HomeMy WebLinkAboutAgenda - 11-18-2003-9bORANGE COUNTY
BI~ARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: November 18, 2003
Action Age
Item No.
SUBJECT: Building Capacity for Public Health Preparedness and Response in Orange
County Health Department
DEPARTMENT: Health PUBLIC HEARING: (Y/N) No
ATTACHMENT(S):
1. OCEAN and Public Health Corps
Recruitment
2. NC DHHS Agreement Addenda
3. Medical Reserve Corps Grant
Narrative
4. Job Duties
5. Diagram of Planning Relationships
INFORMATION CONTACT:
Rosemary Summers, ext 2411
TELEPHONE NUMBERS:
Hillsborough
Chapel Hill
Durham
Mebane
732-8181
968-4501
688-7331
336-227-2031
PURPOSE: To build the capacity of the Orange County Health Department to carryout its
responsibilities in public health preF~aredness and emergency response as part of the overall
Orange County emergency respon:>e through acceptance of funds available and establishing
two public health preparedness po:citions.
BACKGROUND: The Health Dep~irtment has specified emergency response functions under
the broad umbrella of the Orange County Multihazard Plan. In addition, the department has
responsibilities for public health preparedness that do not rise to the level of an emergency
response as defined by the Multihazard Plan (limited waterborne, foodborne or other
communicable disease outbreaks ~s examples). The Health Department has been engaged in
developing plans to respond to public health emergencies for more than five years. Competing
work needs and a lack of funding to hire dedicated staff at the department have prevented a
focused approach to completing thE~ required work. The need for well-developed response plan
has been reflected in a Board of Cc-mmissioners' goal that was first adopted in 1996.
Needs
To illustrate the ongoing need for response capability, it is important to consider that:
• In 1999, 1,324 community rnembers received immune globulin as a result of a Hepatitis
A exposure in a local restaurant over athree-day holiday weekend. The Health
Department utilized twelve nurses from adjacent counties to supplement County staff.
• In 2000, there was a rubella outbreak (8 cases in Orange County) among the Hispanic
population. In the next three months, more than 1000 community members were
vaccinated against rubella t~~ prevent the spread of the outbreak. This effort required
intensive planning and coordination with community partners.
• In 2001, there was a Norwalk virus outbreak in an elementary school in Chapel Hill in
mid-May. Over 100 children were ill. The investigation included surveying parents,
2
establishing a hotline for parent telephone inquiries, working closely with school staff to
monitor attendance, and cormunity outreach. This event was the same time that there
was a "downburst"/tornado in Hillsborough that required a boiled water notice to be
issued to Hillsborough customers.
In October 2001, anthrax sc,~res abounded throughout the country. Orange County was
no exception. Law enforcement investigated more than 300 resident incidents. Ten
samples were sent to the st~rte laboratory for testing. Countless hours were spent in
devising plans to calm public: fears and to follow-upon possible exposures. One incident
had it proven positive would have required at least 80 persons to receive counseling and
antibiotics.
• The spring of 2002 brought ~~ federal and state requirement to develop a mass smallpox
vaccination plan and to vaccinate first responders. Preventing the spread of vaccinia
virus as a result of the vaccine required careful planning and control.
• In 2001 and on, the initial spread of West Nile Virus required staff to develop educational
materials and an outreach plan that would first reach vulnerable populations and then the
entire population. Again, a riotline was established to respond to community concerns.
In 2002, North Carolina had its first human cases.
• In June of 2003, the only confirmed SARS case in North Carolina was in Orange County.
As a new disease, many of the response plans required flexibility and change as the
patterns of disease were better understood internationally. Staff were required to
manage the public health re:~ponse as well as engage in community response planning
with partners. From one case, staff actively monitored 35 individuals for at least aten-
day period to ensure there was no spread. Again, a hotline was established for
community concerns.
• These were all major events. In addition, the department responds as part of the
multihazard plan in "regular" emergency responses such as the December- 2002 ice
storm, hurricane and tornado responses.
• Finally, there are "minor" responses (in the number of actual cases) to pertussis,
meningitis, tuberculosis, and similar cases each year in the County. It is vital to respond
quickly and effectively to cortain the spread of these diseases.
In the past four years, these actual experiences have highlighted the need for fully developed,
dynamic response plans.
Recent Activities
In fiscal year 2002-2003, the feder~~l government allocated additional funds to the state for
disbursement to local health departments for risk communication, planning, and training on a
competitive basis. The Health Department used those funds ($39,000 for six months) to
contract with a nurse who accomplished the following in six months:
• Began developing a medical volunteer corps to augment the department's resources in a
large-scale event (see Attachment 1 for specific numbers already recruited "OCEAN &
Public Health Corps Recruitrnent")
• Reapplied for the Medical RE;serve Corps grant that had been denied in 2002
• Began revising the Orange County Strategic National Pharmaceutical Stockpile Plan
required by the federal government
• Began negotiating memoran~Jums of understanding with the NJNC School of Nursing
regarding emergency response personnel.
A contract was an expedient tool to start this process quickly with partial year funding. It was
also unclear at the time that this furidina would become a permanent allocation to the state from
the federal government. Experience of the last nine months has demonstrated that the scope
of work that is required to successfully finish individual Health Department plans required in the
emergency planning process and to develop a volunteer reserve corps will require personnel
that can develop and maintain effe~;tive, on-going relationships with organizations in the County.
Current Funding Sources and Deliverables
Two sources of funds are available to build the capacity of the health department to develop
public health preparedness and re~:ponse plans.
1. Public Health Preparedness Re~;urring Funds
In late September 2003, the department received notification that the state is allocating federal
funds on a formula basis to all health departments in the state using the same allocation
formula that presently applies to emergency management allocations of federal funds. These
federal funds are anticipated to continue on a yearly basis. These recurring funds total
$69,199 for Orange County and must be spent in the following categories: public health
preparedness and response, smallpox response, strategic national stockpile, and risk
communication. Examples of specific deliverables to the North Carolina Division of Public
Health include (see Attachment 2 for the full listing):
• Establish a process for strategic leadership, direction coordination and assessment of
activities to ensure local readiness, interagency collaboration and preparedness for
bioterrorism, other outbreak;> of infectious disease and other public health threats and
emergencies
• Conduct integrated assessments of public health system capacities
• Exercise comprehensive put~lic health emergency preparedness and response plans at
least annually
• Effectively manage element; of the CDC Strategic National Stockpile at the local level
should it be deployed
2. Medical Reserve Corps Three Year Grant
The Health Department also sought a grant in December of 2002 from the US Department of
Health and Human Services to develop a volunteer medical reserve corps to utilize volunteers
to augment medical personnel in the event of a major communicable disease, natural disaster
or bioterrorist event. That grant was not successful. However, the department reapplied in
June of 2003 and received notification on October 20 that the application was successful. The
department will receive $50,000 Each year for athree-year period beginning September
30, 2003. The narrative from the grant application is provided as Attachment 3. Grant
deliverables include:
• Initial development of the ME~dical Reserve Corps, including specified numbers of
volunteers (50 nurses, 18 pharmacists, 25 other health professionals) in year one
• Development of specific job ~lescriptions, volunteer policies and procedures, a specific
deployment plan, volunteer Evaluation plan, and a training plan
• Conduct of volunteer training
• Collaboration with community and county agencies such as Red Cross, UNC,
Department of Social Servicc~s, and Emergency Management for assignment of medical
volunteers in emergency situations
• Participation in tabletop and training drills
An evaluation of the Medical Reserve Corps grant includes:
• Verifying the numbers and t~~pes of health professionals recruited for the Medical
Reserve Corps
• Effectiveness of training will be measured with pre and post test and participant
evaluations
• Disaster drill/exercises effec~:iveness will be measured by feedback from participants,
volunteers, and community F~artners
• Community confidence will k;~e measured through discussions with collaborative
agencies, stakeholders, and citizens
The grant narrative contains specific activities in each of the three years of the grant. Reports
on activities and evaluation will be made to the granting agency, to the Board of Health, and the
Board of Commissioners on an annual basis. Should the evaluation at the end of the three-
yeargrant period show successful outcomes, the department will seek continuation funding
from the Board of Commissioners.
