June 15, 2022 Membership Meeting

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:

Course Location Date Link if available
MGT-341; Dis. Preparedness Hosp/HC Spooner October (TEEX still determining exact date)
MGT-341; Dis. Preparedness Hosp/HC Fox Valley Tech T.C. July 26-27 https://my.teex.org/TeexPortal/Default.aspx?MO=mCourseCatalog&D=EU&C=MGT341&S=476
CISM – Group Columbia Sheriff Office June 17-18 Contact HERC coordinator
AWR-331; Winter Weather Lincoln County 27-Sep https://ndptc.hawaii.edu/training/delivery/3120/
AWR-232; Mass Fatalities Planning Oneida County Sheriff 29-Jun

 

 

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

May 3, 2022 Membership Meeting

Join us for our membership meeting May 3: https://us06web.zoom.us/j/83510672818?pwd=eE9HcXBPNVhxVVdHUGJBbUxlRFVEdz09

Agenda:

May 3 SCWIHERC Membership Meeting Notes

Recording:

https://us06web.zoom.us/rec/share/oU9dLWPN8fbFNHiXINbtizeS-LweaQaCs90jb342-SdWhBUhPgcmnIjbkxEqyf_W.A1NakBNlcyg75sjN?startTime=1651599029000

Passcode: refer to email from May 3 or ask Jennifer

Reminder that COVID AAR survey is due May 27, see email sent April 23 for more info and link to survey.

Upcoming Trainings and Information:

CourseLocationDateLink if available
MGT-341; Dis. Preparedness Hosp/HC  Spooner  October (TEEX still determining exact date)   
MGT-341; Dis. Preparedness Hosp/HC  Fox Valley Tech T.C.  July 26-27  https://my.teex.org/TeexPortal/Default.aspx?MO=mCourseCatalog&D=EU&C=MGT341&S=476
CHEC – Basic & Advanced  Wausau  May 17-19  Contact HERC coordinator
CISM – Group  Columbia Sheriff Office  June 17-18  Contact HERC coordinator
AWR-331; Winter Weather  Lincoln County  27-Sep  https://ndptc.hawaii.edu/training/delivery/3120/
AWR-232; Mass Fatalities Planning  Oneida County Sheriff  29-Jun   
AWR-326; Tornado Awareness  Lake Delton  17-May  https://ndptc.hawaii.edu/training/delivery/3119/
MGT-439; Pediatric Disaster ResponseMilwaukeeMay 5 – 6Pediatric Disaster Response and Emergency Preparedness | TEEX.ORG

SCWIHERC Exercises

-Burn Surge TTX Due June 30 – Scheduled for NEXT SCWIHERC MEETING (Date TBD soon)

-Medical Response Surge Exercise – Replaces Coalition Surge Test.  Likely 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.  Goal to send out at beginning of June, signatures due by June 30.

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:

  1. 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
  2. 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.
  3. 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.

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

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

Hospitals: creation of a high consequence infectious disease plan/annex at the hospital level that details information regarding medical countermeasures, Strategic National Stockpile, volunteer management (including WEAVR), ASPR pandemic preparedness checklist (https://files.asprtracie.hhs.gov/documents/aspr-tracie-hcc-pandemic-checklist-508.pdf), PPE burn rate calculator (https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/burn-calculator.html), Acute Hospital Care at Home (see COVID-19 email update sent April 1), other healthcare at home initiatives.  Integrating COVID population back into hospital units (in negative pressure rooms) to free up COVID units but maintain them for additional surge readiness.

Local Health Departments: maintaining capacity for contact tracing, testing, and vaccination, cross training staff on all so they can meet current needs. Maintaining testing capacity with state contracts and private testing vendors.  Continue to meet with healthcare partners to maintain readiness.

Other Healthcare providers: continuing to practice good infection control practices including masking per CDC guidelines (https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html), working with local pharmacies to maintain testing and vaccination capacity

What else are we working on? Workplace violence training/escaping violent encounters, missing persons drills, hospital evacuation training, streamlining plain language alerts (getting away from code colors).  Public health also working on responding to higher rates of other communicable diseases, boosting childhood vaccination rates that have suffered during pandemic by promoting Vaccines for Children providers/enrollment, lead screening, home visits, starting WIC in person again.

We could do better on EMResource response rates, especially for MCI events.  Response to these alerts breaks down based on a number of factors, including staff turnover and not being able to keep up with training, how alerts are received, alert fatigue, being able to tell from an alert if something is informational only or requires action.  Will take back to discuss further at state level. EMResource resources are available in SCWIHERC shared drive -> EMResource.  Additional information and resources: https://www.dhs.wisconsin.gov/preparedness/systems/emresource.htm Reach out to Jennifer to troubleshoot/verify alerts/facilitate training.

Brian Kaczmarski, Statewide HERC Coordinator, gave a presentation on the state and regional High Consequence Infectious Disease Plans.  The current version of these plans as well as the slides from the presentation are available in the shared drive.  A resource mentioned during the presentation is the Dane County EMS Primer on Infectious Disease:  https://em.countyofdane.com/documents/pdfs/ems/Infection-Control-EMS-Primer-on-ID-7.11.19.pdf

We then transitioned into a tabletop exercise/discussion on a High Consequence Infectious Disease scenario.  The Situation Manual for this exercise is available in the SCWIHERC shared drive ->Exercise Templates. 

Meeting Attendance:

