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Community Preparedness


Community Preparedness Jim Schwendinger MSN MPH CCRN ANP-C Epi-X & Clinician Communication Team Centers for Disease Control and Prevention (CDC) Mollie Melbourne MPH MEP – PowerPoint PPT presentation

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Title: Community Preparedness

Community Preparedness
  • Jim Schwendinger MSN MPH CCRN ANP-C
  • Epi-X Clinician Communication Team
  • Centers for Disease Control and Prevention (CDC)
  • Mollie Melbourne MPH MEP
  • National Association of Community Health Centers,

  • Continuing Education Credits
    DISCLAIMERIn compliance with continuing
    education requirements, all presenters must
    disclose any financial or other relationships
    with the manufacturers of commercial products,
    suppliers of commercial services, or commercial
    supporters as well as any use of unlabeled
    product(s) or product(s) under investigational
    use. CDC, our planners, and the presenters for
    this seminar do not have financial or other
    relationships with the manufacturers of
    commercial products, suppliers of commercial
    services, or commercial supporters. This
    presentation does not involve the unlabeled use
    of a product or product under investigational

Why take an All Hazards approach ?
  • Natural Disaster
  • Hurricane, Earthquake, Tornado, Flood, Wildfire,
    Ice Storm
  • Terrorist Attack
  • Conventional, Radiologic, Biologic, Chemical
  • Known Infectious Diseases
  • Mumps, Norovirus, E.coli, Influenza, VHF
  • Unique Infectious Diseases
  • SARS, H5N1
  • Infrastructure Challenges
  • Fire, Staff Issues, Power Outage

Our Health Protection Preparedness System A
Network of Shared Responsibility !
  • Local - tribal - state - federal
  • Domestic international
  • Public private
  • Multi-sector
  • Non-partisan
  • Health protection homeland security economic

Federal Planning Resources
  • National Response Framework

ESFs Roles and Responsibilities
  • ESF 1 Transportation (DOT)
  • Aviation/airspace management and control
  • Transportation safety
  • Restoration/recovery of transportation
  • Movement restrictions
  • Damage and impact assessment
  • ESF 2 Communications (DHS-NCS)
  • Coordination with telecommunications and
    information technology industries
  • Restoration and repair of telecommunications
  • Protection, restoration, and sustainment of
    national cyber and information technology
  • Oversight of communications within the Federal
    incident management and response structures
  • ESF 3 Public Works and Engineering (DoD)
  • Infrastructure protection and emergency repair
  • Infrastructure restoration
  • Engineering services and construction management
  • Emergency contracting support for life-saving and
    life-sustaining services
  • ESF 4 Firefighting (USDA)
  • Coordination of Federal firefighting activities
  • Support to wildland, rural, and urban
    firefighting operations

ESFs (cont.)
  • ESF 5 Emergency Management (DHS-FEMA)
  • Coordination of incident management and response
  • Issuance of mission assignments
  • Resource and human capital
  • Incident action planning
  • Financial management
  • ESF 6 Mass Care, Emergency Assistance,
    Housing, and Human Services (DHS-FEMA)
  • Mass care
  • Emergency assistance
  • Disaster housing
  • Human services
  • ESF 7 Logistics Management and Resource
    Support (DHS-FEMA)
  • Comprehensive, national incident logistics
    planning, management, and sustainment capability
  • Resource support (facility space, office
    equipment and supplies, contracting services,
  • ESF 8 Public Health and Medical Services (HHS)
  • Public health
  • Medical
  • Mental health services
  • Mass fatality management

ESFs (cont.)
  • ESF 9 Search and Rescue (DHS-FEMA)
  • Life-saving assistance
  • Search and rescue operations
  • ESF 10 Oil and Hazardous Materials Response
  • Oil and hazardous materials (chemical,
    biological, radiological, etc.) response
  • Environmental short- and long-term cleanup
  • ESF 11 Agriculture and Natural Resources
  • Nutrition assistance
  • Animal and plant disease and pest response
  • Food safety and security
  • Natural and cultural resources and historic
    properties protection and restoration
  • Safety and well-being of household pets
  • ESF 12 Energy (DOE)
  • Energy infrastructure assessment, repair, and
  • Energy industry utilities coordination
  • Energy forecast