Proposed Personnel
The Health Department is proposing two positions to fulfill the current needs for public health
preparedness planning and response. Organizationally, these positions will be located in the
personal health division under the direction of the Risk Management and Training Coordinator
(PHN III).
1. Public Health Preparedness Coordinator
To meet the scope of work requirements in the contract agreement outlined by the North
Carolina Division of Public Health, the Health Department with concurrence by the Board of
Health is proposing a permanent full-time Public Health Preparedness Coordinator who is a
public health nurse. A nurse is proposed in order to provide an additional supervisory capacity
on-site during an actual emergency event that requires nursing response. A nurse will also be
able to provide direct training to staff and supervision of nurse volunteers in fulfilling assigned
responsibilities. The funds allocated to the department are adequate to support the salary,
benefits, and some operational expenses associated with the position such as personal
mileage, training, and office expenses. This position would report to the Risk Management and
Training Coordinator currently within the Personal Health Services Division. Primary
responsibilities are included in Attachment 4. These include finalizing the public health
preparedness plans, revising and updating policies and procedures, and supervising the
medical reserve corps grant implementation. The majority of this position's time will be focused
on keeping all plans current and on supporting an on-going training and exercise program.
2. Medical Reserve Corps Volunte~:r Coordinator
The second position proposed wou d meet the grant requirements contained in the Medical
Reserve Corps grant from the US C~epartment of Health and Human Services. The Health
Department with concurrence by th~~ Board of Health is proposing afull-time permanent public
health educator as a "Volunteer Co~~rdinator" to meet the grant deliverables. The position would
report to the Public Health Preparedness Coordinator. Specific duties of the "Volunteer
Coordinator" position are listed in Attachment 4. These include recruitment, training
development, database management, marketing, and other grant implementation duties. The
volunteers will be utilized whenever possible to keep them active and supplement Health
Department staff in regular activitie:~ such as flu clinics.
Grant funds are sufficient to support the salary and benefits of a public health educator and to
provide operational support such a:~ personal mileage, training, and office supplies.
3. Coordination with EMS
Both positions would be working closely with Emergency Management personnel to ensure that
efforts are coordinated and in concert with overall County plans as contained in the Orange
County Multihazard Plan. There will be close coordination of the Medical Reserve Corps with
the Community Response Teams ~~nd the Immigrant Emergency Communications efforts that
are already underway. The Health Department is already involved in those efforts with
Emergency Management. Attachment 5 is a diagram that provides a visual view of the
relationship between various emergency planning efforts underway in the County. Emergency
Management is fully supportive of the need for both of these positions.
FINANCIAL IMPACT: Two positions are proposed and will be fully funded through two sources
of funding. The Public Health Preparedness Coordinator position will be funded through a
recurring federal allocation to the slate in the amount of $69,199 for Orange County and the
Volunteer Coordinator will be funded through athree-year federal grant in the amount of
$50,000 for each year. The Volunteer Coordinator position funding is for three years duration,
after which the Board of Health and the Board of Commissioners will review the evaluation of
the grant and decide whether the effort merits continuation.
Position Salary &
Benefits Operational
Cost Total
Cost Funding
Available Net Cost to
Count
Preparedness 66,240 2,959 69,199 $69,199 0
Coordinator
Volunteer 46,042 3,958 50,000 $50,000 0
Coordinator
Should these positions be approved, the budget staff will prepare the appropriate budget
amendments for action at a BOCC meeting in December.
RECOMMENDATION(S): The Manager recommends that the Board
• accept the additional allocation of funds from the North Carolina Division of Public Health
in the amount of $69,199 for public health preparedness and response,
• accept the $50,000 grant award from the US Department of Health and Human Services
Public Health Service for development of a Medical Reserve Corps in Orange County,
• authorize a permanent full-time public health nurse position to fulfill the duties as the
Public Health Preparedness Coordinator effective December 1, 2003, and
• authorize a permanent full-tune public health educator as the Volunteer Coordinator
effective December 1, 2003 ~:o fulfill the duties associated with creating a Medical
Reserve Corps in Orange County.
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O.C.E.A.N~. & PUBLIC HEALTH
RESERVE CORPS RECRUITMENT
Total IRN postcards mailed: 2, 312
Total LPN postcards mailed: 184
Total Pharmacist postcards mailed: 270
Total postcards mailed: 2766
Total RN postcards returned expressing interest: 254 (12%)
Total LPN postcards returned expressing interest: 15 (9%)
Total Pharm postcards returned expressing interest: 17 (6%)
Total respon:~es expressing interest: 286 (11%)
Total RNs expressing interest who returned Reg. Form: 94 (37%)
Total LPNs expressing interest who returned Reg. Form: 5 (33%)
Total Pharmacists expres~;ing interest who returned Reg. Form: 6 (35%)
Total respondents expressing interest who returned Reg. Form: 103 (37%)
Number attended 08/27 orientation: 35 of 45 registered (78%)
Number attended 08/30 orientation: 31 of 42 registered (74%)
Number attended 09/09 orientation: 32 of 43 registered (74%)
Total # of volunteers attended orientation: 98 of 130 (75%)
Percent attended orientation that expressed interest: 34%
Number nurses volunteered to staff shelters during Hurricane Isabel: 43 of
266 contacted (16%)
Orange County Health Dept Public Health Reserve Corps
November 2003
DIVISION OF PUBLIC HEALTH /7~~G^~'o~
E OF PUBLIC BEALTH PREPAREDNESS .AND RESPONSr: O
OFFIC
ACTREEMENT ADDENDA
ORANGE CO
Contractor Name
Epidemiology _ _
Section
Public Health Preparedness and Response
Branch
~fi2~-
.,51Q~"-North Carolina Public Health Preparedness and
Response System
Activity Number and Title
August 31, 2003 -August 30, 2004
Effective Period (Beginning and Ending Date)
SFY - 04
ca ear
Revision 1
Revision # Date
This Amendment modifies the existing Aid to Counties Grant for North Carolina State Fiscal Year 2003-
2004. The total amount funded under this Amendment is $4,025,269. The Division of Public Health,
Office of Public Health Preparednes:c and Response has made (these) funds available to Local Health
Departments (LHD) through a fundnig formula that awards Local County Health Departments and Multi
County Districts with specific budgeted amounts based on population percentages (60%j, percentage of
land square miles (20%) and percentage of total square miles (20%). Additionally, a base amount of
$50,000 will be received (awarded) ley each county or district.
