Orientation

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					                   Welcome to the Quarterly Progress Report
The Quarterly Progress Report will serve as the primary deliverable for public health emergency preparedness funding received from
DPHHS. The Department has developed this reporting tool in an effort to standardize the way in which completed activities are
reported, minimize the workload in documenting activities, and eliminate confusion about the key elements to report upon. It is
quantifiable so that we will be able to easily aggregate the data and get you information about how the rest of the state is doing in
comparison to your jurisdiction. We hope this tool accomplishes those goals and feedback about using it is always welcome. Please
provide feedback about using this reporting tool in the space provided on the last tabbed worksheet.
This template is to be used for reporting your activities for Quarter 2 of the 2006 Grant Award year. This activity/reporting timeframe is
December 1, 2005 - February 28, 2006. Similar templates, along with the full guidance, will be provided to you for Quarters 3 and 4
within two weeks of the beginning of each quarter. These reports must be completed quarterly and submitted to Sandy Sands. The
second quarter's report is due no later than February 28, 2006. If you have problems using Excel or filling out the sheet, look
at the "Tips" tab for helpful hints on how to manipulate the worksheet.
The format for reporting each major area of work is meant to be straight-forward and self-explanatory. Where possible, check boxes
have been provided to support simple answers. The Administration tab reflects the general contract expectations and requirements.
Each sheet or tab on the bottom of this Report represents a major area of work. The title of each major work area will be outlined in
yellow at the top of the page. An overview or goal may be provided for the work area and it will be represented in peach. Instructions
that apply to the individual worksheet will be highlighted in green. Each of the items in the Quarterly Report ties directly to a critical task
in the grant application. Each individual element or question is outlined in lavender and has a number associated with it in the far left
margin. The far right column provides a short overview of the guidance necessary to complete the reporting element or will provide a
referral to the full guidance document. In most cases the quick guidance is sufficient. If more elaborate guidance is warranted, full
guidance will provide you with all of the information or tools necessary to complete the work.
This report is for Quarter 2 activities only; future Quarterly Reports will be very similar in content and format. Some activities from
Quarter 1 may still be listed if the activity could be reported in more than one quarter or if it is a recurring activity. You may submit this
We hope you enjoy using this method of reporting your and submit the completed health emergency preparedness and response.
Report electronically; however, you may also print it out accomplishments in public paper form.
Feel free to provide feedback on the "Feedback" tab about how to make this process easier and more meaningful to you. Thank you
for your continued efforts!




1st Quarter Progress Report                                         Pg 1 of 14                                              Due November 30, 2005
                                                             GENERAL GRANT REQUIREMENTS


GOAL: Review the contract and deliverable guide or additional guidance quarterly and meet the following general requirements. This is intended to
be a reference to the services portion of the contract. These will be met through completion of the quarterly report and other stand alone deliverables.
Collaborate with a broad-based coalition of agencies and organizations involved in emergency preparedness and response in the conduct of the
services and development of the deliverables in this Task Order. The Contractor shall work with an existing coalition if one is in existence (such as a Local
Emergency Planning Committee or Tribal Emergency Response Commission), or should convene such a coalition with a membership that represents, at a
minimum, the following agencies and organizations: hospital, health care provider, emergency medical services, disaster and emergency services personnel,
public works, public safety, schools, policy makers, law enforcement, Tribal and Indian Health Services.

Participate in development and implementation of county and multi-county schedules and systems for regular exercise of response plans with all
appropriate partners. The local public health agency is encouraged to be a part of the overall disaster and emergency response system and participate in local,
regional and state exercise activities to reduce duplication of effort, create efficiencies and enhance collaboration, coordination and overall readiness.

Ensure attendance and participation by at least one representative of the local public health agency at DPHHS-sponsored training, technical
assistance opportunities and meetings to discuss public health emergency preparedness and response and asset planning and regional planning efforts.

Participate in local, regional and state emergency preparedness and response planning meetings, including those sponsored by Montana Disaster and
Emergency Services and other emergency response organizations.

Assure adequate staffing to complete all services and deliverables required in this Task Order. The Department suggests minimum staffing specifically
dedicated to execution of this Task Order, at the following levels: .5 FTE for jurisdictions with populations of 5,000 or less; 1.0 FTE for jurisdictions with
populations of 5,000 to 20,000, and 2.0 FTE for jurisdictions with populations of 20,000 or more.

Collaborate with the Department staff and all affiliated contractors.

Submit to the Department’s liaison listed in Section 8 (county) or Section 20 (tribal), the deliverables as outlined and described in the Public Health
Emergency Preparedness Deliverable Guide (Attachment A) provided by the Department and incorporated by reference in this document. Deliverables must be
completed by due dates noted in the Guide, or by negotiated due date as described in Section 5, Source of Funds and Funding Conditions.

