Transcript CDC Region 3 Bio-Emergency Health Official In

CDC Region 3 Bio-Emergency
Health Official/Elected Official
In-Service
[Linda Drey, Health Planner]
2004
Objectives
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Describe the role of local public health in Iowa.
Identify the role of the local board of health.
Identify relationships to the Iowa Department
of Public Health, local board of supervisors,
local county attorney, and other partners.
Understand the aspects of bio-terrorism and
the role/responsibilities of local public health in
the event of a bio-emergency.
Become familiar with CDC Bioterrorism grant
requirements for FY 03-04..
Local Public Health’s Role
Protecting the Health
of the Public!
Public health is responsible to
safeguard the community’s health
through assessment, policy
development and assurance.
Public Health’s Impact
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Public health is not a collection of programs for
the poor.
Has public health affected your life today?
Public health affects everyone who drinks
public drinking water, eats in a restaurant, buys
milk, has an elderly relative who needs home
care, needs emergency medical services,
wants to avoid getting sick from an infectious
disease, and is concerned about preparedness
for natural or intentional disaster.
Public Health vs. Hospital
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Local Public Health
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Is responsible for protecting and safeguarding the
health of all people within its jurisdiction;
Public health touches every person’s life every day;
Promotes physical and mental health;
Prevents disease and injury;
Prevents epidemics and spread of disease;
Promote healthy behaviors
Respond to disasters;
Assures the quality and accessibility of health
services for all
Public Health vs. Hospital
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Hospital/Individual Provider
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Focus is on providing care to specific individuals
seeking care for an illness/injury;
Makes decisions that are best for the respective
patient and not necessarily the general public;
No emphasis/responsibility for the health and
welfare of the general public;
Not required to provide treatment to all
individuals requesting care with a few exceptions
(ER’s, etc.)
Core Public Health Functions
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Assessment
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Policy Development
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Assurance
Core Public Health
Functions/Essential Services
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Assessment
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Monitor health status
Diagnose and investigate health
problems and health hazards in the
community
Evaluate the effectiveness, accessibility,
and quality of personnel and populationbased health services
Core Public Health
Functions/Essential Services
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Policy Development
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Develop policies and plans that support
individual and community health efforts.
Enforce laws and regulations that protect
health and ensure safety.
Research for new insights and innovative
solutions to health problems.
Core Public Health
Functions/Essential Services
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Assurance
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Link people to needed personal health
services and assure the provision of
health care when otherwise unavailable.
Assure a competent public health and
personal health care workforce.
Inform, educate and empower people
about health issues.
Mobilize community partnerships to
identify and solve health problems.
For Local Communities…
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Public health is an economic issue,
because healthy workers are
productive and a good public health
system attracts business.
Public health is an education issue
because healthy children learn.
Public health is the front line defense
for the public’s health promotion and
protection.
Local Public Health System
Public Health Providers
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Local Boards Of Health (County/City/District)
WIC agencies
Maternal Child Health (MCH) agencies
Visiting Nurse Service (VNS) agencies
And others…..perhaps MANY others...
10 Greatest Advances in PH
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Vaccinations
Safer workplaces
Safer and healthier
food
Vehicle safety
Control of infectious
diseases
Family planning
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Advances in treatment
and prevention of heart
disease and stroke
Decrease in tobacco
use
Better care for mothers
and their babies
Fluoridation of drinking
water
Local Boards of Health History
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In 1866 the Local Health Law was
adopted.
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Designated mayor and town council or
township trustee as LBOH.
LBOH had authority to establish
regulations for public health and safety,
control nuisances, and regulate sources of
filth and causes of sickness in
communities.
1967 New Local Health Act
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Chapter 137 of the Code of Iowa:
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Each county required to establish a BOH one member had to be a physician
licensed by the State of Iowa.
BOS to appoint other members.
A city with a population of 25,000 + could
establish a city board of health.
Counties and cities were also allowed to
form district boards of health.
LBOH Power and Jurisdiction
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Chapter 137of the Code of Iowa
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5 members, one must be an Iowa licensed
physician
The BOH has autonomy over public health
matters within the county. (IA Code137.5;
137.6; 137.7)
Can write rules and employ persons for the
discharge of its duties.
LBOH Power & Jurisdiction Cont.
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Boards of Supervisors have little
authority over public health matters.
The Board of Supervisors role is three
fold:
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appoint board of health members;
determine county funding portion of the
local health budget; and
approve regulations adopted by board of
health
LBOH Roles & Responsibilities
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IA Administrative Code 641-Ch.77
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Requires local BOH to carry out the three
core functions and ten essential public
health services.
