1. Environmental Health and Public Health Preparedness

2.                                                                                                 
                                                                                                                                                                                                                                                                                                                                                                  
NACCHO, in collaboration with the Centers for Disease Control and Prevention (CDC).
Disseminate lessons and best practices to the broader public health community.

3. Overall Outcomes
Collaboration between Hennepin County, Ramsey County and City of Minneapolis
Improved environmental health capacity at the local level to respond to public health emergencies
Established systems that will support a coordinated and effective regional response
Model plans, tools, templates that can be shared

4. Nine Grant Goals EH Emergency Response Plans Trained EH Staff
Food operators better prepared
Food safety alert system
Shared data access and EH databases
EH Resource Kit
ECHO
Sharing best-practice information
Mass Care plan with American Red Cross

5. Focus on Four Goals--in year one
EH emergency preparedness plans
Trained EH staff
Food operators better prepared
Risk communication to limited English populations

6. Goal 1 EH Preparedness Plans
Expand all-hazards Environmental Health Emergency Preparedness Plans to reflect common approaches for a regional response
Technical Background Information
Revised preparedness plans
Different models of plans
Job action sheets
Mutual aid agreements, as appropriate
Sharing information
Describe general and specific response actions that EH personnel would be responsible for in an event

7. Environmental Health Emergency Guidance Document
Work in Progress Display Only
Prepared by Twin Cities Metro Advanced Practice Center

8. EH Emergency Guidance Document
Describes general and specific response actions that EH personnel would be responsible for in an emergency
Each topical area includes:
Introduction
Emergency Response Objectives
Priority Activities
Practical Guidance Information

9. Goal 2: Trained EH Staff
Train environmental health staff within Hennepin and Ramsey Counties with requisite knowledge to effectively respond to an environmental health emergency, and test that training

10. Principles of Environmental Health
Promote health and quality of life
Protect the public from health hazards
Protect the environment from contamination

12. Training Format Emergency Preparedness and Response Fundamentals
Overview of Environmental Health Principles
Communicating as a Key Role for EH Professionals
Responding to Emergency Events
Minimizing Health Implications
Putting Principles into Practice
Scenario #1 - elemental mercury contamination.
Scenario #2 - an ammonia release.
Scenario #3 - a natural disaster (i.e., a tornado).

14. Goal 2: What’s next? Roll out initial training
Develop 1-2 advanced training curricula
Provide advanced training
Exercises to test training

15. Goal 3: Prepared Food Operators
Increase capacity within food establishments (retail and restaurants) to identify and respond to public health emergencies affecting food safety
Developed practice recommendations
Survey of food establishments
Emergency Handbook for Food Managers
Tested materials and distribution
Training on food security

16. Benchmark Survey: Purpose
Assess food establishments’ emergency preparedness;
Evaluate needs for emergency training content and delivery formats (including language options);
Evaluate means of emergency info dissemination to food managers;
Establish baseline measurements, to be used in measuring the effect of APC on food establishments’ emergency preparedness.

18. Survey Methods
Phone survey of 379 establishments conducted 20 February to 07 April 2005
Questionnaire developed by collaborative effort between Metro Team and Vashé Research
Statistically designed; stratified random sampling

19. Emergency Prep & Reporting Processes-Survey Results
1/2 of all restaurants and grocery stores claim to have an emergency plan in place
Most establishments claim to inspect food deliveries for evidence of tampering. However, primary focus is on inventory control/theft, rather than food safety.
2/3 of establishments admit to have never had a fire drill.
Food establishments have an overall preference for written materials for training.
Almost all establishments want training materials in English, 42% of respondents would also like to have such materials in Spanish.

20. Types of Emergencies to be Notified About Twin Cities Metro Area Total
Food establishments are mostly interested in alerts pertaining directly to the food and water supply.
Type of emergencies respondent
would want to hear about
n=362
Food contamination information
Food borne outbreaks
Acts of terrorism that affect
the food or water supply
Food recalls
Information about how to manage an emergency
Floods, storms and other
natural disasters
Power outages
Q13. Which of the following types of emergencies would you like to be notified about if such a system were created? Base: Total respondents.