Josh Kowalke- Reedsburg Ambulance

Emily Kosterman- Waupun Memorial

Jeff Kindrai- Grant County Health Dept

Jodi Moyer- Beloit Memorial

Lynn Skatrud- Green County Health Dept

Elizabeth Chilsen- Jefferson County Health Dept

Lisa Herritz- Ho Chunk Nation Health

Andy Koehler- Fort Health Care

Angie Cohen- Grant Regional

Sam LaMuro- Fort Health Care

Jodie Molitor- Sauk County Health Dept

Tina Strandlie- Stoughton Health

Lyle Kratochwill- Richland Hospital

Jennylynde Packham- UW Health Rehab

Sarah Jensen- Marquette County Health Dept

Christal Foreyt- Gundersen Boscobel

Sarah Van Hoof- UW Health

Jessie Phalen- Sauk County Health Dept

Dave Kitkowski- SSM Health St. Clare Baraboo

Nikki Ripp- Adams County Health Dept

Tanna McKeon- Green County EM

Kara Takes- Unified Therapy

Michael Guss- Walworth County Health Dept

Dave Larson- Madison VA

Mike Stephens- UW Health

Lori Mertens Pelleteri- SSM Health

Brenda Totzke- Mile Bluff Medical Center

Sally Blackbourn- Memorial Hospital of Lafayette County

Mary Bender

Kelly Mitchell- UW Health

Ken Van Horn- Public Health Madison and Dane County

Carmen Carpenter- Iowa County Health Dept

Steve Haskell- UW Health

Aurielle Smith- SCWIHERC and PHMDC

Victoria Parker- Watertown Health Dept

Katie Budack- Grant Regional

Michael Niles- Rock County Health Dept

Kurt Hoeper- Upland Hills Health

Julie Gorman- Sauk Prairie Healthcare

Karen Sell- Prairie Ridge Health Columbus

Tammy Kingery- Gundersen Moundview

Jane Lentz-Gervais- Adams County EM

Brianna Juszczak- Mile Bluff Medical Center

Heidi Finucan- Mile Bluff Medical Center

Diana Quinn- SSM Health

Donna Haugom- Jefferson County Emergency Management

Julie Leibfried- Lafayette County Health Dept

Samroz Jakvani- Jefferson County Health Dept

Brian Kaczmarski- WI HERCs

Jennifer Behnke- SCWIHERC

December 1, 2021 Membership Meeting

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

SCWIHERC Hospitals See High Patient Volumes, Limited Resources – News Release

FOR IMMEDIATE RELEASE

September 10, 2021

Hospitals in South Central Wisconsin see high patient volumes, limited resources
Hospitals seek community help to prevent COVID-19 cases putting critical strain on regional healthcare systems

Hospitals and healthcare facilities throughout southcentral Wisconsin are experiencing a high volume of inpatients, limiting hospital beds and putting a strain on resources.

This serious situation is occurring across the 14 counties of the South Central Wisconsin Healthcare Emergency Readiness Coalition, (SCWIHERC). Its member hospitals are asking for our communities’ help.

To better control the situation, the hospitals are urging everyone to continue being vigilant with COVID-19 safety measures, such as receiving any COVID-19 vaccine, masking, and physically distancing where appropriate.

This present high volume of patients spans across critical care areas of the hospitals, like intensive care units (ICU), general medical floors, and emergency departments. With resources stretched, it is becoming more difficult to receive care close to home if you may need it for COVID and non-COVID-related illnesses.

From July 28 to Sept. 1, the total number of COVID-19 hospitalizations increased four-fold in the South Central region. In that same timeframe, there were 5.5 times the number COVID-19 ICU hospitalizations. Many rural hospitals have no or limited ICU capability and are all reliant on the same limited ICU beds in larger cities, including Madison.

While the current high volume in healthcare facilities in the region is a mixture of COVID-19 and non-COVID-19 patients, a rise in preventable COVID-19 admissions is a driving factor. Preventing a further rise in COVID-19 admissions is our focus in this critical time.

In fact, COVID-19 infections requiring hospitalization are increasing at a similar rate to last winter’s surge. With students from pre-K through college returning to classrooms, the Labor Day holiday, and colder weather soon driving people indoors, additional increases are expected which could stretch resources to critical levels.

To receive a COVID-19 vaccine, please contact your local healthcare providers, or visit the state Department of Health Services vaccine webpage.

###

The South Central Wisconsin Healthcare Emergency Readiness Coalition (SCWIHERC) is a coalition that collaborates with 29 area hospitals and numerous other healthcare providers over 14 counties to prepare for and respond to emergencies in South Central Wisconsin.

SCWIHERC Members signing this message:

Organization Media Contact Name and Email (if provided)
South Central Wisconsin Healthcare Emergency Readiness Coalition Jennifer Behnke (jennifer.behnke@scwiherc.org)
Aspirus Divine Savior Hospital and Clinics Haley Gilman (haley.gilman@aspirus.org)
Beloit Health System Megan Goggin (mgoggin@beloithealthsystem.org)
Edgerton Hospital and Health Services  
Grant Regional Health Center  
Gundersen Health System Chris Stauffer (cjstauff@gundersenhealth.org)
Marshfield Medical Center – Beaver Dam Dan Baulch (baulch.dan@marshfieldclinic.org)
Memorial Hospital of Lafayette County and Primary Care Clinics  
Mercyhealth Rebecca Rose (rrose@mhemail.org)
Mile Bluff Medical Center, Mauston  
Prairie Ridge Health  
Reedsburg Area Medical Center Robert Van Meeteren (rvanmeeteren@ramchealth.org)
The Richland Hospital Lyle Kratochwill (lyle.kratochwill@richlandhospital.com)
Sauk Prairie Healthcare Amy Ryan (amy.ryan@saukprairiehealthcare.org)
SSM Health Lisa Adams (Lisa.Adams@ssmhealth.com)
Southwest Health Jaime Collins (collinsj@southwesthealth.org)
Stoughton Health Laura Mays  (lmays@stoughtonhealth.com)
UnityPoint Health – Meriter Nicole Aimone (Nicole.Aimone@unitypoint.org)
UW Health Andrew Hellpap (AHellpap@uwhealth.org)
Watertown Regional Medical Center Steve Hunt (Steven.Hunt@watertownregional.com)
William S. Middleton Memorial Veterans Hospital Paul Rickert (paul.rickert@va.gov)

 

 

May 3, 2021 Meeting

SCWIHERC General Membership Meeting May 3, 2021 Notes

Meeting recording (expires May 3, 2022): https://transcripts.gotomeeting.com/#/s/f3033c32f10107e293a0e392234b83295b8894a7706f834d9982d77fef8671c8

Intro updates and reminders:
SCWIHERC is seeking nominations for a hospital representative on our Board of Directors. Nominations should be sent to jennifer.behnke@scwiherc.org by May 17.
SCWIHERC still has UV lights disinfection lights available to partners, reach out to jennifer.behnke@scwiherc.org for more info.