ESFs (cont.)
  • ESF 13 Public Safety and Security (DOJ)
  • Facility and resource security
  • Security planning and technical resource
  • Public safety and security support
  • Support to access, traffic, and crowd control
  • ESF 14 Long-Term Community Recovery (DHS-FEMA)
  • Social and economic community impact assessment
  • Long-term community recovery assistance to
    States, local governments, and the private sector
  • Analysis and review of mitigation program
  • ESF 15 External Affairs (DHS-FEMA)
  • Emergency public information and protective
    action guidance
  • Media and community relations
  • Congressional and international affairs
  • Tribal and insular affairs

Federal Resources NIMS more
Federal Resources NIMS IRIS
Other Federal Planning Resources All Hazards
  • CDC Emergency Preparedness and Response site
  • The FEMA Plan Ahead site http//
  • http//

13 Get a Kit
  • Water
  • One gallon per person per day - at least three
    days (drinking sanitation)
  • Food
  • At least a three-day supply of non-perishable
  • Battery-powered or hand crank a NOAA Weather
    Radio with tone alert
  • Extra batteries for both
  • Flashlight and extra batteries
  • First aid kit
  • Whistle to signal for help
  • Dust mask
  • To help filter contaminated air
  • Plastic sheeting and duct tape to
  • Moist towelettes, garbage bags and plastic ties
    for personal sanitation
  • Wrench or pliers to turn off utilities
  • Can opener for food (if kit contains canned food)
  • Local maps

Get a Kit Things to Consider
  • Prescription medications, glasses medical
  • KIWY - http//
  • Infant formula and diapers
  • Pet food and extra water for your pet
  • Important family documents - insurance policies,
    ID, bank records
  • In a waterproof, portable container
  • Cash or traveler's checks and change
  • Emergency reference material - first aid book
  • Sleeping bag or warm blanket for each person.
  • Complete change of clothing sturdy shoes.
  • Household chlorine bleach a measuring device
  • Fire Extinguisher
  • Matches in a waterproof container
  • Feminine supplies and personal hygiene items
  • Mess kits, paper cups, plates and plastic
    utensils, paper towels
  • Paper and pencil
  • Books, games, puzzles or other activities for

CDC Resources COCA
  • The Clinician Outreach Communication Activity
  • Weekly informational and monthly training updates
  • COCA Conference Calls
  • Email question and answer service regarding
    emergency preparedness and response topics -
  • COCA website http//

CDC Resources Epi-X
  • To provide secure, moderated communications for
    public health officials to report and discuss
    disease outbreaks and other acute health events
    including terrorism.
  • Epi-X roles
  • State/Territorial Epidemiologist
  • State/Territorial Public Health Laboratory
  • State/Territorial Public Health Officer
  • State/Territorial Public Health Veterinarian
  • State/Territorial Terrorism Response Coordinator
  • Poison Control Center Director
  • HAN Coordinator
  • City, County, or Regional Health Officer
  • Epi-X Help Desk - and

  • CDC-INFO 1-800-232-4636
  • Toll-free
  • 24/7/365
  • Direct connection to the CDC DEOC
  • Flexible Staffing
  • Information provided by CDC SMEs
  • Email

Other Federal Planning Resources Pandemic
  • US Department of Health and Human Services (HHS)
  • - National and HHS Pandemic Influenza Plans
  • - Checklists
  • - Links to WHO and other US government agency
    websites such as FDA, USDA, etc.

