Preparedness - KCHC

Summer 2011 ▪ Vol. 6, No. 2
SEATTLE & KING COUNTY
Healthcare
Preparedness
A NEWSLETTER FOR HEALTHCARE PROFESSIONALS THROUGHOUT SEATTLE & KING COUNTY
September is National Emergency
Preparedness Month
Eighth Annual National Preparedness Month in September: "A Time to
Remember. A Time to Prepare," Encourages Americans to Take Simple
Steps to Prepare for Emergencies
FEMA NEWS RELEASE 2011
WASHINGTON, D.C. -- The eighth annual National Preparedness Month
will kickoff this September, using the slogan: "A Time to Remember. A
Time to Prepare." The campaign seeks to transform awareness into action
by encouraging all Americans to take the necessary steps to ensure that
their homes, workplaces and communities are prepared for disasters and
emergencies of all kinds.
"As we move forward with planning for this year's events and activities,
we also recognize that this September marks the ten year anniversary of
the 9/11 terrorist attacks," said FEMA Administrator Craig Fugate. "By
doing what we can to ensure that our communities, and our nation, are
prepared to respond and recover from all types of disasters and hazards,
we honor the memory of those who were lost that day."
While NPM is held each September, FEMA's Ready Campaign promotes
individual emergency preparedness at home, in the workplace, and
throughout America's communities throughout the year. Ready is a
national campaign, produced in partnership with The Ad Council,
designed to educate and empower Americans to prepare for and
respond to all types of emergencies, including natural disasters and
potential terrorist attacks.
The Ready Campaign's websites (ready.gov and listo.gov) and toll-free
numbers (1-800-BE-READY and 1-888-SE-LISTO) provide free emergency
preparedness information and resources available in English and Spanish.
Full Release: http://www.fema.gov/news/newsrelease.fema?id=56745
National Preparedness Month
was originally created by
FEMA’s Ready Campaign in
response to the tragic events
of 9/11 in order to educate
the public on how to prepare
for emergencies. This
September marks the 10th
anniversary of the 9/11
attacks.
INSIDE THIS ISSUE
Preparedness News 2
Healthcare Coalition News 8
Training Opportunities 13
Conferences & Exercises 15
The King County Healthcare Coalition is administered by Public Health – Seattle & King County
www.kingcountyhealthcarecoalition.org

Save Lives
and Build
Resilience
Tale of
Our Cities
Planning for an
Interdisciplinary
Response to
Terrorist Use
of Explosives
Please join us for
this
unprecedented
gathering of
experts
from around the
world who will
share how their
first-hand
experience
of terrorist events
can benefit your
local planning.
Invited speakers will
include exper ts from
Israel, Pakistan,
India, and London.
MARK YOUR
CALENDARS:
Monday
Nov. 7, 2011
DoubleTree
Seattle Airport
Department of Homeland Security Progress
Fulfilling 9/11 Commission Recommendations
Department of Defense News Release
WASHINGTON—Seven years after the release of the 9/11 Commission report, Secretary
of Homeland Security Janet Napolitano released a Department of Homeland Security
(DHS) report highlighting the significant progress that DHS, along with its many
partners, have made in fulfilling specific recommendations by the 9/11 Commission to
build a country that is stronger, safer and more resilient.
“September
“Ten years after the September 11, 2001 attacks, America
is stronger and more resilient than ever before, but threats
from terrorism persist and challenges remain,” said
Secretary Napolitano. DHS and its many partners across
the Federal government, public and private sectors, and
communities across the country and around the world
have worked since 9/11 to build a new homeland security
enterprise to better mitigate and defend against dynamic
threats, minimize risks, and maximize the ability to respond
to and recover from attacks and disasters of all kinds.
To view the Department’s full report please visit:
www.dhs.gov/9-11-progress-report
will mark the ten
year anniversary
of 9/11; we will
remember those
lost, honor our first
responders, and
renew our
commitment to
prepare and plan
for emergencies.”
Terror Threat 'Most Heightened' Since 9/11
ABC NEWS | By Jason Ryan and Devin Dwyer
The threat of terrorism is at "its most heightened state" since the 9/11 attacks nearly a
decade ago, U.S. Homeland Security Secretary Janet Napolitano said recently. “The
terrorist threat facing our country has evolved significantly in the last ten years -- and
continues to evolve -- so that, in some ways, the threat facing us is at its most
heightened state since those attacks," she said before the House Homeland Security
Committee. Her comments were a sobering reminder that the potential of another
attack is real and growing, most notably from individuals radicalized inside the United
States, despite elaborate security measures implemented by the government since
2001. "One of the most striking elements of today's threat picture is that plots to attack
America increasingly involve American residents and citizens," Napolitano said.
Full Article: http://www.infowars.com/terror-threat-most-heightened-since-911-napolitano-says/
Nationwide Test of the Emergency Alert System
FEMA NEWS RELEASE
The U.S. Department of Homeland Security's Federal Emergency Management
Agency and the Federal Communications Commission (FCC) will conduct the first
nationwide test of the Emergency Alert System. The nationwide test will occur on
Wednesday, November 9 at 11:00am PST and may last up to three and a half minutes.
The EAS is a national alert and warning system established to enable the President of
the United States to address the American public during emergencies. A national test
will help the federal partners and EAS participants determine the reliability of the
system and its effectiveness in notifying the public of emergencies and potential
dangers nationally and regionally.
2