Katherine Johnson, WI DHS OPEHC Systems Coordinator, gave an update on several platforms and projects:
EMResource: SNFs have been built in EMResource and we are working to engage them to have them update their bed availability weekly or as it changes. This was a lesson learned during the pandemic with discharging patients needing post-acute care, and the hope is that this will be an up to date resource that hospital discharge planners can use to find open beds while benefitting SNFs who have open beds. This webinar was recorded to show SNF users the system: https://livestream.com/accounts/14059632/events/9579680/videos/218837973
Event response has been somewhat poor recently, including for real events. Please check your alerts and ensure your phone is confirmed to receive text alerts. We are looking at bringing on voice alerts, which enable the system to robodial any phone number to indicate there is an event going on. This would be particularly beneficial for organizations that carry phones that do not receive text messages.
EMTrack, the patient tracking software, and eICS, incident management software for the HERCs are both expected to go live soon and more information will be coming. This link provides a demo on how EMTrack works: https://transcripts.gotomeeting.com/#/s/33895863d0031880b55f29b72d09045de0f01423fa22932eb66a5bb177404558
WISCOM: WI DHS had a funding opportunity to provide updated type 1 WISCOM radios to all hospitals in the state at no cost to the hospitals. See separate email on May 3 from Jennifer for a flyer with details. Hospitals will be asked to provide a contact where the WISCOM agreement should be sent for signature via Docusign if they wish to receive the new equipment.

We had an open discussion on COVID-19 including strategies for reaching those still unvaccinated. Partners are using different approaches including walk in clinics, flexible clinic hours, targeting outreach to include the homebound, vulnerable, BIPOC communities, using creative venues including parks, malls, job centers, workplaces to meet people where they live, work, and play. Some are holding local vaccinator coordination meetings to guide their planning and improve equity. Business partnerships that were forged during previous outbreaks are now being leveraged to offer vaccine clinics for their workforce.

We reviewed existing SCWIHERC plans and our Health Emergency Planner, Amanda Hauser, gave an overview of the new state and regional burn plans. The burn plans detail how we plan to coordinate and provide care to patients for up to 72 hours in the event of a burn mass casualty incident if the burn centers in the state (UW Health and Columbia St. Mary’s Milwaukee) are already full, and burn victims have to be cared for at all trauma centers (including level I, II, III and IV) until they can be transferred to burn centers in the state or out of the state if needed. Level II trauma centers are asking to serve as burn surge facilities and will hear from us separately on what that entails. Level III and IV trauma centers are being asked to facilitate several RNs, an ED physician, and a general surgeon receive ABLS Now training to be able to provide this care. WI DHS and SCWIHERC have some funding to support the provision of this training.
All SCWIHERC plans can be found in the SCWIHERC shared drive. They were recently updated for the year and we are seeking feedback on them; after they are finalized, we will be asking our partners to sign off acknowledging these plans. See separate email from Jennifer for more information.

SCWIHERC still intends to host a COVID-19 AAR in late summer, hopefully in person! SCWIHERC also intends to host a Healthcare Recovery TTX in the fall, rescheduled from spring 2020.

Meeting attendance:
Kurt Hoeper- Upland Hills Health
Charlie Johnson- SSM Health Waupun
Jodi Moyer- Beloit Health System
Tina Strandlie- Stoughton Health
Laura Kane- UW Health
Eric Anderson- Dane County EMS/EM
Ben Eithun- SCWIHERC and UW Health
Alesha Erdenberger- Care and Rehab
Terra Whirry- Columbia County HD
Tanna McKeon- Green Co EM
Sam LaMuro- Fort Health Care
Josh Kowalke- Reedsburg Area Ambulance
Kara Takes- Unified Therapy
Julie Staffin- Mayville EMS
Jen Weadge- Rock Co HD
Aurielle Smith- PH Madison and Dane County
Mary Tessendorf- Monroe Clinic
Erin Francois- New Glarus Home
Christal Foreyt- Gundersen Boscobel
Dave Kitkowski- St. Clare Baraboo
Gail Scott- Jefferson Co HD
Alison Hanamann- Edgerton Hospital
Amanda Gessler- St. Mary’s Madison
Jeff Kindrai- Grant Co HD
Amy Nehls- Dodge County EM
Leslie Cody- Allay Hospice
Asa Rowan- Beloit Area Community Health Centers
Angie Cohen- Grant Regional Health Center
David Drews- Columbia Co
Belle Koch- Sauk Prairie Hospital
Ed Somers- Clearview Dodge Co
Sharon Warden- Mile Bluff Medical Center
Sally Blackbourn- Memorial Hospital of Lafayette Co
Diana Quinn- SSM Health
Ron Krause- Mercyhealth
Suzanne Schreiner- Adams Co HD
Brian Allen- Southwest Health
Shelly Beschta- Reedsburg Area Medical Center
Christa Drays- Rainbow Hospice
Steve Haskell- UW Health
Dawn Eskau- Marquette Co HD
Mike Hall- Monroe Clinic
Bob Swenarski- St. Mary’s Janesville
Bill Ritzer- Reedsburg Area Medical Center
Kathy Johnson- Columbia County EM
Emily Kosterman- Waupun Memorial Hospital
Sharon Rateike- St. Mary’s Janesville
Carol Brown- Rainbow Hospice
Debbie Siegenthaler- Iowa Co HD
Jane Gervais- Adams Co EM
Ann Zenk- Wisconsin Hospital Association
Stephanie Kuschel- Mercyhealth
Kevin Weber- Sauk Prairie Ambulance
Ben Ruyle- St. Clare Baraboo
Heather Poker- St. Mary’s Madison
Jodie Molitor- Sauk Co HD
Erin Hastert- Lafayette Co HD
Tammy Kingery- Gunderson Moundview
Jennifer Vosen- Sauk Co Health Care Center
Nathan Bubenzer- Meriter UPH
Donna Haugom- Jefferson County EM
Dave Larson- Madison VA
Carrie Meier- Dane County EM
Alison Chouinard- Rock Co HD
Jessica Lake- FBI
Carmen Luther- Reedsburg Area Medical Center
Michael Niles- Rock Co HD
Karen Sell- Prairie Ridge Health Columbus
Katherine Johnson- WI DHS OPEHC
Amanda Hauser- WI DHS OPEHC
Jennifer Behnke- SCWIHERC

November 4, 2020 Meeting

SCWIHERC General Membership Meeting November 4, 2020 Notes

Meeting recording (expires May 4, 2021): https://transcripts.gotomeeting.com/#/s/d6b15298f36934f6312486e2957d822d8628f6199003b08f25da175c27eea927

Doug Hill gave an update on COVID-19 Crisis Standards of Care, including the work being done by the State Disaster Medical Advisory Committee (SDMAC).  The state is expected to release guidance that mimic’s that of the National Academy of Medicine for COVID-19 vaccination priority groups.  Refer to the following documents:

Framework for Equitable Allocation of COVID-19 Vaccine from the National Academy of Medicine:

https://www.nap.edu/read/25917/chapter/1

This figure is on page 30 of the PDF.  Wisconsin’s guidance is likely to mirror this approach:

(Share Ethical standards document here)

Kevin Wernet gave an update on Mortuary Affairs and mass fatality planning.  Key points:

Reach out early to your local EM if you have needs (body bags, cold trailers)

Observe practices that respect the decedent.

