Jon S. Corzine
Governor
PREPAREDNESS TODAY
March 2007
Fred M. Jacobs, M.D., J.D.
Commissioner
N
Commissioner Establishes New Advisory Council
ew Jersey Health and Senior Services Commissioner Fred M. Jacobs, M.D., J.D., established the Health Emergency Preparedness Advisory Council (HEPAC) to support continued enhancements to an all-hazards approach to preparedness, bringing together expertise from multiple disciplines in both the public and private sectors. This new advisory council, which replaces the former Medical Emergency Disaster Preparedness Expert Panel (MEDPREP), was convened in November and held its second meeting in February. MEDPREP has been a critical component of the New Jersey Department of Health and Senior Services (NJDHSS) progress in developing the basis for healthcare system preparedness. “With MEDPREP as a foundation, we will be shifting the focus from individual system integrity," said Dr. Jacobs. "HEPAC will work to maintain and enhance preparedness activities across the health system and to integrate activities with our response partners." HEPAC is comprised of partners from the public and private sectors that will convene quarterly. In addition to providing recommendations to the Department on health system preparedness, HEPAC will serve as a source of subject matter experise during a public health response. HEPAC will also be an advisory body for federal preparedness cooperative agreements and the umbrella organization for committees relevant to health preparedness. These committees, identified by HEPAC members, will address aspects of health preparedness, such as Emergency Medical Services, Education and Training, and Special Health Needs.
Get Flu Ready New Jersey: Commissioner Fred M. Jacobs, M.D., J.D. advises residents to prepare for a possible flu pandemic. The Department launched a statewide public awareness campaign during a press conference. See the related article on page 3.
Many Partners Contribute to Update of Influenza Pandemic Plan
ore than 100 individuals representing public health, law enforcement and homeland security agencies in New Jersey are at work to revise and update the Department’s Influenza Pandemic Plan. New Jersey Department of Health and Senior Services (NJDHSS) employees comprise less than a third of the work group, with the vast majority representing about 50 primarily private sector professional organizations and associations. This group is tasked with updating the third version of the Department plan. The original plan was released in September 2002. DHSS and the partners want a realistic, operational plan that is aligned with the November
continued on pg. 7
M
by Sylvia Bookbinder
Inside Preparedness Today
NJ Learning Management Network Get Flu Ready Communities . . . Safer, Stronger, Better Prepared Emergency Medical Kits for NJ Schools Business Continuity Plan Laboratory Preparedness and Response The Basics of Influenza
New Jersey Learning Management Network: An On-line Resource for Public Health and Preparedness Education
he Workforce Development Program, Office of Public Health Infrastructure, manages the New Jersey Learning Management Network (NJLMN) because of its commitment to continuing education, knowledge development and knowledge transfer for public health professionals throughout the State of New Jersey. The NJLMN is the infrastructure on which access to public health continuing education has been built and can be delivered on a 24/7 basis. This robust network simultaneously serves the diverse needs of nearly 6,000 instructors, learners, and administrators and provides the capacity to develop and deliver courses, manage content and curriculum, assess skills and analyze gaps, communicate with individuals and groups, and track/ report skills and training records. It is designed to provide access to public health continuing education courses, course calendar, online registration, and electronic recordkeeping. It also offers access to over 300 emergency preparedness programs available through a nationwide searchable directory based on 15 nationally recognized competencies, as well as the 40hour Bioterrorism Certificate Program. Currently, more than 140 course sponsors from 93 organizations post courses and manage registration for their courses through the NJLMN. This on-line resource for the workforce development program is the sole method for determining the achievement of annual continuing education requirements associated with the licensure of Health Officers and Registered Environmental Health Specialists licensed by the New Jersey Department of Health and Senior Services (NJDHSS). The NJLMN is organized into learning communities which provide easy access to programs that can serve all public health professionals involved with New Jersey’s public health, safety and emergency preparedness at any stage of their profes-
T
by Parvin Ahmadkhanlou