  • Pandemic influenza Preparedness Checklists
  • State and Local
  • Business
  • Preschool
  • Schools (K-12)
  • Colleges Universities
  • Faith-based Community Organizations
  • Physician Offices and Ambulatory Care
  • Home Health
  • Emergency Medical Services
  • Future Checklists

Preparedness Challenges
  • Disruption of services (police, fire, EMS)
  • Interruption of utilities
  • Decreased or eliminated health infrastructure
  • Communication
  • Transportation
  • Supplies (non-retail)
  • Community infrastructure
  • Schools
  • Retail services

Disruption of services
  • Police
  • Fire
  • EMS
  • Government services
  • US Mail
  • Entitlements
  • Resource agencies

  • Water
  • Electricity
  • Gas
  • Telephone service
  • Cable and other TV service
  • Sewer
  • Sanitation services

Health Infrastructure
  • Decreased or non-existent healthcare services
  • Local clinics
  • Individual provider offices
  • ERs
  • Hospitals
  • Long Term Care facilities

  • Telephone
  • Internet
  • Radio
  • Other

  • Mass transit
  • Emergency vehicles
  • Personal vehicles
  • Physical infrastructure
  • Roads, bridges, tunnels
  • Resources
  • Gas, maintenance items

  • Needed for organizational function
  • Wholesale suppliers
  • Long-term function

Community Infrastructure
  • Schools
  • Businesses
  • Retail services
  • Food
  • Medicine
  • Supplies
  • Shelter-related

Preparation and Response
  • Individuals and Families
  • Businesses
  • Communities
  • Faith-based Organizations
  • Health Care Providers
  • Governments
  • International Organizations

Issues Specific to Selected Populations
  • Planning must take into account the special
    circumstances of any number of select diverse
  • Elderly
  • Homebound Individuals
  • Disabled Persons
  • Single Parents
  • People with Chronic Illnesses
  • Others

Special Populations
  • The Public Health Workbook to Define, Locate and
    Reach Special, Vulnerable and At-Risk Populations
    in an Emergency (DRAFT)
  • Provides a process that can support state, local,
    and tribal planners as they advance in their
    efforts to reach all populationsand
    specifically, special populationsin day-today
    communication and during crisis or emergency

(No Transcript)
Americas Voice for Community Health Care
The NACHC Mission The National Association of
Community Health Centers (NACHC) represents
Community, Migrant, and Homeless Health Centers,
as well as Public Housing Primary Care Programs
and other community-based health centers.
Founded in 1970, NACHC is a nonprofit
organization providing advocacy, education,
training and technical assistance to health
centers in support of their mission to provide
quality health care to underserved populations.
Health Centers at a Glance
  • Located in or serve a high need community
  • Provide comprehensive primary care and supportive
  • Serve all who seek care, regardless of ability to
  • Governed by community board with majority of
    members HC patients
  • Meet performance and accountability requirements
  • Design services to meet the needs of their

Health Centers at a Glance
  • 1,150 community, migrant, homeless, and public
    housing health center organizations with more
    than 6,300 sites
  • Over 112,000 FTEs
  • Provide quality care for 1.47 per patient per
    day (538 annually)

Data source Uniform Data System 2006 National
Association of Community Health Centers - 2007
Health Center Services Include
  • 12-step programs
  • AIDS family social services
  • Breast-feeding classes
  • Cancer, health screenings
  • Case management
  • Childbirth classes
  • Dental care
  • Diabetes management
  • Domestic Violence prevention
  • Early education supports
  • Family planning
  • Flu clinics
  • HIV education/prevention
  • Homeless support services
  • Immunizations
  • Mental health counseling
  • Migrant healthcare
  • Neonatal home visits
  • Nutrition counseling
  • Nutritional assessment
  • Pharmacological screening
  • Prenatal care
  • Primary care
  • School based clinics
  • Senior abuse screening
  • Substance abuse counseling
  • Substance abuse referrals

About Our Patients
  • As of November 2007, 17 million patients with 68
    million patient visits
  • 91.9 of patients fall below 200 FPL
  • Racial and ethnic minorities comprise almost 2/3
    of our patient population
  • 39.8 are uninsured 37.4 have Medicaid or
    another public insurance coverage
  • 28.9 of patients report being best served in a
    language other than English