These funds are made available to L~~cal (County) Health Departments and Multi County Districts to
further assist counties in continuing to strengthen local public health infrastructure and capacity, and to
effectively respond to a possible bio':errorism event. Specifically, under our Continuation Guidance from
the Centers for Disease Control and Prevention (CDC), these funds will be used to enhance strategic
direction, coordination and assessment, public surveillance and detection capacities, risk communication
and health infomnation disseminatio:z, and education and training.
Scope of Work for Local Health Deuartments:
• Establish a process for strategic leadership, direction, coordination, and assessment of activities to
ensure local readiness, interagency collaboration, and preparedness for bioterrorism, other outbreaks of
infectious disease, and other public health threats and emergencies.
• Conduct integrated assessments of public health system capacities related to bioterrorism, other
infectious disease outbreaks, and other public health threats and emergencies to aid and improve
planning, coordination, and imf~lementation.
• Respond to emergencies caused. by bioterrorism, other infectious disease outbreaks, and other public
health threats and emergencies ~:hrough the development, exercise, and evaluation of a comprehensive
public health emergency preparedness and response plan. Exercise this plan at least annually and
incorporate any lessons learned from exercises into successive versions of the plan.
Effectively manage elements oi'the CDC Strategic National Stockpile (SNS) at the county or local
level, should it be deployed-translating SNS plans into fum preparations, periodic testing of SNS
preparedness, and periodic training for entities and individuals that are part of SNS preparedness. At a
minimum, planning and exercises should incorporate the reception of SNS materials at the county's
Local Disinbution Site, distribi:tion to hospitals and Dispensing Sites within the county, and conduct
of dispensing pharmaceuticals toaffected personnel.
Page _ of _ ~` ,
County Health )~' ecto Signature and Date
DIVISION OF PUBLIC HEALTH
OFFICE OF PUBLIC HI' ALTH PREPAREDNESS AND RESPONSE
AG:ItEEMENT ADDENDA
• Detect a terrorist event through ap;~ropriate participation in a highly functioning, mandatory reportable
disease surveillance system, as evidenced by ongoing timely and complete reporting by providers and
laboratories in the jurisdiction, especially of illnesses and conditions possibly resulting from
bioterrorism, other infectious dises~se outbreaks, and other public health threats and emergencies
• Effectively investigate and respozvi to a potential terrorist event as evidenced by a comprehensive and
annually exercised epidemiologic investigation plan that addresses interviews, laboratory information,
identification of exposures, identification of contacts, quarantine and isolation as required.
• Provide needed health/risk information to the public and key partners prior to and during a terrorism
event by establishing critical baseline information 6bout the current communication needs and barriers
within individual communities, and identifying effective channels of communication for reaching the
general public and special populations during public health threats and emergencies.
• Ensure the delivery of appropriate education and training to key public health professionals, infectious
disease specialists, emergency deF~artment personnel, and other healthcare providers (including mental
health care) in preparedness for ez~d response to bioterrorism, as well as, other infectious disease
outbreaks, and other public health threats and emergencies. And, in the delivery of appropriate
education and training, where pos;-bie, use existing curricula and other sources, including Centers for
Public Health Preparedness, other schools of public health, schools of medicine, academic health
centers, CDC training networks, and other providers.
Ensure participation of the Department or District's public health workforce in the online Workforce
Development System competency assessment and training referral modules. At a minimum, 75% of
full time employees will have completed the online assessment by the and of the grant period.
Method of Accountability:
Local (County) Health Departments will establish and maintain a method of reporting monthly fiscal
expenditures and program/project activities. These reports are to be made available to the State's
Bioterrorism Coordinator quarterly or, upon reasonable request.
Isd Budget:
The itemized budget for the new t ;'DC Bioterrorism Grant Year 04 which began August 31, 2003
(listed on budget estimate as Fun~d/RCC/FRCs 1561-2680, 2681, 2687-ET'} i~ to he l~ud¢eted fora 12
month service and vavment oeriai- thsougl},.,~g<~ 30.2004.
Funding for the activities suthori~xd under this Amendment may occur in both NC State Fiscal Years
2203-2004 and 2004-2005. Budget breakdowns for each fiscal year are attached and incorporated
herein by reference. Deparhnen~~a should ensure that adequate funds are reserved to maintafn
any ongoing actlvitiea throngh I:he first two math: of SFY 04-OS. Notification of any reallocation
of budgeted amounts should be submitted to Dr. James Kirkpatrick, Bioterrorism Coordinator, Office
of Public Health Preparedness ami Response.
Page - of_
County Health for Signature and Date ` ~~
DIVIS][ON OF PUBLIC HEALTH
OFFICE OF PUBLIC HEALTH PREPAREDNESS AND RESPONSE
AGREEMENT ADDENDA
Orange County Health Department Epidemiology
Contractor Name Section
f~_ ..A..
Public Health Preparedness and Response
Br
Activity #4519 Bioterrorism - :~mallpoz SFY - 04
Activity Number and Title
August 31, 2003 - August 30, 2004 ~~
Effective Period (Beginning and Ending Date) Revision # Date
The North Carolina Smallpox Vaccination Plan (NCSVP) is a key element of the State's Public Health
Preparedness and Response Plan for Iioterrorism and the overall work of the Department of Health and
Human Services. The North Carolina Smallpox Vaccination Plan involves all North Carolina counties and
local health departments and requires detailed planning at the state, regional and local levels for pre-event
vaccination, ring vaccination and mass vaccination. Under this Agreement Addenda, Local (County) Health
Departments are authorized to administer funds in support of the State's Smallpox preparedness plan and
their county's plans. The total amour: funded under this Agreement Addenda is $1,490,580.
These funds are made available to Local (County) Health Departments and Multi County Districts to
maintain and strengthen state, region«1 and local Smallpox preparedness and response activities.
Specifically, these funds will be used to maintain and enhance activities, including, but not limited to:
Surveillance, Disease Investigation, Vaccination, Mass Care, Mass Fatality, Quarantine/Isolation, Public
Information, and Command/ControU(Jo*+~*++~cations. When such activities are performed, LHDs will
ensure that smallpox is included in the list of possible agents and the particular features of smallpox as a
BT agent are addressed. In support of the overall smallpox preparedness efforts, funds maybe expended
for: education and training, exercises. recruitment of volunteers, maintenance of data bases of vaccination
centers and distribution points, acqui:;ition of equipment and systems for data management, rapid reporting,
outbreak investigation, case finding, i solation and quarantine, contact tracing, vaccination and risk
communication.