sional development. The NJLMN offers access to registration for trainings delivered online, in the classroom, via computer-based training such as CD-ROM and DVD, and satellite-based distance learning, or in a blended approach that combines in-person, self-paced learning and live classroom training. In October 2006, the NJLMN homepage was revised to provide a more dynamic and accessible learning environment. The revision includes a bulletin board to promote timely trainings and conferences, up-to-theminute public health news from the CDC and an extensive pandemic influenza preparedness toolkit with resources for state, local and county public health professionals. In December 2006, the NJLMN and NJDHSS staff began plans to develop a tool to track and verify training records of Medical Reserve Corps (MRC) volunteers. This tool will replace the current countybased MRC tracking system and provide a unified statewide mechanism to manage training data collected and administered by the County MRC Coordinators. The NJLMN provides support to all course sponsors in the form of on-line course applications, program marketing and electronic registration. It also provides NJDHSS administrators with an efficient and effective method for the review and approval of public health continuing education courses, assessment of training needs, and the electronic management and tracking of continuing education achievements of over 5,000 professionals for licensure and other purposes. The NJLMN has been built on a strong pedagogical foundation that promotes successful interactions between learners and instructors. In addition, it provides a resource for “just-in-time” learning at the onset of a major public health threat or emergency. To visit and join the NJLMN go to http://njlmn.rutgers.edu
2
Get Flu Ready New Jersey
T
b y To m S l a t e r
he New Jersey Department of Health and Senior Services recently launched a multi-media public awareness campaign – “Get Flu Ready New Jersey” – to help individuals, famiNew Jersey is preparing lies, businesses and for a flu pandemic. schools prepare for a potential influAre you? enza pandemic. During the month of October, New Jersey Health and Senior Services Commissioner Fred M. Jacobs, M.D., J.D. was featured in public service announcements reminding residents to “get flu ready” by preparing an emergency health plan, practicing good hygiene habits and learning about the potential impact of a pandemic before it occurs.
The New Jersey Department of Health and Senior Services has been preparing for a possible flu pandemic, a worldwide flu that could affect thousands of people like you and your family. In case a flu pandemic occurs, we have increased our ability to detect and contain health threats and to efficiently communicate with health care professionals and the general public.
residents, businesses, schools and health care professionals with a single resource for comprehensive information about the possibility of a global outbreak of influenza. Information is available in both English and Spanish. The website includes resources such as fact sheets, planning checklists, guidelines for health professionals and community presentations. There are also links to the Have a plan. New Jersey Influ• Visit www.NJflupandemic.gov to enza Pandemic find checklists that help families, businesses and schools prepare Plan, the federal • Maintain a supply of food and water in case health officials website instruct you to stay home www.pandemicflu.gov, • Have emergency contact phone numbers available and information Practice healthy habits. from other state To prevent the spread of harmful germs: agencies. • Wash your hands thoroughly with
Emergency Contacts
Be ready.
Although we don’t know when the next flu pandemic will occur or how severe it will be, there are steps you should take now to protect yourself and those around you.
Emergency Contacts
The 30-second public service announcements aired at video screens located in 176 Acme, Pathmark and ShopRite supermarkets throughout New Jersey. The video ran five times an hour daily during the month of October. “Every New Jersey resident should know how to prepare their families, friends, coworkers and neighbors for an influenza pandemic,” Dr. Jacobs said. “We don’t know when a pandemic will occur, or how severe it will be, but there are steps everyone can take now to prepare for a worldwide flu outbreak.” An important component of the campaign is a website dedicated to pandemic influenza – www.NJFluPandemic.gov. The website provides 3
The DHSS, in partner with local health departGet informed & stay informed. ments, has devel• Learn as much as possible about a potential flu pandemic before it occurs oped and distrib• Listen to advice from medical experts • Check www.NJflupandemic.gov uted posters and regularly for the latest information and valuable resources flyers that encourVisit www.NJflupandemic.gov for useful age residents to information on how to prepare for a flu pandemic. “Get Flu Ready New Jersey.” The Get flu ready, New Jersey posters and flyers will be displayed at a wide range of sites, including local municipal buildings, health departments, physicians offices and schools. The posters and flyers are available in both English and Spanish. “Although there is no pandemic, and there are no human cases of avian influenza in the United States, it is important for everyone – from families to schools to businesses to government – to prepare for the possibility of a pandemic,” said Dr. Jacobs.
