April 2007 Ready to Respond MDH Preparedness Newsletter
On this page:
Minnesota Poison Control System – Partners in Preparedness
When do you receive health alerts?
Healthcare System Preparedness
Local Public Health Preparedness
Disaster Strikes – Environmental Health Responds: Stories from the Field
(Aggie Leitheiser, Director of Emergency Preparedness)
- All-Hazards Responds & Recovery Plan approved
Members of the Health Emergency Preparedness Area Command Team (HEPACT) and Dianne Mandernach, Commissioner of Health, officially approved and signed the 2007 Minnesota Department of Health All-Hazards Response & Recovery Base Plan on January 31, 2007. A special thank you is extended to Janice Maine, Office of Emergency Preparedness public health all-hazards planner, who coordinates the planning efforts for the All-Hazards Plan, and to all of you who have helped develop this Plan. We will continue to update and change the Plan as we use and discover which procedures work well and identify others that need some refinements.
- MDH Emergency Preparedness Plans
Includes a link to the MDH All-Hazards Response and Recovery Base Plan.
- MDH Emergency Preparedness Plans
HEPACT signing of the MDH All-Hazards Plan, January 31, 2007
- Staff review Incident Lifecycle Map
The MDH all-preparedness staff meeting on March 22nd provided an opportunity to share program activities through displays and informal discussion. The focus of the meeting was to review the updated Incident Lifecycle Map. The Map provides the framework for Preparedness and Planning, Detection, Response, Recovery and Long-term Recovery functions for MDH. It is a very visual way of showing the many activities spread across the Department and how they relate to each other and to our work. A Roles and Responsibilities workgroup of the State Community Health Services Advisory Committee is developing a companion Map that describes functions for local public health. When these two maps are complete, they will provide guidance for evaluating current efforts and determine priorities for the future.
- Legislative update
Over the next few weeks, the Minnesota legislature will be working to bring current House and Senate proposals together. At this time, the Pandemic Influenza Preparedness Initiative has funding in both versions, but at a much smaller amount than the Governor’s request. (The House has requested about $4 million for unspecified planning and preparedness activities/materials, and the Senate has requested about $6 million for antivirals, supplies, local grants and MDH activities). Continued efforts will be made over the next several months to try to bring those amounts closer to the Governor’s request of $19.75 million.
- CDC progress reports
The Centers for Disease Control and Prevention (CDC) is moving to a new system that will help manage the public health grant this coming year. They are linking progress reports closely to the request for funds for next year which should reduce the effort for applying for funds in the future. We are awaiting information about funding levels for next year.
- HRSA change
The Healthcare System Preparedness Program is also waiting for more information from the Department of Health and Human Services about next year’s grant. The entire program moved out of the Health Resources and Services Administration (HRSA) program to DHHS, so some new approaches are likely.
May this spring bring bright flowers, limited flooding and opportunities for new growth to all of us.
Ready to Respond Conference: Spotlight on Minnesota Health Preparedness
The Minnesota Department of Health’s first Ready to Respond: Spotlight on Minnesota Health Preparedness Conference will be held on Tuesday and Wednesday, May 1 and 2, 2007 at the Earle Brown Heritage Center, 6155 Earle Brown Drive, Brooklyn Park, MN 55430.
The conference is designed to improve the emergency preparedness planning and response capabilities of those attending the conference. Attendees can expect to expand their knowledge through celebrating preparedness successes, acknowledging lessons learned and acquiring tools and templates that will enhance their ability to respond. This conference is also meant to inspire, motivate and energize attendees’ “Ready to Respond” efforts.
- Randi Kaye, CNN correspondent and former WCCO news personality
- Charlie Cook, executive director, Louisiana Spirit
- Gregory Santa Maria, World Trade Center responder and national speaker on preparedness and disaster response
The Ready to Respond: Spotlight on MN Health Preparedness Conference was designed with a variety of health professionals in mind. The conference is primarily for state, regional and local public health programs, tribal preparedness staff, healthcare system preparedness staff, healthcare administrators (including hospital and clinic staff), Community Health Service administrators, Community Health Board members and county commissioners.