Method of Accountability:
• Local (County) Health Departure nts will establish and maintain a method of reporting monthly fiscal
' expenditures and SVP activities. These reports are to be made available to the State's Bioterrorism
Coordinator quarterly or, upon reasonable request.
Itemized Budget:
• The itemized budget for the new CDC Bioterrorism Grant Year 04 which began August 31, 2003
(listed on budget estimate as Futid/RCC/FRC: 1563-2680, 2681, 2686, 2686, 2688-ET) is to be
budgeted fora 12 month service andpavment period, through An~~~t 30 2004. that will extend
/overlap into SFY OS for Julv andi Ate.
Funding for the activities authorized under this Amendment may occur in both NC State Fiscal Years
2203-2004 and 2004-2005. Budget breakdowns for each fiscal year are attached and incorporated
herein by reference. Departments should ensure that adequate funds are reserved to maintain
any ongoing activities through the first two months of SFY 04-05. Notification of any reallocation
of budgeted amounts should be submitted to Dr. James Kirkpatrick, Bioterrorism Coordinator, Office
of Public Health Preparedness acid Response.
Page - of -
County Health` irector Signature and Da e
I`~
DIVISION OF PUBLIC HEALTH
OFFICE OF PUBLIC HEALTH PREPAREDNESS AND RESPONSE
AGREEMENT ADDENDA
Orange Count~~ Health Department
Contractor Name
Activity #4518 Bioterrorism -Strategic National Stockpile
Activity Number and Title
Epidemiology
Section
Public Health Preparedness and Response
Branc
SFI' - 04
ear
August 31, 2003 -August 30, 2004
Effective Period (Beginning and Ending Date)
Orin ,~: _ _
Revision # Date
As a major component of the State's B.egional Public Health Preparedness and Response for Bioterrorism
efforts, all I~TOrth Carolina counties arni host health departments are required by the State to develop and
maintain a Strategic National Stockpile (SNS) Plan, and as such, under this Agreement Addenda, are
authorized to administer funds in support of local!county SNS plans.
These funds are made available to Local (County) Health Departments and Multi County Districts to assist
counties in continuing to develop and strengthen local public health SNS infrastructure and capacity, and to
effectively respond to a possible bioterrorism event. Specifically, under our Continuation Guidance from
the Centers for Disease Control and Prevention (CDC), these funds will be used to develop county SNS
plans, identify SNS distribution and dispensing sites, exercise and evaluate county SNS plans and to recruit
volunteers to man and support local S NS specific activities. The total amount funded under this Agreement
Addenda is $462, 610.
Method of Accountability:
• Local (County) Health Departme:~ts will establish and maintain a method of'reporting monthly fiscal
expenditures and SNS program~project activities. These reports are to be made available to the State's
SNS Manager or Bioterrorism Coordinator quarterly or, upon reasonable request.
Itemized Bud_et:
• The itemized budget for the new CDC Bioterrorism Grant fear 04 which began August 31, 2003
(listed on budget estimate as Fund/RCC/FRC: 1562-2688-ET) is to be budgeted fora 12 month
service and payment veriod, throe fah August 30, 2004.
• Funding for the activities authori:~ed under this Amendment may occur in bath NC State Fiscal Years
2203-2004 and 2004-2005. Budl;et breakdowns for each fiscal year are attached and incorporated
herein by reference. Departments should ensure that adequate funds are reserved to maintain
any ongoing activities through the first t~~~o months of SFY 04-05. Notification of any reallocation
of budgeted amounts should be s ~btnitted to Dr. James Kirkpatrick, Bioterrorism Coordinator, Office
of Public Health Preparedness and Response.
Page _ of - ~ ti-; i'~i.~'~ti ~ •~~ l' "1Li`L J "/ ) 2 /~?
~ ~
~ r'
County Hea ,`, Director Signature and D to
~0
DIVIS]:ON OF PUBLIC HEALTH
OFFICE OF PUBLIC HEALTH PREPAREDNESS AND RESPONSE
AGREEIV~ENT ADDENDA
Orange County Health Department
Contractor Name
Activity #4515: Bioterrorism - Risb: Communication
Activity Number and Title
august 31,.2003 -August 30, 2004
Effective Period (Beginning and Ending Date)
Epidemiology
Section
Public Health Preparedness and Response
Branch
FY - 04
Fiscal Year
evision 1
n # Date
This Amendment modifies the existin;; Aid to Counties Grant for North Carolina State Fiscal Year 2003-
2004. The total amount funded under this Amendment is $332,100.
The North Carolina Department of Health and Human Services, Division of Public Health, Office of
Public Health Preparedness and Response for Bioterrorism recognizes that Risk Communication is an
essential component of the State's ability to respond to a possible bioterrorism or other public health
disaster, by providing the public with information on how and who to contact in matters associated with an
actual or suspected biological attack, or an unusual outbreak of disease. This Agreement Addenda,
authorizes Local (County) Health Departments to administer funds to raise public awareness regarding the
threat of bioterrorism and potential biological agents, and provide citizens with information on steps to take
to prepare for a biological threat or other public health disaster.
~ecifically these funds are to be uses. to:
• Establish and participate in regional meetings for Public Information Officers (PIO) from Public
Health, Hospital Administration ~.nd Law Enforcement
• Identify appropriate Risk Communication training opportunities Public Information Officers and local
and regional media facilitators
• Coordinate Risk Communication educational activities for PIOs and media facilitators
• Develop Risk Communication pr~~cedures and protocols
• Support and participate in "infra-~;ounty" and "inter-county" Risk Communication flow matrix
• Establish "cross-regional" Risk c~~mmunication network
The funds may also be used to pay fon any or all of the following: radio and print advertising; flyers;
brochures; pamphlets; posters, sticker.a, public presentation materials, exhibit panels and other promotional
materials as long as they address one or more of the three objectives listed above.
% + ,
Page _ of _ ; ,~.~. ~t1 d~4.jf.'
~'~~vL•Yi~44.~ u ,La'' '' 7
County Healt)/~ irector Signature and Dafe
1 ' I~M~ ~ ff
I~
Medical Reserve Corps Grant Proposal
Orange County Health Department
Hillsborough, NC 27278
Project Summary
Funding in the amount of $:10,000 is requested from the U.S. Department of Health and
Human Services to assist with development of a volunteer Medical Reserve Corps (MRC) in
Orange County, North Carolina. The MRC will utilize motivated volunteers to strengthen
Orange County's capacity to respond to emergency events and to strengthen the local public
health infrastructure. The MRC urut of Orange County will coordinate with existing community
emergency response systems by providing adequately trained and appropriately credentialed
volunteers during emergencies. Tlie volunteer corps will also help respond to local disease
outbreaks and help address public health needs and problems throughout the year. The volunteer
MRC will consist of medical professionals (i.e. nurses, pharmacists, physicians, physician
assistants, laboratory technicians, 3entists, veterinarians, and health educators) and non-medical
community members (i.e. retired :,eniors, clergy, childcare workers, and security guards).
