Author: schcc

SCWIHERC February 6, 2024 Membership Meeting Notes

Meeting Recording:

https://us06web.zoom.us/rec/share/jP9NVzXIfMqG_5PlUK12jtK_BV-wWYdx8v7upCG2Z2kp-jSUuDQaby3oNJtD6Q4X.f1IEfT6BR0BdBxhr

Passcode: see email from Jennifer February 7.

Hospital:

Dave Larson (Madison VA) recapped a recent internal flood event.  Lessons learned: do frontline staff know who the correct person to contact in an emergency (is this easily found in the emergency response guide?)  It is important to assess the situation yourself to verify incident and inform response (just how big and impactful is the flood?)  Can you repurpose unoccupied clinical spaces to move a unit rather than evacuating or going on diversion?  Think about this ahead of time.

Review ASPR TRACIE Utility Failures in Healthcare Toolkit: https://files.asprtracie.hhs.gov/documents/utility-failures-in-health-care-toolkit-summary.pdf

Match Survey: Every year, we ask you to report any exercises sponsored by your facility and any significant real events affecting your facility that resulted in the activation of your EOP to our Match survey.  ASPR requires that Wisconsin HERCs match10% of our grant funding award every year, and we do this by capturing in-kind efforts in the form of preparedness and response work you do within your own facility, so thank you for your assistance with this! Survey link: https://www.surveygizmo.com/s3/3321278/WHEPP-Exercise-and-Real-Event-Report-F-02007-06-2022

MRSE Prep: Final deadline for hospitals to register is Monday, February 12, to allow facilitator to create paper patient profiles for each participating hospital.  There will be injects related to family reunification again this year, think about using EMTrack to help with this function.  If you want to use EMTrack, please review this video, and reach out to me a week ahead of time to ensure EMTrack user access, and if you need dummy tracking numbers (rather than using your own triage tags).  Video: https://youtu.be/LOFIUfGBwAA

Discussion question:  Why are hospitals (inpatient units and EDs) so full right now?  Hard to discharge to post-acute care impacting throughput/causing backups all the way to the ED, staffing impacting how many units can be open to patients, respiratory season, hard to transfer to higher level of care/psych, Medicaid unwinding impacting primary care availability, also leading to decompensation and increased ED traffic, silver tsunami (Baby Boomer retirements combined with increased need for care).  Is this our new normal post-COVID?  COVID exposed fragility of healthcare system.  Highlighting lack of viable solutions to these problems without systemic changes to policy and reimbursement, which leads us to…

Northwest Wisconsin closure of two hospitals (Sacred Heart Eau Claire and St. Joe’s Chippewa Valley) and 19 clinics.  This closure closes a level III trauma center, and will leave two hospitals in Eau Claire.  EMResource data from last year shows all three Eau Claire hospitals spending more than half of the time at peak census for hospital census.  Also impacts rehab hospital, adult and child psych, referral lab and imaging svcs, home care and hospice, numerous other services.  Already seeing major impacts in that healthcare market and beyond, because some services already ceasing even though final closure date is April.  Related media articles:

https://www.weau.com/2024/01/30/data-reveals-financial-situations-chippewa-valley-hospitals/

https://www.weau.com/2024/01/30/reimbursement-challenges-wisconsin-hospitals/

https://www.weau.com/2024/02/05/gov-evers-hosts-hospital-shutdown-discussion-eau-claire/?outputType=amp

Next Hospital Forum March 20 at noon.

Membership:

HVA Survey due February 21.

Nurses Respond Now course and scholarships still available, see email from Jennifer on January 4.

We are approaching budgeted limit for SCWIHERC scholarships, submit soon if you wish to be considered.  See email from Jennifer on November 3.

UW Health has resources to support Stop the Bleed training, you can borrow equipment and provide your own instructors, or request their instructors.  See attached flyer.

Upcoming Trainings: review email from Jennifer February 1, BDLS/ADLS in 4 weeks!  We have three seats remaining for our region, reach out to Jennifer to register.  WI DHS will also be hosting an EMResource and EMTrack live training on February 13 at noon, this is a great opportunity for a refresher or to train new staff.  Register here: https://events.gcc.teams.microsoft.com/event/1ba3b6f4-f488-4c6d-83f3-d88c014f7a46@f4e2d11c-fae4-453b-b6c0-2964663779aa

Cybersecurity Workshop- one offering April 23-24 in Oshkosh, and another offering pending venue confirmation, likely Menomonie in June.  This offering is heavily tailored to healthcare, but we can accommodate local government that supports public health, EM, EMS if they can send the required team.  To be eligible to register, an organization will have to commit to sending a team of four on the first day (TTX) to include IT/cyber lead(s), operational leader, emergency manager/business continuity plan writer, and one ancillary services rep.  Team of two needed for second day (business continuity plan development), to include operational leader and emergency manager/business continuity plan writer.  Organizations are strongly encouraged to designate backups for their teams to fully leverage this opportunity, in case unforeseen emergencies prevent a team member from attending..  To be equitable, registration will be limited to one per healthcare system.  Official registration email will be shared when venue contract is confirmed for second workshop.  Our region has 6 organization slots for Oshkosh offering, and 3 organization slots for Menomonie offering.

