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2007-0001:
Leadership and Direction...
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Activity Name:
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Leadership and Direction
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What:
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Increase the ability of
public health and medical systems at all levels of government to
coordinate response effort during an event/disaster.
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Why:
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Execution of a cohesive
planning framework is imperative for building and implementing homeland
security initiatives; to include public health and medical efforts that
leverage state and local resources. Defined roles and responsibilities of
public health and medical responders at each level of government within
Texas have not been clearly delineated. Therefore, Department of State
Health Service, as the lead public health agency, should take direct the
coordination of health and medical preparedness activities between state,
regional, and local jurisdictions.The State of Texas, through the State
Emergency Management Plan, has a formalized emergency command structure.
This structure identifies the emergency chain of command from the county
level to the state level, including how to request assets during an
emergency when local assets are exhausted. Currently, not all health and
medical stakeholders consistently use this process. As an example, during
response to Hurricane Rita, all levels of government from the county to
disaster district committee to Health Service Regions, as well as in the
Multi-Agency Coordinating Center (MACC) attempted to ascertain the number
of available beds in local medical needs shelters. The result of this
uncoordinated effort led to severe duplication of efforts as well as
varying numbers of available beds being reported within each shelter. If
all response partners were aware of and used this framework for
requesting assets (i.e., local government to disaster district committee
to state operations center), confusion regarding duplication of requests
for state assets through the State Operations Centers (SOC) would not
have occurred. All stakeholders at all levels of government should be
aware of individual and collective roles and responsibilities during a
health and medical disaster response. Within Texas there are 11 Health
Service Regions (HSRs), of which there are 8 Regional Health Departments
who employ state personnel. These health departments act as the local
health department/authority in jurisdictions where there is none. During
events/disasters, it is unclear when regional staff may access
state-level resources and what their specific roles and responsibilities
are during response efforts. Most local health departments currently have
written Standard Operating Procedures (SOPs) or Guidelines (SOGs) to
outline their roles and responsibilities. Health Service Regions and the
State Health Department need to outline their roles as well and these
need to be coordinated at the local level with both public health and
healthcare system organizations.The best approach to coordinate efforts
is to fully understand the roles and responsibilities at each level of
government. This is accomplished by discussing how to best work together
in a response.The following assumptions apply to this project:• Having
defined, clearly delineated written roles and responsibilities of all
major players will enhance response capability• Awareness will allow
responders to know which entity or job function is responsible for
specific aspects of a disaster response.Benefits of this project will be:
• A unified position/vision will be articulated that integrates the
health and medical response• Roles and responsibilities of preparedness
partners at all levels of government will be defined.• Guidance will be
provided to preparedness partners to increase/ enhance communication
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How:
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A workgroup will be formed
between DSHS and regional staff to develop the procedures needed for
optimal interaction during response to disasters. Once these procedures
have been agreed upon, DSHS and each of the regions can then develop
Standard Operating Guidelines outlining the specific roles and
responsibilities at their level. These Standard Operating Guidelines will
be discussed at the local level with health and medical partners
throughout the state so that each has an understanding of the roles and
responsibilities of each level of government and who has the authority to
provide information or request assets. Once this has been completed, this
information will be shared with the Governor's Division of Emergency
Management (GDEM), who is responsible for state response efforts through
the State Operating Center.Deliverables for this project include the
following: • Standard Operating Guideline outlining roles and
responsibilities of DSHS• Standard Operating Guideline outlining roles
and responsibilities of each of the eight Health Service Regions•
Integrated approach between state, regional, and local response efforts•
Greater understanding of these roles at the State Operations
CentersCapacity to this project: As a central source for coordination of
scientific, public health, and emergency management expertise for
developing and coordinating mitigation, preparedness, response, and
recovery activities, the Community Preparedness Section (CPS), located
within the Prevention and Preparedness (PnP) Division, has the capacity
to help local jurisdictions prepare for, respond to, and recover from
emergencies and disasters in a manner that will protect property and
safeguard lives. Within the CPS, the Public Health Preparedness Unit
(PHPU) strives to protect citizens by preparing for and preventing
bioterrorism events and other naturally occurring public health
emergencies in Texas. Specific services offered include planning and
implementing interventions to ensure preparedness and rapid response to
bioterrorism, natural epidemics, other public health and environmental
threats and emergencies. By working with Local Health Departments (LHDs,
HSRs, Regional Advisory Councils (RACs) hospital/healthcare systems, and
other state, regional and local health and medical entities, DSHS can
effectively maximize resources to prepare for and respond to any
event.Partnership development. By working together with preparedness
partners at all levels of government, relationships will be enhanced with
traditional public health and medical partners and new relationships will
be built with non-traditional partners, such as private providers and
private industry. This will enable the state to leverage needed resources
during an event/disaster.
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Where:
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Initial planning and
coordination efforts will occur at the state level between DSHS and the
eight Health Service Regional offices. Once Standard Operating Guidelines
have been determined, discussions will occur at the local level with
health and medical partners.
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Who Is Responsible:
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Pursuant to the Governor's
responsibility under the Texas Disaster Act of 1975, authority for
statewide planning and coordination has been delegated to the Governor's
Division of Emergency Management (GDEM) headed by the Deputy Director of
the Governor's Office of Homeland Security. Under its delegated authority
GDEM assigns, based on expertise and responsibilities, primary agencies
to take the lead in developing and maintaining appropriate annexes and
appendixes within the State Emergency Management Plan. Individual annexes
of the state's plan are based upon Emergency Support Functions (ESFs),
and are in accordance with the National Response Plan. The Department of
State Health Services (DSHS) has been designated by GDEM as the Primary
Agency for ESF 8 (Public Health and Medical Services). Annex H (Health
and Medical Services) to the State of Texas Emergency Management Plan,
identifies 13 activities that comprise a comprehensive public health and
medical response to a disaster event. DSHS is responsible for supporting
local governments' efforts to meet ESF 8 goals and objectives.
