phase 2: community health councils & community outreach the prepared community fall 2005

Phase 2: Community Health Councils & Community Outreach

The Prepared Community

Fall 2005

Course Developers

New Mexico Department of HealthOffice of Health Emergency Management

UNM HSC School of Medicine Center for Development & Disability

Shaening & Associates, Inc.

Contact Information

Bruce Blair, M.A.Psychosocial Community

Preparedness [email protected]

NMDOH Office of Health Emergency Management2500 Cerrillos Road, Santa Fe, NM 87505

Joan MurphyPopulation Outreach [email protected]

CHCs & Community OutreachObjectives:

to understand the Prepared Community Initiative and be familiar with Phase 1

to understand the role & importance of community outreach in emergency preparedness & response

to identify tools and procedures to provide outreach to the entire community before, during, and after a disaster

to identify tools, procedures and local networks to provide outreach targeted to people with special emergency preparedness considerations

CHCs & Community Outreach

Module 1: The Prepared Community Initiative

Module 2: What Did We Learn in Phase I?

Module 3: An Overview of Community Outreach

Module 4: Targeted Outreach

Module 5: Targeted Outreach Planning

CHCs & Community Outreach

Agenda

9:00 Introductions, Module 1 9:45 Module 210:30 Break10:45 Module 311:45 Lunch12:30 Module 4 1:45 Break 2:00 Module 5 4:00 Adjourn

The Prepared Community Initiative

• Why Are Community Health Councils Involved?

• A Refresher on Phase 1: What Do We Mean by a Prepared Community?

• Gearing Up for Phases 2 & 3: What Do We Mean by a Resilient Community?

Module 1

The Prepared Community Initiative

Positioning Community Health Councils to be collaborative partners in health-related emergency preparedness and response

• Phase 1: The Prepared Community training, Spring 2005, and development of County Health Emergency Management Profiles

• Phase 2: Community Outreach training and development of local outreach; Fall – Winter, 2005-2006

• Phase 3: Community Resilience and Mobilization Planning; Spring 2006

Module 1

Why Are Community Health Councils Involved in Emergency Preparedness?

• What are Community Health Councils? Maternal & Child Health Councils created by

the 1991 State Legislative Session In some counties, MCH Councils expanded to

become Community Health Councils; in others DWI Councils and other groups involved

Spring 2005 – N.M. Health Council Alliance established

Module 1

Why Are Community Health Councils Involved in Emergency Preparedness?

• CHCs are an integral part of the Public Health infrastructure.

• CHCs are connectors:• connected to communities at grass-roots level

• connect and collaborate with other community groups

• becoming increasingly involved in local behavioral health collaboratives

Module 1

Phase 1: A Quick Refresher

Module 1

• What makes an incident an emergency or disaster?

• How is emergency response managed?

• What do we mean by the Prepared Community?

What Makes an Incident an Emergency or Disaster?

affects entire community community needs surpass capacity include:

natural disasters human-caused disasters technological disasters economic disasters

Module 1

How Is Emergency Response Managed?

• Response begins and ends at the local level

• Responding agency (police, fire) becomes on-site Incident Commander

• Command Post is established

Module 1

How Is Emergency Response Managed?

• If the incident exceeds local capacity, the Mayor or Chief Elected Official may request state assistance.

• If the incident exceeds State capacity, the Governor may request Federal assistance.

Module 1

The Incident Command System (ICS)

• On-scene emergency management structure which insures that:

• Everyone is working within the same organizational structure.

• All participants communicate on the same level with the same terminology.

• Resources are utilized effectively.

• ICS is flexible, with the capability to expand or contract to meet the needs of the incident.

Module 1


COMMAND

OPERATIONS PLANNING

LOGISTICSFINANCE /

ADMIN.

Module 1


• The Incident Commander has overall leadership and responsibility.

• The Command Function includes public information and risk communication.

Module 1

Remember: During an emergency or disaster, all public information/risk communication MUST be coordinated through the Incident Command structure.

What is a Prepared Community?