Exercises update:

Medical Response and Surge Exercise on February 27, hospitals please invite your local PH/EM/EMS into your command center to strengthen local relationships and work through collaborative injects in the exercise!  Registration link for exercise participants (hospitals also need to respond separately if they are playing to receive paper patients): https://zoom.us/meeting/register/tJIqduiupz8tE9c1lysrgNc0eargHbMnTh1-#/registration

Chemical Surge Annex plan review and related TTX will be the topic of May 7 SCWIHERC meeting.  In person and virtual options will be provided.

Update to Power Outage exercise: initially we had planned to offer this as a tabletop exercise with one really large group, but the staffing cost to support this is cost-prohibitive.  We are now asking county Emergency Managers to host locally, and connect to virtual facilitation, so participants still have the benefit of local networking and collaboration in person with fellow local responders, and we can still offer this exercise within our budget.  This offering is not a grant requirement, but a high priority for us with power outage ranking #2 on our regional HVA.  Utilizing carryover funding opportunity to bring this to you because it is too costly for our current base budget, and that carryover funding expires June 30.  We are reviewing proposals and will get an exercise save the date out as soon as a facilitator is selected.

Speakers:

Strategic National Stockpile and Chempack:

Kay Mittelstadt-Lock and Curtis Hedman, WI DHS Kay.mittelstadtlock@dhs.wisconsin.gov Curtis.Hedman@dhs.wisconsin.gov

Slides are attached.  Also refer to this guidance on Fourth Generation Agents:

https://chemm.hhs.gov/nerveagents/FGA.htm

https://chemm.hhs.gov/nerveagents/FGA_Safety_Awareness_Bulletin_508.pdf

https://chemm.hhs.gov/nerveagents/FGA_Reference_Guide_508.pdf

https://chemm.hhs.gov/nerveagents/FGA_Medical_Management_Guidelines_508.pdf

Republican National Convention Update:

Michelle McKinney michelle.mckinney@dhs.wisconsin.gov

RNC Hospital Checklist should be available very soon and will be shared at that time, will be discussed at future SCWIHERC Hospital Forums.  Our region should anticipate impacts from RNC activities!

ATT FirstNet Update:

Aaron Midthun Aaron.Midthun@ATT.com 715-559-9057

Refer to meeting recording for full details from speakers.

Sharing resources from the National Healthcare Coalition Preparedness Conference, which four SCWIHERC reps attended:

HIGHLY recommend Miami Dade LE Active Shooter video (12 minutes), to engage your leadership and local law enforcement on the threat of active threat inside a healthcare facility!

Pediatric Readiness:

https://www.chawisconsin.org/initiatives/emergency-care/emergency-department-readiness/

https://www.chawisconsin.org/initiatives/emergency-care/pre-hospital-readiness/

https://wrap-em.org/index.php/jit-resources/pediatric-surge-playbook

https://www.npdcoalition.org/resources/

https://pedspandemicnetwork.org/

Checklist of Essential Pediatric Domains and Considerations for Every Hospital’s Disaster Preparedness Policies

ASPR TRACIE Utility Failures in Healthcare Toolkit: https://files.asprtracie.hhs.gov/documents/utility-failures-in-health-care-toolkit-summary.pdf

Get to know your NWS Warning Coordination Meteorologist and get on their weather alert distro list: NWS Milwaukee: timothy.j.halbach@noaa.gov

PsySTART: https://www4.psystart.net/

Miami Dade LE Active Shooter in Hospitals video: https://www.mdchpc.org/resources.html

Pathways to Health Equity: https://webassets.nationalacademies.org/healthequity/

Meeting attendance:

Marcus Walden- MMC Beaver Dam

Nathan Bubenzer- Meriter UPH

Sarah Jensen- Marquette County HD

Jane Lentz-Gervais- Adams County EM

Dave Kitkowski- St. Clare Baraboo and SCWIHERC

Alaina Landerud- St. Mary’s Madison

Belle Koch- Sauk Prairie Healthcare

Angie Cohen- Grant Regional Health Center

Jim Abitz- Southwest Health Platteville

Jeff Kindrai- Grant County HD

Anthony Rauterberg- Watertown FD

Mile Bluff Medical Center

Brent Skiba- Watertown RMC

Dan Perdue- SSM Health

Gary Trulson- UW Health

Mary Tessendorf- Monroe Hospital

Sam LaMuro- Fort HealthCare

Mike Stephens- Fort HealthCare and SCWIHERC

Colleen Wilson- Waupun Memorial

Dave Larson- Madison VA

Steve Haskell- UW Health

Tammy Kingery- Gundersen Moundview

Leanne Seifert- Watertown RMC

Carmen Luther- Reedsburg AMC and SCWIHERC

Sean Madison- NIPARC

Lori Mertens Pelliteri- Dean Clinics

Keith Hurlbert- Upland Hills Health

Christal Foreyt- Gundersen Boscobel

Jodi Moyer- Beloit Health System

Brian Allen- Southwest Health Platteville

Brooke Fuchs- Rainbow Hospice

Lynn Skatrud- Green County HD

Cody Kowalke- Reedsburg AMC

Carmen Carpenter- Iowa County HD

Gary Ziegler- Green County HD

Jodie Molitor- Sauk County HD

Ken Van Horn- PH Madison and Dane County

Jessie Phalen- Sauk County HD

Josh Kowalke- Reedsburg Ambulance and SCWIHERC

Victoria Parker- Watertown HD

Kimberley Spurgeon- Family Health La Clinica

Michael Niles- Rock County HD

Erin Hastert- Lafayette County HD

Kara Takes- Unified Therapy

Michelle Sullivan- Unified Therapy

Mike Lohmeier- SCWIHERC and UW Health

Kay Mittelstadt-Lock- WI DHS

Curtis Hedman- WI DHS

Jason Witte-WI DHS

Michelle McKinney-WI DHS

Hannah Segaloff- WI DHS

Aaron Midthun- ATT FirstNet

Jennifer Behnke-SCWIHERC

How would you describe the communities we serve?

