Eastside I

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Eastside I Q TabletopDecember 10, 2004

• Testing Community Resources

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Purpose

• The purpose of this is to test the current Zone
  One Plan for the human services network in East
  King County and assess community capacity to
  assist quarantined patients.

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Roles

• Community Based Providers
• Work with Crisis Clinic to respond to client
  needs
• Secure needed supplies / services
• Coordinate / provide delivery of supplies and
  services
• Keep Crisis Clinic apprised of service delivery
  status, any emerging issues or problems
• PH Risk communication

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• Crisis Clinic
• Assist PH by identifying appropriate providers
  for needed services to those in home isolation or
  quarantine
• Coordinate and monitor service delivery with
  providers
• Keep PH apprised of service delivery status, any
  emerging issues or problems

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Objectives

• Clarify the capacity and gaps in the ability of
  community partners to respond to the need for the
  delivery of food and financial assistance.
• Demonstrate that the communication paths within
  Zone 1 Plan between Public Health, Crisis
  Clinic, Hopelink, DSHS and Zone One Emergency
  managers convey the necessary information to all
  partners to assure the food and financial needs
  are met.
• Demonstrate agencies ability to protect client
  confidentiality and maintain consistent public
  health messages.

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Ground Rules

• This will be a structured exercise in a
  controlled environment that allows for meaningful
  dialog leading to realistic strategies and
  approaches. The tabletop is intended to test the
  Zone 1 Plan. If the plan does address a concern,
  please note it. The lessons learned from this
  tabletop exercise will be used to assess and
  adjust the plan, and evaluate systems needed to
  respond to and recover from a community
  quarantine situation.

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Ground Rules (cont)

• Make your best decision based on the information
  that is presented.
• Respond according to your knowledge of the plan,
  procedures and resources. It is ok not to
  know.
• There may be no pat answer.
• It is OK to disagree. Identify the key issues
  contributing to the disagreement and agree to
  find solutions in the future.

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Assumptions

• Public Health - Seattle King County
• Public Health Emergency Operations Center will be
  activated
• Public Health Nurses are monitoring the health,
  medical, prescriptive and daily needs of those
  quarantined.
• PHSKC is issuing press releases daily on the
  status of the outbreak.
• Zone One EOC is on stand by and is in
  communication with Public Health.

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Scenario Background

• A health care provider at our Eastgate Public
  Health Center has recently returned from China. 
  She returned to work and began seeing patients. 
  Her caseload is comprised of low-income, with a
  significant number of limited -English speaking
  patients (Spanish, Russian, Hmong).   
• After a few days back at work, she developed a
  fever and respiratory symptoms.  Due to a staff
  shortage, she continued to work for a few more
  days.  Her symptoms progressed and she was seen
  by another healthcare provider.  Due to her
  symptoms, travel history and because of current
  cases of SARS in China, she was diagnosed as a
  probable suspected SARS case.
• The patients on her caseload range in age from 0
  through adulthood. They live in various
  communities on the Eastside and we now have 100
  patients plus their family members who may have
  been exposed to SARS. They will all be
  quarantined for 10 days.

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Scenario Background (cont)

• Due to the severity of her symptoms and high
  suspicion for SARS, a decision is made to
  quarantine the patients who have been exposed to
  the worker.  In certain cases, family members
  were exposed as well and will need to be
  quarantined.

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Day One Scenario

• Public Health has been in contact with the 72
  quarantined persons. Staff have given the names
  and contact information to the Crisis Line
  Liaison. They have the following needs
• Fifteen families in the Redmond area speak
  Russian and need food by tomorrow dinner
  time. 15
• Twenty-five of the income earners in these
  families don't have sick days and will lose
  money if they don't go to work.  They have no
  savings and will need financial assistance to be
  able to stay in their homes for the 10 day
  quarantine. The dollar total is approximately
  20,000.00 average rental is 800 a month 25
• We also have 3 newspapers (El Mundo, the Korean
  Times and the Asian Weekly ) who  have called and
  started showing up at Hopelinks Redmond food
  bank, Crisis Clinic DSHS and at Bellevue City
  Hall  looking for a story. 15

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Day Two Scenario

• At 11 Am the Crisis Clinic liaison is notified
  by PHSKC about the needs for the day. Crisis
  Clinic calls or faxes to DSHS, Hopelink, and the
  Zone 1 coordinator the following requests
•  
• 3 need a TANF review this week to keep benefits
  coming. 5
• Sixty five (65) Spanish-speaking families are
  scattered between Kirkland, Woodinville and
  Bothell who need food (including corn meal,) and
  other basic toiletries. All live in a variety of
  apartment buildings with a common hallway.  15
• Two people don't have a phone, they use their
  neighbors. In order for monitoring to take place
  they need a cell phone. 5
• The Korean Times  reporter is pursuing
  information at DSHS that they have heard there
  are orders that have been issued for
  less-than-compliant folks. 15

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Day Three

• At 400 PM the Crisis Clinic liaison is
  notified by PHSKC about additional needs
  identified on Day three. Crisis Clinic calls or
  faxes to DSHS, Hopelink, and the Zone 1
  coordinator the following requests
•  
• We have 5  Hmong families living in Duvall that
  need culturally appropriate food (fresh veggies).
  Some need respite care for their elderly
  relatives and 3 need help with natural gas,
  water, sewage and garbage bills. 20

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(Day Four)

• PHSKC notifies Crisis Clinic that
• All rely on TV for their news and
  entertainment.   Most subscribe to satellite TV
  because of their multilingual programming. All
  are at risk of losing this vital connection to
  the world because of lack of money to pay the
  bill. 5

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Day Five

• Some are very worried and keep imagining that
  they have more illness. 20
• A reporter from El Mundo that is calling around
  to every agency for  a  story about an ill staff
  member. 10

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Next Steps

• Revise plan
• Memos of Understanding