September 2013 Inside this issue:
Contents
September 2013 Edition
2013 Summer Summit................................................................ 1
Director’s Chair .......................................................................... 2
Local Public Health Preparedness ............................................. 2
Minnesota Department of Health............................................... 3
Healthcare System Preparedness ............................................... 5
The conference was jointly sponsored by the Office of
Emergency Preparedness (MDH) and the Public Health
Emergency Preparedness Oversight Group, a standing
committee of the State Community Health Services Advisory
Committee (SCHSAC).
Over 96% of the attendees rated the conference as
“Satisfactory” or better! Among the most popular features:
 “When the Rubber Meets the Road” Lessons Learned
from recent public health disaster responses (panelists
from City of Minneapolis and Carlton, Nicollet, and
Nobles Counties).
 The Keynote Address “Fueling Our Tanks” –motivational
tips for our work and personal lives by Dr. Rosie Ward.
 The food and the accommodations.
 The sharing of ideas and resources.
 The opportunities for networking – both regionally and
state-wide.
September is National Preparedness month.............................. 5
Upcoming Events........................................................................ 6
Editorial Board............................................................................ 6
2013 Summer Summit
“Shifting Gears – Capabilities & Coalitions as
Driving Forces to Sustainability”
The call to “Rev Your Engines”
could have been the summons to
the 2013 Public Health
Emergency Preparedness Summit
on July 24 & 25 at the Earle
Brown Heritage Center in
Brooklyn Park. Over 130 state,
local, and tribal public health and
healthcare emergency
preparedness colleagues met to
build on past progress and
strategize on new ways of planning and implementing
preparedness work for Minnesota’s counties and tribal
communities.
Parts of the
“Shifting Gears – Capabilities &
conference
Coalitions as Driving Force to
included a videoSustainability”
conference that
enabled local
The Goal of the Conference: to gain a
directors to join
statewide understanding of the current
the assembly via
future direction of public health
links from around
emergency preparedness at the federal,
the state. In this
state, regional, local and tribal levels
way, more staff
and to equip local and tribal health
could participate
departments with the skills and tools to
in a review of the
successfully meet their grant duties.
history of public
health
preparedness in Minnesota as well as an overview of strategies
and administrative details for the upcoming years of federal
grant funding. (Note: A copy of the presentation on disk will
be sent to anyone who wants it; however the first 20 minutes
of the videoconference is not viewable due to technical
difficulties.)
Most of the really hard work of the conference involved three
workshops where participants learned about new requirements
for the remaining 4 years on the grant and began working on
some of the 2013-14 grant duties, including how to write a
work plan that meets the needs of individual counties, cities,
or tribes. The participants also received several templates that
are intended to help make the work easier and more organized.
September 2013
It’s always difficult to travel and take a day and a half out of
schedules, but the Summit provided an excellent opportunity
for many partners to plan together and to hear a shared vision
for the upcoming years in health readiness.
Director’s Chair
Jane Braun, Director of Emergency Preparedness
Looking Back, and Planning Ahead
Five years ago this week, we were nervously putting the final
pieces in place for the health and medical response to the
challenges of having the Republican National Convention in
town. We had planned for a year and a half, created a number
of new systems (raise your hand if you were part of the
HMJOC!), taken delivery of some huge assets, and learned a
LOT about the politics of preparedness. It was a stressful time
but a tremendous learning experience and opportunity to forge
new partnerships. Looking back, we didn’t yet know a
pandemic would soon follow, alignment of PHEP and HPP
would occur, our regional groups would morph into formal
Health Coalitions, major spring and flash floods would come
up, the capabilities were in the works, and H7N9, MERSCoV, and many other possible concerns would become part of
our discussions. It’s been an exciting five years, and we have
come a long way in moving from the early days of “buying
stuff” to a more mature focus on planning, priorities, and
partnerships.