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Start:
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09/29/2007
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End:
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07/31/2008
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Focus:
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Themes:
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Emergency Operation Centers
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Evaluation
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Hospital and Clinic
Coordination
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Local Public Health
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Mental Health
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Partnerships
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Planning
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Recovery
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Response/Countermeasures
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Training
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Partner Type:
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Agencies, regional
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Agencies, state
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Agencies, tribal
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Emergency medical provider
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Health Care Coalitions
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Healthcare association
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Hospitals
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Medical responder
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Mental and behavioral
health professionals
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Military health
organization
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Other, please specify -
Texas Association of Local Health Officials (TALHO)Local public health
departments
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Audience Type:
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Bioterrorism coordinators
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Elected officials
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Epidemiologists
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First responders
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Hospital
management/administrators
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Local public health
preparedness personnel
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Mental and behavioral
health professionals
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Preparedness personnel
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Public health directors
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Other, please specify -
Regional Advisory Councils (RACs)Councils of Government (COGs)Other
State agenciesMilitary organizations
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Performance Measures:
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Performance Measure 2A
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Performance Measure 6A
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Performance Measure 6B
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Performance Measure 6C
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Performance Measure 9A
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Performance Measure 9B
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Associate to Goals:
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Goal - Target Capability -
Critical Task
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Goal 1: Prevent, Capability
1A, Critical Task 3
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Goal 1: Prevent, Capability
1A, Critical Task 6
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Define Outputs:
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ID
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Project Output
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Report Date
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Type
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Output Target
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Current Value
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Unit Measured
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1
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State-level Standard
Operating Guideline.
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09/29/2007
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Number
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1
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0
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State-level Standard
Operating Guideline. One
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2
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Eight regional-level Standard
Operating Guidelines.
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09/29/2007
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Ratio
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8 / 8
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0 / 8
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Regional-level Standard
Operating Guidelines - one for each region (8)
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2007-0002:
Community Engagement and Citizen Participation...
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Activity Name:
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Community Engagement and
Citizen Participation
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What:
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Raise public awareness and
promote personal preparedness through a comprehensive statewide campaign
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Why:
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The over-arching message for
this campaign is that individuals need to be prepared to protect
themselves and their families from all hazards that threaten Texas,
including natural and man-made disasters and threats to public health.
This project responds to educational public health needs of this state.
Similar projects have been developed and implemented by both public and
private entities at the national, state, and local levels. This project
is part of the work mandated by the cooperative agreement from the
Centers for Disease Control and Prevention (CDC) to address public health
readiness and response.Since September 11, 2001, much has changed in our
world, nation, state, and communities. We have become much more aware of
the devastation that can be caused by unexpected disasters – whether they
are caused by nature, by accident, by disease, or by terrorist attack.
This campaign responds to the ever increasing need to promote the concept
of personal preparedness and public health readiness in Texas. In several
focus groups on the subject of preparedness held recently by DSHS across
Texas, most of the participants said they were not prepared nor were they
particularly concerned about being prepared or making plans. Most said it
would take an imminent disaster to catch their attention and move them to
pull together food and supplies. The report "Are We Ready?"
produced by the Council for Excellence in Government in December 2006
introduced a Public Readiness Index for individuals, families and communities.
Their research shows that "only 8% of the American public has done
everything that is needed to fully prepare for a natural disaster or
terrorist attack. Another 11% say that they have done everything they are
likely to do to prepare for an emergency situation; 49% have done some
things to get ready; and one-third (32%) have taken no steps to
prepare."The following assumptions apply to this project:Personal
preparedness speaks to how individuals and families plan and prepare for
a potential disaster. • Personal preparedness speaks to how individuals
and families plan and prepare for a potential disaster. • Personal and
family preparedness is the foundation of an effective disaster response.
• The more that individuals and families are prepared, the better equipped
communities will be in responding and recovering from a disaster. The
benefit of this project will be that people in Texas will: • Be informed
about the hazards that exist and how they can affect them personally. •
Know how to react when a disaster or emergency does occur. • Have an
evacuation and communications plan in place so everyone in their family
knows what to do and where to go. • Put together disaster supplies to
help sustain them until services are restored or help can be provided.
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How:
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The selected vendor will
create a comprehensive, statewide campaign to raise awareness and promote
personal preparedness in the event of a natural or man-made disaster. The
work on the campaign will start September 1, 2007, and end July 31, 2008.
The primary audience of this campaign is a general market audience in
Texas. A pre- and post-campaign evaluation to be conducted by
SUMA/Orchard Social Marketing is included in the same time period. The
campaign should be based on best practices or evidence-based strategies
for changing behaviors. Public-private or public-public partnerships can
be developed by the selected vendor, as appropriate, to accomplish the
campaign goals. This campaign must be relevant to Texans, culturally
appropriate and communicate messages in creative and compelling ways that
promote understanding by the target audience. This campaign must
compliment local and regional education/media efforts. This campaign
should have components that are evergreen (long term) and self-sustaining
so that the end of the paid media campaign does not signal the end of
behavior change and personal preparedness.Deliverables for this campaign
include the following: • A Consistent and recognizable visual identity
for the campaign materials that presents (positions) these materials as
providing important and trustworthy information regarding preparing for a
disaster.• Website design and production; website conforming to rules on
web site accessibility.Web site must be able to measure visits, downloads
and viewing of any video materials posted on the site.• Paid media
campaign with an emphasis on venues most appropriate for reaching the
target audiences. Vendor must explain strategy and rationale of why media
buys in specific markets are being recommended.• Radio and television ads
and other materials to support a paid media campaign• Earned media
campaign with an emphasis on venues most appropriate for reaching the
target audiences.• Tools and resources for personal preparedness• Tools
and resources for local government and tribal entities to engage their
local communities in personal preparedness• Print materials aligned with
campaign goals• A special events plan as appropriate• Public-private
and/or public-public partnership plan (if applicable).Deliverables must be
in English and Spanish. Vietnamese-language deliverables may be required
in certain circumstances. The campaign vendor has the capacity to develop
the concept, design and produce web site, produce both audio and visual
products, design and produce handouts and other written educational
materials in English, Spanish, and Vietnamese; print or duplicate
materials; procure statewide media buys; and conduct special events. The
social marketing group has the capacity to conduct six focus groups with
medically vulnerable respondents in both English and Spanish and conduct
statewide telephone surveys. DHSH has the capacity to oversee the
execution of the campaign and monitor contractor deliverables.The
proposed campaign will leverage the existing state resources of DSHS and
other state entities as appropriate. Preparedness partners will be
consulted throughout the project to obtain their expertise and knowledge
regarding personal preparedness activities.
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Where:
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The media campaign will take
place throughout the state with emphasis on venues appropriate for
reaching the target audiences. Vendor will purchase media buys in
specific markets to reach target audiences. Radio and television ads will
be broadcast throughout the state. Printed materials will be available
for dissemination throughout the state.