soap and water • Cover your coughs and sneezes, and dispose of tissues • Stay home if you’re sick
Communities of New Jersey . . . Safer, Stronger, Better Prepared
N
by Sally Flanagan
ew Jersey Department of Health and Senior Services (NJDHSS) is extremely proud of the accomplishments that the New Jersey Medical Reserve Corps (NJMRC) Program has achieved during 2006. To date, there are 25 MRC units in the statewide county-based program. Every county in the state has an MRC unit that has a group of healthcare professionals and community health volunteers that are willing to provide volunteer assistance and support to existing resources during a public health emergency. More than 2,500 volunteers have registered and are approved in the electronic database registry. These volunteers have had their credentials reviewed and verified and are ready for activation and deployment in the event of an emergency. To enhance the skills of the volunteers, education and training opportunities have been provided. The National MRC Program Office has outlined and recommended eight core competencies that all active MRC members at a minimum should be able to achieve. These competencies include:
enhance their capability to respond to an event. Through the efforts of the New Jersey Citizen Corps Program, a Public Service Announcement was filmed and aired on the New Jersey Network (NJN) during September 2006 for National Preparedness Month. This activity created awareness of the NJMRC Program and had a positive impact on the recruitment of new volunteers. The MRC unit coordinators and volunteers participated in the National MRC Program Office Activation and Alert Exercise that was held during the summer of 2006. The MRC volunteers were ready to respond to requests that were made by the National Program Office to provide help and assistance in the hurricane scenario that was developed. The exercise and drill tested communication procedures between the National and State systems. New Jersey MRC unit coordinators had the opportunity to attend the Region II MRC Volunteer Summit that was held in November 2006 in Cooperstown, New York. NJDHSS was a supporter of the Volunteer Summit. The Summit provided educational and training experiences for networking and sharing information between MRC Unit Coordinators, Hospital Association Representatives and County Health Department Representatives. Keynote presenters and plenary sessions provided information pertaining to special needs, sheltering needs and plans, support from NACCHO and capacity building, emergency management collaboration, coordinating and expanding volunteer participation, NIMS compliance and on-line approaches to managing MRC training and education. Help spread the word about this vital program. Support this group of dedicated and dynamic individuals that are working to create safer, stronger and better prepared communities in New Jersey. Learn more by visiting the NJMRC website at www.njmrc.nj.gov.
1 Protecting one's overall well-being 2 Personal and family preparedness 3 Knowing the chain of command 4 Describing the role of the MRC unit 5 Communication roles and processes 6 Mental health status of the MRC members 7 Ability to follow procedures 8 Identifying one’s strengths and limits to their
own skills, knowledge and abilities Many of the MRC volunteers have participated in exercises and community drills to enhance their skills and knowledge and have learned how to work with other community response partners. During the year, the New Jersey Citizen Corps Program has provided support and assistance to the NJMRC Program. The MRC units and volunteers have received supplies and equipment that will
4
DHSS Distributes Emergency Medical Kits to New Jersey Schools
he New Jersey Department of Health and Senior Services set a precedent last fall by distributing free emergency medical kits to every public school district in New Jersey. Working with the Department of Education, DHSS sent kits to 610 school districts. Another 300 kits will go to non-public, special services and faith-based schools. Each kit contains basic first-aid equipment as well as equipment that could be used to provide medical treatment during any type of disaster. The location of the kit, as well as contact information for 24-hour access, is registered within the EMS for Special Populations and Services, Office of Emergency Medical
T
by Eric Hicken
Services, Division of Health Infrastructure Preparedness and Emergency Response. A list of school districts that have accepted the kit, and registered its location with the Department, will be provided as needed to preparedness agencies. The kits were funded through the Department’s Health Resources and Services Administration (HRSA) grant, and developed by the New Jersey Emergency Medical Services for Children (EMSC) Program, with advice from the Governor’s EMSC Advisory Council and the MEDPREP Pediatric Committee. As an extension of the State’s strategic stockpile, the kits remain the property of the Department of Health and Senior Services.
by Kevin Hayden and Chris Grady
They could be recalled in the event of a manmade or natural disaster. Schools can use the kits for day-today medical emergencies, providing that items are replaced. An inventory control form is included inside each kit. The kit is packaged in a duffel bag on wheels with a telescoping handle, so it can be moved in the event of an evacuation. Each school district is asked to complete an evaluation form on the kit at the close of the school year. For additional information regarding the school equipment initiative, please contact Eric Hicken at the Office of Emergency Medical Services at 609-633-7777 or eric.hicken@doh.state.nj.us.