As we discussed at the Summit in July, MDH is working hard
on a priority-setting process to re-focus the timing of and
emphasis on activities to reflect the current and future needs
for readiness. We are essentially building a zero-based PHEP
work plan, to which we will assign staff and financial
resources, and make the hard choices on what activities can be
scaled back or eliminated so we can focus on the most critical
needs to build or sustain programs. We are working with the
PHEP Funding Formula Work Group to re-design how the
half of the grant distributed to LHDs and THDs should be
allocated, as well as moving the regional Health Coalitions
into the structures envisioned by ASPR. We also plan to
increase the emphasis on reaching out to the emergency
management community at the state, local and tribal level to
avoid as many gaps and overlaps as possible.
Wishing you a happy and healthy fall!
Ready to Respond Newsletter
Local Public Health Preparedness
March 2013 Public Health Preparedness Summit
(Atlanta, Georgia) makes an impression on three
local health professionals awarded scholarships
through Public Health Emergency Preparedness
(PHEP) carry forward funds
I am so grateful that I had the opportunity to attend the 2013
NACCHO Public Health Preparedness Summit. What an
experience! I attended a variety of the sessions and was able to
take home something from every one. As I look at my notes,
the theme that permeates throughout for me is strike teams.
I am the PHEP Coordinator from Crow Wing County that has
a population of approximately 62,500. Most of the
presentations were from larger county and state entities, but
the ideas I came home with can be adapted to our local plans.
The presenters at one session I attended created mass
dispensing strike teams. We have begun working toward this
concept. It provides us with the opportunity to engage client
service departments that have not worked closely with local
public health in the past and are uncertain on how they fit into
preparing for a large dispensing incident.
Strike teams also came up during a presentation from Fort
Bend County, Texas on volunteer recruitment and retention.
In order to recruit and retain volunteers, this county created
volunteer strike teams that are developed around the ICS
system. Volunteers sign up for position specific training.
There is a volunteer leader working under each leadership
position in their ICS. An example is the Mobile Unit Set-Up
Team. The strike team is called out to set up, staff and take
down the Mobile Unit at county fairs and community events.
They have, among others, a psychological first aid team,
CASPER team, and a student team with members from local
HOSA (Health Occupations Student Organization) and YES
(Youth Engaging in Service) organizations. What a great way
to engage and retain volunteers.
Lynn Jaycox, RN PHN
Crow Wing County
For me the National Public Health Preparedness Summit was a
great experience. A week in Atlanta, GA in March shortened
winter (not really!) but I did return a bit smarter. I saw firsthand how emotionally devastating real events can be, not only
to victims but to responders. The responders to the Aurora
Theater shootings, Hurricane Sandy and the Joplin Tornado
relived every horrific moment as they shared their stories. The
Page 2 of 6
courage they displayed was obvious to the audience and we all
learned from their experiences and planning efforts. In some
cases, the real learning came in the form of changes needing to
be made-what didn’t work but will now.
levels. While the presentations focused on large institutions
(University of Wisconsin and Hamilton County, Ohio), there
were several concepts that can also be used at the rural local
level.
The first session I attended addressed how important it is for
local public health to see Community Engagement as a duty.
We were charged with engaging and integrating community
members into our preparedness planning. The bottom line
being we don’t do public health emergency preparedness FOR
the community, we must do it WITH the community.
There were two points that I pulled from those presentations
on closed PODS that I especially found useful. The first point
was to present the closed POD concept to a group of potential
closed PODS contacts versus just talking to each entity
separately. If you have a room full of people hearing about
what a closed POD is, one person might think that isn’t for
them, but if they see others in the room respond favorably, it
might sway this one person’s original opinion.
The closed POD session was of special interest to me because
we are starting to establish them in our counties. I learned the
strategies we are using for recruitment are good and that
implementing something as simple as annual review meetings
will keep the sites engaged.
Other session topics that made me stop and think: Family
Assistance Centers and the importance of fatality
management, crisis leadership and critical decision makingit’s not for everyone, ways to increase our LTAR score, online screening tools for mass dispensing, and in our rural area
using school buses to deliver drugs door-to-door might be a
really good option.
