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Bioterrorism Preparedness:Bioterrorism Preparedness:Strengthening Nebraska’s Strengthening Nebraska’s

Public Health SystemPublic Health System

Dr. Richard RaymondDr. Richard RaymondChief Medical OfficerChief Medical Officer

NE Health & Human Services SystemNE Health & Human Services System

www.hhs.state.ne.uswww.hhs.state.ne.us

8-20038-2003

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“Preparedness is not an event, it’s a continuous process. We’re more prepared than we were yesterday…we’ll be more prepared in the future.”

Dr. Julie L. Gerberding, Director, Centers for Disease Control and Prevention

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Governor Johanns’ Homeland Security Policy Group

Lt. Governor - Chair State Fire MarshalThe Adjutant General Policy Secretary, HHSSDeputy Director, NEMA Governor’s PolicySuperintendent of State Patrol Research Office Chancellor, University of Nebraska Medical Center

The State’s Chief Medical Officer, the Director of the Nebraska Public Health Lab, and the State’s Chief Information Officer attend every meeting.

This structure created a system for a comprehensive, strategic approach to homeland security rather than a fragmented, departmental approach.

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Governor Johanns’Homeland Leadership Group

NEMA - Coordinates Leadership Group ActivitiesNational Guard

FBIState PatrolFire Marshal

HHSSUniversity of Nebraska Medical CenterDepartment of Environmental Quality

Department of RoadsDepartment of AgricultureAttorney General’s Office

The Leadership Group is responsible for planning, training, and assessment activities, for making recommendations to the Policy

Group, and for implementing Policy Group directives.

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All funding must be approved by the Homeland Security Policy Group

DHS - Local government equipment grants (ODP)DHS - State equipment grantsCDC Bioterrorism fundingHRSA Funding

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“I don’t think there’s any question we are significantly better off today than we were two years ago.”

Dave Heineman, Lt. Governor, Nebraska

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Bioterrorism Preparedness Bioterrorism Preparedness

• Early Detection

• Rapid Identification

• Prompt Treatment

• Prevention of Spread

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Seven Focus AreasSeven Focus Areas

A: Planning and readiness assessment

B: Surveillance and epidemiology capacity

C: Laboratory capacity

D: Chemical Preparedness

E: Health Alert Network

F: Risk communication/health information

G: Education/training of health professionals

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“A state’s public health services are only as good as its local delivery system, and that’s where Nebraska has made marked improvements. Three years ago, the state had only 16 local health departments, which provided services to 22 of its 93 counties. Using part of a $50 million appropriation from the state’s tobacco settlement, and a Turning Point grant, the state built 14 new local departments and restructured two others in a remarkably short time.”

Governing Magazine, February 2004

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Focus Area A: Planning Focus Area A: Planning and Readiness Assessmentand Readiness Assessment

• Strategic National Stockpile• ABX Stockpile• Public Health Law• 10 bed Isolation Unit• Local Planning and Readiness Assessment• Local Emergency Preparedness Coordinator

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• OMMERS• LMMRS• TRIMMERS• Poison Center

Focus Area A: Planning Focus Area A: Planning and Readiness Assessmentand Readiness Assessment

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Focus Area B: Surveillance Focus Area B: Surveillance and Epidemiology Capacityand Epidemiology Capacity

• Lincoln/Lancaster County Health Dept. • Douglas County Health Department• Central Health District• NE Health & Human Services System• Community Health Centers• NEDSS• EPI 101• Local Surveillance Coordinator

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Focus Area C: Focus Area C: Laboratory CapacityLaboratory Capacity

• Unique partnership between HHSS and University of Nebraska Medical Center (UNMC)

• Special pathogens laboratory at Nebraska Public Health lab

• Smallpox and Ricin testing

• SARS and WNV

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Focus Area C: Focus Area C: Laboratory Capacity (cont.)Laboratory Capacity (cont.)

• 85 labs connected via Internet & have digital cameras via computer to transmit photos back to us of questionable takes

• Health Alert Network (HAN) connectedness

• Food/water lab upgrade with Ag

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Focus Area D: Focus Area D: Chemical PreparednessChemical Preparedness

• Nebraska Public Health Laboratory located at UNMC

• Nebraska Center for Bioterrorism Education

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Focus Area E: Focus Area E: Health Alert NetworkHealth Alert Network

Contracts with:

• Every Hospital

• Every Public Health Department

• Every Community Health Center

• Health Professional Tracking Center– (Physicians, Physician Assistants,

Nurse Practitioners, Pharmacists, Veterinarians, Dentists)

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Focus Area E: Focus Area E: Health Alert NetworkHealth Alert Network

Other Contacts:• Poison Center• Community Action Agencies

Activities:• Live, interactive telecommunications• Voice Notification Systems• Tac Pacs• Influenza Survey

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Focus Area F:Focus Area F:Risk Communication and Health Risk Communication and Health

InformationInformation• Adding Video Streaming

• Bioterrorism Web page

• HAN Web page

• Media Message Development

• Building Infrastructure support

• Communication support to local health departments

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““A prepared workforce is an A prepared workforce is an essential component in essential component in strengthening our national public strengthening our national public health system.”health system.”

Joseph M. Henderson

CDC Associate Director

Terrorism, Preparedness & Response

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Focus Area G:Focus Area G:Education and Training of Health Education and Training of Health

ProfessionalsProfessionals• Unique relationship

• 2 medical schools– Creighton University Medical School– University of Nebraska Medical School

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Focus Area G:Focus Area G:Education and Training of Health Education and Training of Health

ProfessionalsProfessionals• Nebraska Health Education Consortium

– 2 Co-chairs– 35 organizations

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Focus Area G:Focus Area G:Education and Training of Health Education and Training of Health

Professionals (continued)Professionals (continued)

• Statewide 2-day symposiums

• Library on Web

• BT Certification

• Speakers Bureau

• AG - LEDRS

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Statewide Preparedness Statewide Preparedness Smallpox Team Smallpox Team

• Nebraska leads nation– 2nd in smallpox vaccination per capita– 6th in number of vaccinations

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Statewide Preparedness Statewide Preparedness Smallpox Team Smallpox Team

Team can:

• Care for patient with suspected smallpox

• Conduct investigations into source of the disease, and

• Provide immunizations for close contacts

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Statewide Preparedness Statewide Preparedness Smallpox Team Smallpox Team

• Local Health Departments/local BT Coordinators

• Health Alert Network keeps health care providers informed of breaking news

• Bioterrorism Education Consortium– Library of information

• HHSS Web site• HHSS video streaming

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For more information, go toFor more information, go to

hhs.state.ne.ushhs.state.ne.us

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