Communicate on a regular basis with Department staff. The Contractor can expect to communicate with project staff by phone, fax, e-mail, mail, etc.

Provide performance, activity and fiscal reports required by the Department as outlined and described in provided guidance.
Notify the Department by July 1, 2006 if the Contractor will not be able to complete any or all deliverables outlined in Attachment A so that funds can be re-
distributed to other projects in a timely manner.
Comply with Administrative Rules of Montana regarding the reporting and control of communicable disease (ARM 37-114-101 – 37-114-1016).
                                         EVALUATION OF REPORT AND PAYMENT FOR ACTIVITIES
GOAL: This section reflects DPHHS's review process for the Quarterly Progress Report and the disbursement of payments for the work
delivered as evidenced by this Quarterly Report.
The subject matter expert at DPHHS who developed the guidance and measures for each major area of work is identified at the top of
each sheet. The subject matter expert will serve as the point-of-contact for clarification of the guidance and expected tasks. Upon receipt
of this Progress Report, each subject matter expert will review and approve their section of the Progress Report; this review will be
conducted within three weeks of the due date of the Report.
Payment will be disbursed when all sections of the Progress Report, as well as any other stand alone deliverables, are approved by
DPHHS subject matter experts. Because this is a new format, payment for Quarter 1 will be made to all jurisdictions, in full, once reviewed
by DPHHS. This will occur within 30 days of the due date for the deliverable. Should report activities for a major area of work not meet the
approval of the subject matter expert, deficiencies and suggested corrections will be communicated to the contract liaison for that section
of work. The subject matter expert will work with the contract liaison to resolve the deficiencies to both parties' satisfaction. Should the
deficiencies not be resolved, future quarterly payments will be withheld until those deficiencies are resolved. In the event that the contract
liaison feels that penalties have been unfairly assessed or feels that the deficiencies have been suitably corrected, the contract liaison may
appeal the withholding of funds to the Public Health System Improvement and Preparedness Bureau Chief.
                                                  COMPUTER TIPS FOR FILLING IN THE WORKSHEET

                               (How to do the "little" things and other stuff that drives you crazy about this worksheet)

This section is not meant to replace formal training in using Excel - we simply offer some of these hints and tips in response to your feedback
                                                 about filling in previous versions of this report.

                     Problem/Question                                                            One Way to Solve It
How do I put text in one of the boxes that asks for it?     Double-click your left mouse button over the text in the box where it says to enter text. This
                                                            will put your cursor directly in the box and you can see the text as you enter it.
How do I put text in one of the boxes?                      Single click your mouse on the box you wish to enter text into. Your text will show up in a box
                                                            above the yellow title box. You can move your cursor up to that box and double click your
                                                            mouse button there to edit or enter your text.
Checking yes/no boxes                                       Roll your mouse cursor over the check-box and it should turn into a "hand" shape. When the
                                                            cursor is a hand, one left mouse button click will check the box for you.
Making boxes bigger so my text fits                         The boxes that require text should automatically expand to fit your text. If it doesn't, click
                                                            somewhere else other than the box you are trying to enter text into. Then move your cursor
                                                            to the far left of the screen where the grey numbers are showing - making sure your cursor is
                                                            directly under the number that corresponds to the line (row) that contains the box you want to
                                                            make bigger. Your cursor will turn into a double headed arrow. When it does, hold down
                                                            your left mouse button and drag it downward to enlarge all of the boxes on that line (row).
                                                                                     QUARTERLY REPORT FOR PLANNING ACTIVITIES

GOAL: If you can confidently answer yes to the shaded questions each quarter, you are on track to successfully complete grant requirements.
This section of the report is submitted by: (This person will serve as the point of                                           DPHHS Subject Matter Experts for this section are:
contact for questions about this section.)                                                                                            Sally Johnson and Art Bicsak
                                                                                                                                        Sally - sajohnson@mt.gov - 444.4016
Type name, email and phone number here                                                                                                    Art - abicsak@mt.gov - 444.1305

                                                                                                                            Was this activity
                                                           SECOND QUARTER ACTIVITIES                                                                           Quick Guidance
                                                                                                                        performed this quarter?
                                                 In this quarter, has your health department executed any new mutual                              The Department must report to the CDC
                                                                                                                            Yes        No
P1: Mutual




                                                 aid agreements, MOUs, or other similar agreements?                                               on improvements made in mutual aid
                               (every quarter)




                                                                                                                                                  throughout the state.
                                                  If yes: list agreements here. Also, please attach documentation.
    Aid




                                                                                                                                                  If your department executed a new
                                                                                                                                                  agreement this quarter, check yes and
                                                                                                                                                  attach documentation and completed
                                                                                          type information here
                                                                                                                                                  agreement.


