1. Schools and Disaster Preparedness PAS Toronto 2007 Linda M. Grant, MD, MPH Boston University School of Medicine Medical Director Boston Public Schools

2. Disclosure Linda Grant has nothing to disclose

3. Goals Highlight the Department of Education guidelines for emergency preparedness Identify the pediatricians role in school disaster preparedness

5. Department of Education Office of Safe and Drug Free Schools

7. What is a crisis?

10. Principles for effective crisis planning Begins at the top Built on needs assessment Coordination with Law enforcement, fire, public health, mental and physical health agencies Input from rest of community with two way communication Have a common vocabulary

11. Principles for effective crisis planning Tailor to the needs of individual schools as well as specific school groups Cover needs of diverse staff and student population (special needs) Readily accessible to staff, parents Practiced regularly Reviewed and revised regularly

12. Prevention/Mitigation

15. Provides check list for schools, workplace, individuals, health care facilities, community agencies (churches) to help guide in planning

17. Second Step: A Violence Prevention Program A classroom-based social skills curriculum for students from preschool through middle school. The curriculum aims to reduce impulsive and aggressive behaviors and increase protective factors and social-emotional competence. Organized by grade level, the program teaches children empathy, problem-solving skills, risk assessment, decision-making, and goal-setting skills. West Covina Unified School District, California

18. The community clinician PREVENTION Community clinicians can increase awareness of their districts health prevention and promotion efforts and include similar prevention messages in their anticipatory guidance. Violence prevention Anti bullying Cough and sneeze etiquette Support for individual preparedness

19. Preparedness

21. Table A. Summary of the Community Mitigation Strategy by Pandemic Severity

22. BPS Pandemic Planning- Information and School Prevention and Preparedness Activities LevelHome/back pack mail Individual School activitiesAdministrators plan Level 1 No pandemic  General prevention techniques.  No emphasis on pandemic  Posters on hand washing  “Perfect attendance “ discussions  Packet to site councils (includes BPHC HO on Pandemic Flu and distinguishing seasonal from pandemic)  In-service on “cough and sneeze etiquette” to staff at beginning of the year as part of nurse responsibilities. Ensure that supplies are available waste receptacles, Kleenex, soap, open bathrooms, alcohol based cleanser etc.  Develop resources: posters, hand washing supplies, masks, isolation procedures  Develop website (internal) for updates  Work with Cluster leaders to develop communication strategies  Use Health Council(an ad hoc subgroup or clinical group) to discuss issues and vet the process (response plan and preparedness)?  Plans for staff sick leave, transportation Level 2 Seasonal Flu  Information about Flu (seasonal)  Same as above Level 3 Pandemic begins somewhere  CDC checklist and emergency health list Inservice to staff Moves from prevention and preparedness to response Level 4 Local signs ? website activation, media Protocols being developed

23. Helping parents be prepared Individual checklist of preparedness Link to community clinicians efforts; reinforce same messaging

24. Emergency preparedness SCHOOL HEALTH ROOM Do the schools in your district have adequate supplies to handle an emergency before outside help arrives?

25. Preparedness for special needs students Do you know if your patients have enough medication or personal supplies to weather a lock down or shelter in place?

27. The community clinician PREPAREDNESS Increasing family awareness of the school district crisis plan should be part of anticipatory guidance, particularly calling attention to the schools plan for parental notification in the event of lock down, shelter in place or evacuation to an alternative site.

28. Response

29. Incident Command Incident Command is the common language that should be used in all emergencies

30. Incident Command The Incident Command System (ICS) is a management system used to organize emergency response. ICS offers a scalable response to an emergency (incident) of any magnitude, and provides a common framework within which people can work together. These people (resources) may be drawn from multiple agencies that do not routinely work together. The system is designed to grow and shrink along with the incident, allowing more resources to be smoothly added into the system when needed and released when no longer needed.

31. The community clinician RESPONSE When a crisis is unfolding, the community pediatrician should follow the predetermined plan and keep informed through the appropriate communication systems established in the planning process.

32. National Incident Management System (NIMS) Relationship: NIMS and NRP Local Response State Response or Support Federal Response or Support NIMS aligns command, control, organization structure, terminology, communication protocols, resources and resource-typing for synchronization of response efforts at all echelons of government National Response Plan (NRP) Incident Activated for incidents of national significance Resources, knowledge, and abilities from Federal departments & agencies DHS integrates and applies Federal resources both pre and post incident Used for all events

33. Recovery

34. The community clinician RECOVERY Clinicians should support efforts to return to learning as soon as possible. The medical community’s collective sense of the emotional impact of a disaster can help guide schools and staff in their continuing interventions. Clinicians may also be part of those interventions.

35. The community clinician SCHOOL CONSULTANT Know who the school consultants are (if at all) in your district and use them to: Obtain copy of emergency plan for district in waiting room Identify school messaging that would be appropriate to reinforce in the waiting room Access school health advisory committees Build school community communication networks

36. School Community Medical/ Mental health Community Public Health Community