Welcome to Greene County Medical Center

Annex E - Resource Management

ACCESS TO RESOURCES
When the capabilities of the county public health agency are inadequate for it to continue to perform the services needed to protect the health of the public, the agency may obtain personnel, equipment, supplies, and other types of resources from other jurisdictions through the use of a mutual aid agreement, such as a “28E” agreement.16
Limited state government assistance, including consultation about technical topics, may be available to LPHAs directly through IDPH. In many instances, however, the LPHA will need to work in cooperation with its local emergency management agency to:

Access the resources of other Iowa jurisdictions through the state mutual aid compact17 process;

Access municipal, county, and state government resources; and

Access federal resources, such as pharmaceuticals or smallpox vaccine through the Strategic National Stockpile,18 which are requested from the federal government through state government.

Note that before these three channels for obtaining assistance can be accessed, the county's senior elected official(s) must formally declare a state of emergency.

Important note:  Under some circumstances, such when a county emergency management agency is not accessible, LPHAs may contact the IDPH Center for Acute Disease Epidemiology directly at its 24-hour number (800-362-2736) to request state and federal resources needed to respond to an emergency.

Iowa law  (section 135.150, currently found in House File 396):
"PUBLIC HEALTH DISASTER" MEANS A STATE OF DISASTER EMERGENCY PROCLAIMED BY THE GOVERNOR IN CONSULTATION WITH THE DEPARTMENT PURSUANT TO SECTION 29C.6 FOR A DISASTER WHICH SPECIFICALLY INVOLVES AN IMMINENT THREAT OF AN ILLNESS
OR HEALTH CONDITION THAT MEETS ANY OF THE FOLLOWING CONDITIONS OF PARAGRAPHS "A" AND "B":

A.  IS REASONABLY BELIEVED TO BE CAUSED BY ANY OF THE FOLLOWING:
(1)    BIOTERRORISM OR OTHER ACT OF TERRORISM.
(2)     THE APPEARANCE OF A NOVEL OR PREVIOUSLY CONTROLLED OR ERADICATED INFECTIOUS AGENT OR BIOLOGICAL TOXIN.
(3)    A CHEMICAL ATTACK OR ACCIDENTAL RELEASE.
(4)    AN INTENTIONAL OR ACCIDENTAL RELEASE OF RADIOACTIVE MATERIAL.
(5) A NUCLEAR OR RADIOLOGICAL ATTACK OR ACCIDENT.

B.  POSES A HIGH PROBABILITY OF ANY OF THE FOLLOWING:
(1)    A LARGE NUMBER OF DEATHS IN THE AFFECTED POPULATION.
(2)    A LARGE NUMBER OF SERIOUS OR LONG-TERM DISABILITIES IN THE AFFECTED POPULATION.  (continued next page)
(3) WIDESPREAD EXPOSURE TO AN INFECTIOUS OR TOXIC AGENT THAT POSES A SIGNIFICANT RISK OF SUBSTANTIAL FUTURE HARM TO A LARGE NUMBER OF THE AFFECTED POPULATION.

"Public health declaration" at the state level occurs when the Governor formally proclaims a disaster emergency.  This can be for any type of disaster, not just one involving public health.  These powers of the Governor are defined in section 29C.6 of state code (see website for more details: www.legis.state.ia.us/IACODE/2003SUPPLEMENT/29C/6.html).

“Public health disaster” The Governor would only declare this under the advisement of the IDPH director.   So, a proclamation is used to officially announce that the state or designated counties within the state are under a public health disaster, provide the reason(s) for the proclamation, and list what resource(s) will be made available.  The two things (i.e., a PH declaration and a PH disaster) really go hand in hand.

A Governor's proclamation of disaster emergency needs to be made to obtain inventory through the SNS.

