CLEARINGHOUSE Records
Agency Name:
San Angelo-Tom Green County Health Department
Contact Person: Mike Loving
Title: Director
Address: P.O. Box 1751
City: San Angelo
State: TX
Zip Code: 76902
Phone: (915) 657-4235
Fax: (915) 657-4553
Email: mikel@wcc.net
Jurisdiction: County
Population: 100,000-249,999
Brief Description of Jurisdiction:
City-county health department serving a population of 102,000 in West Texas. Small town dynamics.
Brief Description of Response Plan:
Police, Sheriff, FBI all call the health department when responding to a possible bioterrorist event. HD personnel respond with law enforcement, take samples if necessary and arrange for testing if necessary. Meetings with EMS and hospitals have taken place so they can update their disaster plans with an eye toward mass casualties, decontamination, possible isolation, alternative locations which could serve a contaminated or infectious population in an attempt to keep contagious diseases out of the hospitals. Participate in the Texas Health Alert network to communicate with other LHDs, Texas Dept of Health and CDC.


Agency Name:
Imperial County Public Health Department/EMS Agenc
Contact Person: John Pritting
Title: EMS Manager
Address: 935 Broadway
City: El Centro
State: CA
Zip Code: 92243
Phone: (760) 482-4468
Fax: (760) 482-4519
Email: johnpritting@imperialcounty.net
Jurisdiction: County
Population: 100,000-249,999
Brief Description of Jurisdiction:
Imperial County is a rural area located in the southeast corner of California bordering San Diego County on the West, Riverside County to the north, Arizona on the east, and Baja California, Mexico along its 90 mile southern border. The county covers 4,597 square miles of desert sand and mountain terrain including the largest inland body of salt water in the U.S. - the Salton Sea. An extensive irrigation system fed by the Colorado River supplies water to more than 1,000 square miles of farmland transforming Imperial County into a leading agricultural area.
Brief Description of Response Plan:
The Imperial County Operational Area Medical/Health Branch Disaster Plan was developed with the participation of key management and staff from the Public Health, Environmental Health, Behavioral Health, and Emergency Medical Services in Imperial County. The plan conforms to the California Standardized Emergency Management System (SEMS), and provides medical and health disaster workers with checklists, procedures, and documentation to effectively manage large-scale disasters. During the immediate aftermath of a major disaster, the emphasis is placed on gathering information to determine the extent of damage and the subsequent impact on the health and safety of the affected population. This is followed by determining the impact on the health care delivery system to determine what resources are available to mitigate the problems. This information provides the Medical/Health Branch with an assessment of the immediate medical needs of the affected population, what medical/health resources are available, and facilitates the development of action plans to address those needs. Once the objectives and tasks are identified, priorities are established for the allocation of resources. When the need for resources exceeds the availability of resources within the Operational Area, a request for mutual aid resources must be submitted through the Regional Disaster Medical/Health Coordinator. This would include a request for pharmaceuticals from the NPS if needed. After the immediate health threats have been identified and a plan developed to mitigate them, the mid to long-range health threats are addressed. The Imperial County plan can be viewed and downloaded from the California EMS Authority website at www.emsa.cahwnet.gov After accessing the website, click on Disaster Medical Division, then click on Sample Disaster Medical Plans, Policies, Procedures, and finally click on Imperial County Plan.


Agency Name:
St.Clair County Health Department
Contact Person: Kevin D. Hutchison
Title: Administratror
Address: 19 Public Square, Suite 150
City: Belleville
State: IL
Zip Code: 62220
Phone: 618-233-7703
Fax: 618-222-1630
Email: kevinh@scchd.org
Jurisdiction: County
Population: 250,000-499,999
Brief Description of Jurisdiction:
St.Clair County is located on the Missippi River side of Illinois directly across from St.Louis Missouri. As part of the metropoliton area, 260,000 persons reside in the county which encompasses 653 square miles. Prominant features include major rail and motor vehicle bridges, Scott Air Force Base, various heavy industry and chemical manufacturers. The St.Clair County Health department has a staff of 75 plus numerous community-based sub contractors for various services. Additionally, East St. Louis and surrounding areas are served by the East Side Public Health District.
Brief Description of Response Plan:
The health department has a comprehensive response plan that includes active participation in a interagency emergency response plan coordinated through the Local Emergency Planning Committee. The health department has existing infectious disease reporting and surveillance systems in place, and has some electronic reporting systems in place with specific hospitals. Additionally, the department has high speed internet capabilities and is linked to the state and CDC Health Alert Networks.


Agency Name:
Office of Emergency Preparedness
Contact Person: Bill Gross
Title: Coord. of Emergency Preparedness
Address: 1500 Marilla (L2AN)
City: Dallas
State: TX
Zip Code: 75201
Phone: 214-670-4275
Fax: 214-670-4677
Email: wgross@ci.dallas.tx.us
Jurisdiction: City
Population: 1 million +
Brief Description of Jurisdiction:
Large Metropolitan City in North Central Texas.
Brief Description of Response Plan:
Biological Agent response plan, written to meet requirements of USPHS MMRS Contract. NPS is incorporated into the mass chemo-prophylaxis portion of the plan.


Agency Name:
Lexington-Fayette Co Health Department
Contact Person: Dr. James Donofrio
Title: Epidemiology/Emergency Health Planning/anti-terror
Address: 650 Newtown Pike
City: Lexington
State: KY
Zip Code: 40508
Phone: (859)288-2373
Fax: (859)2882359
Email: jcdono2@aol.com
Jurisdiction: County
Population: 100,000-249,999
Brief Description of Jurisdiction:
Large number of horse farms,light industry, no heavy industry. At intersection of I-75 and I-64. Near the Blue Grass Army Depot, Chemical Stockpile located in neighboring Madison Co.
Brief Description of Response Plan:
Based on organizational system with general response issues like the line of authority and key personnel up front with the details provided in seperate sections. The biological agents section includes, smallpox, anthrax, plague and botulism toxin, with a special annex for chemical agents included because of our close proximity to the chemical stockpile at the Blue Grass Army Depot. The response system for our city and county (merged government) is based on the use of existing responder resources rather than seperate strike teams for natural or man-made disasters.


Agency Name:
Elyria City Health Department
Contact Person: David Oakes, R.S.
Title: Environmental Health Director
Address: 202 Chestnut St.
City: Elyria
State: OH
Zip Code: 44035
Phone: 440-323-7595
Fax: 440-284-1558
Email: doakes@elyriahealth.com
Jurisdiction: City
Population: 50,000-74,999
Brief Description of Jurisdiction:
About 25 miles west of Cleveland, Ohio, in some ways a suburb of Cleveland, but in adjoining county from Cleveland. Is county seat, with most local and county offices located here. Industry ranges from small machine shops, to world headquarters of major companies. Major roads and rail lines past through city.
Brief Description of Response Plan:
Response plan is material adapted from Ohio Department of Health, plus numerous fact sheets and advisories from CDC, including information for mail handlers, children, and pregnant women. Plan also includes copies of protocols established by our local police and fire departments for handling calls relating to suspicious packages. NPS is briefly mentioned as area is supposed to be included as part of Cleveland area MMRS. Plan includes information which has been forwarded to local hospital on recognition of events and CDC treatment protocols.


Agency Name:
Mid-Michigan District Health Department
Contact Person: Robert Graham, DO, MPH
Title: Medical Director
Address: 615 N. State Street, Suite 2
City: Stanton
State: MI
Zip Code: 48888-9702
Phone: 989-831-5237
Fax: 989-831-5522
Email: rgraham@cmdhd.localhealth.net
Jurisdiction: Multi-county, disctric, or region
Population: 100,000-249,999
Brief Description of Jurisdiction:
A rural district.
Brief Description of Response Plan:
Each county in the district has an emergency operations plan. Police, fire, national guard, EMS, hospitals, and the health department all are part of the emergency operations plan. In the event of an emergency an emergency operations center (EOC)is activated. The local health department joins the EOC and provides imput and can bring in human assets to assist in dealing with the emergency.


Agency Name:
Central Michigan District Health Department
Contact Person: Robert Graham, DO, MPH
Title: Medical Director
Address: 2012 E. Preston
City: Mt. Pleasant
State: MI
Zip Code: 48858
Phone: 989-773-5921
Fax: 989-773-4319
Email: rgraham@cmdhd.localhealth.net
Jurisdiction: Multi-county, disctric, or region
Population: 100,000-249,999
Brief Description of Jurisdiction:
A rural Michigan multi-county district. The largest and busiest Native American owned casino is located in this district.
Brief Description of Response Plan:
Each member county has an emergency operations plan. Multiple agencies are members of the plan. If an emergency develops an emergency operations center is activated. The local health department sits at the EOC during the emergency.