SCWIHERC 9-19-23 Meeting Notes

Recording:

https://us06web.zoom.us/rec/share/RkZE5-Yn4kbKo0YmbprUKT6Oma22-tvuZ9-PEWL56ojOJeYNDb7FIJHKZ8S4VWo8.RTUAf6dYYceI-eyx

Passcode: see email from Jennifer on September 21                                                                    

Hospital:

-Belle Koch of Sauk Prairie Healthcare gave an overview of a recent incident where a 2” water pipe burst and flooded their OB unit and seeped into several other areas, refer to recording for details.

-Mike Stephens of Fort HealthCare gave an overview of a recent event where severe weather resulted in a power outage causing the hospital to run on generator power for over 3 days including one of the chillers.  Refer to recording for details.

-These events prompted a discussion on eICS (electronic ICS platform) and how hospitals use mass notification software (emergency notifications vs open clinical shifts), and who receives those.

-All HERCs have access to eICS and use it at a regional level to document response.  All partners have the ability to link into SCWIHERC’s eICS for two-way information sharing.  Follow up note: there is no discount for eICS through SCWIHERC.

-We held our hospital representative election after reviewing the nominations and bios of two candidates.  Mike Stephens of Fort HealthCare was elected as the new hospital rep.

-Next hospital forum meeting is October 19 at noon, where we will do an overview and demonstration of RMCC operations.

Membership:

SCWIHERC Updates: This year’s specialty annex theme is chemical hazards surge.  SCWIHERC will be drafting a specialty surge annex on chemical hazards, and then we will conduct a TTX on this hazard at our May meeting.  Additionally, we have a grant requirement of conducting a TTX on our Crisis Standards of Care Concept of Operations, which will be integrated into the chem surge tabletop.  We will also be facilitating another Medical Response and Surge Exercise. 

SCWIHERC Leadership is also working with other HERCs statewide on strategies to support long-term sustainability of the HERCs, and will periodically update at future SCWIHERC meetings.

Some recent updates with our Board of Directors: Aurielle Smith was re-elected to serve as Chair, Dave Kitkowski was elected to serve as Vice Chair, and Mike Stephens was elected as the new hospital representative at this meeting.

We reviewed a presentation and several resources related to whole community planning.  The group came up with the word cloud featured above to describe the communities we serve.

The resources mentioned in this presentation are listed here, please note the addition of the CDC Places resource since the agenda was shared.  Refer to the recording for the discussion and slides.

Whole Community Planning Resource Links:

1. ACEP PLANNING CONSIDERATIONS FOR PERSONS WITH ACCESS AND FUNCTIONAL NEEDS IN A DISASTER: https://www.acep.org/siteassets/sites/acep/media/disaster-medicine/planning-for-persons-with-functional-needs-in-a-disaster.pdf
2. ASPR Presentation Reviewing NACCHO Capacity-Building Toolkit: https://www.eventscribe.com/uploads/eventScribe/PDFs/2019/6206/895787.pdf
3. CDC Access and Functional Needs Toolkit: https://www.cdc.gov/orr/readiness/00_docs/CDC_Access_and_Functional_Needs_Toolkit_March2021.pdf
4. CDC/ATSDR Social Vulnerability Index: https://www.atsdr.cdc.gov/placeandhealth/svi/index.html
5. CDC PLACES: Local Data for Better Health: https://www.cdc.gov/places/index.html
6. CMIST Framework: https://www.phe.gov/emergency/events/COVID19/atrisk/discharge-planning/Pages/CMIST-framework.aspx
7. CMIST Update: https://disasterstrategies.org/blog-post/defining-functional-needs-updating-cmist-by-june-isaacson-kailes-disability-policy-consultant/
8. FEMA Inclusion, Diversity, Equity, and Accessibility in Exercises Considerations and Best Practices: https://preptoolkit.fema.gov/documents/d/hseep-resources/idea_guide_final?download=true
9. FEMA National Risk Index: https://hazards.fema.gov/nri/
10. NACCHO Capacity-Building Toolkit for including Aging & Disability Networks in Emergency Planning: https://www.naccho.org/uploads/downloadable-resources/NACCHO_Aging-and-Functional-Needs-Planning-FINAL.pdf
11. Prepared4ALL: https://nationalcenterdph.org/our-focus-areas/emergency-preparedness/prepared4all/online-training/
12. Prepared Caregivers: https://www.caregiver.va.gov/support/docs/Prepared_Military_Caregivers_Disaster_Relief_Toolkit_Final.pdf
13. Public Health is for Everyone: https://www.phetoolkit.org/

Sharing lessons learned and best practices:

Rock County Health Department has been working on a tool to make better informed decisions on where to set up Points of Dispensing sites, they will keep us posted and also submitted an abstract for the NACCHO Preparedness Summit.

