June 2011 Inside this Issue:
CDC Releases Public Health Preparedness Capabilities .......... 1
Presidential Policy Directive/PPD-8: National Preparedness .. 1
Director’s Chair ....................................................................... 2
Change, Opportunity, Uncertainty, and Hope ...................... 2
MDH Division Preparedness News ......................................... 2
Leadership Changes at the Office of Emergency
Preparedness ........................................................................ 2
Fact Sheet on Food Donation: Food Safety after a Disaster 3
Exercise Design Tips ........................................................... 3
OEP Releases 2010 Highlights Document ........................... 4
Healthcare System Preparedness ............................................. 4
Healthcare Preparedness in Minnesota: How Are We
Doing?.................................................................................. 4
Communications Quick Tips ................................................... 4
Have I Got News for You: Stuck in Translation .................. 4
Conference Notes ..................................................................... 5
MDH Hosts the National TRAIN Affiliates ........................ 5
Southeast Region Hosts Medical Reserve Corp (MRC)
Conference ........................................................................... 5
MDH Public Health Laboratory Delivers Annual
Laboratory Conferences ....................................................... 6
Upcoming Events ..................................................................... 6
Road to Resilience: Moving Forward on All-Hazards and
Pandemic Planning............................................................... 6
Editorial Board ......................................................................... 6
CDC Releases Public Health Preparedness
Capabilities
In December 2003,
Homeland Security
Presidential Directive
(HSPD)-8 required the
development of the
National Preparedness
Guidelines. These
guidelines defined what it
meant to be prepared by
providing a vision for
preparedness, establishing
national priorities, and
identifying target
capabilities. Identified by
the Department of
Homeland Security, the
target capabilities are a list of 37 factors needed to prevent,
protect against, respond to, and recover from a variety of
incidents or disasters. The public health community has
struggled to use some of these capabilities to guide their
preparedness activities.
In March, the U.S. Centers for Disease Control and Prevention
(CDC) released Public Health Preparedness Capabilities:
National Standards for State and Local Planning to guide state
and local health departments on the organization of their work,
planning for their priorities, and making decisions regarding
the capabilities they have the resources to build or sustain.
CDC applied a systematic approach to develop 15 public
health preparedness capabilities. The content is based on
evidence-informed documents, relevant preparedness
literature, and subject matter expertise gathered from across
federal, state and local governments as well as other
organizations.
Future federal funding of state and local health department
preparedness activities will be closely tied to these
capabilities, although Minnesota will also maintain a focus on
state-specific public health risks, systems, and lessons learned
from previous incidents and exercises.
If you have not yet reviewed the capabilities, MDH
encourages you to visit the CDC’s Web site and documents at
http://www.cdc.gov/phpr/capabilities .The capabilities list
includes hundreds of functions, tasks and resource elements.
Those marked as a priority, approximately 120, are those that
jurisdictions must complete within the upcoming 5-year
project period.
MDH will continue to provide you updates on the impact of
the capabilities on our preparedness planning as it is shared by
CDC.
Presidential Policy Directive/PPD-8: National
Preparedness
President Obama
signed Presidential Policy Directive/PPD-8 on March 30,
2011. PPD-8 is an executive order related to national
preparedness. From the date of signing, the Assistant to the
President for Homeland Security and Counterterrorism has 60
days to coordinate the interagency development of an
implementation plan for completing the national preparedness
goal and national preparedness system.
January 2011
Presidential Policy Directive (PPD-8) is aimed at
strengthening the security and resilience of the United States
through systematic preparation for the threats that pose the
greatest risk to the security of the Nation, including acts of
terrorism, cyber-attacks, pandemics, and catastrophic natural
disasters.
PPD-8 replaces Homeland Security Presidential Directive-8
(HSPD-8), National Preparedness, issued December 17, 2003,
and HSPD-8 Annex I, National Planning, issued December 4,
2007.