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Who Is Responsible:
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DSHS will be contracting with
a media/advertising agency to conduct the campaign. Vendor will propose
messages regarding individual preparedness that are appropriate for the
various vehicles and diverse audiences proposed for this campaign.
Messages will be consistent and trustworthy, and should provide a call to
action. A social marketing firm will be contracted to conduct the pre-
and post-campaign research project which will include gathering
stakeholder feedback through focus group testing and a statewide
telephone survey. DSHS will maintain primary responsibility for media
relations; review and approval of Spanish translation of materials
produced; health and medical expertise; and liaison as appropriate with
partners.
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Start:
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09/29/2007
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End:
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07/31/2008
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New or Ongoing:
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New
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Focus:
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Themes:
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At-risk Populations
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Border
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Evaluation
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Needs Assessment
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Pandemic Influenza
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Partnerships
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Planning
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Response/Countermeasures
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Risk Communications
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Training
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Tribal
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Partner Type:
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Agencies, quasi-government
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Agencies, regional
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Agencies, state
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Community-based
organizations (CBO)
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Department of Emergency
Management
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Media/Public
relations/Public Affairs
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Private sector business
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Other, please specify -
Texas Association of Local Health Officials (TALHO)Local public health
departments
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Audience Type:
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At-risk populations
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General public
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Other, please specify -
Regional Advisory Councils (RACs)Councils of Government (COGs)Other
State agenciesMilitary organizations
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Performance Measures:
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Pan Flu Thematic Areas:
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Communication
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Community-Wide Healthcare
Coalitions to meet Patient Surge Expected from Pandemic Influenza
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Associate to Goals:
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Goal - Target Capability -
Critical Task
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Goal 6: Control, Capability
6B, Critical Task 1
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Define Outputs:
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ID
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Project Output
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Report Date
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Type
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Output Target
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Current Value
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Unit Measured
|
|
1
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Media Campaign
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09/29/2007
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Number
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1
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0
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One media campaign
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|
2
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Pre-evaluation focus groups
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10/03/2007
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Number
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6
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0
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Six focus groups
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3
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Post evaluation telephone
survey
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09/29/2007
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Number
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1500
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0
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Surveys obtained from 1,500
participants
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4
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Number of events where
members of American Indian Tribes are present
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10/01/2007
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Number
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3
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0
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Number of events
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2007-0003:
Disaster Mental Health...
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Activity Name:
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Disaster Mental Health
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What:
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Enhance state behavioral
health planning efforts to help state and local governments adequately
prepare for mental health issues during a disaster.
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Why:
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The field of Disaster
Behavioral Health (DBH) does not have an abundance of verifiable research
showing the percentage of individuals, families, and communities
psychologically impacted by an event. Even harder to quantify is the
efficacy of interventions, although individuals report decreased stress
(including physical manifestations), faster recovery from the event with
less chronic long-term symptoms of a mental disorder (such as depression,
anxiety, and substance abuse), and decreased risk for Post Traumatic
Stress Disorder (PTSD). This is important as epidemiological statistics
often drive interventions, funding, and interest in programs with
disaster behavioral health as no exception. As a sub-specialty, DBH can
prevent a secondary wave of individual and community disaster impact from
occurring, or at least mitigate the adverse effects of the disaster. For
those impacted by hurricane Katrina, however, more research is being
done; as a conservative estimate 25% to 30% of the survivors are likely
to develop long-term anxiety disorders, depression, and other clinically
debilitating problems. Nearly three decades ago, the Robert T. Stafford
Disaster Relief and Emergency Assistance Act was enacted by Congress to
help state and local governments prepare for disasters. Since its
enactment, states have been required to have a plan for the provision of
disaster behavioral health services in a disaster. The need to enhance
state behavioral health disaster plans has become apparent as disaster
and emergency planning has evolved through the years. Better planning can
help make available appropriate interventions to those in need, and help
promote coordinated response, resiliency and recovery. Basic functions of
a disaster behavioral health response includes: assessing the
psychological impact and behavioral health needs; deploying and
coordinating disaster behavioral health services and resources. (DBH
response and recovery activities include, but are not limited to:
Psychological First Aid, Critical Incident Stress Management for first
responders, referral, and stress management education as well as short
and long-term counseling. Currently, DBH services during a disaster are
(is) state-initiated as opposed to the response beginning at the local
level as with other aspects of response. It is possible, with sound
planning, to fill the complex roles needed to integrate public health and
behavioral health response. To meet this challenge, it is crucial that
the planning process encourage the support and participation of behavioral
health partners at the local, regional, and state levels. To best
facilitate the networking necessary for partners to effectively carry out
the disaster behavioral health response plan, Department of State Health
Services (DSHS) will secure the services of a higher education contractor
to convene partners, gain consensus on partner roles and
responsibilities, identify resources, finalize the plan, and recommend
areas for mutual aid agreements.In essence, this approach will involve
those stakeholders that currently respond independently to an event and
allow them to be involved in the writing of the state plan to increase
coordination and integration. This approach will also provide a
formalized structure for local behavioral response efforts.The following
assumptions apply to this project:• In a natural or man-made disaster
events will occur which will necessitate the coordination and delivery of
crisis intervention and/or disaster behavioral health. • In the State of
Texas Emergency Management Plan, the Department of State Health Services
(DSHS) is designated as the lead agency in the coordination of all
disaster behavioral health including preparedness, response, and
recovery. • Strong working relationships between the Division of
Community Preparedness, Division for Mental Health and Substance Abuse
Services, other DSHS divisions, and other governmental agencies along
with collaborations with private organizations, are necessary for the
successful implementation of behavioral health disaster response
services. These collaborative relationships will enhance present and
future planning, preparation and response efforts.The benefit to Texas of
this project is:• Prevents duplication or gaps in service provision•
Identifies specific roles and responsibilities for each level of
government following the NIMS response structure• Coordinates response
efforts with multiple partners• Response and services will be available
immediately following an event and to a greater number of people
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How:
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The purpose of the Texas
Disaster Behavioral Health Plan is to provide, pursuant to National
Incident Management System (NIMS), operational policies/ procedures and
guidelines for the integrated management of behavioral health services.