Data sources Uniform Data System 2006
National Association of Community Health Centers
The Impact of Health Centers
  • Improve access to primary and preventative care
  • Cost effective care
  • High quality care
  • Reduction in Health Disparities
  • Effective management of chronic illness
  • Improve birth outcomes
  • Create jobs and stimulate economy

Importance of Planning for Health Centers
  • Serve as advocates for medically underserved
  • Mission driven organizations serve their
  • Closely linked with hospitals and health
  • Financially lean need fast recovery
  • Historical roles in emergencies patients WILL
    seek care from their health center
  • Accreditation requirements
  • HRSA Expectations

Potential Roles in Emergency Management
  • Provide services to CHC patients
  • Increase ER Surge Capacity on off site
  • Triage patients
  • Provide mental health services
  • Disease or syndromic surveillance
  • Serve as conduit of information to patients and
  • Outreach to hard to reach populations
  • Mobile clinics
  • Provide culturally competent, linguistically able
    provider/support staff
  • Distribute medications or vaccines to patients,
    staff, community members (PODs)
  • Provide medical/dental/MH staff for alternate
    care sites

Past Experience in Emergencies
  • Treatment of respiratory and eye irritation in
    New York, New Jersey, and Washington DC following
    Sept. 11 attacks
  • Diagnosis and treatment of first monkeypox
    victims in Wisconsin and Illinois
  • Treating storm related injuries and administering
    tetanus and hepatitis after Hurricane Katrina
  • Treating patients at community shelters and
    dispatching mobile clinics in CA during wildfires
    in 2003 2007
  • Augment staff in ER and Medical Care Shelters in
    KY following tornados in 2008

Engaging Health Centers
  • Assess resources, capacity, capabilities
  • Determine role(s) for Health Center
  • Include in exercises and drills
  • Involve in ESF-8 and/or other planning meetings
  • Provide funding and access to other resources

How to Find Health Centers in Your Area
  • Contact the PCA in your state (http//
  • Visit http//

  • Mollie Melbourne
  • Director of Emergency Management
  • National Association of Community Health Centers

  • All hazards preparedness efforts make sense !
  • Natural Disaster
  • Terrorist Attack
  • Known Infectious Diseases
  • Unique Infectious Diseases
  • Infrastructure Challenge
  • Know the current plans planning resources
  • Federal
  • State
  • Local community
  • Businesses

  • Determine the needs of your area, organizations
    and community.
  • Develop preparedness plans.
  • Share resources!
  • Exercise and evaluate.
  • Preparedness actions must be taken BEFORE an
    actual event !

  • CDC Epi-X
  • CDC Emergency Communications System

Thank you!
  • The findings and conclusions in this
    presentation have not been formally disseminated
    by CDC and should not be construed to represent
    any agency determination or policy.

Complacency is the enemy of health protection!
Further questions?
  • Please email us at

  • Continuing Education guidelines require that
    the attendance of all who participate in COCA
    Conference Calls be properly documented. ALL
    Continuing Education credits (CME, CNE, CEU and
    CHES) for COCA Conference Calls are issued online
    through the CDC Training Continuing Education
    Online system http//  
  • Those who participate in the COCA Conference
    Calls and who wish to receive CE credit will need
    complete the online evaluation. If you will
    complete the evaluation by March 26, 2008, use
    the course code EC1265. If you will complete the
    online evaluation between Feb. 27, 2008 and March
    26, 2009, use course code WD1265. CE certificates
    can be printed immediately upon completion of
    your online evaluation. A cumulative transcript
    of all CDC/ATSDR CEs obtained through the CDC
    Training Continuing Education Online System
    will be maintained for each user.

  • CME CDC is accredited by the Accreditation
    Council for Continuing Medical Education (ACCME)
    to provide continuing medical education for
    physicians. CDC designates this educational
    activity for a maximum of 1 Category 1 credit
    toward the AMA Physician's Recognition Award.
    Physicians should only claim credit commensurate
    with the extent of their participation in the
  • CNE This activity for 1.0 contact hours is
    provided by CDC, which is accredited as a
    provider of continuing education in nursing by
    the American Nurses Credentialing Center's
    Commission on Accreditations.
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