Agency Name:
Jefferson County Public Health
Contact Person: Charles Brenon III
Title: EMS Director
Address: 531 Meade St.
City: Watertown
State: NY
Zip Code: 13601
Phone: (315) 786-3760
Fax: (315) 786-3761
Email: brenonc@health.co.jefferson.ny
Jurisdiction: County
Population: 100,000-249,999
Brief Description of Jurisdiction:
Jefferson County is located in northern New York on the shores of Lake Ontario and the St. Lawrence River. Prominent local features include Fort Drum, the St. Lawrence Seaway, US Customs, and the Canadian border. Papermaking and dairy farming are the major area industries.
Brief Description of Response Plan:
The county response to WMD and Bioterrorism is inculded as an annex to the Comprehensive Emergency Response Plan (CEMP). The CEMP is under review and should be formally adopted by the Board of Legislators in the near future. Incident command struture, Public Health notification procedures and integration of response agencies are addressed by the plan. Training exercises sponsored by the county Emergency Management Office have been conducted. The tabletop drills involved area fire, police, EMS, NYS environmental conservation, NYSDOH, Jefferson County Public Health and other agencies. Following 9/11, Jefferson County Public Health has been performing active surveillance of county hospitals. A daily report is generated regarding the number of patients presenting with flu-like symptoms. Calls to 911 are examined daily to determine if there are spikes in specific call types. Emergency Communication with the public can be effected through the Emergency Alert System operated by the county Emergency Management Office. Less urgent information is disseminated through media contacts and press conferences.


Agency Name:
Washoe County District Health Department
Contact Person: Stephanie Beck, R.N.
Title: EMS Coordinator
Address: P.O. Box 11130
City: Reno
State: NV
Zip Code: 89520
Phone: 775-328-2420
Fax: 775-328-2279
Email: sbeck@mail.co.washoe.nv.us
Jurisdiction: Multi-county, disctric, or region
Population: 250,000-499,999
Brief Description of Jurisdiction:
The Health District includes Reno, Sparks and the County which host a large number of annual special events and a large tourism business. There are five area hospitals and an ambulance franchise for ground and helicopter services which serve a population of 330,000.
Brief Description of Response Plan:
Our Terrorism annex was added to our regional hazardous materials plan in August of 2000. The State is still working on a statewide plan for NPA distribution. We are also in the process of developing a pandemic flu plan.


Agency Name:
Pasco County Health Department
Contact Person: Patrick Gardner
Title: Sr, Community Health Nursing Sup
Address: 13941 15 th Street
City: Dade City
State: FL
Zip Code: 33525
Phone: 352-521-1450 ext 320
Fax: 352-523-6910
Email: Patrick_Gardner@doh.state.fl.us
Jurisdiction: County
Population: 250,000-499,999
Brief Description of Jurisdiction:
Pasco County is located just north of McDill Air Force Base, Tampa International Airport and the Tampa Bay area. The county has rural and city areas with several major transportation routes (road and rail). It also has multiple jurisdictions within the county.
Brief Description of Response Plan:
The response plan is divided into four major parts: Continuous Surveillance, Active Investigation, Key Decisions and Emergency Response (Command & Control, Medical Prophylaxis, Fatality Management, Residual Hazard Assessment & Mitigation, Continuity of Infrastructure, Resource Logistics & Support, Care of Casualties & Worried Well, Control of Affected Area / Population and Family Support Services). The plan provides for a structured unified medical command for local and out of area resources and a mechanism to provide medical care in alternate care locations in the event of casualties overwhelming local facilities. The plan also includes the management of patients with known or suspected exotic communicable diseases (such as the Hemorrhagic Fever viruses and other pathogens designated as Biosafety Level 4 - requiring the highest level of containment). The plan is written so that it can be used for unknown pathogens as the causitive agent may not be immediately known. Some Quick Reference tools have also been developed.


Agency Name:
Public Health - Seattle and King County
Contact Person: Maggie Moran
Title: Board of Health Administrator
Address: 999 Third Ave. Suite 1200
City: Seattle
State: WA
Zip Code: 98104-4399
Phone: (206) 205-5680
Fax:
Email: maggie.moran@metrokc.gov
Jurisdiction: County
Population: 1 million +
Brief Description of Jurisdiction:
King County is nearly twice as large as the average county in the United States. With more than 1.5 million people, it ranks as the 12th most populous county in the nation. 2,200 square miles. County Health Department. Department Director/Health Officer dually appointed by Mayor of Seattle and King County Executive. Major medical [University of Washington, Harborview, Providence/Swedish, Group Health], Boeing, Microsoft, Starbucks, numerous dot.coms, higher education, municipal and county government. Health Department Employees: approximately 2,000 FTEs Budget: $238 million
Brief Description of Response Plan:
Seattle & King County was a recipient of CDC funds to plan epidemiological investigations, special surveillance activities and a dispensing template for mass prophylaxis. Our “plan” to date consists of that work and our general emergency preparedness response plan. We are currently assembling over 15 work groups to plan a comprehensive bioterrorism response plan. We currently conduct electronic syndromic surveillance with hospitals,clinics, consulting nurse services and EMS. The data is analyzed on a Monday - Friday basis for unusual events. In addition, daily paper reports are received from the medical examiner and screened for suspicious deaths. In November/December 1999, we participated with CDC and Defense Advanced Research Projects Agency on a real-time World Trade Organization Enhanced Surveillance Project with eight acute care hospitals. We have a draft dispensing plan that incorporates using the NPS and is to be tested in January 2002. We are working with law enforcement and fire to develop a common set of procedures throughout the County for evaluating suspicious substances and with the Hospital Association on a smallpox/bioterrorism response plan. To communicate alerts with providers we use fax and two Internet listserves (one for ID physicians and one for ER directors) and for the public we work with our PIOs and print and broadcast media. Our general preparedness plan uses incident command structures within three Emergency Operations Centers—Seattle, King County and Public Health (the identified lead for bioterrorism).


Agency Name:
Cook County Department of Public Health
Contact Person: Mark Matuck, MPH
Title: Asst. Dir. Communicable Diseases
Address: 1010 Lake St, Ste 300
City: Oak Park, Il
State: IL
Zip Code: 60301
Phone: (708) 492 - 2150
Fax: (708) 492 -2932
Email: ccdph@hotmail.com
Jurisdiction: County
Population: 1 million +
Brief Description of Jurisdiction:
Suburban Cook County surrounds Chicago and borders collar counties. This area serves the majority of the population of the State of Illinois
Brief Description of Response Plan:
Plan Outline E-Mailed to S. Fisher 11/30


Agency Name:
Duval County Health Department
Contact Person: Patricia Frank, RN
Title: Director of Emergency Preparedness and Response
Address: 515 W. 6th St. MC 29
City: Jacksonville
State: FL
Zip Code: 32206
Phone: 904-665-2286
Fax: 904-665-2741
Email: Patricia_Frank@doh.state.fl.us
Jurisdiction: County
Population: 500,000-999,999
Brief Description of Jurisdiction:
We have a large river running through our county. We have a incorporated city/county.
Brief Description of Response Plan:
We received funding from the Domestic Preparedness grants. Our county has been meeting, planning and exerciseing our plans for 3 years. We have involved our Medical Society, hospitals, pharmacy, fire rescue, sheriffs,and our emergency operation center in idenitifing our gaps in our response.