Move decedents out of their unit bed.  If there is no room in your morgue, consider meeting the funeral home director at an entrance rather than bringing them into your facility and onto the patient care units.  Leaving the decedent on the unit and having the funeral home pick up from the unit directly increases their exposure and PPE burn rate.

Kevin also gave an update from the PPE task force.

Key message: every N95 mask that is discarded instead of decontaminated is one less mask we have during this pandemic and for flu season.  If internal resources are not available for decon, everyone is eligible to use the Battelle System.

See Respirator Reuse Guidance: https://www.dhs.wisconsin.gov/publications/p02699.pdf

Email Kevin with any questions on these topics: kevin.wernet@wisconsin.gov

Updates

Hospitals- please fill out the Match survey to capture hospital involvement in real events and exercises.  It takes about 10-15 minutes if you have your AAR handy.  We use this information to capture your in-kind efforts to meet our required 10% match of our federal grant.  Link: https://www.surveygizmo.com/s3/3321278/WHEPP-Exercise-and-Real-Event-Report-F-02007-01-2017

SCWIHERC COVID-19 Mass Vaccination Functional Exercise is rescheduled for December 9, deadline to register is November 25.  To be determined if we will have a spring exercise.  Healthcare Recovery TTX that was originally scheduled for spring 2020 may be postponed to fall 2021 depending on vaccination efforts.

We are offering a virtual condensed public information officer 4 hour course soon.  This course does not replace the G290 PIO curriculum (a 16 hour course), but offers a training for partners in PIO roles that have not been able to take formal training.  The goal is to balance current demands due to COVID surge with the need to deliver this course in time to use the skills learned when communicating with the public regarding COVID-19 vaccination efforts.  We conducted a poll during the meeting to determine when to schedule the course. Update: January was the top choice, we are looking at scheduling in early-mid January.

There are also many virtual training offerings available to keep up on your skills and knowledge since we cannot offer in-person trainings at this time.  Refer to

Center for Domestic Preparedness Virtual Instructor-Led Training: https://cdp.dhs.gov/vilt

Wisconsin Emergency Management virtual offerings (in purple): https://www.trainingwisconsin.org/Schedule.aspx

The list produced by Svea Erlandson and Mariel Torres, our WI DHS Training and Exercise Coordinator and Specialist.

We resumed our weekly SCWIHERC COVID-19 discussion and gave organizational updates.

Meeting attendance:

Brad Armstrong, UPH Meriter

Diana Quinn, SSM Health

Jodi Moyer, Beloit Health Systems

Nathan Bubenzer, UPH Meriter

Sharon Warden, Mile Bluff Medical Center

Alice Salli, Mendota Mental Health Institute

Alison Chouinard, Rock Co Health Dept

Angie Cohen, Grant Regional Health Ctr

Ben Eithun, UW Health/AFCH/SCWIHERC

Bill Ritzer, Reedsburg Area Medical Center

Brian Allen, Southwest Health

Carrie Meier, Dane County EM/EMS

Dave Larson, Madison VA

Deanna Wright, Memorial Hospital of Lafayette Co

Debbie Siegenthaler, Iowa County Health Dept

Diana Arneson, Rock County

Donna Haugom, Jefferson County EM

Gail Scott, Jefferson Co Health Dept

Steve Haskell, UW Health

Jane Gervais, Adams Co EM

Jodie Molitor, Sauk Co Health Dept

Jon Erdmann, Divine Savior

Josh Kowalke, Reedsburg Area Ambulance

Julie Leibfried, Lafayette Co Health Dept

Kacey Kronenfeld, Madison Emergency Physicians

Kate Stauffacher, Recover Health

Ken Kaiser, Grant Regional Health Ctr

Brenda Koehler-Borchardt, Watertown Regional Medical Ctr

Kristin Osterday

Laura Kane, UW Health

Leslie Cody, Allay Home and Hospice

Lisa Herritz, Ho Chunk Nation Health Dept

Patrick Monckton, Southwest Health

John Pettey, St. Mary’s Madison

Bob Swenarski, St. Mary’s Janesville

Sally Blackbourn, Memorial Hospital of Lafayette Co

Sam LaMuro, Fort Health Care

Sharon Foley, Divine Savior

Stephanie Novak, Marquette Co Health Dept

Tina Strandlie, Stoughton Hospital

Anna Taylor, Monroe Clinic

Carmen Luther, Reedsburg Area Medical Center

Lyle Kratochwill, Richland Hospital

Ashley Vickers, Mercy Walworth

Mary Crowley, Juneau County Health Dept

Guests: Doug Hill, WI DHS Crisis Standards of Care; Kevin Wernet, Wisconsin Emergency Management

Facilitated by Jennifer Behnke

Request for Proposal: Points of Dispensing Functional Exercise and COVID-19 After Action Review

SCWIHERC is seeking proposals for two separate events: a points of dispensing functional exercise and a COVID-19 After Action Review.

If you are interested in submitting an RFP, please see the attached documents and submit proposals electronically to Jennifer Behnke by close of business, July 8, 2020.  Entities wishing to be considered for both exercises should submit separate proposals for each exercise.

Points of Dispensing RFP:

COVID-19 After Action Review RFP:

Infection Control Blog

This page is a pilot project of SCWIHERC and will be used to list all infection control/outbreak notices that SCWIHERC receives, including from the Centers for Disease Control and Prevention.

All notices will be removed after 90 days unless SCWIHERC receives notice that the notice is ongoing.

Please send any feedback or questions to Jennifer Behnke

Ongoing- COVID-19 CDC and WI DHS pages
To receive SCWIHERC updates related to COVID-19, subscribe to our mailing list.

Ongoing- Weekly Respiratory Report from WI DHS

March 5, 2020 Meeting

Join us for our March 5 meeting, see the agenda for details:

Recording available until September 6, 2020: https://transcripts.gotomeeting.com/#/s/67b8068bf4188a54d212fee56709134c0d2a1faef818fe85a53ef4ed29a0922a

Reminders:

See separate trainings list for upcoming trainings.