PPD-8 requires the development of a national preparedness
goal within 180 days that identifies the core capabilities
necessary for preparedness and a national preparedness system
within 240 days to guide activities that will enable the Nation
to achieve the goal.
You can find more information about PPD-8 and the National
Preparedness Goal at
http://www.dhs.gov/xabout/laws/gc_1215444247124.shtm
Director’s Chair
(Jane Braun, Director of Emergency Preparedness)
Change, Opportunity, Uncertainty, and Hope
Anyone working in the health readiness field is acutely aware
of all the changes going on at the local, state, national, and
institutional level. The first influenza pandemic in more than
40 years altered everyone’s operating picture. Nearly 10 years
after 9/11, and about nine years into targeted preparedness
funding, we have seen a large shift in focus, expectations, and
resources. At the Office of Emergency Preparedness, we also
have recently undergone a change in leadership, and we are in
the midst of strategic planning that will lead to a restructuring
of how we think about our priorities and organize our work.
The Hospital Preparedness Program and Public Health
Emergency Preparedness cooperative agreement funding
announcements both will result in considerable cuts to MDH,
LHD, tribal, and healthcare system budgets. We have worked
hard to keep the cuts proportional and to share them evenly;
award letters and grant duties will be sent when the
applications are all in and we have a chance to prepare the
contracts. Going forward, there will be a strong focus on risk
assessment and gap analyses in the short term, and on priority
setting and written documentation in the longer term. One
unchanging pillar is to build and maintain the partnerships we
know are vital to our work.
Many of you have been asking questions about the impact of
the potential state government shutdown on your grants,
contracts, and activities. This is a time of great uncertainty,
but the Minnesota Management and Budget website has the
most current and accurate information. MDH staff in all
program areas continue to work and plan to proceed without
Ready to Respond Newsletter
interruption, although a great deal of contingency planning is
also underway.
Despite the challenges, there are many reasons for optimism—
a focus on priorities, clear national guidelines, a commitment
to better coordination of the public health and healthcare
activities, and a chance to re-think how the field of readiness
has evolved in the past ten years and how our actions should
evolve in parallel. I thank you for your tremendous efforts to
date, and look forward to working with you all on determining
how we can best keep Minnesota Ready to Respond in this
new and ever-changing environment.
MDH Division Preparedness News
Leadership Changes at the Office of Emergency
Preparedness
On March 15, 2011, MDH Commissioner Edward Ehlinger
appointed Aggie Leitheiser as Assistant Commissioner for
Health Protection Bureau.
As Assistant Commissioner, Aggie is responsible for
overseeing the Divisions of Environmental Health; Infectious
Disease Epidemiology; Prevention and Control; Public Health
Laboratories; and the Office of Emergency Preparedness.
Aggie is no stranger to the Assistant Commissioner role. She
previously held the position before assuming the position of
Director of OEP in 2005.
In her long and distinguished public health career, Aggie has
also served as Division Director and Assistant Division
Director for the MDH Disease Prevention and Control
Division; HIV Services Planner and Section Chief for the
MDH AIDS/STD Prevention Services Section; Community
Health Services Supervisor for Wright County, and Public
Health Nurse for Marathon County in Wisconsin.
Aggie is also Director of the Public Health Certificate program
in Preparedness, Response and Recovery at the University of
Minnesota. Aggie holds a Bachelors of Science in Nursing
from South Dakota State University and a Masters of Public
Health in Public Health Administration from the University of
Minnesota.
In her place, Jane
Braun has been
appointed the new
Director of
Emergency
Preparedness at
MDH. This
change became
effect on April 6,
2011.
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Jane has been the Deputy Director of Emergency Preparedness
at MDH for the past five years. Previously she served as
Assistant Director for Operations of the Minnesota Cancer
Surveillance System and Infectious Disease Epidemiologist
with the Hennepin County Health Department. She has held
various other positions at MDH in the areas of immunizations,
tuberculosis and chronic disease.
