Twin Cities Metro Advanced Practice Center Overview

1. Twin Cities MetroAdvanced Practice Center Overview Advanced Practice Center Roadshow July 28-29, 2009 Orlando, Florida Brian R. Golob, M.S., C.H.M.M., R.E.H.S. brian.golob@co.hennepin.mn.us 612-543-5204

2. Agenda • Background Information for TCM APC Program • Perspective on EH Emergency Preparedness • Overview of Products

3. Funding Support

4. Twin Cities Metro APC • Collaborative approach exclusively for EH emergency preparedness • Currently in 5th year of funding • Focus on: • Practical and Useful Products • Building EH Capacity

5. Disaster Denial Paradigm • It isn’t going to happen. • If it happens, it will not be as bad as they said it would be. • If it happens, and it is as bad as they said, it will not happen to me. • If it happens and it is as bad as they said, and it happens to me, then someone has planned for it and is coming to help.

6. In the Beginning… • American Journal of Public Health and the Nations Health 1930 • Public Health Management of Disasters The Practice Guide, 2001, APHA • Environmental Health in Emergencies and Disasters, WHO, 2002

7. In the Beginning…(Cont.) • Journal of Environmental Health Article, Sept. 2004 • Journal of Environmental Health Article, Nov. 2004 • Disaster Field Manual for Environmental Health Specialists, 1994, 1998 & 2004 CA Assoc. of EH Administrator

8. Initial Goal:Write an EH Emergency Response Plan • Tracked Down Many Interesting Web Sites • Never Found an EH Emergency Response Plan • Realized that Roles & Responsibilities for EHP were not Defined • Training Materials were Lacking

9. Why Are We Concerned • Natural & man-made emergencies/ disasters can occur anywhere and frequently do • Incidents can affect human health, lives and the infrastructure that supports society

10. Hurricane Earthquake Tsunami Avalanche Volcanic Eruption Landslide Fires Tornado Flood Severe Wind Storm Severe Winter Storm Hail Storm Drought Extreme heat List of Hazards-Natural

11. Dam or Bridge Failure Power Outage/Failure Infectious Disease Transportation Accidents Terrorist Conventional Bomb Chemical Terrorism Contaminated Water Supply Contaminated Food Supply Hazardous Material Incident Radiological Incident Biological Terrorism Nuclear Detonation Cyber Terrorism List of Hazards-Man-made or Technological

12. Defining Key Terms • Hazard is any phenomenon that has the potential to cause damage to humans and their environment • Emergency is not a disaster in itself, but an event requiring immediate response • Disaster overwhelms the affected community and requires outside assistance

13. Emergency or Disaster

14. Emergency or Disaster

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

16. Environmental Health Skills • Assessment • Management • Communication

17. Environmental Health Skills (Cont.) • Assessment • Information Gathering • Data Analysis • Evaluation

18. Environmental Health Skills (Cont.) • Management • Problem solving • Project Management • Reporting

19. Environmental Health Skills (Cont.) • Communication • Education • Risk Communication • Conflict resolution

20. General Environmental Health Emergency Response Actions • Primary responsibility for the “health” of a community • Includes basic services such as food safety, water supply, shelter, sanitation & waste management

21. Immediate Environmental HealthEmergency Response Actions • A rapid initial qualitative assessment to collect information needed to begin an appropriate and timely response

22. Food/waterborne outbreak investigation Water safety & supply Food safety Sanitation Mass care Vector control Solid waste Worker Safety/PPE Hazardous waste Household hazardous waste Medical/infectious waste Chemical incident Radiological incident Flood Tornado/wind damage Specific EH Functional or Topic Areas

23. Twin Cities Metro Advance Practice Center Products • Training for EHP • Food Readiness • EH Planning & Practice

24. Target Audience • Environmental Health Directors, Managers, Supervisors • Public health staff responsible for environmental health programs • Front line staff with years of experience and those who are new in the field

25. Unintended Audiences • Other professionals: fire, police, nurses, doctors, emergency management and haz mat responders • Many people do not know or realize what EH brings to the table • They gained an understanding of the role that EHP would have in a disaster/emergency

26. Overview of Products: EH Training • Emergency Preparedness and Response Fundamentals & Putting Principles into Practice (2005) (Available as a CD and on-line) • Disaster Strikes-Environmental Health Responds: Stories from the Field (2007) (Available as a CD and on-line)

27. Emergency Preparedness and Response Fundamentals & Putting Principles into Practice • Lesson 1: Overview of EH Principles • Lesson 2: Communicating as a Key Role for EH Professionals • Lesson 3: Responding to Emergencies/Disasters • Lesson 4: Minimizing Health Implications

