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State Inititiatives Region I

 

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Connecticut
Mark Cicero, MD, FAAP 

The Connecticut Chapter of the AAP is working with the Connecticut State Medical Society’s (CSMS) Disaster Preparedness Committee to incorporate pediatric disaster preparedness efforts into general efforts at the state level. The CSMS has created subcommittees for Infectious Disease Disasters, Communication during Mass Casualty Incident’s, and Physician Disaster Preparedness. 

The Yale School of Medicine was awarded a federal grant by the Agency for Healthcare Research and Quality. With this grant, Principal Investigator Mark X. Cicero, MD, FAAP, and a team of healthcare education experts, software designers and graphic artists are building a video game entitled “60 Seconds to Survival”. The game, which primarily targets emergency medical technicians and paramedics, sets players in the role of a mass casualty triage officer. 60 Seconds to Survival is planned to offer continuing education credits for prehospital care providers, and will hone triage and scene management knowledge. ​
 
Christopher Pezzullo, DO, FAAP
Katie Herlihy, MD, FAAP ​ 

The Maine Chapter of the AAP has strong ties to the Maine Center for Disease Control and Prevention (CDC). Christopher Pezzullo, DO, FAAP, the Disaster Preparedness Chapter Champion, provides a connection to William Jenkins, MPPM, EMT-B. Mr. Jenkins, Director of Public Health Emergency Preparedness (PHEP), oversees activities in Maine related to the Hospital Preparedness Program grant and the CDC Public Health Emergency Preparedness Program grant. Through Mr. Jenkins, the chapter has a connection to Maine EMS. In the past year, PHEP has reviewed and ultimately increased its medical supplies cache and surge capacity for pediatric emergencies in the state of Maine. The PHEP is evaluating whether to apply for a federal grant to increase pediatric emergency preparedness in Maine.

The chapter continues to encourage and expand participation in the CDC Health Alert Network. Potential areas of interest include identification of contacts at hospitals and office practices to explore ways to improve pediatric preparedness; considering how to coordinate communication efforts when health information needs to be shared in an emergency; performing a pediatric emergency preparedness drill with Public Health Nursing and determining ways to expand environmental health activities to be better prepared for a future disaster. The chapter is currently working with the Executive Director of the Maine Chapter of the AAP to finalize their State Chapter Emergency Preparedness Plan.
 
Sarita Chung, MD, FAAP
 
For the last year, the Massachusetts Chapter has been collaborating with the Massachusetts Emergency Management Agency Children and Disasters task force. This multidisciplinary committee has been focusing on methods to improve the care of children from the planning phases to recovery. Sarita Chung, MD, FAAP, member of the AAP Disaster Preparedness Advisory Council, participates in the Pediatric Medical Group, a subcommittee of the Children and Disasters task force. The Pediatric Medical Group works to ensure that pediatric topics are included in public health emergency planning by focusing on hospital preparedness and information exchange regarding children (to ensure Health Insurance Portability and Accountability Act rules are followed in a disaster), pediatric education for prehospital providers, and surge capacity. To work towards these goals, the Pediatric Medical Group is working with the state Emergency Medical Services for Children program and Massachusetts Department of Public Health to implement a survey to assess pediatric readiness in hospital emergency departments.
 
To further pediatric education, Rochelle Kushner, MD, MPH, directed a course for pediatric emergencies and disaster preparedness geared toward community physicians in Western Massachusetts. The chapter plans to create a strategic plan and identify goals for future activities with input from chapter leaders and other chapter members who might be interested in disaster preparedness and response. Initial efforts will include adding links/materials to chapter and state Web sites and identifying relevant contacts in Massachusetts.
 