- Improve your emergency preparedness planning
- Improve your response capabilities
- Expand your knowledge
- Acknowledge lessons learned
- Acquire tools and templates that will enhance your ability to respond
Minnesota’s preparedness community will go to “codeReady” this May
Stay tuned for a new statewide emergency preparedness public information campaign, codeReady, to be launched this May. The campaign will include publications, billboards, advertisements, fact sheets, a codeReady Web site and other materials that promote personal and family emergency preparedness. The codeReady campaign is a collaboration between the Minnesota Department of Health and the Minnesota Department of Public Safety.
More information will be available in the MDH Pandemic Influenza Newsletter website.
Emergency preparedness activities involve a range of partners who make contributions in many different ways. This article describes how the Minnesota Poison Control System works with emergency preparedness issues such as poison information, professional and public education opportunities.
The Minnesota Poison Control System is a collaboration between the Hennepin Regional Poison Center (HRPC) and the Minnesota Department of Health (MDH). The Poison Center, located in Hennepin County Medical Center, is nationally accredited by the American Association of Poison Control Centers. HRPC serves all citizens and health care providers throughout Minnesota at no direct cost. The HRPC provides medical treatment recommendations and poison information 24 hours a day, 365 days a year. In 2006, the Center’s specialized staff responded to 47,692 exposure calls and 34,825 information calls. HRPC data is utilized to provide real-time surveillance for public health threats.
Pharmacists are certified as specialists in poison information and work with Board Certified Physician Toxicologists to staff the Center 24/7. Staff provide vital toxicology expertise for emergency preparedness planning and during public health events, plus they provide professional and public education.
The HRPC emergency call center data is monitored to recognize early warning signs of a public health event. This surveillance is done in real time with state and federal partners. In addition, all potential foodborne illness cases are reported to the MDH Infectious Disease, Epidemiology, Prevention & Control (IDEPC) Division for follow-up. Upon recognition of a public health event, the HRPC works with state and local agencies to provide accurate assessment and medical treatment information to all callers. Communication in the Poison Center has been expanded to include the Minnesota system for Tracking Resources, Alerts and Communications (MNTrac), Mission Mode and 800 MGHz radio to facilitate information exchange.
The HRPC partners with the MDH Office of Emergency Preparedness to provide technical expertise in support of the Healthcare System Preparedness programs and the Centers for Disease Control and Prevention (CDC) Strategic National Stockpile programs. These activities include planning for the receiving, staging and distribution of federal medical assets (antibiotics, vaccines, and antitoxins) plus hard assets such as ventilators. The Center provides a consultant who serves in a lead position for the Chempack Project and Regional Pharmaceutical Caches.
The Poison Center provides toxicology instruction to health care professionals, including on-site resident teaching and lecturing at statewide conferences. HRPC will offer an Advanced Hazardous Materials Life Support course on April 24 and 25, 2008 in preparation for the Republican National Convention. Contact the HRPC at the number below to schedule a toxicologist to speak at your next meeting or conference.
HRPC also provides public education to children, parents, grandparents, daycare providers, senior citizens and teachers. In 2006, the Center distributed more than 268,000 pieces of educational materials, including Safety Guides, posters, magnets and telephone stickers with the “Poison Help” logo and phone number.
The staff of HRPC, the toxicologists, pharmacists, support staff members and a wonderful volunteer who helps with thousands of mailings a year, invite you to explore the Poison Control website or to contact the Center for toxicology, environmental, surveillance and other potential preparedness partnerships.
Sometimes it might feel like a hassle to receive a Health Alert late in the day, especially on a Friday. But when are most Health Alerts sent? We checked and what we found was surprising.
Some people believe most health alerts are sent on Fridays. It appears Fridays are one of the quietest days for Health Alerts. However, when you receive an alert, especially late in the day, it is particularly memorable. The very busy Health Alerts sent on Thursdays in 2005 were sent during the Hurricane Katrina response.
|Health Alerts by Day of Week
Source: MDH Office of Emergency
The procedure for initiating a Health Alert at MDH contains this caution for subject matter experts:
Note: Make every effort to finalize the content of the Health Alert and send it to firstname.lastname@example.org prior to 3:00 pm. There is a significant amount of time and effort involved at a local public health level to include any local information and then dispatch the alert through their local networks. If you are unable to finalize the alert content prior to 3:00 pm and the information is not of an urgent nature, consider delaying until the next business day.