                                                 Does your plan include an annex to address chemical release                                      Everyone will soon need to have in place
                                                                                                                            Yes        No
                                                 incidents?                                                                                       plans to address the five types of terrorist
                                                   If no: are you in the process of developing an annex to address                                incidents. These are called CBRNE
                                                                                                                            Yes        No
                                                   chemical events?                                                                               (chemical, biological, radiological, nuclear
                                                                                                                                                  and explosive).
                                                 Does your plan include an annex to address radiological incidents?         Yes        No         If your all-hazards plan does not already
                                                                                                                                                  address these, please make plans to add
P4: CBRNE




                                                  If no: are you in the process of developing an annex to address
                                                                                                                            Yes        No         these annexes by Feb. 28, 2006. Final
            (second quarter)




                                                  radiological events?
                                                                                                                                                  annexes must be in place when the final
                                                 Does your plan include an annex that deals with nuclear incidents?         Yes        No         all-hazards plan is submitted on Aug. 15,
                                                                                                                                                  2006. Please identify technical
                                                  If no: are you in the process of developing an annex to address           Yes        No         assistance needs in the comments
                                                  nuclear incidents?                                                                              section below if you have problems
                                                                                                                                                  adding these annexes to your plan.
                                                                                                                            Yes        No         (Note: we're assuming that our basic
                                                 Does your plan include an annex that deals with explosion incidents?
                                                                                                                                                  plans are sufficient to address biological
                                                                                                                                                  incidents.)
                                                  If no: are you in the process of developing an annex to address           Yes        No
                                                  explosions?
                                    Have you begun planning for participating in a local or regional                                   By Feb. 28, 2006, you should begin
                                    exercise?                                                                    Yes              No   planning for the exercise that you will
                                                                                                                                       participate in during the third or fourth
P5: Exercise

                                                                                                                                       quarter. At minimum, jurisdictions are
 Planning
                 (second quarter)


                                                                                                                                       required to participate in a tabletop
                                      If yes: do you plan to participate in the state exercise, your own                               exercise.
                                                                                                                 Local Exercise        You may choose the hazard you wish to
                                      local exercise, or both?
                                                                                                                                       address locally or regionally. Remember,
                                                                                                                                       ODP standards require that an after-
                                                                                                                 Regional Exercise
                                                                                                                                       action report must be completed within 30
                                                                                                                                       days of an exercise or tabletop.




                                                                             Please type any comments about this activity in the box below
      Comments
                                    QUARTERLY REPORT FOR SURVEILLANCE AND EPIDEMIOLOGY ACTIVITIES

This section of the report is submitted by: (This person will serve as the       DPHHS Subject Matter Experts for this section are: Jim Murphy and
point of contact for questions about this section.)                                                       Elton Mosher
                                                                                                     Jim Murphy - jmurphy@mt.gov - 444.0274
                                                                                                    Elton Mosher - emosher@mt.gov - 444-3165
                  Type name, email and phone number here

                      MAJOR ACTIVITY DESCRIPTION                                     Was this activity
                                                                                                                              Quick Guidance
                        Distribution of Information                              performed this quarter?

           Distribute disease reporting materials (blue folders supplied by        Yes            No           This could consist of distributing DPHHS-
           DPHHS or equivalent) to local reporting sources annually.                                           provided reporting packets customized for
   E1




                                                                                                               your area and/or similar materials developed
                                                                                                               locally. Note: this is required to occur at least
                                                                                                               once annually .

           Distribute disease summaries prepared by DPHHS                          Yes            No           Communicable disease updates are e-
           and/or adapted by your agency to providers through local HAN or                                     mailed weekly to jurisdictions by DPHHS.
   E2




           other method at least quarterly.                                                                    We encourage sharing the information, or a
             If yes , how frequently do you distribute summaries to selected                                   local equivalent, with key providers and
             recipients (e.g. weekly, monthly, quarterly)?                           type information here     reporting sources in your area at least once
                                                                                                               a quarter.
           Conduct a minimum of two presentations annually                         Yes            No
                                                                                                               Provision of training/education to reporting
           focusing on disease reporting to local reporting sources and health
                                                                                                               sources is essential to promote timely &
           care providers.
                                                                                                               complete disease reporting. Attending a
             If yes : Title of presentation :                                                                  hospital and/or laboratory staff meeting and
                    Date presentation delivered:                                                               providing a review of reporting requirements
   E3




                    Number of attendees:                                                                       would be one example of this activity.
                                                                                                               DPHHS Epi staff has materials to assist local
             If yes : Title of presentation :                                                                  agencies in these efforts and you can
                                                                                                               contact us for more information. A minimum
                      Date presentation delivered:
                                                                                                               of two presentations are required annually .
                      Number of attendees:
           Annually review and update electronic registry of local reporting                                   Maintaining a simple listing of local reporting
           sources and relevant partners and designate those most likely to                                    sources in an electronic format is required.
                                                                                     Yes          No
           diagnose a communicable disease as a "key" provider.                                                This can be accomplished through an
                                                                                                               Outlook address book, spreadsheet or other
   E4