Jane is a Certified Emergency Manager, Certified Tumor
Registrar and a member of her local Community Emergency
Response Team. She has also completed Red Cross
emergency response training.
Jane holds a Master’s of Science degree in Environmental
Health (with minors in Epidemiology, Biometry and Health
Information Systems) from the University of Minnesota, and a
graduate certificate in Government Management from the
University of St. Thomas.
The Office of Emergency Preparedness currently consists of
45 staff and includes programs in business continuity; grants
management; healthcare system preparedness; exercises,
education and planning; local health department planning and
technical consultation; partner alerting and communication;
and response resource management. It provides the
infrastructure and support for preparedness and response to
public health emergencies for MDH and in support of local
efforts.
Fact Sheet on Food Donation: Food Safety after a
Disaster
After flooding or other disasters, many people want to help by
bringing a favorite hotdish or homemade treats for affected
residents and workers. However, food from a home is not
acceptable at disaster sites.
It is hard to be
sure that food
from a home
will not result
in foodborne
illness that can
spread in large
groups of
people coping
with a disaster.
―We want to
make sure people don’t get sick so they can focus on
protecting their families, homes and businesses‖ stated Rick
Toms, MDH Public Health Sanitarian Supervisor.
It can also be a challenge to turn away well-meaning people
bearing food. Therefore, MDH Environmental Health Services
created a fact sheet entitled DISASTER QUICK TIPS: Food
Donations - Food Safety for distribution to the general public.
It can be found on the MDH Floods website
(www.health.state.mn.us/divs/eh/emergency/natural/floods),
Ready to Respond Newsletter
along with other useful health information and quick tips
regarding floods.
The food donations fact sheet explains that food can be unsafe
if it contains bacteria, has not been cooked at high enough
temperatures, or has not been kept cold enough. Unsafe food
can cause vomiting, diarrhea, stomachaches, headaches, and
muscle pains. Foodborne illness can be even more serious for
babies, pregnant women, children, older adults, and people
with health issues.
The importance of disaster feeding centers using trained food
workers to serve safe food to groups is key. Trained staff
ensures the food and drink they obtain, prepare and serve is
safe. Workers use equipment that helps keep food safe and
ensure floodwater does not touch food or packages that hold
food or drink.
The public may donate food and drink that is commercially
prepared, packaged, and unopened, but notate items that must
be kept cold, frozen or hot to be safe to eat. Food and drink
prepared at home are not acceptable. Operators of feeding
centers can also use money for food, drink, and supplies.
MDH Environmental Health contact information is provided
on the second page of this newest addition to the DISASTER
QUICK TIPS series for the general public.
Donate these needed items:
• Baby formula, liquid or powdered, for mixing with
commercially-bottled water
• Boxed or bagged food
• Canned food
• Commercially bottled juices
• Commercially bottled water
• Dried, packaged food
• Fruit that is whole, uncut, unpeeled
• Drinks in cans or bottles
Exercise Design Tips
We will be offering one or two tips in each Ready to Respond
newsletter that may help you improve your exercise designs
and exercise conduct. These tips are drawn from the
observations of an exercise research* project at MDH, now in
its third year of a five year grant. The research project is a
partnership with the University of Minnesota School of Public
Health; U-SEEE: Creating High Reliability Teams. It is part of
the MDH Exercise Program and focuses on the MDH
Department Operations Center (DOC). These observations are
drawn from the 21 one-hour functional exercises MDH
command and general staff have completed since May 2010.
Tip #1: Exercise Design
It pays to work with subject matter experts while
designing an exercise.
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We all struggle with the inherent artificiality of exercises. We
want our participants to use the exercises to practice how the
system for response works, but too often, they get ―hung up‖
on the details of an exercise. Spending time during the design
phase getting the basic content correct may help players
become more engaged in the exercise.
Healthcare System Preparedness
Healthcare Preparedness in Minnesota: How Are
We Doing?