We talked a bit about Air Quality issues over the summer, especially on communications and messaging with the public.  Strategized on sharing these messages through other leaders and offices so that the message wasn’t coming from public health, where we feel like there is messaging fatigue post-COVID.

Public Health Madison and Dane County shared their lessons learned from responding to this hazard.

Refer to recording for more details.

Next meeting will be November 14, 1-4PM

Meeting attendance:

Mike Stephens- Fort HealthCare

Lisa Herritz- Ho-Chunk Nation

Christal Foreyt- Gundersen Boscobel

Victoria Parker- Watertown HD

Michael Niles- Rock County HD

Karen Nsiah-Ababio- Rock County HD

Tom Ellison- UW Health

Nathan Bubenzer- UPH Meriter

Tina Strandlie- Stoughton Health

Dave Kitkowski- St. Clare Baraboo and SCWIHERC

Tammy Kingery- Gundersen Moundview

Carmen Mihlbauer-Luther- Reedsburg AMC

Ben Thompson- Mercyhealth

Emily Kosterman- Waupun Memorial

Angie Cohen- Grant Regional

Geana Shemak- Iowa Co HD

Ian Fisher- Marshfield Health System

Ken Van Horn- PH Madison and Dane County

Belle Koch- Sauk Prairie Healthcare

Steve Haskell- UW Health

Ed Somers- Clearview

Erin Hastert- Lafayette Co HD

Sally Blackborn- Memorial Hospital of Lafayette Co

Mike Hall- SSM Health Monroe/Janesville

Haley Schreiber- St. Mary’s Janesville

Mary Tessendorf- Monroe Hospital

Jason Witte- WI DHS EMS

Jeff Ethington- UW Health OPO

Brooke Fuchs- Rainbow Hospice

Kara Takes- Unified Therapy

Jessie Phalen- Sauk Co HD

Lynn Skatrud- Green Co HD

Paige Heinke- SSM Health Home Care

Sean Madison- NIPARC

Jodie Molitor- Sauk Co HD

Darienne Blair- Columbia Co HD

Carrie Meier- Dane Co EM

Aurielle Smith- PH Madison and Dane Co, SCWIHERC

Leanne Seifert- Watertown RMC

Taylor Fish- Sauk Co PH

Kelly Heysinger- Unified Therapy

Jennifer Behnke- SCWIHERC

SCWIHERC 1-25-23 Meeting Notes
Recording: see email from Jennifer on January 26.
Hospital Meeting:
ABLS update: still have seats left, still have hospitals in region that haven’t used their seats. All unused seats that were previously earmarked for a hospital in our region will be given up to the first come, first served pool in the region and state if unclaimed after February 10. Then facilities may request extra seats, and other regions may use them as well. Jennifer will send a separate email on this with a specific breakdown of how many seats remain from initial allocation for each facility.
Burn Plan one page quick reference guide: Identified need for this resource after debriefing from Pulaski bonfire incident, wanted to make a resource available for frontline ED staff to know how to activate the burn plan and where to find more information. Please educate your staff on this resource and post where it will be available to them: (in shared drive)
Med shortages: If a medication shortage has been raised to a level of significance that your EOC/IC within your facility is aware of it, please share with Jennifer to be shared for situational awareness to the region (facility will be de-identified), state, feds. State and feds need significant lead time to act on this info, so earlier is better!
Question on readily available safety references and resources for staff that can be included in newsletters etc? Looking for something that has already been created to minimize recreating the wheel. If you identify any, please share with Jennifer.
Public Health Emergency was extended until April, but how are we getting ready to transition to operations after PHE expires and going back to “new” normal? Please start to discuss with your team and share any checklists or resources you have started in anticipation of this task. Jennifer will also look for resources and discuss with other HERC Coordinators.
Anyone using the DASH Tool? Disaster Available Supplies in Hospitals. https://dashtool.org/ Related webinar: https://files.asprtracie.hhs.gov/documents/aspr-tracie-disaster-available-supplies-in-hospitals-dash-webinar-ppt.pdf Recommend entering your information in these forms to find out what your numbers are to start planning and making the case for carrying this inventory of these supplies. Will revisit with March supply chain meeting to continue discussion.

Will discuss new TJC EM standards at next hospital meeting, please bring your questions and discussion points for the group.