To assure an effective, non-biased, stakeholder process DSHS will
establish a contract with an external contractor who will be responsible
for identifying and convening stakeholders, encouraging stakeholder
dialogue, facilitating negotiations, assessing disaster mental
health/behavioral health resources, drafting the Texas Disaster
Behavioral Health Plan, and creating tools to assist local governments in
the development of their local disaster behavioral health plans. The
contractor will be responsible for identifying and convening core stakeholders,
encouraging stakeholder dialogue, facilitating negotiations, assessing
disaster health/behavioral health resources, drafting the Texas Disaster
Behavioral Health Plan, and creating tools to assist local governments in
the development of their local disaster mental/behavioral health plans.
Specific activities include, but are not limited to: • Review of the
SAMHSA Mental Health All-Hazards Disaster Planning Guidance (2003) •
Review of best practices of other states in drafting state-level disaster
mental/behavioral health response plans; • In collaboration with DSHS,
identify key stakeholders (i.e.: local mental health authorities,
hospitals, state hospitals, GDEM, local health departments, regional
health departments, Red Cross) for Texas planning;• Establish a meeting
schedule (no more than six meetings) for stakeholders to discuss the
elements of a mental behavioral health plan, including assignment of
roles and responsibilities; • Educate stakeholders on disaster response
in general and the role of behavioral; health in such a response; •
Conduct an assessment of existing disaster mental/behavioral health
response resources; • Create a state-level draft of a behavioral health
response plan (Appendix 5 to Annex H);• Post draft plan on the DSHS website
for additional stakeholder input; • Produce a planning guidance document
to assist local governments in drafting their local disaster behavioral
health response plans; and • Draft written recommendations for DSHS and
behavioral health partners to better integrate local, regional, and
state-level disaster behavioral health response.DSHS will establish a
contract directly with the University of North Texas, who will be
sub-contracting with the Hogg Foundation. These agencies have the
capacity for: • Establishing credible and effective working relationship
with disaster behavioral health partners at the local, regional, and
state level;• Knowing the practice and processes related to disaster
mental/behavioral health emergency management and response;• Understanding
of the effects disasters and emergencies on the mental health of
populations; • Understanding of the role and responsibilities of the
State Mental Health Authority, State Hospitals, Local Mental Health
Authorities for pre-disaster preparedness, as well as response and
recovery efforts;• Converting stakeholder dialogue and input into
effective policy recommendations; and • Facilitating groups with
divergent opinions, to a common understanding or consensus.
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Where:
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Discussion meetings regarding
the drafting of the state plan will primarily take place at Department of
State Health Service (DSHS) Central Office in Austin, TX. The table-top
exercise will take place in selected locations throughout the state. The
planning guidance document will be distributed to all local governments.
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Who Is Responsible:
|
The President is authorized
to approve crisis counseling services, including financial assistance to
State or local agencies or private mental health organizations to provide
such services or training of disaster workers, to victims of major
disasters in order to relieve mental health problems caused or aggravated
by such major disaster or its aftermath (Robert T. Stafford Disaster
Relief and Emergency Assistance Act (Public Law 93-288) as amended/ §
5183; Crisis counseling assistance and training {Sec. 416}). Pursuant to
the Governor's responsibility under the Texas Disaster Act of 1975,
authority for statewide planning and coordination has been delegated to
the Governor's Division of Emergency Management (GDEM) headed by the
Deputy Director of the Governor's Office of Homeland Security. Under its
delegated authority GDEM assigns, based on expertise and
responsibilities, primary agencies to take the lead in developing and
maintaining appropriate annexes and appendixes within the State Emergency
Management Plan. Individual annexes of the state's plan are based upon
Emergency Support Functions (ESFs), and are in accordance with the
National Response Plan. The Department of State Health Services (DSHS)
has been designated by GDEM as the Primary Agency for ESF 8 (Public
Health and Medical Services). Annex H (Health and Medical Services) to
the State of Texas Emergency Management Plan, identifies 13 activities
that comprise a comprehensive public health and medical response to a
disaster event. DSHS is responsible for supporting local governments'
efforts to meet ESF 8 goals and objectives. The behavioral health plan
serves as appendix five to the Health and Medical Annex of the State
Emergency Management plan.
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|
Start:
|
09/29/2007
|
|
End:
|
02/29/2008
|
|
Focus:
|
|
|
Themes:
|
|
At-risk Populations
|
|
Border
|
|
Exercises
|
|
Hospital and Clinic
Coordination
|
|
Local Public Health
|
|
Mental Health
|
|
Needs Assessment
|
|
Pandemic Influenza
|
|
Planning
|
|
Recovery
|
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Response/Countermeasures
|
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Risk Communications
|
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Training
|
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Volunteer Management
|
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Partner Type:
|
|
Academic / educational
institution
|
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Agencies, federal
|
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Agencies, quasi-government
|
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Agencies, regional
|
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Agencies, state
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Agencies, tribal
|
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Centers for Public Health
Preparedness
|
|
Community-based
organizations (CBO)
|
|
Community health centers
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|
County Health Association
|
|
Critical affiliates, such
as APHL, CSTE
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Department of Emergency
Management
|
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Department of Mental Health
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Emergency medical provider
|
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Emergency response
agency/organization
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|
Faith-based organizations
|
|
Health Care Coalitions
|
|
Health Centers (Community,
Migrant, Rural)
|
|
Healthcare association
|
|
Hospitals
|
|
Law enforcement/public
safety (police/state patrol/fire/etc.)
|
|
Local Board of Health
|
|
Media/Public
relations/Public Affairs
|
|
Medical responder
|
|
Mental and behavioral
health professionals
|
|
Military health
organization
|
|
Private sector business
|
|
School of Public Health
|
|
Other, please specify -
Texas Association of Local Health Officials (TALHO)Local public health
departments
|
|
|
Audience Type:
|
|
At-risk populations
|
|
First responders
|
|
Health Centers (Community,
Migrant, Rural)
|
|
Hospital
management/administrators
|
|
Local public health
preparedness personnel
|
|
Mental and behavioral
health professionals
|
|
Preparedness personnel
|
|
Public health directors
|
|
Public health educators
|
|
Public health information
provider
|
|
Public information officers
|
|
Researchers
|
|
Urgent care clinics
|
|
Volunteers
|
|
|
Performance Measures:
|
|
Associate to Goals:
|
Goal - Target Capability -
Critical Task
|
|
Goal 1: Prevent, Capability
1A, Critical Task 1
|
|
Goal 6: Control, Capability
6C, Critical Task 1
|
|
Goal 9: Improve, Capability
9A, Critical Task 1
|
|
Goal 9: Improve, Capability
9A, Critical Task 2
|
|
Goal 9: Improve, Capability
9A, Critical Task 3
|
|
Goal 9: Improve, Capability
9A, Critical Task 4
|
Define Outputs:
|
ID
|
Project Output
|
Report Date
|
Type
|
Output Target
|
Current Value
|
Unit Measured
|
|
1
|
Arrange and facilitate
meetings
|
09/29/2007
|
Number
|
6
|
0
|
Arrange and facilitate 6
meetings
|
|
2
|
Assessment of existing
disaster mental/behavioral health response resources.
