February 6, 2024 Membership Meeting

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

November 14, 2023 Membership Meeting

Agenda:

SCWIHERC November 14, 2023 Membership Meeting Notes

Meeting recording: https://us06web.zoom.us/rec/share/LdGrskDvUDukdvjAw55DwJDpqYYfXUGytCwHM3f4DnewaxU7ygSc85xmp6TuWCC2.CzBqgIcoEGIn7bc4n

Passcode: see email from Jennifer November 16

Hospital

The hospital group discussed the warehouse survey and discussed the balance of adequate inventory versus space available.  The DASH Tool https://dashtool.org/  is robust and a bit overwhelming, and likely a starting point.  Note that the DASH Tool does let you export results after entering your data.

Suggested meeting topic: FirstNet communications capabilities.  Will work to bring this topic in for a future meeting.

The Hospital Forum will skip meeting in December, Jennifer will send out a survey to schedule for early January.

Membership

Jennifer gave a few SCWIHERC updates.  The Training Needs Assessment Survey was sent out October 25 and will close November 24.  This is very important and our primary source of information for planning trainings in the region and state, please strive to have at least one response per organization, but multiple people from the same organization are welcome to respond!  The ventilator survey, sent Nov 8 and Due Nov 20, can be used to request no-cost ventilators from WI DHS stockpile.  SCWIHERC applied for carryover funding to support a cybersecurity workshop and conduct a power outage tabletop exercise.  Cyber is #3 on our HVA, and WICTRA https://wictra.org/ hosts a two day workshop wherein the first day is doing a TTX to discover your organizational vulnerabilities, and the second day is used to write a cyber event continuity plan.  Power Outage is # 2 on our HVA, and we are looking to host an in-person tabletop exercise like the good old days where we would be grouped together with our local response partners, and cover response to a substantial power outage which affects health partners but also impacts the community.  Other smaller projects for which SCWIHERC requested carryover money include refreshing our website, and continuing our fundraising efforts as a nonprofit organization.  Don’t forget that SCWIHERC is offering scholarships to support emergency preparedness efforts in the region, see email sent November 3.  Also note the following scheduled spring dates: Feb 6 and May 7 for SCWIHERC meetings, February 21 for Medical Surge and Response Exercise (MRSE).

Jim Oleson, WI DHS Warehouse Supervisor, gave an update on warehouse operations.  The state has a glut of supplies received during the pandemic, and needs to demobilize and return to pre-pandemic operations and par levels.  This is the reason behind the warehouse survey which closed yesterday, November 13.  Refer to recording for more details, questions can be sent to james.oleson@dhs.wisconsin.gov

Ann Zenk, Wisconsin Hospital Association, gave a presentation on workforce development and WHA’s work on this topic to train and retain the healthcare workforce.  azenk@wha.org

Traci Lindsey, South Central Wisconsin Area Health Education Centers, also gave a presentation describing SCWAHEC’s mission and work on this topic.  They are interested in hearing from you if your organization can take interns or mentor students in some capacity! trlindsey@scwahec.org

Refer to the recording for more details.

What are we working on and preparing for?

MCI preparedness, upcoming respiratory season, staffing shortages/hiring/retention, cyber threats, decon, PHEP and other emergency plan updates.

Meeting attendance:

Jeff Brown- Mercyhealth

Dave Kitkowski- St. Clare Baraboo and SCWIHERC

Michael Niles- Rock County HD

Karen Nsiah-Ababio- Rock County HD

Jordon Denfeld and Derrick- Maxim Staffing

Karmen Bryer- Beloit Health System

Nathan Bubenzer- Meriter UPH

Dave Larson- Madison VA

Belle Koch- Sauk Prairie Healthcare

Mary Crowley- Juneau County HD

Steve Haskell- UW Health

Patti Miller- City of Beloit EM

Angie Cohen- Grant Regional

Jodi Moyer- Beloit Health System

Carmen Luther- Reedsburg Area Med Ctr

Ben Thompson- Mercyhealth

Christal Foreyt- Gundersen Boscobel

Mary Tessendorf- Monroe Hospital

Tammy Kingery- Gundersen Moundview

Adam Dahle- Encompass Health Rehab Hospital

Mike Stephens- Fort HealthCare

Leanne Seifert- Watertown Regional Med Ctr

Sally Blackbourn- Memorial Hospital of Lafayette County

Sharon Rateike- ECRI

Page Heinke- SSM Health at Home

Kyle Schaeffer- UW Health

Emily Kosterman- Waupun Memorial

Katie Budack- Grant Regional

Tina Strandlie- Stoughton Health

Sarah Jensen- Marquette Co HD

Debbie Siegenthaler- Iowa Co HD

Sean Madison- NIPARC

Victoria Parker- Watertown HD

Lynn Skatrud- Green Co HD

Jodie Molitor- Sauk Co HD

Erin Hastert- Lafayette Co HD

Kara Takes- Unified Therapy

Kimberley Spurgeon- Family Health La Clinica

Gary Ziegler- Green Co EM

Anthony Rauterberg- Watertown FD

Diana Quinn- SSM Health

Jeff Ethington- UW Health OPO

Jim Oleson- WI DHS

Ann Zenk- WHA

Traci Lindsey- SCWAHEC

Jennifer Behnke- SCWIHERC

September 19, 2023 Membership Meeting

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

May 17, 2023 Membership Meeting


Recording link and passcode: See email from Jennifer on May 20.
Hospital:
We discussed how hospitals should prepare for the Medical Response and Surge Exercise on June 14. The scenario will give each hospital a 20% surge of paper patients based on the bed survey responses. The premise of the exercise is that hospitals will then look at their real census and staffing on exercise day, and move through their paper patient surge to determine how many patients they can make room for, how many current admissions where they can expedite discharge, and whether they have enough supplies to care for the paper patients in this scenario. Please consider inviting your local EMS, interfacility transport, public health department, and emergency management reps to your hospital command center during the exercise. There will be a hotwash immediately after the conclusion of the exercise, and we will also talk more in-depth at our June Hospital Forum meeting (June 20 at noon) about how hospitals responded and overall themes, strengths, and areas for improvement.
Reminder that hospitals are asked to complete the MATCH survey to report their in-kind efforts on exercises and real events. These survey responses help the Hospital Preparedness Program meet our 10% grant matching requirement from the feds. Deadline for survey completion for this grant year is June 30 (we will ask again for activities starting July 1 next year). MATCH survey link: https://www.surveygizmo.com/s3/3321278/WHEPP-Exercise-and-Real-Event-Report-F-02007-06-2022
ABLS continues to be a hassle, without warning we learned ABA changed learning platforms about 6 weeks ago, current course progress was lost if the course wasn’t finished at that time, and users cannot find where to access the course on the new platform. Jennifer sent out an email on May 8 to all users on her master registration list requesting that they attempt to log in and find the course, and if it is not there, to reach out to ABLS (ABLS@ameriburn.org) to put in a support ticket. Users should do this before they attempt to resume the course, to be sure the course is actually there when they need it! Related to the Burn Surge Plan- don’t forget to share/post the burn plan activation one-pager so your staff know when and how to activate the burn plan. Link:
We reviewed the poorer than usual EMResource response rates, especially to mass casualty incident type events. Typically two root causes: training is needed to show staff how to do it correctly, or alerts are not getting to the staff tasked with responding. Remember that notification methods include text message (to personal or pass around phones), email, and voice alerts (robodial that can also go to a landline). Group expressed an interest in continued reminders to keep addressing the problem, Jennifer will also compile response rates and share soon. Remember that the success of the RMCC, and more importantly better patient outcomes, are supported when hospitals respond. This is the only way for the field to understand your current capabilities based on your current staffing and patient loads!
Membership:
Medical Response and Surge Exercise: Two specific injects written into exercise to engage local public health and emergency management. Please join your hospital command center in person so you can learn from each other and learn what you can offer each other in this scenario. Even if you cannot be there in person, your hospitals (or the exercise controllers) will reach out to you during the exercise for support on these injects. Please discuss with your staff how you would respond to these injects and add that to feedback survey or email to Jennifer.