Orange County's geograpluc location within the State of North Carolina places it at risk
for natural disasters such as hurricanes and tornadoes. Snow and ice storms also pose significant
risk for the County, and because they occur so rarely, the County is not equipped to sufficiently
respond. An ice storm at the beginning of this year left thousands of citizens without electricity
for nearly two weeks. Orange County Health Department nurses staffed emergency American
Red Cross shelters but found it difficult to provide needed services due to inadequate manpower.
Orange County is also home to the University of North Carolina at Chapel Hill, which
provides a wealth of resources and potential volunteers, but it also creates risks for the
~3
community. The University has a large international student population, which can increase the
community's vulnerability to communicable disease outbreaks such as Severe Acute Respiratory
Syndrome (BARS) and tuberculosis;. Additionally, Orange County is at risk for terrorist attacks
from biological, radiation, and chemical agents because of its position as a university community
and its proximity to the international Research Triangle Park and the Sharon Hams Nuclear Plant
in neighboring Chatham County. These facts are only a few examples of why establishment of a
volunteer MRC unit in Orange County is essential for assuring the health, safety, and well-being
of its citizens.
Orange County Health Department (OCHD) collaborates closely with a number of
community partners including, but not limited to, the Orange County Departments of Emergency
Management and Social Services, the local chapter of the American Red Cross, animal control
services, and local law enforceme~it. The OCHD also works closely with the University of North
Carolina Department of Public Safety, Health Care System, Student Health Services, and
Schools of Nursing, Pharmacy, Public Health, and Medicine.
Federal bioterrorism funding awarded by the State this spring was used in part to begin
establishment of the volunteer MI:C unit. A contract Public Health Preparedness Coordinator
has begun recruitment of the first cadre of medical professionals for the Medical Reserve Corps.
Local licensed nurses and pharmacists have been invited to attend information sessions on the
corps with an objective to recruit at least forty nurses and ten pharmacists to join the corps and
participate in the first training on American Red Cross Mass Shelter Care and Disaster Health
Services. Future trainings will include basic Incident Command System (ICS) operations and
mass prophylaxis/immunization f or potential bioterrorism events.
Iq-
If grant monies are awarded for the MRC unit, a Volunteer Coordinator will be hired and
oriented to continue establishment of the volunteer corps. This individual's primary
responsibilities will include additio:zal volunteer recruitment, credential verification,
development of volunteer role descriptions, training, activation and deployment, program
evaluation, volunteer database management, advocacy and promotion, fiscal management, and
collaboration with community part'lers. The Volunteer Coordinator will also work with
representatives from the Departme~lt of Emergency Management and the Public Health Regional
Surveillance Team to address man~~ower issues pertaining to levels of response for various
emergency events. Appropriate volunteers will then be recruited and trained to participate on the
necessary response teams. When the pool of volunteers is not activated for an emergency
response, the Coordinator will engage them regularly in new and ongoing public health
initiatives in the community or clip ucal setting. These initiatives could include flu clinics,
chronic disease management, language interpretation, nutrition/health education, community
screening/referral programs, well-water evaluations, and kennel inspections.
The program will be evaluated with regard to process, impact, and outcome. Counts and
percentages will be calculated ba:.ed on the number of volunteers that join the MRC and the
number that attend trainings and disaster drills. The effectiveness of trainings will be measured
with pre- and post-tests and participant evaluations. Disaster drill and actual disaster response
will be evaluated based on the number of volunteers responding and demonstration of knowledge
of roles and responsibilities. The success of the program will also be evaluated through surveys
of OCHD staff and partnering ag~~ncies, and volunteers will be surveyed about their satisfaction
with orientation, training and def~loyment. All surveys will request that respondents provide
feedback on areas of concern anc~ recommendations for improvement.
3
15
Project Narrative
Background
The establishment of a Medical Reserve Corps by the Orange County Health Department
will occur in Orange County, North Carolina (Appendix A -Map). Orange County Health
Department (OCHD) is a unit of the; local County govenunent. Orange County has a population
of 118, 000, encompasses approximately 400 square miles and consists of three main
municipalities -the Towns of Chal-el Hill (population 46,800), Can-boro (population 16,800),
and Hillsborough (population 5,500). Since the overall population of the County relative to the
three main municipalities is substazitial, the majority of the population lives in rural areas and
depends on County public agencies; for their services. Due to the geographic location of Orange
County, the community is at risk far hurricanes, tornadoes, and floods. The University of North
Carolina (UNC) is also located in Orange County and has a significant international student
population, thus placing the community at risk for communicable diseases, such as SARS
(Severe Acute Respiratory Syndrome) and tuberculosis. The Orange County Health Deparment
(OCHD) has collaborated closely with Orange County Department of Emergency Management,
Orange County Chapter of the American Red Cross, Orange County Department of Social
Services, local law enforcement, a,~d Animal Control Services in responding to disasters such as
hurricanes, tornadoes, and ice stones. All of these events displace citizens and their pets and
require thorough coordination of services to meet the needs of the community.
The University of North C;~rolina at Chapel Hill consists of a number of health
professional schools and a large tertiary hospital. The OCHD recognizes the wealth of resources
and support available from the university community and has established relationships with
individuals at UNC Hospitals, Stu3ent Health Services, and within the Schools of Public Health,
4
i c~
Nursing, Pharmacy, and Medicine. An ice storm at the beginning of this year and the recent
occurrence of a SARS case in Orange County provided unplanned opportunities to collaborate
with local emergency response parbiers, University officials, and technical experts. Much was
learned from these experiences, an~-the lessons learned have been examined closely in
conjunction with all community pa,-tners in order to revise and refine current preparedness and
disaster response plans. The OCHI), Orange County Department of Emergency Management,
local law enforcement, the University, and the University Health Care System have agreed to
base disaster response on the Incid~:nt Command System (ICS). Health Department staff is
currently participating in ICS training through the Orange County Department of Emergency
Management and is also undergoing American Red Cross Disaster Health Services and Mass
Shelter training. During the recen~: ice storm OCHD nurses and American Red Cross volunteers
found it difficult to meet the needs of many of the citizens displaced from their homes, especially
frail older adults and individuals vrith special needs. There simply were not enough nurses or
volunteers to staff both mass care and special needs shelters. However, given the nature of this
community, there is abundant opportunity to tap into and marshal the energy and capacity of
volunteers to strengthen the public; health infrastructure and emergency response effort.
The mission of the Orangf; County Health Department is "to enhance the quality of life,
promote the health, and preserve the environment for all people in the Orange County
community" The OCHD divisions consist of Central Administration, Personal Health Services,
Health Promotion and Education. Dental Health, Environmental Health, and Animal Control
(Appendix B -Organizational Chart). The volunteer Medical Reserve Corps (MRC) unit will be
established through the Personal Health Services Division, which is the largest division within
the Health Department. Services provided by the Personal Health Services Division include
5
i~
Clinical Services, Community Services, Family Home Visiting, and Risk Management and
Training (Appendix C -Personal Health Services Organizational Chart). The Personal Health
Services Division currently has on :staff twenty-three registered nurses and three and one-half
family nurse practitioners. One nw•se practitioner is assigned to the County Jail and must
respond to that location during disasters and thus cannot be included in shelter staffing.
