Virginia Department of Health In It Together: Building Coalitions to Prepare as One

VDH Preparedness Grant Funding PeriodBP1BP2Incr(Decr)% ChangeBP3Incr(Decr)2% Change PHEP-Base12,528,69611,785,642(743,054)-6%12,574,657789,0157% PHEP-CRI1,584,7151,456,814(127,901)-8%1,517,28960,4754% PHEP-Chem Lab838,795 00%838,79500% Total PHEP14,952,20614,081,251(870,955)-6%14,930,741849,4906% HPP8,739,3188,231,128(508,190)-6%6,188,517(2,042,611)-25% Total Funding23,691,52422,312,379(1,379,145)-6%21,119,258(1,193,121)-5%

FUNDING TRENDS

Performance Tracking National Health Security Preparedness Index (HHS) Centers of Disease Control and Prevention (CDC) Medical Countermeasure Dispensing Technical Assistance Review National Association of County and City Health Officials Project Public Health Ready Commonwealth of Virginia Governor’s Agency Preparedness Assessment Annual Continuity Plan Review

Public Health Preparedness Capabilities 1: Community / Health Care Facility Preparedness 2: Community / Health Care Facility Recovery 3: Emergency Operations Coordination 4: Emergency Public Information / Warning 5: Fatality Management 6: Information Sharing 7: Mass Care 8: Medical Countermeasure Dispensing 9: Medical Materiel Management / Distribution 10: Medical Surge 11: Non-Pharmaceutical Interventions 12: Public Health Laboratory Testing 13: Public Health Surveillance and Epidemiologic Investigation 14: Responder Safety and Health 15: Volunteer Management

Hazard – Vulnerability Analysis A systematic approach to recognizing hazards that may affect public health and health care. Analyze risks associated with each hazard to prioritize planning, mitigation, response and recovery activities. Serve as a needs assessment for the Emergency Management program. Process involves community partners and is communicated to community emergency response agencies.

BP-2 Progress Information Sharing: Provide healthcare situational awareness that contributes to the incident common operating picture. Event Notifications & SitReps are currently being integrated into VHASS. This new version of VHASS will be demonstrated during the Emergency Coordinators Meeting in the afternoon of the second day of the Academy. During this session you will be able to login to VHASS to test it out along with offer recommendations for improving the system. The new VHASS will be fully functional in BP3. Medical Surge: Coordinate integrated healthcare surge operations with pre-hospital EMS operations. Seamlessly transfer disaster patient information from their respective healthcare systems into VHASS. Will enhance both patient tracking and family reunification efforts. Healthcare System Preparedness: Develop, Refine, or Sustain Healthcare Coalitions. Engage federal (i.e., DOD, VA) and state (i.e., behavioral health) partners to become more engaged within the regional healthcare coalitions.

BP-2 Progress Medical Countermeasures Dispensing: Increased Closed POD and Pharmacy Open POD MOUs across the state. Commenced Pilot with Costco as an open/closed POD. Medical Countermeasures Distribution: Enhanced relationships with Private Sector Distribution partners. Initiated Cross Docking planning as a complementary alternative to traditional RSS facility operations Mass Care. Developed health logistics (supplies/commodities) listings for all state shelters Info Sharing. Academy May 20-22, epi seminar/IMT training. Worker Health and Safety. CBERS: Psychological First Aid- 7 sessions statewide this spring. Community Preparedness. Implemented new HAN system

BP2 Progress Non-pharmaceutical interventions. Updated disease-specific guidelines for legionellosis, giardiasis, Chagas disease, Chikungunya virus infection Created a new, comprehensive web site for influenza Surveillance and epidemiologic investigations. Developed protocol for communicating with FBI on diseases on the CDC/USDA select agent list and guidelines for handling laboratory personnel exposures to CDC/USDA select agents, including surveillance and prophylaxis recommendations and tools. Transitioned the syndromic surveillance system to a new, upgraded technical infrastructure. Continued to train the epidemiology workforce through conference calls, meetings, and other resources to keep current with changes in surveillance technology and investigation methods.

BP2 Progress Responder Safety and Health Meetings held with stakeholders in many agency offices to review existing emergency response plans and solicit information on expected roles in a VDH response and needs for training and personal protective equipment. Used that information along with CDC and NIOSH recommendations to develop a matrix of job duties, emergency response roles, hazards likely to be encountered, training, immunization and personal protective equipment requirements. Matrix will be sent to stakeholders for review within the next week, and a draft capability 14 plan will be forwarded to OEPI management by June 1, 2014.