Enabled Mobile Devices Will Receive Emergency
Alerts with Potentially Life Saving Messages
FEMA NEWS RELEASE
Mayor Michael Bloomberg, FEMA Administrator Craig Fugate, FCC Chairman, top
executives from AT&T, Sprint, T-Mobile and Verizon and others convened at the World
Trade Center site to announce PLAN--the Personal Localized Alerting Network. PLAN is a
free service that will allow customers with an enabled mobile device to receive
geographically-targeted, text-like messages alerting them of imminent threats to safety in
their area. This service will be available in New York City by the end of 2011, at least
two calendar quarters before the rest of the nation.
PLAN ensures that emergency alerts will not get stalled by user congestion, which can
happen with standard mobile voice and texting services. Authorized government officials
can send messages, which participating wireless providers then push using their cell
towers to enabled mobile devices in a targeted geographic area. “This new technology
could become a lifeline for millions of Americans and is another tool that will strengthen
our nation’s resilience against all hazards” said FEMA Administrator Fugate.
When PLAN is operational, customers in an area affected by an emergency who have a
PLAN-capable mobile device will receive an alert of ninety characters or less. Consumers
will receive three types of alerts from PLAN: (1) alerts issued by the President; (2) alerts
involving imminent threats to safety of life; and (3) Amber Alerts.
Participating carriers may allow subscribers to block all but Presidential alerts.
SMS Text
Messaging
for Public
Health
Emergencies
DID YOU KNOW…
According to
CTIA Wireless
Association, Billions
of text messages
are sent every day
in the US, and the
vast majority of
people have a cell
phone in their
pocket that can
send and receive
text messages.
More on PLAN: blog.fema.gov/2011/05/plan-another-part-of-publics-emergency.html. Public Health –
Full Article: http://www.fema.gov/news/newsrelease.fema?id=54888
HHS Toolkit of Public Health Emergency Text
Messages
US Department of Health and Human Services Press Release
A new toolkit of prepared cell phone text messages advising
people how to protect their health after a disaster is available
now through the U.S. Department of Health and Human
Services. These messages support state and local emergency
managers in disaster response and are available online at
http://emergency.cdc.gov/disasters/psa.
The toolkit currently features text messages relevant to
hurricanes, floods and earthquakes.
Full Article:
http://www.hhs.gov/news/press/2011pres/06/20110609b.html
911 will Soon Accept Texts, Photos, Video
Mashable.com | Erica Swallow
The FCC wants Americans to be able to send texts, videos, photos and location data to
911. An FCC plan will update the technology that powers the current 911 emergency
response system. The official project name is Next Generation 911-NG911. The plan will
enable the transmission of text messages, voice calls, videos and photos, as well as
automatic location information. The FCC hopes that such a plan will enable emergency
responders to respond faster while also giving individuals more options for contacting
911.
Seattle & King
County have
launched an
important new
initiative to
investigate how
this powerful
mobile technology
can be best used
to protect and
promote the
health of our
residents,
particularly in an
emergency:
To See the full
Report Visit:
http://www.kingcounty.go
v/healthservices/health/pr
eparedness/texting.aspx#o
verview
3
43