One way you can assure accurate content is to include a
subject matter expert (SME) on your exercise design team. If
you were designing a flood scenario and someone proposed
adding an inject about a blizzard, one about major road
closures, and another one about evacuating a hospital, you
might shake your head in disbelief that all these things could
happen during one response. Our Red River flooding SMEs
will remind you that in 2009, all of these things really did
occur.
The goal of the Hospital Preparedness Program is to enable
healthcare facilities to improve surge capacity and enhance
community and hospital preparedness for public health
emergencies. The Minnesota Healthcare System Preparedness
Program’s (HSPP) planning and preparedness activities have
been focused on helping healthcare facilities answer three
questions: ―How prepared do we need to be?‖ How prepared
are we?‖ and ―How do we prioritize efforts to close the gap?‖
To answer these questions on a state level, this program is
currently involved in an extensive program review that
includes a gap analysis.
The SME may participate in different ways; as a regular
member of the exercise design team, as a guest who attends
one or two meetings, or maybe you meet with him/her
individually. Regular membership on the exercise design team
isn’t necessary. What you need from the SME is information
they can provide about how a problem may be detected, how a
response may start and build, and what would happen at
different stages. Taking this extra step can assure participants
that the exercise mirrors real responses and that helps them
respond in as realistic manner as possible.
Each of the eight Regional Healthcare System Preparedness
Programs is participating in an extensive review of their
program deliverables from the past six years. During the
review process, they will demonstrate all the work that has
been accomplished within the region and identify
preparedness areas that need more attention. By the end of this
review, we will have a picture of healthcare preparedness in
Minnesota.
*These activities are sponsored by University of Minnesota:
Simulations and Exercises for Educational Effectiveness (USEEE), supported in part through a grant from the Centers for
Disease Control and Prevention (CDC)/COTPER, Grant
Number 1P01TP000301-03. The contents are solely the
responsibility of the authors and do not necessarily represent
the official views of CDC. Principal Investigator: Debra K.
Olson.
OEP Releases 2010 Highlights Document
The 2010 Annual Report for the Office of Emergency
Preparedness is now online.
This document highlights MDH responses to 2010 public
health emergencies, including: fall and spring floods, egg
recall and the metro nurses’ strike. In addition to expanding
upon OEP programs, such as Minnesota Responds, MNTrac
and MNTrain, the annual report also highlights the work OEP
does every day and throughout the year to improve readiness.
You can view the 2010 annual report in its entirety by using
this link. You can also access it via the OEP webpage at:
http://www.health.state.mn.us/macros/topics/emergency.html.
The gap analysis is focusing on the sub-capabilities the
Federal Government has provided as priority areas for
planning. These sub-capabilities include: interoperable
communication systems, tracking of bed availability, the
Emergency System for Advance Registration of Volunteer
Health Professionals (ESAR-VHP) and Medical Reserve
Corps (MRC) Programs, fatality management, medical
evacuation/shelter in place, and partnership/coalition
development. In addition, healthcare facilities are to plan for
alternate care sites, mobile medical assets, pharmaceutical
caches, personal protective equipment, decontamination and
critical infrastructure protection.
The ultimate result of the HSPP gap analysis is for enhanced
healthcare surge capacity and strengthened community and
healthcare preparedness throughout Minnesota. We plan to use
the feedback attained from the HSPP program review and gap
analysis to identify and prioritize our future planning and
preparedness activities.
Communications Quick Tips
Have I Got News for You: Stuck in Translation
Sending documents out for translation just before or during an
incident – such as flooding – can take as long to complete as
the emergency itself, or even longer.
Exactly how long it takes depends on the translation agency
and the stable of translators it employs, languages involved,
Ready to Respond Newsletter
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ease of formatting and whether community review and editing
is involved. It also depends on whether final documents are
reviewed in house, how long it takes translators to correct any
errors found during an in-house review and any problems that
arise while making documents compliant with standards set by
the American with Disabilities Act (ADA).