Agency Name:
Clark County Health District
Contact Person: Donald S. Kwalick, MD, MPH
Title: Chief Health Officer
Address: 625 Shadow Lane
City: Las Vegas
State: NV
Zip Code: 89127
Phone: (702) 383-1201
Fax: (702) 383-6341
Email: dkwalick@cchd.org
Jurisdiction: County
Population: 1 million +
Brief Description of Jurisdiction:
Our jursidiction is approximately 7,200 square miles. It is one County which is the County of Clark and boarders on California, Utah and Arizona. Prominent Institutions: Boulder (Hoover) Dam; Nellis Air Force Base; McCarran International Airport; World Famous Las Vegas Strip and Nevada Test Site.
Brief Description of Response Plan:
The Clark County Health District (CCHD) response plan has been developed to integrate with the Clark County Emergency Operations Plan (CCEOP), which is responsible for coordinating responses to all emergencies, including other trained emergency response whose roles are identified in the EOP. CCHD provides the ten essential public health services. Administration, Environmental Health, Nursing and Epidemiology, will determine basic intervention capabilities, necessary supplies needed for same, storage and distribution, and maintenance of accurate emergency phone tree. Epidemiology monitors health status, diagnose, and investigates health problems and hazards through a surveillance system with sentinel sites for reporting flu-like and gastrointestinal illnesses. The Health Alert Network is integral to our Epidemiology department who is educating community physicians and other health care providers Community partnerships are in place to inform, educate, identify and solve health problems. Mutual agreements exist to support individual and community health efforts. The CCHD Public Information Office is part of the County Joint Information Center. CCHD Chief Health Officer is the authority to contact CDC to access the National Pharmaceutical Stockpile. Locations are identified within the governmental jurisdiction that are suitable for Emergency Operations Centers and alternative treatment centers for public health operations. A cadre of Public Health Nurses are educated to assist in mass casualty events. The Incident Command System is used throughout the County by most organizations. Hospitals have begun educating staff in ICS. The need for a Public Health laboratory located in the Las Vegas area is essential and identifying resources is being pursued. To ensure a competent public health and personal health care workforce CCHD plan has is division specific training. CCHD is working with the State Epidemiologist to review current infectious disease regulations and will recommend change to the legislative body as needed. CCHD Senior Management Team is using the National Performance Standards to identify gaps within our plan.


Agency Name:
DeKalb County Board of Health
Contact Person: Darren Collins
Title: Emergency Preparedness Coordinator
Address: 445 Winn Way, P.O. Box 987
City: Decatur
State: GA
Zip Code: 30031
Phone: (404) 508-7997
Fax: (404) 508-7813
Email: dfcollins@gdph.state.ga.us
Jurisdiction: County
Population: 500,000-999,999
Brief Description of Jurisdiction:
DeKalb County, Georgia has a population of about 625,000 people and covers an area of 268 square miles. Since 1970, DeKalb has been the most densely populated county in the state. The county includes suburban and urban areas, with a portion of the City of Atlanta within its borders. DeKalb is the most ethnically diverse county in the state. With a Refuge Relocation Center in Atlanta, the county becomes home to a large influx of immigrants and refugees each year.
Brief Description of Response Plan:
The DeKalb County Board of Health – Center for Public Health Preparedness has developed a Bioterrorism Response Plan. This planning document provides a reasonable approach to respond to a bioterrorist event in our communities. This document is based on the principles of Incident Command and was developed in collaboration with over 40 local, state and federal response agencies. The document is written in a very functional format and it includes agency specific action items for each response sector in the community. This document is the product of partnerships between a significant number of agencies and their representatives. Without their steadfast support, the foundation upon which this plan was built would not exist. We would encourage you to build relationships with the members of the first response community prior to embarking on this planning process.


Agency Name:
San Luis Obispo County Public Health Agency
Contact Person: Ann McDowell
Title: Epidemiologist
Address: 2191 Johnson Ave
City: San Luis Obispo
State: CA
Zip Code: 93406
Phone: (805) 788-2095
Fax:
Email: amcdowell@co.slo.ca.us
Jurisdiction: County
Population: 100,000-249,999
Brief Description of Jurisdiction:
This is a small county in the central california coastal region. We also have a Nuclear Power Plant, and have done extensive disaster planning around nulear issues. This has helped our Bioterrorism planning tremendously.
Brief Description of Response Plan:
Our plan is an overview of the responsibilities surrounding each of several areas, including: Early Recognition and surveillance, Mass patient Care, Mass Immunization and Prophylaxis, Mass Fatality management, Environmental Surety and Command and Control. The expansion and coordiantion of medical resources is covered extensively, as well as use and protection of first responders.


Agency Name:
Ontario County Public Health
Contact Person: Jody Gray
Title: Public Health Director
Address: 3019 County Complex Drive
City: Canandaigua
State: NY
Zip Code: 14424
Phone: 585-396-4343
Fax:
Email: jody.gray@co.ontario.ny.us
Jurisdiction: County
Population: 75,000-99,999
Brief Description of Jurisdiction:
2 cities (on opposite sides of the county)surrounded by several small towns and rural areas; 3 hospitals; a large portion of our economy is tourism (fingerlakes of NY)
Brief Description of Response Plan:
We are in the process of working on our response plan, according to CDC and NYSDOH guidelines and recommendations.