How a Vancouver Hospital Readied
for the Hockey Riots
CTV NEWS | Angela Mulholland
A police car burns during a riot in
downtown Vancouver,
Wednesday, June 15, 2011.
(Geoff Howe / THE CANADIAN PRESS)
Remembering this spring's Stanley Cup riots in Vancouver can still make
many Canadians cringe. The four hours of destruction that rained down
on the city stunned the whole country. But St. Paul's Hospital in
Vancouver's downtown had actually had been preparing for them since
long before the playoffs began. For each playoff game, as many as
75,000 people had filled the downtown to watch on giant screens. By the
time Game 7 rolled around, tension was mounting and hospital staff
knew that even with a win, there was going to be trouble.
By 10 p.m. that night, the riots were well underway and the injuries
pouring in. But St. Paul's was ready to handle them, says Jeanette
Beattie, the hospital's head of emergency preparedness.
Like many large hospitals in Canada, St. Paul's has staff whose sole job is to plan the hospital's response to
disasters, manmade or otherwise. Beattie says on the night of the hockey riots, St. Paul's was able to make use
of all the training and preparations done ahead of the Vancouver Olympics. They had practiced what they'd
do by running mock scenario drills. One major exercise they practiced involved police, paramedics, and 85
volunteers in full costume and "moulage" makeup pretending to be injured passengers from a plane crash.
Beattie says in all, 140 groups took part, learning how to coordinate an efficient response that would allow the
injured to be transported and treated quickly.
On the night of the riots, things started to get ugly around 8
p.m., when spectators started throwing bottles and burning
Boston Bruins jerseys. By 10 p.m., there were so many injured
pouring into St. Paul's and nearby Vancouver General Hospital,
both declared a Code Orange -- hospital code for an influx of
mass casualties. Staff were asked not to go home after their
shifts but to help out in the emergency department in whatever
way they could. Nine physicians were brought into the ER,
instead of the usual two, and more security staff were called in.
A contingent of nurses was assigned to run a pre-arranged
decontamination station outside the ER, for the tear gas injuries.
They set out garbage bins filled with water so people could
dunk their heads to relieve the burning from the gas. By keeping
the tear gas injuries outside, staff ensured the ER itself was never
contaminated with the powder.
Tear gas was expelled very close to the hospital,
forcing an emergency shut off of St. Paul’s HVAC
system; meaning that the hospital's operating rooms
were no longer "negative pressure rooms"
(Geoff Howe / THE CANADIAN PRESS)
Other staff operated a triage station in a courtyard outside the emergency department to treat those with
minor injuries. Inside, doctors dealt with the more serious injuries, such as stab wounds, burns, and broken limbs.
Other nurses were also asked to help patients who were having trouble with the psychological impact of the
night. "People really were traumatized. There was the fear, the pepper spray, boyfriends hurt, girlfriends hurt. So
we had two psychosocial leads come in," says Beattie.
In all, 147 injured rioters and bystanders headed to St. Paul's ER -- most of them arriving in a two-hour period --
about twice as many as the emergency department typically sees in a night. Only four had to be admitted.
Beattie says the system ran smoothly amid the chaos and pretty much according to plan. The only thing that
the hospital had not prepared for was the drifting tear gas.
That lesson will likely be integrated into the hospital's planning as it gets ready for the next disaster, because as
Beattie points out, when it comes to disaster management, "the planning never stops."
Full Article: http://www.ctv.ca/CTVNews/Canada/20110805/vancouver-riots-hospital-preps-110807/
HEALTHCARE PREPAREDNESS Seattle & King County 4

In Joplin's Tornado Emergency, Electronic
Health Records Were Key
NPR BLOG| Alan Greenblatt
In the days following the devastating tornado in Joplin, Mo., one of the reports widely
shared locally was news of X-rays having been blown all the way to Springfield, some
70 miles away. The hospital that lost those X-rays, St. John's Regional Medical Center,
was badly damaged by the storm and has been shut down. But it still has its patient
records intact. The hospital had completed its conversion to electronic health records
on May 1 — three weeks before the storm.
A mobile field hospital has been set up in the St. John's parking lot, complete with CT
scans and surgical theaters. And St. John's patients going to facilities elsewhere are
finding that their prescriptions and treatment schedules are available to providers.
"The bottom line is, if we didn't have the electronic health records, we would not be
back operational today," says Mike McCreary, chief of technology services for the
Sisters of Mercy Health System, which runs St. John's.
The experience in Joplin suggests that patient records may be more securely
preserved electronically than on paper or on film. But you still need power to access
them.
Full Article: http://www.npr.org/blogs/health/2011/06/12/137106957/in-joplins-tornado-emergencyelectronic-health-records-were-key
Majority of U.S. Hospitals Meet All-Hazards
Preparedness Measures
HHS Press Release
More than 76 percent of hospitals participating in the National
Hospital Preparedness Program (HPP) met 90 percent or more
of all program measures for all-hazards preparedness in 2009,
according to a report released by the U.S. Department of
Health and Human Services’ Assistant Secretary for
Preparedness and Response.
From Hospitals to Healthcare Coalitions: Transforming Health
Preparedness and Response in Our Communities, the
program’s first state-by-state report, identifies the advances
that states have made in preparing hospitals for all types of
disasters. The report also discusses the next steps the program
will take to boost community resilience.
From
Hospitals to
Healthcare
Coalitions:
Transforming
Health
Preparedness
& Response in
Our
Communities
The Hospital
Preparedness
Program (HPP) has
become a critical
component of
community
resilience and
enhancing the
response
capabilities of our
healthcare system.
The report
describes the
achievements of
our State partners
in building
healthcare
preparedness
across the nation.
To see the
agreement visit:
http://www.phe.gov/Pre
paredness/planning/hp
p/Documents/hpp-
healthcarecoalitions.pdf
All states, eight U.S. territories and four large metropolitan areas participate in the
cooperative agreement grant program, which provides federal funds, technical
assistance, and guidelines for hospital preparedness. Of the more than 6,300 hospitals
across the nation, more than 85 percent take advantage of the program.
The report suggests that, as an increasing number of hospitals meet performance
measures program, participants also focus on building coalitions within communities
so that hospitals, government agencies, non-government organizations, businesses,
and community residents work as a team to prepare for and respond to disasters. The
report recommends that these coalitions involve all populations within communities,
including children, pregnant women, the elderly, and those who are vulnerable in
other ways.
Full Release: http://www.hhs.gov/news/press/2011pres/05/20110505a.html
5