1. Informed and involved public2. Prepared and informed professionals3. Planning, preparation and policies4. Communication systems and connectivity5. Scientific and technical support and other

resources6. Administration, management, and fiscal

systems

Module 1

Informed & Involved Public

information to help individuals & families develop emergency plans

information for non-English speakers, people with sensory disabilities, those in remote areas, & others with special response needs

culturally sensitive communication

Module 1

Informed & Involved Public:Role of the CHC

Develop relationships with County Emergency Manager, Local Emergency Planning Committee, first responder groups, Red Cross, etc.

Participate in local emergency planning and advocate for inclusion of health issues in emergency planning

Develop relationships with local/district public health offices

Module 1

Informed & Involved Public:Role of the CHC

Identify and understand various populations and vulnerable groups in community.

Identify community resources. Create network of individuals,

organizations, and agencies willing to reach out.

Module 1

Phase 2 of Our State-Wide Plan

In Phase 2 of the Prepared Community Initiative, Community Health Councils will create/develop local outreach capabilities:

• creating/developing outreach networks that would be established pre-disaster and utilized before, during, and after a disaster

• identifying the “gate keepers” / leaders / communicators

• determining how to reach the greatest number of people in the shortest amount of time (especially populations with special health care needs)

Module 1

Phase 3 of Our State-Wide Plan

• Community Health Councils will develop community resilience, mobilization, and psychosocial response plans.

• Plans will be integrated with the county’s Emergency Operations Plan (EOP).

Module 1

Remember: Always work in collaboration with local

emergency management!

Community Resiliency Is…

• The Individual• Teaching people to access their innate

resiliency• Moving beyond psychological limitations that

block one’s ability to thrive; learning problem solving skills

• Engaging, committing, volunteering• Seeing the community as part of their “family”

Module 1


• The Family

• Family support systems• Communication, cohesion, emotional connection,

mutual respect, commitment• Presence of a caring adult(s)• Spiritual wellness• Family time and routines• Family problem-solving skills• A Family Emergency Plan

Module 1


• The Community• Community support systems (social support)

• Seeing the community as a “family” inclusive of all segments of the population

• Availability of resources

• Community engagement in its process of well-being; shared concern

• The community must ultimately take ownership of the process initially begun by others.

Module 1

Community Resiliency

• Preparedness facilitates recovery.

• Preparedness facilitates rapid deployment.

• Preparedness is good role modeling for others in the community.

Module 1

On a Related Note…

• Resilience in New Mexico Schools Creating a meaningful role for youth in the

community, through: an asset-based, injury prevention program enhanced connections between CHCs, schools, and

school-based health centers new curricula, such as the High School First

Responder Course

Module 1

What Did We Learn in Phase 1?

• What do New Mexico’s counties look like?

• What did we find out in the Profiles?• What did we learn from what we

found?

Module 2

What Do New Mexico’s Counties

Look Like ?

Module 2

Counties With PopulationsLess Than 20,000

Catron (3,535)

Colfax (14,189) DeBaca (2,132) Guadalupe (4,545) Harding (751) Hidalgo (5,343) Lincoln (19,814) Los Alamos (18,305)

Mora (5,269) Quay (9,811) Roosevelt (18,121) Sierra (12,988) Socorro (18,043) Torrance (16,664) Union (3,934)

Module 2

Counties With Populations Under 20,000 Spread Over More Than 3000 Square Miles

Catron (3,535) over 6,929 square miles Colfax (14,189) over 3,757 square miles Guadalupe (4,545) over 3,030 square miles Hidalgo (5,343) over 3,446 square miles * Lincoln (19,814) over 4,831 square miles Sierra (12,988) over 4,180 square miles Socorro (18,043) over 6,646 square miles Torrance (16,664) over 3,345 square miles * Union (3,934) over 3,830 square miles *Harding (751) over 2,125 square miles (fits the same ratio)

Module 2

Our Larger Counties-Populations Over 45,000

Bernalillo (573,675) Chaves (60,177) Curry (45,022) Doña Ana (178,664) Eddy (51,139) Lea (55,655)

McKinley (73,973) Otero (61,577) Sandoval (96,071) San Juan (120,367) Santa Fe (134,525) Valencia (67,578)