Please monitor WISCOM HRCRD5 open/clr at all times.  WISCOM should be used to verbalize EMResource/WI Trac alerts for redundancy.

Please remember to submit the MATCH survey for all hospital-based exercises and real events using this link:

We had an in-depth discussion about COVID-19 Preparedness and Response.  WI DHS created a survey to assess the PPE situation for all partners in the state, and this survey data is being shared with federal partners to assess the need to mobilize stockpiles, so please fill out the survey emailed out by Jennifer.  Please find the one best representative in your facility to respond to the survey to avoid conflicting duplicate survey responses.  Feel free to fill out the survey multiple times if the PPE situation in your organization changes.  The SCWIHERC COVID-19 briefings will continue weekly until further notice.

The next portion of the meeting was dedicated to the Coalition Surge Test After Action Review and Facilitated Discussion.  This information can be found in the after action report when available.

The Hospital and Medical Surge workgroups met in the afternoon and discussed surge planning in response to respiratory virus season and COVID-19, as well as MCI readiness.  Three resources were shared by Jennifer:

CDC Mass Casualty Predictor Model

https://hsdl.org/?view&did=24463

Trauma centers: Prepare for mass casualty incidents by understanding the 10 predictable stages of disruption

https://www.trauma-news.com/2016/07/trauma-centers-prepare-mass-casualty-incidents-understanding-10-predictable-stages-disruption/

Strategies for Improved Hospital Response to Mass Casualty Incidents

https://www.cambridge.org/core/services/aop-cambridge-core/content/view/AFA27D8C7A03E987F93BE04CD75FD142/S1935789318000046a.pdf/strategies_for_improved_hospital_response_to_mass_casualty_incidents.pdf

Meeting attendance:

Ashley Buys- UW Health

Jacob Greenberg- UW Health

Mary Crowley- Juneau Co HD

Lisa Herritz- Ho Chunk Nation HD

Laura Kane- UW Health AFCH

Asa Rowan, Community Health Systems

Sheryl Krause- Fort Healthcare

Brenda Koehler-Borchardt- Watertown Regional Medical Ctr

Jeff Kindrai- Grant County HD

Thomas Ellison- UW Health

Joe Meagher- Dodge Co EM

Amy Nehls- Dodge Co EM

Dave Larson0 Madison VA Hospital

Jane Gervais- Adams Co EM

Samantha Marcelain- Gundersen Moundview

Christal Foreyt- Gundersen Boscobel

Joni Marty- Green Co HD

Alison Chouinard- Rock Co HD

DeAnn McAllan- American Red Cross

Mary Tesserdorf- Monroe Clinic

Jodi Moyer- Beloit Health System

Johnny Holt- St. Clare Baraboo

Jon Erdmann- Divine Savior

Sharon Foley- Divine Savior

John Rago- Baraboo EMS

Julie Gorman- Sauk Prairie Healthcare

Abigail Kuehn- Watertown HD

Victoria Parker- Watertown HD

LuAnn Reuter- Prairie Ridge Health

Karen Sell- Prairie Ridge Health

Kyle Schaefer- UW Health

Jeff Ethington- UW Health OPO

Julie Muhle- Marshfield Medical Center Beaver Dam

John Pettey- St. Mary’s Madison

Jennifer Behnke- SCWIHERC

Online:

Dave Kitkowski- St. Clare Baraboo

Tana Buss- UW Health

Emily Kosterman- Waupun Memorial

Sue Matye- Iowa Co HD

Tanna McKeon- Green Co EM

Stephanie Kuschel- MercyHealth Janesville/NIPARC

Jen Boigenzahn- Gundersen

Carol Brown- Rainbow Hospice

Sarah Hughes- PH Madison Dane Co

Kathy Noe-

Sharon Rateike- St. Mary’s Janesville

Patrick Monckton- Southwest Health

Brian Allen- Southwest Health

Erin Hastert- Lafayette Co HD

Angie Cohen- Grant Regional Health Center

November 20, 2019 Meeting

November 20, 2019 Membership Meeting Notes

SCWIHERC Updates:

As of October 23, SCWIHERC is incorporated, now we are seeking nonprofit status to help support our long-term sustainability.

Our spring tabletop exercise topic is healthcare system recovery. The scenario will be written to engage all core partners: hospitals, public health, EMS, emergency management, and other healthcare providers. Tentative dates are April 14-16. We need exercise design team members, please let Jennifer know if you are interested in being on the design team.

The coalition surge test will be taking place again in late winter. We need to simulate evacuation of 430 patients to meet our 20% surge threshold required by our grant. If you are interested in volunteering to be an evacuating hospital, please let Jennifer know. If we do not have enough volunteers, we will ask hospitals directly to meet our federal requirements.

A training matrix was distributed listing all upcoming trainings for the remainder of the grant year. That information is summarized here: http://www.scwiherc.org/category/training/http://www.scwiherc.org/category/training/
CORRECTION: the training matrix had an error, the PER 211: Medical Management of CBRNE Incidents is May 18-19, NOT May 17.

Tracey Froiland, Fox Valley HERC Coordinator, presented on their Infectious Disease Go-Team. They pioneered this novel concept of forming a team to care for high consequence infectious disease patients in their home using telemedicine. This specially-trained team can also support caring for these patients in a hospital setting. See their promotional video for more info: https://www.youtube.com/watch?v=L4O3ZWkJgJ8
Tracey’s slides will be available in the SCWIHERC shared drive soon.

We had several partners present on different organizations that provide human personnel assets used in response. Presentation highlights:

WEAVR- Wisconsin Emergency Assistance Volunteer Registry: https://weavrwi.org/
Individual registry- Wisconsin’s ESAR-VHP. A database of individuals who can support the health needs of an incident. Pre-registered individuals have been vetted through a background check and credential verification. Individuals who are registered in WEAVR and deployed through a WEAVR request during a federal or state declared emergency are offered liability protection through Wisconsin Statute 257. The state is seeking clarification from the Office of Legal Counsel on whether this liability protection is available in the absence of federal or state declaration.
Registration in WEAVR is not a commitment to serve in any emergency. Please encourage your staff and partners to register!

