Welcome to Greene County Medical Center

Annex B - Communication

PURPOSE
To describe the system for providing information to the general public through the media and other information outlets, to maintain an uninterrupted flow of information among response partners during a bio-emergency, and to facilitate communication among federal, state and local agencies about:

1.Disease characteristics and spread;
2.Recommendations for and availability of vaccines, antivirals, and other treatments; and
3.Other recommended health measures.

SITUATION
Timely, relevant, and accurate communication during all phases of a bio-emergency is critical for an effective response operation.  Key recipients and/or providers of information during a bio-emergency include public health officials, government officials, health-care providers, the media, and the general public.

1.Different types of information will have to be communicated (e.g., requiring a response v. informational, technical v. general), often to different target audiences.
2.There will be widespread circulation of conflicting information, misinformation, and rumors.  To alleviate this, communication must be coordinated among all relevant agencies to ensure consistent messages to the general public.
3.There will be a great demand for accurate and timely information, including:

a.The number of ill, their identities (will be requested by family members), and their locations;
b.Disease complications and mortality rates;
c.Disease control efforts, including availability and use of vaccines, antivirals and other preventive and treatment measures;
d.“Dos and Don'ts” for the general public; and
e.Availability of essential community services.

4. There will be a need for information for the general public about how and why a priority group list for receipt of vaccine/pharmaceuticals was developed, if such a list is indeed developed.   In the event of shortages, the targeted group may have to be further prioritized.  Information should include the rationale for the list, how the decisions were made, and what other control measures people can take until vaccine and/or antibiotics are available for everyone.
5. Public education will be an important part of the immunization/ pharmaceutical campaign because it is likely that the following problems will be encountered:

a.Any symptom or illness that occurs soon after vaccination may be attributed to the vaccine and any febrile respiratory illness that occurs post-vaccination may be viewed as vaccine failure.
b.Prophylactic antibiotics/antivirals may need to be taken for a period of up to 60 days and the recipient will need clear instructions on how to complete the course of treatment and where to get additional doses of antibiotics/antivirals.
c.Concerned and potentially exposed persons (sometimes called the “worried well”) may unnecessarily access the health-care system, thereby placing it under additional strain.

6. Certain groups will be hard to reach, including people whose primary language is not English; people who are homeless; people who are hearing, vision, and/or mobility impaired; the frail elderly; people with mental impairments; etc.
7. During a prolonged bio-emergency, such as an influenza pandemic or other highly contagious disease outbreak, demand for medical information will be so great that existing methods for educating health-care providers will have to be expanded.

STATE COMMUNICATION RESPONSIBILITIES

Iowa Health Alert Network (HAN)
The system and infrastructure to manage the flow of critical information among relevant state and local public health agencies and other emergency response partners will be provided through the Iowa HAN, a system designed to facilitate communication and ensure a coordinated response to an unexpected public health emergency.  All relevant agencies will have:

1.Around-the-clock secure access to critical, up-to-date data; and
2.The ability to disseminate information immediately via a web-based system.

When applicable, messages will include instructions on where and how to access additional information.

LEVELS OF ALERTS AND MODE OF DISSEMINATION:

Low-Level Alert
Purpose: Routine messages from Iowa HAN contain information related to the grants, procedures, notices about upcoming meetings or events, and update information about health threats and concerns. Routine messages from the Homeland Security and Emergency Management Division or other agencies may be disseminated as well.

Recipients: Low-level alerts are sent to the appropriate disciplines such as Local Public Health Agencies (LPHA) and hospitals.

Mode: Usually sent by e-mail only.

Medium-Level Alert
Purpose: This category includes most of the health alerts you receive from Iowa HAN.  Included is information about a health threat that may or may not include recommendations for action beyond your agency.  Typical medium level health alerts include such things as a measles case, an event that may be featured in the media and cause public concern, or an outbreak of food borne illness.

Recipients: Medium level alerts are sent to the appropriate discipline and the Homeland Security and Emergency Management (HLSEM) Duty Officer and LPHA.

Mode: Usually sent by e-mail.  Pagers may be used if notification must be timely.

High-Level Alert
Purpose: If a health threat is extremely serious in nature, threatens a large population, and/or requires immediate action, it will be sent as a high-level health alert.

Recipients: High-level alerts are sent to the appropriate discipline as well as HLSEM Duty Officer, LPHA, and Hospitals.

