[TCRA] Mass clinic to test county's preparedness

Greg Hammerel w9gdh at chibardun.net
Thu Oct 13 15:06:47 CDT 2005

Barron Co ARC2 (ARES/RACES) will be involved.  We will use 146.58 
simplex at Barron High School and the Mobile Command Post.  443.650 + 
110.9 repeater will be used to communicate outside of the city of 
Barron.  This test will run from 9AM to 12 noon,  OCT 14. If you would 
like to participate in this test be at the BARRON HIGH SCHOOL 
http://www.barron.k12.wi.us/highschool/ and meet at the MOBILE COMMAND 
POST vehicle. Use 146.58 if you need help finding us.


Mass clinic to test county's preparedness

by Jeremy A. Jensen 	October 05, 2005

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The above photo shows the interior of the Mobile Command Center, 
designed to serve as the county's dispatch center in case of a catastrophe.

Emergency preparedness. In the wake of Hurricanes Katrina and Rita - and 
going back as far as the 9/11 tragedy - the nation has become consumed 
with the question, "If a tragedy or national disaster occurs, are we 
prepared?" That question has been met with different answers at various 
levels of government: some positive, some negative.

In Barron County, there is a group of people who have been focusing 
their energies for the last two years on making sure the county is 
prepared to respond to a catastrophe. While county residents can rest 
easy that a hurricane will not be making its way through the county in 
the near future, concerns such as communicable disease outbreaks, 
tornadoes and chemical spills are very real.

"Emergency preparedness has really come to the forefront of people's 
concern since the fallout of Hurricane Katrina," says Barron County 
Public Health Officer Hilde Perala. "We've been getting a lot of 
questions about whether the county is prepared or not, and people don't 
realize that we have been looking at this issue since well before Katrina."

In fact, says Perala, Barron County has been working on developing a 
Public Health Emergency Plan since the 9/11 attacks.

"Public Health has always had a piece of that [preparedness] puzzle," 
says Perala. "We are involved in the prevention of communicable disease; 
however, it was only after 9/11 and the anthrax scare that the federal 
government really started focusing on it and the money started coming in."

That planning will be put to the test Friday, Oct. 14, at Barron High 
School, as over 400 volunteers will be routed through a mass clinic in 
an exercise sponsored by the Public Health Department and the county's 
Emergency Management Department. The purpose of the exercise is to help 
the agencies involved in emergency preparedness diagnose where problems 
may occur in the event of a real tragedy, and address those issues 

"Obviously it's always better to test a plan before you try and put it 
in a real-life application," says Perala. "By conducting the mass 
clinic, we can assess any weak areas in the county's Public Health 
Emergency Plan and try to find solutions."

"That's why we need it to be as close to real life as possible," adds 
Kaye Thompson, county public health educator and local emergency 
preparedness planner. "What's the point of doing an exercise that 
doesn't really test the system?"

The scenario

The scenario for the exercise is as follows: there has been a report of 
pneumonic plague that has been traced to the county fair, and the 
county's Public Health Department has to ascertain the extent of 
exposure and vaccinate the entire population of the county within a 
matter of days. An added factor to the scenario is that the county has 
been "notified" that it cannot receive help from surrounding counties 
due to similar outbreaks at their fairs.

The 400 volunteer "patients" will be directed to go to Barron High 
School - the county's mass clinic site - in waves, simulating the ebb 
and flow of patients the clinic could expect in the event of a health 
emergency. Once at the clinic, the patients will be sent through each of 
the following six stations:

* Triage - Symptomatic patients are separated from those without symptoms;

* Registration - Patients are greeted, registered, and given information;

* Education - Questions are answered about the agent/disease and medication;

* Screening - Patients are screened for contraindications (allergic 
reactions) to the medications and given a prescription;

* Dispensing/vaccination - Patients are provided with the prescribed 

* Exit - Screening papers are collected and final questions answered.

Perala says that to meet the department's goal of 400 "patients," many 
more volunteers are needed.

"We are about halfway there at this point," says Perala. "We expect it 
to only take an hour of their time, so we hope more people will step 
forward and volunteer."

Thompson adds that if a person does volunteer, they need to treat their 
commitment seriously.

"They should treat it like a doctor's appointment," Thompson says. "They 
should show up at the time they are told to show up; if they don't, it's 
not really a full test of the system."

The backbone of PHEP

The Public Health Emergency Plan, or PHEP, incorporates not only efforts 
by the Public Health Department, but other agencies as well.

In the fall of 2002, the Western Regional Partnership for Public Health 
Preparedness (WRPPHP) was established by nine local Public Health 
Departments to develop core expertise in public health preparedness.
Member agencies include Barron County Health and Human Services, 
Chippewa County Department of Public Health, Dunn County Health 
Department, Eau Claire City-County Health Department, Pepin County 
Health Department, Pierce County Health Department, Polk County Health 
Department, Rusk County Department of Health and Human Services and St. 
Croix County Department of Health and Human Services.

The WRPPHP is staffed by personnel with skills in a number of health- 
and emergency-related areas, such as epidemiology, environmental health,
communications, and preparedness planning and assessment.

The hope is that if the county is ever in an emergency situation, and 
did not have a resource desperately needed at its disposal, then the 
county could contact one of the other members to bring in that resource. 
One example of this network is for what Perala calls, "special populations."

