Healthy NH Shelters

October 29, 2014

AcknowledgementsShelter Surveillance Work

Group and Exercise Planning Team

Participants – that’s you!

Funding

Thank you!Manchester Health

Department for letting us use their space

American Red Cross for providing refreshments

Healthy NH SheltersExercise BriefingOctober 29, 2014Manchester Health Department

Exercise Scope: tabletop; 2 hours

Mission area: Response

Objectives and Public Health Preparedness Capabilities

Exercise Objective Core CapabilityIdentify the roles and responsibilities of the participating agencies during health surveillance in mass care shelters.

PHP Capability 1: Community Preparedness;

HP Capability 1: Healthcare System Preparedness

Identify all existing laws, plans, policies and procedures related to health surveillance in shelters and how they can be coordinated for a more efficient response.

PHP Capability 7: Mass Care

Exercise Objective Core Capability

Evaluate the guidance, policies, and protocols to implement health surveillance in mass care shelters.

PHP Capability 7: Mass Care;

PHP Capability 13: Public Health Surveillance and Epidemiological Investigation

Evaluate communication flow and information sharing between the shelters, the SEOC and the NH DHHS ICC/DPHS.

PHP Capability 3: Emergency Operations Coordination;

PHP Capability 6: Information Sharing

Assist the shelter with identifying and implementing infection prevention and control measures for the shelter.

PHP Capability 13: Public Health Surveillance and Epidemiological Investigation

Participant Roles and ResponsibilitiesPlayers: Respond to situation presented

based on current plans, policies, and procedures

Observers: Support players in developing responses, but do not participate in moderated discussion

Facilitators: Provide situation updates and moderate discussions

Evaluators: Observe and document player discussions

Exercise Structure2 modulesBreakHotwash & Evaluation Forms

Exercise Guidelines This is an open, low-stress, no-fault

environment. Varying viewpoints, even disagreements, are expected.

Base your responses on the current plans and capabilities of your organization.

Decisions are not precedent setting; consider different approaches and suggest improvements.

Issue identification is not as valuable as suggestions and recommended actions that could improve efforts; problem-solving efforts should be the focus.

Assumptions and Artificialities The exercise is conducted in a no-

fault learning environment wherein capabilities, plans, systems, and processes will be evaluated

The exercise scenario is plausible, and events occur as they are presented

All players receive information at the same time

Module 1: Storm Headless Horseman

Module 1 Objectives (30 mins) Identify the roles and

responsibilities of the participating agencies during health surveillance in mass care shelters.

Identify all existing laws, plans, policies and procedures related to health surveillance in shelters and how they can be coordinated for a more efficient response.

10/22/14 In the news……

ISIS Using Chemical Weapons?

Ebola Quarantine Rules

Will Hawaii’s Volcanic Menace Stop?

10/22/14 – Weather Forecast A major storm with torrential

downpours and heavy winds is expected to hit NH

Worry about power outages and flooding

With Halloween around the corner the storm was nicknamed the Headless Horseman

DiscussionWhat is your agencies role pre-event when bad weather is coming?

Is there anything being done to pre-designate or set-up shelters?

10/23/14 – Storm Headless Horseman hits NH

Heavy rains

High winds

Saturated ground

10/23/14 Flash Flood Watch in effect for

entire state of NH

10/23/14 Multiple vehicle

accidents across state 1 fatality; 5 sent to the

hospital

One person sent to the hospital after trying to clear a fallen tree from his driveway

10/24/14 – after the storm DPW starts to

clear the damage

Flash flood warning goes into effect

Power is out to 300,000 people across NH

10/24/2014 – Shelter Granite State High

School opens a shelter for residents, pets and individuals with functional needs

It is run by the municipality with help from the Public Health Region

10/24/14 – ARC Shelter American Red

Cross sets up a shelter in the neighboring region

DiscussionWhat is your agencies role in

setting up, running or assisting shelters during emergencies?

How can your agency help with surveillance in shelters?

DiscussionAre there

existing laws, plans, policies or procedures that can assist with conducting surveillance in shelters?

Surveillance in SheltersWhen does the surveillance

process start for shelters?

Should any of the surveillance forms be started prior to opening a shelter?

Module 2: Granite State High School Shelter

Module 2 Objectives (70 mins) Evaluate the guidance, policies, and

protocols to implement health surveillance in mass care shelters.

Evaluate communication flow and information sharing between the shelters, the SEOC and the NH DHHS ICC/DPHS.

Assist the shelter with identifying and implementing infection prevention and control measures for the shelter.

10/25/14 Power outages

expected to be out for approximately 7-10 days

Flooding severe in some places and people can’t return home

10/25/14Both shelters are filling up

quicklyGranite State High School

shelter 120 residents 30 volunteers/staff during the day 15 volunteers/staff at night 1-2 medical staff available each

shift

Granite State High School

Number Category Numbe

r Category

68 Females 52 Males

35 Families w/o children

14 Families w/children

1 Service Dogs 10People with durable medical equipment

2 Group Home adult residents

2 Group Home staff

30 Shelter staff – day shift

15 Shelter staff – night shift

Discussion Who oversees surveillance and

infection control in shelters?

Who would be tasked to contact the state to report outbreaks or communicable diseases?

Who is responsible for triage at the shelter?

DiscussionWhat

communication pathways exist between shelters (including ARC shelters) and the state?

10/25/14 Granite State High School is working with

the municipality and giving updates on shelter counts and issues to the LEOC

Shelter mentions that they may need help with medical supplies for some of the residents from the group home

The residents from the group home brought some yummy delicious Halloween cupcakes they made before the storm hit and shares them with everyone….they are so nice!

SEOC to GSHS The SEOC ESF-8

reaches out to the GSHS to check-in and asks if they have started to conduct surveillance using the forms

GSHS didn’t know they were supposed to fill out forms

DiscussionHow can the GSHS access the

forms?

What can the SEOC do to assist the shelter?

How can the shelter get the forms to the SEOC daily?

DiscussionWho keeps track of the

summary forms and monitors for trends?

If a possible outbreak is identified, who assists?

10/26/14 – 10/28/14 GSHS has been

filling out the summary form and sending it to the NH DHHS ICC email address daily

10/28/14 – Concord, we have a problem

10/2

6/20

14

10/2

7/20

14

10/2

8/20

14

10/2

9/20

140

2

4

6

8

10

12

14

5

12

1

VomitingDiarrheaFever

DiscussionWhat is the problem?

Who gets notified?

Who takes control of the outbreak investigation?

Discussion What additional information is

needed from the shelter?

What measures are given to the shelter to try to stop the outbreak?

What actions should have been taken before this started to prevent it?

Back to the cupcakes… Two of the ill residents are

from the group home and one of the ill residents is a staff person from the group home.

Investigation reveals that all the ill residents ate the cupcakes

One resident is transported to the hospital for dehydration and test results point to norovirus

American Red Cross Shelter If this same situation happened at

an ARC shelter: Who is notified?

Who is in charge of notifying the state of an outbreak situation?

What ARC resources are available to help mitigate the situation?

Remaining Thoughts?

HotwashStrengths

Areas for Improvement

Thank you for coming!Please fill out your evaluation form before you leave!