Although it can sometimes take most of the day to make sure the content is complete and accurate, the MDH Office of Emergency Preparedness Partner Alerting and Communication Team will make every effort to get Health Alerts out early in the day and especially avoid Friday afternoons. Please don’t hesitate to send your concerns and comments to email@example.com.
NIMS/HICS Recommendations for Minnesota hospitals and healthcare systems
In 2003, President George W. Bush issued Homeland Security Presidential Directive-5 (HSPD-5) which created the National Incident Management System (NIMS). NIMS provides a consistent template for governmental, private sector and nongovernmental organizations to work together during an incident. The system applies to a variety of incidents and hazard situations, and is intended to improve coordination and cooperation between public and private responders. Until NIMS, there had been no standard for domestic incident response that united all levels of government and all emergency response agencies.
HSPD-5 required adoption of NIMS by September 2006 across all sectors of federal, state and local governments, and by local organizations except hospitals, which have until August 2008 to comply. NIMS compliance is a requirement to receive federal assistance (e.g., grants, contracts). This includes hospitals seeking funds from Health Resources and Services Administration (HRSA), Agency for Healthcare Research Quality (AHRQ), or Centers for Disease Control and Prevention (CDC).
The specific compliance requirements outlined for hospitals by the NIMS Integration Center (NIC) are found in Appendix I: NIMS Implementation Activities for Hospitals and Healthcare Systems (PDF: 2 pages). The 17 hospital-specific elements address preparedness activities, resource management, communications and information management, supporting technologies, and training and exercises. NIMS compliance does not require a hospital take a single approach to emergency preparedness, but rather take a series of steps that will improve institutional readiness and integration into a community-based response system.
The Hospital Incident Command System (HICS) is a model of critical components and incident command designed to be used by all hospitals, regardless of their size or patient care capabilities, and to assist with their emergency planning and response efforts for all hazards. By embracing the concepts and incident command design outlined in HICS, a hospital will be consistent with National Incident Management System incident command design guidelines and will participate in a system that promotes greater national standardization in terminology, response concepts and procedures. The Minnesota Department of Health’s Office of Emergency Preparedness Healthcare System Preparedness Program recently completed the Hospital Incident Command System (HICS) Training Recommendations. These recommendations will assist Minnesota hospitals and clinics to integrate HICS/NIMS training plans toward compliance. The recommendations include:
- Target staff requirements by the NIMS Integration Center
- Examples of target healthcare personnel with suggestion to refer to the organization’s Emergency Operations Plan (EOP)
- Guidance on coursework access and examination
- Tips for organizing and tracking coursework certificates
- Competencies addressed by the HICS/NIMS coursework.
Cook County’s Public Health Disaster Response
“In Cook County, we have the grand opportunity of living in the boreal forest,” reports Joni Kristenson, public health nurse and coordinator at Cook County Public Health and Human Services. “Trees are our back yard, yet every summer, fire becomes a potential threat and a possibility because of varying temperatures. This fire threat is five-fold: to people, property, tourism, the economy and the public’s health.”
Cook County Public Health and Human Services (CCPHHS) has several important roles regarding fires and other natural disasters:
- Education and public awareness. During an incident, CCPHHS staff will write and send messages about health hazards, such as “Smoke-Is-In-The-Air” and describe the potential impact on people’s health. Local radio, regional media and Internet are typical vehicles used to send public health messages.
- Evacuation. When the authorities call for evacuation of an area, CCPHHS staff will:
- Register all individuals who evacuate
- Coordinate congregate care
- Provide other services as requested by the Emergency Operations Center.
In 2006, Cook County experienced four major events:
- A wildfire in July
- An extensive regional exercise in September, followed the next day with
- Another wildfire that involved evacuations
- A Norovirus outbreak in November.