Module 2

Counties With 0-19 Age Group Comprising 1/3 or More of Total Population

Bernalillo: 159,294 of 573,675 Chaves: 19,105 of 60,177 Curry: 14,981 of 45,022 Dona Ana: 57,721 of 178,664 Hidalgo: 1,743 of 5,343 Lea: 18,034 of 55,655 McKinley: 29,767 of 73,973 Roosevelt: 5,856 of 18,121 San Juan: 42,039 of 120,367 Torrance: 5,297 of 16,664

Module 2

Counties With Senior Populations (Age 65 and Over) of 4,500 or More*

Bernalillo (66,710) Chaves (8,859) Curry (5,223) Dona Ana (19,754) Eddy (7,438) Grant (5,256) Lea (6,790) Luna (4,719)

McKinley (5,332) Otero (7,786) Rio Arriba (4,672) Sandoval (10,497) San Juan (11,024) Santa Fe (15,041) Valencia (7,199)

* There are 221,091 seniors in New Mexico

Module 2

What Did We Find Out In The Profiles ?

Module 2

Populations With Different Planning Needs – Children & Youth

• 10 counties have populations 0 – 19 who make up 1/3 or more of the county’s total.

• Children are separated from families during the day (usually at school).

• Many counties report large numbers of children are unsupervised after school (few or NO after school programs).

• Elevated teen suicide rates in many counties.

Module 2

Populations With Different Planning Needs – Elderly

Module 2

• Significant number of elderly who live on their own in remote rural areas (may have limited or NO transportation).

• Counties often report 850 or more grandparent-headed households, where grandparents have sole responsibility for raising some or all of their grandchildren.

Populations With Different Planning Needs

Module 2

• Chronic Mental Illness: many counties report serious limitations in their county’s mental health resources.

• Cognitive or Developmental Issues: many counties were unable to report numbers of people in this category.

• Substance Abuse Issues: many counties indicate that as many as 1/3 or more of their populations have substance abuse issues.

• Physical Disabilities: many counties report 2,500 or more instances per county; may include elevated state-wide rates of asthma, diabetes, cleft lip/cleft palate.

Populations With Different Planning Needs

Module 2

• Non-English Speakers: many counties report 25% or more non-English speakers

• Incarcerated & Institutionalized Individuals: most counties contain at least a county or municipal jail and many contain state facilities

Populations Living In Poverty

• Tend to be uninsured or underinsured• Significantly less access to the health

care system• Children living in poverty often depend

on school lunch programs for nutritious meals

• Less prepared for emergency or disastrous events

Module 2

The Unseen/Unrecorded Populations

• The “undocumented” population• Migrant workers• The homeless• College students• Tourists – State and National Parks• A major Boy Scout camp (Philmont)

Module 2

What Do Our Counties Say Are Their Greatest Needs ?

General Health & Psychosocial Needs:

• Need to address severe shortages of medical, dental, mental health and specialist providers

• Need to promote healthier families

• Need to provide better elder care

Module 2

What Do Our Counties Say Are Their Greatest Needs ?

Emergency Management Needs:

• Need more early warning devices for “critical facilities”

• Need to address shortages of equipment (communication, vehicles, etc.)

• Need more disaster response training for fire, police, EMS and other emergency responders

• Need better communication between county agencies and integration of their plans

Module 2

What Did We Learn From What

We Found?

Module 2

Geographic Challenges

• Much of the state’s counties are rural or frontier in nature.• Small populations spread over significant

square mileage Distances, geography, poor road conditions,

and poorly maintained communications infrastructure

Small villages with only one way in & out

Module 2

Family Challenges• Significant numbers of working parents

separated from their children during the day; separation is compounded during an emergency.

• Counties often reported 1,000 or more female head-of-households with children.

• In 55% of grandparent-households, grandparents have sole responsibility for raising some or all of their grandchildren; this could represent 850 or more households.

Module 2

Community Challenges

Some counties report:

• NO current county Emergency Manager

• Emergency Operations Plans (EOPs) that are not current (with some last updated in the late 1980s)

• No pre-identified Emergency Operations Center (EOC)

• Noticeable lack of coordination between different agencies involved in emergency response

• CHCs where leadership is in disarray/disorganized

Module 2

Community ChallengesIn many counties there is:

• A lack of medical, dental, behavioral health providers and poor quality of service

• NO hospital…residents have to go to adjoining counties for services

• Minimal ambulance/EMS services• Low-literacy rates and a need for multiple language

materials for emergency response • An economy that ranges from “fragile” to non-

existent (by their own report)

Module 2

An Overview of Community Outreach

• About Community Outreach

• Variables in Outreach Planning

• Reaching the Whole Community

Module 3


Community Outreach… an essential component of preparedness &

response to public health emergencies There are things we can do before, during, and

after an emergency or disaster to reach large numbers of people in a short time.

