2003 Model Practice Application (Public)

Rockland County Emergency Preparedness and Bioterrorism Committee

Rockland County Department of Health

Through the initiative of the Rockland County EMS Coordinator and the Public Health Administrator, an Emergency Preparedness and Bioterrorism Committee was created in March 1999. This program, under the leadership of the health department and the auspices of the County Executive’s office, took a pro-active approach to a growing bioterrorism threat. The committee has been conducting monthly meetings since March 1999. Its main goal is a unified and coordinated county response to a bioterrorism disaster or a public health emergency event. Many county, state, and private health entities and federal agencies are represented on this committee. Three subcommittees formulate policies and procedures on planning, readiness, assessment, disease surveillance, epidemiology, training, education, and communications. This countywide cooperation of public and private agencies has enhanced Rockland County’s ability to deal with a public health emergency.

This program of establishing the County Emergency Preparedness Committee has enabled the county to have a more focused response to any public health emergency with a broad base. Communications between the health department, Office of Fire and Emergency Services, state agencies (New York State Emergency Office), local law enforcement agencies, State Police, FBI local representative, representatives of four local hospitals, Department of Mental Health, Board of Cooperative Education Services (BOCES) are constantly improved and updated. Disease surveillance procedures are streamlined with the involvement of the representatives from local hospitals, nursing care agencies, and health care providers. This innovation of a focused and coordinated response from a broad base was best demonstrated during the anthrax threat in late 2001. The health department established guidelines for individuals exposed to an unknown substance and also for individuals at no or low risk of exposure to an unknown substance. Law enforcement and HAZMAT teams were in constant communication with the health department regarding threat assessment and immediate responses that were needed. Rapid detection was made possible due to the foresight of the Committee to acquire detection devices and strips specific to certain biologic agents, including anthrax. Due to the ability to communicate rapidly among representative members of the Committee, the anthrax threat was contained on different fronts.

This innovation of a focused and coordinated response from a broad base was best demonstrated during the anthrax threat in late 2001. The health department established guidelines for individuals exposed to an unknown substance and also for individuals at no or low risk of exposure to an unknown substance. Law enforcement and HAZMAT teams were in constant communication with the health department regarding threat assessment and immediate responses that were needed. Rapid detection was possible due to the foresight of the committee to acquire detection devices and strips specific to certain biologic agents, including anthrax. Thanks to the ability of members of the committee to communicate rapidly with one other, the anthrax threat was contained on different fronts.

The Rockland County Health Department spearheaded this initiative in 1999 and has assumed the leadership role in the Rockland County Emergency Preparedness and Bioterrorism Committee. Supported by the Office of Fire and Emergency Services, the health department increased the visibility of the committee in the county by extending invitations to stakeholder agencies (e.g., federal, state, county, medical, nursing care agencies, hospitals, law enforcement).

To foster collaboration, the health department, in cooperation with the Office of Fire and Emergency Services, invited the following agencies to join the committee:: County Executive Office, Good Samaritan Hospital, Suffern, NY, Helen Hayes Hospital, Poison Control Center, Valley Cottage Veterinary Society, County Sheriff Department, New York State Police, Federal Bureau of Investigation (local representative), Board of Cooperative Education Services (BOCES), local police departments from five towns, Refuah Health Center, Nyack Hospital, Nyack, NY, New York State Emergency Management Office (NYSEMO), Rockland Psychiatric Center, Rockland Paramedic, Rockland County Department of Mental Health, Rockland County Department of Planning, Rockland County Department of Hospitals, and Rockland County Medical Examiner’s Office. The representatives of these agencies have shown unwavering commitment in attending the committee’s monthly meeting.

Each representative is a member of one of the three subcommittees: Planning, Readiness and Assessment; Epidemiology and Disease Surveillance; Training, Education and Communication. Each working committee is instrumental in formulating and constantly improving the Rockland County Bioterrorism Contingency Plan.

The program costs are minimal. Each representative is required to attend the two-hour monthly meetings. During the meeting, lunch is served. Initial funding came from the County Executive’s Office. The Committee is currently supported by the CDC Bioterrorism Grant. Since 1999, the meetings have taken place at the Fire Training Center, in Pomona, New York, which provides three classrooms and the multi-purpose room (which is also the Emergency Operations Center) that is equipped with a satellite communications system.

The Rockland County Emergency Preparedness and Bioterrorism Committee is recognized in the county and the New York Metropolitan Region for its pioneering accomplishments. These accomplishments include bringing an awareness of the threat of bioterrorism long before September 11. It has unified different public and private agencies in achieving a coordinated response to a bioterrorist threat. It has developed a network for better organization and communication among these agencies. The committee has established a regional and state presence at other planning meetings. It constantly identifies resources such as funding, inventory needs and consultants. It conducts community needs assessment on a regular basis. The committee has a sizeable and valuable membership of key stakeholders. It has instituted training programs and certifications that are still ongoing. The Rockland County Bioterrorism Contingency Plan is a testament of the committee’s impact on emergency preparedness in the county.

Skills and training needs assessments were distributed to fire, police, EMS agencies, hospital staff, and health department staff. These assessments were used in the planning of training sessions. Evaluation tools have been developed and distributed to training participants. These evaluations are reviewed upon completion. The committee is instrumental in the identification, assessment of areas of improvement in emergency preparedness in the county.

The greatest challenge to the program was sustaining the interest of each participant agency. This obstacle appeared persistent but not insurmountable. The prevailing conditions in the United States have reinvigorated the interest in the program and highlighted its relevance. The events of September 11 and the anthrax threat of 2001 galvanized such interest. Subsequently, the committee has devised ways to improve through the different subcommittees. Through collaboration with other agencies, the health department is given an active role in the traditional emergency response family.

Another challenge was keeping up to date with relevant information from different national, state, and local agencies. The solutions included improving communications among agencies, sharing information, and providing relevant training. Communications have become more effective and efficient by maintaining and constantly updating a communications directory of all the committee members. An additional challenge included the standardization of command and control procedures. This is being addressed based on the Incident Command Structure, and the work is still in progress. The committee is planning to designate a repository of emergency preparedness plans of each participant agency and reference it to the County Emergency Preparedness Plan.

Every second or third Tuesday of the month, the committee meets for two hours. The three subcommittees use the first hour to meet as working groups. The individual subcommittees agree on the agenda that reflects their most pressing concerns. The staff is composed mainly of the representatives of participating agencies. The committee is chaired by the Director of Emergency Preparedness/Public Health of the Health Department. The Health Commissioner’s secretary takes on the clerical duties. No other ancillary staff is needed. Policies and procedures are formulated and incorporated into the Rockland County Bioterrorism Contingency Plan, which is being maintained by the Office of Fire and Emergency Services. The most important element is the level of commitment of each representative of a participating agency. Throughout the four years of its existence, the committee continues to enjoy a robust commitment from its members.