Agency Name:
Combined Health District of Montgomery County
Contact Person: J. Michael Phillips
Title: Environmental Health Director
Address: 117 South Main Street
City: Dayton
State: OH
Zip Code: 45422-1280
Phone: (937) 225-4443
Fax: (937) 496-3072
Email: mphillips@chdmc.org
Jurisdiction: Multi-county, disctric, or region
Population: 100,000-249,999
Brief Description of Jurisdiction:
See below
Brief Description of Response Plan:
Dayton Metropolitan Medical Response System Deliverable #2 Development Plan Contract #233 ¡V 01 ¡V 0027 Introduction Problem The Dayton Area began preparing for the possibility of a terrorist threat nearly two years ago, training all Dayton Fire Department (DFD) personnel, as well as many other emergency workers from the area, in the U.S. Department of Justice program, ¡§Emergency Response to Terrorism: Basic Concepts.¡¨ That was followed with the series of Domestic Preparedness courses. Since the events of September 11, 2001, the attitude concerning the possibility of domestic terrorism has changed in nearly every one. People who were skeptical are now concerned. Those who were concerned are even more so. We recognize that our previous training has only begun to prepare us for the magnitude of events which may occur. We also recognize that preparing for Mass Casualty Incidents resulting from intentional acts helps to better prepare us for natural disasters, and therefore provides greater protection for the citizens we serve. Mission Statement It is the Mission of the Dayton Metropolitan Medical Response System to provide for an improved response to disasters of any type. To accomplish that mission, we will work to improve the regional training, equipment, supplies, accessibility, and functionality for responses to large numbers of people with unexpected, urgent medical needs. In doing so we will focus on the incidents resulting from ¡§B-NICE¡¨ agents: Biological Nuclear Incendiary Chemical Explosive We recognize that no single entity can effectively handle a major incident. Our efforts will be collaborative. We will involve multiple local governments, the State of Ohio, as well as federal agencies and private entities. We have already secured the participation of Police, Fire, EMS, hospitals, Emergency Management Agency, public utilities, Public Health, the FBI, and many others. As a necessary component of our response, we will provide for improved safety for all responders. In the end, we will be better able to provide a coordinated response to a major event in the greater Dayton area, while simultaneously being able to offer improved support in the event of a catastrophe in any neighboring area. Philosophy The Dayton Metropolitan Medical Response System (DMMRS) will enhance our community¡¦s ability to mitigate the results of any B-NICE incident, or comparable natural disaster. MMRS will provide the structure to ensure that emergency health needs can be guaranteed. This plan shall include the identification of all necessary equipment, supplies, communications, personnel, training, and expertise to mitigate the effects of such an incident. As one component of our planning, we will investigate the feasibility, costs, and benefits of creating a Metropolitan Medical Strike Team (MMST) in the Dayton area. In some cities, a deployable MMST is designed and equipped to respond to the scene of a suspected terrorist incident, identify an unknown chemical agent, triage and treat contaminated patients, assist with the decontamination of those patients, coordinate the appropriate disposition of those patients, mitigate the hazard and contain the device if possible. Our investigation will reveal whether such a team will effectively add to the capability of the normal emergency responders in the Dayton area. Particularly in view of the fact that several credible targets are located in communities distinct from the core City, an MMST providing leadership assistance and guidance may be a viable option for our area. The DMMRS will measurably improve our community¡¦s preparedness for a biological event, whether it is terrorist initiated or naturally occurring. These preparations will establish surveillance mechanisms, provide pharmaceutical and other supply caches, and pre-plan the coordinated forward movement of patients. The DMMRS will further develop written plans for mass inoculation or immunization, mass fatality management, training of emergency responders, and integration with state and federal agencies, as well as provide for the protection and reassurance of emergency care and hospital workers, and their families. Purpose This document: Defines the mission of the Dayton Metropolitan Medical Response System States the Philosophy of the MMRS Policy Committee Provides background information on the Dayton/Miami Valley Region Exhibits the commitment of Dayton government to the system development Provides a list of members in the DMMRS Policy Group Defines the Committee¡¦s approach to system development Background The City of Dayton and the surrounding metropolitan area are located in the southwestern sector of Ohio and covers 800 square miles. The region has a population of approximately 715,000. The City of Dayton, itself accounts for 181,000 of the population. Within the metropolitan area, there are major interstate highways, an international airport, two rail lines, and a network of pipelines that serve the area. In addition, there are approximately 1,400 facilities which store, use, or manufacture hazardous substances. The area is home to Wright Patterson Air Force Base, a Department of Energy installation, and federal, state and local government agencies. While past planning prepared for threats to the area in the form of chemical releases from transportation and fixed facilities and weather related emergencies (winter storms, tornadoes, flooding, etc.), it excluded terrorist attacks. With the increasing potential for terrorist attacks, we now must also identify potential targets within our community. The criteria for identifying possible terrorist targets is the potential of the target to fulfill at least one of the following terrorist objectives: Produce casualties Disrupt transportation Destroy utilities Disrupt government Destroy communications Disrupt commerce Dayton¡¦s metropolitan medical response area has many facilities that meet one or more of these objectives. As such, local jurisdictions will identify potential targets, and prepare a WMD preplan that incorporates the MMRS plan for each potential target. The following generic list will provide guidance to local jurisdictions in their identification of potential target sites: Federal Government Facilities IRS Federal buildings Congressional Representative Offices Government Records Facilities Military Facilities Law Enforcement Agencies Recruiting Stations Postal Services Buildings U.S. Courts Department of Energy Facilities DOD Hospitals State of Ohio Facilities IEPA Ohio National Guard Correctional Institutions Ohio Tax Department Offices OSP Offices County Facilities County Buildings Fairgrounds Courts Jails/Correction Centers City/Township/Village Facilities Convention Centers Fire Departments Government Centers Police Departments Public Utilities Communications Centers Private Corporate Headquarters Newspapers Large Office Complexes Hotels Convention Facilities Theatres Sports Arenas Utility Companies Auditoriums Hospitals Television/Radio Stations Shopping Centers Transportation Facilities Pipeline & Petroleum Terminals Bus Depots Airports Railroad Switching Yards Key Bridges, Intersections, and Rail Lines Social Events Locations Fairgrounds Parks with scheduled Events Downtown Dayton Area Dayton Air Show/Trap Shoot Academic Locations Private and Public Colleges Vocational Schools Wright State & Nutter Center University of Dayton & Arena Central State University Wilberforce University Basic Defensive Capability Dayton Fire Department provides a number of services to the community, including Emergency Medical Services and Fire Suppression, as well as multiple rescue teams. Those teams provide for vehicular rescue, high angle rescue, trench rescue, and underwater dive rescue, among others. DFD personnel, along with personnel representing many other Fire Departments, are members of Ohio Task Force 1, a FEMA-sponsored USAR Team. DFD is also the home of the Regional Hazardous Materials Response Team. Dayton Police Department operates a Bomb Squad and Special Weapons and Tactics Team. All uniformed members of the Dayton Fire Department are trained and certified to at least the level of Emergency Medical Technician ¡V Basic. Over 100 of the 441 members of the Department are Certified Paramedics. The overwhelming majority of DFD personnel are trained to the Hazardous Materials (Haz-Mat) Operations level. Haz-Mat Team members are trained at the Haz-Mat Technician level. All personnel are issued Personal Protective Equipment (PPE) to form a fire fighting ensemble. Positive pressure Self-Contained Breathing Apparatus (SCBA) are available on all apparatus other than emergency medical transport units (Ambulances and Medic Units). The Hazardous Materials Team has 48 level ¡§A¡¨ entry suits and125 level ¡§B¡¨ suits. Haz-Mat can call on an expanded network of Liaison personnel comprised of personnel from numerous Fire Departments around the region. The Dayton Fire Department currently relies on Dreager tubes and Industrial Scientific metering for WMD quality agents. Computer hazard prediction models include Cameo and others. As mentioned above, the entire Dayton Fire Department was trained in the DOJ/OJP ¡§Emergency Response to Terrorism: Basic Concepts.¡¨ Following that training, the City of Dayton hosted the Department of Defense Domestic Preparedness Train the Trainer Program. Emergency response agencies from the entire tri-state region were included among the attendees. 294 trainers were trained from 17 hospitals, 28 fire departments, 14 police departments, from 8 different counties. Since that time, area hospitals and police agencies have presented the relevant courses to their personnel. Dayton Fire Department trained its entire force in the Awareness and Operations programs. All paramedics have received the EMS component, and all Officers and paramedics completed the Incident Command course. Furthermore, Dayton Fire Department has regional resources at its disposal. DFD is a signatory to a formal, multi-county Mutual Aid agreement, which provides the services of an untold quantity of apparatus and responders to meet any emergency situation. In Montgomery County alone, there are well over 1,000 trained firefighters, EMTs, and Paramedics who would respond to a call for assistance. The Haz-Mat team includes what are called ¡§Liaison Members:¡¨ trained personnel from other communities around the region, who participate in regular Haz-Mat trainings, and provide a deep pool of personnel for any extensive incident. Dayton Police Department is an excellent resource for intelligence gathering. They work cooperatively on a regular basis with other law enforcement agencies at the municipal, county, state, and federal levels. Interagency ventures take place frequently with the involvement of the Federal Bureau of Investigation (FBI) and the U.S. Marshall¡¦s office, as well as with numerous local police departments. Dayton Police Officers are trained in crowd control and perimeter security. At a recent Full Scale Chemical Weapons Exercise (CWFSE), we received effusive praise for the cooperative attitudes in our Unified Command structure, involving Fire, EMS, Haz-Mat, local law enforcement, FBI, the Emergency Management Agency, the National Guard CST, and others. The Greater Dayton Area Hospital Association (GDAHA) sponsors a National Disaster Medical System (NDMS) Disaster Medical Assistance Team (DMAT) in conjunction with the Federal Emergency Management Agency (FEMA). Although not available for local deployment, the expertise that has been gained by the team members would be invaluable in a crisis situation. GDAHA also has an active Domestic Preparedness Committee. Comprised primarily of hospital personnel, it includes representation from Dayton Fire Department, and works closely with Dayton MMRS. Following a review of the training, personal protective equipment (PPE), detection capabilities, decontamination gear, and communication capabilities for the City of Dayton¡¦s Fire Department and Police Department (including EMS and Hazardous Materials response capabilities), we believe that Dayton, Ohio has adequate resources to cope with most ¡§normal¡¨ hazardous materials incidents. However, in the event of a WMD incident, we find it difficult to envision any City being fully prepared. We intend to strengthen our resources in a number of areas, including detection capabilities, personal protective gear (especially for the police), medication resources, and disaster response equipment. We also intend to expand the number of interagency training opportunities. Coordinated Response for Public Safety, Public Health, and Health Services. The Dayton Metropolitan Medical Response System plan will utilize existing resources, and review existing plans for disaster mitigation. We will update those plans, and improve any issues that are determined necessary in such plans to include Domestic Preparedness and Weapons of Mass Destruction. We will simultaneously improve coordination among the various plans. The majority of WMD incidents will be handled with an on-scene command post under an Incident Command System. Large-scale WMD disasters will require the activation of city and/or county Emergency Operation Centers (EOC). If a WMD incident occurs, the incident commander will have Fire/EMS dispatch notify all area hospitals and health departments early in the event. The DMMRS will investigate the feasibility and benefits of a Metropolitan Medical Strike Team (MMST) to respond to a weapon of mass destruction incident at the request of the local Incident Commander (IC). Activation will be through the 911 system. Since the DMMRS is built upon already existing emergency services, the DMMRS System will be operational 24 hours each day. The DMMRS Operations Plan will evaluate and improve existing plans at the City and County levels. Through increased training, the DMMRS will offer guidance and assistance in the following areas: ƒæ Identification of the Weapon Material or Agent ƒæ Extraction of Victims ƒæ Decontamination of Victims ƒæ Administration of the Appropriate Antidote ƒæ Triage of Victims ƒæ Provisions for Primary Care ƒæ Transportation to Medical Care Facilities Additional consideration will be given to post-treatment care of patients, tracking and follow-up of exposed patients, as well as provision for appropriate mental health services to emergency workers, victims, and families, and others in the community that need assistance handling the unusual stress of a WMD incident. City Commitment The City of Dayton leadership is committed to preparing our community for the event of a terrorist incident and fully supports the implementation of the DMMRS. The City Manager¡¦s Office and the Safety Director¡¦s Office have pledged support for the contract. Dayton Fire Department has assigned Captain Rennes Bowers to work full time on issues related to Domestic Preparedness and Weapons of Mass Destruction. Captain Bowers is assisted in his efforts by numerous other personnel, both from within the Fire Department and from the Community. The Department¡¦s Chief Medical Director, Randy Marriott, MD, is intimately involved, well-read regarding WMD issues, and also fully behind these efforts. System Contract Requirements 1. Meet with Project Officer The Project Officer and Fire Department point of contact will meet with the Development Team early in 2002. 2. Plan Development Approach A multi-jurisdictional, multi-agency, and multi-disciplinary team has been formed to comprise the DMMRS Policy Group, which will function also as the Development Team to build the system. The group includes representation from the following: Montgomery County Department of Health, the Dayton Fire Department, Dayton Police Department, the Centerville Police Department, the Xenia Police Department, the Montgomery County Sheriffs Department, the Greene County Sheriffs Dept.,the Miami Valley Emergency Management Agency, Montgomery County Coroner¡¦s Office, the Montgomery County Fire Chief¡¦s Association, the Greater Dayton Area Hospital Association, Wright State University School of Medicine, local Emergency Department Physicians, the Ohio Department of Health, Ohio Emergency Management Agency, Veterans Affairs Medical Center, American Red Cross-Dayton Area Chapter, the Dayton International Airport Fire Department, the FBI, CareFlight Helicopter EMS, local laboratory facilities, the Southwest Ohio Critical Stress Management Team, multiple area hospitals, the Miami Valley Fire/Ems Alliance,the National Guard 52nd CST, Greene County Combined Health Dept., and Wright Patterson Air Force Base Readiness Division and Fire Department. The group was kept small by design in order to facilitate effective discussion, but large enough to cover the Dayton geographic community. See appendix A for a detailed list of the members. This Policy Group will also be the Development Team. It has been decided that the co-chairs for this committee will be the Fire Department¡¦s Weapons of Mass Destruction Captain, and the local EMA representative. These officers will facilitate the meetings and provide minutes and agendas before each meeting. Meetings are tentatively scheduled to be held monthly. Other existing groups will be informed and consulted during the process and report back to the DMMRS Policy Group. These groups include, but are not limited to GDAHA¡¦s Domestic Preparedness Committee, the Greater Miami Valley EMS Council, the County LEPCs, the Ohio National Guard and the FBI. Once the system becomes operational, medical oversight will remain with the Dayton Fire Department Chief Medical Director. 3. Primary DMMRS Plan All existing plans will be reviewed, updated and improved where necessary. The system will look at areas of deficiency, and offer plans to resolve those problems. The system will also examine new issues prompted by the Domestic Preparedness Program and integrate response to Weapons of Mass Destruction into existing plans. County and State Disaster Plans will also be reviewed, and recommendations for change will be made when needed. The geographic area covered by this plan will be, at a minimum, Montgomery County and its contiguous counties (Greene, Miami, Warren, and Preble). However, discussions have already begun among the six Ohio MMRS cities to provide complete statewide coverage, by designating areas to each MMRS. Mental Health/CISM The Dayton community has an existing system for identifying and meeting the emotional and psychological needs of responders, patients and the community as a whole. The area utilizes multiple mental health resources, including various agency peer counselor programs, and a not-for-profit Critical Incident Stress Management (CISM) Team that has provided assistance to numerous public safety personnel over the years from its inception. Trained individuals are available 24 hours a day for defusings and debriefings. The Dayton Area Chapter of the American Red Cross also plays an important role in offering assistance and responding to disaster situations where indicated. A plan for Mental Health/CISM will be delivered to the Project Officer no later than 180 days from the date the contract is awarded. 