Lessons learned from Cook County’s 2006 experiences:
- Equipment is good
Trailers for supplies, portable generators and “sticky walls” are great assets.
- Watch for media mayhem
While the media have an important role in helping with education, public health needs to help determine where and how they set up their operations.
- The more the merrier
New partners were helpful. The Cook County Highway Department helped with traffic and signage. Border Patrol coordinated security and county law enforcement helped with fire operations. The Planning Chief, who serves as personnel director during her day job, has the authority to request any staff help with short- and long-term staffing needs.
- The National Incident Management System (NIMS) works!
Learning about the structure of the Incident Management System allowed CCPHHS staff to be more focused, confident, efficient and effective.
“Our work continues,” Kristenson said. “Cook County is still updating our plans based on these experiences. Roles and responsibilities for community partners, such as Red Cross, are still being defined.”
Winona CHS staff led roundtable discussion at national conference
Four staff from Winona County Community Health Services joined other health leaders at the Public Health Preparedness Summit held in Washington DC from February 19-23, 2007. The Summit brought together federal, state and local health officials to share ways to be better prepared for a health emergency.
The Winona County team led a roundtable discussion, Maintaining Community Emergency Response Team (CERT) Post Federal Funding, and explained the County’s solution to funding CERT after federal funds ran out. Maintenance costs of this CERT program are low and the county dedicates funding to promote preparedness efforts. Speakers included CHS Administrator Lynn Theurer, Nursing Director Merrily Hazelton, Health Educator Amie Queensland and Preparedness Coordinator Jeff Peterson.
Winona County’s Community Emergency Response Team is used for emergencies and also assists with training and other events, such as mass dispensing activities. By keeping the volunteer organization involved, members remain with the group and expensive training of new volunteers is not needed. Both Queensland and Peterson are CERT instructors so training updates are handled in-house with minimal expense.
The goal of the 2007 Public Health Preparedness Summit was to improve the ability of participants to plan, prepare, respond to and recover from public health emergencies.
Revised MDH Emergency Preparedness Web page
Check this out! Emergency Preparedness, Response and Recovery
You’ll find information on these topics:
- Individual/family preparedness
- Types of emergencies (biological hazards, chemical emergencies, explosions, natural disaster, radiation and nuclear emergencies, and more)
- Public health and healthcare system emergency preparedness
Recent events such as Hurricane Katrina, industrial chemical releases and Avian H5N1 Influenza (“Bird flu”) are part of our collective consciousness. These incidents fuel our focus on building capacities to curtail the chaos that can occur in our communities. Do environmental health professionals know what to do when a disaster strikes their community?
In February 2007, the Twins Cities Metro Advanced Practice Center (APC) produced a new training module, Disaster Strikes – Environmental Health Responds: Stories from the Field. This module addresses eight environmental health core competencies:
- Organizational knowledge and behavior
- Information gathering
- Data analysis
- Problem solving
- Record keeping
The eight lessons in this module focus on each core competency and include an overview, stories, action steps, lessons learned, quiz questions and complementary resources. Audio is provided for most screens and a transcript of the entire module can be printed. Each lesson can stand alone as an individual training unit, or all lessons can be completed in one session. While presented with a logical flow based on the sequence of activities that would take place during a response effort, the eight lessons can be viewed in any order.
One viewer of this program commented, “This module effectively illustrates vital skills that all environmental health professionals need when an emergency or disaster strikes. The unique approach of weaving real-life experiences and practical advice throughout the lessons brought the materials to life.”To order
- Disaster Strikes – Environmental Health Responds: Stories from the Field
Online training tool. Feb 2007. Attention: Non-MDH link
- Emergency Preparedness and Response Fundamentals & Putting Principles into Practice
Online training tool. June 2005. Attention: Non-MDH link
To receive free copies of both modules, contact Brian.firstname.lastname@example.org or call him at 612-543-5204, Hennepin County Human Services and Public Health Department.
Sign up for ECHO E-Bulletins and updates
An emergency siren sounds. A serious disease outbreak hits the community. How can you get life-saving information to protect yourself or your family? What if you have limited English?
