Polk County Special Populations Planning

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Polk County Special Populations Planning

• Jay Shrader, DirectorWestern Region Partnership
  for Public Health Preparedness
• Kathy Poirier, DirectorPolk County Emergency
  Management
• Rick Gates, Veterans Service Officer
• Polk County Veterans Affairs

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Polk County

• Population 43,319
• Age Distribution
• Under 5 5.9 (6.4)
• Under 18 26.2 (25.5)
• Over 65 15.1 (13.1)
• Persons below poverty 7.1 (8.1)
• Persons per square mile 45.0 (98.8)
• Persons with a Disability (age 5) 6,860
  (790,917)
• 8 Public Schools, 3 Parochial, 3 Medical Centers
• 45 Minutes from MPLS/St. Paul
• Largest Municipality 2,800
• 2 radio stations, no daily newspapers
• 400 lakes and rivers heavy tourist area

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Objectives

• Provide overview of the Polk County Special Needs
  Plan for Disasters and Emergencies
• Provide overview of the Polk County Special Needs
  Registry
• Discuss successes, unexpected findings, and
  barriers

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The Catalyst

• Following Hurricane Katrina, Governor Doyle
  ordered evacuation plans
• CDC / HHS placed great emphasis on special
  populations planning
• After Action Report from recent exercises
• Media and stakeholders inquiries forced action
• Polk County resident approached County Board
  Chairperson

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The Process

• Process took from May - November of 2006
• Established and received buy-in from core
  committee EM, PH, VA, HS, Home Care, Aging
• Research and fact finding
• Seminole County EM, Florida
• Community engagement
• 12 meetings 120 participants
• Business, government, special needs individuals
• Plan and Registry reviewed and signed into County
  EOP (Annex E) in November 2006
• Registry live in December
• Website Developed with on-line registry
  www.co.polk.wi.us/emgt

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The Plan

• Goal Reach everyone in a community!!!!
• Shelter-in-Place vs. Evacuation
• CDC Categories Economic Disadvantaged, Limited
  Language Competence, Disability, Cultural /
  Geographic Isolation, Age, and Pets/Animals
  (Added by Committee)

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The Plan

• Category, Subset, Point of Contact, Barriers to
  Reach / Concerns, Estimated Population Size,
  Communication Mechanism, Location, Action Needed

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The Registry

• Result of planning process Committee driven
• Intended for individuals with severe health and
  medical needs
• Purpose of Registry is two fold
• Special needs can self-identify
• Emergency Responders have data to foster
  effective response
• Both on-line and paper applications
• 2006 Planning Year 2007 Implementation, Testing,
  Exercising 2008 Updating and Revising
• Registry has 22 individuals thus far

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The Registry

• Disclaimer, disclaimer, disclaimer on forms,
  posters, website, etc The Registry is a
  voluntary program and in no way ensures immediate
  or preferential treatment in an emergency.
  Individuals must have their own individual plan
  for the first 48-72 hours of an emergency.
• Information to be used only during an emergency.
• Corp Counsel reviewed legal and liability issues
  including HIPPA (based on HHS Memo re Hurricane
  Katrina and voluntary approach)

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HHS Memo re HIPPA
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Registry Eligibility

• The Registry is for those individuals who are not
  in a care facility, such as a hospital, nursing
  home or congregate living facility. These
  facilities are required to have an evacuation
  plan in place for their residents and patients to
  be transported to another healthcare facility.
  The Registry is for individuals who are not part
  of a group facility and have no other alternative
  but to seek assistance from the County. 
• Must be a Polk County resident.
• Individuals, who due to mobility restrictions,
  require assistance of others with medical
  management activities of daily living and basic
  needs, when that assistance may be unavailable
  during an emergency or disaster.
• They have a respiratory condition requiring
  special equipment such as monitors or oxygen.
• There may be other conditions which would render
  an individual eligible for special needs
  emergency sheltering and these will be considered
  by the review of the registration form by a
  Review Team. 

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The Registry Operations Flow
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The Registry at Work

• During an incident, EM will query the database to
  determine affected population.
• EM will notify ER partners via phone, email,
  dispatch, radio or fax of special needs
  population in geographical area. EM may work
  with local PH to develop a Command Caller
  Scenario.
• EM or designee will attempt to contact individual
  or emergency contact of the incident and
  provide/receive status.
• ER community will use data to establish an
  effective response.

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Other Issues

• Cost In kind support of approx 600.00 per year
  for materials
• Staffing EM Director manages logistics Review
  Team oversees operations
• Maintenance registrants must update application
  annually
• Training training to ER responders on the
  registry and ethical considerations when dealing
  with special populations (section in plan)

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Registry Levels of Enrollment

• Determined by Review Team
• Level 1 Requires urgent attention. Individuals
  medical information indicates immediate emergency
  response assistance is necessary for survival.
• Level 2 Requires moderate attention.
  Individuals medical information indicates an
  eventual emergency response is necessary but is
  not considered immediate or life-threatening.
• Level 3 Requires little attention. Individuals
  medical information indicates there is no
  immediate attention required. However, if time
  and resources permit, the individual should be
  contacted by emergency responders.
• Not eligible for the program.

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Registry Examples Level 1

• 45 YR Male Live with spouse hearing loss, end
  stage renal failure (life sustaining equipment)
• 65 Yr Male lives alone severe diabetic, left
  leg amputated, wheelchair, partially deaf and
  blind, insulin dependant
• 44 Yr Male Lives with caregiver gun-shot in
  chin, paralyzed from neck down

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Registry Examples Level 2, 3

• Level 2
• 90 Yr Female lives alone, blind
• Level 3
• 74 Yr Male lives with spouse, cancer of the
  stomach (removed), g-tube feeder special dietary
  needs
• To be reviewed
• 64 Yr Male lives with spouse, laryngectomee
  (neck breather), in emergency oxygen must be
  administered through the throat.
• 76 Yr Female lives alone, dementia, diabetic,
  arthritis, life sustaining medications.

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Website FAQ
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Online Application
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Paper Application
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Registry Poster
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Letter Sent
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Resource Sent
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What worked?

• Core committee very dedicated
• Support from administration and department heads
• Community buy-in and participation
• Debate is healthy were a very healthy
  committee!
• In-kind support (IT, Corp Counsel, EM, VA, PH,
  Home Care, Aging)
• Its working, so far!

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Barriers

• Defining Special Populations
• Levels of Enrollment in Registry need to be more
  defined
• Must have same individual (s) facilitate the
  process from A to Z
• Must have same agency reps in process from A to Z
• Time consuming resource intensive
• Long term commitment unknown yet
• Marketing
• Getting people signed up
• Equal workloads among players!!!

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Unexpected Findings

• Positive public perception of local government
• Cohesion among community agencies and
  governmental departments
• Excitement and enthusiasm
• Interest among counties across WI

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Next Steps

• MOUs with participating agencies
• Establish Line of Succession
• Continue Outreach Training / Education
• GIS (Geographic Information Services)
• Exercise

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Questions?

• Jay Shrader jasons_at_co.polk.wi.us(715)485-9116
• Kathy Poirierkathyp_at_co.polk.wi.us(715)485-9280
• Rick Gatescvso_at_co.polk.wi.us(715)485-9244