Required to meet at least quarterly.
Required to comply with open meeting
laws.
LBOH must report to the IDPH on certain
activities defined in IAC 641-77.5.
Local Boards of Health
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Powers of Local Boards of Health
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Legal Responsibility of Local Board of
Health
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Refer to LBOH Guidebook page 9…
Refer to LBOH Guidebook page 10…
Working with the County Board of
Supervisors
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Refer to LBPH Guidebook page 12...
Local Boards of Health in Iowa
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99 county Boards of Health
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1 District Health Department
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Siouxland District Health Department
2 City Boards of Health
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Council Bluffs
Ottumwa
Bioterrorism/Bio-emergencies
are Different
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Medical and public health systems are usually
first to detect bioterrorism.
A delay is likely between the release of the
agent and the knowledge that the occurrence
is a bioterrorist act.
A short window of opportunity exists between
the first cases and the second wave.
Public health officials must determine that an
attack occurred, identify the organism, and
prevent more casualties.
Local Public Health BioEmergency Planning
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Need to build the infrastructure of local public
health across Iowa and the nation.
In Iowa, the IDPH is the lead public health
agency and coordinates the CDC Iowa Public
Health Cooperative Agreement (public health
BT grant)
Each local health department charged with
developing a bio-emergency plan by Aug.
2004.
Public Health Infrastructure
Public
Health
Response
Bioterrorism
 Emerging Infections
 Other Public Hlth Programs
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Essential
Scientific
Capabilities
Basic
Infrastructure
Surveillance
Laboratory
Epidemic
Practice
Investigations
Information
Systems
Organizational
Workforce
Capacity
Reference: Public Health Practice Program Office (PHPPO), CDC, 1999.
BT Core Capacities – 10/15/01
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Mission
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To protect the publics health and safety by
developing the capacity of state and local
public health systems to prepare for and
respond to a bioterrorist act.
BT Core Capacities
Framework
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Surveillance and Epidemiologic
Investigation
Identification
Communication
Mobilization
Public Health Interventions
BT Core Capacities
Framework
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Goals
Pre-Event Objectives
Event Objectives
Indicators (pre-event and event)
Planning/Policy Indicators
 Workforce/Training Indicators
 Evaluation/Quality Indicators
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BT Core Capacities Example
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Mobilization
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Pre-Event Objective: Identify organizations
that comprise the public health response
system and integrate preparedness
activities with partners
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P/P: plans that define roles and responsibilities
W/T: train staff in response role within larger
emergency response system
E/Q: review plans periodically and adjust
Activation of Federal Assistance
Major disaster
Internal local and State resources
State resources exhausted
Governor requests President to declare disaster
Federal Assistance- based on severity and need
FEMA may request DOD or National Guard
Federal Response Plan
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FBI leads on information release I crisis
management
FEMA leads on information release in
consequence management
Transfer from the FBI to FEMA by
Attorney General
Core Federal Responses:
DOJ/FBI
DOD
DOE
EPA
FEMA
HHS
Health and Human Services
(HHS) Provides
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Technical support,
personnel and
equipment
Disease detectives
Agent identification;
collection and testing
of samples
Medical
management
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Medical supplies, drugs
and vaccinations (SNS)
Regulatory follow up
(e.g. FDA)
Outbreak/disease threat
assessment
Onsite safety
Mass fatality
management
CDC Bioterrorism Grant 03-04
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Focus Area A: Planning & Assessment
Focus Area B: Surveillance & Epidemiology
Focus Area C: Laboratory Biological Agents
Focus Area D: Laboratory Chemical Agents
Focus Area E: Health Alert Network/IT
Focus Area F: Risk Communication
Focus Area G: Education & Training
Strategic National Stockpile (SNS)
Smallpox
Funding Formula – for LPHA
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Base aware per LPHA: 30%
Population: 40%
Critical Assets: 15%
Agricultural Value: 15%
Funding
% of Total
Funding
Local public health agencies
CDC Regions (6)
IDPH
Shared Capacity
UHL
TOTAL
21%
Total Funding
$2,644,609
20% $2,504,515
21% $2,669,579
21% $2,594,892
17% $2,188,378
100% $12,601,973
LPHA Grant Responsibilities
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By July 15, 2004 complete county bioemergency plan and submit template checklist
to IDPH.
By July 15, 2004 complete mass dispensing
plan, policies and procedures for smallpox/oral
prophylaxis and submit checklist to IDPH.
By July 15, 2004 submit improvement plan for
reportable disease surveillance system for your
county to IDPH.
LPHA Progress Report
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Two progress reports are due to IDPH
from each local public health agency as
a part of the CDC grant.
