1. WI Public Health Preparedness (PHP) Update for Public Health Council WI Division of Public Health Department of Health & Family Services April 11, 2008

2. PHP Funding Waiting for Public Health Emergency Preparedness (PHEP) guidance for Budget Period 9 Expect an 11% reduction in PHEP funding Continuation of activities and priority projects Last year for Pandemic Influenza funding

3. PHP Funding The Pandemic and All Hazards Preparedness Act (PAHPA) requires a state match of 5% in the budget period in which fiscal year 2009 funds are distributed (Budget Period 10 – 8/09 to 8/10); Following year 10% will be required

4. Site Visits CDC conducted SNS (Strategic National Stockpile) site visit on November 20, 2007 WI received an overall score of 86, putting us in the “green” or “ready” category

5. Site Visits CDC PHEP (Public Health Emergency Preparedness) site visit December 10-12, 2007 Results: – Excellent progress in Pandemic Influenza planning – Risk Communication plans and toolkits are comprehensive – Good working relationship with local health departments and tribes

6. Site Visits – Good progress toward Public Health Information Network (PHIN) compliance – State Laboratory of Hygiene is a first-class operation – WI has improved its epidemiologic capacity and surveillance program – City of Milwaukee doing excellent job in coordinating with non-public health agencies in preparedness and response planning

7. Site Visits – WI is doing an outstanding job in tactical communications planning – WI has solid training and exercise plan for 2008, and is doing a good job in assuring locals conduct exercises and drills and submit After Action Reports

8. Site Visits CDC site visit recommendations: – Utilize expertise of surrounding states – Allocate more resources at the state level to SNS – Recruit, train and maintain a large group of volunteers – Obtain local and tribal concurrence with work plan

9. PHP Program Challenges Diminishing preparedness funding Requirement for state match Improving state-level pandemic influenza plans without supplemental funding and across multiple state agencies Finding, training and keeping a sufficient preparedness workforce

10. Pandemic Influenza Priority Projects 2007-2008 Pandemic Triggers: Identify the timing of actions for response activities Pandemic Continuity of Operations (COOP) Planning: Plan for and test workforce surge capacity and capabilities Antivirals and Personal Protective Equipment (PPE): Prioritization, distribution, and purchase of antivirals and PPE

11. Exercises and Evaluation Pandemic Triggers Exercise: Test of the Pandemic Triggers Guidance Pandemic Countermeasures Exercise on Antiviral Distribution: Test of the Policy on the Distribution of Antiviral Medications Community Disease Containment Exercises: Conducted by local health departments

12. Pan Flu Competitive Grant Applications Public Engagement: 4-5 town hall meetings on the topic of school, business, and public event closure in a pandemic Electronic Laboratory Data Exchange: Web- based data entry of influenza results and other reportable disease conditions Pandemic Influenza and At-Risk Populations: Rapid evaluation and education of newly-arrived refugees

13. Interagency Coordination March 12 and 14 meetings at the Department of Military Affairs Avian Influenza Coordination Team Report to the Governor Operational Planning

14. Pandemic.Wisconsin.Gov Up-to-date information on pandemic, avian, and seasonal influenza Resources for: - Communities- Healthcare Providers - Businesses- Individuals & Families - Schools WI Pandemic Toolkit Resources: – Fact Sheets – Frequently Asked Questions – Promotional Materials

15. Hospital Preparedness Program State Expert Panels Materials Management: Establishment of a stockpile of medical/surgical supplies, available to hospitals when the supply chain has been disrupted Palliative Care: Template policies for hospitals on how to manage a large number of patients in need of “comfort care” – when other treatments are unavailable – when “survivability” is low

16. Hospital Preparedness Program State Expert Panels Long-Term Care Facilities: Involvement of long-term care industry in emergency preparedness – Nursing Homes – Assisted Living Facilities – Group Homes Patient Tracking: the ability to track patients from the field to one or more hospitals until time of final discharge

17. Hospital Preparedness Program State Expert Panels Dispatch: Template Policy on Dispatch Response for a Multiple Victim Incident Ethics: identification of ethical issues in a disaster Fatality Management: Template Policy for Coroners and Medical Examiners and other responders, on management of a large number of fatalities