|
10/03/2007
|
Number
|
1
|
0
|
One assessment
|
|
3
|
State-level behavioral health
response plan (Appendix 5 to Annex H).
|
10/03/2007
|
Number
|
1
|
0
|
One plan (Appendix 5 to Annex
H)
|
|
4
|
Planning guidance document
(estimated 5-6 pages) to assist local governments in drafting their local
disaster mental/behavioral health response plans.
|
09/29/2007
|
Number
|
1
|
0
|
One planning document
|
|
5
|
Document of written
recommendations for DSHS and mental/behavioral health partners to better
integrate local, regional, and state-level disaster mental/behavioral
health response.
|
10/03/2007
|
Number
|
1
|
0
|
One document
|
|
|
|
2007-0004: Mass
Prophylaxis...
|
|
Activity Name:
|
Mass Prophylaxis
|
|
What:
|
The capacity statewide to
receive, distribute and dispense medical countermeasures in order to
provide preventative medication to the any community in Texas within 48
hours of the decision to do so.
|
|
Why:
|
Public Health experts have
shown that a 48-hour response to an aerosolized anthrax attack is a
critical turning point in the reduction or morbidity and mortality in an
effected community. State and local plans have been revised to meet the
48-hour requirement, but these plans cannot be effective without the
supporting infrastructure necessary for a robust response. Most local
health departments and health service regions have plans in place to
receive and dispense SNS materials, but some do not have the detailed
supporting procedures for these plans as well as the supporting
infrastructure and personnel necessary to carry-out the plans.The state,
regional and local jurisdictions in Texas must have plans, procedures,
supporting infrastructure and personnel pre-identified to facilitate a
rapid response should materials from the Strategic National Stockpile
(SNS) be needed. Pre-identification of personnel is vitally important for
an immediate response. A concentrated effort is necessary to ensure that
every community has the capacity for a 48-hour response. The best
approach for this project is a concentrated effort to bring every
jurisdiction to a minimum level within the next year. Efforts at the
state level will be focused on providing clear, thorough written guidance
and templates to assist local and regional jurisdictions.The SNS is a
complex program with multiple facets cutting across every major area of
public health and medical preparedness. It takes a great deal of time and
effort to hire personnel and train them on the intricacies of this
planning effort. This is compounded by the fact that there is a great
deal of turnover due to the high demands and pressures of this occupation
and the tremendous room for growth. These same issues are faced with
volunteer recruitment and retention as interest may fade over time if
regular communication is not maintained. Constant revision of plans,
procedures and programs is necessary as lessons are learned through real
events and exercises and federal guidelines change in response to new
information. All of these factors contribute to making the SNS program
and ever-growing and changing program.With the development of the new CDC
technical assistance review tool, there is greater emphasis on written
documentation. This emphasis should allow for greater continuity as
personnel change, but written plans and procedures are left behind.The
following assumptions apply to this project:• Local health departments
are independent from the state and as such have the autonomy and authority
to determine the best response for the local jurisdiction within broad
parameters.• Minimum personnel necessary will be identified by each
local, regional and state jurisdiction based on the respective plan and
procedural requirements.The benefits of this project include:• The
ability to provide medical countermeasures quickly• Identification of
gaps in response and provide greater consistency in response capacity
statewide• Volunteers and/or staff will be pre-identified so that they
can be trained.• Pre-identified staff will be able to test their
functioning during a planned exercise.• Stronger partnership building
between public health, emergency management, law enforcement and health
care industry will occur.
|
|
How:
|
The Texas SNS Program Manual
and provide training on manual content will be developed. The scalable
SNS plans and standard operating guidelines with supporting
infrastructure to provide oral medications during an event to the entire
population within 48 hours in accordance with the current Texas SNS
Program Manual will continue to be developed and augmented. Local health
departments will continue to recruit Staff/volunteers to carry out all
SNS functions.The State, regions, and local health departments have to
maintain an SNS preparedness program that is self-sustaining where
possible.Strong partnerships will be maintained and further strengthened
at the state-level with the other agencies listed in the Texas SNS Plan.
Local and regional public health agencies will be encouraged to build
strong relationships with emergency management, law enforcement,
hospitals and hospital planning groups.
|
|
Where:
|
The majority of this work
must be completed at the local level through the coordination of local
health departments and health service regions in jurisdictions without a
local health department. In addition the health service region serves as
a coordinating body for planning across multiple counties and serves as
the lead for receiving planning. The Texas Department of State Health Services
central office provides guidance, training and technical assistance for
these efforts.
|
|
Who Is Responsible:
|
The Texas Department of State
Health Services headquarters and health service regions, in coordination
with contracted local health departments will be responsible for
coordinating SNS response plans and related efforts. Success will depend
upon a favorable response from hospitals and hospital coordinating
entities, law enforcement and emergency management.
|
|
Start:
|
9/29/2007
|
|
End:
|
07/31/2008
|
|
New or Ongoing:
|
Ongoing
|
|
Focus:
|
|
|
Themes:
|
|
Exercises
|
|
Local Public Health
|
|
Pandemic Influenza
|
|
Partnerships
|
|
Planning
|
|
Response/Countermeasures
|
|
Risk Communications
|
|
Training
|
|
Volunteer Management
|
|
|
Partner Type:
|
|
Academic / educational
institution
|
|
Agencies, federal
|
|
Agencies, quasi-government
|
|
Agencies, regional
|
|
Agencies, state
|
|
Agencies, tribal
|
|
Association of State and
Territorial Health Officials (ASTHO)
|
|
Centers for Disease Control
and prevention
|
|
Centers for Public Health
Preparedness
|
|
Community-based
organizations (CBO)
|
|
Community health centers
|
|
Coroners / medical
examiners
|
|
County Health Association
|
|
Critical affiliates, such
as APHL, CSTE
|
|
Department of Agriculture
|
|
Department of Education
|
|
Department of Emergency
Management
|
|
Department of
Environmental/Natural resources
|
|
Department of Family and
Children Services
|
|
Department of Mental Health
|
|
Emergency medical provider
|
|
Emergency response
agency/organization
|
|
Faith-based organizations
|
|
Health Care Coalitions
|
|
Health Centers (Community,
Migrant, Rural)
|
|
Healthcare association
|
|
Hospitals
|
|
Institute of Public Health
|
|
Laboratories, animal
|
|
Laboratories, clinical
|
|
Laboratories, hospital
|
|
Laboratories,
pharmaceutical
|
|
Laboratories, private
|
|
Law enforcement/public
safety (police/state patrol/fire/etc.)