                                                                                                               computer application. This activity requires
             If yes , were any new reporting sources designated as key               Yes           No          reviewing and updating the list of reporting
             providers?                                                                                        sources and key providers (those most likely
                                                                                                               to diagnose a CD) developed earlier.
               MAJOR ACTIVITY DESCRIPTION                                     Was this activity
                                                                                                                   Quick Guidance
            Ongoing Evaluation of Disease Reporting                       performed this quarter?
      What was the average time between diagnosis or lab test and                                    This requires calculating how many days
      receipt of reportable condition by your agency?                                                elapsed between diagnosis/lab test and
                                                                                                     receipt for each report received by your
E5


                                                                                              (days) agency and then calculating the average.
                                                                                                     DPHHS has developed and distributed a
                                                                                                     basic tracking tool to assist, for more
                                                                                                     information contact the CD Program.

      What was the average time between local receipt/review and                                     This requires calculating how many days
      submission to DPHHS of the above?                                                              elapsed between receipt/review of each
                                                                                                     report received by your agency and
E6




                                                                                              (days) submission to DPHHS. DPHHS has
                                                                                                     developed and distributed a basic tracking
                                                                                                     tool to assist, for more information contact
                                                                                                     the CD Program.
      What percentage of the cases were reported within 24 hours of                                 Of all cases received and evaluated in E5,
E7




      diagnosis?                                                                                (%) list the percentage received by your agency
                                                                                                    within 1 working day of diagnosis.

      What percentage of reports were considered complete (e.g. had
                                                                                                    Provide the percentage of reports received
      sufficient information to allow immediate follow-up with provider
                                                                                                    that had sufficient information to allow
      and/or patient)?
                                                                                                    immediate follow-up (at a minimum:
                                                                                                    complete patient name, date of diagnosis,
E8




                                                                                                (%)
                                                                                                    and a provider to contact for additional
                                                                                                    information) . DPHHS has developed and
                                                                                                    distributed a basic tracking tool to assist, for
                                                                                                    more information contact the CD Program.

      Were matches with DPHHS statistics or line listings                                            To ensure complete reporting, periodic
      conducted this quarter?                                                                        "matches" with DPHHS communicable
                                                                                                     disease updates (by comparing the numbers
E9




                                                                             Yes         No
                                                                                                     of reports listed in your jurisdiction) or by
                                                                                                     name are required. To ensure accuracy,
                                                                                                     discrepancies can be resolved with DPHHS.
       If yes, with whom (which reporting source)? List sources here                     No          To ensure complete reporting, a "match" with
E10




                                                                              Yes
                                                                                                     a local reporting source (lab, hospital, clinic)
                                                                                                     is required at least annually. This activity is
                                                                                                     intended to document the level of reporting
         Detail any efforts to correct deficiencies in timeliness and/or completeness of reporting identified
         as a result of evaluation efforts. Please note if local protocols were modified as a result of these
                                                                                                                 Document any efforts to correct reporting
  E11
         efforts.
           Type answer here:
                                                                                                                 problems identified in items E5 through E10
                                                                                                                 above.


                                   MAJOR ACTIVITY DESCRIPTION
                                                                                                                              Quick Guidance
                                After-hours Receipt of Urgent Reports
         Number of disease calls/reports received after regular business                                       How many disease calls/reports were
         hours this quarter?                                                                                   received via your after-hours system?     We
  E12




                                                                                                               suggest including suspected as well as
                                                                                                      (number)
                                                                                                               confirmed disease reports and DPHHS/
                                                                                                               health referrals that were received outside of
                                                                                                               normal hours.

                                 MAJOR ACTIVITY DESCRIPTION
Maintain an Active Surveillance Network by Contacting Key Providers and Laboratories on a Regular                             Quick Guidance
                        Basis (Solicit Reports and Disseminate Information)
         Number of surveillance sites identified for active surveillance?                                      The number of key providers targeted for
                                                                                                               active surveillance will be listed here. These
  E13




                                                                                                      (number) are sites that are contacted every week or
                                                                                                               two to solicit reports and share relevant
                                                                                                               information.
         Number of key surveillance sites (above) that are laboratories?                                       Laboratories are essential reporting sources
  E14




                                                                                                               and we recommend contacting labs in your
                                                                                                      (number)
                                                                                                               area at least weekly. Provide the number of
                                                                                                               labs targeted for AS in this space.