BP-3 Focus Healthcare System Preparedness: Determine gaps in healthcare preparedness and identify resources for mitigation of these gaps. Make statewide assessments of each healthcare coalition’s capabilities and identify any resource, training, and/or procedural gaps to set the baseline level of capability of each. Cross-train among RHCC. Crisis Standards of Care: Develop Concept of Operations. Conduct a national assessment of CSC plans to aide in the CSC plan development in Virginia. Develop an Incident Action Plan for Crisis Standards of Care, and a draft Governors declaration to support CSC implementation. Medical countermeasure distribution. Implement cross- docking as a complement/supplement alternative to RSS facility operations.

BP-3 Focus Medical countermeasure dispensing. Provide influenza vaccine to health districts in order practice mass dispensing techniques, tracking throughput measures and to provide protection to the public. Mass care. Continue refining VDH role in state managed shelters. Info Sharing and Community Preparedness. CBERS with pharmacist; new system to communicate with clinicians in community. Info Sharing and Emergency Response. Revise system for internal communication

BP-3 Focus Non-pharmaceutical interventions. Update guidance for clinicians for the Category A bioterrorism agents. Revise epidemiologic response plans according to a new agency template. Continue to maintain the Virginia Disease Control Manual, with recommendations for disease control measures identified in each chapter. Responder Safety and Health. Ensure appropriate staff are engaged and critical roles identified in the plan filled. Develop and provide training on the responder safety and health plan.

Epi BP-3 Focus Surveillance and epidemiologic investigations. Migrate the electronic disease surveillance system to a new, upgraded infrastructure and incorporate disease- specific data collection templates in the system. Continue to increase electronic laboratory reporting, including receiving reports from hospital/health system labs. Develop more timely statistical reports on disease occurrence and provide data analysis tools to health districts.

Purpose of Workshop Consideration of cross-docking as a complement / supplement alternative to traditional modes of receiving, staging, and storing SNS assets for distribution

Incident Commander Dr. Marissa Levine Info/Intel Chief Suzi Silverstein Sit Awareness Unit Josh Czarda Planning Chief Bob Mauskapf Technical Advisors Four (4) Regional Coordinators Operations Chief Dr. David Trump SNS Coordinator Cindy Shelton Hospital/Medical Community Branch Jenny Smock EMS Unit Gary Brown ESF3 Drinking Water Branch John Aulbach Fatality Management Dr. Bill Gormley Environmental Health Allen Knapp Radiological Health Steve Harrison CHS Branch Bob Hicks 35 Local Health District Directors Epi Branch Dr. Laurie Forlano Surveillance Unit Dr. Diane Woolard Admin/Logistics/ Finance Chief Richard Corrigan HR Becky Bynum Finance Beth Franklin Procurement/ General Services Steve VonCanon IT Debbie Condrey PIO Maribeth Brewster Liaison Officer Joe Hilbert Safety Officer Dr. Joanne Wakeham VEOC/ESF8 Liaison TBD VDH All Hazard Incident Management Team 3/1/2014

Health Care Organizations in Coalitions Total HCOsHCOs in HCC% HCOs in HCC 24-hour Acute Care HCOs (Non-Federal) Acute Care Hospitals % Children’s Hospitals 4375% Rehabilitation Hospitals 12867% Psychiatric Hospitals 10880% Critical Access Hospitals (CAHs) 77100% 24-hour Sub-Acute or Long Term Care HCOs (Non-Federal) Skilled Nursing Facilities (SNFs) (aka Rehabilitation facilities) % Assisted Living Facilities % Intermediate Care Facilities for Persons with Mental Retardation 5359% Programs for All-Inclusive Care for the Elderly (PACE) 1200% Hospice (Medicare-Medicaid) 12400% Outpatient HCOs (Non-Federal) Ambulatory Surgical Centers (ASCs) 5800% Health Agencies (HHAs) 70300% Organ Procurement Organizations (OPOs) 200% Rural Health Clinics (RHCs) 22100% Federally Qualified Health Centers (FQHCs) % Community Health Centers (that are not FQHCs) 55100% End Stage Renal Dialysis (ESRDs) Facilities % Hospitals (Federal) Veteran’s Administration (VA) Medical Centers 33100% Department of Defense (DoD) Hospitals 33100%

Virginia Medical Reserve Corps Volunteers Protecting Virginia’s Health 31 Units 13,500+ Volunteers 5,600+ Health Care Volunteers $ 890,000 in volunteer time for 2013

Questions? VDH Staff Contact Information Dr. Dave Trump, Acting Chief Deputy Commissioner Public Health and Preparedness Bob Mauskapf, Director, Emergency Preparedness Cindy Shelton, Assistant Director, Emergency Preparedness Jennifer Freeland VDH State Volunteer Coordinator Kim Allan, Operations Director Suzi Silverstein, Director, Risk Communication and Education Jenny Smock, State Hospital Coordinator General Info / Contact