Considering these facts, it becomes very challenging at times to meet the community's needs
during disasters or to provide servi~~es for public health needs and problems throughout the year.
Sununarv of Existing Resources acid Community partnerships
In Apri12003, the Orange (~owlty Health Department received Federal funding through
the State for bioterrorism planning and response. A portion of this funding was utilized to begin
development of the volunteer MR~~, but this current funding source ceases on August 31, 2003.
Through the use of these funds, the Health Department entered into a contract with Carla Julian,
a registered nurse with a Master oPPublic Health (see Appendix D biographical sketch). As the
Public Health Preparedness Coordinator, Ms. Julian's primary responsibilities have been to begin
recruitment of the first cadre of volunteers for the reserve corps and to work closely with the
Health Director to finalize the County's Public Health Preparedness and Bioterrorism Response
Plan (Appendix E -Plan without appendicies). To date, the Coordinator has met a number of
the contractual deliverables. In s•~mmary, the Coordinator has sent invitations to approximately
2,500 professional nurses and 27:i pharmacists inviting them to an information session on the
County's Medical Reserve Corps (Appendix F -Invitation Cards). She has established
relationships with key disaster preparedness contacts at the University of North Carolina (i.e.
Department of Environmental Health and Safety, Student Health Services, and the Schools of
6
I$
Nursing, Pharmacy and Public Health). The Coordinator has also established relationships with
representatives from the Orange County Chapter of the American Red Cross, local Citizen Corps
representative and Community Emergency Response Team (CERT) coordinator (Eric Griffin),
and the Public Health Regional Surveillance Team. In conjunction with bioterrorism planning
efforts, the Coordinator has met with local emergency management, law enforcement, University
public safety, mental health profes:;ionals, school representatives, and water and sewer authority
representatives. All community partners are supportive of the establishment of a Medical
Reserve Corps in Orange County, ;end letters of support have been provided by the Orange
County Department of Emergency Management (Appendix G), the Orange County Chapter of
the American Red Cross (Appendix H), University of North Carolina 'School of Nursing
(Appendix >), and the Orange County Board of Health (Appendix ~.
To date, more than 150 nw-ses and at least 10 pharmacists have expressed an interest in
attending an information session on the Orange County Health Department's volunteer MRC.
These information sessions have teen scheduled for late August and early September of this
year. Other key partnerships include the UNC School of Public Health and the North Carolina
Center for Public Health PrepareCness who have offered to assist in disaster planning and
response by providing discipline-specific contacts at the School of Public Health and to sign a
Memorandum of Agreement outlining this relationship. The UNC School of Nursing is also
willing to sign a Memorandum oi~Agreement and has offered to provide faculty, staff, and
student volunteers and to assist v~~ith MRC training.
Orange County community partners and linkages currently have the capability of
providing tactical support and technical expertise, but the County lacks sufficient trained
manpower to respond to local emergency events or to provide services for unmet public health
7
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needs and problems. During the icf; storm at the beginning of this year, the OCHD worked
closely with the local chapter of the. American Red Cross to staff shelters, but meeting the needs
of all involved citizens was difficult due to a shortage of nurses and trained volunteers. The
Orange County Chapter of the Ame:rican Red Cross establishes the shelters but does not provide
staff or volunteers for Disaster Health Services. Instead, OCHD nurses are mandated to staff all
emergency shelters, and a MRC unit is desperately needed to provide additional surge capacity
to meet the needs of the communit:~ during times of need.
Organizational Structure
With creation of the Medic,~.l Reserve Corps underway, a planning body will be
established under the auspices of the Orange County Board of Health (Appendix K -
Membership Roster) and direction of the Health Director, Rosemary Summers (Appendix L -
biographical sketch). This planning body will include representatives from the MRC and the
Personal Health Services and Health Promotion and Education Divisions of the OCHD.
Representatives from the following; entities will also be encouraged to join the planning body:
Orange County American Red Cress, Orange County Departments of :Emergency Management
and Social Services, tJNC Schools of Nursing and Pharmacy, the Latino community, the
Disability Awareness Council, and the public at-large.
The Medical Reserve Corps Volunteer Coordinator will be a Public Health Nurse I
position (Appendix M -Job Description) and will report to the Public Health Preparedness
Coordinator once that position is supported by the County. In general, the Volunteer
Coordinator will be responsible for continued volunteer recruitment, credential verification,
development of volunteer role descriptions, training, activation and deployment, program
8
ao
evaluation, volunteer database man,~.gement, advocacy and promotion, fiscal management, and
collaboration with community partners. The Volunteer Coordinator will work closely with the
Public Health Preparedness and Risk Management/Training Coordinators to develop training
opportunities for volunteers in such areas as Incident Command System, bioterrorism, and
American Red Cross Disaster Services. The Volunteer Coordinator will also work with
representatives from the Department of Emergency Management and the Public Health Regional
Surveillance Team to address manI-ower issues pertaining to levels of response for various
emergency events. Appropriate volunteers will then be recruited and trained to participate on the
necessary response teams.
Current Status of Medical Reserve Corps
The Public Health Preparedness and Risk Management and Training Coordinators have
begun establishment of the MRC unit and have accomplished the following tasks:
• Established relationships with and discussed creation of the MRC with key community
partners including local Citizen Corps and CERT coordinator (Eric Griffm); Public
Health Regional Surveillance Team; Orange County Chapter of the American Red Cross;
Orange County Departments of Emergency Management and Social Services; local law
enforcement; and LTNC Hospitals, Student Health Services, and Schools of Nursing,
Public Health, and Pharmacy.
• Obtained database of all O:-ange County licensed RNs and LPNs from the North Carolina
Board of Nursing (approxi:;nately 2,500 total).
• Obtained database of all Orange County licensed pharmacists from the North Carolina
Board of Pharmacy (approximately 275 total).
9
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Mailed postcards to all licensed Orange County nurses and pharmacists inviting them to
an information session on the Medical Reserve Corps.
Hired a temporary administrative assistance to assist with postcard mailings, organize
respondents into temporary database, correct address errors, re-mail returned postcards,
and assist with organizatioxi of information sessions.
Contacted all interested respondents via letter or telephone regarding the MRC
information sessions and fixture training topics.
Completed Respiratory Tr<<ining and Fit-Testing for Personal Protective Equipment
(respirators) in order to fit-test volunteers for respirators on-site during emergencies.
Ordered and obtained all b•aining materials to conduct information sessions and initial
MRC training modules.
Goals/Objectives/Strategies
Orange County Health D~artment Medical Reserve Corps Goal Statement
A volunteer citizen corps of qualified, trained medical professionals and non-medical
community members will provide: additional response capacity during emergency events,
strengthen the public health infrastructure, and help address public health needs and problems
throughout the year.