MRC- Medical Reserve Corps. Brenda Lutz-Hanson presented on the Region 4 MRC and the purpose, mission, and sustaining of MRCs in Wisconsin. The entry point for MRCs in Wisconsin is registering in WEAVR and selecting the affiliation with an MRC. Currently, Region 5 (SCWIHERC’s region) has no active MRCs. Managing an MRC is often, but not always, done by local health departments. There is some work involved, but federal grant dollars may be available to support this effort. Contact Jennifer for more information.

DMAT- Wisconsin’s Disaster Medical Assistance Team. Patty Scanlin presented on this asset. They deploy outside of Wisconsin to assist medical operations after disasters and for large, planned events such as presidential funerals or inaugurations. They have field hospital capabilities. DMAT personnel are vetted by the federal process that takes 1-2 years and train on personal time, but are paid during deployment. Deployment notice may be as short as 12-24 hours, and deployments can last from 10-14 days.

American Red Cross- Connie Miley spoke about the volunteer capabilities and opportunities with American Red Cross. They often support sheltering and mass care operations all over the state and country.

Team Rubicon- Jodi Moyer spoke the mission and capabilities of Team Rubicon. They deploy nationally and focus on debris cleanup but have other capabilities. They are a veteran founded organization and 75% of their volunteer force is veterans. They are supported by donations from individuals and companies, and receive no payments by individuals impacted by disasters.

A question came up about requesting and utilizing any of these resources. It is strongly recommended that all requests are made through local emergency management. This helps ensure that those affected receive the most appropriate resource for their needs, and also may have reimbursement ramifications if federal or state funding is available for incident response and/or recovery.

Svea Erlandson, WI DHS Training and Exercise Coordinator, facilitated our Training and Exercise Planning Workshop in the afternoon. We reviewed data from the training needs assessment survey, and then had a productive conversation about developing training priorities and how to support these with available trainings. The three training priorities identified included Ensuring the Continuity of Healthcare Service Delivery, Catastrophic Event Preparedness for the Health Sector, and Health Emergency Management Orientation for partners in Wisconsin. These priorities will guide trainings offered in the July 1, 2020 to June 30, 2021 grant year.

Our meeting concluded with discussion on special populations and triaging the most important needs according to life safety priorities.

Grant guidance on this topic: Support HCC members with situational awareness and information technology (IT) tools already in use that can help identify children, seniors, pregnant women, people with disabilities, and others with unique needs. Support HCC member agencies in developing or augmenting existing response plans for these populations, including mechanisms for family reunification. Identify potential health care delivery system support for these populations (pre- and post-event) that can prevent stress on hospitals during a medical surge event. Assess needs and contribute to medical planning that may enable individuals to remain in their residences during certain emergencies. When that is not possible, coordinate with the jurisdiction’s ESF-8 lead agency to support the jurisdiction’s ESF-6 (Mass Care, Emergency Assistance, Housing, and Human Services) lead agency with access to medical care including at shelter sites. Coordinate with the jurisdiction’s ESF-8 lead agency to assess medical transport needs for these populations.

Jennifer also offered a definition for those with access and functional needs according to FEMA: Children and adults with physical, mobility, sensory, intellectual, developmental, cognitive, or mental health disabilities. Older adults. People with temporary or chronic health conditions (including taking daily medication). Women in late stages of pregnancy. People needing bariatric equipment. People with limited English proficiency, low literacy, or additional communications needs. People with very low incomes. People without access to transportation. People experiencing homelessness.

Based on this guidance and definition, the group identified these most urgent life safety priorities:

Electricity dependent individuals- how to find them before the incident, how to empower them to prepare for a power outage, how to care for them during a power outage, and how to partner with other groups to support these three capabilities. This includes home health, durable medical equipment suppliers, primary care providers.

Individuals with unreliable transportation options- planning for those who need transportation assistance for their medical appointments, and for those who don’t have the transportation means to evacuate when a community evacuation is ordered.

Individuals on medications for medical conditions- helping these individuals maintain an adequate supply of medications before an incident so they don’t run during an incident when normal suppliers may be disrupted, or if they cannot travel to refill meds. This includes working with other healthcare providers to share this message with vulnerable patients.

Supporting Home Health Agency Continuity of Operations- recognizing that HHAs are critical to keeping individuals with various conditions healthy and able to live at home, we will look for ways to support HHA continuity of operations so they can continue to do what they do every day even after a large or disruptive incident.

Meals on Wheels- supporting these agencies that meet the basic dietary needs of vulnerable individuals on a daily basis so that they can continue this important mission even after incidents.

Supporting better communications for these special populations, including the English as a second language community and those with low literacy levels. Not only translating written materials and having sufficient interpreter services available for every step of preparedness, response, and recovery, but also utilizing multiple channels of information dissemination. This can include traditional media channels like television, radio, and print, but also cultural and faith-based organizations that serve a role in gathering and outreach to these individuals and groups.

Important partners to engage in supporting these important missions can include local human services agencies, primary care organizations, home health agencies, long-term care organizations, Aging and Disability Resource Centers, WIC (Women, Infants, and Children) nutrition programs, 211 and United Way, and cultural and faith-based organizations.
The next steps proposed by the group include inviting representatives from these important partners to a round-table discussion to more thoroughly explore how we can work with these partners to promote preparedness, and support response and recovery efforts for these special populations.

Meeting Attendance:

