Eastside I & Q Tabletop December 10, 2004 Testing Community Resources

Purpose The purpose of this is to test the current Zone One Plan for the human services network in East King County and assess community capacity to assist quarantined patients.

Roles Community Based Providers Work with Crisis Clinic to respond to client needs Secure needed supplies / services Coordinate / provide delivery of supplies and services Keep Crisis Clinic apprised of service delivery status, any emerging issues or problems PH Risk communication

Crisis Clinic Assist PH by identifying appropriate providers for needed services to those in home isolation or quarantine Coordinate and monitor service delivery with providers Keep PH apprised of service delivery status, any emerging issues or problems

Objectives Clarify the capacity and gaps in the ability of community partners to respond to the need for the delivery of food and financial assistance. Demonstrate that the communication paths within Zone 1 Plan between Public Health, Crisis Clinic, Hopelink, DSHS and Zone One Emergency managers convey the necessary information to all partners to assure the food and financial needs are met. Demonstrate agencies ability to protect client confidentiality and maintain consistent public health messages.

Ground Rules This will be a structured exercise in a controlled environment that allows for meaningful dialog leading to realistic strategies and approaches. The tabletop is intended to test the Zone 1 Plan. If the plan does address a concern, please note it. The lessons learned from this tabletop exercise will be used to assess and adjust the plan, and evaluate systems needed to respond to and recover from a community quarantine situation.

Ground Rules (cont) Make your best decision based on the information that is presented. Respond according to your knowledge of the plan, procedures and resources. It is ok not to know. There may be no pat answer. It is OK to disagree. Identify the key issues contributing to the disagreement and agree to find solutions in the future.

Assumptions Public Health - Seattle & King County: Public Health Emergency Operations Center will be activated Public Health Nurses are monitoring the health, medical, prescriptive and daily needs of those quarantined. PHSKC is issuing press releases daily on the status of the outbreak. Zone One EOC: is on stand by and is in communication with Public Health.

Scenario Background A health care provider at our Eastgate Public Health Center has recently returned from China. She returned to work and began seeing patients. Her caseload is comprised of low-income, with a significant number of limited -English speaking patients (Spanish, Russian, Hmong). After a few days back at work, she developed a fever and respiratory symptoms. Due to a staff shortage, she continued to work for a few more days. Her symptoms progressed and she was seen by another healthcare provider. Due to her symptoms, travel history and because of current cases of SARS in China, she was diagnosed as a probable suspected SARS case. The patients on her caseload range in age from 0 through adulthood. They live in various communities on the Eastside and we now have 100 patients plus their family members who may have been exposed to SARS. They will all be quarantined for 10 days.

Scenario Background (cont) Due to the severity of her symptoms and high suspicion for SARS, a decision is made to quarantine the patients who have been exposed to the worker. In certain cases, family members were exposed as well and will need to be quarantined.

Day One Scenario Public Health has been in contact with the 72 quarantined persons. Staff have given the names and contact information to the Crisis Line Liaison. They have the following needs: Fifteen families in the Redmond area speak Russian and need food by tomorrow dinner time.15 Twenty-five of the income earners in these families don't have sick days and will lose money if they don't go to work. They have no savings and will need financial assistance to be able to stay in their homes for the 10 day quarantine. The dollar total is approximately $20, average rental is $800 a month 25 We also have 3 newspapers (El Mundo, the Korean Times and the Asian Weekly ) who have called and started showing up at Hopelinks Redmond food bank, Crisis Clinic DSHS and at Bellevue City Hall looking for a story. 15

Day Two Scenario At 11 Am the Crisis Clinic liaison is notified by PHSKC about the needs for the day. Crisis Clinic calls or faxes to DSHS, Hopelink, and the Zone 1 coordinator the following requests: 3 need a TANF review this week to keep benefits coming. 5 Sixty five (65) Spanish-speaking families are scattered between Kirkland, Woodinville and Bothell who need food (including corn meal,) and other basic toiletries. All live in a variety of apartment buildings with a common hallway. 15 Two people don't have a phone, they use their neighbors. In order for monitoring to take place they need a cell phone. 5 * The Korean Times reporter is pursuing information at DSHS that they have heard there are orders that have been issued for less- than-compliant folks. 15 *

Day Three At 4:00 PM the Crisis Clinic liaison is notified by PHSKC about additional needs identified on Day three. Crisis Clinic calls or faxes to DSHS, Hopelink, and the Zone 1 coordinator the following requests: We have 5 Hmong families living in Duvall that need culturally appropriate food (fresh veggies). Some need respite care for their elderly relatives and 3 need help with natural gas, water, sewage and garbage bills. 20*

(Day Four) PHSKC notifies Crisis Clinic that: All rely on TV for their news and entertainment. Most subscribe to satellite TV because of their multilingual programming. All are at risk of losing this vital connection to the world because of lack of money to pay the bill. 5

Day Five Some are very worried and keep imagining that they have more illness. 20* A reporter from El Mundo that is calling around to every agency for a story about an ill staff member. 10*

Next Steps Revise plan Memos of Understanding