SCWIHERC will be doing annual review of plans, making updates, and requesting documentation that your organization received our plans via DocuSign in Junem completion requested by June 30. This is an annual federal requirement that HERCs must meet to show the feds that we pr ovided these plans to our partners, your completion of the DocuSign is our official documentation for this requirement.

Several opportunities remain from now until June 30: Flyers for all are attached.
Media Relations Workshop June 1, 11 seats remain

Active Shooter Incident Management Basic for First Responders June 6 or 7, 60 seats remain

CMS Virtual Exercise June 21, room for 100 more organizations! Please continue to target and share this with long-term care facilities, hospices, home health agencies, ambulatory surgery centers, outpatient physical/occupational therapy providers, end stage renal disease (dialysis) providers, federally qualified health centers, rural health centers, and intermediate care facilities for individuals with intellectual disabilities. This exercise is customized to these audiences to help test their emergency operations plan, communication plan, and help them satisfy an exercise requirement!

Mark Paulson, WI DHS Radiation Protection Section Manager, joined us to give a presentation on their office and the support and resources offered. Refer to recording and remember that these resources can be reached 24/7 at 608-258-0099 (WI DHS emergency line).

We then proceeded through the tabletop exercise on a radiation injury scenario (SitMan link: ). This is here for your organization if you would like to review this scenario internally with your staff and leadership. https://drive.google.com/file/d/1W4BTeB51-XwBKA8e6L2PPiSjJ7tyoqjg/view?usp=share_link

Other helpful resources:

Radiation Emergency Assistance Center/Training Site: https://orise.orau.gov/reacts/index.html

WI DHS web page that links to a lot of the resources below and some WI specific guides: https://www.dhs.wisconsin.gov/radiation/protection/index.htm
Radiological Dispersal Device (RDD) Response Guidance Planning for the First 100 Minutes: Video and link to guidance https://www.dhs.gov/publication/st-frg-rdd-response-guidance-planning-first-100-minutes
First 100 minute guidance https://www.dhs.gov/sites/default/files/publications/nustl_rdd-responseplanningguidance-public_28oct2021-508-revised.pdf
CDC Population Monitoring and Reception Centers: https://www.cdc.gov/nceh/radiation/emergencies/populationmonitoring.htm?msclkid=79e6b5b7d14411ec9ad290c77bf9f899
Guide to operating shelter during a radiation emergency: https://www.emergency.cdc.gov/radiation/pdf/operating-public-shelters.pdf
Points of Dispensing to Community Rection center planning toolkit: https://www.cdc.gov/nceh/radiation/emergencies/pdf/POD_to_CRC_Planning_Tool-508.pdf
Video and job aid for screening people for external contamination: https://www.cdc.gov/nceh/radiation/emergencies/screeningvideos/index.htm
Just in time training resources and quick reference guides for clinical staff: https://orise.orau.gov/resources/reacts/references.html

Radiation Injury Treatment Network: https://ritn.net/

ASPR TRACIE: https://asprtracie.hhs.gov/technical-resources/32/radiological-and-nuclear/27

Some strengths and areas of improvement from our discussion will be captured and shared in a brief after action report and improvement plan in the next few weeks.

Next meeting in new grant year yet to be scheduled, but likely in September, watch email!
Meeting attendance:
Lisa Herritz- Ho Chunk Nation
Jim Abitz- Southwest Health
Angie Cohen- Grant Regional
Steve Haskell- UW Health
Belle Koch- Sauk Prairie
Jodi Moyer- Beloit Health System
Matt Christian- Marshfield Medical Center Beaver Dam
Nathan Bubenzer- Meriter UPH
Lyle Kratochwill- Richland Hospital
Carmen Luther- Reedsburg AMC
Diana Quinn- SSM Health
Chad Atkinson- Mercyhealth
Christal Foreyt- Gundersen Boscobel
Dave Larson- Madison VA
Paige Heinke- SSM Health
Colleen Wilson- Waupun Memorial
Mike Hall- Monroe Hospital
Carol Quest- Watertown PH
Eric Anderson- Dane County EM/EMS
Dave Kitkowski- St. Clare Baraboo
Joe Meagher- Dodge County EM
Sharon Rateike- St. Mary’s Janesville
Lisa Peters- Gundersen Moundview
Tom Ellison- UW Health
Tammy Kingery- Gundersen Moundview
Leanne Seifert- Watertown RMC
Carmen Carpenter- Iowa County PH
Brent Skiba- Watertown RMC
Mike Stephens- Fort Health Care
Loni Hefner- Access Community Health Centes
Samroz Jakvani- Jefferson County PH
Hannah Sedlacek- Adams County HHS
Victoria Parker- Watertown PH
Matt Bartol- Dodge County EM/PH
Erin Hastert- Lafayette County PH
Kimberley Spurgeon- Family La Clinica
Lynn Skatrud- Green County PH
Michael Niles- Rock County PH
Jeff Kindrai- Grant County PH
Stacy Blakemore- Sauk Co EM
Gary Ziegler- Green County EM
Josh Kowalke- Reedsburg Area Ambulance
Roman Mullen- Dodge County PH
Carol Brown- Rainbow Hospice
Lisa Schweitzer- SSM Health
Sarah Jensen- Marquette County PH
Mark Paulson- WI DHS
Aurielle Smith- Public Health Madison and Dane County, SCWIHERC
Mike Lohmeier- SCWIHERC and UW Health
Dan Williams- SCRTAC
Jennifer Behnke- SCWIHERC

March 22, 2023 Membership Meeting

SCWIHERC 3-22-23 Meeting Notes

Recording: See email from Jennifer on March 24 for link and passcode.

Hospital:

We discussed the end of the Public Health Emergency and how the hospitals are modifying policies in response.  There is quite a bit of variability in policies regarding masking for patients, visitors, clinical and non-clinical staff.  This is an evolving topic and those still requiring masking continue to discuss and prepare for changing those policies soon. 

We discussed the DASH Tool and many had an opportunity to use it since our last meeting.  Consensus is that the tool is straightforward and easy to use. https://dashtool.org/ Related webinar: https://files.asprtracie.hhs.gov/documents/aspr-tracie-disaster-available-supplies-in-hospitals-dash-webinar-ppt.pdf   Many noted that their current inventory management systems also account for certain scenarios and increased burn rates that are also considered by the DASH Tool. 

Next Hospital Forum is April 12 at noon, will resume discussion on TJC New Emergency Management Standards that was started in February.

Membership:

SCWIHERC is planning several activities before June 30:

ActivityTarget AudienceNotesProposed Date(s)
Radiation Injury Annex Review and TTXEveryoneNext Regional MeetingMay 17- scheduled!
Medical Response and Surge Exercise (MRSE)Hospitals, everyoneVirtual functional, about three hoursJune
CMS Partners Virtual ExerciseSNF, Home Health, Hospice, Amb Surgery Ctrs, ESRD providers, PT/OT, FQHC, RHC, ICFIIDVirtual functional, about three hoursJune
Media Relations WorkshopPartners who deal with the mediaIn-person workshop, 6-8 hoursJune
Active Shooter Incident Management Basic (with TtT)First RespondersStudents: 4 hour slots over two days Trainers: both full daysJune
Tech Systems In-service (EMResource, EMTrack, eICS, WEAVR)Anyone who uses any of these systems and wants to learn more/needs a refresher (new staff!)Virtual over Zoom, come and go for each session (60-90 min) as you wishMay

All activities will be promoted by email when the dates are confirmed and registration is available.