         Percentage of above sites contacted as scheduled?                                                      Key providers are contacted each week or
  E15




                                                                                                                every other week as part of active
                                                                                                            (%)
                                                                                                                surveillance efforts. Provide the percentage
                                                                                                                of contacts made as scheduled.

         Number of new cases of a reportable condition
  E16




                                                                                                                 Provide the number of new reports received
         identified as a result of active surveillance?                                               (number)
                                                                                                                 as a result of your AS efforts.

         Number of cases updated as a result of your active surveillance                                       Provide the number of reports updated as a
  E17




         calls?                                                                                                result of your AS efforts. This may include
                                                                                                      (number)
                                                                                                               the results of lab tests on suspected cases
                                                                                                               or other updates.
Comments   Please type any comments about this activity in the box below
                                         QUARTERLY REPORT FOR RISK COMMUNICATION ACTIVITIES

This section of the report is submitted by: (This person will serve as the              DPHHS Subject Matter Expert for this section is:
point of contact for questions about this section.)                                                 Mary Ann Dunwell
                                                                                            Mary Ann Dunwell - mdunwell@mt.gov - 444.1281
                    Type name, email and phone number here

                    MAJOR ACTIVITY DESCRIPTION                                     Was this activity
                                                                                                                       Quick Guidance
                         General Activities                                    performed this quarter?
              Attend or take Training Communications Center course                                       Designed for preparedness coordinator,
              entitled "Crisis and Emergency Risk Communication: By              Yes         No          public information officer, and other
              Leaders For Leaders" training                                                              community and health department leaders.
     RC4




                If yes, number of people completing course                                               You may complete the course at an on-site
                                                                                                         DPHHS training (to be announced), or online
                                                                                                         on the DPHHS TCC (available after Jan. 1,
                                                                                                         06) before the end of FY 05-06 grant year.
                                                                                              (number)
              Establish a procedure for disseminating public information                                 Please consider how to utilize video DVDs,
              related to mass dispensing/vaccination if SNS Points of             Yes       No           signage, partnering with the news media,
     RC5




              Dispensing (PODs) are activated.                                                           reaching and planning for special
                                                                                                         populations, communication points for
                                                                                                         before, during, and after POD activation, ie
                                                                                                         medication regimen follow-up.

              By testing or using a real event, perform a drill of media and                             Please update contact lists as part of this
              partner contact information via phone, fax and email and use       Yes         No          event or drill.
     RC6




              this information to update contact lists.
                If yes, number of contacts updated
                                                                                              (number)
              Establish/update emergency information messaging strategy                                  Please review and update previously
                                                                                 Yes         No
     RC7




              regarding special population groups                                                        prepared special populations documents that
                                                                                                         served as deliverables.
                If yes, number of groups identified
                                                                                              (number)
Comments   Please type any comments about this activity in the box below
                                                  QUARTERLY REPORT FOR TRAINING ACTIVITIES
GOAL: Once the learning management system is populated with data from the TRAIN system (pre-October 2005 data), it is expected that each local
health jurisdiction will keep the data bank up-to-date on a quarterly basis and that competencies will be identified and entered for each training event
attended.
To calculate percentage of completion, use this formula: % = number of public health staff attending the training divided by total number of public
health staff.

This section of the report is submitted by: (This person will serve as the
                                                                                    DPHHS Subject Matter Expert for this section is: Luella Schultz
point of contact for questions about this section.)

                                                                                                  Luella Schultz - lschultz@mt.gov - 444.5949
                      Type name, email and phone number here

                                                                                        Was this activity
                       FIRST QUARTER ACTIVITIES                                                                               Quick Guidance
                                                                                    performed this quarter?
           For public health staff - enter ALL training into the Learning
                                                                                      Yes         No
    T1




           Management System (the Training and Communications Center                                            See GOAL above!
           or TCC).

           Identify all individuals who are expected to report for duty following                               Reporting form will be provided at a later
                                                                                      Yes         No
           activation of the local Public Health Emergency Response Plan                                        date. Information to be submitted will
    T3




           and/or staff who have emergency response roles documented in                                         include the individual's name, job title,
           their position descriptions.                                                                         phone number(s) and e-mail address.

           All public health staff have registered as a user of the Montana                                     http://www.montanapublichealthtcc.org/
    T4




                                                                                      Yes         No
           Public Health Training and Communications Center (TCC).

           Identified level of ICS Training for those individuals identified in                                 Survey form provided by Subject Matter
    T5




                                                                                      Yes         No
           Task 3 (T3) above                                                                                    Expert.

           Each public health staff person has attended one training that                                       See formula for calculating percent
                                                                                      Yes         No
           improves his/her emergency preparedness competencies (on-line                                        completion above
    T6




           completion counts)
             If no , specify % of staff that has completed one training                                   (%)
           Identified competencies for training attended by PH staff and                                        http://healthlinks.washington.edu/nwcphp/
    T7




                                                                                      Yes         No
           entered data into the TCC                                                                            comps/
T10 T9 T8   Identified which PH staff have had personal protective equipment                              Survey form provided by Subject Matter
                                                                                  Yes         No
            (PPE) training                                                                                Expert.