It was all this and so much more. Thank you to MDH and my
Director for the opportunity to attend.
Marcia Schroeder RN, PHEP Coordinator
Stevens Traverse Grant Public Health
My name is Candi Schafer and I am a Public Health Nurse
from Human Services of Faribault and Martin Counties.
Working in a rural county, I have many duties and wear many
hats every day. A portion of my duties is Public Health
Preparedness. I had the honor of being picked for a
scholarship from MDH to attend this year’s Public Health
Preparedness National Summit in Atlanta Georgia from March
12-15, 2013.
The Summit was amazing. The size of the conference and
variety of participants (local, state, national and international)
was an eye opener. There were so many levels of knowledge
and resources in one building. The variety of presentations
offered was very diverse and there seemed to be every subject
imaginable for public health preparedness.
My favorite activities were two sessions on closed PODS and
exploring the exhibitors/vendors from around the country.
There were a myriad of resources in one room with a lot of
resources that were free for us to take. The closed POD
sessions were near and dear to my heart because we have
recently begun closed POD planning on our regional and local
Ready to Respond Newsletter
The second important thing that I bought home was to make
sure to present why a closed pod will help each individual
entity. Let them know how they will benefit as a company by
being a closed POD. Stress how quickly their staff/ clientele/
family will get their medication/vaccination right at the
worksite so minimal work time is lost and employees aren’t
worried if their families are getting what they need for
coverage. The flip side would be employees taking time off to
stand in a long line with their families at an open POD and
missing work. If the entity is healthcare and has patients/
clientele, this also is a quick and easy way to get their clients
medicated/vaccinated versus trying to figure out how to get
them through the open POD.
Overall, I felt that this experience was wonderful and very
beneficial and worth my time to attend. I hope that others are
able to attend this summit in the future. I highly recommend it
and would return in a heartbeat.
Candi Schafer
Faribault and Martin Counties
Minnesota Department of Health
Pertussis: Minnesota Data Informing National
Recommendations
Pertussis (whooping cough) reached epidemic levels in
Minnesota in 2012, with 4,144 cases statewide. Case numbers
had not been this high since a vaccine for pertussis was
developed in the 1940s. Prior to 2012, pertussis had been
increasing since the 1980s. Furthermore, the number of cases
in children age 7-10 years increased more than six-fold
between 2007 and 2009 and that trend has continued. These
increases have occurred despite high pertussis immunization
rates. In Minnesota in 2012, 786 (87 percent) of the 905 cases
age 7-10 years were fully immunized in accordance with
Page 3 of 6
current immunization recommendations. Minnesota’s pertussis
data reflect national trends, although Minnesota and other
states with strong surveillance programs have reported the
highest rates.
Waning immunity?
The Advisory Committee on Immunization Practices (ACIP)
sets the national standard for vaccine recommendations.
Protection from the pertussis vaccine has long been known to
wane over time; however, because pertussis disease is less
severe for adolescents and adults than for young children,
booster doses following the initial five doses as the childhood
immunization series were not recommended initially. But in
2006, in response to the increase in pertussis disease,
particularly in adolescents, and data to support that
adolescents and adults are often the source of pertussis for
young infants, a booster dose of pertussis vaccine was licensed
and recommended for adolescents beginning at 11 years of
age. This booster is generally given prior to starting middle
school. We are one of four states that participated in a CDC
study to examine the source of pertussis transmission to
infants.
In 2011, in response to the increase in pertussis in preadolescent children, we collaborated with the Centers for
Disease Control and Prevention (CDC) and the state health
department in Oregon to conduct a study of the pertussis
vaccination history of cases born between 1998 and 2003.
Minnesota and Oregon were “selected based on the quality of
statewide pertussis surveillance data and the strength of the
state Immunization Information System.” The study findings
suggest an earlier waning of protection from the current
pertussis vaccine than previously thought. These findings and
other studies, in conjunction with surveillance data, help to
inform CDC and ACIP in making public health policy and
immunization recommendations.
