Massachusetts Local Board of Health Emergency Operations Plan Template

State: NH Type: Model Practice Year: 2005

As Massachusetts has no county health system, developing a statewide/regional plan for emergencies has been difficult. Massachusetts Health Officers Association (MHOA) (a SACCHO), along with the four statewide public health organizations (collectively known as the Coalition for Local Public Health) recognized the need to provide a tool to assist local health departments in their emergency planning. Funding was jointly requested by the coalition, through the Massachusetts Department of Public Health, and with the awarded grant, SYA Group, Inc. was contracted to develop the template which is being submitted for consideration of a best practice. Response to the tool has been extremely positive and met our expectations. The target audience was Local Board of Health personnel in 351 towns and cities throughout the Commonwealth of Massachusetts. The template was designed for use by local public health department personnel and encourages the identification of planning partners representing other local departments and organizations involved in emergency response including law enforcement, fire/hazmat, emergency medical services (EMS), public works, public officials, and volunteer organizations. With minimal revision, the template can be replicated for use by local health departments and agencies anywhere in the United States. The key elements to replicate the practice are template on CD-ROM with detailed instructions for use and optional training seminars to introduce the template. Training can be accomplished using a train-the-trainer approach.
The Massachusetts Local Board of Health Emergency Operations Plan template addresses the current public health issue on how to improve readiness of local public health agencies to respond to public health emergencies including pandemics, bioterrorism, and unusual disease outbreaks. Local Health Agents throughout the Commonwealth expressed their concern that the preparation of plans and protocols for public health emergency response was very difficult because of limited resources and other pressing public health responsibilities. It was determined that a useful template had to be more accessible to local Public Health Agents and lead them step by step through pre-event planning. This was particularly relevant within the Commonwealth because, without a County government infrastructure to assist, the local Public Health Agents are “on their own” for at least the first 72 hours following an emergency. Therefore, they must build partnerships within towns and with neighboring towns. They also must know how to contact and request assistance from the State Department of Public Health (DPH) and other regional representatives. The Massachusetts Local Board of Health Emergency Operations Plan template addresses this public health planning issue by placing a step by step, fill-in-the blanks template into the hands of each local Health Agent and department. The template helps them to identify local response procedures, contacts, protocols, and resources. The template is accessed and prepared using MS Word. Local Public Health Agents reported that this approach is more acceptable and user friendly at this time than any of the existing web-based programs. MHOA was aware of existing bioterrorism response planning templates available from other organizations. Web-based and other available templates were in use in some towns, however, local Health Agents communicated to MHOA that these other approaches were not meeting their needs. They needed a simpler template that (1) identified, summarized, and grouped their responsibilities, (2) provided step-by-step instructions about what they needed to do for planning and for response, 3) provided fill-in-the-blank checklists and fill-in-the-blank instructions that, when complete, resulted in an all hazards cohesive plan, (4) provided a clear explanation of the application of ICS for use by local public health departments/agencies.(5) provide a consistent standard in which planning and training could be accomplished across the state.
Agency Community RolesThe local public health agency (Local Boards of Health/ Health departments in the Commonwealth of Massachusetts) role is to use the template to prepare a local public health response plan. The template instructions include a 10-step local planning process that includes instructions and suggestions to involve local planning partners. Each template section identifies planning partners needed for the discussion. Planning partners are expected to provide information on local response resources and existing procedures and protocols and assist the work of “filling-in” the template checklists and instructions. Planning partners identify cross-walks among disciplines (law enforcement, fire/hazmat, public works, and emergency medical services) and determine how these agencies will coordinate and communicate during an emergency. The project also provided a collaboration of the major public health organizations and members in MA. Costs and ExpendituresThe original outlay of $30,000 to do the template/trainings came from the MDPH. All planning time, including local staff time to work on the development of the template was done in– kind. As the template is now finalized, keeping the document current will be the responsibility of the individual departments and has been built into template maintenance. Any updated information will be disseminated through the coalition and its membership lists. Individual community budgets/regional funds through cooperative agreement helped support this practice.  ImplementationImplementation Steps:Distribute template binders to all public health departments at training seminars: January 2005,Conduct 5 training seminars in 5 regions of the Commonwealth: January 2005, andProvide on-going support for local planning: January 2005 and on-going.
All 5 local public health organizations representing over 3,000 public health professionals are committed to ensuring the template is utilized and trainings continue. MHOA will take the lead in assisting LHD in developing their plans and will utilize recently formed regional coalitions throughout state to assist with this process.The template includes instructions for plan maintenance and annual review of plans for update, drills and exercises that will be held, and it will be updated to include new information from the State Department of Health, the Federal Department of Homeland Security, the CDC, etc. The template will be updated every year, or as needed. As the bulk of the work has been accomplished through this project, very little is required of LPHA other than utilizing and filling in the template.