|
|
Local Board of Health
|
|
Local utilities department
(water and electricity)
|
|
Media/Public
relations/Public Affairs
|
|
Medical responder
|
|
Mental and behavioral
health professionals
|
|
Military health
organization
|
|
National Association of
City and County Health Officials (NACCHO)
|
|
Port authority
|
|
Private sector business
|
|
School of Public Health
|
|
Sentinel surveillance
physicians, frontline clinicians
|
|
U.S. postal service
|
|
|
Audience Type:
|
|
Administrative support
staff
|
|
Administrators
|
|
Allied health professionals
|
|
At-risk populations
|
|
Bioterrorism coordinators
|
|
Business and civic leaders
|
|
Chemical terrorism
coordinators
|
|
Children
|
|
Communications providers
|
|
Conference organizers
|
|
Coroners/medical examiners
|
|
Dental professionals
|
|
Educators
|
|
Elected officials
|
|
Environmental health
professionals
|
|
Epidemiologists
|
|
First responders
|
|
Food services
agents/providers
|
|
General public
|
|
Health Centers (Community,
Migrant, Rural)
|
|
Hospital
management/administrators
|
|
Infection control
practitioners
|
|
Information
specialists/technical support staff
|
|
Laboratorians
|
|
Laboratories
|
|
Law enforcement/public
safety
|
|
Legal professionals
|
|
Local public health
preparedness personnel
|
|
Media representatives
|
|
Mental and behavioral
health professionals
|
|
Nurses
|
|
Nursing home managers
|
|
Pharmacists
|
|
Physicians
|
|
Preparedness personnel
|
|
Public health directors
|
|
Public health educators
|
|
Public health information
provider
|
|
Public health nurses
|
|
Public health vaccination
staff
|
|
Public information officers
|
|
Researchers
|
|
Urgent care clinics
|
|
Veterinarians
|
|
Volunteers
|
|
|
Performance Measures:
|
|
Performance Measure 9A
|
|
Performance Measure 9B
|
|
|
Pan Flu Thematic Areas:
|
|
Antiviral Drug Distribution
Plan - submitted separately
|
|
Communication
|
|
Coordination of Law
Enforcement
|
|
Mass Vaccination
|
|
Associate to Goals:
|
Goal - Target Capability -
Critical Task
|
|
Goal 6: Control, Capability
6E, Critical Task 1a
|
|
Goal 6: Control, Capability
6E, Critical Task 1b
|
|
Goal 6: Control, Capability
6E, Critical Task 2
|
Define Outputs:
|
ID
|
Project Output
|
Report Date
|
Type
|
Output Target
|
Current Value
|
Unit Measured
|
|
1
|
80% of the required plans,
procedures, memorandums of agreement for resources needed, and rosters of
staff and/or volunteers for response will be completed.
|
10/03/2007
|
Ratio
|
41 / 59
|
8 / 59
|
Total score reported on the
self-assessment Technical Assistance Review SNS score
|
|
|
|
2007-0005: Mass
Fatality Management...
|
|
Activity Name:
|
Mass Fatality Management
|
|
What:
|
Ensure that the state is
prepared, through improved surge capacity, to respond in a coordinated
fashion to incidents involving mass fatalities through the development of
a state Mass Fatality Management (MFM) Plan, the provision of templates
for regional/local plans, and Standard Operating Guidelines for public
health agencies.
|
|
Why:
|
The State of Texas has a
population of approximately 24 million. In Texas, hurricanes, industrial
accidents, pandemic influenza, and terrorist incidents are considered the
most likely scenarios which could result in mass fatalities. However, any
catastrophic incident or public health emergency has this potential. The
death care industry, as well as local and state governments, has limited
experience with planning, responding, and recovering from a mass fatality
event. Such an event for any community requires extensive collaboration
among a wide range of entities. Hurricanes, industrial accidents,
pandemic influenza, and terrorist incidents are only a few of the
possible catastrophic events in this state. These types of events would
present problems that the state as a whole has never had to face. A
catastrophic incident resulting in mass fatalities will require response
activities and considerations not currently a part of our paradigm.
