Polk County Special Populations Planning

Jay Shrader, DirectorWestern Region Partnership for Public Health Preparedness

Kathy Poirier, DirectorPolk County Emergency Management

Rick Gates, Veterans Service Officer Polk County Veterans Affairs

Polk County Population: 43,886 Age Distribution

Under 5: 5.9% (6.4) Under 18: 26.2% (25.5) Over 65: 15.1% (13.1)

Persons below poverty: 7.1% (8.1) Persons per square mile: 45.0 (98.8) Persons with a Disability (age 5+): 6,860 (790,917) 8 Public Schools, 3 Parochial, 3 Medical Centers 45 Minutes from MPLS Largest Municipality: 2,000+ 2 radio stations, no daily newspapers 400 lakes and rivers – heavy tourist area

Objectives Provide overview of the Polk County

Special Needs Plan for Disasters and Emergencies

Provide overview of the Polk County Special Needs Registry

Discuss successes, unexpected findings, and barriers

The Catalyst… Following Hurricane

Katrina, Governor Doyle ordered evacuation plans

CDC / HHS placed great emphasis on special populations planning

After Action Report from recent exercises

Media and stakeholder’s inquiries forced action

Polk County resident approached County Board Chairperson

The Process Process took from May - November of 2006 Established and received buy-in from core

committee: EM, PH, VA, HS, Home Care, Aging Research and fact finding

Seminole County EM, Florida Community engagement

12 meetings; 120 participants Business, government, special needs individuals

Plan and Registry reviewed and signed into County EOP in November 2006

Registry live in December Website Developed with on-line registry

www.co.polk.wi.us/emgt

The Plan Goal: Reach everyone in a

community!!!! Push vs. Pull Communication Shelter-in-Place vs.

Evacuation CDC Categories: Economic

Disadvantage, Limited Language Competence, Disability, Cultural / Geographic Isolation, Age, and Pets/Animals (Added by Committee)

The Plan Category, Subset, Point of Contact,

Barriers to Reach / Concerns, Estimated Population Size, Communication Mechanism, Location, Action Needed

The Registry Result of planning process – Committee

driven Intended for individuals with severe health

and medical needs Purpose of Registry is two fold:

1) Special needs can self-identify2) Emergency Responders have data to foster

effective response Both on-line and paper applications 2006 Planning Year; 2007

Implementation, Testing, Exercising; 2008 Updating and Revising

Registry has 18 individuals thus far

The Registry Disclaimer, disclaimer, disclaimer on forms,

posters, website, etc: The Registry is a voluntary program and in no way ensures immediate or preferential treatment in an emergency. Individuals must have their own individual plan for the first 48-72 hours of an emergency.

Information to be used only during an emergency.

Corp Counsel reviewed legal and liability issues including HIPPA (based on HHS Memo re: Hurricane Katrina and voluntary approach)

HHS Memo re: HIPPA

Registry EligibilityThe Registry is for those individuals who are not in a care facility, such as a hospital, nursing home or congregate living facility. These facilities are required to have an evacuation plan in place for their residents and patients to be transported to another healthcare facility. The Registry is for individuals who are not part of a group facility and have no other alternative but to seek assistance from the County. 

Must be a Polk County resident. Individuals, who due to mobility restrictions, require

assistance of others with medical management activities of daily living and basic needs, when that assistance may be unavailable during an emergency or disaster.

They have a respiratory condition requiring special equipment such as monitors or oxygen.

There may be other conditions which would render an individual eligible for special needs emergency sheltering and these will be considered by the review of the registration form by a Review Team. 

The Registry Operations FlowSpecial Needs Registry

Application

Completed Paper and mailed in

Completed On-Line – Applicant information

downloaded into Special Needs Registry database

Email Notification Sent to Emergency Management

Emergency Management Receives

Instant Email Verification Receipt sent to Applicant

EM sends applicant letter confirming receipt of letter

EM and PH convene Review Team

Application Denied Additional Information Needed

EM sends out letters and other resources

Application Approved – Level assigned

EM updates registry Review Team member contacts applicant for

additional info

The Registry at Work During an incident, EM will query the

database to determine affected population. EM will notify ER partners via phone, email,

dispatch, radio or fax of special needs population in geographical area. EM may work with local PH to develop a Command Caller Scenario.

EM or designee will attempt to contact individual or emergency contact of the incident and provide/receive status.

ER community will use data to establish an effective response.

Other Issues Cost: In kind support of approx

$600.00 per year for materials Staffing: EM Director manages

logistics; Review Team oversees operations

Maintenance: registrants must update application annually

Training: training to ER responders on the registry and ethical considerations when dealing with special populations (section in plan)

Registry Levels of EnrollmentDetermined by Review Team:

Level 1: Requires urgent attention. Individual’s medical information indicates immediate emergency response assistance is necessary for survival.

Level 2: Requires moderate attention. Individual’s medical information indicates an eventual emergency response is necessary but is not considered immediate or life-threatening.

Level 3: Requires little attention. Individual’s medical information indicates there is no immediate attention required. However, if time and resources permit, the individual should be contacted by emergency responders.

Not eligible for the program.

Registry Examples: Level 1 45 YR Male: Live with spouse; hearing

loss, end stage renal failure (life sustaining equipment)

65 Yr Male: lives alone; severe diabetic, left leg amputated, wheelchair, partially deaf and blind, insulin dependant

44 Yr Male: Lives alone with caregiver; gun-shot in chin, paralyzed from neck down

Registry Examples: Level 2, 3 Level 2

90 Yr Female: lives alone, blind Level 3

74 Yr Male: lives with spouse, cancer of the stomach (removed), g-tube feeder; special dietary needs

To be reviewed 36 Yr Female: lives alone, brain cancer,

diabetes, kidney disease, seizures, wheelchair bound

63 Yr Female: lives with sister, quadriplegic, insulin dependant, brain injury, life sustaining medications

Website FAQ

Online Application

Paper Application

Registry Poster

Letter Sent

Resource Sent

What worked? Core committee very dedicated Support from administration and

department heads Community buy-in and participation Debate is healthy… we’re a very

healthy committee! In-kind support (IT, Corp Counsel,

EM, VA, PH, Home Care, Aging) It’s working, so far!

Barriers Defining Special Populations Levels of Enrollment in Registry need to be

more defined Must have same individual (s) facilitate the

process from A to Z Must have same agency reps in process

from A to Z Time consuming – resource intensive Long term commitment unknown yet Marketing Getting people signed up Equal workloads among players!!!

Unexpected Findings Positive public perception of local

government Cohesion among community agencies

and governmental departments Excitement and enthusiasm Interest among counties across WI

Next Steps MOU’s with

participating agencies

Establish Line of Succession

Continue Outreach Training / Education

GIS (Geographic Information Services)

Exercise

Questions? Jay Shrader

jasons@co.polk.wi.us(715)485-9116

Kathy Poirierkathyp@co.polk.wi.us(715)485-9280

Rick Gatescvso@co.polk.wi.us(715)485-9244