"We are fully prepared to handle a number of special populations," says 
Perala. "We have Hispanic and Somalian interpreters, as well as people 
who are experts in giving care to elderly people and those with 

But if there was a need for a Hmong interpreter, Perala says they would 
have to ask a surrounding county for assistance.

"In a situation like that, we would look to Eau Claire County or Dunn 
County; areas that have a larger Hmong population," says Perala. 
"Likewise, if those areas were in need of an interpreter who spoke 
Somali, we would probably be contacted."

Help can also come on a larger, more regional scale. In January 2003, 12 
Consortias of Local Public Health Departments were established and 
finalized. These consortia were developed in order to foster cooperation 
between regional agencies and provide the necessary resources for 
planning and training health professionals and volunteers to respond to 
man-made or natural public health disasters.

"The consortias are also a part of the Public Health Emergency Plan," 
says Perala. "It's a way of coordinating resources on a regional scale 
that maximizes all of the resources available and keeps the entire 
region functioning in the event of a disaster."

Ahead of the curve

Even though the consortias have been around since 2003, Barron County is 
the first county in the state of Wisconsin to attempt a mass clinic 
exercise. Perala says officials involved with the PHEP and emergency 
management have participated in "tabletop exercises" where scenarios are 
laid out and then the appropriate actions to be taken are discussed.

"This pneumonic plague scenario actually continues from a tabletop 
session we had on Sept. 9," Perala explains. "We now have to take all of 
the things we talked about and the lessons we have learned and try to 
put them into practice."

Other counties have participated in tabletop exercises and small 
mobilizations, but Perala says the county's mass clinic exercise is the 
first of its kind.

"We wanted to take the exercises one step further from just talking 
about them and actually do them," says Perala. "We are ahead of the 
curve, you might say."

Being ahead of the curve does have its price though, as Perala and 
Thompson have started from scratch to create both the PHEP and sketch 
out the mass clinic.

"A lot of Kaye's life in the last 18 months has been dedicated to this," 
says Perala. "I think the mass clinic will show just how hard she has 

"I have spent an enormous amount of time on this," says Thompson, 
referring to the eight-inch thick binder that houses the county's PHEP. 
"It's obviously worth it though if we can be prepared if anything was 
ever to happen."

Reckoning Day

As the day when 400 patients attempt to squeeze into a mass clinic over 
a span of two and a half hours draws near, Perala and Thompson both 
admit they have butterflies. What if there aren't enough volunteers? 
What if someone doesn't do their job properly? What if communications fail?

"At this point, we're not going to worry about those things as much," 
says Perala. "We will go through the exercise and then assess the 
results afterward."

Perala's goal is to get eight people per minute through the clinic, 
which is a pace that would allow the entire county to be vaccinated in 
six days - no easy task to be sure. However, Perala says that is only 50 
percent of where they would need to be in an actual emergency.

"We would actually be aiming for three days to vaccinate the entire 
county," says Perala. "By running at 50 percent, that allows us to make 
assessments as we go along and experiment with some things."

Other agencies involved

The county's Public Health Department is not the only agency involved in 
the mass clinic. Perala says the Department of Health and Human 
Services, Barron Medical Center, City of Barron Police, the county's 
Office on Aging, the Sheriff's Department, all county clinics and all 
WITC police and nursing students have been invited to participate in the 

"This is truly a county-wide plan, so we want to get as many agencies 
involved as possible," says Perala. "We want to make sure we can serve 
the residents of the county when they will need us the most."

Randy Books, director of the Barron County Emergency Management 
department, will also be using the exercise to test his latest piece of 
equipment - a 31-foot-long vehicle known as the Barron County Mobile 
Command Center. Designed to be a backup dispatch center and a mobile 
communications station, Books says the vehicle is functionality defined.

The MCM is equipped with the same software and displays the county has 
in its dispatch center, 911 call capabilities, its own radio frequency, 
two "ham" radio stations, four permanent phone lines (expandable to 18), 
cell phone, DVD/VCR combo with television (to monitor news stations and 
training), printer, fax machine, a 15-kilowatt generator, and a 25-foot 
telescoping antenna mast. Books also points out the appearance of 
dry-erase boards on just about every surface in the vehicle.

"You can never have enough dry-erase boards," says Books. "This is a 
functional machine; there's not a lot of extra bells and whistles here, 
just what we need to function in case of a major emergency."

Books is awaiting the mass clinic with anticipation, as it will be an 
opportunity for him to put the MCM to the test.
"We had it out at Cumberland's Rutabaga Fest to help with communications 
there, and we've done a few other small exercises with it," says Books. 
"This will be its most extensive use to this point. It's a good 
opportunity to get the bugs worked out."

Books says the MCM will be staffed with five people minimum in the event 
of an emergency, but there are no plans at this time to test the command 
center to its fullest capabilities.

"There are a couple of other items I would like to see in here before we 
give it the full test, and I'm working on some grant money to purchase 
those things," says Books, who points out that county taxpayers have 
only had to pay a small fraction of the $130,000 cost of the vehicle to 
this point as most of the money has come from Homeland Security grants. 
"We just want to use it as a portable communications center at the mass 
clinic, to run communications out of here instead of the Sheriff's 

While Books admits his role is more on the logistics side of things, he 
knows that the mass clinic exercise will have to bring all parts of the 
puzzle together to succeed.

"We've talked about this for quite a while, and now it's time to see if 
it works," Books says. "If not, well, at least we know before a real 
disaster hits."

©The Chetek Alert 2005

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