Scott Shone, PhD APHL NBSGTS St. Louis, MO 3/1/16. Newborn Screening Contingency Plan Update

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Scott Shone, PhD APHL NBSGTS St. Louis, MO 3/1/16 Newborn Screening Contingency Plan Update

Background Newborn Screening Saves Lives Act of 2008 o Directs CDC with HRSA and State Agencies to develop a national NBS contingency plan for use by a state, region, or consortia of states in the event of a public health emergency. 2008 CDC/HRSA Workshop o Federal partners; State public health programs (including newborn screening programs, state labs, maternal child health programs); State emergency preparedness programs; and Clinicians 2010 Current plan published

Background, cont d Strategic Objectives of Current Plan 1. A framework for specimen collection is established. 2. Specimens are shipped to the designated newborn screening laboratory site. 3. Specimens are processed. 4. Screening results are reported to the newborn screening follow-up program and physicians and families. 5. Positive diagnostic screening results are confirmed. 6. Availability of treatment and management resources is ensured. 7. Families are educated about newborn screening. 8. Carry out other activities determined appropriate by the HHS Secretary.

Background Newborn Screening Saves Lives Reauthorization Act of 2014 o The plan shall be updated as needed and at least every five years.

Project Goal: Assess and update the Newborn Screening Contingency Plan With a focus on addressing gaps in laboratory and clinical follow-up Objectives: 1. Seek stakeholder input on the current plan with regard to gaps in laboratory and clinical follow-up. (Public Comment) 2. Convene representative stakeholders and subject matter experts to draft content and review updates. (Advisory Committee) 3. Provide a final approved guidance document for dissemination.

Advisory Committee Co-chairs: Debbie Badawi, MD, Chief, Child and Adolescent Health Unit, Maryland Department of Health and Mental Hygiene; and Scott Shone, PhD, Program Manager, Newborn Screening Laboratory, New Jersey Department of Health Newborn screening programs Public Health Labs Regional Collaboratives Family Voices Newborn screening HIT Metabolic Specialists Title V AAP AMCHP APHL ASTHO CDC HRSA March of Dimes NACCHO

Committee Purpose 1. Provide content expertise, draft content and review updates 2. Provide guidance on a public comment survey and help disseminate the survey 3. Participate in Committee calls and meetings 4. Develop and assist in dissemination of the updated plan and any resources

Timeline Dec 2015 Advisory Committee Orientation & Kick-off Call Jan. 2016 - Advisory Committee Call Jan. Feb. 2016 Public Comment Survey Open Feb. 27, 2016 In-person Advisory Committee Meeting o Recommendations for updates to the plan and resources o Dissemination plan for updated CONPLAN and resources March June 2016: o Incorporate recommended updates o Circulate updated draft to Advisory Committee for final review/comment o Finalize updates June 2016 Submit final product June and beyond Disseminate and promote updated plan and resources

Meeting Framework 1. Develop a clear outline of updates to be made, including new content and updates and/or drafting language or edits to the text 2. Develop clear next steps in terms of what needs to be addressed and coordinated in order to complete recommended updates by June 2016 (with consensus on roles and tasks going forward). Outcomes: List of recommended updates and completed action plans

Survey Overview: Open from Jan. 12 Feb. 15, 2016 Included background/demographic questions and guiding questions Comment could be provided in general, or on specific sections of the current plan Widely disseminated by partners, Committee members and organizations

Background Information Respondents were asked general background information about their experience with emergencies affecting NBS, status of NBS contingency plans, familiarity with their state and the national CONPLAN, and familiarity with EMAC. Background questions were tailored by stakeholder audience: 1. State/Territorial Newborn Screening Programs; Labs; MCH/CYSHCN Programs 2. Other stakeholders Hospitals, Physicians, Specialists, Preparedness Programs, Local Health Depts., Families and Consumers, etc.

Public Comment - Themes General Comments Components of a CONPLAN Considerations for the Committee Addressing Gaps in Follow-up Helpful Resources and Formats Beyond on the Plan Comments Specific to the Current Document

Plan Components Communication Vulnerability Assessment Planning Assumptions Essential Functions Preparation Documents Training and Exercise Funding guidelines MOUs Case Examples How to connecting with other states / supports

OTHER CONSIDERATIONS Point-of-Care EMAC Statutes and Privacy Concerns Technology Differences in State Panels Facilities near State Lines Language Barriers Risk of delayed response Competing Priorities Minimize Redundancy Centralize operations and communications

HELPFUL RESOURCES / FORMATS Overall, it should be: clear, concise and user-friendly State Samples / Examples Tables & Action Steps Checklists & Flowcharts Web-based, editable templates List of states able to provide services Case examples Training and Exercise Resources

Contingency Planning Preparedness

Contingency Planning Preparedness Contingency Plan: a plan designed to take a possible future event or circumstance into account. Preparedness: a continuous cycle of planning, organizing, training, equipping, exercising, evaluating, and taking corrective action in an effort to ensure effective coordination during incident response.

Bring NBS to Emergency Planners

Plan MUST be Usable

Best Practices Resources Lack of collection cards Plan to obtain card from national stockpile Primary courier not operating Identify alternate courier for transporting specimens Reagent storage fails Alternate source for reagents LIMS Server Crashes Establish manual reporting method Treatment center is evacuated Other local, state or regional options NBS Contingency Planning Process Map EMAC Mission Ready Packages

Wisdom from The Lorax

Wisdom from The Lorax