Mode: Sent by pager and email. The message on the pager will, in most cases, alert you that an email message has been sent.

Expected action upon receipt of an alert unless specifically requested, there is no need to acknowledge receipt of the message.

In most cases, the alerts are sent for information and no action is required.  There may be situations, however, that require activation of local emergency plans, or a portion thereof.  Such situations are dictated by the plans, operating procedures, and/or policies.

HAN System Update
The IDPH, in cooperation with several local and state agencies, is in the process of implementing the web-based health alert notification portion of the system.  This system will allow over 1200 users to notify partners of potential or real health concerns and emergencies via email, pager, text messaging, telephone, fax, and cell phone.  Additionally, the system will serve as a public health directory for the users and will have collaboration features to share documents.  It is anticipated that this system will be operational by the end of 2003.  A rollout of the system and several training sessions will be held across the state in early 2004.

In an effort to have a more redundant system, IDPH and a private Iowa vendor are in the process of installing an 800 MHz digital, trunked radio system in each of Iowa's 117 hospitals, University Hygienic Lab, Iowa Poison Center, State Emergency Operations Center, and IDPH offices in Des Moines.  Plans to expand the system to the 99 local public health agencies in 2004 are being explored.

The HAN / Disease Reporting Committee will serve in an advisory role during implementation, testing, and operations of the HAN system.  Policies and procedures for the HAN system, as well as a Continuous Quality Improvement program, will be established with active input by this committee and assigned work-groups representative of the six planning regions, hospitals, laboratories, local public health, and the medical community.

Redundant communication systems include:
1.E-mail messages – Should be supplemented by a pager notification when the message requires an immediate response or is otherwise of an urgent nature.  NOTE:  This is the primary means of notification until HAN is in operation.
2.The Iowa Online Warrants and Articles (IOWA) System – Provides access, through public safety answering points (PSAPs) to local contacts designated to receive information during bio-emergencies.  NOTE:  This is a backup system only, to be used only when other alternatives are not available.
3.The IDPH web site – For fact sheets and guidelines on control measures, epidemiologic information appropriate for the public, and links to CDC informational sites, access the Center for Acute Disease Epidemiology page at:
http://www.idph.state.ia.us/eedo/cade.asp
4.The IDPH Center for Acute Disease Epidemiology on-call staff – Available 24/7 to respond to inquiries from public health and health-care providers about disease reporting at 800-362-2736.  If the inquiry involves a suspected or known terrorist act, call 866-834-9671.
5.Mass mailings/faxes – IDPH maintains databases of LPHAs, health-care providers, hospitals, and other health-care agencies/facilities.
6.Newsletter articles – For example, as published in regular and emergency editions of the Iowa Health Focus Newsletter or in the Friday Update (both distributed electronically by IDPH).
7.Scheduled Conference Calls with Local Officials- The LPHA will participate in IDPH calls to the counties for specific direction and information.

For more information...

Please contact Tom Boeckmann, Health Alert Network Officer.

Office: 319.472.5340
Fax: 319.472.5642
Cell: 515.201.8733
Pager: 515.234.6827
Email: Tom.Boeckmann@idph.state.ia.us

IDPH EMERGENCY 24-HOUR NOTIFICATION NUMBER – 1-866-834-9671

Other State Responsibilities for Communication
During a bio-emergency, the Iowa Department of Public Health (IDPH) Center for Acute Disease Epidemiology, will have primary responsibility for:

1.Collecting and interpreting surveillance data, and disseminating this information to federal, local and other state agencies, hospitals, and other health-care providers.
2.Providing up-to date information on the bio-emergency to other bureaus/programs within IDPH.
3.Developing and disseminating guidelines for preventing, diagnosing, and treating infectious diseases to:

a.Local public health agencies;
b.Hospitals (specifically hospital administrators, physicians, hospital disaster coordinators, emergency department directors, infection control practitioners, and hospital epidemiologists);
c.Other health-care providers.

4.Ensuring that all residents of the community, including special needs groups, have access to appropriate, accessible, and understandable information about disease control measures and available treatment services by performing the following activities:

a.Developing informational materials for all non-English speaking populations residing in Iowa that are large enough to justify such an undertaking;
b.Identifying and working with non-English media (communities with non-English speaking populations should consider having pre-scripted information in their languages as part of this annex);
c.Utilizing all programs within the department that serve populations for which the primary language is not English, or that serve other special needs groups, such as people who are homeless, people who are homebound, etc.;
d.Utilizing the programs and services of all other applicable state government agencies, including but not limited to the Department for the Blind, the Department of Human Rights, the Department of Elder Affairs, the Department of Education, etc.;
e.Identifying groups who can advise public health and health-care providers on the subject of making information accessible to people who are vision or hearing impaired.