DHSS Business Continuity Plan In Development
he Department of Health and Senior Services has begun to develop Continuity of Operations Plans (COOP) for its business practices as part of a Department-wide program. The State Governmental Operating Group (SGOG) coordinated training for each state agency in April of last year. As part of that group, DHSS is required to develop a COOP program. Since that time the department has embarked on developing the COOP model for its senior level staff, operating divisions, units, offices and personnel. A Business Impact Analysis (BIA) is an important component of a COOP. The BIA helps to prioritize business functions that may be impacted by a business interruption. Both COOP and BIA are important tools for the employer and the employees. COOP includes issues associated with the personnel within an organization, the programs that are provided by that organization and the venues in which the programs are provided. Each of these components is an integral part of good business planning for catastrophic events. The impact of specific 5
T
events would affect profits in the business community. In government the impact affects the performance of the Department providing services. It is people, programs, and places that affect profits or performance. Chris Grady and Tim Joo of the Division of Health Infrastructure Preparedness and Emergency Response, are coordinating a work group of members from each division to compile the necessary information to develop a department-wide COOP. The work group utilizes worksheets and templates to capture key operational components of DHSS. Currently, this phase is nearing completion. Chris and Tim will then consolidate and coordinate all worksheets and templates into a comprehensive COOP. The DHSS COOP will become part of the Department’s Comprehensive Emergency Management Plan.
he New Jersey Department of Health and Senior Services (DHSS) recently conducted a statewide bioterrorism preparedness and response exercise for clinical laboratories. The Sentinel Communications and Operational Preparedness Exercise, or project SCOPE, involved the design, execution and analysis of a tabletop and fullscale clinical and public health laboratory exercise. The drill tested the preparedness and response levels of the State’s Laboratory Response Network (LRN) to a bioterrorism event, including an evaluation of its ability to detect the organisms, report findings to the appropriate agencies, refer samples and confirm the identification of an agent. SCOPE marks the first full-scale testing of the coordinated response to public health emergencies between New Jersey’s sentinel clinical laboratories and the DHSS Public Health and Environmental Laboratory (PHEL). Sentinel laboratories’ response is critical, not only to the speed and accuracy of the diagnosis of an infectious disease, but also to providing defensible evidence in the form of laboratory data. Production of timely, accurate and secure results requires not only standardized, controlled laboratory test methods, but also coordination between the different laboratories and other agencies. The National Laboratory Response Network (LRN) was created to facilitate this process. The network is comprised of federal, state and local laboratories across the nation and some countries abroad. The mission of the LRN is to partner with members to maintain an integrated national and international network of clinical and public health laboratories that can respond quickly to acts of chemical or biological terrorism, emerging infectious diseases and other public health threats and emergencies. The role of the sentinel laboratory is to provide routine diagnostic services, rule in or rule out suspected agents, and refer any suspected isolates for confirmation to a state public health or national reference laboratory for further testing. DHSS coordinated the exercise with staff from the Division of Health Infrastructure Preparedness and Emergency Response (HIPER) and with funding from the Health Resources and Services Administration (HRSA). Holy Name Hospital hosted the SCOPE tabletop in which approximately 90 professionals participated in the four-hour exercise. 6
T
SCOPE Looks at Laboratory Preparedness and Response
by Meena Rathee
Five sentinel laboratories, one from each of the state’s geographical regions, received a grant of $25,000 to participate in the exercise, including Holy Name Hospital in Teaneck, Barnert Hospital in Paterson, Robert Wood Johnson University Hospital in Hamilton, Robert Wood Johnson University Hospital in New Brunswick and AtlantiCare Medical Center in Atlantic City. The full-scale, week-long component took place in six locations (the five grantee hospitals laboratories and at the PHEL). Specimens were delivered simultaneously to the grantees to begin play. Exercise injects were added to make it realistic and to test whether plans, policies and procedures were effective. PHEL played a crucial role by providing technical expertise, samples for testing the bioterrorism agents and confirming results of referred specimens. All participating laboratorians were evaluated on their bioterrorism testing skills. Evaluators positioned at all exercise locations observed players and exercise events. On conclusion of the full-scale segments and the termination of the entire exercise, exercise controllers at each location held hot-wash sessions to capture observations and opinions from participants. These brief and informal reports were made part of the final after-action report. Participants were provided with exercise critique forms to offer their observations. SCOPE was designed to give participants the opportunity to assess their abilities to perform critical tasks for responding to a public health emergency resulting from a deliberate introduction of a bioterrorism agent. Through this assessment, participants can identify strengths, weaknesses and future training needs. The laboratories performed well and were provided with a valuable learning experience. At the same time, they were able to identify specific system weaknesses, such as the packaging, shipping and transportation of referred specimens. The overall process and findings were shared with all New Jersey laboratorians at the After Action Report conference held on October 25, 2006.