Bob Swenarski- St. Mary’s Janesville
Juan Cullum- Mercyhealth Janesville
Jodie Molitor- Sauk County Health Dept
Alice Salli- Mendota Mental Health
Mary Crowley- Juneau County Health Dept
Lisa Herritz- Ho-Chunk Nation Health Dept
Asa Rowan- Community Health Systems Beloit
Gail Scott- Jefferson County Health Dept
Samantha LaMuro- Fort Healthcare
Mike Hall- Monroe Clinic
Kelly Pederson- St. Mary’s Madison
Nikki Salas- Watertown Regional Med Ctr
Brenda Koehler Borchardt- Watertown Regional Med Ctr
Marie-Noel Sandoval- Rock County Health Dept
Douglas MacFarlane- Crossroads Care Center of Mayville
Tina Strandlie- Stoughton Hospital
Christal Foreyt- Gundersen Boscobel Hospital and Clinics
Josh Kowalke- Reedsburg Ambulance
Jill Lenz- Columbia County Health Dept
Susan Lorenz- Columbia County Health Dept
Mike Lohmeier- SCWIHERC Medical Advisor
Carrie Meier- Dane County Emergency Mgmt
Connie Miley- American Red Cross
Jon Erdmann- Divine Savior Healthcare
John Longo- WI DHS OPEHC
Tracey Froiland- FVHERC
Mike Stephens- UW Health
Sarah Mattes- Public Health Madison Dane County
Steve Haskell- UW Health
Patricia Scanlin- UW Health TAC, WI DMAT
Sharon Foley- Divine Savior Healthcare
Alison Chouinard- Rock County Health Dept
Julie Muhle- Beaver Dam Marshfield Medical Center
Marla Noordhof- Beaver Dam Marshfield Medical Center
Abbey Kuehn- Watertown Health Dept.
Sarah Stewart- Watertown Health Dept
Dan Michaels- Public Health Madison and Dane County
Dave Larson- Madison VA Hospital
Joe Meagher- Dodge County Emergency Mgmt
Jodi Moyer- Beloit Health System
Nathan Bubenzer- Meriter UnityPoint Health
Sue Matye- Iowa County Health Dept
Karen Sell- Prairie Ridge Health Columbus
Amy Hollis- Monroe Clinic
Svea Erlandson- WI DHS OPEHC
Brenda Lutz-Hanson- La Crosse County Health Dept
Jeff Ethington- UW Health OPO
Jennifer Behnke- SCWIHERC

September 10, 2019 Workgroup Meeting- Spec Path, PHEP, Spec Pop

9-10-19 Special Pathogens, PHEP, Special Populations Workgroup Meeting

General

Reminder that the Closed POD workshop is September 26.  Formal registration is closed but Jennifer can still add a few attendees, email her for last minute registrations.

The plan for the next meeting includes an infectious disease go team presentation, human personnel assets (WEAVR, MRC, DMAT) presentation, Training and Exercise Planning Workshop, workgroups.  It wiill consume most of work day but we will provide lunch, partners are welcome to come and go.  Looking at November 20, somewhere in the Madison area.

We talked about hosting a communications workshop covering the topics of social media, media relations, Joint Information Systems operations, organizational internal communications (with staff/patients), message mapping.  Partners agreed this is a good topic.

We talked about the opportunity for a healthcare recovery/continuity of operations tabletop exercise, which is strongly suggested in the grant language: Supporting member organizations in defining what their “essential functions” that must be maintained after disruption of normal activities and determining priority for restoration if compromised and determining what the coalition might do to assess and support the maintenance of these functions. Admin/Finance operations, Supply Chain, Shelter in place, staff support and resilience including mental health support.  Suggested to add a 96-hour sustainability plan component.  This is distinct from the business continuity planning workshop offered in April, as we will be more formally exploring how an emergency disrupts healthcare delivery, how we assess essential services and how to prioritize restoring them, and how SCWIHERC can assist this effort.  Targeted audience includes all coalition disciplines.

We also talked about the opportunity for a communications workshop and what our current gaps are that should be addressed by this.  We came up with social media, media relations, Joint Information Systems operations, organizational internal communications (with staff/patients), and message mapping.  There is a vendor used by another region that conducts customized workshops on these topics and this could be an opportunity, especially if we can invite members of the media for a meet and greet to build relationships before incidents happen.  A suggestion was made to include other media outlets (TV/radio/newspaper) outside the Madison market in addition to the Madison market.

Reminder that the Coalition Surge Test will also be an exercise this year.

SCWIHERC scholarship opportunity announcement coming soon.  Public health partners are asked to utilize PHEP funding instead, they will have funding comparable to last year for scholarships.

The goal for all workgroups is to define goals and objectives, nominate a leader, share lessons learned, and make progress on grant requirements relevant to the workgroup.

Special Pathogens Discussion

Grant guidance on this topic:

Educate stakeholders on current policies and practices regarding the type of PPE necessary for various infectious pathogens, and the availability of PPE resources, to include stockpiling considerations, vendor-managed inventories, and the potential for reuse of equipment.

During an infectious disease outbreak, ASPR and CDC require that recipients and HCCs coordinate the following activities to ensure the ability to surge to meet the demands during a highly infectious disease response: Establish a Medical Common Operating Picture, Develop or update plans accordingly, Establish key indicators and EEIs, Provide real-time information sharing, Coordinate public messaging.

Support and promote regional PPE procurement, Equip, train, and provide resources necessary to protect responders, employees, and their families from hazards during response and recovery operations. PPE, MCMs, workplace violence training, psychological first aid training, others.

We discussed the special capabilities of certain organizations in our region related to handling patients with high consequence infectious diseases (HCID).  Nomenclature note:  while these capabilities were built using support and guidance prescribed by the Ebola grant administered through ASPR/HPP, we have updated the preparedness and response activities to encompass all high consequence infectious diseases.

UW Hospital is a category 1 Ebola Treatment Facility.  Their activities and capabilities include the ability to treat up to 2 confirmed HCID/Ebola patients at a time.  They support this through their HCID team which includes representatives from infection control, infectious disease, emergency medicine, and others.  They do quarterly training and a required annual HCID drill with performance measures reported to the feds.

St. Mary’s Madison is a category 2 Assessment Facility. Under ideal circumstances, if public health is alerted to a potential HCID patient, they are directed to St. Mary’s rather than presenting at their preferred hospital or clinic.  Their activities and capabilities include being able to admit and treat a suspected HCID/Ebola patient for up to 72 hours, the window it could take to receive confirmed positive laboratory results for a patient.  If the patient is confirmed positive, they are transferred to a treatment facility, which could include UW Hospital or the regional treatment center, which is the University of Minnesota Medical Center West Bank.  St. Mary’s does quarterly training and a required annual HCID drill with performance measures reported to the feds.

The University of Minnesota Medical Center West Bank is the region’s treatment center (referring to HHS/FEMA regions, not HERC regions) and has greater capacity for HCID patients than UW Hospital.

It is protocol for a confirmed positive patient to be transferred to UMMC West Bank.  Situations that would alter this protocol include if the patient was not stable enough for transfer, terminally ill, or if UMMC West Bank’s HCID unit was full.

Transportation of a confirmed positive HCID patient must be done by agencies that are specially trained and have HCID plans and procedures.  Madison Fire has the capability to transfer within Dane County, and Baraboo EMS has the capability to transfer anywhere within Wisconsin and from anywhere in Wisconsin to UMMC West Bank.