Bacteria Detected by Air Monitor in East King County:
No Human Health Effects
Subsequent test negative; findings consistent with naturally occurring bacteria
WA Department of Health & Public Health-Seattle & King County News Release
A federal air monitoring system
designed to monitor threats to human
health in the Puget Sound region
recently identified bacteria that can
cause tularemia, an infectious disease,
in a daily air sample taken from a
monitoring station in east King County.
Bacteria levels were low, close to the
detection limit, and a subsequent test
found no bacteria present. Since the
air monitoring system was established
nationally in 2003, similar positive test
results due to naturally-occurring
bacteria have been common in other
areas of the country.
The bacteria, Francisella tularensis, are
found throughout Washington,
commonly carried by rabbits, squirrels,
and other rodents. People rarely are
infected with tularemia; only two cases
have been identified in Washington this
year. Typically, Washington sees
between one and 10 human cases per
year.
State and local officials agree the
detection shows the public health
response plan worked.
The air monitors detected bacteria
even though levels were low, state
and local health teamed with law
enforcement and confirmed there’s
no threat, and research showed no
signs of illnesses reported in the area.
Notice has been sent to area health
care providers.
The air monitoring system that
detected the bacteria is called
BioWatch, a federal program that
operates nationwide in major
metropolitan areas. The program
routinely collects air samples and
tests them for trace amounts of
biologic material that could be due
to either an intentional attack or a
natural occurrence. There are several
monitors located throughout the
Puget Sound area in King, Pierce, and
Snohomish counties. This is the first
time that a sample from the Puget
Sound area has tested positive.
Locations of the monitors are
withheld for security purposes.
Full Release:
http://www.doh.wa.gov/Publicat/2011_news/11-112.htm
Francisella tularensis is very
infectious. A small number
(10-50 or so organisms) can
cause disease. If F. tularensis
were used as a weapon, the
bacteria would likely be made
airborne for exposure by
inhalation. People who inhale
an infectious aerosol would
generally experience severe
respiratory illness, including
life-threatening pneumonia
and systemic infection, if they
are not treated. ~ CDC
Radiation Levels Mapped in Puget Sound by Helicopter
WA Department of Health News Release
Lessons from the nuclear incidents in Fukushima, Japan show the value of a
project to measure background radiation levels in several parts of the state. A
low-flying helicopter will gather radiological readings this summer around
Puget Sound. Radiation detection equipment mounted in a helicopter will
measure “gamma emitters” like cesium and radioactive iodine — materials
that would likely increase in a radiation emergency. This kind of material
releases X-rays, or gamma radiation, a type that can be easily measured from
the helicopter. State radiation experts expect to find natural radioactivity and
material produced by licensed radioactive material users such as hospitals.
Mapping the normal amounts and location of radioactive material will provide
a baseline for comparison to assess contamination if there were a nuclear
incident like the events in Fukushima.
The Washington State Department of Health is overseeing the project as the U.S. Department of Energy’s Remote
Sensing Laboratory Aerial Measurement System conducts the flyover. Information about the project is available
on the agency Aerial Radiological Survey website www.doh.wa.gov/ehp/rp/rep/aerial.htm .
HEALTHCARE PREPAREDNESS Seattle & King County
6

FEMA Won't Pick Up $30
Million Tab to Prepare
for Flooding
SEATTLE TIMES │Craig Welch
They lined up more than 100,000 feet of giant
sandbags, relocated offices, installed emergency
pipes and generators and even elevated
streetlights to keep them dry and visible.
King County, the State and four area cities spent more than $30 million in 2009 because
the federal government said it might have to flood the Green River Valley so the
damaged Howard Hanson Dam wouldn't blow. But the Federal Emergency
Management Agency (FEMA) still refuses to help foot the bill, arguing that there was
never an imminent threat. "That's just baffling to us," said Hillman Mitchell, King County's
emergency-management director. "Uniformly, everyone has been surprised by these
denials."
The dispute dates back to January 2009, when a series of storms seriously weakened the
right abutment of the Howard Hanson Dam. It wasn't until late that summer that Col.
Anthony Wright, with the U.S. Army Corps of Engineers in Seattle, said he feared that if
future rains filled the reservoir behind the dam to capacity the structure would fail. He
said he believed there was a 1 in 3 chance he might have to inundate Auburn, Kent,
Renton and Tukwila to avoid a more deadly catastrophe.
Because that part of South King County is home to 26,000 residents and 100 million
square feet of buildings, local governments began preparing for the worst. But even
though the White House declared the region a disaster area during the January storms,
FEMA said the new threat that emerged that summer wasn't actually urgent enough.
"The applicants' reliance upon the USACE's (U.S. Army Corps of Engineers') 'one in three'
risk of flooding statements does not meet FEMA's eligibility of an immediate threat," the
federal agency wrote in December.
Full Article: http://seattletimes.nwsource.com/html/localnews/2015589986_flood13m.html
FEMA Computer Program Models Catastrophic
Disasters for Seattle, King County
The Associated Press
King County
Hazard
Maps
The City of
Seattle has
created
Interactive
Hazard maps
using Seattle GIS
data & Microsoft
Virtual Earth.
Map your area
to find flood
prone areas,
known slide
areas and
liquefaction
zones.
With the disaster modeling program on his computer, project analyst Adam Campbell
dials up a 7.2 earthquake for Seattle and King County. He's looking for how many
buildings will topple, how much debris will fill the streets, making them impassable for
emergency responders. He wants to know how many casualties the massive quake will
produce. "Cascadia is a scary fault," said Campbell, a contractor for Federal
Emergency Management Agency, in what will prove to be an understatement, as he
demonstrates the program to The Associated Press. Minutes later, FEMA's Hazus
computer program churns out its hair-raising answers: Billions of dollars in structural
damage; area hospitals leveled; tons of debris blocking the streets, and more than
1,000 deaths and several more thousand injured. http://web1.seattle
"The data that comes out of a tool like Hazus shows our risks and what kind of impacts
could occur here," said John Schelling of the Washington Emergency Management
department. "The program brings some resolution. It provides some context so people
can begin to see some of the challenges following these types of disasters."
.gov/dpd/maps/d
pdgis.aspx
3
7
7