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Due April 10, 2004
September 10, 2004
LPHA Regional Responsibilities
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Submit county information for Regional
Resource Directory for reports due Jan.
5, April 1, and July 1.
Submit the # of trained staff in advanced
epidemiology/surveillance for Aug. 1
report.
Submit the # of trained staff in EPI-INFO
for Aug. 1 report.
Regional Grant Reports
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As a member of Region 3 (16-county
area of northwest Iowa) each county
must submit requested information in
addition to what is asked for in the
regional resource directory for a regional
report compiled by the regional planner.
The report is due:
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April 10, 2004
September 10, 2004
WELCOME TO
BIOTERRORISM
BASICS
Objectives
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Upon completion of the course,
learners should be able to:
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Define terrorism using the B-NICE model
Define the role of public health in dealing
with a terrorism attack
List three or more messages that should
be sent to the general public regarding
terrorism
Terrorism
Terrorism is the unlawful use of force
or violence against persons or
property to intimidate or coerce a
government, the civilian population,
or any segment thereof, in
furtherance of political or social
objectives.
FBI Definition from
28 CFR Section 0.85.
PSYCHOLOGICAL IMPACT
of terror…intrusive thoughts,
nightmares and sleeping difficulties,
anxiety or fear, alienation from
people, ‘jumpiness’, emotional
numbness and problems with social
relationships
Objectives of Terrorism
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Bring down a government or
regime
Attack those who attack their
religion
 Cause
a Change!!!
Countermeasures to Terror
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Awareness of terrorism objectives
Deny the objective of the attack
President Bush:
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Keep shopping, keep traveling
Subsidies for airlines, insurance
industry to keep working
Public Health’s Role in a
Bio-Emergency
1.
2.
3.
4.
PREPARE
RESPOND
MITIGATE
RECOVER
Why Iowa?
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Nearly 1000 interstate bridges
More than 100 dams
Greatest concentration of hog lots in the
nation
Critical rail links
Over 3000 miles of pipelines (natural gas,
gasoline, etc.)
Iowa is a symbol of stability
Not In My Back Yard Syndrome
Types of Terrorism B-NICE
 Biologic
 Nuclear
 Incendiary
 Chemical
 Explosive
Bioterrorism
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Since 1985, the number of terrorist
incidents involving the threatened or
actual use of chemical, biological,
radiologic, or nuclear materials has
risen sharply; (Tucker, 1999)
The threat to the nation from biologic
weapons is no longer a debate issue.
(Russell, 1997)
Why Bioterrorism?
Poor man’s nuclear bomb
 Cheap
 Easily available
 Compact
 Deadly
 Psychological Impact
 Stealthy
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Ease of Dissemination
100
80
60
40
20
0
Category A
Category B
Category C
Mortality Rates
80
70
60
50
Category A
Category B
Category C
40
30
20
10
0
Mortality Rates
CDC Assistance
Local level needs CDC
help to identify Category
B and Category C
diseases/agents.
Public Health Staff Roles
• Describe the public health role in emergency
response in a range of emergencies that might
arise.
• Describe the chain of command in emergency
response
•Identify and locate the agency emergency
response plan
Public Health Staff Roles Cont.
• Describe your functional role in an emergency
situation
• Demonstrate correct use of all communication
equipment used in an emergency
• Describe communication role(s) in emergency
response
• Recognize unusual events that might indicate an
emergency and describe appropriate action
Public Health’s Message
to the Community
Preparation
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Communities prepare for a
number of disasters including:
 Ice Storms
 Tornadoes
 Chemical spills
 And now…terrorism
Be Alert and Stay Calm!
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Report suspicious activity
Use common sense
Don’t approach
Write down a description
First responders are trained to
protect lives and property.
Stay tuned to local radio stations
for emergency messages.
Are You Prepared Personally?
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Have a family emergency plan that includes:
 Phone tree or notification plan for all family
members.
 Identify a family meeting place
 Know school and workplace procedures
 Battery powered radio, flashlights and batteries
 First aid kit and other special needs
 Basic supplies for 72 hours
Actions You Can Take
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You as a member of the public health
community may play a critical role.
Be prepared to identify possible incidents.
Be prepared to respond appropriately and
rapidly.
If a bio-emergency happens, it won’t be
business as usual for any member of the
public health team.
Contact Information
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Linda Drey – Health Planning & Development Coordinator
Siouxland District Health Department
Phone 712-279-6119
Cell 712-490-5937
Fax 712-255-02604
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Kevin Grieme – Health Planner
Siouxland District Health Department
Phone 712-279-6119
Cell 712-898-5176
Fax 712-255-02604