At the local level, a public health declaration is made by the chief elected official of the jurisdiction to which that declaration is to apply.  A mayor for a municipality, or the Board of Supervisors for a county, may declare a public health disaster after consulting with the LPHA.  It is generally necessary to obtain a declaration if material resources need to be requested from entities outside of the jurisdiction, such as from another county or from the state.  Note that declaring a disaster at the municipal or county level does not guarantee that any additional resources will be made available from any level of government, including the state.  It is just a preliminary step that paves the way for this to occur, should such resources become available and should the jurisdiction be eligible for them.

"Public health emergency” is a more general term than the others discussed so far, and does not have a specific, standard definition.  This is any set of conditions that a jurisdiction's public health authority considers a serious threat to the health of those members of the public it has a responsibility to protect from harm.  This applies to pathogens (i.e., biological agents and the products of these agents), but also could apply to nuclear, radiological, and chemical threats/incidents, provided they put the public at risk.  Using this term has advantages and drawbacks.

"Bioemergency" is a situation in which a pathogen poses an immediate and severe threat to the lives or health of people in Iowa, to the extent that day-to-day operations of public health authorities are insufficient to address this threat.   This definition is narrower than what would be considered a public health emergency since it does not include nuclear, radiological, and chemical threats/incidents.

Regulatory Compliance:
The PH department will address and resolve all licensure, permit, and certification issues that could arise during an emergency through communication with the EOC and state/federal agencies.   The department staff will obtain legal interpretation and advise from the GCMC appointed attorney and/or the county attorney regarding public health laws.

See also GCMC policy on emergency credentialing of staff.

The following are a few essential resource management activities for the management of facilities, supplies, equipment, & staff, and the tracking of expenditures:
Coordination by the ICS Logistics Officer to rapidly obtain (through purchase or contract) necessary services or resources.  This includes acquiring and maintining the necessary supplies, equipment and personal protective equipment that may be needed.  The Logistics officer will work with Planning and Operations Officers to determine availability of facilities that may be needed during an emergency public health response.  MOUs are in place for potential POD locations in the county.  After the recovery effort is complete, the Logistics Officer will ensure that borrowed resources are returned to the lender in good condition and that purchased resources are paid for in a timely manner.

Coordination by the ICS Finance Officer to identify, document, and track expenditures during an event.  This includes keeping track of where equipment and/or supplies are borrowed from or purchased; tracking of personnel hours devoted to emergency-response-related activities (this include volunteer hours); tracking the location of personnel, equipment, and supplies during all phases of the response; and maintaining an accurate accounting of all emergency-response-related expenditures;

Rigorous performance of these activities throughout the response period will minimize problems with obtaining disaster-related financial reimbursement from the federal government (when available), and will also provide valuable data for future planning purposes.

Source website for the forms that would be filled out during the recovery phase of a declared emergency regarding assets received or expended: www.fema.gov.publicassistance.

Go to the Doc Net forms section. You will have to download Surfer to obtain the forms. She specifically noted the forms Force/Account Labor and Force/Account Equipment as being applicable. These forms are downloadable to any computer and also can be printed out readily for use as hard copy.

The forms Homeland Security mentioned as being helpful are:

FF90-123 Force Account Labor

F90-127 Force Account Equipment,

FF90-124 Materials Summary for expended resource tracking.

FF90-125 Rented Equipment Summary Record for tracking use of other agencies' borrowed equipment or outside vendor rented equipment.

A bio-emergency often will not be confined to a single jurisdiction, and may affect the entire state. Therefore, county public health agencies should not rely entirely on the possibility of obtaining additional resources from other jurisdictions or from state or federal government. If practicable, each agency should maintain a stock of supplies sufficient to carry out essential functions under emergency conditions for three to five days, or until such time as it is reasonable to expect replenishment of these supplies from normal channels, such as vendors. Supplies to consider stocking include, but are not limited to, those listed on the following page.

See also the Point of Distribution (POD) plan.

Attachment 1 – Emergency Supply Stockpile for Greene County Medical Center Public Health

Attachment 2 – Critical Supply Vendor List

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