Expect the Unexpected: Disaster Averted
Imagine dozens of cases of botulism cropping up throughout
the metro area. Response staff throughout the state and
country would switch into high
gear to determine what was causing
the outbreak of botulism.
Clostridium botulinum is a
bacterium that produces botulinum
toxin, one of the most deadly
toxins known to man. A large
outbreak could point toward large
scale contamination or an
intentional release.
Epidemiologists and the FBI would
be actively investigating each case
to determine what they might have
in common and what the source might me.
Release of toxin into the environment was averted because of
an astute citizen. In August of 2012, the MDH Public Health
Laboratory (PHL) was notified of an unusual package
discovered at a private residence. Thankfully the homeowner
contacted the University of Minnesota Veterinary Diagnostic
Laboratory who in turn notified the Minnesota Department of
Health Infectious Disease Epidemiology Prevention and
Control Division. Two bottles of purified Clostridium
botulinum toxin A and B were found in the rafters of the
house. At the time the bottles were purchased, toxins and
other bacteria were not regulated, so large quantities could be
ordered from a pharmaceutical company. The bottles were
unopened, properly labeled and found in their original packing
materials. The inquiry from the homeowner was “is this
dangerous, and how should I dispose of them?” Both
questions are extremely important. If distributed in an
effective and malicious manner, the amount of toxin found
had the potential to kill more than 200,000 people!
FBI was notified immediately and investigation into the
package was initiated. The box was
addressed to a University researcher,
and materials were dated December
20, 1960. This package had been
sitting around for a long time. MDH
worked with the North Metro
Chemical Assessment Team to
secure the package and deliver it to
MDH-PHL. We contacted the CDC
botulism laboratory in Atlanta, GA
to determine the best way to destroy
the toxin. In the end, due to many
relationships and communication networks that have been
built, everything was handled perfectly, and the potential for
disaster was averted.
Ready to Respond Newsletter
Page 4 of 6
Online Risk Communication Training Module
being planned by MDH Communications, OEP
Minnesota Department of Health (MDH) Communications
and the Office of Emergency Preparedness are working on an
online risk communication training module that can be used to
meet federal emergency preparedness grant requirements.
They hope to have the new training module available for use
later this year.
The online training will be based on the live risk
communication training session that was offered by MDH as a
teleconference and streaming video session May 21.
“Rather than simply making video of the original training
session, we hope to provide an enhanced, interactive training
experience,” MDH Risk Communication Specialist Buddy
Ferguson said. “We hope to include elements like live video
links, photos and important reference or source documents, as
well as interactive quiz features that will highlight key points.”
Like the May 21 training session, the online version will focus
on the theory and practice of risk communication, including
the psychology of a crisis; credibility and the spokesperson
role: audiences and delivery vehicles; communication strategy
and message development; the media in a crisis, and the
impact of social media on risk communication. The training
will also touch on communication planning, including public
communication relating to mass dispensing activities.
The online training will be offered as one option for fulfilling
requirements for the Strategic National Stockpile Local
Technical Assistance Review (L-TAR) assessment,
requirements for Capability 4 (Public Information and
Warning) under the CDC Public Health Emergency
Preparedness grant and other grant-related risk communication
training requirements. Participants will be able to track their
progress and receive credit for the training on the MN.TRAIN
website (http://mn.train.org). Prospective participants in the
online training are encouraged to visit the website and create
an account.
Ferguson noted that the new online training module will be
only one of several options for meeting risk communication
requirements. “Online, interactive training in Crisis and
Emergency Risk Communication – or CERC – is also
available on the CDC website, and other training opportunities
are available,” he said. “However, training in risk
communication is vital for anyone who may be called on to
communicate with the public during a crisis or emergency.
We want to make sure people have has many options as
possible for receiving this training.”
Ready to Respond Newsletter
Healthcare System Preparedness
Pediatric “Toolkit”
On April 9th, the Healthcare System Preparedness Program
(HSPP) rolled out its long anticipated Pediatric Surge Toolkit.