The best strategy, budgets permitting, is to get materials
translated well before they are needed, especially those for
recurring emergencies such as flooding. A case in point
involves four Minnesota Department of Health (MDH) flood
fact sheets sent out March 7 this year for translation, two of
them into 14 languages and two into 12 languages.
The first translated fact sheet arrived back at MDH March 24
and the last arrived April 8. Some of the 50 translated
documents required complete reformatting, which was done in
house, and others were returned to translators to correct errors
found during an in-house review, such as incorrect titles and
missing characters. Most corrected translations arrived back at
MDH by April 13. However, as of May 1, one language still
was in the hands of translators.
Meanwhile, the state went into emergency mode before any
translations were completed and it wound down before all
translations were in hand. The Minnesota State Emergency
Operations Center (SEOC) opened March 17 and the MDH
Department Operations Center (DOC) began holding weekly
briefings. On April 19, the SEOC reduced its response to a
Level III and the MDH DOC demobilized.
The lesson learned is to translate materials well in advance,
whenever possible. At least in this case, the translated fact
sheets still hold value for future flood emergencies.
Conference Notes
MDH Hosts the National TRAIN Affiliates
The TRAIN Affiliate Consortium (TAC) Annual Meeting is
sponsored by the Public Health Foundation and Knowledge
Management Interactive; the funders and builders of the
TRAIN learning management system. You may be more
familiar with MN.TRAIN, the free to use, password protected
system for public health and health care professionals to
obtain continuing education. The Minnesota Department of
Health (MDH) in St. Paul was the host site for this meeting in
2011.
There are 23 states that use the TRAIN learning management
system, along with the National Medical Reserve Corps and
the Centers for Disease Control and Prevention. The purpose
of the annual meeting is to build a team network environment
of TRAIN affiliates through computer training, team building,
creating tools for use, searching for and sharing solutions to
common problems, researching and developing returns on
investment, marketing and training strategies.
Ready to Respond Newsletter
MN.TRAIN is speeding along and being used around the state
of Minnesota by active and retired health professionals to
maintain or advance their learning and to empower the public
health workforce. If you are new to the MN.TRAIN system
and want to take advantage of its great learning services, send
an email to [email protected] to request more
information. Or you can go to http://mn.train.org create an
account (it’s free to use) and start learning today.
Southeast Region Hosts Medical Reserve Corp
(MRC) Conference
The SE Region hosted a MRC conference on May 21.
Each of the eleven counties in the region has an MRC. The
group thought a regional conference would be a great
opportunity for MRC volunteers from around the region to
network and learn together. There are currently over 600
volunteers registered within the region.
The conference consisted of
two sessions of presentations
that fill many of the core
competencies that the
volunteers need. Some of the
volunteers are new and are
just starting out with trainings
and others have been around
and need additional training
opportunities. Sessions were chosen based on the level of
volunteer experience. At each session the volunteers were able
to choose from three presentations. The presentations for this
conference included:
Family Preparedness – ability to understand key
components of personal and family preparedness plans
and contents for home kits and got kits.
Blood Borne Pathogens, Infection Control and HIPAA
– ability to recognize tasks that may involve exposure to
blood borne pathogens or other infectious organisms.
Identify methods to reduce exposure and personal
protective equipment. Understand the requirements of
HIPAA and how it applies to disaster situations.
Mass Dispensing – the purpose, components, function
and roles and responsibilities of volunteers at a mass
dispensing site.
Psychological First Aid – identify the basic elements of
psychological first aid and how to provide emotional care
and comfort.
Incident Command IS700 – become familiar with the
five ICS management functions and basic responsibilities
and how to operate within the ICS structure.
Pets in Disasters – basic strategies on how to manage
pets and support pet owners in a disaster.
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MDH Public Health Laboratory Delivers Annual
Laboratory Conferences
Staff from the MDH Public Health Laboratory (MDH-PHL)
Emergency Preparedness and Response Unit once again
delivered their annual conference series in April and May.