4. Forward Movement of Patients The DMMRS will make full use of the National Disaster Medical System and/or the county or state system, in the event that the patient load on Dayton overwhelms the capacity for care at the local level. All Montgomery County hospitals participate in our area disaster plan, and in the National Disaster Medical System. A plan for the forward movement of patients will be delivered to the Project Officer no later than 240 days from the date the contract is awarded. Efforts to develop this plan are already underway. 5. Responding to a Weapons of Mass Destruction Event Coordinating Services An event involving a weapon of mass destruction presents several unique challenges above and beyond the response to incidents of natural or accidental origin. Some of these challenges include: 1. Always a crime scene 2. Little or no warning 3. Lethal agents designed to kill or incapacitate thousands of patients 4. Hysteria and fear 5. Contaminated patients 6. Large number of self-referring patients 7. Medical system overwhelmed 8. Mass casualties 9. Long term ecological effects 10. Long term psychological effects The DMMRS will make sure that the unique characteristics of WMD incidents are recognized, and that operational plans are in place to address the issues. The contract focuses on incidents involving chemical, nuclear, biological or explosive agents. While the system will be designed to augment and improve response to large-scale incidents, an emphasis will be placed on the terrorism and weapons of mass destruction aspect. Numerous agencies will be involved including Public Safety (Fire, EMS, and Police), Public Health, and the Hospital Community. Fire and EMS are well-trained in the use of the Incident Command System (ICS). Hospitals in our area are developing and moving to the use of ICS, as are area police agencies. In the event of a WMD incident, we intend to implement ICS, and employ a Unified Command Post for a large scale incident. Dayton Fire Department Computer-Aided Dispatch Center (CAD) has pre-designated call lists to insure the response of all appropriate agencies. A complete plan for responding to events involving weapons of mass destruction will be delivered to the Project Officer no later than 270 days from the date the contact is awarded. 6. Strike Team Development The development of a Metropolitan Medical Strike Team (Strike Team) could become a component of the DMMRS Contract. The Policy Group will discuss the possible benefits with other City¡¦s that have a elected to form such teams, and explore the resources needed to integrate an MMST locally, including issues of coordination, training, and equipment. If formed, the Dayton Metropolitan Medical Strike Team would operate under the auspices of the Dayton Fire Department, and would utilize resources and personnel from the Fire and Police Departments, local hospitals, and other agencies. Because of the critical time element in patient decontamination, any Strike Team would be required to be response ready on a 24-hour basis. We would explore the appropriate organizational structure for an MMST, and most likely follow the template found in the Field Operations Guide, with modifications for local needs. If included, a plan for the Strike Team will be delivered to the Project Officer no later than 365 days from the date the contract is awarded. 7. Early Recognition of a Biological Event The DMMRS will make full use of existing surveillance mechanisms performed by hospitals and public health agencies. The DMMRS will also examine other avenues to recognize a biological event. We will provide for heightened awareness in Public Safety Dispatch Centers to an increasing volume of calls related to conditions that could be biological in nature, and explore monitoring of veterinary medicine treatment aberrations, Department of Agriculture reports, Primary and Secondary school absences, and Medical Examiner reports. In addition, the local health departments receive communicable disease reports on a routine basis from hospitals, physicians and laboratories. Partly as a result of efforts by members of the DMMRS, a hospital coalition comprised of 18 facilities has recently developed and implemented an expedited reporting system regarding issues related to biological agents. The network receives not only reportable diseases under Ohio law, but also preliminary suspected cases of communicable disease in the early stage of diagnosis before confirmation, and statistical information on patients presenting with unwarranted concerns of biological agent contamination. When appropriate, this information is forwarded to the State Health Department, and may be disseminated to other hospital and public safety agencies in the future. The same hospital coalition, the Greater Dayton Area Hospital Association, has also motivated all 18 facilities to complete a ¡§Gap Analysis¡¨ of each facility¡¦s preparedness for a WMD incident. They are in the process of consolidating those documents into an effective regional hospital capability Gap Analysis. A plan for the early recognition of a biological event will be delivered to the Project Officer no later than 545 days from the date the contract is awarded. Mass Immunization/Prophylaxis The release of a biological agent into a populated area may cause the health care system to respond with a mass immunization program in order to reduce health risks to the population. Public health agencies already have plans in place for mass immunization. Their plans will be examined to make sure that they provide for the large population possibilities associated with a deliberate release. Additional personnel and locations will be considered in order to accommodate a significant population. The media will be included in the plan, both to instruct the public on who needs treated and where to seek that treatment, and to help reduce the anxiety that will be associated with such a program. Some public service announcements regarding Anthrax concerns are already in development by members of GDAHA, and the Wright State University School of Medicine. Certain biological agents will require prophylaxis of the responder/provider population, as well as the population as a whole. The emphasis will be to provide for the provider/responder first by Proactive Immunization, and then to address the remaining population. A group of responders/providers who are comfortable and protected will be better able to take care of the needs of the general population. Different means of administering and providing the medications will be examined. A plan for mass immunization and prophylaxis will be delivered to the Project Officer no later than 545 days from the effective date of the contract. Mass Fatality Management The County Coroner¡¦s Offices have the responsibility for the management of fatalities. Their existing plans will be reviewed to include management of mass fatalities resulting from WMD. When necessary, we will provide for augmentation of the existing plans involving mass casualties, including identification, decontamination, respectful care, storage, and disposition of a large number of deceased. A plan for the management of a mass fatality event will be delivered to the Project Officer no later than 545 days from the date the contract is awarded. 8. Local Hospital Healthcare System Hospital Notification Hospitals and emergency responders must exchange information via phone, radio, or fax about the initial responders¡¦ observations from the WMD incident scene. Such vital information must include: ƒæ Estimated Number of Victims ƒæ Victims¡¦ Initial Symptoms ƒæ Agent Identification ƒæ Agent Toxicology ƒæ Decontamination Procedures ƒæ Pharmaceutical Distribution Plans Several mechanisms exist for local EMS units to notify area hospitals of incoming patient loads or disaster situations. Nearly all communities have the capability to utilize the statewide Mutual Aid and Disaster frequencies, as do most or all hospitals. We are also investigating the potential for expanded utilization among hospitals of the City of Dayton¡¦s 800 MHz trunked radio system. Hospital Decontamination As discussed above, there are multiple mechanisms EMS units to notify area hospitals when a Mass Casualty Incident (MCI) occurs. However, in the event of a sudden exposure of a large group of people to deadly chemical agents, almost certainly significant numbers of victims would self-triage, and obtain transport to a hospital by every means available, exclusive of EMS, while still contaminated with the agents involved. That would pose a true threat to the hospitals ability to continue functioning, and require hospitals to perform mass decontamination outside the emergency department doors. Therefore, hospitals must have the ability to perform mass decontamination in order to protect other patients and staff. Most area hospitals are currently only capable of decontaminating one patient at a time. Obviously when presented with hundreds of patients, a large-scale operation will be needed. We will investigate the feasibility of inexpensive but effective large scale decontamination systems, which simultaneously protect modesty, account for valuables, and preserve evidence, as necessary. Personnel in the hospitals will need to be trained and equipped to be able to accomplish personal protection and decontamination. Issues such as water drainage and personal belongings will also be addressed. Hospital Lockdown Not every hospital in the system will have the ability to conduct mass decontamination. However, hospitals not performing mass decontamination must be able to secure their building to assure restricted access. They are still likely to have patients arriving and trying to enter the facility through a number of entrances. While not denying care, these hospitals may be able to decontaminate those patients who self-transport. Regardless of decontamination capability, all hospitals will need to control access following a large-scale event both to prevent internal contamination of the facility, and to guard against the hospital becoming a secondary target. A plan for these components will be delivered to the Project Officer no later than 545 days from the effective date of the contract. 9. Training Personnel Finally, we will explore, develop, recommend, and may provide training opportunities for all the various personnel involved with such an eventuality. Training for the City of Dayton Fire and Police Departments that was started under the Domestic Preparedness Program will continue. The Domestic Preparedness exercises have been completed, including a chemical weapons tabletop exercise and a full scale exercise. We intend to schedule additional exercise, including a biological weapons tabletop exercised scheduled for February, 2002. Continuing education is an important component of all emergency training. The Dayton Fire Department Haz-Mat Team and area Liaison Members should drill together monthly. EMS and interagency drills should also be held regularly. There is a regional disaster drill held periodically in conjunction with Dayton International Airport, and we will expand on such drills. Selected Dayton Fire Department paramedics also receive specialized training for work with the Dayton Police SWAT Team, and those training and continuing education programs will be continued. Many members of agencies within our community will require additional training in order to effectively function in the DMMRS. The training requirements vary in accordance to the role that the individual will perform. All clinical hospital employees will receive at least a one-hour awareness program. All attempts will be made to incorporate the required training into existing training schedules. The DMMRS expects to use instructors trained under the Department of Defense training program for the hospitals, and many area hospital already have employees who have completed that Train-the-Trainer program. Emergency department staff may have a higher training requirement, reflecting their position as the initial casualty receivers. DMMRS will explore the Domestic Preparedness Hospital Provider Program, and other programs, as well as established hospital security measures. Various hospital staff will be identified and tasked with specific response functions. These staff members, such as maintenance and security, will receive training based upon the missions assigned to them. This training may include patient decontamination and/or hospital lockdown procedures. All components of the DMMRS will be required to drill and exercise on a frequent and scheduled basis, in order to ensure system effectiveness and to identify and correct operational deficiencies. A training plan will be delivered to the Project Officer no later than 545 days from the effective date of the contract. 10. Pharmaceutical Acquisition/Maintenance Obviously, it will be crucial to have necessary pharmaceuticals readily available to treat patients exposed to a WMD. The plan will determine the type and amount of antidotes, vaccines, and antibiotics needed to provide for a minimum of 1,000 persons in the community for 48 hours; purchase the appropriate agents or have contractual agreements with various pharmaceutical supply facilities; plan for the store of these medications; and plan for distribution and administration of medicines and the required rotation of all pharmaceutical stock. At this juncture, we anticipate inclusion of at least the following agents: Atropine Pralidoxime (2-PAM) Valium Cyanide antidotes (Amyl Nitrite, Sodium Nitrite, Sodium Thiosulfate) DMMRS will locate and assure acceptable storage arrangements for the purchased pharmaceuticals. We will include in those considerations security, mobility, emergency access, and temperature control. An antibiotics cache will be available to protect first responders against biological agents. Provisions for administration by area paramedics to other providers have already been included in the regional plan. A plan for the acquisition and maintenance of needed pharmaceuticals will be delivered to the Project Officer no later than 545 days from the effective date of the contract. Equipment Acquisition/Maintenance Various types of Incident Command System (ICS), detection, decontamination and protective equipment may be purchased under this contract. The DMMRS Coordinator, in conjunction with the Director of the Dayton Fire Department, the DFD Chief Medical Director, and other personnel, will decide which equipment will be purchased and when. Other cities are being polled now to gain insight on the types of equipment carried and available vendors. A plan for the acquisition and maintenance of needed equipment will be delivered to the Project Officer no later than 545 days from the effective date of the contract. Medical Treatment and Protocol Implementation Numerous protocols and treatment regimens exist for the treatment of patients that fall victim to an attack involving weapons of mass destruction. The medical representatives on the DMMRS Policy Group will examine all current protocols, and recommend changes where needed. We are fortunate that the regional EMS protocols have just been extensively revised. Since members of the DMMRS were key members of the Committee which developed the revised Standing Orders, those protocols now include provisions for chemical and biological agents which may be utilized as Weapons of Mass Destruction. A plan outlining desired protocols and treatment regimens will be delivered to the Project Officer no later than 545 days from the effective date of the contract. APPENDIX A MMRS POLICY COMMITTEE / DEVELOPMENT TEAM Name E-Mail Office # Organization Anders, Rosanne randers@frognet.net 937-854-4822 MVEMA Beal, Tom BEALTD@DOE.MD.GOV 937-865-4897 BWXT Technologies,Inc Fire Chief/Fire Protection Supervisor Bernitt, Pat pbernitt@gdahin.org 937-228-1000 Greater Dayton Area Hospital Association Bowers, Rennes Rennes.bowers@ci.dayton.oh.us 937-333-4551 937-623-8323 Dayton Fire Dept., WMD, MMRS Coordinator Brannen, Don dbrannen@gcchd.org 937-374-5600 Gr Co Combined Health Bristow, Denny dennybristow@aol 937-854-4822 Haz Mat Calloway, Lacey Lacey.calloway@cityofdayton.org 937-333-4504 Dayton Fire Dept. Devoe, Jeff fdevoe@co.greene.oh.us 937-562-4800 Gr. Co. Sheriff Dept. Gerstner, David David.gerstner@ci.dayton.oh.us 937-333-4544 Dayton Fire Dept. Gunter, Rob rgunter@frognet.net 937-854-4822 MVEMA Haverland, Mike mhav@infinet.com 512-5103 Fire/EMS Alliance Kimbler, Dave Dkim4509@aol.com 937-333-3144 Dayton Fire King-Edrington, Linda CISM Leopold, Deb dleopold@gcchd.org 937-374-5600 Gr. Combined Health Environmental Health Long, Tom tlong@mvh.org 208-2803 Miami Valley Hospital Middleton, Adam Adam.middleton@medcath.com 513-221-8064 O¡¦Shaughnessy, Fran foshaughnessy@dac.redcross.org 937-222-0124 ext. 107 American Red Cross Phillips, Mike mphillips@chdmc.org 937-225-4443 Montg. Combined Health Prindle, Eric eprindle@ci.xenia.oh.us 937-376-7220 Xenia Police Pulsifer, Portia plpulsifer@dps.state.oh.us 614-889-7167 OEMA Rymer, Steve Contact via Tom Long MVH Stevers, Jim Jim.stevers@med.va.gov 937-268-6511 ext. 2067 VA Center Stogsdill, Mike Michael.Stogsdill@oh.ngb.army.mil 614-419-8892 National Guard 52nd CST Studebacker, Vicki Vicki.a.studebaker@questdiagnostics.com 937-208-3572 Compunet Walker, Steve swalker@ci.centerville.oh.us 937-433-7661 Centerville Police Wall, Ken 937-222-7485 FBI Zaharieff, Alex jalexz@msn.com 937-376-7278 MVEMA LAW ENFORCEMENT AGENCY SECTION Name E-Mail Office # Organization Bean, Randy Dayton Police Bardur, John John.bardun@cityofdayton.com Office: 333-1361 Pager: 940-5776 Dayton Police Devoe, Jeff fdevoe@co.greene.oh.us Office: 937-562-4800 Home: 372-7707 Gr. Co. Sheriff Dept. Plummer, Phil Cell: 478-5367 Pgr. 851¡X0923 Home: 898-4483 Mont. Co. Sheriff Dept. Prindle, Eric eprindle@ci.xenia.oh.us 937-376-7220 Greene Co. Law Enforcement Assoc. Xenia Walker, Steve swalker@ci.centerville.oh.us Office: 937-433-7661 Home: 937-885-3504 Montg. Co. Law Enforcement Assoc. Centerville


