Emergency Preparedness and Response Brazos County Health Department
Funding 2005 budget = $225,166 04 = $259,599 (includes smallpox money) Less than a 1% decrease in funding from 04 to 05 when smallpox money is factored out. Last year of a 5 year plan focusing on bioterrorism New 5 year plan being formulated All hazards
Funding Grant year began September 1, 2004 Budget and work plan not approved until December 1, 2004. Same delays expected next grant year.
Focus Areas Five assigned focus areas: A Preparedness and Response B Surveillance and Epidemiology E HAN/Communications and IT F Health Information Dissemination G Training and Education
Preparedness and Response Creation of an all-hazards public health emergency response plan. Health and medical (Annex H) Comply with Emergency Support Function (ESF) 8. NIMS Compliant Creation of a comprehensive bioterrorism response plan. Appendix 2 of Annex H SOG s in progress
Preparedness and Response Creation of a Strategic National Stockpile distribution plan. Appendix 3 of Annex H Develop capabilities to respond to situations posing a threat to public health. Bioterrorism Infectious disease outbreak HAZMAT Mass casualty
Common Plan Requirements Coordination with local agencies. Planning Exercises Recruitment of volunteers. Must have up to 300 volunteers to staff the first 24 hours of a major operation. RSVP Informal agreements
Common Plan Requirements Identification of mass vaccination and medication distribution sites. MOAs Security coordination with local law enforcement. Critical assets Hospitals
In-house Assets (Personnel) EPR Coordinator (MS) Deputy Sheriff Paramedic HAZMAT Technician Assistant EPR Coordinator (MPH) Epidemiologist HAZMAT Technician
In-house Assets (Personnel) Nursing staff (4 Registered Nurses) Epidemiology Immunizations Environmental (6 Sanitarians, BSH) Food safety Environmental safety Community Education (2 Educators) Media liaison Just-in-time training of volunteers
In-house Assets (Equipment) Response vehicle. 6 other fleet vehicles if needed Scene support Generators (3 5.5 KW) Portable lighting units (6 1000W) Command post Personal protective gear PAPR s (6 RRPAS units) Level B/C suits
In-house Assets (Equipment) Detection equipment M256 Chemical Agent Detection Kit Radiological Detection Emergency Medical Support Full medical kit (BLS) Oxygen Emergency generator 35 KW fixed generator
Current Capabilities Investigate suspicious illnesses Infectious Food borne Establish Incident Command Post Coordinate mass vaccination/prophylaxis Provide support to HAZMAT teams Personnel monitoring Decontamination
Current Capabilities Assist with search and rescue efforts Medical support Communications Assist with evacuation and mass care Hurricane plan
Future Capabilities Cooperative agreement with the Sheriff s Office to form a Bio/Chem support team. Sheriff s Office to provide assistance with disease investigations and security Health department to provide assistance to support tactical operations.
