Idaho’s Approach to Project Public Health Ready (PPHR)

Darce Vassar Travis BestRod Horejs

Darce Vassar PHP Program Manager

North Central District Health Department

First Speaker

Public Health in IdahoBoundary

Bonner

Kootenai

Benewah Shoshone

LatahClearwater

Nez Perce

Lewis

Idaho

Adams

Valley

Washington

Payette

Canyon

Boise

Ada

OwyheeTwin Falls

Jerome

Blaine

Lincoln

Minidoka

Cassia

Power

OneidaFranklin

Bear Lake

Bannock

Caribou

Bingham

CusterClark Fremont

TetonJefferson Madison

Bonneville

Butte

Gooding

CamasElmore

Gem

Lemhi

1

2

3

4

56

7

Boundary

Bonner

Kootenai

Benewah Shoshone

LatahClearwater

Nez Perce

Lewis

Idaho

Adams

Valley

Washington

Payette

Canyon

Boise

Ada

OwyheeTwin Falls

Jerome

Blaine

Lincoln

Minidoka

Cassia

Power

OneidaFranklin

Bear Lake

Bannock

Caribou

Bingham

CusterClark Fremont

TetonJefferson Madison

Bonneville

Butte

Gooding

CamasElmore

Gem

Lemhi

1

2

3

4

56

7

•Boards of Health

•District Directors

The Project

• Voluntary review

• Very well organized

• Great support infrastructure

• Logical design– Planning– Workforce competency– Exercise / Simulation

Poll Question

My public health jurisdiction:

A. Has not yet considered doing PPHR

B. Is considering doing PPHR

C. Is in the process of doing PPHR

D. Has completed PPHR

Tools that Worked

• Design them to be user friendly.

• Make them accessible to everyone.

• Allow them to adapt as the project grows.

For list of tools

NACCHO EQUIPh • www.naccho.org/EQUIPh/index.cfm

Northwest Center for Public Health Practice • www.nwcphp.org/technical-assistance/specialproject

NWCPHP role in PPHR NACCHO EQUIPh

Momentum is KEY

• Don’t miss a meeting– In-house team meetings– Regional conference calls with NACCHO– National PPHR meetings

Enthusiasm from the top down is

essential!

Make PPHR the Cornerstone

• Whether it has been done or needs to be done, PPHR can be utilized as a catalyst for accomplishing and/or fine-tuning tasks.

Poll Question

In my opinion, the most important challenge of participating in PPHR might be:

A. Early state of development of standards for PH preparedness.

B. Inconsistencies between state and CDC expectations

C. Fluctuating expectations in a dynamic field of practice.

D. Substantial non-reimbursed costs associated with participating in PPHR

Lesson Learned

“One result of PPHR is that the details are never fine enough.”

Rod HorejsPHP Program Manager

Southeastern District Health Department

Next Speaker

Public Health in Idaho

Boundary

Bonner

Kootenai

Benewah Shoshone

LatahClearwater

Nez Perce

Lewis

Idaho

Adams

Valley

Washington

Payette

Canyon

Boise

Ada

OwyheeTwin Falls

Jerome

Blaine

Lincoln

Minidoka

Cassia

Power

OneidaFranklin

Bear Lake

Bannock

Caribou

Bingham

CusterClark Fremont

TetonJefferson Madison

Bonneville

Butte

Gooding

CamasElmore

Gem

Lemhi

1

2

3

4

56

7

Boundary

Bonner

Kootenai

Benewah Shoshone

LatahClearwater

Nez Perce

Lewis

Idaho

Adams

Valley

Washington

Payette

Canyon

Boise

Ada

OwyheeTwin Falls

Jerome

Blaine

Lincoln

Minidoka

Cassia

Power

OneidaFranklin

Bear Lake

Bannock

Caribou

Bingham

CusterClark Fremont

TetonJefferson Madison

Bonneville

Butte

Gooding

CamasElmore

Gem

Lemhi

1

2

3

4

56

7

•Boards of Health

•District Directors

The Wild Frontier...

The Southeastern Health Dept. District (SDHD)• 8 counties• 158,000 people• 11,000 square miles• Borders Utah & Wyoming

A LOT of sagebrush!

Idaho’s Composition

Idaho Code § 39-401 establishes the Public Health Districts, and states in part:

“The various health districts… are not a single department of state government unto themselves, nor are they a part of any of twenty (20) departments of state government authorized by [the] … Idaho constitution… Its legislative intent is that the health districts operate and be recognized not as state agencies or departments, but as governmental entities whose creation has been authorized by the state, much in the manner as other single purpose districts.”

“The various health districts… are not a single department of state government unto themselves, nor are they a part of any of twenty (20) departments of state government authorized by [the] … Idaho constitution… Its legislative intent is that the health districts operate and be recognized not as state agencies or departments, but as governmental entities whose creation has been authorized by the state, much in the manner as other single purpose districts.”

Poll Question

The primary goal of PPHR is to:

A. Help LPHAs become better prepared

B. Assess and document the level of preparedness that they have already achieved

C. Both A &B

D. None of the above

Benefits of Project Public Health Ready

• Provided focus

• Fostered planning

• Complemented the inclusion of all staff capabilities

Relationship Building

• Reinforced and revived community partner relationships

• Established communicationwith nontraditional partners

• Encouraged and supported neighboring jurisdiction communications

Project Public Health Ready is a tool

Project Public Health Ready is:

• Credible

• Tangible

• Reportable

• Inclusive

The Hard Work Paid Off!