Final HVA is available and posted to SCWIHERC shared drive.  Of note: supply chain, staffing shortage, and workplace violence have all moved up in ranking, and are recent additions to the HVA.

We had a lengthy discussion on Supply Chain.  This is our #7 ranking hazard on our regional HVA.  Vulnerabilities exposed or exacerbated by pandemic continue to exist today.  This topic is emphasized by HPP grant and ASPR TRACIE because it is so impactful to response to all hazards!

Refer to the discussion questions in separate attachment, and this resource: https://files.asprtracie.hhs.gov/documents/aspr-tracie-partnering-with-the-healthcare-supply-chain-during-disasters.pdf 

Organizations are encouraged to facilitate internal discussion on this topic.

Refer to the recording for full discussion, some very high level themes and takeaways:

-Supply chain for both pharmacy and other materials is incredibly complex.  We appreciate our materials management partners for everything they do to obtain the supplies we need to care for patients.  Maintaining relationships with vendors is critical.

-Pharmacy shortages are not new but possibly more prevalent now.  Constant state of reaching out to health system motherships, retain pharmacies, other potential sources.  Entire pharmacy roles exist just to modify formularies and communicating changes to clinical staff is constant.

-The task of balancing is constant: just in time delivery and lean principles vs paying and storing a glut of supplies that may never be used.  This is a struggle for all orgs.

-Small wholesalers and creative partnerships and resources have been a lifeline in the past: homemade supplies, partnering with others who can produce items we need (face shields, hand sanitizer, 3D printing)

-Suggested systemic measures to improve situation include government incentives for increased production, onshore/domestic production to significantly cut lead and shipping time could relieve allocation pressure. 

What are we concerned about right now?  ED Boarding, lack of post-acute care discharge beds, lack of transportation for patient transfer, delayed care keeping acute care busy, ED is the primary care of last/only resort so they stay full.  Chronic issues!

  • Meeting attendance:
  • Angie Zastrow- Rainbow Hospice
  • Nathan Bubenzer- UPH Meriter
  • Chad Atkinson- Mercyhealth
  • Belle Koch- Sauk Prairie Healthcare
  • Gary Trulson- UW Health
  • Jessica Palzewics- Marshfield Medical Center Beaver Dam
  • Jodi Moyer- Beloit Health System
  • Karmen Bryer- Beloit Health System
  • Bob Swenarski- St. Mary’s Janesville and SCWIHERC
  • Nikki Ripp- Adams County HHS
  • Casey Farnum- UW Health
  • Loni Hefner- Access Community Health Centers
  • Seaton
  • Chris Brownell- Grant Regional Health Center
  • Dave Larson- Madison VA
  • Lynn Skatrud- Green County HD
  • Mary Crowley- Juneau County HD
  • Lori Mertens Pelliteri- Dean Clinics
  • Christal Foreyt- Gundersen Boscobel
  • Jane Lentz-Gervais- Adams Co EM
  • Colleen Wilson- Waupun Memorial
  • Marie Darling Ellis- Columbia County HHS
  • Diana Quinn- SSM Health
  • Bill Sobaskie- Madison VA
  • Mike Hall- Monroe Hospital
  • Leanne Seifert- Watertown Regional Med Ctr
  • Lisa Herritz- Ho-Chunk Nation
  • Carmen Mihlbauer-Luther- Reedsburg Area Med Ctr and SCWIHERC
  • Tina Strandlie- Stoughton Health
  • Daniel Pease- Town of Beloit Fire
  • Carmen Carpenter- Iowa Co HD
  • Eric Anderson- Dane County EM/EMS
  • Charlie Johnson- St. Mary’s Madison
  • Kimberley Spurgeon- Family Health La Clinica
  • Hannah Sedlacek- Adams Co HHS
  • Jeff Kindrai- Grant Co HD
  • Jason Witte- WI DHS EMS
  • Erin Hastert- Lafayette Co HD
  • Kara Takes
  • Jessie Phalen- Sauk Co HD
  • Paige Heinke
  • Patti Miller- City of Beloit EM
  • Gary Ziegler- Green Co EM
  • Matt Bartol- Dodge Co PH/EM
  • Michael Niles- Rock Co HD
  • Samroz Jakvani- Jefferson Co HD
  • Sarah Jensen- Marquette Co HD
  • Matt Christian- Marshfield Medical Center Beaver Dam
  • Sally Blackbourn- Memorial Hospital of Lafayette Co
  • Dan Williams- SCRTAC
  • Mike Lohmeier- SCWIHERC and UW Health
  • Jennifer Behnke-SCWIHERC

January 25, 2023 Membership Meeting

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

November 9, 2022 Membership Meeting

SCWIHERC 11-9-22 Meeting Notes

Recording: https://us06web.zoom.us/rec/share/PQWEweQMuvett1Y6doMZ2uxAiWsRWIxKJ2e-ShmfTi13VDo0zbQRmaUqARLRCylN.FFBdmVxW9rubyYJ7
Passcode: See email sent November 10

Hospital Meeting:
EMResource reminders- PEDs surge bed count, update at least once daily, not going away as long as surge is an issue. PEDS ED Boarders expected to go up

ABLS- next batch expiring in February, sending periodic updates. Seat allocation: 5 nonphysician seats for each level III, IV and unclassified, 12 nonphysician setas for each level I and II. 2 physician seats for each hospital. Reach out at any time to enroll new students, check assignment, with other questions.

Open discussion: violent patients and patient security screening. Barriers to implementation- staffing. Seeing increase in threats from patients/visitors. Not necessarily weapons, but more physical aggression/assault directed at staff. Is incidence increasing, or reporting increasing? Both. Increasing visitors d/t decreasing COVID restrictions is a factor.
De-escalation options: Crisis Prevention Institute Nonviolent Crisis Intervention, MOAB (management of aggressive behavior), increasing posted signage on patient/visitor behavior expectations, higher security presence in facility, DT4EMS, active threat drills at service level. Safety solution in another state: installed hotel safes in trauma bays to store contraband/weapons while the patient was admitted, have security staff move weapon off patient. Some states have quite intensive security screening procedures compared to us. Shared escalation policy- green, yellow, red, full lockdown, policy shared by email November 10.

HCID discussion: need a review of Ebola state ConOps and how ETCs/Regional Treatment Centers are involved, include transportation plan.

Membership Meeting:

Leadership review SCWIHERC and OPEHC: http://www.scwiherc.org/category/who-are-we/ or first tab of Coalition phone book in SCWIHERC shared drive.

Fiscal and Sustainability Update- The HERCs have been presented with a lot of new policies that impact how we do business. Grant funds are only reimbursable after expenses have been incurred, so how do we solve cash flow to pay for vendors and services up front? Historically have had the benefit of having a fiscal agent, but now that we are an incorporated legal entity, this is not allowed anymore. Current coping mechanism is HERC staff have been putting expenses on personal credit, which is not advisable or sustainable. To better explore options, SCWIHERC will be recruiting a Sustainability Coordinator to explore our options for revenue sources and cash flow issues. Sustainability Coordinator Request for Application emailed and posted to scwiherc.org on November 10. SCWIHERC Board welcomes any and all suggestions and ideas on how to cope with these issues. Additional fiscal policies that have been recently updated include a Net 30 days from submission turnaround time on funding disbursement, we cannot spend grant funds on food, any HERC travel is reimbursed at the state rate (previously was federal rate), must use state procurement guidelines for competitive bids, and all HERC expenses must be explicitly approved by the state ahead of time to be reimbursed.