New Hampshire
Diana Dorsey, MD, FAAP
Leonard Masters Small, MD, FAAP

The Public Health Emergency Response Subcommittee has a goal to improve performance on selected functionalities by the National Health Security Preparedness Index. Multiple objectives have been identified. These include:​
  • Improving emergency planning for children and other at-risk populations.
  • Strengthen collaboration with the New Hampshire Pediatric Society to identify pediatricians who are cognizant of and willing to participate in disaster planning for children.
  • Eleven of 20 hospitals (55%) that provide pediatric inpatient services do not address pediatric patients in their disaster plans. A multi-agency collaboration meeting has taken place. Ongoing meetings and partnerships with the New Hampshire Hospital Association, pediatricians, schools, and others are anticipated to begin in late summer.
  • Statewide reunification services and related plans are needed. A multi-agency task force including the Department of Children, Youth and Families, state police, judicial system, United States Department of Health & Human Services, Department of Education, and many more have been working for several months to identify needs and barriers to reunify children during and after a disaster.
  • A tabletop exercise of the draft State of New Hampshire Multi-Agency Reunification Services Plan (NH MARSP) is scheduled for early Fall 2016. The National Center for Missing and Exploited Children (NCMEC) will be assisting with the exercise.
New Hampshire - State Reunification Services Planning Coalition
The goal of this coalition is to:
  1. Improve the ability to conduct reunification services within the state during and immediately after a catastrophic disaster.
  2. Increase the capacity to conduct reunification services.
  3. Incorporate reunification services into State and local Emergency Operations Plans (EOP) Mass Care Annex.
  4. Include reunification services in EOP training and exercise plans.​
The Coalition will aim to adapt the Homeland Security and Emergency Management (HSEM)/Department of Education (DOE) school reunification annex. A "decision tree" will be used to illustrate all possible agencies and organizations with resources for reunification services. The Coalition will also determine a process and ownership for cross-referencing reports of missing, injured, and deceased persons with information reported in reunification systems, evacuation tracking systems, registries, social media, and other information resources.

The New Hampshire Chapter of the AAP received grants from the US Department of Homeland Security (DHS) and the Centers for Disease Control and Prevention (CDC) Public Health Emergency Preparedness (PHEP) cooperative agreement. The PHEP funds support activities of the State General Population Shelter Committee and work groups. The primary goal of the committee is to provide a unified framework for local municipalities to develop and activate a comprehensive mass care services plan. Diana Dorsey, MD, FAAP, and Leonard Masters Small, MD, FAAP, participated on the “Infant, Children and Youth” shelter committee, Dr Dorsey also participated on the “Chronic Illness” shelter group representing children with special health care needs. Shelter guidance will be released at the June 2015 Annual State Emergency Preparedness Conference. This includes an updated New Hampshire General Population Shelter Guidance, along with specific shelter operations documents including Child-Friendly Spaces Guidance and Operations, Food Services Guidance and Operations, and a Health Services Guidance and Operations.

The funding was also used to purchase two QuickSeries Publishing guides. These Guides were adapted for use in New Hampshire.
  1. Emergency Shelters: Operations Guide - this guide is for use by the New Hampshire general population shelter workers as a shelter operations quick reference tool.
  2. Emergency Preparedness for People with Disabilities and Others with Access and Functional Needs - this guide is for use by the general public. The guide provides information on developing a personal, family, and pet preparedness and response kit and plan.
In a separate grant supporting hospital preparedness, the HHS Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) Pediatric Surge work group is developing a new product titled “New Hampshire Hospital Guidelines for Management of Pediatric Patients in Disasters”. This product was based on the “Hospital Guidelines for Management of Pediatric Patients in Disasters” and approved for use in NH.

In October 2014, a New Hampshire Integrated Emergency Volunteer Training Conference was held. Some of the sessions included “Mental Health of Children During Disasters”, “Advances in Shelter Registration and Functional Needs”, and “Conducting Health Surveillance in Shelters”. The next New Hampshire training conference will take place in 2016.

Drs Dorsey and Small presented a Pediatric Grand Rounds at Dartmouth–Hitchcock Medical Center titled “Disaster Preparedness and Response” in November 2014, which can be viewed online.
 
Rhode Island
Susan Duffy, MD, FAAP
For more information, e-mail DisasterReady@aap.org.
 
 
The Vermont Chapter received a grant from the AAP Friends of Children Fund to support the Tropical Storm Irene Flood Disaster Relief for Vermont Children and Families project. Some of the goals of this grant were to provide funds to improve safe play areas for children, to provide mental health support to schools and communities, and to provide community education about disasters and long term effects. As part of the long-term effects, one goal was to provide communities with education on the health issues with clean up and loss of environment following Hurricane Irene. Activities included partial funding of a weekend-long program on recovery for children and families. The grant also provided expansion of mental counseling for students in a school severely damaged by the flood. Funds also were used to plan new play areas in multiple communities that lost a majority of safe play areas for children. One unique and potentially widespread project included The Arts Bus Project, in which a book of children’s artwork is being created following the hurricane. The book aims to showcase and provide art therapy to children, as well as to help identify and treat the mental health effects of disasters on children.
 
The AAP Vermont Chapter Executive Director, Stephanie Winters, serves on the Vermont Department of Health Senior Advisory Committee for Public Health and Preparedness and advocates on a state level for planning specifically for the needs of children. The Vermont Chapter is currently seeking a chapter champion for disaster preparedness and may appoint a resident in partnership with an experienced AAP member. Goals for future disaster planning revolve around an identification system for children separated from their parents during a disaster, as well as working with hospitals to develop an improved system to triage and care for children when there are mass casualties after a disaster.
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