Coalition
Staff 2011
administrative staff
Alison Alcoba
(206) 263-8701
alison.alcoba@kingcounty.gov
coalition program manager
Cynthia Dold
(206) 263-8715
Cynthia.dold@kingcounty.gov
training & exercise manager
Danica Little
(206)947-5565
Danica.mann@kingcounty.gov
resource & information systems
Jennifer Chi
(206)263-8720
Jennifer.Chi@kingcounty.gov
clinical planner
Kay Koelemay, MD
(206) 263-8188
Kathryn.Koelemay@kingcounty.gov
administrator
Lydia Bristol
(206) 263-8721
Lydia.Bristol@kingcounty.gov
health systems response planner
Onora Lien
(206) 263-8717
Onora.Lien@kingcounty.gov
planning support manager
Rebecca Lis
(206) 263-8754
Rebecca.Lis@kingcounty.gov
In addition to Coalition
program staff, the
Healthcare Coalition has
benefitted from the
ongoing work from the
following individuals:
legal workgroup
Amy Eiden, JD
(206) 296-9015
amy.eiden@kingcounty.gov
puget sound call center
coordination
Joe Cropley
(206)517-2383
cropley@wapc.org
KING COUNTY HEALTHCARE COALITION
The Coalition is a network of healthcare organizations &
providers that are committed to coordinating their emergency
preparedness & response activities. The purpose is to develop &
maintain a comprehensive system that assures coordination,
effective communications, & optimal use of available health
resources in response to emergencies & disasters.
Planning for Crisis
Standards of Care:
Establishing the Path
Forward for King County
On July 14 th , 2011, the King County Healthcare Coalition, in collaboration with
Public Health - Seattle & King County, hosted a one-day symposium, to hear
from national subject matter experts and state and local representatives on
best practices, current capabilities and planning gaps related to local and
state readiness for providing medical care during circumstances when
resources are scarce and the standards of care change. Invited speakers
included members of the Institute of Medicine’s committee, Dan Hanfling, MD
and John Hick, MD. Other speakers represented the State of Washington
Office of the Attorney General, the Washington State Department of Health,
Seattle Children’s Hospital, the King County Healthcare Coalition and Public-
Health – Seattle & King County. More than130 participants attended the
workshop representing various healthcare sectors including: Hospitals, Long
Term Care, Behavioral Health, In-Home Services, Ambulatory Care, Ancillary
Services, Emergency Medical Services, and federal, State, and local Public
Health.
The purpose of this workshop was to begin developing a vision and framework
for implementing crisis standards of care in King County. The workshop
included presentations on the Institute of Medicine’s guidelines, best practices
from the state of Minnesota’s experiences addressing these issues, legal
protections currently in place in Washington State, and local and state level
planning concerning crisis standards of care. The workshop also included
facilitated breakout discussions regarding legal protections that are critical in
implementation of crisis standards of care, a proposed healthcare institutional
response structure, a proposed King County response structure and necessary
public engagement work relating to crisis standards of care.
As a follow up to the workshop the Healthcare Coalition will be working with
regional partners to continue developing the systems necessary to respond to
a crisis standard of care event. The immediate priorities are to:
• Advocate for legislative changes to protect healthcare workers in
Washington State
• Establish a King County Disaster Clinical Advisory Committee, to work with
the Healthcare Coalition on disaster planning and build the structures
necessary to support disaster response
• Continue work on regional medical surge and resource conservation
• Begin work on clinical protocol for managing patient care when resources
are scarce
For Additional Information contact kchc@kingcounty.gov
8