Training, Exercises, SALT Triage and RMCC Project and Training: Training needs assessment was sent out October 26, sent again November 10, due Nov 30. Your input is requested and valued!

Working on request for application to find a contractor to assist with planning and conducting our Medical Response Surge Exercise (MRSE), which replaced the Coalition Surge Test (CST) from the before COVID times. This exercise will also test our pediatric surge plan to satisfy another grant deliverable. Plan to use a Wisconsin Dells peak tourism season scenario for surge. Other planned TTX is for radiological surge, which is the topic of our specialty surge annex this year.

Still continuing with SALT Triage and Regional Medical Coordination Center project and training. Offered 5 first receiver train the trainer sessions in May, about half of hospitals participated. Still hoping to have other hospitals participate, please reach out to plan a regional training or to request triage ribbon kits or replacement ribbons. Youtube training video for hospitals: https://www.youtube.com/watch?v=N7OG8a7vXnE

Also continuing to offer similar training to EMS agencies in the region, also incorporating training on RMCC resource-activation and coordination. Reach out to schedule these sessions!

Will Koehne, WI DHS OPEHC Epidemiologist, gave an interview of Hospital Dashboards on PCA Portal, review recording, email Jennifer or Will William.koehne@dhs.wisconsin.gov for access. Other systems’ discussion deferred at this time.

RSV surge- Please update bed count (green banner) daily! What will be the issues with PEDs surge? Short on pediatric providers and staff for both ED and inpatient. Some have developed some education for nursing and family practice to augment clinical care- partner with your respiratory therapy! Jennifer will forward clinical resources from the National Pediatric Disaster Coalition/AAP to hospitals.

No reports of diesel fuel shortage in the region at this time, but have seen elsewhere in the state. Be sure you have a priority contract with your vendor and please relay any news of shortages to Jennifer and your county emergency manager for situational awareness.

No reports of albuterol shortage in the region at this time, but have seen elsewhere in the state. Reports of etomidate, fentanyl, and racemic EPI shortages.

Doug Hill gave an update on Crisis Standards of Care. Note that Wisconsin Hospital Mutual Aid MOU will be sunsetting and not renewed, due to a lack of interest from hospital leaders and WHA. Refer to recording and this 2010 WHA document he referenced: https://www.wha.org/WisconsinHospitalAssociation/media/WHACommon/EmergencyPrep/HospitalsGuideforMassCasualtyEvents6-2010.pdf
Doug Hill can be reached at djh1967@gmail.com

Meeting attendance:
Matt Bartol- Dodge County HHS, EM
Tom Ellison- UW Health
Lyle Kratochwill- Richland Hospital
Christal Foreyt- Gundersen Boscobel
Mary Crowley- Juneau Co HD
Amanda Diedrich- Juneau Co HD
Sarah Jensen- Marquette Co HD
Jodi Moyer- Beloit Health System
S Eaton
Donna Haugom- Jefferson Co EM
Tina Strandlie- Stoughton
Belle Koch, Sauk Prairie Hospital
Carmen Luther- Reedsburg Area Med Ctr
Jim Abitz- Southwest Health
Ron Krause- Mercyhealth
Matt Christian- Marshfield Med Ctr Beaver Dam
Jennylynde Packham- UW Health Rehab
Dan Williams- SCRTAC
Adrianne Bonow
Eric Anderson- Dane County EM
Dave Larson- Madison VA
Mike Stephens- UW Health
Steve Haskell- UW Health
Nathan Bubenzer- Meriter UPH
Katie Budack- Grant Regional
Dave Kitkowski- St. Clare Baraboo
Sam LaMuro- Fort HealthCare
Jodie Molitor- Sauk Co HD
Nina Gregerson- PH Madison and Dane County
Leanne Siefert- Watertown Regional Med Ctr
Karen Greenwald- Dodge Co HD
Kimberley Spurgeon- Family Health La Clinica
Heather Poker- St. Mary’s Madison
Tammy Kingery- Gundersen Moundview
Samroz Jakvani- Jefferson Co HD
Laura Kane- UW Health
Sally Blackbourn- Memorial Hospital of Lafayette Co
Carrie Meier- Dane Co EM
Sharone Rateike- St. Mary’s Janesville
Elizabeth Chilsen- Jefferson Co HD
Nick Metz- Upland Hills Health
Victoria Parker- Watertown HD
Lynn Skatrud- Green Co HD
Emily Kosterman- Waupun Memorial
Jane Gervais- Adams Co EM
Jeff Kindrai- Grant Co HD
Colton Ritchie- PH Madison and Dane County
Ken Van Horn- PH Madison and Dane County
Tanna McKeon- Green Co EM
Debbie Siegenthaler- Iowa Co HD
Andrea Murleau
Madison Dillinger
Chad Atkinson- Mercyhealth Janesville
Will Koehne- WI DHS OPEHC
Doug Hill- CSC Project
Aurielle Smith- PHMDC and SCWIHERC
Mike Lohmeier- UW Health and SCWIHERC
Jennifer Behnke- SCWIHERC

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

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

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

August 27, 2019 Workgroup Meeting- Hospital, Surge, Evac, CMS

8-27-19 Hospital, Surge, Evacuation, CMS Partners Workgroup Meeting

Jennifer gave some reminders for upcoming events: SCWIHERC Closed POD Workshop September 26; Special Pathogens, Public Health Emergency Preparedness, and Special Populations Planning workgroup September 10.

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.  We talked about how there is some overlap with the business continuity planning workshop we offered in April.  We will pursue planning something like this and are looking for volunteers to participate on the exercise design team.

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).  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.  We also talked about the Basic PIO course (G290) offered by Wisconsin Emergency Management.  If there is enough demand for this course that exceeds local emergency management agencies’ ability to fund this course, SCWIHERC could potentially fund a course, but partners are encouraged to take advantage of the offerings on the WEM Training Portal.

We had a discussion of the history of Medical Reserve Corps groups in our region, because there are none currently active.  It was suggested to have presenters come to talk about different opportunities and groups, including WEAVR, Medical Reserve Corps, and Disaster Medical Assistance Teams.  This is a potential future presentation topic.

Jennifer is working on a patient tracking project with the Office of Preparedness and Emergency Healthcare along with Robert Goodland, region 1 RTAC coordinator.  After an extensive review of previous pilots and current patient tracking procedures in Wisconsin, as well as best practices found in other states, there will be a patient tracking workgroup forming.  We are seeking one hospital and one EMS representative from each HERC region in the state to participate in this workgroup.  Jennifer will share more information about the degree of commitment involved soon.  Any interested parties should reach out to Jennifer.

We had a discussion about the idea of a hospital HazMat/Decon mutual aid team.  Many hospitals, especially on nights and weekends, have lean staffing that would not be able to support a complex decon operation.  Additionally, clinical staff would be needed for patient care and therefore would also be unavailable.  There was a mention of an initiative in another HERC region- the infectious disease mobile go team.  There team has members of multiple hospitals and can deploy to the hospital or into the community to care for a patient with a high consequence infectious disease.  We would like to hear more about this concept and then further discuss the possibility of a similar team trained in both HCID patient care and HazMat decon.

We discussed the SCWIHERC MCI Surge Functional Exercise held on June 19 and the AAR-IP draft that is out for review.  A few improvement items were suggested:

-All situational awareness updates from an incident be communicated by WI Trac update AND by WISCOM radio update.