            Provided PPE training for those who have not had it
                                                                                  Yes         No

            Identified which PH staff have had HAZMAT training and what                                   Survey form provided by Subject Matter
                                                                                  Yes         No
            level of training was received                                                                Expert.

            All PH staff has completed IS-700 training                                                    Potential payment deduction if not 100%
                                                                                  Yes         No
T11




                                                                                                          See the "Evaluation and Payment" tab.
                                                                                                          Please contact Luella Schultz for
                                                                                                          assistance in meeting this goal.

                                                  Please type any comments about this activity in the box below
Comments
                                                              QUARTERLY REPORT FOR FOOD AND WATER SAFETY ACTIVITIES

This section of the report is submitted by: (This person will serve as the
                                                                                                          DPHHS Subject Matter Expert for this section is: Lisa Dickman
point of contact for questions about this section.)

                                                                                                                        Lisa Dickman - ldickman@mt.gov - 444.2989
                                            Type name, email and phone number here

                                                                                                             Was this activity
                                            MAJOR ACTIVITY DESCRIPTION                                                                             Quick Guidance
                                                                                                         performed this quarter?
                                 Attend "Preparedness and Response to Agricultural Terrorism" (food         Yes         No           Enter the names and job titles of any
          (1st or 2nd Quarter)




                                 security) training in either Billings or Helena?                                                    public health staff members who attend
                                                                                                                                     any of the "Preparedness and Response
                                     If yes : Name of participant :
  F1




                                                                                                                                     to Agricultural Terrorism" trainings
                                              Job title:
                                                                                                                                     provided this year.
                                     If yes : Name of second participant (optional):
                                              Job title:
                                 Complete online course "Protecting the Food Supply from Intentional        Yes         No            http://www.fda.gov/ora/training/orau/Food
        (2nd Quarter)




                                 Adulteration: An Introductory Training Session to Raise Awareness"?                                            Security/default.htm
 F3




                                     If yes : Name of participant :                                                                  Please contact Lisa if you have problems
                                              Job title:                                                                             accessing the course.

                                                                           Please type any comments about this activity in the box below
   Comments
                       QUARTERLY REPORT FOR HEALTH ALERT NETWORK AND INFORMATION SYSTEM ACTIVITIES
OVERVIEW: The "Communications" Section of the report lists core groups of contacts who are to receive test HAN messages. These tests may be
conducted 1) as part of a larger exercise, 2) by the health agency working with its contacts, or 3) with specific subgroups of message recipients around
specific issues (e.g., announcing daycare immunization requirements through the local media as a "test" of the HAN/risk communications systems) as
long as an acknowledgement for the receipt of the message is requested. With agencies more accustomed to tests of the communications systems,
(e.g., dispatch centers) then tests of communications may be conducted more directly. The template below is intended to assist you with the submission
of the data associated with each required task.

This section of the report is submitted by: (This person will serve as the                DPHHS Subject Matter Experts for this section are:
point of contact for questions about this section.)                                               Jim Aspevig and Gerry Wheat
                                                                                                  Jim Aspevig - jaspevig@mt.gov - 444.5441
                      Type name, email and phone number here                                      Gerry Wheat - gwheat@mt.gov - 444.6736

                   MAJOR ACTIVITY DESCRIPTION                                         Was this activity
                                                                                                                            Quick Guidance
          HAN System and Notification/Communications Testing                      performed this quarter?

           Test of HAN System for dispatch centers/law enforcement centers          Yes          No            The key features of a test of the HAN
           in jurisdiction.                                                                                    system are that the message (1) requires
                                                                                                               a reply/acknowledgement and (2) that it is
             If yes : Date (mm/dd/yyyy) and Time (hh:mm) test initiated
                                                                                                               broadcast to a group or groups. An
             Number of dispatch centers/law enforcement centers in
   H1