Editorial Staff
Rosemary Kidder Coordinator, Preparedness Policy, HIPER e-mail: rosemary.kidder@doh.state.nj.us Linda Nasta Risk Communications Specialist, NJDHSS e-mail: linda.nasta@doh.state.nj.us Joseph Rizzo Layout, HIPER e-mail: joseph.rizzo@doh.state.nj.us Tom Slater Risk Communications Manager, NJDHSS e-mail: thomas.slater@doh.state.nj.us Rebecca Werbel Director of Policy, HIPER e-mail: rebecca.werbel@doh.state.nj.us
Many Partners
continued from pg.1
2005 federal Health and Human Services (HHS) “Public Health Guidance for State and Local Partners.” Work group members have been divided among seven technical sections:
1 2 3 4 5 6 7
surveillance and laboratory diagnostics healthcare planning and infection control clinical guidelines vaccine and antiviral drug distribution and use community disease control and prevention public health communications psychosocial considerations
M
DHSS Presentation Explains the Basics of Influenza
Each work group is lead by a chairperson who is working with professionals at DHSS and external organizations. Select components of the DHSS plan will be submitted to the CDC by March 1, 2007. The Department is also assisting with local public health planning. Staff, in cooperation with a small multidisciplinary group of local and LINCS agency staff, has developed a “Local Public Health Pan Flu Checklist.” This checklist combines the latest guidance from HHS with the unique needs of New Jersey’s local public health infrastructure. This document can also guide and promote discussion within each LINCS agency jurisdiction so that local public health plans and responsibilities can be better coordinated. DHSS is working with other state departments through the New Jersey Office of Homeland Security and Preparedness (NJOHSP) to develop an overall state pandemic influenza plan. Specific sections of the overall state plan will be submitted to the CDC by March 1, 2007. Additional work with NJOHSP is focused on developing a statewide pandemic influenza education and training program. This training would help departments and agencies understand the impact of a potential influenza pandemic on day-to-day operations. While preparing for continuity of essential services, departments and agencies need to know and plan for their roles in supporting the health response to an influenza pandemic. Also in cooperation with NJOHSP, DHSS created an on-line pan flu training program for first responders: police, fire and EMS.
any people may not understand the difference between avian influenza and pandemic influenza. While health experts worldwide are closely monitoring human cases of avian flu occurring overseas, there is no way to predict whether this particular strain of avian flu will lead to the next pandemic. In an effort to raise public awareness about the differences between avian influenza, seasonal influenza and an influenza pandemic, DHSS has developed an educational presentation for community audiences to explain the differences between avian, pandemic and seasonal influenza. “Influenza: Facing New Global Challenges,” is available through the LINCs agencies as well as DHSS. The presentation also provides an overview of preparedness activities at federal, state and local agencies, as well as at healthcare facilities. DHSS provides speakers on pandemic flu planning for statewide health professional organization meetings. In November, the Department participated in a session at the New Jersey State League of Municipalities Annual Conference at the Atlantic City Convention Center. The session, called “Avian Flu: Is Your Community Prepared?” helped identify resources for local municipalities to better prepare their residents for a potential worldwide outbreak of influenza. For more information, visit www.NJFluPandemic.gov.
7