LOCAL COMMUNICATION RESPONSIBILITIES

Local Public Health Agency
During a bio-emergency, the local public health agency director, or a designee, will have primary responsibility for:

1.Meeting with the jurisdiction's public information officer (PIO) to review this annex, the Communication/Public Information Annex of the local multi-hazard emergency response plan, and any other applicable emergency communication plans and procedures.  The local PIO should monitor the situation and be prepared to respond to public and media requests for information.
2.Working with the local PIO to set up a local joint information center to coordinate the development and dissemination of timely, accurate information to the general public, consistent with information provided by the local EOC, IDPH, or in the event of a statewide emergency, the State Joint Information Center (generally located at the State Emergency Operations Center, or SEOC).
3.Ensuring that the local joint information center includes multi-line phone banks for answering calls from the public and redundant communication systems in case the phone lines are down.
4.Releasing information through the local joint information center concerning what volunteer goods and services are needed, if any, and where volunteers and donors may go to deliver such goods or services, if applicable.
5.Providing key response partners, such as hospitals and law enforcement agencies, with around-the-clock access to designated agency personnel.
6.Gathering all records kept during each phase of the incident and preparing a chronological summary of events, actions taken, inquiries made, and responses given.  This includes collecting newspaper clippings and TV videotapes, if available, to assist with debriefings and to provide a historical record.
7.Surveying the local media for suggestions to improve the emergency communications process for future bio-emergencies.

Local Public Information Officer
All news releases to the local media should be handled by the authorized PIO and should be consistent with information put out by state government's public information officer and by spokespeople from other affected entities, such as hospitals, schools, and businesses.  The following page provides some additional PIO considerations in checklist form.

Communication networks, equipment and back-up systems are in place at County EOC locations at the Law Enforcement Center, the Greene Co. EMS office.  Networks are also in place at GCMC for hospital and PH EOC purposes.

In addition, see also the GCMC public health risk/crisis communication plan that follows after page 26.  The communication systems are tested and exercised at least annually.

Checklist for the Public Information Officer during a bio-emergency:

Ensure that all information is clear, confirmed, and approved by the appropriate authority before releasing it to the media or public. Do not release unconfirmed information or speculate on the extent of the emergency, despite repeated urging by reporters to do so. Never hesitate to say, “I don't know, but will attempt to find out.”

Monitor news programs and review news articles for accuracy. Correct serious misinformation whenever possible.

Establish a joint information center/media center and provide sufficient staffing and telephones to handle incoming media and public inquiries and gather status information. This center should have access to clinicians for consultation and referrals.

Provide public information according to pre-established priorities.

Ensure that official spokespersons are thoroughly briefed about all aspects of the emergency.

Keep the local public health agency director informed of all media actions taken or planned.

Keep public information officers in other jurisdictions and at other government levels informed of information released.

Maintain a log and a file for all information received and released.

Release emergency instructions/information to the public as necessary. (Closing of public facilities, where to get vaccine, etc.).

Release prevention, control, and treatment information, as appropriate.

Respond promptly to media and public calls.

Widely publicize a public inquiry telephone line number when operational.

Attend periodic briefings and planning sessions.

Consider additional methods of distributing emergency instructions.

Arrange media briefings/press conferences on a regular or “as needed” basis.

Prepare news releases at regularly scheduled intervals, whenever practicable.

Provide emergency information in foreign languages, as required to serve all significant non-English-speaking sectors of the population.

Release morbidity and mortality figures in a timely manner.

Attachment 1 – Media Contact Listings

Attachment 2 – Communication with Special Needs Groups
LPHAs should identify groups in their communities that will require special efforts to ensure that they receive all the information necessary to protect them during a bio-emergency. Outreach conducted during the pre-emergency period will ensure that channels are in place to facilitate communication with special groups during a real emergency. Special groups include non-English speaking populations, the hearing or vision impaired, the homeless, etc.

US Patent Numbers 7,720,998 B2, 7,836,207