Membership Meeting:
Plug for WEM Governor’s Conference, registration and agenda info: https://wigcot.eventsair.com/2023-wisconsin-governors-conference-on-emergency-management-homeland-security Starts end of February in West Madison/Middleton.
HVA Survey due February 24, see email from Jennifer on January 24 for link.
Exercise update: currently soliciting bids for Medical Response and Surge Exercise (MRSE). Must be completed by June 30, goal of exercise day between May and early June. Exercise info: https://aspr.hhs.gov/HealthCareReadiness/guidance/MRSE/Pages/default.aspx Seeking exercise design team members, please email Jennifer if interested! Also NucRad TTX based on draft surge plan to be held May 17 as part of SCWIHERC meeting. NucRad is topic for this year’s specialty surge.
March 22 meeting will have supply chain integrity theme, please invite your internal and external (vendor) supply chain partners!
Anticipating funding to continue SALT Triage Ribbon and RMCC training project this spring, target audience is EMS providers but we should probably offer at least one more session for hospital audience, only about half participated in May 2022.
SCWIHERC is planning a virtual information sharing systems in-service day in late spring, more hands-on approach for using various systems (EMResource, EMTrack, eICS, others?). More info to come.
Sam Anderson, WI DHS OPEHC Training and Exercise Coordinator Samuel.Anderson@dhs.wisconsin.gov Sam talked about the training needs assessment survey results, statewide results included in email from Jennifer January 25 but regional results will also be compiled later. Looking at optimal and efficient planning with expensive course offerings (CHEC, BDLS, ADLS etc.) in the face of limited funding availability.
Presentations and extensive discussion on using EmPOWER tool, refer to recording. https://empowerprogram.hhs.gov/
Mandi Walsh, Health Preparedness and Response Ops Specialist mandi.walsh@dhs.wisconsin.gov
Ken Van Horn, Emergency Preparedness Coordinator, PHMDC KVanHorn@publichealthmdc.com
ONLY Local Health Officer or their designee can request the data! Recommend pulling practice data set out of PCA Portal and practicing sorting and deleting data to find what you need to take action. Ken will share his notes with LHDs when he has a chance.
While using/requesting the response data, we learned that we can speed up the request and implementation by making sure we knew how exactly we could share the files with only applicable people (easy on most systems, not on ours)and, after scrambling to find some people to help sort data on Dec. 23 right before a holiday, are putting together a list of people who can step in and are comfortable with this data set.
Note that coordination of safety checks should triage patients based on the type of device they are relying on and how emergent it is to life safety (cardiac devices, ventilators). Coordinate with your local EOC and EMS to create your own triage criteria. Pros and cons to using law enforcement officers to conduct safety checks: keeps fire/EMS free for response and other 911, but not all communities feel safe answering the door to law enforcement unannounced. Consider in your response planning!
Other current topics: Feds will not mobilize Tamiflu from SNS until all other local/regional resources have been exhausted. More info in email from Jennifer Friday, January 20. What else are we focusing on? Staff burnout and wellbeing. Remember that “Now What?” modules are available on demand from SCWIHERC shared drive under best practices, resiliency. These are in five units and can be used one at a time at small staff meetings etc.
Next meeting: March 22, 1-4PM.
Meeting attendance:
Jane Lentz-Gervais, Adams Co EM
Josh Kowalke, Reedsburg Area Ambulance Service
Mary Crowley, Juneau Co PH
Lynn Skatrud, Green Co PH
Dave Kitkowski, St. Clare Baraboo,
Gary Ziegler, Green Co EM
Victoria Parker, Watertown PH
Ken Van Horn, PH Madison and Dane Co
Tom Ellison, UW Health
Roman Mullen, Dodge Co PH
Nick Metz, Upland Hills Health
Lori Mertens Pelliteri, Dean Clinics
S Eaton, Community Health Systems
Charlie Johnson, St. Mary’s Madison
Lisa Herritz, Ho Chunk Nation
Colleen Wilson, Waupun Memorial
Marie Ellis, Columbia Co PH
Christal Foreyt, Gundersen Boscobel
Ian Fisher, Marshfield Medical Center Beaver Dam
Carmen Luther, Reedsburg Area Medical Center
LuAnn Reuter, Prairie Ridge Health Columbus,
Chad Atkinson, Mercyhealth Janesville
Mike Stephens, UW Health
Jodi Moyer, Beloit Memorial
Emily Kosterman, Waupun Memorial
Sally Blackbourn, Memorial Hospital of Lafayette County
Sarah Jensen, Marquette Co PH
Steve Haskell, UW Health
Colton Ritchie, PH Madison and Dane Co
Dave Larson, Madison VA
Belle Koch, Sauk Prairie Hospital
Katie Budack, Grant Regional
Jennylynde Packham, UW Health Rehab Hospital
Leanne Seifert, Watertown Regional Medical Center
Kimberley Spurgeon
Carol Brown, Rainbow Hospice
Mike Hall, Monroe Hospital
Nathan Bubenzer, Meriter
Tammy Kingery, Gundersen Moundview
Joe Meagher, Dodge Co EM
Jim Abitz, Southwest Health
Mary B, Jefferson Co HD
Bob Swenarski, St. Mary’s Janesville
Keith Hurlbert, Iowa Co EM
Diana Quinn, SSM Health
Angie Cohen, Grant Regional
Dan Williams, SCRTAC
Aurielle Smith, PH Madison and Dane Co
Jeff Kindrai, Grant Co PH
Carrie Meier, Dane County EM
Samroz Jakvani, Jefferson Co PH
Matt Bartol, Dodge County PH/EM
Madison Dillinger
Jodie Moliter, Sauk Co PH
Annie Fridh, Community Health Systems
Carly Tibbits, Iowa Co PH
Patti Miller
Cara MacKenzie
Karen Greenwald, Dodge Co PH
Alesha Erdenberger
RoAnn Warden, Green Co PH
Mary Tessendorf, Monroe Hospital
Julie Staffin, Mayville EMS
Sam Anderson, WI DHS OPEHC
Mandi Walsh, WI DHS OPEHC
Jennifer Behnke, SCWIHERC

June 15 SCWIHERC Membership Meeting Notes

Recording: https://us06web.zoom.us/rec/share/wYwuz5B6WVGw6soEGLGesQok22HqbqntjDjYXnPow9qNH43d4sWKCVrDmKeEdd9q.uli6SRc1SaAX19OL

Passcode: See email sent June 15

Reminder that DocuSign signatures for annual plan review are due June 30.  Reminder email was sent directly to signer on file for your organization.  Will resend any unsigned plans 7-10 days before deadline.