Issues not often considered with other types of responses will have to be
assessed and planned for. Some of the special considerations are: legal
issues involved in the pronouncement and certification of death,
cultural/religious considerations in the disposition of human remains;
temporary storage of human remains awaiting final disposition; disease
spread prevention; autopsy capacity issues; dispensation of certain laws
or regulations; disaster mental health services. Communities may have dealt
with some of these issues on separate occasions but a mass fatality event
would, in all likelihood, require addressing most of the listed issues,
if not all, at one time.Addressing the complexity of these extraordinary
issues will require extensive collaboration among many partners, and
across jurisdictional borders. In conjunction with preparedness partners,
it will be important to develop a basic template for mass fatality
plans/standard operating guidelines that will be applicable to all
jurisdictions. The template for Standard Operating Guidelines (SOGs) will
include provisions for integrated local, regional, and state planning
efforts. Joint efforts in preparedness and response efforts are the only
manner in which the state will be able to effectively manage a mass
fatality event. Therefore, the overall strategy is to improve integrated
preparedness and response management for a mass fatality event.The
following assumptions apply to this project:• Successful mass fatality
operations will require extensive cooperation by many stakeholder
agencies and organizations who may be engaged with one another for the
first time.• A mass fatality incident or public health emergency
involving mass fatalities will quickly overwhelm a community.• A pandemic
influenza event with mass fatalities will impact everyone across the
nation, and quickly overwhelm even federal resources, which will limit
the assistance that we receive from our federal partners.• A response to
a mass fatality event has never been undertaken. The benefits of this
project will be: • The identification and inclusion of multiple
stakeholder organizations• Familiarization of all “players” with each
other• Identification of the community’s resources and help identify any
gaps• Leveraging of resources• Reduction of the spread of disease•
Consideration of cultural and religious variations in the preparation and
burial of deceased individual • Delineation of response roles and
responsibilities for all agencies and organizations , which will also
assist in identifying any gaps• Promotion of well orchestrated,
integrated response operations
|
|
How:
|
DSHS will educate our health
and medical preparedness partners on the fundamental elements of a mass
fatality event and recommend they establish a planning workgroup
comprised of local and regional partners. Each of the workgroups can
identify the unique characteristics of this type of event and develop
plans, training, and exercises that will create a collaborative response
effort. The expectation is that we will integrate all appropriate ESF
partners to address the preparedness and response activities needed for a
mass fatality event. The state will develop a Mass Fatality Appendix to
Annex H, Health and Medical services to the State of Texas Emergency
Management Plan. Each of the 48 local health departments receiving
preparedness funds will develop Standard Operating Guidelines (SOGs)
which outline their roles and responsibilities for mass fatality
management. Regions, acting as local health departments in areas where
there are none will also develop SOGs.Partnerships that have already been
developed include: • Preparedness Coordinating Council• local health
departments• health service regions• regional area councils• councils of
governmentAll of the established partnerships will be used and any not
yet developed will be pursued.
|
|
Where:
|
Planning and coordination
efforts will occur at the state, regional, and local levels between
public health and medical entities once DSHS has released the template.
|
|
Who Is Responsible:
|
Pursuant to the Governor's
responsibility under the Texas Disaster Act of 1975, authority for
statewide planning and coordination has been delegated to the Governor's
Division of Emergency Management (GDEM) headed by the Deputy Director of
the Governor's Office of Homeland Security. Under its delegated authority
GDEM assigns, based on expertise and responsibilities, primary agencies
to take the lead in developing and maintaining appropriate annexes and
appendixes within the State Emergency Management Plan. Individual annexes
of the state's plan are based upon Emergency Support Functions (ESFs),
and are in accordance with the National Response Plan. The Department of
State Health Services (DSHS) has been designated by GDEM as the Primary
Agency for ESF 8 (Public Health and Medical Services). Annex H (Health
and Medical Services) to the State of Texas Emergency Management Plan,
identifies 13 activities that comprise a comprehensive public health and
medical response to a disaster event. DSHS is responsible for supporting
local governments' efforts to meet ESF 8 goals and objectives.
|
|
Start:
|
09/29/2007
|
|
End:
|
07/31/2008
|
|
New or Ongoing:
|
Ongoing
|
|
Focus:
|
|
|
Themes:
|
|
Border
|
|
Evaluation
|
|
Exercises
|
|
Hospital and Clinic
Coordination
|
|
Mental Health
|
|
Needs Assessment
|
|
Partnerships
|
|
Planning
|
|
Recovery
|
|
Response/Countermeasures
|
|
Training
|
|
Tribal
|
|
|
Partner Type:
|
|
Other, please specify -
Texas Association of Local Health Officials (TALHO)Local public health
departments
|
|
|
Audience Type:
|
|
Administrative support
staff
|
|
Administrators
|
|
Allied health professionals
|
|
At-risk populations
|
|
Bioterrorism coordinators
|
|
Business and civic leaders
|
|
Chemical terrorism
coordinators
|
|
Children
|
|
Communications providers
|
|
Conference organizers
|
|
Coroners/medical examiners
|
|
Dental professionals
|
|
Educators
|
|
Elected officials
|
|
Environmental health
professionals
|
|
Epidemiologists
|
|
First responders
|
|
Food services
agents/providers
|
|
General public
|
|
Health Centers (Community,
Migrant, Rural)
|
|
Hospital
management/administrators
|
|
Infection control
practitioners
|
|
Information
specialists/technical support staff
|
|
Laboratorians
|
|
Laboratories
|
|
Law enforcement/public
safety
|
|
Legal professionals
|
|
Local public health
preparedness personnel
|
|
Media representatives
|
|
Mental and behavioral
health professionals
|
|
Nurses
|
|
Nursing home managers
|
|
Pharmacists
|
|
Physicians
|
|
Preparedness personnel
|
|
Public health directors
|
|
Public health educators
|
|
Public health information
provider
|
|
Public health nurses
|
|
Public health vaccination
staff
|
|
Public information officers
|
|
Researchers
|
|
Urgent care clinics
|
|
Veterinarians
|
|
Volunteers
|
|
|
Performance Measures:
|
|
|
Pan Flu Thematic Areas:
|
|
Facilitating Medical Surge
|
|
Fatality Management
|
|
Associate to Goals:
|
Goal - Target Capability -
Critical Task
|
|
Goal 1: Prevent, Capability
1A, Critical Task 3
|
|
Goal 6: Control, Capability
6G, Critical Task 3
|
Define Outputs:
|
ID
|
Project Output
|
Report Date
|
Type
|
Output Target
|
Current Value
|
Unit Measured
|
|
1
|
State level appendix to Annex
H, Health and Medical services, to the State of Texas Emergency
Management Plan.
|
09/29/2007
|
Number
|
1
|
0
|
One appendix to Annex H
|
|
2
|
Internal mass fatality
Standard Operating Guidelines (SOGs) delineating and describing Health
Service Region(HSR)/Local Health Departments (LHDs) roles and
responsibilities in support of the community's all-hazards emergency
management plan.
|
09/29/2007
|
Ratio
|
47 / 59
|
0 / 59
|
One SOG written for each
HSR/LHD
|
|
3
|
Planning guidelines provided
to Health Service Regions (HSRs) and Local Health Departments (LHDs) for
mass fatality Standard Operating Guidelines (SOGs).
|
10/03/2007
|
Number
|
1
|
0
|
One planning guideline
|
|
|
|
2007-0009:
Epidemiology, Surveillance and Medical Surge for Pandemic Influenza...