Agency Name:
Middle-Brook Regional Health Commission
Contact Person: Kevin G. Sumner
Title: Health Officer/Director
Address: 1200 Mountain Avenue
City: Middlesex
State: NJ
Zip Code: 08846-1702
Phone: 732-356-8090
Fax: 732-356-1249
Email: mbrhc@superlink.net
Jurisdiction: Multi-county, disctric, or region
Population: 25,000-49,999
Brief Description of Jurisdiction:
We are a regional health department serving the residents of six member municipalities.
Brief Description of Response Plan:
We do not currently have a response plan , but are actively pursuing the development of one through a county-wide task force.


Agency Name:
LINCOLN COUNTY HEALTH DEPARTMENT
Contact Person: DIANE MILLER
Title: PUBLIC HEALTH ADMINISTRATOR
Address: P.O. BOX 165, 44 HEALTH WAY
City: STANFORD
State: KY
Zip Code: 40484
Phone: (606) 365-3106
Fax: (606) 365-1640
Email: dianemiller@searnet.com
Jurisdiction: County
Population: 0-24,999
Brief Description of Jurisdiction:
Jurisdiction is Lincoln County which is a rural county.
Brief Description of Response Plan:
In process of writing plan for the department. Reviewed County Plan to incorporate with this department. Local hospital, city and county government, fire department, law enforcement and local health department is part of county plan.