Upcoming Trainings and Information:

SCWIHERC Exercises

-Medical Response Surge Exercise – Replaces Coalition Surge Test.  Planning to start this summer.  Tie into DARES scenario?

-Pediatric Surge TTX – As part of MRSE exercise/scenario?

Annual Plans Review:

After plans are reviewed and updated, Docusign process, same as last year.  Sent to every core organization except EMS (which will be sent June 16), signatures due by June 30.

Scholarships:

Scholarship opportunities start July 1!  $2,000 aggregate limit per active member (must provide proof of participation in 2 SCWIHERC events in previous 365 day period), must meet other application requirements.  Valid on conference registration fees, travel (mileage/flight/lodging). Scholarship opportunity excludes PHEP recipients, please use PHEP funds!

Burn Surge Plan Review and Tabletop Exercise: SitMan and slides available in Shared Drive, also review recording.

Hospital Meeting:

ABLS:

Is a mess, please continue to send your registered student information, please be patient and standby!  Student will receive an email when successfully enrolled and course is accessible.

SALT Triage First Receiver Train the Trainer

Resuming this project after COVID delay. Three facets of training/maintaining staff proficiency:

• SALT Triage First Receiver video, which should be viewed by anyone in your organization who might be put to the task of triage in the event that you have an MCI in your community that would result in self-presenting patients. Link: https://youtu.be/N7OG8a7vXnE
• Train the Trainer sessions for our Champions to review the concepts and receive training on our SALT ribbon bags, see emailed out April 27.  We will distribute the ribbon bags for your facility to your Champion at these trainings.
• Your Champions bring their training and ribbon bags back to your facility, where they train your other staff on these SALT triage concepts, and how to use the ribbon bags, and maintain a regular competency program for your new hires and as part of annual training for current staff.

About half of hospitals have received their bags and participated in our SCWIHERC trainings in mid-May.  Direct outreach to hospitals that haven’t is forthcoming.  We really encourage all of our regional hospitals to join this project to ensure they have staff that know how to field triage self-presenting patients and their triage methods are consistent with EMS field triage.

CSC Updates: Doug Hill

Wisconsin Hospital Mutual Aid MOU- There is not a strong statewide desire to renew this document as a state.  Opportunity to develop regional MOUs if desired, (what are next steps/follow up?)

CSC Concept of Operations- Doug Hill is developing as part of grant deliverables, but it leans more along the lines of allocation of scarce resources than crisis standards of care.

CSC Article: https://www.tandfonline.com/doi/full/10.1080/15265161.2021.1925778 PDF of article available in Best Practices Folder of shared drive.

GE IV Contrast Shortage- Looks like we’re coming out of it. No current concerns.

TJC EM Standards Update Resources:

From Wakefield Brunswick:

https://8233470.fs1.hubspotusercontent-na1.net/hubfs/8233470/2022%20WB%20TJC%20Standards%20Crosswalk.pdf?utm_medium=email&_hsmi=207521692&_hsenc=p2ANqtz-8dPgjm85QpnPpWdrX8hL1gewNlqdhFXI3TKJ3RQj94aWfzvV35_6ylXflyGk2iBM2kZVTOEAHyqcgKHFbUAe3jItIfTKK5kRgzctEhCiWw3v73pVQ&utm_content=207521692&utm_source=hs_email

https://vimeo.com/678545023/05ccb3f28a?utm_medium=email&_hsmi=213264864&_hsenc=p2ANqtz–YF8DR8UWsCCEpSDw2u7Ia-GOcd8m0JFWlXuLfmKMfQ81o-zjbMvb93-rVgSKR4oMXb_LUZJFofUzC7UnNeuS3NiTG5U6Nr-NUjcoW9bZMxb_yh4M&utm_content=213264864&utm_source=hs_email

AHEPP Webinar June 15 1100 recording will be posted to notes at http://www.scwiherc.org/june-15-2022-membership-meeting/ when available.

Lessons Learned and Best Practices from COVID-19 and other real events:

How are we remaining nimble for future variants/surge/vaccination/testing?

What else are we working on? Mass casualty drills, implementing SALT Triage in ED.

What else are we responding to? Current event in Dane County from June 13 storm, widespread power outages including some persisting into 48+ hours (as of the time of these notes being written).  Compounded by heat advisory.  More widespread severe storms anticipated tonight through whole region and state, be prepared!  Current lessons learned:  cell networks were jammed immediately after power outage, don’t forget basics like Wireless Priority Service, WISCOM radio, GETS cards, FirstNet.  When SCWIHERC Responder has communication issues (Jennifer lost power during event and cell service was spotty for a few hours), that will be posted on EMResource under coalition header at top of page (hover over Jennifer’s name), and as out of office reply on email when possible, with further instruction.