18. Hospital Preparedness Program State Expert Panels Radiation Emergencies: Template policy for hospitals and EMS on the management of patients exposed to or contaminated with radiological agents Pediatric Preparedness: “Patient At Risk” - a database of all pediatric patients with chronic illnesses – Expansion 1: all pediatric patients with medical problems – Expansion 2: all adult patients with medial problems

19. Wisconsin Emergency Assistance Volunteer Registry - WEAVR Wisconsin’s answer to ESAR VHP Confidential, electronic registry for health professional volunteers and others Collaboration with state and local agencies New WEAVR will integrate with MRC Units New WEAVR can serve as central registry

20. WEAVR Today Over 2100 health professionals registered Various licenses, degrees, certifications and skills, including languages spoken New and improved WEAVR is in the customization process at this time

21. Medical Reserve Corps - MRC Dedicated to establishing teams of local volunteer medical and public health professionals to contribute their skills and expertise throughout the year as well as during times of community need.

23. Complementary Systems MRC Units - locally managed Volunteers support & local emergency & non- emergency events Training provided MRC volunteers can be WEAVR members WEAVR - statewide Volunteers - back-up for first responders Volunteers are called upon only in times of emergency Just-In-Time training WEAVR members can be MRC volunteers

24. Special Populations Taskforce Charge Toolkit Parking Lot Issues

25. Antiviral Distribution Policy Developed by the Antiviral Distribution Expert Panel Pandemic Flu local objective

26. Antiviral Medications State-owned cache – Treatment influenza pandemic only 1 cache site (so far) Deployment being developed – Initial outbreak – Pre-deploy when pandemic is imminent – Treatment of ill by priority Activated by Division of Public Health

27. Cached Medical Countermeasures Antiviral Medications – Treats 153,000 patients CHEMPACK – Treats 24,350 victims IPS – Interim Pharmaceutical Stockpile – Prophylaxis for 540,000

28. CHEMPACK Nerve agent antidote – Organophosphate poisoning only Federally owned, locally cached 31 CHEMPACK sites across Wisconsin Following the “Golden Hour” rule Secondary response Activated through emergency dispatch

29. SNS Deployment Tribes and local public health agencies have mass clinic (medicine distribution) plan 223 locations identified as dispensing sites Tribes and local public health will need help to dispense medications – Health professionals and other volunteers – Law enforcement for crowd and traffic control – Local EM for command, control communications

30. SNS Not Just Drugs Pandemic Influenza Countermeasures – Masks, respirators, ventilators Federal Medical Stations – Modular equipment and supply package – 250 beds package/50 bed modules – 72 hours of medicines and supplies Emergency purchase program

31. Wisconsin State Laboratory of Hygiene (WCLN & LRN & C-LRN) National Guard 54 th CST WMD Federal Agencies FBI(HMRU), USSS, USPIS State Agency Labs DATCP(FERN) WVDL(NAHLN) WI Crime Lab Emergency Laboratory Response Capabilities An expanding list of partners

32. WSLH Local Health Dept. State Agencies DHFS, DNR, WEM Fire/HazMat CST Private Contractors Law Enforcement Partners in Emergency Response Providing laboratory resources to response partners

33. Upcoming Exercises SNS AntiViral Distribution Tabletop Exercise Wisconsin Medical Society April 30, 2008 Operation Sno-White Tabletop Exercise Portage County Health Department May 8, 2008 WI Dells Tabletop Exercise Sauk County Health Department May 29, 2008 Pandemic Triggers Tabletop Exercise Crowne Plaza Hotel July 17, 2008

34. DPH EOC Management Team Goals and Mission Statement To direct and oversee the Incident Command System (ICS) structure and overall operations within the DPH EOC.

35. DPH EOC Management Team Goals and Mission Statement Maintain strategies to ensure timely and effective notification and response during planned or unplanned emergency public health events.

36. Partner Communications & Alerting PCA Expert Panel – Policies, Procedures & Technology Health Communications PHIN Directory & Directory Exchange PHIN Portal

37. The Future NEW Broadcast Communications System – Coming this FALL Directory Roles & Exchange