1. presented DATE to GROUP NAME The Great Lakes Border Health Initiative

2. What is GLBHI? A collaborative effort between jurisdictions in the U.S. & Canada to enable infectious disease surveillance and facilitate communication

3. Who is GLBHI?

4. History of GLBHI Before 2004

5. History of GLBHI Before 2004

6. History of GLBHI Now

7. History of GLBHI 2004 –Early Warning Infectious Disease Surveillance –Michigan and Ontario –Border Health Initiative 2005 –New York, Wisconsin, Minnesota –Great Lakes Border Health Initiative

8. History of GLBHI 2006 –MI-HAN enrollment: Ontario –Ohio 2007 –Epi-X enrollment: Ontario –Pennsylvania & Indiana

9. History of GLBHI 2008 –CIOSC enrollment: United States

10. Organization

11. About the Committees Members include: –State/Provincial representatives –Local public health representatives –Tribal/First Nations representatives –Federal representatives US/Canadian co-chairs Scheduled to meet monthly to bi-monthly

12. About the Steering Committee Members –Co-chairs of subcommittees –State/Provincial leads –Other key representatives Directs the actions of the subcommittees Tasks determined by grant agreement All participating organizations represented

13. About the Lab Subcommittee Routine surveillance sharing Lab capabilities Sharing of protocols Exploring import-export permits from CDC & PHAC

14. About the Legal Subcommittee Data Sharing Agreement Evaluates privacy laws and policies of potential new partner states Provides legal counsel for other committees as issues/questions arise

15. About the Food Protection & Defense Subcommittee Newest subcommittee Currently working to establish relationships and communications channels between critical partners

16. About the PH Communication Subcommittee Communication links & tools –Communication Guideline –Communication System Matrix –Reportable Disease List Epi-X & CIOSC enrollment exchange

17. About the Ad hoc Subcommittees Education & Training Emergency Response Direct Care

18. Tools for Collaboration Face-to-face meetings Communication pathways –Federal –Local/Regional Data Sharing Agreement Infectious Disease Emergency Communications Guideline

20. IDECG Decision Tree

22. 1.Might the event have a serious public health impact across the border? –Event due to unknown agent with unpredictable public health impact –Event due to known agent with the following factors: Unusual disease pattern Previously eradicated agent Known agent, but new for the geographical region Potential to cause epidemic, even if no or few human cases are being identified Indication of treatment failure Known potential to cause severe illness –Accidental or intentional release of dangerous, banned or restricted chemical or radioactive agent

23. IDECG Decision Tree

24. 2.Is there significant risk of international spread? –Evidence of epidemiological link to similar events in other countries –Need to alert in regard to the potential for cross border movement of the agent, vehicle or host –Cross border assistance is needed to detect, investigate, respond and control the current event, or prevent new cases. –Inadequate human, financial, material or technical resources

25. IDECG Decision Tree

26. 3.Might international travel or trade restriction be necessary? –Similar events in the past have resulted in international restriction on trade and/or travel across the border –The source is suspected or known to be a food product, water or any other goods that might be contaminated that has been exported/imported across the border –The event might have occurred in association with an international gathering –The event has caused requests for more information by cross border officials or media

27. Emergency Contacts

28. State Maps

29. Immediately Notifiable Diseases Epi-developed list “Pick up the phone and call now” diseases Trumps the Decision Tree

30. Immediately Notifiable Diseases

31. Data Sharing Agreement

32. Ratified by all GLHBI partners All states vetted by Legal Subcommittee prior to Steering Committee approval –Privacy laws and policies

33. GLBHI Directory For non-emergency usage State, local, federal and tribal contacts Available by request

34. GLBHI Website www.michigan.gov/borderhealth –Overview of GLHBI Explanation Brochure Poster

35. GLBHI Website www.michigan.gov/borderhealth –Tools for Border Health Important Documents, Best Practices & Helpful Resources Related Organizations Local Travel Resources for Americans and Canadians International Travel Resources for Americans and Canadians

36. GLBHI Website www.michigan.gov/borderhealth –News & Updates GLBHI Calendar GLBHI annual conference presentations available online Other important reports and happenings GLBHI News & Updates Archive

37. Recent & Future Efforts Learning from the past: –Historical mapping of regional influenza progression Functionally exercising an infectious disease emergency in the GLBHI region Pursuing northern border consistency Continuing quality improvement of tools/systems Long-term strategizing

38. Questions?? Michigan GLBHI Contacts Diane Krueger, Project Coordinator kruegerd@michigan.gov 517-335-6533 Carol Somers, Support Staff somersc@michigan.gov 517-373-4501