Module 3

Remember: During an emergency or disaster, all public information/risk communication MUST be coordinated through the Incident Command structure.


Before an emergency: to provide preparedness information to

the community, including individual and family preparedness

to identify and locate persons with disabilities, the elderly and others with special response considerations

to establish relationships, trust, credibility

Module 3


During an emergency:

to provide information about: the incident, what is being done,

and the continuing risk where and how to get treatment,

including vaccination, prophylaxis

to locate and ensure the safety of vulnerable populations

Module 3


During an emergency:

to reassure people that they are safe

to validate their feelings & responses

to assess the impact of the emergency on individuals and the community

Module 3


After an emergency: to assess the ongoing needs of individuals

and the community

to help people access resources they need, including:

counseling and other psychosocial support financial assistance (FEMA, crime victims

assistance) other practical assistance

Module 3

Variables in Outreach Planning nature and magnitude of health

impact, including whether or not the illness is communicable

characteristics of community duration of outreach effort


Module 3

Communicable vs Non-Communicable Illness non-communicable: provide information

about where, when and how to get help communicable: reduce need for people to

gather in public locations to receive care


Module 3

Characteristics of Community Geographic: rural or urban; large

distances to travel; apartments or single-family homes

Cultural and language: non-English speakers; undocumented individuals


Module 3


Duration of Outreach Effort most effective if all people in target

population are contacted within 72 hours should continue until community has

recovered from event and activities have returned to normal

Module 3


Outreach mission/duration may change if: new information becomes available a secondary incident or wave of disease

happens there is a rapidly increasing number of

deaths

Module 3


CHCs can play a vital role by: identifying procedures and tools to provide

outreach to the whole community identifying procedures, tools, and local

networks to provide outreach to populations with special response considerations

First, let’s look at some approaches to providing outreach to the whole community.

Module 3

Reaching the Whole Community

The CHC can help to reach the whole community before, during, and after an emergency working with: Local media Reverse 9-1-1 Phone banks/hotlines Other methods

Module 3


Local Media (newspapers, radio & TV stations) can play a critical role:

BEFORE an emergency: disseminating public preparedness education/information establishing credibility as source of emergency information for

their audience DURING an emergency:

assisting in community mobilization activities disseminating information about where to go for help, treatment,

etc. AFTER an emergency:

disseminating information about where to go for resources, etc. disseminating information about how people can help

Module 3


Local Media – What Can Be Done? Develop and maintain media contact list,

including: names, phone numbers, and email addresses policies for Public Service Announcements (PSAs)

and advertisements deadlines for stories, ads, PSAs audience description and size

Module 3


Local Media – What Can Be Done? Engage, inform, and educate the media

about: what they can do to help local emergency management and response; the

command structure and the role of the PIO importance of alternate formats (closed

captioning, verbal messaging, etc.)

Module 3


Local Media – What Can Be Done? Remember, in an emergency, the Public

Information Officer (PIO) at the local Emergency Operations Center (EOC) or Command Post is the official spokesperson.

All media inquiries must be referred to the PIO.

Be sure you know who the PIO is and how to contact him or her.

Module 3


Reverse 9-1-1 calls phone numbers in the community &

plays pre-recorded message most useful BEFORE an emergency to alert

the community could be used DURING an emergency to

provide information about what to do, where to get help, etc.

Module 3


Reverse 9-1-1 can be programmed to target certain key

areas limited capacity (typical system can make

48 calls at one time; at 30 seconds per call, it would take 17 hours to call 100,000 households)

Module 3


Reverse 9-1-1 – What Can Be Done?

find out if your community has Reverse9-1-1 and how it works, or work to have it implemented, if feasible

work to ensure the entire community can be contacted and that specific areas or vulnerable groups can be targeted when appropriate

Module 3


Emergency Phone Lines most useful immediately BEFORE and

DURING an emergency to answer questions and let people know what to do and where to go for treatment, resources, etc.