Focus Area B SURVEILLANCE AND EPIDEMIOLOGY CAPACITY
Brazos County s Capacity New: Never had the capacity for creating our own baseline disease occurrence numbers Everything on paper in a file somewhere Unusual disease occurrence based on nurses intuition rather than on actual numbers Expanding: Going beyond relying on physicians to report Implementation of online reporting and automatic data extraction from electronic medical records Using school absentee data to detect outbreaks Flu surveillance
Epidemiology The definition of epidemiology is the study of the distribution and determinance of health related states or events in populations and the application of this study to control of health problems. In other words, it is the basic science of public health. It is used to study risk associated with exposures, to identify and control epidemics, and to monitor population rates of disease and exposures. - North Carolina Center for Public Health Preparedness
Epidemiologist Tasked to: Develop and maintain a disease and syndromic surveillance system for Brazos County Obtain and analyze disease data for the purpose of detecting outbreaks Publish aggregated results of disease occurrence to the BCHD website for use by health care providers
Online Reporting for Notifiable Conditions
What is a notifiable condition? One of 62 diseases or conditions that physicians are required by law to report to their local health department Any rare disease that is not naturally occurring in a specific area
How are notifiable conditions currently reported? Physicians, veterinarians, nurses, daycare workers, etc may call or fax a report to the local health department. Calls are made to a short list of physicians offices to request disease reports. Typical response, We have nothing to report
Why is an electronic reporting system indicated? Electronic record of disease reports Run statistics Create a good picture of Brazos County s health Quick access to data for timely detection of outbreaks or possible bio-attacks Ease of use Reporting is not a priority The easier it is to report, the more reports we receive
Implementation Hospitals ESSENCE system and notifiable disease data extraction being set up by Doucet Consulting Private Physicians Online reporting via the web
What is ESSENCE? Syndromic disease surveillance system Uses patient chief complaint records to track symptoms that could be related to a bio-attack Developed for the Department of Defense by Johns Hopkins University
What have we accomplished? Met with Johns Hopkins staff Met with St. Joseph s IT staff and received approval to pull data electronically Prototype webpage and web reporting forms coded Server to hold disease database has been configured
What will online reporting look like when we finish? Hospitals Automatic data transfer via private fiber or secure connection (real time) Website Authentication page all participating providers will have a username and password Click on disease to report, fill in basic patient demographics Immediately reportable diseases will send an automatic text page or email to appropriate personnel. State of the community page with weekly or monthly reports of disease occurrence
Authentication Page
Disease Reporting Page
Disease Reporting Page (cont.)
Alert Screen
Epi-1 form
Confirmation Screen
How will online reporting benefit us? True picture of the community s health Use data to form a baseline of disease and symptom occurrence in order to detect outbreaks or bioterrorism events Up-to-date data will help us plan for future expansion of services Use local data to apply for grants to expand services
Communications and IT Redundant Communications Focus Health Alert Network Currently 240 local contacts in database Doctors, Chiefs, Emergency Management, Hospital ICP s, Schools Recently used to keep schools informed about flu and GI disease outbreaks and their progression. Very underutilized statewide.
Communications and IT Bryan/Brazos County 800Mhz radio system. Now on the air Base station in EHS Mobile radios in 6 vehicles + Risk Mgmt 8 portable radios + Risk Mgmt Will be purchasing 1 mobile (new vehicle) and 1 portable (Health Authority) In daily use
Communications and IT Dialogic Reverse 911 System $47,000 initiative Installed and operational at the 911 District Emergency personnel contact Emergency notification of the public Geographic notification
Communications and IT Globalstar Satellite Phones 4 purchased w/ contracts Health Department County Judge Emergency Management Coordinator Sheriff Uninterruptible back-up communication
Communications and IT PolyCom Video Conferencing Units Used to visually connect the 3 Emergency Operations Centers and the Health Department Bryan/Brazos County EOC College Station EOC TAMU EOC Health Department (2 units purchased with TIF funds)
Communications and IT Servers Disease reporting Syndromic surveillance Health Department Website www. brazoshealth.org
Communications and IT *In Progress* Field mobile data unit Mobile data terminal to be installed in Emergency Response Vehicle Field e-mail capability Data transfer and communications with 911.
Risk Communications Risk communications plan established. Coordination with media on-going.
Training In-house All BCHD employees have completed an awareness level bioterrorism course. http://www.ualbanycphp.org/learning/registration/ detail_terrorism.cfm 6 staff have attended the T-TIER program at the TAMU Health Science Center 2 have attended T-TIER II Continuing education provided to BT committee Tabletop exercise EPR coordinators have acquired several hundred hours of CE each Several national-level conferences
Training Community 60+ participants in Basic Disaster Life Support Working with Region 7 and the Texas A&M Health Science Center to create a conference to bring together community leaders and emergency responders. April 25-27 Austin Smallpox training Community education opportunities recruiting
Future Endeavors Execute local agreements for medication distribution centers. Bryan and CS ISD s Execute agreement with Sheriff s Office and proceed with establishment of support team. Provide education to local medical providers and emergency service workers.
Future Endeavors Coordinate efforts with the local hospitals and establish better lines of communication. Conduct cooperative exercises with local responders Tabletop Functional Continue to take advantage of educational opportunities.
Thank You