-Hospital staff need training in triage to manage large numbers of patients that self-present after an incident.  SCWIHERC is currently developing training materials for the SALT Triage Ribbon Initiative, and we will invite local hospitals to participate in this training as well in an effort to unify EMS and hospitals in using the same triage practices.

-Hospitals need to think about perimeter control and patient access points during a mass casualty incident with large numbers of patients.  All EMS transports should come one place, all untriaged patients should come to another access point where they can be separated (incident casualties versus normal unrelated ED traffic), and then casualties can further be triaged and sorted.  Without a plan that addresses these issues, hospitals can very quickly deplete their staffing and resources on “green patients” (walking wounded) before they start receiving the most critically injured patients.

-Prior to a mass shooting in another area, that area cross-credentialed its clinical staff to enable them to work in other facilities.  Jennifer will look into this more as a future discussion/presentation topic.

We discussed the needs of our CMS partners and how better to engage them.  It was noted that they are critical in the continuum of healthcare service delivery, including helping patients to cope with emergencies and disasters so that they don’t decondition and require acute care, thereby surging local hospitals.  Additionally, they can provide assistance in caring for individuals who are expeditiously discharged from hospitals (like during an emergency evacuation).  There are 9 types of “CMS partners” found in Wisconsin (these are agencies affected by the CMS Emergency Preparedness Rule that was enforced starting November 15, 2017): home health agencies, skilled nursing facilities, ambulatory surgery centers, hospices, physical/occupational/speech therapy providers, end stage renal disease (dialysis) providers, federally qualified health centers, intermediate care facilities for individuals with intellectual disabilities, and critical access hospitals.  It was noted that these agencies are often looking for assistance to meet their annual community-based full-scale exercise requirement.  Jennifer noted that a workshop was held in Dane County last year to address this requirement, and we could potentially duplicate this effort for partners throughout the rest of the region.

Finally, we talked about planning logistics of the next workgroup meetings.  Meeting quarterly seems to be a good schedule, and keeping these workgroup topics together makes sense at this time.  We discussed continuing to hold meetings in a central location (Dane County) versus moving the meetings to alternating parts of the region.  Those in attendance at this meeting, including partners traveling from outside Dane County, agreed that holding meetings consistently in a central location was preferred over rotating meeting locations throughout the region.

Meeting Attendees:

Sam LaMuro- Fort Healthcare

Kim Cox- WI DHS OPEHC

Christal Foreyt- Gundersen Boscobel

Tina Strandlie- Stoughton Hospital

Juan Cullum- Mercy Janesville

Bob Swenarski- St. Mary’s Janesville

Cheryl Meyer- Marquardt Home Health

Jodi Moyer- Beloit Health System

Steve Haskell- UW Health

Mike Stephens- UW Health

Nathan Bubenzer- Meriter

Dave Larson- Madison VA

Dan Michaels- Public Health Madison Dane County

Ben Eithun- American Family Children’s Hospital, SCWIHERC Chair

Tom Ellison- UW Health

Alice Salli- Mendota Mental Health Institute, Central Wisconsin Center

Jeff Ethington- UW Organ Procurement Organization

Jennifer Behnke- SCWIHERC Coordinator

Sharon Rateike- St. Mary’s Janesville

Dave Kitkowski- St. Clare Baraboo

Dan Williams- South Central Regional Trauma Advisory Council

Kyle Schaeffer- UW Health

Bill Ritzer- Reedsburg Area Medical Center

Samantha Marcelain- Gundersen Moundview

Mary Crowley- Juneau County Health Department

June 7, 2019 Meeting

June 7, 2019 Meeting Notes

Meeting slides:

Hospital Meeting:

Reminders and Updates: The Match Survey is due June 30 for any real events or exercises in which your hospital was a primary player/responder.  We use this data to document in kind support because ASPR requires that we match a percentage of our grant funding through in-kind support.  If you have your AAR handy, this should take you less than 10 minutes.

Next WISCOM roll call will be June 18, so we can do a radio check for our exercise on June 19.  Jennifer will send you a heads up like usual.

We discussed the upcoming SCWIHERC MCI Surge Functional Exercise.  Exercise document packets were available at the meeting for attendees.  Each packet contains the ExPlan, Controller/Evaluator Handbook, the Master Scenario Events List, the Exercise Evaluation Guides, the Player Briefing, the Communications Plan, a facility sign-in sheet, a Regional Medical Coordination map, and a paper patient packet customized for each facility.  The docs will also be emailed out a few days before the exercise, including the communications plan which already needs updates. If you did not attend the meeting in person, Jennifer will mail the packet to you.  The controller evaluator briefing will be June 13 at 9:30, and we will have a briefing the morning of the exercise as well.

We discussed the future of the hospital workgroup.  Hospital members agreed there is still value to the workgroup.  We will include topics like open discussions on hospital-focused lessons learned, regulatory/accreditation compliance, and other topics that come up.

Christal Foreyt discussed the Center for Domestic Preparedness HERT course and talked about opportunities for HAZMAT training and education, and decon team recruitment.  We discussed the opportunity for a HAZMAT mutual aid team when a hospital doesn’t have enough internal staff to do a large scale decon operation.  We also discussed the need for hospitals to be doing decon drills with their local fire departments.  The hospital workgroup will follow up on this topic in the future.

Kyle Schaefer debriefed the SIMCOM 2019 exercise.  Our region did a great job responding to WISCOM roll call as part of SIMCOM, we had the highest response rate of the seven regions in the state.  This roll call included flipping to the encrypted channel, and we learned a few things about how the encrypted channel works.  Kyle and Bill Tyler may follow up with any information learned from the vendors on this.

Membership Meeting

Save the Date:  The SCWIHERC Closed POD (point of dispensing) Workshop will be September 26.  This will have a presentation on closed POD planning and operations, a panel of representatives from healthcare, a university, and a private business talking about their closed PODS including opportunities for Q&A, and a tabletop exercise with local public health reps to help facilities at all stages of the closed POD planning process.

A reminder that the SCWIHERC MCI Surge Functional Exercise is June 19.  There will be many WI Trac alerts that go out that morning, apologies in advance for any alert fatigue.  It should be a great opportunity to illustrate SCWIHERC response operations and the regional medical coordination plan, as well as how WI Trac supports information sharing and situational awareness during an incident.

Doodle Polls will be sent out to determine future dates for workgroup meetings.  Until each meeting establishes its own agenda and meeting schedule, we will lump similarly themed workgroups to make the most of partner’s travel:

Hospital-surge-evacuation-CMS partners

Special pathogens-public health emergency preparedness (PHEP)-special populations planning.

We discussed and clarified portions of the response plan.  ASPR will expect all core disciplines sign off on the plan in the future.

We discussed regional training needs. ASPR places a significant emphasis on training in the new grant, and we have to submit tentative training plans for the year to ASPR by July 31.  We also discussed strategies for improving attendance at trainings, as it is not fiscally responsible to offer trainings that are less than 20% full.  In the future, SCWIHERC may consider subsidizing travel to trainings to assist partners in attending.  A tentative training plan was drafted based on the results of the training needs assessment conducted in late fall/winter 2018, Jennifer will coordinate with other regions to bring these trainings to our region or elsewhere in the state.  See meeting slides for details.