Meeting Attendance:

Jane Lentz-Gervais- Adams County EM

Charlie Johnson- St. Mary’s Madison

Jeff Kindrai- Grant County HD

Brent Skiba- Watertown Regional Medical Center

Mike Tedeschi- NEWHERC

Lisa Herritz- Ho Chunk Nation

Joe Meagher- Dodge County EM

Jennylynde Packham- UW Health Rehab

Dave Kitkowski- St. Clare Baraboo

Katie Budack- Grant Regional Health Center

Matt Christian- Marshfield Medical Center Beaver Dam

Angie Cohen- Grant Regional Health Center

Doug Hill- CSC Coordinator

Tina Strandlie- Stoughton Health

Bill Ritzer- Reedsburg Area Medical Center

Galen Kennedy

Kara Takes- Unified Therapy

Diana Quinn- SSM Health

Lynn Skatrud- Green County HD

Michael Niles- Rock County HD

Nathan Bubenzer- UPH Meriter

Ed Somers Clearview Dodge County

Suzanne Schreiner- Adams County HHS

Rodney Punzel- UW Health

Julie Gorman- Sauk Prairie Healthcare

Jodie Molitor- Sauk County HD

Jen Hankwitz- UW Health

Brian Allen- Southwest Health

Michael Stephens- UW Health

Alice Salli- Mendota Mental Health Institute

Sam LaMuro- Fort HealthCare

Mary Tessendorf- Monroe Hospital

Steve Haskell- UW Health

Jim Abitz- Southwest Health

Carol Brown- Rainbow Hospice

Jennifer Lorenz- Mercyhealth Janesville

Kurt Hoeper- Upland Hills Health

Sarah Jensen- Marquette County HD

Sally Blackbourn- Memorial Hospital of Lafayette County

Lori Mickelson- UW Health Burn Program

Carmen Carpenter

Mike Hall- Monroe Hospital

Dave Larson- Madison VA

Dr. Mike Lohmeier- SCWIHERC

Jennifer Behnke- SCWIHERC

December 1 SCWIHERC Membership Meeting Notes

Meeting Recording Link (will expire November 30, 2022): https://transcripts.gotomeeting.com/#/s/5cf0be5de39db689f4f6e1cb48dd4a53eeef6f86fa0aa3509f3d0de1a9bf5793

We started by reviewing EMResource user info and event notification preferences.  Both of these are found under the “Preferences” tab.  It is recommended that your ED HUC desk landline number be added to the EM Coordinator’s EMResource notification voice section under “Preferences” and “User info.”  Remember to click save when navigating away from this form.  Then go into event notifications and check the voice box for MCI region 5, MCI statewide/bordering regions, Bed Count region 5, Bed Count Statewide/bordering regions, general announcement region 5 and statewide/bordering regions, and any other alerts you want the ED to receive. Click save when navigating away from this form.  Be sure the EM Coordinator and any other appropriate users are receiving other important notifications such as resource request, be on the look out, Amber alert, etc.  Note that we have recently noted serious delays in notifications coming from certain events (seems to be tied to general announcement type events) and an escalated support ticket has been started with Juvare.

Anyone needing help setting up or verifying alerts, or refresher EMResource training with staff, should reach out to Jennifer.

We discussed the Regional Medical Coordination Center concept.  Any time an incident happens within SCWIHERC’s 14 county region, we may activate the RMCC to help the field determine where to transport patients from the field.  The recommended threshold for activation is 5 patients or more.  It is critical for hospitals to respond to the MCI alert within 15 minutes.  This helps the field help your facility by trying not to give you more than you can handle, which is important with high census right now.  If the needs of the field can’t be met with the numbers currently entered, you may be asked to refresh your bed counts accordingly.  Please also be aware that the field may send you at least one patient prior to receiving counts, which is also why your response is important.  If there is an MCI close to your facility, your facility should always expect to receive some patients from that scene.

We reviewed the EmPOWER and Social Vulnerability Index data.  Jennifer sent out the most recent update on October 20.  It is a grant deliverable to send this out twice a year.  There is a summary of numbers of electricity-dependent CMS beneficiaries broken down by county in this update, and there is a new spreadsheet that breaks out those beneficiaries based on categories like ventilators, oxygen tanks or concentrators, dialysis, electric mobility devices etc.  The spreadsheet contains tons of information and definitions.  These numbers are helpful for planning and should be shared with local planning partners.  The limitation to this data is it is all de-identified, so it doesn’t help us find these populations until after an emergency has occurred, therefore we don’t know how to use this list to the greatest benefit of our communities.  There are opportunities for whole community preparedness and collaboration with other providers, such as home health and hospice agencies, dialysis and durable medical equipment providers, to better prepare for caring for these populations.

General EmPOWER data can be found at: https://empowermap.hhs.gov/

The EmPOWER spreadsheet is obtained from HHS and uploaded to the PCA Portal where Health Departments and HERC Coordinators can retrieve it.

Social Vulnerability Index data is at https://www.atsdr.cdc.gov/placeandhealth/svi/index.html

Including county level data: https://svi.cdc.gov/prepared-county-maps.html

We had a discussion on several topics related to COVID-19 response:

Questions on how orgs are adapting their ICS structure to such a long event:  holding meetings virtually, relying on dashboards for info sharing, moving to weekly meetings.

Questions on how orgs are managing their AAR process:  several subsections or versions of AAR to cover different phases of pandemic.