21. Emergency Handbook for Food Managers – 3 Part Format
Educational booklet for food managers
Discussion guide plus photo lessons (multiple languages) for training food workers
Discard or salvage guide
Food security self inspection checklist
Food safety self inspection checklist
Employee illness log

22. Emergency Handbook for Food Managers-Goals
Practical, relatively simple and low cost steps to keep food safe
Who to call
Steps to take first and recovery after an emergency

23. Available in:
Multiple languages
Hardcopy
Online CD

25. Emergency Handbook for Food Managers-Topics Addressed
Power Outage
Fire
Flood or Sewage
Water Disruption
Tornado & Wind
Bioterrorism
Dirty Bomb
Chemical Incident
Solid Waste Service Disruption
Pest Control
Maintain Food Safety in a Disaster
Clean Up After Disaster
Food Security Checklist

27. Conducting On-site Technical Assistance in Food Security
Management
Products
Personnel
Property
Overwhelmingly receptive
Most never consider food security
Every restaurant has one or two areas needing improvement

28. Food Security
Risk Management based on FDA guidelines for food retail and food service establishments.
Voluntary self evaluation
Create awareness among diverse groups to identify low cost, practical steps to improve food security.

29. Progress on Food Security
Conducted 115 self evaluations with Food Managers
Introduced the topic of food security to 950 Minneapolis food establishments.
Met with local and state officials to introduce our approach to food security.
Met with food trainers and nutritionists to create awareness and introduce our approach to food security.

30. Results From Food Manager Survey
Ranked themselves high for:
Purchasing from Commercial suppliers
Keeping records for product trace back
Restricting Customers to public areas
Having proper lighting
Monitoring truck shipments
Having alarms and security cameras as appropriate
Ranked themselves low for:
Establishing a Food Security plan
Training employees in food security and tampering
Restricting personal items in food preparation areas
Locking and labeling hazardous materials
Placing “Employees Only” signs on restricted areas
Monitoring for unusual activity or packages

31. Goal 7: ECHO [Emergency Community Health Outreach]
Enhance capacities to provide rapid and appropriate risk communication to limited English-speaking populations regarding environmental health emergencies
Phone line
Fax
TV show
Community involvement
What’s next?
Liasions between the public health reisk communicators and the target communities
Establish a multicultural/multilingual message ECHO phone line
Educate key LPH leadership staff, environmental health staff and other risk
communications spokespersons on environmental health emergency preparedness
issues and messages

32. Other Goals 4. Food safety alert system
5. Shared EH databases & common inspection data
6. EH Resource Kit
8. Sharing
9. Mass Care plan with Red Cross .

33. Goal 4: Food Safety Alert System
Develop a common methodology to provide food establishments with time-sensitive public health emergency information.
Convened IS staff from Minneapolis, Hennepin and Ramsey
Completed inventory of basic EH data systems and types fpr all EH jurisdictions
Examining common databases

34. Goal 5: Shared databases
Develop protocols and obtain tools and equipment to allow shared access to EH databases of food service establishments to facilitate mutual aid
Examine the benefits of common software program for EH inspections across the target service area to facilitate mutual aid and use of shared staff during an emergency response.

35. Goal 6: EH Resource Kit
Develop an Environmental Health Resource Kit of technical information for emergency response.
Include resource materials and website locations with specific technical information for supervisors and field staff regarding potential scenarios.
Capture information that already exists into one place, and develop new information, when needed.
Scope of the proposed resource kit
Scan for existing information I
Convene an advisory panel
Prepare technical information
Compile and distribute the EH Resource Kit.
Establish and document a system for keeping the EH Resource Kit information updated

36. Goal 8: Sharing
Share newly created best practice information and materials for environmental health preparedness and response with others.
Finished materials available thru NACCHO
Poster at ASTHO/NACCHO
Presentations at other meetings
CDs available
Handbook to be distributed to all high risk food establishments in Hennepin and Ramsey

37. Goal 9: Mass Care Plan
Prepare a Mass Care plan jointly with the local American Red Cross chapter(s)
Prepare a coordinated mass care plan
Develop Memorandums of Agreement with the ARC, as appropriate.
Document the Mass Care plans jointly with the ARC

38. How to Link EH and EP Clarify and describe roles for EH professionals
Provide training for EH professionals
Write EH emergency response plan integrated into county’s public health emergency response plan & the county’s emergency response plan
Engage EH front line staff in preparation and development of the EH emergency response plan
Write topic specific incident action plans
Plan for and conduct tabletops exercises & drills with emergency management staff and other response partners

39. Further Information Hennepin County Saint Paul – Ramsey County
Susan Palchick
Brian Golob
Saint Paul – Ramsey County
Zack Hansen
Cheryl Armstrong
City of Minneapolis
Curt Fernandez
Susan Kulstad