The Pediatric Surge Toolkit was designed to help nonpediatric specialty healthcare facilities care for children when
and if they become overwhelmed by a larger than usual
number of pediatric patients.
Many facilities care for pediatric patients on a day in and day
out basis, but they are rarely taxed with large numbers.
Therefore they don’t often have enough supplies, staff familiar
with pediatrics, or simply enough resources in general to
handle an influx of pediatric patients. Nor do they have all the
things that need to be thought about when caring for one of
our most precious assets – our children.
Personnel from all regions of the state and various types and
sizes of healthcare facilities were represented at the one day
training. The goal is that each region will work with facilities
in their regions to provide training on the toolkit and
preferably some hands on clinical training as well.
The toolkit was a collaborative effort between HSPP staff,
regional personnel, Emergency Medical Services for Children
(EMSC), and pediatric clinicians. The toolkit has a template
that can be modified by healthcare facilities to better prepare
for surge, and it has educational components as well that can
also be modified to fit their needs. The template provides a
basis for facilities to start or continue to build out their plans
to accommodate pediatric patients in larger numbers than
usual if needed.
Over the course of the coming year, regions will be working
with facilities and providing education to make this toolkit /
template an asset for planning as well as valuable for actual
response. The Pediatric Surge Toolkit has been in the making
since the middle of 2012, and it was rolled out on time and on
target thanks to the work of an outstanding committee.
September is National Preparedness month
September is a good month to update or develop
your family’s emergency preparedness plan
September is National Preparedness month. If you and your
family have created an emergency preparedness plan, that is
wonderful. This may be a good month to make necessary
Page 5 of 6
updates to your family’s plan if
needed. If you need to design a
plan for your family, it is as
easy as one- two- three.
ONE: Develop a plan.
Talk with your family about
potential disasters that could
affect your family: e.g. house fire, weather-related
incident, or other type of disaster that may occur
when you are not home.
TWO: Create a kit for your family. What kinds of things
will you need in your kit? Examples:
• Food/water – don’t forget about your pet
• Board Games
• Emergency contact numbers
• Medications
• Emergency Preparedness Radio
THREE: Practice your plan.
• Practice two places where your family will meet.
• Check to see if your kit is up-to- date.
• Know where to find your plan.
Editorial Board
Editorial Board members include representatives from MDH
divisions that receive preparedness funds.
Jane Braun, Director of Emergency Preparedness
Chris Everson, Infectious Disease Epidemiology, Prevention
& Control
Don Sheldrew, Office of Emergency Preparedness
Nancy Torner, Communications Office
Maureen Sullivan, Public Health Laboratory
Steven Dwine, Office of Emergency Preparedness
Tina Firkus, Editor, Office of Emergency Preparedness
Contributors to this issue
Jane Braun, MDH Office of Emergency Preparedness
Buddy Ferguson, MDH Communications Office
Don Sheldrew, MDH Office of Emergency Preparedness
Lynn Jaycox, Crow Wing County
Marcia Schroeder, Stevens Traverse Grant Counties
Candi Schafer, Faribault and Martin Counties
Maureen Sullivan, MDH Public Health Laboratory
Claudia Miller, MDH Infectious Disease Epidemiology,
Prevention & Control Division
By completing these three steps ahead of time, you and your
family will have the tools needed to know what to do when an
emergency occurs.
Below are additional resources that can assist with your family
preparedness planning.
1. CDC - http://emergency.cdc.gov/preparedness/
2. Ready.Gov - http://www.ready.gov/make-a-plan
3. Sites for Children - http://www.ready.gov/kidscoming-soon
4. Sites for Senior Citizens http://www.ready.gov/seniors
Thanks for being prepared!
Upcoming Events
•
•
Community Health Conference – September 25-27,
Craguns
Minnesota Symposium on Terrorism and Emergency
Preparedness (M-STEP) – November 12 & 13,
Minneapolis Marriott Northwest, Brooklyn Park
Ready to Respond Newsletter
Page 6 of 6