Discussion around current visitor policies:  only allowing one visitor at a time, in some cases only one visitor per day (same person can come and go, but multiple visitors cannot).  Some variation with OB, PEDs, and end of life patients.  Offering or requiring visitors wear masks. No visitors for COVID positives or respiratory patients until COVID ruled out. Meriter shared external link to their policies: https://www.unitypoint.org/madison/coronavirus-updates-closings.aspx

Lots of discussion on how visitor policies have led to an increase in security and behavioral events due to visitors’ unwillingness to comply.

General discussion around coping with surge.  Facility closed urgent care to move staff to ED, but caused an uptick in ED visits.  Biggest barriers are staffing shortage, lack of physical room, extended wait for transfers, lack of transportation options.   Question on using Critical Care Paramedics to augment Respiratory Therapy in hospitals?  Also still asking for another ACF to decompress surge.

Shortage of post-acute care available beds, including noting problems with major variations from one facility to another in admission parameters (COVID history, how many days since COVID negative, patient can’t have visitors for 90 days after COVID (note that prohibiting visitors is not allowed and addressed by CMS here: https://www.cms.gov/files/document/qso-20-39-nh-revised.pdf)

Also don’t forget RAST resource for helping LTCF with outbreaks: https://www.dhs.wisconsin.gov/publications/p02883.pdf

Joe Cordova reviewed the resources for staffing assistance.  This process will be coming down officially in writing, but consists of: 2 attempts at WEAVR outreach (first doesn’t yield much, sometimes second does) WEAVR request procedure: https://content.govdelivery.com/accounts/WIDHS/bulletins/2f696ca. WI DHS staffing resource assistance (Jennifer emailed on Oct 1).  If those resources aren’t sufficient, email Joe (joseph.cordova@wi.gov) to discuss the process of applying for federal staffing assistance (Jennifer emailed the form and additional FEMA information to hospitals on November 20.  Do not submit this form to your local Emergency Manager, email Joe with questions).  Note that federal staffing requests are usually only granted for 2-3 week deployments, and that FEMA will want requestors to provide details both on how staff will be used, and what the facility’s plan for staffing is once the deployment, if granted, ends.

Finally, we shared identified needs and ideas for supporting staff mental health and resiliency.  With staffing being one of our biggest limiting factors, and staff burnout being one of the biggest causes, providing staff support should be an organizational priority.

Ideas shared include giving staff the opportunity to share their stories and know that they are not alone.  Having separate support groups for leadership where they can feel vulnerable.  Manager purchased the book ER Nurses by James Patterson and wrote a message of appreciation and admiration for each of them inside.  Offering support groups to staff.  Deployed a therapist to round on units for staff.  Hospital wellness coordinator shared materials and resources, Jennifer will try to get and share. “Managing the soft side of hard stuff.”  Jennifer shared debriefing that another colleague did for HERC staff, will look at SCWIHERC offering that in an anonymous and virtual environment where staff can just drop in and talk with their peers from outside their organization.  Will look at providing a separate offering for leaders so they have a safe space to feel vulnerable outside their normal management duties.

SCWIHERC Deliverables/Projects Update agenda item was not covered due to lack of time, will be covered at a future meeting.

Meeting attendance:

Chad Atkinson- Mercyhealth

Jeff Ethington- UW Health OPO

Joe Meagher- Dodge County EM

Diana Quinn- SSM Health

Lisa Herritz- Ho Chunk Nation

Steve Haskell- UW Health

Sharon Warden- Mile Bluff Medical Center

Kara T-Unified Therapy

Lori Mertens Pelliteri- SSM Health

Alice Salli- Mendota Mental Health

Mary Tessendorf- Monroe Hospital

Aurielle Smith- SCWIHERC and Public Health Madison Dane County

Jane Gervais- Adams Co EM

Mike Hall- Monroe Hospital

Tom Ellison- UW Health

Dave Larson- Madison VA

Asa Rowan- Beloit Area Community Health Systems

Jodie Molitor- Sauk Co HD

Kurt Hoeper- Upland Hills Health

Gail Scott- Jefferson Co HD

Bob Swenarski- St. Mary’s Janesville

Allison Davey- Green Lake Co HD

Keith Hurlbert- Iowa Co EM

Kathy Johnson- Columbia Co EM

Angie Cohen- Grant Regional Health Center

Tina Strandlie- Stoughton Health

Sarah Jensen- Marquette Co HD

Sam LaMuro- Fort Health Care

Amy Nehls- Dodge Co EM

Jeff Kindrai- Grant Co EM

Matt Byczek- UnityPoint Health

Jessie Phalen- Sauk Co HD

Ron Krause- Mercyhealth

Brenda Koehler-Borchardt- Watertown Regional Medical Center

Amanda Dederich- Juneau Co HD

Angie Zastrow- Rainbow Hospice

Laura Kane- UW Health

Josh Kowalke- Reedsburg Ambulance

Katrina Harwood- Rock Co HD

Christal Foreyt- Gundersen Boscobel

Suzanne Schreiner- Adams Co HD

Nathan Bubenzer- UPH Meriter

Carrie Meier- Dane Co EM

Julie Gorman- Sauk Prairie Healthcare

Brian Allen- Southwest Health

Samroz Jakvani- Jefferson Co HD

Megan Lee- UW Health

Russ Sprecher- St Clare Meadows

Julie Liebfried- Lafayette Co HD

Mike Stephens- UW Health

Michael Niles- Rock Co HD

Joe Cordova- WI DHS

Jennifer Behnke- SCWIHERC