                                                                                                               example of a test HAN message will be
             jurisdiction                                                                             (number)
                                                                                                               provided in the detailed HAN guidance.
             Number of the above whom successfully responded to E-
             mail/digital messaging within 2 hours                                                    (number)
             Number of the above whom successfully responded to HAN fax
             message within 2 hours                                                                   (number )
           Test of HAN System for DES Coordinators and/or emergency                 Yes          No            Emergency services include fire, police,
           services in jurisdiction.                                                                           etc. However, if your jurisdiction has
             If yes : Date (mm/dd/yyyy) and Time (hh:mm) test initiated                                        included law enforcement in responding
             Number of DES Coordinators/emergency services contacts in                                         to H1 (above) as part of the dispatch
   H2




             jurisdiction                                                                             (number) center, do not "double count" it here.
             Number of the above whom successfully responded to E-
             mail/digital messaging within 2 hours                                                    (number)
             Number of the above whom successfully responded to HAN fax
             message within 2 hours                                                                   (number )
     Test of HAN System for hospitals in jurisdiction.                     Yes   No            Key HAN contact(s) should be identified
                                                                                               for hospitals in the jurisdiction in
                                                                                               coordination with the local Hospital
       If yes : Date (mm/dd/yyyy) and Time (hh:mm) test initiated
H3                                                                                             Preparedness Program and a process for
       Number of hospitals in jurisdiction                                            (number) HAN notification and testing should be
       Number of the above whom successfully responded to E-                                   developed jointly.
       mail/digital messaging within 2 hours                                          (number)
       Number of the above whom successfully responded to HAN fax
       message within 2 hours                                                         (number )
     Test of HAN System for clinicians/clinical facilities designated as   Yes   No             Include local clinical facilities which the
     public health/epi contacts in jurisdiction.                                                jurisdiction has identified as playing a role
       If yes : Date (mm/dd/yyyy) and Time (hh:mm) test initiated                               in public health response. A jurisdiction
       Number of clinicians/clinical facilities designated as public                            may elect to notify some or all providers in
H4




       health/epi contacts in jurisdiction                                            (number) a facility as individuals or they may elect
       Number of the above whom successfully responded to E-                                    to treat the facility as a single unit for the
       mail/digital messaging within 2 hours                                          (number) purposes of notification and notify a single
       Number of the above whom successfully responded to HAN fax                               contact or very limited number of
       message within 2 hours                                                         (number ) contacts.
     Test of HAN System for EMS contacts in jurisdiction.                  Yes   No             EMS should be managed as a distinct
                                                                                                group in the local HAN system, separate
       If yes : Date (mm/dd/yyyy) and Time (hh:mm) test initiated                               from the "Hospital" contacts identified in
       Number of EMS contacts in jurisdiction                                         (number) H3. The test message may be sent to
H5




       Number of the above whom successfully responded to E-                                    both groups (Hospital & EMS) at the
       mail/digital messaging within 2 hours                                          (number) same time, but the rate of response
       Number of the above whom successfully responded to HAN fax                               should be broken out for reporting.
       message within 2 hours                                                         (number )
     Test of HAN System for media contacts (local TV, newspaper, or        Yes   No            Very few HAN System messages are
     radio) in jurisdiction.                                                                   appropriate to forward directly to the
       If yes : Date (mm/dd/yyyy) and Time (hh:mm) test initiated                              media. Messages will probably need to
                                                                                      (number) be re-framed using the concepts required
H6




       Number of media contacts in jurisdiction
       Number of the above whom successfully responded to E-                                   for effective risk communications, prior to
       mail/digital messaging within 2 hours                                          (number) sending a message to media partners.
       Number of the above whom successfully responded to HAN fax
       message within 2 hours                                                         (number )
      Have you sent any HAN messages to your local HAN contacts this               Yes        No            H-7 asks whether you have written and
      quarter?                                                                                              sent your own HAN messages and
                                                                                                            measures the LHJ’s capacity to create
        If yes: Date(s) (mm/dd/yyyy) and Time (hh:mm) of HAN
                                                                                                            and sent its own HAN messages. A “yes”
        message(s).
                                                                                                            response includes messages your agency
        Number of HAN recipients contacted in jurisdiction.                                        (number) originated and sent to its local HAN
H7

        If a message receipt was requested, number of the above whom                                        contacts during the reporting period. It
        successfully responded to E-mail/digital messaging within 2                                         does not include messages your agency
        hours?                                                                                     (number) forwarded that first originated, in whole or
                                                                                                            part through DPHHS HAN or CDC.
        Number of the above whom successfully responded to HAN fax
        message within 2 hours.
                                                                                                   (number)
      Test of your instant notification system for initial             public      Yes        No            Initial public health responders are those
      health responders in jurisdiction.                                                                    considered necessary to activate an
                                                                                                            Incident Command Post (or EOC) and
        If yes : Date of test                                                                               initiate a public health response. Your
H8




                                                                                                            instant notification system includes any
        Number of public health responders included in test
                                                                                                   (number) technology or internal process, such as a
                                                                                                            call down list or notification tree, that
        Number of the above whom successfully responded to test within
                                                                                                            allows you to immediately notify and call
        2 hours                                                                                    (number) staff in.

                 MAJOR ACTIVITY DESCRIPTION                                          Was this activity
                                                                                                                           Quick Guidance
                   Priority Service Restoration                                  performed this quarter?