Obi
First Quarter' Year One Funding
1. Fifty percent of the licensed nurses (approximately 100) who respond to the invitation
postcard will attend one of tliree scheduled information sessions on the MRC and Health
Department roles and respor.~sibilities by September 30, 2003.
10
as
2. Seventy-five percent of the licensed pharmacists (approximately 15) who respond to the
invitation postcard will attend one of three scheduled information sessions on the MRC and
Health Department roles and re:;ponsibilities by September 30, 2003.
3. Obtain approval of finalized Volunteer Coordinator job description from Orange County
Personnel Department by OctoY~er 31, 2003.
4. Meet with representatives from local Childcare Services Association to develop plans for
establishment of on-site childcare services for employees and volunteers at shelters and/or
staging areas during disaster response by October 31, 2003.
5. Recruit, hire, and orient Volunteer Coordinator by November 30, 2003.
6. Twenty percent of licensed nur;~es (approximately 40) who respond to invitation cards and/or
attend an information session v~~ill join the MRC by November 30, 2003.
7. Fifty percent of licensed pharmacists (approximately 10) who respond to invitation cards
and/or attend an information session will join the MRC by November 30, 2003.
8. Develop and administer questionnaires to volunteers to document current place of
employment, specialty area, inrerests, skills, and anticipated MRC availability and
commitment by November 30, 2003.
9. Verify licensure and credentials of 100% of volunteers by December 15, 2003.
10. Complete design of MRC database inclusive of licensure verification reminders by
December 31, 2003.
11. Develop volunteer MRC role descriptions by December 31, 2003.
12. Assure a qualified corps of ini~:ial volunteers by providing Health Department orientation and
disaster response training by L-ecember 31, 2003.
11
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• Obtain input from internal stakeholders, including Orange County Health Director,.
Risk Management & Training Coordinator, and Health Department Division
Directors to identify volunteer roles and training needs.
• Collaborate with Orange: County Chapter of the American Red Cross to develop
Disaster Shelter, Mass Care, and Disaster Health Services training for MRC.
• Collaborate with the Orange County Department of Social Services and the Orange
County Chapter of the ~~merican Red Cross to develop Special Needs Shelter
Training.
13. Seventy-five percent of volunt~~er nurses (approximately 30) and eighty percent of
pharmacists (approximately 8) who join the MRC will attend, Disaster Shelter, Mass Care,
and Disaster Health Services b-aining by December 31, 2003.
Second Quarter Year One Funding
1. Develop MRC activation and deployment plan in conjunction with Orange County Health
Director, OCHD Division Directors, Orange County Department of Emergency
Management, UNC Health C~~re System Disaster Committee, and Orange County American
Red Cross by January 31, 2004.
• MRC activation and deployment plan will be based on the Incident Command
System.
• MRC volunteers will undergo basic Incident Command System training.
• Activation and Deployment plans will be developed for events with and without
warning to include activation triggers, alert/notification system, request from
agency/agencies for ~~ctivation of MRC, assessment of type and kind of volunteers
12
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needed, pre-designated staging areas, assignment of roles and responsibilities,
reporting chain of comir~and, and check-in/check-out procedures.
2. Seventy-five percent of MRC licensed nurse volunteers (approximately 30) will attend
additional trainings by March 31, 2004.
• Provide basic Incident C',ommand System training as described above.
• Collaborate with the Ul`dC School of Nursing on development of additional training
modules such as biologi.caUradiation/chemical agents and mass
prophylaxis/immunizati on for bioterrorism events.
• Collaborate with LTNC School of Nursing and local Area Health Education Center
(AHEC) to provide continuing education credits for nurses who attend MRC training.
3. Eighty percent of MRC license:d pharmacists (approximately 8) will attend additional
trainings by March 31, 2004.
• Provide basic Incident Command System training as described above.
• Collaborate with UNC School of Pharmacy, OCHD pharmacists, and Orange County
Board of Health pharir~acist member on development of additional training modules
such as on-site medication dispensing at emergency shelters,
biologicaUradiation/chemical agents and mass prophylaxis/immunization.
• Collaborate with IJNC' School of Pharmacy and local AHEC to provide continuing
education credits for Pharmacists who attend MRC training.
4. Establish MRC policies and Procedures related to volunteer recruitment, orientation, training,
deployment, precepting/mentoring, evaluation, and recognition by March 31, 2004.
13
as
Third Ouarter• Year One Funding
1. Begin recruitment efforts for additional medical professionals for MRC by June 30, 2004.
• Obtain current database:; of Orange County licensed nurses and pharmacists to begin
recruitment of additional nurse and pharmacist volunteers.
• Collaborate with LTNC ~~chool of Social Work and Orange County Department of
Social Services on social worker recruitment efforts.
• Contact State Social Worker licensing board to explore procurement of Licensed
Clinical Social Worker ~3atabase.
• Collaborate with the iJrdC health professional schools and State licensing boards to
identify additional medical professional recruitment targets such as laboratory
technicians, epidemiologists, biostatiticians, physicians, physician assistants, dentists,
dental assistants, certified nursing assistants, veterinarians, vet technicians, etc.
2. In collaboration with community partners, participate in tabletop and actual training drills in
preparation for activation and deployment of volunteer MRC by June 30, 2004.
3. Activate MRC unit to respond to any emergency events. Deploy, monitor and evaluate
volunteers and document type of emergency, number of volunteers responding, and volunteer
participants' evaluation of the event and response effort.
• All nurses and other LT]~1C Hospital employees must be identified upon joining the
MRC. UNC Hospital Employees must report to the hospital if required before
assisting in any public health response efforts. Close collaboration with UNC
Hospitals must occur fir coordination of volunteers when mass casualty response is
not necessary or when all off-duty nurses are not needed for small-scale mass
casualty responses.
14
acs
4. In interim, assign volunteers to new and ongoing public health initiatives to support/expand
public health efforts in the community. Provide orientation and training on responsibilities
and duties and assign volunteer to staff preceptor by June 30, 2004.
5. Identify volunteers that are interested in developing outreach programs under the direction
OCHD leaders to address additional public health needs and problems in the community
throughout the year by June 30, 2004.
Fourth Quarter' Year One Funding
1. Begin recruitment efforts for nun-medical professional volunteers such as retired seniors,
childcare workers, clergy, security guards, administrative assistants, information specialists,
and language interpreters by August 31, 2004.
2. Recruit 20 additional nurses (goa150 total) and 10 additional pharmacists (goal 18 total) by
September 30, 2004.
3. Recruit twenty-five additional medical professional volunteers including social workers,
laboratory technicians, dentist:>, dental assistants, physicians, physician assistants, nursing
assistants, epidemiologists, biostatiticians, veterinarians, and vet technicians by September
30, 2004.
4. By September 30, 2004, identify training needs for second cadre of volunteers including
Health Department orientation, American Red Cross Disaster Services (Mass Care, Disaster
Health Services, and Disaster Mental Health Services), Incident Command System,
biologicaUradiation/chemical agent response efforts, and mass prophylaxis and
immunization. Collaborate with Health Department Directors and community partners to
identify other discipline-specific training needs.
