capable of confirming or ‘ruling-out’ bioterrorism agents using the required standardized, validated CDC methods.
The Commissioner’s Terrorism and Health Task Force met on July 15th in St. Paul. Task Force members received the latest information on SARS, Monkey Pox, and West Nile Virus; learned about the MDH Laboratory Response Network; heard about the TopOff2 exercise in Chicago and an SNS exercise in Iowa; and received an update on the CDC and HRSA grants. Members also generated a list of possible scenarios and evaluation questions that could be used in health-related emergency response exercises. The next meeting will be held on October 15, 2003 from 1:00 – 4:00 pm at the MDH Snelling Office Park in St. Paul.
The MDH Community Health Division has created a web site that contains registration
information for the September 2003 Health Emergency Preparedness Conference.
The Institute of Medicine of the National Academies offers an example for a public health strategy that may serve as a base from which plans to prevent and respond to the psychological consequences of a variety of terrorism events can be formulated.