Module 3


Emergency Phone Lines could be a temporary toll-free number set

up at the time of the emergency OR an existing hot/warm line or crisis response line expanded to deal with emergency needs

callers could get a pre-recorded message or a live operator

live operators could screen callers & refer them elsewhere for specific help

Module 3


Emergency Phone Lines – What Can Be Done? find out what hot/warm lines and crisis response

lines exist in the community research what would be required to expand the

capacity of those lines or set up a new, temporary phone bank:

additional toll-free phone lines trained phone bank volunteers strategies to inform the public about the

existence of this service

Module 3


2-1-1 Line toll-free number to help people find necessary

services and supports (food, housing, job training, childcare, medical care, etc.)

several communities have begun to develop this resource

could be a valuable resource, especially AFTER an emergency, but would require additional resources (referral sources, trained volunteers, more phone accessibility, etc.)

Module 3


2-1-1 Line – What Can Be Done? explore the use of 211 services in an

emergency: understand the types of resources

included in the 211 database and how new resources can be added

identify additional resources available and add to central 211 database

recruit volunteers if appropriate

Module 3


Presentations and Briefings BEFORE an emergency, the CHC and others could:

make presentations for community organizations, churches, schools, etc.

set up and staff booths at malls, fairs, etc. to distribute preparedness information

DURING and AFTER an emergency, the CHC and others could go to places where people are gathered (shelters, etc.) to provide information, refer people to other resources, and assess needs

Module 3

Reaching the Whole Community Other Outreach Methods

flyers – the CHC and others could develop informational flyers to be distributed by USPS, stuck on garbage cans by refuse workers, posted in key locations, left at doors; these could be useful BEFORE, DURING and AFTER an emergency

websites – the CHC and others (including CHC member organizations) could use their websites to include preparedness tips BEFORE an emergency and updates DURING and AFTER an emergency

Module 3

Targeted Outreach• Who are the individuals and

groups who might need Targeted Outreach?

• What are some approaches to Targeted Outreach?

• How do we get started?

Module 4

Who Might Need Targeted Outreach?

Community Outreach is especially critical when there are barriers to seeking & getting assistance, including:

cultural & language barriers

economic & transportation barriers

special response considerations, such as disabilities & age

Module 4


Public information and community outreach is critical in emergency preparedness and response.

The elderly, people with disabilities, people who don’t speak English, and other people with special response considerations may not always get the information they need.

These groups may require more targeted outreach in the event of an emergency.

Module 4


It’s important that people with disabilities and other response needs have access to resources they need to prepare for, survive, and recover from an emergency.

While we know approximate numbers of people with different types of disabilities and other response needs, we don’t have any comprehensive list of who they are, where they live or what those needs are.

Module 4


Many local, community-based organizations DO know their members, friends and members.

AND, the Health Emergency Management profiles you created for your communities contain more specific information on people with disability and other special response considerations.

Module 4


• Children• Elderly• People with chronic mental illness • People with substance abuse problems• People with developmental disabilities• People with physical disabilities

Module 4


• People with visual impairments• People who are deaf or have hearing

impairments• Non-English speaking populations• Undocumented individuals• People who are homeless• Incarcerated and other institutionalized

people

Module 4

Targeted Outreach Approaches

Some of the approaches to provide outreach to the whole community could be effective for targeted groups as well, including reverse 9-1-1, presentations and briefings, and flyers.

Some additional, more targeted approaches could include: door-to-door contact phone trees word of mouth buddy system

Module 4


Door-to-Door most labor intensive but most thorough decisions include:

Who will be visited? Who will make the contact? Who has most

credibility, trust? How long will they spend at each place? What if no one answers the door?

Module 4


Phone Trees also labor intensive decisions include:

Who will be called? Who will make the contact? Who has most

credibility, trust? What if no one answers the phone?

Module 4


Both door-to-door contact and phone trees can be used: BEFORE an emergency, to notify people of a

possible event; provide preventive information

DURING an emergency, to ensure people know what to do and where to go

AFTER an emergency, to ensure people have the resources they need to recover from the emergency

Module 4


Word of Mouth Include message in emergency alerts to pass on

the information (“If you know someone who may not be receiving this message…”)

“Check Your Neighbors” Encourage community members to look in on

their neighbors, especially people who may need special assistance.