Award for PPHR

Lesson Learned

This is my story and I am sticking to it …

Travis Best

PHP Program Manager

Southwest District Health

Next Speaker

Public Health in Idaho

Boundary

Bonner

Kootenai

Benewah Shoshone

LatahClearwater

Nez Perce

Lewis

Idaho

Adams

Valley

Washington

Payette

Canyon

Boise

Ada

OwyheeTwin Falls

Jerome

Blaine

Lincoln

Minidoka

Cassia

Power

OneidaFranklin

Bear Lake

Bannock

Caribou

Bingham

CusterClark Fremont

TetonJefferson Madison

Bonneville

Butte

Gooding

CamasElmore

Gem

Lemhi

1

2

3

4

56

7

Boundary

Bonner

Kootenai

Benewah Shoshone

LatahClearwater

Nez Perce

Lewis

Idaho

Adams

Valley

Washington

Payette

Canyon

Boise

Ada

OwyheeTwin Falls

Jerome

Blaine

Lincoln

Minidoka

Cassia

Power

OneidaFranklin

Bear Lake

Bannock

Caribou

Bingham

CusterClark Fremont

TetonJefferson Madison

Bonneville

Butte

Gooding

CamasElmore

Gem

Lemhi

1

2

3

4

56

7

•Boards of Health

•District Directors

Southwest District Health

• Diverse population – 227,000

• 12,000 square miles & two frontier counties

• Duck Valley Indian Reservation/Idaho-Nevada

• 105 full-time employees

• $8 million annual budget

Project Style Approach

• Concept: Work it as a project!

• Organization: Project team.

• Outcome: Visualize the end product.

ProjectPublic Health

Readyfor

SWDH

PHP PlanEPI Plan

Smallpox PlanSNS Plan

CommunicationPlan

Training PlanSurge Plan

Evidence

ApplicationExec. OverviewPPHR Checklist

PHP PlansPPHR Evidence

Planning Process

Cross Walk of Criteria/Evidence

E. Situation and Assumptions 1._X_ Description of situations likely to affect local emergency response - unique vulnerabilities and distinguishing characteristics that may affect the circumstances of an emergency event Tab A-24; EPI Plan Page 22._X_ Consideration of availability and surge capacity of personnel, treatment facilities, laboratories, redundant communications, pharmacologic supplies and security; in relation to scope and duration for anticipated events 3._X_ Acknowledgement of mutual aid agreements, if available. SNS Plan Attachment 8, Pg 83

F. Role(s) and Responsibility (who does what) in table or other formatDescription of the emergency response responsibilities of the local emergency agency(ies) or team(s). This table indicates the primary and secondary support roles for local, state and federal asset acquisition. Describe roles and responsibilities for ESF-8 functions1._X_ List, table or other format indicating the necessary roles to be filled during response operations and detail of the specific functions of each role. PHP Plan 12.0 attachment2._X_ Identification of the LPHA response roles and associated response functions for: a._X_ Command and Control PHP Plan 4.0 /Page 9b._X_ Communication Communications Plan ,Page 9; PHP Plan 8.0/Pg 19c._X_ Early Recognition and Surveillance EPI Plan Pg 3-4; PHP Plan 4.0/Pg 9, A16 d._X_ Investigation PHP Plan Pg 14; EPI Plan 6.0/Pg 9; Smallpox Plan 7.0/Pg 56 e._X_ Epidemiology EPI Plan 8.0 /Pg 11, and 9.0/Pg 13, Appendix C Pg 25 f._X_ Sample testing EPI Plan 11.2 -11.3 Pg 14, Tab B12 Evidence of current packaging and shipping regulations on infectious substances and dangerous goods. Capability to transport specimens/samples to a confirmatory reference lab on nights, weekends, and holidays. a._X_ Evidence management EPI Planb._X_ Mass Prophylaxis and Immunization SNS Plan Pg 16c._X_ Mass Patient Care Surge Plan, Section 2, Pg 3; Surge Pland._X_ Mass Fatality Management Coroner e._X_ Environmental Surety EPI Plan Appendix D/Pg26f._X_ Mental Health of Public Health Emergency Response Personnel Surge Plan Appendix D/Pg 20-24

The Magnitude of Exercising

• Approach

• Cost containment

Nampa Flu Clinic

Poll Question

In my opinion, the most important reason why we participated in PPHR (or will in the future) is to:

A. Use as a framework in organizing preparedness activities

B. Share ideas, materials, and support from colleagues in the national program

C. Earn recognition for the department’s efforts.

D. Improve relationships and a sense of purpose with critical local partners

The Future of PPHR

• Design team

• Collaboration

• Concepts on the table

The Future of PPHR

• The current pilot three round is the final pilot phase

• The criteria are being finalized into a national standard for PH– Planning– Workforce competency– Exercise / Simulation

The Future of PPHR

• The re-recognition cycle will be four years.

• Re-recognition documentation will be to augment the first submission.

Lesson Learned

This is my story and I am sticking to it …

Public Health Ready Map

All seven health districts in Idaho are:

Public Health Ready

Open Dialogue

Comments/questions?

Travis ~ Rod ~ Darce