An answer is available -- ECHO. Emergency and Community Health Outreach (ECHO) is a program that ensures people with limited English proficiency receive life-saving health and safety information—in some of the languages they understand best.
ECHO TV began in September 2004 as a first-of-its-kind television series in the United States. Each month it produces a twenty-minute television program on a current health and safety issue in multiple languages. Topics range from influenza prevention to winter survival. Each episode includes a pre-recorded story, as well as a question and answer period in which ECHO hosts interview guest community leaders or topic experts who are fluent in the language in which the program is being produced. All shows are also open-captioned in English to help viewers improve English language skills.
ECHO TV’s series of programs on health issues and emergency preparedness are broadcast on Twin Cities Public Television (tpt) – MN-Channel 17 Echo Television Show in the metro area. Metro viewers with cable and satellite TV can access tpt’s Minnesota Channel on Comcast digital cable channel 243, Time Warner digital cable channels 234 and 1021, and via over-the-air digital receivers at channel 17-2. In greater Minnesota, check local listings for channel information.
To receive updates when new information is added to the ECHO Web, or to receive newsletters and information from governmental agencies, visit Echo Minnesota and click on E-Subscribe.
To hear toll-free, pre-recorded health and safety messages in 10 languages during non-emergency times, call ECHO Phone at 1-888-883-8831.
New airborne infectious disease training available online
Staff from the Minnesota Department of Health Office of Emergency Preparedness Healthcare System Preparedness Program and the University of Minnesota Department of Environmental Health and Safety recently completed the Airborne Infectious Disease Management Manual.
This user guide was written to assist hospitals in developing strategies for temporary negative pressure isolation and to provide instruction on equipment used for airborne infectious disease management. Preventative maintenance schedules and a sample log for measuring particle counts are included for performance improvement planning.
Many regions in Minnesota have purchased high efficiency particulate air (HEPA) machines, particle counters and pressure gauges with Health Resource Service Administration (HRSA) funds. When temporary set up of an Airborne Infection Isolation room or surge area is needed in an emergency, hospitals will most likely have the facility engineer complete the set up. In some instances, infection control professionals, safety officers, emergency preparedness representatives and/or nursing supervisors may assist.
Temporary negative pressure is also used during construction projects in healthcare facilities to reduce risks associated with airborne infectious disease. The temporary measures a facility decides to use should be incorporated into the facility's infection control and emergency response plans.
MDH also teamed up with the University of Minnesota Emergency Readiness Education and Training (MERET) and wrote two online training modules.
- Design and Maintenance of Airborne Infection Isolation Rooms (AIIR) module provides an overview of AIIRs and principles of airborne infectious disease management.
- Methods for Achieving Temporary Negative Pressure Isolation (TNPI) describes how to create temporary negative pressure isolation. Temporary anterooms and airborne infection isolation surge capacity is also discussed.
These modules are available online at the University of MN School of Nursing and School of Public Health Centers for Public Health Education and Outreach (CPHEO) at University of Minnesota Center for Public Health Education and Outreach. Scroll to “Six Meret modules are online now” and click on the manual you want to view.
What’s Your RQ (Readiness Quotient)?
In recent years, the American people have been urged to “get ready” and to prepare for emergencies -- from natural disasters to terrorist attacks. But no one has ever given the public a simple, comprehensive and consistent tool to actually measure how prepared they are. No one has ever provided communities and the nation as a whole with a practical “gauge” to assess their preparedness, recognize their successes, and identify gaps where more work needs to be done.
Using The Public Readiness Index (PRI) -- a first-of-its kind tool -- individuals, families and communities can determine and evaluate their RQ or readiness quotient. See how you stack up against the national average and learn specific steps you can take to better prepare yourself and your family, as well as things you can do to encourage your community, schools, and workplace to be better prepared.
Ready to Respond/MDH Preparedness Newsletter
Editorial Board members include representatives from MDH divisions that receive preparedness funds.
If you have an idea for an article, please contact any of these people.
Aggie Leitheiser, Director of Emergency Preparedness
Contributors to this issue
Brian Golob, Hennepin County Human Services and Public Health Department