Erica Kane from Emergency Medical Services for Children shared a presentation, including EMSC performance measure data for region 5.  EMSC also has resources available for pediatric patients, such as comfort kits and pediatric prehospital care guides.  Erica can be reached at ekane@chw.org and refer to the slides and their website: https://www.chawisconsin.org/initiatives/emergency-care/emergency-medical-services-for-children/

EMSC Slides

We talked about measles preparedness for anticipated measles cases in the state.  The incident/case response flowchart shared by Public Health Madison Dane County will be distributed by email to the WALHDAB group and public health representatives.  We also discussed getting ahead of taking care of our first responder community and others who may be exposed without adequate PPE.  All questions should be directed to your local public health officer.  The WI DHS Bureau of Communicable Diseases is working on some uniform guidelines and communications resources.  The most up to date information from WI DHS can always be found at https://www.dhs.wisconsin.gov/immunization/measles.htm including guidance at the bottom for public health and healthcare organizations.

Cassidy Walsh gave an introduction to the Inventory Management and Tracking System available to health departments for medical countermeasures tracking.  More information is at https://www.phe.gov/about/sns/Pages/imats.aspx and in this flyer:

We introduced Kim Cox, the new HPP-PHEP program coordinator for WI DHS.  She gave some updates from WI DHS including new staff and some new requirements from our new ASPR HPP Cooperative Agreement that starts July 1, 2019.  Jennifer also shared some new requirements of note to the membership.  See meeting slides for details.

Svea Erlandson, WI DHS State Training and Exercise Coordinator, gave the region an introduction to the Dells-Delton Area Response Exercise Series (DARES) being planned.  This is WEM’s capstone exercise for 2020 (2016 was Miles Paratus, 2018 was Dark Sky).  With this exercise taking place in our region, and its scenarios involving mass casualty incidents, medical surge, family assistance centers, and mass fatality management.  With the unique mix of permanent residents and seasonal visitors to the Dells area, our health partners have a unique opportunity to take advantage of multiple training and exercise opportunities through this series.  Contact Jennifer to see the slides shared on DARES.  Svea can be reached at charlotte.erlandson@dhs.wisconsin.gov

Meeting Attendance:

Jeff Kindrai- Grant County PH

Sam LaMuro- Fort Healthcare

Gail Scott- Jefferson CO PH

Elizabeth Chilsen- Jefferson Co PH

Donna Haugom- Jefferson Co EM

Jim Acker- Watertown Fire

Alison Chouinard- Rock County PH

Asa Rowan- Community Health Systems

Mary Crowley- Juneau Co PH

Mike Lohmeier- SCWIHERC/UW Health

Jeff Ethington- UW Organ and Tissue Donation

Joni Marty- Green Co PH

Tanna McKeon- Green Co EM

Jane Gervais- Adams Co EM

Nathan Bubenzer- Meriter

Erica Kane- EMSC/CHAW

Libby Halma- EMSC/CHAW

Marla Noordhof- Beaver Dam Community Hospital

Doug Voegeli- PH Madison Dane Co

Sharon Warden- Mile Bluff Medical Center

Christal Foreyt- Gunderson Boscobel Hospital and Clinics

Sharon Foley- Divine Savior Healthcare

Angie Cohen- Grant Regional Health Center

Amy Hollis- Monroe Clinic

Jill Lenz- Columbia Co PH

Tracy Buchman- Stoughton Hospital

Tina Strandlie- Stoughton Hospital

Dave Larson- Madison VA

Cassidy Walsh- Sauk Co PH

Joe Meagher- Dodge Co EM

Jennifer Justus- Mercy Walworth

Mandy McGowan- UnityPoint at Home

Karen Sell- Columbus Community Hospital

Juan Cullum- Mercyhealth Janesville

Stephanie Kuschel- NIPARC

Ron Krause- Mercyhealth

Kyle Schaefer- UW Hospital

Mike Stephens- UW Hospital

Steve Haskell- UW Hospital

Ben EIthun- UW Health AFCH

Barb Kuska- Beloit Health System

Lynda Brereton St. Mary’s Madison

Stephanie Lehmann- SSM Health

Bob Swenarski- St. Mary’s Janesville

Jon Erdmann- Divine Savior Healthcare

Tom Eliison- UW Health

Dan Williams- SCRTAC

Bill Brotzman- Badger Prairie Healthcare Center

Kim Cox- WI DHS OPEHC

Svea Erlandson- WI DHS OPEHC

Online:

Alice Salli- Mendota Mental Health

Allison Davey- Marquette Co PH

Bill Ritzer- Reedsburg Area Medical Center

Brian Allen- Southwest Health

Carmen Luther- Reedsburg Area Medical Center

Elisa Stott- Beaver Dam CH, Beloit MH, Edgerton HHS

Lisa Pickarts- Sauk Prairie Hospital

Sally Blackbourn- Memorial Hospital of Lafayette County

Samantha Marcelain- Gundersen Moundview Hospital

Sharon Rateike- St. Mary’s Janesville

Suzanne Schreiner- Adams Co PH

Sean Marquis- Mercyhealth

February 1, 2019 Meeting

Meeting slides:

February 1 Meeting Notes

See attached slides

Hospital

Reminders- Match survey link for all hospital centric exercises and real events

WISCOM- The February Roll Call will also include the redundant communications drill (WI Trac alert tells you when roll call is scheduled).  The SIMCOM exercise is in May this year and May Roll Call will be part of that exercise.

Jennifer went over the upcoming coalition surge test and the expectations of all hospitals in the coalition.  Exercise is no notice, but occurs between February 25 and March 8.  After Action Review is March 5, please plan to attend.  See separate CST planning notes in January 24 email from Jennifer.

Jennifer will be reaching out to hospitals seeking their level of desired participation in and expectations for SCWIHERC MCI Surge Exercise.

Based on meeting survey, we will continue hospital discipline meeting, with critical access hospital topics on hospital agenda.

 

Membership

HVA survey went out in email from Jennifer February 1.  Please complete by March 1.

Coalition Surge Test briefing for membership.  Partners may reach out in search of resources during exercise according to their plans.  Injects have been written into exercise to engage public health and emergency management from counties that house evacuating facilities. Whole coalition will see alerts and updates via WI Trac and email.

Doug Hill, DHS Crisis Standards of Care project manager, gave an overview of crisis standards of care and let a discussion about it, see slides.  Please reach out to Doug if you would like to be part of the CSC workgroup.  This will be a complex, multi-year project.

We reviewed the meeting survey results, a summary of which can be found here:

https://www.surveymonkey.com/stories/SM-RV6Y9YG8/

Starting with the new grant year (after July 1), we will hold membership meetings quarterly and combine them with exercises/training opportunities/speakers when possible.  We will also hold discipline specific meetings: hospital, public health, CMS partners.  We will facilitate additional workgroups open to all interested parties:

-pandemics, public health emergency preparedness grant deliverables (combined with public health discipline meeting)

-vulnerable populations

-evacuation

-surge

-patient tracking (facilitated by Jennifer as state patient tracking co-coordinator)

-crisis standards of care (facilitated by Doug Hill)

We will also reevaluate other workgroups in the future

-mental health- provide offerings to engage mental health providers

-pediatrics (possibly statewide group instead of regional)

-family assistance center

-critical transportation

Recent conferences were reviewed.  Highlights:

Regional Disaster Health Response System:

https://www.phe.gov/Preparedness/planning/RDHRS/Pages/default.aspx

Alison presented the High Consequence Infectious Disease Toolbox:

http://www.health.state.mn.us/divs/idepc/dtopics/hcid/

and the Travel Clinical Assistant:

https://dph.georgia.gov/TravelClinicalAssistant

Patty talked about the Association of Healthcare Emergency Preparedness Professionals (AHEPP) conference.  She shared some presentations which are uploaded in the SCWIHERC Google Drive.

Finally, we shared lessons learned from the past few months, focusing on flooding recovery and the recent extreme cold weather.