Baraboo EMS has a cache of PPE, two ISO PODS, and procedures for transporting a HCID patient.  There is one medic donning a full PAPR who accompanies the patient (contained in an ISO POD), a driving medic that wears certain PPE, and the ambulance is followed by a chase vehicle with additional supplies that can offer support as needed.  Several medics are trained in these plans and there is a very specific procedure for disinfecting the rig after transport is complete.

We were able to share lessons learned from a recent event wherein a patient with a fever of unknown origin with a positive travel history was transported by ambulance to a local facility and held until HCID was ruled out.  Emphasis was placed on adhering to existing plans for these events, including prescribed communications channels.

The conversation evolved into discussion of how frontline healthcare facilities can be better prepared, and the wide assortment of PPE that is available.  It was suggested that this workgroup follow up in the future with a PPE show and tell, wherein regional partners can view the different types of PPE available and perhaps move toward a goal of having the same PPE throughout the region, potentially giving us power as a region to negotiate pricing.

Many other resources were mentioned in the special pathogens discussion, listed here:

National Ebola Training and Education Center courses https://courses.netec.org/

EMS Infectious Disease Handbook https://em-ems.countyofdane.com/documents/pdf/Infection-Control-EMS-Primer-on-ID-7.11.19.pdf

WI DHS MN DPH Joint Ebola Transport Exercise Video https://vimeo.com/329950429/472b98ee2f

CDC PPE Training videos https://www.cdc.gov/vhf/ebola/hcp/ppe-training/comprehensive-ppe-training.html

High Consequence Infectious Disease Toolbox https://www.health.state.mn.us/diseases/hcid/index.html

WI DHS Disease Fact Sheets https://www.dhs.wisconsin.gov/disease/index.htm

UW Health Special Pathogens Team Blog https://spteam.uwhealth.org/

Public Health Emergency Preparedness (PHEP)

We discussed the upcoming Closed POD workshop and how SCWIHERC and the contractor are lending support, but this event will be driven by local public health partners.  The event will start with a presentation on closed POD planning and logistics from Dan Michaels at Public Health Madison and Dane County, and then we will have a panel representing hospitals (Meriter), Universities (UW Madison), and private businesses (West Bend Mutual) as well as WI DHS medical countermeasures.  They have a list of talking points to address including the process for creating their own closed POD plan.  There will be time for Q&A from the audience.  We will then break for lunch and return for a tabletop exercise on an anthrax scenario in the afternoon.  Prior to the workshop, Jennifer will share the registration list, the closed POD template, and the TTX Situation Manual with public health partners for their awareness.  Printed closed POD templates will be available at the workshop for reference, but local public health representatives should be the gatekeepers of the electronic template, so planning is not occurring without local public health awareness.  The situation manual will be available to all partners after the exercise on the SCWIHERC shared drive, so they can use the exercise internally as they see fit.

We explored other opportunities for the PHEP workgroup to work collaboratively.  It was mentioned that local public health is waiting on the state to update the PHEP plan, and the state will look into this.  There was an idea to bring local public health partners together to share information and resources for completing the portions of the PHEP plan that require local customization.  We will bring this idea to Southern WALHDAB for feedback.

Special Populations Discussion

This topic was unfortunately cut short due to the great conversations taking place on the previous topics.

Grant guidance on this topic:

Support HCC members with situational awareness and information technology (IT) tools already in use that can help identify children, seniors, pregnant women, people with disabilities, and others with unique needs.  Support HCC member agencies in developing or augmenting existing response plans for these populations, including mechanisms for family reunification.  Identify potential health care delivery system support for these populations (pre- and post-event) that can prevent stress on hospitals during a medical surge event.  Assess needs and contribute to medical planning that may enable individuals to remain in their residences during certain emergencies. When that is not possible, coordinate with the jurisdiction’s ESF-8 lead agency to support the jurisdiction’s ESF-6 (Mass Care, Emergency Assistance, Housing, and Human Services) lead agency with access to medical care including at shelter sites.  Coordinate with the jurisdiction’s ESF-8 lead agency to assess medical transport needs for these populations.

Jennifer also offered a definition for those with access and functional needs according to FEMA: Children and adults with physical, mobility, sensory, intellectual, developmental, cognitive, or mental health disabilities.  Older adults. People with temporary or chronic health conditions (including taking daily medication).  Women in late stages of pregnancy.  People needing bariatric equipment.  People with limited English proficiency, low literacy, or additional communications needs.  People with very low incomes.  People without access to transportation.  People experiencing homelessness.

In planning for these populations, we talked about the need to engage more partners including home health agencies, aging and disability resource centers, family care organizations, primary care clinics, durable medical equipment companies, and 211.  In the absence of comprehensive planning and up to date information, 211 can be used for just in time resource sharing to identify these populations after an event to connect them with the resources needed.  Additionally, durable medical equipment companies have accurate and comprehensive lists of electricity dependent individuals, including those who have only private insurance, that can be used during emergencies.

Meeting Attendance:

Jeff Kindrai- Grant Co Health Dept

Gail Scott- Jefferson Co Health Dept

Donna Haugom- Jefferson Co EM

Alison Chouinard- Rock Co Health Dept

Kim Cox- WI DHS OPEHC

Sam LaMuro- Fort Healthcare

Brenda Klahn- St. Mary’s Janesville

Steve Haskell- UW Health

Sharon Rateike- St. Mary’s Janesville

Jony Marty- Green County Health Dept

Dave Larson- Madison VA

Anna Robb- Stoughton Hospital

Lynda Brereton- St. Mary’s Madison

Carol Quest- Watertown Health Dept

Kathy Noe- Mile Bluff Medical Ctr

John Rago- Baraboo EMS

Brad Armstrong- Meriter UPH

Nathan Bubenzer- Meriter UPH

Dan Michaels- PHMDC

Ben Eithun- UW Health AFCH

Tom Ellison- UW Health

Christal Foreyt- Gundersen Boscobel

Mike Stephens- UW Health

Juan Cullum- Mercyhealth Janesville

Mike Lohmeier- SCWIHERC/UW Health

Mary Crowley- Juneau Co Health Dept

Dave Kitkowski- St. Clare Baraboo

Alison Hanaman- Edgerton Hospital

Suzanne Schreiner- Adams Co Health Dept

Lisa Herritz- Ho Chunk Nation

John Longo- WI DHS OPEHC

Jennifer Behnke- SCWIHERC