|
|
Activity Name:
|
Epidemiology, Surveillance
and Medical Surge for Pandemic Influenza
|
|
What:
|
Enhance communications and
collaborations between animal health, public health, and the poultry
industry.Identify, discuss and seek solutions to areas of dissonance in
emergency management practices that may interfere with a combined
animal/human outbreak.Discuss the establishment of Avian Influenza Rapid
Response Teams
|
|
Why:
|
While there are many common
procedures for the identification and surveillance of avian influenza
between the animal and human health professionals, there is no formal
mechanism for sharing information and data or collaboration during
simultaneous human/animal outbreaks. Complementary approaches based on
mutual understanding of agency specific roles and responsibilities during
an outbreak are essential for an organized response. Traditional siloed
approaches to outbreak control is problematic when both human/animal
outbreaks coexist, especially within the same time and space. Issues
related to the establishment of unified command must be addressed prior
to an actual event. This rapid response training brings together animal
and human health professionals to begin identifying and working through
areas of dissonance and improve collaboration and information sharing
during any zoonotic emergency.The following assumptions apply to this project:•
Highly Pathogenic Avian Influenza will occur in US poultry production
facilities and may jump to humans.• Satisfactory response requires a
multi-agency approach to solving the problems associated with a zoonotic
emergency involving both animals and humans.• The potential for medical
surge among the "worried well" may overtax limited hospital
resources (especially in rural communities).• When hospital resources are
overtaxed, alternate methods for service delivery must be considered.• Both
public and animal health will be onsite simultaneously.
|
|
How:
|
Invite hospital infection
control practitioners and administrative staff to participate in
informational sessions and tabletop exercise to test surge elements
associated with worried well and patients with symptoms using a
pre-pandemic scenario (i.e. outbreak of avian influenza among poultry
that transmits to a limited number of humans).Provide a series of
informational/training sessions based on "Avian Influenza Rapid
Response Training" in preparation for the tabletop exercise to
include but not limited to:• Basic epidemiologic and clinical information
on avian influenza, pandemic influenza and seasonal influenza.•
Surveillance and laboratory issues in animals and humans• Avian influenza
among humans• Personal Protective Equipment for emergency responders•
BiosecurityConduct and evaluate a tabletop exercise that brings the
responders for a poultry outbreak, responders for a subsequent human
outbreak of avian influenza, and hospital first responders to examine
surveillance, laboratory, outbreak management, infection control,
personal protection, and medical surge issues.• Identify and discuss
barriers to collaboration, information sharing and management of the
incident.• Analyze differences in perceptions and approaches to handling
the simultaneous occurrence of avian influenza among both animals and
humans.
|
|
Where:
|
Educational Seminars and
Exercise will be held in College Station, Texas. This is a rural college
town in east Texas. OASPR participating hospitals throughout the state
will be encouraged to exercise surge components.
|
|
Who Is Responsible:
|
DSHS will take the lead for
the development of the seminars and the tabletop exercise.
|
|
Start:
|
09/29/2007
|
|
End:
|
02/28/2008
|
|
New or Ongoing:
|
New
|
|
Focus:
|
|
|
Themes:
|
|
Exercises
|
|
Lab: Biological
|
|
Pandemic Influenza
|
|
Response/Countermeasures
|
|
Surveillance
|
|
Other, please specify -
Medical surge
|
|
|
Partner Type:
|
|
Agencies, regional
|
|
Agencies, state
|
|
Department of Agriculture
|
|
Hospitals
|
|
Laboratories, animal
|
|
Laboratories, clinical
|
|
|
Audience Type:
|
|
Conference organizers
|
|
Epidemiologists
|
|
First responders
|
|
Hospital
management/administrators
|
|
Infection control
practitioners
|
|
Laboratorians
|
|
Local public health
preparedness personnel
|
|
Nurses
|
|
Physicians
|
|
Preparedness personnel
|
|
Veterinarians
|
|
|
Performance Measures:
|
|
Performance Measure 2A
|
|
Performance Measure 6C
|
|
Performance Measure 9A
|
|
Performance Measure 9B
|
|
|
Pan Flu Thematic Areas:
|
|
Facilitating Medical Surge
|
|
Surveillance and Laboratory
|
|
Associate to Goals:
|
Goal - Target Capability -
Critical Task
|
|
Goal 1: Prevent, Capability
1A, Critical Task 4
|
|
Goal 1: Prevent, Capability
1A, Critical Task 4a
|
|
Goal 2: Detect and Report,
Capability 2A, Critical Task 1
|
|
Goal 2: Detect and Report,
Capability 2A, Critical Task 1a
|
|
Goal 2: Detect and Report,
Capability 2A, Critical Task 1b
|
|
Goal 2: Detect and Report,
Capability 2A, Critical Task 2
|
|
Goal 2: Detect and Report,
Capability 2A, Critical Task 2a
|
|
Goal 3: Detect and Report,
Capability 3A, Critical Task 1
|
|
Goal 3: Detect and Report,
Capability 3A, Critical Task 1d
|
|
Goal 3: Detect and Report,
Capability 3A, Critical Task 2
|
|
Goal 3: Detect and Report,
Capability 3A, Critical Task 2a
|
|
Goal 5: Investigate,
Capability 5A, Critical Task 1
|
|
Goal 5: Investigate, Capability
5A, Critical Task 2
|
|
Goal 5: Investigate,
Capability 5A, Critical Task 3
|
|
Goal 6: Control, Capability
6C, Critical Task 2
|
|
Goal 6: Control, Capability
6C, Critical Task 2a
|
|
Goal 6: Control, Capability
6D, Critical Task 1
|
|
Goal 6: Control, Capability
6D, Critical Task 2
|
|
Goal 6: Control, Capability
6D, Critical Task 4
|
|
Goal 6: Control, Capability
6F, Critical Task 1
|
|
Goal 6: Control, Capability
6F, Critical Task 3
|
|
Goal 6: Control, Capability
6F, Critical Task 3a
|
|
Goal 9: Improve, Capability
9A, Critical Task 2
|
|
Goal 9: Improve, Capability
9A, Critical Task 3
|
|
Goal 9: Improve, Capability
9A, Critical Task 4
|
Define Outputs:
|
ID
|
Project Output
|
Report Date
|
Type
|
Output Target
|
Current Value
|
Unit Measured
|
|
1
|
Avian Influenza Rapid
Response Team Training session
|
09/29/2007
|
Number
|
1
|
0
|
Completion of one education
session prior to exercise
|
|
2
|
Evaluation (tabletop
exercise) of Avian Influenza Rapid Response Team training
|
09/29/2007
|
Number
|
1
|
0
|
Completion of one tabletop
exercise
|
|
|