1. Greater Nashua Public Health Region Hazard Vulnerability Assessment Project Overview

2. Objectives & Agenda Provide an overview of the Greater Nashua Hazard Vulnerability Assessment (HVA) Describe the HVA process Describe regional HVA findings and our action plan Describe how being involved in risk mitigation plan implementation will benefit your organization.

3. Origins of the HVA 13 NH DHHS- funded regions Public health, health care and behavioral health-focused HVA a part of scope of work.

4. Origins of the HVA HPP and PHEP Capabilities Define standards for health and public health system preparedness HVA as foundational element Collaborative process to reduce risk

5. Greater Nashua HVA: Goals Assess hazard impacts on the health care, behavioral health, and public health systems Staff, infrastructure that make up these systems as well as the people that use these systems. Identify risk mitigation strategies that could reduce impacts from these hazards.

6. Desired End Result of HVA Hazards assessment: What are our highest risk hazards? Preparedness assessment: What are we good at? Where are our weak spots? Mitigation plan development: What can we do about it? Mitigation plan implementation Reduced risk

7. Steps to the HVA process Step 1: Rate impact severity of 7 predetermined hazards Step 2: Rate our region’s preparedness using the PHEP & HPP capabilities as a framework Step 3: Develop risk mitigation action plan for our region

8. Greater Nashua HVA Participants American Red Cross AMR Ambulance City of Nashua Building Safety Environmental Health Department Public Health Department Police Department Welfare Department Daniel Webster College Dartmouth-Hitchcock Greater Nashua Medical Reserve Corps Greater Nashua Mental Health Lamprey Health Care MIAMMO CERT Milford School District Northeast Rehab Hospital NH Division of Public Health Services Rivier Health Services Southern NH Medical Center St. Joseph’s Hospital The Courville at Nashua Town of Brookline Town of Merrimack, Police Department Town of Pelham, Fire Department Town of Wilton Walgreens

9. Which hazards were reviewed? Hurricane Flood Winter Storm Earthquake Influenza Pandemic Heat Wave Radiological Dispersal Device (RDD) - Likely to occur - Potential severity - Involve all aspects of response

10. How was risk defined? Risk= Hazard Probability x (Severity – Preparedness)

11. How do we measure impact? 4 main categories Human Impact & Service Demand Health Care Infrastructure Impact Community Impact Public Health Infrastructure Impact

12. The Indicators - Examples ED visits Staffed beds available Population displacement Increases in lab test demand Considerations for indicator selection: Reflect hazard impact Data available

13. How did we measure impact? Compare available data from an “average” day to that from a “bad” day for each indicator Qualitatively rate the severity of impact for each category for the region using pre-set scale From one (1): very low to five (5): very high

14. Step # 1: Rating Impact Severity

15. Hazard Impacts for Greater Nashua Hazards Human Impact & Service Demand Interruption of Health Care Services Community Impact Public Health Infrastructure Impact Hurricane 33.544 Flood 2222 Winter Storm 32.53.54 Earthquake 5555 Influenza Pandemic 5545 Heat Wave 3222 RDD 5555

16. Greater Nashua Risk Assessment Findings 123 Hazard Severity of Impact – Rank Order Hazard Probability Risk Score - Rank Order Flood24 (High)7 Winter Storm33 (Medium)6 Hurricane42 (Low)5 Earthquake71 (Very low)4 Heat Wave13 (Medium)3 Radiological Dispersal Device (RDD) 41 (Very low)1 Influenza Pandemic41 (Very low)1

17. Step #2: Rating Preparedness

18. Mitigation Capabilities Community Preparedness Community Recovery Information Sharing How did we measure preparedness?

19. General Response Capabilities Emergency Operations Coordination Emergency Public Information and Warning Non-Pharmaceutical Interventions Responder Safety and Health Volunteer Management How did we measure preparedness?

20. Medical Response Capabilities Fatality Management Mass Care Medical Countermeasure Dispensing Medical Materiel Management and Distribution Medical Surge Public Health Laboratory Testing Public Health Surveillance and Epidemiological Investigation How did we measure preparedness?

21. Example Volunteer Management

22. Mitigation CapabilitiesMedical Response Capabilities CapabilityScore Scenario Changes CapabilityScore Scenario Changes Community Preparedness 3 Fatality Management 2.5 Community Recovery 2.5 Mass Care 3.7 Blizzard, hurricane, RDD =3 Information Sharing 3.375 Medical Countermeasure Dispensing 4.0 General Response Capabilities Medical Materiel Management & Distribution 3.6 CapabilityScore Scenario Changes Medical Surge 3.1 2.5 pandemic; 2.0 RDD, quake Emergency Operations Coordination 3.9 Public Health Laboratory Testing 3.9 Emergency Public Information & Warning 3.8 Public Health Surveillance & Epidemiological Investigation 3.5 2.5 RDD Non-Pharmaceutical Interventions 3.375 Responder Safety & Health 2.625 Volunteer Management 2.6

23. Step #3: Developing a Risk Mitigation Plan Select mitigation strategies the region can implement to reduce risk, based on the findings of the HVA Develop preliminary action plan.

24. Mitigation Strategies Selected Strategy 1: Improve recruitment, coordination, and engagement of volunteers. Strategy 2: Increasing community preparedness and recovery capability.

25. Implementing the Greater Nashua Action Plan 1.How might the proposed mitigation strategies improve your response? 2.What are some feasible ways your agency can support implementation of this plan?

26. Thank you!