These day-long conferences in each of Minnesota’s eight
Healthcare System Preparedness Program (HSPP) regions
provided valuable education and training on the expanding
roles of clinical laboratories in a wide range of emergency
responses, as well as other topics for clinic- and hospital-based
laboratories in the Minnesota Laboratory System (MLS). This
is the seventh year that the MDH-PHL will produce the
conferences; it is also the second year that several regions will
be incorporating the laboratory conference into broader
regional emergency preparedness and response conferences.
One of the conference objectives for 2011 was to highlight the
importance of developing a continuity of operations plan
(COOP) in order to maintain critical laboratory functions
during incidents that affect hospital or clinic operations. This
year’s conferences included a brief, high-level overview of the
concept of continuity of operations, the basic components of a
COOP, and examples of when a COOP might be used in a
clinical laboratory. The discussion continued with a small
group role-play session in which participants use critical
thinking skills to apply COOP concepts to a series of scenarios
based on actual lab emergencies that have occurred throughout
the state.
Additional conference sessions included an update on
infectious disease outbreaks and an introduction to the
laboratory section of the Minnesota Mobile Medical Unit.
Since the ongoing nuclear crisis in Japan continues to generate
public concern about radiologic emergencies, this year’s
conferences also included a review of basic radiation safety
concepts for clinical laboratories.
The 2011 MLS Regional Laboratory Conferences were held
in: Bemidji (Northwest), North Mankato (South Central),
Rochester (Southeast), Grand Rapids (Northeast), Willmar
(Southwest), St. Paul (Metro), and Alexandria (West Central
and Central).
Upcoming Events
Road to Resilience: Moving Forward on AllHazards and Pandemic Planning
The Office of Emergency Preparedness is co-hosting a
conference with the University of Minnesota’s School of
Public Health PERL Center on July 27 – 28 at the Northland
Inn Conference Center. The conference will focus on building
resiliency using lessons learned from the public health
response to H1N1. Some identified objectives include:
Ready to Respond Newsletter
Share tools, templates and lessons learned that will
enhance the ability of public health to respond to
emergencies and future pandemics across Minnesota,
North Dakota and Wisconsin.
Build resiliency and improve health, emergency
preparedness, response and recovery of state, local and
tribal agencies.
Develop an understanding of the public health target
capabilities and their impact on public health agencies,
including grant duties and reporting.
Build upon lessons learned from the H1N1 pandemic.
The conference will open for registration on June 13. In the
meantime, proposals can be submitted by visiting the
conference website at www.togopartners.com/rr.
Details will be posted as they emerge on OEP’s website and
on MN.TRAIN. You can find the conference using conference
ID: 1027849.
Editorial Board
Editorial Board members include representatives from MDH
divisions that receive preparedness funds.
Jane Braun, Director of Emergency Preparedness
Jessica Southwell, Infectious Disease, Epidemiology,
Prevention and Control
Kirsti Taipale, Office of Emergency Preparedness
Lynne Markus, Environmental Health
Nancy Torner, Communications Office
Nathan Kendrick, Public Health Laboratory
Sara Radjenovic, Editor, Office of Emergency Preparedness
Steven Dwine, Office of Emergency Preparedness
Contributors to this issue
Deb Radi, Office of Emergency Preparedness
Geri Maki, Office of Emergency Preparedness
Jane Braun, Office of Emergency Preparedness
Janice Maine, Office of Emergency Preparedness
Jessica Southwell, Infectious Disease, Epidemiology,
Prevention and Control
Lynne Markus, Environmental Health
Mickey Scullard, Office of Emergency Preparedness
Nancy Torner, Communications Office
Nathan Kendrick, Public Health Laboratory
Sara Radjenovic, Office of Emergency Preparedness
Steve Dwine, Office of Emergency Preparedness
Tina Firkus, Office of Emergency Preparedness
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