28. Emergency Preparedness and Response Fundamentals & Putting Principles into Practice (Cont.) • Three Real World Disasters • Scenario # 1 – Elemental Hg • Scenario # 2 – Train Derailment Anhydrous Ammonia Release • Scenario # 3 – F5 Tornado

29. Disaster Strikes –Environmental Health Responds: Stories from the Field • Interviewed 22 EHP across the country • Learned how they dealt with 9 disasters & 1 emergency • They shared valuable tips, techniques and lessons learned • Experience is a powerful teacher • Focused on 8 EH Core Competencies

30. Disaster Strikes – Environmental Health Responds (Cont.) • Organizational Knowledge & Behavior • Collaboration • Information Gathering • Data Analysis • Problem Solving • Reporting, Documentation, and Record Keeping • Communication • Education

31. Overview of Products: Food Readiness • Emergency Handbook for Food Managers includes a readiness guide and photo lessons (2005) (Available as a hardcopy, CD and PDF in English, Spanish, Arabic, Chinese, Hmong & Somali)

32. Information sheet titled Who to Contact in an Emergency (Released 2005 & Revised 2006). (Available as a hardcopy and PDF in English) Police Dept. Local Health Dept. Insurance Carrier Local Utility Governmental Agency for Chemical Spill/Release Well Water Disinfection Potable Water Supply Waste Mgt Assistance Overview of Products: Food Readiness (Cont.)

33. Overview of Products: Food Readiness (Cont.) • Emergency Readiness for Food Workers Trainer Guide (2006) (Available as a hardcopy and PDF in English)

34. Overview of Products: Food Readiness (Cont.) • Information sheet titled In an Emergency: Discard or Salvage (2005)* • Information sheet titledIn an Emergency: Equipment & Supplies List for Food Service (2005)* * PDFs in English, Spanish, Arabic, Chinese, Hmong, Laotian, Oromo, Russian, Somali & Vietnamese

35. Overview of Products: Food Readiness (Cont.) • Food Safety and Security Self Audit Checklist (2007)* * PDFs inEnglish, Spanish, Arabic, Chinese, Hmong, Laotian, Oromo, Russian, Somali & Vietnamese

36. Overview of Products: Food Readiness (Cont.) • 2005 Baseline Survey on Emergency Preparedness at Twin Cities Metro Food Service Establishments (Available in hardcopy and archived at NACCHO) • 2007 Benchmark Survey on Emergency Preparedness at Twin Cities Metro Food Service Establishments (Work in Progress)

37. Overview of Products: Food Readiness (Cont.) • Clarifies Best Practices • Includes Food Security and Emergency Preparedness

38. Overview of Products: EH Planning & Practice • Solid Waste Management and Highly Pathogenic H5N1 Avian Influenza Virus Decision Tree Guidance Document (Released 2007) (Available in hardcopy and on CD)

39. Overview of Products: EH Planning & Practice (Cont.) • Environmental Health Emergency Response Guide

40. Overview of Products: EH Emergency Response Guide (Cont.) • Describe general and specific response actions that EH personnel would be responsible for in a disaster/emergency • Each topical area includes: • Introduction • Emergency Response Objectives • Priority Activities • Practical Guidance Information

41. Food/waterborne outbreak investigation Water safety & supply Food safety Sanitation Mass care Vector control Solid waste Worker Safety/PPE Hazardous waste Household hazardous waste Medical/infectious waste Chemical incident Radiological incident Flood Tornado/wind damage Overview of Products: EH Emergency Response Guide (Cont.)

42. Overview of Products: EH Planning & Practice (Cont.) • Environmental Health Resource Compendium for Emergency Response

43. Overview of Products: EH Planning & Practice (Cont.) • Hennepin County EH Emergency Response Plan • St. Paul-Ramsey County EH Standard Operating Procedures Annex

44. Sneak Preview • Special Event Planning Toolkit • Community Engagement Food Protection/EP Tool Kit • EH Emergency Preparedness Planning Toolkit • Disaster Simulation Training Module or “Game”

45. Special Event Planning Toolkit Planning process guidance Training materials Training program guidance Inspection process and form Communication protocol/reporting template Mutual-aid agreement and staff identification Tool for estimating agency resource

46. Community Engagement Food Protection/EP Tool Kit • For local EH agencies to use • Engage food service establishments • Increase the capacity of food managers and front-line food workers to protect the food supply

47. EH Emergency Preparedness Toolkit • Package a tool for EH Managers • Ensure that EH Plan is in place • EH Staff are oriented to the plan & available resources

48. Disaster Simulation Training Module or “Game” • Describe the role of EHP in a disaster • Make informed and sound decisions related to preparation, response and recovery efforts • Addresses a flood and a train derailment

50. Brian R. Golob, M.S.,C.H.M.M., R.E.H.S. brian.golob@co.hennepin.mn.us 612-543-5204