Coalition Workgroup & Project Updates
Outlined below are current updates for some of the Healthcare Coalition Committees
& Workgroups. Please consult the Coalition website for additional information.
Planning Projects:
Alternate Care Facilities
The Patient Care Working Group has held two meetings to discuss issues related to
patient care, including review of the draft ACF staffing plan, which includes suggested
staffing numbers for different ACF sizes and configurations, from 50-250 beds. Once that
review takes place Public Health – Seattle & King County will finalize the plan and
recommended next steps, and present it to the Healthcare Coalition Executive Council
for approval.
Ambulatory Care Planning
Coalition staff has developed a draft King County Ambulatory Care Emergency
Response Plan that is being reviewed by Ambulatory Care Committee members;
comments are due by August 29, 2011. The plan will seek to increase coordination,
communications, and the effective use of resources among ambulatory care providers
in responding to emergencies.
Behavioral Health Planning
• The planning team is currently evaluating the PsySTART Rapid Mental Health Triage
system as a possible tool to aid in disaster mental health response. The PsySTART system
would facilitate a standardized triage approach and would assist in aggregating the
potential mental health needs during a response, helping to improve situational
awareness and resource allocation strategies.
• The planning team is currently assessing a curriculum on Psychological Consequences
of Disaster developed by RAND and LA County, CA to identify tools that can be
incorporated into planning and training locally.
Call Center Coordination Planning
Public Health Seattle-King County and the Washington Poison Center continue to
partner on further development of the Public Information Call Center (PICC)
capabilities. A joint effort between the Preparedness and Environmental Health sections
of PHSKC has resulted in the creation of a Flood Health and Safety Hotline which can be
activated in the event of a major flooding emergency. A call center exercise to test this
new platform was completed on June 15th. The PICC will now have the infrastructure,
technology, and training in place to activate for either a large scale flood or flu
event. Planning is underway to expand the scope of the PICC to provide assistance
during localized disasters and regional evacuations.
Crisis Standards of Care Planning
The Coalition and Public Health – Seattle & King County hosted a one-day workshop on
July 14, 2011 called “Planning for Crisis Standards of Care in our Community: Establishing
the Path Forward” to launch planning in King County and identified next steps based on
planning work that has been done in our region and state to date.
Two members of the Institute of Medicine Workgroup that developed the 2009 Letter
Report Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations, Dr.
Dan Hanfling (Vice Chair) and Dr. John Hick, presented at the workshop.
Emergency Department Saturation Planning
• May 31 concluded a successful No Divert Pilot by the Central Region Emergency
Management Service & Trauma Care Council, with King County hospitals. The threemonth
pilot succeeded in significantly reducing incidents of hospitals diverting
ambulances.
• The work of the ED Saturation Steering Committee will be shifted to the Central Region
Trauma Council for support going forward.
9

Coalition Workgroup & Project
Updates Continued
Family Assistance & Patient Tracking Planning
• The Patient Tracking Steering Committee is developing a concept of operations for
patient tracking including identifying minimum data points for different phases of
response and roles and responsibilities of EMS, hospitals and other partner
agencies. The concept of operations is anticipated to be finished by late fall 2011.
• The Family Assistance Planning team is in the process of developing guidance and
recommendations for hospitals to develop plans for family reception/family
information centers.
.
Hospital Planning
• The King County Hospital Emergency Response Plan has been updated and
submitted to the Department of Health as a grant deliverable in June 2011.
• Assessing hospitals' surge capacity and capabilities for managing an influx of
patients was a priority for planning in 2010-2011. Based on a series of
standardized site visits and assessments, all hospitals in the region have identified
additional spaces and strategies within their facilities to accommodate a surge
of patients, creating substantially increased regional capacity.
In Home Services Planning
• The Coalition Staff has drafted an In Home Services Regional Emergency Response
Plan which is being reviewed by the group; comments are due by August 29, 2011.
The plan will be adapted primarily for King County but will also be shared at a
statewide level.
Long Term Care Planning
The Nursing Home Steering Committee recently joined together to contact all
members of the Long Term Care Mutual Aid Plan in order to promote wider
participation in WATrac and remind participants to update their agency emergency
contacts in WATrac. The committee continues to actively recruit more members for
the group, especially those with clinical expertise.
Mass Fatality Planning
The mass fatality planning team has finalized guidelines for all types of healthcare
organizations in King County on Mass Fatality Management. The mass fatality
planning team has also created a standardized Mass Fatality Plan template for all
healthcare organizations to use for internal planning, which integrates into the King
County All Hazards Mass Fatality Plan.
Pediatric Planning
• In order to support hospitals in implementing the Regional Pediatric Plan, the
Pediatric Taskforce and the Coalition team are currently implementing a region
wide “pediatric toolkit”. King County hospitals with emergency departments are
currently involved in building their internal pediatric emergency response
capacities and capabilities, including identifying physician and nursing leadership
and incorporating length-based "color-coding" in routine pediatric medical
management for appropriate weight-based medication and equipment decisions.
Volunteer Management System
• In May the Corps received a request from the Surgeon Generals office to help
medical volunteers connect with the Red Cross who needed support due to the
floods and tornadoes in the south and Midwest. Two King County EMT’s and one
RN were deployed as Red Cross volunteers in Joplin.
• The Public Health Reserve Corps is currently at 382 adding about 10 new volunteers
per month.
10
9