 

February 1 Meeting Attendance (H) Indicates Hospital Meeting Attendance

Patty Walgenbach, Waupun Memorial (H)

Tina Strandlie, Stoughton Hospital (H)

Dave Larson, Madison VA (H)

Lynda Brereton, St. Mary’s Madison (H)

Heather Poker, St. Mary’s Madison (H)

Austine Duru, St. Mary’s Madison

Karen Munt, UPH Meriter (H)

Karen Sell, Columbus Community Hospital (H)

Marla Noordhof, Beaver Dam Community Hospital (H)

Sharon Foley, Divine Savior Healthcare (H)

Sam LaMuro, Fort Healthcare (H)

Gail Hanlon, Sauk Prairie Healthcare (H)

Kristy Tremelling, Sauk Prairie Healthcare (H)

Doug Hill, DHS CSC Project Manager (H)

Kyle Schaefer, UW Health (H)

Michael Stephens, UW Health (H)

Casey Farnum, UW Health (H)

Steve Haskell, UW Health (H)

Tom Ellison, UW Health

Jennifer Justus, Mercyhealth Walworth (H)

Carrie Meier, Dane County EM

Gail Scott, Jefferson Co PH

Donna Haugom, Jefferson Co EM

Jon Erdmann, Divine Savior Healthcare (H)

Kathy Johnson, Columbia Co EM

Jane Gervais, Adams Co EM

Sue Matye, Iowa Co PH

Cassidy Walsh, Sauk Co PH

Jessi Phalen, Sauk Co PH

Jim Acker, Watertown FD

Dan Michaels, PH Madison Dane Co

Alison Chouinard, Rock Co PH

Carol Quest, Watertown PH

Mary Crowley, Juneau Co PH

Thera Hawkin, Juneau Co PH

Joe Meagher, Dodge Co EM

RoAnn Warden, Green Co EM

Jeff Kindrai, Grant Co PH

Susan Lorenz, Columbia Co PH

Sarah Mattes, PH Madison Dane Co

Aurielle Smith, WI DHS

Brian Allen- Southwest Health (H)

Alice Salli- Mendota Mental Health (H)

Brian Cushman- Upland Hills Health (H)

Josh Kowalke- Reedsburg Area Ambulance Service

Allison Davey- Marquette Co PH

Bill Ritzer, Reedsburg AMC (H)

Bob Swenarski, St. Mary’s Janesville (H)

Brenda Koehler Borchardt- Watertown RMC (H)

Stephanie Alami- Central Wisconsin Center (H)

Brittany Rasmussen- Dodge County PH

Wendi Stitzer- Gundersen Boscobel (H)

Tanna McKeon- Grant County EM

Sean Marquis- Mercyhealth Janesville (H)

December 7, 2018 Meeting

This meeting could not be recorded due to audio recording limitations.

Meeting slides:

211 Presentation slides:

December 7 Hospital Meeting Notes

See slides for additional information.

Hospital meeting format and frequency: We are looking at changing the structure and frequency of all of our meetings.  We discussed how often we would like to meet, and what we would like to work on.  It was discussed that the hospital group would like to meet no less than quarterly.  We also brainstormed ideas for workgroups to get some work done on important coalition topics, which is summarized in the membership meeting notes below.  Jennifer will distribute a survey to help inform these changes and we will discuss at our next meeting.

The coalition surge test is still a no notice exercise but will be around the same time this year as it was last year (late February/early March). We still need volunteer hospitals to simulate evacuation to meet our evacuation minimum of 444 patients.  We will be adding injects to the exercise to better engage public health and emergency management.

We discussed WI Trac issues with using the wrong event templates (ie using an MCI template to distribute situational awareness updates).  ***Update*** NICU and Labor and Delivery categories have been added to the bed count events in WI Trac, but do not appear on the main dashboard at this time.

Membership meeting notes

Aurielle Smith has resigned from her position as trauma rep effective at the end of 2018.  She will be leaving her position at UW Health to pursue other opportunities.  Karen Munt at Meriter retires from full time status at the end of the year, with a full retirement date in spring.  Good luck to both of these valuable partners in their future endeavors!

There has been very strong interest in the Center for Domestic Preparedness Wisconsin Week trip scheduled for April 28 – May 4, 2019.  There are many more interested parties than available seats, especially in our region.  Anyone filling out the preregistration survey at this point is unlikely to get a seat.  Remember that individuals can apply independently for CDP’s courses year-round.

211 Presentation- See slides. Reach out to Charlene Mouille, with questions or to establish or strengthen your relationship with 211.  cmouille@unitedwaywi.org

Please keep your coalition phone book info up to date.  You received the link for this secured document in an email from Jennifer on November 20.  This link is not publicly available to protect the information.

Emergency Power Facility Assessment Tool Update (EPFAT)- You must download a security certificate to access this website, which is difficult because the needed certificate is found on the website.  Jennifer reached out to US Army Corps of Engineers to explain why this extra step was an additional barrier to sharing this information, and continues to provide feedback on the situation.  If your IT department can install this certificate for you, you can upload your information regarding back up power into EPFAT.  Certificate is found at
https://iase.disa.mil/pki-pke/getting_started/Pages/windows.aspx

The coalition is looking to revamp the meeting structure and schedule for next year after receiving feedback and learning of best practices in other coalitions.  We are looking at only meeting as a large group 1-2x/yr, and having specialized groups meet throughout the year, representing certain disciplines (CMS partners, county jurisdiction like public health and emergency management, etc.).  We are also looking at establishing workgroups that would be led by volunteers within the coalition to make progress on specialized plans and topics.  Ideas for these work groups include evacuation, supply chain, PEDs, pandemic planning, critical transportation, public health emergency preparedness grant deliverables, critical access hospital regulatory requirements, mental health.  Jennifer will develop and distribute a survey to gather input on how partners would like this to look and we will discuss at the February meeting.

SCWIHERC and SCRTAC applied for an opioid minigrant for $40000 and were approved for $35000.  This fund will support prescriber education for surgical patients on appropriate dose quantity and strength of narcotics prescribed based on their situation.  This project is being led by the Surgical Collaborative of Wisconsin.  Once developed, information on how to access this education will be distributed by Jennifer.

Regional Medical Coordination- UW Hospital has formally agreed to act as our regional medical coordinating center.  An MOU is being drafted to formalize this relationship.  We will start looking at borrowing EMS training materials from Dane County (where this procedure has been operational for almost two years) to share with the rest of the region.

Stop the Bleed- We have 15 classroom kits remaining.  Our training has been used so often that it is starting to show signs of wear and tear.  We will be purchasing a larger cache of training materials and will have a set to be permanently housed within each county of the region if they request it.

SCRTAC coordinator Dan Williams gave a presentation on falls prevention and a pilot project being conducted in Northeast Wisconsin, using an application called JotForm.  Review the slides on this information, the Youtube video we viewed is embedded in the slides.  Our next step is to hold a listening session with all involved stakeholders to discuss the best way to develop, use, and process referrals from this project.

Two recent Ebola-related exercises were conducted in our region.  St. Mary’s Madison, Baraboo EMS, and Public Health Madison Dane County shared lessons learned from their Joint WI/MN Ebola Transport Full Scale Exercise, and UW Health shared lessons learned from their Special Pathogens Response Full Scale Exercise.

We did not have a lot of time to discuss lessons learned from real events, but will resume the conversation in February.