15
a~
5. Collaborate with identified volunteers, Health Department leaders, and community partners
to establish one volunteer outre;ich program for unmet public health need or problem by
September 30, 2004.
Evaluation
Program process and impact will be measured through use of a Microsoft Excel database,
which has been created to track nurse and pharmacist response rates to invitation postcards in
absolute numbers and percentages. Counts and percentages will also be collected and evaluated
of the number of nurses, pharmacists, and other medical professionals and non-medical citizens
who join the volunteer Medical Re;verve Corps. Logs will be maintained of those who attend
information sessions and trainings, counts will be done based on logs, and percentages will be
calculated relative to the number oi'participants that were scheduled to attend the information
sessions and trainings.
The effectiveness of trainings will be measured with pre- and post-tests and participant
evaluations. Disaster drilUexercise success will be measured based on participant feedback,
number of volunteers and community partners participating, and volunteer demonstration of
understanding of protocols, roles a1d responsibilities. Community confidence following
establishment of the MRC unit wil l be measured through use of surveys and discussions with
collaborative agencies, stakeholders, and citizens.
Program outcome will be measured based on actual disaster response through
documentation of the event, numbf;r and type of volunteers needed/responding, demonstration of
understanding of activation and de~aloyment protocols and roles and responsibilities. Disaster
response performance will also be measured through feedback from community partners and
16
a8
citizen surveys of community confi3ence following the disaster response effort. Volunteer
outreach programs for public healtY~ needs and problems will be measured based on number of
citizens served, client outcomes, and consumer satisfaction following service provision.
In addition to the objective measures identified above, the success of the program will be
evaluated through surveys of OCHD staff and partnering agencies to determine the effectiveness
of training and performance of vol~znteers. Volunteers will also be surveyed regarding their
satisfaction with orientation, traini~ig and deployment. All surveys will request that respondents
provide feedback on areas of concf;rns and recommendations for improvement.
Plan for Sustaining Medical Reserve Corps Unit
Detailed documentation will be maintained on the MRC volunteer demographics,
policies, procedures, objectives, d~-i11 and actual disaster response, and evaluations. Reports will
be submitted to the Orange County Board of Health, County Managers, and the Board of County
Commissioners throughout the program duration. Prior to termination of Federal Funding, the
Orange County Health Department will seek County funding for continuation of the Medical
Reserve Corps unit.
Statement of Willingness
The Orange County Health Department is willing to contribute written information to the
Office of the Surgeon General on our local Medical Reserve Corps unit's progress, lessons
learned, best practices, and areas for improvement.
The Health Department i:; willing to accept any type of technical assistance that maybe
needed, such as development of operational plans or evaluation approaches.
17
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Attachment 4
Job Duties
Public Health Preparedness Coordinator
Ora~~ge County Health Department
1. Revise and update all Public Health Bioterrorism and Emergency Preparedness and Response plans
through coordination with multiple community partners (e.g. EMS, UNC Health Care, Red Cross,
Law Enforcement etc.)
Examples of plans needing revision or development:
• Infectious Agent Preparedness Plan
o Smallpox Preparedness Plan
o SARS Response Plan
o Influenza Pandemic Response Plan
o Some foodborne and waterborne outbreaks (like shigella)
• Chemical Public Health Response Plan
• Radiological Public Health Response Plan
• Strategic National Stockpile Pixblic Health Management Plan
o Mass Vaccination/Prophylaxsis Plan
• Non-infectious Agent Preparedness Plan
o West Nile Virus Plan
o Anthrax Response Plan.
o Some foodborne and waterborne pathogens (like crpytosporidium)
• General Communicable Disea:;e Response Plan
o TB, Hepatitis, HIV, STI,
2. Revise and update all public health emergency preparedness and response policies and procedures
such as staff policies in working ir.. infectious and non-infectious environments; required staffing
levels for vaccination sites and qu<<lification of staff for each duty.
3. Organize and coordinate County B ioterrorism/Emergency Preparedness meetings and various
subcommittees (information mana,;ement, exercise design and evaluation)
4. Co-chair County Exercise Design ~3ubcommittee in collaboration with Emergency Management
Specialist: organize meetings, assi;~t with selection of agenda items, and participate in exercise
design, planning, implementation, and evaluation.
Establish Memorandums of Agreement with UNC Health Professional Schools and other community
partners to make those resources available when needed.
6. Supervise the development, review, and revisions of Medical Reserve Corps plan of action
consistent with risks and vulnerabilities of the community. Recruit, train and supervise Volunteer
Coordinator for the Medical Reserve Corps Cooperative Agreement.
8. Provide nursing supervision of nurse volunteers at emergency sites as needed.
9. Provide training to volunteer nurses in emergency procedures and policies such as
• vaccination training for specified agents;
• appropriate personal protectivE; clothing requirements and procedures for dressing and
undressing;
• N-95 mask fit training and use; mass triage and care principles, etc.
Attachment 4
10. Staff emergency shelters and mass medication prophylaxis sites as needed during natural and man-
made disasters or communicable disease outbreaks.
11. Search for additional grant funding; sources, complete grant applications, and administer funded
grants per guidelines.
Attachment 4
Job Duties
Medical Reserve Corps Volunteer Coordinator
Ora~ige County Health Department
1. Recruit medical personnel, develop volunteer role descriptions, verify credentials,
develop training, and evaluate training.
Medical reserve corps will include nurses, pharmacists, social workers, physicians, health
educators, laboratorians, and o .hers.
2. Identify and deploy Medic~d Reserve Corps volunteers to effectively respond to
emergency situations and to address public health needs and problems throughout the
year.
3. Identify potential pools of ~~olunteers; coordinate with partner agencies in recruitment
efforts assuring non-duplication of efforts; maintain interest and commitment of recruits.
4. Develop training curriculum in conjunction with partners (Red Cross, EMS,
University of North Carolina, f:tc.), identify resources to undertake training; assist with
training presentations, particip;ite in coordination of emergency exercise program.
Training will include topics su~:h as disaster response roles, psychological support of
victims, specific training for each job description such as history screener, etc.
5. Assess volunteer coordination efforts to assure program objectives are met and
deployment is successful. Assist with program revision based on evaluation. Prepare
Medical Reserve Corps Federal Grant reports as required.
6. Develop/manage a database of Volunteers -demographics, service area, credentials,
specialty areas, experience, training history, deployment so that the data can be accessed
to secure volunteers when needed.
7. Assist with development ofpress releases, PSAs, and articles with regard to
Volunteer Medical Reserve Corps advocacy, recruitment, and sustainability. Make
presentations to community groups regarding Medical Reserve Corps. Honor and
appreciate volunteers on a regular basis.
8. Secure training resources, manage materials, and administer grant.
9. Serve on committees/task forces addressing Orange County's emergency response
needs (i.e. Epi Team, Bioterrorism Response Team, Red Cross Disaster Committee, etc.)
Coordinate with Community Response Team and Immigrant Communication
Committees already functioning through Emergency Management.
31
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