Coalition Workgroup & Project
Updates Continued
Resource and Information Management:
Information Management Planning
The Coalition and Public Health – Seattle & King County will continue to outline a
new strategy and tools for situational awareness during a response. All member
healthcare sectors have been consulted to inform how facilities are surveyed and
sent information by Health and Medical Area Command.
Resource Management and Conservation Planning
The Coalition has completed a research project outlining literature, national best
practices, and tools on resource conservation strategies. The activity identified
potential critical resource failure points and outlined a process for creating a
regional resource conservation plan. Moving forward, this project will be aligned with
crisis standards of care planning activities.
WATrac Planning
• Staff from the Coalition, WATrac state implementation team, and the King County
Mental Health, Chemical Abuse and Dependency Services Division(MHCADS )are
working together to outline how MHCADS organizations can use WATrac’s
Knowledgebase (virtual library) and Command Center (online chat) features. They
are developing recruitment and training strategies so that each Behavioral Health
organization has at least three staff able to receive alerts through WATrac.
• The Coalition facilitated the statewide WATrac configuration for In Home
Services. Based on their decisions, In Home Service providers will track agency
status and visit availability during a response.
Training & Exercises:
Exercises
• The Long Term Care Steering Committee participated in an exercise to test their
skills and the tools developed to support their role in a nursing home evacuation
event. Lessons learned include further training on WATrac, both for Steering
Committee members as well as long term care partners, further training in ICS, and
regular testing of communication alerts to the Long Term Care group.
• Twelve King County hospitals participated in a regional evacuation exercise,
“Operation Red Rover.” The exercise identified areas for improvement which
include further education across the region about the role of the Disaster Medical
Control Center (DMCC, formerly hospital control), communications, medical surge,
patient tracking and evacuation operations, standardized templates for collecting
surge information and for patient tracking, and training to job specific duties such
as evacuation coordinator responsibilities and down time procedures.
Trainings
• Our Business Resiliency Workshop has been modified into 1-day training applicable
to statewide partners.
• Orientation training to the Regional Medical Evacuation Plan (Hospital Plan) and
the Long Term Care Evacuation Plan were developed and are available on the
coalition website for use by partner organizations.
• Dr. Merritt Schreiber, a consultant hired to assist with developing a disaster
behavioral health concept of operations for the region, provided two briefings to
healthcare and emergency response partners on the Psychological
Consequences of Disaster and the Mental Health Impacts of Disasters on Children,
respectively.
• A workshop “Preparing Healthcare Organizations for Mass Fatality Management”
was held on July 28, 2011 to train on the healthcare mass fatality management
guidelines and provide a facilitated discussion.
King
County
Healthcare
Coalition
2010-2011
Annual
Report
“The Healthcare
Coalition is a
national model
for disaster
resilience, built
on the value of
effective local
partnerships to
save lives.”
David Fleming,
MD
Director & Health
Officer
Public Health-Seattle &
King County
To View:
http://www.kingcountyhealt
hcarecoalition.org/aboutthe-coalition/publications
For a hard copy
of the 2009
Report please
email:
kchc@kingcounty.gov
10 11

We Need Your Help
Our federal funding has been cut by ten
percent. As times change, our primary grant -
from the U.S. Assistant Secretary for
Preparedness and Response – has provided a
solid foundation for our work, but is decreasing
steadily. With this in mind, the Coalition’s
Executive Council invites you to join our
exciting and necessary new endeavor: our
inaugural fundraising campaign.
Thank You to
Our Financial
Supporters!
We are already halfway to accomplishing our
first year’s goal. On June 30 th , 2011 the
healthcare and business communities in King
County came together to show their support
for the Healthcare Coalition. Thanks to their
enthusiasm, we have already received
commitments totaling more than $100,000 –
exceeding half of our $200,000 fundraising
goal for 2011-2012.
Your support makes a difference. We invite
you to join the roster of local organizations and
businesses supporting the Coalition. By joining
our inaugural fundraising campaign, you help
to build a resilient King County community that
can respond and recover from natural and
man-made disasters.
Contributions to the Coalition’s work are
payable to our partnering organization, the
Foundation for Health Care Quality, a Seattlebased
501(c)(3) non-profit organization.
We are extremely grateful to our financial
supporters and acknowledge their
contributions in our website, newsletters, staff
presentations, all of our conferences, and in an
annual thank you advertisement in The Seattle
Times.
Please join us. If you are interested in
opportunities to support the King County
Healthcare Coalition, in joining the Coalition,
or would like to learn more, please visit
www.kingcountyhealthcarecoalition.org
12