Agency Name:
Multnomah County Health Department
Contact Person: Bill Collins
Title: EMS Administrator
Address: 426 SW Stark St.
City: Portland
State: OR
Zip Code: 97204
Phone: 503 988 3220
Fax: 503 988 4017
Email: william.e.collins@co.multnomah.or.us
Jurisdiction: County
Population: 500,000-999,999
Brief Description of Jurisdiction:
Multnomah County is geographically the smallest county in Oregon spanning over 465 square miles and yet it contains approximately 20% of the state’s population due to the high density found in Portland and the surrounding cities. Of the 660,000 residents, 95% live in urban areas; 80% live in Portland.
Brief Description of Response Plan:
The County Health Department is the local agency responsible for the provision of public health services and emergency plans for oversight of the medical system. The Department provides coordination for all emergency medical response and staffs the Medical Branch in the EOC of the Cities and County. ICS is used by all responders and by the area hospitals. The Health Officer is joint command for bioterrorism events. Multnomah County Health Department has developed an Emergency Preparedness and Response Plan outlining the role the Department will play in an emergency situation, either natural or human-caused. The Department has provided the lead for the health and medical aspects of a regional MMRS response plan. The MMRS public health group is currently working with area hospitals, medical societies, and private phisicians on the development of a bioterrorism response plan for the Portland metro area (Multnomah, Washington and Clackamas Counties in Oregon, and Clark/Skamania Counties in Washington State) in order to ensure a coordinated response. Planning efforts are centered on response to a smallpox case. The group consists of four work teams addressing the following areas: 1) Steering/Governance/Communication 2) Surveillance and Field Epidemiology 3) Vaccination, and 4) Patient Management, Isolation & Quarantine and Follow-up. A draft will be developed by late April.


Agency Name:
Marion City Health Department
Contact Person: Michael J. Fielding
Title: Health Commissioner
Address: 233 West Center Street
City: Marion
State: OH
Zip Code: 43302
Phone: 740-387-2875
Fax: 740-383-2251
Email: mfmchd@gte.net
Jurisdiction: City
Population: 25,000-49,999
Brief Description of Jurisdiction:
The City of Marion is located within the Central Ohio Region about 55 miles north of the capital city Columbus, Ohio. The population is approximately 38,000. The work force is primarily blue collar.
Brief Description of Response Plan:
The Marion City Health Department emergency response plan is a general guidance tool for responding to all emergencies that may occur within the City. This plan meshes well with the county-wide plan setup and maintained by the local Emergency Management Agency (EMA). This plan is a


Agency Name:
Newington Health Department
Contact Person: Robert Cosgrove, MPH, RS
Title: Public Health Coordinator
Address: 131 Cedar Street
City: Newington
State: CT
Zip Code: 06111
Phone: 860-665-8588
Fax: 860-665-8577
Email: rcosgrove@ci.newington.ct.us
Jurisdiction: Town/township
Population: 25,000-49,999
Brief Description of Jurisdiction:
Suburban township bordering cities of Hartford, New Britain. Blue-collar type community with volunteer fire department. Town Manager/Town Council form of government.
Brief Description of Response Plan:
Current response plan only addresses natural disasters and chemical releases; we are currently updating plan to include a bioterrorism component.All town depts have delineated roles in the EOP to include health, EMS, and area hospitals.


Agency Name:
Benton County Health Department
Contact Person: Tracy Rank
Title: EPHS Assistant
Address: PO Box 935
City: Warsaw
State: MO
Zip Code: 65355
Phone: 660-438-2876
Fax: 660-438-5746
Email: rankt@lpha.state.mo.us
Jurisdiction: County
Population: 0-24,999
Brief Description of Jurisdiction:
Our jurisdiction is approximately 45 miles from Whiteman Airforce Base and within the flight pattern for the aircraft. We are the home of Truman Lake and Dam. We are made up of several resort areas throughout the county. We have alot of
Brief Description of Response Plan:
In our response plan it is outlined that the Health Dept. will take the lead role in the event of a terrorist attack. We will follow the federal Five Year Strategic Objectives established by CDC 1999-2004. In the event of an attack we will follow the 2002 version of the county Emergency Operations Plan. We have developed an inner-agency terrorism task force team and also a task force committee made up of citizens from the private and public sector. Our plan outlines the chain of command to be followed. It outlines various other things in detail including but not limited to:public education, safety of employees, infection control, laboratory procedures, epidemiology procedures, decontamination procedures, distribution plan of supplies/medication, quarantine/isolation procedures, fatality plan, mass patient care, media coverage, pharmaceutical stockpiles, education of health professionals, passive/active surveillance, indicators of a possible bioterrorism event. We have included several quick reference attachments in our plan.


Agency Name:
SEK Multi County Health Department
Contact Person: Judy Richey
Title: Aministrator
Address: 221 S. Jefferson P.O. Box 304
City: Iola
State: KS
Zip Code: 66749
Phone: 620-365-2191
Fax: 620-365-3128
Email: alhealth@midusa.net
Jurisdiction: Multi-county, disctric, or region
Population: 0-24,999
Brief Description of Jurisdiction:
Allen, Anderson, Linn, Bourbon, Woodson Counties in KS.
Brief Description of Response Plan:
Our response plans are not completed for each of the five counties but we are working on the plans.


Agency Name:
Washington County Public Health Service
Contact Person: Patricia L. Harrison, BSN,MPS
Title: Director of Public Health/Patient Services
Address: 415 Lower Main Street
City: Hudson Falls
State: NY
Zip Code: 12839
Phone: 518-746-2400
Fax: 518-746-2410
Email: pharrison@co.washington.ny.us
Jurisdiction: County
Population: 50,000-74,999
Brief Description of Jurisdiction:
This is a rural county comprised of 17 towns. Town populations range from 506-12,000 persons. The Agency is the primary provider of homecare and preventive services to a county that is only 22 miles wide but 90 miles long. We rely on the State Health Departments District Office for environmental needs.
Brief Description of Response Plan:
Our plan incorporates local,district and state agency involvement. We cross county and state lines with Warren County and Vt.for hospital emergency and treatment planning, collaboration and ED surveillance. Involvement of emergency services, other county departments and other agencies has been excellent. NPS is incorporated with NYSDOH involvement.The local infectious disease specialist and the NYSDOH staff are listed as resources as well. We have also FOILED for addresses of healthcare professionals in the county to develop a volunteer list for an emergency and/or mass immunization clinics. We are also working with emergency services to develop batch fax lists and email list serves of physician groups, schools, nursing homes, hospitals and veterinarians for notification of any emergency situations and for educational purposes.