      Has the local public health agency or the public health agency as            Yes        No               If routine phone service is disrupted, a
      part of the county/tribal government achieved the designation of                                         designation of "Priority Service
      "Priority Service Restoration" from its' telephone service provider?                                     Restoration" for the local health agency or
                                                                                                               county/tribal government assures that the
                                                                                                               local telephone company will work to
H9




                                                                                                               restore service ASAP. You should have
        If yes , provide the TSP code number you were issued and the                                           been issued a Telecommunication
        date that priority service restoration designation was achieved.                                       Service Priority (TSP) Code #, please list
                                                                                                               it to the left and the date you were
                                                                                TSP Code #            (date)   approved for the service.

      Has the local public health agency or the public health agency as            Yes        No              If routine cellular telephone service is
      part of the county/tribal government achieved the designation of                                        disrupted in a jurisdiction, a designation of
H10




      "Priority Service Restoration" from its' cellular telephone service                                     "Priority Service Restoration" for the local
      provider?                                                                                               health agency or county/tribal government
        If yes , provide date that priority service restoration designation                                   helps to assure that cellular service will be
                                                                                                       (date) restored ASAP.
        was achieved.
                  Our local Health Agency depends exclusively on a DPHHS-provided


H11
                                                                                               Yes        No              If all of your cell phones are provided by
                  Cell phone & Service Plan.                                                                              DPHHS, please answer yes.

                           MAJOR ACTIVITY DESCRIPTION                                            Was this activity
                                                                                                                                       Quick Guidance
                  Pandemic Influenza Information Systems Preparation                         performed this quarter?
                  Does your public health agency currently use WIZRD to access the                                        WIZRD is the statewide Immunization
H15 H14 H13 H12

                  Montana State Immunization Registry?                                         Yes        No              Registry used to support mass
                                                                                                                          vaccination events.
                  Number of clinicians and/or clinical facilities in jurisdiction planning                               Count of clinicians or major clinics
                  to provide influenza vaccine during the 2005-2006 season?                                              providing flu vaccine to adults and
                                                                                                               (number ) children in the local health jurisdiction.
                  Number of other clinicians and/or clinical facilities in jurisdiction                                  Count of clinicians or major clinics
                  planning to provide other vaccines (i.e. not influenza)?                                               providing all other vaccines to adults and
                                                                                                               (number ) children in the local health jurisdiction.
                  Number of clinicians/clinical facilities receiving       marketing                                     Count of clinics or individual clinicians
                  materials and/or a local health department visit encouraging the use                                   contacted by the health department to
                  of WIZRD during the reporting period?                                                        (number ) encourage the use of WIZRD.
                  Number of clinicians and/or clinical facilities in jurisdiction                                        Count of providers expressing serious
H17 H16




                  expressing, for the first time, an interest in using/accessing WIZRD                                   verbal commitment to access WIZRD in
                  during the reporting period?                                                                 (number ) order to enter and/or view client info.
                  Number of clinicians and/or clinical facilities using WIZRD?                                           Count of clinics in jurisdiction currently
                                                                                                                         using WIZRD to enter and/or retrieve the
                                                                                                               (number ) vaccination histories of their clients.
                   MAJOR ACTIVITY DESCRIPTION
                                                                                      Was this activity
               Learning Management System Utilization                                                                    Quick Guidance
                                                                                  performed this quarter?
      (Montana Public Health Training and Communications Center)

           Does your public health agency currently use its' "team room" in the    Yes            No        The Learning Management System (LMS)
           Montana Public Health TCC to support communications and                                          has a communication feature that local
           document exchange?                                                                               health agencies may use, to better
                                                                                                            manage local web-based
            Do the following local partners have access to your local team         Yes            No        communications. DPHHS HAN/
            room?
                                                                                                            Informatics staff is working with Distance
                                                                                                  No
H18




            Dispatch Centers/Law Enforcement                                       Yes                      Learning staff to make "team rooms"
            Hospitals/Hospital Administrators                                      Yes            No        available to each local health jurisdiction.
                                                                                                            Team rooms will represent a locally
            Clinicians/Clinical Facilities                                         Yes            No        accessible form of web-board. For each
            Local DES Coordinator(s)                                               Yes            No        type of local partner in the list, respond
                                                                                                            "yes" if at least one representative of that
            EMS                                                                    Yes             No       local agency has access to your local
            Other Emergency Services (e.g., Fire, LEPC, TERC)                      Yes             No       team room.

                                                  Please type any comments about this activity in the box below
Comments
                         Quarterly Progress Report Feedback
  We hope you enjoy using this method of reporting your accomplishments in public
health emergency preparedness and response. Feel free to provide feedback about how
             to make this process easier and/or more meaningful to you.
                        1. What were the strengths of this format for reporting progress?

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           2. What suggestions do you have for improving this format for reporting progress?

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