Attendance:

Donna Haugom, Jefferson County EM

Gail Scott, Jefferson County Health Dept

Lynda Brereton, St. Mary’s Madison

Sam LaMuro, Fort Healthcare

Asa Rowan, Beloit Area Community Health Center,

Karen Sell, Columbus Community Hospital

Aurielle Smith, UW Health/ WI DHS

Jim Todd, SSM Health at Home

Dave Larson, Madison VA

Karen Munt, Meriter

Nikki Salas, Watertown Reg Med Ctr

Jim Acker, Watertown FD

Marla Noordhof, Beaver Dam Community Hospital

Joni Marty, Green County PH

Sharon Foley, Divine Savior Healthcare

Christal Foreyt, Gundersen Boscobel

Sue Matye, Iowa County Health Dept

David Pluymers, Rock County PH

Barbara Kuska, Beloit Health System

Michael Stephens, UW Health Univ Hospital

Ben Eithun, UW Health AFCH

Casey Farnum, UW Health Univ Hospital

John Rago, Baraboo EMS

Sarah Mattes, Public Health Madison Dane County

Doug Hill, Crisis Standards of Care Coordinator

Kathy Johnson, Columbia County EM

Tanna McKeon, Green County EM

Mike Lohmeier, SCWIHERC Medical Advisor

Jessie Phalen, Sauk County Health Dept

Carol Quest, Watertown Health Dept

Lisa Pickarts, Sauk Prairie Hospital

Jeff Kindrai, Grant County Health Dept

Tina Strandlie, Stoughton Hospital

Tracy Buchman, Stoughton Hospital

Bob Swenarski, St. Mary’s Janesville

Tom Ellison, UW Health Trauma

Joe Meagher, Dodge County EM

Dan Williams, SCRTAC, Madison FD

Steve Haskell, UW Health

Alison Hanaman, Edgerton Hospital

Bill Ritzer, Reedsburg Area Med Ctr

Brian Allen, Southwest Health

Patrick Monckton, Southwest Health

Casi Frie, St. Clare Baraboo

Elisa Stott, Beloit, Beaver Dam, Edgerton

Judy Nowicki, Gundersen Moundview

Lisa Heritz

Sharon Warden, Mile Bluff MC

Abby Sauer, Dodge County PH

Alice Salli, Mendota Mental Health

Allison Davey, Marquette County PH

Erin Hastert- Lafayette Co PH

Kelly Lapp- St. Clare Baraboo

Peter Rabe

Rachel, Beaver Dam Community Hospital

Sally Blackbourn, Memorial Hospital of Lafayette County

Stephanie Alami, Central WI Center

Susan Lorenz, Columbia County PH

Carrie Meier, Dane County EM/EMS

 

 

August 3, 2018 Meeting Notes

This meeting was not recorded due to audio/visual limitations.
Meeting slides:

Notes from August 3 meeting
Hospital Meeting:
Requirements for drilling WI Trac (bed counts and MCI counts) are no longer in the grant, therefore WIHERC (formally WHEPP) has stopped requiring them and scheduling them. The consensus among the group was to keep doing them at the same intervals as we previously had.
We talked about the SCWIHERC MCI Surge full scale exercise. The exercise will be held in June 2019, exact date to be determined. This is a coalition-based exercise that focuses on how we respond to MCIs as a region, and may not cover every aspect of every facility’s surge or emergency operations plan. Hospitals are not required to participate, but participating hospitals must provide an internal controller/evaluator. The exercise will focus on medical surge and regional medical coordination from the point of secondary triage in the field through hospital placement, and will look at resource sharing and communication plans/protocols. The SCWIHERC hospital group will be involved in exercise planning at hospital meetings, but Jennifer is also looking for volunteers to be on the exercise design team.

Membership Meeting:

Jennifer introduced two new members of our Board, Aurielle Smith (UW Health) representing Trauma and Jim Acker (Watertown Fire) representing EMS.

Claudine McCarthy from the DHS Office of Preparedness and Emergency Health Care gave a presentation on the HPP grant, capabilities, and coalition workplan.  More info can be found at

Walk in items/partner updates:

The Cybersecurity TTX will be held on September 27 at Madison Turners Hall, 3001 S Stoughton Rd.

We found out we have fewer closed POD sites in our region than we thought.  We identified a need to update our closed POD plans, and a workshop/exercise to explore the new closed POD template available to public health, similar to the one recently delivered in region 7.

With the recent outbreak of coagulopathy related to synthetic cannabinoids tainted with brodifacoum, Americares is an organization that is providing no cost vitamin K tablets (the standard treatment/antidote to brodifacoum poisoning).  Please share this information with your clinicians and pharmacies.

We shared lessons learned from recent events.  Please make it a priority to respond to WI Trac alerts requesting your resources.  In two recent events, WI Trac response has been inadequate and this lack of information created uncertainty when responding to the incident.

We broke into small groups and did some strategic planning for the coalition, which will be used for future planning.

Meeting attendees:

Gail Scott, Jefferson Cty Health Dept

Donna Haugom, Jefferson Cty EM

Lynda Brereton, St Mary’s Madison

Heather Poker, St. Mary’s Madison

Paul Hable, Fort Healthcare

Ben Eithun, UW Health

Mike Stephens, UW Health

Karen Munt, Meriter

Barb Kuska, Beloit Health System

Patty Walgenbach, Waupun Memorial

Christal Foreyt, Gundersen Boscobel

Sharon Foley, Divine Savior

Angie Cohen, Grant Regional

Jon Erdmann, Divine Savior

Jeff Jelinek, Sauk Co EM

Bob Swenarski, St. Mary’s Janesville

Tracy Buchman, Stoughton Hospital

Tina Strandlie, Stoughton Hospital

Nikki Salas, Watertown Hospital

Stephanie Alami, Central WI Center

Mary Crowley, Juneau Co Health Dept

Jane Gervais, Adams Co EM

Karen Sell, Columbus Community Hospital

Casey Farnum, UW Health

Dan Michaels, PHMDC

Steve Haskell, UW Health

Claudine McCarthy, DHS OPEHC

Sharon Warden, Mile Bluff Med Ctr

Lisa Pickarts, Sauk Prairie Hospital

Jennifer Justus, Mercy Walworth

Stephanie Kuschel, NIPARC

Sam Nepple, Mercyhealth

Ashley Vickers, Mercy Walworth

Asa Rowan, Community Health Systems of Beloit

Cassidy Walsh, Sauk Co Health Dept

Dave Larson, Madison VA Hospital

Cindy Fraker, Divine Savior

Susan Lorenz, Columbia County HHS

Joe Meagher, Dodge Cty EM

Brittany Bleich, Dodge/Watertown Public Health

John Rago, Baraboo EMS

Tanna McKeon, Green Cty EM

Kathy Johnson, Columbia Cty EM

Bob Bentley, Ingleside Manor

Aurielle Smith, UW Health

Alison Chouinard, Rock Cty Health Dept

RoAnn Warden, Green County Health Dept

Jim Acker, Watertown FD

Mike Lohmeier, SCWIHERC/UW Health

Bill Ritzer, Reedsburg Area Medical Center

Carmen Luther, Reedsburg Area Medical Center

Brian Allen, Southwest Health

Patrick Monckton, Southwest Health

Casi Frie, St Clare Baraboo

Cheryl Meyer, Marquardt Mgmt

Dan Williams, SCRTAC

Elisa Stott, Beaver Dam Community Hospital

Erin Hastert, Lafayette Cty Health Dept

Janene Clark, Dells Delton EMS

Jennifer Johnson, Marquardt Village

Josh Kowalke Reedsburg Area Ambulance Service

Kelly Lapp, St. Clare Baraboo

Lyle Kratochwill, Richland Hospital

Mandy McGowan, UnityPoint at Home

Michelle Hemp, UnityPoint

Sally Blackbourn, Memorial Hospital of Lafayette Cty

Sam LaMuro, Fort Health Care

Sister Faustina, St. Elizabeth Home

Suzanne Schreiner, Adams Cty Health Dept