Agency Name:
McLean County Health Department
Contact Person: Bob Keller
Title: Director
Address: 200 W. Front St.
City: Bloomington
State: IL
Zip Code: 61761
Phone: (309)888-5450
Fax:
Email: bobk@mclean.gov
Jurisdiction: County
Population: 1 million +
Brief Description of Jurisdiction:
Central Illinois. Population 150,433. Houses two university. 70% urban, 30% rural. Largest geographic county within the state of Illinois
Brief Description of Response Plan:
The health department acts as a second line responder. The department works with law enforcement on tracking potential contacts. The NPS is integrated as part of a larger county disaster plan and a statewide plan. The Illinois Department of Public Health is responsible for deilivering push packages to local jursidictions. The local plan identifies those administering medications, the site where medication is to be administered, transportation plans, as well as security protocol.


Agency Name:
Jefferson County Health & Welfare Department
Contact Person: A.C. Walkes, M.D.
Title: Health Authority Director
Address: 1295 Pearl Street
City: Beaumont
State: TX
Zip Code: 77701
Phone: (409) 835-8530
Fax: (409)835-8658
Email: austin@co.jefferson.tx.us
Jurisdiction: County
Population: 250,000-499,999
Brief Description of Jurisdiction:
Jefferson County Health Department Director serves a population of 252,051 in collaboration with the surrounding 7 Counties, with a population of 300,771.
Brief Description of Response Plan:
To communicate with law enforcement entities within the collaborative, as well as, public health directors, and the local health departments within the cities of Beaumont and Port Arthur, Texas. Respond and triage patients to local hospitals, and to Lamar University Montagne Center, when necessary, for decontamination, take samples and forward to laboratory in Houston, Texas. Hold meetings and workshops with local Emergency Planning Committees, to up-date disaster plans, to meet the needs of injured or exposed citizens in the event of an attack of mass destruction, to contain the spread of disease, and quarantine areas.


Agency Name:
Harvey County Health Dept.
Contact Person: Rita Flickinger
Title: director
Address: 316 Oak St.
City: Newton
State: KS
Zip Code: 67114
Phone: 316-283-1637
Fax: 316-283-0057
Email: rflickinger@harveycounty.com
Jurisdiction: County
Population: 25,000-49,999
Brief Description of Jurisdiction:
Small rural county in Kansas next to the largest population center in Kansas - Wichita.
Brief Description of Response Plan:
currently working on plan to complement the Kansas Dept. of Health and Environment plan.


Agency Name:
Barber County Community Health Dept
Contact Person: Kathy Prilliman
Title: NP, Administrtor
Address: 117 E Kansas
City: Medicine Lodge
State: KS
Zip Code: 67104
Phone: 620-886-3747
Fax: 620-886-3747
Email: kathyprilliman@hotmail.com
Jurisdiction: County
Population: 0-24,999
Brief Description of Jurisdiction:
Rural, sparsely populated
Brief Description of Response Plan:
We used the Kansas Department of Health and Environment(KDHE) Bioterrorism Template to construct our county plan - We would initiate use of NPS through KDHE epidemiolgist, have 24-48hr stock of Doxy/Cipro on hand - Atropine:additional stock available 1 hour travel time away. Have no bioterrorism response agreements with neighboring counties at this time - may in future. Disaster plan meeting held by hospitals recenently changed to include public health. Public Health Deparment does not have a copy of the county Emergency Management Plan - have requested one. No county-wide Emergency Management task force is in place at this time.


Agency Name:
San Juan Basin Health Department
Contact Person: Joe Fowler
Title: RN
Address: POBox 140
City: Durango
State: CO
Zip Code: 81302
Phone: (970)247-5702 ext 272
Fax: (970)247-9126
Email: joe@sjbhd.org
Jurisdiction: Multi-county, disctric, or region
Population: 25,000-49,999
Brief Description of Jurisdiction:
Public Health Dept in SW Colo covering 2 counties Largest health dept in SWColo. Located in Durango which is county seat, Pop approx 20,000.
Brief Description of Response Plan:
Plan mailed to NAACHO 2/20/02.NPS would be triggered by call from the governor or director of State HD. Contact names & numbers of key partners in med community included in plan,not roles.Agency plans exchanged between HD and local hosp.


Agency Name:
Lake County General Health District
Contact Person: Joel Lucia
Title: Health Commissioner
Address: 33 Mill St.
City: Painesville
State: OH
Zip Code: 44077
Phone: 440-350-2543
Fax: 440-350-2548
Email: jlucia@lcghd.org
Jurisdiction: County
Population: 100,000-249,999
Brief Description of Jurisdiction:
An urban &nd rural County immediately to the east of Cleveland. Population is 227,511 in 231 square miles. Lake County has 23 political subdivisions including 9 cities
Brief Description of Response Plan:
This plan is designed as an annex to a County wide plan, thus the response of other agencies is not detailed in the plan. The plan is mainly meant as response considerations for the Health District and contains contact mechanism for other county and State agencies. The plan is mainly designed to delinate the response to overt incidents although covert incident response is also considered.


Agency Name:
Boulder County Health Department
Contact Person: Neal Griggsmiller
Title: Director of Administrative Services
Address: 3450 Broadway
City: Boulder
State: CO
Zip Code: 80304
Phone: 303-441-1142
Fax: 303-441-1452
Email: naghe@co.boulder.co.us
Jurisdiction: County
Population: 250,000-499,999
Brief Description of Jurisdiction:
Boulder County encompasses 753 square miles in the north-central part of Colorado, approximately 27 miles northwest of Denver. The geography in the county is quite diverse, ranging from the rolling plains and lush farmland in the eastern part of the county to the spectacular scenery of Rocky Mountain National Park in the western half. Elevations in Boulder County vary from the 5,000-foot level of the plains to the 14,000-foot peaks of the Continental Divide. Boulder County has both rural and urban settings. Municipalities in the county include Boulder, Longmont, Louisville, Lafayette, Lyons, Nederland, Ward, Jamestown, Superior, and Erie. The unincorporated areas of Boulder County include the communities of Niwot, Gunbarrel, and Allenspark. Boulder County is home to one of the largest concentrations of scientific, research, and high-tech industry. Additionally, the University of Colorado at Boulder, two school districts, and numerous recreational facilities are located here. Currently, the population of Boulder County is approximately 267,000. Boulder County Health Department (BCHD) provides public health services to all residents of Boulder County. We maintain strong collaborative relationships with health and human service agencies, educational institutions, a wide range of community-based organizations, and other government agencies/programs.
Brief Description of Response Plan:
Boulder County Health Department`s Emergency Response Plan includes a general public health strategy addressing all potential local disaster events. It includes a chain-of-command structure and a plan of operations. Additionally, the Emergency Plan addresses bioterrorism with its specific role in community disease surveillance and investigation. The Emergency Plan is built on the model that public health activities will be organized and delivered through six general work teams. Activities related to the NPS are included in the roles and responsibilities (especially the distribution of drugs and vaccines) of the Community Health Services Team. The Bioterrorism Plan also includes the CDC`s notification system for reporting suspicious bioterrorist events to State Health authorities, FBI, and others. The Plan assumes a close working relationship with local medical, hospital, and EMS personnel.


Agency Name:
Marion County Health Department
Contact Person: Marshal Bickert
Title: Emergency Preparedness Coordinator
Address: 98 McKinley Park Blvd
City: Marion
State: OH
Zip Code: 43302
Phone: 740-387-6520 ext 124
Fax: 740-383-2546
Email: mbickert@marionhealthdept.com
Jurisdiction: County
Population: 50,000-74,999
Brief Description of Jurisdiction:
Marion City and County Health Departments cover areas of urban underdevelopment mixed with large agriculture and wildlife areas.
Brief Description of Response Plan:
Marion City and County Health Departments have developed the REVERT plan (Rapid, Emergency Volunteer Education and Response Template). The plan enables small and medium sized health departments to rapidly recruit, train, and disperse large numbers of voluteers in response to any type of public health emergency. This plan is invaluable for mass prophylaxis and/or vaccination.


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