Buddy System Identify community members to serve as

“buddies” to people with disabilities and other special response considerations.

Module 4

How Do We Get Started? identify & train a network of individuals,

organizations, and agencies willing to reach out

identify effective and appropriate outreach methods/channels for your community

identify & develop tools and materials

establish procedures for mobilizing the community network

Module 4

Recruiting Network Members Who Would Be a Good Network

Member? knowledgeable about the community

trusted by the community

knowledgeable and respectful of different cultures

Module 4

Recruiting Network Members Who Would Be a Good Network

Member? comfortable initiating conversations with people

who have not asked for help

able to quickly establish rapport and credibility

quick thinking and diplomatic

Module 4

Recruiting Network Members

A good place to start: members of your Council & organizations in your Community Profile

Use your network of contacts, friends, and organizations you know.

Search out and locate grass-roots organizations in your community.

Search for “opinion leaders” – people who are well known and respected in the community – again, use your Community Profile.

Module 4

Recruiting Network Members Possible Members of the Outreach

Network: advocacy & consumer organizations service providers businesses serving people with disabilities lay community health leaders

(promotoras, CHRs) American Red Cross

Module 4


Module 4

Possible Members of the Outreach Network: HAM radio operators civic & service organizations faith-based organizations neighborhood associations school organizations


Getting the word out… Conduct Town Hall meetings and make

presentations to community groups, churches. Place ads and PSAs, distribute flyers. Collaborate with your local Emergency Manager

and LEPC. Collaborate with existing volunteer

organizations (Red Cross, VOAD, etc.).

Module 4

Training Network Members

Network Members will need: familiarity with your procedures for

activation, tracking, etc.

familiarity with community resources

“just-in-time” training related to the specific situation

Module 4

Training Network Members

Look for additional training opportunities, such as: Answering the Call Psychological First Aid Cultural Competence Stress Management

Module 4

Identifying Outreach Methods

What are the best methods or channels for disseminating information in your area?

What technological issues would affect your choice of method (phone line capacity, internet access, etc.)?

What factors would affect door-to-door contact and other in-person contact?

Module 4

Identifying & Developing Tools

Build a library of informational materials, such as tips for responders, family and individual guides for preparedness, flyers, fact sheets

Develop a list of websites to search for additional information

Module 4

Establishing Procedures Develop and regularly update your

Network contact list. Develop a way to communicate with

partners (phone tree, listserv, etc.) Develop protocols for mobilizing the

network, tracking contacts made, etc.

Module 4



Implementing Your Outreach Plan

Before an emergency: Establish relationships with targeted population

groups, build trust and credibility. Provide information to responders on locating

vulnerable populations. Provide information to responders on working

with vulnerable populations.

Module 4


Before an emergency: Disseminate information to the community (tips

on coping, community resources, where to get help, etc.).

Make presentations to schools, churches, employers, community centers.

Module 4

Implementing Your Outreach Plan During an emergency:

Activate Outreach Network (via phone trees, email, etc.).

Distribute relevant informational materials, fact sheets, etc. to members of the Outreach Network about the incident, where people need to go to get help, what is being done, ongoing risks, etc.

Implement outreach (door-to-door contact, visits to shelters, distribution of flyers, etc.).

Module 4


During an emergency: Remember, always work in collaboration

with local emergency management.

Refine outreach plan depending on specific emergency.

Update voice mail message to provide emergency information, how to reach your organization, etc.

Module 4


After an emergency: Continue outreach (door-to-door contact,

visits to shelters, etc.) to assess ongoing needs.

Continue to provide information about the situation, where to get help, etc.

Module 4


After an emergency: Review what happened. What worked? What

didn’t? How might your outreach planning need to change?

Use this as an opportunity to get the community involved in “visioning the future.” What is needed to make the community more resilient? What are the community’s strengths?

Module 4



phase 2: community health councils & community outreach the prepared community fall 2005

Documents

community resilience

community outreachobjectives

community groupsbecoming

resilient community

prepared community training

community outreach training

emergency response

maternal child health