Training Opportunities
Note: The following list of available training opportunities are provided for your
interest. Making each opportunity known as available is not necessarily an
endorsement as to the value of each training.
King County Pediatric Disaster Response Workshop
Date: September 20, 2011
Location: Valley Medical Center
Topics Include: Mass Casualty Triage, Pediatric Resource Book, Pediatric
Assessment Triangle, “Color-Coding Kids”
For more information please email KCHC@kingcounty.gov
Regional Emergency Management Response Seminar
Dates: October 4, 2011 OR October 13, 2011
Target Audience: Evergreen Quake Exercise series players
This seminar seeks to promote and improve operational awareness of
regional emergency management response at all levels of government to a
large-scale earthquake in the Puget Sound Region.
To Apply: https://www.surveymonkey.com/s/3S9CBZF
Building Collaborative Disaster Planning Processes Between
Hospitals and Emergency Management
Dates: Free Online Training Course
This free first-of-its-kind awareness-level integrative training covers the
development and maintenance of pre-incident plans ensuring the
efficient distribution of patients, the sharing of information and
resources, and the coordination between state and local agencies with
hospitals and others responding to the medical needs of disaster
victims.
http://www.acep.org/collaborativeplanning/
Hospital Emergency Management Concepts and Implications of
WMD Terrorist Events
Dates: Free Online Training Course
A basic overview of information about hospital management planning.
Hospital preparation for major events using an “all hazards” approach will also
improve readiness for major disasters and incidents that are common.
http://www.hsp.wvu.edu/courses
Basic Crisis & Emergency Risk Communication for Public Health
Workers during Local Emergencies
Dates: Free Online Training Course
This is a course on basic crisis and emergency risk communications for public
health workers during local emergencies.
www.ncdp.mailman.columbia.edu/risk/
13

WATrac:
Washington
State’s System for
tracking regional
resources,
emergency
alerting, &
communications.
It’s a database
driven web
application that
provides tools for
coordinated
preparedness &
response by the
health & medical
sectors statewide.
The system is
designed to track
facility status &
bed availability &
make the data
accessible in
real-time.
For More
Information on
WATrac email:
Support@WAtrac.org
Upcoming Trainings Continued:
WATrac Command Center Specialist Webinar
Dates: October 18th, 9:00—11:30 am
This online training is open to healthcare agencies that need to view Regional
Status data, access Knowledgebase documents, &chat in Command Center
rooms.
https://watrac.webex.com
WATrac Training Videos
Dates: Free Online Training Course
Videos are now available on the WATrac WebEx webinar training site. A series of
short training videos, 5 to 20 minutes each.
To access the training videos: https://watrac.webex.com.
On the left of the screen, under the heading Attend a Session, click on Recorded
Sessions.
The recorded sessions currently available are:
1. Regional Status Module
2. Create A Command Center Room
3. Updating Bed Availability & Agency Status
4. Knowledgebase
5. Acknowledging an Alert
6. Specialty Tracking (Pilot Project)
7. Adding and Editing User Accounts
NEW WATrac Activity Toolkits
WATrac has new training Toolkits developed to supply healthcare agencies with
an easy to use resource that will help to test emergency response capabilities and
incorporate the use of WATrac into internal, regional, and multi-jurisdictional
exercises.
1. Command Center Specialist Toolkit - This version is designed for
organizations that do not track resources or status in WATrac.
2. Agencies Updating Status & Beds Toolkit - Designed for agencies that
use only bed availability & agency status and perform searches in Regional
Status.
3. WATrac Specialist Toolkit - This toolkit is designed for agencies with a
WATrac Specialist. This includes Hospitals, Public Health, EMS, Community
Health Centers, Tribal Health, and In-Home Services providers that have
completed full system implementation.
To download copies of the Activity Toolkits go to https://www.watrac.org
1. Login into WATrac
2. Click Knowledgebase on the System Navigation Bar
3. Expand the WATrac Policies &Training Materials folder
4. Expand the Training Materials folder
5. Expand the Activity Toolkit folder to view the Toolkit options
14

Regional
Exercise
WINTER
BLAST
SAVE THE DATE
October 18, 2011
Winter Blast will test
the communications
plan outlined in the
ESF8 plan and each
healthcare sector
plan as well as
resource requesting,
interoperable
communications and
reverse surge
(limited staffing)
within hospitals.
The exercise will
include ALL
healthcare partners
such as ambulatory
care, ancillary
service providers, in
home services,
hospitals, long term
care, and behavioral
health.
For More
Information contact
KCHC@kingcounty.gov
Conference Opportunities
Note: The following list of available conference opportunities are provided for your
interest. Making each opportunity known as available is not necessarily an
endorsement as to the value of each conference.
August 30, 2011
Annual Technologies for Critical Incident Preparedness
Conference and Exposition (TCIP 2011)
Location: National Harbor, MD
http://tcipexpo.com/
September 13-14, 2011
IT for Disaster Response
Location: Springfield, VA
http://afei.org/events/1A07/Pages/default.aspx
September 13-14, 2011
The 5th National Emergency Management Summit 2011
Location: New York, New York
http://ww.emergencymanagementsummit.com/
Oct 4-7, 2011
National Emergency Managers Association 2011 Emergency
Management Policy & Leadership Forum
Location: Austin, TX
http://www.nemaweb.org/
Oct 29-Nov 2, 2011
2011 Emergency Preparedness & Hazmat Response Conference
Location: Washington, DC
http://www.2011conference.net/
November 12-17, 2011
International Association of Emergency Managers 59th Annual
Conference & EMEX 2011
Location: Las Vegas, NV
http://www.iaem.com/
About this Newsletter
This publication is sent quarterly via email. Please feel
free to share resources through this newsletter.
To subscribe, unsubscribe or submit information,
please contact Lydia Ortega
Lydia.ortega@kingcounty.gov
The King County Healthcare Coalition is administered by Public Health – Seattle & King County 15